25-28
An older adult client is prescribed a vasodilator for hypertension. Which adverse effect is of greatest concern for an older adult taking this class of drug? Hypotension Dry mouth Constipation Restlessness
Hypotension
Nitroglycerin is the drug of choice in treating angina. What does nitroglycerin release into the vascular smooth muscle of the target tissues? Nitric oxide Calcium channel blocker Platelet-aggregating factor Antithrombin factor
Nitric oxide
A nurse is caring for a client with an average heart rate of 56 beats/min. The client has no adverse symptoms associated with this heart rate and is receiving no treatment. Which activity modification should the nurse suggest to avoid further slowing of the heart rate? "Avoid bearing down while having a bowel movement." "Avoid strenuous aerobic exercise." "Avoid stress or overexcitement." "Limit your intake of caffeinated drinks."
"Avoid bearing down while having a bowel movement."
A client has been diagnosed with chronic obstructive arterial disease. Which client statement indicates she understands how to manage this disease? "I don't need to monitor my blood pressure." "I should stay in bed with my legs elevated." "I should have my LDL monitored." "Diabetes mellitus has no effect on my condition."
"I should have my LDL monitored."
When explaining a new diagnosis of complete heart block to a client and family, the nurse should include which statement? "This means that your atria are not contracting normally; they are quivering." "One consequence of this type of block is a very slow heart rate that limits circulation to the brain." "This type of dysrhythmia requires defibrillation, which will occur in the cardiac catheter lab later today." "It's pretty common for everyone to experience this dysrhythmia, especially during times of stress in their lives."
"One consequence of this type of block is a very slow heart rate that limits circulation to the brain."
A nurse educator is teaching a group of nurses at a long-term care facility about atrial fibrillation in light of its prevalence in older adults. Which statement by the nurses would the educator most want to correct? "An ECG of someone in atrial fibrillation would be almost random in appearance." "The contraction of the ventricles and the atria can range from 400-600 beats per minute." "The electrical impulses go in chaotic directions and so the atria can't contract properly." "It can be hard to measure at the bedside because not all ventricular beats make a palpable pulse."
"The contraction of the ventricles and the atria can range from 400-600 beats per minute."
A client in the nursing home wonders why he is having these signs and symptoms of left-sided heart failure. Which explanation will the nurse give the client? "The left ventricle is not adequately perfusing your gastrointestinal tract, leading to diarrhea and vomiting." "The left ventricle is having problems pumping blood forward, and this is causing blood to back up into your lungs." "The left ventricle is pumping excessive amounts of blood through the carotid arteries causing headache." "The left ventricle is having problems pumping blood forward, so blood is backing up systemically causing edema in your feet."
"The left ventricle is having problems pumping blood forward, and this is causing blood to back up into your lungs."
A young nurse working on a cardiac floor who is working with a nursing student informs the student that there are numerous ways to evaluate coronary blood flow. Which does she identify as the most frequently used cardiovascular diagnostic procedure? 12-lead ECG Cardiac CT Stress test Cardiac catherization
12-lead ECG
The nurse knows that systolic hypertension is characterized by systolic pressure of ____mm Hg or higher.
140
In hypovolemic shock, renal perfusion and urinary output decline. The nurse will monitor urinary output and knows that output below which level indicates inadequate renal perfusion? 60—40 mL/hour 40—20 mL/hour 20 mL/hour 80—60 mL/hour
20 mL/hour
During an acute MI, there is ischemic damage to the heart muscle. The location and extent of the ischemic damage is the major predictor of complications, ranging from cardiac insufficiency to death, following an MI. What is the "window of opportunity" in restoring blood flow to the affected area so as to diminish the ischemic damage to the heart and maintain the viability of the cells? 10 to 30 minutes 10 to 20 minutes 20 to 40 minutes 30 to 40 minutes
20 to 40 minutes
The semilunar valves of the heart open at the onset of the ejection period. Approximately what percentage of the stroke volume is ejected during the first quarter of systole? 50% 40% 60% 70%
60%
Which of the following factors affect cardiac performance? Select all that apply. Myocardial contractility Preload Heart rhythm Afterload
Preload Afterload Myocardial contractility
Because of its location, the presence of an abdominal aortic aneurysm may first be identified by which clinical manifestation? Indigestion A pulsating mass Midabdominal pain Constipation
A pulsating mass
The client tells the provider he has lower back pain. Although most abdominal aneurysms are asymptomatic, the provider examines the client for which initial sign of this condition? The pulse is unobtainable in one or both arms A pulsating mass in the abdomen Hemiplegia Syncope
A pulsating mass in the abdomen
ST-elevated myocardial infarction (STEMI) is accompanied by severe, crushing pain. Morphine is the drug of choice used to treat the pain of STEMI when the pain cannot be relieved with oxygen and nitrates. Why is morphine considered the drug of choice in STEMI? Action increases autonomic nervous system activity. Action relieves pain and gives sense of depression. Action increases anxiety, in turn increasing metabolic demands of the heart. Action decreases metabolic demands of the heart.
Action decreases metabolic demands of the heart.
When trying to educate a client about the release of free radicals and the role they play in formation of atherosclerosis, which statement is most accurate? Activated cells that release free radicals oxidize LDL, which is harmful to the lining of your blood vessels. Activated cells roam the vascular system looking for inflammatory cells to engulf. The end result of oxidation is rupture of the plaque, resulting in hemorrhage. Oxidized free radicals produce toxic metabolic waste that can kill liver cells.
Activated cells that release free radicals oxidize LDL, which is harmful to the lining of your blood vessels.
A client is rushed to the emergency department with assessment findings of urticaria, wheezing, chest tightness, and difficulty breathing. The client is most likely experiencing which type of shock? Septic Neurogenic Anaphylactic Cardiogenic
Anaphylactic
The nurse is developing a plan of care for a postsurgical client. A major goal is to prevent the formation of prevent deep vein thrombosis (DVT). The most important intervention for the nurse to implement would be: Apply ice compresses to the site of the DVT hourly. Massage legs to maintain blood flow. Apply sequential pneumatic compression devices to lower extremities. Ensure that the client remains on bed rest.
Apply sequential pneumatic compression devices to lower extremities.
The nurse recognizes that there are many factors that influence blood flow within the systemic circulation. In the circulatory system, which of the following are called resistance vessels? Arterioles Capillaries Venules Aorta
Arterioles
Following several weeks of increasing fatigue and a subsequent diagnostic workup, a client has been diagnosed with mitral valve regurgitation. Failure of this heart valve would have which hemodynamic consequences? Backflow from the left ventricle to left atrium Inhibition of the SA node's normal action potential Backflow from the right ventricle to the right atrium during systole Backup of blood from the right atrium into the superior vena cava
Backflow from the left ventricle to left atrium
Which cardiac drug classification decreases sympathetic outflow to the heart and is the is the cornerstone of therapy for catecholaminergic polymorphic ventricular tachycardia (CPVT)? Potassium blockers Sodium channel blockers Calcium channel blockers Beta-adrenergic blockers
Beta-adrenergic blockers
A pregnant female client is at risk for the development of preeclampsia-eclampsia. Select the most important data to assess. Blood pressure 130/88 and hyperglycemia occurring during the 22nd week of pregnancy Blood pressure 160/100 mm Hg and proteinuria during the 30th week of pregnancy Blood pressure 90/60 and proteinuria in the second trimester Blood pressure 140/90 and glucose in the urine during the 36th week of pregnancy
Blood pressure 160/100 mm Hg and proteinuria during the 30th week of pregnancy
Which blood vessels function without the benefit of having walls comprised of three muscular layers? Arteries Arterioles Veins Capillaries
Capillaries
Select the correct sequence of blood return to the heart. Capillaries, arterioles, veins, left atrium Capillaries, venules, veins, left atrium Capillaries, arterioles, arteries, right atrium Capillaries, venules, veins, right atrium
Capillaries, venules, veins, right atrium
The ability in the heart to increase output as needs of the body change depends on which physiologic factors? Select all that apply. Cardiac reserve Heart rate Afterload Preload Cardiac contractility
Cardiac contractility Heart rate Preload Afterload
The distensibility of the blood vessel is the major factor in which of the vessel's characteristics? Compliance Wall tension Resistance Laminar blood flow SUBMIT ANSWER
Compliance
A client has been admitted after being resuscitated from a cardiac arrest. The client is prescribed Class I for electrocardiogram monitoring. What type of monitoring will the nurse perform for this client? Continuous cardiac monitoring No monitoring is indicated Monitoring only with chest pain Intermittent cardiac monitoring
Continuous cardiac monitoring
A client has been admitted after being resuscitated from a cardiac arrest. The client is prescribed Class I for electrocardiogram monitoring. What type of monitoring will the nurse perform for this client? Intermittent cardiac monitoring Continuous cardiac monitoring No monitoring is indicated Monitoring only with chest pain
Continuous cardiac monitoring
The heart valves control the direction of blood flow. What is the function of the pulmonic valve? Controls the direction of blood flow from the right side of the heart to the lungs Controls the direction of blood flow from the left side of the heart to the systemic circulation Controls the direction of blood flow from the right side of the heart to the systemic circulation Controls the direction of blood flow from the left side of the heart to the lungs
Controls the direction of blood flow from the right side of the heart to the lungs
A nurse is monitoring a client with a consistent and regular heart rate of 128 beats/min. Which physiologic alteration would be consistent with this finding? Increase in respiratory rate and temperature Increase in ventricular filling time and decrease in cardiac output Decrease in ventricular filling time and blood pressure Decrease in blood pressure and increase in cardiac output
Decrease in ventricular filling time and blood pressure
A client has been prescribed a thiazide diuretic, hydrochlorothiazide (HCTZ), for the initial treatment of hypertension. What effect does the nurse know this drug will have on the body to consequently decrease blood pressure? Decrease heart rate Decrease vascular volume Increase vasoconstriction Decrease renin release
Decrease vascular volume
Angina pectoris is a chronic ischemic CAD that is characterized by a symptomatic paroxysmal chest pain or pressure sensation associated with transient myocardial ischemia. What precipitates an attack of angina pectoris? Sedentary lifestyle Exposure to heat Abrupt change in position Emotional stress
Emotional stress
An older adult client's blood pressure (BP) is 120/80 mm Hg when in a lying position. When the nurse retakes the client's BP in a sitting position, the BP is 92/60 mm Hg. Which intervention is appropriate for the nurse to implement? Administering oxygen as prescribed Contacting the health care provider immediately Keeping the client in a supine position throughout the day Encouraging the client to maintain hydration throughout the day
Encouraging the client to maintain hydration throughout the day
The school nurse is doing a health class on the functional organization of the circulatory system. What is the function of the capillaries in the circulatory system? Distribute oxygenated blood to the tissues Exchange gases, nutrients, and wastes Pump blood Collect deoxygenated blood from the tissues
Exchange gases, nutrients, and wastes
What should the nurse teach the client with peripheral vascular disease and intermittent claudication about exercise? Exercise is not recommended in this population. Clients with intermittent claudication should exercise only their arms. Exercise can increase blood vessel growth and help to decrease symptoms. Aerobic exercise is not recommended but isometric exercise is.
