Clinical Guidelines in Primary
h h h h
Care 4th Edition Test bank/Stu
h h h h
dyGuide
Chapterh1hCardiovascularhDisorders
MULTIPLEhCHOICE
1.Thehnursehishawarehthaththehmusclehlayerhofhthehheart,hwhichhishresponsiblehforhthehheartshc
ontraction,hishthe:
a. endocardium.
b. pericardium.
c. mediastinum.
d. myocardium.
ANS:hD
Thehmyocardiumhishthehspecializedhmusclehlayerhthathallowshthehhearthtohcontract.h2
.Thehnursehclarifieshthaththehmasterhpacemakerhofhthehhearthishthe:
a. lefthventricle.
b. atrioventricularh(AV)hnode.
c. sinoatrialh(SA)hnode.
d. bundlehofhHis.
ANS:hC
ThehSAhnodehishthehmasterhpacemakerhofhthehheart.
3. Thehnursehishawarehthaththehsymptomshofhanhimpendinghmyocardialhinfarctionh(MI)hdifferhinhw
omenhbecausehacutehchesthpainhish nothpresent.hWomenharehfrequentlyhmisdiagnosedhashhaving:
a. hepatitishA.
b. indigestion.
c. urinaryhinfection.
d. menopausalhcomplications.
,ANS:hB
Indigestion,hgallbladderhattack,hanxietyhattack,handhdepressionharehfrequenthmisdiagnoseshforh
womenhhavinghanhMI.
4. ThehnursehidentifieshthehLUBBhsoundhofhthehLUBB/DUBBhofhthehcardiachcyclehashthehsoundhofht
he:
a. AVhvalveshclosing.
b. closurehofhthehsemilunarhvalves.
c. contractionhofhthehpapillaryhmuscles.
d. contractionhofhthehventricles.
ANS:hA
ThehLUBBhishthehfirsthsoundhofhahlowhpitchhheardhwhenhthehAVhvalveshclose.
5.Ahpatienthish admittedhfromhthehemergencyhdepartment.hThehemergencyhdepartmenthphysicianhn
oteshthehpatienthhashahdiagnosishofhhearthfailurehwithhahNewhYorkhHearthAssociationh(NYHA)hcla
ssificationhofhIV.hThish indicateshthehpatientshconditionhas:
a. moderatehhearthfailure.
b. severehhearthfailure.
c. congestivehhearthfailure.
d. negligiblehhearthfailure.
ANS:hB
ClasshIV:hSevere;hpatienthunablehtohperformhanyhphysicalhactivityhwithouthdiscomfort.hAnginahorhs
ymptomshofhcardiachinefficiencyhmayhdevelophathrest.
6. Thehnursehassesseshthaththehhomehhealthhpatienthhashnohsignshorhsymptomshofhhearthfailure,hbuthd
oeshhavehahhistoryhofhrheumatichfeverhandhhashbeenhrecentlyhdiagnosedhwithhdiabeteshmellitus.hTh
ehnursehishawarehthathusinghthehAmericanhCollegehofhCardiologyhandhthehAmericanhHearthAssoci
ationh(ACC/AHA)hstaging,hthishpatienthwouldhbeha:
a. stagehA.
b. stagehB.
c. stagehC.
d. stagehD.
ANS:hA
ThehACC/AHAhstaginghdescribeshstagehAhashahpersonhwithouthsymptomshofhhearthfailure,hbuth
withhprimaryhconditionsh associatedhwithhthehdevelopmenthofhthehdisease.
,7. Thehnursehcaringhforhahpatienthrecoveringhfromhahmyocardialhinfarcthwhohish onhremotehtelemetryhr
ecognizeshthehneedhforhaddedhinstructionhwhenhthehpatienthsays:
a. Ihcanhambulatehinhthehhallwayhwithhthishgadgethon.
b. IhalwayshtakehoffhthehtelemetryhdevicehwhenhIhshower.
c. MyhEKGh ishbeinghwatchedhbyhonehofhthehnursesh inhCCUhonhthehhomehunit.
d. Ihamhablehtohsleephjusthfinehwithhthishdevicehon.
ANS:hB
Remotehtelemetryhallowshthehpatienthtohbehonhahseparatehunit,hbuthbehmonitoredhinhahcentralhloc
ation.hThehpatientshcanhbehambulatoryhandhcanhsleephwithhthehmonitorhon.hThey
shouldhnothremovehthehmonitorhtohshower.
8. Thehnursehassesseshpittinghedemahthathcanhbehdepressedhapproximatelyhinchhandhrefillsh inh15hs
econds.hThehnursehwouldhdocumenththish assessmenthas:
a. +1hedema.
b. +2hedema.
c. +3hedema.
d. +4hedema.
ANS:hB
Ah+2hedemahcanhbehdocumentedhifhthehskinhcanhbehdepressedhinchhandhrespondhwithinh15hs
econds.
