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MED-SURG > CARDIO SG's > Flashcards

CARDIO SG's Flashcards

1
Q

A 44-year-old patient is admitted with a sudden, severe chest tightness unrelieved by rest or nitroglycerin, and profused sweating. Which test would exhibit an elevated level only if he has had an MI?

A

Serum troponin

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2
Q

A 54 year old man complains of pain when walking and numbness of his lower extremities. On examination, the nurse notes that both extremities are pale and cool to touch. The highest priority nursing diagnosis would be

A

Ineffective peripheral tissue perfusion

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3
Q

A 50-year old male is pulseless and losses consciousness. He was hooked in the cardiac monitor and reflects a an ECG of ventricular fibrillation. What appropriate procedure would a nurse anticipate to prepare in relation to the condition of the patient?

A

Defribillation

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4
Q

The following are manifestation for right sided heart failure except:

A

Pulmonary edema

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5
Q

The patient has experienced an MI and has ST-segment elevation on the ECG. The priority nursing diagnosis would be

A

Ineffective tissue perfusion

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6
Q

Diagnositc imaging reveals that the quantity of fluid in a client’s pericardial sac is dangerouls increased. The nurse should collaborate with the othe members of the care team to prevent the development of what complication?

A

Cardiac tamponade:
Cardiac tamponade happens when the fluid sac around your heart fills with blood or other fluid, putting pressure on your heart.

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7
Q

The patient has heart failure and artherosclerosis. Which patient statement regarding healthy food choices demonstrates a need for further teaching?

A

I need to watch red meat intake, but can have all the cheese I want

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8
Q

The patient asks What causes angina pectoris an accurate response by a nurse would be;

A

It is caused by a decreased blood flow to the myocardium due to partial obstruction of the coronary arteries.

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9
Q

When administering cardiac glycosides and furosemide at the same time, which serum electrolyte should be monitored

A

Sodium

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10
Q

A cardiac patient’s resistance to left ventricular filling has caused blood to back up into the patient’s circulatory system. What health problem is likely to result?

A

Pulmonary edema

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11
Q

What is the best position to put a client with heart failure to reduce congestion?

A

High fowler’s position

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12
Q

Further assessment of a client with rheumatic fever reveals a sudden irregular, airless involuntary movements. These assessment findings are also know as:

A

Chorea

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13
Q

The nurse is performing an initial assessment of a client diagnosed with Heart failure. The nurse also assess the patient’s sensorium and LOC. Why is the assessment of the patient’s sensorium and LOC important in patients with heart failure?

A

Heart failure ultimately affects oxygen transportation to the brain

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14
Q

Which of the following is a late manifestation of digitalis toxicity?

A

Visual disturbances

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15
Q
  1. The most common heart disease for adults in the United States is:

a. angina pectoris.
b. coronary artery disease.
c. myocardial infarction.
d. valvular heart disease.

A

b. coronary artery disease.

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16
Q
  1. Lumen narrowing with atherosclerosis is caused by:

a. atheroma formation on the intima.
b. scarred endothelium.
c. thrombus formation.
d. all of the above.

A

d. all of the above.

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17
Q
  1. A healthy level of serum cholesterol would be a reading of:

a. 160 to 190 mg/dL.
b. 210 to 240 mg/dL.
c. 250 to 275 mg/dL.
d. 280 to 300 mg/dL.

A

a. 160 to 190 mg/dL.

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18
Q
  1. Which of the following findings is not a significant risk factor for heart disease?
    a. Cholesterol, 280 mg/dL
    b. LDL, 160 mg/dL
    c. High-density lipoproteins (HDL), 80 mg/dL
    d. A ratio of low-density lipoproteins (LDL) to HDL, 4.5 to 1.0
A

c. High-density lipoproteins (HDL), 80 mg/dL

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19
Q
  1. Hypertension is repeated blood pressure measurements exceeding:
    a. 110/80 mm Hg.
    b. 120/80 mm Hg.
    c. 130/90 mm Hg.
    d. 140/90 mm Hg.
A

d. 140/90 mm Hg.

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20
Q
  1. The incidence of coronary artery disease tends to be equal for men and women after the age of:

a. 45 years.
b. 50 years.
c. 55 years.
d. 65 years.

A

d. 65 years.

