Test bank for Clinical Guidelines in Primary Care 4th Edition by Hollier -2023-2024
Chapter 1 Cardiovascular Disorders
MULTIPLE CHOICE
1.The nurse is aware that the muscle layer of the heart, which is responsible for the hearts
contraction, is the:
- endocardium.
- pericardium.
- mediastinum.
- myocardium.
ANS: D
The myocardium is the specialized muscle layer that allows the heart to contract.
2.The nurse clarifies that the master pacemaker of the heart is the:
- left ventricle.
- atrioventricular (AV) node.
- sinoatrial (SA) node.
- bundle of His.
ANS: C
The SA node is the master pacemaker of the heart.
- The nurse is aware that the symptoms of an impending myocardial infarction (MI) differ in
women because acute chest pain is not present. Women are frequently misdiagnosed as having:
- hepatitis A.
- indigestion.
- urinary infection.
- menopausal complications. 1 / 4
ANS: B
Indigestion, gallbladder attack, anxiety attack, and depression are frequent misdiagnoses for women having an MI.
- The nurse identifies the LUBB sound of the LUBB/DUBB of the cardiac cycle as the sound of
the:
- AV valves closing.
- closure of the semilunar valves.
- contraction of the papillary muscles.
- contraction of the ventricles.
ANS: A
The LUBB is the first sound of a low pitch heard when the AV valves close.
5.A patient is admitted from the emergency department. The emergency department physician notes the patient has a diagnosis of heart failure with a New York Heart Association (NYHA)
classification of IV. This indicates the patients condition as:
- moderate heart failure.
- severe heart failure.
- congestive heart failure.
- negligible heart failure.
ANS: B
Class IV: Severe; patient unable to perform any physical activity without discomfort. Angina or symptoms of cardiac inefficiency may develop at rest.
- The nurse assesses that the home health patient has no signs or symptoms of heart failure, but
does have a history of rheumatic fever and has been recently diagnosed with diabetes mellitus.The nurse is aware that using the American College of Cardiology and the American Heart
Association (ACC/AHA) staging, this patient would be a:
- stage A.
- stage B.
- stage C.
- stage D.
ANS: A
The ACC/AHA staging describes stage A as a person without symptoms of heart failure, but with primary conditions associated with the development of the disease. 2 / 4
- The nurse caring for a patient recovering from a myocardial infarct who is on remote telemetry
recognizes the need for added instruction when the patient says:
- I can ambulate in the hallway with this gadget on.
- I always take off the telemetry device when I shower.
- My EKG is being watched by one of the nurses in CCU on the home unit.
- I am able to sleep just fine with this device on.
ANS: B
Remote telemetry allows the patient to be on a separate unit, but be monitored in a central location. The patients can be ambulatory and can sleep with the monitor on. They should not remove the monitor to shower.
- The nurse assesses pitting edema that can be depressed approximately inch and refills in 15
seconds. The nurse would document this assessment as:
- +1 edema.
- +2 edema.
- +3 edema.
- +4 edema.
ANS: B
A +2 edema can be documented if the skin can be depressed inch and respond within 15 seconds.
- What do dark or cold spots on a thallium scan indicate?
- Tissue with adequate blood supply
- Dilated vessels
- Areas of neoplastic growth
- Tissue that has inadequate perfusion
ANS: D
Thallium scans show adequate perfused areas by the collection of thallium. Dark spots or cold spots indicate tissues that have inadequate perfusion.
- The nurse recognizes the echocardiogram report that shows an ejection factor of 42% as an
indication of:
- normal heart action.
- mild heart failure.
- moderate heart failure. 3 / 4
- severe heart failure.
ANS: C
An ejection factor (cardiac output) of 42% indicates moderate heart failure.
- The nurse takes into consideration that age-related changes can affect the peripheral
circulation because of:
- sclerosed blood vessels.
- hypotension.
- inactivity.
- poor nutrition.
ANS: A
Aging causes sclerotic changes in the blood vessels that lead to decreased elasticity and narrowing of the vessel lumen.
- The nurse assessing a cardiac monitor notes that the cardiac complexes each have a P wave
followed by a QRS and a T. The rate is 120. The nurse recognizes this arrhythmia as:
- sinus bradycardia.
- atrial fibrillation.
- sinus tachycardia.
- ventricular tachycardia.
ANS: C
Sinus tachycardia has a P wave followed by the QRS and the T. All the components of the complex are present and in the correct order, but the rate is over 100 beats a minute.
- After an influenza-like illness, the patient complains of chills and small petechiae in his
mouth and his legs. A heart murmur is detectable. These are characteristic signs of:
- congestive heart failure.
- heart block.
- aortic stenosis.
- infective endocarditis.
ANS: D
Collection of subjective data includes noting patient complaints of influenza-like symptoms with recurrent fever, undue fatigue, chest pain, and chills. Objective data may reveal the significant
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