Critical Care Cardiovascular Function exam with correct answers 2024.

For both outpatients and inpatients scheduled for diagnostic procedures of the cardiovascular system, the nurse performs a thorough initial assessment to establish an accurate baseline data. Which of the following data is necessary to collect if the patient is experiencing chest pain? - ANSWER-Description of the pain When caring for a client with dysfunction in the conduction system, at which period would the nurse note that cells are resistant to stimulation? - ANSWER-During the refractory period The ability of the cardiac muscle to shorten in response to an electrical impulse is termed which of the following? - ANSWER-Contractility The nurse prepares to auscultate heart sounds. Which nursing interventions would be most effective to assist with this procedure? - ANSWER-Explain to the client that the nurse will be listening to different areas of the chest and may listen for a long time, but that does not mean that anything abnormal is heard. The nurse is administering a beta blocker to a patient in order to decrease automaticity. Which medication will the nurse administer? - ANSWER-Lopressor The nurse in a cardiac clinic is taking vital signs of a 58-year-old man who is 3 months status post myocardial infarction (MI). While the physician is seeing the client, the client's spouse approaches the nurse and asks about sexual activity. "We are too afraid he will have another heart attack, so we just don't have sex anymore." The nurse's best response is which of the following? - ANSWER-"The physiologic demands are greatest during orgasm and are equivalent to walking 3 to 4 miles per hour on a treadmill." The nurse is taking a health history from a client admitted with the medical diagnosis of cardiovascular disease (CVD). Identify which of the following symptoms indicate CVD. - ANSWER-Chest pain, weight gain, fatigue The nurse is preparing to apply ECG electrodes to a male patient who requires continuous cardiac monitoring. Which of the following should the nurse complete to optimize skin adherence and conduction of the heart's electrical current? - ANSWER-Clip the patient's chest hair prior to applying the electrodes. The client with a diagnosis of heart failure reports frequently awakening during the night with the need to urinate. The nurse offers which explanation? - ANSWER-Edema is collected in dependent extremities during the day; at night when the client lays down, it is reabsorbed into the circulation and excreted by the kidneys. A patient has been diagnosed with congestive heart failure (CHF). The physician has ordered a medication to enhance contractility. The nurse would expect which medication to be ordered for the patient? - ANSWER-Digoxin (Lanoxin) You are the clinic nurse doing assessments on your clients before they have outpatient diagnostic testing done. What would you document when assessing the client's pulse? - ANSWER-Rate, quality, and rhythm The client is admitted for a scheduled cardiac catheterization. On the morning of the procedure, while assessing the client's morning laboratory values, the nurse notes a blood urea nitrogen (BUN) of 34 mg/dL and a creatinine of 4.2 mg/dL. The nurse makes it a priority to notify the physician for which of the following reasons? - ANSWER-The client is at risk for renal failure due to the contrast agent that will be given during the procedure. The nurse correctly identifies which of the following data as an example of BP and HR measurements in a patient with postural hypotension? - ANSWER-Supine: BP 120/70 mm Hg, HR 70 bpm; sitting: BP 100/55 mm Hg, HR 90 bpm; standing: BP 98/52 mm Hg, HR 94 bpm For both outpatients and inpatients scheduled for diagnostic procedures of the cardiovascular system, the nurse performs a thorough initial assessment to establish accurate baseline data. Which of the following data is necessary to collect if the patient is experiencing chest pain? - ANSWER-Description of the pain The clinic nurse caring for a client with a cardiovascular disorder is performing an assessment of the client's pulse. Which of the following steps is involved in determining the pulse deficit? - ANSWER-Count the heart rate at the apex. Within the physiology of the heart, each chamber has a particular role in maintaining cellular oxygenation. Which chamber of the heart is responsible for receiving oxygenated blood from the lungs? - ANSWER-Left atrium The nurse is reviewing discharge instructions with a patient who underwent a left groin cardiac catheterization 8 hours ago. Which of the following instructions should the nurse include? - ANSWER-"Do not bend at the waist, strain, or lift heavy objects for the next 24 hours." A student nurse is to perform a cardiac assessment for a client and asks the instructor why the aortic valve closure is best heard on the right side of the sternum. The best response of the nurse is which of the following? - ANSWER-"The aortic arch causes the closure of the aortic valve to be heard best on the right side of the sternum." It is important for a nurse to understand cardiac hemodynamics. For blood to flow from the right ventricle