Cardiovascular
(Aortic/mitral) (regurgitation/stenosis) is manifested by heart failure.
Mitral regurgitation is manifested by heart failure.
Mitral regurgitation would allow blood to flow from the (left/right) (atrium/ventricle) to the (left/right) (atrium/ventricle).
Mitral regurgitation would allow blood to flow from the left ventricle to the left atrium.
(Aortic/mitral) (regurgitation/stenosis) is manifested by pulmonary edema and heart failure.
Mitral stenosis is manifested by pulmonary edema and heart failure.
Cardiac cells can withstand ischemic conditions for _____ minutes before irreversible cell injury occurs.
20 - Cardiac cells can withstand ischemic conditions for about 20 minutes before irreversible hypoxic injury causes cellular death (apoptosis) and tissue necrosis.
A function of the pericardium is to: provide a barrier against extracardial infections. improve blood flow through the heart. play a role in cardiac conduction. assist in cardiac contraction.
A function of the pericardium is to provide a barrier against extracardial infections.
Aortic ____ is manifested by widened pulse pressure, while aortic ____ is manifested by narrowed pulse pressure.
Aortic regurgitation is manifested by widened pulse pressure, while aortic stenosis is manifested by narrowed pulse pressure.
Aortic regurgitation would allow blood to flow back into the (left/right) (atrium/ventricle).
Aortic regurgitation would allow blood to flow back into the left ventricle.
For an infection to progress to septic shock, what must occur? The individual must be immunosuppressed. The myocardium must be impaired. The infection must be gram negative. Bacteria must enter the bloodstream.
Bacteria must enter the bloodstream -
A 10-year-old male presents with fever, lymphadenopathy, arthralgia, and nosebleeds and is diagnosed with rheumatic heart disease. While planning care, which characteristic changes should the nurse remember? Blood-borne organisms that adhere to the valvular surface Antigens that bind to the valvular lining, triggering an autoimmune response High fevers that damage collagen in valve leaflets Rheumatoid factor in the blood, stimulating valvular degeneration
Antigens that bind to the valvular lining, triggering an autoimmune response - The immune response cross-reacts with molecularly similar self-antigens in heart, muscle, joints, and the brain, causing an autoimmune response resulting in diffuse, proliferative, and exudative inflammatory lesions in these tissues.
(Aortic/mitral) (regurgitation/stenosis) is manifested by narrowed pulse pressure.
Aortic stenosis is manifested by narrowed pulse pressure.
(Answer all of the following.) As left heart failure progresses: left ventricular preload (increases, decreases) systemic vascular resistance (increases, decreases) left end-diastolic volume (increases, decreases) pulmonary vascular restistance (increases, decreases)
As left heart failure progresses: left ventricular preload increases systemic vascular resistance increases left end-diastolic volume increases pulmonary vascular resistance increases All of them increase!
An older adult is diagnosed with cerebral aneurysm. Where does the nurse suspect the cerebral aneurysm is located? Vertebral arteries Basilar artery Circle of Willis Carotid arteries
Circle of Willis - Cerebral aneurysms often occur in the circle of Willis.
Mitral stenosis would impair blood flow from the (left/right) (atrium/ventricle) to the (left/right) (atrium/ventricle).
Mitral stenosis would impair blood flow from the left atrium to the left ventricle.
An 8-week-old infant presents to the pediatrician for a well-baby checkup. Physical exam reveals a murmur, and an echocardiogram confirms a ventricular septal defect. Which genetic disorder is likely to accompany this diagnosis? Huntington disease Color blindness Down syndrome Hemophilia
Down syndrome - Down syndrome is the genetic factor that would most likely accompany the diagnosis of a congenital heart defect.
Which chamber of the heart generates the highest pressure? Right atrium Left atrium Left ventricle Right ventricle
Left ventricle
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? Raynaud disease Myocardial infarction (MI) Orthostatic hypotension Angina
Myocardial infarction - The diagnosis of acute MI is made on the basis of serial cardiac biomarker alterations. The cardiac troponins (troponins I and T) are the most specific indicators of MI. Elevated troponins I and T are indicative of MI.
