TEST BANK
GUIDELINES IN PRIMARY CARE, 4TH EDITION
Amelie Hollier
,Clinical Guidelines in Primary Care 4th Edition Hollier Test Bank
Table of Contents
Chapter 1: Cardiovascular Disorders
Chapter 2: Dermatologic Disorders
Chapter 3: Ear Nose & Throat Disorders
Chapter 4: Endocrine Disorders
Chapter 5: Gastrointestinal Disorders
Chapter 6: Genetic Disorders
Chapter 7: Health Promotion - Pediatric
Chapter 8: Hematologic Disorders
Chapter 9: Lactation and Breastfeeding
Chapter 10: Men’s Health Disorders
Chapter 11: Neurologic Disorders
Chapter 12: Ophthalmic Disorders
Chapter 13: Orthopedic Disorders
Chapter 14: Pregnancy
Chapter 15: Psychiatric Disorders, Violence, Abuse, Neglect
Chapter 16: Pulmonary Disorders
Chapter 17: Sexually Transmitted Diseases
Chapter 18: Urologic Disorders
Chapter 19: Women’s Health Disorders
,Chapter 1: Cardiovascular Disorders
Clinical Guidelines in Primary Care 4th Edition Test bank
MULTIPLE CHOICE
1. The nurse is aware that the muscle layer of the heart, which is responsible for the hearts
contraction, is the:
a. endocardium.
b. pericardium.
c. mediastinum.
d. myocardium.
ANS: D
The myocardium is the specialized muscle layer that allows the heart to contract.
2. The nurse clarifies that the master pacemaker of the heart is the:
a. left ventricle.
b. atrioventricular (AV) node.
c. sinoatrial (SA) node.
d. bundle of His.
ANS: C
The SA node is the master pacemaker of the heart.
3. The nurse is
aware that the symptoms of an impending myocardial infarction (MI) differ in
women because acute chest pain is not present. Women are frequently misdiagnosed as having:
a. hepatitis A.
b. indigestion.
c. urinary infection.
d. menopausal complications.
,ANS: B
Indigestion, gallbladder attack, anxiety attack, and depression are frequent misdiagnoses for
women having an MI.
4. The nurse identifies the LUBB sound of the LUBB/DUBB of the cardiac cycle as the sound of
the:
a. AV valves closing.
b. closure of the semilunar valves.
c. contraction of the papillary muscles.
d. contraction of the ventricles.
ANS: A
The LUBB is the first sound of a low pitch heard when the AV valves close.
5. A patient is admitted from the emergency department. The emergency department physician
notes the patient has a diagnosis of heart failure with a New York Heart Association (NYHA)
classification of IV. This indicates the patients condition as:
a. moderate heart failure.
b. severe heart failure.
c. congestive heart failure.
d. negligible heart failure.
ANS: B
Class IV: Severe; patient unable to perform any physical activity without discomfort. Angina or
symptoms of cardiac inefficiency may develop at rest.
6. The nurse assesses that the home health patient has
no signs or symptoms of heart failure, but
does have a history of rheumatic fever and has been recently diagnosed with diabetes mellitus.
The nurse is aware that using the American College of Cardiology and the American Heart
Association (ACC/AHA) staging, this patient would be a:
a. stage A.
b. stage B.
c. stage C.
d. stage D.
ANS: A
The ACC/AHA staging describes stage A as a person without symptoms of heart failure, but
with primary conditions associated with the development of the disease.
,7. The znurse zcaring zfor za zpatient zrecovering zfrom za zmyocardial zinfarct zwho zis zon zremote
ztelemetry zrecognizes zthe zneed zfor zadded zinstruction zwhen zthe zpatient zsays:
a. I zcan zambulate zin zthe zhallway zwith zthis zgadget zon.
b. I zalways z take zoff zthe ztelemetry zdevice zwhen z I zshower.
c. My zEKG zis zbeing zwatched zby zone zof zthe znurses z in zCCU zon zthe zhome zunit.
d. I zam zable zto zsleep zjust zfine zwith zthis zdevice zon.
ANS: zB
Remote ztelemetry zallows zthe zpatient zto zbe zon za zseparate zunit, zbut zbe zmonitored zin za zcentral
zlocation. zThe zpatients zcan zbe zambulatory zand zcan zsleep zwith zthe zmonitor zon. zThey
should znot zremove zthe zmonitor zto zshower.
