Deck 24: Alterations of Cardiovascular Function

Question 1

A patient presents to a primary care provider reporting chest pain and is diagnosed with atherosclerosis. What is this disease caused by?

A) Arterial wall thinning and weakening
B) Abnormally dilated arteries and veins
C) An accumulation of lipid-laden macrophages within the arterial wall
D) Autonomic nervous system imbalances

Answer 1

An accumulation of lipid-laden macrophages within the arterial wall

Question 2

A 75-year-old obese female presents to her primary care provider reporting edema in the lower extremities. Physical examination reveals that she has varicose veins and chronic venous insufficiency. Upon performing the history, which of the following is a possible cause for the varicose veins?

A) Extreme exercise
B) Long periods of standing
C) Trauma to the deep veins
D) Ischemia

Answer 2

Long periods of standing

Question 3

Individuals with Raynaud phenomenon need to be counseled to avoid which of the following conditions?

A) Allergic reactions
B) Cold exposure
C) Hot water immersion
D) Tissue injury

Answer 3

Cold exposure

Question 4

A patient presents to the emergency department reporting difficulty swallowing and shortness of breath. A CT scan would most likely reveal an aneurysm in the:

A) cerebral vessels.
B) renal arteries.
C) inferior vena cava.
D) thoracic aorta.

Question 5

A patient presents with severe chest pain and shortness of breath and is diagnosed with pulmonary embolism. Where did the embolism most likely originate?

A) The left ventricle
B) Systemic arteries
C) A deep vein of the leg
D) The superficial veins of the arm

Question 6

When a patient is diagnosed with coronary artery disease, what condition should the nurse also consider?

A) Myocardial hypertrophy
B) Myocardial ischemia
C) Cardiac necrosis
D) Systemic inflammation

Question 7

A 52-year-old is diagnosed with primary hypertension but has no other health problems. What might be the first consideration for managing the condition?

A) A beta-adrenergic agonist
B) An alpha-adrenergic agonist
C) A recommendation to reduce sodium intake
D) A calcium channel agonist

Question 8

What is the most common cause of myocardial ischemia?

A) Idiopathic vasospasm
B) Arterial emboli from a heart valve
C) Atherosclerosis
D) Venous emboli

Question 9

A 30-year-old white female was recently diagnosed with primary hypertension. She reports that she eats fairly well, and has a moderate red meat consumption. She also reports that her father and grandmother have hypertension. A nurse determines which of the following risk factors is most likely associated with this diagnosis?

A) Ethnicity
B) Diet
C) Age
D) Family history

Question 10

An older adult is diagnosed with cerebral aneurysm. Where does the nurse suspect the cerebral aneurysm is located?

A) Vertebral arteries
B) Basilar artery
C) Circle of Willis
D) Carotid arteries

Question 11

A 52-year-old male presents with pooling of blood in the veins of the lower extremities and edema. The diagnosis is chronic venous insufficiency. What is an expected assessment finding of this disorder?

A) Deep vein thrombus formation
B) Skin hyperpigmentation
C) Gangrene
D) Edema above the knee

Question 12

A nurse takes an adult patient's blood pressure and determines it to be normal. What reading did the nurse obtain?

A) Systolic pressure between 140 and 150 mm Hg
B) Systolic pressure less than 120 mm Hg and diastolic pressure less than 80 mm Hg
C) Systolic pressure less than 100 mm Hg regardless of diastolic pressure
D) Systolic pressure greater than 140 mm Hg and a diastolic pressure of 100 mm Hg

Question 13

When a nurse checks the patient for orthostatic hypotension, what activity did the nurse have the patient engage in?

A) Physical exertion
B) Eating
C) Standing up
D) Lying down

Question 14

A 50-year-old male with a 30-year history of smoking was diagnosed with bronchogenic cancer. He developed edema and venous distension in the upper extremities and face. Which of the following diagnosis will the nurse observe on the chart?

A) Thromboembolism
B) Deep vein thrombosis
C) Superior vena cava syndrome (SVCS)
D) Chronic venous insufficiency

Question 15

Most cases of combined systolic and diastolic hypertension have no known cause and are documented on the chart as _____ hypertension.

A) primary
B) secondary
C) congenital
D) acquired

Question 16

What term should the nurse use to document a detached blood clot?

A) Thrombus
B) Embolus
C) Thromboembolus
D) Infarction

Question 17

A patient is diagnosed with coronary artery disease. Which of the following modifiable risk factors would the nurse suggest?