A newborn experiences frequent periods of cyanosis, usually occurring during crying or after feeding. Which cardiac diagnosis does this history support? Atrioventricular canal (AVC) defect Ventricular septal defect (VSD) Tetralogy of Fallot. Atrial septal defect (ASD)
Tetralogy of Fallot - Infants with tetralogy of Fallot experience cyanosis after crying or during feeding. Infants with AVC defect may experience cyanosis, but it is not related to feeding or crying. Infants do not experience cyanosis with either VSD or ASD.
A patient is diagnosed with orthostatic hypotension. Which of the following symptoms would most likely be reported? Headache and blurred vision Nausea and vomiting Chest pain and palpitations Syncope and fainting
Syncope and fainting - Orthostatic hypotension is often accompanied by dizziness, blurring or loss of vision, and syncope or fainting
A nurse takes an adult patient's blood pressure and determines it to be normal. What reading did the nurse obtain? Systolic pressure between 140 and 150 mm Hg Systolic pressure less than 120 mm Hg and diastolic pressure less than 80 mm Hg Systolic pressure less than 100 mm Hg regardless of diastolic pressure Systolic pressure greater than 140 mm Hg and a diastolic pressure of 100 mm Hg
Systolic pressure less than 120 mm Hg and diastolic pressure less than 80 mm Hg - A systolic pressure of 140 mm Hg or more would indicate stage I hypertension. A systolic pressure of less than 100 mm Hg would indicate low blood pressure. A diastolic pressure greater than 90 mm Hg would indicate hypertension.
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? Tamponade Exudate Aneurysm Pulsus paradoxus
Tamponade - Muffled heart sounds are an indication of tamponade, and with tamponade the blood backs up into the venous system, leading to hepatomegaly.
The ________ conducts action potentials down the atrioventricular septum. The ________ conducts the potential along the atria while the __________ conducts impulses to the ventricles. Choices: Sinoatrial (SA) node, Atrioventricular (AV) node, Bundle of His
The bundle of His conducts action potentials down the atrioventricular septum. The sinoatrial node conducts the potential along the atria while the atrioventricular node conducts impulses to the ventricles.
The pericardium is: the outer muscular layer of the heart. the innermost layer of the heart chambers. a membranous sac that encloses the heart. the heart's fibrous skeleton.
The pericardium is the membranous sac that surrounds the heart. - The outer layer that acts as the fibrous skeleton of the heart is the myocardium. The innermost layer of the heart is the endocardium.
The most common cause of myocardial ischemia is: idiopathic vasospasm. arterial emboli from a heart valve. atherosclerosis. venous emboli.
atherosclerosis - The most common cause of myocardial ischemia is atherosclerosis. Myocardial ischemia is not caused by idiopathic vasospams or venous emboli. Arterial emboli may cause ischemia, but atherosclerosis is the major cause of myocardial ischemia.
What is the nurse monitoring when observing the QRS complex on the electrocardiogram? Ventricular activity Pulmonary artery closure Mitral valve opening Aortic valve closing
Ventricular activity - The QRS complex represents the sum of all ventricular muscle cell depolarizations
What is the most common type of congenital heart defect assessed for in infants? Atrial septal defect (ASD) Ventricular septal defect (VSD) Tetralogy of Fallot Atrioventricular canal defect
Ventricular septal defect (VSD)
A 30-year-old female presents to her primary care provider with fever, cardiac murmur, and petechial skin lesions and is diagnosed with infective endocarditis. The most likely cause of the disease is: a. bacteria. b. viruses. c. fungi. d. parasites.
a. bacteria - Infective endocarditis is due to a bacterial infection
Most cases of combined systolic and diastolic hypertension have no known cause and are documented on the chart as _____ hypertension. a. primary b. secondary c. congenital d. acquired
a. primary - Most cases of hypertension are diagnosed as primary hypertension, not secondary, which is due to a known cause.
Select all that apply: A nurse recalls acute orthostatic hypotension can be caused by: (select all that apply) prolonged immobility. drug action. starvation. volume depletion. exercise.
a. prolonged immobility b. drug action c. starvation d. volume depletion - Acute orthostatic hypotension occurs as a result of drug action, prolonged immobility, starvation, and volume depletion. Physical exhauation, rather than exercise, could cause it too.
