Cardiomyopathy NCLEX questions

Cardiomyopathy ScienceMedicineNursing jacky070305 Save Cardiomyopathy NCLEX questions 25 terms iliana26076Preview Arrhythmia NCLEX-style questions 26 terms Alix_VanderWiele Preview Cardiomyopathy 43 terms kehowardPreview Cardio Teacher Sm The nurse is caring for a client diagnosed with dilated cardiomyopathy. which clinical manifestation does the nurse anticipate during the physical assessment? SATA

• Fatigue
• Lower extremity edema
• Syncope
• Dyspnea
• Angina

Answer: A, B, D

• Fatigue
• Lower extremity edema
• Dyspnea

Rationale: Clinical manifestations of dilated cardiomyopathy include dyspnea, orthopnea, weakness, fatigue, peripheral edema, and ascites.Syncope and angina are commonly associated with hypertrophic cardiomyopathy and other forms of cardiomyopathy, but not with dilated cardiomyopathy.A client states to the nurse, "I know I have high BP, but I don't want to take medication." Based on this data, which health problem is the client at risk for developing?

• Gastritis
• Diabetes
• Cardiomyopathy
• Metabolic Syndrome
• Cardiomyopathy

Rationale: Hypertension places the client at risk for development of cardiomyopathy. Hypertension has not been associated with gastritis, diabetes, or metabolic syndrome.

A client diagnosed with cardiomyopathy reports having to rest between activities during the day. The client asks the nurse why this is occurring.Which reason should the nurse include in the response to the client?

• Increased stroke volume
• Decreased cardiac output
• An elongated and dilated aorta
• Increased blood pressure
• Decreased cardiac output

Rationale: Decreased cardiac output is a result of decreased efficiency and contractibility of the myocardium. Rest could be required after each activity that puts physiological stress on the heart. Less blood is pumped from the heart to the rest of the body with a decreased cardiac output, and this has a direct effect on the activity level that can be tolerated. It is unknown if the client has increased stroke volume, an elongated and dilated aorta, or high blood pressure.A client admitted with the diagnosis of cardiomyopathy becomes short of breath with ambulation and eating and fatigued with routine care activities. Which nursing diagnosis does the nurse include in the client's plan of care?

A) Imbalanced Nutrition: Less than Body Requirements

• Deficient Knowledge
• Activity Intolerance
• Self-Care deficit
• Activity Intolerance

Rationale: The client is short of breath with ambulation and eating and fatigued with routine care activities. The nursing diagnosis of Activity Intolerance is appropriate for the client at this time. Shortness of breath with meals does not indicate that the client has Imbalanced Nutrition.There is not enough information to determine if the client has a knowledge deficit. Fatigue with routine care activities does not necessarily mean that the client has a Self-Care Deficit.The nurse identifies the diagnosis of Excess Fluid volume as appropriate for a client with cardiomyopathy. Which interventions should the nurse emphasize when planning this client's care? SATA

• Monitor B-type natriuretic peptide (BNP) level.
• Provide O2 as prescribed
• Assess respiratory status and lung sounds every 4 hours as needed.
• Provide information about activity upon discharge
• Monitor intake and output

Answer: C, E

• Assess respiratory status and lung sounds q 4hr PRN
• Monitor I & Os

Rationale: Interventions appropriate for the nursing diagnosis of Excess Fluid Volume include assessing respiratory status and lung sounds every

• hours and as needed, and monitoring intake and output. Monitoring BNP level and providing oxygen are interventions appropriate for the

diagnosis of Decreased Cardiac Output. Providing information about activity upon discharge would be appropriate for the nursing diagnosis of Activity Intolerance The nurse is providing teaching to a client diagnosed with cardiomyopathy. What statement made by the client indicates the discharge teaching was effective?

• "I will exercise as much as possible, regardless of feeling weak and short of breath."
• "My pants getting tight around the waist means I'm eating too much and should cut back on food."
• "I will eat foods containing sodium only if drinking water with them."
• "I will see my cardiologist next week to discuss implanting a pacemaker."
• "I will see my cardiologist next week to discuss implanting a pacemaker."

Rationale: Pacemakers are needed in some clients with cardiomyopathy to prevent sudden cardiac death. The client should discuss the need for a pacemaker with his cardiologist. The other client statements indicate that discharge teaching was not effective and the client needs additional instruction and follow-up.

The nurse is caring for a client with hypertrophic cardiomyopathy. Based on this diagnosis, which class of medications does the nurse anticipate being prescribed?

