Deck 33: Cardiovascular System Introduction

Question 1

A patient is scheduled for a heart catheterization.What action should the nurse implement in preparation for this examination?

A) Ask the patient about allergies to seafood or iodine.
B) Remove all metal objects.
C) Give the patient a special heart diet.
D) Test arterial blood gases (ABGs).

Answer 1

Ask the patient about allergies to seafood or iodine.

Question 2

A nurse should anticipate that a patient taking Vasotec, an angiotensin-converting enzyme (ACE)inhibitor, should have which positive outcome to this drug?

A) Increased fluid retention
B) Decreased blood pressure
C) Decreased urine output
D) Increased appetite

Answer 2

Decreased blood pressure

Question 3

A 68-year-old patient is scheduled for open heart surgery in the morning and is crying.What is the most appropriate response by the nurse?

A) "Everything will go great! Dr.C.is the best!"
B) "I know how you feel, so do not cry."
C) "Tell me what concerns you the most."
D) "I will call the physician for a sedative.You are too upset."

Answer 3

"Tell me what concerns you the most."

Question 4

What is increased in hypertension that in turn causes an increase in the work of the heart?

A) Preload
B) Stroke volume
C) Contractility
D) Afterload

Question 5

Laboratory tests are performed to identify damage to the heart muscle.Which test is elevated the earliest with heart damage?

A) Creatine phosphokinase-MB (CPK-MB)
B) Lactate dehydrogenase (LDH)
C) Lipid profile
D) Troponin

Question 6

A stress test is scheduled for a 41-year-old patient.What action should the nurse implement to prepare the patient for the examination?

A) Have the patient sign a consent form.
B) Give the patient a special heart diet.
C) Prepare the patient for sedation.
D) Remove all metal objects.

Question 7

What action should a nurse expect to implement when a patient returns from a cardiac catheterization?

A) Ambulate the patient in the hall.
B) Check the puncture site.
C) Monitor the gag reflex.
D) Remove the gel from all sites on the skin.

Question 8

A nurse records the finding of a normal sinus rhythm (NSR)when the P, Q, R, S, and T are all present in the electrocardiographic complex.What additional information should the nurse document?

A) Rate of 82 seconds
B) PR interval of 0.36 second
C) QRS complex of 0.16 second
D) Inverted T

Question 9

A physician has ordered continuous pulse oximetry.What should the nurse explain to the patient about this procedure?

A) Involves a single prick
B) Measures the amount of oxygen in the blood
C) Is applied to the wrist
D) Identifies damaged cells in the myocardium

Question 10

A nurse performs an apical-radial pulse evaluation, with the result of 100/88.What is the pulse deficit?

A) 12
B) 24
C) 76
D) 88

Question 11

A dopamine infusion is being administered to a patient with shock.For what should the nurse be alert?

A) Sharp spike in blood pressure
B) Tremor of the hands
C) Increasing urinary output
D) Hyperirritability of the patient

Question 12

A nurse explains that cardiac rehabilitation lasts from the end of acute care to the return to home and beyond.What does this service include?

A) One-on-one individualized care
B) Focus on the patient rather than the family
C) Telemetry-monitored exercise
D) Rejection from the program for noncompliance

Question 13

A patient with atrial fibrillation is prescribed amiodarone for the dysrhythmia.Which potential adverse reaction should the nurse report?

A) Ataxia
B) Decreasing pulse rate
C) Decreasing blood pressure
D) Increase in cardiac output

Question 14

Which heart sound should the nurse record as normal?

A) Ventricular gallop in a 20-year-old patient
B) Atrial gallop in a 25-year-old patient
C) Friction rub in a 45-year-old patient
D) Medium diastolic murmur in a 50-year-old patient

Question 15

A medication, simvastatin (Zocor), is administered to lower a patient's cholesterol level.Follow-up lipid levels are reviewed by the nurse.Which level indicates the desired therapeutic range?

A) High-density lipoprotein (HDL), 29 mg/dL; low-density lipoprotein (LDL), 160 mg/dL
B) HDL, 38 mg/dL; LDL, 120 mg/dL
C) HDL, 56 mg/dL; LDL, 106 mg/dL
D) HDL, 42 mg/dL; LDL, 98 mg/dL

Question 16

A 29-year-old patient is to receive cardioversion for a dysrhythmia.What should the nurse instruct the patient to expect?

