NCLEX Cardiovascular Flashcards

Terms Definitions
A patient with a tricuspid valve disorder will have impaired blood flow between the

A. vena cava and right atrium.
B. left atrium and left ventricle.
C. right atrium and right ventricle.
D. right ventricle and pulmonary artery.
C. right atrium and right ventricle.
A patient with an MI of the anterior wall of the left ventricle most likely has an occlusion of then

A. right marginal artery.
B. left circumflex artery.
C. left anterior descending artery.
D. right anterior descending artery.
C. left anterior descending artery.
If the Purkinje system is damaged, conduction of the electrical impulse is impaired through the

A. atria.
B. AV node.
C. ventricles.
D. bundle of His.
C. ventricles.
Prolonged pressure on the skin causes reddened areas at the point of contact due to

A. arterial vasodilation from smooth muscle relaxation.
B. compression of veins resulting in venous engorgement.
C. occlusion of major arteries causing infarction of the
D. tissue damage and inflammation resulting from impaired capillary blood flow.
When a person’s blood pressure rises, the homeostatic mechanism to compensate for an elevation involves stimulation of

A. chemoreceptors that inhibit the sympathetic nervous system, causing vasodilation.
B. baroreceptors that inhibit the parasympathet
C. baroreceptors that inhibit the sympathetic nervous system, causing a decreased heart rate.
When checking the capillary filling time of a patient, the color returns in 10 seconds. The nurse recognizes this finding as indicative of

A. a normal response.
B. thrombus formation in the veins.
C. lymphatic obstruction of venous return.
D. impaired a
D. impaired arterial flow to the extremities.
The auscultatory area in the left midclavicular line at the level of the fifth ICS is the

A. aortic area.
B. mitral area.
C. tricuspid area.
D. pulmonic area.
B. mitral area.
When assessing the patient, the nurse notes a palpable precordial thrill. This finding may be caused by

A. heart murmurs.
B. gallop rhythms.
C. pulmonary edema.
D. right ventricular hypertrophy.
A. heart murmurs.
When assessing the cardiovascular system of a 79-year-old patient, the nurse expects to find

A. a narrowed pulse pressure.
B. diminished carotid artery pulses.
C. difficulty in isolating the apical pulse.
D. an increased heart rate in response to stress
C. difficulty in isolating the apical pulse.
An important nursing responsibility for a patient having an invasive cardiovascular diagnostic study is

A. checking the peripheral pulses and percutaneous site.
B. instructing the patient about radioactive isotope injection.
C. informing the patient tha
A. checking the peripheral pulses and percutaneous site.
A P wave on an ECG represents an impulse

A. arising at the SA node and repolarizing the atria.
B. arising at the SA node and depolarizing the atria.
C. arising at the AV node and depolarizing the atria.
D. arising at the AV node and spreading to the bun
B. arising at the SA node and depolarizing the atria.
If a patient has decreased cardiac output caused by fluid volume deficit and marked vasodilation, the regulatory mechanism that will increase the blood pressure by improving both of these is

A. release of antidiuretic hormone (ADH).
B. secretion of pros
D. activation of the renin-angiotensin-aldosterone system.Q
While obtaining subjective assessment data from a patient with hypertension, the nurse recognizes that a modifiable risk factor for the development of hypertension is

A. hyperlipidemia.
B. excessive alcohol intake.
C. a family history of hypertension.
D
B. excessive alcohol intake.
Target organ damage that can occur from hypertension includes

A. headache and dizziness.
B. retinopathy and diabetes.
C. hypercholesterolemia and renal dysfunction.
D. renal dysfunction and left ventricular hypertrophy.
D. renal dysfunction and left ventricular hypertrophy.
A high-risk population that should be targeted in the primary prevention of hypertension is

A. smokers.
B. African Americans.
C. business executives.
D. middle-aged women.
B. African Americans.
In teaching a patient with hypertension about controlling the condition, the nurse recognizes that

A. all patients with elevated BP require medication.
B. it is not necessary to limit salt in the diet if taking a diuretic.
C. obese persons must achieve
D. lifestyle modifications are indicated for all persons with elevated BP.
A major consideration in the management of the older adult with hypertension is to

