Question 1

Upon assessment of the patient,the nurse finds a widened pulse pressure and throbbing peripheral pulses.Which valve disorder does the nurse suspect?

Accepted Answer

Aortic regurgitation is manifested by widened pulse pressure resulting from increased stroke volume and diastolic backflow.
Mitral regurgitation is manifested by heart failure.
Mitral stenosis is manifested by pulmonary edema and heart failure.
Aortic stenosis is manifested by narrowed pulse pressure.

Question 2

Which characteristic changes should the nurse keep in mind while caring for a patient with left heart failure? As left heart failure progresses:

Accepted Answer

Left ventricular preload increases in left heart failure because less blood is ejected from the left ventricle.
Left heart failure does not lead to a decrease in systemic resistance; it leads to an increase in resistance.
Left end-diastolic volume will increase.
Pulmonary vascular resistance will increase.

Question 3

When a patient with left heart failure starts to have a cough and dyspnea,which principle should the nurse remember? Pulmonary symptoms,common to left heart failure,are a result of:

Accepted Answer

The clinical manifestations of left heart failure are the result of pulmonary vascular congestion and inadequate perfusion of the systemic circulation.
The clinical manifestations of left heart failure are the result of pulmonary vascular congestion and inadequate perfusion of the systemic circulation.Pulmonary edema does occur,but it is not due to inflammation.
The clinical manifestations of left heart failure are the result of pulmonary vascular congestion and inadequate perfusion of the systemic circulation.Decreased cardiac output does occur,but the pulmonary symptoms are related to pulmonary congestion.
The clinical manifestations of left heart failure are the result of pulmonary vascular congestion and inadequate perfusion of the systemic circulation.They are not due to bronchoconstriction.

Question 4

A 30-year-old female presents to her primary care provider with fever,cardiac murmur,and petechial skin lesions.She is diagnosed with infective endocarditis.When the patient wants to know what caused the disease,what is the nurse's best response? The most likely cause of the disease is:

Accepted Answer

Infective carditis is due to a bacterial infection.
Infective carditis is due to a bacterial infection,not a viral infection.
Infective carditis is due to a bacterial infection,not a fungus.
Infective carditis is due to a bacterial infection,not an infection caused by a parasite.

Question 5

When a person is in shock,a nurse remembers impairment in cellular metabolism is cause by:

Accepted Answer

In shock,impaired cellular metabolism is caused by inadequate tissue perfusion.
Impairment of cellular metabolism is the result of inadequate tissue perfusion; toxic substances could develop,but it would be secondary to the inadequate perfusion.
Free radicals are not the cause of impaired cellular metabolism.
Lack of inadequate tissue perfusion leads to impaired cellular metabolism; lack of nervous control would lead to vasodilation,but perfusion still occurs.

Question 6

Which condition should cause the nurse to assess for high-output failure in a patient?

Accepted Answer

Common causes of high-output failure include anemia.
Common causes of high-output failure include anemia,not metabolic alkalosis.
Common causes of high-output failure include anemia,not hypothyroidism.
Common causes of high-output failure include anemia,not hypovolemia.

Question 7

A 72-year-old female has a history of right heart failure caused by a right ventricular myocardial infarction.Which of the following symptoms are specifically related to her right heart failure?

Accepted Answer

Right-sided failure allows blood to back up into the systemic circulation,leading to peripheral edema.
Right-sided failure allows blood to back up into the systemic circulation,leading to edema.Since it is backed up into the venous system,hypertension is less likely.
Right-sided failure leads to edema and a greater venous blood volume,which would lead to increased urinary output.
Dyspnea upon exertion is more indicating of left-sided failure.

Question 8

A 59-year-old female is diagnosed with left ventricular failure.If a decrease in kidney perfusion occurs,the nurse knows this would ultimately cause:

Accepted Answer

With a decrease in kidney perfusion,renin is released with the ultimate outcome of increased systemic vascular resistance to raise blood pressure to increase blood flow to the kidney.
Ventricular preload will increase,not decrease.
Capillary permeability will likely decrease.
Cardiac oxygen demand will increase,not decrease.