A patient presents to a primary care provider reporting chest pain and is diagnosed with atherosclerosis. This disease is caused by: arterial wall thinning and weakening. abnormally dilated arteries and veins. abnormal thickening and hardening of vessel walls. autonomic nervous system imbalances.
abnormal thickening and hardening of vessel walls - Atherosclerosis is a form of arteriosclerosis characterized by thickening and hardening of the vessel wall. Affected arteries are narrowed.
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? Acute pericarditis Myocardial infarction (MI) Stable angina Pericardial effusion
acute pericarditis - Severe chest pain that worsens with respirations or lying down in a patient with fever, tachycardia, and a friction rub is characteristic of acute pericarditis.
The foramen ovale allows flow of blood between the left and right ______.
atrium
Which condition should cause the nurse to assess for high-output failure in a patient? Metabolic alkalosis Hypothyroidism Hypovolemia Anemia
anemia - Common causes of high-output failure include anemia
Which statement indicates the nurse understands coronary ostia? The coronary ostia (the openings to the coronary arteries) are found in the: left ventricle. inferior vena cava. coronary sinus. aorta.
aorta
Upon assessment of the patient, the nurse finds a widened pulse pressure and throbbing peripheral pulses. Which valve disorder does the nurse suspect? Mitral regurgitation Mitral stenosis Aortic regurgitation Aortic stenosis
aortic regurgitation - Aortic regurgitation is manifested by widened pulse pressure resulting from increased stroke volume and diastolic backflow.
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? Mitral regurgitation Mitral stenosis Aortic regurgitation Aortic stenosis
aortic regurgitation - Aortic regurgitation would allow backward flow of blood into the left ventricle.
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? Aortic regurgitation Aortic stenosis Mitral regurgitation Mitral stenosis
aortic stenosis - Aortic stenosis would impair blood flow from the left ventricle to the aorta.
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? Administer a diuretic to decrease volume. Apply oxygen to increase myocardial oxygen supply. Encourage exercise to increase heart rate. Give an antibiotic to decrease infection.
apply oxygen to increase myocardial oxygen supply - Increasing the myocardial oxygen supply is indicated to treat ischemia.
A 15-year-old male who is allergic to peanuts eats a peanut butter cup. He then goes into anaphylactic shock. Which assessment findings will the nurse assess for? a. Bradycardia, decreased arterial pressure, and oliguria b. Bronchoconstriction, hives or edema, and hypotension c. Hypertension, anxiety, and tachycardia d. Fever, hypotension, and erythematous rash
b. bronchoconstriction, hives or edma, and hypotension - Anaphylactic shock is characterized by bronchoconstriction, hives, and hypotension; it does not involve oliguria, bradycardia, or hypotension. Septic shock, not anaphylactic shock, is manifested by fever and rash.
An 82-year-old female was admitted to the hospital with confusion and severe hypotension. Her body's compensatory mechanisms are increased heart rate, vasoconstriction, and movement of large volumes of interstitial fluid to the vascular compartment. What kind of shock does the nurse suspect the patient is experiencing? a. Anaphylactic b. Hypovolemic c. Neurogenic d. Septic
b. hypovolemic - In hypovolemic shock, heart rate and SVR increase, boosting both cardiac output and tissue perfusion pressures. Interstitial fluid moves into the vascular compartment.
When a patient is diagnosed with coronary artery disease, the nurse assesses for myocardial: a. hypertrophy. b. ischemia. c. necrosis. d. inflammation.
b. ischemia - Coronary artery disease leads to myocardial ischemia.
A 20-year-old underwent an echocardiogram to assess chest pain. Results revealed a congenital defect in the papillary muscles. Which of the following would the nurse expect to occur? Closure of the semilunar valve Backward expulsion of the atrioventricular valves Closure of the atrioventricular valve Backward expulsion of the semilunar valves
backward expulsion of the AV valves
Blood flow is affected by: (select all that apply) blood viscosity. blood vessel diameter. blood pressure. blood vessel length. blood composition. blood volume.
blood viscosity blood vessel diameter blood pressure blood vessel length - Resistance to flow is generally greater in longer tubes because resistance increases with length but decreases with a wider diameter. Blood flow varies inversely with the viscosity of the fluid. Thick fluids move more slowly and experience greater resistance to flow than thin fluids. Increased blood pressure decreases blood flow because resistance is increased. Blood volume, not composition, plays a role in blood flow.
