de wit med surg Ch 17 NCLEX "The Cardiovascular System" EAQ

A patient is to wear fitted elastic stockings. Which instruction should be given to the patient? 1 "Do not wash the stockings in warm water." 2 "Replace the stockings at least every 6 months." 3 "Put the stockings on after you have walked around for about an hour." 4 "Lubricate your legs with a water-repellent petroleum jelly before putting stockings on."

"Replace the stockings at least every 6 months." The stockings lose their elasticity and should be replaced every 6 months. The legs should not be lubricated before putting the stockings on; the stockings should be washed after each use; and the stockings should be applied before getting out of bed each morning.

The patient asks the nurse what kind of cardiovascular disorders the electrocardiogram (ECG) is used to diagnose. Which response by the nurse is most accurate? 1 "The ECG detects cardiovascular disorders that alter the heartbeat sounds." 2 "The ECG detects disorders in the electrical impulses, heart rate, and rhythm." 3 "The ECG detects cardiovascular disorders that cause a change in heart size and shape." 4 "The ECG detects cardiovascular disorders that respond to increased stress and oxygen demand."

"The ECG detects disorders in the electrical impulses, heart rate, and rhythm." The ECG records the electrical impulses of the heart, detecting disorders in the electrical impulses, heart rate, and rhythm. An echocardiogram would detect disorders that change the heart's shape and size and alter the heart sounds. A stress test would detect disorders that occur with increased oxygen demand.

The student nurse is discussing the cardiovascular system with a patient. Which comment by the student is correct regarding the origin of the heart's natural pacemaker impulse? "The heart's natural pacemaker is the bundle of His." 2 "The heart's natural pacemaker is the Purkinje fibers." 3 "The heart's natural pacemaker is the left bundle branch." 4 "The heart's natural pacemaker is the sinoatrial (SA) node."

"The heart's natural pacemaker is the sinoatrial (SA) node." The SA node is located in the right atrium and is called the "pacemaker" of the heart because it normally initiates the electrical impulses. The natural pacemaker in the heart is not the bundle of His, Purkinje fibers, or the left bundle branch.

The patient who is scheduled for a nuclear (thallium) imaging scan asks the nurse about the purpose of this test. Which response by the LPN/LVN is correct? 1 "This test measures the electrical activity within the heart." 2 "This test evaluates blood flow in various parts of the heart." 3 "This test determines the pressure in various chambers of the heart." 4 "This test provides visual information about the interior of a coronary artery."

"This test evaluates blood flow in various parts of the heart." The thallium perfusion imaging scan evaluates blood flow in various parts of the heart and can determine areas of infarction in the heart. This test does not measure electrical activity within the heart or pressure in various chambers of the heart, nor does it provide visual information about the interior of a coronary artery.

A pt is scheduled for cardiac catheterization this morning. Before the procedure can be started, what must be accomplished?

*Assess renal status. *Assess the pt's allergy status, especially related to iodine. *The physician must obtain informed consent for the procedure from the pt.

The nurse is preparing to implement a teaching plan for a pt w/ mild HTN. What should be included in the plan for this pt?

*Controlling stress *Controlling weight *Restricting sodium intake *Monitoring and keeping cholesterol level normal

The prevention of leg ulcers is extremely important. What are some ways to help prevent leg ulcers? Select all that apply. 1 Avoiding extreme cold 2 Proper positioning and exercise 3 Avoiding injury to the feet and legs 4 Wearing elastic bandages or support hose 5 Maintain a blood glucose level of more than 200 mg/dL

1 Avoiding extreme cold 2 Proper positioning and exercise 3 Avoiding injury to the feet and legs 4 Wearing elastic bandages or support hose Ways to help prevent leg ulcers include avoiding extreme cold, proper positioning and exercise, avoiding injury to the feet and legs, and wearing elastic bandages or support hose. Maintaining a blood glucose level of more than 200 mg/dL would be a risk factor for leg ulcers and would be detrimental to the healing process of existing leg ulcers.

The nurse is preparing to implement a teaching plan for a patient with mild hypertension. What should be included in the plan for this patient? Select all that apply. 1 Controlling stress 2 Controlling weight 3 Restricting sodium intake 4 Maintaining a sedentary lifestyle 5 Monitoring and keeping cholesterol level normal

1 Controlling stress 2 Controlling weight 3 Restricting sodium intake 5 Monitoring and keeping cholesterol level normal Stress, high cholesterol level, high sodium intake, and obesity are contributing factors for hypertension and should be addressed. A sedentary lifestyle is a contributing factor for hypertension and should be avoided.

