cardiac Flashcards
A nurse is describing the process by which blood is ejected into circulation as the
chambers of the heart become smaller. The instructor categorizes this action of the
heart as what?
A) Systole
B) Diastole
C) Repolarization
D) Ejection fraction
Ans: A
Feedback:
Systole is the action of the chambers of the heart becoming smaller and ejecting blood.
This action of the heart is not diastole (relaxations), ejection fraction (the amount of
blood expelled), or repolarization (electrical charging).
- During a shift assessment, the nurse is identifying the client’s point of maximum
impulse (PMI). Where will the nurse best palpate the PMI?
A) Left midclavicular line of the chest at the level of the nipple
B) Left midclavicular line of the chest at the fifth intercostal space
C) Midline between the xiphoid process and the left nipple
D) Two to three centimeters to the left of the sternum
Ans: B
Feedback:
The left ventricle is responsible for the apical beat or the point of maximum impulse,
which is normally palpated in the left midclavicular line of the chest wall at the fifth
intercostal space.
- The nurse is calculating a cardiac patient’s pulse pressure. If the patient’s blood pressure
is 122/76 mm Hg, what is the patient’s pulse pressure?
A) 46 mm Hg
B) 99 mm Hg
C) 198 mm Hg
D) 76 mm Hg
Ans: A
Feedback:
Pulse pressure is the difference between the systolic and diastolic pressure. In this case,
this value is 46 mm Hg.
- The nurse is caring for a patient admitted with unstable angina. The laboratory result
for the initial troponin I is elevated in this patient. The nurse should recognize what
implication of this assessment finding?
A) This is only an accurate indicator of myocardial damage when it reaches its peak
in 24 hours.
B) Because the patient has a history of unstable angina, this is a poor indicator of
myocardial injury.
C) This is an accurate indicator of myocardial injury.
D) This result indicates muscle injury, but does not specify the source.
Ans: C
Feedback:
Troponin I, which is specific to cardiac muscle, is elevated within hours after
myocardial injury. Even with a diagnosis of unstable angina, this is an accurate
indicator of myocardial injury.
The nurse is conducting patient teaching about cholesterol levels. When discussing the
patient’s elevated LDL and lowered HDL levels, the patient shows an understanding of
the significance of these levels by stating what?
A) ìIncreased LDL and decreased HDL increase my risk of coronary artery disease.î
B) ìIncreased LDL has the potential to decrease my risk of heart disease.î
C) ìThe decreased HDL level will increase the amount of cholesterol moved away
from the artery walls.î
D) ìThe increased LDL will decrease the amount of cholesterol deposited on the
artery walls.î
Ans: A
Feedback:
Elevated LDL levels and decreased HDL levels are associated with a greater incidence
of coronary artery disease.
- The physician has placed a central venous pressure (CVP) monitoring line in an acutely
ill patient so right ventricular function and venous blood return can be closely
monitored. The results show decreased CVP. What does this indicate?
A) Possible hypovolemia
B) Possible myocardial infarction (MI)
C) Left-sided heart failure
D) Aortic valve regurgitation
Ans: A
Feedback:
Hypovolemia may cause a decreased CVP. MI, valve regurgitation and heart failure are
less likely causes of decreased CVP.
- While auscultating a patient’s heart sounds, the nurse hears an extra heart sound
immediately after the second heart sound (S2). An audible S3 would be considered an
expected finding in what patient?
A) An older adult
B) A 20-year-old patient
C) A patient who has undergone valve replacement
D) A patient who takes a beta-adrenergic blocker
Ans: B
Feedback:
S3 represents a normal finding in children and adults up to 35 or 40 years of age. In
these cases, it is called a physiologic S3. It is an abnormal finding in a patient with an
artificial valve, an older adult, or a patient who takes a beta blocker.
- The physical therapist notifies the nurse that a patient with coronary artery disease
(CAD) experiences a much greater-than-average increase in heart rate during physical
therapy. The nurse recognizes that an increase in heart rate in a patient with CAD may
result in what?
A) Development of an atrial-septal defect
B) Myocardial ischemia
C) Formation of a pulmonary embolism
D) Release of potassium ions from cardiac cells
Ans: B
Feedback:
Unlike other arteries, the coronary arteries are perfused during diastole. An increase in
heart rate shortens diastole and can decrease myocardial perfusion. Patients,
particularly those with CAD, can develop myocardial ischemia. An increase in heart
rate will not usually result in a pulmonary embolism or create electrolyte imbalances.
Atrial-septal defects are congenital.
- The nurse is caring for a patient who has a history of heart disease. What factor should
the nurse identify as possibly contributing to a decrease in cardiac output?
A) A change in position from standing to sitting
B) A heart rate of 54 bpm
C) A pulse oximetry reading of 94%
D) An increase in preload related to ambulation
Ans: B
Feedback:
Cardiac output is computed by multiplying the stroke volume by the heart rate. Cardiac
output can be affected by changes in either stroke volume or heart rate, such as a rate of
54 bpm. An increase in preload will lead to an increase in stroke volume. A pulse
oximetry reading of 94% does not indicate hypoxemia, as hypoxia can decrease
contractility. Transitioning from standing to sitting would more likely increase rather
than decrease cardiac output.
