Deck 26: Alterations of Cardiovascular Function

Question 1

A patient is diagnosed with coronary artery disease.Which of the following modifiable risk factors would the nurse suggest the patient change?

A) Eating meat
B) Living arrangements
C) Drinking tomato juice
D) Smoking cigarettes

Answer 1

Smoking cigarettes

Question 2

Superior vena cava syndrome (SVCS), causing venous distention in the upper extremities, is a result of progressive superior vena cava:

A) inflammation.
B) occlusion.
C) distention.
D) sclerosis.

Answer 2

occlusion.

Question 3

A 75-year-old obese female presents to her primary care provider reporting edema in the lower extremities.Physical exam reveals that she has varicose veins.Upon performing the history, which of the following is a possible cause for the varicose veins?

A) Extreme exercise
B) Long periods of standing
C) Trauma to the deep veins
D) Ischemia

Answer 3

Long periods of standing

Question 4

When a nurse checks the patient for orthostatic hypotension, what activity did the nurse have the patient engage in?

A) Physical exertion
B) Eating
C) Standing up
D) Lying down

Question 5

A 30-year-old White female was recently diagnosed with primary hypertension.She reports that she eats fairly well, usually moderate red meat consumption.She also reports that her father has hypertension as well.A nurse determines which of the following risk factors is most likely associated with this diagnosis?

A) Race
B) Diet
C) Age
D) Genetic

Question 6

The most common cause of myocardial ischemia is:

A) idiopathic vasospasm.
B) arterial emboli from a heart valve.
C) atherosclerosis.
D) venous emboli.

Question 7

A patient presents to a primary care provider reporting chest pain and is diagnosed with atherosclerosis.This disease is caused by:

A) arterial wall thinning and weakening.
B) abnormally dilated arteries and veins.
C) abnormal thickening and hardening of vessel walls.
D) autonomic nervous system imbalances.

Question 8

Foam cells in a fatty streak are:

A) deposited adipose cells.
B) injured neutrophils.
C) macrophages that engulf low-density lipoprotein (LDL).
D) lipid-laden mast cells.

Question 9

An older adult is diagnosed with cerebral aneurysm.Where does the nurse suspect the cerebral aneurysm is located?

A) Vertebral arteries
B) Basilar artery
C) Circle of Willis
D) Carotid arteries

Question 10

What term should the nurse use to document a detached blood clot?

A) Thrombus
B) Embolus
C) Thromboembolus
D) Infarction

Question 11

A nurse takes an adult patient's blood pressure and determines it to be normal.What reading did the nurse obtain?

A) Systolic pressure between 140 and 150 mm Hg
B) Systolic pressure less than 120 mm Hg and diastolic pressure less than 80 mm Hg
C) Systolic pressure less than 100 mm Hg regardless of diastolic pressure
D) Systolic pressure greater than 140 mm Hg and a diastolic pressure of 100 mm Hg

Question 12

A 52 year old is diagnosed with primary hypertension but has no other health problems.Present treatment would cause the nurse to anticipate administering which drug to the patient?

A) A beta-adrenergic agonist
B) An alpha-adrenergic agonist
C) A diuretic
D) A calcium channel agonist

Question 13

A patient is diagnosed with orthostatic hypotension.Which of the following symptoms would most likely be reported?

A) Headache and blurred vision
B) Nausea and vomiting
C) Chest pain and palpitations
D) Syncope and fainting

Question 14

A patient presents with severe chest pain and shortness of breath and is diagnosed with pulmonary embolism.The embolism most likely originated from the:

A) left ventricle.
B) systemic arteries.
C) deep veins of the leg.
D) superficial veins of the arm.

Question 15

Individuals with Raynaud disease need to be counseled to avoid which of the following conditions to prevent severe symptoms?

A) Allergic reactions
B) Cold exposure
C) Hot water immersion
D) Tissue injury

Question 16

A patient presents to the emergency department reporting difficulty swallowing and shortness of breath.A CT scan would most likely reveal an aneurysm in the:

A) cerebral vessels.
B) renal arteries.
C) inferior vena cava.
D) thoracic aorta.

Question 17

A 50-year-old male with a 30-year history of smoking was diagnosed with bronchogenic cancer.He developed edema and venous distention in the upper extremities and face.Which of the following diagnosis will the nurse observe on the chart?

A) Thromboembolism
B) Deep vein thrombosis
C) Superior vena cava syndrome (SVCS)
D) Chronic venous insufficiency

Question 18

When a patient is diagnosed with coronary artery disease, the nurse assesses for myocardial:

A) hypertrophy.
B) ischemia.
C) necrosis.
D) inflammation.

