Question 1

A patient is diagnosed with septic shock and has a decrease in afterload.The nurse would expect which initial changes in the patient's cardiac status? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

Accepted Answer

A) Increase in cardiac output 
B) Increase in blood pressure 
C) Decrease in cardiac output 
D) Decrease in blood pressure 
E) No change in blood pressure or cardiac output A,D

Question 2

Review of the medical record reveals that a patient has a summation gallop.Which pattern of heart sounds would the nurse expect?

Accepted Answer

A) S1 followed closely by S2 
B) S1 followed closely by S2 followed closely by S3 
C) S1 followed closely by a split S2 
D) S4 followed by S1 followed by S2 followed by S3 followed by S4 D

Question 3

A patient admitted with a cardiac arrhythmia is scheduled to have an electrophysiology study (EPS).The nurse would reinforce which teaching about this test?

Accepted Answer

A) This test will be helpful in determining if you need a pacemaker. 
B) This test will help us determine how your heart responds to stress. 
C) We can learn about the strength of your heart valves with this test. 
D) This test will reveal the health of your heart's blood supply system. A

Question 4

The nurse is caring for a patient having a transesophageal echocardiogram (TEE).What is an appropriate nursing intervention for the care of this patient?

Accepted Answer

A) Dim the lights in the room. 
B) Insert an intravenous catheter. 
C) Assess pedal pulses bilaterally. 
D) Apply pressure to the sheath puncture site.

Question 5

It is suspected that a patient who was severely injured in an automobile accident may have had a myocardial infarction (MI)prior to the crash.Which laboratory test result drawn while the patient was in the emergency department would the nurse evaluate as supporting that theory?

Accepted Answer

A) Increased serum potassium 
B) Increased creatine kinase level 
C) Increased BNP level 
D) Increased troponin level

Question 6

A patient's cardiac index will be calculated.What nursing interventions are necessary before this calculation is completed? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

Accepted Answer

A) Assure that there is an accurate current weight on the medical record. 
B) Compare fluid input and output for the last 12 hours. 
C) Measure the patient's height. 
D) Figure the patient's age in years and months. 
E) Obtain the patient's current heart rate.

Question 7

A patient with a steadily increasing preload was experiencing a corresponding increase in stroke volume,but it has now begun to decrease.Which rationale would the nurse provide for this occurrence?

Accepted Answer

A) This fluctuation will occur until maximum preload has been reached. 
B) The patient's heart rate is increasing,which causes a drop in stroke volume. 
C) The patient's preload has reached a critical point and now stroke volume will decrease. 
D) It is necessary to assess for a secondary pathophysiological event causing the stroke volume to decrease.

Question 8

A patient is admitted with a decrease in cardiac output.Which assessment findings would the nurse attribute to that condition?

Accepted Answer

A) Increased output of very clear urine 
B) Cool hands and feet 
C) Localized edema in the calf 
D) Bounding apical impulse

Question 9

It is determined that a patient has poor cardiac contractility.The nurse would anticipate administering which type of drugs to improve contractility? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

Accepted Answer

A) Cardiac glycosides 
B) Loop diuretics 
C) Sympathomimetic agents 
D) Phosphodiesterase inhibitors 
E) Angiotension-converting enzyme (AC
E) inhibitors

Question 10

A patient has been admitted with chest pain and generalized discomfort.Which assessment is essential for the nurse to set realistic goals for patient therapy and education?

Accepted Answer

A) The patient's functional status prior to illness 
B) Family history of disease,diet history,and prior medical history 
C) Demographic data including age,sex,race,and weight of patient 
D) Cardiovascular risk factors,such as history of smoking and stress level

Question 11

Which assessment techniques will the nurse use to evaluate the patient's cardiac output? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

Accepted Answer

A) Inspection of color changes in the periphery 
B) Strength of pulses 
C) Percussion of heart borders 
D) Auscultation of heart sounds 
E) Pulse pressure determination

Question 12

The nurse is instructing a patient who is scheduled for a cardiac catheterization.Which comment made by the patient would indicate the need for additional education?

