390 Exam 2
1. A defect in which BP-regulating mechanisms can result in the development of hypertension? (select
all that apply)
a. Release of norepinephrine
b. Secretion of prostaglandins
c. Stimulation of the sympathetic nervous system
d. Stimulation of the parasympathetic nervous system
e. Activation of the renin-angiotensin-aldosterone system *** a,c,e
2. Which item in a patient history would the nurse recognize as a modifiable risk factor for the
development of hypertension?
a. Low-calcium diet
b. Excess alcohol use
c. Family history of hypertension
d. Consumption of a high-protein diet *** b
3. Which information would the nurse apply to a teaching plan for a patient with hypertension?
a. All patients with elevated BP need drug therapy
b. Obese persons must achieve a normal weight to lower BP.
c. It is not necessary to limit salt in the diet if taking a diuretic.
d. Lifestyle modifications are needed for persons with elevated BP. *** d
4. Which consideration would the nurse include in the management of the older adult with
hypertension?
a. Preventing primary hypertension from converting to secondary hypertension
b. Recognizing that the older adult is less likely to adhere to the drug therapy regimen than a younger
adult
,c. Ensuring that the patient receives larger initial doses of antihypertensive drugs because of impaired
absorption
d. Using a precise technique in assessing the BP of the patient because of the possible presence of
orthostatic hypertension *** d
5. A patient with newly discovered high BP has an average reading of 158/98 mm Hg after 3 months of
exercise and diet modifications. Which management strategy would the nurse expect?
a. Drug therapy will be needed because the BP has not reached the goal.
b. BP monitoring should continue for 3 months to confirm a diagnosis of hypertension.
c. Lifestyle changes are less important since they were not effective, and drugs will be started.
d. More changes in the patient's lifestyle are needed for a longer time before starting drug therapy. ***
a
6. A patient is admitted to the hospital in a hypertensive emergency (BP 244/142 mm Hg). Sodium
nitroprusside is started to treat the elevated BP. Which management strategies would the nurse
anticipate? (select all that apply)
a. Measuring hourly urine output
b. Continuous BP monitoring with an arterial line
c. Decreasing the MAP by 50% within the first hour
d. Maintaining bed rest and giving tranquilizers to lower the BP
e. Assessing the patient for signs of heart failure and changes in mental status *** a,b,e
1. A patient with syncope has continuous ECG monitoring. The rhythm strip shows: Atrial rate 74
beats/min and regular; ventricular rate 62 beats/min and irregular; P wave normal shape; PR interval
lengthens progressively until a P wave is not conducted; QRS normal shape. Which intervention would
the nurse prioritize?
a. Administer epinephrine 1 mg IV push.
b. Prepare the patient for synchronized cardioversion.
c. Observe for symptoms of hypotension and angina.
,d. Apply transcutaneous pacemaker pads on the patient. *** c
4. The nurse prepares a patient for elective synchronized cardioversion. Which information would the
nurse consider in planning for the procedure?
a. Defibrillation delivers a lower dose of electrical energy.
b. Cardioversion is a treatment for atrial bradydysrhythmias.
c. Defibrillation delivers a shock during the QRS complex.
d. Cardioversion is painful for an awake patient. *** d
5. Which patient teaching points would the nurse include when providing discharge instructions to a
patient with a new permanent pacemaker? (select all that apply)
a. Avoid or limit air travel.
b. Take and record a daily pulse rate.
c. Obtain and wear a Medic Alert ID device at all times.
d. Avoid lifting arm on the side of the pacemaker above shoulder.
e. Do not use a microwave oven because it interferes with pacemaker function. *** b,c
6. Which information would the nurse teach the patient scheduled for a radiofrequency catheter
ablation procedure?
a. Ventricular bradycardia may be induced and treated during the procedure.
b. A catheter will be placed in both femoral arteries to allow double-catheter intervention.
c. The procedure will destroy areas of the conduction system that are causing rapid heart rhythms.
d. General anesthetic will be given to prevent the awareness of any "sudden cardiac death" experiences.
*** c
1. Which statements accurately describe heart failure with preserved ejection fraction (HFpEF)? (select
all that apply)
, a. Uncontrolled hypertension is a primary cause.
b. Left ventricular ejection fraction may be within normal limits.
c. The pathophysiology involves ventricular relaxation and filling.
d. Multiple evidence-based therapies have been shown to decrease mortality.
e. Therapies focus on symptom control and treatment of underlying conditions. *** a,b,c,e
2. Which compensatory mechanism involved in both chronic heart failure and acute decompensated
heart failure leads to fluid retention and edema?
a. Ventricular dilation
b. Ventricular hypertrophy
c. Increased systemic blood pressure
d. Renin-angiotensin-aldosterone activation *** d
3. The nurse is caring for a patient with acute decompensated heart failure who is receiving IV
dobutamine. Which drug action is expected? (select all that apply)
a. Raises the heart rate
b. Dilates renal blood vessels
c. Increases heart contractility
d. Acts as a selective β-agonist
e. Increases systemic vascular resistance *** c,d
4. A patient with chronic heart failure and atrial fibrillation is treated with low-dose digitalis and a loop
diuretic. Which actions would the nurse take to prevent complications of this drug combination? (select
all that apply)
a. Monitor serum potassium levels.
b. Teach the patient how to take a pulse rate.
c. Keep an accurate measure of intake and output.
