Chapter 14: The Cardiovascular System

Where is Erb's point located? 3rd right rib space 4th left rib space 3rd left rib space 4th right rib space

3rd left rib space

The nurse hears high-pitched swooshing sounds over the carotid artery on the right side. What is this sound indicative of? Bruits Murmurs Normal findings Gallops

Bruits

The nurse is integrating health promotion education into the assessment of a client's heart and neck vessels. What teaching point addresses the most significant risk factor for coronary artery disease? "Your risk for heart disease will drop greatly if you're able to stop smoking." "If you can eliminate red meat from your diet, your risk of heart disease will drop significantly." "Anything that you can do to reduce stress in your life will benefit your heart health." "Try to ensure that you're screened for heart disease at least once every six months."

"Your risk for heart disease will drop greatly if you're able to stop smoking."

A nurse auscultates a client's heart rate and rhythm and finds the rhythm to be irregular. What would the nurse do next? Auscultate for pulse rate deficit. Inspect for a lift. Listen for a ventricular gallop. Palpate for a thrill.

Auscultate for pulse rate deficit.

What is located at the right and left 2nd intercostal spaces next to the sternum? Pulmonary vein Base of the heart Aortic valve Apex of the heart

Base of the heart

During an interview with the nurse, a client complains of a fatigue that seems to get worse in the evening. Which of the following causes of fatigue would explain this pattern? Decreased cardiac output Upper respiratory infection Severe muscular exertion Depression

Decreased cardiac output Explanation:Fatigue may result from compromised cardiac output. Fatigue related to decreased cardiac output is worse in the evening or as the day progresses, whereas fatigue seen with depression is ongoing throughout the day. Severe muscular exertion and an upper respiratory infection may be associated with fatigue, but not the pattern mentioned in the scenario.

How does the nurse differentiate a pleural friction rub from a pericardial friction rub? Have the client hold his or her breath; if the rub persists, it is pericardial Turn the client on the right side; if the rub persists, it is pericardial Auscultate the upper back; if a rub is present, it is pleural Auscultate the base of the heart; if a rub is present, it is pericardial

Have the client hold his or her breath; if the rub persists, it is pericardial Pericardial friction rubs can be differentiated from pleural friction rubs by having the client hold the breath. If present without breathing, the rub is pericardial. Turning the client to the right side and auscultating either the base of the heart or the upper back do not differentiate between pericardial and pleural friction rubs.

During the health history interview with a 40-year-old man, the nurse uses the genogram to specifically assess for major family risk for cardiovascular disease by asking about which of the following? Heart attacks in his father and siblings Weight patterns within his family Diabetes mellitus in his extended family Hypertension in his grandparents

Heart attacks in his father and siblings

A nurse is preparing a health education session for a local community group. When addressing the relationship between coronary artery disease (CAD) and culture, what information would the nurse include? Hypertension is seen more in white women than in African-American women. Hispanic Americans have a higher rate of CAD than white Americans. Hypertension is more prevalent in African Americans than among Caucasians. Caucasians usually possess greater lifestyle risks for CAD than African Americans.

Hypertension is more prevalent in African Americans than among Caucasians.

The nurse understands that when the sympathetic nervous system is stimulated what occurs? Select all that apply. Increased cardiac output Decreased cardiac output Increased blood pressure Decreased blood pressure Increased heart rate

Increased cardiac output Increased blood pressure Increased heart rate Explanation:When the sympathetic nervous system is stimulated, epinephrine and norepinephrine are released which causes an increased heart rate and cardiac output and and increase in the blood pressure.