8. The znurse zassesses zpitting zedema zthat zcan zbe zdepressed zapproximately zinch zand zrefills
zin z15 zseconds. zThe znurse zwould zdocument zthis zassessment zas:
a. +1 zedema.
b. +2 zedema.
c. +3 zedema.
d. +4 zedema.
ANS: zB
A z+2 zedema zcan zbe zdocumented zif zthe zskin zcan zbe zdepressed zinch zand zrespond zwithin z15
zseconds.
9. What zdo zdark zor z cold zspots z on za zthallium zscan zindicate?
a. Tissue zwith zadequate zblood zsupply
b. Dilated zvessels
c. Areas zof zneoplastic zgrowth
d. Tissue zthat zhas zinadequate zperfusion
ANS: zD
Thallium zscans zshow zadequate zperfused zareas zby zthe zcollection zof zthallium. zDark zspots zor
zcold zspots zindicate ztissues zthat zhave zinadequate zperfusion.
10. The znurse zrecognizes zthe zechocardiogram zreport zthat zshows zan zejection zfactor zof z42%
zas zan zindication zof:
a. normal zheart zaction.
b. mild zheart zfailure.
c. moderate zheart zfailure.
, d. severe zheart zfailure.
ANS: zC
An zejection zfactor z(cardiac zoutput) zof z42% zindicates zmoderate zheart zfailure.
11. The znurse ztakes zinto zconsideration zthat zage-related zchanges zcan zaffect zthe
zperipheral zcirculation zbecause zof:
a. sclerosed zblood zvessels.
b. hypotension.
c. inactivity.
d. poor znutrition.
ANS: zA
Aging zcauses zsclerotic zchanges zin zthe zblood zvessels zthat zlead zto zdecreased zelasticity zand
znarrowing zof zthe zvessel zlumen.
12. The znurse zassessing za zcardiac zmonitor znotes zthat zthe zcardiac zcomplexes zeach zhave za zP
zwave zfollowed zby za zQRS zand za zT. zThe zrate zis z120. zThe znurse zrecognizes zthis zarrhythmia
zas:
a. sinus zbradycardia.
b. atrial zfibrillation.
c. sinus ztachycardia.
d. ventricular ztachycardia.
ANS: zC
Sinus ztachycardia zhas za zP zwave zfollowed zby zthe zQRS zand zthe zT. zAll zthe zcomponents zof zthe
zcomplex zare zpresent zand zin zthe zcorrect zorder, zbut zthe zrate zis zover z100 zbeats za zminute.
13. After zan zinfluenza-like zillness, zthe zpatient zcomplains zof zchills zand zsmall zpetechiae zin
zhis zmouth zand zhis zlegs. zA zheart zmurmur zis zdetectable. zThese zare zcharacteristic zsigns
zof:
a. congestive zheart zfailure.
b. heart zblock.
c. aortic zstenosis.
d. infective zendocarditis.
ANS: zD
Collection zof zsubjective zdata zincludes znoting zpatient zcomplaints zof zinfluenza-like zsymptoms
zwith zrecurrent zfever, zundue zfatigue, zchest zpain, zand zchills. zObjective zdata zmay zreveal zthe
zsignificant
,signs zof zpetechiae zin zthe zconjunctiva zand zmouth. zBoth zsubjective zdata zand zobjective zdata zare
zindicative zof zinfective zendocarditis.
14. The znurse znotes za zrun zof zthree zventricular zcontractions z(PVC) zthat zare znot zpreceded
zby za zP zwave. zThis zparticular zarrhythmia zcan zprogress zinto:
a. atrial zfibrillation zand zpossible zemboli.
b. sinus ztachycardia zand zsyncope.
c. ventricular ztachycardia zand zdeath.
d. sinus zbradycardia zand zfatigue.
ANS: zC
PVCs zare zcapable zof zprogressing zinto zventricular ztachycardia zand zdeath.
15. The znurse zreminds zthe zpatient zwho zis zon zCoumadin zfor zthe ztreatment zof zatrial zfibrillation
zthat zthe zideal zis zto zmaintain zthe zinternational znormalized zratio z(INR) zat zbetween:
a. 1 zand z2.
b. 2 zand z3.
c. 3 zand z4.
d. 4 zand z5.
ANS: zB
The zdesired z INR zfor zthe zmonitoring zof zanticoagulant ztherapy zis zbetween z2 zand z3.
