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 innermost layer of the heart chambers
A membranous sac that encloses the heart
The heart’s fibrous skeleton
The outer muscular layer of the heart
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?
Bundle of His
Sinoatrial (SA) node
Atrioventricular (AV) node
A cardiologist is teaching about the period that follows depolarization of the myocardium and represents a period during which no new cardiac potential can be propagated. What is the cardiologist describing?
The _____ represents the sum of all ventricular muscle cell depolarization.
A 65-year-old male develops blockage in the pulmonary artery. As a result of the blockage, blood would first back up into the:
Which principle should the nurse remember when planning nursing care for a patient with heart problems? As stated by the Frank-Starling law, there is a direct relationship between the _____ of the blood in the heart at the end of diastole and the _____ of contraction during the next systole.
While planning care for a heart patient, which principle should the nurse recall? Right ventricular afterload is affected by:
Right end-diastolic pressure
Vascular resistance in the systemic vessels
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?
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:
A patient researches baroreceptors online. Which information indicates a good understanding? Baroreceptors are located in the:
Circle of Willis
Superior vena cava
A nurse is evaluating the direct end effect of the renin-angiotensin-aldosterone system. Which principle should the nurse remember?
Angiotensin I promotes sodium and water reabsorption by the kidneys.
Aldosterone increases renal retention of water only.
Angiotensin II causes systemic vasoconstriction.
Renin promotes the excretion of sodium and water in the renal tubules.
When a patient wants to know about the renin-angiotensin-aldosterone system, what is the nurse’s best response? Conversion of angiotensin I to angiotensin II happens in the:
Which statement indicates the nurse understands blood flow? Oxygenated blood flows through the:
A 60-year-old male presents to his primary care provider reporting chest pain. He is diagnosed with atherosclerosis. This disease is caused by:
Abnormal thickening and hardening of vessel walls
Arterial wall thinning and weakening
Abnormally dilated arteries and veins
Autonomic nervous system imbalances
When a nurse checks the patient for orthostatic hypotension, what did the nurse have the patient do?
What term should the nurse document for a detached blood clot?
A 32-year-old female presents with lower leg pain, with swelling and redness. While obtaining the patient’s history, which finding could have caused her condition?
Heart valve damage
A 28-year-old female presents with severe chest pain and shortness of breath. She is diagnosed with pulmonary embolism, which most likely originated from the:
Superficial veins of the arm
Deep veins of the leg
Individuals with Raynaud disease need to be counseled to avoid which of the following conditions to prevent severe symptoms?
Hot water immersion
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?
Trauma to the deep veins
Long periods of standing
While planning care for a patient with superior vena cava syndrome (SVCS), which principle should the nurse remember? SVCS is a progressive _____ of the superior vena cava (SVC) that leads to venous distention of the upper extremities and head.
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?
Drinking tomato juice
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:
Arterial emboli from heart valve
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:
The myocardial oxygen supply has fallen below demand.
The vagus nerve is stimulated.
Cardiac output has fallen below normal levels.
Myocardial stretch has exceeded the upper limits.
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:
Myocardial infarction (MI)
A 49-year-old male presents to his primary care provider reporting chest pain. EKG reveals ST elevation. He is diagnosed with myocardial ischemia. Which of the following interventions would be most beneficial?
Give an antibiotic to decrease infection.
Apply oxygen to increase myocardial oxygen supply.
Encourage exercise to increase heart rate.
Administer a diuretic to decrease volume.
A 60-year-old female had a myocardial infarction. She was brought to the hospital 30 minutes later. She survived, but now the nurse is providing care for impaired ventricular function because:
There is a temporary alteration in electrolyte balance.
The resulting ischemia leads to hypoxic injury and myocardial cell death.
The cells become hypertrophic.
There is too much stress on the heart.
While planning care, the nurse remembers which principle? In valvular _____, the valve opening is constricted and narrowed because the valve leaflets, or cusps, fail to open completely.
A 60-year-old female was diagnosed with mitral stenosis. As a result, the nurse realizes the patient has incomplete emptying of the:
A 72-year-old female has a history of hypertension and atherosclerosis. An echocardiogram reveals backflow of blood into the left ventricle. Which of the following is the most likely diagnosis documented on the chart?
Most cases of combined systolic and diastolic hypertension have no known cause and are documented on the chart as _____ hypertension.
Which characteristic changes should the nurse keep in mind while caring for a patient with left heart failure? As left heart failure progresses:
Systemic vascular resistance decreases.
Left ventricular preload increases.
