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Nursing care for cardiac disorders

Total questions: 60

Worksheet time: 3600secs

Name
Class
Date
1.

When do coronary arteries primarily receive blood flow?

a)

During inspiration

b)

During diastole

c)

During expiration

d)

During systole

2.

Atherosclerosis impedes coronary blood flow by which of the following mechanisms?

a)

Plaques obstruct the vein

b)

Plaques obstruct the artery

c)

Blood clots form outside the vessel wall

d)

Hardened vessels dilate to allow the blood to flow through

3.

Which of the following actions is the first priority care for a client exhibiting signs and symptoms of coronary artery disease?

a)

Decrease anxiety

b)

Enhance myocardial oxygenation

c)

Administer sublignual nitroglycerin

d)

Educate the client about his symptoms

4.

Which of the following illnesses is the leading cause of death in the US?

a)

Cancer

b)

Coronary artery disease

c)

Liver failure

d)

Renal failure

5.

Which of the following conditions most commonly results in CAD?

a)

Atherosclerosis

b)

 DM

c)

MI

d)

Renal failure

6.

Which of the following risk factors for coronary artery disease cannot be corrected?

a)

Cigarette smoking

b)

DM

c)

Heredity

d)

HPN

7.

Exceeding which of the following serum cholesterol levels significantly increases the risk of coronary artery disease?

a)

100 mg/dl

b)

150 mg/dl

c)

175 mg/dl

d)

200 mg/dl

8.

Medical treatment of coronary artery disease includes which of the following procedures?

a)

Cardiac catheterization

b)

Coronary artery bypass surgery

c)

Oral medication administration

d)

Percutaneous transluminal coronary angioplasty

9.

Prolonged occlusion of the right coronary artery produces an infarction in which of he following areas of the heart?

a)

Anterior

b)

Apical

c)

Inferior

d)

 Lateral

10.

Which of the following is the most common symptom of myocardial infarction?

a)

Chest pain

b)

Dyspnea

c)

Edema

d)

Palpitations

11.

Which of the following landmarks is the corect one for obtaining an apical pulse?

a)

Left intercostal space, midaxillary line

b)

Left fifth intercostal space, midclavicular line

c)

Left second intercostal space, midclavicular line

12.

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)

Cardiac

b)

Gastrointestinal

c)

Musculoskeletal

d)

Pulmonary

13.

A murmur is heard at the second left intercostal space along the left sternal border.Which valve area is this?

a)

Aortic

b)

Mitral

c)

Pulmonic

d)

Tricuspid

14.

Which of the following blood tests is most indicative of cardiac damage?

a)

Lactate dehydrogenase

b)

Complete blood count

c)

Troponin I

d)

Creatine kinase

15.

What is the primary reason for administering morphine to a client with myocardial infarction?

a)

To sedate the client

b)

To decrease the client's pain

c)

To decrease the client's anxiety

d)

To decrease oxygen demand on the client's heart

16.

Which of the followng conditions is most commonly responsible for myocardial infarction?

a)

Aneurysm

b)

Heart failure

c)

Coronary artery thrombosis

d)

Renal failure

17.

What supplemental medication is most frequently ordered in conjuction with furosemide (Lasix)?

a)

Chloride

b)

Digoxin

c)

Potassium

d)

Sodium

18.

After myocardial infarction, serum glucose levels and free fatty acids are both increase. What type of physiologic changes are these?

a)

Electrophysiologic

b)

Hematologic

c)

Mechanical

d)

Metabolic

19.

Which of the following complications is indicated by a third heart sound (S3)?

a)

Ventricular dilation

b)

Systemic hypertension

c)

Aortic valve malfunction

d)

Increased atrial contractions

20.

After an anterior wall

myocardial infarction, which of the following problems is indicated by auscultation of crackles in the lungs?

a)

Left-sided heart failure

b)

Pulmonic valve malfunction

c)

Right-sided heart failure

d)

Tricuspid valve malfunction

21.

