Med Surge Ch 31 Cardiac Disorders Nclex Questions And Answers
Most Recent Reviewed Edition.
A patient admitted 24 hours ago previously with heart failure has lost 1 kg of weight, has a heart
rate of 88, which was 105 on admission, and now has crackles only in the bases of the lungs.
How should the nurse interpret these assessment findings?
1. More aggressive treatment is needed
2. The patient's condition unchanged from admissions
3. The treatment regimen is achieving the desired effect
4. No further treatment is required at this time because the failure has resolved - ans3. The main
goals for care of heart failure are to slow its progression, reduce cardiac workload, improve
cardiac function, and control fluid retention. A weight loss of 1 kg and crackles in the lung bases
indicate control of fluid retention. A HR of 88 indicates reduced cardiac workload and improved
cardiac function. The patient's condition has improved since admission. Because the patient
continues to have crackles in the lungs, heart failure has not completely resolved.
A patient considering heart valve replacement asks if a biologic or mechanical valve is better to
use. How should the nurse respond?
1. Biologic valves tend to be more durable than mechanical valves.
2. The need to take drugs to prevent rejection of biologic tissue is a major consideration
3. Clotting is a risk with mechanical valves, necessitating anticoagulant drug therapy after
insertion
4. Endocarditis is a risk following valve replacement that is more easily treated with mechanical
valves - ans3. Lifetime anticoagulant therapy to prevent clot formation is necessary following
insertion of a mechanical valve. Biologic valves are prone to deterioration. Drugs to prevent
tissue rejection are not needed after biologic valve replacement surgery. Infections are easier to
treat after biologic valve replacement surgery
A patient experiencing acute pulmonary edema is prescribed morphine sulfate 2-5 mg IV as
needed for pain and dyspnea. What action should the nurse take with this prescribed medication?
1. Administer the drug as ordered, monitoring respiratory status
2. Withhold the drug until the patient's respiratory status improves
, Med Surge Ch 31 Cardiac Disorders Nclex Questions And Answers
Most Recent Reviewed Edition.
3. Questions the order because no time intervals have been specified
4. Administer the drug only when the patient complains of chest pain - ans1. Morphine is
administered IV to relieve anxiety and improve the efficacy of breathing. It also is a vasodilator
that reduces venous return and lowers left atrial pressure. The nurse should provide the
medication and monitor the patient's respiratory status. The medication should not be withheld to
wit for the patient's respiratory status to improve. The medication order is correct as written and
does not need to be questioned. The medication is not being used to treat chest pain.
A patient is diagnosed with left ventricular failure. Which findings should the nurse recognize as
being consistent with this diagnosis? (Select all that apply)
1. Fatigue
2. Substernal chest pain during exercise
3. cm jugular vein distention at 30 degrees
4. Bilateral inspiratory crackles to midscapulae
5. Complaints of shortness of breath with minimal exertion - ans1,4,5
In left ventricular failure, the CO falls and pressure in the pulmonary vascular system increases.
Fatigue is a common early manifestation. Pulmonary congestion causes shortness of breath with
minimal exertion. On auscultation of the lungs, inspiratory crackles may be heard in the lung
bases. Jugular vein distention is a manifestation of right ventricular failure. Chest pain with
exercise can be due to angina pectoris or valvular disease.
A patient with heart failure has an ejection fraction of 25%. What does this information indicate
to the nurse about the patient's health status?
1. Ventricular function is severely impaired
2. Cardiac output is greater than normal, which overtaxes the heart
3. The amount of blood being ejected from the ventricles is within normal limits
4. Twenty-five percent of the blood entering the ventricle remains in the ventricle after systole -
ans1. Normal ejection fraction is 60%. An ejection fraction of 25% indicates severe impairment
of ventricular function; CO is decreased.
Most Recent Reviewed Edition.
A patient admitted 24 hours ago previously with heart failure has lost 1 kg of weight, has a heart
rate of 88, which was 105 on admission, and now has crackles only in the bases of the lungs.
How should the nurse interpret these assessment findings?
1. More aggressive treatment is needed
2. The patient's condition unchanged from admissions
3. The treatment regimen is achieving the desired effect
4. No further treatment is required at this time because the failure has resolved - ans3. The main
goals for care of heart failure are to slow its progression, reduce cardiac workload, improve
cardiac function, and control fluid retention. A weight loss of 1 kg and crackles in the lung bases
indicate control of fluid retention. A HR of 88 indicates reduced cardiac workload and improved
cardiac function. The patient's condition has improved since admission. Because the patient
continues to have crackles in the lungs, heart failure has not completely resolved.
A patient considering heart valve replacement asks if a biologic or mechanical valve is better to
use. How should the nurse respond?
1. Biologic valves tend to be more durable than mechanical valves.
2. The need to take drugs to prevent rejection of biologic tissue is a major consideration
3. Clotting is a risk with mechanical valves, necessitating anticoagulant drug therapy after
insertion
4. Endocarditis is a risk following valve replacement that is more easily treated with mechanical
valves - ans3. Lifetime anticoagulant therapy to prevent clot formation is necessary following
insertion of a mechanical valve. Biologic valves are prone to deterioration. Drugs to prevent
tissue rejection are not needed after biologic valve replacement surgery. Infections are easier to
treat after biologic valve replacement surgery
A patient experiencing acute pulmonary edema is prescribed morphine sulfate 2-5 mg IV as
needed for pain and dyspnea. What action should the nurse take with this prescribed medication?
1. Administer the drug as ordered, monitoring respiratory status
2. Withhold the drug until the patient's respiratory status improves
, Med Surge Ch 31 Cardiac Disorders Nclex Questions And Answers
Most Recent Reviewed Edition.
3. Questions the order because no time intervals have been specified
4. Administer the drug only when the patient complains of chest pain - ans1. Morphine is
administered IV to relieve anxiety and improve the efficacy of breathing. It also is a vasodilator
that reduces venous return and lowers left atrial pressure. The nurse should provide the
medication and monitor the patient's respiratory status. The medication should not be withheld to
wit for the patient's respiratory status to improve. The medication order is correct as written and
does not need to be questioned. The medication is not being used to treat chest pain.
A patient is diagnosed with left ventricular failure. Which findings should the nurse recognize as
being consistent with this diagnosis? (Select all that apply)
1. Fatigue
2. Substernal chest pain during exercise
3. cm jugular vein distention at 30 degrees
4. Bilateral inspiratory crackles to midscapulae
5. Complaints of shortness of breath with minimal exertion - ans1,4,5
In left ventricular failure, the CO falls and pressure in the pulmonary vascular system increases.
Fatigue is a common early manifestation. Pulmonary congestion causes shortness of breath with
minimal exertion. On auscultation of the lungs, inspiratory crackles may be heard in the lung
bases. Jugular vein distention is a manifestation of right ventricular failure. Chest pain with
exercise can be due to angina pectoris or valvular disease.
A patient with heart failure has an ejection fraction of 25%. What does this information indicate
to the nurse about the patient's health status?
1. Ventricular function is severely impaired
2. Cardiac output is greater than normal, which overtaxes the heart
3. The amount of blood being ejected from the ventricles is within normal limits
4. Twenty-five percent of the blood entering the ventricle remains in the ventricle after systole -
ans1. Normal ejection fraction is 60%. An ejection fraction of 25% indicates severe impairment
of ventricular function; CO is decreased.
