Circulation Study Questions

Your client is being prepared for echocardiography when they ask you why they need to have this test. What would be your best response? a) "Echocardiography is a way of determining the functioning of the left ventricle of your heart." b) "Echocardiography will tell your doctor if you have cancer of the heart." c) "This test can tell us a lot about your heart." d) "This test will find any congenital heart defects."

a) "Echocardiography is a way of determining the functioning of the left ventricle of your heart."

A patient is brought to the ER complaining of fatigue, large amounts of bruising on the extremities, and abdominal pain localised in the left upper quadrant. A health history reveals the patient has been treated three times in the past 2 months for a sore throat. Lab tests indicate severe anaemia, significant neutropenia, and thrombocytopenia. Based on the symptoms, with what could the patient be diagnosed? a) Aplastic anaemia b) Haemolytic anaemia c) Iron deficiency anaemia d) Sickle cell anaemia

a) Aplastic anaemia

The nurse is relating the deficits in a patient's synchronization of the atrial and ventricular events to his diagnosis. What are the physiologic characteristics of the nodal and Purkinje cells that provide this synchronization? Select all that apply. a) Automaticity b) Excitability c) Independence d) Conductivity e) Loop connectivity

a) Automaticity b) Excitability d) Conductivity

A patient with sickle cell anemia is to begin treatment for the disease with hydroxyurea (Hydrea). What does the nurse inform the patient will be the benefits of treatment with this medication? (Select all that apply.) a) Decreased need for blood transfusions b) Decreased need for other analgesic medications c) Ability to reverse the damage done from sickling of cells d) Fewer painful episodes of sickle cell crisis e) Lower incidence of acute chest syndrome

a) Decreased need for blood transfusions d) Fewer painful episodes of sickle cell crisis e) Lower incidence of acute chest syndrome

The nurse is reviewing the medication administration record of a patient who takes a variety of medications for the treatment of hypertension. What potential therapeutic benefits of antihypertensives should the nurse identify? Select all that apply. a) Decreased strength and rate of myocardial contractions b) Increased venous return c) Decreased peripheral resistance d) Decreased blood volume e) Decreased blood viscosity

a) Decreased strength and rate of myocardial contractions c) Decreased peripheral resistance d) Decreased blood volume

Choose the statements that correctly match the hypertensive medication with its side effect. Select all that apply. a) Direct vasodilators may cause headache and tachycardia. b) With thiazide diuretics, monitor serum potassium levels. c) With adrenergic inhibitors, cough is a common side effect. d) With ACE inhibitors, assess for bradycardia. e) Beta-blockers may cause sedation

a) Direct vasodilators may cause headache and tachycardia. b) With thiazide diuretics, monitor serum potassium levels.

Age-related changes associated with the cardiac system include which of the following? Select all that apply. a) Endocardial fibrosis b) Increased size of the left atrium c) Increase in the number of SA node cells d) Myocardial thinning

a) Endocardial fibrosis b) Increased size of the left atrium

The thalassaemia's are a group of hereditary anaemias characterised by which of the following? Select all that apply. a) Extreme microcytosis b) Thrombocytopenia c) Anaemia d) Hypochromia e) Haemolysis

a) Extreme microcytosis c) Anaemia d) Hypochromia e) Haemolysis

The nurse is interviewing a client who is complaining of chest pain. Which of the following questions related to the client's history are most important to ask? Select all that apply. a) How would you describe your symptoms? b) Are you allergic to any medications or foods? c) Do you have any children? d) How did your mother die?

a) How would you describe your symptoms? b) Are you allergic to any medications or foods? d) How did your mother die?

Which of the following is accurate regarding the use of corticosteroids for immune haemolytic anaemia? Select all that apply. a) If the haemoglobin returns to normal, the corticosteroid dose can be lowered. b) Corticosteroids are not effective in the treatment of immune haemolytic anaemia. c) The treatment consists of low doses of corticosteroids. d) They decrease the macrophages ability to clear the antibody-coated RBCs. e) They produce lasting effects.

a) If the haemoglobin returns to normal, the corticosteroid dose can be lowered. d) They decrease the macrophages ability to clear the antibody-coated RBCs.

A 59-year-old client has just received a diagnosis of hypertension from his cardiologist after the completion of diagnostics. After discussing the diagnosis and its consequences with the physician, the client asks you questions regarding his condition. What can the client do to decrease the consequences of his hypertension? Select all that apply. a) Manage stress effectively. b) Use smokeless tobacco. c) Get plenty of rest. d) Lose weight.

a) Manage stress effectively. d) Lose weight.

