Question 1

What chamber is unable to empty completely in the presence of mitral stenosis?
A) Right atrium
B) Right ventricle
C) Left atrium
D) Left ventricle

Accepted Answer

Mitral stenosis impedes blood flow from the left atrium to the left ventricle, causing the left atrium to be unable to empty completely.

Question 2

A 62-year-old male presents to his primary care provider reporting chest pain at rest and with exertion. He does not have a history of coronary artery disease and reports that the pain often occurs at night. He is most likely experiencing which type of angina?
A) Unstable
B) Stable
C) Prinzmetal
D) Silent

Accepted Answer

The patient is most likely experiencing Prinzmetal angina, also known as variant angina, which commonly occurs at rest and at night. It is caused by vasospasms of the coronary arteries, rather than fixed stenosis, which is typical of stable and unstable angina. The patient's lack of a history of coronary artery disease also supports this diagnosis. Silent angina is asymptomatic, and unstable angina occurs at rest but is typically caused by fixed atherosclerotic plaque.

Question 3

A 49-year-old male presents reporting chest pain. EKG reveals ST elevation. He is diagnosed with myocardial ischemia. Which of the following interventions would be most beneficial?
A) Administer a diuretic to decrease volume.
B) Apply oxygen to increase myocardial oxygen supply.
C) Encourage exercise to increase heart rate.
D) Give an antibiotic to decrease infection.

Accepted Answer

In this scenario, the patient is presenting with myocardial ischemia, which indicates a lack of blood flow and oxygen to the heart muscle. Oxygen delivery to the heart is critical in this situation, and therefore, administering supplemental oxygen would be the most beneficial intervention. Administering a diuretic or encouraging exercise could potentially worsen the patient's condition by decreasing blood flow even further. Giving an antibiotic is not indicated as there is no indication of infection in this scenario.

Question 4

A 51-year-old male is at the health clinic for an annual physical examination. After walking from the car to the clinic, he developed substernal pain. He also reported discomfort in his left shoulder and his jaw, lasting 2 to 3 minutes and then subsiding with rest. He indicates that this has occurred frequently over the past few months with similar exertion. What is he likely experiencing?
A) Stable angina
B) Unstable angina
C) Prinzmetal angina
D) Myocardial infarction (MI)

Accepted Answer

The symptoms described are characteristic of stable angina, which is chest pain that occurs predictably with exertion and is relieved by rest.

Question 5

Upon assessment of the patient, the nurse finds a widened pulse pressure and throbbing peripheral pulses. Which valve disorder does the nurse suspect?
A) Mitral regurgitation
B) Mitral stenosis
C) Aortic regurgitation
D) Aortic stenosis

Accepted Answer

A widened pulse pressure and throbbing peripheral pulses are characteristic findings of aortic regurgitation. Mitral regurgitation and mitral stenosis typically do not present with these symptoms. Aortic stenosis may present with a narrow pulse pressure and weak peripheral pulses.

Question 6

A 60-year-old female has survived a myocardial infarction. The nurse is providing care for impaired ventricular function because:
A) there is a temporary alteration in electrolyte balance.
B) there is too much stress on the heart.
C) the cells become hypertrophic.
D) the resulting ischemia leads to hypoxic injury and myocardial cell death.

Accepted Answer

Impaired ventricular function after a myocardial infarction is due to hypoxic injury and myocardial cell death resulting from ischemia. The other options may also contribute to the pathophysiology of the condition, but D is the primary cause.

Question 7

A 72-year-old 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?
A) Mitral regurgitation
B) Mitral stenosis
C) Aortic regurgitation
D) Aortic stenosis

Accepted Answer

The answer of A 72-year-old has a history of hypertension...

Question 8

A 67-year-old was previously diagnosed with rheumatic heart disease. Tests now show chronic inflammation that impairs blood flow from the left ventricle into the aorta. Which diagnosis does this history support?
A) Aortic regurgitation
B) Aortic stenosis
C) Mitral regurgitation
D) Mitral stenosis

Accepted Answer

Aortic stenosis is characterized by the narrowing of the aortic valve, which impairs blood flow from the left ventricle into the aorta. This condition can be a consequence of chronic inflammation due to rheumatic heart disease.

