Deck 17: Cardiovascular System

Question 1

The nurse is assessing a client and notes a loud,blowing sound over the right carotid artery.The nurse would suspect the client has developed which of the following disorders?
1)Mitral stenosis
2)Aortic regurgitation
3)Atrial septal defect
4)Stricture of the carotid

Answer 1

4

Question 2

The nurse is preparing to assess the client's cardiovascular system.Which of the following positions will the nurse need to place the client in during the assessment?
1)Dorsal recumbent
2)Leaning forward
3)Right lateral position
4)Left lateral position
5)Sitting upright

Answer 2

1,2,4,5

Question 3

The nurse is percussing the client's anterior chest and notes a dull sound over an area where lung tissue is normally found.Which of the following would the nurse associate with this finding?
1)This is a normal finding.
2)The client's heart may be enlarged.
3)The client has developed a murmur.
4)The client has a pulse deficit.

Answer 3

2

Question 4

The nurse is performing a cardiac assessment and prepares to palpate the client's heartbeat on the client's chest.Draw an arrow pointing to this area.

Question 5

The nurse is interviewing a client who has recently been diagnosed with atherosclerosis in the client's coronary arteries.Which of the following questions by the nurse has the highest priority to help the nurse determine the client's most important risk factor for this condition?
1)"Can you please tell me about the vitamins or supplements that you take?"
2)"Have you ever been diagnosed with rheumatic fever?"
3)"Do you smoke or are you exposed to secondhand smoke?"
4)"Have you ever had a diagnostic test,such as an electrocardiogram,stress test,or echocardiogram,or a surgical procedure for a cardiovascular problem?"

Question 6

The nurse is performing a focused interview with an adult male client who recently experienced a myocardial infarction.The nurse requests information about how he felt during the time of the myocardial infarction.Which of the following client statements would be unexpected?
1)"I couldn't catch my breath."
2)"My chest didn't actually ever hurt."
3)"My wife said I looked like someone poured water all over me."
4)"I got so sick to my stomach."

Question 7

The nurse is preparing to perform a cardiac assessment on a client.Rank the following pieces of the assessment in order of occurrence.
1)Auscultation of the client's heart,apical pulse,and carotid arteries Choice
2)Inspection of the client's head and neck,chest,abdomen,and extremities Choice
3)Percussion of the client's chest Choice
4)Palpation of the precordium and pulses

Question 8

During the focused interview,the client makes the following statements.Which of the following statements indicates that the client has an increased risk of developing cardiovascular disease?
1)"I was diagnosed with hypothyroidism about 5 years ago."
2)"My doctor always tells me when I come in that my blood pressure is low."
3)"I know my grandmother had diabetes,but every time it has been checked mine has been normal."
4)"My total cholesterol has always been around 170."

Question 9

The nurse is reviewing the client's chart.The client's blood pressure has been consistently elevated over the last eight years.The client has been noncompliant with lifestyle changes and medication use designed to reduce the client's blood pressure.Today,the nurse is able to palpate a heave on the client's chest.Draw an arrow to the most likely location that the nurse is able to palpate the heave.

Question 10

The client has a history of rheumatic fever.Draw an arrow pointing to the layer of the heart that is most at risk for damage due to this infection.

Question 11

The nurse who works on a cardiac unit is teaching the student nurse about heart sounds.The student nurse asks how the S1 heart sound is produced.Which of the following is the nurse's best response?
1)"It results from the closure of the semilunar valves."
2)"It is heard when the aortic valve closes just slightly faster than the pulmonic valve."
3)"It results from the closure of the atrioventricular valves."
4)"It is caused by atrial contraction and ejection of blood into the ventricles in late diastole."

Question 12

A 39-year-old client has been admitted to the hospital with complaints of increasing fatigue.The history is remarkable for rheumatic fever as a child.The nurse hears a diastolic murmur at the apex when the client is in the left lateral position.The murmur is described as a rumble without radiation.This description is most consistent with:
1)tricuspid regurgitation.
2)mitral regurgitation.
3)mitral stenosis.
4)pulmonic stenosis.

Question 13

The client's stroke volume is 72 ml/beat.The client's heart rate is 82 beats per minute.
What is the client's cardiac output?____________

Question 14

The Intensive Care Unit nurse is performing a cardiac assessment on a newly admitted 72-year-old client and notes the following findings: peripheral edema,jugular venous distention of 5 cm above the sternal angle when the client is at a 45 degree angle,and an enlarged liver.These findings are most consistent with which of the following disorders?
1)Pulmonary edema
2)Left-sided heart failure
3)Myocardial infarction
4)Right-sided heart failure

Question 15

During the cardiac assessment of a client,the nurse hears a loud rumbling during diastole that increases toward the end of the sound.This sound is heard with the bell of the stethoscope over the lower left sternal border.The nurse would suspect which of the following in this client?
1)Aortic stenosis
2)Tricuspid stenosis
3)Mitral regurgitation
4)Pulmonic stenosis

Question 16

During the focused interview,the client answers the nurse's questions.Which of the following statements by the client suggests that the client has an increased risk of developing cardiovascular disease?
1)"I have been stressed out since my divorce last year."
2)"I'm what you call a Type C personality."
3)"I went on this new diet because I gained 30 pounds in the last 9 months."
4)"On my new diet,I can eat only grains and vegetables."
5)"I think about my job all of the time."

