MSN 377 Exam 1 Practice Questions And
Answers Verified 100% Correct
Chapter 32: Cardiovascular System
A bruit is the sound created by turbulent blood flow in an artery.
Thrills are palpable vibrations felt when there is turbulent blood flow
through the heart or in a blood vessel. Heaves are sustained lifts over
the precordium that can be observed or palpated. A murmur is the
sound caused by turbulent blood flow through the heart.
The nurse has received the laboratory results for a patient who
developed chest pain 4 hours ago and may be having a myocardial
infarction. The most important laboratory result to review will be
a. LDL cholesterol.
b. troponins T and I.
c. C-reactive protein.
d. creatine kinase-MB (CK-MB). - ANSWER -ANS: B
Cardiac troponins start to elevate hours (average 4 to 6 hours) after
myocardial injury and are specific to myocardium. Creatine kinase
(CK-MB) is specific to myocardial injury and infarction, but it does not
increase until 6 hours after the infarction occurs. LDL cholesterol and
C-reactive protein are useful in assessing cardiovascular risk but are
,not helpful in determining whether a patient is having an acute
myocardial infarction.
When assessing a newly admitted patient, the nurse notes a thrill
along the left sternal border. To obtain more information about the
cause of the thrill, which action will the nurse take next?
a. Auscultate for any cardiac murmurs.
b. Find the point of maximal impulse.
c. Compare the apical and radial pulse rates.
d. Palpate the quality of the peripheral pulses. - ANSWER -ANS: A
Both thrills and murmurs are caused by turbulent blood flow, such
as occurs when blood flows through a damaged valve. Relevant
information includes the quality of the murmur, where in the
cardiac cycle the murmur is heard, and where on the thorax the
murmur is heard best. The other information also is important in
the cardiac assessment but will not provide information that is
relevant to the
thrill.
The nurse hears a murmur between the S1 and S2 heart sounds at the
patients left 5th intercostal space and midclavicular line. How will the
nurse record this information?
a. Systolic murmur heard at mitral area.
,b. Diastolic murmur heard at aortic area.
c. Systolic murmur heard at Erbs point.
d. Diastolic murmur heard at tricuspid area. - ANSWER -ANS: A
The S1 signifies the onset of ventricular systole. S2 signifies the
onset of diastole. A murmur occurring between these two sounds is a
systolic murmur. The mitral area is the intersection of the left 5th
intercostal space and the midclavicular line. The other responses
describe murmurs heard at different landmarks on the chest and/or
during the diastolic phase of the cardiac cycle.
The RN is observing a student nurse who is doing a physical
assessment on a patient. The RN will need to intervene immediately if
the student nurse
a. places the patient in the left lateral position to check for the
point of maximal impulse (PMI).
b. presses on the skin over the tibia for 10 seconds to check for
edema.
c. palpates both carotid arteries simultaneously to compare pulse
quality.
d. documents a murmur heard along the left sternal border as an
aortic murmur. - ANSWER -ANS: C
, The carotid pulses should never be palpated at the same time to avoid
vagal stimulation, dysrhythmias, and decreased cerebral blood flow.
The other assessment techniques also need to be corrected.
However, they are not dangerous to the patient.
Which action will the nurse implement for a patient who arrives for a
calcium-scoring CT scan?
a. Administer oral sedative medications.
b. Teach the patient about the procedure.
c. Ask whether the patient has eaten today.
d. Insert a large gauge intravenous catheter. - ANSWER -ANS: B
The nurse will need to teach the patient that the procedure is rapid
and involves little risk. The other actions are not necessary.
Which information obtained by the nurse who is admitting the patient
for magnetic resonance imaging (MRI) will be most important to
report to the health care provider before the MRI?
a. The patient has an allergy to shellfish and iodine.
Answers Verified 100% Correct
Chapter 32: Cardiovascular System
A bruit is the sound created by turbulent blood flow in an artery.
Thrills are palpable vibrations felt when there is turbulent blood flow
through the heart or in a blood vessel. Heaves are sustained lifts over
the precordium that can be observed or palpated. A murmur is the
sound caused by turbulent blood flow through the heart.
The nurse has received the laboratory results for a patient who
developed chest pain 4 hours ago and may be having a myocardial
infarction. The most important laboratory result to review will be
a. LDL cholesterol.
b. troponins T and I.
c. C-reactive protein.
d. creatine kinase-MB (CK-MB). - ANSWER -ANS: B
Cardiac troponins start to elevate hours (average 4 to 6 hours) after
myocardial injury and are specific to myocardium. Creatine kinase
(CK-MB) is specific to myocardial injury and infarction, but it does not
increase until 6 hours after the infarction occurs. LDL cholesterol and
C-reactive protein are useful in assessing cardiovascular risk but are
,not helpful in determining whether a patient is having an acute
myocardial infarction.
When assessing a newly admitted patient, the nurse notes a thrill
along the left sternal border. To obtain more information about the
cause of the thrill, which action will the nurse take next?
a. Auscultate for any cardiac murmurs.
b. Find the point of maximal impulse.
c. Compare the apical and radial pulse rates.
d. Palpate the quality of the peripheral pulses. - ANSWER -ANS: A
Both thrills and murmurs are caused by turbulent blood flow, such
as occurs when blood flows through a damaged valve. Relevant
information includes the quality of the murmur, where in the
cardiac cycle the murmur is heard, and where on the thorax the
murmur is heard best. The other information also is important in
the cardiac assessment but will not provide information that is
relevant to the
thrill.
The nurse hears a murmur between the S1 and S2 heart sounds at the
patients left 5th intercostal space and midclavicular line. How will the
nurse record this information?
a. Systolic murmur heard at mitral area.
,b. Diastolic murmur heard at aortic area.
c. Systolic murmur heard at Erbs point.
d. Diastolic murmur heard at tricuspid area. - ANSWER -ANS: A
The S1 signifies the onset of ventricular systole. S2 signifies the
onset of diastole. A murmur occurring between these two sounds is a
systolic murmur. The mitral area is the intersection of the left 5th
intercostal space and the midclavicular line. The other responses
describe murmurs heard at different landmarks on the chest and/or
during the diastolic phase of the cardiac cycle.
The RN is observing a student nurse who is doing a physical
assessment on a patient. The RN will need to intervene immediately if
the student nurse
a. places the patient in the left lateral position to check for the
point of maximal impulse (PMI).
b. presses on the skin over the tibia for 10 seconds to check for
edema.
c. palpates both carotid arteries simultaneously to compare pulse
quality.
d. documents a murmur heard along the left sternal border as an
aortic murmur. - ANSWER -ANS: C
, The carotid pulses should never be palpated at the same time to avoid
vagal stimulation, dysrhythmias, and decreased cerebral blood flow.
The other assessment techniques also need to be corrected.
However, they are not dangerous to the patient.
Which action will the nurse implement for a patient who arrives for a
calcium-scoring CT scan?
a. Administer oral sedative medications.
b. Teach the patient about the procedure.
c. Ask whether the patient has eaten today.
d. Insert a large gauge intravenous catheter. - ANSWER -ANS: B
The nurse will need to teach the patient that the procedure is rapid
and involves little risk. The other actions are not necessary.
Which information obtained by the nurse who is admitting the patient
for magnetic resonance imaging (MRI) will be most important to
report to the health care provider before the MRI?
a. The patient has an allergy to shellfish and iodine.