Exercise can increase blood vessel growth and help to decrease symptoms.
The nursing instructor is teaching about cardiomyopathies in class. Which type does she tell the students is the most common cause occurring in young athletes? Acquired Does not usually occur in young athletes Mixed Genetic
Genetic
A client with malignant hypertension is at risk for a hypertensive crisis, including the cerebral vascular system often causing cerebral edema. The nurse would assess this client for which signs and symptoms? Restlessness and nervousness Papilledema and lethargy Headache and confusion Stupor and hyperreflexia
Headache and confusion
Release of which humoral factors will result in vasodilation? Norepinephrine Histamine Angiotensin II Serotonin
Histamine
The nurse knows that which statement regarding heart failure is most accurate? The most common cause of left-sided failure is right-sided failure. Low-output failure is caused by excessive metabolic demands. In compensated failure, an increase in preload causes an increase in ventricular contractility. Right-sided failure is often the result of increased afterload due to hypertension.
In compensated failure, an increase in preload causes an increase in ventricular contractility.
When will the nurse plan to assess a client's blood pressure to confirm the possible diagnosis of orthostatic hypotension? In the evening just before sleep Within a half-hour after the heaviest meal of the day In the morning before arising from bed Midmorning right after taking a short walk
In the morning before arising from bed
A nursing instructor is explaining arterial circulation to a group of nursing students. What is the most appropriate information for the nurse to provide concerning arterial pressure gradient in the arterial side of systemic circulation? Arteries are more distensible than veins. It contains one-sixth of the total blood volume. The vascular pressure is lower than the venous circulation. It contains approximately two-thirds of the total blood volume.
It contains one-sixth of the total blood volume.
Which of the following is true regarding pulmonary circulation? It is a low-pressure system that allows for improved gas exchange. It consists of the left side of the heart, the aorta, and its branches. It is the larger of the two circulatory systems. The system functions with an increased arterial pressure to circulate through the distal parts of the body.
It is a low-pressure system that allows for improved gas exchange.
A client is scheduled to have a Holter monitor for 48 hours to detect disturbances in conduction. Which action is important for the nurse to tell the client to ensure accuracy in correlating dysrhythmias with symptoms? It is important to keep a diary of activities and symptoms. The client may feel a pins and needles sensation while the monitor is connected. If the monitor detects a lethal dysrhythmia, it will defibrillate to correct the dysrhythmia. The client must limit activity while the Holter monitor is in place.
It is important to keep a diary of activities and symptoms.
The nurse is counseling a client regarding a high cholesterol level. The nurse teaches the client that which lipoprotein is the main carrier of cholesterol? HDL VLDL LDL IDL
LDL
The physician states that a client has adequate collateral circulation. The nurse interprets this as: Establishment of compensatory lymphatic drainage Long-term compensatory regulation of blood flow Development of increased collagen Anastomosis of the arterial and venous circulation
Long-term compensatory regulation of blood flow
Which description sums up the basic pathophysiology of heart failure that the nurse would include when educating a client? Low cardiac output due to reduced pumping ability Myocardial remodeling of scar tissue Activated sympathetic (adrenergic) reflexes Reduced tissue perfusion, especially to the kidney
Low cardiac output due to reduced pumping ability
A nurse is assessing a female client and notes that her left arm is swollen from the shoulder down to the fingers, with non-pitting edema. The right arm is normal. The client had a left-sided mastectomy 1 year ago. What does the nurse suspect is the problem? Arteriosclerosis Venous stasis Deep vein thrombosis Lymphedema
Lymphedema
Which related circulatory complication can result from surgical treatment for metastatic breast cancer? Tachycardia when at rest Hypotension upon standing Irregular heart rate Lymphedema in the affected arm
Lymphedema in the affected arm
A nurse is providing care for a number of older clients on a restorative care unit of a hospital. Many of the clients have diagnoses or histories of hypertension and the nurse is responsible for administering a number of medications relevant to blood pressure control. Which assessment would the nurse be most justified in eliminating during a busy morning on the unit? Noting the sodium and potassium levels of a client who is receiving a diuretic. Measuring the pulse of a client taking an ACE inhibitor. Measuring the heart rate of a client who takes a β-adrenergic blocker. Checking the recent potassium levels of a client receiving an ACE inhibitor.
Measuring the pulse of a client taking an ACE inhibitor.
A client who developed a deep vein thrombosis during a prolonged period of bed rest has deteriorated as the clot has dislodged, resulting in a pulmonary embolism. Which type of shock is this client at risk of experiencing? Distributive shock Obstructive shock Hypovolemic shock Cardiogenic shock
Obstructive shock
A client with a long history of stable angina suddenly experiences substernal pain that radiates to the left arm, neck, and jaw. He describes the pain as severe and feels as if he is suffocating. He has taken nitroglycerin and not experienced any relief. The client is most likely experiencing: Onset of STEMI Pneumonia Acute respiratory distress syndrome (ARDS) Gastroesophageal reflux disease (GERD)
Onset of STEMI
The older adult client tells the health care provider about experiencing dizziness when changing from a lying to a sitting position. The provider will document which condition in the medical record? Systolic hypertension Decrease in peripheral vascular resistance Orthostatic hypotension Increased responsiveness to catecholamines
Orthostatic hypotension
A client experiencing a sinus arrest would demonstrate which symptom or finding? Heart rate of greater than 100 beats/min Prolonged periods of asystole demonstrated on an electrocardiogram Spontaneous persistent sinus bradycardia P-wave that occurs more frequently than expected
Prolonged periods of asystole demonstrated on an electrocardiogram
A client experiencing a sinus arrest would demonstrate which symptom or finding? Spontaneous persistent sinus bradycardia P-wave that occurs more frequently than expected Prolonged periods of asystole demonstrated on an electrocardiogram Heart rate of greater than 100 beats/min
Prolonged periods of asystole demonstrated on an electrocardiogram
The nurse knows that vasopressin (antidiuretic hormone, ADH) plays which role in blood pressure control? Promotes retention of water Increases osmolality of body fluids Produces prolonged increase in blood pressure Decreases blood volume SUBMIT ANSWER
Promotes retention of water
A group of nursing students is preparing for their final exams and are discussing cardiac dysrhythmias. One of the students states that severe tachyarrhythmias would cause an increase in blood pressure. The group helps the student to understand that the opposite would more than likely occur because of: Reduced diastolic pressures Reduced systolic filling time Increased systolic filling time Reduced diastolic filling time SUBMIT ANSWER
Reduced diastolic filling time
A client is prescribed an angiotensin-converting enzyme (ACE) inhibitor for hypertension. The nurse knows that ACE inhibitors are contraindicated by which clinical condition? Diabetes Renal artery stenosis Coronary artery disease Heart failure
Renal artery stenosis
The electrical activity of the heart is recorded on the ECG. What does the T wave on the ECG represent? Repolarization of the atrium Depolarization of the sinoatrial node Depolarization of the ventricular conduction system Repolarization of the ventricles
Repolarization of the ventricles
A client has had an acute myocardial infarction (MI). The brother of the client has a history of angina. The client asks how he will know if his brother's pain is angina or if the brother is actually having an MI. Which statement is correct? Rest and intake of nitroglycerin relieve chest pain with angina; they do not relieve chest pain with an MI. Pain is more severe and lasts longer with angina than with an MI. Chest pain with angina only occurs at rest; MI pain occurs during a stressful time. Chest pain with angina only occurs during the day; MI pain is more likely at night.
Rest and intake of nitroglycerin relieve chest pain with angina; they do not relieve chest pain with an MI.
A teenager is seen in the emergency room with reports of a sore throat, headache, fever, abdominal pain, and swollen glands. His mother tells the nurse that he was seen 3 weeks before in the clinic and treated with antibiotics for strep throat. He was better for a few days but now he seems to have gotten worse in the last 2 days. What should the nurse suspect is wrong with this client? Meningitis Flu Mononucleosis Rheumatic fever
Rheumatic fever
What is the correct sequence for the generation of electrical impulses in the heart causing ventricular contraction? SA node - AV node - bundle of His - bundle branches - Purkinje fibers SA node - AV node - bundle branches - Purkinje fibers - bundle of His AV node - bundle of HIS - bundle branches - SA node - Purkinje fibers AV node - SA node - bundle of His - bundle branches - Purkinje fibers
SA node - AV node - bundle of His - bundle branches - Purkinje fibers
A nurse preparing education on managing the risk factors for coronary artery disease (CAD) will stress which information? Select all that apply. Importance of exercise on managing hypertension Smoking cessation techniques Identification of high cholesterol foods Stress management techniques Signs and symptoms of type 2 diabetes mellitus
Smoking cessation techniques Identification of high cholesterol foods Importance of exercise on managing hypertension Signs and symptoms of type 2 diabetes mellitus
The difference between the end-diastolic and end-systolic volumes is called what? Ejection fraction Cardiac reserve Cardiac output Stroke volume
Stroke volume
What is the primary cause of heart failure in infants and children? Idiopathic heart disease Reactions to medications Structural heart defects Hyperkalemia
Structural heart defects
The smooth muscle cells produce vasoconstriction of blood vessels due to innervation by which part of the nervous system? Sympathetic Peripheral Parasympathetic Central
Sympathetic
Which client is at the greatest risk of developing rheumatic heart disease? Child with impetigo on the face Older adult with shingles Teenager with untreated strep throat Young adult with viral meningitis
Teenager with untreated strep throat
A client diagnosed with giant cell arteritis will likely experience pain located in which region of the head? Ophthalmic Carotid Vertebral Temporal
Temporal
The nurse is reviewing the circulatory system. Which statements are correct about the functional organization of the circulatory system? Select all that apply. The arterial system distributes oxygenated blood to the tissues. The capillaries pump blood. The venous system collects deoxygenated blood from the tissues. The heart exchanges gases, nutrients, and wastes.
