Deck 28: Assessment of Cardiovascular Function

Question 1

A patient's QRS complex is becoming increasingly wider. What is occurring within the heart muscle that is reflected on this tracing?
1)The ventricles are repolarizing.
2)Atrial repolarization is occurring.
3)Ventricular depolarization is prolonged.
4)The atria depolarize and the impulse at the atrioventricular (AV) node is delayed.

Answer 1

3

Question 2

The nurse correlates which arterial blood gas result to the activation of chemoreceptors in the carotid bodies and aortic arch that lead to an increased respiratory rate?
1)HCO₃^- 24 mEq/L
2)PaCO₂ 30 mm Hg
3)PaO₂ 60 mm Hg
4)pH 7.42

Answer 2

1

Question 3

A patient who is admitted for a potential heart attack is prescribed serial blood draws for creatine kinase (CK), creatine kinase myocardial bands (CK-MB), and troponin. After blood is drawn for the baseline, which frequency does the nurse schedule for the follow-up blood draws for the next 12 hours?
1)Every 1 to 2 hours
2)Every 2 to 3 hours
3)Every 3 to 4 hours
4)Every 4 to 5 hours

Answer 3

3

Question 4

A patient is scheduled for a transesophageal echocardiogram (TEE). Results from this diagnostic evaluation provides which specific information related to the cardiac system?
1)Cardiac filling pressures
2)Integrity of cardiac arteries
3)Heart function during stress
4)Presence of clots in the atria

Question 5

The nurse correlates which blood pressure readings with stage 2 hypertension?
1)The patient with average blood pressure readings of 128/70 on three separate occasions
2)The patient with average blood pressure readings of 128/90 on three separate occasions
3)The patient with average blood pressure readings of 138/88 on three separate occasions
4)The patient with average blood pressure readings of 142/92 on three separate occasions

Question 6

The nurse assesses for which heart sound in the patient diagnosed with mitral valve stenosis?
1)Click
2)Friction rub
3)Atrial gallop
4)Ventricular gallop

Question 7

The nurse is reviewing the anatomy of the heart with a patient scheduled for cardiac surgery. Which patient statement indicates additional teaching is required?
1)"Oxygenated blood returns to the left atrium through the pulmonary vein."
2)"The right atrium receives blood from the superior and inferior vena cava."
3)"Blood leaves the right ventricle and travels through the pulmonary vein to the lungs."
4)"Blood leaves the right ventricle and travels through the pulmonary artery to the lungs."

Question 8

Which of the following statements from a patient having an annual physical indicates the need for further teaching regarding normal blood pressure parameters?
1)"As long as my blood pressure is not above 120/80, I know that I am fine."
2)"The bottom number needs to be below 80 to be considered normal."
3)"The top number needs to be below 120 to be considered normal."
4)"If the bottom number is above 90, I may have hypertension."

Question 9

The nurse auscultates a cardiac click and recognizes that this may be caused by which cardiac disorder?
1)Aortic regurgitation
2)Mitral valve stenosis
3)Pericarditis
4)Aortic stenosis

Question 10

A patient is being assessed for heart disease. The nurse instructs the patient to avoid eating and drinking fluids for 12 hours for which diagnostic test?
1)Lipid panel
2)Homocysteine
3)C-reactive protein
4)Partial thromboplastin time

Question 11

The nurse notes that a patient is scheduled for a brain natriuretic peptide level to be drawn. What patient teaching should the nurse prepare for this patient?
1)Low-fat diet
2)Signs of heart failure
3)Symptoms of a heart attack
4)Lung versus heart problems

Question 12

The nurse correlates a patient's blood pressure of 174/98 mm Hg most directly to which aspect of cardiac output?
1)Preload
2)Heart rate
3)Afterload
4)Contractility

Question 13

The nurse is preparing to determine a patient's cardiac output. Which measurement should be used for preload?
1)Heart rate
2)Blood pressure
3)Mean arterial pressure
4)Central venous pressure

Question 14

A patient is being evaluated for a possible myocardial infarction, but the patient is not sure when the pain started because he has a history of gastroesophageal reflux. He has had intermittent chest pain, with some episodes of dizziness and fatigue, over the last week. Which diagnostic result will be most helpful in determining whether the patient has suffered cardiac injury?
1)Elevated creatine kinase (CK)
2)Elevated creatine kinase myocardial bands (CK-MB)
3)Elevated myoglobin
4)Elevated troponin