The nurse knows that hypokalemia is a very serious condition. What are some signs of hypokalemia? Select all that apply. 1 Fatigue 2 Confusion 3 Weakness 4 Muscle cramps 5 New onset of tachycardia

1 Fatigue 2 Confusion 3 Weakness 4 Muscle cramps Fatigue, weakness, confusion, muscle cramps, and new onset of bradycardia (not tachycardia) are signs of a low potassium level or hypokalemia.

While assessing the heart sounds of a patient, what actions should a nurse take? Select all that apply. 1 Listen for murmurs with the bell of the stethoscope. 2 Ask the patient to lean forward to enhance the sounds. 3 Listen to the fourth intercostal space for the aortic area. 4 Place the patient in a left side-lying position to detect sounds. 5 Use the diaphragm of the stethoscope to listen to S1 and S2 sounds.

1 Listen for murmurs with the bell of the stethoscope. 2 Ask the patient to lean forward to enhance the sounds. 4 Place the patient in a left side-lying position to detect sounds. 5 Use the diaphragm of the stethoscope to listen to S1 and S2 sounds. The nurse listens to the S1 and S2 sounds with the diaphragm of the stethoscope because they are high pitched. Murmurs can be detected with the bell of the stethoscope. The nurse instructs the patient to lean forward or to get into a left side-lying position to enhance the sounds. The second intercostal space, to the right of the sternal border, is the best place to listen to the aortic area.

What is included in the nursing assessment of a cardiac patient? Select all that apply. 1 Pain 2 Fatigue 3 Dyspnea 4 Leg edema 5 Orthopnea 6 Weight loss

1 Pain 2 Fatigue 3 Dyspnea 4 Leg edema 5 Orthopnea Pain in this context refers to chest pain; this includes the radiation of the chest pain to the jaw, shoulder, or arm, as well as the quality of the pain. Fatigue is related to impaired oxygenation. Dyspnea is shortness of breath with exertion. Leg edema is related to the compromised pumping action of the heart. Orthopnea is difficulty breathing when in the supine position. Patients with cardiac disorders will more likely experience weight gain rather than weight loss.

When checking the apical pulse, it should be counted for how long? 1 1 minute 2 2 minutes 3 3 minutes 4 30 seconds

1 minute The apical pulse should be counted for a full minute. It is not appropriate to count for only 30 seconds. Counting for 2 or 3 minutes is not necessary to obtain the apical pulse.

Place the pathway of blood flow through the heart in order.

1.Right atrium 2.Tricuspid valve 3.Right ventricle 4.Pulmonic valve 5.Left atrium 6.Mitral valve 7.Left ventricle 8.Aortic valve The correct pathway of blood flow is through the right atrium, the tricuspid valve, the right ventricle, the pulmonic valve, the left atrium, the mitral valve, the left ventricle, and the aortic valve.

Place the impulse conduction pathway in order. 1.Sinoatrial node 2.Atrioventricular node 3.Bundle of His 4.Right and left bundle branches 5.Purkinje fibers

1.Sinoatrial node 2.Atrioventricular node 3.Bundle of His 4.Right and left bundle branches 5.Purkinje fibers The correct impulse conduction pathway is the sinoatrial node, the atrioventricular node, bundle of His, right and left bundle branches, and Purkinje fibers.

Superior vena cava/inferior vena cava → Right atrium → valve → Right ventricle → valve → Pulmonary artery → Capillaries in the lung → Pulmonary veins → Left atrium → valve → Left ventricle → valve → Aorta

1.Tricuspid 2.Pulmonic 3.Mitral 4.Aortic The tricuspid valve lies between the right atrium and the right ventricle; the pulmonic valve lies between the right ventricle and the pulmonary artery; the mitral valve lies between the left atrium and the left ventricle; and the aortic valve lies between the left ventricle and the aorta.

Place the answer options in the correct order to complete the description of the blood circulation pattern through the heart valves. Superior vena cava/inferior vena cava → Right atrium → valve → Right ventricle → valve → Pulmonary artery → Capillaries in the lung → Pulmonary veins → Left atrium → valve → Left ventricle → valve → Aorta

1.Tricuspid 2.Pulmonic 3.Mitral 4.Aortic The tricuspid valve lies between the right atrium and the right ventricle; the pulmonic valve lies between the right ventricle and the pulmonary artery; the mitral valve lies between the left atrium and the left ventricle; and the aortic valve lies between the left ventricle and the aorta.