Question 17

The nurse is performing a cardiac assessment on a 70-year-old client admitted with hypertension.The nurse determines that the apical impulse can be palpated in an area 2 cm in diameter at the point of maximal impulse.The nurse suspects that the client may have developed which of the following problems?
1)Left ventricular hypertrophy
2)Aortic stenosis
3)Right ventricular volume overload
4)Enlarged left atrium

Question 18

The client's healthcare provider determines that the client's left ventricle is functioning adequately.Identify the left ventricle by drawing an arrow to it.

Question 19

The student nurse is assessing the client's cardiovascular system while the experienced nurse observes.The employment of which of the following techniques by the student nurse indicate the need for further education?
1)The client complains of discomfort while lying flat.The student nurse auscultates the client's chest quickly while the client continues to lie flat.
2)The student nurse determines that the apical impulse is located at the fifth intercostal space at the midclavicular line.
3)The student nurse examines the client's legs and notes that the client's hair is evenly distributed.
4)The student nurse gently palpates the client's carotid arteries simultaneously to determine pulse strength,rhythm,and rate.
5)The student nurse examines the client's hands and fingers and notes the presence of clubbing.

Question 20

The nurse is preparing to assess the female client's cardiovascular system during the client's visit to the healthcare provider's office.Which of the following items should the nurse have available in the room in order to complete the examination?
1)Ruler (metric)
2)Stethoscope
3)Lamp
4)Client gown and a drape
5)Doppler

Question 21

The nurse is assessing a 20-year-old client and notes the presence of bilateral earlobe creases.The nurse would choose which of the following actions?
1)Refer the client to a plastic surgeon.
2)Document this finding as normal.
3)Document the finding and notify the healthcare provider.
4)Ask the client about any history of injuries to his ears.
5)Assess the client's risk factors for coronary artery disease.

Question 22

The client has been admitted to the Coronary Care Unit with a myocardial infarction.Which of the following statements by the client indicate that adequate learning has occurred?
1)"I'm just sick to my stomach because I ate something that didn't agree with me."
2)"I think I must have given myself a little too much insulin this morning."
3)"I've been breathing fast and my heart's been racing because my heart's not working right."
4)"Just give me something for the nausea and I can go home."

Question 23

The nurse is caring for a client admitted with a grade 3 heart murmur heard during systole.The nurse would suspect which of the following cardiac conditions?
1)Mitral regurgitation
2)Mitral stenosis
3)Aortic stenosis
4)Pulmonic stenosis
5)Tricuspid stenosis

Question 24

The student nurse is speaking with a nurse regarding the objectives of Healthy People 2020.Which of the following statements by the student nurse indicates that the student nurse requires further education regarding these objectives?
1)"Parents of school-aged children really need to be educated about the importance of treating strep throat."
2)"African Americans really need to be educated about the symptoms associated with hypertension."
3)"People who smoke are twice as likely to die from a heart attack when compared to those who don't smoke."
4)"African Americans can benefit greatly from education aimed at increasing their understanding about the importance of exercise."

Question 25

The nurse is assessing a client who is 7 months pregnant.The nurse would document which of the following cardiac findings as normal in this client?
1)Increased systolic and diastolic blood pressures when standing
2)Point of maximal impulse palpated at fourth intercostal space and left of midclavicular line
3)Bradycardia
4)Diastolic murmur

Question 26

The nurse notes the pregnant client's blood pressure has dropped from 122/70 taken during her second month of pregnancy to 118/64 during her fifth month of pregnancy.Which of the following actions by the nurse is most appropriate?
1)Assess for signs of hemorrhage.
2)Document the blood pressure as a normal finding .
3)Consult the healthcare provider.
4)Tell the client to come in the next day so the nurse can recheck her blood pressure.

Question 27

The nurse is assessing a full-term African American newborn that is 18 hours old.The nurse would document which of the following as a normal finding?
1)Lethargy
2)Heart rate 115-120
3)Bulging of the precordium
4)Pale conjunctiva

Question 28

The nurse is performing a cardiac assessment on a healthy elderly adult client.Which of the following findings may be expected when compared to when the client was middle-aged?
1)Systolic murmur
2)Increased cardiac output
3)Increased systolic blood pressure
4)Increased stroke volume
5)Slight decrease in heart rate

Question 29

The client is 3 months pregnant.The nurse recently reviewed the objectives of Healthy People 2020 regarding pregnant women.Which of the following statements by the client indicates adequate education has occurred according to the objectives?
1)"I never got my rubella vaccination so I've been staying away from my niece who has rubella."
2)"I stopped taking Accutane for my acne before we started trying to get pregnant."
3)"I have been so careful about taking my insulin now that I'm pregnant."
4)"I have just one glass of wine each evening."
5)"I had to change to a different medication to prevent my seizures before we got pregnant."