Question 1

A 75-year-old male has severe chest pain and dials 911.Lab tests at the hospital reveal elevated levels of cardiac troponins I and T.Based upon the lab findings,the nurse suspects which of the following has occurred?
A) Raynaud disease
B) Myocardial infarction (MI)
C) Orthostatic hypotension
D) Varicose veins

Accepted Answer

The diagnosis of acute MI is made on the basis of serial cardiac biomarker alterations.The cardiac troponins (troponins I and T)are the most specific indicators of MI.
Elevated troponins I and T are indicative of MI,not Raynaud disease.
Elevated troponins I and T are indicative of MI,not orthostatic hypotension.
Elevated troponins I and T are indicative of MI,not varicose veins.

Question 2

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

Accepted Answer

Valvular dysfunction is often related to rheumatic fever.
Valvular dysfunction is often related to rheumatic fever; heart failure decreases cardiac output,but does not affect valvular function.
Valvular dysfunction is often related to rheumatic fever; it is not due to connective tissue disorders.
Valvular dysfunction is often related to rheumatic fever; syphilis infection could affect valves,but it is not the most common.

Question 3

A 60-year-old female had a myocardial infarction.She was brought to the hospital 30 minutes later.She survived,but now 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.

Accepted Answer

The patient has impaired ventricular functioning because a portion of the myocardium has died due to ischemia.
Impaired ventricular function is due to damage to the myocardium; it is not due to electrolyte imbalance.
There was stress on the heart,but the impaired functioning is due to myocardial damage secondary to ischemia.
The impaired ventricular dysfunction is due to myocardial cell death,not hypertrophy.

Question 4

A 67-year-old female was previously diagnosed with rheumatic heart disease.Tests reveal lipoprotein deposition with chronic inflammation that impairs blood flow from the left ventricle into the aorta.Which of the following is the most likely diagnosis recorded on the chart?
A) Aortic regurgitation
B) Aortic stenosis
C) Mitral regurgitation
D) Mitral stenosis

Accepted Answer

Aortic stenosis would impair blood flow from the left ventricle to the aorta.
Aortic regurgitation would allow blood to flow back into the left ventricle.
Mitral regurgitation would allow blood to flow from the left ventricle to the left atrium.
Mitral stenosis would impair blood flow from the left atrium to the left ventricle.

Question 5

A 51-year-old male presents with recurrent chest pain on exertion.He is diagnosed with angina pectoris.When he asks what causes the pain,how should the nurse respond? 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.

Accepted Answer

Angina is chest pain caused by myocardial ischemia,which develops if the flow or oxygen content of coronary blood is insufficient to meet the metabolic demands of myocardial cells.
A decrease in cardiac output would lead to general systemic symptoms,not just chest pain,which is due to a decrease in myocardial oxygenation.
Myocardial stretch does not affect angina symptoms.
When the vagus nerve is stimulated,a change in rate occurs; it does not precipitate chest pain.

Question 6

A 56-year-old male is diagnosed with coronary artery disease.Which of the following modifiable risk factors would the nurse suggest the patient change?
A) Eating meat
B) Living arrangements
C) Drinking tomato juice
D) Smoking cigarettes

Accepted Answer

Cigarette smoking leads to vasoconstriction and should be the first behavior the patient changes.
Eating meat alone would not lead to the development of coronary artery disease; cigarette smoking leads to vasoconstriction and should be the first behavior the patient changes.
The living arrangement of the patient's home would not lead to the development of coronary artery disease; cigarette smoking leads to vasoconstriction and should be the first behavior the patient changes.
Drinking tomato juice would not lead to the development of coronary artery disease; cigarette smoking leads to vasoconstriction and should be the first behavior the patient changes.

Question 7

A 50-year-old male with a 30-year history of smoking was diagnosed with bronchogenic cancer.He developed edema and venous distention 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

Accepted Answer

SVCS is a progressive occlusion of the superior vena cava that leads to venous distention in the upper extremities and head.
Thromboembolism would not lead to the generalized symptoms described in the patient.
Deep vein thrombosis would not lead to upper extremity symptoms.
Chronic venous insufficiency would primarily affect one extremity.

Question 8

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.He most likely has:
A) Mild to moderate atherosclerosis
B) Impending myocardial infarction (MI)
C) Electrical conduction problems in the heart
D) Decreased myocardial oxygen demand

Accepted Answer

Unstable angina is an indication of impending MI.
Unstable angina could be caused by moderate atherosclerosis,but it is an indication of impending MI.
Unstable angina could be caused by altered electrical conduction,but it is an indication of impending MI.
Unstable angina is due to a decrease in myocardial oxygen,but it is an indication of impending MI.

