Question 1

The nurse recognizes that a pericardial friction rub may occur as a result of which of these conditions?

Accepted Answer

Pericardial friction rub is a grating, scratching sound heard on auscultation of the heart caused by the movement of the inflamed pericardial surfaces against each other. It may be heard in conditions such as pericarditis or myocardial infarction with pericarditis. Pneumonia and pleurisy do not typically cause pericardial friction rub, and while mitral valve prolapse may cause a murmur, it does not typically produce a friction rub.

Question 2

What effect does the parasympathetic nervous system have on the heart?

Accepted Answer

The parasympathetic nervous system, through the vagus nerve, decreases heart rate by releasing acetylcholine which slows down the rate of firing of the SA node, therefore slowing the heart rate.

Question 3

Which of these factors is reflected by central venous pressure (CVP)?

Accepted Answer

Central venous pressure (CVP) primarily reflects the volume status of the body, indicating hydration levels and venous return to the heart.

Question 4

The nurse is assisting with preparing a patient who is diabetic for cardiac surgery in 3 hours. During data collection, the patient states, "I took my usual insulin dose this morning." Which of the following actions should the nurse take?

Accepted Answer

The nurse should inform the physician that the patient has taken their usual insulin dose to ensure that appropriate adjustments can be made for the patient's blood sugar during and after the surgery. The other options do not address the potential impact of the patient's insulin dose on their surgical outcome.

Question 5

The nurse is caring for a patient who returns from having a cardiac catheterization with a right femoral entry site. Which of the following actions would the nurse take?

Accepted Answer

After a cardiac catheterization via a femoral artery approach, it's important to minimize movement of the leg where the catheter was inserted to prevent bleeding from the site. Ambulating, performing range of motion exercises, or bending the knees could increase the risk of bleeding or hematoma formation at the catheter entry site.

Question 6

At which of these rates can the atrioventricular node initiate a heartbeat?

Accepted Answer

The atrioventricular node is capable of initiating a heartbeat at a rate of 40 to 60 beats per minute. This is known as the atrioventricular nodal rhythm, and it occurs when the SA node fails to initiate a heartbeat or when its conduction is blocked. While the other rates listed are within the normal range for heart rate, they do not relate to the specific function of the atrioventricular node.

Question 7

The nurse is collecting data for a patient with hypertension. Which of these is a modifiable cardiovascular risk factor that the nurse should identify for care planning?

Accepted Answer

Activity level is a modifiable cardiovascular risk factor as it can be changed through lifestyle modifications. Heredity, ethnic origin, and gender are non-modifiable risk factors.

Question 8

A patient is being discharged with a prescription for warfarin (Coumadin). Which of these, if stated by a patient, indicates to the nurse correct understanding of beverages to avoid?

Accepted Answer

Cranberry juice can interact with warfarin and should be avoided. Grapefruit juice should also be avoided, but it is not listed as an option. Orange juice and beer do not interact with warfarin in a significant way.

Question 9

Which of these, if stated by a patient, indicates to the nurse correct understanding of what to do if a symptom occurs while wearing a Holter monitor?

Accepted Answer

Pushing the event button on the Holter monitor allows the device to record the patient's heart activity during the occurrence of a symptom or event. This provides valuable information for the physician to make an accurate diagnosis and determine the appropriate treatment. Notification of the physician can also be helpful, but pushing the event button is the immediate action to take during a symptom while wearing a Holter monitor. Calling an ambulance or taking an apical pulse are not related actions to take during this situation.

Question 10

The nurse is using a stethoscope to listen to a patient's heart sounds. The nurse recognizes that the "dupp" of the characteristic "lubb-dupp" heart sound indicates what part of the cardiac cycle?

Accepted Answer

The "dupp" sound of the "lubb-dupp" heart sound indicates the closure of the aortic and pulmonary semilunar valves, which occurs at the end of systole (contraction phase) when the ventricles are emptying blood into the aorta and pulmonary artery. This closure of the valves prevents backflow of blood into the ventricles.

