Patho Chapter 19 Review Questions

Cardiac tamponade and pericardial effusion can be life-threatening when the pericardial sac _____ and ______ the heart.

fills rapidly; compresses

What is the most important factor in myocardial oxygen demand?

heart rate

The nursing student has learned in his class that coronary artery disease (CAD) is heart disease caused by:

impaired coronary blood flow

A client who has been diagnosed with mitral valve prolapse asks the nurse if there are any dietary medications that should be incorporated into her lifestyle. The best response would be:

"Refraining from caffeine, alcohol, and cigarettes may be sufficient to control symptoms"

A client has been diagnosed with mitral valve stenosis following his recovery from rheumatic fever. Which teaching point would be most accurate to convey to the client?

"Your mitral valve isn't opening up enough for blood to flow into the part of your heart that sends blood into circulation."

While studying the physiology of the heart, the nursing students have learned that which of the following influence the blood flow in the coronary vessels that supply the myocardium? Select all that apply.

- the aortic pressure - autoregulatory mechanisms - compression of the intramyocardial vessels

A client who has been admitted to the emergency room with symptoms of a STEMI is given nitroglycerine. The nurse explains to the client's wife that this medication is given for which reason? Select all that apply.

- to relieve coronary pain - for its vasodialation effect

Tetralogy of Fallot is a congenital condition of the heart that manifests in four distinct anomalies of the infant heart. It is considered a cyanotic heart defect because of the right-to-left shunting of the blood through the ventricular septal defect. A hallmark of this condition is the "tet spells" that occur in these children. What is a tet spell?

A hypercyanotic attack brought on by periods of stress

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 decreases metabolic demands of the heart

It is known that over 100 distinct myocardial diseases can demonstrate clinical features associated with dilated cardiomyopathy (DCM). What is the most common identifiable cause of DCM in the United States?

Alcoholic cardiomyopathy

Four clients were admitted to the emergency department with severe chest pain. All were given preliminary treatment with aspirin, morphine, oxygen, and nitrates and were monitored by ECG. Which client most likely experienced myocardial infarction?

An 80-year-old woman whose pain started at 6 AM shortly after awakening and was not relieved by nitrates or rest; the ECG showed ST-segment elevation with inverted T waves and abnormal Q waves; levels of cardiac markers subsequently rose

The nursing instructor, when teaching the students about coronary artery disease (CAD), identifies which of the following as the main cause of CAD?

Atherosclerosis

Coronary artery bypass grafting (CABG) is a treatment modality for which disorder of cardiac function?

Atherosclerosis and unstable angina

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 the left atrium

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

The nurse anticipates that which clients would be considered a good candidate for coronary artery bypass grafting (CABG)?

Client with failed a percutaneous coronary intervention (PCI) and a history of myocardial infarction (MI) experiencing new-onset pain and ST elevation

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?

Conversion from aerobic to anaerobic metabolism

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?

Emotional stress

About a week after dental cleaning and root canal, a client has developed an infection of the thin, three-layered membrane that lines the heart and covers the valves. What is this client's most likely diagnosis?

Endocarditis

Chronic stable angina, associated with inadequate blood flow to meet the metabolic demands of the myocardium, is caused by:

Fixed coronary obstruction

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?

Genetic

A community health nurse is conducting a seminar at a local church group on health and wellness. Which of the following does she tell the group is the leading cause of death in the United States?

Heart disease

The health care provider is discussing major risk factors for coronary artery disease (CAD) with a client. The most important information for the provider to include would be:

History of cigarette smoking and elevated blood pressure

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?

Hypertrophic cardiomyopathy

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?

Infective endocarditis

While discussing the heart, the nursing instructor teaches about pericarditis. Which statement does the instructor state best defines this disease?

It is an inflammatory process

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

Exudate in the pericardial cavity is a characteristic of which cardiac condition?

Pericardial effusion

Which client is at the greatest risk of developing rheumatic heart disease?

Teenager with untreated strep throat

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 disabling effects that result from involvement of heart valves

A client has been diagnosed with aortic stenosis and asks the nurse what this means. The most appropriate response would be:

The valve opening is narrowed and produces increased resistance to blood flow out of the ventricle and into the aorta.

Which serum biomarker is highly specific for myocardial tissue?

Troponin

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?

Troponin level

A preventive measure to decrease the risk of developing rheumatic heart disease includes:

prompt diagnosis of streptococcal infections with a throat culture

The nurse determines that teaching has been effective when a client diagnosed with chronic stable angina (CSA) states:

"Angina may result from exertional activity or emotional stress and be relieved within minutes by rest or by nitroglycerin.

A 78-year-old man has been experiencing nocturnal chest pain over the last several months, and his family physician has diagnosed him with variant angina. Which of the following teaching points should the physician include in his explanation of the man's new diagnosis?

"I'm going to start you on low-dose aspirin, and it will help greatly if you can lose weight and keep exercising."

A client who was diagnosed with myocarditis asks the nurse what caused his disease. Which response by the nurse is most accurate?

It is usually caused by a viral infection

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?

Hypertrophic cardiomyopathy (HCM)