9. Whathdohdarkhorhcoldhspotsh onhahthalliumhscanhindicate?
a. Tissuehwithhadequatehbloodhsupply
b. Dilatedhvessels
c. Areashofhneoplastichgrowth
d. Tissuehthathhashinadequatehperfusion
ANS:hD
Thalliumhscanshshowhadequatehperfusedhareashbyhthehcollectionhofhthallium.hDarkhspotshorhcoldhs
potshindicatehtissueshthathhavehinadequatehperfusion.
10. Thehnursehrecognizeshthehechocardiogramhreporththathshowshanhejectionhfactorhofh42%hashanhi
ndicationhof:
a. normalhhearthaction.
b. mildhhearthfailure.
c. moderatehhearthfailure.
, d. severehhearthfailure.
ANS:hC
Anhejectionhfactorh(cardiachoutput)hofh42%hindicateshmoderatehhearthfailure.
11. Thehnursehtakeshintohconsiderationhthathage-
relatedhchangeshcanhaffecththehperipheralhcirculationhbecausehof:
a. sclerosedhbloodhvessels.
b. hypotension.
c. inactivity.
d. poorhnutrition.
ANS:hA
Aginghcauseshsclerotichchangeshinhthehbloodhvesselshthathleadhtohdecreasedhelasticityhandhn
arrowinghofhthehvesselhlumen.
12. ThehnursehassessinghahcardiachmonitorhnoteshthaththehcardiachcomplexesheachhhavehahPhwavehf
ollowedhbyhahQRShandhahT.hThehratehish120.hThehnursehrecognizeshthisharrhythmiahas:
a. sinushbradycardia.
b. atrialhfibrillation.
c. sinushtachycardia.
d. ventricularhtachycardia.
ANS:hC
SinushtachycardiahhashahPhwavehfollowedhbyhthehQRSh andhthehT.hAllhthehcomponentshofhthehc
omplexharehpresenthandh inhthehcorrecthorder,hbuththehratehish overh100hbeatshah minute.
13. Afterhanhinfluenza-
likehillness,hthehpatienthcomplainshofhchillshandhsmallhpetechiaehinhhishmouthhandhhish legs.hAhh
earthmurmurhishdetectable.hTheseharehcharacteristichsignshof:
a. congestivehhearthfailure.
b. hearthblock.
c. aortichstenosis.
d. infectivehendocarditis.
ANS:hD
Collectionhofhsubjectivehdatahincludeshnotinghpatienthcomplaintshofhinfluenza-
likehsymptomshwithhrecurrenthfever,hunduehfatigue,hchesthpain,handhchills.hObjectivehdatahmayhrevea
lhthehsignificant
h h h h
Care 4th Edition Test bank/Stu
h h h h
dyGuide
Chapterh1hCardiovascularhDisorders
MULTIPLEhCHOICE
1.Thehnursehishawarehthaththehmusclehlayerhofhthehheart,hwhichhishresponsiblehforhthehheartshc
ontraction,hishthe:
a. endocardium.
b. pericardium.
c. mediastinum.
d. myocardium.
ANS:hD
Thehmyocardiumhishthehspecializedhmusclehlayerhthathallowshthehhearthtohcontract.h2
.Thehnursehclarifieshthaththehmasterhpacemakerhofhthehhearthishthe:
a. lefthventricle.
b. atrioventricularh(AV)hnode.
c. sinoatrialh(SA)hnode.
d. bundlehofhHis.
ANS:hC
ThehSAhnodehishthehmasterhpacemakerhofhthehheart.
3. Thehnursehishawarehthaththehsymptomshofhanhimpendinghmyocardialhinfarctionh(MI)hdifferhinhw
omenhbecausehacutehchesthpainhish nothpresent.hWomenharehfrequentlyhmisdiagnosedhashhaving:
a. hepatitishA.
b. indigestion.
c. urinaryhinfection.
d. menopausalhcomplications.
,ANS:hB
Indigestion,hgallbladderhattack,hanxietyhattack,handhdepressionharehfrequenthmisdiagnoseshforh
womenhhavinghanhMI.
4. ThehnursehidentifieshthehLUBBhsoundhofhthehLUBB/DUBBhofhthehcardiachcyclehashthehsoundhofht
he:
a. AVhvalveshclosing.
b. closurehofhthehsemilunarhvalves.
c. contractionhofhthehpapillaryhmuscles.
d. contractionhofhthehventricles.
ANS:hA
ThehLUBBhishthehfirsthsoundhofhahlowhpitchhheardhwhenhthehAVhvalveshclose.
5.Ahpatienthish admittedhfromhthehemergencyhdepartment.hThehemergencyhdepartmenthphysicianhn
oteshthehpatienthhashahdiagnosishofhhearthfailurehwithhahNewhYorkhHearthAssociationh(NYHA)hcla
ssificationhofhIV.hThish indicateshthehpatientshconditionhas:
a. moderatehhearthfailure.
b. severehhearthfailure.
c. congestivehhearthfailure.
d. negligiblehhearthfailure.
