Ch 27- Disorders of Cardiac function
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 client experiences chest pain
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
What is the most common identifiable cause of secondary cardiomyopathy?
Alcohol abuse
Coronary artery bypass grafting (CABG) is a treatment modality for which disorder of cardiac function?
Atherosclerosis and unstable angina
A client awaiting a heart transplant is experiencing decompensation of her left ventricle that will not respond to medications. The health care providers (HCP) suggest placing the client on a ventricular assist device (VAD). The client asks what this equipment will do. Which response by the HCP most accurately describes the purpose of a VAD?
"Decreases the workload of the myocardium while maintaining cardiac output and systemic arterial pressure."
In heart failure, what causes the increase in renal secretion of renin?
Decreased cardiac output SUBMIT ANSWER
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
Which conditions reflect failure of the circulatory system? Select all that apply.
• Circulatory shock• Heart failure
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 report episodes of dizziness or fainting."
A client with heart failure asks, "Why am I taking a 'water pill' when it's my heart that is having a problem?" While educating the client about the Frank-Starling mechanism, which explanation is most appropriate to share?
"Since your heart is not pumping efficiently, the kidneys are getting less blood flow; therefore, the kidneys are holding on to sodium and water."
A client awaiting a heart transplant is experiencing decompensation of her left ventricle that will not respond to medications. The physicians suggest placing the client on a ventricular assist device (VAD). The client asks what this equipment will do. The health care providers respond:
"This device will decrease the workload of the myocardium while maintaining cardiac output and systemic arterial pressure."
A client diagnosed with diastolic heart failure asks the nurse to explain why this has developed. The nurse knows that which conditions are often associated with diastolic failure? Select all that apply.
- Constrictive pericarditis - Myocardial hypertrophy - Ischemic heart disease
A 60-year-old woman has just been diagnosed with heart failure and her primary care provider is describing the concept of adaptation. Which compensatory mechanisms may have masked the client's heart failure? Select all that apply.
- Hypertrophy of the myocardium - Sympathetic nervous stimulation - Increased renin-angiotensin-aldosterone system (RAAS) function - Increased preload
Which statements regarding heart failure are true? Select all that apply
- In uncompensated left-sided heart failure, there is pulmonary congestion and edema. - In compensated heart failure, cardiac output is normal. - In uncompensated right-sided heart failure, there is peripheral venous congestion and
Which statements regarding causes of systolic and diastolic dysfunction are most accurate? Select all that apply.
- Myocardial hypertrophy causes diastolic dysfunction.• - Ischemic heart disease causes systolic dysfunction. - Valvular insufficiency causes systolic dysfunction.
For which consequences of cardiogenic shock will the nurse monitor a trauma client? Select all that apply.
-Decreased stroke volume -Decreased cardiac output -Increased afterloading
When the electrocardiogram (ECG) of a client in the emergency department indicates an ST elevation myocardial infarction (STEMI) in progress, the physician orders a beta-adrenergic blocker. Which factors in the client's history will cause the nurse to withhold medication pending discussion with physician? Select all that apply.
-Myocardial infarction caused by cocaine use -Third-degree heart block -Shock
On the third day following an acute myocardial infarction, the client asks the nurse how the heart muscle will heal. What is the nurse's best response? A. "The body will clear away the dead cells and you will be left with some scar tissue on your heart muscle." B. "The heart muscle cells that were damaged will eventually regenerate and be functional again." C. "New blood vessels will be formed to help increase blood supply to the damaged area and speed the healing." D. "The cells affected by lack of blood flow have died and will remain as a nonfunctioning part of your heart muscle."
A. "The body will clear away the dead cells and you will be left with some scar tissue on your heart muscle."
A client asks the purpose of an exercise stress test. What is the nurse's best response? A. "The test is used to measure functional status during stress." B> "This will help you endure exercise." C. "This test is necessary prior to starting medication therapy for obesity." D. "This is to assess your tolerance of isometric exercise."
