Answer questions related to different conditions affecting the cardiovascular system. Test your knowledge about the concepts related to the heart’s normal function, diagnostic tests, disease conditions and therapeutic communication.
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Cardiovascular Nursing
Questions related to different conditions affecting the cardiovascular system. Test your knowledge about the concepts related to the heart's normal function, diagnostic tests, disease conditions and therapeutic communication.
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Question 1
A murmur is heard at the second left intercostal space along the left sternal border. Which valve area is this?
A
Tricuspid
B
Mitral
C
Pulmonic
D
Aortic
Question 1 Explanation:
Abnormalities of the pulmonic valve are auscultated at the second left intercostal space along the left sternal border. Aortic valve abnormalities are heard at the second intercostal space, to the right of the sternum. Mitral valve abnormalities are heard at the fifth intercostal space in the midclavicular line. Tricuspid valve abnormalities are heard at the third and fourth intercostal spaces along the sternal border.
Question 2
Which of the following complications is of greatest concern when caring for a preoperative abdominal aneurysm client?
A
Aneurysm rupture
B
Diminished pedal pulses
C
HPN
D
Cardiac arrythmias
Question 2 Explanation:
Rupture of the aneurysm is a life-threatening emergency and is of the greatest concern for the nurse caring for this type of client. Hypertension should be avoided and controlled because it can cause the weakened vessel to rupture. Diminished pedal pulses, a sign of poor circulation to the lower extremities, are associated with an aneurysm but isn’t life threatening. Cardiac arrhythmias aren’t directly linked to an aneurysm.
Question 3
Which of the following classes of medications protects the ischemic myocardium by blocking catecholamines and sympathetic nerve stimulation?
A
Beta-adrenergic blockers
B
Calcium channel blockers
C
Narcotics
D
Nitrates
Question 3 Explanation:
Beta-adrenergic blockers work by blocking beta receptors in the myocardium, reducing the response to catecholamines and sympathetic nerve stimulation. They protect the myocardium, helping to reduce the risk of another infarction by decreasing the workload of the heart and decreasing myocardial oxygen demand. Calcium channel blockers reduce the workload of the heart by decreasing the heart rate. Narcotics reduce myocardial oxygen demand, promote vasodilation, and decreased anxiety. Nitrates reduce myocardial oxygen consumption by decreasing left ventricular end-diastolic pressure (preload) and systemic vascular resistance (afterload).
Question 4
What is the most common cause of abdominal aortic aneurysm?
A
Atherosclerosis
B
HPN
C
DM
D
Syphilis
Question 4 Explanation:
Atherosclerosis accounts for 75% of all abdominal aortic aneurysms. Plaques build up on the wall of the vessel and weaken it, causing an aneurysm. Although the other conditions are related to the development of an aneurysm, none is a direct cause.
Question 5
Dyspnea, cough, expectoration, weakness, and edema are classic signs and symptoms of which of the following conditions?
A
Heart Failure
B
Myocardial Infarction
C
Hypertension
D
Pericarditis
Question 5 Explanation:
These are the classic symptoms of heart failure. Pericarditis is exhibited by a feeling of fullness in the chest and auscultation of a pericardial friction rub. Hypertension is usually exhibited by headaches, visual disturbances and a flushed face. Myocardial infarction causes heart failure but isn’t related to these symptoms.
Question 6
When do coronary arteries primarily receive blood flow?
A
During inspiration
B
During systole
C
During expiration
D
During diastole
Question 6 Explanation:
Although the coronary arteries may receive a minute portion of blood during systole, most of the blood flow to coronary arteries is supplied during diastole. Breathing patterns are irrelevant to blood flow
Question 7
Which of the following symptoms usually signifies rapid expansion and impending rupture of an abdominal aortic aneurysm?