Question 9

A 50-year-old obese male with hypertension and coronary artery disease visits a nutritionist for food counseling.He has an elevated level of low-density lipoprotein (LDL)and a low level of high-density lipoprotein (HDL).Which of the following should the nurse advise him to avoid?
A) Monounsaturated fats
B) Polyunsaturated fats
C) Saturated fats
D) Trans fats

Accepted Answer

Trans fats are primarily found in artificially solidified (hydrogenated)oils (e.g.,margarine and vegetable shortening).By becoming more solid,they lose essential fatty acids (EFAs).They can raise LDL and lower HDL levels.
Trans fats,not monounsaturated fats,are primarily found in artificially solidified (hydrogenated)oils (e.g.,margarine and vegetable shortening).By becoming more solid,they lose EFAs.They can raise LDL and lower HDL levels.
Trans fats,not polyunsaturated fats,are primarily found in artificially solidified (hydrogenated)oils (e.g.,margarine and vegetable shortening).By becoming more solid,they lose EFAs.They can raise LDL and lower HDL levels.
Trans fats,not saturated fats,are primarily found in artificially solidified (hydrogenated)oils (e.g.,margarine and vegetable shortening).By becoming more solid,they lose EFAs.They can raise LDL and lower HDL levels.

Question 10

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

Accepted Answer

Chest pain that occurs at rest and at night is descriptive of Prinzmetal angina.
Unstable angina is a form of acute coronary syndrome that results from reversible myocardial ischemia.
Stable angina is predictable and occurs with activity.
Silent angina has few,if any,symptoms.

Question 11

When a patient asks the nurse what is the most common cause of myocardial ischemia,which statement is the correct response? The most common cause of myocardial ischemia is:
A) Idiopathic vasospasm
B) Arterial emboli from heart valve
C) Atherosclerosis
D) Venous emboli

Accepted Answer

The most common cause of myocardial ischemia is atherosclerosis.
Atherosclerosis,not vasospasm,is the major cause of myocardial ischemia.
Arterial emboli may cause ischemia,but atherosclerosis is the major cause of myocardial ischemia.
Venous emboli would not lead to myocardial ischemia; atherosclerosis is the major cause of myocardial ischemia.

Question 12

A 28-year-old female presents to the ER reporting severe chest pain that worsens with respirations or lying down.She has a fever,tachycardia,and a friction rub.Based upon the assessment findings,the nurse determines the patient is experiencing:
A) Acute pericarditis
B) Myocardial infarction (MI)
C) Stable angina
D) Pericardial effusion

Accepted Answer

Severe chest pain that worsens with respirations or lying down in a patient with fever,tachycardia,and a friction rub is characteristic of acute pericarditis.
MI pain does not worsen with respiration; the patient is experiencing symptoms of pericarditis.
Stable angina does not worsen with respiration or lying down; the patient is experiencing symptoms of pericarditis.
Pericardial effusion is not manifested by these symptoms; the patient is experiencing symptoms of pericarditis.

Question 13

A 49-year-old male presents to his primary care provider 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.

Accepted Answer

Increase myocardial oxygen supply is indicated to treat ischemia.
Oxygen is indicated,not a decrease in volume.
Heart rate should be decreased to decrease cardiac workload.
Antibiotics are not the most beneficial; oxygen is.

Question 14

A 52-year-old female is diagnosed with coronary artery disease.The nurse assesses for myocardial:
A) Hypertrophy
B) Ischemia
C) Necrosis
D) Inflammation

Accepted Answer

Coronary artery disease leads to myocardial ischemia.
Coronary artery disease would not lead to hypertrophy,but to ischemia.
Coronary artery disease can contribute to necrosis,but obstruction by a clot would more likely lead to necrosis.
Coronary artery disease would lead to myocardial ischemia,not inflammation.

Question 15

A 51-year-old male is at the health clinic for an annual physical exam.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.The nurse suspects he is most likely experiencing:
A) Stable angina
B) Unstable angina
C) Prinzmetal angina
D) Myocardial infarction (MI)

Accepted Answer

Stable angina is associated with activity and subsides with rest.
Unstable angina is a form of acute coronary syndrome that results from reversible myocardial ischemia and occurs at rest.
Chest pain that occurs at rest and at night is descriptive of Prinzmetal angina.
MI pain does not subside with rest.

Question 16

A 56-year-old male presents to his primary care provider for a checkup.Physical exam 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

Accepted Answer

Muffled heart sounds is an indication of tamponade,and with tamponade the blood backs up into the venous system,leading to hepatomegaly.
Muffled heart sounds with hepatomegaly are symptoms of tamponade,not exudates.
An aneurysm could present without symptoms; tamponade presents with muffled heart sounds.
Pulsus paradoxus is manifested by a change in blood pressure during inspiration and expiration.