The arterial system distributes oxygenated blood to the tissues. The venous system collects deoxygenated blood from the tissues.
During an assessment of a client with ankle swelling, the nurse observes jugular venous pulsations 5 cm above the sternal angle when the head of his bed is elevated 45 degrees. What is the correct interpretation of this finding? The client has increased pressure related to right-sided heart failure. The client has decreased fluid volume. The client has an increased cardiac output. The client has stenosis of the jugular veins.
The client has increased pressure related to right-sided heart failure
Which client will the nurse prioritize to assess first? The client with a sinus dysrhythmia The client with sinus arrest The client with tachycardia The client with sinus bradycardia SUBMIT ANSWER
The client with sinus arrest
Which client will the nurse prioritize to assess first? The client with sinus arrest The client with a sinus dysrhythmia The client with sinus bradycardia The client with tachycardia
The client with sinus arrest
Downstream peripheral pulses have a higher pulse pressure because the pressure wave travels faster than the blood itself. What occurs in peripheral arterial disease? Downstream peripheral pulses are increased even more than normal. The pulse decreases, rather than increases, in amplitude. Downstream peripheral pulses are greater than upstream pulses. The reflected wave is transmitted more rapidly through the aorta.
The pulse decreases, rather than increases, in amplitude.
Where in the body is lipoprotein synthesized? Select all that apply. The small intestine The pancreas The liver The large intestine SUBMIT ANSWER
The small intestine The liver
A client has been diagnosed with aortic stenosis and asks the nurse what this means. The mostappropriate response would be: The valve opening is narrowed and produces increased resistance to blood flow out of the left ventricle and into the aorta. The valve opens backward, permitting blood to flow from the right ventricle into the right atrium. The valve opening is incompetent, thereby allowing blood to flow back from the pulmonary artery and into the left atrium. The valve opening permits backward flow to occur when the valve should be closed. SUBMIT ANSWER
The valve opening is narrowed and produces increased resistance to blood flow out of the left ventricle and into the aorta.
A client comes to the emergency room with all the symptoms of a myodardial infarction. Which lab value, known to have a high specificity for myocardial tissue considered the primary biomarker test for diagnosing an MI, does the nurse suspect the physician will order? Phosphorous Creatine kinase Potassium Troponin assays
Troponin assays
A client with a suspected MI is brought to the emergency department by ambulance. The nurse caring for this client would expect to receive an order for which laboratory test to confirm a diagnosis of MI? Creatine kinase marker Calcium level Troponin level Complete blood components
Troponin level
The nurse identifies the blood vessel layer that constricts to regulate and control diameter as: Tunica media Tunica externa Tunica adventitia Tunica intima
Tunica media
Which blood vessel layer is composed primarily of smooth muscle cells? Endothelium Tunica intima Tunica media Tunica externa
Tunica media
A client presents with uncharacteristic chest pain, and his ECG reveals T-wave elevation. This finding suggests an abnormality with which aspect of the cardiac cycle? Atrial depolarization Ventricular repolarization Depolarization of the AV node Ventricular depolarization
Ventricular repolarization
A client with a history of angina presents with uncharacteristic chest pain. The subsequent electrocardiogram (ECG) reveals T-wave elevation. This finding suggests an abnormality with which aspects of the cardiac cycle? Atrial depolarization Depolarization of the atrioventricular node, bundle branches, and Purkinje system Ventricular depolarization Ventricular repolarization
Ventricular repolarization
Mitral valve prolapse occurs frequently in the population at large. Its treatment is aimed at relieving the symptoms and preventing complications of the disorder. Which drug is used in the treatment of mitral valve prolapse to relieve symptoms and aid in preventing complications? Calcium-channel blocking drugs Antianxiety drugs Broad-spectrum antibiotic drugs beta-adrenergic blocking drugs (beta-blockers)
beta-adrenergic blocking drugs (beta-blockers)
An older adult client has been diagnosed with chronic heart failure. He is prescribed an ACE inhibitor to treat the symptoms and improve his quality of life. This drug will alleviate the client's symptoms of heart failure by: promoting cardiac output through a reduction in afterload. enhancing inotropy by maximizing calcium channel function. selectively blocking the synthesis of renin in the kidneys. blocking the conversion of angiotensin I to angiotensin II.
blocking the conversion of angiotensin I to angiotensin II.
The pathophysiology of heart failure involves an interaction between decreased pumping ability and the ________ to maintain cardiac output. parasympathetic system aortic hypertrophy compensatory mechanisms electrical conductivity
compensatory mechanisms
Cardiac tamponade and pericardial effusion can be life-threatening when the pericardial sac _______ and ______ the heart. contracts; friction rubs thickens; stretches fills rapidly; compresses ruptures; releases
fills rapidly; compresses
A client has just returned from his surgical procedure. During initial vital sign measurements, the nurse notes that the client's heart rate is 111 beats/minute and the BP is 100/78 (borderline low). In this early postoperative period, the nurse should be diligently monitoring the client for the development of: renal failure due to an overdose of medication. hypovolemic shock due to acute intravascular volume loss. side effects from the administration of midazolam, causing excessive vasoconstriction. pulmonary embolism due to development of deep vein thrombosis.
hypovolemic shock due to acute intravascular volume loss.
The health care team is developing a plan of care for a client diagnosed with congestive heart failure (CHF). The primary treatment goal would be: improving quality of life by relieving symptoms. eliminating CHF through curing the disease. maintaining higher oxygen levels to decrease the work of breathing. placing a stent for fluid drainage from the heart.
improving quality of life by relieving symptoms.
A client who is experiencing angina at rest that has been increasing in intensity should be instructed to: see the doctor for evaluation immediately. take a second nitroglycerine. not worry about it as this is common for someone who has already had a myocardial infarction. give it 5-10 minutes more to see if there is relief.
see the doctor for evaluation immediately.
A client's blood pressure is persistently in the range of 130 to 135 mm Hg systolic and 85 to 88 mm Hg diastolic. The nurse knows that the client's blood pressure would be classified as ________ according to American Heart Association guidelines? elevated stage 2 hypertension stage 1 hypertension normal blood pressure
stage 1 hypertension
The heart is a four-chambered pump. Which chamber of the heart pumps blood into the systemic circulation? Right ventricle Left ventricle Right atrium Left atrium
Left ventricle
The stroke volume is the amount of blood ejected with every contraction of the ventricle. It is broken down into quarters. What is the approximate amount of the stroke volume per quarter? 50%, 30%, 20%, and little blood 25%, 25%, 25%, and 25% 60%, 20%, 20%, and little blood 40%, 40%, 10%, and 10%
60%, 20%, 20%, and little blood
In which situation is blood most likely to be rapidly relocated from central circulation to the lower extremities? A client is helped out of bed and stands up. A client reclines from a sitting to supine position. A client does isotonic exercises in a wheelchair. A client undergoes a stress test on a treadmill.
A client is helped out of bed and stands up.
A client is admitted to the cardiac unit with a diagnosis of pericarditis. The nurse is teaching th client about the anatomical location of the infection. The nurse evaluates the effectiveness of the teaching when the client correctly identifies which of the following as the location of the pericardium? The electrical conduction system of the heart A membranous sac that encloses the heart The outer muscular layer of the heart The innermost lining of the heart chambers
A membranous sac that encloses the heart
A client arrives at the emergency room with dizziness and a near syncopal episode. Vital signs include a heart rate of 46 and blood pressure of 86/50. The cardiac monitors show regular rhythm as above. The client states his physician has been running blood work to rule out hypothyroidism. Based on the rhythm, what does the nurse report the client has? A symptomatic tachyarrhythmia A symptomatic bradyarrhythmia Wolff-Parkinson-White syndrome A symptomatic third-degree AV block
A symptomatic bradyarrhythmia
The nurse, assessing a client with early signs of constrictive pericarditis, should monitor the client for which clinical manifestations? Exercise intolerance Ascites Weight loss Muscle wasting
Ascites
A new intensive care unit nurse is taking a cardiac dysrhythmia course in preparation for working in the unit. Which abnormality could cause a client to develop sinus arrest rhythm? Select all that apply. Hyperthyroidism K+ greater than 6 K+ less than 3 Hypothyroidism Acute bacterial myocarditis
Acute bacterial myocarditis K+ greater than 6 K+ less than 3
A client is transported to the emergency department in respiratory distress after eating peanuts. The following interventions are ordered by the health care provider. Which intervention should the nurse complete first? Administer diphenhydramine. Start a normal saline infusion. Administer epinephrine (adrenaline). Complete a 12-lead ECG.
Administer epinephrine (adrenaline).
