Deck 13: Assessing the Cardiovascular System

Question 1

Which of the following clients would be considered at risk for the development of cardiovascular disease?

A) The 65-year-old male who consumes one alcoholic drink a day
B) The 50-year-old female who consumes 25 grams of fiber per day
C) The 40-year-old male who consumes 300 mg of saturated fats and cholesterol a day
D) The 30-year-old female who walks every day for 35 minutes

Answer 1

The 40-year-old male who consumes 300 mg of saturated fats and cholesterol a day

Question 2

The physician would like to assess the patient for the cause of a heart murmur. Which test would the nurse anticipate the physician ordering?

A) Holter monitor
B) Echocardiogram
C) Exercise stress test
D) Electrocardiogram (EKG)

Answer 2

Echocardiogram

Question 3

What areas of the heart do the semilunar valves separate?

A) The right atrium from the right ventricle
B) The left atrium from the left ventricle
C) The ventricles from the pulmonary and systemic circulation
D) The right ventricle from the pulmonary artery

Answer 3

The ventricles from the pulmonary and systemic circulation

Question 4

When auscultating heart sounds S₁ and S₂, the nurse should do which of the following?

A) Instruct the client to breathe deeply.
B) Clip the hair of the male hairy chest.
C) Use the diaphragm of the stethoscope.
D) Listen at the left sternal border, 2nd intercostal space.

Question 5

The new graduate nurse is auscultating the patient's heart sounds. The nurse preceptor should intervene when the new nurse places the patient in which of the following positions?

A) Semi-Fowler's
B) Fowler's
C) Right-sided lying position
D) Supine

Question 6

The nurse is assessing the patient's heart sounds and hears a sound that has a thud-like quality that occurs directly before the S₁ heart sound. How does the nurse document this sound?

A) S₄
B) S₃
C) Murmur
D) Pericardial friction rub

Question 7

The patient has had some blood work done. The results show cardiac tissue damage due to decreased oxygenation. The laboratory values were elevated levels 7 days after cardiac tissue damage. Which laboratory test did the patient have?

A) Creatine kinase-MB
B) Troponin level
C) Total cholesterol level
D) High density lipoprotein (HDL-C)

Question 8

To auscultate the aortic area, where would the nurse place the stethoscope?

A) Right sternal border, 2nd intercostal space
B) Left sternal border, 2nd intercostal space
C) Left sternal border, 4th intercostal space
D) Left sternal border, 5th intercostal space

Question 9

The patient sees a cardiologist every 6 months for a grade V heart murmur. What is the characteristic of a grade V heart murmur?

A) Faint but can be identified immediately
B) Moderately loud
C) Loud and associated with a palpable thrill
D) Loud with palpable thrill heard with only the rim of the stethoscope touching the skin

Question 10

The nurse suspects the patient has a pericardial friction rub. What would the nurse expect to find when assessing the patient?

A) A high-pitched sound heard after the S₁ sound
B) A muffled, grating sound heard at the apex of the heart
C) A swishing or unusually prolonged sound heard during diastole
D) A low-pitched sound that occurs at the end of diastole

Question 11

The nurse knows that the patient understands teaching about a Holter monitor when the patient states which of the following?

A) "This test will use high-frequency sound waves to help diagnose cardiovascular disorders."
B) "This test will last 24 hours and will record cardiac electrical activity."
C) "This test will take place while I walk on a treadmill."
D) "This test will help visualize the size and shape of my heart."

Question 12

At what age does the U.S. Preventive Services Task Force (USPSTF) recommend screening for men who are at increased risk for coronary artery disease for lipid disorders?

A) 20 to 35
B) 20 to 45
C) 35 and older
D) 45

Question 13

What is the most reported symptom of the cardiac system?

A) Shortness of breath
B) Palpitations
C) Angina
D) Edema of the lower extremities

Question 14

The nurse is completing a teaching plan for the patient regarding prevention of coronary artery disease. What should the nurse include in the teaching plan?

