Deck 35: Cardiac Disorders

Question 1

A 68-year-old patient is scheduled for open heart surgery in the morning and is crying.The appropriate response from the nurse would be:

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 1

"Tell me what concerns you the most."

Question 2

A stress test is scheduled for a 41-year-old patient.To prepare for the examination,the nurse should:

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.

Answer 2

Have the patient sign a consent form.

Question 3

When the patient with angina pectoris complains of chest pain at rest that takes three nitroglycerin (NTG)pills to relieve the pain,the nurse assesses this as a major symptom of:

A) Stable angina
B) Unstable angina
C) Full-blown acute myocardial infarction (MI)
D) Pulmonary embolus

Answer 3

Unstable angina

Question 4

A 29-year-old patient is to receive cardioversion for his dysrhythmia.The nurse will 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 5

The nurse would anticipate that a patient taking Vasotec,an angiotensin-converting enzyme (ACE)inhibitor,would have which one of the following positive outcomes to this drug?

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

Question 6

The nurse explains that when fibrous plaques of atherosclerosis are laid down in the vessels,they serve as a(n):

A) Stent to keep the vessel open
B) Trap to which other substances adhere
C) Threat to the integrity of the vessel wall
D) Embolus.

Question 7

A 49-year-old patient has multiple risk factors for coronary artery disease.A modifiable risk factor that the patient can focus on is:

A) Family history
B) Age
C) Smoking
D) Male gender

Question 8

The nurse performs an apical-radial pulse evaluation,with the result of 100/88.This pulse deficit assessment is:

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

Question 9

When a patient returns from a cardiac catheterization,the nurse would expect to:

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 10

When the patient asks what a transesophageal echocardiogram (TEE)is and what it is expected to do,the nurse explains that the TEE:

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

Question 11

The heart sound the nurse would record as normal would be:

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 12

On auscultation,the nurse detects a heart murmur.The nurse knows that a heart murmur indicates:

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

Question 13

The physician has ordered continuous pulse oximetry.The nurse explains to the patient that the 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 14

The nurse explains that hypertension increases the work of the heart because of increasing:

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

Question 15

An important teaching point for a patient with mitral stenosis is to:

A) Obtain a place on the heart transplant list.
B) Balance activity with oxygen supply.
C) Increase daily fluid intake to over 2000 ml.
D) Have an annual electrocardiogram.

Question 16

When the nurse assesses an inverted T wave on the ECG of a patient who had an acute MI 2 days earlier,the nurse interprets this as an indication of a(n):

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

Question 17

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?" The nurse responds that the pacemaker will:

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

Question 18

The nurse explains that cardiac rehabilitation lasts from the end of acute care to the return to home and beyond.This service includes:

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 19

Laboratory tests are performed to identify damage to the heart muscle.The test that is elevated the earliest with heart damage is:

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

Question 20

The 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,as well as a(n):

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

Question 21

To treat a dysrhythmia,atropine sulfate has been administered intravenously.The nurse would monitor for:

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

Question 22

The patient with AF is prescribed amiodarone for the dysrhythmia.The nurse should report the adverse reaction of:

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

Question 23

The nurse should include in the patient's discharge instruction after an acute MI:

A) Cautions about use of morphine
B) Detailed symptoms that indicate impending MI
C) Written instructions on diet and follow-up appointments
D) High-energy exercise program directions

Question 24

The nurse explains that factors that affect stroke volume are:

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

Question 25

A patient is scheduled for a heart catheterization.In preparation for this examination,the nurse would:

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

Question 26

A 46-year-old patient is receiving propranolol (Inderal),a nonselective beta-adrenergic blocker for his heart condition.The nurse would teach the patient to:

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 27

The nurse takes into consideration the age-related changes in the heart,which are:

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

Question 28

The nurse urges the 50-year-old overweight executive who had an MI 3 months earlier to take up some conditioning exercises for 30 minutes a day to:

A) Lose weight.
B) Improve function of the left ventricle.
C) Decrease arterial stiffening.
D) Decrease cholesterol levels
E) Improve cardiac dysrhythmia.

Question 29

To decrease the workload of the heart on a patient with acute congestive failure,the nurse should:

A) Eliminate unnecessary activities.
B) Direct the patient in active range-of-motion exercises.
C) Help the patient change positions every 2 hours.
D) Assist the patient to ambulate to the bathroom.
E) Give a partial bed bath rather than full bed bath.

Question 30

A patient with acute congestive heart failure has jugular vein distention,crackles bilaterally,and dyspnea.The nursing diagnosis with the highest priority would be:

A) Activity intolerance
B) Excess fluid volume
C) Anxiety
D) Ineffective coping

Question 31

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 32

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

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 33

The nurse uses a picture to demonstrate the conduction pathway through the chambers of the heart.(Arrange the following options in the correct sequence.)

A) Atria contract.
B) Conduction occurs through the bundle branches.
C) AV node fires.
D) Purkinje fibers conduct.
E) SA node fires.
F) Ventricles contract.

Question 34

The nurse caring for a patient on lidocaine to increase ventricular conduction is alarmed when assessments reveal:

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

Question 35

A patient is receiving digoxin,0.25 mg daily.Before giving the medication,the nurse would:

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 36

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 37

A dopamine infusion is being administered to a patient with shock.The nurse should be alert for:

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

Question 38

The nurse records a "1" for the pulse quality of the pedal pulse.This means that the pulse is:

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