Question 11

The nurse is caring for a patient who asks, "What do high levels of low-density lipoproteins indicate?" What response by the nurse would be appropriate?

Accepted Answer

High levels of low-density lipoproteins (LDLs) indicate an increased risk for coronary artery disease. LDLs are commonly referred to as "bad" cholesterol because they contribute to the buildup of plaque in the arteries, which can lead to atherosclerosis and increase the risk for heart attack and stroke.

Question 12

The layer of the artery wall that helps maintain diastolic blood pressure is composed of which of these tissues?

Accepted Answer

The layer of the artery wall that helps maintain diastolic blood pressure is the tunica media, which is composed of smooth muscle and elastic connective tissue. Smooth muscle can contract and relax to change the diameter of the blood vessel, while elastic connective tissue allows the vessel to stretch and recoil. Both of these functions are important in maintaining proper blood pressure during diastole.

Question 13

The nurse is reinforcing teaching on the role high-density lipoproteins play in cardiac disease. Which of these patient statements indicates correct understanding of the teaching?

Accepted Answer

High-density lipoprotein (HDL) plays a protective role against coronary artery disease by removing excess cholesterol from the bloodstream and preventing accumulation in the arterial walls. Option A, C, and D are incorrect as they do not reflect the actual role of HDL in cardiac disease.

Question 14

While caring for a patient who will undergo a cardiac catheterization, the nurse recognizes that teaching is effective by which of the following statements?

Accepted Answer

The correct answer is D: "The table may move while the test is being done." This statement demonstrates the patient's understanding of a potential aspect of the procedure, indicating effective teaching.

Question 15

The nurse is caring for a patient who had a cardiac catheterization using the left femoral site for entry. Which of the following data are most important to monitor?

Accepted Answer

Monitoring the left pedal pulse is important as the cardiac catheterization was done using the left femoral site and there is a risk of damage to the femoral artery which can affect blood flow to the lower extremities. Orientation status, pupil reaction, and right foot sensation are not directly related to the procedure and are not the priority in this situation.

Question 16

Which chamber of the heart has the greatest workload and usually fails first as a result?

Accepted Answer

The left ventricle has the greatest workload as it pumps blood to the entire body, while the right ventricle only pumps blood to the lungs. Therefore, the left ventricle usually fails first.

Question 17

Which of these is referred to as the pacemaker of the heart?

Accepted Answer

The sinoatrial node, also known as the SA node, is referred to as the pacemaker of the heart because it initiates the electrical signals that cause the heart to beat.

Question 18

When a patient who is wearing a Holter monitor asks how to bathe, what would be an appropriate response by the nurse?

Accepted Answer

Taking a sponge bath is the appropriate response as the Holter monitor should not be submerged in water. A tub bath or shower with the monitor on may damage the device and compromise the accuracy of the readings. Removing the monitor before showering is also not recommended as it should be worn continuously for the prescribed timeframe.

Question 19

What is the purpose of the epicardium of the heart?

Accepted Answer

The epicardium is the outermost layer of the heart and serves to protect and cover the heart muscle, as well as prevent friction between the heart and surrounding structures such as the pericardial sac.

Question 20

The nurse is providing care for a patient whose central venous pressure (CVP) is 12 mm Hg. Which of the following actions is most appropriate?

Accepted Answer

A CVP of 12 mm Hg is within the normal range (2-12 mm Hg), so there is no immediate need for intervention related to the patient's fluid volume status. However, listening to breath sounds is a key component of respiratory assessment, which is important for overall patient monitoring and may uncover any respiratory issues that need to be addressed. Assessing urine specific gravity and skin turgor may be appropriate for assessing dehydration or fluid overload, but these assessments are not directly related to CVP monitoring. Determining level of consciousness is important for neurological assessment but is also not directly related to CVP monitoring.

Quiz 21: Cardiovascular System Function, Assessment, and Therapeutic Measures