Question 19

Most cases of combined systolic and diastolic hypertension have no known cause and are documented on the chart as _____ hypertension.

A) primary
B) secondary
C) congenital
D) acquired

Question 20

A 52-year-old male presents with pooling of blood in the veins of the lower extremities and edema.The diagnosis is chronic venous insufficiency, and an expected assessment finding of this disorder is:

A) deep vein thrombus formation.
B) skin hyperpigmentation.
C) gangrene.
D) edema above the knee.

Question 21

A 51-year-old male is at the health clinic for an annual physical exam.After walking from the car to the clinic, he developed substernal pain.He also reported discomfort in his left shoulder and his jaw, lasting 2-3 minutes and then subsiding with rest.He indicates that this has occurred frequently over the past few months with similar exertion.The nurse suspects he is most likely experiencing:

A) stable angina.
B) unstable angina.
C) Prinzmetal angina.
D) myocardial infarction (MI).

Question 22

A 67 year old was previously diagnosed with rheumatic heart disease.Tests now reveal lipoprotein deposition with chronic inflammation that impairs blood flow from the left ventricle into the aorta.Which diagnosis does this history support?

A) Aortic regurgitation
B) Aortic stenosis
C) Mitral regurgitation
D) Mitral stenosis

Question 23

Upon assessment of the patient, the nurse finds a widened pulse pressure and throbbing peripheral pulses.Which valve disorder does the nurse suspect?

A) Mitral regurgitation
B) Mitral stenosis
C) Aortic regurgitation
D) Aortic stenosis

Question 24

Many valvular stenosis and regurgitation disorders in adults have a common etiology.Which of the following conditions should alert the nurse that the patient may have both types of valve dysfunctions?

A) Heart failure
B) Connective tissue disorders
C) Rheumatic fever or heart disease
D) Syphilis infection

Question 25

A 10-year-old male presents with fever, lymphadenopathy, arthralgia, and nosebleeds.He is diagnosed with rheumatic heart disease.The most likely cause of this disease is:

A) congenital heart defects.
B) human immunodeficiency virus (HIV) infections.
C) group A beta-hemolytic streptococcus infections.
D) acute pericarditis.

Question 26

A 72 year old has a history of hypertension and atherosclerosis.An echocardiogram reveals backflow of blood into the left ventricle.Which of the following is the most likely diagnosis documented on the chart?

A) Mitral regurgitation
B) Mitral stenosis
C) Aortic regurgitation
D) Aortic stenosis

Question 27

Which valvular condition is characterized by the valve opening being constricted and narrowed, causing the valve leaflets, or cusps, to fail to open completely?

A) Regurgitation
B) Insufficiency
C) Stenosis
D) Incompetence

Question 28

A 28 year old presents to the ER reporting severe chest pain that worsens with respirations or lying down.Other signs include a fever, tachycardia, and a friction rub.Assessment findings support which medical diagnosis?

A) Acute pericarditis
B) Myocardial infarction (MI)
C) Stable angina
D) Pericardial effusion

Question 29

A 75-year-old male has severe chest pain and dials 911.Based upon the lab findings indicating a patient has elevated levels of cardiac troponins I and T, the nurse suspects which of the following has occurred?

A) Raynaud disease
B) Myocardial infarction (MI)
C) Orthostatic hypotension
D) Angina

Question 30

A 68-year-old male presents to the ER reporting chest pain.He has a history of stable angina that now appears to be unstable.He most likely has:

A) mild to moderate atherosclerosis.
B) impending myocardial infarction (MI).
C) electrical conduction problems in the heart.
D) decreased myocardial oxygen demand.

Question 31

A 51-year-old male presents with recurrent chest pain on exertion and is diagnosed with angina pectoris.The pain occurs when:

A) cardiac output has fallen below normal levels.
B) the myocardial oxygen supply has fallen below demand.
C) myocardial stretch has exceeded the upper limits.
D) the vagus nerve is stimulated.

Question 32

A 35 year old presents with pulmonary hypertension and is diagnosed as being in right heart failure.Which is the most likely cause of this condition?

A) Aortic stenosis
B) Tricuspid regurgitation
C) Aortic regurgitation
D) Mitral regurgitation

Question 33

The nurse realizes the patient diagnosed with mitral stenosis has incomplete emptying of the:

A) right atrium.
B) right ventricle.
C) left atrium.
D) left ventricle.