A
Angina
B
Absent pedal pulses
C
Lower back pain
D
Abdominal pain
Question 7 Explanation:
Lower back pain results from expansion of the aneurysm. The expansion applies pressure in the abdominal cavity, and the pain is referred to the lower back. Abdominal pain is most common symptom resulting from impaired circulation. Absent pedal pulses are a sign of no circulation and would occur after a ruptured aneurysm or in peripheral vascular disease. Angina is associated with atherosclerosis of the coronary arteries.
Question 8
After an anterior wall myocardial infarction, which of the following problems is indicated by auscultation of crackles in the lungs?
A
Tricuspid valve malfunction
B
Left-sided heart failure
C
Pulmonic valve malfunction
D
Right-sided heart failure
Question 8 Explanation:
The left ventricle is responsible for the most of the cardiac output. An anterior wall MI may result in a decrease in left ventricular function. When the left ventricle doesn’t function properly, resulting in left-sided heart failure, fluid accumulates in the interstitial and alveolar spaces in the lungs and causes crackles. Pulmonic and tricuspid valve malfunction causes right-sided heart failure.
Question 9
Which of the following blood vessel layers may be damaged in a client with an aneurysm?
A
Externa
B
Interna
C
Interna and Media
D
Media
Question 9 Explanation:
The factor common to all types of aneurysms is a damaged media. The media has more smooth muscle and less elastic fibers, so it’s more capable of vasoconstriction and vasodilation. The interna and externa are generally no damaged in an aneurysm.
Question 10
Which of the following complications of an abdominal aortic repair is indicated by detection of a hematoma in the perineal area?
A
Stage 1 pressure ulcer
B
Hernia
C
Retroperitoneal rupture at the repair site
D
Rapid expansion of the aneurysm
Question 10 Explanation:
Blood collects in the retroperitoneal space and is exhibited as a hematoma in the perineal area. This rupture is most commonly caused by leakage at the repair site. A hernia doesn’t cause vascular disturbances, nor does a pressure ulcer. Because no bleeding occurs with rapid expansion of the aneurysm, a hematoma won’t form.
Question 11
In which of the following areas is an abdominal aortic aneurysm most commonly located?
A
Distal to the iliac arteries
B
Distal to the renal arteries
C
Adjacent to the aortic branch
D
Proximal to the renal arteries
Question 11 Explanation:
The portion of the aorta distal to the renal arteries is more prone to an aneurysm because the vessel isn’t surrounded by stable structures, unlike the proximal portion of the aorta. Distal to the iliac arteries, the vessel is again surrounded by stable vasculature, making this an uncommon site for an aneurysm. There is no area adjacent to the aortic arch, which bends into the thoracic (descending) aorta.
Question 12
Septal involvement occurs in which type of cardiomyopathy?
A
Restrictive
B
Dilated
C
Congestive
D
Hypertrophic
Question 12 Explanation:
In hypertrophic cardiomyopathy, hypertrophy of the ventricular septum – not the ventricle chambers – is apparent. This abnormality isn’t seen in other types of cardiomyopathy.
Question 13
What supplemental medication is most frequently ordered in conjuction with furosemide (Lasix)?
A
Sodium
B
Potassium
C
Chloride
D
Digoxin
Question 13 Explanation:
Supplemental potassium is given with furosemide because of the potassium loss that occurs as a result of this diuretic. Chloride and sodium aren’t loss during diuresis. Digoxin acts to increase contractility but isn’t given routinely with furosemide.
Question 14
Which of the following actions is the first priority care for a client exhibiting signs and symptoms of coronary artery disease?
A
Enhance myocardial oxygenation
B
Educate the client about his symptoms
C
Decrease anxiety
D
Administer sublignual nitroglycerin
Question 14 Explanation:
Enhancing mocardial oxygenation is always the first priority when a client exhibits signs and symptoms of cardiac compromise. Without adequate oxygen, the myocardium suffers damage. Sublingual nitorglycerin is administered to treat acute angina, but its administration isn't the first priority. Although educating the client and decreasing anxiety are important in care delivery, nether are priorities when a client is compromised.
