Question 1

J. Andrews is admitted with angina pectoris and was ruled out for a myocardial infarction. The nurse reviews her laboratory results and plans to include dietary teaching after noting that Ms. Andrews's lipid profile shows which of the following sets of values?
A)Cholesterol: 180, HDL: 40, triglycerides: 220
B)Cholesterol: 190, HDL: 40, triglycerides: 160
C)Cholesterol: 120, HDL: 25, triglycerides: 220
D)Cholesterol: 220, HDL: 40, triglycerides: 190

Accepted Answer

A cholesterol level > 220 indicates elevated cholesterol; the ratio of HDL to total cholesterol of less than 1:5 indicates increased cardiovascular risk; triglycerides > 190 indicates increased risk, (exception: triglycerides > 190 without elevated cholesterol do not indicate increased cardiac risk until they reach 250.)

Question 2

Rodrick Simpson a.k.a. "Crook", a 35-year-old gangster, was knifed in a street fight. He was admitted through the Emergency Department and is now in the ICU. An assessment of his condition reveals the following: respirations shallow and rapid, paradoxical pulse, CVP 15 cm H2O, BP 90mmHg systolic, skin cold and pale, and urinary output 60-100mL.hr for the last 2 hours. Analyzing these findings, the nurse will base a nursing diagnosis on the conclusion that the client has which one of the following conditions?
A)Hypovolemic shock
B)Cardiac tamponade
C)Wound dehiscence
D)Atelectasis

Accepted Answer

All of the client's manifestations are found in both cardiac tamponade and hypovolemic shock except the increase in urinary output. In shock, urinary output decreases to less than 30mL/hr; thus, this is a sign that would distinguish hypovolemic shock from cardiac tamponade and from the basis for a nursing diagnosis.

Question 3

A 45-year-old client with leg ulcers and arterial insufficiency is admitted to the hospital. The nurse understands that leg ulcers of this nature are usually caused by:
A)Decreased arterial blood flow secondary to vasoconstriction
B)Decreased arterial blood flow leading to hyperemia
C)Atherosclerotic obstruction of arteries
D)Trauma to the lower extremities

Accepted Answer

Decreased arterial flow is a result of vasospasm. The etiology is unknown. It is more problematic in colder climates or when the person is under stress. Hyperemia occurs when the vasospasm is relieved.

Question 4

GB is diagnosed with thromboangiitis obliterans (Buerger's disease). As a nurse caring for her, it is essential for you to teach modifications to which risk factor of the disease?
A)Familial tendency
B)Cigarette smoking
C)Excessive stress
D)Diet low in vitamin C and iron

Accepted Answer

Cigarette smoking. Buerger's disease may result in occlusion of the vessels and thrombus formation. It occurs predominantly in men between 20 to 55 years of age who smoke cigarettes or chew tobacco. A familial tendency is noted, but cigarette smoking is consistently a risk factor. Symptoms of the disease improve with smoking cessation.

Question 5

Arnold Swanson, a 54-year-old janitor of Middletown High School, suddenly felt a crushing chest pain while doing his early chores one morning. He called for his neighbor to drive him to the nearest hospital. Upon arrival in the Emergency Department, the doctor ordered for a 12-lead ECG to determine a possible myocardial infarction. The nurse would know that an early finding in the ECG of a client with an infarcted myocardium would be:
A)Disappearance of QRS complex
B)Elevated ST segments
C)Absence of P wave
D)Flattened T waves

Accepted Answer

Elevated ST segments. This is a typical early finding after a myocardial infarct because of the altered contractility of the heart. The other choices are not typical of MI.

Question 6

Arnold Swanson, who had a myocardial infarction 2 days ago, has been complaining to the nurse about issues related to his hospital stay. The best initial nursing response would be to:
A)Allow him to release his feelings and then leave him alone to allow him to regain his composure.
B)Refocus the conversation on his fears, frustrations, and anger about his condition.
C)Explain how his being upset dangerously disturbs his need for rest.
D)Attempt to explain the purpose of different hospital routines.

Accepted Answer

Refocus the conversation on his fears, frustrations, and anger about his condition. This provides the opportunity for the client to verbalize feelings underlying behavior and can be helpful in relieving anxiety. Anxiety can be a stressor that can activate the sympatho-adrenal response, causing the release of catecholamines that can increase cardiac contractility and workload that can further increase myocardial oxygen demand.

Question 7

Thrombus formation is a danger for all postoperative clients. The nurse should act independently to prevent this complication by:
A)Encouraging adequate fluids
B)Applying elastic stockings
C)Gently massaging the legs with lotion
D)Performing active-assistive leg exercises

Accepted Answer

Performing active-assistive leg exercises. Inactivity causes venous stasis, hypercoagulability, and external pressure against the veins, all of which lead to thrombus formation. Early ambulation or exercise of the lower extremities reduces the occurrence of this phenomenon.

