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Care of the Patient with a Cardiovascular or a Peripheral Vascular Disorder _ Nursing Test bank

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1.The nurse is aware that the muscle layer of the heart, which is responsible for the heart’s contraction, 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. PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 1533 OBJ: 2 TOP: Myocardium KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity 2.The nurse claries that the master pacemaker of the heart is the: a. left ventricle. b. atrioventricular (AV) node.

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1/21/2018 Chapter 47: Care of the Patient with a Cardiovascular or a Peripheral Vascular Disorder | Nursing Test Banks




Nursing Test Banks
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Chapter 47: Care of the Patient with a Cardiovascular
or a Peripheral Vascular Disorder
Chapter 47: Care of the Patient with a Cardiovascular or a Peripheral Vascular Disorder


Cooper and Gosnell: Foundations and Adult Health Nursing, 7th Edition


MULTIPLE CHOICE


1.The nurse is aware that the muscle layer of the heart, which is responsible for the heart’s contraction, 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.


PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 1533


OBJ: 2 TOP: Myocardium KEY: Nursing Process Step: Implementation


MSC: NCLEX: Physiological Integrity


2.The nurse clari es that the master pacemaker of the heart is the:


a. left ventricle.


b. atrioventricular (AV) node.

https://boostgrade.info/chapter-47-care-of-the-patient-with-a-cardiovascular-or-a-peripheral-vascular-disorder/ 1/31

,1/21/2018 Chapter 47: Care of the Patient with a Cardiovascular or a Peripheral Vascular Disorder | Nursing Test Banks


c. sinoatrial (SA) node.


d. bundle of His.



ANS: C


The SA node is the master pacemaker of the heart.


PTS: 1 DIF: Cognitive Level: Application REF: Page 1533


OBJ:10TOP:Acute myocardial infarction


KEY: Nursing Process Step: Planning MSC: NCLEX: Physiological Integrity


3.The nurse is aware that the symptoms of an impending myocardial infarction (MI) di er in women because
acute chest pain is not present. Women are frequently misdiagnosed as having:


a. hepatitis A.


b. indigestion.


c. urinary infection.


d. menopausal complications.



ANS: B


Indigestion, gallbladder attack, anxiety attack, and depression are frequent misdiagnoses for women having an
MI.


PTS: 1 DIF: Cognitive Level: Application REF: Page 1559


OBJ:16TOP:MIs in women


KEY: Nursing Process Step: Planning MSC: NCLEX: Physiological Integrity


4.The nurse identi es 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.

https://boostgrade.info/chapter-47-care-of-the-patient-with-a-cardiovascular-or-a-peripheral-vascular-disorder/ 2/31

,1/21/2018 Chapter 47: Care of the Patient with a Cardiovascular or a Peripheral Vascular Disorder | Nursing Test Banks


d. contraction of the ventricles.



ANS: A


The LUBB is the rst sound of a low pitch heard when the AV valves close.


PTS: 1 DIF: Cognitive Level: Application REF: Page 1535


OBJ: 4 TOP: Lubb sound KEY: Nursing Process Step: Assessment


MSC: NCLEX: Physiological Integrity


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) classi cation of IV. This
indicates the patient’s 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 symptoms of
cardiac ine ciency may develop at rest.


PTS: 1 DIF: Cognitive Level: Knowledge REF: Page 1565, Box 47-3


OBJ:9TOP:Classi cation of heart failure


KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity


6.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:


a. stage A.



https://boostgrade.info/chapter-47-care-of-the-patient-with-a-cardiovascular-or-a-peripheral-vascular-disorder/ 3/31

, 1/21/2018 Chapter 47: Care of the Patient with a Cardiovascular or a Peripheral Vascular Disorder | Nursing Test Banks

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 primary
conditions associated with the development of the disease.


PTS: 1 DIF: Cognitive Level: Analysis REF: Page 1565, Box 47-3


OBJ: 9 TOP: Heart failure KEY: Nursing Process Step: Assessment


MSC: NCLEX: Physiological Integrity


7.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:


a. “I can ambulate in the hallway with this gadget on.”


b. “I always take o 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 ne 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.


PTS: 1 DIF: Cognitive Level: Application REF: Page 1539


OBJ:6TOP:Remote telemetry


KEY: Nursing Process Step: Evaluation MSC: NCLEX: Physiological Integrity


8.The nurse assesses pitting edema that can be depressed approximately inch and re lls in 15 seconds. The
nurse would document this assessment as:


a. +1 edema.

https://boostgrade.info/chapter-47-care-of-the-patient-with-a-cardiovascular-or-a-peripheral-vascular-disorder/ 4/31

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