Clinical Guidelines in Primary Care
m m m m
m4th Edition Test
m m
bank/StudyGuide
Chapterm1mCardiovascularmDisorders
MULTIPLEmCHOICE
1. Themnursemismawaremthat mthemmusclemlayermof mthemheart,mwhichmismresponsiblemformthemhea
rtsmcontraction,mismthe:
a. endocardium.
b. pericardium.
c. mediastinum.
d. myocardium.
ANS:mD
Themmyocardiummismthemspecialized mmusclem layermthat mallowsmthemheart mtomcontract.
2. Themnursemclarifiesmthat mthemmastermpacemakermof mthemheart mismthe:
a. left mventricle.
b. atrioventricularm(AV)mnode.
c. sinoatrialm(SA)mnode.
d. bundlemof mHis.
ANS:mC
ThemSAmnodemismthemmastermpacemakermof mthemheart.
3. Themnursemismawaremthat mthemsymptomsmof manmimpendingmmyocardialminfarctionm (MI)mdiffermi
nmwomenmbecausemacutemchest mpainmismnot mpresent.mWomenmaremfrequentlymmisdiagnosed masmha
ving:
a. hepatitismA.
b. indigestion.
c. urinaryminfection.
d. menopausalmcomplications.
,ANS:mB
Indigestion,mgallbladdermattack,manxietymattack,mand mdepressionmaremfrequent mmisdiagnosesmformw
omenmhavingmanmMI.
4. ThemnursemidentifiesmthemLUBB msound mof mthemLUBB/DUBBmof mthemcardiacmcyclemasmthemsound
of mthe:
m
a. AV mvalvesmclosing.
b. closuremof mthemsemilunarmvalves.
c. contractionmof mthempapillarymmuscles.
d. contractionmof mthemventricles.
ANS:mA
ThemLUBBmismthemfirst msound mof mamlow mpitchmheard mwhenmthemAVmvalvesmclose.
5. Ampatient mismadmitted mfrommthememergencymdepartment.mThememergency mdepartment mphysici
anmnotesmthempatient mhasmamdiagnosismof mheart mfailure mwithmamNew mYorkmHeart mAssociationm(N
YHA)mclassificationmof mIV.mThismindicatesmthempatientsmconditionmas:
a. moderatemheart mfailure.
b. severemheart mfailure.
c. congestivemheart mfailure.
d. negligiblemheart mfailure.
ANS:mB
ClassmIV:mSevere;mpatient munablemtomperformmanymphysicalmactivitymwithout mdiscomfort.mAnginam
ormsymptomsmof mcardiacminefficiencymmaymdevelopmat mrest.
6. Themnursemassessesmthat mthemhomemhealthmpatient mhasmnomsignsmormsymptomsmof mheart mfailure,m
but mdoesmhavemamhistorymof mrheumaticmfevermand mhasmbeenmrecentlymdiagnosed mwithmdiabetesmm
ellitus.mThemnursemismawaremthat musingmthemAmerican mCollege mof mCardiologymand mthemAmerican
mHeart mAssociationm(ACC/AHA)mstaging,mthismpatient mwould mbema:
a. stagemA.
b. stagemB.
c. stagemC.
d. stagemD.
ANS:mA
ThemACC/AHA mstagingmdescribesmstagemA masmampersonmwithout msymptomsmof mheart mfailure,mbut m
withmprimarymconditionsmassociated mwithmthemdevelopment mof mthemdisease.
,7. Themnursemcaringmformampatient mrecoveringmfrommammyocardialminfarct mwhomismon mremotemteleme
trymrecognizesmthemneed mformadded minstructionmwhenmthempatient msays:
a. I mcanmambulateminmthemhallwaymwithmthismgadget mon.
b. I malwaysmtakemoff mthemtelemetrymdevicemwhenmI mshower.
c. MymEKG mismbeingmwatched mbymonemof mthemnursesminmCCUmonmthemhomemunit.
d. I mammablemtomsleepmjust mfinemwithmthismdevicemon.
ANS:mB
Remotemtelemetrymallowsmthempatient mtombemonmamseparatemunit,mbut mbemmonitored minmamcentralmlo
cation.mThempatientsmcanmbemambulatorymand mcanmsleepmwithmthemmonitormon.mThey
should mnotmremovemthemmonitormtomshower.
8. Themnursemassessesmpittingmedemamthat mcanmbemdepressed mapproximatelyminchmand mrefillsmin m
15mseconds.mThemnursemwould mdocument mthismassessment mas:
a. +1medema.
b. +2medema.
c. +3medema.
d. +4medema.
ANS:mB
Am+2medemamcanmbemdocumented mif mthemskinmcanmbemdepressed minchmand mrespond mwithinm15msec
onds.