Which intervention is the priority for the medical management of a client with a dissecting aortic aneurysm? Administration of pain medication and antianxiety medication Administration of sodium nitroprusside and beta-adrenergic blocking medications (beta-blockers) Administration of epinephrine and intravenous fluids Administration of medication to increase blood pressure
Administration of sodium nitroprusside and beta-adrenergic blocking medications (beta-blockers)
Which client would the nurse recognize as needing to be assessed for orthostatic hypotension? A 42-year-old client who has a history of poorly controlled type 1 diabetes A 78-year-old client who has begun reporting frequent headaches unrelieved by over-the-counter analgesics A 65-year-old client whose vision has become much less acute in recent months and who has noticed swelling in the ankles An 80-year-old client who has experienced two falls while attempting to ambulate to the bathroom
An 80-year-old client who has experienced two falls while attempting to ambulate to the bathroom
A client has been diagnosed with atrial flutter. Which assessment finding correlates with this diagnosis? A slow atrial rate A ventricular heart rate above 240 beats/min An increased blood pressure An atrial heart rate above 240 beats/min
An atrial heart rate above 240 beats/min
A client has been diagnosed with atrial flutter. Which assessment finding correlates with this diagnosis? An atrial heart rate above 240 beats/min A slow atrial rate An increased blood pressure A ventricular heart rate above 240 beats/min
An atrial heart rate above 240 beats/min
A client is diagnosed with an abdominal aortic aneurysm that the physician just wants to "watch" for now. When teaching the client about signs/symptoms to watch for, the nurse will base the teaching on which physiologic principle? The larger the aneurysm, the less tension placed on the vessel. Small diameter of this vessel will cause it to rupture more readily. The primary cause for rupture relates to increase in abdominal pressure, such as straining to have a bowel movement. As the aneurysm grows, more tension is placed on the vessel wall, which increases the risk for rupture.
As the aneurysm grows, more tension is placed on the vessel wall, which increases the risk for rupture.
Following several weeks of increasing fatigue and a subsequent diagnostic workup, a client has been diagnosed with mitral valve regurgitation. Failure of this heart valve would have which hemodynamic consequences? Inhibition of the SA node's normal action potential Backup of blood from the right atrium into the superior vena cava Backflow from the right ventricle to the right atrium during systole Backflow from the left ventricle to left atrium
Backflow from the left ventricle to left atrium
A client who is taking a diuretic asks the nurse to explain how a drug that makes her urinate more frequently can help her hypertension. The nurse will explain that diuretics exert their antihypertensive action in which ways? Select all that apply. By inhibiting the movement of calcium into arterial smooth muscle cells By blocking the release of antidiuretic hormone from the posterior pituitary By reducing peripheral vascular resistance By inhibiting the conversion of angiotensin I to angiotensin II. By decreasing vascular volume through the process of increasing sodium and water excretion
By decreasing vascular volume through the process of increasing sodium and water excretion By reducing peripheral vascular resistance
The parasympathetic nervous system causes a slowing of the heart rate by increasing control of which brain center that receives information from areas of the nervous system? Vessel constriction Cardioinhibitory center Smooth muscle tone Norepinephrine
Cardioinhibitory center
A nurse educator explains a type of cardiac condition as "a heterogeneous group of diseases of the myocardium associated with mechanical and/or electrical dysfunction that usually exhibit inappropriate ventricular hypertrophy or dilation and often lead to cardiovascular death or progressive heart failure." Which condition fits this definition? Cardiomyopathy Myocardial infarction Heart failure Rheumatic cardiac disease
Cardiomyopathy
A nurse is providing care for a client with a history of severe atherosclerosis. Which clinical manifestations should the nurse anticipate and assess in the client? Select all that apply Necrosis of the vessel wall. Peripheral vasodilation to compensate for ischemia. Aneurysm formation due to weakening of blood vessel walls. Motor deficits in muscles distal to plaque formation. Cognitive deficits due to ischemia or thrombosis. SUBMIT ANSWER
Cognitive deficits due to ischemia or thrombosis. Aneurysm formation due to weakening of blood vessel walls.
A nurse is monitoring a client with a consistent and regular heart rate of 128 beats/min. Which physiologic alteration would be consistent with this finding? Increase in ventricular filling time and decrease in cardiac output Decrease in ventricular filling time and blood pressure Decrease in blood pressure and increase in cardiac output Increase in respiratory rate and temperature
Decrease in ventricular filling time and blood pressure
An older adult client is newly diagnosed with hypertension. Which vascular changes in the aging adult can lead to hypertension? Decreased venous connective tissue elasticity Increased venous connective tissue elasticity Decreased aorta and large artery elasticity Increased arterial connective tissue elasticity
Decreased aorta and large artery elasticity
Which vascular changes can occur in older adults because of the increase in blood pressure during the aging process? Increased elasticity in venous connective tissue Decreased elasticity in venous connective tissue Decreased elasticity in arterial connective tissue Increased elasticity in arterial connective tissue
Decreased elasticity in arterial connective tissue
The nurse is assisting a client who had a myocardial infarction 2 days ago during a bath. The client suddenly lost consciousness and the nurse was unable to feel a pulse. Cardiopulmonary resuscitation was begun and the client was connected to the monitor with a gross disorganization without identifiable waveforms or intervals observed. What is a priorityintervention at this time? Synchronized cardioversion Applying a transcutaneous pacemaker Immediate defibrillation Administration of atropine
Immediate defibrillation
The nurse is assisting a client who had a myocardial infarction 2 days ago during a bath. The client suddenly lost consciousness and the nurse was unable to feel a pulse. Cardiopulmonary resuscitation was begun and the client was connected to the monitor with a gross disorganization without identifiable waveforms or intervals observed. What is a priorityintervention at this time? Synchronized cardioversion Immediate defibrillation Applying a transcutaneous pacemaker Administration of atropine
Immediate defibrillation
If a client experiences sympathetic nervous stimulation of the heart, the nurse will observe which changes in manifestations? Decreased rate and force of contraction Increased heart rate and increased contractility Increased heart rate and decreased contractility Decreased contractility and decreased heart rate
Increased heart rate and increased contractility
Respiratory sinus dysrhythmia is considered a more optimal rhythm than a rhythm where all RR intervals are equal. In respiratory sinus dysrhythmia, what is the variation in cardiac cycles related to? Intra-abdominal pressure changes due to vagal nerve stimulus Intra-abdominal pressure changes that occur with respiration Intrathoracic pressure changes due to inadequate oxygenation Intrathoracic pressure changes that occur with respiration SUBMIT ANSWER
Intrathoracic pressure changes that occur with respiration
The nurse is teaching a group of clients about hypertension. The nurse determines that teaching was effective when the clients state: Select all that apply. The incidence increases with age. It is often associated with individuals of normal weight. The diastolic pressure is equal to 80 mm Hg. It is the most common cardiovascular disorder. The systolic pressure is ≥140 mm Hg.
It is the most common cardiovascular disorder. The incidence increases with age. The systolic pressure is ≥140 mm Hg.
Which of the following blood flow patterns reduces friction, allowing the blood layers to slide smoothly over one another? Crosswise Laminar Turbulent Axially
Laminar
A client is at high risk for the development of rheumatic heart disease. The most important information for the nurse to provide would be: Avoiding frequent dental examinations Yearly electrocardiography after the age of 50 Annual blood specimen assessed for rheumatoid factor Prompt diagnosis and treatment of streptococcal infections SUBMIT ANSWER
Prompt diagnosis and treatment of streptococcal infections
Colloidal osmotic pressure acts differently than the osmotic effects of the plasma proteins. What is its action? Controls the direction of the fluid flow in the large arteries Pulls fluid into the interstitial spaces Pulls fluid back into the capillary Pushes fluid into the extracellular spaces
Pulls fluid back into the capillary
The heart consists of four valves. Which are the semilunar valves? Select all that apply. Pulmonary Aortic Tricuspid Mitral
Pulmonary Aortic
The client's ultrasound shows a thrombus in the venous sinus in the soleus muscle. The nurse explains that early treatment is important to prevent: Pulmonary embolism Cerebrovascular accident Loss of pulses in the limb Acute myocardial infarction
Pulmonary embolism
The heart is a four-chambered pump. What is the function of the right ventricle? Pumps blood to the lungs Receives oxygenated blood from the lungs Receives blood returning to the heart from the systemic circulation Pumps blood into the systemic circulation
Pumps blood to the lungs
The nurse is interpreting an electrocardiogram of a 65-year-old woman. Which should the nurse recognize as representing ventricular depolarization? QRS complex ST segment P wave T wave
QRS complex
The nurse is interpreting an electrocardiogram of a 65-year-old woman. Which should the nurse recognize as representing ventricular depolarization? ST segment P wave T wave QRS complex
QRS complex
A nurse is evaluating hypertension risk factors with a black male who is a lawyer in a busy legal firm. He reports that he eats fairly well, usually having red meat and potatoes daily. His father and older brother have hypertension. His paternal grandfather had a stroke. The lawyer drinks about four beers and eats salted popcorn while watching television in the evening and has gained 15 lb (6.8 kg) in the past year. Which risk factors or hypertension are nonmodifiable? Select all that apply. Stress Obesity Race Family history Excessive alcohol consumption
Race Family history
A client has prominent jugular veins. What type of medical problem is associated with prominent jugular veins? Left-sided heart failure Cerebrovascular accident (stroke) Shock Right-sided heart failure
Right-sided heart failure
What is the correct sequence for the generation of electrical impulses in the heart causing ventricular contraction? SA node - AV node - bundle branches - Purkinje fibers - bundle of His AV node - bundle of HIS - bundle branches - SA node - Purkinje fibers SA node - AV node - bundle of His - bundle branches - Purkinje fibers AV node - SA node - bundle of His - bundle branches - Purkinje fibers
SA node - AV node - bundle of His - bundle branches - Purkinje fibers
A 20-year-old college student, with no past medical history, arrives at the emergency room complaining of severe palpitations and dizziness that started this morning following a night of studying. The student is very upset that this is happening because the final exams are the following day. The cardiac monitor shows a heart rate of 110, regular rhythm with occasional premature ventricular complexes. The nurse explains to the student that this can happen in healthy hearts and is usually caused by stimulation of: Parasympathetic nervous system Atrial ectopic foci Sympathetic nervous system Vagal nerve
Sympathetic nervous system
There are three main atrial pressure waves that occur during the cardiac cycle. Which wave occurs during the last part of diastole and is caused by atrial contraction? b a c v SUBMIT ANSWER
a
A nurse is assessing a client who lost consciousness during a wrestling match when his opponent applied a neck hold. The client likely lost consciousness because:
a baroreceptor was stimulated.
A nursing student is studying the properties of cardiac rhythm to better understand what causes dysrhythmias to occur. The student begins to understand that there is a programmed ability for certain cells to conduct impulses. Interruption in this ability can result in abnormalities of cardiac rate and rhythm; this property would be: automaticity. refractoriness. conductivity. excitability.
conductivity.
