WorksheetsPerfusion
Total questions: 70
Worksheet time: 4hrs 30mins
A 52-year-old female is admitted to the cardiac unit with a diagnosis of pericarditis. She asks the nurse to explain where the infection is. In providing an accurate description, the nurse states that the pericardium is:
The outer muscular layer of the heart
The innermost layer of the heart chambers
A membranous sac that encloses the heart
The heart’s fibrous skeleton
A 65-year-old male develops blockage in the pulmonary artery. As a result of the blockage, blood would first back up into the:
Aorta
Left ventricle
Pulmonary veins
Right ventricle
A nurse is teaching about the heart. Which information should the nurse include? The chamber of the heart that generates the highest pressure is the:
Right atrium
Left atrium
Left ventricle
Right ventricle
A nurse recalls the chamber that receives blood from the systemic circulation is the:
Right atrium
Right ventricle
Left atrium
Left ventricle
Which statement indicates the nurse understands blood flow? Oxygenated blood flows through the:
Superior vena cava
Pulmonary veins
Pulmonary artery
Cardiac veins
A 65-year-old male is transported to the ER for chest pain. An electrocardiogram reveals a prolonged QRS interval. What is the nurse monitoring when the nurse observes the QRS complex on the electrocardiogram? The QRS complex reflects:
Ventricular activity
Pulmonary artery closure
Mitral valve opening
Aortic valve closing
While viewing the electrocardiogram, the nurse recalls the _____ conducts action potentials down the atrioventricular septum.
Bachmann bundle
Bundle of His
Sinoatrial node
Atrioventricular node
A 50-year-old female received trauma to the chest that caused severe impairment of the primary pacemaker cells of the heart. Which of the following areas received the greatest damage?
Atrioventricular (AV) node
Sinoatrial (SA) node
Bundle of His
Ventricles
Which information by the nurse indicates a good understanding of depolarization? Depolarization of a cardiac muscle cell occurs as the result of:
A decrease in the permeability of the cell membrane to ions
The rapid movement of ions across the cell membrane
A blockade by calcium ions
Stimuli instigated during the refractory period
A nurse is discussing the pressure generated at the end of diastole. Which term is the nurse describing?
Preload
Afterload
Systemic vascular resistance
Total peripheral resistance
While planning care for a heart patient, which principle should the nurse recall? Right ventricular afterload is affected by:
Vascular resistance in the systemic vessels
Right end-diastolic pressure
Pressures in the vena cava
Pulmonary vascular resistance
A nurse observes a cardiologist multiplying the heart rate by stroke volume. What is the cardiologist measuring?
Vascular resistance
Preload
Cardiac output
Ejection fraction
Increases in which of the following would cause the nurse to assess for decreased blood flow? (Select all that apply.)
Blood viscosity
Blood vessel diameter
Blood pressure
Blood vessel length
A 60-year-old male presents to his primary care provider reporting chest pain. He is diagnosed with atherosclerosis. This disease is caused by:
Arterial wall thinning and weakening
Abnormally dilated arteries and veins
Abnormal thickening and hardening of vessel walls
Autonomic nervous system imbalances
Most cases of combined systolic and diastolic hypertension have no known cause and are documented on the chart as _____ hypertension.
Primary
Secondary
Congenital
Acquired
When a nurse checks the patient for orthostatic hypotension, what did the nurse have the patient do?
Physical exertion
Eat
Stand up
Lie down
A 50-year-old male is diagnosed with orthostatic hypotension. Which of the following symptoms would he most likely experience?
Headache and blurred vision
Nausea and vomiting
Chest pain and palpitations
Syncope and fainting
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?
Extreme exercise
Long periods of standing
Trauma to the deep veins
Ischemia
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?
Eating meat
Living arrangements
Drinking tomato juice
Smoking cigarettes
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:
Idiopathic vasospasm
Arterial emboli from heart valve
Atherosclerosis
Venous emboli
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:
Cardiac output has fallen below normal levels.
The myocardial oxygen supply has fallen below demand.
Myocardial stretch has exceeded the upper limits.
The vagus nerve is stimulated.