A. prevent pseudohypertension from converting to true hypertension.
B. recognize that the older adult is less likely to comply with the drug therapy than a younger adult.
D. use careful technique in assessing the BP of the patient because of the possible presence of an auscultatory gap.
A patient with newly diagnosed hypertension has a blood pressure of 158/98 after 12 months of exercise and diet modifications. The nurse advises the patient that

A. medication may be required because the BP is still not within the normal range.
B. conti
A. medication may be required because the BP is still not within the normal range.
A patient is admitted to the hospital in hypertensive crisis. The nurse recognizes that the hypertensive urgency differs from hypertensive emergency in that

A. the BP is always higher in a hypertensive emergency.
B. hypertensive emergencies are associat
B. hypertensive emergencies are associated with evidence of target organ damage.
In teaching a patient about coronary artery disease, the nurse explains that the changes that occur in this disorder involve

A. diffuse involvement of plaque formation in coronary veins.
B. formation of fibrous tissue around coronary artery orifices.
C.
C. accumulation of lipid and fibrous tissue within the coronary arteries.
After teaching about ways to decrease risk factors for CAD, the nurse recognizes that additional instruction is needed when the patient says,

A. “I would like to add weight lifting to my exercise program.”
B. “I can’t keep my blood pressure norm
A. “I would like to add weight lifting to my exercise program.”
A hospitalized patient with angina tells the nurse that she is having chest pain. The nurse bases her actions on the knowledge that anginal pain

A. will be relieved by rest, nitroglycerin, or both.
B. is less severe than pain of a myocardial infarction.
A. will be relieved by rest, nitroglycerin, or both.
The clinical spectrum of acute coronary syndrome includes

A. unstable angina and STEMI.
B. unstable angina and NSTEMI.
C. stable angina and sudden cardiac death.
D. unstable angina, STEMI, and NSTEMI.
D. unstable angina, STEMI, and NSTEMI.
In planning activity for the patient recovering from an MI, the nurse recognizes that the healing heart wall is most vulnerable to stress

A. 3 weeks after the infarction.
B. 4 to 6 days after the infarction.
C. 10 to 14 days after the infarction.
D. whe
C. 10 to 14 days after the infarction.
A patient is admitted to the CCU with chest pain of 24 hours’ duration, ECG findings consistent with an acute MI, and occasional ventricular arrhythmias. The nurse plans care for the patient based on the expectation that the patient will be managed with
C. continuous ECG monitoring.
The most common pathologic finding in individuals with sudden cardiac death is

A. cardiomyopathies.
B. mitral valve disease.
C. atherosclerotic heart disease.
D. left ventricular hypertrophy.
C. atherosclerotic heart disease.
A compensatory mechanism involved in congestive heart failure that leads to inappropriate fluid retention and additional workload of the heart is

A. ventricular dilation.
B. ventricular hypertrophy.
C. neurohormonal response.
D. sympathetic nervous syst
C. neurohormonal response.
The drug used in the management of a patient with acute pulmonary edema that will decrease both preload and afterload and provide relief of anxiety is

A. morphine.
B. amrinone.
C. dobutamine.
D. aminophylline.
A. morphine.
A patient with chronic congestive heart failure and atrial fibrillation is treated with a digitalis preparation and a loop diuretic. To prevent possible complications of this combination of drugs, the nurse needs to

A. monitor serum potassium levels.
B.
A. monitor serum potassium levels.
The nurse plans care for the patient with dilated cardiomyopathy based on the knowledge that

A. family members may be at risk because of the infectious nature of the disease.
B. medical management of the disorder focuses on treatment of the underlying c
C. the prognosis of the patient is poor, and emotional support is a high priority of care.
The primary causes of death in patients with heart transplants in the first year include

A. infection and rejection.
B. rejection and arrhythmias.
C. arrhythmias and infection.
D. myocardial infarction and lymphoma.
A. infection and rejection.
A patient with a stable blood pressure and no symptoms has the following electrocardiogram characteristics: atrial rate—74 and regular; ventricular rate—62 and irregular; P wave—normal contour; PR interval—lengthens progressively until a P wave is
D. careful observation for symptoms of hypotension.
The cardiac monitor of a patient in the cardiac care unit following an acute MI indicates ventricular bigeminy. The nurse anticipates

