Study Guide Questions: Chapter 30 - Assessment of the Cardiovascular System

What is the best technique for assessing a client's right lower leg for arterial insufficiency?

Palpate the peripheral arteries using a head-to-toe approach with side-to-side comparison

What does the nurse suspect when a client states "I get short of breath whenever I lie down for several hours?"

Paroxysmal nocturnal dyspnea

What is the priority medical-surgical concept when the nurse is assessing a client with cardiovascular disease (CVD)?

Perfusion

Which tests will the nurse teach a client are routinely done for follow-up monitoring when the client is discharged with a prescription for warfarin?

Prothrombin time (PT) and international normalized ratio (INR)

Which action does the nurse perform to prevent kidney toxicity when caring for a client after cardiac catheterization?

Provide intravenous and oral fluids for 12 to 24 hours

Which client has an abnormal heart sound?

S3 in a 54 year old

What common assessment finding would the nurse expect to find in an older adult with cardiovascular disease?

S4 heart sounds

Which information from a client's medical history causes the nurse to check for abnormalities of the heart valves?

Streptococcal infections of the throat

For which pathophysiological conditions can a normal healthy heart adapt to maintain perfusion to the body tissues?

Stress and infection

When a client is hypovolemic, which tissue reacts and sends fewer impulses to the CNS?

Stretch receptors

What does the nurse suspect when a client who had a bruit on assessment during the previous 2 days does not have a bruit on assessment today?

The occlusion of the blood vessel is now 90%

Which laboratory value test elevation does the nurse consider most significant in the diagnosis of a client's myocardial infarction (MI)?

Troponin T and I

Which statement about the peripheral vascular system is accurate?

Veins have valves that direct blood flow to the heart and prevent backflow

Which statement by a client to the nurse indicates an understanding of cigarette usage related to cardiovascular risks?

"I need to be completely cigarette free for at least 3 years."

What is the best advice the nurse would give to a client to moderate to severe cramping sensation in their legs or buttocks associated with an activity such as walking?

"Resting or lowering the affected extremity can relieve the pain."

Which instruction would the nurse give a client who is to have an exercise electrocardiography test?

"Wear comfortable loose-fitting clothes and supportive, rubber-soled shoes."

How many cigarette pack-years has this client smoked: Smoked half a pack a day for 6 years?

3 pack-years

What would the nurse calculate the cardiac output to be when the client's heart rate is 68 beats/min and the stroke volume is 50 mL?

3400 L/min

Which statements about intravascular ultrasonography (IVUS) are accurate? (SATA) A. A flexible catheter with a miniature transducer is introduced at the distal tip to view the coronary arteries B. Injection of a contrast dye through a catheter permits viewing the coronary arteries C. The catheter has a transducer which emits sounds waves that reflect off the plaque and the arterial wall to create an image of the blood vessel D. The catheter is advanced through either the inferior or the superior vena cava and is guided by fluoroscopy E. IVUS can be used in vessels as small as 2mm to assess the nature of plaques or vessel condition following an intervention

A. C. E.

Which instructions would the nurse give the LVN/LPN monitoring a client after cardiac catheterization by radial artery approach? (SATA) A. Monitor the client's vital signs every 15 minutes for 1 hour B. Assess the insertion site for bloody drainage or hematoma C. Keep the client in bed for at least 6 hours D. Assess peripheral pulses and skin temperature and color with every vital sign check E. Monitor intake and output F. Provide oral fluids for adequate contrast excretion

A. B. D. E. F.

What is the lowest mean arterial pressure (MAP) necessary to perfuse the major organs of the body?

60 to 70 mm Hg

What is the client's pulse pressure when the nurse finds that his or her blood pressure is 148/86 mm Hg?

62 mm Hg

What is the correct technique for the nurse to use to check a client's lower extremities using the ankle-brachial index?

A blood pressure cuff is applied to the lower extremities and the systolic pressure is measured by Doppler ultrasound at both the dorsalis pedis and posterior tibial pulses

Which American Heart Association guidelines would the nurse teach a client to fight obesity and improve cardiovascular health? (SATA) A. Don't consume more calories than you can use in a day B. Consume foods that contain vitamins, minerals, and fiber C. Choose foods that are healthy and low in calories D. Avoid gas-producing vegetables such as cabbage or broccoli E. Eat vegetable, fruit, and whole-grain foods F. For calcium, choose whole milk dairy products

A. B. C. E.

Which techniques would the medical-surgical nurse use when inspecting a client's precordium? (SATA) A. Look at the chest from the side, at a right angle, and downward over areas of the precordium where vibrations are visible B. Note any movement over the aortic, pulmonic, and tricuspid areas C. Use percussion over the heart area to determine its size D. Observe for the location of the point of maximal impulse and note any shift E. Palpate the areas over the aortic, pulmonic, and tricuspid valves F. Listen to the heart sounds in a systemic order

A. B. D.

Which assessment data would the nurse expect for a client diagnosed with angina? (SATA) A. Pain relieved at rest B. Sudden onset of pain C. Intermittent pain relieved by sitting upright D. Substernal pain that may spread across chest, back, and arms E. Sharp, stabbing pain that is moderate to severe F. Pain that usually lasts less than 15 minutes

A. B. D. F.

Which cardiovascular assessment changes would the nurse expect in an older client? (SATA) A. Presence of murmurs B. Atrial dysrhythmias C. Fewer premature ventricular contractions D. Very short QT interval on ECG E. Increased dizziness F. Positive orthostatic blood pressure