A) "Drink one beer a week to help increase the high-density lipoproteins (HDLs)."
B) "If you smoke, you should quit smoking."
C) "Drink a glass of red wine each night to help decrease your cholesterol levels."
D) "Intake of alcohol has no relation to heart disease."

Question 15

What statement made by the patient would lead the nurse to suspect a heart attack?

A) "I have a burning pain in my epigastric area."
B) "I am hot and sweaty."
C) "I have a headache and sore muscles."
D) "I have pressure in the center of my chest."

Question 16

When assessing the patient for an S₃ heart sound, the nurse uses which of the following information to provide care for the patient?

A) The S₃ heart sound occurs directly after the S₁ heart sound.
B) S₃ is indicative of rapid ventricular filling.
C) S₃ is considered abnormal in physically active young adults.
D) S₃ may be due to scar tissue of hypertensive heart disease or coronary artery disease.

Question 17

The nurse is auscultating the patient's heart and hears an ejection click. What does the nurse suspect the patient may have?

A) Turbulent blood flow
B) Pericarditis
C) Hypertension
D) Mitral valve prolapse

Question 18

While assessing the patient, the nurse hears an S₄ heart sound. What can the nurse interpret from this finding?

A) The patient may have aortic valve regurgitation.
B) The patient may have hypertension.
C) The patient has a pulse deficit.
D) The patient may have a valve with a defective leaflet.

Question 19

The nurse auscultates a thrill at the left sternal border, 4th intercostal space. The nurse knows that this may indicate which of the following?

A) Aortic stenosis
B) Pulmonic stenosis
C) Aortic aneurysm
D) Ventricular enlargement

Question 20

The nurse is reviewing the patient's chart. Which information in the chart would concern the nurse the most?

A) The patient has a low-density lipoprotein (LDL) of 190 mg/dL.
B) The patient stated that he sleeps with one pillow at night.
C) The patient's father had a heart attack at age 70.
D) The patient's total cholesterol is 180 mg/dL.

Question 21

Compared to white adults, which of the following statements about cultural groups is true regarding heart disease?

A) African Americans have a higher rate of high blood pressure than white adults.
B) Asian Americans have a higher rate of high blood pressure than white adults.
C) Hispanic Americans are more likely than non-Hispanic white adults to have coronary heart disease.
D) Asian Americans are more likely than whites to be obese, causing heart disease.

Question 22

You are palpating the apical pulse on a slightly overweight male patient but cannot feel the pulsation of the apical pulse. What will be your next step?

A) Ask the patient to sit up straight and lean forward.
B) Ask the patient to turn slightly on his left side.
C) Ask the patient to turn slightly on his right side.
D) Ask the patient to take a deep breath and hold it.

Question 23

An 86-year-old female patient comes to the emergency room complaining of chest pain, heart palpitations, and shortness of breath. You take her vital signs: blood pressure 160/100, apical pulse 92, carotid pulse 104, respiratory rate 24, tympanic temperature 100.4°F. What is the pulse deficit?

A) 196
B) 60
C) 12
D) 8

Question 24

While interpreting heart sounds it is essential to understand from which part of the cardiac cycle heart sounds are being generated. Which technique will assist you to interpret the cardiac cycle as you auscultate heart sounds?

A) Use the bell of the stethoscope at each of the five cardiac landmarks.
B) Use the diaphragm of the stethoscope at each of the five landmarks.
C) Listen with your eyes closed as you auscultate the heart sounds.
D) Palpate the carotid artery simultaneously while auscultating the heart.

Question 25

You are auscultating heart sounds using the bell of the stethoscope. You hear a "swooshing" sound at Erb's point. Identify the area where you hear this heart murmur.

