Question 1

A patient is admitted with a decrease in cardiac output.Which assessment findings would the nurse attribute to that condition?

Accepted Answer

Cool hands and feet are indicative of decreased cardiac output as less blood is making it to the extremities. Increased output of very clear urine (A) is not necessarily indicative of decreased cardiac output, as it could be due to other factors such as increased fluid intake. Localized edema in the calf (C) is not typically associated with decreased cardiac output but rather venous insufficiency or DVT. Bounding apical impulse (D) is not associated with decreased cardiac output but rather with increased cardiac output or hypertrophy.

Question 2

Testing indicates that a patient has a high preload.What changes would the nurse expect in this patient's cardiac function? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

Accepted Answer

C,D

Question 3

Which assessment techniques will the nurse use to evaluate the patient's cardiac output? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

Accepted Answer

Assessment techniques to evaluate cardiac output include inspection of color changes in the periphery (A) to assess for cyanosis or pallor that may indicate poor perfusion, strength of pulses (B) to evaluate the force of blood flow, auscultation of heart sounds (D) to detect abnormalities in heart function, and pulse pressure determination (E) to assess the difference between systolic and diastolic pressures, which can give insights into cardiac output and vascular resistance. Percussion of heart borders (C) is not directly used to evaluate cardiac output but rather to assess the size and position of the heart.

Question 4

Review of the medical record reveals that a patient has a summation gallop.Which pattern of heart sounds would the nurse expect?

Accepted Answer

A summation gallop occurs when both S3 and S4 heart sounds are present, creating a quadruple rhythm, often heard in cases of severe heart failure.

Question 5

A patient is scheduled for an exercise electrocardiogram.The nurse will ensure that which objects are in the room prior to the beginning of the test?

Accepted Answer

A defibrillator should be available during an exercise electrocardiogram (ECG) to manage potential life-threatening arrhythmias that could occur during the test.

Question 6

A patient's cardiac index will be calculated.What nursing interventions are necessary before this calculation is completed? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

Accepted Answer

To calculate cardiac index, the nurse needs accurate weight, height, and heart rate measurements. Therefore, it is necessary to assure that there is an accurate current weight on the medical record, measure the patient's height, and obtain the patient's current heart rate. Comparing fluid input and output for the last 12 hours and figuring the patient's age are not necessary for calculating cardiac index.

Question 7

The nurse has auscultated the patient's heart sounds and has measured vital signs.Which finding would the nurse evaluate as indicating greatest need for additional assessment?

Accepted Answer

A split in heart sounds can indicate a problem with the timing of the heart's contractions and may require further evaluation. The other findings (pulse pressure, pulse strength, and apical pulse rate) are within normal limits or not necessarily concerning in isolation.

Question 8

A patient with a steadily increasing preload was experiencing a corresponding increase in stroke volume,but it has now begun to decrease.Which rationale would the nurse provide for this occurrence?

Accepted Answer

When the preload reaches a critical point, it can result in a decrease in stroke volume. This can occur due to factors such as decreased contractility or increased afterload. It is important to monitor the patient closely and intervene as needed to prevent further decreases in stroke volume.

Question 9

A patient admitted with a cardiac arrhythmia is scheduled to have an electrophysiology study (EPS).The nurse would reinforce which teaching about this test?

Accepted Answer

An electrophysiology study (EPS) is used to diagnose and treat heart rhythm disorders by testing the electrical activity of the heart. It can help determine if a patient needs a pacemaker by identifying issues with the heart's electrical signals.

Question 10

A patient with left-sided heart failure is hospitalized with pulmonary edema.The nurse providing this patient's care would consider which physiology when explaining this disorder to the patient's family?

Accepted Answer

In left-sided heart failure, the heart cannot adequately pump blood from the left ventricle to the rest of the body, causing a backup of blood into the pulmonary veins. These veins have no valves, and the increased pressure in the vessels causes fluid to leak into the lungs, leading to pulmonary edema.

Question 11

The nurse is instructing a patient who is scheduled for a cardiac catheterization.Which comment made by the patient would indicate the need for additional education?

Accepted Answer

Placing a warm pack at the puncture site can increase bleeding and should be avoided after a cardiac catheterization. Cold packs or ice may be applied instead.

Question 12

A patient is admitted with the complaint of chest pain.Questions about which history will best help the nurse determine if the pain is from cardiac or pulmonary origin?

Accepted Answer

Asking about what precipitated the pain (exertion or rest), what it feels like (pressure, squeezing, tightness), and where it is located (central, left chest) can help determine if the pain is cardiac or pulmonary in origin. Deficits in movement, timing of pain, and dietary changes may not necessarily differentiate between the two. Changes in dietary habits, smoking history, and presence of cough may be more indicative of pulmonary issues but not necessarily cardiac. Home remedies, activity level, and fluid intake changes may not provide much insight into the origin of the pain.

Question 13

Testing reveals that a patient's myocardial infarction (MI)damaged the papillary muscles of the mitral valve.The nurse plans care based on the knowledge that the patient is at high risk for which complication?

Accepted Answer

Damage to the papillary muscles of the mitral valve can lead to mitral valve regurgitation, which can cause left ventricular dysfunction and ultimately result in catastrophic left heart failure. Extension of myocardial damage, pulmonary edema from right heart failure, and pulmonary embolism are all possible complications of MI but are not directly related to papillary muscle damage.

Question 14

Cardiac catheterization reveals that a patient has an isolated lesion in the right coronary artery that occludes 90% of the vessels' lumen.The nurse plans care for this patient based on the knowledge that total occlusion of the artery will result in damage to which portion of the heart?