A client has been diagnosed with diabetes mellitus. Which lab result would the practitioner expect? Elevation of HDL Decreased VLDL Elevation of triglycerides Decreased LDL
Elevation of triglycerides
A nurse is caring for a client with an average heart rate of 56 beats/min. The client has no adverse symptoms associated with this heart rate and is receiving no treatment. Which activity modification should the nurse suggest to avoid further slowing of the heart rate? "Avoid strenuous aerobic exercise." "Limit your intake of caffeinated drinks." "Avoid bearing down while having a bowel movement." "Avoid stress or overexcitement."
"Avoid bearing down while having a bowel movement."
Dilated cardiomyopathy with left ventricular dysfunction is characterized by which change in the ventricular wall? Thickness Contractility Thinning Rigidity
Thinning
An older adult client newly diagnosed with systolic hypertension asks her health care provider why this happens. Which response is most accurate? "Your heart has to work harder to pump blood through your vessels as you get older." "With age, your arteries lose their elasticity and are replaced with collagen, which makes your arteries stiffer." "Everyone over the age of 50 tends to have their blood pressure creep up over the years." "If you slow down and rest more, your blood pressure will more than likely return to its normal level."
"With age, your arteries lose their elasticity and are replaced with collagen, which makes your arteries stiffer."
Paroxysmal supraventricular tachycardia arises from which form of reentry? Orthodromic True Bundle of His nodal Arterioventricular (AV) nodal
Arterioventricular (AV) nodal
Coronary artery bypass grafting (CABG) is a treatment modality for which disorder of cardiac function? Pericardial effusion and cardiac tamponade Dilated cardiomyopathies Aortic valve regurgitation and aortic stenosis Atherosclerosis and unstable angina
Atherosclerosis and unstable angina
Which cardiac drug classification decreases sympathetic outflow to the heart and is the is the cornerstone of therapy for catecholaminergic polymorphic ventricular tachycardia (CPVT)? Beta-adrenergic blockers Sodium channel blockers Calcium channel blockers Potassium blockers SUBMIT ANSWER
Beta-adrenergic blockers
Which antiarrhythmic medication works by blunting the effect of sympathetic nervous system stimulation on the heart? Antianginal drugs, such as nitroglycerin Sodium channel blockers, such as lidocaine Calcium channel blockers, such as verapamil Beta-blockers, such as metoprolol
Beta-blockers, such as metoprolol
A client's echocardiogram identified a narrowed valve that has resulted in a decreased blood flow between the left atria and left ventricle. The nurse would interpret this as the: Pulmonic valve Bicuspid valve Tricuspid valve Aortic valve
Bicuspid valve
A nurse is participating in a health fair and is addressing many of the varied factors that can contribute to hypertension. The nurse should be cognizant of the higher incidence and prevalence of hypertension in which groups? Native American/First Nation and white people Aboriginal and South Asian people East Asian and black people Black and South Asian people
Black and South Asian people
A pregnant female client is at risk for the development of preeclampsia-eclampsia. Select the most important data to assess. Blood pressure 160/100 mm Hg and proteinuria during the 30th week of pregnancy Blood pressure 90/60 and proteinuria in the second trimester Blood pressure 140/90 and glucose in the urine during the 36th week of pregnancy Blood pressure 130/88 and hyperglycemia occurring during the 22nd week of pregnancy
Blood pressure 160/100 mm Hg and proteinuria during the 30th week of pregnancy
Levels of endothelins may be increased in clients with heart failure. Which of the following is the primary action of endothelins? Diuretic Vasodilation Natriuretic Vasoconstriction
Vasoconstriction
For clients with heart failure, which pathophysiologic response helps maintain the cardiac reserve? Aortic hypertrophy Parasympathetic system Electrical conductivity Compensatory mechanisms SUBMIT ANSWWhich serum biomarker is highly specific for myocardial tissue?
Compensatory mechanisms
The nursing instructor is teaching her nursing students about cardiac function and different heart diseases. Which disease does she tell the students is caused by calcified scar tissue that develops between the visceral and parietal layers of the serous pericardium? Acute pericarditis Pleural effusion Mediastinal radiation Constrictive pericarditis
Constrictive pericarditis
A nurse is planning a community education program on lifestyle modification to manage hypertension. Which topic should be included in the teaching plan? Select all that apply. Stop smoking. Limit alcohol consumption. Avoid aerobic physical activity. Reduce dietary sodium intake. Consume a diet rich in fruits, vegetables, and low-fat dairy products.
Consume a diet rich in fruits, vegetables, and low-fat dairy products. Reduce dietary sodium intake. Stop smoking. Limit alcohol consumption.
When an acute MI occurs, many physiologic changes occur very rapidly. What causes the loss of contractile function of the heart within seconds of the onset of an MI? Overproduction of energy capable of sustaining normal myocardial function Conversion from aerobic to anaerobic metabolism Conversion from anaerobic to aerobic metabolism Inadequate production of glycogen with mitochondrial shrinkage SUBMIT ANSWER
Conversion from aerobic to anaerobic metabolism
A client is immobilized following a hip injury. The client has developed lower leg discoloration with edema, pain, and tenderness in the midcalf area. How should the nurse document these clinical findings? Stasis ulcerations Deep vein thrombosis Primary varicose veins Arterial insufficiency
Deep vein thrombosis
A client's electrocardiogram monitor begins to sound an alarm and shows sustained ventricular fibrillation. The client is unconscious and without a pulse. Which priority intervention should the nurse take? Administer IV push atropine Notify the client's attending physician Defibrillate the client Perform synchronized cardioversion
Defibrillate the client
The nurse is assessing the electrical activity of the heart recorded on the electrocardiogram (ECG). What does the P wave represent? Repolarization of the atrium Depolarization of the ventricular conduction system Repolarization of the ventricles Depolarization of the sinoatrial node
Depolarization of the sinoatrial node
Implantation of a pacemaker is most likely to benefit a client with which cardiomyopathy? Dilated cardiomyopathy (DCM) Myocarditis Takotsubo cardiomyopathy Primary restrictive cardiomyopathy
Dilated cardiomyopathy (DCM)
A client is having an electrocardiogram and the nurse notes a previously undocumented prolonged QT complex suggestive of long QT syndrome. What action should the nurse take first? Ask the client about any symptoms currently being experienced. Prepare the client for urgent defibrillation. Double check the placement of the electrocardiogram leads on the client. Request a second nurse examine the electrocardiogram for verification.
Double check the placement of the electrocardiogram leads on the client.
The nurse is reviewing laboratory results for a client who is experiencing angina. Which finding might be expected in a client with dyslipidemia? Elevated total cholesterol Normal cholesterol and triglycerides Decreased triglycerides Decreased low-density lipoproteins
Elevated total cholesterol
The client undergoes a cardiac catheterization to evaluate symptoms of chest pain and shortness of breath. The test shows lesions in the coronary arteries that have begun to reduce the size of the vessel lumen. This type of lesion is known as: Fatty streak Thrombus Complicated lesion Fibrous atheromatous plaque
Fibrous atheromatous plaque
Atherosclerosis begins in an insidious manner with symptoms becoming apparent as long as 20 to 40 years after the onset of the disease. Although an exact etiology of the disease has not been identified, epidemiologic studies have shown that there are predisposing risk factors to this disease. What is the major risk factor for developing atherosclerosis? Male sex Familial history of premature coronary heart disease Hypercholesterolemia Increasing age
Hypercholesterolemia
The nurse is teaching a class on reduction of cardiovascular disease. Which action/activity demonstrates an intervention that is cognizant of the modifiable risk factors for hyperlipidemia? Encouraging a friend to cook with transfats, as they extend the shelf life of foods Going for a brisk walk with a friend and talking to him about continuing to exercise regularly Talking to a friend about using more saturated and less unsaturated fats when cooking Encouraging a friend to be tested for familial hypercholesterolemAn older adult client is newly diagnosed with hypertension. Which vascular changes in the aging adult can lead to hypertension?
Going for a brisk walk with a friend and talking to him about continuing to exercise regularly
Which lab result strongly suggests an immunologic response in the client with possible rheumatic heart disease? High C-reactive protein levels Elevated white blood cell count Elevated erythrocyte sedimentation rate (ESR) Group A (β-hemolytic) streptococcal antibodies
Group A (β-hemolytic) streptococcal antibodies
A 50-year-old man is having routine blood work done as part of his yearly physical. The doctor informs him that his good cholesterol is low. To which form of cholesterol is the doctor referring? LDL IDL VLDL HDL
HDL
Nearly everyone with pericarditis has chest pain. With acute pericarditis, the pain is abrupt in onset, sharp, and radiates to the neck, back, abdomen, or sides. What can be done to ease the pain of acute pericarditis? Have the client sit up and lean forward. Have the client swallow slowly and frequently. Have the client breathe deeply. Have the client change positions to unaffected side.
Have the client sit up and lean forward.