Question 15
Which of the following complications is indicated by a third heart sound (S3)?
A
Ventricular dilation
B
Aortic valve malfunction
C
Increased atrial contractions
D
Systemic hypertension
Question 15 Explanation:
Rapid filling of the ventricles causes vasodilation that is auscultated as S3. Increased atrial contraction or systemic hypertension can result is a fourth heart sound. Aortic valve malfunction is heard as a murmur.
Question 16
Which of the following sounds is distinctly heard on auscultation over the abdominal region of an abdominal aortic aneurysm client?
A
Friction rubs
B
Bruit
C
Crackles
D
Dullness
Question 16 Explanation:
A bruit, a vascular sound resembling heart murmur, suggests partial arterial occlusion. Crackles are indicative of fluid in the lungs. Dullness is heard over solid organs, such as the liver. Friction rubs indicate inflammation of the peritoneal surface.
Question 17
What is the most common symptom in a client with abdominal aortic aneurysm?
A
Upper back pain
B
Headache
C
Diaphoresis
D
Abdominal pain
Question 17 Explanation:
Abdominal pain in a client with an abdominal aortic aneurysm results from the disruption of normal circulation in the abdominal region. Lower back pain, not upper, is a common symptom, usually signifying expansion and impending rupture of the aneurysm. Headache and diaphoresis aren’t associated with abdominal aortic aneurysm.
Question 18
Which of the following recurring conditions most commonly occurs in clients with cardiomyopathy?
A
Pericardial effusion
B
MI
C
DM
D
Heart failure
Question 18 Explanation:
Because the structure and function of the heart muscle is affected, heart failure most commonly occurs in clients with cardiomyopathy. Myocardial infarction results from prolonged myocardial ischemia due to reduced blood flow through one of the coronary arteries. Pericardial effusion is most predominant in clients with percarditis. Diabetes mellitus is unrelated to cardiomyopathy.
Question 19
What is the first intervention for a client experiencing myocardial infarction?
A
Administer morphine
B
Obtain an electrocardiogram
C
Administer sublingual nitroglycerin
D
Administer oxygen
Question 19 Explanation:
Administering supplemental oxygen to the client is the first priority of care. The myocardium is deprived of oxygen during an infarction, so additional oxygen is administered to assist in oxygenation and prevent further damage. Morphine and sublingual nitroglycerin are also used to treat MI, but they’re more commonly administered after the oxygen. An ECG is the most common diagnostic tool used to evaluate MI.
Question 20
Which of the following illnesses is the leading cause of death in the US?
A
Renal failure
B
Liver failure
C
Coronary artery disease
D
Cancer
Question 20 Explanation:
Coronary artery disease accounts for over 50% of all deaths in the US. Cancer accounts for approximately 20%. Liver failure and renal failure account for less than 10% of all deaths in the US.
Question 21
Which of the following blood tests is most indicative of cardiac damage?
A
Lactate dehydrogenase
B
Complete blood count
C
Creatine kinase
D
Troponin I
Question 21 Explanation:
Troponin I levels rise rapidly and are detectable within 1 hour of myocardial injury. Troponin I levels aren't detectable in people without cardiac injury. Lactate dehydrogenase is present in almost all body tissues and not specific to heart muscle. LDH isoenzymes are useful in diagnosing cardiac injury. CBC is obtained to review blood counts, and a complete chemistry is obtained to review electrolytes. Because CK levles may rise with skeletal muscle injury, CK isoenzymes are required to detect cardiac injury.
Question 22
Which of the following conditions most commonly results in CAD?
A
Renal failure
B
Atherosclerosis
C
MI
D
DM
Question 22 Explanation:
Atherosclerosis, or plaque formation, is the leading cause of CAD. DM is a risk factor for CAD but isn't the most common cause. Renal failure doesn't cause CAD, but the two conditions are related. Myocardial infarction is commonly a result of CAD.