Question 17

A 42-year-old female 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

Accepted Answer

In constrictive pericarditis,fibrous scarring compresses the heart and eventually reduces cardiac output.
In constrictive pericarditis,fibrous scarring compresses the heart and eventually reduces cardiac output.Pericardial effusion is manifested by chest pain.
Cardiomyopathy is a general term for pathophysiological changes in the heart.In constrictive pericarditis,fibrous scarring compresses the heart and eventually reduces cardiac output.
Hemorrhage in the pericardial cavity will lead to tamponade.In constrictive pericarditis,fibrous scarring compresses the heart and eventually reduces cardiac output.

Question 18

While planning care for a patient with superior vena cava syndrome (SVCS),which principle should the nurse remember? SVCS is a progressive _____ of the superior vena cava (SVC)that leads to venous distention of the upper extremities and head.
A) Inflammation
B) Occlusion
C) Distention
D) Sclerosis

Accepted Answer

SVCS is a progressive occlusion of the SVC that leads to venous distention in the upper extremities and head.
SVCS is a progressive occlusion,not inflammation,of the SVC that leads to venous distention in the upper extremities and head.
SVCS is a progressive occlusion,not distention,of the SVC that leads to venous distention in the upper extremities and head.
SVCS is a progressive occlusion,not sclerosis,of the SVC that leads to venous distention in the upper extremities and head.

Question 19

A 55-year-old male died of a myocardial infarction.Autopsy would most likely reveal:
A) Embolization of plaque from the aorta
B) Decreased ventricular diastolic filling time
C) Platelet aggregation within the atherosclerotic coronary artery
D) Smooth muscle dysplasia in the coronary artery

Accepted Answer

The autopsy would reveal platelet aggregation within an atherosclerotic coronary artery.
The cause is most likely occlusion of the coronary artery,not emboli from the aorta.
The cause is most likely occlusion of the coronary artery,not decreased filling time.
The cause is most likely occlusion of the coronary artery,not dysplasia in the artery.

Question 20

While planning care,the nurse remembers which principle? In valvular _____,the valve opening is constricted and narrowed because the valve leaflets,or cusps,fail to open completely.
A) Regurgitation
B) Insufficiency
C) Stenosis
D) Incompetence

Accepted Answer

Valvular stenosis occurs when the valve opening is constricted and narrowed.
Valvular regurgitation occurs when blood moves backward into the chamber from which it came.
Valvular insufficiency occurs when blood regurgitates backward into the chamber from where it came.
Valvular incompetence leads to regurgitation.

Quiz 23: Alterations of Cardiovascular Function

A 75-year-old male has severe chest pain and dials 911.Lab tests at the hospital reveal elevated levels of cardiac troponins I and T.Based upon the lab findings,the nurse suspects which of the following has occurred?

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 dysfunction?

A 60-year-old female had a myocardial infarction.She was brought to the hospital 30 minutes later.She survived,but now the nurse is providing care for impaired ventricular function because:

A 67-year-old female was previously diagnosed with rheumatic heart disease.Tests reveal lipoprotein deposition with chronic inflammation that impairs blood flow from the left ventricle into the aorta.Which of the following is the most likely diagnosis recorded on the chart?

A 51-year-old male presents with recurrent chest pain on exertion.He is diagnosed with angina pectoris.When he asks what causes the pain,how should the nurse respond? The pain occurs when:

A 56-year-old male is diagnosed with coronary artery disease.Which of the following modifiable risk factors would the nurse suggest the patient change?

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

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.He most likely has:

A 50-year-old obese male with hypertension and coronary artery disease visits a nutritionist for food counseling.He has an elevated level of low-density lipoprotein (LDL) and a low level of high-density lipoprotein (HDL) .Which of the following should the nurse advise him to avoid?

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?

When a patient asks the nurse what is the most common cause of myocardial ischemia,which statement is the correct response? The most common cause of myocardial ischemia is:

A 28-year-old female presents to the ER reporting severe chest pain that worsens with respirations or lying down.She has a fever,tachycardia,and a friction rub.Based upon the assessment findings,the nurse determines the patient is experiencing:

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

A 52-year-old female is diagnosed with coronary artery disease.The nurse assesses for myocardial:

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

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

While planning care for a patient with superior vena cava syndrome (SVCS) ,which principle should the nurse remember? SVCS is a progressive _____ of the superior vena cava (SVC) that leads to venous distention of the upper extremities and head.

A 55-year-old male died of a myocardial infarction.Autopsy would most likely reveal:

While planning care,the nurse remembers which principle? In valvular _____,the valve opening is constricted and narrowed because the valve leaflets,or cusps,fail to open completely.