Which of the following diagnostic tools is most commonly used to determine the location of myocardial damage?

a)

. Cardiac catheterization

b)

Cardiac enzymes

c)

Echocardiogram

d)

Electrocardiogram

22.

What is the first intervention for a client experiencing myocardial infarction

a)

Administer morphine

b)

. Administer oxygen

c)

Administer sublingual nitroglycerin

d)

Obtain an electrocardiogram

23.

What is the most appropriate nursing response to a myocardial infarction client who is fearful of dying?

a)

"Tell me about your feeling right now."

b)

"When the doctor arrives, everything will be fine."

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."

24.

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

25.

What is the most common complication of a myocardial infarction?

a)

Cardiogenic shock

b)

Heart failure

c)

Arrhythmias

d)

Pericarditis

26.

With which of the following disorders is jugular vein distention most prominent?

a)

Abdominal aortic aneurysm

b)

Heart failure

c)

Myocardial infarction

d)

Pneumothorax

27.

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 10 degrees

c)

Raised 30 degrees

d)

Supine position

28.

Which of the following parameters should be checked before administering digoxin?

a)

Apical pulse

b)

Blood pressure

c)

Radial pulse

d)

Respiratory rate

29.

Toxicity from which of the following medications may cause a client to see a green halo around lights?

a)

Digoxin

b)

Furosemide

c)

Metoprolol

d)

Enalapril

30.

Which ofthe following symptoms is most commonly associated with left-sided heart failure?

a)

Crackles

b)

Arrhythmias

c)

Hepatic engorgement

d)

Hypotension

31.

In which of the following disorders would the nurse expect to assess sacral eddema in bedridden client?

a)

DM

b)

Pulmonary emboli

c)

Renal failure

d)

Right-sided heart failure

32.

Which of the following symptoms might a client with right-sided heart failure exhibit?

a)

Adequate urine output

b)

Polyuria

c)

Oliguria

d)

Polydipsia

33.

. Which of the following classes of medications maximizes cardiac performance in clients with heat failure by increasing ventricular contractility?

a)

Beta-adrenergic blockers

b)

Calcium channel blockers

c)

Diuretics

d)

Inotropic agents

34.

Stimulation of the sympathetic nervous system produces which of the following responses?

a)

Bradycardia

b)

Tachycardia

c)

Hypotension

d)

Decreased myocardial contractility

35.

Which of the following conditions is most closely associated with weight gain, nausea, and a decrease in urine output?

a)

Angina pectoris

b)

Cardiomyopathy

c)

Left-sided heart failure

d)

Right-sided heart failure

36.

What is the most common cause of abdominal aortic aneurysm?

a)

Atherosclerosis

b)

DM

c)

HPN

d)

Syphilis

37.

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

38.

A pulsating abdominal mass usually indicates which of the following conditions?

a)

Abdominal aortic aneurysm

b)

Enlarged spleen

c)

Gastic distention

d)

Gastritis

39.

What is the most common symptom in a client with abdominal aortic aneurysm?

a)

Abdominal pain

b)

Diaphoresis

c)

Headache

d)

Upper back pain

40.

Which of the following symptoms usually signifies rapid expansion and impending rupture of an abdominal aortic aneurysm?

a)

Abdominal pain

b)

Absent pedal pulses

c)

Angina

d)

Lower back pain

41.

What is the definitive test used to diagnose an abdominal aortic aneurysm?

a)

Abdominal X-ray

b)

Arteriogram

c)

CT scan

d)

Ultrasound

42.

Which of the following complications is of greatest concern when caring for a preoperative abdominal aneurysm client?

a)

HPN

b)

Aneurysm rupture

c)

Cardiac arrythmias

d)

Diminished pedal pulses

43.

Which of the following blood vessel layers may be damaged in a client with an aneurysm?

a)

Externa

b)

Interna

c)

Media

d)

Interna and Media

44.

When assessing a client for an abdominal aortic aneurysm, which area of the abdomen is most commonly palpated?

a)

Right upper quadrant

b)

Directly over the umbilicus

c)

Middle lower abdomen to the left of the midline

d)

Midline lower abdomen to the right of the midline

45.