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
c. Prinzmetal - Chest pain that occurs at rest and at night is descriptive of Prinzmetal angina. Unstable angina is a form of acute coronary syndrome that results from reversible myocardial ischemia. Stable angina is predictable and occurs with activity. Silent angina has few, if any, symptoms.
A 20-year-old female is being admitted to the hospital with fever and septic shock. Which set of assessment findings would the nurse expect the patient to exhibit? a. Bradycardia, palpitations, confusion, truncal rash b. Severe respiratory distress, jugular venous distention, chest pain c. Low blood pressure and tachycardia d. Reduced cardiac output, increased systemic vascular resistance, moist cough
c. low blood pressure and tachycardia - Clinical manifestations of shock will include a low blood pressure and tachycardia. Severe respiratory distress, jugular vein distention, and chest pain are symptoms of heart failure, particularly pulmonary edema. Cardiac output is reduced, but there is a decrease in systemic vascular resistance.
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
c. stenosis - Valvular stenosis occurs when the valve opening is constricted and narrowed. Valvular regurgitation/insufficiency occurs when blood moves backward into the chamber from which it came. Valvular incompetence leads to regurgitation.
What term should the nurse use to document a detached blood clot? a. Thrombus b. Embolus c. Thromboembolus d. Infarction
c. thromboembolus - A thrombus is a clot that remains attached to a vessel wall; a detached thrombus is a thromboembolus. An embolus is a bolus of material floating in the bloodstream. An infarction is death of tissue.
A newborn develops a murmur and cyanosis shortly after birth. A diagnosis of pulmonic stenosis (PS) is made after an echocardiogram revealed narrowing of the pulmonary: a. tree b. artery c. valve d. vein
c. valve - PS is a narrowing or stricture of the pulmonary valve causing resistance to blood flow from the right ventricle to the pulmonary artery.
A nurse observes a cardiologist multiplying the heart rate by stroke volume. What is the cardiologist measuring? Vascular resistance Preload Cardiac output Ejection fraction
cardiac output CO=HR*SV
Baroreceptors are located in the: renal artery. superior vena cava. carotid artery. circle of Willis.
carotid artery
Which structures act as anchors for the atrioventricular valves? Chordae tendineae Great vessels Coronary ostia Trabeculae carneae
chordae tendineae - The atrioventricular valve openings are attached to the papillary muscles by the chordae tendineae.
Individuals with Raynaud disease need to be counseled to avoid which of the following conditions to prevent severe symptoms? Allergic reactions Cold exposure Hot water immersion Tissue injury
cold exposure - Raynaud disease demonstrates symptoms when extremities are exposed to cold.
A 30-year-old White female was recently diagnosed with primary hypertension. She reports that she eats fairly well, usually moderate red meat consumption. She also reports that her father has hypertension as well. A nurse determines which of the following risk factors is most likely associated with this diagnosis? a. Race b. Diet c. Age d. Genetic
d. genetic - Genetic factors, such as family history of hypertension, are the number one factor in the development of hypertension. Race and diet may be factors, but genetic factors are primary. Age is a factor, but not in this case; since the patient is 30, genetics are a greater factor.
A 75-year-old female has been critically ill with multiple organ dysfunction syndrome (MODS) for longer than a week and has developed a severe oxygen supply and demand imbalance. The statement that best describes this imbalance is which of the following? a. Increased oxygen delivery to cells fails to meet decreased oxygen demands. b. The amount of oxygen consumed by cells depends only on the needs of cells, because there is oxygen in reserve. c. The situation results in supply-independent consumption. d. The reserve has been exhausted, and the amount of oxygen consumed depends on the amount the circulation is able to deliver.
d. the reserve has been exhausted, and the amount of oxygen consumed depends on the amount the circulation is able to deliver - In MODS, the reserve has been exhausted and the body cannot meet the oxygenation demands.
A newborn is suspected of having coarctation of the aorta. Which of the following assessments would aid in diagnosis? a. Cyanosis b. Bounding pedal pulses c. Cool arms d. Weak or absent femoral pulses
d. weak or absent femoral pulses - The newborn will have weak or absent femoral pulses because blood flow is obstructed near the lower extremities, not bounding pedal pulses. Coarctation is not a cyanotic defect. The infant will have warm arms because blood flow is present in the upper extremities.