• Digoxin
• Vasodilators
• Nitrates
• Beta-blockers
• Beta blockers

Rationale: Beta blockers may be prescribed to relax the heart, stabilize the rhythm, and slow the heart's pumping action in clients with hypertrophic cardiomyopathy. Digoxin is contraindicated for the client with hypertrophic cardiomyopathy. Vasodilators and nitrates are not used to treat hypertrophic cardiomyopathy.A client with cardiomyopathy receiving diuretic therapy has a urine output of 200 mL in 8 hours. Which action by the nurse is correct?

• Assist the client to ambulate
• Document a normal urine output
• Notify the healthcare provider
• Measure abdominal girth
• Notify the healthcare provider

Rationale: The nurse should notify the healthcare provider, because a urine output of 200 cc in 8 hours is less than 30 cc per hour. The client could be dehydrated despite having peripheral edema. The nurse should not assist the client out of bed to ambulate at this time. This is not a normal urine output. Abdominal girth is not an objective measurement of fluid volume; daily weight is more precise.A client is diagnosed with cardiomyopathy asks the nurse to explain the different types of the disease. Which is inappropriate for the nurse to include in the teaching session?

• Dilated cardiomyopathy
• Restrictive cardiomyopathy
• Hypotrophic cardiomyopathy
• Arrythmogenic right ventricular dysplasia
• Hypotrophic cardiomyopathy

Rationale: The types of cardiomyopathy include dilated, restrictive, hypertrophic, arrythmogenic right ventricular dysplasia, and unclassified.The nurse is caring for a patient diagnosed with cardiomyopathy. The client experiences tachycardia. Which medication does the nurse anticipate being prescribed?

• ACE inhibitor
• Angiotensin II receptor blocker
• Beta blocker
• Cardiac glycoside
• Beta Blocker

Rationale: A client with cardiomyopathy experiencing tachycardia may take a beta blocker to lower the heart rate. ACE inhibitors and angiotensin II receptor blockers are used to decrease blood pressure in a client with cardiomyopathy. Cardiac glycosides are used in congestive heart failure and do not assist in lowering the heart rate in a client with cardiomyopathy.

A nurse is caring for a client with cardiomyopathy who is experiencing activity intolerance. Which intervention is inappropriate for this nursing diagnosis?

• Spacing out nursing intervention so client fatigue is lessened
• Assisting with client ADLs as necessary
• Using passive and active ROM exercises as tolerated
• Consulting with a physical therapist on an activity plan.
• Spacing out nursing intervention so client fatigue is lessened

Rationale: The client who is experiencing activity intolerance should have nursing interventions implemented that encourage and preserve client energy. Assisting the client with ADLs, utilizing ROM exercises, and consulting with physical therapy are all interventions that support this nursing diagnosis. The nurse should cluster nursing activities, not space them out, in order to conserve client energy. This allows the client to rest between periods of nursing care.A nurse is educating a client with cardiomyopathy about diet choices that are appropriate for the client's condition. Which statement is inappropriate for the nurse to include in the teaching session?

• "It's important to monitor your sodium intake."
• "Increasing your dietary protein helps with cardiac cell repair."
• "Here is a list of high-fat, high cholesterol foods to avoid."
• "I have notified the dietician regarding your condition in order to provide you with more information."
• "Increasing your dietary protein helps with cardiac cell repair."

Rationale: Diet is an important part of long-term management of heart failure. It also contributes to reducing fluid retention. The nurse should instruct the client with cardiomyopathy to monitor sodium intake and to avoid high-fat, high-cholesterol food. Instructing the client to increase protein is not appropriate and is not shown effective in managing cardiomyopathy. Consulting with the dietitian is appropriate with this client.A 14 year old child was recently diagnosed with hypertrophic cardiomyopathy. During a follow-up appointment, the mother asks the nurse, "How will this affect my child's ability to play football in the fall?" How should the nurse respond?

• "This shouldn't affect his ability to play football."
• "Children with cardiomyopathy should not play football."
• "He could participate in flag football but not tackle football."
• "This may actually make him a better, stronger football player."
• "Children with cardiomyopathy should not play football."

Rationale: Children with cardiomyopathy should not play competitive sports due to the possibility of collapse or increased heart failure.Depending on the child's clinical status, low-impact activities may be appropriate, but this should be discussed with the child's physician.A 72-year-old client diagnosed with hypertrophic cardiomyopathy is speaking to the healthcare team about treatment options. Which treatment option would likely not be recommended for this client, even though it's commonly used to treat younger clients with this condition?

• Defibrillator implantation
• Beta-blocker administration
• Calcium channel blocker
• Physical activity restrictions
• Defibrillator implantation

Rationale: Treatment guidelines for older clients with HCM are not well established, although they may include the use of beta blockers and/or calcium channel blockers. The client will also likely have restrictions on physical activity. However, the low morbidity and mortality rates among older clients do not support the use of the defibrillator devices frequently implanted in younger clients.