Patho Exam 3
The health care provider is teaching a client about modifiable risk factors for atherosclerosis. The most appropriate information to provide would be: a. Family history of heart disease b. Hypertension c. Being male d. 55 years of age
b
The nurse is caring for a client who has just experienced an acute myocardial infarction. Which type of shock is this client likely to experience? a. Neurogenic b. Cardiogenic c. Hypovolemic d. Septic
b
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: a. Increased ejection fraction b. Decreased cardiac output c. Decreased retention of sodium d. Increased renal blood flow
b
A client is immobilized following a hip injury. The client has developed unilateral lower leg discoloration with edema, pain, and tenderness in the midcalf area. How should the nurse document these clinical findings? a. Stasis ulcerations b. Arterial insufficiency c. Primary varicose veins d. Deep vein thrombosis
D
What is the primary physiologic result of obstructive shock? a. Elevated right heart pressure b. Left ventricular hypertrophy c. Decreased right heart pressure d. Right atrial hypertrophy
a
A 22-year-old man is experiencing hypovolemic shock following a fight in which his carotid artery was cut with a broken bottle. Which immediate treatments are likely to most benefit the man? a. Infusion of normal saline or Ringers lactate to maintain the vascular space. b. Resolution of compensatory pulmonary edema and heart dysrhythmias. c. Administration of oxygen and epinephrine to promote perfusion. d. Infusion of vasodilators to foster perfusion and inotropes to improve heart contractility.
a
A client diagnosed with septic shock who is experiencing tissue hypoxia likely will activate which pathophysiologic process? a. Inflammatory mediators b. Anaphylactic response c. Preexisting coagulation disorder d. Aerobic metabolism
a
A client has been diagnosed with deep vein thrombosis (DVT). The nurse is planning care and recognizes that the client is most at risk for: a. Pulmonary embolism b. Vasculitis c. Polyarteritis nodosa d. Arterial insufficiency
a
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. hypovolemic shock due to acute intravascular volume loss. b. renal failure due to an overdose of medication. c. side effects from the administration of midazolam, causing excessive vasoconstriction. d. pulmonary embolism due to development of deep vein thrombosis.
a
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, and this is causing blood to back up into your lungs. b. The left ventricle is pumping excessive amounts of blood through the carotid arteries causing headache. c. The left ventricle is having problems pumping blood forward, so blood is backing up systemically causing edema in your feet. d. The left ventricle is not adequately perfusing your gastrointestinal tract, leading to diarrhea and vomiting.
a
A client is admitted for observation due to abnormal heart sounds, pulmonary congestion, nocturnal paroxysmal dyspnea, and orthopnea. Upon auscultation a low-pitched, rumbling murmur, best heard at the apex of the heart, is also heard. Which condition does the client likely have? a. Mitral valve stenosis b. Mitral valve prolapse c. Aortic valve prolapse d. Aortic valve stenosis
a
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. Anaphylactic b. Cardiogenic c. Septic d. Neurogenic
a
A client who is relatively healthy is seen in the clinic for a regular checkup. While there he tells the nurse that he is worried that he may develop a heart condition. When the nurse asks him why he is worried he tells her that his mother had aortic valve stenosis and is afraid that he might get it. He then asks to be tested for the disease. What should the nurse tell this client about diagnosing a valvular defect? a. Valvular defects usually are detected through cardiac auscultation. b. Blood work can help to diagnose a valvular defect. c. An ECG can be done to rule out this disease. d. An MRI, which is more expensive, can be helpful in this diagnosis.
a
If a client experiences sympathetic nervous stimulation of the heart, the nurse will observe which changes in manifestations? a. Increased heart rate and increased contractility b. Increased heart rate and decreased contractility c. Decreased contractility and decreased heart rate d. Decreased rate and force of contraction
a
Severe shock can be followed by acute lung injury/acute respiratory distress syndrome (ALI/ARDS) characterized by: a. ventilation-perfusion mismatch. b. hyperinflated alveolar sacs. c. excessive surfactant. d. hyperventilation.
