NRSG 3420 EXAM 2 With Correct
Solutions.
A client with angina has been prescribed nitroglycerin. Before administering the drug, the nurse should
j j j j j j j j j j j j j j
inform the client about what potential adverse effects?
j j j j j j j j
A) Nervousness or paresthesia
j j j
B)Throbbing headache or dizziness j j j
C) Drowsiness or blurred vision
j j j j
D) Tinnitus or diplopia - CORRECT ANSWER✔✔Correct response:
j j j j j j j
Throbbing headache or dizziness
j j j
Explanation: j
Headache and dizziness commonly occur when nitroglycerin is taken at the beginning of therapy.
j j j j j j j j j j j j j
Nervousness, paresthesia, drowsiness, blurred vision, tinnitus, and diplopia do not typically occur as a result
j j j j j j j j j j j j j j j
of nitroglycerin therapy.
j j j
,Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed.,
j j j j j j j j j j j j j j
Philadelphia, Wolters Kluwer, 2018, Chapter 27: Management of Patients with Coronary Vascular Disorders,
j j j j j j j j j j j j j
Chart 27-3, p. 759.
j j j j
Chapter 27: Management of Patients with Coronary Vascular Disorders - Page 759
j j j j j j j j j j j
The physical therapist notifies the nurse that a client with coronary artery disease (CAD) experiences a much
j j j j j j j j j j j j j j j j
greater-than-average increase in heart rate during physical therapy. The nurse recognizes that an increase in
j j j j j j j j j j j j j j j
heart rate in a client with CAD may result in what?
j j j j j j j j j j j
A) Development of an atrial-septal defect
j j j j j
B) Myocardial ischemia
j j
C) Formation of a pulmonary embolism
j j j j j
D) Release of potassium ions from cardiac cells - CORRECT ANSWER✔✔Correct response:
j j j j j j j j j j j
Myocardial ischemia j
Explanation:
Unlike other arteries, the coronary arteries are perfused during diastole. An increase in heart rate shortens
j j j j j j j j j j j j j j j
diastole and can decrease myocardial perfusion. Clients, particularly those with CAD, can develop myocardial
j j j j j j j j j j j j j j
ischemia. An increase in heart rate will not usually result in a pulmonary embolism or create electrolyte
j j j j j j j j j j j j j j j j j
imbalances. Atrial-septal defects are congenital.
j j j j j
Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed.,
j j j j j j j j j j j j j j
Philadelphia, Wolters Kluwer, 2018, Chapter 25: Assessment of Cardiovascular Function, Coronary Arteries,
j j j j j j j j j j j j
p. 675.
j j
Chapter 25: Assessment of Cardiovascular Function - Page 675
j j j j j j j j
,The nurse is providing care for a client with high cholesterol and triglyceride values. In teaching the client
j j j j j j j j j j j j j j j j j
about therapeutic lifestyle changes such as diet and exercise, the nurse realizes that the desired goal for
j j j j j j j j j j j j j j j j j
cholesterol levels is which of the following?
j j j j j j j
A) High HDL values and high triglyceride values
j j j j j j j
B) Absence of detectable total cholesterol levels
j j j j j j
C) Elevated blood lipids, fasting glucose less than 100
j j j j j j j j
D) Low LDL values and high HDL values - CORRECT ANSWER✔✔Correct response:
j j j j j j j j j j j
Low LDL values and high HDL values
j j j j j j
Explanation:
The desired goal for cholesterol readings is for a client to have low LDL and high HDL values. LDL exerts a
j j j j j j j j j j j j j j j j j j j j
harmful effect on the coronary vasculature because the small LDL particles can be easily transported into the
j j j j j j j j j j j j j j j j j
vessel lining. In contrast, HDL promotes the use of total cholesterol by transporting LDL to the liver, where it is
j j j j j j j j j j j j j j j j j j j j
excreted. Elevated triglycerides are also a major risk factor for cardiovascular disease. A goal is also to keep
j j j j j j j j j j j j j j j j j j
triglyceride levels less than 150 mg/dL. All individuals possess detectable levels of total cholesterol.