A. performing defibrillation.
B. treatment with IV lidocaine.
C. insertion of a temporary pacemaker.
D. continuing moni
B. treatment with IV lidocaine.
The nurse prepares a patient for electrical cardioversion knowing that cardioversion differs from defibrillation in that

A. defibrillation requires a greater dose of electrical current.
B. defibrillation is synchronized to countershock during the QRS co
D. cardioversion may be done on a nonemergency basis with sedation of the patient.
When providing discharge instructions to a patient with a new permanent pacemaker, the nurse teaches the patient to

A. take and record a daily pulse rate.
B. request special hand scanning at airport and other security gates.
C. immobilize the arm and sh
A. take and record a daily pulse rate.
The nurse plans care for the patient with an implantable cardioverter-defibrillator based on the knowledge that

A. antiarrhythmia drugs can be discontinued.
B. all members of the patient’s family should learn CPR.
C. the patient should not drive until
B. all members of the patient’s family should learn CPR.
A 62-year-old woman weighs 92 kg and has a history of daily alcohol intake, smoking, high blood pressure, high sodium intake, and sedentary lifestyle. The nurse identifies the risk factors most highly related to peripheral arterial disease in this patient
C. cigarette smoking and hypertension.
Significant risk factors for peripheral arterial disease include

A. sedentary lifestyle, stress, obesity.
B. advanced age, female gender, familial tendency.
C. cigarette smoking, hyperlipidemia, hypertension.
D. protein S deficiency, protein C deficienc
C. cigarette smoking, hyperlipidemia, hypertension.
Rest pain is a manifestation of peripheral arterial disease that occurs as a result of

A. the beginning of a venous leg ulcer.
B. inadequate blood flow to the nerves of the feet.
C. inadequate blood flow to the muscles during exercise.
D. inadequate blo
B. inadequate blood flow to the nerves of the feet.
A patient with infective endocarditis develops sudden left leg pain with pallor, paresthesia, and a loss of peripheral pulses. The nurse’s initial action should be to

A. notify the physician.
B. elevate the leg to promote venous return.
C. wrap the le
A. notify the physician.
The patient who is most likely to have the highest risk for deep vein thrombosis is a

A. 25-year-old obese woman who is 3 days postpartum.
B. 40-year-old woman who smokes and uses oral contraceptives.
C. 62-year-old man who has had a stroke with left-si
B. 40-year-old woman who smokes and uses oral contraceptives.
The nurse suspects the presence of a deep vein thrombosis based on the findings of

A. paresthesia and coolness of the leg.
B. pain in the calf that occurs with exercise.
C. generalized edema of the involved extremity.
D. pallor and cyanosis of the invol
C. generalized edema of the involved extremity.
Nursing interventions indicated in the plan of care for the patient with acute lower extremity deep vein thrombosis include

A. applying elastic compression stockings.
B. administering anticoagulants as ordered.
C. positioning the leg dependently to prom
B. administering anticoagulants as ordered.
The nurse instructs the patient discharged on anticoagulant therapy to

A. limit intake of vitamin C.
B. report symptoms of nausea to the physician.
C. have blood drawn routinely to check electrolytes.
D. be aware of and report signs or symptoms of bleed
D. be aware of and report signs or symptoms of bleeding.
A patient with a deep vein thrombosis suddenly develops dyspnea, tachypnea, and chest pain. Initially the most appropriate action by the nurse is to

A. auscultate for abnormal lung sounds.
B. administer oxygen and notify the physician.
C. ask the patien
D. elevate the head of the bed 30 to 45 degrees to facilitate breathing.
A person who starts smoking in adolescence and continues to smoke into middle age:

A. Has an increased risk for alcoholism
B. Has an increased risk for obesity and diabetes
C. Has an increased risk for stress-related illnesses
D. Has an increased risk f
D. Has an increased risk for cardiopulmonary disease and lung cancer