The nurse is assessing the patient's cardiovascular system. Which sign(s) or symptom(s) should the nurse be alert to? Select all that apply. 1 Pulse rate above 80 2 Crackles in the lungs 3 Patient descriptions of interrupted sleep patterns 4 Patient statements regarding death of close family member 5 Patient statements such as, "My shoes started feeling tight a few days ago"

2 Crackles in the lungs 3 Patient descriptions of interrupted sleep patterns 4 Patient statements regarding death of close family member 5 Patient statements such as, "My shoes started feeling tight a few days ago" Crackles in the lungs, interrupted sleep patterns, and complaints of increasing tightness of shoes indicate fluid retention and edema. A patient who experienced the death of a close family member would be under stress, which is a possible cause of cardiac disorder. Unless unusual for a particular patient, a pulse rate of 80 to 100 beats/min is considered within normal limits.

The nurse knows the importance of teaching the public the various warning signs of a heart attack so that immediate action can be taken. What are those warning signs? Select all that apply. 1 Eye pain 2 Jaw pain 3 Chest pain 4 Shortness of breath 5 Feeling of impending doom

2 Jaw pain 3 Chest pain 4 Shortness of breath 5 Feeling of impending doom Jaw pain, chest pain, shortness of breath, and the feeling of impending doom are among the various warning signs of a heart attack. Eye pain is not associated with a heart attack.

What can help to prevent cardiovascular disease in women? Select all that apply. 1 Increasing stress 2 Refraining from smoking 3 Exercising for 30 minutes four to five times per week 4 Maintaining a body mass index (BMI) of more than 30 5 If diabetes is present, keeping the blood sugar level less than 100 mg/dL

2 Refraining from smoking 3 Exercising for 30 minutes four to five times per week 5 If diabetes is present, keeping the blood sugar level less than 100 mg/dL Things that can help to prevent cardiovascular disease in women include refraining from smoking, exercising for 30 minutes four to five times a week, and, if diabetes is present, keeping the blood sugar level less than 100 mg/dL. In addition, it is important to maintain a BMI of less than 30 (not more than 30) and to decrease (not increase) stress.

The nurse has just provided information about heart function to a group of nursing students. Which statement made by the student indicates that further instruction is needed? 1 A lowered ejection fraction causes improved tissue perfusion. 2 Cardiac output is the product of the stroke volume and heart rate. 3 The ejection fraction is the percentage of blood that is ejected by the heart. 4 An injury or illness such as a heart attack can affect the contractility and therefore the cardiac output and the stroke volume.

A lowered ejection fraction causes improved tissue perfusion. An ejection fraction that is low is associated with diminished tissue perfusion. Cardiac output equals the stroke volume multiplied by the heart rate. The ejection fraction is the percentage of blood that is ejected by the heart. An injury or illness can affect contractility, cardiac output, and stroke volume.

The application of elastic stockings is most appropriate for which patient? 1 A patient with cold extremities 2 A patient with a venous disorder 3 A patient with an arterial disorder 4 A patient with a weak, thready pulse

A patient with a venous disorder The application of elastic stockings is most appropriate for a patient with a venous disorder. Elastic stockings are not used for patients with arterial disorders. Cold extremities and a weak, thready pulse are symptoms of arterial insufficiency.

While obtaining objective data during the assessment of the cardiovascular system of a patient, what finding(s) can cause concern for a nurse? Select all that apply. 1 A thready pulse is present. 2 Hands and feet are cold to touch. 3 Edema is absent in the extremities. 4 Veins in the neck are not distended. 5 Capillary refill takes longer than 2 seconds.

A thready pulse is present. Hands and feet are cold to touch. Capillary refill takes longer than 2 seconds. Hands and feet that are cold to the touch may indicate intermittent claudication, peripheral arterial disease, low cardiac output, or severe anemia. Capillary refill that takes more than 2 seconds indicates the possibility of reduced arterial capillary perfusion or anemia. Blood loss, decreased cardiac output, aortic valve disease, or peripheral arterial disease can result in a thready pulse. The absence of edema in the extremities and a lack of distention of the veins in the neck are not causes for concern.

The nurse is caring for a pt following an angiogram. Which action should the nurse include in the pt's care?

Assess for allergies to radiopaque dye

When performing a cardiovascular assessment, which action should the LPN/LVN take? 1 Check the patient's urine for acetone. 2 Obtain a sputum specimen from the patient. 3 Find out whether the patient is the youngest in the family. 4 Assess the patient's apical pulse rate and rhythm, noting the presence of pulse deficit.

