Question 1

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

Accepted Answer

Chronic pulmonary disease and elevated pulmonary vascular resistance can lead to right heart failure, also known as cor pulmonale, due to the increased workload on the right side of the heart.

Question 2

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

Accepted Answer

The symptoms and compensatory mechanisms described are characteristic of hypovolemic shock, which occurs due to significant fluid loss leading to decreased blood volume and hypotension.

Question 3

Which condition should cause the nurse to assess for high-output failure in a patient?
A) Metabolic alkalosis
B) Hypothyroidism
C) Hypovolemia
D) Anemia

Accepted Answer

Anemia can lead to high-output heart failure because the heart has to work harder to supply enough oxygen to tissues due to the reduced oxygen-carrying capacity of the blood.

Question 4

Which characteristic changes should the nurse keep in mind while caring for a patient with left heart failure? As left heart failure progresses:
A) left ventricular preload increases.
B) systemic vascular resistance decreases.
C) left end-diastolic volume decreases.
D) pulmonary vascular resistance decreases.

Accepted Answer

In left heart failure, the left ventricle struggles to pump blood effectively, leading to an increase in left ventricular preload due to the accumulation of blood in the left atrium and pulmonary circulation.

Question 5

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

Accepted Answer

Untreated hypertension causes increased afterload, leading to myocardial hypertrophy and ventricular remodeling as the heart works harder to pump blood against the elevated pressure.

Question 6

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:
A) bacteria.
B) viruses.
C) fungi.
D) parasites.

Accepted Answer

Infective endocarditis is most commonly caused by bacteria, particularly Streptococcus and Staphylococcus species.

Question 7

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

Accepted Answer

Anaphylactic shock is characterized by bronchoconstriction, hives or edema, and hypotension due to the severe allergic reaction.

Question 8

Inflammatory cells have difficulty limiting the colonization of microorganisms in infective endocarditis because the:
A) microorganisms are resistant.
B) valves are avascular.
C) microorganisms are sequestered in a fibrin clot.
D) colonies overwhelm the phagocytes.

Accepted Answer

Microorganisms in infective endocarditis are sequestered in a fibrin clot, which makes it difficult for inflammatory cells to reach and eliminate them.

Question 9

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:
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.

Accepted Answer

The patient is likely experiencing neurogenic shock due to the spinal cord injury, which leads to a loss of sympathetic tone and resultant vasodilation.

Question 10

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.

Accepted Answer

In the context of acute myocardial infarction, the primary cause of shock is typically cardiogenic shock, which is due to decreased cardiac contractility. This results in the heart's inability to pump sufficient blood to meet the body's needs.

Question 11

When a person is in shock, a nurse remembers 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.

Accepted Answer

Inadequate tissue perfusion leads to insufficient oxygen and nutrients reaching cells, impairing cellular metabolism and causing shock.

Question 12

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 distention, chest pain
C) Low blood pressure and tachycardia
D) Reduced cardiac output, increased systemic vascular resistance, moist cough

Accepted Answer

In septic shock, the patient typically presents with low blood pressure due to vasodilation and tachycardia as a compensatory mechanism to maintain cardiac output.

Question 13

During shock states, glucose uptake is usually:
A) enhanced.
B) normal.
C) impaired.
D) energy intensive.

Accepted Answer

During shock states, the body's stress response often leads to impaired glucose uptake due to insulin resistance and altered cellular metabolism.

Question 14

A patient with left heart failure starts to have a cough and dyspnea.Pulmonary symptoms common to left heart failure are a result of:
A) inflammatory pulmonary edema.
B) decreased cardiac output.
C) pulmonary vascular congestion.
D) bronchoconstriction.

Accepted Answer

In left heart failure, the left ventricle fails to pump blood efficiently, leading to a backup of blood in the pulmonary circulation, causing pulmonary vascular congestion and resulting in symptoms like cough and dyspnea.

Question 15

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.

Accepted Answer

Neurogenic shock is caused by the inhibition of the sympathetic nervous system, leading to vasodilation and decreased blood pressure.

Question 16

A 73 year old has increased pulmonary pressure resulting in right heart failure.A potential cause for the right heart to fail is:
A) hypertension.
B) left heart failure.
C) acute pneumonia.
D) pericarditis.

Accepted Answer

Left heart failure can lead to increased pulmonary pressure, causing the right heart to work harder and potentially fail.

Question 17

One consequence of switching from aerobic to anaerobic cellular metabolism during shock states is:
A) decreased adenosine triphosphate (ATP) production.
B) cellular dehydration.
C) cellular alkalosis.
D) free radical formation.

Accepted Answer

During anaerobic metabolism, cells produce less ATP compared to aerobic metabolism, leading to decreased energy availability.

Question 18

The onset of anaphylactic shock is usually:
A) mild.
B) sudden and life threatening.
C) delayed by several hours.
D) delayed by 24 hours.

Accepted Answer

Anaphylactic shock is a severe, life-threatening allergic reaction that can occur within minutes of exposure to an allergen.

Question 19

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.

Accepted Answer

Rheumatic heart disease is caused by an autoimmune response to a previous Group A Streptococcus infection, where antigens bind to the heart's valvular lining, leading to inflammation and damage.

Question 20

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

Accepted Answer

Right heart failure leads to systemic venous congestion, causing symptoms like peripheral edema, which is significant swelling in the lower legs and feet.

Quiz 26: Alterations of Cardiovascular Function

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?

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

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

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:

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:

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?

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

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:

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:

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

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?

During shock states, glucose uptake is usually:

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

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

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

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

The onset of anaphylactic shock is usually:

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 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?