A. "The test is used to measure functional status during stress."
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? A. 20 mL/hour B. 60—40 mL/hour C. 80—60 mL/hour D. 40—20 mL/hour
A. 20 mL/hour
What is the primary cause of heart failure in infants and children? A. Structural heart defects B. Reactions to medications C. Idiopathic heart disease D. Hyperkalemia
A. Structural heart defects
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 epinephrine (adrenaline).
The nurse is preparing to auscultate for a mitral valve stenosis murmur. Where is the best location to place the stethoscope?
At the apex of the heart
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? A. "The left ventricle is having problems pumping blood forward, so blood is backing up systemically causing edema in your feet." B. "The left ventricle is having problems pumping blood forward, and this is causing blood to back up into your lungs." C. "The left ventricle is not adequately perfusing your gastrointestinal tract, leading to diarrhea and vomiting." D. "The left ventricle is pumping excessive amounts of blood through the carotid arteries causing headache."
B. "The left ventricle is having problems pumping blood forward, and this is causing blood to back up into your lungs."
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? A. Backflow from the right ventricle to the right atrium during systole B. Backflow from the left ventricle to left atrium C. Inhibition of the SA node's normal action potential D. Backup of blood from the right atrium into the superior vena cava
B. Backflow from the left ventricle to left atrium
The health care provider is reviewing diagnostic tests that were ordered for a client diagnosed with heart failure. Select the test that would provide information about the client's ejection fraction and ventricular preload. A. Intracranial pressure (ICP) measurement B. Cardiac computerized axial tomography (CCT) C. Electrocardiography (EKG) D. Chest x-ray
B. Cardiac computerized axial tomography (CCT) Cardiac magnetic resonance imaging (CMRI) and cardiac computerized axial tomography (CCT) are used to document ejection fraction, ventricular preload assessment, and regional wall motion.
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: A. Acute respiratory distress syndrome (ARDS) B. Onset of STEMI C. Gastroesophageal reflux disease (GERD) D. Pneumonia
B. Onset of STEMI The onset of STEMI involves abrupt and significant chest pain. The pain typically is severe, often described as being constricting, suffocating, and crushing. Substernal pain that radiates to the left arm, neck, or jaw is common,
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? A. "I'll be sure to take my beta-blocker whenever I feel short of breath." B. "BI know it's healthy to drink a lot of water, and I'm going to make sure I do this from now on." C. "I'm trying to think of ways that I can cut down the amount of salt that I usually eat." D. "I'm going to avoid as much physical activity as I can so that I preserve my strength."
C. "I'm trying to think of ways that I can cut down the amount of salt that I usually eat."
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? A. Neurogenic B. Cardiogenic C. Anaphylactic D. Septic
C. Anaphylactic
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? A. Rheumatic cardiac disease B. Myocardial infarction C. Cardiomyopathy D. Heart failure
C. Cardiomyopathy
A newborn is diagnosed with Tetralogy of Fallot. Prior to surgery, which abnormality should be corrected to prevent a stroke? A. Weight of 3200 grams B. Frequent liquid-pasty stools C. Iron deficiency anemia D. Urine output 8 times/day
C. Iron deficiency anemia
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? A. Abdominal aortic aneurysm B. Pneumonia C. Pericarditis D. Myocardial infarction
C. Pericarditis
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? A. Cardiogenic B. Neurogenic C. Septic D. Anaphylactic
C. Septic
A client has been diagnosed with heart failure. The client's cardiac contractility will be primarily affected by which factor?
Ca2+ levels in the myocardium
The nursing student correctly identifies which major risk factors for coronary artery disease? Select all that apply.
Cigarette smoking Elevated blood pressure Elevated LDL Diabetes Abdominal obesity
A nurse is assessing a client in shock for complications of acute renal failure. Which assessment is priority for the nurse to obtain?