a
The client tells the provider he has lower back pain. Although most abdominal aneurysms are asymptomatic, the provider examines the client for which initial sign of this condition? a. A pulsating mass in the abdomen b. Syncope c. The pulse is unobtainable in one or both arms d. Hemiplegia
a
The client undergoes a cardiac catheterization to evaluate symptoms of chest pain and shortness of breath. The test shows lesions in the coronary arteries that have begun to reduce the size of the vessel lumen. This type of lesion is known as: a. Fibrous plaque b. Complicated lesion c. Thrombus d. Fatty streak
a
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: a. The condition is getting progressively worse. b. The client is improving. c. Results are not significant assessment data. d. The more the results continue to increase, the better outcome for the client.
a
The heart is a four-chambered pump. What is the function of the right ventricle? a. Pumps blood to the lungs b. Receives blood returning to the heart from the systemic circulation c. Receives oxygenated blood from the lungs d. Pumps blood into the systemic circulation
a
The nurse is counseling a client regarding a high cholesterol level. The nurse teaches the client that which lipoprotein is the main carrier of cholesterol? a. LDL b. HDL c. VLDL d. IDL
a
The nurse is reviewing laboratory results for a client who is experiencing angina. Which finding might be expected in a client with dyslipidemia? a. Elevated total cholesterol b. Decreased low-density lipoproteins c. Decreased triglycerides d. Normal cholesterol and triglycerides
a
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? a. Viral infections b. Radiation c. Bacterial infections d. Connective tissue disease
a
The professor knows that the pathophysiology student understands the structure and function of blood vessels when the student states: a. Capillaries permit the exchange of material between the blood and interstitial fluid. b. Arteries include internal valves to aid in the unidirectional flow of blood toward the heart. c. Veins have a three-layered wall with a thick tunica media, which gives it the properties of contractility and elasticity.; d. Venules transport blood away from the heart and help control blood pressure.
a
When trying to educate a client about the release of free radicals and the role they play in formation of atherosclerosis, which statement is most accurate? a. Activated cells that release free radicals oxidize LDL, which is harmful to the lining of your blood vessels. b. Oxidized free radicals produce toxic metabolic waste that can kill liver cells. c. The end result of oxidation is rupture of the plaque, resulting in hemorrhage. d. Activated cells roam the vascular system looking for inflammatory cells to engulf.
a
Which client will likely experience difficulty maintaining lipoprotein synthesis, resulting in elevated LDL levels? a. 35-year-old client with history of hepatitis C and B with end-stage liver disease. b. 44-year-old female admitted for hysterectomy due to cervical cancer with metastasis. c. 55-year-old male admitted for exacerbation of chronic obstructive pulmonary disease (COPD). d. 27-year-old client with pancreatitis related to alcohol abuse
a
Which of the following are characteristic signs of acute arterial embolism? aPallor, pulselessness, and pain b. Paralysis, warmth, and paranoia c. Purpura, muscle weakness, and shortness of breath d. Pain, increased blood pressure, and warmth
a
Which of the following is associated with stasis of blood, increased blood coagulability, and vessel wall injury? a. Venous thrombosis b. Peripheral artery disease (PAD) c. Varicose veins d. Chronic venous insufficiency
a
A client has just been diagnosed with hypercholesterolemia and is asking what treatment will be needed. About which topics should the nurse educate the client? Select all that apply. a. Smoking cessation b. Dietary measures to reduce LDL levels c. Weight reduction if overweight d. Decreasing physical activity e. Increased intake of fats and sodium
a,b,c
A 75-year-old client is being evaluated for heart failure. Which questions will the nurse ask to confirm common signs and symptoms observed in older adults experiencing heart failure? Select all that apply. a. Do you have swelling in your ankles? b. Are you eating more than usual? c. Do you easily get tired? d. Are you feeling depressed? e. Do you get up often during the night to urinate?