A) Eating out to increase variety
B) Change living arrangements
C) Decreasing tomato juice consumption
D) Stop smoking cigarettes

Question 18

A patient is diagnosed with orthostatic hypotension. Which of the following symptoms would most likely be reported?

A) Headache and blurred vision
B) Nausea and vomiting
C) Chest pain and palpitations
D) Syncope and fainting

Question 19

What are foam cells?

A) Deposited adipose cells in fatty streaks
B) Injured neutrophils
C) Macrophages that have engulfed low-density lipoprotein (LDL).
D) Lipid-laden mast cells.

Question 20

Superior vena cava syndrome (SVCS), causing venous distension in the upper extremities, is a result of progressive superior vena cava:

A) inflammation.
B) occlusion.
C) distension.
D) sclerosis.

Question 21

What chamber is unable to empty completely in the presence of mitral stenosis?

A) Right atrium
B) Right ventricle
C) Left atrium
D) Left ventricle

Question 22

A 62-year-old male presents to his primary care provider reporting chest pain at rest and with exertion. He does not have a history of coronary artery disease and reports that the pain often occurs at night. He is most likely experiencing which type of angina?

A) Unstable
B) Stable
C) Prinzmetal
D) Silent

Question 23

A 49-year-old male presents reporting chest pain. EKG reveals ST elevation. He is diagnosed with myocardial ischemia. Which of the following interventions would be most beneficial?

A) Administer a diuretic to decrease volume.
B) Apply oxygen to increase myocardial oxygen supply.
C) Encourage exercise to increase heart rate.
D) Give an antibiotic to decrease infection.

Question 24

A 51-year-old male is at the health clinic for an annual physical examination. After walking from the car to the clinic, he developed substernal pain. He also reported discomfort in his left shoulder and his jaw, lasting 2 to 3 minutes and then subsiding with rest. He indicates that this has occurred frequently over the past few months with similar exertion. What is he likely experiencing?

A) Stable angina
B) Unstable angina
C) Prinzmetal angina
D) Myocardial infarction (MI)

Question 25

Upon assessment of the patient, the nurse finds a widened pulse pressure and throbbing peripheral pulses. Which valve disorder does the nurse suspect?

A) Mitral regurgitation
B) Mitral stenosis
C) Aortic regurgitation
D) Aortic stenosis

Question 26

A 60-year-old female has survived a myocardial infarction. The nurse is providing care for impaired ventricular function because:

A) there is a temporary alteration in electrolyte balance.
B) there is too much stress on the heart.
C) the cells become hypertrophic.
D) the resulting ischemia leads to hypoxic injury and myocardial cell death.

Question 27

A 72-year-old has a history of hypertension and atherosclerosis. An echocardiogram reveals backflow of blood into the left ventricle. Which of the following is the most likely diagnosis documented on the chart?

A) Mitral regurgitation
B) Mitral stenosis
C) Aortic regurgitation
D) Aortic stenosis

Question 28

A 67-year-old was previously diagnosed with rheumatic heart disease. Tests now show chronic inflammation that impairs blood flow from the left ventricle into the aorta. Which diagnosis does this history support?

A) Aortic regurgitation
B) Aortic stenosis
C) Mitral regurgitation
D) Mitral stenosis

Question 29

A nurse recalls that the most common cardiac valve disorder is:

A) mitral valve prolapse.
B) pulmonary stenosis.
C) tricuspid valve prolapse.
D) aortic stenosis.

Question 30

A 51-year-old male presents with recurrent chest pain on exertion and is diagnosed with angina pectoris. The pain occurs when:

A) cardiac output has fallen below normal levels.
B) the myocardial oxygen supply has fallen below demand.
C) myocardial stretch has exceeded the upper limits.
D) the vagus nerve is stimulated.

Question 31

A 42-year-old is diagnosed with constrictive pericarditis. The nurse assesses the blood pressure for decreased cardiac output because of:

A) pericardial effusions.
B) fibrosis and calcification of the pericardial layers.
C) cardiomyopathy.
D) hemorrhage in the pericardial cavity.

Question 32

A 55-year-old male died of a myocardial infarction. What would autopsy most likely reveal?

A) Embolization of plaque from the aorta
B) Decreased ventricular diastolic filling time
C) Indications of myocardial ischemia and necrosis
D) Smooth muscle dysplasia in the coronary artery

Question 33

Many valvular stenosis and regurgitation disorders in adults have a common etiology. Which of the following conditions should alert the nurse that the patient may have both types of valve dysfunctions?

A) Heart failure
B) Connective tissue disorders
C) Rheumatic fever or heart disease
D) Syphilis infection

Question 34

A 68-year-old male presents to the ER reporting chest pain. He has a history of stable angina that now appears to be unstable. What does he most likely have?