Continuously measuring urine output
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
What is the most important factor in myocardial oxygen demand? A Hyperthermia B Respiratory rate C Degree of anxiety D Heart rate
D Heart rate
Anaphylactic shock is the most severe form of systemic allergic reaction. Immunologically medicated substances are released into the blood, causing vasodilation and an increase in capillary permeability. What physiologic response often follows the vascular response in anaphylaxis? A. Bronchodilation B. Uterine smooth muscle relaxation C. Gastrointestinal relaxation D. Laryngeal edema
D. Laryngeal edema The vascular response in anaphylaxis is often accompanied by life-threatening laryngeal edema and bronchospasm, circulatory collapse, contraction of gastrointestinal and uterine smooth muscle, and urticaria (hives) or angioedema.
A client has developed pericarditis. The nurse knows this condition will increase the risk for developing which condition?
Diastolic dysfunction
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
Increased cardiac workload with left-sided heart failure can result in which change to the myocardial cells?
Hypertrophy
In a client with hypovolemic shock, which assessment findings alert the nurse that compensatory mechanisms are attempting to support cardiac output. Select all that apply.
Increased heart rate Vasoconstriction Activation of the renin-angiotensin-aldosterone system (RAAS
Which intervention will the nurse anticipate being prescribed to treat an adult admitted to the ICU with acute respiratory distress syndrome (ARDS)?
Increasing oxygen concentration in the inspired air
Increased secretion of renin in heart failure is caused by which event?
Low cardiac output
Following cardiac surgery, the nurse suspects the client may be developing a cardiac tamponade. Which clinical manifestations would support this diagnosis? Select all that apply
Low BP—84/60 mm Hg Muffled heart tones Narrowed pulse pressure
A client was in car accident client while not wearing a seatbelt and has sustained multiple rib fractures. During assessment, the nurse is having a hard time hearing heart sounds, and the client reports chest pain/pressure repeatedly. This client may be experiencing:
Pericardial effusion
Exudate in the pericardial cavity is a characteristic of which cardiac condition?
Pericardial effusion
The nurse caring for a client 12 hours after a coronary bypass graft notes a sudden decrease in the amount of chest tube drainage, a rapidly narrowing pulse pressure, paradoxical pulse, and shortened amplitude of the QRS complex on the electrocardiogram monitor. Which action should the nurse take next?
Prepare for pericardiocentesis
Heart failure can increase one's risk for developing manifestations related to which complications? Select all that apply.
Pulmonary congestion Systemic congestion Low cardiac outpu
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?
Raising the head of the bed to a high Fowler's position
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?
Rheumatic fever
The nurse should anticipate administering intravenous antibiotic therapy as a priority to a client experiencing which type of shock?
Septic shock
How can the health care provider determine if the client has "aerobic fitness"?
Tests help to determine aerobic fitness by measuring heart rate while under the stress of exercise.
When lecturing to a group of students about the pathophysiologic principles behind heart failure, the instructor defines cardiac output as which example?
The amount of blood the heart pumps each minute
Which serum biomarker is highly specific for myocardial tissue?
Troponin
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?
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?
Troponin level
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: A. Valvular stenosis B. Pericardial effusion C. Infective endocarditis D. Valvular regurgitation
Valvular regurgitation
A client who has progressed to late-stage heart failure is experiencing sympathetic stimulation. The nurse would correlate which manifestations with sympathetic response? Select all that apply.
VasoconstrictionArrhythmiasIncreased oxygen demand
A person with blood pressure of 68/38 fainted after donating a unit of blood. The blood bank technician stated that the person was experiencing low preload from loss of blood volume. The nurse knows that preload refers to which of the following?