a,b,d,e
The nurse will monitor the client for which possible respiratory manifestations of heart failure? Select all that apply. a. Exertional dyspnea b. Chronic, dry cough c. Hyperventilation d. Orthopnea e. Cheyne-Stokes respiration
a,b,d,e
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. a. Narrowed pulse pressure b. Muffled heart tones c. Bounding femoral pulse d. Heart rate 78 e. Low BP—84/60 mm Hg
a,b,e
The nurse is educating a client diagnosed with pre-hypertension about reducing modifiable risk factors. Which risk factors will the nurse address? Select all that apply. a. Decreasing salt intake b. Decreasing alcohol consumption. c. Working less to decrease stress level d. Have genetic counseling e. Increasing dietary potassium
a,b,e
The nurse is teaching a group about cardiovascular risk factors and complications. Which clients are at risk for developing an aortic dissection? Select all that apply. a. A client who is 36 weeks pregnant b. A male with acute renal failure c. A 59-year-old male with a blood pressure of 180/100 d. A client who has recently had coronary artery bypass grafting. e. A 30-year-old female with Marfan syndrome
a,c,e
When an acute event occurs and the circulatory system can no longer provide the body with adequate perfusion of its tissues and organs, cellular hypoxia occurs and the body goes into shock. What are the causes of shock in the human body? Select all that apply. a. Obstruction of blood flow b. Excessive vasoconstriction c. Maldistribution of blood flow d. Hypervolemia e. Hypovolemia
a,c,e
A client is concerned about his family history of atherosclerosis and asks the nurse if there is anything he can do to decrease his risk. The client has type 2 diabetes. Which responses by the nurse are most accurate? Select all that apply. a. Control blood glucose levels b. Increase LDL levels c. Decrease smoking d. Control hypertension e. Maintain normal weight
a,d,e
Heart failure can increase one risk for developing manifestations related to which complications? Select all that apply. a. Systemic congestion b. Atherosclerosis c. Low cardiac output d. Pulmonary congestion e. Hypertension
a,d,e
The nurse is teaching a group of clients about hypertension. The nurse determines that teaching was effective when the clients state: Select all that apply. a. It is the most common cardiovascular disorder. b. The diastolic pressure is equal to 80 mm Hg. c. It is often associated with individuals of normal weight. d. The systolic pressure is ≥140 mm Hg. e. The incidence increases with age.
a,d,e
When a physician suspects a client has suffered an acute myocardial infarction, which serum biomarkers should they order? Select all that apply. a. Troponin 1 b. Phosphorous c. Magnesium d. Troponin T e. Creatine kinase
a,d,e
A client who is experiencing angina at rest that has been increasing in intensity should be instructed to: a. take a second nitroglycerine. b. see the doctor for evaluation immediately. c. not worry about it as this is common for someone who has already had a myocardial infarction. d. give it 5-10 minutes more to see if there is relief.
b
A client with malignant hypertension is at risk for a hypertensive crisis, including the cerebral vascular system often causing cerebral edema. The nurse would assess this client for which signs and symptoms? a. Papilledema and lethargy b. Headache and confusion c. Restlessness and nervousness d. Stupor and hyperreflexia
b
A nurse educator is defining heart failure to a group of recent graduates who will begin providing care on a cardiac unit. The educator should describe which phenomenon? a. "Heart failure is a complex syndrome resulting from any functional or structural disorder of the heart that results in or increases the risk of infarction." b. "Heart failure is a complex syndrome resulting from any disorder of the heart that results in or increases the risk of developing manifestations of low cardiac output and/or pulmonary or systemic congestion." c. "Heart failure is a complex syndrome resulting from a lack of oxygen to the heart that results in or increases the risk of developing manifestations of low cardiac output and/or pulmonary or systemic congestion." d. "Heart failure is a complex syndrome resulting in a structural disorder of the heart that ultimately results in pulmonary or systemic congestion."
b
A nurse is assessing a client in shock for complications of acute renal failure. Which assessment is priority for the nurse to obtain? a. Evaluating the blood for a decrease in the blood urea nitrogen level (BUN) b. Continuously measuring urine output c. Asking the client if he or she is experiencing bilateral flank pain d. Evaluating the blood for a decreased creatinine level
b
A young college football player was bought to the emergency room after collapsing on the football field during practice. When arriving he was unconscious and his ECG was abnormal. Subsequently he died after arresting in the emergency room. What does the physician suspect is the likely cause of this? a. Pericarditis b. Hypertrophic cardiomyopathy c. Dehydration d. Heart attack
b
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. Orthostatic hypotension b. Increased vascular stiffness c. Loss of action potential d. Increased cardiac contractility
b
Atherosclerosis begins in an insidious manner with symptoms becoming apparent as long as 20 to 40 years after the onset of the disease. Although an exact etiology of the disease has not been identified, epidemiologic studies have shown that there are predisposing risk factors to this disease. What is the major risk factor for developing atherosclerosis? a. Increasing age b. Hypercholesterolemia c. Familial history of premature coronary heart disease d. Male sex
b
During assessment of a 66-year-old woman, the nurse practitioner notes a pulsating abdominal mass and refers the woman for further treatment. Which aspects of the pathophysiology of aneurysms would the health care provider explain to this client? a. Aneurysms are commonly a result of poorly controlled diabetes mellitus. b. Hypertension is a frequent modifiable contributor to aneurysms. c. Individuals with an aneurysm are normally asymptomatic until the aneurysm ruptures. d. Aneurysms can normally be resolved with lifestyle and diet modifications.