16. What zshould za zperson zwith zunstable zangina z avoid?
a. Walking zoutside
b. Eating zred zmeat
c. Swimming zin zwarm zpool
d. Shoveling zsnow
ANS: zD
The zperson zwith zangina zshould zavoid zexposure zto zcold, zheavy zexercise, zeating zheavy zmeals,
zand zemotional zstress.
17. The zelderly zpatient zwith zangina zpectoris zsays zshe zis zunsure zhow zshe zshould ztake
znitroglycerin zwhen zshe zhas zan zattack. zThe znurses zmost zhelpful zresponse zwould zbe:
a. Continue zto ztake znitroglycerin zsublingually zat z5-minute zintervals zuntil zthe zpain zis zrelieved.
If zthe zpain zis znot zrelieved zafter zthree zdoses zof znitroglycerin zat z5-minute zintervals, zcall zyour
b. zphysician zand zcome zto zthe zhospital.
, c. When znitroglycerin zis znot zrelieving zthe zpain, zlie zdown zand zrest.
d. Use zoxygen zat zhome zto zrelieve zpain zwhen znitroglycerin zis znot zsuccessful.
ANS: zB
Administer zprescribed znitroglycerin. zRepeat zevery z5 zminutes, zthree ztimes. zIf zpain zis
zunrelieved, znotify zthe zphysician. zNitroglycerin zadministered zsublingually zusually zrelieves
zangina zsymptoms zbut zdoes znot zrelieve zthe zpain zfrom zan zMI. zAdministering znitroglycerin
zmore zthan zthree ztimes zwill zprobably znot zrelieve zthe zpain.
18. The zpatient zhas zbeen zhospitalized zfor zhypertensive zepisodes zthree ztimes zin zthe zlast
zmonths. zWhile zpreparing zthe zdischarge zteaching zplan, zthe znurse zassesses zthat zhe zdoes znot
zcomply zwith zhis zmedication zregimen. zThe znurses zimmediate zcourse zof zaction zwould zbe zto:
a. reteach zhim zabout zhis zmedications.
b. have za zserious ztalk zwith zhim zand zhis zfamily zabout zcompliance.
c. arrange zfor zhome zvisits zafter zdischarge.
d. collect zmore zinformation zto zidentify zhis zreasons zfor znoncompliance.
ANS: zD
Nursing zinterventions zinclude zmeasures zto zprevent zdisease zprogression zand zcomplications.
zReteaching zabout zmedication zwill znot zidentify zthe zcause zof znoncompliance.
19. What zis zthe zmajor zcause z of zcardiac zvalve zdisease?
a. Rheumatic zfever
b. Long zhistory zof zmalnutrition
c. Drug zabuse
d. Obesity
ANS: zA
Rheumatic zfever, za zstreptococcal zinfection, zis zthe zmajor zcause zof zcardiac zvalve zdisease.
20. The zpatient zhas za ztotal zcholesterol zof z190 zwith za zhigh-density zlipid z(HDL) zof z110 zand za
zlow- zdensity zlipid z(LDL) zof z80. zThe znurses zreaction zis zone zof:
a. satisfaction. zThis zis zgood zcholesterol zcontrol.
b. determination. zThis zis zevidence zthat zmore zinstruction zis znecessary.
c. inquiry. zThis zneeds zto zclarified zas zto zthe zcause zof znoncompliance zwith zthe zdrug zprotocol.
d. regret. zThis zshows zvery zpoor zcholesterol zcontrol.
ANS: zA
,Total zcholesterol zof zless zthan z200 zis zdesirable. zThe zhigher zthe znumber zof zHDLs zthe zbetter. zA
zhigh znumber zof zLDLs zputs zthe zpatient zat zrisk zfor zheart zdisease.
21. A zpatient, zage z72, zwas zadmitted zto zthe zmedical zunit zwith za zdiagnosis zof zangina
zpectoris. zCharacteristic zsigns zand zsymptoms zof zangina zpectoris zinclude:
a. substernal zpain zthat zradiates zdown zthe zleft zarm.
b. epigastric zpain zthat zradiates zto zthe zjaw.
c. indigestion, znausea, zand zeructation.
d. fatigue, zshortness zof zbreath, zand zdyspnea.
