Clinical Guidelines in Primary Care 4th Edition Test Bank

,ClinicaljGuidelinesjinjPrimaryCarej4thjEditionjTestjbankjChapter
j1jCardiovascularjDisorders


MULTIPLEjCHOICE
1. Thejnursejisjawarejthatjthejmusclejlayerjofjthejheart,jwhichjisjresponsiblejforjthejheartsjco
ntraction,jisjthe:

a. endocardium.
b. pericardium.
c. mediastinum.
d. myocardium.

ANS:jD
Thejmyocardiumjisjthejspecializedjmusclejlayerjthatjallowsjthejheartjtojcontract.
2. Thejnursejclarifiesjthatjthejmasterjpacemakerjofjthejheartjisjthe:

a. leftjventricle.
b. atrioventricularj(AV)jnode.
c. sinoatrialj(SA)jnode.
d. bundlejofjHis.

ANS:jC
ThejSAjnodejisjthejmasterjpacemakerjofjthejheart.
3. Thejnursejisjawarejthatjthejsymptomsjofjanjimpendingjmyocardialjinfarctionj(MI)jdifferjinjwo
menjbecausejacutejchestjpainjisjnotjpresent.jWomenjarejfrequentlyjmisdiagnosedjasjhaving:

a. hepatitisjA.
b. indigestion.
c. urinaryjinfection.
d. menopausaljcomplications.

,ANS:jB
Indigestion,jgallbladderjattack,janxietyjattack,jandjdepressionjarejfrequentjmisdiagnosesjforjwome
njhavingjanjMI.
4. ThejnursejidentifiesjthejLUBBjsoundjofjthejLUBB/DUBBjofjthejcardiacjcyclejasjthejsoundjofjthe:

a. AVjvalvesjclosing.
b. closurejofjthejsemilunarjvalves.
c. contractionjofjthejpapillaryjmuscles.
d. contractionjofjthejventricles.

ANS:jA
ThejLUBBjisjthejfirstjsoundjofjajlowjpitchjheardjwhenjthejAVjvalvesjclose.
5. Ajpatientjisjadmittedjfromjthejemergencyjdepartment.jThejemergencyjdepartmentjphysicianjn
otesjthejpatientjhasjajdiagnosisjofjheartjfailurejwithjajNewjYorkjHeartjAssociationj(NYHA)jclas
sificationjofjIV.jThisjindicatesjthejpatientsjconditionjas:

a. moderatejheartjfailure.
b. severejheartjfailure.
c. congestivejheartjfailure.
d. negligiblejheartjfailure.

ANS:jB
ClassjIV:jSevere;jpatientjunablejtojperformjanyjphysicaljactivityjwithoutjdiscomfort.jAnginajorjsy
mptomsjofjcardiacjinefficiencyjmayjdevelopjatjrest.
6. Thejnursejassessesjthatjthejhomejhealthjpatientjhasjnojsignsjorjsymptomsjofjheartjfailure,jbutjdoe
sjhavejajhistoryjofjrheumaticjfeverjandjhasjbeenjrecentlyjdiagnosedjwithjdiabetesjmellitus.jThejn
ursejisjawarejthatjusingjthejAmericanjCollegejofjCardiologyjandjthejAmericanjHeartjAssociation
j(ACC/AHA)jstaging,jthisjpatientjwouldjbeja:


a. stagejA.
b. stagejB.
c. stagejC.
d. stagejD.

ANS:jA
ThejACC/AHAjstagingjdescribesjstagejAjasjajpersonjwithoutjsymptomsjofjheartjfailure,jbutjwithjp
rimaryjconditionsjassociatedjwithjthejdevelopmentjofjthejdisease.

, 7. Thejnursejcaringjforjajpatientjrecoveringjfromjajmyocardialjinfarctjwhojisjonjremotejtelemetryjrec
ognizesjthejneedjforjaddedjinstructionjwhenjthejpatientjsays:

a. Ijcanjambulatejinjthejhallwayjwithjthisjgadgetjon.
b. Ijalwaysjtakejoffjthejtelemetryjdevicejwhenj Ijshower.
c. MyjEKGjisjbeingjwatchedjbyjonejofjthejnursesjinjCCUjonjthejhomejunit.
d. Ijamjablejtojsleepjjustjfinejwithjthisjdevicejon.

ANS:jB
Remotejtelemetryjallowsjthejpatientjtojbejonjajseparatejunit,jbutjbejmonitoredjinjajcentraljlocation.j
Thejpatientsjcanjbejambulatoryjandjcanjsleepjwithjthejmonitorjon.jThey
shouldjnotjremovejthejmonitorjtojshower.
8. Thejnursejassessesjpittingjedemajthatjcanjbejdepressedjapproximatelyjinchjandjrefillsjinj15jsec
onds.jThejnursejwouldjdocumentjthisjassessmentjas:

a. +1jedema.
b. +2jedema.
c. +3jedema.
d. +4jedema.

ANS:jB
Aj+2jedemajcanjbejdocumentedjifjthejskinjcanjbejdepressedjinchjandjrespondjwithinj15jseconds.
9. Whatjdojdarkjorjcoldjspotsjonjajthalliumjscanjindicate?

a. Tissuejwithjadequatejbloodjsupply
b. Dilatedjvessels
c. Areasjofjneoplasticjgrowth
d. Tissuejthatjhasjinadequatejperfusion

ANS:jD
Thalliumjscansjshowjadequatejperfusedjareasjbyjthejcollectionjofjthallium.jDarkjspotsjorjcoldjspots
jindicatejtissuesjthatjhavejinadequatejperfusion.


10.Thejnursejrecognizesjthejechocardiogramjreportjthatjshowsjanjejectionjfactorjofj42%jasjanjin
dicationjof:

a. normaljheartjaction.
b. mildjheartjfailure.
c. moderatejheartjfailure.