Which of the following conditions is linked to more than 50% of clients with abdominal aortic aneurysms?

a)

DM

b)

HPN

c)

PVD

d)

Syphilis

46.

Which of the following sounds is distinctly heard on auscultation over the abdominal region of an abdominal aortic aneurysm client?

a)

Bruit

b)

Crackles

c)

Dullness

d)

Friction rubs

47.

Which of the following groups of symptoms indicated a ruptured abdominal aneurysm?

a)

Lower back pain, increased BP, decreased RBC, increased WBC

b)

Severe lower back pain, decreased BP, decreased RBC, increased WBC

c)

Severe lower back pain, decreased BP, decreased RBC, decreased WBC

d)

Intermittent lower back pain, decreased BP, decreased RBC, increased WBC

48.

Which of the following complications of an abdominal aortic repair is indicated by detection of a hematoma in the perineal area?

a)

Hernia

b)

Stage 1 pressure ulcer

c)

Retroperitoneal rupture at the repair site

d)

Rapid expansion of the aneurysm

49.

Which hereditary disease is most closely linked to aneurysm?

a)

Cystic fibrosis

b)

. Lupus erythematosus

c)

Marfan's syndrome

d)

Myocardial infarction

50.

Which of the following treatments is the definitive one for a ruptured aneurysm?

a)

Antihypertensive medication administration

b)

Aortogram

c)

Beta-adrenergic blocker administration

d)

Surgical intervention

51.

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

52.

What is the term used to describe an enlargement of the heart muscle?

a)

Cardiomegaly

b)

Cardiomyopathy

c)

Myocarditis

d)

Pericarditis

53.

Which of the following classes of drugs is most widely used in the treatment of cardiomyopathy?

a)

Antihypertensive

b)

Beta-adrenergic blockers

c)

Calcium channel blockers

d)

Nitrates

54.

Which of the following assessments would be an important finding for a patient with arterial disease?

a)

Altered sensation to touch

b)

Intermittent claudicatio with exercise

c)

  Brownish discoloration around the ankles

d)

1Non-pitting edema on the lower extremities

55.

A nurse is assessing the blood pressure of a client diagnosed with primary hypertension. Which of the following that a nurse avoid to ensures accurate measurement?

a)

Seating the client with arm bared, supported, and at heart level.

b)

Using a cuff with a rubber bladder that encircles at least 80% of the limb.

c)

Taking a blood pressure within 15 minutes after nicotine or caffeine ingestion.

d)

Measuring the blood pressure after the client has been seated quietly for 5 minutes

56.

Which findings that suggested to the nurse a presence of a deep vein thrombosis?

a)

paresthesia and coolness of the leg

b)

pain in the calf that occurs with exercise.

c)

generalized edema of the involved extremity

d)

pallor and cyanosis of the involved extremity.

57.

What nursing interventions indicated in the plan of care for the patient with acute lower extremity deep vein thrombosis?

a)

applying elastic compression stockings.

b)

administering anticoagulants as ordered.

c)

positioning the leg dependently to promote arterial circulation

d)

encouraging walking and leg exercises to promote venous return.

58.

The nurse on duty is giving a discharge teachings to a group of patients. Which discharge instruction is appropriate to a patient for discharge with anticoagulant therapy?

a)

limit intake of vitamin C.

b)

report symptoms of nausea to the physician.

c)

have blood drawn routinely to check electrolytes

d)

be aware of and report signs or symptoms of bleeding.

59.

A client is receiving spironolactone to treat hypertension. Which of the following instructions should the nurse provide?

a)

"Eat foods high in potassium."

b)

  "Take daily potassium supplements."

c)

"Discontinue sodium restrictions."

d)

  "Avoid salt substitutes."

60.

Which of the following arteries primarily feeds the anterior wall of the heart?

a)

Circumflex artery

b)

Internal mammary artery

c)

Left anterior descending artery

d)

Right coronary artery

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