Question 15

A patient with a blood pressure of 88/50 mm Hg has a heart rate of 112 beats per minute. The nurse correlates this change in heart rate to which physiological mechanism?
1)Positive chronotropic effect
2)Negative chronotropic effect
3)Force of the mechanical contraction
4)Reaction to ventricular volume at the end of diastole

Question 16

The nurse is caring for a patient with respiratory acidosis. Based on the actions of these chemoreceptors to this acidosis, the nurse assesses for which physiological response?
1)Decreased blood pressure
2)Decreased heart rate
3)Increased respiratory rate
4)Increased temperature

Question 17

After palpating a patient's radial pulses, the nurse proceeds to palpate the brachial, carotid, femoral, popliteal, and posterior tibial pulses. The nurse completes this more comprehensive assessment based on which finding?
1)Skin warm and dry
2)Various skin temperatures
3)Edema of the left lower extremity
4)Respiratory rate of 24 and labored

Question 18

The nurse is preparing to auscultate the heart sounds of a patient with mitral valve regurgitation. Which sound should the nurse expect to hear?
1)Rub
2)Click
3)Murmur
4)Atrial gallop

Question 19

While auscultating a patient's heart rate the nurse hears scratching sounds. What is most likely causing this sound?
1)Epicardium adhering to the heart surface
2)Inflammation of the pericardium
3)Parietal pericardium adhering to the sternum
4)Endocardium adhering to the heart chambers

Question 20

The nurse notes that a patient has bilateral lower extremity edema. For which health problem should the nurse assess further?
1)Pericarditis
2)Cardiac tamponade
3)Lymph obstruction
4)Venous insufficiency

Question 21

The nurse recognizes which hemodynamic parameters as measurements of afterload? Select all that apply.
1)Central venous pressure
2)Left atrial pressure
3)Pulmonary vascular resistance
4)Right atrial pressure
5)Systemic vascular resistance

Question 22

A patient is prescribed a 12-lead electrocardiogram. In which order should the nurse apply the V leads? (Enter the number of each step in the proper sequence; do not use punctuation or spaces. Example: 1234)
1) Midaxillary line
2) Between V2 and V4
3) Midclavicular line fifth intercostal space
4) Fourth intercostal space left of the sternum
5) Fourth intercostal space right of the sternum 6. Between V4 and V6 anterior axillary line

Question 23

The nurse correlates which assessment finding to activation of the renin-angiotensin-aldosterone system? Select all that apply.
1)Increased blood pressure
2)Increased heart rate
3)Increased sodium reabsorption
4)Increased urine output
5)Increased oxygen saturation

Question 24

A patient is recovering from a cardiac catheterization that was performed via the right groin. Which assessment requires the nurse to notify the healthcare provider immediately?
1)Pain at the insertion site
2)Urine output 250 mL/2 hours
3)Oozing serosanguinous drainage at the puncture site
4)Decreased pulses in the right foot

Question 25

The nurse documents a patient's heart sounds. Which descriptors does the nurse use for intensity of heart sounds? Select all that apply.
1)High
2)Faint
3)Loud
4)Harsh
5)Medium

Question 26

Which information should the nurse include when documenting the characteristics of normal heart sounds? Select all that apply.
1)Pitch
2)Clicks
3)Quality
4)Intensity
5)Location

Question 27

The nurse correlates which variables as directly influencing stroke volume? Select all that apply.
1)Afterload
2)Conductivity
3)Contractility
4)Coronary circulation
5)Preload

Question 28

The nurse is reviewing data collected during the assessment of an older patient. Which finding does the nurse consider as being an age-related change of the cardiovascular system?
1)First heart sound louder
2)Friction rub auscultated
3)Heart rate 64 and regular
4)Blood pressure 168/96 mm Hg

Question 29

The nurse is preparing a teaching tool about the cardiac electrical conduction system. In which order should the nurse explain the route of the action potential? (Enter the number of each step in the proper sequence; do not use punctuation or spaces. Example: 1234)
1) Impulse travels to the bundle of His
2) Sinoatrial node fires in the right atrium
3) Impulse extends through Purkinje fibers
4) Impulse travels through bundle branches
5) Impulse travels to the atrioventricular node 6. Impulse spreads through atrial myocardium

Question 30

The nurse is preparing content for a community health fair on risk factors for heart disease. What should the nurse include as nonmodifiable risk factors? Select all that apply.
1)Age
2)Weight
3)Alcohol intake
4)Ethnic background
5)Parents' health history