to the pulmonary artery, the following must occur: - ANSWER-Right ventricular pressure must be higher than pulmonary arterial pressure. A 52-year-old female patient is going through menopause and asks the nurse about estrogen replacement for its cardioprotective benefits. What is the best response by the nurse? - ANSWER-"Current evidence indicates that estrogen is ineffective as a cardioprotectant; estrogen is actually potentially harmful and is no longer a recommended therapy." After a physical examination, the provider diagnosed a patient with a grade 4 heart murmur. During assessment, the nurse expects to hear a murmur that is: - ANSWER-Loud and may be associated with a thrill sound similar to (a purring cat). The nurse is reviewing the results of the patient's echocardiogram and observes that the ejection fraction is 35%. The nurse anticipates that the patient will receive treatment for what condition? - ANSWER-Heart failure When the balloon on the distal tip of a pulmonary artery catheter is inflated and a pressure is measured, the measurement obtained is referred to as the - ANSWER-pulmonary artery wedge pressure. The nurse is caring for a client anticipating further testing related to cardiac blood flow. Which statement, made by the client, would lead the nurse to provide additional teaching? - ANSWER-"My niece thought that I would be ordered a magnetic resonance imaging even though I have a pacemaker." The nurse is assessing the cardiovascular status of a client who was found unresponsive in a lobby area. Following transfer of the client, the family asks how blood circulates through the body. The nurse is most correct to state the proper circulation as which? Place the pattern of circulation in the correct order beginning in the right atrium. Use all options. - ANSWER-• Right ventricle • Pulmonary Artery • Pulmonary Vein • Left Atrium • Left Ventricle • Aorta Decreased pulse pressure reflects which of the following? - ANSWER-Reduced stroke volume A 97-year-old client with a history of atrial fibrillation is being admitted to the assisted living center where you practice nursing. In your initial assessment, you measure his apical pulse and compare it to his peripheral pulse. The difference between the two is known as what? - ANSWER-Pulse deficit Within the physiology of the heart, each chamber has a particular role in maintaining cellular oxygenation. Which chamber of the heart is responsible for pumping blood to all the cells and tissues of the body? - ANSWER-Left ventricle The nurse is caring for a patient with clubbing of the fingers and toes. The nurse should complete which of the following actions given these findings? - ANSWER-Obtain an oxygen saturation level. The nurse is assessing heart sounds in a patient with heart failure. An abnormal heart sound is detected early in diastole. How would the nurse document this? - ANSWER-S3 The nurse reviews a patient's lab results and notes a serum calcium level of 7.9 mg/dL. The nurse knows that this reading can also be associated with which of the following? - ANSWER-Impaired myocardial contractility The nurse is assessing a patient who complains of feeling "light-headed." When obtaining orthostatic vital signs, what does the nurse determine is a significant finding? - ANSWER-A heart rate of more than 20 bpm above the resting rate You are monitoring the results of laboratory tests performed on a client admitted to the cardiac ICU with a diagnosis of myocardial infarction. Which test would you expect to show elevated levels? - ANSWER-Enzymes Within the heart, several structures and several layers all play a part in protecting the heart muscle and maintaining cardiac function. The inner layer of the heart is composed of a thin, smooth layer of cells, the folds of which form heart valves. What is the name of this layer of cardiac tissue? - ANSWER-Endocardium A nurse assessing a client who underwent cardiac catheterization finds the client lying flat on the bed. His temperature is 99.8° F (37.7° C). His blood pressure is 104/68 mm Hg. His pulse rate is 76 beats/minute. She detects weak pulses in the leg distal to the puncture site. Skin on the leg is cool to the touch. The puncture site is dry, but swollen. What is the most appropriate action for the nurse to take? - ANSWER-Contact the physician and report her findings. The nurse is caring for a client on a monitored telemetry unit. During morning assessment, the nurse notes abnormal ECG waves on the telemetry monitor. Which action would the nurse do first? - ANSWER-Assess the client. The nurse is caring for a patient with a diagnosis of pericarditis. Where does the nurse understand the inflammation is located? - ANSWER-The thin fibrous sac encasing the heart When assessing a patient with left-sided heart failure, what would be noted on auscultation of lungs? - ANSWER-Wheezes with wet lung sounds You are caring for a client with a damaged tricuspid valve. You know that the tricuspid valve is held in place by which of the following? - ANSWER-Chordae tendineae The nurse is assessing a patient's blood pressure. What does the nurse document as the difference between the systolic and the