The nurse is assessing a patient who is a strict vegetarian. What type of anemia is the nurse aware that this patient is at risk for? a) Megaloblastic anemia b) Aplastic anemia c) Iron deficiency anemia d) Sickle cell anemia

a) Megaloblastic anemia

A 55-year-old black male is found to have a blood pressure of 150/90 mm Hg during a work-site health screening. What should the nurse do? a) Recommend he have his blood pressure rechecked within 2 weeks. b) Recommend he see his physician immediately for further evaluation. c) Consider this to be a normal finding for his age and race. d) Recommend he have his blood pressure rechecked in 1 year.

a) Recommend he have his blood pressure rechecked within 2 weeks.

A client has hereditary haemochromatosis. Laboratory test results indicate an elevated serum iron level, high transferrin saturation, and normal complete blood count (CBC). It is most important for the nurse to a) Remove the prescribed one unit of blood. b) Educate about precautions to follow after a liver biopsy. c) Instruct the client to limit iron intake in the diet. d) Inform the client to limit ingestion of alcohol.

a) Remove the prescribed one unit of blood.

The nurse understands that an overall goal of hypertension management includes which of the following? a) There is no indication of target organ damage. b) There is no complaint of postural hypotension. c) The patient maintains a normal blood pressure reading. d) There are no complaints of sexual dysfunction.

a) There is no indication of target organ damage.

The nurse is teaching a patient about some of the health consequences of uncontrolled hypertension. What health problems should the nurse describe? Select all that apply. a) Transient ischemic attacks b) Cerebrovascular accident c) Venous insufficiency d) Right ventricular hypertrophy e) Retinal hemorrhage

a) Transient ischemic attacks b) Cerebrovascular accident e) Retinal hemorrhage

The nurse is caring for a patient with diabetes who is scheduled for a cardiac catheterization. Prior to the procedure, it is most important for the nurse to ask which of the following questions? a) "Are you having chest pain?" b) "Are you allergic to shellfish?" c) "What was your morning blood sugar reading?" d) "When was the last time you ate or drank?"

b) "Are you allergic to shellfish?"

A 1-minute ECG tracing of a patient with a regular heart rate reveals 25 small square boxes within an RR interval. The nurse correctly identifies the patient heart rate as which of the following? a) 80 bpm b) 60 bpm. c) 100 bpm d) 70 bpm

b) 60 bpm.

Which type of sickle crisis occurs as a result of infection with the human parvovirus? a) Acute chest syndrome b) Aplastic crisis c) Sequestration crisis d) Sickle crisis

b) Aplastic crisis

A patient with hypertension is waking up several times a night to urinate. The nurse knows that what laboratory studies may indicate pathologic changes in the kidneys due to the hypertension? (Select all that apply.) a) Complete blood count (CBC) b) Creatinine c) Urine for culture and sensitivity d) AST and ALT e) Blood urea nitrogen (BUN)

b) Creatinine e) Blood urea nitrogen (BUN)

A patient in hypertensive urgency is admitted to the hospital. The nurse should be aware of what goal of treatment for a patient in hypertensive urgency? a) Normalizing BP within 2 hours b) Normalizing BP within 24 to 48 hours c) Obtaining a BP of less than 120/80 mm Hg within 36 hours d) Obtaining a BP of less than 110/70 mm Hg within 36 hours

b) Normalizing BP within 24 to 48 hours

The nurse is caring for a client with long-standing hypertension. As a client advocate, which instruction is most helpful in preventing further complications? a) Focus on exercise at least twice a week. b) Obtain a regular appointment with eye doctor. c) Avoid use of caffeinated beverages. d) Maintain a healthy diet of fruits and vegetables.

b) Obtain a regular appointment with eye doctor.

The critical care nurse is caring for a patient just admitted in a hypertensive emergency. The nurse should anticipate the administration of what medication? a) Warfarin (Coumadin) b) Sodium nitroprusside (Nitropress) c) Furosemide (Lasix) d) Ramipril (Altace)

b) Sodium nitroprusside (Nitropress)

The nurse is seeing a client for the first time and has just checked the client's blood pressure. For what value would the nurse consider the client prehypertensive? a) Diastolic blood pressure is between 70 and 79 mm Hg. b) Systolic BP is between 120 and 130 mm Hg. c) Systolic BP is above 180 mm Hg. d) Diastolic blood pressure is at 100 mm Hg.

b) Systolic BP is between 120 and 130 mm Hg.