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21
Q
  1. The pain of angina pectoris is produced primarily by:

a. coronary vasoconstriction.
b. movement of thromboemboli.
c. myocardial ischemia.
d. the presence of atheromas.

A

c. myocardial ischemia.

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22
Q
  1. The nurse advises a patient that sublingual nitroglycerin should alleviate angina pain within:

a. 3 to 4 minutes.
b. 10 to 15 minutes.
c. 30 minutes.
d. 60 minutes.

A

a. 3 to 4 minutes.

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23
Q
  1. Patient education includes telling someone who takes nitroglycerin sublingually that he or she should take 1, then go quickly to the nearest emergency department if no relief has been obtained after taking ______ tablet(s) at 5-minute intervals.

a. 1
b. 2
c. 3
d. 4 to 5

A

c. 3

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24
Q
  1. The scientific rationale supporting the administration of beta-adrenergic blockers is the drugs’ ability to:

a. block sympathetic impulses to the heart.
b. elevate blood pressure.
c. increase myocardial contractility.
d. induce bradycardia.

A

a. block sympathetic impulses to the heart.

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25
Q
  1. An antidote for propranolol hydrochloride (a beta-adrenergic blocker) that is used to treat bradycardia is:

a. digoxin.
b. atropine.
c. protamine sulfate.
d. sodium nitroprusside.

A

b. atropine.

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26
Q
  1. Calcium channel blockers act by:

a. decreasing SA node automaticity.
b. increasing AV node conduction.
c. increasing the heart rate.
d. creating a positive inotropic effect.

A

a. decreasing SA node automaticity.

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27
Q
  1. In the United States, about 1 million people will have an acute myocardial infarction each year. Of these 1 million, what percentage will die?
    a. 10% to 15%
    b. 25%
    c. 30% to 40%
    d. 60%
A

b. 25%

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28
Q
  1. The classic ECG changes that occur with an MI include all of the following except:

a. an absent P wave.
b. an abnormal Q wave.
c. T-wave inversion.
d. ST-segment elevation.

A

a. an absent P wave.

29
Q
  1. The most common site of myocardial infarction is the:

a. left atrium.
b. left ventricle.
c. right atrium.
d. right ventricle.

A

b. left ventricle.

30
Q
  1. Which of the following statements about myocardial infarction pain is incorrect?

a. It is relieved by rest and inactivity.
b. It is substernal in location.
c. It is sudden in onset and prolonged in duration.
d. It is viselike and radiates to the shoulders and arms.

A

a. It is relieved by rest and inactivity.

31
Q
  1. Myocardial cell damage can be reflected by high levels of cardiac enzymes. The cardiac-specific isoenzyme is:

a. alkaline phosphatase.
b. creatine kinase (CK-MB).
c. myoglobin.
d. troponin.

A

b. creatine kinase (CK-MB).

32
Q
  1. The most common vasodilator used to treat myocardial pain is:

a. amyl nitrite.
b. Inderal.
c. nitroglycerine.
d. Pavabid HCl.

A

c. nitroglycerine.

33
Q
  1. An intravenous analgesic frequently administered to relieve chest pain associated with myocardial infarction is:
    a. meperidine hydrochloride.
    b. hydromorphone hydrochloride.
    c. morphine sulfate.
    d. codeine sulfate.
A

c. morphine sulfate.

34
Q
  1. A candidate for percutaneous transluminal coronary angioplasty (PTCA) is a patient with coronary artery disease who:

a. has compromised left ventricular function.
b. has had angina longer than 3 years.
c. has at least 70% occlusion of a major coronary artery.
d. has questionable left ventricular function.

A

c. has at least 70% occlusion of a major coronary artery.

35
Q
  1. A goal of dilation in PTCA is to increase blood flow through the artery’s lumen and achieve a residual stenosis of less than:
    a. 20%.
    b. 35%.
    c. 60%.
    d. 80%.
A

a. 20%.

36
Q
  1. The nurse expects a postoperative PTCA patient to be discharged:
    a. the same day as surgery.
    b. within 24 hours of the procedure.
    c. 3 days later.
    d. after 1 week.
A

b. within 24 hours of the procedure.