Question 9

A nurse recalls that the most common cardiac valve disorder is:
A) mitral valve prolapse.
B) pulmonary stenosis.
C) tricuspid valve prolapse.
D) aortic stenosis.

Accepted Answer

The answer of A nurse recalls that the most common...

Question 10

A 51-year-old male presents with recurrent chest pain on exertion and is diagnosed with angina pectoris. The pain occurs when:
A) cardiac output has fallen below normal levels.
B) the myocardial oxygen supply has fallen below demand.
C) myocardial stretch has exceeded the upper limits.
D) the vagus nerve is stimulated.

Accepted Answer

Angina pectoris is caused by an imbalance between myocardial oxygen supply and demand, with demand exceeding supply during episodes of increased oxygen requirement such as exercise.

Question 11

A 42-year-old is diagnosed with constrictive pericarditis. The nurse assesses the blood pressure for decreased cardiac output because of:
A) pericardial effusions.
B) fibrosis and calcification of the pericardial layers.
C) cardiomyopathy.
D) hemorrhage in the pericardial cavity.

Accepted Answer

Constrictive pericarditis is characterized by fibrosis and calcification of the pericardial layers, which impairs cardiac filling and causes decreased cardiac output. Pericardial effusions, cardiomyopathy and hemorrhage in the pericardial cavity can also cause decreased cardiac output, but these are not the primary mechanisms of constrictive pericarditis.

Question 12

A 55-year-old male died of a myocardial infarction. What would autopsy most likely reveal?
A) Embolization of plaque from the aorta
B) Decreased ventricular diastolic filling time
C) Indications of myocardial ischemia and necrosis
D) Smooth muscle dysplasia in the coronary artery

Accepted Answer

The autopsy would most likely reveal indications of myocardial ischemia and necrosis, which are characteristic findings in a myocardial infarction.

Question 13

Many valvular stenosis and regurgitation disorders in adults have a common etiology. Which of the following conditions should alert the nurse that the patient may have both types of valve dysfunctions?
A) Heart failure
B) Connective tissue disorders
C) Rheumatic fever or heart disease
D) Syphilis infection

Accepted Answer

Rheumatic fever or heart disease can lead to both valvular stenosis and regurgitation.

Question 14

A 68-year-old male presents to the ER reporting chest pain. He has a history of stable angina that now appears to be unstable. What does he most likely have?
A) Mild to moderate atherosclerosis
B) Impending myocardial infarction (MI)
C) Electrical conduction problems in the heart
D) Decreased myocardial oxygen demand

Accepted Answer

Unstable angina is often a sign of an impending myocardial infarction (MI) due to increased severity of coronary artery blockage, leading to reduced blood flow to the heart muscle.

Question 15

A 28-year-old presents to the ER reporting severe chest pain that worsens with respirations or lying down. Other signs include a fever, tachycardia, and a friction rub. Assessment findings support which medical diagnosis?
A) Acute pericarditis
B) Myocardial infarction (MI)
C) Stable angina
D) Pericardial effusion

Accepted Answer

The presence of chest pain that worsens with respirations or lying down, along with a fever, tachycardia, and a friction rub are all classic signs of acute pericarditis. Myocardial infarction (B) would typically present with different signs and symptoms such as ST-segment changes on an EKG, elevated cardiac enzymes, and chest pain that is not necessarily affected by respirations or positional changes. Stable angina (C) would not typically present with a friction rub or a fever. Pericardial effusion (D) may also present with a friction rub, but the worsening chest pain with respirations or lying down is not typically seen with this condition.

Question 16

A 10-year-old male presents with fever, lymphadenopathy, arthralgia, and nosebleeds. He is diagnosed with rheumatic heart disease. What is the most likely cause of this disease?
A) Congenital heart defects
B) Human immunodeficiency virus (HIV) infections
C) Group A beta-hemolytic streptococcus infections
D) Acute pericarditis

Accepted Answer

Rheumatic heart disease is a complication of rheumatic fever, which is caused by an autoimmune reaction to infection with Group A beta-hemolytic streptococcus.