A) Mild to moderate atherosclerosis
B) Impending myocardial infarction (MI)
C) Electrical conduction problems in the heart
D) Decreased myocardial oxygen demand

Question 35

A 28-year-old presents to the ER reporting severe chest pain that worsens with respirations or lying down. Other signs include a fever, tachycardia, and a friction rub. Assessment findings support which medical diagnosis?

A) Acute pericarditis
B) Myocardial infarction (MI)
C) Stable angina
D) Pericardial effusion

Question 36

A 10-year-old male presents with fever, lymphadenopathy, arthralgia, and nosebleeds. He is diagnosed with rheumatic heart disease. What is the most likely cause of this disease?

A) Congenital heart defects
B) Human immunodeficiency virus (HIV) infections
C) Group A beta-hemolytic streptococcus infections
D) Acute pericarditis

Question 37

Which valvular condition is characterized by the valve opening being constricted and narrowed, preventing blood from flowing forward?

A) Regurgitation
B) Insufficiency
C) Stenosis
D) Incompetence

Question 38

A 56-year-old presents to his primary care provider for a checkup. Physical examination reveals edema, hepatomegaly, and muffled heart sounds. Which of the following is of greatest concern to the nurse?

A) Tamponade
B) Exudate
C) Aneurysm
D) Pulsus paradoxus

Question 39

A 75-year-old male has severe chest pain and dials 911. Based upon the laboratory findings indicating a patient has elevated levels of cardiac troponins I and T, the nurse suspects which of the following has occurred?

A) Raynaud disease
B) Myocardial infarction (MI)
C) Orthostatic hypotension
D) Angina

Question 40

A 35-year-old presents with pulmonary hypertension and is diagnosed as being in right heart failure. Which is the most likely cause of this condition?

A) Aortic stenosis
B) Tricuspid regurgitation
C) Aortic regurgitation
D) Mitral regurgitation

Question 41

A 30-year-old female presents to her primary care provider with fever, cardiac murmur, and petechial skin lesions and is diagnosed with infective endocarditis. What is the most likely cause of the disease?

A) Bacteria
B) Viruses
C) Fungi
D) Parasites

Question 42

What is one consequence of switching from aerobic to anaerobic cellular metabolism during shock?

A) Decreased adenosine triphosphate (ATP) production
B) Cellular dehydration
C) Cellular alkalosis
D) Free radical formation

Question 43

Which characteristic changes should the nurse keep in mind while caring for a patient with progressive left heart failure?

A) Left ventricular preload increases
B) Systemic vascular resistance decreases
C) Left end-diastolic volume decreases
D) Pulmonary vascular resistance decreases

Question 44

The onset of anaphylactic shock is usually:

A) mild.
B) sudden and life-threatening.
C) delayed by several hours.
D) delayed by 24 hours.

Question 45

A 72-year-old female has a history of right heart failure caused by a right ventricular myocardial infarction. Which of the following symptoms are specifically related to her right heart failure?

A) Significant edema to both lower legs and feet
B) Hypertension
C) Decreased urine output
D) Dyspnea upon exertion

Question 46

A 27-year-old male is admitted to a neurological unit with a complete C-5 spinal cord transection. On initial assessment, he is bradycardic, hypotensive, and hyperventilating. He appears to be going into shock. What is the most likely mechanism of his shock?

A) Hypovolemia caused by blood loss
B) Hypovolemia caused by evaporative fluid losses
C) Vasodilation caused by Gram-negative bacterial infection
D) Vasodilation caused by a decrease in sympathetic stimulation

Question 47

An 82-year-old female was admitted to the hospital with confusion and severe hypotension. Her body's compensatory mechanisms are increased heart rate, vasoconstriction, and movement of large volumes of interstitial fluid to the vascular compartment. What kind of shock does the nurse suspect the patient is experiencing?

A) Anaphylactic
B) Hypovolemic
C) Neurogenic
D) Septic

Question 48

When a person is in shock, a nurse remembers that impairment in cellular metabolism is caused by:

A) release of toxic substances.
B) free radical formation.
C) inadequate tissue perfusion.
D) lack of nervous or endocrine stimulation.

Question 49

A 15-year-old male who is allergic to peanuts eats a peanut butter cup. He then goes into anaphylactic shock. Which assessment findings will the nurse assess for?