Question 34

A 62-year-old male presents to his primary care provider reporting chest pain at rest and with exertion.He does not have a history of coronary artery disease and reports that the pain often occurs at night.He is most likely experiencing which type of angina?

A) Unstable
B) Stable
C) Prinzmetal
D) Silent

Question 35

A 60-year-old female has survived a myocardial infarction.The nurse is providing care for impaired ventricular function because:

A) there is a temporary alteration in electrolyte balance.
B) there is too much stress on the heart.
C) the cells become hypertrophic.
D) the resulting ischemia leads to hypoxic injury and myocardial cell death.

Question 36

A 55-year-old male died of a myocardial infarction.Autopsy would most likely reveal:

A) embolization of plaque from the aorta.
B) decreased ventricular diastolic filling time.
C) platelet aggregation within the atherosclerotic coronary artery.
D) smooth muscle dysplasia in the coronary artery.

Question 37

A 49-year-old male presents reporting chest pain.EKG reveals ST elevation.He is diagnosed with myocardial ischemia.Which of the following interventions would be most beneficial?

A) Administer a diuretic to decrease volume.
B) Apply oxygen to increase myocardial oxygen supply.
C) Encourage exercise to increase heart rate.
D) Give an antibiotic to decrease infection.

Question 38

A 56 year old presents to his primary care provider for a checkup.Physical exam reveals edema, hepatomegaly, and muffled heart sounds.Which of the following is of greatest concern to the nurse?

A) Tamponade
B) Exudate
C) Aneurysm
D) Pulsus paradoxus

Question 39

A nurse recalls the most common cardiac valve disease in the United States is:

A) mitral valve prolapse.
B) pulmonary stenosis.
C) tricuspid valve prolapse.
D) aortic stenosis.

Question 40

A 42 year old is diagnosed with constrictive pericarditis.The nurse assesses the blood pressure for decreased cardiac output because of:

A) pericardial effusions.
B) fibrosis and calcification of the pericardial layers.
C) cardiomyopathy.
D) hemorrhage in the pericardial cavity.

Question 41

A 65-year-old male is diagnosed with chronic pulmonary disease and elevated pulmonary vascular resistance.Which of the following heart failures should the nurse assess for in this patient?

A) Right heart
B) Left heart
C) Low-output
D) High-output

Question 42

An 82-year-old female was admitted to the hospital with confusion and severe hypotension.Her body's compensatory mechanisms are increased heart rate, vasoconstriction, and movement of large volumes of interstitial fluid to the vascular compartment.What kind of shock does the nurse suspect the patient is experiencing?

A) Anaphylactic
B) Hypovolemic
C) Neurogenic
D) Septic

Question 43

Which condition should cause the nurse to assess for high-output failure in a patient?

A) Metabolic alkalosis
B) Hypothyroidism
C) Hypovolemia
D) Anemia

Question 44

Which characteristic changes should the nurse keep in mind while caring for a patient with left heart failure? As left heart failure progresses:

A) left ventricular preload increases.
B) systemic vascular resistance decreases.
C) left end-diastolic volume decreases.
D) pulmonary vascular resistance decreases.

Question 45

A 65-year-old male with a history of untreated hypertension is now experiencing left heart failure.A nurse recalls his untreated hypertension led to:

A) ventricular dilation and wall thinning.
B) myocardial hypertrophy and ventricular remodeling.
C) inhibition of renin and aldosterone.
D) alterations in alpha and beta receptor function.

Question 46

A 30-year-old female presents to her primary care provider with fever, cardiac murmur, and petechial skin lesions and is diagnosed with infective endocarditis.The most likely cause of the disease is:

A) bacteria.
B) viruses.
C) fungi.
D) parasites.

Question 47

A 15-year-old male who is allergic to peanuts eats a peanut butter cup.He then goes into anaphylactic shock.Which assessment findings will the nurse assess for?

A) Bradycardia, decreased arterial pressure, and oliguria
B) Bronchoconstriction, hives or edema, and hypotension
C) Hypertension, anxiety, and tachycardia
D) Fever, hypotension, and erythematous rash

Question 48

Inflammatory cells have difficulty limiting the colonization of microorganisms in infective endocarditis because the:

A) microorganisms are resistant.
B) valves are avascular.
C) microorganisms are sequestered in a fibrin clot.
D) colonies overwhelm the phagocytes.

Question 49

A 27-year-old male is admitted to a neurologic unit with a complete C-5 spinal cord transection.On initial assessment, he is bradycardic, hypotensive, and hyperventilating.He appears to be going into shock.The most likely mechanism of his shock is:

A) hypovolemia caused by blood loss.
B) hypovolemia caused by evaporative fluid losses.
C) vasodilation caused by gram-negative bacterial infection.
D) vasodilation caused by a decrease in sympathetic stimulation.