The risk of lung cancer is 10 times greater for a person who smokes than for a nonsmoker. Cigarette smoking worsens peripheral vascular and coronary artery disease. Inhaled nicotine causes vasoconstriction of peripheral and coronary blood vessels, increasing blood pressure and decreasing blood flow to peripheral vessels.
Conditions such as shock and severe dehydration resulting from extracellular fluid loss cause:

A. Hypoxia
B. Hypovolemia
C. Hypervolemia
D. Uncontrolled bleeding
B. Hypovolemia

Conditions such as shock and severe dehydration cause extracellular fluid loss and reduced circulating blood volume (hypovolemia).
Left-sided heart failure is characterized by:

A. Increased cardiac output
B. Lowered cardiac pressures
C. Decreased functioning of the left atrium
D. Decreased functioning of the left ventricle
D. Decreased functioning of the left ventricle

Left-sided heart failure is an abnormal condition characterized by decreased functioning of the left ventricle. If left ventricular failure is significant, the amount of blood ejected from the left ventricle drops greatly, which results in decreased cardiac output.
The nurse is concerned when a client's heart rate, which is normally 95 beats per minute, rises to 220 beats per minute, because a rate this high will:

A. Exhaust the client
B. Decrease metabolic rate
C. Reduce coronary artery perfusion
D. Provide too m
C. Reduce coronary artery perfusion

Coronary arteries fill and perfuse the myocardium (heart muscle) during diastole. When the heart rate is elevated, more time is spent in systole and less in diastole; hence, the myocardium may not be perfused adequately. The client may be exhausted, but the primary concern is myocardial perfusion. Major organs will adjust to increased blood flow. This is usually not a problem. With a heart rate this high, metabolic rate will be increased, not decreased.
The nurse is caring for a client who has undergone cardiac catheterization. The client says to the nurse, "The doctor said my cardiac output was 5.5 L/min. What is normal cardiac output?" Which of the following is the nurse's best response?

A.
C. "The normal cardiac output for an adult is 4 to 6 L/min."
A client asks why smoking is a major risk factor for heart disease. In formulating a response, the nurse incorporates the understanding that nicotine:

A. Causes vasodilation
B. Causes vasoconstriction
C. Increases the level of high-density lipoproteins
B. Causes vasoconstriction
The nurse suspects left-sided heart failure in a newly admitted client when the nurse notes which of the following symptoms? (Select all that apply.)

A. Distended neck veins
B. Bilateral crackles in the lungs
C. Weight gain of 2 lb in past 2 days
D. Sho
B. Bilateral crackles in the lungs
D. Shortness of breath, especially at night

Left-sided heart failure results in ineffective ejection of blood from the left ventricle. This causes a backup of blood into the lungs. Thus, symptoms of left-sided heart failure are usually related to the lungs.
A thoracic aortic aneurysm is found when a patient has a routine chest x-ray. The nurse anticipates that additional diagnostic testing to determine the size and structure of the aneurysm will include:

a. CT scan
B. angiography
c. echocardiography
d. ultr
a. CT scan
A patient with a small abdominal aneurysm is not a good surgical candidate. The nurse teaches the patient that one of the best ways to prevent expansion of the lesion is to:
control hypertension with prescribed therapy.
During preoperative prep of patient scheduled for an abdominal aortic aneurysm the nurse establishes basline data for the patient knowing that

a. postop all pphysiologic processes will be altered
b. The cause of the aneurysm is a systemic vasuclar disea
b. The cause of the aneurysm is a systemic vascular disease
During the patient's acute postop period following repair of an aneurysm, the nurse should ensure that:

a. hypothermia is maintained to decrease 02 need
b. the blood pressure and all peripheral pulses are evaluated at least every hour
c. IV fluids are ad
b. the blood pressure and all peripheral pulses are evaluated at least every hour
Following an ascending aortic aneurysm repair, the nurse monitors for and immediately reports:

a. shallow resp and poor coughing
b. decreased drainaged from chest tubes
c. change in level of consciousness and ability to speak
d. lower extremity pulses th
c. change in level of consciousness and ability to speak
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