Question 1

A patient is diagnosed with epicarditis.What should the nurse recall regarding the purpose of the epicardium when caring for this patient?

Accepted Answer

The epicardium covers the heart muscle and prevents friction for efficient function.A.B.D.The epicardium does not line the heart chambers or the coronary vessels and does not contract and pump blood from the ventricles.

Question 2

A patient is being instructed about a Holter monitor.Which statement indicates that the patient knows what to do a symptom occurs while wearing a Holter monitor?

Accepted Answer

When wearing a Holter monitor,the patient is to record a diary of activities and symptoms and push the event button if symptoms occur.A.B.C.These actions do not need to be taken if a symptom occurs while wearing the monitor.

Question 3

A patient with type 1 diabetes mellitus arrives for cardiac surgery.During the assessment,the nurse learns the patient self-administered the usual insulin dose.Which action should the nurse take?

Accepted Answer

The patient usually takes nothing by mouth (NPO)8 to 12 hours before surgery.Due to this,patients with diabetes have insulin and oral hypoglycemic agents reduced or withheld the morning of surgery with blood glucose monitoring.A.Vital sign measurement is not going to help determine the impact of the insulin dose on the patient's preoperative and postoperative status.B.The patient should have been instructed to withhold all medications the morning of the surgery.D.The patient should be NPO for surgery.

Question 4

A patient has sustained damage to the sinoatrial node.Which heart rates indicate that the patient's atrioventricular node has taken over as the pacemaker for the heart?

Accepted Answer

If the sinoatrial (SA)node becomes nonfunctional,the atrioventricular (AV)node can initiate each heartbeat,but at a slower rate of 40 to 60 beats per minute.B.The Bundle of His can generate a heartbeat at the rate of 20 to 35.A.No cardiac tissue will generate this speed of heartbeat.D.This is a normal heartbeat which would be generated by the sinoatrial node.

Question 5

The nurse is reinforcing teaching provided to a patient about the role high-density lipoproteins (HDLs)play in cardiac disease.Which patient statement indicates correct understanding of the teaching?

Accepted Answer

HDLs play a protective role against coronary artery disease because they carry cholesterol to the liver to be metabolized.A.B.D.These statements are incorrect about the role of high-density lipoproteins.

Question 6

The nurse is collecting data from a patient with hypertension.Which modifiable cardiovascular risk factor should the nurse identify for care planning?

Accepted Answer

Activity level is a modifiable risk factor.A.B.C.These factors are not modifiable as they cannot be changed.

Question 7

The nurse is reviewing the anatomy and physiology of the cardiac system with a patient scheduled for pacemaker insertion.Which chamber of the heart should the nurse instruct has the greatest workload and usually fails first as a result?

Accepted Answer

The thicker walls of the left ventricle pump with approximately five times the force of the right ventricle.This difference in force is due to the great difference between systemic and pulmonary blood pressure.A.B.D.These heart chambers do not have the same workload volume as the left ventricle.

Question 8

A patient will be wearing a Holter monitor for 2 days.What should the nurse instruct the patient about bathing while wearing the monitor?

Accepted Answer

The patient wears loose-fitting clothing and may only sponge bathe while wearing the monitor.B.C.D.The patient should not take a tub bath,shower,or remove the monitor.

Question 9

The nurse is caring for a patient recovering from a cardiac catheterization with a right femoral artery entry site.Which action should the nurse take?

Accepted Answer

The extremity used for catheter insertion must not be moved or flexed for several hours after the procedure.A.B.D.Since the extremity should not be moved these actions are contraindicated.

Question 10

The nurse is using a stethoscope to listen to a patient's heart sounds.The nurse recognizes that the "dupp" of the characteristic "lubb-dupp" heart sound indicates what part of the cardiac cycle?

Accepted Answer

The "dupp" indicates closure of the aortic and pulmonary semilunar valves.A.B.C.The atrioventricular valves (mitral,tricuspid)are all the same type of valves,and their closure is indicated by the "lubb" sound.

Question 11

The nurse is measuring a patient's central venous pressure (CVP).Which patient factors is reflected by this pressure reading?