A) Administration of a short-acting sedative
B) Digoxin dose to be taken as scheduled
C) Procedure to be completely safe
D) Pacemaker spikes to be carefully monitored

Question 17

A patient asks what a transesophageal echocardiogram (TEE)is and what it is expected to do? What is the best explanation by the nurse?

A) Measures conductivity
B) Records the force of contraction
C) Evaluates the efficiency of the valves
D) Checks the volume of the preload

Question 18

On auscultation, a nurse detects a heart murmur.What should the nurse know that a heart murmur indicates?

A) Valves that do not close correctly
B) Pericardium that is inflamed
C) Decrease in pacemaker cells
D) Loud ventricular gallop

Question 19

A patient has had atropine sulfate that has been administered intravenously to treat a dysrhythmia.What should the nurse assess this patient for after administration?

A) Weight gain
B) Tachycardia
C) Muscle twitching
D) Incontinence of urine

Question 20

A nurse assesses an inverted T wave on the ECG of a patient who had an acute MI two days earlier.How should the nurse interpret this finding?

A) Normal recovery
B) New MI
C) Abnormal waveform
D) Congestive heart failure

Question 21

Vascular disease disorders often require the use of elastic stockings.Which action should the nurse implement when caring for a patient with elastic stockings?

A) Apply the stockings and roll down the cuff.
B) Remove the stockings for skin inspection two times a day.
C) Remove the stockings when the patient is ambulating.
D) Inspect the skin for pressure or irritation daily.

Question 22

A nurse cautions a patient with peripheral vascular disease (PVD)that continued smoking causes detrimental vasoconstriction for up to ____ after only one cigarette.

A) 10 minutes
B) 20 minutes
C) 30 minutes
D) 1 hour

Question 23

Which technique should the nurse implement when performing the Allen test on a patient to evaluate the adequacy of circulation in the radial artery?

A) Asks the patient to relax the hand by the side
B) Compresses only the ulnar artery to blanch the hand
C) Releases pressure on both arteries at the same time
D) Observes whether the color is returning to the hand, which indicates perfusion

Question 24

A patient inquires how something as simple as walking could help his venous vascular disorder.What is the best response by the nurse when explaining the benefits of walking?

A) Improves the strength of the vascular walls
B) Boosts venous circulation through leg muscle activity
C) Increases cardiac output
D) Clears plaques from the veins

Question 25

A nurse records a "1" for the pulse quality of the pedal pulse.What interpretation is correct regarding the pulse?

A) Absent
B) Normal
C) Thready
D) Forceful

Question 26

A nurse is educating a patient regarding a stress test on a treadmill.Teaching includes that this test is a noninvasive procedure.What additional information is appropriate for the nurse to include?

A) Is monitored continuously by blood pressure and an electrocardiogram
B) Will last about 1 hour
C) Is meant to stimulate claudication and dyspnea
D) Will require a period of bed rest afterward

Question 27

What is a normal age-related change in older adults that makes them susceptible to cardiovascular disease?

A) Increase in cardiac output
B) Increase in stroke volume
C) Stiff peripheral vessels
D) Oxygen capacity improvement

Question 28

A patient is receiving digoxin 0.25 mg/day.What should the nurse do prior to administering this medication?

A) Count an apical pulse for 15 seconds.
B) Hold the dose if the apical rate is 57 beats/min.
C) Give the dose if the apical rate is 59 beats/min.
D) Double the dose if the rate is 62 beats/min.

Question 29

A nurse is caring for a patient who has had an angiogram.What should the nurse make a point of care to assess and document on this patient?

A) Fluid intake
B) Peripheral pulses in the affected leg
C) Inquiring about an allergy to iodine
D) Decreased blood pressure

Question 30

A nurse is preparing to administer low-molecular-weight heparin (LMWH).What is a major advantage related to the administration of LMWH?

A) It can be given orally.
B) It is provided fixed doses.
C) It is given only after partial thromboplastin time (PTT)laboratory work.
D) It provides an immediate effect.

Question 31

Which instruction is most appropriate for a patient with arterial insufficiency?

A) Frequently allow the legs to dangle dependently.
B) Rub the legs vigorously.
C) Stand often to keep blood flow in the legs.
D) Walk barefoot.