b
Exudate in the pericardial cavity is a characteristic of which cardiac condition? a. Constrictive pericarditis b. Pericardial effusion c. Acute pericarditis d. Cardiac tamponade
b
From which one of the following sites is a fatal pulmonary thromboembolism most likely to originate? a. The endocardium over an acute myocardial infarction b. Deep vein thrombosis of the leg c. The hepatic vein in chronic passive congestion of the liver d. An atherosclerotic plaque in the aorta
b
In heart failure, what causes the increase in renal secretion of renin? a. Increased metabolic demand b. Decreased cardiac output c. Increased renal perfusion d. Hypertension
b
The cardiac cycle describes the pumping action of the heart. Which statement is correct about systole? a. Ventricles relax and blood fills the heart. b. Ventricles contract and blood is ejected from the heart. c. Atria contract and blood is ejected from the heart. d. Atria relax and blood fills the heart.
b
The health care provider is reviewing the results of a client's magnetic resonance imaging (MRI). The results indicate a small spherical dilation at the circle of Willis. The provider would interpret this as: a. Fusiform aneurysm b. Berry aneurysm c. Dissecting aneurysm d. Saccular aneurysm
b
The nurse is reviewing a clients history and recognizes that the client smokes cigarettes. The nurse is concerned because smoking does which of the following? a. Decreases serum lipid levels and increases inflammation, thereby promoting hyperlipidemia b. Injures the endothelial cells lining the blood vessels, thereby promoting thrombus development c. Promotes vasodilation and decreases peripheral resistance, thereby increasing cardiac workload d. Increases serum HDL levels, thereby promoting fat oxidation
b
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? a. "I should begin an aerobic exercise program." b. "I should report episodes of dizziness or fainting." c. "I should take my verapamil at the same time every day." d. "I should limit my daily alcohol ingestion to two drinks."
b
The nurse knows that vasopressin (antidiuretic hormone, ADH) plays which role in blood pressure control? a. Increases osmolality of body fluids b. Promotes retention of water c. Produces prolonged increase in blood pressure d. Decreases blood volume
b
The nurse obtains a blood pressure reading of 150/96 mm Hg from a client at the clinic. What instructions for follow-up does the nurse anticipate giving to this client? a. Education about antihypertensive medications b. Confirm within 2 months c. Recheck in 1 year d. Recheck in 2 years
b
The older adult client tells the health care provider about experiencing dizziness when changing from a lying to a sitting position. The provider will document which condition in the medical record? a. Decrease in peripheral vascular resistance b. Orthostatic hypotension c. Increased responsiveness to catecholamines d. Systolic hypertension
b
The pathophysiology of heart failure involves an interaction between decreased pumping ability and the ________ to maintain cardiac output. a. parasympathetic system b. compensatory mechanisms c. electrical conductivity d. aortic hypertrophy
b
The postoperative client has a catheter in his brachial artery for continuous blood pressure monitoring. Which assessment would be a concern for the nurse? a. Pulses are present in the radial artery. b. The client states his hand is numb. c. The client states his feet are cold. d. The nail beds are pink.
b
The student attends a health fair and has his serum cholesterol checked. He has a high lipoprotein level (LDL). He understands which of the following about LDL cholesterol? a. It transports cholesterol away from cells to the liver for excretion. b. It is believed to play an active role in the pathogenesis of the atherosclerotic lesion. c. It is associated with a low intake of saturated fats. d. It has a low cholesterol content.