ANS: zA
The zpain zoften zradiates zdown zthe zleft zinner zarm zto zthe zlittle zfinger zand zalso zupward zto zthe
zshoulder zand zjaw.
22. A zpatient zadmitted zto zthe zemergency zroom zwith za zpossible zmyocardial zinfarction z(MI)
zhas zreports zback zfrom zthe zlaboratory. zWhich zlaboratory zreport zis zspecific zfor zmyocardial
zdamage?
a. CK-MB
b. Elevated zwhite zcount
c. Elevated zsedimentation zrate
d. Low zlevel zof zsodium
ANS: zA
The zCK-MB zis zelevated zwhen zthere zis zinfarcted zmyocardial zmuscle. zThe zelevated zwhite
zcount, zlow zsodium, zand zESR zare znonspecific.
23. The zpatient, zage z26, zis zhospitalized zwith zcardiomyopathy. zWhile zobtaining za znursing
zhistory zfrom zher, zthe znurse zrecognizes zthat zthe zincreased zincidence zof zcardiomyopathy zin
zyoung
adults zwho zhave zminimal zrisk zfactors zfor zcardiovascular zdisease zis zrelated zto zwhich zfactor(s)?
a. Cocaine zuse
b. Viral zinfections
c. Vitamin zB1 z deficiencies
d. Pregnancy
ANS: zA
Cardiomyopathy zcaused zby zcocaine zabuse zis zseen zmore zfrequently zthan zever zbefore. zCocaine
zalso zcauses zhigh zcirculating zlevels zof zcatecholamines, zwhich zmay zfurther zdamage
zmyocardial zcells, zleading zto zischemic zor zdilated zcardiomyopathy. zThe zcardiomyopathy
zproduced zis zdifficult zto ztreat. zInterventions zdeal zmainly zwith zthe zHF zthat zensues.
, 24. The zpatient zhas zbecome zvery zdyspneic, zrespirations zare z32, zand zthe zpulse zis z100. zThe
zpatient zis zcoughing zup zfrothy zred zsputum. zWhat zshould zbe zthe zinitial znursing zintervention?
a. Lay zthe zpatient zflat zto zreduce zhypotension zand zthe zsymptoms zof zcardiogenic zshock.
b. Place zpatient zin zside-lying zposition zto zreduce zthe zsymptoms zof zatrial zfibrillation.
Place zpatient zupright zwith zlegs zin zdependent zposition zto zreduce zthe zsymptoms zof zpulmonary
c. zedema.
d. Lay zthe zpatient zflat zand zelevate zthe zfeet zto zincrease zvenous zreturn zin zcardiogenic zshock.
ANS: zC
Signs zand zsymptoms zof zpulmonary zedema zare zrestlessness; zvague zuneasiness; zagitation;
zdisorientation; zdiaphoresis; zsevere zdyspnea; ztachypnea; ztachycardia; zpallor zor zcyanosis;
zcough zproducing zlarge zquantities zof zblood-tinged, zfrothy zsputum; zaudible zwheezing zand
zcrackles; zand zcold zextremities. zThe zlegs zin za zdependent zposition zwill zdecrease zvenous
zreturn zand zease zthe zpulmonary zedema.
25. The znurse zcaring zfor za zpatient zrecovering zfrom za zmyocardial zinfarction z(MI) zteaches
zwhich zmethod zto zavoid zthe zValsalva zmaneuver zduring za zbowel zmovement?
a. Mouth zbreathing
b. Pursing zthe zlips zand zwhistling
c. Taking za zdeep zbreath zand zholding zit
d. Breathing zrapidly zthrough zthe znose
ANS: zA
Mouth zbreathing zwill zlessen zthe zseverity zof zstraining zand zwill zdecrease zthe zeffect zof zthe
zValsalva zmaneuver zon zintrathoracic zpressure.
26. The znurse zreminds zthe zpatient zthat zthe zNational zHeart, zLung, zand zBlood zInstitute
zrecommends za zlipid zstudy zevery years.
a. 2
b. 3
c. 4
d. 5
ANS: zD
The zNational zHeart, zLung, zand zBlood zInstitute zrecommend za zlipid zstudy zevery z5 zyears zfor zall
zAmericans, zbut zespecially zfor zthe zolder zadult.
27. During za zhealth zinterview zby zthe zhome zhealth znurse, zwhich zpatient zcomplaint zsuggests
zleft- zsided zheart zfailure?