Question 50

A patient was admitted to the intensive care unit with a diagnosis of acute myocardial infarction (MI) and is being treated for shock.The primary cause of shock is most likely:

A) rapid heart rate.
B) decreased cardiac contractility.
C) increased capillary permeability.
D) decreased afterload due to vasodilation.

Question 51

When a person is in shock, a nurse remembers impairment in cellular metabolism is caused by:

A) release of toxic substances.
B) free radical formation.
C) inadequate tissue perfusion.
D) lack of nervous or endocrine stimulation.

Question 52

A 20-year-old female is being admitted to the hospital with fever and septic shock.Which set of assessment findings would the nurse expect the patient to exhibit?

A) Bradycardia, palpitations, confusion, truncal rash
B) Severe respiratory distress, jugular venous distention, chest pain
C) Low blood pressure and tachycardia
D) Reduced cardiac output, increased systemic vascular resistance, moist cough

Question 53

During shock states, glucose uptake is usually:

A) enhanced.
B) normal.
C) impaired.
D) energy intensive.

Question 54

A patient with left heart failure starts to have a cough and dyspnea.Pulmonary symptoms common to left heart failure are a result of:

A) inflammatory pulmonary edema.
B) decreased cardiac output.
C) pulmonary vascular congestion.
D) bronchoconstriction.

Question 55

Neurogenic shock can be caused by any factor that inhibits the:

A) parasympathetic nervous system.
B) sympathetic nervous system.
C) somatic nervous system.
D) thalamus.

Question 56

A 73 year old has increased pulmonary pressure resulting in right heart failure.A potential cause for the right heart to fail is:

A) hypertension.
B) left heart failure.
C) acute pneumonia.
D) pericarditis.

Question 57

One consequence of switching from aerobic to anaerobic cellular metabolism during shock states is:

A) decreased adenosine triphosphate (ATP) production.
B) cellular dehydration.
C) cellular alkalosis.
D) free radical formation.

Question 58

The onset of anaphylactic shock is usually:

A) mild.
B) sudden and life threatening.
C) delayed by several hours.
D) delayed by 24 hours.

Question 59

A 10-year-old male presents with fever, lymphadenopathy, arthralgia, and nosebleeds and is diagnosed with rheumatic heart disease.While planning care, which characteristic changes should the nurse remember?

A) Blood-borne organisms that adhere to the valvular surface.
B) Antigens that bind to the valvular lining, triggering an autoimmune response.
C) High fevers that damage collagen in valve leaflets.
D) Rheumatoid factor in the blood, stimulating valvular degeneration.

Question 60

A 72-year-old female has a history of right heart failure caused by a right ventricular myocardial infarction.Which of the following symptoms are specifically related to her right heart failure?

A) Significant edema to both lower legs and feet
B) Hypertension
C) Decreased urine output
D) Dyspnea upon exertion

Question 61

A patient most prone to multiple organ dysfunction syndrome (MODS) is a patient with:

A) myocardial infarction (MI).
B) pulmonary disease.
C) septic shock.
D) autoimmune disease.

Question 62

For an infection to progress to septic shock, what must occur?

A) The individual must be immunosuppressed.
B) The myocardium must be impaired.
C) The infection must be gram negative.
D) Bacteria must enter the bloodstream.

Question 63

Which of the following findings in the patient with Raynaud disease would indicate a need for further teaching?

A) The patient eats bananas twice a day.
B) The patient smokes cigarettes.
C) The patient wears mittens outside.
D) The patient takes calcium channel blockers.

Question 64

A nurse recalls acute orthostatic hypotension can be caused by: (Select all that apply.)

A) prolonged immobility.
B) drug action.
C) starvation.
D) volume depletion.
E) exercise.

Question 65

A 75-year-old female has been critically ill with multiple organ dysfunction syndrome (MODS) for longer than a week and has developed a severe oxygen supply and demand imbalance.The statement that best describes this imbalance is which of the following?

A) Increased oxygen delivery to cells fails to meet decreased oxygen demands.
B) The amount of oxygen consumed by cells depends only on the needs of cells, because there is oxygen in reserve.
C) The situation results in supply-independent consumption.
D) The reserve has been exhausted, and the amount of oxygen consumed depends on the amount the circulation is able to deliver.

Question 66

Cardiac cells can withstand ischemic conditions for _____ minutes before irreversible cell injury occurs.