b
Which client with cardiomyopathy does the nurse identify as having the greatest risk for a complication? a. Client with peripheral edema and 2-kg weight gain b. Client with an ejection fraction of 25% and atrial fibrillation c. Client with hepatomegaly and ascites d. Client with orthopnea and activity intolerance
b
Which statement regarding heart failure is true? a. The most common cause of congestive heart failure is angina pectoris. b. In compensated heart failure, an increase of end-diastolic volume causes increased force of left ventricular contraction. c. The edema of right-sided heart failure is associated with low plasma osmotic pressure. d. The most common cause of left-sided heart failure is right-sided heart failure.
b
A nurse in a nursing home is concerned that a resident may be developing left-sided heart failure. Manifestations of left-sided heart failure would include which symptom? a. Fatigue, headache b. Diarrhea, nausea, vomiting c. Dyspnea, cough d. Weakness, peripheral edema
c
A client has been diagnosed with a dissecting aortic aneurysm. It is most important for the nurse to assess the client for: a. Late hypertensive crisis b. Chest pain radiating to the right arm c. Tonic-clonic seizures d. Tearing or ripping-type pain in the chest or back
d
The nurse is reviewing the circulatory system. Which statements are correct about the functional organization of the circulatory system? Select all that apply. a. The capillaries pump blood. b. The arterial system distributes oxygenated blood to the tissues. c. The heart exchanges gases, nutrients, and wastes. d. The venous system collects deoxygenated blood from the tissues.
b,d
A 13-year-old boy has had a sore throat for at least a week, vomiting for 2 days, cervical lymph nodes are swollen, and he moves stiffly because his joints hurt. Throat cultures show infection with group A streptococci. This child is at high risk for development of which cardiac abnormality? a. Myocarditis b. Unstable angina c. Mitral valve stenosis d. Vasculitis and aneurysm of the coronary arteries
c
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. Anaphylactic b. Cardiogenic c. Septic d. Neurogenic
c
A 52-year-old man who is moderately obese has recently been diagnosed with hypertension by the health care provider. Which client statement indicates a need for further health promotion teaching? a. "Im trying to cut back on the amount of salt that I cook with and add to my food." b. "Ive starting going to the gym before work three times a week." c. "Im going to eat organic foods from now on but Im glad I dont have to watch my fat intake." d. "Im planning to lose 15 lb (7 kg) before the end of this year."
c
A client blood pressure is persistently in the range of 130 to 135 mm Hg systolic and 85 to 88 mm Hg diastolic. How will the nurse classify this client blood pressure? a. Normal b. Elevated c. Stage 1 hypertension d. Stage 2 hypertension
c
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. Myocardial infarction b. COPD c. Pericardial effusion d. Pericarditis
c
A client experiencing increasing fatigue in recent months has an echocardiogram that reveals the clients end-diastolic volume is insufficient. Which other parameter of cardiac performance will directly decrease as a result? a. Afterload b. Inotropy c. Preload d. Cardiac contractility
c
A client has been diagnosed with diabetes mellitus. Which lab result would the practitioner expect? a. Elevation of HDL b. Decreased LDL c. Elevation of triglycerides d. Decreased VLDL
c
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. Pneumonia b. Abdominal aortic aneurysm c. Pericarditis d. Myocardial infarction
c
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: a. Pulmonary hypertension b. Pericarditis c. Pericardial effusion d. Cardiomyopathy
c
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. Neurogenic shock b. Hypovolemic shock c. Obstructive shock d. Distributive shock
c
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? a. Blood ejected from each ventricle with each contraction b. Blood pumped by each ventricle in 1 minute c. Venous return to the heart d. Resistance to ventricular emptying
c
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 condition is worsening? a. Copious urination b. Shortness of breath c. Weight gain d. Decreased blood pressure
c
An older adult client blood pressure (BP) is 120/80 mm Hg when in a lying position. When the nurse retakes the client BP in a sitting position, the BP is 92/60 mm Hg. Which intervention is appropriate for the nurse to implement? a. Contacting the health care provider immediately b. Keeping the client in a supine position throughout the day c. Encouraging the client to maintain hydration throughout the day d. Administering oxygen as prescribed
c
An older adult client newly diagnosed with systolic hypertension asks her health care provider why this happens. Which response is most accurate? a. "Everyone over the age of 50 tends to have their blood pressure creep up over the years." b. "Your heart has to work harder to pump blood through your vessels as you get older." c. "With age, your arteries lose their elasticity and are replaced with collagen, which makes your arteries stiffer." d. "If you slow down and rest more, your blood pressure will more than likely return to its normal level."