Which intervention by the client will decrease overall cardiovascular risk? Activity limitations to control glucose levels Higher levels of fitness and exercise Excess alcohol consumption, especially red wine Psychological counseling to deal with stress
Higher levels of fitness and exercise
Humoral control of blood flow involves the effect of vasodilator and vasoconstrictor substances in the blood. Select the factor that has a powerful vasodilator effect on arterioles and increases capillary permeability. Norepinephrine Histamine Serotonin Prostaglandins
Histamine
A client with a history of Wolff-Parkinson-White (WPW) syndrome is admitted for symptomatic tacharrhythmias resistant to medications. Which cause can result in the development of reentry circuits abnormalities? Select all that apply. Hyperglycemia Myocardial infarction Hyperkalemia Hypothyroidism Myocardial ischemia
Hyperkalemia Myocardial ischemia Myocardial infarction
A client with a history of Wolff-Parkinson-White (WPW) syndrome is admitted for symptomatic tacharrhythmias resistant to medications. Which cause can result in the development of reentry circuits abnormalities? Select all that apply. Hypothyroidism Myocardial ischemia Hyperkalemia Hyperglycemia Myocardial infarction
Hyperkalemia Myocardial ischemia Myocardial infarction
A client has developed atherosclerosis. The nurse knows that a major cause for this disorder is: Hypertension History of myocardial infarction Elevated HDL cholesterol Heart failure
Hypertension
The health care provider is teaching a client about modifiable risk factors for atherosclerosis. The most appropriate information to provide would be: 55 years of age Family history of heart disease Hypertension Being male
Hypertension
A 17-year-old athlete died suddenly during a track meet and it was subsequently determined that he had heart disease. Which condition was the most likely cause of his heart failure? Atrial regurgitation Mitral valve prolapse Hypertrophic cardiomyopathy Dilated cardiomyopathy
Hypertrophic cardiomyopathy
Football fans at a college have been shocked to learn of the sudden death of a star player, an event that was attributed in the media to "an enlarged heart." Which disorder was the player's most likely cause of death? Arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D) Hypertrophic cardiomyopathy (HCM) Dilated cardiomyopathy (DCM) Takotsubo cardiomyopathy
Hypertrophic cardiomyopathy (HCM)
A client has just been told that he has an infection of the inner surface of the heart. He is also told that the bacteria has invaded his heart valves. What term is used for this disease process? Cardiomyopathy Pericarditis Infective endocarditis Myocardial infarction
Infective endocarditis
Nursing students who are studying for their upcoming cardiac exam are discussing how the heart could possibly continue to beat once removed from the body. One of the students explains that this phenomenon is directly related to automaticity. What is automaticity? Inherent low-impulse conductivity Inherent discharge rate of 40-60 Inherent discharge rate of 60-80 Inherent spontaneous action-potential
Inherent spontaneous action-potential
Nursing students who are studying for their upcoming cardiac exam are discussing how the heart could possibly continue to beat once removed from the body. One of the students explains that this phenomenon is directly related to automaticity. What is automaticity? Inherent spontaneous action-potential Inherent discharge rate of 60-80 Inherent discharge rate of 40-60 Inherent low-impulse conductivity
Inherent spontaneous action-potential
A nurse is teaching a client with newly diagnosed hypertension about antihypertensive drug therapy. The nurse determines that the knowledge is understood when the client correctly describes which of the following as the mechanism of action of an angiotensin-converting enzyme (ACE) inhibitor? Inhibits the conversion of angiotensin I to angiotensin II, decreasing angiotensin II levels and reducing its effect on vasoconstriction Decreases vascular volume by suppressing renal reabsorption of sodium Decreases the heart rate, which will cause a decrease in cardiac output Inhibits the movement of calcium into cardiac and vascular smooth muscle
Inhibits the conversion of angiotensin I to angiotensin II, decreasing angiotensin II levels and reducing its effect on vasoconstriction
When the semilunar valves open it signals the onset of the ejection period. The aortic pressure reflects changes in the ejection of blood from which part of the heart? Right atrium Left ventricle Right ventricle Left atrium
Left ventricle
The nurse determines that the capillary pore exchange of a client's gases, nutrients, and/or waste products would be best facilitated by which organ? Kidney Bone Liver Brain
LivThe difference between the end-diastolic and end-systolic volumes is called what?
A nurse notes that the PR interval on a client's electrocardiogram tracing is 0.22 seconds. Which action should the nurse take? Administer atropine and place external pacemaker on the client. Call the health care provider. Administer oxygen via nasal cannula. Monitor the client and document the findings.
Monitor the client and document the findings.
The pericardium is a tri-layer sac. Which layer prevents acute dilation of the heart chambers and exerts a restraining effect on the left ventricle? Parietal layer Visceral layer Inner serous layer Outer fibrous layer
Outer fibrous layer
Considering the PQRST complex of an electrocardiogram (ECG), which letter designation represents atrial depolarization? QRS complex ST segment T wave P wave
P wave
Considering the PQRST complex of an electrocardiogram (ECG), which letter designation represents atrial depolarization? QRS complex T wave P wave ST segment
P wave
The nurse assesses the electrocardiogram for depolarization of the atria. What portion of the ECG will the nurse be assessing? T wave above the baseline U wave above the baseline Q wave below the baseline P wave above the baseline
P wave above the baseline
The nurse assesses the electrocardiogram for depolarization of the atria. What portion of the ECG will the nurse be assessing? U wave above the baseline P wave above the baseline T wave above the baseline Q wave below the baseline
P wave above the baseline
Which of the following are characteristic signs of acute arterial embolism? Pain, increased blood pressure, and warmth Purpura, muscle weakness, and shortness of breath Paralysis, warmth, and paranoia Pallor, pulselessness, and pain
Pallor, pulselessness, and pain
A monitored hospitalized client with a pulmonary embolism has been in atrial fibrillation (AF) for 4 days. The nurse observes the rhythm spontaneously convert to a normal sinus rhythm. Which form of AF is this? Chronic Permanent Persistent Paroxysmal
Paroxysmal
A monitored hospitalized client with a pulmonary embolism has been in atrial fibrillation (AF) for 4 days. The nurse observes the rhythm spontaneously convert to a normal sinus rhythm. Which form of AF is this? Persistent Permanent Chronic Paroxysmal
Paroxysmal
A client has been diagnosed with deep vein thrombosis (DVT). The nurse is planning care and recognizes that the client is most at risk for: Polyarteritis nodosa Pulmonary embolism Vasculitis Arterial insufficiency
Pulmonary embolism
A nurse preceptor is evaluating the skills of a new registered nurse (RN) caring for clients experiencing shock. Which action by the new RN indicates a need for more education? Inserting an IV to begin a normal saline infusion Administration of 2L of oxygen by nasal cannula Placing a pulse oximeter on the client to monitor oxygenation status Raising the head of the bed to a high Fowler's position
Raising the head of the bed to a high Fowler's position
A female client tells the health care provider that she has recently been experiencing episodes of changes occuring in the color of her fingertips, especially when she experiences cold temperatures. She further states that the tips become pale, turn a bluish color, and then become reddened. The client is most likely experiencing: Atherosclerosis Thromboangiitis obliterans Vasculitis Raynaud phenomenon
Raynaud phenomenon
The nurse is reviewing the anatomy and physiology of the heart. What is the function of the right atrium? Pumps blood to the lungs Receives oxygenated blood from the lungs Pumps blood into the systemic circulation Receives blood returning to the heart from the systemic circulation
Receives blood returning to the heart from the systemic circulation
A nurse witnesses an older adult woman sitting outside who suddenly faints and is helped to the ground by family. She is awake, although confused, heart rate 130, RR 28. The woman states that all of a sudden she felt dizzy, but denies other symptoms. She says that her husband died last week and she has been very upset. The nurse determines that which of the following is the most likely reason for the syncopal episode? Blood loss Congestive heart failure Severe pain Severe anxiety
Severe anxiety
The diagnosis is hypovolemic shock. The nurse knows that causes of hypovolemic shock include which of the following? Select all that apply. Excessive vasoconstriction Severe burns 15% blood volume loss Severe dehydration Myocardial infarction
Severe burns 15% blood volume loss Severe dehydration
A 28-year-old marathon runner comes to the clinic to obtain a physical exam for a new job. The nurse assesses a regular pulse rate of 52 beats per minute (bpm). Which common dysrhythmia is the nurse aware this client most likely has related to maintaining a large stroke volume? Atrial flutter Sinus tachycardia Atrial fibrillation Sinus bradycardia SUBMIT ANSWER
Sinus bradycardia
A 20-year-old college student, with no past medical history, arrives at the emergency room complaining of severe palpitations and dizziness that started this morning following a night of studying. The student is very upset that this is happening because the final exams are the following day. The cardiac monitor shows a heart rate of 110, regular rhythm with occasional premature ventricular complexes. The nurse explains to the student that this can happen in healthy hearts and is usually caused by stimulation of: Vagal nerve Parasympathetic nervous system Atrial ectopic foci Sympathetic nervous system
Sympathetic nervous system
A 60-year-old woman who has lost an extensive amount of blood in a work-related accident says that when her blood pressure was checked in the hospital, the top number (systolic pressure) was lower than usual but the bottom number (diastolic pressure) was about the same. The nurse recognizes that which reason accounts for this lack of change in the diastolic pressure? Blood volume rapidly increased. Heart rate increased with blood loss. Stroke volume increased with blood loss. Systemic vasoconstriction maintained the diastolic pressure.
Systemic vasoconstriction maintained the diastolic pressure.
A client says that when the hospital checked his blood pressure after he lost a lot of blood in a work-related accident, the top number (systolic pressure) was lower than usual but the bottom number (diastolic pressure) was about the same. Why is this? Systemic vasodilation maintained the diastolic pressure. The heart rate increased with blood loss. The stroke volume increased with blood loss. Systemic vasoconstriction maintained the diastolic pressure.
Systemic vasoconstriction maintained the diastolic pressure.
What does the nurse teach is the principal factor that determines how long the client can exercise? The client's age The client's mental status The client's heart and lung capacity The client's medical history
The client's heart and lung capacity
The health care provider is reviewing lab results of a client diagnosed with heart failure. The provider notes that the client's ANP and BNP levels have been increasing and remain significantly elevated. These results would be interpreted as: The more the results continue to increase, the better outcome for the client. The condition is getting progressively worse. The client is improving. Results are not significant assessment data.
The condition is getting progressively worse.