One consequence of switching from aerobic to anaerobic cellular metabolism during shock states is: decreased adenosine triphosphate (ATP) production. cellular dehydration. cellular alkalosis. free radical formation.
decreased ATP production - Anaerobic metabolism leads to decreased ATP production
A patient was admitted to the intensive care unit with a diagnosis of acute myocardial infarction (MI) and is being treated for shock. The primary cause of shock is most likely: rapid heart rate. decreased cardiac contractility. increased capillary permeability. decreased afterload due to vasodilation.
decreased cardiac contractility - MI leads to decreased cardiac contractility due to a damaged myocardium and would lead to shock.
A patient presents with severe chest pain and shortness of breath and is diagnosed with pulmonary embolism. The embolism most likely originated from the: left ventricle. systemic arteries. deep veins of the leg. superficial veins of the arm.
deep veins of the leg - The most likely origin of the embolism is from the deep veins of the legs. (Remember, this is why you don't massage or apply SCDs when you suspect deep vein thrombosis.)
Coarctation of the aorta is the local narrowing of the aorta near the: aortic valve. ductus arteriosus. diaphragm. bifurcation into the common iliac arteries.
ductus arteriosus -
What term is used to describe the patent opening between the aorta and pulmonary artery in a fetus? Foramen ovale Sinus venosus Ductus arteriosus Septal defect
ductus arteriosus - In the fetal circulation, the ductus arteriosus is an opening between the aorta and the pulmonary artery.
A 42-year-old is diagnosed with constrictive pericarditis. The nurse assesses the blood pressure for decreased cardiac output because of: pericardial effusions. fibrosis and calcification of the pericardial layers. cardiomyopathy. hemorrhage in the pericardial cavity.
fibrosis and calcification of the pericardial layers - In constrictive pericarditis, fibrous scarring compresses the heart and eventually reduces cardiac output. Pericardial effusion is manifested by chest pain. Cardiomyopathy is a general term for pathophysiological changes in the heart. Hemorrhage in the pericardial cavity will lead to tamponade.
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: congenital heart defects. human immunodeficiency virus (HIV) infections. group A beta-hemolytic streptococcus infections. acute pericarditis.
group A beta-hemolytic streptococcus infections - Rheumatic fever is a systemic, inflammatory disease caused by a delayed exaggerated immune response to infection by the group A beta-hemolytic streptococcus
During shock states, glucose uptake is usually: enhanced. normal. impaired. energy intensive.
impaired - Some compensatory mechanisms activated by shock contribute to decreased glucose uptake by the cells.
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: mild to moderate atherosclerosis. impending myocardial infarction (MI). electrical conduction problems in the heart. decreased myocardial oxygen demand.
impending MI - Unstable angina is an indication of impending MI. Unstable angina could be caused by moderate atherosclerosis, altered electrical conduction, or a decrease in myocardial oxygen, but it is an indication of impending MI.
When a person is in shock, a nurse remembers impairment in cellular metabolism is caused by: release of toxic substances. free radical formation. inadequate tissue perfusion. lack of nervous or endocrine stimulation.
inadequate tissue perfusion - In shock, impaired cellular metabolism is caused by inadequate tissue perfusion.
A 22-year-old pregnant woman presents to her OB/GYN for a prenatal checkup. The fetal heartbeat sounds irregular, and a fetal echocardiogram reveals an atrioventricular canal (AVC) defect. This defect is the result of: failure of the ductus arteriosus to close. incomplete fusion of the endocardial cushions. a patent foramen ovale. a right-to-left shunt.
incomplete fusion of the endocardial cushions - AVC defect is the result of incomplete fusion of endocardial cushions. A patent ductus is the failure of the ductus arteriosus to close. The infant will not experience a patent foramen ovale. Flow is generally left to right, not right to left.
The nurse realizes the patient diagnosed with mitral stenosis has incomplete emptying of the: right atrium. right ventricle. left atrium. left ventricle.
left atrium - Mitral stenosis would result in incomplete emptying of the left atrium, as the mitral valve is located between the left atrium and left ventricle.
A 73-year-old has increased pulmonary pressure resulting in right heart failure. A potential cause for the right heart to fail is: hypertension. left heart failure. acute pneumonia. pericarditis.
left heart failure - Right-sided failure often follows left-sided failure when pulmonary congestion forces backward flow of blood into the left ventricle.