c
Congenital heart defects can cause a right heart-to-left heart shunting of blood that results in increased: a. Right atrial blood volume b. Pulmonary blood volume c. Unoxygenated blood flow d. Right ventricle workload
c
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 players most likely cause of death? a. Takotsubo cardiomyopathy b. Arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D) c. Hypertrophic cardiomyopathy (HCM) d. Dilated cardiomyopathy (DCM)
c
Humoral control of blood flow involves the effect of vasodilator and vasoconstrictor substances in the blood. Select the factor that has a powerful vasodilator effect on arterioles and increases capillary permeability. a. Serotonin b. Norepinephrine c. Histamine d. Prostaglandins
c
Select the response that best describes the pressure-sensitive receptors that respond to changes in the stretch of the vessel wall. a. Chemoreceptors b. Cardiovascular centers c. Baroreceptors d. Neural pathways
c
Sepsis is growing in incidence in the United States. Its pathogenesis includes neutrophil activation, which kills microorganisms. Neutrophils also injure the endothelium, releasing mediators that increase vascular permeability. What else do neutrophils do in sepsis? a. Cause bradycardia b. Vasoconstrict the capillary bed c. Release nitric oxide d. Activate erythropoiesis
c
The client ultrasound shows a thrombus in the venous sinus in the soleus muscle. The nurse explains that early treatment is important to prevent: a. Acute myocardial infarction b. Loss of pulses in the limb c. Pulmonary embolism d. Cerebrovascular accident
c
The heart controls the direction of blood flow. What is the role of the aortic valve? a. Controls the direction of blood flow from the atria to the ventricles b. Controls the direction of blood flow from the ventricles to the atria c. Controls the direction of blood flow from the left side of the heart to the systemic circulation d. Controls the direction of blood flow from the left side of the heart to the lungs
c
The nurse is developing a plan of care for a client diagnosed with stable angina. Select the most important goal for this client. a. Ensuring adequate oxygenation with continuous oxygen administration b. Preventing clotting disorders c. Myocardial infarction prevention d. Assisting the client to return to previous lifestyle
c
The nurse knows that the primary long-term regulation of blood pressure is exerted by which body system? a. Hormonal activity b. Humoral influence c. The kidneys d. Neural mechanisms
c
The nurse should anticipate administering intravenous antibiotic therapy as a priority to a client experiencing which type of shock? a. Anaphylactic shock b. Hypovolemic shock c. Septic shock d. Cardiogenic shock
c
The smooth muscle cells produce vasoconstriction of blood vessels due to innervation by which part of the nervous system? a. Peripheral b. Central c. Sympathetic d. Parasympathetic
c
Which client would the nurse recognize as needing to be assessed for orthostatic hypotension? a. A 42-year-old client who has a history of poorly controlled type 1 diabetes b. A 78-year-old client who has begun reporting frequent headaches unrelieved by over-the-counter analgesics c. An 80-year-old client who has experienced two falls while attempting to ambulate to the bathroom d. A 65-year-old client whose vision has become much less acute in recent months and who has noticed swelling in the ankles
c
Which health condition can contribute to diastolic dysfunction heart failure? a. chronic bradycardia b. anemia c. myocardial hypertrophy d. ischemic heart disease
c
Which serum biomarker is highly specific for myocardial tissue? a. Creatine kinase b. C-reactive protein c. Troponin d. White blood cells
c
While discussing the heart, the nursing instructor teaches about pericarditis. Which statement does the instructor state best defines this disease? a. It is a result of suffering a myocardial infarction. b. It is an autoimmune response to stress. c. It is an inflammatory process. d. It is a congenital disease.