37
Q
  1. The nurse needs to be alert to assess for clinical symptoms of possible postoperative complications of PTCA, which include:

a. abrupt closure of the artery.
b. arterial dissection.
c. coronary artery vasospasm.
d. all of the above.

A

d. all of the above.

38
Q
  1. A candidate for coronary artery bypass grafting (CABG) must meet which of the following criteria?

a. A blockage that cannot be treated by PTCA
b. Greater than 60% blockage in the left main
coronary artery.
c. Unstable angina.
d. All of the above.

A

d. All of the above.

39
Q
  1. The most common nursing diagnosis for patients awaiting cardiac surgery is:
    a. activity intolerance.
    b. fear related to the surgical procedure.
    c. decreased cardiac output.
    d. anginal pain.
A

b. fear related to the surgical procedure.

40
Q
  1. Extremity paresthesia, dysrhythmias (peaked T waves), and mental confusion after cardiac surgery are signs of electrolyte imbalance related to the level of:
    a. calcium.
    b. magnesium.
    c. potassium.
    d. sodium.
A

c. potassium.

41
Q
  1. A complication after cardiac surgery that is associated with an alteration in preload is:
    a. cardiac tamponade.
    b. elevated central venous pressure.
    c. hypertension.
    d. hypothermia.
A

a. cardiac tamponade.

42
Q

CASE STUDY: Decreased Myocardial Tissue Perfusion
Mr. Lillis, a 46-year-old bricklayer, is brought to the emergency department by ambulance with a suspected diagnosis of myocardial infarction. He appears ashen, is diaphoretic and tachycardiac, and has severe chest pain. The nursing diagnosis is decreased cardiac output, related to decreased myocardial tissue perfusion.

  1. The nurse knows that the most critical time period for his diagnosis is:
    a. the first hour after symptoms begin.
    b. within 24 hours after the onset of symptoms.
    c. within the first 48 hours after the attack.
    d. between the third and fifth day after the attack.
A

a. the first hour after symptoms begin.

43
Q
  1. Because the area of infarction develops over minutes to hours, the nurse knows to interpret the following ECG results as indicative of initial myocardial injury:
    a. abnormal Q waves.
    b. enlarged T wave.
    c. inverted T wave.
    d. ST segment depression.
A

b. enlarged T wave.

44
Q
  1. The nurse evaluates a series of laboratory tests within the first few hours. She knows that a positive indicator of cell damage is:

a. decreased level of troponin.
b. elevated creatine kinase (CK-MB).
c. lower level of myoglobin.
d. all of the above.

A

b. elevated creatine kinase (CK-MB).

45
Q
  1. The nurse needs to look for symptoms associated with one of the major causes of sudden death during the first 48 hours, which is:
    a. cardiogenic shock.
    b. pulmonary edema.
    c. pulmonary embolism.
    d. ventricular rupture.
A

a. cardiogenic shock.

46
Q
  1. The nurse is aware that ischemic tissue remains sensitive to oxygen demands, because scar formation is not seen until the:
    a. second week.
    b. third week.
    c. sixth week.
    d. eighth week.
A

b. third week.

47
Q
  1. Mr. Lillis needs to be advised that myocardial healing will not be complete for about:

a. 2 months.
b. 4 months.
c. 6 months.
d. 8 months.

A

a. 2 months.

48
Q
  1. The primary cause of heart failure is:

a. arterial hypertension.
b. coronary atherosclerosis.
c. myocardial dysfunction.
d. valvular dysfunction.

A

b. coronary atherosclerosis.

49
Q
  1. The dominant function in cardiac failure is:

a. ascites.
b. hepatomegaly.
c. inadequate tissue perfusion.
d. nocturia.

A

c. inadequate tissue perfusion.

50
Q
  1. On assessment, the nurse knows that a patient who reports no symptoms of heart failure at rest but is symptomatic with increased physical activity would have a heart failure classification of:
    a. I.
    b. II.
    c. III.
    d. IV.
A

a. I.

51
Q
  1. The diagnosis of heart failure is usually confirmed by: a. a chest x-ray.
    b. an echocardiogram.
    c. an electrocardiogram.
    d. ventriculogram.
A

b. an echocardiogram.

52
Q
  1. A key diagnostic laboratory test for heart failure is the:
    a. blood urea nitrogen (BUN).
    b. complete blood cell count.
    c. B-type natriuretic peptide.
    d. serum electrolyte counts.
A

c. B-type natriuretic peptide.