Question 9

A 60-year-old female was diagnosed with mitral stenosis.As a result,the nurse realizes the patient has incomplete emptying of the:

Accepted Answer

Mitral stenosis would result in incomplete emptying of the left atrium,as the mitral valve is located between the left atrium and left ventricle.
Mitral stenosis would result in incomplete emptying of the left atrium,as the mitral valve is located between the left atrium and left ventricle.
Mitral stenosis would result in incomplete emptying of the left atrium,as the mitral valve is located between the left atrium and left ventricle.
Mitral stenosis would result in incomplete emptying of the left atrium,as the mitral valve is located between the left atrium and left ventricle.

Question 10

A 73-year-old female has increased pulmonary pressure resulting in right heart failure.The nurse should monitor for a possible complication because a potential cause for her heart to fail is:

Accepted Answer

Right-sided failure often follows left-sided failure when pulmonary congestion forces backward flow of blood into the left ventricle.
Right-sided failure often follows left-sided failure when pulmonary congestion forces backward flow of blood into the left ventricle.It is not due to hypertension.
Right-sided failure often follows left-sided failure when pulmonary congestion forces backward flow of blood into the left ventricle.It is not due to pneumonia.
Right-sided failure often follows left-sided failure when pulmonary congestion forces backward flow of blood into the left ventricle.It is not due to pericarditis.

Question 11

A 68-year-old female is experiencing left heart failure.Physical exam reveals elevated blood pressure.The nurse understands this is most likely caused by:

Accepted Answer

The sympathetic nervous system increases peripheral vascular resistance (PVR)and leads to hypertension.
The sympathetic nervous system increases PVR and leads to hypertension.The stress hormones do not increase contractility.
The sympathetic nervous system increases PVR and leads to hypertension.Catecholamines and angiotensin increase blood pressure,but are not cardiotoxic.
The sympathetic nervous system increases PVR and leads to hypertension.Diastolic dysfunction does not lead to elevated blood pressure.

Question 12

A 72-year-old female has a history of hypertension and atherosclerosis.An echocardiogram reveals backflow of blood into the left ventricle.Which of the following is the most likely diagnosis documented on the chart?

Accepted Answer

Aortic regurgitation would allow backward flow of blood into the left ventricle.
Mitral regurgitation would allow backward flow of blood into the left atrium.
Mitral stenosis would impede blood flow from the right atrium into the right ventricle.
Aortic stenosis would impede blood flow into the aorta.

Question 13

A nurse is teaching staff about endocarditis.Which information should the nurse include? Inflammatory cells have difficulty limiting the colonization of microorganisms in infective endocarditis because the:

Accepted Answer

In endocarditis,bacterial colonies are inaccessible to host defenses because they are embedded in the protective fibrin clots.
In endocarditis,bacterial colonies are inaccessible to host defenses because they are embedded in the protective fibrin clots; it is not because the microorganisms are resistant.
In endocarditis,bacterial colonies are inaccessible to host defenses because they are embedded in the protective fibrin clots; it is not because the valves are avascular.
In endocarditis,bacterial colonies are inaccessible to host defenses because they are embedded in the protective fibrin clots; it is not because the colonies overwhelm the phagocytes.

Question 14

A 65-year-old male is diagnosed with chronic pulmonary disease and elevated pulmonary vascular resistance.Which of the following heart failures should the nurse assess for in this patient?

Accepted Answer

Right-sided failure occurs when the patient experiences chronic pulmonary disease and elevated pulmonary vascular resistance because the blood has difficulty overcoming the pressure and blood builds up in the right side of the heart.
Pulmonary congestion leads to right-sided failure,not left.
Pulmonary congestion leads to right-sided failure,not low-output failure.
Pulmonary congestion leads to right-sided failure,not high-output failure.

