Deck 12: Cardiovascular Disorders

Question 1

Clinical manifestations of right-sided heart failure include

A) elevated central venous pressure and sacral edema.
B) pulmonary congestion and jugular venous distention.
C) hypertension and chest pain.
D) liver tenderness and pulmonary edema.

Answer 1

elevated central venous pressure and sacral edema.

Question 2

The nurse should anticipate which of the following as the most common complication after an MI?

A) Pulmonary edema
B) Cardiogenic shock
C) Dysrhythmias
D) Deep vein thrombosis

Answer 2

Dysrhythmias

Question 3

One differentiating factor between stable angina and unstable angina is that stable angina

A) responds predictably well to nitrates.
B) is not precipitated by activity.
C) has a low correlation to CAD.
D) is a result of coronary artery spasm.

Answer 3

responds predictably well to nitrates.

Question 4

A 66-year-old patient is admitted to the critical care unit with a diagnosis of acute inferior MI.A 12-lead electrocardiogram (ECG)is done to validate the area of infarction.Which finding on the ECG is most conclusive for infarction?

A) Inverted T waves
B) Tall, peaked T waves
C) ST segment depression
D) Pathologic Q waves

Question 5

In the acute phase after STEMI, fibrinolytic therapy is used in combination with heparin to recanalize the coronary artery.The initial heparin bolus is

A) 60 units/kg maximum 5000 units.
B) 30 units/kg maximum 3000 units.
C) 25 units/kg maximum of 2500 units.
D) 12 units/kg maximum of 1000 units.

Question 6

Which classification of dysrhythmia is most common with an inferior wall infarction in the first hour after STEMI?

A) Sinus tachycardia
B) Multifocal PVCs
C) Atrial fibrillation
D) Sinus bradycardia

Question 7

Which of the following assessment findings is most specific for acute onset of pulmonary edema?

A) Pulmonary crackles
B) Peripheral edema
C) Pink, frothy sputum
D) Elevated central venous pressure

Question 8

The most frequent dysrhythmia seen initially with sudden cardiac death is

A) premature ventricular contractions.
B) ventricular tachycardia.
C) ventricular fibrillation.
D) asystole.

Question 9

Patient teaching regarding valvular heart disease should include which of the following?

A) Increase fluid intake to increase cardiac output.
B) Monitor and increase sodium intake to replace sodium lost with diuretics.
C) Increase daily activity until shortness of breath occurs.
D) Take prophylactic antibiotics before undergoing any invasive procedure.

Question 10

Which of the following values, when elevated, places the patient at lowest risk for CAD?

A) Very-low-density lipoproteins (VLDLs)
B) Triglycerides
C) Low-density lipoproteins (LDLs)
D) High-density lipoproteins (HDLs)

Question 11

Which of the following cholesterol values indicates a heightened risk for the development of CAD?

A) Total cholesterol level of 170 mg/dL
B) HDL cholesterol level of 30 mg/dL
C) Triglyceride level of 120 mg/dL
D) LDL cholesterol level >190 mg/dL

Question 12

You are teaching a patient with endocarditis about his diagnosis.Which statement below is correct?

A) Endocarditis is a viral infection that is easily treated with antibiotics.
B) The risk of this diagnosis is occlusion of the coronary arteries.
C) A long course of antibiotics is needed to treat this disorder.
D) Complications are rare after antibiotics have been started.

Question 13

Assessment of a patient with pericarditis may reveal which of the following signs and symptoms?

A) Ventricular gallop and substernal chest pain
B) Narrowed pulse pressure and shortness of breath
C) Pericardial friction rub and pain
D) Pericardial tamponade and widened pulse pressure

Question 14

One of the reasons that contributes to higher mortality rates from acute MI in women is:

A) waiting longer to seek medical care.
B) being younger when symptoms occur.
C) risk factors associated with MI are more stronger in women than men.
D) women have smaller hearts than men.

Question 15

A 66-year-old patient is admitted to the critical care unit with a diagnosis of acute inferior MI.A 12-lead electrocardiogram (ECG)is done to validate the area of infarction.For the above patient, which leads on the ECG would correlate with an inferior wall MI?

A) II, III, aVF
B) V₅ to V₆, I, aVL
C) V₂ to V₄
D) V₁ to V₂

Question 16

Medical management of hypertrophic cardiomyopathy includes

A) beta-blockers.
B) positive inotropes.
C) an intensive exercise regimen.
D) aortic valve replacement.

Question 17

Nursing management of the patient with angina is directed toward

A) immediate administration of antiplatelet therapy.
B) assessment of history of previous anginal episodes.
C) assessment and documentation of chest pain episodes.
D) administration of prophylactic lidocaine for ventricular ectopy.

Question 18

An essential aspect of teaching that may prevent recurrence of heart failure is

A) notifying the physician if a 2-lb weight gain occurs in 24 hours.
B) compliance with diuretic therapy.
C) taking nitroglycerin if chest pain occurs.
D) assessment of an apical pulse.

