NUR 280 Cardiac Quiz

NUR 280 Cardiac Quiz

• A patient with persistent, primary hypertension remains apathetic about his high blood

pressure, stating, "I don't feel sick, and it doesn't seem to be causing me any problems that I can tell." How could a clinician best respond to this patient's statement?

• "That's true, but it's an indicator that you're not taking very good care of yourself."
• "You're right, but it's still worthwhile to monitor it in case you do develop problems."
• "You may not sense any problems, but it really increases your risk of heart disease and

stroke."

• "Actually, high blood pressure makes you very susceptible to getting diabetes in the future."

Answer

• "You may not sense any problems, but it really increases your risk of heart disease and

stroke." Hypertension is a highly significant risk factor for heart disease and stroke. It would be inappropriate to promote monitoring without promoting lifestyle modifications or other interventions to lower the patient's blood pressure, or teaching the patient about the deleterious effects of hypertension. It is likely unproductive to simply characterize the patient's hypertension as demonstrating that he does not "take care" of himself. Hypertension is not a risk factor for the development of diabetes mellitus.

• A male patient with a history of angina has presented to the emergency department with

uncharacteristic chest pain and his subsequent ECG reveals T-wave elevation.This finding suggests an abnormality with which of the following aspects of the cardiac cycle?

• Ventricular depolarization
• Ventricular repolarization
• Depolarization of the AV node, bundle branches, and Purkinje system
• Atrial depolarization

Answer

• Ventricular repolarization 1 / 3

The T wave on electrocardiography (ECG) corresponds to ventricular repolarization.Atrial depolarization is represented by the P wave and ventricular depolarization by the QRS complex. The isoelectric or zero line between the P wave and the Q wave represents depo- larization of the AV node, bundle branches, and Purkinje system.

• A nurse is performing patient health education with a 68-year-old man who has recently

been diagnosed with heart failure. Which of the following statements demonstrates an accurate understanding of his new diagnosis?

• "I'm going to avoid as much physical activity as I can so that I preserve my strength."
• "I know it's healthy to drink a lot of water, and I'm going to make sure I do this from now

on."

• "I'll be sure to take my beta blocker whenever I feel short of breath."
• "I'm trying to think of ways that I can cut down the amount of salt that I usually eat."

Answer

• "I'm trying to think of ways that I can cut down the amount of salt that I usually eat."

Salt and fluid restrictions are indicated for most patients with heart failure (HF). Beta blockers do not address shortness of breath, and cardiac medications are not normally taken in response to acute symptoms. Patients should be encouraged to maintain, and increase, physical activity within the limits of their condition.

• A patient who developed a deep vein thrombosis during a prolonged period of bedrest has

deteriorated as the clot has dislodged and resulted in a pulmonary embolism.Which of the following types of shock is this patient at risk of experiencing?

• Distributive shock
• Hypovolemic shock
• Obstructive shock
• Cardiogenic shock 2 / 3

Answer

• Obstructive shock

Obstructive shock results from mechanical obstruction of the flow of blood through the central circulation, such as the blockage that characterizes a pulmonary embolism.

• A patient with a diagnosis of chronic renal failure secondary to diabetes has seen a gradual

increase in her blood pressure over the past several months, culminating in a diagnosis of secondary hypertension. Which of the following has most likely resulted in the patient's increased blood pressure?

• Coarctation of the patient's aorta
• Increased sympathetic stimulation by the autonomic nervous system (ANS)
• Increased levels of adrenocortical hormones
• Activation of the renin-angiotensin-aldosterone mechanism

Answer

• Activation of the renin-angiotensin-aldosterone mechanism

The reduced renal blood flow that occurs with renovascular disease causes the affected kidney to release excessive amounts of renin, increasing circulating levels of angiotensin II and raising blood pressure. A renal etiology is not associated with secondary hypertension due to hormonal factors, sympathetic stimulation, or coarctation of the aorta.

• A patient with a history of heart failure has been referred for an echocardiogram. Results of

this diagnostic test reveal the following findings

heart rate 80 beats per minute; end-diastolic

volume (preload)120 mL; end-systolic volume 60 mL. What is this patient's ejection fraction?

A. 50%

• 180 mL
• / 3