NUR361 CARDIAC EXAM 1 QUESTIONS
WITH VERIFIED ANSWERS AND
RATIONALES
\.22. The nurse is caring for a client with mitral valve stenosis. What clinical
manifestation alerts the nurse to the possibility that the client's stenosis has
progressed?
a. Oxygen saturation of 92%
b. Dyspnea on exertion
c. Muted systolic murmur
d. Upper extremity weakness - ANSWERS✔-B
Dyspnea on exertion develops as the mitral valvular orifice narrows and pressure
in the lungs increases.
\.23. The nurse is caring for a client diagnosed with aortic stenosis. What
assessment finding does the nurse expect in this client?
a. Bounding arterial pulse
b. Slow, faint arterial pulse
c. Narrowed pulse pressure
d. Elevated systolic pressure - ANSWERS✔-C
In aortic stenosis, the client presents with narrowed pulse pressure when blood
pressure (BP) is assessed.
,\.24. A client who has had a prosthetic valve replacement asks the nurse why he
must take anticoagulants for the rest of his life. What is the nurse's best response?
a. "The prosthetic valve places you at greater risk for a heart attack."
b. "Blood clots form more easily in artificial replacement valves."
c. "The vein taken from your leg reduces circulation in the leg."
d. "The surgery left a lot of small clots in your heart and lungs." - ANSWERS✔-B
Synthetic valve prostheses and scar tissue provide surfaces on which platelets can
aggregate easily and initiate the formation of blood clots.
\.25. The nurse is discharging a client home following mitral valve replacement.
What statement indicates that the client requires further education?
a. "I will be able to carry heavy loads after 6 months of rest."
b. "I will have my teeth cleaned by the dentist in 2 weeks."
c. "I will avoid eating foods high in vitamin K, like spinach."
d. "I will use an electric razor instead of a straight razor to shave." - ANSWERS✔-B
Clients who have defective or repaired valves are at high risk for endocarditis. The
client who has had valve surgery should avoid dental procedures for 6 months
because of the risk for endocarditis. When undergoing any invasive procedure, the
client needs to be placed on prophylactic antibiotics.
\.26. The nurse is obtaining the admission health history for a young adult who
presents with fever, dyspnea, and a murmur. What priority data does the nurse
inquire about?
a. Family history of coronary artery disease
, b. Recent travel to Third World countries
c. Pet ownership, especially cats with litter boxes
d. History of a systemic infection within the past month - ANSWERS✔-D
The clinical manifestations suggest infective endocarditis, which can occur within
2 to 4 weeks after a systemic infection or bacteremia. Assessing for coronary
artery disease, recent travel, or pet ownership is not related to endocarditis.
\.35. An older adult client is admitted with fluid volume excess. Which diagnostic
study does the nurse facilitate as a priority?
a. Echocardiography
b. Chest x-ray
c. T4 and thyroid-stimulating hormone (TSH)
d. Arterial blood gas - ANSWERS✔-A
Echocardiography is considered the best tool for the diagnosis of heart failure. A
chest x-ray probably will be done, and if the client has dyspnea, an arterial blood
gas will be drawn, but the echocardiogram is the priority. T4 and TSH might be
ordered to assess for a contributing cause of heart failure.
\.1. The nurse is taking the history of a client with suspected coronary artery
disease (CAD). Which situation correlates with stable angina?
a. Chest discomfort at rest and inability to tolerate mowing the lawn
b. Chest discomfort when mowing the lawn and subsiding with rest
c. Indigestion and a choking sensation when mowing the lawn
d. Jaw pain that radiates to the shoulder after mowing the lawn - ANSWERS✔-B
WITH VERIFIED ANSWERS AND
RATIONALES
\.22. The nurse is caring for a client with mitral valve stenosis. What clinical
manifestation alerts the nurse to the possibility that the client's stenosis has
progressed?
a. Oxygen saturation of 92%
b. Dyspnea on exertion
c. Muted systolic murmur
d. Upper extremity weakness - ANSWERS✔-B
Dyspnea on exertion develops as the mitral valvular orifice narrows and pressure
in the lungs increases.
\.23. The nurse is caring for a client diagnosed with aortic stenosis. What
assessment finding does the nurse expect in this client?
a. Bounding arterial pulse
b. Slow, faint arterial pulse
c. Narrowed pulse pressure
d. Elevated systolic pressure - ANSWERS✔-C
In aortic stenosis, the client presents with narrowed pulse pressure when blood
pressure (BP) is assessed.
,\.24. A client who has had a prosthetic valve replacement asks the nurse why he
must take anticoagulants for the rest of his life. What is the nurse's best response?
a. "The prosthetic valve places you at greater risk for a heart attack."
b. "Blood clots form more easily in artificial replacement valves."
c. "The vein taken from your leg reduces circulation in the leg."
d. "The surgery left a lot of small clots in your heart and lungs." - ANSWERS✔-B
Synthetic valve prostheses and scar tissue provide surfaces on which platelets can
aggregate easily and initiate the formation of blood clots.
\.25. The nurse is discharging a client home following mitral valve replacement.
What statement indicates that the client requires further education?
a. "I will be able to carry heavy loads after 6 months of rest."
b. "I will have my teeth cleaned by the dentist in 2 weeks."
c. "I will avoid eating foods high in vitamin K, like spinach."
d. "I will use an electric razor instead of a straight razor to shave." - ANSWERS✔-B
Clients who have defective or repaired valves are at high risk for endocarditis. The
client who has had valve surgery should avoid dental procedures for 6 months
because of the risk for endocarditis. When undergoing any invasive procedure, the
client needs to be placed on prophylactic antibiotics.
\.26. The nurse is obtaining the admission health history for a young adult who
presents with fever, dyspnea, and a murmur. What priority data does the nurse
inquire about?
a. Family history of coronary artery disease
, b. Recent travel to Third World countries
c. Pet ownership, especially cats with litter boxes
d. History of a systemic infection within the past month - ANSWERS✔-D
The clinical manifestations suggest infective endocarditis, which can occur within
2 to 4 weeks after a systemic infection or bacteremia. Assessing for coronary
artery disease, recent travel, or pet ownership is not related to endocarditis.
\.35. An older adult client is admitted with fluid volume excess. Which diagnostic
study does the nurse facilitate as a priority?
a. Echocardiography
b. Chest x-ray
c. T4 and thyroid-stimulating hormone (TSH)
d. Arterial blood gas - ANSWERS✔-A
Echocardiography is considered the best tool for the diagnosis of heart failure. A
chest x-ray probably will be done, and if the client has dyspnea, an arterial blood
gas will be drawn, but the echocardiogram is the priority. T4 and TSH might be
ordered to assess for a contributing cause of heart failure.
\.1. The nurse is taking the history of a client with suspected coronary artery
disease (CAD). Which situation correlates with stable angina?
a. Chest discomfort at rest and inability to tolerate mowing the lawn
b. Chest discomfort when mowing the lawn and subsiding with rest
c. Indigestion and a choking sensation when mowing the lawn
d. Jaw pain that radiates to the shoulder after mowing the lawn - ANSWERS✔-B
