Exam 2 Review Flashcards
When caring for a patient who has intermittent claudication, the cardiac-vascular nurse advises the patient to:
A. Apply compression stockings before getting out of bed.
B. Elevate the legs when sitting.
C. Refrain from exercise.
D. Walk as tolerated.
Answer: D
Rationale: Claudication pain is associated with PAD which leads to a decreased blood flow to the extremity. We need gravity to encourage blood flow
Hypertension is known as the silent killer. This phrase is associated with the fact that hypertension often goes undetected until symptoms of other system failures occur. This may occur in the form of: SATA
A. Cerebrovascular accident
B. Liver disease
C. Coronary Artery Disease
D. Pulmonary disease
Answer: A,C
Rationale: Increased BP over a prolonged period of time can lead to damage of blood vessels and organs.
The nurse notes bilateral ankle edema on a client diagnosed with peripheral vascular disease (PVD). The nurse knows this is due to:
A. Decreased blood volume
B. Increased venous pressure
C. Decreased muscular activity
D. Increased venous blood flow
Answer: B
Rationale: PVD leads to blood pooling in the extremity.
Which mismatching would you see in a patient with pneumonia?
A. V without Q
B. Q without V
C. Both
D. Neither
Answer: B
Rationale: This affects the flow of air into and out of the lungs
If BP is increased, how will the RAAS system respond? SATA
A. Release more aldosterone
B. Release less aldosterone
C. Tell the Kidney to excrete sodium
D. Tell the Kidney to retain sodium
Answer: B,C
Rationale: The RAAS system would be less active to lower BP. Less fluid volume = lower BP.
How does the RAAS system increase CO
A. Decreases Venous Return
B. Increases HR
C. Increases Venous Return
D. Decreases HR
Answer: C
Rationale: More fluid volume in the venous system = more blood return to the heart.
Which are possible clinical manifestations of R Sided HF? SATA
A. COPD
B. Productive cough w/ pink, frothy sputum
C. JVD
D. Peripheral Edema
Answer: C, D
Rationale: R sided leads to systemic congestion
Which are common causes of Right Sided HF? SATA
A. Pulmonary HTN
B. Left Ventricle Dysfunction
C. COPD (Cor Pulmone)
D. Acute MI
Answer: A, B, C
Rationale: The right side is affected by issues in the pulmonary system commonly.
Heart Failure Tip
Remember this is a reduced PUMPING ABILITY of the heart. If it fails, think of where the blood will go if it can’t pump the blood out.
You suspect your pt has developed an acute arterial occlusion of the lower extremity. What s/s should you assess for? SATA
A. Bounding pulses
B. Cold foot
C. Numbness/tingling of extremity
D. Tachycardia
Answer: B, C
Rationale: Arterial occlusion = blood cannot get to the extremity
Describe the patho of chronic venous insufficiency. SATA
A. Systemic rise in BP
B. Incompetent Valves
C. Back Flow of Blood
D. Atherosclerotic build up
Answer: B,C
Rationale: Veins need valves to move blood back to the heart. Incompetent valves = backflow and pooling of blood.
What does aldosterone do? SATA
A. Sodium secretion
B. Water secretion
C. Sodium reabsorption
D. Water reabsorption
Answer: C,D
Rationale: Aldosterone wants to increase BP. More fluid = higher BP.
Where sodium goes, water follows (Salt Sucks)
What are typical CM of an acute MI? SATA
A. Severe Chest Pain on exertion, relieved by rest
B. Relieved with Nitroglycerin medication
C. Radiating pain to the neck and jaw
D. Anxiety and an impending sense of doom
Answer: C,D
What would you expect to see in a venous ulcer? SATA
A. Weeping
B. Dry
C. Coin shaped
D. Irregular margins
Answer: A, D
Rationale: Venous = incompetent valves = blood pooling = skin breakdown
Which cholesterol is “bad”?
A. HDL
B. LDL
Answer: B
HDL = we want HIGH bc HEALTHY. LDL - we want LOW because LOUSY
How does the body compensate for Hypotension? SATA
A. Slows heart rate
B. Heart contracts harder
C. Releases ADH
D. Vasoconstriction of blood flow to non vital organs
Answer: B,C,D
Rationale: hypotensive = not enough blood to organs. Body wants to protect vital organs and increase blood flow as much as possible
What CM might you see in someone with an unruptured AAA? SATA
A. Fever
B. Pulsating mass, Bruits
C. Asymptomatic
D. Flank ecchymosis
Answer: B, C
What is our concern if we notice bruising along the back and sharp chest pain in this patient?
Define Valve Stenosis
A. valve does not open completely
B. Valve does not close completely
C. Valve is fully functional
Answer: A
Define Regurgitation
When monitoring the weight of a patient in heart failure which weights would be concerning? SATA
A. 2 lbs a week
B. 2 lbs overnight
C. 1 lb overnight
D. 5 lbs a week
Answer: B,D
Rationale: Daily weights are our best indicator for fluid volume status. HF exacerbation leads to fluid overload!
What is the hallmark CM of pericarditis?
A. Pericardial Friction Rub
B. Crackles
C. Murmur
D. Muffled Heart Beat
Answer: A
What position will bring this patient relief?
You’r patient with pericarditis now presents with muffled heart sounds, hypotension, JVD, and tachycardia. What complication would you suspect?
A. Pneumonia
B. Pleural effusion
C. Cardiac tamponade
D. MI
Answer: C
How will your SNS affect your heart rate
A. Increase
B. Decrease
C. No affect
Answer: A
“Fight or Flight”
How does the RAAS system regulate BP? SATA
A. Adjusting PVR
B. Adjusting Heart Rate
C.Vasoconstriction
D. Adjusting Fluid Volume
Answer: C, D
What complication will a COPD patient develop due to hypoxemia?
A. Pneumonia
B. PE
C. Pulmonary HTN
D. Left Sided Heart Failure
Answer: C
Rationale: Hypoxemia = vasoconstriction and shunting = increased PVR = HTN
Why does prolonged bed rest cause atelectasis? SATA
A. Lack of Nutrition
B. Compression of Alveoli
C. Deep Breathing
D. Shallow Breathing
Answer: B, D
Which condition will cause ventilation to exceed perfusion?
A. Cystic Fibrosis
B. PE
C. Lung Cancer
D. Asthma
Answer: B
Rationale: A pulmonary embolism will affect blood flow to the pulmonary tissues, it will not affect air moving into and out of the lungs
What are complications of mitral valve regurgitation? SATA
A. Peripheral edema
B. Pulmonary edema
C. Rise in pressure of the Left Atrium
D. Increased Cardiac Output
Answer: B,C
Rationale: Mitral valve is located on the L side of the heart between the atrium and ventricle. Regurgitation would lead to an increased pressure in the L atrium and back flow into the pulmonary circulation.
Which clinical manifestations of a tension pneumothorax should be of immediate concern to the nurse? SATA
A. Tracheal Deviation
B. Bradypnea
C. Flattened neck veins
D. Decreased cardiac output
E. Decreased LOC
Answer: A,D,E
What is another name for compound fracture?
A. Transverse
B. Closed
C. Open
D. Spiral
Answer: C
What type of fracture is slanted across the bone shaft.
A. Transverse Fracture
B. Spiral Fracture
C. Oblique Fracture
D. Compound Fracture
Answer: C
Which statement by the nurse describes a comminuted fracture to the client?
A. “The ends of the broken bones are forced together.”
B. “The bone is breaking through the skin.”
C. The bone is broken into many pieces.”
D. “A fragment of the bone is separated from the rest of the bone.”
Answer: C
