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Clinical.Guidelines.in.PrimaryCare.3rd.Edition.Test.bankChapter.1
.Cardiovascular.Disorders
MULTIPLE.CHOICE
1. The.nurse.is.aware.that.the.muscle.layer.of.the.heart,.which.is.responsible.for.the.hearts.contr
action,.is.the:
a. endocardium.
b. pericardium.
c. mediastinum.
d. 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:
a. left.ventricle.
b. atrioventricular.(AV).node.
c. sinoatrial.(SA).node.
d. bundle.of.His.
ANS:.C
The.SA.node.is.the.master.pacemaker.of.the.heart.
3. The.nurse.is.aware.that.the.symptoms.of.an.impending.myocardial.infarction.(MI).differ.in.wome
n.because.acute.chest.pain.is.not.present..Women.are.frequently.misdiagnosed.as.having:
a. hepatitis.A.
b. indigestion.
c. urinary.infection.
d. menopausal.complications.
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ANS:.B
Indigestion,.gallbladder.attack,.anxiety.attack,.and.depression.are.frequent.misdiagnoses.for.women.
having.an.MI.
4. The.nurse.identifies.the.LUBB.sound.of.the.LUBB/DUBB.of.the.cardiac.cycle.as.the.sound.of.the:
a. AV.valves.closing.
b. closure.of.the.semilunar.valves.
c. contraction.of.the.papillary.muscles.
d. 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.not
es.the.patient.has.a.diagnosis.of.heart.failure.with.a.New.York.Heart.Association.(NYHA).classific
ation.of.IV..This.indicates.the.patients.condition.as:
a. moderate.heart.failure.
b. severe.heart.failure.
c. congestive.heart.failure.
d. negligible.heart.failure.
ANS:.B
Class.IV:.Severe;.patient.unable.to.perform.any.physical.activity.without.discomfort..Angina.or.sym
ptoms.of.cardiac.inefficiency.may.develop.at.rest.
6. The.nurse.assesses.that.the.home.health.patient.has.no.signs.or.symptoms.of.heart.failure,.but.does.h
ave.a.history.of.rheumatic.fever.and.has.been.recently.diagnosed.with.diabetes.mellitus..The.nurse.i
s.aware.that.using.the.American.College.of.Cardiology.and.the.American.Heart.Association.(ACC/
AHA).staging,.this.patient.would.be.a:
a. stage.A.
b. stage.B.
c. stage.C.
d. stage.D.
ANS:.A
The.ACC/AHA.staging.describes.stage.A.as.a.person.without.symptoms.of.heart.failure,.but.with.pri
mary.conditions.associated.with.the.development.of.the.disease.
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7. The.nurse.caring.for.a.patient.recovering.from.a.myocardial.infarct.who.is.on.remote.telemetry.recog
nizes.the.need.for.added.instruction.when.the.patient.says:
a. I.can.ambulate.in.the.hallway.with.this.gadget.on.
b. I.always.take.off.the.telemetry.device.when. I.shower.
c. My.EKG.is.being.watched.by.one.of.the.nurses. in.CCU.on.the.home.unit.
d. 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..Th
e.patients.can.be.ambulatory.and.can.sleep.with.the.monitor.on..They
should.not.remove.the.monitor.to.shower.
8. The.nurse.assesses.pitting.edema.that.can.be.depressed.approximately.inch.and.refills.in.15.seco
nds..The.nurse.would.document.this.assessment.as:
a. +1.edema.
b. +2.edema.
c. +3.edema.
d. +4.edema.
ANS:.B
A.+2.edema.can.be.documented.if.the.skin.can.be.depressed.inch.and.respond.within.15.seconds.
9. What.do.dark.or.cold.spots.on.a.thallium.scan.indicate?
a. Tissue.with.adequate.blood.supply
b. Dilated.vessels
c. Areas.of.neoplastic.growth
d. Tissue.that.has.inadequate.perfusion
ANS:.D
Thallium.scans.show.adequate.perfused.areas.by.the.collection.of.thallium..Dark.spots.or.cold.spots.in
dicate.tissues.that.have.inadequate.perfusion.
10. The.nurse.recognizes.the.echocardiogram.report.that.shows.an.ejection.factor.of.42%.as.an.indic
ation.of:
a. normal.heart.action.
b. mild.heart.failure.
c. moderate.heart.failure.
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