Which of the following tests used to diagnose heart disease is least invasive? a) Coronary arteriography b) Transthoracic echocardiography c) Magnetic resonance imaging d) Cardiac catheterization

b) Transthoracic echocardiography

The nurse is volunteering at a community blood pressure screening. A client, never diagnosed with hypertension, presents with a blood pressure of 158/90 mm Hg. Which assessment questions, asked by the nurse, are appropriate? Select all that apply. a) "Did you have a beer after work?" b) "Do you have a friend accompanying you?" c) "Have you recently drunk a caffeinated beverage?" d) "Do you smoke?" e) "Are you married and with children?"

c) "Have you recently drunk a caffeinated beverage?" d) "Do you smoke?"

A nurse is preparing a client for an exercise stress test the following morning. Which client statement indicates a need for additional teaching? a) "I won't smoke for 2 to 3 hours before the test." b) "I'll have to sign a consent form before the test." c) "I won't eat or drink anything after midnight tonight." d) "I'll likely be able to take my regular medications before the test."

c) "I won't eat or drink anything after midnight tonight."

The nurse is planning the care of a patient who has been diagnosed with hypertension, but who otherwise enjoys good health. When assessing the response to an antihypertensive drug regimen, what blood pressure would be the goal of treatment? a) 156/96 mm Hg or lower b) Average of 2 BP readings of 150/80 mm Hg c) 140/90 mm Hg or lower d) 120/80 mm Hg or lower

c) 140/90 mm Hg or lower

The following clients are in need of exercise electrocardiography. Which client would the nurse indicate as most appropriate for a drug-induced stress test? a) A 68-year-old housewife with history of osteoporosis b) A 72-year-old retired janitor obtaining a cardiac baseline c) A 55-year-old recovering from a fall and broken femur d) A 48-year-old policemen with history of knee replacement 4 years ago

c) A 55-year-old recovering from a fall and broken femur

A community health nurse teaching a group of adults about preventing and treating hypertension. The nurse should encourage these participants to collaborate with their primary care providers and regularly monitor which of the following? a) Heart rate b) Potassium levels c) Blood lipid levels d) Sodium levels

c) Blood lipid levels

A patient has been scheduled for cardiovascular computed tomography (CT) with contrast. To prepare the patient for this test, what action should the nurse perform? a) Keep the patient NPO for at least 6 hours prior to the test. b) Limit the patient's activity for 2 hours before the test. c) Establish peripheral IV access. d) Teach the patient to perform incentive spirometry.

c) Establish peripheral IV access.

A patient was admitted to the hospital with the following lab values: hemoglobin 5 g/dL, abnormally shaped erythrocytes, leukocyte count 2000/mm 3 with hypersegmented neutrophils and a platelet count of 48,000/mm 3. The platelets appear abnormally large. A bone marrow biopsy was competed and revealed hyperplasia. Based on this information, the nurse determines that patient most likely has which of the following diagnoses? a) Hemolytic anemia b) Thalassemia c) Folic acid deficiency d) Sickle cell anemia

c) Folic acid deficiency

A male client has a hemoglobin count of 10.2 gm/dl, a hematocrit value of 36%, and a low ferritin level. What question should the nurse ask first? a) How much alcohol do you drink? b) Are you taking iron supplements? c) Have you experienced abdominal pain? d) Can you explain your typical diet?

c) Have you experienced abdominal pain?

Which iron-rich foods should a nurse encourage an anemic client requiring iron therapy to eat? a) Lobster and squash b) Cheese and bananas c) Lamb and peaches d) Shrimp and tomatoes

c) Lamb and peaches

The nurse in an oncology clinic notes that the client being treated has hypertension. What tumor is a predisposing condition for secondary hypertension? a) Lymphoma b) Wilms' tumor c) Pheochromocytoma d) Astrocytoma

c) Pheochromocytoma

The most common cause of iron deficiency anaemia in men and postmenopausal women is a) menorrhagia. b) chronic alcoholism. c) bleeding. d) iron malabsorption

c) bleeding.

After teaching the patient about taking daily oral iron preparations for a moderate iron deficiency anemia, which statement made by the patient indicates to the nurse that additional instruction is still needed? a) "I will increase my fluid and fiber intake while I am taking the iron tablets." b) "I will occasionally take a stool softener if I feel constipated." c) "I will take the iron with orange juice about an hour before eating." d) "I will call the doctor if my stools turn black."

d) "I will call the doctor if my stools turn black."

The nurse is caring for a female client who has had 25 mg of oral hydrochlorothiazide added to her medication regimen for the treatment of hypertension (HTN). Which of the following instructions should the nurse give the patient? a) "You may develop dry mouth or nasal congestion while on this medication." b) "Take this medication before going to bed." c) "You may drink alcohol while taking this medication." d) "Increase the amount of fruits and vegetables you eat."

d) "Increase the amount of fruits and vegetables you eat."