j j j j j j j j j j j j j j
Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed.,
j j j j j j j j j j j j j j
Philadelphia, Wolters Kluwer, 2018, Chapter 27: Management of Patients with Coronary Vascular Disorders,
j j j j j j j j j j j j j
Controlling Cholesterol Abnormalities, p. 753.
j j j j j
Chapter 27: Management of Patients with Coronary Vascular Disorders - Page 753
j j j j j j j j j j j
The health care provider has placed a central venous pressure (CVP) monitoring line in an acutely ill client so
j j j j j j j j j j j j j j j j j j
right ventricular function and venous blood return can be closely monitored. The results show decreased
j j j j j j j j j j j j j j j
CVP. What does this indicate?
j j j j j
, A) Possible hypovolemia
j j
B) Possible myocardial infarction (MI)
j j j j
C) Left-sided heart failure
j j j
D) Aortic valve regurgitation - CORRECT ANSWER✔✔Correct response:
j j j j j j j
Possible hypovolemia j
Explanation:
Hypovolemia may cause a decreased CVP. MI, valve regurgitation and heart failure are less likely causes of
j j j j j j j j j j j j j j j j
decreased CVP.
j j
Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed.,
j j j j j j j j j j j j j j
Philadelphia, Wolters Kluwer, 2018, Chapter 25: Assessment of Cardiovascular Function, Central Venous
j j j j j j j j j j j j
Pressure Monitoring, p. 706.
j j j j
Chapter 25: Assessment of Cardiovascular Function - Page 706
j j j j j j j j
The nursing instructor is teaching nursing students about myocardial contractility and ejection fractions.
j j j j j j j j j j j j
What diagnostic tests can determine client ejection fractions? Select all that apply.
j j j j j j j j j j j j
A) Echocardiogram
j
B) Cardiac catheterization
j j
C) Magnetic resonance imaging
j j j
D) Positron emission tomography scan
j j j j
E) Troponin levels - CORRECT ANSWER✔✔Correct response:
j j j j j j
Echocardiogram
Cardiac catheterization j
Solutions.
A client with angina has been prescribed nitroglycerin. Before administering the drug, the nurse should
j j j j j j j j j j j j j j
inform the client about what potential adverse effects?
j j j j j j j j
A) Nervousness or paresthesia
j j j
B)Throbbing headache or dizziness j j j
C) Drowsiness or blurred vision
j j j j
D) Tinnitus or diplopia - CORRECT ANSWER✔✔Correct response:
j j j j j j j
Throbbing headache or dizziness
j j j
Explanation: j
Headache and dizziness commonly occur when nitroglycerin is taken at the beginning of therapy.
j j j j j j j j j j j j j
Nervousness, paresthesia, drowsiness, blurred vision, tinnitus, and diplopia do not typically occur as a result
j j j j j j j j j j j j j j j
of nitroglycerin therapy.
j j j
,Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed.,
j j j j j j j j j j j j j j
Philadelphia, Wolters Kluwer, 2018, Chapter 27: Management of Patients with Coronary Vascular Disorders,
j j j j j j j j j j j j j
Chart 27-3, p. 759.
j j j j
Chapter 27: Management of Patients with Coronary Vascular Disorders - Page 759
j j j j j j j j j j j
The physical therapist notifies the nurse that a client with coronary artery disease (CAD) experiences a much
j j j j j j j j j j j j j j j j
greater-than-average increase in heart rate during physical therapy. The nurse recognizes that an increase in
j j j j j j j j j j j j j j j
heart rate in a client with CAD may result in what?
j j j j j j j j j j j
A) Development of an atrial-septal defect
j j j j j
B) Myocardial ischemia
j j
C) Formation of a pulmonary embolism
j j j j j
D) Release of potassium ions from cardiac cells - CORRECT ANSWER✔✔Correct response:
j j j j j j j j j j j
Myocardial ischemia j
Explanation:
Unlike other arteries, the coronary arteries are perfused during diastole. An increase in heart rate shortens
j j j j j j j j j j j j j j j
diastole and can decrease myocardial perfusion. Clients, particularly those with CAD, can develop myocardial
j j j j j j j j j j j j j j
ischemia. An increase in heart rate will not usually result in a pulmonary embolism or create electrolyte
j j j j j j j j j j j j j j j j j
imbalances. Atrial-septal defects are congenital.