The nursing instructor is teaching the students about rheumatic fever. She tells the students that it is an important cause of heart disease and is very serious mainly for which reason? The cost associated with treating the disease The fact that it affects young and old The disabling effects that result from involvement of heart valves That there is no definitive test used for diagnoses
The disabling effects that result from involvement of heart valves
A 23-year-old college basketball player is brought to the emergency room following a syncopal episode The paramedic giving report reveals the initial rhythm demonstrated a heart rate of 250 (via AED) with differently shaped QRS complexes that rotated "around a point" and spontaneously converted to normal sinus rhythm. What does the nurse identify as a likely initial rhythm? Acquired torsades de pointes Paroxysmal atrial fibrillation Recurrent atrial flutter Torsades de pointes
Torsades de pointes
Which type of pacing involves the placement of large patch electrodes on the anterior and posterior chest wall that can be connected by a cable to an external pulse generator? Epicardial Transcutaneous Transvenous Permanent
Transcutaneous
Which type of pacing involves the placement of large patch electrodes on the anterior and posterior chest wall that can be connected by a cable to an external pulse generator? Permanent Transcutaneous Epicardial Transvenous
Transcutaneous
A client with a 2-week history of hyperthyroidism due to a virus is admitted for nonemergent cardioversion. The client states that she has been experiencing intermittent episodes of palpitations over the past week along with shortness of breath and fatigue. The nurse attaches the client to a cardiac monitor and notes that the client is in normal sinus rhythm with frequent episodes of atrial fibrillation. The nurse anticipates which of the following to be ordered prior to the cardioversion to avoid a possible stroke? Transesophageal echocardiography Ultrasound of the thorax Chest x-ray Pulmonary function studies
Transesophageal echocardiography
The heart consists of four valves. Which are the heart's atrioventricular valves? Select all that apply. Tricuspid Aortic Mitral Pulmonary
Tricuspid Mitral
Which serum biomarker is highly specific for myocardial tissue? Troponin Creatine kinase White blood cells C-reactive protein
Troponin
Which serum biomarker is highly specific for myocardial tissue? White blood cells C-reactive protein Creatine kinase Troponin
Troponin
Which blood vessel layer is made primarily of muscle? Tunica adventitia Tunica intima Tunica externa Tunica media
Tunica media
A client is told that she has cardiac valve leaflets, or cusps, that are floppy and fail to shut completely, permitting blood flow even when the valve should be completely closed. The nurse knows that this condition can lead to heart failure and is referred to as: Valvular stenosis Valvular regurgitation Pericardial effusion Infective endocarditis
Valvular regurgitation
A client who lives with angina pectoris has taken a sublingual dose of nitroglycerin to treat the chest pain he experiences while mowing his lawn. This drug facilitates release of nitric oxide, which will have what physiologic effect? Reduction of cardiac refractory periods Vasodilating effects reducing preload and afterload Increased preload Decreased heart rate and increased stroke volume
Vasodilating effects reducing preload and afterload
Which pathogenesis is primarily responsible for Raynaud phenomenon? Vasospasm causing excessive vasoconstriction Vasculitides resulting from damaged vessels due to hypertension Occlusion by atherosclerosis Thrombi formation blocking blood flow
Vasospasm causing excessive vasoconstriction
The cardiac cycle describes the pumping action of the heart. Which statement is correct about systole? Atria contract and blood is ejected from the heart. Ventricles relax and blood fills the heart. Atria relax and blood fills the heart. Ventricles contract and blood is ejected from the heart.
Ventricles contract and blood is ejected from the heart.
A 45-year-old client is undergoing exercise stress testing. At which point will the test be halted and not allowed to continue? When the electrocardiogram (ECG) shows sinus tachycardia When the client states feeling soreness in the muscles When the client experiences chest pain When the heart rate reaches 135 beats/min
When the client experiences chest pain
The shape of the QRS complexes on the ECG is determined by the direction of the electrical impulse in relation to the placement of the electrode on the chest wall. QRS complexes greater than 0.12 second could indicate: early repolarization in the ventricles. cardiac ischemia in the atria. potential development of sick sinus syndrome. delayed conduction in the bundle branches.
delayed conduction in the bundle branches.
An 80-year-old male client arrives for his yearly physical without any complaints, and following the checkup the physician explains that he has noted atrial fibrillation (AF) on the client's ECG. Before the physician can explain the disorder, the client becomes very upset and states he thinks he is going to die. The physician explains that atrial fibrillation involves the top chambers of the heart and that: many people live with atrial fibrillation without even knowing they have it. the client will be placed on anticoagulants immediately. the client will experience severe palpitations. atrial fibrillation is a disorganized ventricular rhythm with recurrent circuits.
many people live with atrial fibrillation without even knowing they have it.
Which health condition can contribute to diastolic dysfunction heart failure? anemia myocardial hypertrophy ischemic heart disease chronic bradycardia SUBMIT ANSWER
myocardial hypertrophy
Which sequence is the correct pathway for blood flow through the heart? right atrium - tricuspid valve - right ventricle - pulmonary artery - lungs - pulmonary vein - left atrium - mitral valve - left ventricle - aorta right atrium - bicuspid valve - right ventricle - pulmonary artery - lungs - pulmonary vein - left atrium - tricuspid valve - left ventricle - aorta left atrium - bicuspid valve - left ventricle - pulmonary artery - lungs - pulmonary vein - right atrium - tricuspid valve - right ventricle - aorta left atrium - tricuspid valve - left ventricle - pulmonary artery - lungs - pulmonary vein - right atrium - mitral valve - right ventricle - aorta
right atrium - tricuspid valve - right ventricle - pulmonary artery - lungs - pulmonary vein - left atrium - mitral valve - left ventricle - aorta
During a prenatal education class, an expectant mother tells the group about a friend whose blood pressure became so high during pregnancy that she had to be admitted to the hospital. Which statement should the nurse include in the response to this expectant mother? "Essentially, experts don't really know why so many pregnant women develop high blood pressure." "By avoiding salt, staying active and minimizing weight gain, you can prevent this during your pregnancy." "I'm sure this was hard for your friend, but rest assured that it won't affect your baby even if it affects you." "A large increase in blood pressure is a normal part of the changes in blood circulation that accompany pregnancy."
"Essentially, experts don't really know why so many pregnant women develop high blood pressure."
The nurse is teaching a client with a diagnosis of hypertrophic cardiomyopathy and aortic valve stenosis. Which statement by the client shows that the client understands this condition? "I should take my verapamil at the same time every day." "I should begin an aerobic exercise program." "I should limit my daily alcohol ingestion to two drinks." "I should report episodes of dizziness or fainting."
"I should report episodes of dizziness or fainting."
A nurse is performing client health education with a 68-year-old man who has recently been diagnosed with heart failure. Which statement demonstrates an accurate understanding of his new diagnosis? "I'm going to avoid as much physical activity as I can so that I preserve my strength." "I'm trying to think of ways that I can cut down the amount of salt that I usually eat." "I'll be sure to take my beta-blocker whenever I feel short of breath." "I know it's healthy to drink a lot of water, and I'm going to make sure I do this from now on."
"I'm trying to think of ways that I can cut down the amount of salt that I usually eat."
A nurse educator is explaining normal cardiac conduction and action potentials to a nursing cohort. How can the nurse best describe the term "slow response" (calcium current) to the students? "It facilitates the entrance of calcium needed for cardiac muscle contraction." "The calcium current provides for the binding of intracellular calcium for the repolarization of electrical activity." "It facilitates the entrance of calcium for the excitation-contraction mechanism that couples the electrical activity with muscle contraction." "The calcium current provides for the entrance of calcium that stimulates the AV node."
"It facilitates the entrance of calcium for the excitation-contraction mechanism that couples the electrical activity with muscle contraction."
A client who will be undergoing a Holter monitor examination would be given which instruction? "Lay very still during the procedure for an accurate reading." "Keep a diary of your activities and symptoms throughout the examination." "Wear clothing that you can exercise in during the test." "You will need to have an intravenous injection prior to the start of the test." SUBMIT ANSWER
"Keep a diary of your activities and symptoms throughout the examination."
A client who will be undergoing a Holter monitor examination would be given which instruction? "Lay very still during the procedure for an accurate reading." "Keep a diary of your activities and symptoms throughout the examination." "You will need to have an intravenous injection prior to the start of the test." "Wear clothing that you can exercise in during the test."
"Keep a diary of your activities and symptoms throughout the examination."
A client asks the purpose of an exercise stress test. What is the nurse's best response? "The test is used to measure functional status during stress." "This will help you endure exercise." "This is to assess your tolerance of isometric exercise." "This test is necessary prior to starting medication therapy for obesity."
"The test is used to measure functional status during stress."
What should the nurse teach the client prior to ergometry? "This is an invasive test." "Do not eat prior to having this test." "You must be able to jog to do this test." "This test evaluates cardiac function."
"This test evaluates cardiac function."
What should the nurse teach the client prior to ergometry? "You must be able to jog to do this test." "Do not eat prior to having this test." "This is an invasive test." "This test evaluates cardiac function." SUBMIT ANSWER
"This test evaluates cardiac function."
A client asks why he has not had major heart damage since his cardiac catheterization revealed he has 98% blockage of the right coronary artery. The nurse's best response is: "You must have been taking a blood thinner for a long time." "You have small channels between some of your arteries, so you can get blood from a patent artery to one severely blocked." "With this amount of blockage, your red blood cells get through the vessel one by one and supply oxygen to the muscle." "You are just a lucky person since most people would have had a massive heart attack by now."
"You have small channels between some of your arteries, so you can get blood from a patent artery to one severely blocked."
Which enzyme has a powerful vasodilator effect on arterioles and increases capillary permeability? Arachidonic acid Prostaglandins Serotonin Histamine
Histamine
The nurse is caring for a client who suffered a massive myocardial infarction and is scheduled for an immediate permanent pacemaker insertion due to severe ischemia and damage to both SA and AV nodes. The nurse would expect which of the following? Severely elevated diastolic pressure Tachycardia with rate between 100-120 Bradycardia with rate of 20-40 Heart rate between 40-60
Bradycardia with rate of 20-40
A nurse is teaching a client with newly diagnosed hypertension about antihypertensive drug therapy. The nurse determines that the the knowledge is understood when the client correctly matches which drug category to the action of decreasing vascular volume by suppressing renal reabsorption of sodium and increasing salt and water excretion? Diuretics Calcium channel blockers Beta-blockers Angiotensin-converting enzyme (ACE) inhibitors
Diuretics
The nurse knows that which group of antihypertensive drugs is usually the least expensive and are well tolerated? Calcium channel blockers Angiotensin-converting enzyme (ACE) inhibitors Beta-adrenergic blockers Diuretics
Diuretics
A grandmother who works as a cook at a nearby school was recently hospitalized when she lost an extensive amount of blood in a work-related accident. The grandmother tells the nurse that she heard that she would keep feeling faint until the brain made more blood. The nurse knows that when the blood pressure dropped, the pressure in the carotid arteries decreased. This was detected by baroreceptors in the carotid arteries. What did the baroreceptors do? Increase parasympathetic stimulation of the heart and blood vessels Inhibit renin release from the kidneys to promote fluid retention Stimulate the brain to form new red blood cells Increase sympathetic stimulation of the heart and blood vessels
Increase sympathetic stimulation of the heart and blood vessels
ECG monitoring has been found to be more sensitive than a client's report of symptoms when identifying transient ongoing myocardial ischemia. Why is this? Most ECG-detected ischemic events cause a great deal of pain. The ECG can look at ischemic events from different directions. Most ECG-detected ischemic events are clinically silent. ECG monitoring is reliable only when the client remains still.