A 55-year-old man newly diagnosed with hypertension returns to his physician's office for a routine follow-up appointment after several months of treatment with Lopressor (metoprolol). During the nurse's initial assessment the patient's blood pressure (BP) is recorded as 180/90 mm Hg. The patient states he does not take his medication as prescribed. The best response by the nurse is which of the following? a) "Your hypertension must be treated with medications; you need to take your Lopressor every day." b) "Be certain to discuss your noncompliance with your medication regimen with the physician." c) "It is very important for you to take your medication as prescribed, or you could experience a stroke." d) "The medication you were prescribed may cause sexual dysfunction; are you experiencing this side effect?"

d) "The medication you were prescribed may cause sexual dysfunction; are you experiencing this side effect?"

The nurse accompanies a client to an exercise stress test. The client can achieve the "target heart rate," but the ECG leads show an ST-segment elevation. The nurse recognizes this as a "positive" stress test, and will begin to prepare the client for which of the following procedures? a) Pharmacologic stress test b) Transesophageal echocardiogram c) Telemetry monitoring d) Cardiac catheterization

d) Cardiac catheterization

The nurse is assessing the client newly prescribed Lasix 20mg daily for 3+ pitting edema. To evaluate the effectiveness of diuretic therapy, which of the following would be documented? a) Urine output b) Weight c) Blood pressure d) Edema

d) Edema

A patient arrives at the clinic for a follow-up visit for treatment of hypertension. The nurse obtains a blood pressure reading of 180/110 but finds no evidence of impending or progressive organ damage when performing the assessment on the patient. What situation does the nurse understand this patient is experiencing? a) Secondary hypertension b) Primary hypertension c) Hypertensive emergency d) Hypertensive urgency

d) Hypertensive urgency

A nurse is preparing to assess a patient for postural BP changes. Which of the following indicates the need for further education? a) Taking the patient's BP with the patient sitting on the edge of the bed with feet dangling b) Obtaining the supine measurements prior to the sitting and standing measurements c) Positioning the patient supine for 10 minutes prior to taking the initial BP and HR d) Letting 30 seconds elapse after each position change before measuring BP and heart rate (HR)

d) Letting 30 seconds elapse after each position change before measuring BP and heart rate (HR)

The hospital nurse cares for many patients who have hypertension. What nursing diagnosis is most common among patients who are being treated for this health problem? a) Noncompliance with treatment regimen related to medication costs b) Deficient knowledge regarding BP monitoring c) Deficient knowledge regarding the lifestyle modifications for management of hypertension d) Noncompliance with therapeutic regimen related to adverse effects of prescribed therapy

d) Noncompliance with therapeutic regimen related to adverse effects of prescribed therapy

A 28-year-old female patient presents to the emergency department (ED) stating severe restlessness and anxiety. Upon assessment, the patient's heart rate is 118 bpm and regular, the patient's pupils are dilated, and the patient appears excitable. Which action should the nurse take next? a) Prepare to administer a calcium channel blocker. b) Place the patient on supplemental oxygen. c) Instruct the patient to hold her breath and bear down. d) Question the patient about alcohol and illicit drug use.

d) Question the patient about alcohol and illicit drug use.

A critical care nurse is caring for a patient with autoimmune haemolytic anaemia. The patient is not responding to conservative treatments, and his condition is now becoming life threatening. The nurse is aware that a treatment option in this case may include what? a) Hepatectomy b) Platelet transfusion c) Vitamin K administration d) Splenectomy

d) Splenectomy

A patient with sickle cell disease comes to the emergency department complaining of severe pain in the back, right hip, and right arm. What intervention is important for the nurse to provide? a) Administer ibuprofen b) Administer aspirin c) Begin oxygen at 2 L/M d) Start an intravenous line with dextrose 5% in 0.25 normal saline

d) Start an intravenous line with dextrose 5% in 0.25 normal saline

The nurse caring for a patient whose sudden onset of sinus bradycardia is not responding adequately to atropine. What might be the treatment of choice for this patient? a) Implanted pacemaker b) Asynchronous defibrillator c) ICD d) Trancutaneous pacemaker

d) Trancutaneous pacemaker

The nurse is auscultating a client's heart sounds and notes a murmur at the left fourth intercostal space and lateral to the sternum. At which cardiac valve would the nurse document this murmur? a) Mitral valve b) Pulmonic valve c) Aortic valve d) Tricuspid valve

d) Tricuspid valve

The couple with the lowest risk of having a child with sickle cell anemia disease is the one in which the: a) father is HbS and the mother is HbAS. b) father is HbS and the mother is HbS. c) father is HbAS and the mother is HbAS. d) father is HbA and the mother is HbS.

d) father is HbA and the mother is HbS.