Question 23
What is the most appropriate nursing response to a myocardial infarction client who is fearful of dying?
A
"When the doctor arrives, everything will be fine."
B
"Tell me about your feeling right now."
C
"This is a bad situation, but you'll feel better soon."
D
"Please be assured we're doing everything we can to make you feel better."
Question 23 Explanation:
Validation of the client’s feelings is the most appropriate response. It gives the client a feeling of comfort and safety. The other three responses give the client false hope. No one can determine if a client experiencing MI will feel or get better and therefore, these responses are inappropriate.
Question 24
After myocardial infarction, serum glucose levels and free fatty acids are both increase. What type of physiologic changes are these?
A
Metabolic
B
Hematologic
C
Mechanical
D
Electrophysiologic
Question 24 Explanation:
Both glucose and fatty acids are metabolites whose levels increase after a myocardial infarction. Mechanical changes are those that affect the pumping action of the heart, and electro physiologic changes affect conduction. Hematologic changes would affect the blood.
Question 25
Which hereditary disease is most closely linked to aneurysm?
A
Marfan's syndrome
B
Cystic fibrosis
C
Lupus erythematosus
D
Myocardial infarction
Question 25 Explanation:
Marfan’s syndrome results in the degeneration of the elastic fibers of the aortic media. Therefore, clients with the syndrome are more likely to develop an aortic aneurysm. Although cystic fibrosis is hereditary, it hasn’t been linked to aneurysms. Lupus erythematosus isn’t hereditary. Myocardial infarction is neither hereditary nor a disease.
Question 26
Which of the following is the most common symptom of myocardial infarction?
A
Palpitations
B
Dyspnea
C
Chest pain
D
Edema
Question 26 Explanation:
The most common symptom of an MI is chest pain, resulting from deprivation of oxygen to the heart. Dyspnea is the second most common symptom, related to an increase in the metabolic needs of the body during an MI. Edema is a later sign of heart failure, often seen after an MI. Palpitations may result from reduced cardiac output, producing arrhythmias.
Question 27
Which of the following risk factors for coronary artery disease cannot be corrected?
A
Cigarette smoking
B
HPN
C
DM
D
Heredity
Question 27 Explanation:
Because "heredity" refers to our genetic makeup, it can't be changed. Cigarette smoking cessation is a lifestyle change that involves behavior modification. Diabetes mellitus is a risk factor that can be controlled with diet, exercise, and medication. Altering one's diet, exercise, and medication can correct hypertension.
Question 28
Which of the following heart muscle diseases is unrelated to other cardiovascular disease?
A
Cardiomyopathy
B
Coronary artery disease
C
Myocardial infarction
D
Pericardial Effusion
Question 28 Explanation:
Cardiomyopathy isn’t usually related to an underlying heart disease such as atherosclerosis. The etiology in most cases is unknown. Coronary artery disease and myocardial infarction are directly related to atherosclerosis. Pericardial effusion is the escape of fluid into the pericardial sac, a condition associated with pericarditis and advanced heart failure.
Question 29
Exceeding which of the following serum cholesterol levels significantly increases the risk of coronary artery disease?
A
175 mg/dl
B
200 mg/dl
C
150 mg/dl
D
100 mg/dl
Question 29 Explanation:
Cholesterol levels above 200 mg/dl are considered excessive. They require dietary restriction and perhaps medication. Exercise also helps reduce cholesterol levels. The other levels listed are all below the nationally accepted levels for cholesterol and carry a lesser risk for CAD.
Question 30
Which of the following treatments is the definitive one for a ruptured aneurysm?
A
Beta-adrenergic blocker administration
B
Surgical intervention
C
Antihypertensive medication administration
D
Aortogram
Question 30 Explanation:
When the vessel ruptures, surgery is the only intervention that can repair it. Administration of antihypertensive medications and beta-adrenergic blockers can help control hypertension, reducing the risk of rupture. An aortogram is a diagnostic tool used to detect an aneurysm.