j j j j j
Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed.,
j j j j j j j j j j j j j j
Philadelphia, Wolters Kluwer, 2018, Chapter 25: Assessment of Cardiovascular Function, Coronary Arteries,
j j j j j j j j j j j j
p. 675.
j j
Chapter 25: Assessment of Cardiovascular Function - Page 675
j j j j j j j j
,The nurse is providing care for a client with high cholesterol and triglyceride values. In teaching the client
j j j j j j j j j j j j j j j j j
about therapeutic lifestyle changes such as diet and exercise, the nurse realizes that the desired goal for
j j j j j j j j j j j j j j j j j
cholesterol levels is which of the following?
j j j j j j j
A) High HDL values and high triglyceride values
j j j j j j j
B) Absence of detectable total cholesterol levels
j j j j j j
C) Elevated blood lipids, fasting glucose less than 100
j j j j j j j j
D) Low LDL values and high HDL values - CORRECT ANSWER✔✔Correct response:
j j j j j j j j j j j
Low LDL values and high HDL values
j j j j j j
Explanation:
The desired goal for cholesterol readings is for a client to have low LDL and high HDL values. LDL exerts a
j j j j j j j j j j j j j j j j j j j j
harmful effect on the coronary vasculature because the small LDL particles can be easily transported into the
j j j j j j j j j j j j j j j j j
vessel lining. In contrast, HDL promotes the use of total cholesterol by transporting LDL to the liver, where it is
j j j j j j j j j j j j j j j j j j j j
excreted. Elevated triglycerides are also a major risk factor for cardiovascular disease. A goal is also to keep
j j j j j j j j j j j j j j j j j j
triglyceride levels less than 150 mg/dL. All individuals possess detectable levels of total cholesterol.
j j j j j j j j j j j j j j
Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed.,
j j j j j j j j j j j j j j
Philadelphia, Wolters Kluwer, 2018, Chapter 27: Management of Patients with Coronary Vascular Disorders,
j j j j j j j j j j j j j
Controlling Cholesterol Abnormalities, p. 753.
j j j j j
Chapter 27: Management of Patients with Coronary Vascular Disorders - Page 753
j j j j j j j j j j j
The health care provider has placed a central venous pressure (CVP) monitoring line in an acutely ill client so
j j j j j j j j j j j j j j j j j j
right ventricular function and venous blood return can be closely monitored. The results show decreased
j j j j j j j j j j j j j j j
CVP. What does this indicate?
j j j j j
, A) Possible hypovolemia
j j
B) Possible myocardial infarction (MI)
j j j j
C) Left-sided heart failure
j j j
D) Aortic valve regurgitation - CORRECT ANSWER✔✔Correct response:
j j j j j j j
Possible hypovolemia j
Explanation:
Hypovolemia may cause a decreased CVP. MI, valve regurgitation and heart failure are less likely causes of
j j j j j j j j j j j j j j j j
decreased CVP.
j j
Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed.,
j j j j j j j j j j j j j j
Philadelphia, Wolters Kluwer, 2018, Chapter 25: Assessment of Cardiovascular Function, Central Venous
j j j j j j j j j j j j
Pressure Monitoring, p. 706.
j j j j
Chapter 25: Assessment of Cardiovascular Function - Page 706
j j j j j j j j
The nursing instructor is teaching nursing students about myocardial contractility and ejection fractions.
j j j j j j j j j j j j
What diagnostic tests can determine client ejection fractions? Select all that apply.
j j j j j j j j j j j j
A) Echocardiogram
j
B) Cardiac catheterization
j j
C) Magnetic resonance imaging
j j j
D) Positron emission tomography scan
j j j j
E) Troponin levels - CORRECT ANSWER✔✔Correct response:
j j j j j j
Echocardiogram
Cardiac catheterization j