A nurse cares for a client who suffered a myocardial infarction two (2) days ago. A high pitched, scratchy, scraping sound is heard that increase with exhalation and when the client leans forward. The nurse recognizes this sound as a result of what process occurring within the pericardium? Inflammation of the pericardial sac Increased pressure within the ventricle Incompetent mitral valve Inability of the atria to contract

Inflammation of the pericardial sac

A group of students is reviewing information about the different types of murmurs. Which of the following would they identify as examples of midsystolic murmurs? Mitral regurgitation Innocent Mitral stenosis Ventricular septal defect

Innocent

The nurse is caring for a client who has an elevated cholesterol level. To reduce the mean total blood cholesterol and low-density lipoprotein (LDL) cholesterol levels, what diet should the nurse discuss with the client? High-protein, low-fat meals High-protein, low-carbohydrate meals Low-cholesterol, low-carbohydrate meals Low-fat, low-cholesterol meals

Low-fat, low-cholesterol meals

A client complains of difficulty sleeping, stating he has to sit up with the help of several pillows and cannot breathe when lying flat. This client has a condition known as what? Tachypnea Sleep apnea Orthopnea Pneumonia

Orthopnea Orthopnea, which is dyspnea that occurs when lying down and improves when sitting up, is part of the cardiovascular review of systems and, if positive, may indicate congestive heart failure.

A 58-year-old teacher presents with breathlessness with activity. The client has no chronic conditions and does not take any medications, herbs, or supplements. Which of the following symptoms is appropriate to ask about in the cardiovascular review of systems? Abdominal pain Hematochezia Tenesmus Orthopnea

Orthopnea which is dyspnea that occurs when lying down and improves when sitting up, is part of the cardiovascular review of systems and, if positive, may indicate congestive heart failure. (less)

The nurse is preparing to assess a client's carotid arteries. Which of the following would be most appropriate? Palpate the arteries before auscultating them Use the diaphragm of the stethoscope Ask the client to breathe in and out deeply Palpate each artery individually to compare

Palpate each artery individually to compare Explanation:When assessing a client's carotid arteries, the nurse should palpate each artery individually because bilateral palpation could result in reduced cerebral blood flow. Auscultation should be done before palpation because palpation may increase or slow the heart rate, changing the strength of the carotid pulse heard. The nurse should use the bell of the stethoscope to auscultate the arteries and have the client hold his or her breath for a moment so breath sounds do not conceal any vascular sounds.

The nurse is assessing the carotid arteries of a client with a history of heart disease. What action should the nurse perform during this assessment? Palpate the client's carotid arteries prior to auscultation. Palpate the client's left and right carotid arteries simultaneously. Palpate the client's carotid arteries gently if an occlusion is audible. Instruct the client to inhale and exhale forcefully during auscultation.

Palpate the client's carotid arteries gently if an occlusion is audible.

While auscultating the client's heart at the third intercostal space and on the left sternal border, the nurse notes a high-pitched, scratchy sound that increases with exhalation with the client leaning forward. How would the nurse document the findings? Summation gallop Mid-systolic click Pericardial friction rub Aortic ejection click

Pericardial friction rub

A client comes to the emergency department reporting a sudden onset of dyspnea. What finding is a manifestation of dyspnea? Painful breathing Inability to breathe Rapid breathing Shortness of breath

Shortness of breath

The nurse is providing teaching about cardiovascular disease in a community setting. What risk factors would the nurse identify to the group as those they can modify through lifestyle choices? Select all that apply. Family history Age Smoking Cholesterol Blood pressure

Smoking Cholesterol Blood pressure

The nurse auscultates the apical pulse and then palpates the PMI (point of maximal impulse). To best palpate the PMI, the nurse places two fingers at the left border of the heart in the 5th intercostal space. False True

True

The bicuspid, or mitral, valve is located between the right atrium and the right ventricle. between the left atrium and the left ventricle. at the exit of each ventricle near the great vessels. at the beginning of the ascending aorta.

between the left atrium and the left ventricle.

The nurse prepares to perform a cardiovascular examination. The nurse understands the components of this examination include (Select all that apply.) examining the neck inspecting and palpating the precordium inspecting the hands and lower legs examining the face auscultating the lungs

examining the neck examining the face inspecting the hands and lower legs inspecting and palpating the precordium