Question 31
Which of the following parameters should be checked before administering digoxin?
A
Radial pulse
B
Blood pressure
C
Respiratory rate
D
Apical pulse
Question 31 Explanation:
An apical pulse is essential or accurately assessing the client’s heart rate before administering digoxin. The apical pulse is the most accurate point in the body. Blood pressure is usually only affected if the heart rate is too low, in which case the nurse would withhold digoxin. The radial pulse can be affected by cardiac and vascular disease and therefore, won’t always accurately depict the heart rate. Digoxin has no effect on respiratory function.
Question 32
Which of the following systems is the most likely origin of pain the client describes as knifelike chest pain that increases in intensity with inspiration?
A
Gastrointestinal
B
Cardiac
C
Musculoskeletal
D
Pulmonary
Question 32 Explanation:
Pulmonary pain is generally described by these symptoms. Musculoskeletal pain only increase with movement. Cardiac and GI pains don't change with respiration.
Question 33
Which of the following classes of drugs is most widely used in the treatment of cardiomyopathy?
A
Calcium channel blockers
B
Nitrates
C
Beta-adrenergic blockers
D
Antihypertensive
Question 33 Explanation:
By decreasing the heart rate and contractility, beta-adrenergic blockers improve myocardial filling and cardiac output, which are primary goals in the treatment of cardiomyopathy. Antihypertensives aren’t usually indicated because they would decrease cardiac output in clients who are often already hypotensive. Calcium channel blockers are sometimes used for the same reasons as beta-adrenergic blockers; however, they aren’t as effective as beta-adrenergic blockers and cause increase hypotension. Nitrates aren’t’ used because of their dilating effects, which would further compromise the myocardium.
Question 34
Which of the following classes of medications maximizes cardiac performance in clients with heat failure by increasing ventricular contractility?
A
Inotropic agents
B
Beta-adrenergic blockers
C
Diuretics
D
Calcium channel blockers
Question 34 Explanation:
Inotropic agents are administered to increase the force of the heart’s contractions, thereby increasing ventricular contractility and ultimately increasing cardiac output. Beta-adrenergic blockers and calcium channel blockers decrease the heart rate and ultimately decrease the workload of the heart. Diuretics are administered to decrease the overall vascular volume, also decreasing the workload of the heart.
Question 35
When assessing a client for an abdominal aortic aneurysm, which area of the abdomen is most commonly palpated?
A
Directly over the umbilicus
B
Midline lower abdomen to the right of the midline
C
Right upper quadrant
D
Middle lower abdomen to the left of the midline
Question 35 Explanation:
The aorta lies directly left of the umbilicus; therefore, any other region is inappropriate for palpation.
Question 36
What is the definitive test used to diagnose an abdominal aortic aneurysm?
A
Ultrasound
B
Arteriogram
C
Abdominal X-ray
D
CT scan
Question 36 Explanation:
An arteriogram accurately and directly depicts the vasculature; therefore, it clearly delineates the vessels and any abnormalities. An abdominal aneurysm would only be visible on an X-ray if it were calcified. CT scan and ultrasound don’t give a direct view of the vessels and don’t yield as accurate a diagnosis as the arteriogram.
Question 37
In which of the following disorders would the nurse expect to assess sacral edema in bedridden client?
A
DM
B
Right-sided heart failure
C
Renal failure
D
Pulmonary emboli
Question 37 Explanation:
The most accurate area on the body to assed dependent edema in a bedridden client is the sacral area. Sacral, or dependent, edema is secondary to right-sided heart failure. Diabetes mellitus, pulmonary emboli, and renal disease aren’t directly linked to sacral edema.
Question 38
Medical treatment of coronary artery disease includes which of the following procedures?
A
Cardiac catheterization
B
Percutaneous transluminal coronary angioplasty
C
Coronary artery bypass surgery
D
Oral medication administration
Question 38 Explanation:
Oral medication administration is a noninvasive, medical treatment for coronary artery disease. Cardiac catheterization isn't a treatment but a diagnostic tool. Coronary artery bypass surgery and percutaneous transluminal coronary angioplasty are invasive, surgical treatments.