Question 8

Josef Braga was ordered Digoxin 0.25 mg. OD. The nurse should include in her teaching plan how this drug affects Mr. Braga's condition. Which statement is poor knowledge regarding this drug?
A)It has positive inotropic and negative chronotropic effects.
B)The positive inotropic effect will decrease urine output.
C)Toxicity can occur more easily in the presence of hypokalemia, liver, and renal problems.
D)Do not give the drug if the apical rate is less than 60 beats per minute.

Accepted Answer

The positive inotropic effect will decrease urine output. Inotropic effect of drugs on the heart causes increased force of its contraction. This increases cardiac output that improves renal perfusion, resulting in an improved urine output.

Question 9

The nurse is teaching the client regarding his permanent artificial pacemaker. The nurse needs to enhance the client's understanding regarding the artificial pacemaker if he/she states:
A)"I will take my pulse rate once a day, in the morning upon awakening."
B)"I may be allowed to use electrical appliances."
C)"I have to observe regular follow up care."
D)"I may engage in contact sports."
E)Any of the above

Accepted Answer

"I may engage in contact sports." The client should be advised by the nurse to avoid contact sports. This will prevent trauma to the area of the pacemaker generator.

Question 10

A client receiving heparin sodium asks the nurse how the drug works. Which of the following points would the nurse include in the explanation to the client?
A)It dissolves existing thrombi.
B)It prevents the conversion of factors that are needed in the formation of clots.
C)It inactivates thrombin that forms and dissolves existing thrombi.
D)It interferes with vitamin K absorption.

Accepted Answer

It prevents the conversion of factors that are needed in the formation of clots. Heparin is an anticoagulant. It prevents the conversion of prothrombin to thrombin. It does not dissolve a clot.

Question 11

A female patient undergoes surgery and the abdominal aortic aneurysm is resected and replaced with a graft. When she arrives at the recovery room, she is still in shock. The nurse's priority should be:
A)Placing her in Trendelenburg position
B)Putting several warm blankets on her
C)Monitoring her hourly urine output
D)Assessing her VS, especially her RR

Accepted Answer

Assessing her VS, especially her RR should be the nurse's priority. Shock is characterized by reduced tissue and organ perfusion and eventual organ dysfunction and failure. Checking on the VS, especially the RR, which detects the need for oxygenation, is a priority to help detect its progress and provide for prompt management before the occurrence of complications.

Question 12

The nurse is teaching a group of call center agents about deep vein thrombosis. She includes in her teaching plan the factors that usually cause deep vein thrombosis (DVT) which includes:
A)Aerobic exercise
B)Inactivity
C)Pregnancy
D)Tight clothing

Accepted Answer

A thrombus lodged in a vein can cause venous occlusion as a result of venous stasis. Inactivity can cause venous stasis, leading to DVT. Aerobic exercise helps to prevent venous stasis. Pregnancy and tight clothing can cause varicose veins, which can lead to venous stasis and eventually DVT, but these are not primary causes.

Quiz 1: Cardiovascular

J. Andrews is admitted with angina pectoris and was ruled out for a myocardial infarction. The nurse reviews her laboratory results and plans to include dietary teaching after noting that Ms. Andrews's lipid profile shows which of the following sets of values?

A 45-year-old client with leg ulcers and arterial insufficiency is admitted to the hospital. The nurse understands that leg ulcers of this nature are usually caused by:

GB is diagnosed with thromboangiitis obliterans (Buerger's disease) . As a nurse caring for her, it is essential for you to teach modifications to which risk factor of the disease?

Arnold Swanson, who had a myocardial infarction 2 days ago, has been complaining to the nurse about issues related to his hospital stay. The best initial nursing response would be to:

Thrombus formation is a danger for all postoperative clients. The nurse should act independently to prevent this complication by:

Josef Braga was ordered Digoxin 0.25 mg. OD. The nurse should include in her teaching plan how this drug affects Mr. Braga's condition. Which statement is poor knowledge regarding this drug?

The nurse is teaching the client regarding his permanent artificial pacemaker. The nurse needs to enhance the client's understanding regarding the artificial pacemaker if he/she states:

A client receiving heparin sodium asks the nurse how the drug works. Which of the following points would the nurse include in the explanation to the client?

A female patient undergoes surgery and the abdominal aortic aneurysm is resected and replaced with a graft. When she arrives at the recovery room, she is still in shock. The nurse's priority should be:

The nurse is teaching a group of call center agents about deep vein thrombosis. She includes in her teaching plan the factors that usually cause deep vein thrombosis (DVT) which includes: