Chapter 17 -The cardiovascular system

The nurse is assessing a female patient with a family history of coronary artery disease (CAD). Which report is most concerning to the nurse? a. "I get a little short of breath after climbing the three flights of stairs to my apartment." b. "I stay tired all of the time, and it feels like my bra is too tight." c. "I awaken frequently in the night, and my husband says that I snore." d. "I notice wheezing after I dust or when I exercise."

"I stay tired all of the time, and it feels like my bra is too tight."

Which preventative measure(s) may protect against development of cardiovascular disease? (Select all that apply.) a. Exercising regularly for at least 30 minutes a day b. Maintaining high-density lipoprotein (HDL) greater than 50 mg/dL c. Refraining from smoking d. Obtaining and maintaining a healthy weight e. Maintaining triglycerides above 150 mg/dL

A. Exercising regularly for at least 30 minutes a day B. Maintaining high-density lipoprotein (HDL) greater than 50 mg/dL C. Refraining from smoking D. Obtaining and maintaining a healthy weight

Which factors may affect the volume of cardiac output? (Select all that apply.) a. Heart rate b. Peripheral pulses c. Preload d. Contraction strength e. Afterload

A. Heart rate C. Preload D. Contraction strength E. Afterload

The nurse is outlining a teaching program for diabetic patients. Which teaching point about heart disease prevention should the nurse emphasize most? a. Keep blood sugar below 100 mg/dL. b. Prevent infections. c. Eat meals at regular times. d. Use sterile technique in insulin injections

A. Keep blood sugar below 100 mg/dL

The nurse is caring for an older adult patient. While auscultating the patient's apical pulse, the nurse notices an irregular rhythm. The nurse suspects which causative factor for the patient's dysrhythmia? a. Loss of cells in the sinoatrial (SA) nodes b. Increased peripheral resistance c. Hypertension d. Atherosclerosis

A. Loss of cells in the sinoatrial (SA) nodes

Which layer of the heart contains muscle fibers that contract to pump blood? a. Myocardium b. Endocardium c. Epicardium d. Pericardium

A. Myocardium

Which modifiable risk factors increase a patient's risk for heart disease? (Select all that apply.) a. Smoking b. Race c. Obesity d. Sedentary lifestyle e. Age

A. Smoking C. Obesity D. Sedentary lifestyle

The patient asks if it is harmful for him to drink a glass of wine with dinner on a daily basis. Which is the nurse's best response? a. "As long as it is okay with your physician, moderate alcohol intake can be beneficial to your cardiovascular health." b. "Drinking wine on a daily basis may lead to you having issues with increased blood pressure." c. "You may want to be careful because drinking wine with dinner may stimulate your appetite significantly." d. "This practice may cause your triglyceride level to rise, so I would discourage it."

A."As long as it is okay with your physician, moderate alcohol intake can be beneficial to your cardiovascular health."

The nurse is caring for a patient with a history of hypertension. Which information is most important for the nurse to obtain? a. "Do you take a daily multivitamin?" b. "Do you use over-the-counter decongestants or diet pills?" c. "How often do you use laxatives?" d. "How often do you use antacids?"

B. "Do you use over-the-counter decongestants or diet pills?"

The nurse is caring for a patient with a blood pressure of 140/90, an apical pulse of 82, and a radial pulse of 76. Which value indicates that the nurse accurately calculated the patient's pulse pressure? a. 6 b. 50 c. 82 d. 90

B. 50

Which disorder(s) is/are examples of congenital heart defects? (Select all that apply.) a. Arteriosclerosis b. Coarctation of the aorta c. Septal defects d. Valvular defects e. Atherosclerosis

B. Coarctation of the aorta C. Septal defects D. Valvular defects

In a blood pressure of 120/80, what does the "80" indicate? a. Pulse pressure b. Pressure in the relaxed ventricles . c. Relative ejection factor d. Stroke volume

B. Pressure in the relaxed ventricles

The nurse is caring for a 50-year-old patient who complains of tingling in his toes. Which other assessment finding would cause the nurse to suspect arterial insufficiency? a. Equal warmth in bilateral feet b. Shiny, hairless legs c. Thin, brittle toenails d. Pedal edema

B. Shiny, hairless legs

While performing a focused cardiac assessment, the nurse auscultates an abnormal swooshing sound. Which action is most appropriate to clarify the nurse's finding? a. The nurse uses the diaphragm of the stethoscope while asking the patient to take a deep breath. b. The nurse uses the bell of the stethoscope while asking the patient to lean forward. c. The nurse asks the patient about a history of heart stents. d. The nurse asks the patient about a history of cardiac dysrhythmias

B. The nurse uses the bell of the stethoscope while asking the patient to lean forward

Which statement accurately describes the purpose of a Doppler flow study? a. To detect a clot in a coronary artery b. To visualize obstructions in leg vessels c. To assess efficiency of blood flow through heart chambers d. To detect a defective heart valve

B. To visualize obstructions in leg vessels

The nurse is caring for a patient on lisinopril (Zestril). The patient asks how this medication affects blood pressure. Which response best explains the medication's effects? a. "This medication blocks epinephrine and lowers the heart rate, which impacts blood pressure." b. "This medication stimulates the release of sodium and water to be excreted." c. "This medication lowers blood pressure by blocking an enzyme that causes blood vessels to constrict." d. "This medication decreases cardiac output."

C. "This medication lowers blood pressure by blocking an enzyme that causes blood vessels to constrict."

When using a 0 to 4+ scale to grade pulse quality, how should the nurse record a normal volume pulse? a. 1+ b. 2+ c. 3+ d. 4+

C. 3+

The 65-year-old patient complains of leg pain that disappears at rest after having walked a short distance. The nurse recognizes that the patient's symptoms are consistent with which problem? a. Muscle spasm b. Deep venous thrombosis c. Claudication d. Angiospasm

C. Claudication

The 85-year-old patient with a newly diagnosed heart murmur expresses concern that he has never been notified of this finding before. What is the most likely cause of this patient's heart murmur? a. Hypertension b. Atherosclerosis c. Insufficient valves d. Weakened pacemaker

C. Insufficient valves

The nurse is caring for a patient who just returned from a transradial heart catheterization. Which action indicates the priority care for the postprocedure period? a. The nurse encourages the patient to increase fluid intake. b. The nurse checks the presence and strength of pedal pulses. c. The nurse places the pulse oximeter on the thumb or first digit of the affected hand. d. The nurse places the blood pressure cuff on the arm corresponding to the affected hand.

C. The nurse places the pulse oximeter on the thumb or first digit of the affected hand

The nurse is caring for a patient who is scheduled to undergo a stress echocardiogram. Which statement indicates that the nurse's teaching about preparation for the test has been successful? a. "I should eat a full meal to give me energy to walk on the treadmill." b. "I will avoid smoking for fours before the test." c. "I will have to move extremely quickly from the treadmill to the table." d. "I should wear comfortable house shoes during the test."

C."I will have to move extremely quickly from the treadmill to the table."

The nurse is teaching a patient about the purpose of his telemetry. Which statement indicates that the nurse's teaching has been successful? a. "I will need to stay in bed when the monitor is reading my heart waves." b. "This test will help determine if I have a blockage in my arteries." c. "If there is a problem with my heart valves, it will show up with telemetry." d. "The nurses will be able to monitor my heart rate and rhythm."

D. "The nurses will be able to monitor my heart rate and rhythm."

The nurse is educating a female patient with a family history of coronary artery disease (CAD) about risk factors and prevention of heart disease in women. Which information is most important for the nurse to include? a. Women should maintain a body mass index (BMI) of less than 28. b. Women should utilize estrogen supplementation to decrease risk of heart disease. c. Women should drink one alcoholic beverage daily. d. Women should incorporate stress reduction techniques into their daily lifestyle

D. Women should incorporate stress reduction techniques into their daily lifestyle.

_________ is the acute symptom most experienced by African Americans when having a myocardial infarction (MI).

dyspnea

The nurse who uses a regular sized adult blood pressure cuff on a large adult will get a blood pressure reading that is falsely __________.

elevated high

The nurse assessing the heart places the stethoscope between the fifth and sixth ribs at the mid-clavicular line to hear the point of _________.

maximal impulse

When the nurse uses the PQRST tool for pain assessment, the "R" prompts an inquiry about the __________ of the pain.

radiation