Which characteristic changes should the nurse keep in mind while caring for a patient with left heart failure? As left heart failure progresses: left ventricular preload increases. systemic vascular resistance decreases. left end-diastolic volume decreases. pulmonary vascular resistance decreases.
left ventricular preload increases
A 2-week-old infant who presents with poor feeding, fatigue, dyspnea, and a murmur is diagnosed with a patent ductus arteriosus (PDA). This condition results in a(n): decreased pulmonary blood flow. right-to-left shunt. left-to-right shunt. increased systemic blood flow.
left-to-right shunt - PDA is failure of the fetal ductus arteriosus to close. The continued patency of this vessel allows blood to flow from the higher-pressure aorta to the lower-pressure pulmonary artery, causing a left-to-right shunt.
A 75-year-old obese female presents to her primary care provider reporting edema in the lower extremities. Physical exam reveals that she has varicose veins. Upon performing the history, which of the following is a possible cause for the varicose veins? Extreme exercise Long periods of standing Trauma to the deep veins Ischemia
long periods of standing - The probable cause of the patient's varicose veins is gradual venous distention caused by the action of gravity on blood in the legs due to long periods of standing. Varicose veins are most likely due to long periods of standing leading to the action of gravity promoting venous distention. Exercise would help prevent this. Trauma can occur, but usually this affects the more superficial veins. Ischemia affects arteries, not veins.
Foam cells in a fatty streak are: deposited adipose cells. injured neutrophils. macrophages that engulf low-density lipoprotein (LDL). lipid-laden mast cells.
macrophages that engulf low-density lipoprotein (LDL) - Foam cells are lipid-laden macrophages that engulf LDL. They are deposited in vessels.
The primary cardiovascular control center is located in the: cerebral cortex. thalamus. medulla. hypothalamus.
medulla - The primary cardiovascular control center is in the brainstem in the medulla. The cerebral cortex, the thalamus, and hypothalamus are secondary control sites.
Inflammatory cells have difficulty limiting the colonization of microorganisms in infective endocarditis because the: microorganisms are resistant. valves are avascular. microorganisms are sequestered in a fibrin clot. colonies overwhelm the phagocytes.
microorganisms are sequestered in a fibrin clot - In endocarditis, bacterial colonies are inaccessible to host defenses because they are embedded in the protective fibrin clots.
A nurse recalls the most common cardiac valve disease in the United States is: mitral valve prolapse. pulmonary stenosis. tricuspid valve prolapse. aortic stenosis.
mitral valve prolapse - Mitral valve prolapse is the most common valve disorder in the United States.
A 65-year-old male with a history of untreated hypertension is now experiencing left heart failure. A nurse recalls his untreated hypertension led to: ventricular dilation and wall thinning. myocardial hypertrophy and ventricular remodeling. inhibition of renin and aldosterone. alterations in alpha and beta receptor function.
myocardial hypertrophy and ventricular remodeling - With hypertension comes increased afterload and resistance to ventricular emptying and more workload for the ventricle, which responds with hypertrophy of the myocardium and ventricular remodeling.
Superior vena cava syndrome (SVCS), causing venous distention in the upper extremities, is a result of progressive superior vena cava: a. inflammation. b. occlusion. c. distention. d. sclerosis.
occlusion - SVCS is a progressive occlusion of the SVC that leads to venous distention in the upper extremities and head.
An infant undergoes an echocardiogram for a suspected heart defect. Tests reveal an opening in the middle of the atrial septum. What term would the nurse use to describe this defect? Ostium primum Ostium secundum Sinus venosus Eisenmenger syndrome
ostium secundum - An opening in the middle of the atrial septum is referred to as an ostium secundum ASD.
A 55-year-old male died of a myocardial infarction. Autopsy would most likely reveal: embolization of plaque from the aorta. decreased ventricular diastolic filling time. platelet aggregation within the atherosclerotic coronary artery. smooth muscle dysplasia in the coronary artery.
platelet aggregation within the atherosclerotic coronary artery - The autopsy would reveal platelet aggregation within an atherosclerotic coronary artery. The cause of death is most likely occlusion of the coronary artery.