c
A client comes to the emergency room with reports of chest pain. When the nurse reads his ECG she sees changes which include T-wave inversion, ST-segment elevation, and an abnormal Q wave. What should she suspect? a. Pleural effusion b. Pericarditis c. Coronary artery disease (CAD) d. Acute myocardial infarction
d
The nursing student, when studying about coronary artery disease, learns that it is commonly divided into different types of disorders. Which disorders would be included? Select all that apply. a. Primary heart disease b. Secondary heart disease c. Acute coronary syndrome d. Tertiary heart disease e. Chronic ischemic heart disease
c,e
A 20-year-old college student has a pelvic fracture and a severed leg from a motorcycle accident. She lost several units of blood. When the student arrived in the emergency department, her blood pressure was very low, her pulse was high, and her skin was pale. The nurse knows that this client has developed which type of shock? a. Cardiogenic b. Obstructive c. Distributive d. Hypovolemic
d
A client has been diagnosed with chronic obstructive arterial disease. Which client statement indicates she understands how to manage this disease? a. I should stay in bed with my legs elevated. b. I dont need to monitor my blood pressure. c. Diabetes mellitus has no effect on my condition. d. I should have my LDL monitored.
d
A client has developed atherosclerosis. The nurse knows that a major cause for this disorder is: a. Elevated HDL cholesterol b. History of myocardial infarction c. Heart failure d. Hypertension
d
A client has developed cardiogenic shock. The most frequent cause of this type of shock is: a. Heart failure b. Hypertension c. Allergic reaction d. Myocardial infarction
d
A client presents to the emergency department with a sudden onset of acute pain in his left lower leg. The practitioner is unable to palpate pedal pulses and finds the client to be in atrial fibrillation. Which test will the practitioner order to find the source of the emboli? a. Chest x-ray b. Ultrasound of the kidney c. CT of the head d. Echocardiogram
d
A client who has been admitted to the ICU with a diagnosis of pericardial effusion begins to experience severe tachycardia. Upon assessment, the nurse finds that his central venous pressure is increased, he has jugular vein distention, his systolic blood pressure has dropped, and there is a narrow pulse pressure. His heart sounds appear to be very muffled. Which diagnosis should the nurse suspect the physician will make? a. Myocardial infarction b. Thrombosis c. Pericarditis d. Cardiac tamponade
d
A client with heart failure tells the nurse that he is frustrated and is unable to get "a good night's rest." The client relates that he falls asleep and is suddenly awakened and feels as though he is having a hard time breathing and is suffocating. The nurse recognizes this assessment as: a. Orthopnea b. Cardiac asthma c. Sleep apnea d. Paroxysmal nocturnal dyspnea
d
Anaphylactic shock causes severe hypoxia very quickly because of which reason? a. Heart rate and contractility are reduced. b. Generalized vasoconstriction reduces venous return. c. Metabolic rate is greatly increased. d. Histamine release causes massive vasodilation.
d
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. Gastrointestinal relaxation b. Uterine smooth muscle relaxation c. Bronchodilation d. Laryngeal edema
d
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? a. Abrupt change in position b. Sedentary lifestyle c. Exposure to heat d. Emotional stress
d
At 4 AM the hemodynamic monitoring for a critically ill client in the intensive care unit indicates that the clients mean arterial pressure (MAP) is at the low end of the normal range; at 5 AM the clients MAP has fallen definitively below normal. The nurses should prioritize assessments for: a. ischemic stroke and ischemic heart disease. b. orthostatic hypotension and cerebral aneurysm. c. dependent edema and decreased cognition. d. organ damage and hypovolemic shock.