Question 19

A patient with diagnosis of CAD with chest pain is admitted into the critical care unit.The patient is suddenly awakened with severe chest pain.Three nitroglycerin sublingual tablets are administered 5 minutes apart without relief.A 12-lead ECG reveals nonspecific ST segment elevation.This patient probably has

A) silent ischemia.
B) stable angina.
C) unstable angina.
D) Prinzmetal angina.

Question 20

Data concerning coronary artery disease (CAD)and specific risk factors have demonstrated

A) a low correlation of modifiable risk factors to CAD.
B) the onset of CAD in middle age.
C) an association between development of specific risk factors and CAD.
D) no decisive correlation between risk factors and CAD.

Question 21

Which of the following are mechanisms responsible for a myocardial infarction (MI)?

A) Coronary artery thrombosis
B) Plaque rupture
C) Coronary artery spasm near the ruptured plaque
D) Preinfarction angina
E) Hyperlipidemia

Question 22

The patient is on day 3 of hospitalization in the ICU.The 45-year-old patient was admitted with a diagnosis of acute MI.The patient complains of fatigue, not sleeping the past two nights, and change in appetite.The nurse is aware that these are symptoms of

A) angina.
B) anxiety.
C) depression.
D) endocarditis.

Question 23

A patient is admitted for palliative care for end-stage heart failure.The nurse's primary goal is

A) to reverse heart failure with the use of diuretics.
B) to increase activity tolerance.
C) symptom management and relief of pain.
D) to increase cardiac output related to alteration of contractility.

Question 24

A patient is admitted to the ICU with diagnosis of fever of unknown origin.The patient is complaining of fatigue, malaise, joint pain, and shivering.VS include: T 103F, HR 90 beats/min, RR 22 breaths/min, BP 132/78, and O₂ sat 94% on 2L/NC.Blood cultures are ordered.The patient has a history of MI 3 months ago.The nurse suspects that the patient has developed

A) CAD.
B) heart failure.
C) endocarditis.
D) pulmonary embolus.

Question 25

Dyspnea with wheezing, a nonproductive cough, and pulmonary crackles that progress to the gurgling sounds of pulmonary edema is described as

A) dyspnea.
B) orthopnea.
C) paroxysmal nocturnal dyspnea.
D) cardiac asthma.

Question 26

Three days after an anterior wall MI, a patient is in the critical care unit.The patient is receiving oxygen at 4 L/min by nasal cannula; nitroglycerin paste, 1-inch q6h; and Lopressor 25 mg PO q12h.The monitor shows that the patient is beginning to have premature ventricular contractions (PVCs).Over the course of the next several hours, the PVCs increase in frequency to more than 15 per minute, with occasional runs of multifocal bigeminal PVCs.The patient's vital signs follow: heart rate, 84 beats/min; sinus rhythm with described PVCs; blood pressure, 124/68 mm Hg; respirations, 20 breaths/min; and SpO₂, 92%.Laboratory values are blood pH, 7.44; potassium, 4.4 mEq/L; and magnesium, 1.0 mEq/L.Which of the following, if ordered, would be inappropriate for this patient?

A) Lidocaine 100 mg IV push
B) Increase oxygen to 6 L/min by nasal cannula
C) Potassium chloride 40 mEq in 250 mL 0.9% saline IV piggyback over a 4-hour period
D) Magnesium sulfate 2 g IV piggyback over a 2-hour period

Question 27

Which of the following effects can be associated with physical exercise?

A) Decreased LDL cholesterol
B) Increased HDL cholesterol
C) Decreased triglycerides
D) Increased insulin resistance
E) Decreased incidence of depression

Question 28

A patient presents with severe substernal chest pain.The patient exclaims, "This is the most severe pain I have ever felt!" The patient reports that the pain came on suddenly about 2 hours ago and that three sublingual nitroglycerin tablets have not relieved the pain.The 12-lead ECG reveals only the following abnormalities: T-wave inversion in leads I, aVL, V₄, and V₅; pathologic Q waves in leads II, III, and aVF; ST segment elevation in leads V₁, V₂, V₃, and V₄.Which of the following is probably accurate about this patient?

A) This patient has an old lateral wall infarction.
B) This patient is having an inferior wall infarction.
C) This patient is having an acute anterior wall infarction.
D) This patient is having a posterior wall infarction.

Question 29

A patient has been newly diagnosed with stable angina.He tells the nurse he knows a lot about his diagnosis already because his father had the same diagnosis 15 years ago.The nurse asks him to state what he already knows about angina.Which of the following responses by the patient indicates the need for additional education?

A) He should stop smoking.
B) He can no longer drink colas or coffee.
C) He can no longer get a strong back massage.
D) He should take stool softeners to prevent straining.

Question 30

Which of the following clinical manifestations are indicative of left ventricular failure?

A) Cool, pale extremities
B) Jugular venous distention
C) Liver tenderness
D) Weak peripheral pulses
E) Rales