Deck 37: Circulation

Question 1

Chronic stress may lead directly to cardiovascular disease because of the repeated release of which of the following?

A) Histamine
B) Catecholamines
C) Cortisol
D) Protease

Answer 1

Catecholamines

Question 2

The nurse administers sublingual nitroglycerine,a vasodilator,to a patient diagnosed with angina.When the patient's chest pain is not relieved,the nurse prepares to give another nitroglycerine tablet.What is the nurse's priority action prior to administering the next dose of medication?

A) Notify the physician.
B) Elevate the head of the bed.
C) Measure the patient's blood pressure.
D) Place the patient on a cardiorespiratory monitor.

Answer 2

Measure the patient's blood pressure.

Question 3

A patient diagnosed with hypertension is taking an angiotensin-converting enzyme (ACE)inhibitor.When planning care,which of the following outcomes would be appropriate for the patient?

A) BP will be lower than 135/85 on all occasions.
B) BP will be normal after 2 to 3 weeks on medication.
C) Patient will not experience dizziness on rising.
D) Urine output will increase to at least 50 mL/hr.

Answer 3

BP will be lower than 135/85 on all occasions.

Question 4

The nurse plans to maintain hydration for the patient at risk for thrombus formation.What evaluation finding is an indicator that the intervention is successful?

A) The patient denies pain in the lower legs.
B) The patient denies chest pain or difficulty breathing
C) Urine output exceeds 1,500 mL per 24-hour period.
D) There is a weight gain of 5 pounds within 24 hours.

Question 5

The nurse is assessing a male patient diagnosed with chronic heart failure 10 years ago.Which finding would indicate poor perfusion to the tissues?

A) Blood pressure reading of 102/64
B) Absence of hair on the lower legs and feet
C) Pulse rate of 104 beats/min
D) Shortness of breath when supine

Question 6

The nurse is teaching a pregnant woman about the increased oxygen demand that develops during pregnancy.The nurse knows the patient comprehends the teaching when she makes the following statement:

A) "I may need to drink more fluids to make more oxygen."
B) "I may need to take an iron supplement so that I am not anemic."
C) "I will need a multivitamin supplement for several months."
D) "I will need to eat more fruits and vegetables."

Question 7

The patient diagnosed with inadequate closure of the mitral valve is scheduled for surgery and asks the nurse,"Why does it matter if my valve leaks?" What is the nurse's best response to explain why this mitral valve needs to be repaired?

A) "Blood backflows from the left ventricle to the left atrium, reducing available blood flowing to the body."
B) "Blood backflows from the right ventricle to the right atrium, reducing available blood flow to the lungs."
C) "Blood backflows from the aorta into the left ventricle, reducing blood pressure and causing dizziness."
D) "Blood backflows from the pulmonary artery into the right ventricle, reducing blood flow to the lungs."

Question 8

The nurse analyzes the patient's ECG and compares it with a baseline ECG recorded before the patient began having chest pain.What finding indicates a problem with the ventricle?

A) Prolonged QRS segment
B) Elevated P wave
C) Absence of T wave
D) Prolonged PR interval

Question 9

You are preparing the nursing care plan for a middle-aged patient admitted to the intensive care unit for an acute myocardial infarction (heart attack).His symptoms include tachycardia,palpitations,anxiety,jugular vein distention,and fatigue.Which of the following nursing diagnoses is most appropriate?

A) Decreased Cardiac Output
B) Impaired Tissue Perfusion
C) Impaired Cardiac Contractility
D) Impaired Activity Tolerance

Question 10

The nurse administers a beta-adrenergic agent to a patient with congestive heart failure.What assessment findings would indicate the drug was working?

A) Heart rate changes from 92 beats/min to 76 beats/min.
B) Cardiac monitor shows narrowing of the QRS segment.
C) There is tingling in the fingers and toes.
D) There is increased urine output.

Question 11

The nurse is providing teaching for a weight loss group on the cardiac dangers of obesity.Which statement,if made by the nurse,would be incorrect?

A) "Obesity increases the risk of atherosclerosis."
B) "Obesity increases the risk of hypertension."
C) "Obesity can reduce pumping action of the heart."
D) "Tissue perfusion is diminished by obesity."

Question 12

The nurse is assessing a patient who is complaining of chest pain,clutching his chest,and is short of breath.Which assessment question would be appropriate for the nurse to ask?

A) "Please describe your pain, its location, and what you've done to treat it."
B) "Does the pain radiate to your arm, jaw, or shoulder?"
C) "What are your current medications including supplements or vitamins?"
D) "What is your medical history beginning with most recent?"