Accepted Answer

The right coronary artery primarily supplies blood to the right side of the heart, including the right atrium and the right ventricle. A total occlusion of this artery would most significantly affect the right ventricle, leading to damage or dysfunction in that area.

Question 15

A patient has been admitted with chest pain and generalized discomfort.Which assessment is essential for the nurse to set realistic goals for patient therapy and education?

Accepted Answer

Understanding the patient's functional status prior to illness is essential to set realistic goals for therapy and education, as it provides a baseline to measure progress and tailor interventions.

Question 16

It is suspected that a patient who was severely injured in an automobile accident may have had a myocardial infarction (MI)prior to the crash.Which laboratory test result drawn while the patient was in the emergency department would the nurse evaluate as supporting that theory?

Accepted Answer

An increased troponin level is a hallmark indicator of myocardial infarction, as troponin is released when heart muscle is damaged. Increased serum potassium and increased creatine kinase level may also indicate myocardial damage, but are not specific to MI. Increased BNP level is associated with heart failure, but not necessarily MI.

Question 17

The nurse is caring for a patient having a transesophageal echocardiogram (TEE).What is an appropriate nursing intervention for the care of this patient?

Accepted Answer

Inserting an intravenous catheter is an appropriate nursing intervention for a patient having a transesophageal echocardiogram (TEE) as it will allow medication administration or fluid replacement if needed during the procedure. Dimming the lights, assessing pedal pulses, and applying pressure to the sheath puncture site are not specifically related to TEE care.

Question 18

A patient is scheduled for an echocardiogram with measurement of ejection fraction.The nurse explains to the patient that this test will provide the most information about which cardiac characteristic?

Accepted Answer

An echocardiogram with measurement of ejection fraction provides information on the strength of the heartbeat, specifically the percentage of blood that is ejected from the heart with each contraction. It does not measure the amount of blood pumped per minute (A), resistance the heart beats against (C), or the amount of blood in the heart before it beats (D).

Question 19

A patient is diagnosed with septic shock and has a decrease in afterload.The nurse would expect which initial changes in the patient's cardiac status? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

Accepted Answer

A decrease in afterload generally leads to an increase in cardiac output because the heart can pump more efficiently when there is less resistance in the blood vessels. However, in the context of septic shock, the systemic vasodilation that contributes to decreased afterload also leads to a decrease in blood pressure.

Question 20

It is determined that a patient has poor cardiac contractility.The nurse would anticipate administering which type of drugs to improve contractility? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

Accepted Answer

Cardiac glycosides, sympathomimetic agents, and phosphodiesterase inhibitors are all drugs that can improve cardiac contractility. Loop diuretics and ACE inhibitors are not indicated for this purpose.

Quiz 13: Determinants and Assessment of Cardiac Function

A patient is admitted with a decrease in cardiac output.Which assessment findings would the nurse attribute to that condition?

Testing indicates that a patient has a high preload.What changes would the nurse expect in this patient's cardiac function? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

Which assessment techniques will the nurse use to evaluate the patient's cardiac output? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

Review of the medical record reveals that a patient has a summation gallop.Which pattern of heart sounds would the nurse expect?

A patient is scheduled for an exercise electrocardiogram.The nurse will ensure that which objects are in the room prior to the beginning of the test?

A patient's cardiac index will be calculated.What nursing interventions are necessary before this calculation is completed? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

The nurse has auscultated the patient's heart sounds and has measured vital signs.Which finding would the nurse evaluate as indicating greatest need for additional assessment?

A patient with a steadily increasing preload was experiencing a corresponding increase in stroke volume,but it has now begun to decrease.Which rationale would the nurse provide for this occurrence?

A patient admitted with a cardiac arrhythmia is scheduled to have an electrophysiology study (EPS) .The nurse would reinforce which teaching about this test?

A patient with left-sided heart failure is hospitalized with pulmonary edema.The nurse providing this patient's care would consider which physiology when explaining this disorder to the patient's family?

The nurse is instructing a patient who is scheduled for a cardiac catheterization.Which comment made by the patient would indicate the need for additional education?

A patient is admitted with the complaint of chest pain.Questions about which history will best help the nurse determine if the pain is from cardiac or pulmonary origin?

Testing reveals that a patient's myocardial infarction (MI) damaged the papillary muscles of the mitral valve.The nurse plans care based on the knowledge that the patient is at high risk for which complication?

Cardiac catheterization reveals that a patient has an isolated lesion in the right coronary artery that occludes 90% of the vessels' lumen.The nurse plans care for this patient based on the knowledge that total occlusion of the artery will result in damage to which portion of the heart?

A patient has been admitted with chest pain and generalized discomfort.Which assessment is essential for the nurse to set realistic goals for patient therapy and education?

It is suspected that a patient who was severely injured in an automobile accident may have had a myocardial infarction (MI) prior to the crash.Which laboratory test result drawn while the patient was in the emergency department would the nurse evaluate as supporting that theory?

The nurse is caring for a patient having a transesophageal echocardiogram (TEE) .What is an appropriate nursing intervention for the care of this patient?

A patient is scheduled for an echocardiogram with measurement of ejection fraction.The nurse explains to the patient that this test will provide the most information about which cardiac characteristic?

A patient is diagnosed with septic shock and has a decrease in afterload.The nurse would expect which initial changes in the patient's cardiac status? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

It is determined that a patient has poor cardiac contractility.The nurse would anticipate administering which type of drugs to improve contractility? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.