Assess the patient's apical pulse rate and rhythm, noting the presence of pulse deficit. When performing a cardiovascular assessment, the apical pulse rate and rhythm should be assessed, noting the presence of any pulse deficit. The apical pulse should be counted for a full minute. The carotid, femoral, popliteal, and pedal pulses should also be palpated and compared bilaterally, noting quality and character. It is not necessary to find out whether the patient is the youngest in the family. A sputum specimen and urinalysis for acetone are not part of the cardiovascular assessment.

When performing a cardiovascular assessment, which action should the LPN/LVN take?

Assess the pt's apical pulse rate and rhythm, noting the presence of pulse deficit.

When a patient returns to the unit after a cardiac catheterization, which nursing intervention should immediately follow taking vital signs? 1 Providing the patient with fluids 2 Assessing the patient's peripheral pulses 3 Placing the patient in a warm bed and encouraging sleep 4 Reapplying the patient's dressing where the catheter was inserted

Assessing the patient's peripheral pulses Nursing priority is given to maintaining adequate arterial circulation following cardiac catheterization. The most effective way to evaluate this is by assessing arterial pulses on the extremity used for catheter insertion, usually the leg. Although significant comfort measures are helpful in maintaining activity restrictions (bed rest) after the procedure, neither of these nursing actions is of specific priority. Oral and IV fluids are necessary to flush the nephrotoxic dye, used for the procedure, through the kidneys and eliminate it as quickly as possible in urine; however, this is not the priority in this scenario. The dressing (often simply an adhesive bandage but possibly a pressure dressing) should be frequently assessed for oozing or bleeding but should not be removed at this time.

When a pt returns to the unit after a cardiac catheterization, which nursing intervention should immediately follow taking vital signs?

Assessing the pt's peripheral pulses

A patient with heart failure will have which laboratory value monitored to determine the progression of the disease? 1 Troponin 2 C-reactive protein (CRP) 3 Complete blood count (CBC) 4 B-type natriuretic peptide (BNP)

B-type natriuretic peptide (BNP) BNP levels determine the degree of heart failure. Troponins increase after heart muscle damage within 4 to 6 hours of the injury. Increased CRP levels indicate inflammation in heart disease, as well as in other illnesses. A CBC measures several blood cell values for a variety of illnesses.

After a positive troponin test with an abnormal electrocardiography, the patient is scheduled for a procedure that will assess the size and patency of the coronary arteries. What procedure is the patient scheduled for? 1 Angiogram 2 Echocardiography 3 Cardiac catheterization

Cardiac catheterization A cardiac catheterization has several purposes and uses, including assessing the pumping action of the heart, the cardiac output, and the size and patency of the coronary arteries. An angiogram identifies thrombi within the venous system. Echocardiography is useful for evaluating the size, shape, and position of structures, as well as movement within the heart. It is the test of choice for valve problems. A transesophageal echocardiogram provides images of the heart, the mitral valve, the atrial septum, and the thoracic aorta.

A patient has a history of crushing chest pain, dyspnea, and diaphoresis. The nurse anticipates which diagnostic test will be performed to provide the most detailed information regarding heart function? 1 ECG 2 MRI 3 PET scan 4 Cardiac catheterization

Cardiac catheterization A cardiac catheterization provides detailed information about actual blood flow through the heart's chambers and valves, with critical pressure readings. The MRI, ECG, and PET scan identify structures, structural changes, and impulse conduction changes.

Which health promotion technique will the nurse emphasize to patients to decrease coronary artery disease? 1 Control hypertension. 2 Learn to ignore stress. 3 Increase low-density lipoproteins. 4 Perform heavy exercise several times per month.

Control hypertension. Health promotion activities for coronary artery disease include controlling hypertension, reducing (not increasing) low-density lipoproteins, participating in regular moderate exercise (not irregular heavy exercise), and obtaining and maintaining an ideal body weight. Learning to handle stress, rather than ignoring stress, promotes health.

Which would most indicate fluid overload? 1 Bruits 2 Rubor 3 Crackles 4 Murmurs

Crackles Crackles are a sign of beginning pulmonary congestion and fluid overload. Rubor is a dusky red color that is related to severe peripheral arterial disease. A bruit is a "whooshing" or "purring" sound that is made when blood passes through a partially obstructed artery. A murmur is associated with a "swooshing" sound from turbulent blood flow.