Question 17

Which valvular condition is characterized by the valve opening being constricted and narrowed, preventing blood from flowing forward?
A) Regurgitation
B) Insufficiency
C) Stenosis
D) Incompetence

Accepted Answer

Stenosis is a condition in which the opening of a valve is narrowed, preventing blood from flowing forward.

Question 18

A 56-year-old presents to his primary care provider for a checkup. Physical examination reveals edema, hepatomegaly, and muffled heart sounds. Which of the following is of greatest concern to the nurse?
A) Tamponade
B) Exudate
C) Aneurysm
D) Pulsus paradoxus

Accepted Answer

The symptoms of edema, hepatomegaly, and muffled heart sounds are indicative of cardiac tamponade, which is a medical emergency requiring immediate attention.

Question 19

A 75-year-old male has severe chest pain and dials 911. Based upon the laboratory findings indicating a patient has elevated levels of cardiac troponins I and T, the nurse suspects which of the following has occurred?
A) Raynaud disease
B) Myocardial infarction (MI)
C) Orthostatic hypotension
D) Angina

Accepted Answer

Elevated levels of cardiac troponins I and T are specific markers for myocardial infarction (MI), indicating damage to the heart muscle.

Question 20

A 35-year-old presents with pulmonary hypertension and is diagnosed as being in right heart failure. Which is the most likely cause of this condition?
A) Aortic stenosis
B) Tricuspid regurgitation
C) Aortic regurgitation
D) Mitral regurgitation

Accepted Answer

Pulmonary hypertension leading to right heart failure is most commonly caused by tricuspid regurgitation. This occurs when the tricuspid valve between the right atrium and right ventricle fails to close properly, causing blood to flow back into the atrium during ventricular contraction. This increases pressure within the right atrium and right ventricle, leading to pulmonary hypertension and eventually right heart failure. Aortic stenosis, aortic regurgitation, and mitral regurgitation typically cause left-sided heart failure.

Quiz 24: Alterations of Cardiovascular Function

What chamber is unable to empty completely in the presence of mitral stenosis?

A 62-year-old male presents to his primary care provider reporting chest pain at rest and with exertion. He does not have a history of coronary artery disease and reports that the pain often occurs at night. He is most likely experiencing which type of angina?

A 49-year-old male presents reporting chest pain. EKG reveals ST elevation. He is diagnosed with myocardial ischemia. Which of the following interventions would be most beneficial?

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

A 60-year-old female has survived a myocardial infarction. The nurse is providing care for impaired ventricular function because:

A 72-year-old 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?

A 67-year-old was previously diagnosed with rheumatic heart disease. Tests now show chronic inflammation that impairs blood flow from the left ventricle into the aorta. Which diagnosis does this history support?

A nurse recalls that the most common cardiac valve disorder is:

A 51-year-old male presents with recurrent chest pain on exertion and is diagnosed with angina pectoris. The pain occurs when:

A 42-year-old is diagnosed with constrictive pericarditis. The nurse assesses the blood pressure for decreased cardiac output because of:

A 55-year-old male died of a myocardial infarction. What would autopsy most likely reveal?

Many valvular stenosis and regurgitation disorders in adults have a common etiology. Which of the following conditions should alert the nurse that the patient may have both types of valve dysfunctions?

A 68-year-old male presents to the ER reporting chest pain. He has a history of stable angina that now appears to be unstable. What does he most likely have?

A 28-year-old presents to the ER reporting severe chest pain that worsens with respirations or lying down. Other signs include a fever, tachycardia, and a friction rub. Assessment findings support which medical diagnosis?

A 10-year-old male presents with fever, lymphadenopathy, arthralgia, and nosebleeds. He is diagnosed with rheumatic heart disease. What is the most likely cause of this disease?

Which valvular condition is characterized by the valve opening being constricted and narrowed, preventing blood from flowing forward?

A 56-year-old presents to his primary care provider for a checkup. Physical examination reveals edema, hepatomegaly, and muffled heart sounds. Which of the following is of greatest concern to the nurse?

A 75-year-old male has severe chest pain and dials 911. Based upon the laboratory findings indicating a patient has elevated levels of cardiac troponins I and T, the nurse suspects which of the following has occurred?

A 35-year-old presents with pulmonary hypertension and is diagnosed as being in right heart failure. Which is the most likely cause of this condition?