1. A defect in which BP-regulating mechanisms can result in the development of hypertension? (select
all that apply)
a. Release of norepinephrine
b. Secretion of prostaglandins
c. Stimulation of the sympathetic nervous system
d. Stimulation of the parasympathetic nervous system
e. Activation of the renin-angiotensin-aldosterone system *** a,c,e
2. Which item in a patient history would the nurse recognize as a modifiable risk factor for the
development of hypertension?
a. Low-calcium diet
b. Excess alcohol use
c. Family history of hypertension
d. Consumption of a high-protein diet *** b
3. Which information would the nurse apply to a teaching plan for a patient with hypertension?
a. All patients with elevated BP need drug therapy
b. Obese persons must achieve a normal weight to lower BP.
c. It is not necessary to limit salt in the diet if taking a diuretic.
d. Lifestyle modifications are needed for persons with elevated BP. *** d
4. Which consideration would the nurse include in the management of the older adult with
hypertension?
a. Preventing primary hypertension from converting to secondary hypertension
b. Recognizing that the older adult is less likely to adhere to the drug therapy regimen than a younger
adult
,c. Ensuring that the patient receives larger initial doses of antihypertensive drugs because of impaired
absorption
d. Using a precise technique in assessing the BP of the patient because of the possible presence of
orthostatic hypertension *** d
5. A patient with newly discovered high BP has an average reading of 158/98 mm Hg after 3 months of
exercise and diet modifications. Which management strategy would the nurse expect?
a. Drug therapy will be needed because the BP has not reached the goal.
b. BP monitoring should continue for 3 months to confirm a diagnosis of hypertension.
c. Lifestyle changes are less important since they were not effective, and drugs will be started.
d. More changes in the patient's lifestyle are needed for a longer time before starting drug therapy. ***
a
6. A patient is admitted to the hospital in a hypertensive emergency (BP 244/142 mm Hg). Sodium
nitroprusside is started to treat the elevated BP. Which management strategies would the nurse
anticipate? (select all that apply)
a. Measuring hourly urine output
b. Continuous BP monitoring with an arterial line
c. Decreasing the MAP by 50% within the first hour
d. Maintaining bed rest and giving tranquilizers to lower the BP
e. Assessing the patient for signs of heart failure and changes in mental status *** a,b,e
1. A patient with syncope has continuous ECG monitoring. The rhythm strip shows: Atrial rate 74
beats/min and regular; ventricular rate 62 beats/min and irregular; P wave normal shape; PR interval
lengthens progressively until a P wave is not conducted; QRS normal shape. Which intervention would
the nurse prioritize?
a. Administer epinephrine 1 mg IV push.
b. Prepare the patient for synchronized cardioversion.
c. Observe for symptoms of hypotension and angina.
,d. Apply transcutaneous pacemaker pads on the patient. *** c
4. The nurse prepares a patient for elective synchronized cardioversion. Which information would the
nurse consider in planning for the procedure?
a. Defibrillation delivers a lower dose of electrical energy.
b. Cardioversion is a treatment for atrial bradydysrhythmias.
c. Defibrillation delivers a shock during the QRS complex.
d. Cardioversion is painful for an awake patient. *** d
5. Which patient teaching points would the nurse include when providing discharge instructions to a
patient with a new permanent pacemaker? (select all that apply)
a. Avoid or limit air travel.
b. Take and record a daily pulse rate.
c. Obtain and wear a Medic Alert ID device at all times.
d. Avoid lifting arm on the side of the pacemaker above shoulder.
e. Do not use a microwave oven because it interferes with pacemaker function. *** b,c
6. Which information would the nurse teach the patient scheduled for a radiofrequency catheter
ablation procedure?
a. Ventricular bradycardia may be induced and treated during the procedure.
b. A catheter will be placed in both femoral arteries to allow double-catheter intervention.
c. The procedure will destroy areas of the conduction system that are causing rapid heart rhythms.
d. General anesthetic will be given to prevent the awareness of any "sudden cardiac death" experiences.
*** c
1. Which statements accurately describe heart failure with preserved ejection fraction (HFpEF)? (select
all that apply)
, a. Uncontrolled hypertension is a primary cause.
b. Left ventricular ejection fraction may be within normal limits.
c. The pathophysiology involves ventricular relaxation and filling.
d. Multiple evidence-based therapies have been shown to decrease mortality.
e. Therapies focus on symptom control and treatment of underlying conditions. *** a,b,c,e
2. Which compensatory mechanism involved in both chronic heart failure and acute decompensated
heart failure leads to fluid retention and edema?
a. Ventricular dilation
b. Ventricular hypertrophy
c. Increased systemic blood pressure
d. Renin-angiotensin-aldosterone activation *** d
3. The nurse is caring for a patient with acute decompensated heart failure who is receiving IV
dobutamine. Which drug action is expected? (select all that apply)
a. Raises the heart rate
b. Dilates renal blood vessels
c. Increases heart contractility
d. Acts as a selective β-agonist
e. Increases systemic vascular resistance *** c,d
4. A patient with chronic heart failure and atrial fibrillation is treated with low-dose digitalis and a loop
diuretic. Which actions would the nurse take to prevent complications of this drug combination? (select
all that apply)
a. Monitor serum potassium levels.
b. Teach the patient how to take a pulse rate.
c. Keep an accurate measure of intake and output.