An 8-week-old infant's well-baby check reveals a murmur, and an echocardiogram shows a large ventricular septal defect. If left untreated, what condition could develop? Pulmonary hypertension Cyanosis Dysrhythmias Valve damage
pulmonary hypertension - If the degree of shunting is significant and not corrected, the child is at risk for developing pulmonary hypertension.
A patient with left heart failure starts to have a cough and dyspnea. Pulmonary symptoms common to left heart failure are a result of: inflammatory pulmonary edema. decreased cardiac output. pulmonary vascular congestion. bronchoconstriction.
pulmonary vascular congestion - The clinical manifestations of left heart failure are the result of pulmonary vascular congestion and inadequate perfusion of the systemic circulation. Pulmonary edema does occur, but it is not due to inflammation. Decreased cardiac output does occur, but the pulmonary symptoms are related to pulmonary congestion. Pulmonary symptoms are not due to bronchoconstriction.
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? Heart failure Connective tissue disorders Rheumatic fever or heart disease Syphilis infection
rheumatic fever or heart diease - Valvular dysfunction is often related to rheumatic fever.
A 65-year-old male is diagnosed with chronic pulmonary disease and elevated pulmonary vascular resistance. Which of the following heart failures should the nurse assess for in this patient? Right heart Left heart Low-output High-output
right heart - Right-sided failure occurs when the patient experiences chronic pulmonary disease and elevated pulmonary vascular resistance because the blood has difficulty overcoming the pressure and blood builds up in the right side of the heart. Pulmonary congestion leads to right-sided failure.
As a result of blockage in the pulmonary artery, blood would first back up into the: aorta. left ventricle. pulmonary veins. right ventricle.
right ventricle Blockage in the pulmonary artery would cause blood to back up into the right ventricle
A patient most prone to multiple organ dysfunction syndrome (MODS) is a patient with: myocardial infarction (MI). pulmonary disease. septic shock. autoimmune disease.
septic shock - The most common cause of MODS is septic shock.
A 72-year-old female has a history of right heart failure caused by a right ventricular myocardial infarction. Which of the following symptoms are specifically related to her right heart failure? Significant edema to both lower legs and feet Hypertension Decreased urine output Dyspnea upon exertion
significant edema to both lower legs and feet - Right-sided failure allows blood to back up into the systemic circulation, leading to peripheral edema. Since it is backed up into the venous system, hypertension is less likely. Right-sided failure leads to edema and a greater venous blood volume, which would lead to increased urinary output. Dyspnea upon exertion is more indicating of left-sided failure.
A 52-year-old male presents with pooling of blood in the veins of the lower extremities and edema. The diagnosis is chronic venous insufficiency, and an expected assessment finding of this disorder is: deep vein thrombus formation. skin hyperpigmentation. gangrene. edema above the knee.
skin hyperpigmentation - Symptoms include edema of the lower extremities and hyperpigmentation of the skin of the feet and ankles but deep vein thrombi do not form. Edema in these areas may extend to the knees but not above. Gangrene does not occur in veins but in arteries.
A patient is diagnosed with coronary artery disease. Which of the following modifiable risk factors would the nurse suggest the patient change? Eating meat Living arrangements Drinking tomato juice Smoking cigarettes
smoking cigarettes - Cigarette smoking leads to vasoconstriction and should be the first behavior the patient changes. Eating meat alone would not lead to the development of coronary artery disease.
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: Stable angina Unstable angina Prinzmetal angina Myocardial infarction (MI)
stable angina - Stable angina is associated with activity and subsides with rest. Unstable angina is a form of acute coronary syndrome that results from reversible myocardial ischemia and occurs at rest. Chest pain that occurs at rest and at night is descriptive of Prinzmetal angina. MI pain does not subside with rest.
When a nurse checks the patient for orthostatic hypotension, what activity did the nurse have the patient engage in? Physical exertion Eating Standing up Lying down
standing up - Orthostatic hypotension refers to a drop in blood pressure when standing up
The onset of anaphylactic shock is usually: mild. sudden and life threatening. delayed by several hours. delayed by 24 hours.
sudden and life threatening - The onset of anaphylactic shock is usually sudden and life threatening, not mild or delayed.