A) Bradycardia, decreased arterial pressure, and oliguria
B) Bronchoconstriction, hives or edema, and hypotension
C) Hypertension, anxiety, and tachycardia
D) Fever, hypotension, and erythematous rash

Question 50

Neurogenic shock can be caused by any factor that inhibits the:

A) parasympathetic nervous system.
B) sympathetic nervous system.
C) somatic nervous system.
D) thalamus.

Question 51

A patient with left heart failure starts to have a cough and dyspnea. Why does this happen?

A) Pulmonary symptoms are due to inflammatory pulmonary edema.
B) There is a decreased cardiac output.
C) Left heart failure results in pulmonary vascular congestion.
D) Reflexive bronchoconstriction occurs.

Question 52

Which condition should cause the nurse to assess for high-output failure in a patient?

A) Metabolic alkalosis
B) Hypothyroidism
C) Hypovolemia
D) Anemia

Question 53

A 73-year-old has increased pulmonary pressure resulting in right heart failure. What is a potential cause for the right heart to fail?

A) Hypertension
B) Left heart failure
C) Acute pneumonia
D) Pericarditis

Question 54

A 65-year-old male is diagnosed with chronic pulmonary disease and elevated pulmonary vascular resistance. Which of the following heart failures should the nurse assess for in this patient?

A) Right heart
B) Left heart
C) Low-output
D) High-output

Question 55

A 10-year-old male presents with fever, lymphadenopathy, arthralgia, and nosebleeds and is diagnosed with rheumatic heart disease. While planning care, which characteristic changes should the nurse remember?

A) Blood-borne organisms that adhere to the valvular surface
B) Antigens that bind to the valvular lining, triggering an autoimmune response
C) High fevers that damage collagen in valve leaflets
D) Rheumatoid factor in the blood, stimulating valvular degeneration

Question 56

A 20-year-old female is being admitted to the hospital with fever and septic shock. Which set of assessment findings would the nurse expect the patient to exhibit?

A) Bradycardia, palpitations, confusion, truncal rash
B) Severe respiratory distress, jugular venous distension, chest pain
C) Low blood pressure and tachycardia
D) Reduced cardiac output, increased systemic vascular resistance, moist cough

Question 57

Why do inflammatory cells have difficulty limiting the colonization of micro-organisms in infective endocarditis?

A) The micro-organisms are highly resistant.
B) The valves are avascular.
C) Micro-organisms become embedded in fibrin clots.
D) Microbial colonies overwhelm the phagocytes.

Question 58

A 65-year-old male with a history of untreated hypertension is now experiencing left heart failure. A nurse recalls that his untreated hypertension led to:

A) ventricular dilation and wall thinning.
B) myocardial hypertrophy and ventricular remodelling.
C) inhibition of renin and aldosterone.
D) alterations in alpha and beta receptor function.

Question 59

During shock states, glucose uptake is usually:

A) enhanced.
B) normal.
C) impaired.
D) energy intensive.

Question 60

A patient was admitted to the intensive care unit with a diagnosis of acute myocardial infarction (MI) and is being treated for shock. The primary cause of shock is most likely:

A) rapid heart rate.
B) decreased cardiac contractility.
C) increased capillary permeability.
D) decreased afterload due to vasodilation.

Question 61

A 75-year-old female has been critically ill with multiple organ dysfunction syndrome (MODS) for longer than a week and has developed a severe oxygen supply and demand imbalance. What statement best describes this imbalance?

A) Increased oxygen delivery to cells fails to meet decreased oxygen demands.
B) The amount of oxygen consumed by cells depends only on the needs of cells, because there is oxygen in reserve.
C) The situation results in supply-independent consumption.
D) The oxygen reserve has been exhausted, leaving oxygen consumption dependent on what amount the circulation is able to deliver.

Question 62

Which of the following is a management strategy for Raynaud phenomenon?

A) The patient should eat bananas twice a day.
B) The patient should stop smoking cigarettes.
C) The patient should wear mittens inside.
D) The patient should take calcium channel blockers.

Question 63

For an infection to progress to septic shock, what must occur?

A) The individual must be immunosuppressed.
B) The myocardium must be impaired.
C) The infection must be Gram negative.
D) Bacteria must enter the bloodstream.

Question 64

What condition leaves a patient most prone to multiple organ dysfunction syndrome (MODS)?

A) Myocardial infarction (MI)
B) Pulmonary disease
C) Septic shock
D) Autoimmune disease

Question 65

Cardiac cells can withstand ischemic conditions for _____ minutes before irreversible cell injury occurs.

Question 66

A nurse recalls that acute orthostatic hypotension can be caused by which of the following? (Select all that apply.)

A) Prolonged immobility
B) Drug action
C) Starvation
D) Volume depletion
E) Exercise