Question 1

A 51-year-old male is at the health clinic for an annual physical exam.After walking from the car to the clinic, he developed substernal pain.He also reported discomfort in his left shoulder and his jaw, lasting 2-3 minutes and then subsiding with rest.He indicates that this has occurred frequently over the past few months with similar exertion.The nurse suspects he is most 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 with exertion and is relieved by rest. It is predictable and has been occurring over the past few months with similar exertion.

Question 2

A 67 year old was previously diagnosed with rheumatic heart disease.Tests now reveal lipoprotein deposition with 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

The history of lipoprotein deposition with chronic inflammation impairing blood flow from the left ventricle into the aorta is indicative of aortic stenosis, which is characterized by narrowing of the aortic valve, often due to calcification or fibrosis, leading to restricted blood flow.

Question 3

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 signs of aortic regurgitation, where blood flows back into the left ventricle, causing increased stroke volume and a subsequent increase in systolic pressure.

Question 4

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 is a common cause of both valvular stenosis and regurgitation due to inflammation and scarring of the heart valves.

Question 5

A 10-year-old male presents with fever, lymphadenopathy, arthralgia, and nosebleeds.He is diagnosed with rheumatic heart disease.The most likely cause of this disease is:
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 infection with group A beta-hemolytic streptococcus.

Question 6

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

Aortic regurgitation is characterized by the backflow of blood from the aorta into the left ventricle during diastole, which aligns with the echocardiogram findings.

Question 7

Which valvular condition is characterized by the valve opening being constricted and narrowed, causing the valve leaflets, or cusps, to fail to open completely?
A) Regurgitation
B) Insufficiency
C) Stenosis
D) Incompetence

Accepted Answer

Stenosis is the condition where the valve opening is constricted and narrowed, preventing the valve leaflets from opening completely.

Question 8

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 symptoms described, including chest pain that worsens with respiration or lying down, fever, tachycardia, and a friction rub, are characteristic of acute pericarditis.

Question 9

A 75-year-old male has severe chest pain and dials 911.Based upon the lab 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 heart muscle damage.

Question 10

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.He most likely has:
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 due to increased blockage or rupture of atherosclerotic plaques, leading to reduced blood flow to the heart muscle.

Question 11

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 occurs when the myocardial oxygen supply is insufficient to meet the demand, typically due to narrowed coronary arteries.

Question 12

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

Tricuspid regurgitation is the most likely cause of right heart failure in a 35-year-old patient with pulmonary hypertension. Tricuspid regurgitation occurs when the tricuspid valve, which separates the right atrium from the right ventricle, does not close properly, allowing blood to leak back into the right atrium. This can lead to right ventricular enlargement and failure, as well as pulmonary hypertension.

Question 13

The nurse realizes the patient diagnosed with mitral stenosis has incomplete emptying of the:
A) right atrium.
B) right ventricle.
C) left atrium.
D) left ventricle.

Accepted Answer

Mitral stenosis leads to incomplete emptying of the left atrium because the mitral valve is narrowed, impeding blood flow from the left atrium to the left ventricle.

Question 14

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's symptoms, including chest pain at rest, occurring at night, and without a history of coronary artery disease, are characteristic of Prinzmetal angina, which is caused by coronary artery spasm.

Question 15

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

The myocardial infarction causes ischemia, leading to hypoxic injury and death of myocardial cells, impairing ventricular function.

Question 16

A 55-year-old male died of a myocardial infarction.Autopsy would most likely reveal:
A) embolization of plaque from the aorta.
B) decreased ventricular diastolic filling time.
C) platelet aggregation within the atherosclerotic coronary artery.
D) smooth muscle dysplasia in the coronary artery.

Accepted Answer

Platelet aggregation within the atherosclerotic coronary artery is a common finding in myocardial infarction, as it leads to the formation of a thrombus that can occlude the coronary artery, causing the infarction.

Question 17

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

Administering oxygen can help increase the oxygen supply to the heart muscle, which is crucial in the setting of myocardial ischemia and ST elevation, indicating a possible heart attack.

Question 18

A 56 year old presents to his primary care provider for a checkup.Physical exam 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 nurse recalls the most common cardiac valve disease in the United States is:
A) mitral valve prolapse.
B) pulmonary stenosis.
C) tricuspid valve prolapse.
D) aortic stenosis.

Accepted Answer

Mitral valve prolapse is the most common cardiac valve disease in the United States, characterized by the improper closure of the mitral valve during heartbeats.

Question 20

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 restricts the heart's ability to expand and fill properly, leading to decreased cardiac output.

Quiz 26: Alterations of Cardiovascular Function

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

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

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

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?

Which valvular condition is characterized by the valve opening being constricted and narrowed, causing the valve leaflets, or cusps, to fail to open completely?

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

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.He most likely has:

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

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?

The nurse realizes the patient diagnosed with mitral stenosis has incomplete emptying of the:

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

A 55-year-old male died of a myocardial infarction.Autopsy would most likely reveal:

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

A nurse recalls the most common cardiac valve disease in the United States is:

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