A) A
B) B
C) C
D) D
E) E

Question 26

Place the following steps to assess the anterior chest for a cardiovascular assessment in order (1-7). (Enter the number of each step in the proper sequence. Do not use punctuation or spaces. Example: 1234.)
____1. Adjust the head of the examining table so that the patient is supine with head and chest elevated at 30 degrees.
____2. Document your findings.
____3. Drape the patient so only the chest area is exposed.
____4. Palpate the precordium for vibrations.
____5. Palpate the apical pulse.
____6. Inspect the symmetry of the chest.
____7. Auscultate heart sounds

Question 27

Electrical impulses are initiated in the right atrium. Put the route that the impulses travel from the base of the heart to the apex of the heart in the correct sequence (1-4). (Enter the number of each step in the proper sequence. Do not use punctuation or spaces. Example: 1234.)
1. Bundle of His
2. Sinoatrial node
3. Purkinje fibers
4. Atrioventricular node

Question 28

Which of the following statements is true about the chambers of the heart? Select all that apply.

A) The left atria pumps blood to the left ventricle.
B) The right atria pumps deoxygenated blood.
C) The left ventricle pumps blood out to the aorta.
D) The right ventricle does most of the work of the heart.
E) The left ventricle pumps oxygenated blood.

Question 29

The nurse is assessing the patient and suspects that the patient has developed congestive heart failure. What signs or symptoms help to validate the nurse's suspicions? Select all that apply.

A) A faint, low-pitched S₃ heart sound is heard upon auscultation.
B) Closing of the atrioventricular valves is heard upon auscultation.
C) The patient reports use of two to three pillows to sleep comfortably at night.
D) The peripheral edema is 3+ bilaterally.

Question 30

The nurse is attempting to assess the patient's apical pulse and cannot palpate it. In which of the following patients would it be difficult to palpate the patient's apical pulse? Select all that apply.

A) The female patient with small breasts
B) The male patient with enlarged pectoral muscles
C) The patient who has chronic obstructive pulmonary disease
D) The patient who is underweight
E) The patient who has fluid around the heart

Question 31

The nurse is teaching the patient about modifiable risk factors for coronary artery disease. Which factors would the nurse include in the teaching plan? Select all that apply.

A) Uncontrolled high blood pressure
B) Family history
C) Diabetes
D) Smoking
E) Gender

Question 32

Which of the following is true regarding heart murmurs? Select all that apply.

A) Murmurs produce a swishing sound.
B) Murmurs are caused by pericarditis.
C) Murmurs occur during systole only.
D) Murmurs can be innocent.
E) Babies are born with murmurs.

Question 33

Which of the following is typically a cause of a heart murmur? Select all that apply.

A) Increased blood flow through a normal valve
B) Blood flow into a dilated chamber
C) Heart failure
D) Blood flow through a dilated valve
E) Regurgitation of blood through an incompetent valve

Question 34

The nurse suspects the patient has an aortic valve murmur. How would the nurse assess the patient? Select all that apply.

A) Instruct the patient to sit up and lean forward.
B) Use the bell of the stethoscope.
C) Place the stethoscope on the 2nd right intercostal space (ICS).
D) Take the patient's pulse while auscultating the heart.
E) Instruct the patient to breath normally.

Question 35

You are performing a cardiac assessment and inspecting the anterior chest. The purpose of inspecting the anterior chest is to assess for which of the following? Select all that apply.

A) Symmetry
B) Murmurs
C) Pulsations
D) Heaves
E) Vibrations

Question 36

You are auscultating a patient's heart sounds at the 2nd left intercostal space. You hear a split S₂ [dub] sound. This is a normal heart sound that is affected by ____________________.

Question 37

You are performing a cardiovascular assessment and are palpating the precordium. Using the ____________________ surface of your right hand, you will gently palpate the five landmarks.

Question 38

____________________ is an electrical current moving from cell to cell that produces a positively charged wave through the myocardium. The interior of the cell becomes positively charged and initiates a contraction of the resting myocytes.

Question 39

Identify the configuration of the following heart murmur: ___________________ starts loud and then gradually fades away.