A. B. E. F.

Which assessment factors for a 62 year old client would the nurse recognize as modifiable risk factors for heart disease? (SATA) A. History of smoking B. Age C. Obesity D. Ethnic background E. Sedentary lifestyle F. Gender

A. C. E.

Which mechanisms regulate and mediate blood pressure? (SATA) A. Kidneys B. Gastrointestinal system C. Autonomic nervous system D. Respiratory system E. Endocrine system F. Carbon dioxide elimination

A. C. E.

Which statements about the structure of the heart are accurate? (SATA) A. The heart normally pumps about 5 L of blood per minute. B. A muscular wall called the septum separates only the ventricles of the heart. C. The pericardium is a covering that protects the heart. D. The left ventricle pumps deoxygenated blood to the lungs. E. The right ventricle pumps blood into the aorta and systemic arterial system. F. Coronary artery blood flow occurs primarily during diastole.

A. C. F.

Which may be causes of a client's pericardial friction rub? (SATA) A. Myocardial infarction B. Pulmonary edema C. Cardiac tamponade D. Infection E. Inflammation F. Thoracotomy

A. C. D. E. F.

What action does the nurse plan to take prior to a cardiac catheterization when a client states he or she has an allergy to seafood and iodine-containing dyes?

Administer an antihistamine and/or a steroid before the test

What does the nurse suspect when assessing a client at risk for CVD who states, "My right foot turns very dark red when I sit too long and when I put my foot up, it turns pale"?

Arterial insufficiency

When the nurse assesses a client in the clinic for a physical examination and finds decreased skin temperature, what does this most likely indicate?

Arterial insufficiency

Which medications will the nurse expect the cardiologist to put on hold before an exercise stress test?

Atenolol and diltiazem

Which statements about blood pressure are accurate? (SATA) A. The right ventricle of the heart generates the greatest amount of blood pressure. B. Diastolic blood pressure is primarily determined by the amount of peripheral vasoconstriction. C. Systolic blood pressure is the amount of pressure or force generated by the left ventricle to distribute blood into the aorta with each contraction of the heart. D. Diastolic pressure is the highest pressure generated during contraction of the ventricles. E. To maintain adequate blood flow through the coronary arteries, mean arterial pressure (MAP) must be at least 90 mm Hg. F. Paradoxical blood pressure is an exaggerated decrease in systolic pressure by more than 10 mm Hg during the inspiratory phase of the respiratory cycle.

B. C. F.

Which triad of symptoms would the nurse assess for in a woman at risk for cardiovascular disease? (SATA) A. Severe chest pain B. Feeling of abdominal fullness C. Chronic fatigue despite adequate rest D. Extremity pain E. Dyspnea or inability to catch her breath F. Intermittent claudication

B. C. E.

Which questions would the nurse ask to assess a client's nicotine dependence? A. "What brand of cigarettes do you smoke?" B. "Do you smoke even when you are ill?" C. "How soon after you wake up in the morning do you smoke?" D. "What happened the last time you tried to quit smoking?" E. "Do you wake up in the middle of the night to smoke?" F. "Do you find it difficult to not smoke in places where smoking is prohibited?"

B. C. E. F.

Which action by an older adult are likely to cause the experience of syncope? (SATA) A. Walking briskly for 20 minutes B. Turning the head C. Laughing D. Performing a Valsalva maneuver E. Rapidly swallowing fluids F. Shrugging the shoulders

B. D. F.

Which questions would the nurse ask a client when a client is admitted reporting chest pain? (SATA) A. "How do you feel about the chest pain?" B. "How long does the pain last and how often does it occur?" C. "Where does the pain occur and what does it feel like?" D. "Have you had other symptoms that occur with the chest pain and what are they?" E. "What activities were you doing when the pain occurred?" F. "Is this episode of chest pain different from other episodes you have had?"

B. C. D. E. F.

Which client serum lipid tests suggest an increased risk for cardiovascular disease (CVD)? (SATA) A. HDL 65 mg/dL B. LDL 170 mg/dL C. Triglycerides 185 mg/dL D. Total cholesterol 175 mg/dL E. VLDL 39 mg/dL F. Total cholesterol 250 mg/dL

B. C. E. F.

Before administering which class of drugs would the nurse always check the client's heart rate?

Beta blockers

Which exercise regimen would the nurse teach an older adult is best to meet guidelines for physical fitness to promote heart health?

Brisk walk for 20 to 30 minutes each day

What is the nurse's best action when auscultating S1 for a client is difficult?

Have the client lean forward or roll to his or her left side

What is the priority problem when a nurse assesses a client with CVD and notes skin that is pale, cool, and moist?

Decreased perfusion

Which statement best defines the cardiovascular concept of preload?

Degree of myocardial fiber stretch at the end of diastole and just before the heart contracts

Which is the most common and normal response by a client to a cardiovascular illness?

Denial

Which parameter indicates to the nurse that a client's exercise ECG should be stopped?

ECG shows ST-segment depression

What is the nurse's first action when the health care provider prescribes orthostatic blood pressure checks for a client?

Measure the blood pressure after the client has been supine for 3 minutes

Which statement best describes the functional capability of a client who is categorized as New York Heart Association Class II?

Ordinary physical activity results in fatigue, palpitations, dyspnea, and anginal pain