A patient asks the nurse for suggestions to decrease the risk for heart disease. Which modifiable risk factors can the nurse suggest to the patient? Select all that apply. 1 Age 2 Diet 3 Exercise 4 Heredity 5 Smoking cessation

Diet 3 Exercise 4 Heredity 5 Smoking cessation Individuals have the ability to manage their diet and weight through healthy choices and exercise. They also have the ability to stop smoking. Individuals cannot change or modify their heredity or age.

The health care provider suspects that a patient has a mitral valve disorder. Which diagnostic test does the nurse expect the health care provider to request? 1 Holter monitor 2 Echocardiography 3 Electrocardiography 4 Cardiac catheterization

Echocardiography Echocardiography is useful for evaluating the size, shape, and position of structures, as well as movement within the heart. It is the test of choice for valve problems. Electrocardiography records the electrical impulses of the heart and determines the presence of injury at rest. A Holter monitor records the electrical function of the heart during daily activity and is used to determine whether activity causes abnormalities. A cardiac catheterization has several purposes and uses, including assessing the pumping action of the heart, the cardiac output, and the size and patency of the coronary arteries.

A patient enters the emergency department with chest pain. What test does the nurse expect to be requested immediately to record the electrical impulses of the heart and to determine the presence of injury at rest? 1 Holter monitor 2 Echocardiography 3 Electrocardiography 4 Cardiac catheterization

Electrocardiography Electrocardiography records the electrical impulses of the heart and determines the presence of injury at rest. A Holter monitor records the electrical function of the heart during daily activity and is used to determine whether activity causes abnormalities. Echocardiography is useful for evaluating the size, shape, and position of structures, as well as movement within the heart. It is the test of choice for valve problems. A cardiac catheterization has several purposes and uses, including assessing the pumping action of the heart, the cardiac output, and the size and patency of the coronary arteries.

What are the three layers of the heart wall? Select all that apply. 1 Epicardium 2 Pericardium 3 Ectocardium 4 Myocardium 5 Endocardium

Epicardium Myocardium Endocardium The heart wall consists of three layers: the epicardium, the myocardium, and the endocardium. The pericardium is a double-layered sac that surrounds the heart. There is not an ectocardium.

The nurse is assessing a pt who states he has been dx w/ intermittent claudication. The nurse anticipates that the pt's cramping pain will be brought on by what activity or position? 1 Exercise 2 Standing in one place 3 Having an extremity in dependent position 4 Having an extremity above the level of the heart

Exercise Intermittent claudication is characterized by cramping pain in the muscles brought on by exercise and relieved by rest. It is a common symptom of arterial insufficiency to the lower extremities. Intermittent claudication is not aggravated by standing in one place, having the extremity in the dependent position, or having an extremity above the level of the heart.

A patient is awaiting coronary angiogram. What emotional concern is consistent with this situation? 1 Fear 2 Pain 3 Stability 4 Relaxation

Fear Fear is a common emotion experienced by patients who are awaiting coronary angiogram. Pain, stability, and relaxation are not emotional concerns.

A patient has been having episodes of syncope that occur 1 or 2 times a week. Which monitoring device will most likely identify an underlying dysrhythmia? 1 Holter monitor 2 Echocardiogram 3 Telemetry monitoring 4 Hemodynamic monitoring

Holter monitor A Holter monitor uses a small recorder and helps to correlate any dysrhythmias with the activity at that time. Telemetry monitoring is the continuous monitoring of the cardiac rate and rhythm, but the patient is monitored only at the hospital. Hemodynamic monitoring determines the pressure, flow, and oxygenation within the cardiovascular system. An echocardiogram uses ultrasound to detect structural abnormalities.

When evaluating risk factors for cardiovascular disease, which does the nurse identify as a modifiable risk factor? 1 Age 2 Active lifestyle 3 Hyperlipidemia 4 Family history of cardiovascular disease

Hyperlipidemia Hyperlipidemia is a modifiable risk factor for cardiovascular disease. The ratio of high-density lipoproteins (HDLs) to low-density lipoproteins (LDLs) is the best predictor of cardiovascular disease. A diet that is high in saturated fat, calories, and cholesterol contributes to hyperlipidemia. Dietary control is an important factor for modifying this risk factor. A family history of cardiovascular disease is a risk factor for cardiovascular disease; however, it is a nonmodifiable risk factor. Advanced age is a risk factor for cardiovascular disease; however, it is a nonmodifiable risk factor. Inactive lifestyle is a modifiable risk factor for cardiovascular disease.