d
Atherosclerotic peripheral vascular disease is symptomatic with at least 50% occlusion. Due to ischemia, which initial peripheral symptom is associated with this disease? a. Bulging pulse b. Edema c. Varicosities d. Calf pain
d
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. Inhibition of the SA nodes normal action potential c. Backup of blood from the right atrium into the superior vena cava d. Backflow from the left ventricle to left atrium
d
For clients with heart failure, which pathophysiologic response helps maintain the cardiac reserve? a. Electrical conductivity b. Aortic hypertrophy c. Parasympathetic system d. Compensatory mechanisms
d
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 faster than normal; skin cool and moist b. Heart rate slower than normal; skin warm and dry c. Heart rate slower than normal; skin warm and dry d. Heart rate slower than normal; skin cool and moist
d
On a holiday trip home, the nurses mother states that the nurses father was diagnosed with right-sided heart failure. Which manifestation exhibited by the father does the nurse know might have preceded this diagnosis? a. Vertigo, headache b. Weakness, palpitations c. Dyspnea, cough d. Peripheral edema, weight gain
d
The health care team proposes a treatment plan for a client with peripheral artery disease. Which treatment measures are likely included? a. Weight training to strengthen the vastus lateralis b. Isometric exercise to increase cardiac endurance c. Aerobic exercise to decrease respiratory stress d. Exercise training like walking to increase collateral circulation
d
The nurse anticipates that which client would be considered a good candidate for coronary artery bypass grafting (CABG)? a. A 78-year-old client admitted with increasing fatigue related to aortic stenosis b. Client who failed a percutaneous coronary intervention (PCI) and has a history of myocardial infarction (MI) experiencing new-onset pain and ST elevation c. A 24-year-old client who suffered an auto accident and was diagnosed with pericardial effusion and cardiac tamponade d. A 87-year-old client admitted with uncontrolled dilated cardiomyopathy
d
The nurse is developing a plan of care for a postsurgical client. A major goal is to prevent the formation of deep vein thrombosis (DVT). Which nursing intervention should the nurse implement? a. apply ice compresses to the site of the DVT hourly b. ensure that the client remains on bed rest c. massage legs to maintain blood flow d. apply sequential pneumatic compression devices to lower extremities
d
The nurse knows that coarctation of the aorta can be a secondary cause of hypertension. Which blood pressure finding can be characteristic of this condition? a. Blood pressure in legs 20 mm Hg higher than in the arms b. Prominent femoral pulses c. Widened pulse pressure in the legs d. Blood pressure in arms 20 mm Hg higher than in the legs
d
The nurse suspects a client has stage 2 systolic hypertension. What systolic pressure would confirm the nurses suspicion? a. 119 mm Hg or lower b. 120 to 129 mm Hg c. 130 to 139 mm Hg d. 140 mm Hg or higher
d
When lecturing to a group of students about the pathophysiologic principles behind heart failure, the instructor defines cardiac output as which example? a. Strength of the right ventricular pump to move blood b. The volume of blood stretching the heart muscle at the end of diastole c. The amount of blood pumped out of the heart with each beat d. The amount of blood the heart pumps each minute
d
Which hypertensive individual is most likely to have his or her high blood pressure diagnosed as secondary rather than essential? a. A 40-year-old smoker who eats excessive amounts of salt and saturated fats b. A Black man who leads a sedentary lifestyle c. A 69-year-old woman with a diagnosis of cardiometabolic syndrome d. A 51-year-old male who has been diagnosed with glomerulonephritis
d
Which individual is likely experiencing the manifestation of acute coronary syndrome (ACS)? a. A client who has recently been diagnosed with variant (vasospastic) angina b. A client who sometimes experiences chest pain when climbing stairs c. A client whose most recent ECG indicates that silent myocardial ischemia has occurred d. A client who occasionally experiences persistent and severe chest pain when at rest
d
Which sequence is the correct pathway for blood flow through the heart? a. left atrium - bicuspid valve - left ventricle - pulmonary artery - lungs - pulmonary vein - right atrium - tricuspid valve - right ventricle - aorta b. right atrium - bicuspid valve - right ventricle - pulmonary artery - lungs - pulmonary vein - left atrium - tricuspid valve - left ventricle - aorta c. left atrium - tricuspid valve - left ventricle - pulmonary artery - lungs - pulmonary vein - right atrium - mitral valve - right ventricle - aorta d. right atrium - tricuspid valve - right ventricle - pulmonary artery - lungs - pulmonary vein - left atrium - mitral valve - left ventricle - aorta
d
Which type of aortic aneurysm is the most common? a. Thoracic b. Aortic arch c. Ascending aorta d. Abdominal aortic
d
While teaching a client with new-onset right-sided heart failure, the nurse should educate the client to monitor for fluid accumulation by: a. taking blood pressure daily and calling the physician if it is decreased. b. measuring his or her urine output daily to check for a decrease in output. c. listening to the breath sound with a stethoscope every morning. d. recording weight every day at the same time with same type of clothing.
d
While working triage in the emergency department, which client report should alert the nurse to imminent danger and, thus, that client should be seen first? a. Athletic client reporting the kneecap popping in and out of socket. b. A client reporting painful urination and experiencing fever and chills. c. A client with a history of chronic obstructive pulmonary disease experiencing a productive cough with green sputum. d. A client holding the abdomen and reporting a tearing and ripping feeling inside.
d