GUIDELINES IN PRIMARY CARE, 4TH EDITION
Amelie Hollier
,Clinical Guidelines in Primary Care 4th Edition Hollier Test Bank
Table of Contents
Chapter 1: Cardiovascular Disorders
Chapter 2: Dermatologic Disorders
Chapter 3: Ear Nose & Throat Disorders
Chapter 4: Endocrine Disorders
Chapter 5: Gastrointestinal Disorders
Chapter 6: Genetic Disorders
Chapter 7: Health Promotion - Pediatric
Chapter 8: Hematologic Disorders
Chapter 9: Lactation and Breastfeeding
Chapter 10: Men’s Health Disorders
Chapter 11: Neurologic Disorders
Chapter 12: Ophthalmic Disorders
Chapter 13: Orthopedic Disorders
Chapter 14: Pregnancy
Chapter 15: Psychiatric Disorders, Violence, Abuse, Neglect
Chapter 16: Pulmonary Disorders
Chapter 17: Sexually Transmitted Diseases
Chapter 18: Urologic Disorders
Chapter 19: Women’s Health Disorders
,Chapter 1: Cardiovascular Disorders
Clinical Guidelines in Primary Care 4th Edition Test bank
MULTIPLE CHOICE
1. The nurse is aware that the muscle layer of the heart, which is responsible for the hearts
contraction, is the:
a. endocardium.
b. pericardium.
c. mediastinum.
d. myocardium.
ANS: D
The myocardium is the specialized muscle layer that allows the heart to contract.
2. The nurse clarifies that the master pacemaker of the heart is the:
a. left ventricle.
b. atrioventricular (AV) node.
c. sinoatrial (SA) node.
d. bundle of His.
ANS: C
The SA node is the master pacemaker of the heart.
3. The nurse is
aware that the symptoms of an impending myocardial infarction (MI) differ in
women because acute chest pain is not present. Women are frequently misdiagnosed as having:
a. hepatitis A.
b. indigestion.
c. urinary infection.
d. menopausal complications.
,ANS: B
Indigestion, gallbladder attack, anxiety attack, and depression are frequent misdiagnoses for
women having an MI.
4. The nurse identifies the LUBB sound of the LUBB/DUBB of the cardiac cycle as the sound of
the:
a. AV valves closing.
b. closure of the semilunar valves.
c. contraction of the papillary muscles.
d. contraction of the ventricles.
ANS: A
The LUBB is the first sound of a low pitch heard when the AV valves close.
5. A patient is admitted from the emergency department. The emergency department physician
notes the patient has a diagnosis of heart failure with a New York Heart Association (NYHA)
classification of IV. This indicates the patients condition as:
a. moderate heart failure.
b. severe heart failure.
c. congestive heart failure.
d. negligible heart failure.
ANS: B
Class IV: Severe; patient unable to perform any physical activity without discomfort. Angina or
symptoms of cardiac inefficiency may develop at rest.
6. The nurse assesses that the home health patient has
no signs or symptoms of heart failure, but
does have a history of rheumatic fever and has been recently diagnosed with diabetes mellitus.
The nurse is aware that using the American College of Cardiology and the American Heart
Association (ACC/AHA) staging, this patient would be a:
a. stage A.
b. stage B.
c. stage C.
d. stage D.
ANS: A
The ACC/AHA staging describes stage A as a person without symptoms of heart failure, but
with primary conditions associated with the development of the disease.
,7. The znurse zcaring zfor za zpatient zrecovering zfrom za zmyocardial zinfarct zwho zis zon zremote
ztelemetry zrecognizes zthe zneed zfor zadded zinstruction zwhen zthe zpatient zsays:
a. I zcan zambulate zin zthe zhallway zwith zthis zgadget zon.
b. I zalways z take zoff zthe ztelemetry zdevice zwhen z I zshower.
c. My zEKG zis zbeing zwatched zby zone zof zthe znurses z in zCCU zon zthe zhome zunit.
d. I zam zable zto zsleep zjust zfine zwith zthis zdevice zon.
ANS: zB
Remote ztelemetry zallows zthe zpatient zto zbe zon za zseparate zunit, zbut zbe zmonitored zin za zcentral
zlocation. zThe zpatients zcan zbe zambulatory zand zcan zsleep zwith zthe zmonitor zon. zThey
should znot zremove zthe zmonitor zto zshower.