9. What mdomdarkmormcold mspotsmonmamthalliummscanmindicate?
a. Tissuemwithmadequatemblood msupply
b. Dilated mvessels
c. Areasmof mneoplasticmgrowth
d. Tissuemthat mhasminadequatemperfusion
ANS:mD
Thalliummscansmshowmadequatemperfused mareasmbymthemcollectionmof mthallium.mDarkmspotsmormcol
d mspotsmindicatemtissuesmthat mhaveminadequatemperfusion.
10. Themnursemrecognizesmthemechocardiogrammreport mthat mshowsmanmejectionmfactormof m42%masm
anmindicationmof:
a. normalmheart maction.
b. mild mheart mfailure.
c. moderatemheart mfailure.
, d. severemheart mfailure.
ANS:mC
Anmejectionmfactorm(cardiacmoutput)mof m42%mindicatesmmoderatemheart mfailure.
11. Themnursemtakesmintomconsiderationmthat mage-
related mchangesmcanmaffect mthemperipheralmcirculationmbecausemof:
a. sclerosed mblood mvessels.
b. hypotension.
c. inactivity.
d. poormnutrition.
ANS:mA
Agingmcausesmscleroticmchangesminmthemblood mvesselsmthat mlead mtomdecreased melasticitymand mnarro
wingmof mthemvesselmlumen.
12. Themnursemassessingmamcardiacmmonitormnotesmthat mthemcardiacmcomplexesmeachmhavema mPmwa
vemfollowed mbymamQRSmand mamT.mThemratemism120.mThemnursemrecognizes mthismarrhythmiamas:
a. sinusmbradycardia.
b. atrialmfibrillation.
c. sinusmtachycardia.
d. ventricularmtachycardia.
ANS:mC
SinusmtachycardiamhasmamPmwavemfollowed mbymthemQRSmand mthemT.mAllmthemcomponentsmof mthemc
omplexmarempresent mand minmthemcorrect morder,mbut mthemratemismoverm100mbeatsmamminute.
13. Aftermanminfluenza-
likemillness,mthempatient mcomplainsmof mchillsmand msmallmpetechiaem inmhismmouthmand mhismlegs
.mAmheart mmurmurmismdetectable.mThesemaremcharacteristicm signs mof:
a. congestivemheart mfailure.
b. heart mblock.
c. aorticmstenosis.
d. infectivemendocarditis.
ANS:mD
Collectionmof msubjectivemdatamincludesmnotingmpatient mcomplaintsmof minfluenza-
likemsymptomsmwithmrecurrent mfever,munduemfatigue,mchest mpain,mand mchills.mObjectivemdatammaymr
evealmthemsignificant
m m m m
m4th Edition Test
m m
bank/StudyGuide
Chapterm1mCardiovascularmDisorders
MULTIPLEmCHOICE
1. Themnursemismawaremthat mthemmusclemlayermof mthemheart,mwhichmismresponsiblemformthemhea
rtsmcontraction,mismthe:
a. endocardium.
b. pericardium.
c. mediastinum.
d. myocardium.
ANS:mD
Themmyocardiummismthemspecialized mmusclem layermthat mallowsmthemheart mtomcontract.
2. Themnursemclarifiesmthat mthemmastermpacemakermof mthemheart mismthe:
a. left mventricle.
b. atrioventricularm(AV)mnode.
c. sinoatrialm(SA)mnode.
d. bundlemof mHis.
ANS:mC
ThemSAmnodemismthemmastermpacemakermof mthemheart.
3. Themnursemismawaremthat mthemsymptomsmof manmimpendingmmyocardialminfarctionm (MI)mdiffermi
nmwomenmbecausemacutemchest mpainmismnot mpresent.mWomenmaremfrequentlymmisdiagnosed masmha
ving:
a. hepatitismA.
b. indigestion.
c. urinaryminfection.
d. menopausalmcomplications.
,ANS:mB
Indigestion,mgallbladdermattack,manxietymattack,mand mdepressionmaremfrequent mmisdiagnosesmformw
omenmhavingmanmMI.
4. ThemnursemidentifiesmthemLUBB msound mof mthemLUBB/DUBBmof mthemcardiacmcyclemasmthemsound
of mthe:
m
a. AV mvalvesmclosing.
b. closuremof mthemsemilunarmvalves.
c. contractionmof mthempapillarymmuscles.
d. contractionmof mthemventricles.
ANS:mA
ThemLUBBmismthemfirst msound mof mamlow mpitchmheard mwhenmthemAVmvalvesmclose.
5. Ampatient mismadmitted mfrommthememergencymdepartment.mThememergency mdepartment mphysici
anmnotesmthempatient mhasmamdiagnosismof mheart mfailure mwithmamNew mYorkmHeart mAssociationm(N
YHA)mclassificationmof mIV.mThismindicatesmthempatientsmconditionmas:
a. moderatemheart mfailure.
b. severemheart mfailure.
c. congestivemheart mfailure.
d. negligiblemheart mfailure.