Venous return to the heart
The pathophysiology of heart failure involves an interaction between decreased pumping ability and the ________ to maintain cardiac output.
compensatory mechanisms
Which health condition can contribute to diastolic dysfunction heart failure?
myocardial hypertrophy
A client has developed cardiogenic shock. The most frequent cause of this type of shock is:
myocardial infarction
A client reports severe indigestion that has been intermittent; however, the pain is now constant and feels like a vise. The nurse does an ECG and recognizes that the situation is possibly emergent due to ST-segment elevation, which could indicate:
myocardial infarction
The nurse is developing a plan of care for a client diagnosed with stable angina. Select the most important goal for this client.
myocardial infarction prevention
A nurse is assessing a client diagnosed with severe mitral valve stenosis. The nurse anticipates which classic assessment finding?
orthopnea
A client has been experiencing increasing fatigue in recent months, a trend that has prompted an echocardiogram. The results suggest that the client's end-diastolic volume is insufficient. Which parameter of cardiac performance will directly decrease as a result of this finding?
preload
While teaching a client with new-onset right-sided heart failure, the nurse should educate the client to monitor for fluid accumulation by:
recording weight every day at the same time with same type of clothing.
Which of the following describes surgical correction of tetralogy of Fallot?
Closure of the ventricular-septal defect and relief of the right ventricular outflow obstruction
When a physician suspects a client has suffered an acute myocardial infarction, which serum biomarkers should he order? Select all that apply.
- Troponin 1 - Creatine kinase - Troponin T
Which client should most benefit from treatment with anti-thrombin agents?
57-year-old client who has recently been diagnosed with unstable angina
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.
For its vasodilation effect and To relieve coronary pain
Acute pulmonary edema often occurs with heart failure. Which signs of acute pulmonary edema should the nurse monitor their clients for? Select all that apply.
Frothy, blood-tinged sputum Respiratory crackles Confusion Rapid pulse
A client who has just recently completed his second series of radiation therapy for lung cancer was admitted yesterday to an acute care facility with ascites. He begins to have jugular vein distention, pedal edema, and dyspnea upon exertion as well as fatigue. What should the nurse suspect?
He has developed constrictive pericarditis. SUBMIT ANSWER
Chronic stable angina, associated with inadequate blood flow to meet the metabolic demands of the myocardium, is caused by:
Fixed coronary obstruction
The sympathetic (adrenergic) nervous system is an important compensatory mechanism in heart failure. Which statements regarding the sympathetic nervous system response to heart failure are correct? Select all that apply.
-The sympathetic nervous system responds rapidly to a fall in cardiac output. -The sympathetic nervous system increase in heart rate and force of contraction support cardiac output. -The sympathetic nervous system increase in cardiac workload and oxygen use can cause ischemia and worsening of heart failure.
The nurse is monitoring hourly urine output of a client diagnosed with hypovolemic shock. The nurse is most concerned if the client's output is:
20 mL/hour
Dysrhythmias can occur in clients with heart failure. The dysrhythmia that occurs most frequently in heart failure is: A. Atrial fibrillation B. Ventricular fibrillation C. Atrioventricular heart block D. Nodal tachycardia
A. Atrial fibrillation
Neurogenic shock, or spinal shock, is a phenomenon caused by the inability of the vasomotor center in the brain stem to control blood vessel tone through the sympathetic outflow to the blood vessels. In neurogenic shock, what happens to the heart rate and the skin? A. Heart rate slower than normal; skin warm and dry B. Heart rate slower than normal; skin cool and moist C. Heart rate slower than normal; skin warm and dry D. Heart rate faster than normal; skin cool and moist
A. Heart rate slower than normal; skin warm and dry
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? A. Infective endocarditis B. Cardiomyopathy C. Pericarditis D. Myocardial infarction
A. Infective endocarditis
A pediatric nurse is assessing a newborn diagnosed with persistent patency of the ductus arteriosus. Which assessment findings are associated with this heart defect? Select all that apply. A. Murmur heard at the second intercostal space, during both systole and diastole. B. BP 84/30 classified as a wide pulse pressure. C. Shortness of breath with activity such as kicking. D. Stridor with inspiratory wheezes. E. Bulging jugular neck veins.
A. Murmur heard at the second intercostal space, during both systole and diastole. B. BP 84/30 classified as a wide pulse pressure.
