Question 1

The patient has a total cholesterol of 190 with a high-density lipid (HDL) of 110 and a low-density lipid (LDL) of 80. The nurse's reaction is one of:

Accepted Answer

Total cholesterol of less than 200 is desirable. The higher the number of HDLs the better. A high number of LDLs puts the patient at risk for heart disease.

Question 2

The nurse takes into consideration that age-related changes can affect the peripheral circulation because of:

Accepted Answer

Aging causes sclerotic changes in the blood vessels that lead to decreased elasticity and narrowing of the vessel lumen.

Question 3

The nurse identifies the "LUBB" sound of the "LUBB/DUBB" of the cardiac cycle as the sound of the:

Accepted Answer

The LUBB is the first sound of a low pitch heard when the AV valves close.

Question 4

What do dark or "cold" spots on a thallium scan indicate?

Accepted Answer

Thallium scans show adequate perfused areas by the collection of thallium. Dark spots or "cold spots" indicate tissues that have inadequate perfusion.

Question 5

The patient has been hospitalized for hypertensive episodes three times in the last months. While preparing the discharge teaching plan, the nurse assesses that he does not comply with his medication regimen. The nurse's immediate course of action would be to:

Accepted Answer

Nursing interventions include measures to prevent disease progression and complications. Reteaching about medication will not identify the cause of noncompliance.

Question 6

The nurse assesses that the home health patient has no signs or symptoms of heart failure, but does have a history of rheumatic fever and has been recently diagnosed with diabetes mellitus. The nurse is aware that using the American College of Cardiology and the American Heart Association (ACC/AHA) staging, this patient would be a:

Accepted Answer

The ACC/AHA staging describes stage A as a person without symptoms of heart failure, but with primary conditions associated with the development of the disease.

Question 7

What is the major cause of cardiac valve disease?

Accepted Answer

Rheumatic fever, a streptococcal infection, is the major cause of cardiac valve disease.

Question 8

The nurse is aware that the muscle layer of the heart, which is responsible for the heart's contraction, is the:

Accepted Answer

The myocardium is the specialized muscle layer that allows the heart to contract.

Question 9

The nurse assessing a cardiac monitor notes that the cardiac complexes each have a P wave followed by a QRS and a T. The rate is 120. The nurse recognizes this arrhythmia as:

Accepted Answer

Sinus tachycardia has a P wave followed by the QRS and the T. All the components of the complex are present and in the correct order, but the rate is over 100 beats a minute.

Question 10

After an influenza-like illness, the patient complains of chills and small petechiae in his mouth and his legs. A heart murmur is detectable. These are characteristic signs of:

Accepted Answer

Collection of subjective data includes noting patient complaints of influenza-like symptoms with recurrent fever, undue fatigue, chest pain, and chills. Objective data may reveal the significant signs of petechiae in the conjunctiva and mouth. Both subjective data and objective data are indicative of infective endocarditis.

Question 11

The nurse reminds the patient who is on Coumadin for the treatment of atrial fibrillation that the ideal is to maintain the international normalized ratio (INR) at between:

Accepted Answer

The desired INR for the monitoring of anticoagulant therapy is between 2 and 3.

Question 12

The elderly patient with angina pectoris says she is unsure how she should take nitroglycerin when she has an attack. The nurse's most helpful response would be:

Accepted Answer

Administer prescribed nitroglycerin. Repeat every 5 minutes, three times. If pain is unrelieved, notify the physician. Nitroglycerin administered sublingually usually relieves angina symptoms but does not relieve the pain from an MI. Administering nitroglycerin more than three times will probably not relieve the pain.

Question 13

The nurse caring for a patient recovering from a myocardial infarct who is on remote telemetry recognizes the need for added instruction when the patient says:

Accepted Answer

Remote telemetry allows the patient to be on a separate unit, but be monitored in a central location. The patients can be ambulatory and can sleep with the monitor on. They should not remove the monitor to shower.

Question 14

The nurse recognizes the echocardiogram report that shows an ejection factor of 42% as an indication of:

Accepted Answer

An ejection factor (cardiac output) of 42% indicates moderate heart failure.

Question 15

The nurse assesses pitting edema that can be depressed approximatel $\frac { 1 } { 4 }$ y inch and refills in 15 seconds. The nurse would document this assessment as:

Accepted Answer

Pitting edema that can be depressed approximately 1/4 inch and refills in 15 seconds is typically documented as +2 edema.

Question 16

What should a person with unstable angina avoid?

Accepted Answer

The person with angina should avoid exposure to cold, heavy exercise, eating heavy meals, and emotional stress.

Question 17

The nurse is aware that the symptoms of an impending myocardial infarction (MI) differ in women because acute chest pain is not present. Women are frequently misdiagnosed as having:

Accepted Answer

Indigestion, gallbladder attack, anxiety attack, and depression are frequent misdiagnoses for women having an MI.

Question 18

A patient is admitted from the emergency department. The emergency department physician notes the patient has a diagnosis of heart failure with a New York Heart Association (NYHA) classification of IV. This indicates the patient's condition as:

Accepted Answer

Class IV: Severe; patient unable to perform any physical activity without discomfort. Angina or symptoms of cardiac inefficiency may develop at rest.

Question 19

The nurse notes a run of three ventricular contractions (PVC) that are not preceded by a P wave. This particular arrhythmia can progress into:

Accepted Answer

PVCs are capable of progressing into ventricular tachycardia and death.

Question 20

The nurse clarifies that the master pacemaker of the heart is the:

Accepted Answer

The SA node is the master pacemaker of the heart.

Quiz 47: Care of the Patient with a Cardiovascular or a Peripheral Vascular Disorder