Question 1

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?

Accepted Answer

Right-sided failure allows blood to back up into the systemic circulation, leading to peripheral edema.Since it is backed up into the venous system, hypertension is less likely.Right-sided failure leads to edema and a greater venous blood volume, which would lead to increased urinary output.Dyspnea upon exertion is more indicating of left-sided failure.

Question 2

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

Accepted Answer

Common causes of high-output failure include anemia, not metabolic alkalosis, not hypothyroidism, and not hypovolemia.

Question 3

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

Accepted Answer

With hypertension comes increased afterload and resistance to ventricular emptying and more workload for the ventricle, which responds with hypertrophy of the myocardium and ventricular remodeling.Ventricular dilation can occur, but the wall will thicken, not thin.Renin and aldosterone release are increased, not inhibited.Alterations in alpha and beta functioning may occur, but the response to hypertension is myocardial hypertrophy and ventricular remodeling.

Question 4

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?

Accepted Answer

Clinical manifestations of shock will include a low blood pressure and tachycardia.Tachycardia, not bradycardia, will occur.Severe respiratory distress, jugular vein distention, and chest pain are symptoms of heart failure, particularly pulmonary edema.Cardiac output is reduced, but there is a decrease in systemic vascular resistance.

Question 5

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?

Accepted Answer

The immune response cross-reacts with molecularly similar self-antigens in heart, muscle, joints, and the brain, causing an autoimmune response resulting in diffuse, proliferative, and exudative inflammatory lesions in these tissues.It is not due to blood-borne organisms, high fevers, or rheumatoid factors.

Question 6

During shock states, glucose uptake is usually:

Accepted Answer

Some compensatory mechanisms activated by shock contribute to decreased glucose uptake by the cells, not enhanced uptake, not normal uptake, and not energy-intensive uptake.

Question 7

A 27-year-old male is admitted to a neurologic 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.The most likely mechanism of his shock is:

Accepted Answer

The patient is experiencing neurogenic shock in which blood volume has not changed, but SVR decreases drastically so that the amount of space containing the blood has increased, leading to hypotension.In this type of shock, blood loss has not occurred.In this type of shock, fluid loss has not occurred.Vasodilation due to infection would be septic shock; the type of shock described in the patient is due to loss of sympathetic stimulation.

Question 8

Inflammatory cells have difficulty limiting the colonization of microorganisms in infective endocarditis because the:

Accepted Answer

In endocarditis, bacterial colonies are inaccessible to host defenses because they are embedded in the protective fibrin clots; it is not because the microorganisms are resistant, that the valves are avascular, or that the colonies overwhelm the phagocytes.

Question 9

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?

Accepted Answer

Anaphylactic shock is characterized by bronchoconstriction, hives, and hypotension; it does not involve oliguria, bradycardia, or hypotension.Septic shock, not anaphylactic shock, is manifested by fever and rash.

Question 10

The onset of anaphylactic shock is usually:

Accepted Answer

The onset of anaphylactic shock is usually sudden and life threatening, not mild or delayed.

Question 11

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:

Accepted Answer

MI leads to decreased cardiac contractility due to a damaged myocardium and would lead to shock.A rapid heart rate would not cause shock.Increased capillary permeability would not lead to shock.Decreased afterload will not lead to shock associated with MI.

Question 12

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

Accepted Answer

Left ventricular preload increases in left heart failure because less blood is ejected from the left ventricle.Left heart failure does not lead to a decrease in systemic resistance; it leads to an increase in resistance.Left end-diastolic volume will increase.Pulmonary vascular resistance will increase.

Question 13

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.The most likely cause of the disease is:

Accepted Answer

Infective endocarditis is due to a bacterial infection, not a viral, fungal, or parasitic infection.

Question 14

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

Accepted Answer

Right-sided failure often follows left-sided failure when pulmonary congestion forces backward flow of blood into the left ventricle.It is not due to hypertension, pneumonia, or pericarditis.

Question 15

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?

Accepted Answer

In hypovolemic shock, heart rate and SVR increase, boosting both cardiac output and tissue perfusion pressures.Interstitial fluid moves into the vascular compartment.In anaphylactic shock, bronchoconstriction occurs with hypotension.In neurogenic shock, hypotension occurs, but fluid does not shift.In septic shock, interstitial fluid shift does not occur.

Question 16

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

Accepted Answer

In shock, impaired cellular metabolism is caused by inadequate tissue perfusion.
Impairment of cellular metabolism is the result of inadequate tissue perfusion; toxic substances could develop, but it would be secondary to the inadequate perfusion.Free radicals are not the cause of impaired cellular metabolism.The lack of nervous control would lead to vasodilation, but perfusion still occurs.

Question 17

One consequence of switching from aerobic to anaerobic cellular metabolism during shock states is:

Accepted Answer

Anaerobic metabolism leads to decreased ATP production, not cellular dehydration, not cellular alkalosis, and not free radical formation.

Question 18

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?

Accepted Answer

Right-sided failure occurs when the patient experiences chronic pulmonary disease and elevated pulmonary vascular resistance because the blood has difficulty overcoming the pressure and blood builds up in the right side of the heart.Pulmonary congestion leads to right-sided failure, not left, not low-output failure, and not high-output failure.

Question 19

A patient with left heart failure starts to have a cough and dyspnea.Pulmonary symptoms common to left heart failure are a result of:

Accepted Answer

The clinical manifestations of left heart failure are the result of pulmonary vascular congestion and inadequate perfusion of the systemic circulation.Pulmonary edema does occur, but it is not due to inflammation.Decreased cardiac output does occur, but the pulmonary symptoms are related to pulmonary congestion.Pulmonary symptoms are not due to bronchoconstriction.

Question 20

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

Accepted Answer

Neurogenic shock is caused by any factor that inhibits the sympathetic nervous system or overstimulates the parasympathetic nervous system.Neurogenic shock is not caused by inhibition of the somatic system or of the thalamus.

Quiz 24: Alterations of Cardiovascular Function