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? A. Vasodilating effects reducing preload and afterload B. Decreased heart rate and increased stroke volume C. Reduction of cardiac refractory periods D. Increased preload
A. Vasodilating effects reducing preload and afterload
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? A. Weight gain B. Copious urination C. Shortness of breath D. Decreased blood pressure
A. Weight gain
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: A. selectively blocking the synthesis of renin in the kidneys. B. enhancing inotropy by maximizing calcium channel function. C. blocking the conversion of angiotensin I to angiotensin II. D. promoting cardiac output through a reduction in afterload.
A. blocking the conversion of angiotensin I to angiotensin II.
The nursing student has learned in his class that coronary artery disease (CAD) is heart disease caused by: A. impaired coronary blood flow. B. a congenital defect. C. exposure to too much sunlight. D. Frequent exercise.
A. impaired coronary blood flow.
A preventive measure to decrease the risk of developing rheumatic heart disease includes: A. prompt diagnosis of streptococcal infections with a throat culture. B. blood specimen assessed for rheumatoid factor. C. scheduling regular hearing examinations. D. yearly electrocardiography after the age of 50.
A. prompt diagnosis of streptococcal infections with a throat culture.
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? A. COPD B. Pericardial effusion C. Pericarditis D. Myocardial infarction
B. Pericardial effusion
Which client is at the greatest risk of developing rheumatic heart disease? A. Child with impetigo on the face B. Teenager with untreated strep throat C. Young adult with viral meningitis D. Older adult with shingles
B. Teenager with untreated strep throat
Which disease is caused by calcified scar tissue that develops between the visceral and parietal layers of the serous pericardium? A. mediastinal radiation B. constrictive pericarditis C. pleural effusion D. acute pericarditis
B. constrictive pericarditis In constrictive pericarditis, fibrous, calcified scar tissue develops between the visceral and parietal layers of the serous pericardium. -Acute pericarditis is due to inflammation of the pericardium. -Pericardial effusion is caused by accumulation of fluid and can lead to cardiac tamponade.
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: A. placing a stent for fluid drainage from the heart. B. improving quality of life by relieving symptoms. C. maintaining higher oxygen levels to decrease the work of breathing. D. eliminating CHF through curing the disease.
B. improving quality of life by relieving symptoms.
Assessment of an older adult client reveals bilateral pitting edema of the client's feet and ankles; difficult to palpate pedal pulses; breath sounds clear on auscultation; oxygen saturation level of 93% (0.93); and vital signs normal. What is this client's most likely health problem? A. pericarditis B. right-sided heart failure C.cor pulmonale D. cardiogenic shock
B. right-sided heart failure A major effect of right-sided heart failure is the development of peripheral edema. -A client who is in shock would not have stable vital signs. -Cor pulmonale would be accompanied by manifestations of lung disease. -Pericarditis is an inflammation of the pericardium exhibited by fever, precordial pain, dyspnea, and palpitations.
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? A. 33-year-old man whose pain started at 7 AM during moderate exercise and was relieved by nitrates; ECG was normal; cardiac markers remained stable B. 67-year-old woman whose pain started at 2 AM while she was asleep and that responded to nitrates; the ECG showed dysrhythmias and ST-segment elevation; cardiac markers remained stable C. 80-year-old woman whose pain 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 D. 61-year-old man whose pain started at 9 AM during a short walk and responded to nitrates, but not to rest; ECG and cardiac markers remained stable, but anginal pattern worsened
C. 80-year-old woman whose pain 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 chest pain of myocardial infarction does not respond to rest or to nitrates. Ischemic injury to the myocardium alters the ECG patterns, often elevating the ST segment and inverting T waves. -Abnormal Q waves indicate necrosis. -Cardiac markers are released in response to myocardial injury; rising levels indicate damage to the heart
An 86-year-old client is disappointed to learn that he or she has class II heart failure despite a lifelong commitment to exercise and healthy eating. Which age-related change predisposes older adults to the development of heart failure? A. Loss of action potential B. Orthostatic hypotension C. Increased vascular stiffness D. Increased cardiac contractility
C. Increased vascular stiffness Increased vascular stiffness in older adults causes a progressive increase in systolic blood pressure with advancing age
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? A. Cardiogenic shock B. Distributive shock C. Obstructive shock D. Hypovolemic shock
C. Obstructive shock
Which client with cardiomyopathy does the nurse identify as having the greatest risk for a complication?