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:
Stable angina
Unstable angina
Prinzmetal angina
Myocardial infarction (MI)
When a staff member asks what the patent opening between the aorta and pulmonary artery in a fetus is called, how should the nurse reply? It is the:
Foramen ovale
Sinus venosus
Ductus arteriosus
Septal defect
A 3-year-old male is diagnosed with Kawasaki disease. Which of the following does the nurse suspect is the most likely cause?
A genetic defect causing left heart failure
Autoimmune injury to the lymphatic vessels
Infectious pericarditis
Inflammation of the small capillaries, arteries, and veins
During ventricular systole, closure of the atrioventricular (AV) valves coincides with:
atrial chamber filling.
aortic valve opening.
isovolumetric contraction.
semilunar valves opening.
Preload represents the volume work of the heart and is largely determined by:
venous blood return.
vascular resistance.
force of contraction.
ventricular emptying.
A large increase in heart rate can cause:
increased blood viscosity.
loss of action potential.
decreased stroke volume.
reduced cardiac contractility.
A male patient with a history of angina has presented to the emergency department with uncharacteristic chest pain and his subsequent ECG reveals T-wave elevation. This finding suggests an abnormality with which of the following aspects of the cardiac cycle?
Atrial depolarization
Ventricular depolarization
Ventricular repolarization
Depolarization of the AV node, bundle branches, and Purkinje system
A patient with a diagnosis of secondary hypertension has begun to experience signs and symptoms that are ultimately suggestive of decreased cardiac output. Which of the following factors that determine cardiac output is hypertension likely to affect most directly?
Preload
Afterload
Contractility
Heart rate
A patient who lives with a diagnosis of angina pectoris has taken a sublingual dose of nitroglycerin to treat the chest pain he experienced while mowing his lawn. This drug has resulted in a release of nitric oxide, which will have what effect?
Smooth muscle relaxation of vessels
Decreased heart rate and increased stroke volume
Increased preload
Reduction of cardiac refractory periods
The most important complication of atherosclerosis is _________, which may cause occlusion of small heart vessels.
ulceration
thrombosis
fatty streaks
fibrous plaque
A serum marker for systemic inflammation, _______, is now considered a major risk factor marker for atherosclerosis, and vascular disease.
leukocytosis
homocysteine
serum lipoprotein
C-reactive protein
A patient’s primary care provider has added 20 mg of Lasix (furosemide) to his medication regimen to treat his primary hypertension. How does this diuretic achieve its therapeutic effect?
By decreasing vascular volume by increasing sodium and water excretion
By blocking the release of antidiuretic hormone from the posterior pituitary
By inhibiting the conversion of angiotensin I to angiotensin II.
By inhibiting the movement of calcium into arterial smooth muscle cells
A patient is receiving homecare for the treatment of a wound on the inside of her lower leg which is 3 cm in diameter with a yellow wound bed and clear exudate. Assessment of the patient’s legs reveals edema and a darkened pigmentation over the ankles and shins of both legs. What is this patient’s most likely diagnosis?
Chronic venous insufficiency
Deep vein thrombosis
Varicose veins
Peripheral arterial disease
A postsurgical patient’s complaints of calf pain combined with the emergence of swelling and redness in the area have culminated in a diagnosis of deep vein thrombosis. What treatment options will be of greatest benefit to this patient?
Analgesics and use of a pneumatic compression device
Massage followed by vascular surgery
Frequent ambulation and the use of compression stockings
Anticoagulation therapy and elevation of the leg
When stroke volume decreases, which of the following could maintain cardiac output?
Decreased peripheral resistance
Increased heart rate
Decreased venous return
General vasodilation
Which of the following drugs decrease sodium and fluid retention in the body?
warfarin (Coumadin)
digoxin (Lanoxin)
nitroglycerin (Isordil)
hydrochlorothiazide (HydroDIURIL)
A drug taken in small doses on a continuing basis to reduce platelet adhesion is:
acetylsalicylic acid (ASA).
streptokinase.
acetaminophen
heparin
A partial obstruction in a coronary artery will likely cause:
pulmonary embolus.
hypertension
angina attacks.
myocardial infarction.
Cigarette smoking is a risk factor in coronary artery disease because smoking:
reduces vasoconstriction and peripheral resistance.
decreases serum lipid levels.
promotes platelet adhesion.
increases serum HDL levels.