A 50-year-old male with a 30-year history of smoking was diagnosed with bronchogenic cancer. He developed edema and venous distention in the upper extremities and face. Which of the following diagnosis will the nurse observe on the chart? Thromboembolism Deep vein thrombosis Superior vena cava syndrome (SVCS) Chronic venous insufficiency
superior vena cava syndrome (SVCS) - SVCS is a progressive occlusion of the superior vena cava that leads to venous distention in the upper extremities and head.
Neurogenic shock can be caused by any factor that inhibits the: parasympathetic nervous system. sympathetic nervous system. somatic nervous system. thalamus.
sympathetic nervous system - Neurogenic shock is caused by any factor that inhibits the sympathetic nervous system or overstimulates the parasympathetic nervous system.
A 51-year-old male presents with recurrent chest pain on exertion and is diagnosed with angina pectoris. The pain occurs when: cardiac output has fallen below normal levels. the myocardial oxygen supply has fallen below demand. myocardial stretch has exceeded the upper limits. the vagus nerve is stimulated.
the myocardial oxygen supply has fallen below demand. - Angina is chest pain caused by myocardial ischemia, which develops if the flow or oxygen content of coronary blood is insufficient to meet the metabolic demands of myocardial cells.
Which of the following findings in the patient with Raynaud disease would indicate a need for further teaching? The patient eats bananas twice a day. The patient smokes cigarettes. The patient wears mittens outside. The patient takes calcium channel blockers.
the patient smokes cigarettes - Cigarette smoking should be stopped to eliminate the vasoconstricting effects of nicotine. The bananas do not cause problems in this patient. The patient should wear mittens outside. Calcium channel blockers are an acceptable treatment for Raynaud disease.
A 60-year-old female has survived a myocardial infarction. The nurse is providing care for impaired ventricular function because: there is a temporary alteration in electrolyte balance. there is too much stress on the heart. the cells become hypertrophic. the resulting ischemia leads to hypoxic injury and myocardial cell death.
the resulting ischemia leads to hypoxic injury and myocardial cell death. - The patient has impaired ventricular functioning because a portion of the myocardium has died due to ischemia.
A patient presents to the emergency department reporting difficulty swallowing and shortness of breath. A CT scan would most likely reveal an aneurysm in the: cerebral vessels. renal arteries. inferior vena cava. thoracic aorta.
thoracic aorta - Thoracic aortic aneurysms can cause dysphagia (difficulty swallowing) and dyspnea (breathlessness). Aneurysms in cerebral vessels will produce a headache. Aneurysms in the renal arteries will produce flank pain. Aneurysms in the inferior vena cava may produce chest pain.
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? Aortic stenosis Tricuspid regurgitation Aortic regurgitation Mitral regurgitation
tricuspid regurgitation - Tricuspid regurgitation leads to volume overload in the right atrium and ventricle, increased systemic venous blood pressure, and right heart failure.
A 27-year-old male is admitted to a neurologic unit with a complete C-5 spinal cord transection. On initial assessment, he is bradycardic, hypotensive, and hyperventilating. He appears to be going into shock. The most likely mechanism of his shock is: hypovolemia caused by blood loss. hypovolemia caused by evaporative fluid losses. vasodilation caused by gram-negative bacterial infection. vasodilation caused by a decrease in sympathetic stimulation.
vasodilation caused by a decrease in sympathetic stimulation - The patient is experiencing neurogenic shock in which blood volume has not changed, but SVR decreases drastically so that the amount of space containing the blood has increased, leading to hypotension. In this type of shock, blood loss has not occurred. In this type of shock, fluid loss has not occurred. Vasodilation due to infection would be septic shock; the type of shock described in the patient is due to loss of sympathetic stimulation.
A 1-month-old infant visits his primary care provider for a well-baby check. Physical exam reveals decreased cardiac output, hypotension, tachycardia, and a loud murmur suggestive of aortic stenosis. Which condition would be expected with this diagnosis? Atrial dilation Ventricular hypertrophy Atrial rigidity Decreased contractility
ventricular hypertrophy - The infant with aortic stenosis will also be experiencing ventricular hypertrophy because of the resistance of blood flow from the left ventricle into the aorta.
Intrauterine exposure to which factor could be responsible for a diagnosis of congenital heart disease? Diabetes Alcohol exposure Viral infection Dextroamphetamine
viral infection - One of the identified causes of cardiac defects is an intrauterine viral infection, especially rubella.