ANS:mB
ClassmIV:mSevere;mpatient munablemtomperformmanymphysicalmactivitymwithout mdiscomfort.mAnginam
ormsymptomsmof mcardiacminefficiencymmaymdevelopmat mrest.
6. Themnursemassessesmthat mthemhomemhealthmpatient mhasmnomsignsmormsymptomsmof mheart mfailure,m
but mdoesmhavemamhistorymof mrheumaticmfevermand mhasmbeenmrecentlymdiagnosed mwithmdiabetesmm
ellitus.mThemnursemismawaremthat musingmthemAmerican mCollege mof mCardiologymand mthemAmerican
mHeart mAssociationm(ACC/AHA)mstaging,mthismpatient mwould mbema:
a. stagemA.
b. stagemB.
c. stagemC.
d. stagemD.
ANS:mA
ThemACC/AHA mstagingmdescribesmstagemA masmampersonmwithout msymptomsmof mheart mfailure,mbut m
withmprimarymconditionsmassociated mwithmthemdevelopment mof mthemdisease.
,7. Themnursemcaringmformampatient mrecoveringmfrommammyocardialminfarct mwhomismon mremotemteleme
trymrecognizesmthemneed mformadded minstructionmwhenmthempatient msays:
a. I mcanmambulateminmthemhallwaymwithmthismgadget mon.
b. I malwaysmtakemoff mthemtelemetrymdevicemwhenmI mshower.
c. MymEKG mismbeingmwatched mbymonemof mthemnursesminmCCUmonmthemhomemunit.
d. I mammablemtomsleepmjust mfinemwithmthismdevicemon.
ANS:mB
Remotemtelemetrymallowsmthempatient mtombemonmamseparatemunit,mbut mbemmonitored minmamcentralmlo
cation.mThempatientsmcanmbemambulatorymand mcanmsleepmwithmthemmonitormon.mThey
should mnotmremovemthemmonitormtomshower.
8. Themnursemassessesmpittingmedemamthat mcanmbemdepressed mapproximatelyminchmand mrefillsmin m
15mseconds.mThemnursemwould mdocument mthismassessment mas:
a. +1medema.
b. +2medema.
c. +3medema.
d. +4medema.
ANS:mB
Am+2medemamcanmbemdocumented mif mthemskinmcanmbemdepressed minchmand mrespond mwithinm15msec
onds.
9. What mdomdarkmormcold mspotsmonmamthalliummscanmindicate?
a. Tissuemwithmadequatemblood msupply
b. Dilated mvessels
c. Areasmof mneoplasticmgrowth
d. Tissuemthat mhasminadequatemperfusion
ANS:mD
Thalliummscansmshowmadequatemperfused mareasmbymthemcollectionmof mthallium.mDarkmspotsmormcol
d mspotsmindicatemtissuesmthat mhaveminadequatemperfusion.
10. Themnursemrecognizesmthemechocardiogrammreport mthat mshowsmanmejectionmfactormof m42%masm
anmindicationmof:
a. normalmheart maction.
b. mild mheart mfailure.
c. moderatemheart mfailure.
, d. severemheart mfailure.
ANS:mC
Anmejectionmfactorm(cardiacmoutput)mof m42%mindicatesmmoderatemheart mfailure.
11. Themnursemtakesmintomconsiderationmthat mage-
related mchangesmcanmaffect mthemperipheralmcirculationmbecausemof:
a. sclerosed mblood mvessels.
b. hypotension.
c. inactivity.
d. poormnutrition.
ANS:mA
Agingmcausesmscleroticmchangesminmthemblood mvesselsmthat mlead mtomdecreased melasticitymand mnarro
wingmof mthemvesselmlumen.
12. Themnursemassessingmamcardiacmmonitormnotesmthat mthemcardiacmcomplexesmeachmhavema mPmwa
vemfollowed mbymamQRSmand mamT.mThemratemism120.mThemnursemrecognizes mthismarrhythmiamas:
a. sinusmbradycardia.
b. atrialmfibrillation.
c. sinusmtachycardia.
d. ventricularmtachycardia.
ANS:mC
SinusmtachycardiamhasmamPmwavemfollowed mbymthemQRSmand mthemT.mAllmthemcomponentsmof mthemc
omplexmarempresent mand minmthemcorrect morder,mbut mthemratemismoverm100mbeatsmamminute.
13. Aftermanminfluenza-
likemillness,mthempatient mcomplainsmof mchillsmand msmallmpetechiaem inmhismmouthmand mhismlegs
.mAmheart mmurmurmismdetectable.mThesemaremcharacteristicm signs mof:
a. congestivemheart mfailure.
b. heart mblock.
c. aorticmstenosis.
d. infectivemendocarditis.
ANS:mD
Collectionmof msubjectivemdatamincludesmnotingmpatient mcomplaintsmof minfluenza-
likemsymptomsmwithmrecurrent mfever,munduemfatigue,mchest mpain,mand mchills.mObjectivemdatammaymr
evealmthemsignificant