Pulmonary vascular resistance decreases.
Left end-diastolic volume decreases.
A 65-year-old male with a history of untreated hypertension is now experiencing left heart failure. A nurse recalls his untreated hypertension led to:
Inhibition of renin and aldosterone
Alterations in alpha and beta receptor function
Ventricular dilation and wall thinning
Myocardial hypertrophy and ventricular remodeling
A 59-year-old female is diagnosed with left ventricular failure. If a decrease in kidney perfusion occurs, the nurse knows this would ultimately cause:
Decreased cardiac oxygen demand
Decreased left ventricular preload
Increased systemic vascular resistance
Increased pulmonary capillary permeability
When a patient with left heart failure starts to have a cough and dyspnea, which principle should the nurse remember? Pulmonary symptoms, common to left heart failure, are a result of:
Decreased cardiac output
Inflammatory pulmonary edema
Pulmonary vascular congestion
A 65-year-old male is diagnosed with chronic pulmonary disease and elevated pulmonary vascular resistance. Which of the following heart failures should the nurse assess for in this patient?
Right heart failure
Left heart failure
When a person is in shock, a nurse remembers impairment in cellular metabolism is cause by:
Inadequate tissue perfusion
Lack of nervous or endocrine stimulation
Free radical formation
Release of toxic substances
One consequence of switching from aerobic to anaerobic cellular metabolism during shock states is:
Decreased adenosine triphosphate (ATP) production
A 27-year-old male is admitted to a neurologic unit with a complete C-5 spinal cord transection. On initial assessment, he is bradycardic, hypotensive, and hyperventilating. He appears to be going into shock. The most likely mechanism of his shock is:
Vasodilation caused by gram-negative bacterial infection
Vasodilation caused by a decrease in sympathetic stimulation
Hypovolemia caused by evaporative fluid losses
Hypovolemia caused by blood loss
A 15-year-old male who is allergic to peanuts eats a peanut butter cup. He then goes into anaphylactic shock. Which assessment findings will the nurse assess for?
Bronchoconstriction, hives or edema, and hypotension
Hypertension, anxiety, and tachycardia
Fever, hypotension, and erythematous rash
Bradycardia, decreased arterial pressure, and oliguria
For an infection to progress to septic shock, which of the following factors should the nurse determine occurred?
The myocardium must be impaired.
Bacteria must enter the bloodstream.
The infection must be gram negative.
The individual must be immunosuppressed.
Which patient is most prone to multiple organ dysfunction syndrome (MODS)? In a patient with:
Which is the most common type of congenital heart defect the nurse should assess for in infants?
Atrioventricular canal defect
Ventricular septal defect (VSD)
Atrial septal defect (ASD)
Tetralogy of Fallot
A newborn experiences frequent periods of cyanosis, usually occurring during crying or after feeding. Which of the following is the most likely diagnosis the nurse will observe on the chart?
Atrioventricular canal (AVC) defect
A newborn baby is severely cyanotic. An echocardiogram reveals transposition of the great arteries. A nurse assesses for which of the following, as it usually occurs with this defect?
The aorta leaving the right ventricle
The pulmonary artery leaving the right ventricle
A newborn child is diagnosed with tetralogy of Fallot. What symptoms would the nurse expect to observe in the child?
High-pitched cry and dyspnea
Epistaxis and anemia
Cyanosis and hypoxia
Leg pain and twitching
A 5-year-old female is found to have hypertension during three separate visits to her primary care provider. The nurse would expect tests to suggest that the hypertension is secondary to:
A 1-month-old infant visits his primary care provider for a well-baby check. Physical exam reveals decreased cardiac output, hypotension, tachycardia, and a loud murmur suggestive of aortic stenosis. Which of the following would be expected with this diagnosis?
The nasopharynx is lined with a ciliated mucosal membrane with a highly vascular blood supply. The nurse is discussing the functions of this membrane. Which information should be included? One function of the membrane is to:
A 42-year-old male was involved in a motor vehicle accident during which he suffered a severe head injury. He died shortly after the accident from loss of respiration. The nurse suspects the area of the brain most likely involved is the:
While planning care for a patient with respiratory difficulty and retaining too much carbon dioxide, which principle should the nurse recall? _______ would be stimulated in an attempt to maintain a normal homeostatic state.
