Patho PrepU quiz (Ch.32)
Hypertrophic cardiomyopathy (HCM)
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 of the following disorders was the player's most likely cause of death?
Unoxygenated blood flow
Congenital heart defects can cause a right heart-to-left heart shunting of blood that results in increased:
Heart Rate
What is the most important factor in myocardial oxygen demand?
Mitral valve stenosis.
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?
Hypertrophic cardiomyopathy
A 17-year-old athlete died suddenly during a track meet and it was subsequently determined that he had heart disease. Which condition was the most likely cause of his heart failure?
Pericardial effusion
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 250ML of fluid in the pericardial cavity. Which disease should the nurse suspect this client to be suffering?
Mitral valve stenosis
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?
Pericarditis
A client is seen in the emergency room with complaints of 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?
Pericardial effusion
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:
Cardiac tamponade
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?
Congenital defects Rheumatic heart disease Trauma Ischemic heart disease Inflammation Degenerative changes
A client who has just been diagnosed with atrial stenosis asks his nurse what can cause a problem with heart valves. Which causes of dysfunction of the heart valves should the nurse relay to this client? Select all that apply.
constrictive pericarditis
A client who has just recently completed his second series of radiation therapy for lung cancer was admitted yesterday to an acute care facility with ascites. He begins to have jugular vein distention, pedal edema, and dyspnea upon exertion as well as fatigue. What should the nurse suspect?
See the doctor for evaluation immediately.
A client who is experiencing angina at rest that has been increasing in intensity should be instructed to do which of the following?
"Aspirin will help prevent blood clotting."
A client with a history of acute coronary syndrome asks why she needs to take aspirin 81 mg every day. The most appropriate response by the nurse would be:
Heart disease
A community health nurse is conducting a seminar at a local church group on health and wellness. Which of the following does she tell the group is the leading cause of death in the United States?
Cardiomyopathy
A nurse educator explains a type of cardiac condition as "a heterogeneous group of diseases of the myocardium associated with mechanical and/or electrical dysfunction that usually exhibit inappropriate ventricular hypertrophy or dilation and often lead to cardiovascular death or progressive heart failure." Which condition fits this definition?
Prompt diagnosis of streptococcal infections with a throat culture
A preventative measure to decrease the risk of developing rheumatic heart disease includes which of the following?
Rheumatic fever
A teenager is seen in the emergency room with complaints of a sore throat, headache, fever, abdominal pain, and swollen glands. His mother tells the nurse that he was seen three weeks before in the clinic and treated with antibiotics for a strep throat. He was better for a few days but now he seems to have gotten worse in the last two days. What should the nurse suspect is wrong with this client?
Hypertrophic cardiomyopathy
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?
Emotional stress
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?
Atherosclerosis and unstable angina
Coronary artery bypass grafting (CABG) is a treatment modality for which of the following disorders of cardiac function?
Fixed coronary obstruction
Chronic stable angina, associated with inadequate blood flow to meet the metabolic demands of the myocardium, is caused by:
Pericardial effusion
Exudate in the pericardial cavity is a characteristic of which cardiac condition?
Thinning
Dilated cardiomyopathy with left ventricular dysfunction is characterized by which change in the ventricular wall?
Vegetative valve destruction
Endocarditis and rheumatic heart disease are both cardiac complications of systemic infections. Characteristics include a new or changed heart murmur caused by:
Β-Adrenergic-blocking drugs
Mitral valve prolapse occurs frequently in the population at large. Its treatment is aimed at relieving the symptoms and preventing complications of the disorder. Which drug is used in the treatment of mitral valve prolapse to relieve symptoms and aid in preventing complications?
Action decreases metabolic demands of the heart.
ST-elevated myocardial infarction is accompanied by severe, crushing pain. Morphine is the drug of choice used to treat the pain of STEMI when the pain cannot be relieved with oxygen and nitrates. Why is morphine considered the drug of choice in STEMI?
Prepare for pericardiocentesis
The nurse caring for a patient 12 hours post coronary bypass graft notes a sudden decrease in the amount of chest tube drainage, a rapidly narrowing pulse pressure, paradoxical pulse, and shortened amplitude of the QRS complex on the electrocardiogram monitor. Which of the following should the nurse do next?
T-wave changes
The nurse is assessing the ECG of a client who is experiencing unstable angina. The nurse observes
Myocardial infarction prevention
The nurse is developing a plan of care for a client diagnosed with stable angina. Select the most important goal for this client.
"I should report episodes of dizziness or fainting."
The nurse is teaching a patient with a diagnosis of hypertrophic cardiomyopathy and aortic valve stenosis. Which of the following statements by the patient shows that the patient understands this condition?
Pericardiocentesis
The nurse working on the cardiac floor identifies which of the following to be the initial treatment of choice for small pericardial effusions and mild cardiac tamponade?
Genetic
The nursing instructor is teaching about cardiomyopathies in class. Which type does she tell the students is the most common cause occurring in young athletes?
Constrictive pericarditis
The nursing instructor is teaching her nursing students about cardiac function and different heart diseases. Which of the following disease does she tell the students is caused by calcified scar tissue that develops between the visceral and parietal layers of the serous pericardium?
Blood cultures Antibiotics Monitoring for emboli
Two weeks after receiving a prosthetic mitral valve, a patient presents to the emergency department with fever, anorexia, and splinter hemorrhages of the nails. Which interventions will the nurse likely implement? Select all that apply.
aerobic to anaerobic metabolism
When an acute MI occurs, many physiologic changes occur very rapidly. What causes the loss of contractile function of the heart within seconds of the onset of an MI?
Teenager with untreated strep throat
Which of the following patients is at the greatest risk of developing rheumatic heart disease?
One with an ejection fraction of 25% and atrial fibrillation
Which of the following patients with cardiomyopathy does the nurse identify as having the greatest risk for a complication?