diastolic pressure? - ANSWER-Pulse pressure Which of the following is an early warning symptom of acute coronary syndrome (ACS) and heart failure (HF)? - ANSWER-Fatigue The nurse is awaiting results of cardiac biomarkers for a patient with severe chest pain. The nurse would identify which cardiac biomarker as remaining elevated the longest when myocardial damage has occurred? - ANSWER-Troponin T and I The patient has a heart rate of 72 bpm with a regular rhythm. Where does the nurse determine the impulse arises from? - ANSWER-The sinoatrial node A nurse is aware that the patient's heart rate is influenced by many factors. The nurse understands that the heart rate can be decreased by: - ANSWER-Stimulation of the vagus nerve. The nurse is caring for a client with an elevated blood pressure and no previous history of hypertension. At 0900, the blood pressure was 158/90 mm Hg. At 0930, the blood pressure is 142/82 mm Hg. The nurse is most correct when relating the fall in blood pressure to which structure? - ANSWER-Baroreceptors A patient's heart rate is observed to be 140 bpm on the monitor. The nurse knows that the patient is at risk for what complication? - ANSWER-Myocardial ischemia A nurse working in a cardiac step-down unit understands that the following drugs can affect the contractility of the heart. The nurse recognizes that contractility is depressed by which of the following drugs? - ANSWER-Lopressor The nurse admits a 52-year-old woman with a medical diagnosis of "rule out MI." The client is very frightened and expresses surprise that a woman would have heart problems. Which of the following responses by the nurse would be most appropriate? - ANSWER-"A woman's heart is smaller and has smaller arteries that become occluded more easily." The area of the heart that is located at the third intercostal (IC) space to the left of the sternum is which of the following? - ANSWER-Erb's point The nurse is caring for an elderly client with left-sided heart failure. When auscultating lung sounds, which adventitious sound is expected? - ANSWER-Crackles A 79-year-old client with a history of right-sided heart failure lives in the long-term care facility where you practice nursing. In your daily assessment, you are required to record the level of this client's peripheral edema. Which of the following would be the main area for examination? - ANSWER-Feet and ankles The nurse is caring for a patient with an intra-arterial BP monitoring device. The nurse recognizes the most preventable complication associated with hemodynamic monitoring includes which of the following? - ANSWER-Catheter-related bloodstream infections (CRBSI) The nurse is providing discharge instructions to a client with unstable angina. The client is ordered Nitrostat 1/150 every 5 minutes as needed for angina. Which side effect, emphasized by the nurse, is common especially with the increased dosage? - ANSWER-Orthostatic hypotension The nurse is caring for a patient prescribed warfarin (Coumadin) orally. The nurse reviews the patient's prothrombin time (PT) level to evaluate the effectiveness of the medication. The nurse should also evaluate which of the following laboratory values? - ANSWER-International normalized ratio (INR) Which of the follow arteries carries deoxygenated blood? - ANSWER-Pulmonary artery Within the physiology of the heart, each chamber has a particular role in maintaining cellular oxygenation. Which chamber of the heart is responsible for pumping blood to the lungs to be oxygenated? - ANSWER-Right ventricle A patient had a cardiac catheterization and is now in the recovery area. What nursing interventions should be included in the plan of care? (Select all that apply.) - ANSWER-• Checking the insertion site for hematoma formation • Evaluating temperature and color in the affected extremity • Assessing the peripheral pulses in the affected extremity A client is experiencing an irregular heartbeat. The client asks the nurse how a heartbeat occurs. The nurse explains the conduction system of the heart beginning with the sinoatrial node (SA node). Place the conduction sequence of the heart in order beginning with the SA node. Use all options. - ANSWER-• Atrial cell stimulation • AV node • Bundle of His • Bundle branches • Purkinje fibers The nurse is caring for a client with ECG changes consistent with a myocardial infarction. Which of the following diagnostic test does the nurse anticipate to confirm heart damage? - ANSWER-Nuclear cardiology The area of the heart that is located at the third IC space to the left of the sternum is the - ANSWER-Erb's point. A patient is admitted to a hospital to confirm a diagnosis of postural hypotension. The nurse assesses the patient's blood pressure every 4 hours. Which of the following is an indicator of postural hypotension that occurs when the patient moves from a lying to a sitting or standing position? - ANSWER-Heart rate increased from 85 to 110 bpm. The nurse is reviewing the results of the patient's echocardiogram and observes that the ejection fraction is 35%. The nurse anticipates that the patient will receive treatment for what condition? - ANSWER-Heart failure