Question 13

Three days ago,a patient had cardiac surgery to bypass three occlusions of his coronary arteries.Veins for the bypass were harvested from his right leg.He informs the nurse that his leg is warm and tender in his right calf.The nurse notes a 3-cm periwound erythema and swelling at the distal end of the incision.Staples are intact along the incision,and there is no drainage.Vital signs are stable.The nurse would suspect that the patient has what kind of complication?

A) Deep vein thrombosis
B) Dehiscence of the wound
C) Internal bleeding
D) Infection at the incisional site

Question 14

The nurse is planning care for an elderly patient diagnosed with end-stage heart failure and a nursing diagnosis of Decreased Cardiac Output secondary to ineffective left ventricular function.What outcome would the nurse plan for this patient to measure improvement in cardiac output?

A) Brisk capillary refill in feet bilaterally.
B) Heart rate within expected range
C) Breath sounds clear with no shortness of breath
D) Regular pulse rhythm

Question 15

The nurse is caring for a patient with reduced perfusion to the extremities.The nurse evaluates the patient and finds the response to therapy is not optimal.What lifestyle change does the nurse suspect is contributing to the lack of response?

A) Following a vegetarian diet
B) Taking daily brisk walks
C) Ingesting 1,500 mL of fluid per day
D) Smoking cessation when the diagnosis was received

Question 16

The nurse is preparing to apply a cardiac monitor to a patient.Where should the nurse place the electrodes?

A) Over the indicated rib
B) Near the indicated rib
C) On soft spongy areas
D) On the abdomen

Question 17

A patient with heart failure has BP 120/60,HR 64,R 18,T 97.6°F,coarse crackles bilaterally,and 3+ edema to the lower extremities.An appropriate nursing diagnosis for this patient is:

A) Impaired gas exchange
B) Excess Fluid Volume
C) Ineffective Tissue Perfusion
D) Deficient Knowledge

Question 18

The nurse is reviewing the results of the patient's laboratory findings and notes an elevated C-reactive protein (CRP).What does this indicate?

A) The patient had a myocardial infarction.
B) The patient has inflammation in the body.
C) The patient has reduced cardiac output.
D) The patient's diet is high in cholesterol.

Question 19

For which patient might the nurse use the nursing diagnosis of Risk for Ineffective Renal Tissue Perfusion?

A) Patient with hypertension who is noncompliant with medication administration
B) Patient with angina who takes nitroglycerine when experiencing chest pain
C) Patient diagnosed with pneumonia, becoming short of breath with activity
D) Patient with a hemorrhagic stroke secondary to head trauma

Question 20

A nurse is performing cardiopulmonary resuscitation on an infant.When performing chest compressions,the nurse understands that the compression rate is at least:

A) 60 times a minute
B) 80 times a minute
C) 100 times a minute
D) 120 times a minute

Question 21

Which of the following medications would you expect to be included in the treatment of a patient with congestive heart failure? Select all that apply.

A) Nitrates
B) Beta-adrenergic agents
C) Diuretics
D) Anticoagulants

Question 22

Your client is a healthy older adult who has comes to the health clinic because she reports not feeling like herself.When you are gathering data in your client's health history,she tells you that she is feeling more fatigue when walking up stairs and doing her normal household activities.What are normal physiological changes in the cardiovascular system that occur with aging? Select all that apply.

A) Cardiac contractile strength is reduced.
B) Heart valves become more rigid.
C) Peripheral vessels lose elasticity.
D) Heart responds to increased oxygen demands.

Question 23

The nurse admits to the coronary care unit a patient diagnosed with an acute myocardial infarction.The patient's blood pressure reading is 86/38 secondary to an infusing nitroglycerine drip.Pulse rate is 120 beats/min and respirations are 14 breaths/min.The patient is pale and grimacing,and moans occasionally.What nursing diagnoses would the nurse anticipate for this patient? Select all that apply.

A) Acute Pain
B) Anxiety related to shortness of breath
C) Risk for shock
D) Decreased Cardiac Output
E) Decreased Cardiac Perfusion

Question 24

Which outcome statement is related to Decreased Cardiac Output? Select all that apply.

A) No dyspnea or shortness of breath with exertion
B) Normal skin color
C) Respiratory rate less than 16 breaths/min
D) Brisk capillary refill

Question 25

The nurse is preparing patient teaching for a patient diagnosed with peripheral edema secondary to right-sided heart failure.What intervention will promote circulation and reduce edema in the lower extremities?

A) Encourage frequent ambulation.
B) Administer antihypertensive medications.
C) Encourage vigorous exercise for 30 minutes a day.
D) Administer oxygen when short of breath.

Question 26

As the nurse caring for a patient who has suffered a myocardial infarction that has damaged the sinoatrial (SA)node,you should plan to monitor for which of the following potential complications? Select all that apply.

A) Decreased heart rate
B) Increased heart rate
C) Decreased cardiac output
D) Decreased strength of ventricular contractions