When a patient has altered tissue perfusion, which intervention should be included in the patient's care? 1 Keep the patient's environment on the cool side. 2 Instruct the patient to avoid extremes of temperature. 3 Use local applications of heat, such as hot water bottles. 4 Instruct the patient to wear underclothing made of elastic materials.

Instruct the patient to avoid extremes of temperature. The patient with peripheral vascular disease has blood flow that is slow or altered, which is caused by constriction of the vessels. With this altered tissue perfusion, the smooth muscles of the arterial walls respond to temperature by constricting in the presence of cold and extreme heat and relaxing in the presence of warmth; therefore, the best nursing measure is to avoid these extreme temperature changes.

When a pt has altered tissue perfusion, which intervention should be included in the pt's care?

Instruct the pt to avoid extremes of temperature.

Which receives oxygenated blood within the heart? Select all that apply. 1 Vena cava 2 Left atrium 3 Right atrium 4 Left ventricle 5 Right ventricle

Left atrium Left ventricle The left atrium and the left ventricle receive oxygenated blood from the lungs and pump it through the systemic circulation. The vena cava, the right atrium, and the right ventricle receive unoxygenated blood.

The nurse is caring for a patient after a cardiac catheterization via the femoral site. Which actions should the nurse take? Select all that apply. 1 Maintain bed rest. 2 Monitor the puncture site. 3 Place the specimen tube on ice. 4 Keep the patient's leg extended. 5 Check peripheral pulse on the affected extremity.

Maintain bed rest. 2 Monitor the puncture site. 4 Keep the patient's leg extended. 5 Check peripheral pulse on the affected extremity. Postprocedure nursing care for cardiac catheterization includes enforcing bed rest, monitoring the puncture site, maintaining the leg in an extended position per protocol, and checking the vital signs and peripheral pulses on the affected extremity. Placing the specimen tube on ice is an action that the nurse would take for arterial blood gases.

A nurse is attending to a patient during exercise or stress testing. What interventions does the nurse perform for this patient? 1 Monitor the vital signs continuously during the test. 2 Instruct the patient to wear a hospital gown and slippers for the test. 3 Inform the patient that testing continues if chest pain is experienced. 4 Ensure that the patient is has had nothing to eat since midnight on the day of the test.

Monitor the vital signs continuously during the test. The nurse should monitor the vital signs continuously during the test. The testing is stopped if chest pain develops. The patient should eat a light meal 2 to 3 hours before the test. The patient should wear comfortable clothes and walking shoes, not a hospital gown and slippers.

Why is intravenous morphine sulfate the analgesic drug used if nitroglycerin, oral nitrates, and oxygen do not relieve acute angina pain? 1 Morphine sulfate decreases the blood level of B-type natriuretic peptide. 2 Morphine sulfate is not as addictive as other narcotics that are given intravenously. 3 Morphine sulfate decreases both anxiety and cardiac workload, as well as alleviates pain. 4 Morphine sulfate causes the troponin test to be more sensitive to showing damage to the heart.

Morphine sulfate decreases both anxiety and cardiac workload, as well as alleviates pain. The analgesic drug intravenous morphine sulfate is used if nitroglycerin, oral nitrates, and oxygen do not relieve acute angina pain since it decreases both anxiety and breathing effort, in addition to alleviating pain. Morphine sulfate can be as addictive as some other narcotics. B-type natriuretic peptide indicates the degree of heart failure, and morphine sulfate does not directly affect its result. Morphine sulfate does not cause the troponin test to be more sensitive to showing damage to the heart.

Which abnormal sound of the heart is associated with a "swooshing" sound from turbulent blood flow? 1 S₁ 2 S₂ 3 Bruit 4 Murmur

Murmur A murmur is associated with a "swooshing" sound from turbulent blood flow. A bruit is a "whooshing" or "purring" sound that is made when blood passes through a partially obstructed artery. S 1and S 2are normal heart sounds.

The LPN/LVN discovered a carotid bruit when assessing a 76-year-old patient. What does a carotid bruit indicate? 1 Presence of an aortic aneurysm 2 Presence of a cardiac dysrhythmia 3 Obstruction to blood flow in a carotid vessel 4 Faster than usual blood flow through a carotid vessel

Obstruction to blood flow in a carotid vessel A bruit can be detected by listening with the bell of the stethoscope applied lightly over the skin of an artery. A whooshing or purring sound is heard when blood passes through the partially obstructed artery. Bruit does not indicate an aortic aneurysm, cardiac dysrhythmia, or faster than usual blood flow through the carotid.