8. The znurse zassesses zpitting zedema zthat zcan zbe zdepressed zapproximately zinch zand zrefills
zin z15 zseconds. zThe znurse zwould zdocument zthis zassessment zas:
a. +1 zedema.
b. +2 zedema.
c. +3 zedema.
d. +4 zedema.
ANS: zB
A z+2 zedema zcan zbe zdocumented zif zthe zskin zcan zbe zdepressed zinch zand zrespond zwithin z15
zseconds.
9. What zdo zdark zor z cold zspots z on za zthallium zscan zindicate?
a. Tissue zwith zadequate zblood zsupply
b. Dilated zvessels
c. Areas zof zneoplastic zgrowth
d. Tissue zthat zhas zinadequate zperfusion
ANS: zD
Thallium zscans zshow zadequate zperfused zareas zby zthe zcollection zof zthallium. zDark zspots zor
zcold zspots zindicate ztissues zthat zhave zinadequate zperfusion.
10. The znurse zrecognizes zthe zechocardiogram zreport zthat zshows zan zejection zfactor zof z42%
zas zan zindication zof:
a. normal zheart zaction.
b. mild zheart zfailure.
c. moderate zheart zfailure.
, d. severe zheart zfailure.
ANS: zC
An zejection zfactor z(cardiac zoutput) zof z42% zindicates zmoderate zheart zfailure.
11. The znurse ztakes zinto zconsideration zthat zage-related zchanges zcan zaffect zthe
zperipheral zcirculation zbecause zof:
a. sclerosed zblood zvessels.
b. hypotension.
c. inactivity.
d. poor znutrition.
ANS: zA
Aging zcauses zsclerotic zchanges zin zthe zblood zvessels zthat zlead zto zdecreased zelasticity zand
znarrowing zof zthe zvessel zlumen.
12. The znurse zassessing za zcardiac zmonitor znotes zthat zthe zcardiac zcomplexes zeach zhave za zP
zwave zfollowed zby za zQRS zand za zT. zThe zrate zis z120. zThe znurse zrecognizes zthis zarrhythmia
zas:
a. sinus zbradycardia.
b. atrial zfibrillation.
c. sinus ztachycardia.
d. ventricular ztachycardia.
ANS: zC
Sinus ztachycardia zhas za zP zwave zfollowed zby zthe zQRS zand zthe zT. zAll zthe zcomponents zof zthe
zcomplex zare zpresent zand zin zthe zcorrect zorder, zbut zthe zrate zis zover z100 zbeats za zminute.
13. After zan zinfluenza-like zillness, zthe zpatient zcomplains zof zchills zand zsmall zpetechiae zin
zhis zmouth zand zhis zlegs. zA zheart zmurmur zis zdetectable. zThese zare zcharacteristic zsigns
zof:
a. congestive zheart zfailure.
b. heart zblock.
c. aortic zstenosis.
d. infective zendocarditis.
ANS: zD
Collection zof zsubjective zdata zincludes znoting zpatient zcomplaints zof zinfluenza-like zsymptoms
zwith zrecurrent zfever, zundue zfatigue, zchest zpain, zand zchills. zObjective zdata zmay zreveal zthe
zsignificant
,signs zof zpetechiae zin zthe zconjunctiva zand zmouth. zBoth zsubjective zdata zand zobjective zdata zare
zindicative zof zinfective zendocarditis.
14. The znurse znotes za zrun zof zthree zventricular zcontractions z(PVC) zthat zare znot zpreceded
zby za zP zwave. zThis zparticular zarrhythmia zcan zprogress zinto:
a. atrial zfibrillation zand zpossible zemboli.
b. sinus ztachycardia zand zsyncope.
c. ventricular ztachycardia zand zdeath.
d. sinus zbradycardia zand zfatigue.
ANS: zC
PVCs zare zcapable zof zprogressing zinto zventricular ztachycardia zand zdeath.
15. The znurse zreminds zthe zpatient zwho zis zon zCoumadin zfor zthe ztreatment zof zatrial zfibrillation
zthat zthe zideal zis zto zmaintain zthe zinternational znormalized zratio z(INR) zat zbetween:
a. 1 zand z2.
b. 2 zand z3.
c. 3 zand z4.
d. 4 zand z5.
ANS: zB
The zdesired z INR zfor zthe zmonitoring zof zanticoagulant ztherapy zis zbetween z2 zand z3.