ANS:hB
ClasshIV:hSevere;hpatienthunablehtohperformhanyhphysicalhactivityhwithouthdiscomfort.hAnginahorhs
ymptomshofhcardiachinefficiencyhmayhdevelophathrest.
6. Thehnursehassesseshthaththehhomehhealthhpatienthhashnohsignshorhsymptomshofhhearthfailure,hbuthd
oeshhavehahhistoryhofhrheumatichfeverhandhhashbeenhrecentlyhdiagnosedhwithhdiabeteshmellitus.hTh
ehnursehishawarehthathusinghthehAmericanhCollegehofhCardiologyhandhthehAmericanhHearthAssoci
ationh(ACC/AHA)hstaging,hthishpatienthwouldhbeha:
a. stagehA.
b. stagehB.
c. stagehC.
d. stagehD.
ANS:hA
ThehACC/AHAhstaginghdescribeshstagehAhashahpersonhwithouthsymptomshofhhearthfailure,hbuth
withhprimaryhconditionsh associatedhwithhthehdevelopmenthofhthehdisease.
,7. Thehnursehcaringhforhahpatienthrecoveringhfromhahmyocardialhinfarcthwhohish onhremotehtelemetryhr
ecognizeshthehneedhforhaddedhinstructionhwhenhthehpatienthsays:
a. Ihcanhambulatehinhthehhallwayhwithhthishgadgethon.
b. IhalwayshtakehoffhthehtelemetryhdevicehwhenhIhshower.
c. MyhEKGh ishbeinghwatchedhbyhonehofhthehnursesh inhCCUhonhthehhomehunit.
d. Ihamhablehtohsleephjusthfinehwithhthishdevicehon.
ANS:hB
Remotehtelemetryhallowshthehpatienthtohbehonhahseparatehunit,hbuthbehmonitoredhinhahcentralhloc
ation.hThehpatientshcanhbehambulatoryhandhcanhsleephwithhthehmonitorhon.hThey
shouldhnothremovehthehmonitorhtohshower.
8. Thehnursehassesseshpittinghedemahthathcanhbehdepressedhapproximatelyhinchhandhrefillsh inh15hs
econds.hThehnursehwouldhdocumenththish assessmenthas:
a. +1hedema.
b. +2hedema.
c. +3hedema.
d. +4hedema.
ANS:hB
Ah+2hedemahcanhbehdocumentedhifhthehskinhcanhbehdepressedhinchhandhrespondhwithinh15hs
econds.
9. Whathdohdarkhorhcoldhspotsh onhahthalliumhscanhindicate?
a. Tissuehwithhadequatehbloodhsupply
b. Dilatedhvessels
c. Areashofhneoplastichgrowth
d. Tissuehthathhashinadequatehperfusion
ANS:hD
Thalliumhscanshshowhadequatehperfusedhareashbyhthehcollectionhofhthallium.hDarkhspotshorhcoldhs
potshindicatehtissueshthathhavehinadequatehperfusion.
10. Thehnursehrecognizeshthehechocardiogramhreporththathshowshanhejectionhfactorhofh42%hashanhi
ndicationhof:
a. normalhhearthaction.
b. mildhhearthfailure.
c. moderatehhearthfailure.
, d. severehhearthfailure.
ANS:hC
Anhejectionhfactorh(cardiachoutput)hofh42%hindicateshmoderatehhearthfailure.
11. Thehnursehtakeshintohconsiderationhthathage-
relatedhchangeshcanhaffecththehperipheralhcirculationhbecausehof:
a. sclerosedhbloodhvessels.
b. hypotension.
c. inactivity.
d. poorhnutrition.
ANS:hA
Aginghcauseshsclerotichchangeshinhthehbloodhvesselshthathleadhtohdecreasedhelasticityhandhn
arrowinghofhthehvesselhlumen.
12. ThehnursehassessinghahcardiachmonitorhnoteshthaththehcardiachcomplexesheachhhavehahPhwavehf
ollowedhbyhahQRShandhahT.hThehratehish120.hThehnursehrecognizeshthisharrhythmiahas:
a. sinushbradycardia.
b. atrialhfibrillation.
c. sinushtachycardia.
d. ventricularhtachycardia.
ANS:hC
SinushtachycardiahhashahPhwavehfollowedhbyhthehQRSh andhthehT.hAllhthehcomponentshofhthehc
omplexharehpresenthandh inhthehcorrecthorder,hbuththehratehish overh100hbeatshah minute.
13. Afterhanhinfluenza-
likehillness,hthehpatienthcomplainshofhchillshandhsmallhpetechiaehinhhishmouthhandhhish legs.hAhh
earthmurmurhishdetectable.hTheseharehcharacteristichsignshof:
a. congestivehhearthfailure.
b. hearthblock.
c. aortichstenosis.
d. infectivehendocarditis.
ANS:hD
Collectionhofhsubjectivehdatahincludeshnotinghpatienthcomplaintshofhinfluenza-
likehsymptomshwithhrecurrenthfever,hunduehfatigue,hchesthpain,handhchills.hObjectivehdatahmayhrevea
lhthehsignificant