Question 32

A nurse assesses a patient's capillary refill time as less than 3 seconds.What does this assessment indicate?

A) Hypertension
B) Tissue perfusion
C) Fluid volume excess
D) Increased blood viscosity

Question 33

A nurse records that a patient has a 3+ edema to the right foot.How deep did the nurse's thumb depress the edematous area?

A) More than 1 inch
B) To 1 inch
C) To inch
D) Less than inch

Question 34

What is contraindicated for a patient performing Buerger-Allen exercises?

A) Lying on the stomach
B) Raising legs for 2 minutes until they blanch
C) Lowering the legs until the color returns
D) Keeping legs flat for 5 minutes and then repeat the exercise

Question 35

A diuretic medication, furosemide (Lasix), is being administered for congestive heart failure.Which assessment is not an anticipated consequence of the therapy?

A) Increased urinary output
B) Weight loss
C) Thirst
D) Muscle weakness

Question 36

A nurse is performing an intake examination on a patient with peripheral vascular disease (PVD).Which lifestyle information identified by the patient aggravates vascular disease?

A) Riding a bicycle to work
B) Drinking red wine every day
C) Being employed as an air traffic controller
D) Eating chocolate candy every day

Question 37

A 46-year-old patient is receiving propranolol (Inderal), a nonselective beta-adrenergic blocker, for a heart condition.What patient teaching is most appropriate?

A) Sit or lie down when taking the drug.
B) Limit caffeine intake.
C) Double the dose if symptoms occur.
D) Never stop taking the drug abruptly.

Question 38

Which assessment should be immediately addressed in a patient on lidocaine?

A) Slowed ventricular rate
B) Occasional PVCs
C) Increase in temperature to 102 $\degree$ F
D) Nausea and vomiting

Question 39

A patient with an irregular sinoatrial (SA)node conduction has a permanent pacemaker with the code AAIOO and is now going home.The patient asks, "What happens when my real SA node fires on its own?" How should the nurse respond regarding what the pacemaker should do?

A) Not fire
B) Fire only the ventricles
C) Change the rate of firing
D) Fire both the atria and the ventricles.

Question 40

A nurse performs Homans maneuver by flexing the knee and sharply dorsiflexing the foot.What response indicates a positive Homans sign?

A) Cramping of the toes
B) Resisting dorsiflexion
C) Pain in the calf area
D) Blanching of the sole

Question 41

A nurse explains that the lining of a vessel that allows for smooth blood flow and also reduced resistance in the vessel is the ______ of the vessel.

Question 42

Which factors affect stroke volume? (Select all that apply.)

A) Contractility
B) Climate
C) Age
D) Preload
E) Afterload

Question 43

Which statement made by a patient indicates to the nurse that a teaching plan for the use of warfarin was not effective?

A) "I don't take aspirin anymore."
B) "I read that grapefruit interferes with warfarin."
C) "I'm drinking too much tea.My urine looks like tea."
D) "I wear my medical alert bracelet all the time."

Question 44

At rest, the cardiac cells in the myocardium are electrically polarized, with the inside of the cell being more ______ than the outside of the cell.

Question 45

Why do older persons adapt more slowly to changes in the peripheral vascular system? (Select all that apply.)

A) Slowing heart rate
B) Decreasing cardiac output
C) Increasing stroke volume
D) Stiffening of blood vessels
E) Thickening of aorta

Question 46

A nurse suspects a circulatory disorder in one leg.Which assessments should the nurse include when comparing both legs? (Select all that apply.)

A) Color
B) Warmth
C) Muscle strength
D) Pulse quality
E) Hair loss on extremity

Question 47

What medication obtained in a patient's history will lessen the effects of warfarin (Coumadin)?

A) Iron supplement for anemia
B) Simvastatin (Zocor)for the control of cholesterol
C) Furosemide (Lasix)for fluid retention
D) Yaz (drospirenone/estradiol)as an oral contraceptive

Question 48

A nurse explains that when a patient history reveals a recent episode of vomiting and diarrhea, the nurse anticipates that this fluid loss will cause ______ and increased blood viscosity.

Question 49

Which age-related changes in the heart should a nurse take into consideration? (Select all that apply.)

A) Decrease in contractility
B) Thickened valves
C) Stiffened valves
D) Decreased SA node cells
E) Increased nerve fibers in ventricles