Question 15

A 65-year-old male with a history of untreated hypertension is now experiencing left heart failure.A nurse recalls his untreated hypertension led to:

Accepted Answer

With hypertension comes increased afterload and resistance to ventricular emptying and more workload for the ventricle,which responds with hypertrophy of the myocardium and ventricular remodeling.
Ventricular dilation can occur,but the wall will thicken,not thin.
Renin and aldosterone release are increased,not inhibited.
Alterations in alpha and beta functioning may occur,but the response to hypertension is myocardial hypertrophy and ventricular remodeling.

Question 16

A 50-year-old male visits the cardiologist for an EKG.Results indicate that he has no PR interval and a variable QRS rate with rhythm irregularity.Which of the following is the most likely diagnosis to be recorded on the chart?

Accepted Answer

Atrial fibrillation is characterized by no PR interval and a variable QRS response.
Atrial tachycardia is characterized by a normal PR interval.
Sinus dysrhythmia is characterized by a change in rhythm associated with inspiration and expiration.
Idioventricular dysrhythmia is characterized by absent P waves.

Question 17

A 35-year-old male presents with pulmonary hypertension.Testing reveals he is in right heart failure.Which of the following is the most likely diagnosis the nurse will see listed on the chart?

Accepted Answer

Tricuspid regurgitation leads to volume overload in the right atrium and ventricle,increased systemic venous blood pressure,and right heart failure.
Aortic stenosis is manifested by narrowed pulse pressure.
Aortic regurgitation is manifested by widened pulse pressure resulting from increased stroke volume and diastolic backflow.
Mitral regurgitation is manifested by heart failure,but not pulmonary hypertension.

Question 18

A 10-year-old male presents with fever,lymphadenopathy,arthralgia,and nose bleeds.He is diagnosed with rheumatic heart disease.When a staff member asks what caused the disease,what is the nurse's most correct response? The most likely cause of this disease is:

Accepted Answer

Rheumatic fever is a systemic,inflammatory disease caused by a delayed exaggerated immune response to infection by the group A â-hemolytic streptococcus.
Rheumatic fever is a systemic,inflammatory disease caused by a delayed exaggerated immune response to infection by the group A â-hemolytic streptococcus,not by congenital heart defects.
Rheumatic fever is a systemic,inflammatory disease caused by a delayed exaggerated immune response to infection by the group A â-hemolytic streptococcus,not by HIV infections.
Rheumatic fever is a systemic,inflammatory disease caused by a delayed exaggerated immune response to infection by the group A â-hemolytic streptococcus,not by acute pericarditis.

Question 19

A 10-year-old male presents with fever,lymphadenopathy,arthralgia,and nose bleeds.He is diagnosed with rheumatic heart disease.While planning care,which characteristic changes should the nurse remember?

Accepted Answer

The immune response cross-reacts with molecularly similar self-antigens in heart,muscle,joints,and the brain,causing an autoimmune response resulting in diffuse,proliferative,and exudative inflammatory lesions in these tissues.
The immune response cross-reacts with molecularly similar self-antigens in heart,muscle,and joints,and the brain,causing an autoimmune response resulting in diffuse,proliferative,and exudative inflammatory lesions in these tissues.It is not due to blood-borne organisms.
This immune response cross-reacts with molecularly similar self-antigens in heart,muscle,joints,and the brain,causing an autoimmune response resulting in diffuse,proliferative,and exudative inflammatory lesions in these tissues.It is not due to high fevers.
This immune response cross-reacts with molecularly similar self-antigens in heart,muscle,joints,and the brain,causing an autoimmune response resulting in diffuse,proliferative,and exudative inflammatory lesions in these tissues.It is not due to rheumatoid factors.

Question 20

A nurse recalls the most common cardiac valve disease in the United States,which tends to be most prevalent in young women,is:

Accepted Answer

Mitral valve prolapse is the most common valve disorder in the United States.
Mitral valve prolapse,not pulmonary stenosis,is the most common valve disorder in the United States.
Mitral valve prolapse,not tricuspid valve prolapse,is the most common valve disorder in the United States.
Mitral valve prolapse,not aortic stenosis,is the most common valve disorder in the United States.

Quiz 23: Alterations of Cardiovascular Function