Most ECG-detected ischemic events are clinically silent.
ECG monitoring has been found to be more sensitive than a client's report of symptoms when identifying transient ongoing myocardial ischemia. Why is this? The ECG can look at ischemic events from different directions. ECG monitoring is reliable only when the client remains still. Most ECG-detected ischemic events are clinically silent. Most ECG-detected ischemic events cause a great deal of pain.
Most ECG-detected ischemic events are clinically silent.
A client comes to the emergency room exhibiting signs and symptoms of right-sided heart failure. Upon X-ray it is determined that he has 250 mL of fluid in the pericardial cavity. Which disease should the nurse suspect this client is suffering? Pericardial effusion COPD Pericarditis Myocardial infarction
Pericardial effusion
Exudate in the pericardial cavity is a characteristic of which cardiac condition? Constrictive pericarditis Pericardial effusion Cardiac tamponade Acute pericarditis
Pericardial effusion
The nurse working on the cardiac floor identifies which of the following to be the initial treatment of choice for small pericardial effusions and mild cardiac tamponade? NSAIDS Colchicine Corticosteroids Pericardiocentesis
Pericardiocentesis
A client is seen in the emergency room reporting sharp chest pain that started abruptly. He says it has radiated to his neck and abdomen. He also states that it is worse when he takes a deep breath or swallows. He tells the nurse that when he sits up and leans forward the pain is better. Upon examination the nurse notes a pericardial friction rub and some EKG changes. Which disease should the nurse suspect this client to have? Pericarditis Myocardial infarction Pneumonia Abdominal aortic aneurysm
Pericarditis
On a holiday trip home, the nurse's mother states that the nurse's father was diagnosed with right-sided heart failure. Which manifestation exhibited by the father does the nurse know might have preceded this diagnosis? Dyspnea, cough Peripheral edema, weight gain Vertigo, headache Weakness, palpitations
Peripheral edema, weight gain
A 20-year-old college student being treated for a kidney infection developed a temperature of 104ºF (40°C) in spite of treatment with antibiotics. Her pulse was high, her blood pressure was low, and her skin was hot, dry, and flushed. The nurse knows that this client most likely is experiencing which type of shock? Cardiogenic Neurogenic Septic Anaphylactic
Septic
The nurse should anticipate administering intravenous antibiotic therapy as a priority to a client experiencing which type of shock?
Septic shock
A nurse is explaining the conduction system of the heart to a client who is experiencing an dysrhythmia. Which would be the most accurate explanation? Internodal pathways, atrioventricular (AV) node, sinoatrial node (SA), AV bundle, Purkinje fibers AV node, sinoatrial node (SA), atrioventricular (AV) bundle, Purkinje fibers, intermodal pathways Sinoatrial node (SA), atrioventricular (AV) bundle, internodal pathways, AV node, Purkinje fibers Sinoatrial node (SA), internodal pathways, atrioventricular (AV) node, AV bundle, Purkinje fibers
Sinoatrial node (SA), internodal pathways, atrioventricular (AV) node, AV bundle, Purkinje fibers
A nurse is explaining the conduction system of the heart to a client who is experiencing an dysrhythmia. Which would be the most accurate explanation? Sinoatrial node (SA), atrioventricular (AV) bundle, internodal pathways, AV node, Purkinje fibers Internodal pathways, atrioventricular (AV) node, sinoatrial node (SA), AV bundle, Purkinje fibers Sinoatrial node (SA), internodal pathways, atrioventricular (AV) node, AV bundle, Purkinje fibers AV node, sinoatrial node (SA), atrioventricular (AV) bundle, Purkinje fibers, intermodal pathways
Sinoatrial node (SA), internodal pathways, atrioventricular (AV) node, AV bundle, Purkinje fibers
A 28-year-old marathon runner comes to the clinic to obtain a physical exam for a new job. The nurse assesses a regular pulse rate of 52 beats per minute (bpm). Which common dysrhythmia is the nurse aware this client most likely has related to maintaining a large stroke volume? Sinus tachycardia Atrial fibrillation Sinus bradycardia Atrial flutter
Sinus bradycardia
A client is seen in the emergency department complaining of chest discomfort, productive cough, and a fever of over 101°F (38.3°C) for 3 days. The nurse performs an electrocardiogram and observes a rate of 110 beats per minute (bpm) with a normal P wave and a PR interval of 0.12 second preceding each QRS complex. What does the nurse determine the rhythm to be? Sick sinus syndrome Third-degree heart block Atrial flutter Sinus tachycardia
Sinus tachycardia
A client is seen in the emergency department complaining of chest discomfort, productive cough, and a fever of over 101°F (38.3°C) for 3 days. The nurse performs an electrocardiogram and observes a rate of 110 beats per minute (bpm) with a normal P wave and a PR interval of 0.12 second preceding each QRS complex. What does the nurse determine the rhythm to be? Third-degree heart block Sick sinus syndrome Sinus tachycardia Atrial flutter
Sinus tachycardia
If the parasympathetic neurotransmitter releases acetylcholine, the nurse should anticipate observing what changes in the ECG pattern? Complete cardiac standstill Heart rate 150 beats/minute, labeled as supraventricular tachycardia Disorganized ventricular fibrillation Slowing of heart rate to below 60 beats/minute
Slowing of heart rate to below 60 beats/minute
A client has just been diagnosed with hypercholesterolemia and is asking what treatment will be needed. About which topics should the nurse educate the client? Select all that apply. Decreasing physical activity Increased intake of fats and sodium Dietary measures to reduce LDL levels Smoking cessation Weight reduction if overweight
Smoking cessation Dietary measures to reduce LDL levels Weight reduction if overweight
The nurse knows that the primary long-term regulation of blood pressure is exerted by which body system? Humoral influence The kidneys Hormonal activity Neural mechanisms
The kidneys
A client has been diagnosed with aortic stenosis and asks the nurse what this means. The mostappropriate response would be: The valve opening permits backward flow to occur when the valve should be closed. The valve opening is narrowed and produces increased resistance to blood flow out of the left ventricle and into the aorta. The valve opens backward, permitting blood to flow from the right ventricle into the right atrium. The valve opening is incompetent, thereby allowing blood to flow back from the pulmonary artery and into the left atrium.
The valve opening is narrowed and produces increased resistance to blood flow out of the left ventricle and into the aorta.
Which dysrhythmia is considered to be the most fatal and requires immediate treatment? Premature ventricular contractions Atrial flutter Premature atrial contractions Ventricular fibrillation
Ventricular fibrillation
Which dysrhythmia is considered to be the most fatal and requires immediate treatment? Ventricular fibrillation Atrial flutter Premature atrial contractions Premature ventricular contractions
Ventricular fibrillation
A client presents with uncharacteristic chest pain, and his ECG reveals T-wave elevation. This finding suggests an abnormality with which aspect of the cardiac cycle? Atrial depolarization Ventricular depolarization Ventricular repolarization Depolarization of the AV node
Ventricular repolarization
A client with a history of angina presents with uncharacteristic chest pain. The subsequent electrocardiogram (ECG) reveals T-wave elevation. This finding suggests an abnormality with which aspects of the cardiac cycle? Depolarization of the atrioventricular node, bundle branches, and Purkinje system Atrial depolarization Ventricular repolarization Ventricular depolarization
Ventricular repolarization
Cardiac output is defined as which physiologic function per minute? Select all that apply. Heart rate x stroke volume Arterial afterload Contractility force generated Ventricular volume load Volume of blood pumped
Volume of blood pumped Heart rate x stroke volume
A telehealth nurse is talking with a client who has a history of right-sided heart failure. The nurse should question the client about which assessment finding that would indicate the client's condition is worsening? Copious urination Decreased blood pressure Weight gain Shortness of breath
Weight gain
A telehealth nurse is talking with a client who has a history of right-sided heart failure. The nurse should question the client about which assessment finding that would indicate the client's condition is worsening? Weight gain Decreased blood pressure Copious urination Shortness of breath
Weight gain
A client with new onset atrial fibrillation (AF) is being admitted to the hospital for possible cardioversion. The initial vital signs include a heart rate of 160 and blood pressure of 90/60. The admission nurse anticipates the presence of a pulse deficit. To verify this finding which action would the nurse take? Assess both the carotid and radial pulses for a full minute. With another nurse, assess the apical and radial pulses simultaneously for one minute. Assess the radial pulse bilaterally for a full minute with the client in the lateral position. Assess the apical pulse for a full minute with client in the supine position.
With another nurse, assess the apical and radial pulses simultaneously for one minute.
Atherosclerotic plaque is most likely to be unstable and vulnerable to rupture when the plaque has a thin fibrous cap over a: large lipid core. vessel wall injury. red thrombus. calcified lesion.
large lipid core.
An 80-year-old male client arrives for his yearly physical without any complaints, and following the checkup the physician explains that he has noted atrial fibrillation (AF) on the client's ECG. Before the physician can explain the disorder, the client becomes very upset and states he thinks he is going to die. The physician explains that atrial fibrillation involves the top chambers of the heart and that: the client will be placed on anticoagulants immediately. the client will experience severe palpitations. many people live with atrial fibrillation without even knowing they have it. atrial fibrillation is a disorganized ventricular rhythm with recurrent circuits.
many people live with atrial fibrillation without even knowing they have it.