16. What zshould za zperson zwith zunstable zangina z avoid?
a. Walking zoutside
b. Eating zred zmeat
c. Swimming zin zwarm zpool
d. Shoveling zsnow
ANS: zD
The zperson zwith zangina zshould zavoid zexposure zto zcold, zheavy zexercise, zeating zheavy zmeals,
zand zemotional zstress.
17. The zelderly zpatient zwith zangina zpectoris zsays zshe zis zunsure zhow zshe zshould ztake
znitroglycerin zwhen zshe zhas zan zattack. zThe znurses zmost zhelpful zresponse zwould zbe:
a. Continue zto ztake znitroglycerin zsublingually zat z5-minute zintervals zuntil zthe zpain zis zrelieved.
If zthe zpain zis znot zrelieved zafter zthree zdoses zof znitroglycerin zat z5-minute zintervals, zcall zyour
b. zphysician zand zcome zto zthe zhospital.
, c. When znitroglycerin zis znot zrelieving zthe zpain, zlie zdown zand zrest.
d. Use zoxygen zat zhome zto zrelieve zpain zwhen znitroglycerin zis znot zsuccessful.
ANS: zB
Administer zprescribed znitroglycerin. zRepeat zevery z5 zminutes, zthree ztimes. zIf zpain zis
zunrelieved, znotify zthe zphysician. zNitroglycerin zadministered zsublingually zusually zrelieves
zangina zsymptoms zbut zdoes znot zrelieve zthe zpain zfrom zan zMI. zAdministering znitroglycerin
zmore zthan zthree ztimes zwill zprobably znot zrelieve zthe zpain.
18. The zpatient zhas zbeen zhospitalized zfor zhypertensive zepisodes zthree ztimes zin zthe zlast
zmonths. zWhile zpreparing zthe zdischarge zteaching zplan, zthe znurse zassesses zthat zhe zdoes znot
zcomply zwith zhis zmedication zregimen. zThe znurses zimmediate zcourse zof zaction zwould zbe zto:
a. reteach zhim zabout zhis zmedications.
b. have za zserious ztalk zwith zhim zand zhis zfamily zabout zcompliance.
c. arrange zfor zhome zvisits zafter zdischarge.
d. collect zmore zinformation zto zidentify zhis zreasons zfor znoncompliance.
ANS: zD
Nursing zinterventions zinclude zmeasures zto zprevent zdisease zprogression zand zcomplications.
zReteaching zabout zmedication zwill znot zidentify zthe zcause zof znoncompliance.
19. What zis zthe zmajor zcause z of zcardiac zvalve zdisease?
a. Rheumatic zfever
b. Long zhistory zof zmalnutrition
c. Drug zabuse
d. Obesity
ANS: zA
Rheumatic zfever, za zstreptococcal zinfection, zis zthe zmajor zcause zof zcardiac zvalve zdisease.
20. The zpatient zhas za ztotal zcholesterol zof z190 zwith za zhigh-density zlipid z(HDL) zof z110 zand za
zlow- zdensity zlipid z(LDL) zof z80. zThe znurses zreaction zis zone zof:
a. satisfaction. zThis zis zgood zcholesterol zcontrol.
b. determination. zThis zis zevidence zthat zmore zinstruction zis znecessary.
c. inquiry. zThis zneeds zto zclarified zas zto zthe zcause zof znoncompliance zwith zthe zdrug zprotocol.
d. regret. zThis zshows zvery zpoor zcholesterol zcontrol.
ANS: zA
,Total zcholesterol zof zless zthan z200 zis zdesirable. zThe zhigher zthe znumber zof zHDLs zthe zbetter. zA
zhigh znumber zof zLDLs zputs zthe zpatient zat zrisk zfor zheart zdisease.
21. A zpatient, zage z72, zwas zadmitted zto zthe zmedical zunit zwith za zdiagnosis zof zangina
zpectoris. zCharacteristic zsigns zand zsymptoms zof zangina zpectoris zinclude:
a. substernal zpain zthat zradiates zdown zthe zleft zarm.
b. epigastric zpain zthat zradiates zto zthe zjaw.
c. indigestion, znausea, zand zeructation.
d. fatigue, zshortness zof zbreath, zand zdyspnea.