Accepted Answer

A) "The nurse will check my feet very often after the procedure." 
B) "I will place a warm pack at the puncture site for pain relief." 
C) "I should let the nurse know if I need to cough after the procedure is done." 
D) "I will have someone available to drive me home following the procedure."

Question 13

The nurse has auscultated the patient's heart sounds and has measured vital signs.Which finding would the nurse evaluate as indicating greatest need for additional assessment?

Accepted Answer

A) Pulse pressure of 38 mm Hg 
B) Bounding,vigorous pulse 
C) Split of S2 
D) Apical pulse of 66

Question 14

A patient is admitted with the complaint of chest pain.Questions about which history will best help the nurse determine if the pain is from cardiac or pulmonary origin?

Accepted Answer

A) Deficits in movement,timing of the pain,and dietary changes in the last 24 hours 
B) What precipitated the pain,what it feels like,and where it is located 
C) Changes in dietary habits,smoking history,and presence of cough 
D) What home remedies were tried,activity level,and fluid intake changes

Question 15

Cardiac catheterization reveals that a patient has an isolated lesion in the right coronary artery that occludes 90% of the vessels' lumen.The nurse plans care for this patient based on the knowledge that total occlusion of the artery will result in damage to which portion of the heart?

Accepted Answer

A) Right ventricle 
B) Anterior aspect of the left ventricle 
C) The septum 
D) The lateral wall of the left ventricle

Question 16

Testing reveals that a patient's myocardial infarction (MI)damaged the papillary muscles of the mitral valve.The nurse plans care based on the knowledge that the patient is at high risk for which complication?

Accepted Answer

A) Extension of the myocardial damage 
B) Catastrophic left heart failure 
C) Pulmonary edema from right heart failure 
D) Pulmonary embolism from clots in the left atrium

Question 17

Testing indicates that a patient has a high preload.What changes would the nurse expect in this patient's cardiac function? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

Accepted Answer

A) Heart rate will decrease. 
B) Afterload will increase. 
C) Stroke volume will decrease. 
D) Stoke volume will increase. 
E) Blood pressure will decrease.

Question 18

A patient with left-sided heart failure is hospitalized with pulmonary edema.The nurse providing this patient's care would consider which physiology when explaining this disorder to the patient's family?

Accepted Answer

A) The normally high-pressure pulmonary circuit can damage lung tissue and cause pulmonary edema. 
B) Since pulmonary veins have no valves,blood can back up into the lungs causing pulmonary edema. 
C) The oxygen-rich blood that enters the pulmonary circuit tends to increase pressures in the tissue,causing pulmonary edema. 
D) The arteries of the pulmonary circuit are single layer.

Question 19

A patient is scheduled for an echocardiogram with measurement of ejection fraction.The nurse explains to the patient that this test will provide the most information about which cardiac characteristic?

Accepted Answer

A) The amount of blood the heart pumps every minute 
B) The strength of the heartbeat 
C) The amount of resistance the heart beats against 
D) The amount of blood in the heart before it beats

Question 20

A patient is scheduled for an exercise electrocardiogram.The nurse will ensure that which objects are in the room prior to the beginning of the test?

Accepted Answer

A) Oral fluids 
B) A defibrillator 
C) External pacemaker 
D) Portable chest x-ray machine

Exam 13: Determinants and Assessment of Cardiac Function

A patient is diagnosed with septic shock and has a decrease in afterload.The nurse would expect which initial changes in the patient's cardiac status? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

Review of the medical record reveals that a patient has a summation gallop.Which pattern of heart sounds would the nurse expect?

A patient admitted with a cardiac arrhythmia is scheduled to have an electrophysiology study (EPS) .The nurse would reinforce which teaching about this test?

The nurse is caring for a patient having a transesophageal echocardiogram (TEE) .What is an appropriate nursing intervention for the care of this patient?

It is suspected that a patient who was severely injured in an automobile accident may have had a myocardial infarction (MI) prior to the crash.Which laboratory test result drawn while the patient was in the emergency department would the nurse evaluate as supporting that theory?

A patient's cardiac index will be calculated.What nursing interventions are necessary before this calculation is completed? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.