Client with an ejection fraction of 25% and atrial fibrillation
Which statement regarding heart failure is true?
Compensated congestive heart failure may be clinically asymptomatic.
For clients with heart failure, which pathophysiologic response helps maintain the cardiac reserve?
Compensatory mechanisms
What should the nurse teach the pregnant woman about congenital heart defects? A. Congenital heart defects cannot be prevented. B. Congenital heart defects occur during conception. C. Congenial heart defects occur prior to conception as a result of exposure to toxins. D. Congenital heart defects occur between the 3rd and 8th weeks of development before you know you are pregnant.
D. Congenital heart defects occur between the 3rd and 8th weeks of development before you know you are pregnant.
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? A. Have the client breathe deeply. B. Have the client change positions to unaffected side. C. Have the client swallow slowly and frequently. D. Have the client sit up and lean forward.
D. Have the client sit up and lean forward.
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? A. Takotsubo cardiomyopathy B. Arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D) C. Dilated cardiomyopathy (DCM) D. Hypertrophic cardiomyopathy (HCM)
D. Hypertrophic cardiomyopathy (HCM)
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? A. Weakness, palpitations B. Vertigo, headache C. Dyspnea, cough D. Peripheral edema, weight gain
D. Peripheral edema, weight gain In right-sided heart failure, blood backs up into the venous side of the circulatory system causing increased hydrostatic pressure in capillaries and leakage of plasma, which forms peripheral edema
Heart failure and circulatory shock are both conditions of circulatory system failure. Which statement regarding these conditions is correct? A. They have the same etiology. B. They have the same pathogenesis. C. They have the same remediation. D. They have the same compensatory mechanisms.
D. They have the same compensatory mechanisms.
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: A. renal failure due to an overdose of medication. B. pulmonary embolism due to development of deep vein thrombosis. C. side effects from the administration of midazolam, causing excessive vasoconstriction. D. hypovolemic shock due to acute intravascular volume loss.
D. hypovolemic shock due to acute intravascular volume loss.
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 condition is getting progressively worse.
A 20-year-old male client is experiencing a severe immunologically mediated reaction in which histamines have been released into the blood. Which type of reaction is most likely occurring with this client?
anaphylatic shock
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?
beta-adrenergic blocking drugs (beta-blockers)
Unstable angina (UA)/non-ST-segment elevation myocardial infarction (NSTEMI) is a clinical syndrome that ranges in severity between stable angina and MI. It is classified according to its risk of causing an acute MI and is diagnosed based on what assessment data? Select all that apply.
d)Serum biomarkerse)ECG pattern
The nurse is developing a plan of care for a client with heart failure. The most important information for the nurse to consider would be:
decreased cardiac output
A nurse is teaching a client with newly diagnosed dilated cardiomyopathy (DCM) about associated treatments. The nurse determines that the knowledge is understood when the client correctly matches which drug category to the primary action of decreasing preload by suppressing renal reabsorption of sodium and increasing salt and water excretion?
diuretics
A client with heart failure has just had an automatic defibrillator implanted. When the nurse is performing follow-up assessment the next month, which finding is most likely the result of a complication?
fever and diaphors
A client who is experiencing angina at rest that has been increasing in intensity should be instructed to:
see the doctor for evaluation immediately.
The plaques in a client's coronary arteries are plentiful, and most have small- to moderate-sized lipid cores with thick fibrous caps. This form of atherosclerosis is most closely associated with which diagnosis?
stable angina
Levels of endothelins may be increased in clients with heart failure. Which of the following is the primary action of endothelins?
vasoconstriction
The nursing student has learned in class that pericarditis is an inflammatory process of the pericardium. What is known to be the main cause of pericarditis?
viral infections