ANS: zA
The zpain zoften zradiates zdown zthe zleft zinner zarm zto zthe zlittle zfinger zand zalso zupward zto zthe
zshoulder zand zjaw.
22. A zpatient zadmitted zto zthe zemergency zroom zwith za zpossible zmyocardial zinfarction z(MI)
zhas zreports zback zfrom zthe zlaboratory. zWhich zlaboratory zreport zis zspecific zfor zmyocardial
zdamage?
a. CK-MB
b. Elevated zwhite zcount
c. Elevated zsedimentation zrate
d. Low zlevel zof zsodium
ANS: zA
The zCK-MB zis zelevated zwhen zthere zis zinfarcted zmyocardial zmuscle. zThe zelevated zwhite
zcount, zlow zsodium, zand zESR zare znonspecific.
23. The zpatient, zage z26, zis zhospitalized zwith zcardiomyopathy. zWhile zobtaining za znursing
zhistory zfrom zher, zthe znurse zrecognizes zthat zthe zincreased zincidence zof zcardiomyopathy zin
zyoung
adults zwho zhave zminimal zrisk zfactors zfor zcardiovascular zdisease zis zrelated zto zwhich zfactor(s)?
a. Cocaine zuse
b. Viral zinfections
c. Vitamin zB1 z deficiencies
d. Pregnancy
ANS: zA
Cardiomyopathy zcaused zby zcocaine zabuse zis zseen zmore zfrequently zthan zever zbefore. zCocaine
zalso zcauses zhigh zcirculating zlevels zof zcatecholamines, zwhich zmay zfurther zdamage
zmyocardial zcells, zleading zto zischemic zor zdilated zcardiomyopathy. zThe zcardiomyopathy
zproduced zis zdifficult zto ztreat. zInterventions zdeal zmainly zwith zthe zHF zthat zensues.
, 24. The zpatient zhas zbecome zvery zdyspneic, zrespirations zare z32, zand zthe zpulse zis z100. zThe
zpatient zis zcoughing zup zfrothy zred zsputum. zWhat zshould zbe zthe zinitial znursing zintervention?
a. Lay zthe zpatient zflat zto zreduce zhypotension zand zthe zsymptoms zof zcardiogenic zshock.
b. Place zpatient zin zside-lying zposition zto zreduce zthe zsymptoms zof zatrial zfibrillation.
Place zpatient zupright zwith zlegs zin zdependent zposition zto zreduce zthe zsymptoms zof zpulmonary
c. zedema.
d. Lay zthe zpatient zflat zand zelevate zthe zfeet zto zincrease zvenous zreturn zin zcardiogenic zshock.
ANS: zC
Signs zand zsymptoms zof zpulmonary zedema zare zrestlessness; zvague zuneasiness; zagitation;
zdisorientation; zdiaphoresis; zsevere zdyspnea; ztachypnea; ztachycardia; zpallor zor zcyanosis;
zcough zproducing zlarge zquantities zof zblood-tinged, zfrothy zsputum; zaudible zwheezing zand
zcrackles; zand zcold zextremities. zThe zlegs zin za zdependent zposition zwill zdecrease zvenous
zreturn zand zease zthe zpulmonary zedema.
25. The znurse zcaring zfor za zpatient zrecovering zfrom za zmyocardial zinfarction z(MI) zteaches
zwhich zmethod zto zavoid zthe zValsalva zmaneuver zduring za zbowel zmovement?
a. Mouth zbreathing
b. Pursing zthe zlips zand zwhistling
c. Taking za zdeep zbreath zand zholding zit
d. Breathing zrapidly zthrough zthe znose
ANS: zA
Mouth zbreathing zwill zlessen zthe zseverity zof zstraining zand zwill zdecrease zthe zeffect zof zthe
zValsalva zmaneuver zon zintrathoracic zpressure.
26. The znurse zreminds zthe zpatient zthat zthe zNational zHeart, zLung, zand zBlood zInstitute
zrecommends za zlipid zstudy zevery years.
a. 2
b. 3
c. 4
d. 5
ANS: zD
The zNational zHeart, zLung, zand zBlood zInstitute zrecommend za zlipid zstudy zevery z5 zyears zfor zall
zAmericans, zbut zespecially zfor zthe zolder zadult.
27. During za zhealth zinterview zby zthe zhome zhealth znurse, zwhich zpatient zcomplaint zsuggests
zleft- zsided zheart zfailure?