Question 39
Prolonged occlusion of the right coronary artery produces an infarction in which of he following areas of the heart?
A
Anterior
B
Lateral
C
Inferior
D
Apical
Question 39 Explanation:
The right coronary artery supplies the right ventricle, or the inferior portion of the heart. Therefore, prolonged occlusion could produce an infarction in that area. The right coronary artery doesn't supply the anterior portion ( left ventricle ), lateral portion ( some of the left ventricle and the left atrium ), or the apical portion ( left ventricle ) of the heart.
Question 40
Which of the following arteries primarily feeds the anterior wall of the heart?
A
Internal mammary artery
B
Right coronary artery
C
Circumflex artery
D
Left anterior descending artery
Question 40 Explanation:
The left anterior descending artery is the primary source of blood for the anterior wall of the heart. The circumflex artery supplies the lateral wall, the internal mammary artery supplies the mammary, and the right coronary artery supplies the inferior wall of the heart.
Question 41
Which of the following cardiac conditions does a fourth heart sound (S4) indicate?
A
Normally functioning heart
B
Dilated aorta
C
Decreased myocardial contractility
D
Failure of the ventricle to eject all the blood during systole
Question 41 Explanation:
An S4 occurs as a result of increased resistance to ventricular filling after atrial contraction. This increased resistance is related to decrease compliance of the ventricle. A dilated aorta doesn’t cause an extra heart sound, though it does cause a murmur. Decreased myocardial contractility is heard as a third heart sound. An s4 isn’t heard in a normally functioning heart.
Question 42
Which of the following diagnostic tools is most commonly used to determine the location of myocardial damage?
A
Echocardiogram
B
Cardiac catheterization
C
Electrocardiogram
D
Cardiac enzymes
Question 42 Explanation:
The ECG is the quickest, most accurate, and most widely used tool to determine the location of myocardial infarction. Cardiac enzymes are used to diagnose MI but can’t determine the location. An echocardiogram is used most widely to view myocardial wall function after an MI has been diagnosed. Cardiac catheterization is an invasive study for determining coronary artery disease and may also indicate the location of myocardial damage, but the study may not be performed immediately.
Question 43
Which of the following symptoms might a client with right-sided heart failure exhibit?
A
Oliguria
B
Polyuria
C
Adequate urine output
D
Polydipsia
Question 43 Explanation:
Inadequate deactivation of aldosterone by the liver after right-sided heart failure leads to fluid retention, which causes oliguria. Adequate urine output, polyuria, and polydipsia aren’t associated with right-sided heart failure.
Question 44
A pulsating abdominal mass usually indicates which of the following conditions?
A
Enlarged spleen
B
Gastritis
C
Abdominal aortic aneurysm
D
Gastic distention
Question 44 Explanation:
The presence of a pulsating mass in the abdomen is an abnormal finding, usually indicating an outpouching in a weakened vessel, as in abdominal aortic aneurysm. The finding, however, can be normal on a thin person. Neither an enlarged spleen, gastritis, nor gastic distention cause pulsation.
Question 45
With which of the following disorders is jugular vein distention most prominent?
A
Pneumothorax
B
Abdominal aortic aneurysm
C
Myocardial infarction
D
Heart failure
Question 45 Explanation:
Elevated venous pressure, exhibited as jugular vein distention, indicates a failure of the heart to pump. Jugular vein distention isn’t a symptom of abdominal aortic aneurysm or pneumothorax. An MI, if severe enough, can progress to heart failure; however, in and of itself, an MI doesn’t cause jugular vein distention.
Question 46
Which of the following groups of symptoms indicated a ruptured abdominal aneurysm?