What are some common problems of patients with cardiovascular disorders? Select all that apply. Pain 2 Fatigue 3 Dyspnea 4 Fluid volume deficit 5 Altered tissue perfusion

Pain 2 Fatigue 3 Dyspnea 4 Fluid volume deficit 5 Altered tissue perfusion Common problems of patients with cardiovascular disorders include pain, fatigue, dyspnea, fluid volume overload (not deficit), and altered tissue perfusion.

The nurse knows the patient who has had a leg amputated is at risk for disturbed body image. What is an appropriate outcome for this patient to maintain a healthy body image? 1 Patient will focus on learning to walk. 2 Patient will identify personal strengths. 3 Patient will accept phantom pain as a normal phenomenon. 4 Patient will refrain from discussing negative feelings with family.

Patient will identify personal strengths. Assisting the patient to identify personal strengths will be most beneficial in assisting the patient to work toward accepting the amputation and new body image. Appropriate outcomes for this patient also include focusing on learning to walk and accepting phantom pain as a normal phenomenon. The patient should not refrain from discussing negative feelings with family.

Which are most related to the electrical conduction pathway of the heart? Select all that apply. Which are most related to the electrical conduction pathway of the heart? Select all that apply. 1 Systole 2 Diastole 3 Purkinje fibers 4 Sinoatrial node 5 Atrioventricular node

Purkinje fibers 4 Sinoatrial node 5 Atrioventricular node Purkinje fibers, the sinoatrial node, and the atrioventricular node are part of the electrical conduction pathway of the heart. The cardiac cycle consists of the contraction of the muscle (systole) and the relaxation of the muscle (diastole).

When the tissues of a light-skinned person have an adequate supply of oxygenated blood, the person's skin will have what appearance? 1 Rosy 2 Rubor 3 Cyanotic 4 Jaundiced

Rosy When tissues of a light-skinned person have adequate supply of oxygenated blood, the person's skin will appear rosy. Rubor is a dusky red color that is related to severe peripheral arterial disease. Cyanosis occurs with a lack of perfusion of the tissues. Jaundice is a yellowish color of the skin and mucous membranes that occurs related to liver dysfunction or a rapid breakdown of red blood cells.

Which is the correct impulse pattern of the cardiac conduction system? 1 Purkinje fibers→ Bundle of His → Sinoatrial (SA) node → Bundle branches 2 Right and Left bundle branches → Sinoatrial (SA) node → Bundle of His → Atrioventricular (AV) node → Purkinje fibers 3 Purkinje fibers → Sinoatrial (SA) node → Right and left bundle branches → Atrioventricular (AV) node 4 Sinoatrial (SA) node → Atrioventricular (AV) node → Bundle of His → Right and left bundle branches → Purkinje fibers

Sinoatrial (SA) node → Atrioventricular (AV) node → Bundle of His → Right and left bundle branches → Purkinje fibers The impulse pattern of the cardiac conduction system is as follows: SA node → AV node → Bundle of His → Right and left bundle branches → Purkinje fibers.

What important nursing consideration should be implemented when helping a patient with fatigue or weakness? 1 Space nursing actions out appropriately 2 Complete all tasks after a nutritious meal 3 Complete all tasks during the first hour of awakening 4 Complete activities of daily living quickly to allow for longer periods of rest

Space nursing actions out appropriately When assisting a patient with fatigue or weakness, the nurse should space nursing actions out appropriately. Completing all tasks at once or quickly would contribute to fatigue, weakness, or potential injury; this would not contribute to the patient's self-esteem.

The home care nurse is teaching the pt how to best monitor his edema. What is the best method for a pt at home to monitor his peripheral edema? 1 Checking for pitting 2 Measuring the extremity 3 Measuring intake and output 4 Taking daily weight measurements

Taking daily weight measurements

What is the function of the sinoatrial (SA) node? 1 The SA node causes the ventricles to pump. 2 The SA node is located in the upper left atrium. 3 The SA node is considered the pacemaker of the heart. 4 The SA node receives impulses from the atrioventricular node and relays them to the Purkinje fibers.

The SA node is considered the pacemaker of the heart. The SA node is considered the pacemaker of the heart. The SA node is located in the upper right atrium, and it does not cause the ventricles to pump. The atrioventricular node receives impulses from the SA node and relays them to the bundle of His.

