NR 443 CHAPTER 36: CARDIAC DISORDERS
Chapter 36: Cardiac Disorders
Linton: Introduction to Medical-Surgical Nursing, 6th Edition
MULTIPLE CHOICE
1. A nurse performs an apical-radial pulse evaluation, with the result of 100/88. What is the
pulse deficit?
a. 12
b. 24
c. 76
d. 88
ANS: A
To detect an apical-radial pulse deficit, the rates should be counted simultaneously and
compared for differences. If a difference exists between the apical rate and the radial rate,
then a pulse deficit is present. For example, in atrial fibrillation, a pulse deficit exists.
DIF: Cognitive Level: Analysis REF: p. 687 OBJ: 8
TOP: Vital Sign Assessment: Pulse Deficit
KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
2. What is increased in hypertension that in turn causes an increase in the work of the
heart?
a. Preload
b. Stroke volume
c. Contractility
d. Afterload
ANS: D
An increase blood pressure creates an increase in afterload because the heart must work
harder to push the blood out of the left ventricle into the circulating volume.
DIF: Cognitive Level: Comprehension REF: p. 685-686 OBJ: 7
TOP: Hypertension Effect on Afterload KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
3. Which heart sound should the nurse record as normal?
a. Ventricular gallop in a 20-year-old patient
b. Atrial gallop in a 25-year-old patient
c. Friction rub in a 45-year-old patient
d. Medium diastolic murmur in a 50-year-old patient
ANS: A
Ventricular gallops are considered normal in individuals younger than 30 years of age. All
other options are pathologic abnormalities.
, DIF: Cognitive Level: Application REF: p. 688 OBJ: 7
TOP: Heart Sound Assessment KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
4. A 49-year-old patient has multiple risk factors for coronary artery disease. Which risk
factor is considered modifiable?
a. Family history
b. Age
c. Smoking
d. Male gender
ANS: C
Smoking, a high-fat diet, hypertension, sedentary lifestyle, and stress are considered
modifiable risk factors.
DIF: Cognitive Level: Comprehension REF: p. 708 OBJ: 7
TOP: Coronary Artery Disease Risk Factors
KEY: Nursing Process Step: Assessment
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of
Disease
5. A patient asks what a transesophageal echocardiogram (TEE) is and what it is expected
to do? What is the best explanation by the nurse?
a. Measures conductivity
b. Records the force of contraction
c. Evaluates the efficiency of the valves
d. Checks the volume of the preload
ANS: C
TEE evaluates the efficiency of the valves.
DIF: Cognitive Level: Application REF: p. 689 OBJ: 6
TOP: TEE KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of
Disease
6. A nurse records the finding of a normal sinus rhythm (NSR) when the P, Q, R, S, and T
are all present in the electrocardiographic complex. What additional information should the
nurse document?
a. Rate of 82 seconds
b. PR interval of 0.36 second
c. QRS complex of 0.16 second
d. Inverted T
ANS: A
NSR requires the presence of P, Q, R, S, and T waves, in that order, and all pointing in the
same direction, with a rate of 60 to 100 seconds. Normal intervals are a PR interval of 0.12
to 0.20 seconds and a QRS complex less than 0.10 second.
Chapter 36: Cardiac Disorders
Linton: Introduction to Medical-Surgical Nursing, 6th Edition
MULTIPLE CHOICE
1. A nurse performs an apical-radial pulse evaluation, with the result of 100/88. What is the
pulse deficit?
a. 12
b. 24
c. 76
d. 88
ANS: A
To detect an apical-radial pulse deficit, the rates should be counted simultaneously and
compared for differences. If a difference exists between the apical rate and the radial rate,
then a pulse deficit is present. For example, in atrial fibrillation, a pulse deficit exists.
DIF: Cognitive Level: Analysis REF: p. 687 OBJ: 8
TOP: Vital Sign Assessment: Pulse Deficit
KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
2. What is increased in hypertension that in turn causes an increase in the work of the
heart?
a. Preload
b. Stroke volume
c. Contractility
d. Afterload
ANS: D
An increase blood pressure creates an increase in afterload because the heart must work
harder to push the blood out of the left ventricle into the circulating volume.
DIF: Cognitive Level: Comprehension REF: p. 685-686 OBJ: 7
TOP: Hypertension Effect on Afterload KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
3. Which heart sound should the nurse record as normal?
a. Ventricular gallop in a 20-year-old patient
b. Atrial gallop in a 25-year-old patient
c. Friction rub in a 45-year-old patient
d. Medium diastolic murmur in a 50-year-old patient
ANS: A
Ventricular gallops are considered normal in individuals younger than 30 years of age. All
other options are pathologic abnormalities.
, DIF: Cognitive Level: Application REF: p. 688 OBJ: 7
TOP: Heart Sound Assessment KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
4. A 49-year-old patient has multiple risk factors for coronary artery disease. Which risk
factor is considered modifiable?
a. Family history
b. Age
c. Smoking
d. Male gender
ANS: C
Smoking, a high-fat diet, hypertension, sedentary lifestyle, and stress are considered
modifiable risk factors.
DIF: Cognitive Level: Comprehension REF: p. 708 OBJ: 7
TOP: Coronary Artery Disease Risk Factors
KEY: Nursing Process Step: Assessment
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of
Disease
5. A patient asks what a transesophageal echocardiogram (TEE) is and what it is expected
to do? What is the best explanation by the nurse?
a. Measures conductivity
b. Records the force of contraction
c. Evaluates the efficiency of the valves
d. Checks the volume of the preload
ANS: C
TEE evaluates the efficiency of the valves.
DIF: Cognitive Level: Application REF: p. 689 OBJ: 6
TOP: TEE KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of
Disease
6. A nurse records the finding of a normal sinus rhythm (NSR) when the P, Q, R, S, and T
are all present in the electrocardiographic complex. What additional information should the
nurse document?
a. Rate of 82 seconds
b. PR interval of 0.36 second
c. QRS complex of 0.16 second
d. Inverted T
ANS: A
NSR requires the presence of P, Q, R, S, and T waves, in that order, and all pointing in the
same direction, with a rate of 60 to 100 seconds. Normal intervals are a PR interval of 0.12
to 0.20 seconds and a QRS complex less than 0.10 second.