The term arteriosclerosis specifically refers to:
development of atheromas in large arteries.
intermittent vasospasm in coronary arteries.
degeneration with loss of elasticity and obstruction in small arteries.
ischemia and necrosis in the brain, kidneys, and heart.
A modifiable factor that increases the risk for atherosclerosis is:
leading a sedentary lifestyle.
being female and older than 40 years of age.
excluding saturated fats from the diet.
familial hypercholesterolemia.
The basic pathophysiology of myocardial infarction is best described as:
cardiac output that is insufficient to meet the needs of the heart and body.
temporary vasospasm that occurs in a coronary artery.
total obstruction of a coronary artery, which causes myocardial necrosis.
irregular heart rate and force, reducing blood supply to coronary arteries.
Significant signs of right-sided congestive heart failure include:
severe chest pain and tachycardia.
edematous feet and legs with hepatomegaly.
frequent cough with blood-streaked frothy sputum.
orthopnea, fatigue, increased blood pressure.
Which of the following drugs improves cardiac efficiency by slowing the heart rate and increasing the force of cardiac contractions?
Furosemide
Digoxin
Epinephrine
Nifedipine
The basic pathophysiological change associated with essential hypertension is:
development of lipid plaques in large arteries.
recurrent inflammation and fibrosis in peripheral arteries.
degeneration and loss of elasticity in arteries.
increased systemic vasoconstriction.
Uncontrolled hypertension is most likely to cause ischemia and loss of function in the:
kidneys, brain, and retinas of the eye.
peripheral arteries in the legs.
aorta and coronary arteries.
liver, spleen, and stomach.
The term intermittent claudication refers to:
sensory deficit in the legs due to damage to nerves.
chest pain related to ischemia.
ischemic muscle pain in the legs, particularly with exercise.
dry, cyanotic skin with superficial ulcers.
An echocardiogram is used to demonstrate any abnormal:
activity in the conduction system.
movement of the heart valves.
change in central venous pressure.
blood flow in coronary arteries.
Which of the following is NOT true of the drug nitroglycerin?
It decreases myocardial workload by causing systemic vasodilation.
It may be administered sublingually, transdermally, or by oral spray.
Dizziness or syncope may follow a sublingual dose.
It strengthens the myocardial contraction.
When reviewing the 12-lead electrocardiograph (ECG) for a healthy 79-year-old patient who is having an annual physical examination, what will be of most concern to the nurse?
The PR interval is 0.21 seconds.
The QRS duration is 0.13 seconds.
There is a right bundle-branch block.
The heart rate (HR) is 42 beats/minute.
To determine the effects of therapy for a patient who is being treated for heart failure, which laboratory result will the nurse plan to review?
Troponin
Homocysteine (Hcy)
Low-density lipoprotein (LDL)
B-type natriuretic peptide (BNP)
The standard policy on the cardiac unit states, “Notify the health care provider for mean arterial pressure (MAP) less than 70 mm Hg.” The nurse will need to call the health care provider about the
postoperative patient with a BP of 116/42.
newly admitted patient with a BP of 150/87.
patient with left ventricular failure who has a BP of 110/70.
patient with a myocardial infarction who has a BP of 140/86.
Which action should the nurse take when administering the initial dose of oral labetalol (Normodyne) to a patient with hypertension?
Encourage the use of hard candy to prevent dry mouth.
Instruct the patient to ask for help if heart palpitations occur.
Ask the patient to request assistance when getting out of bed.
Teach the patient that headaches may occur with this medication.
The nurse is reviewing the laboratory test results for a patient who has recently been diagnosed with hypertension. Which result is most important to communicate to the health care provider?
Serum creatinine of 2.8 mg/dL
Serum potassium of 4.5 mEq/L
Serum hemoglobin of 14.7 g/dL
Blood glucose level of 96 mg/dL
Heparin is ordered for a patient with a non–ST-segment-elevation myocardial infarction (NSTEMI). What is the purpose of the heparin?
Heparin enhances platelet aggregation.
Heparin decreases coronary artery plaque size.
Heparin prevents the development of new clots in the coronary arteries.
Heparin dissolves clots that are blocking blood flow in the coronary arteries.