53
Q
  1. According to the American College of Cardiology and the American Heart Association, a patient presenting with left ventricular dysfunction without symptoms of heart failure would be classified as:

a. stage A.
b. stage B.
c. stage C.
d. stage D.

A

b. stage B.

54
Q
  1. The treatment for cardiac failure is directed at:

a. decreasing oxygen needs of the heart.
b. increasing the cardiac output by strengthening muscle contraction or decreasing peripheral resistance. c. reducing the amount of circulating blood volume.
d. all of the above.

A

b. increasing the cardiac output by strengthening muscle contraction or decreasing peripheral resistance.

55
Q
  1. A primary classification of medications used in the treatment of systolic heart failure is:

a. angiotensin-converting enzyme inhibitors.
b. beta-blockers.
c. diuretics.
d. calcium-channel blockers.

A

a. angiotensin-converting enzyme inhibitors.

56
Q
  1. The nurse knows that this angiotensin-converting enzyme inhibitor ordered by the physician has a rapid onset of action within 15 minutes.
    a. Altace
    b. Capoten
    c. Lotensin
    d. Vasotec
A

b. Capoten

57
Q
  1. An example of a potassium-sparing diuretic that might be prescribed for a person with congestive heart failure is:

a. Aldactone.
b. Mykrox.
c. Zaroxolyn.
d. Lasix.

A

a. Aldactone.

58
Q
  1. The primary underlying disorder of pulmonary edema is:

a. decreased left ventricular pumping.
b. decreased right ventricular elasticity.
c. increased left atrial contractility.
d. increased right atrial resistance.

A

a. decreased left ventricular pumping.

59
Q
  1. Pulmonary edema is characterized by:

a. elevated left ventricular end-diastolic pressure.
b. a rise in pulmonary venous pressure.
c. increased hydrostatic pressure
d. All of the above

A

d. All of the above

60
Q
  1. With pulmonary edema, there is usually an alteration in:
    a. afterload.
    b. contractility.
    c. preload.
    d. all of the above.
A

b. contractility.

61
Q
  1. A commonly prescribed diuretic that is given intravenously to produce a rapid diuretic effect is:
    a. Bumex.
    b. Lasix.
    c. Mykrox.
    d. Zaroxolyn.
A

b. Lasix.

62
Q
  1. Morphine is given in acute pulmonary edema to redistribute the pulmonary circulation to the periphery by decreasing:
    a. peripheral resistance.
    b. pulmonary capillary pressure.
    c. transudation of fluid.
    d. all of the above.
A

d. all of the above.

63
Q
  1. A recommended position for a patient in acute pulmonary edema is:
    a. prone, to encourage maximum rest, thereby decreasing respiratory and cardiac rates.
    b. semi-Fowler’s, to facilitate breathing and promote pooling of blood in the sacral area.
    c. Trendelenburg, to drain the upper airways of congestion.
    d. upright with the legs down, to decrease venous return.
A

d. upright with the legs down, to decrease venous return.

64
Q
  1. Cardiogenic shock is pump failure that occurs primarily as the result of:
    a. coronary artery stenosis.
    b. left ventricular damage.
    c. myocardial ischemia.
    d. right atrial flutter.
A

c. myocardial ischemia.

65
Q
  1. A clinical manifestation of pericardial effusion is:
    a. widening pulse pressure.
    b. a decrease in venous pressure.
    c. shortness of breath.
    d. an increase in blood pressure.
A

c. shortness of breath.

66
Q
  1. The most reliable sign of cardiac arrest is:
    a. absence of a pulse.
    b. cessation of respirations.
    c. dilation of the pupils.
    d. inaudible heart sounds.
A

a. absence of a pulse.

67
Q
  1. Brain damage occurs with cessation of circulation after an approximate interval of:
    a. 2 minutes.
    b. 4 minutes.
    c. 6 minutes.
    d. 8 minutes.
A

b. 4 minutes.

68
Q
  1. The drug of choice during cardiopulmonary resuscitation to suppress ventricular dysrhythmias is:
    a. atropine.
    b. epinephrine.
    c. lidocaine.
    d. morphine.
A

b. epinephrine.

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