A
Intermittent lower back pain, decreased BP, decreased RBC, increased WBC
B
Severe lower back pain, decreased BP, decreased RBC, increased WBC
C
Lower back pain, increased BP, decreased RBC, increased WBC
D
Severe lower back pain, decreased BP, decreased RBC, decreased WBC
Question 46 Explanation:
Severe lower back pain indicates an aneurysm rupture, secondary to pressure being applied within the abdominal cavity. When rupture occurs, the pain is constant because it can’t be alleviated until the aneurysm is repaired. Blood pressure decreases due to the loss of blood. After the aneurysm ruptures, the vasculature is interrupted and blood volume is lost, so blood pressure wouldn’t increase. For the same reason, the RBC count is decreased – not increase. The WBC count increases as cells migrate to the site of injury.
Question 47
What is the term used to describe an enlargement of the heart muscle?
A
Cardiomyopathy
B
Pericarditis
C
Myocarditis
D
Cardiomegaly
Question 47 Explanation:
Cardiomegaly denotes an enlarged heart muscle. Cardiomyopathy is a heart muscle disease of unknown origin. Myocarditis refers to inflammation of heart muscle. Pericarditis is an inflammation of the pericardium, the sac surrounding the heart.
Question 48
What is the primary reason for administering morphine to a client with myocardial infarction?
A
To decrease the client's pain
B
To decrease the client's anxiety
C
To sedate the client
D
To decrease oxygen demand on the client's heart
Question 48 Explanation:
Morphine is administered because it decreases myocardial oxygen demand. Morphine will also decrease pain and anxiety while causing sedation, but isn't primarily given for those reasons.
Question 49
Which of the following conditions is linked to more than 50% of clients with abdominal aortic aneurysms?
A
HPN
B
DM
C
PVD
D
Syphilis
Question 49 Explanation:
Continuous pressure on the vessel walls from hypertension causes the walls to weaken and an aneurysm to occur. Atherosclerotic changes can occur with peripheral vascular diseases and are linked to aneurysms, but the link isn’t as strong as it is with hypertension. Only 1% of clients with syphilis experience an aneurysm. Diabetes mellitus doesn’t have direct link to aneurysm.
Question 50
Which of the following symptoms is most commonly associated with left-sided heart failure?
A
Hepatic engorgement
B
Crackles
C
Arrhythmias
D
Hypotension
Question 50 Explanation:
Crackles in the lungs are a classic sign of left-sided heart failure. These sounds are caused by fluid backing up into the pulmonary system. Arrhythmias can be associated with both right and left-sided heart failure. Left-sided heart failure causes hypertension secondary to an increased workload on the system.
Question 51
Atherosclerosis impedes coronary blood flow by which of the following mechanisms?
A
Hardened vessels dilate to allow the blood to flow through
B
Plaques obstruct the vein
C
Blood clots form outside the vessel wall
D
Plaques obstruct the artery
Question 51 Explanation:
Arteries, not veins, supply the coronary arteries with oxygen and other nutrients. Atherosclerosis is a direct result of plaque formation in the artery. Hardened vessels can't dilate properly and, therefore, constrict blood flow.
Question 52
Toxicity from which of the following medications may cause a client to see a green halo around lights?
A
Metoprolol
B
Digoxin
C
Furosemide
D
Enalapril
Question 52 Explanation:
One of the most common signs of digoxin toxicity is the visual disturbance known as the green halo sign. The other medications aren’t associated with such an effect.
Question 53
Which of the followng conditions is most commonly responsible for myocardial infarction?
A
Coronary artery thrombosis
B
Heart failure
C
Renal failure
D
Aneurysm
Question 53 Explanation:
Coronary artery thrombosis causes occlusion of the artery, leading to myocardial death. An aneurysm is an outpouching of a vessel and doesn't cause an MI. Renal failure can be associated with MI but isn't a direct cause. Heart failure is usually the result of an MI.
Question 54
Which of the following types of cardiomyopathy can be associated with childbirth?