During the administration of the thrombolytic agent to a patient with an acute myocardial infarction (AMI), the nurse should stop the drug infusion if the patient experiences
bleeding from the gums.
increase in blood pressure.
a decrease in level of consciousness.
a nonsustained episode of ventricular tachycardia.
A patient is recovering from a myocardial infarction (MI) and develops chest pain on day 3 that increases when taking a deep breath and is relieved by leaning forward. Which action should the nurse take next?
Assess the feet for pedal edema.
Palpate the radial pulses bilaterally.
Auscultate for a pericardial friction rub.
Check the heart monitor for dysrhythmias.
The nurse obtains the following data when assessing a patient who experienced an ST-segment-elevation myocardial infarction (STEMI) 2 days previously. Which information is most important to report to the health care provider?
The troponin level is elevated.
The patient denies ever having a heart attack.
Bilateral crackles are auscultated in the mid-lower lobes.
The patient has occasional premature atrial contractions (PACs).
While assessing a 68-year-old with ascites, the nurse also notes jugular venous distention (JVD) with the head of the patient’s bed elevated 45 degrees. The nurse knows this finding indicates
decreased fluid volume.
jugular vein atherosclerosis.
incompetent jugular vein valves.
increased right atrial pressure.
Which diagnostic test will be most useful to the nurse in determining whether a patient admitted with acute shortness of breath has heart failure?
Serum troponin
B-type natriuretic peptide
Arterial blood gases
12-lead electrocardiogram
A patient has recently started on digoxin (Lanoxin) in addition to furosemide (Lasix) and captopril (Capoten) for the management of heart failure. Which assessment finding by the home health nurse is a priority to communicate to the health care provider?
Presence of 1 to 2+ edema in the feet and ankles
Palpable liver edge 2 cm below the ribs on the right side
Weight increase from 120 pounds to 122 pounds over 3 days
Serum potassium level 3.0 mEq/L after 1 week of therapy
To determine whether there is a delay in impulse conduction through the atria, the nurse will measure the duration of the patient’s
P wave.
Q wave.
P-R interval.
QRS complex.
A patient with dilated cardiomyopathy has new onset atrial fibrillation that has been unresponsive to drug therapy for several days. The priority teaching needed for this patient would include information about
anticoagulant therapy.
permanent pacemakers.
electrical cardioversion.
IV adenosine (Adenocard).
Which laboratory result for a patient with multifocal premature ventricular contractions (PVCs) is most important for the nurse to communicate to the health care provider?
Serum potassium 2.9 mEq/L
Blood glucose 243 mg/dL
Serum sodium 134 mEq/L
Serum chloride 92 mEq/L
A patient’s cardiac monitor shows a pattern of undulations of varying contours and amplitude with no measurable ECG pattern. The patient is unconscious and pulseless. Which action should the nurse take first?
Perform immediate defibrillation.
Give epinephrine (Adrenalin) IV.
Prepare for endotracheal intubation.
Give ventilations with a bag-valve-mask device.
The nurse obtains a health history from a 65-year-old patient with a prosthetic mitral valve who has symptoms of infective endocarditis (IE). Which question by the nurse is most appropriate?
“Do you have a history of a heart attack?”
“Is there a family history of endocarditis?”
“Have you had any recent immunizations?”
“Have you had dental work done recently?”
The nurse identifies the nursing diagnosis of decreased cardiac output related to valvular insufficiency for the patient with infective endocarditis (IE) based on which assessment finding(s)?
Fever, chills, and diaphoresis
Urine output less than 30 mL/hr
Petechiae on the inside of the mouth and conjunctiva
Increase in heart rate of 15 beats/minute with walking
The nurse suspects cardiac tamponade in a patient who has acute pericarditis. To assess for the presence of pulsus paradoxus, the nurse should
note when Korotkoff sounds are auscultated during both inspiration and expiration.
subtract the diastolic blood pressure (DBP) from the systolic blood pressure (SBP).
check the electrocardiogram (ECG) for variations in rate during the respiratory cycle.
listen for a pericardial friction rub that persists when the patient is instructed to stop breathing.
When caring for a patient with infective endocarditis of the tricuspid valve, the nurse should monitor the patient for the development of
flank pain.
splenomegaly.
shortness of breath.
mental status changes.
