Deck 23: Alterations of Cardiovascular Function

Question 1

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

Answer 1

Skin hyperpigmentation

Question 2

A 32-year-old female presents with lower leg pain,with swelling and redness.While obtaining the patient's history,which finding could have caused her condition?

A) Venous thrombus
B) Heart valve damage
C) Bacterial infection
D) Atherosclerosis

Answer 2

Venous thrombus

Question 3

A 65-year-old male presents for a routine checkup.A blood pressure check reveals a systolic pressure of 160 mm Hg and a diastolic pressure of 70 mm Hg.Which of the following is the most likely cause of this type of pressure elevation?

A) Vasospasm
B) Rigidity of the aorta
C) Decreased sodium intake
D) Lung disease

Answer 3

Rigidity of the aorta

Question 4

A patient wants to know what causes atherosclerosis.How should the nurse respond? In general,atherosclerosis is caused by:

A) High serum cholesterol levels
B) Endothelial injury and inflammation
C) An increase in antithrombotic substances
D) Congenital heart disease

Question 5

A 55-year-old female has undiagnosed hypertension.She presents to her primary care provider reporting impaired vision and chronic edema.Lab tests reveal that she also has renal insufficiency.While planning care,the nurse realizes the most likely cause for these findings is:

A) Clotting and gangrene
B) Free radical injury and cell toxicity
C) End-organ damage
D) Hypertrophy and hyperplasia

Question 6

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 mm Hg 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 7

What term should the nurse document for a detached blood clot?

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

Question 8

A 65-year-old female 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 9

A nurse monitors the patient for _____ when rapid onset of malignant hypertension results.

A) Atherosclerosis
B) Encephalopathy
C) Pulmonary edema
D) Acute renal failure

Question 10

When a nurse checks the patient for orthostatic hypotension,what did the nurse have the patient do?

A) Physical exertion
B) Eat
C) Stand up
D) Lie down

Question 11

A staff member asks a nurse what foam cells are.What is the nurse's best response? 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 12

A 52-year-old male is diagnosed with primary hypertension.He 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 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

Question 14

A 28-year-old female presents with severe chest pain and shortness of breath.She is diagnosed with pulmonary embolism,which 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

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 16

A 30-year-old Caucasian female was recently diagnosed with primary hypertension.She reports that she eats fairly well,usually having red meat and potatoes daily.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) Genes

Question 17

A 60-year-old male 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 18

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 19

A 50-year-old male is diagnosed with orthostatic hypotension.Which of the following symptoms would he most likely experience?

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

Question 20

A 60-year-old male presents to his primary care provider reporting chest pain.He 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 21

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

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

Question 22

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 dysfunction?

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

Question 23

A 60-year-old female had a myocardial infarction.She was brought to the hospital 30 minutes later.She survived,but now 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 24

A 67-year-old female was previously diagnosed with rheumatic heart disease.Tests reveal lipoprotein deposition with chronic inflammation that impairs blood flow from the left ventricle into the aorta.Which of the following is the most likely diagnosis recorded on the chart?

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

Question 25

A 51-year-old male presents with recurrent chest pain on exertion.He is diagnosed with angina pectoris.When he asks what causes the pain,how should the nurse respond? 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 26

A 56-year-old male 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

Question 27

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 28

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 29

A 50-year-old obese male with hypertension and coronary artery disease visits a nutritionist for food counseling.He has an elevated level of low-density lipoprotein (LDL)and a low level of high-density lipoprotein (HDL).Which of the following should the nurse advise him to avoid?

A) Monounsaturated fats
B) Polyunsaturated fats
C) Saturated fats
D) Trans fats

Question 30

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 31

When a patient asks the nurse what is the most common cause of myocardial ischemia,which statement is the correct response? The most common cause of myocardial ischemia is:

A) Idiopathic vasospasm
B) Arterial emboli from heart valve
C) Atherosclerosis
D) Venous emboli

Question 32

A 28-year-old female presents to the ER reporting severe chest pain that worsens with respirations or lying down.She has a fever,tachycardia,and a friction rub.Based upon the assessment findings,the nurse determines the patient is experiencing:

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

Question 33

A 49-year-old male presents to his primary care provider 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 34

A 52-year-old female is diagnosed with coronary artery disease.The nurse assesses for myocardial:

A) Hypertrophy
B) Ischemia
C) Necrosis
D) Inflammation

Question 35

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 to 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 36

A 56-year-old male 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 37

A 42-year-old female 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 38

While planning care for a patient with superior vena cava syndrome (SVCS),which principle should the nurse remember? SVCS is a progressive _____ of the superior vena cava (SVC)that leads to venous distention of the upper extremities and head.

A) Inflammation
B) Occlusion
C) Distention
D) Sclerosis

Question 39

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 40

While planning care,the nurse remembers which principle? In valvular _____,the valve opening is constricted and narrowed because the valve leaflets,or cusps,fail to open completely.