What is the stroke volume? 1 The amount of blood ejected by a ventricle during contraction 2 The regulation of blood flow from the right ventricle to the right atrium 3 The amount of venous blood returned to the heart during a given period of time 4 The force in the blood vessels that the left ventricle must overcome to eject blood from the heart

The amount of blood ejected by a ventricle during contraction The stroke volume equals the amount of blood ejected by a ventricle during contraction. It does not describe the blood flow between the right atrium and right ventricle, the amount of venous blood returned to the heart, or the force that ventricles have to overcome to eject blood from the heart.

What does an increase in the level of B-type natriuretic peptide (BNP) indicate? 1 The degree of heart failure present 2 A risk factor for atherosclerotic heart disease 3 Detects damage to the myocardium from myocardial infarction 4 Determines pressure, flow, and oxygenation within the cardiovascular system

The degree of heart failure present An increase in the B-type natriuretic peptide (BNP) indicates the degree of heart failure present. An elevation in serum lipids indicates a risk factor for atherosclerotic heart disease. The myoglobin laboratory test detects damage to the myocardium from myocardial infarction. Hemodynamic monitoring via a Swan-Ganz catheter determines pressure, flow, and oxygenation within the cardiovascular system.

The nurse is providing education to a patient in the clinic for his annual examination on cardiovascular health. Which of these factors, if present in the patient's history, is most closely related to the development of arteriosclerosis? 1 The patient is an accountant. 2 The patient has diabetes mellitus. 3 The patient is to receive chemotherapy. 4 The patient had rheumatic fever as a child.

The patient has diabetes mellitus. Although a sedentary profession, chemotherapy drugs, diabetes mellitus, and rheumatic fever as a child are factors that can affect the vessels, diabetes directly causes physical changes in the vessel walls, leading to more rapid arteriosclerosis.

The nurse is preparing to obtain a patient's blood pressure reading. In which situation would the nurse temporarily defer the reading? 1 The patient defecated 30 minutes ago. 2 The patient ate a high-fat meal 1 hour ago. 3 The patient smoked a cigarette 20 minutes ago. 4 The patient drank two glasses of water within the past hour.

The patient smoked a cigarette 20 minutes ago. For more accurate readings, be certain the patient has not had a cigarette or any caffeine for the past 30 minutes. Blood pressure may drop in some people (especially the elderly) immediately after a meal. Defecation, high-fat meals, and ingestion of water do not affect blood pressure readings.

The spouse of a patient with a cardiovascular disorder is concerned that the cardiac rehabilitation staff is pushing the patient too hard to exercise. How can a health care practitioner know if the patient is tolerating the activity appropriately? Select all that apply. 1Systolic blood pressure does not rise. 2 There is no abnormal heart rate or rhythm. 3 There is no complaint of mild tiredness or sweating. 4 There is no complaint of chest pain, dyspnea, or severe fatigue. 5 The heart rate does not rise more than 20 beats per minute over the baseline rate.

There is no abnormal heart rate or rhythm. There is no complaint of chest pain, dyspnea, or severe fatigue. The heart rate does not rise more than 20 beats per minute over the baseline rate. A health care practitioner can know if the patient is tolerating an exercise activity appropriately if there is no abnormal heart rate or rhythm; if there is no complaint of chest pain, dyspnea, or severe fatigue; and it the heart rate does not rise by more than 20 beats per minute over the baseline rate. The patient is tolerating activity if the systolic blood pressure does not fall. Complaints of mild tiredness or sweating are expected during activity.

The pt who is scheduled for a nuclear (thallium) imaging scan asks the nurse about the purpose of this test. Which response by the LPN/LVN is correct?

This test evaluates blood flow in various parts of the heart.

Which cardiac marker is specific to the heart, is not influenced by skeletal muscle trauma or renal failure, and rises 4 hours after a myocardial infarction? 1 Troponin I 2 Homocysteine 3 Creatine kinase-MB 4 B-type natriuretic peptide

Troponin I Troponin I is a myocardial muscle protein that is released into the circulation after myocardial injury. It can identify very small amounts of myocardial injury. It rises 4 to 6 hours after a myocardial infarction, it peaks at 10 to 24 hours, and it returns to normal within 10 days. Troponin I is specific to the heart, it is not influenced by skeletal muscle trauma or renal failure, and it is very useful for diagnosing a myocardial infarction. Creatine kinase-MB is another cardiac enzyme that is elevated after a myocardial infarction; however, it is also elevated by other factors (e.g., surgery, muscle trauma). It rises within 2 to 3 hours after a myocardial infarction, it peaks at 24 hours, and it returns to normal within 24 to 40 hours. Homocysteine is not a cardiac marker. B-type natriuretic peptide determines the degree of heart failure.