Accepted Answer

CVP reflects fluid volume status,so an increased CVP indicates fluid overload,and a decreased CVP indicates fluid deficit.B.C.D.CVP is not used to determine cardiac output,blood pressure,or peripheral vascular resistance.

Question 12

The nurse reviews the cardiac catheterization procedure with a patient scheduled for the test in 2 hours.Which patient statement indicates that teaching has been effective?

Accepted Answer

Patients should be told that during the test they are awake,and a warm,flushing sensation may be felt when the dye is injected; the room has a lot of equipment; a movable table is used; the patient's vital signs and electrocardiogram (ECG)are monitored constantly; and the length of the procedure is 2 to 3 hours.A.B.D.These statements indicate that teaching has not been effective.

Question 13

The nurse is caring for a patient who had a cardiac catheterization using the left femoral site for entry.Which data is most important for the nurse to monitor?

Accepted Answer

The priority assessment is to ensure that circulation is not compromised.The puncture site and most importantly the peripheral pulses which are distal to the procedure site are verified as being present.A.C.A cardiac catheterization should not affect pupil reaction or orientation status.D.The patient's left femoral artery was the entry site.The patient's right foot should not be affected.

Question 14

A patient asks the nurse to explain what high levels of low-density lipoproteins (LDLs)means.What response by the nurse would be appropriate?

Accepted Answer

High levels of LDLs are linked to an increase in coronary artery disease because they circulate cholesterol in the arteries.A.C.D.These responses are not correct about low-density lipoproteins.

Question 15

The nurse suspects that a patient's heart rate is being affected by parasympathetic influence.What should the nurse recall as the effect the parasympathetic nervous system has on the heart?

Accepted Answer

Parasympathetic impulses-along the vagus nerve to the sinoatrial (SA)node,atrioventricular (AV)node,and atrial myocardium-decrease heart rate.B.The parasympathetic nervous system does not influence the resting phase.C.D.The parasympathetic nervous system does not increase cardiac output or the strength of contractions.

Question 16

The nurse is helping a patient understand why the heart beat can change in speed.When doing so,what should the nurse explain as being the pacemaker of the heart?

Accepted Answer

The sinoatrial (SA)node is a specialized mass of cardiac muscle that depolarizes rhythmically and most rapidly,about 100 times per minute,and therefore initiates each heartbeat.For this reason,the SA node is sometimes called the pacemaker of the heart.A.C.D.These structures are not considered the pacemaker of the heart.

Question 17

The nurse is explaining the regulation of blood pressure to a patient newly diagnosed with hypertension.What tissues within the artery wall that helps maintain diastolic blood pressure should the nurse identify for the patient?

Accepted Answer

The middle artery layer of smooth muscle and elastic connective tissue maintains normal blood pressure (BP),especially diastolic BP,by changing the diameter of the artery.B.C.D.These tissues are not within the layers of the arterial walls.

Question 18

The nurse is providing care for a patient whose right atrial pressure (RAP)is 12 mm Hg.Which action should the nurse take?

Accepted Answer

Normal RAP is 2 to 6 mm Hg.This pressure reflects fluid volume status,so an increased level indicates heart failure.The heart is not pumping effectively,so blood is backing up,raising the RAP reading and placing the patient at risk of pulmonary edema.A.C.D.These actions would not be indicated for this pressure reading.

Question 19

Upon auscultating a patient's heart sounds,the nurse is concerned that a pericardial friction rub is present.Which health problem should the nurse suspect is possibly occurring in this patient?

Accepted Answer

A pericardial friction rub may occur after a myocardial infarction or chest trauma.A.B.C.A pericardial friction rub is not associated with these health problems.

Question 20

The nurse instructs a patient on beverages to avoid when taking the prescribed medication warfarin (Coumadin).Which beverage should the patient state that indicates teaching has been effective?

Accepted Answer

Warfarin is mainly metabolized by the cytochrome P450 isoenzyme CYP2C9,and cranberry juice contains flavonoids known to inhibit P450 enzymes.Bleeding problems and hemorrhage have been attributed to this interaction.A.B.C.There is no reason for the patient to avoid these beverages.

Quiz 21: Cardiovascular System Function, Assessment, and Therapeutic Measures