A
Hypertrophic
B
Myocarditis
C
Dilated
D
Restrictive
Question 54 Explanation:
Although the cause isn’t entirely known, cardiac dilation and heart failure may develop during the last month of pregnancy of the first few months after birth. The condition may result from a preexisting cardiomyopathy not apparent prior to pregnancy. Hypertrophic cardiomyopathy is an abnormal symmetry of the ventricles that has an unknown etiology but a strong familial tendency. Myocarditis isn’t specifically associated with childbirth. Restrictive cardiomyopathy indicates constrictive pericarditis; the underlying cause is usually myocardial.
Question 55
Which of the following landmarks is the correct one for obtaining an apical pulse?
A
Left fifth intercostal space, midclavicular line
B
Left second intercostal space, midclavicular line
C
Left seventh intercostal space, midclavicular line
D
Left intercostal space, midaxillary line
Question 55 Explanation:
The correct landmark for obtaining an apical pulse is the left intercostal space in the midclavicular line. This is the point of maximum impulse and the location of the left ventricular apex. The left second intercostal space in the midclavicular line is where the pulmonic sounds are auscultated. Normally, heart sounds aren't heard in the midaxillary line or the seventh intercostal space in the midclavicular line.
Question 56
What is the most common complication of a myocardial infarction?
A
Heart failure
B
Arrhythmias
C
Cardiogenic shock
D
Pericarditis
Question 56 Explanation:
Arrhythmias, caused by oxygen deprivation to the myocardium, are the most common complication of an MI. cardiogenic shock, another complication of MI, is defined as the end stage of left ventricular dysfunction. The condition occurs in approximately 15% of clients with MI. Because the pumping function of the heart is compromised by an MI, heart failure is the second most common complication. Pericarditis most commonly results from a bacterial of viral infection but may occur after MI.
Question 57
Stimulation of the sympathetic nervous system produces which of the following responses?
A
Tachycardia
B
Hypotension
C
Decreased myocardial contractility
D
Bradycardia
Question 57 Explanation:
Stimulation of the sympathetic nervous system causes tachycardia and increased contractility. The other symptoms listed are related to the parasympathetic nervous system, which is responsible for slowing the heart rate.
Question 58
What position should the nurse place the head of the bed in to obtain the most accurate reading of jugular vein distention?
A
High-fowler's
B
Raised 30 degrees
C
Supine position
D
Raised 10 degrees
Question 58 Explanation:
Jugular venous pressure is measured with a centimeter ruler to obtain the vertical distance between the sternal angle and the point of highest pulsation with the head of the bed inclined between 15 and 30 degrees. Inclined pressure can’t be seen when the client is supine or when the head of the bed is raised 10 degrees because the point that marks the pressure level is above the jaw (therefore, not visible). In high Fowler’s position, the veins would be barely discernible above the clavicle.
Question 59
Which of the following types of cardiomyopathy does not affect cardiac output?
A
Hypertrophic
B
Restrictive
C
Dilated
D
Obliterative
Question 59 Explanation:
Cardiac output isn’t affected by hypertrophic cardiomyopathy because the size of the ventricle remains relatively unchanged. Dilated cardiomyopathy, and restrictive cardomyopathy all decrease cardiac output.
Question 60
Which of the following conditions is most closely associated with weight gain, nausea, and a decrease in urine output?
A
Left-sided heart failure
B
Cardiomyopathy
C
Right-sided heart failure
D
Angina pectoris
Question 60 Explanation:
Weight gain, nausea, and a decrease in urine output are secondary effects of right-sided heart failure. Cardiomyopathy is usually identified as a symptom of left-sided heart failure. Left-sided heart failure causes primarily pulmonary symptoms rather than systemic ones. Angina pectoris doesn’t cause weight gain, nausea, or a decrease in urine output.
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Answer questions related to different conditions affecting the cardiovascular system. Test your knowledge about the concepts related to the heart’s normal function, diagnostic tests, disease conditions and therapeutic communication.