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

Question 41

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 42

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 43

When a patient with left heart failure starts to have a cough and dyspnea,which principle should the nurse remember? 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 44

A 30-year-old female presents to her primary care provider with fever,cardiac murmur,and petechial skin lesions.She is diagnosed with infective endocarditis.When the patient wants to know what caused the disease,what is the nurse's best response? The most likely cause of the disease is:

A) Bacteria
B) Viruses
C) Fungi
D) Parasites

Question 45

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

A) Release of toxic substances
B) Free radical formation
C) Inadequate tissue perfusion
D) Lack of nervous or endocrine stimulation

Question 46

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 47

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 48

A 59-year-old female is diagnosed with left ventricular failure.If a decrease in kidney perfusion occurs,the nurse knows this would ultimately cause:

A) Decreased left ventricular preload
B) Increased pulmonary capillary permeability
C) Increased systemic vascular resistance
D) Decreased cardiac oxygen demand

Question 49

A 60-year-old female was diagnosed with mitral stenosis.As a result,the nurse realizes the patient has incomplete emptying of the:

A) Right atrium
B) Right ventricle
C) Left atrium
D) Left ventricle

Question 50

A 73-year-old female has increased pulmonary pressure resulting in right heart failure.The nurse should monitor for a possible complication because a potential cause for her heart to fail is:

A) Hypertension
B) Left heart failure
C) Acute pneumonia
D) Pericarditis

Question 51

A 68-year-old female is experiencing left heart failure.Physical exam reveals elevated blood pressure.The nurse understands this is most likely caused by:

A) Sympathetic nervous system compensation for decreased cardiac output
B) Stress hormones promoting increased cardiac contractility
C) Cardiotoxic effects of catecholamines and angiotensin
D) Diastolic dysfunction

Question 52

A 72-year-old female 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 53

A nurse is teaching staff about endocarditis.Which information should the nurse include? 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 54

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 failure
B) Left heart failure
C) Low-output failure
D) High-output failure

Question 55

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 56

A 50-year-old male visits the cardiologist for an EKG.Results indicate that he has no PR interval and a variable QRS rate with rhythm irregularity.Which of the following is the most likely diagnosis to be recorded on the chart?

A) Atrial tachycardia
B) Atrial fibrillation
C) Sinus dysrhythmia
D) Idioventricular rhythm

Question 57

A 35-year-old male presents with pulmonary hypertension.Testing reveals he is in right heart failure.Which of the following is the most likely diagnosis the nurse will see listed on the chart?

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

Question 58

A 10-year-old male presents with fever,lymphadenopathy,arthralgia,and nose bleeds.He is diagnosed with rheumatic heart disease.When a staff member asks what caused the disease,what is the nurse's most correct response? The most likely cause of this disease is:

A) Congenital heart defects
B) Human immunodeficiency virus (HIV) infections
C) Group A ß-hemolytic streptococcus infections
D) Acute pericarditis

Question 59

A 10-year-old male presents with fever,lymphadenopathy,arthralgia,and nose bleeds.He 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 nurse recalls the most common cardiac valve disease in the United States,which tends to be most prevalent in young women,is:

A) Mitral valve prolapse
B) Pulmonary stenosis
C) Tricuspid valve prolapse
D) Aortic stenosis

Question 61

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 62

What factors make a patient prone to neurogenic shock? 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 63

A 50-year-old male was admitted to the intensive care unit with a diagnosis of acute myocardial infarction (MI).He is being treated for shock.His cardiopulmonary symptoms include low blood pressure,tachycardia,and tachypnea.His skin is pale and cool.The primary cause of his shock is most likely:

A) Rapid heart rate
B) Decreased cardiac contractility
C) Increased capillary permeability
D) Decreased afterload due to vasodilation

Question 64

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 65

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 66

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 67

Which patient is most prone to multiple organ dysfunction syndrome (MODS)? In a patient with:

A) Myocardial infarction (MI)
B) Pulmonary disease
C) Septic shock
D) Autoimmune disease

Question 68

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, tachycardia, generalized edema
D) Reduced cardiac output, increased systemic vascular resistance, moist cough

Question 69

Which of the following lab tests will the nurse check to help diagnose heart failure and provide insight into its severity?

A) Renin level
B) Brain natriuretic
C) Potassium
D) Troponin

Question 70

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 71

The hypotensive state seen in septic shock can lead to:

A) Bradycardia due to an overworked heart
B) Gut lining disruption and the translocation of bacteria into the bloodstream
C) Decreased oxygen demand of highly metabolic tissue
D) The increased spread of infection

Question 72

A nurse is planning care for a patient in shock.Which principle should the nurse remember? During shock states,glucose uptake is usually:

A) Enhanced
B) Normal
C) Impaired
D) Energy intensive

Question 73

Which organ should the nurse monitor closely since it is often the first to fail in patients with multiple organ dysfunction syndrome (MODS)?

A) Liver
B) Heart
C) Lungs
D) Pancreas

Question 74

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 75

A patient has been researching cardiac cells on the internet.Which information indicates the patient has a good understanding? Cardiac cells can withstand ischemic conditions for _____ minutes before irreversible cell injury occurs.

Question 76

For an infection to progress to septic shock,which of the following factors should the nurse determine occurred?

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 77

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 78

A nurse is teaching a patient about anaphylactic shock.Which information should the nurse include? The onset of anaphylactic shock is usually:

A) Mild
B) Immediate and life threatening
C) Delayed by several hours
D) Delayed by 24 hours