A patient asks how oxygen is transported in the body. What is the nurse’s best response? Most of the oxygen (O2) is transported:
Dissolved in the plasma
Bound to hemoglobin
As a free-floating molecule
In the form of carbon dioxide (CO2)
Which principle should the nurse remember while planning care for a patient with respiratory problems? Diffusion of respiratory gases takes place at the:
A 10-year-old female develops pneumonia. Physical exam reveals subcostal and intercostal retractions. She reports that breathing is difficult and she feels she cannot get enough air. What term should the nurse use to document this condition?
A nurse is teaching staff about pulmonary edema. Which information should the nurse include? The most common cause of pulmonary edema is:
A 50-year-old male presents with hypotension, hypoxemia, and tracheal deviation to the left. Tests reveal that the air pressure in the pleural cavity exceeds barometric pressure in the atmosphere. Based upon these assessment findings, what does the nurse suspect the patient is experiencing?
A 20-year-old male presents to his primary care provider reporting difficulty breathing when lying down. What term should the nurse use to document this condition?
A 42-year-old female presents with dyspnea; rapid, shallow breathing; inspiratory crackles; decreased lung compliance; and hypoxemia. Tests reveal a fulminant form of respiratory failure characterized by acute lung inflammation and diffuse alveolocapillary injury. Which of the following is the most likely diagnosis the nurse will observe on the chart?
Malignant respiratory failure
Acute respiratory distress syndrome (ARDS)
Postoperative respiratory failure
A nurse is preparing to teach the staff about asthma. Which information should the nurse include? Airway obstruction contributing to increased airflow resistance and hypoventilation in asthma is caused by:
Collapse of the cartilaginous rings in the bronchi
Mucus secretion, bronchoconstriction, and airway edema
Type II alveolar cell injury and decreased surfactant
Alveolar fibrosis and pulmonary edema
A 25-year-old male presents with chronic bronchitis of 5 months’ duration. When obtaining the patient’s history, which of the following findings is most likely to cause this condition?
A 30-year-old female received a severe head injury in a motor vehicle accident. She is now experiencing respiratory abnormalities characterized by alternating periods of deep and shallow breathing with periods of apnea. What term should the nurse use when charting this condition?
When the nurse observes a diagnosis of nosocomial pneumonia, the patient generally acquires this pneumonia:
At day care centers
In the winter season
Which of the following patients is at highest risk for developing pulmonary embolism (PE)?
36-year-old woman with a history of alcohol abuse who is recovering from a gastric ulcer
28-year-old woman who had a baby 6 months earlier
21-year-old male with a hemophilia bleeding disorder
72-year-old male who is recovering from hip replacement surgery in the hospital
When a patient has a massive pulmonary embolism (PE), what complications will the nurse monitor for?
Damage to the lung microcapillaries
Chronic obstructive pulmonary disease (COPD)
Shock and death
Disseminated intravascular coagulation (DIC)
A 1-year-old female is diagnosed with croup. When the parent asks what caused this, what is the nurse’s best response? The most likely cause of this disease is:
A 6-month-old female presents with rhinorrhea, cough, poor feeding, lethargy, and fever. She is diagnosed with bronchiolitis. Which of the following will the nurse most likely observe on the culture report?
Group A beta-hemolytic streptococcus
Respiratory syncytial virus
Haemophilus B influenzae
While planning care, a nurse recalls respiratory distress and hypoxemia in laryngotracheobronchitis are caused by:
Infectious pulmonary edema
While reviewing lab results, to help confirm a diagnosis of cystic fibrosis in a 1-year-old child which substance will be present in the child’s sweat?
To prevent sudden infant death syndrome, the nurse should instruct parents to:
Keep the infant’s room very warm.
Breast-feed their infants.
Always lay infants down on their backs to sleep.
Place infants on a soft mattress for sleeping.
A newborn has respiratory distress syndrome. When obtaining the patient’s history, which of the following is the most important predisposing factor for this condition?
Low birth weight
Alcohol consumption by the mother during pregnancy
Smoking by the mother during pregnancy
During a respiratory assessment of an infant with respiratory distress syndrome, a sinking in the supraclavicular and intercostal areas of the thorax was noted with inspiration. This observation is documented as:
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:
A 20-year-old male is in acute pain. An arterial blood gas reveals decreased carbon dioxide (CO2) levels. Which of the following does the nurse suspect is the most likely cause?
A 65-year-old female with emphysema presents to the ER for difficulty breathing. Physical exam reveals bluish skin and mucous membranes. How should the nurse chart this condition? Patient has:
A 28-year-old male reports to his primary care provider that he has had a cold for a week and is coughing up bloody secretions. When giving report, what term should the nurse use to describe this condition?