Page 1 Clinical Guidelines in Primary Care 5th Edition Testbank Hollier Test Bank 9781565332737 Page 1 of 217
Clinical Guidelines in Primary
Care 4th Edition Testbank
Hollier Test Bank/StudyGuide
Chapter 1 Cardiovascular Disorders
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.
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,Page 2 Clinical Guidelines in Primary Care 5th Edition Testbank Hollier Test Bank 9781565332737 Page 2 of 217
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.
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,Page 3 Clinical Guidelines in Primary Care 5th Edition Testbank Hollier Test Bank 9781565332737 Page 3 of 217
7. The nurse caring for a patient recovering from a myocardial infarct who is on remote telemetry
recognizes the need for added instruction when the patient says:
a. I can ambulate in the hallway with this gadget on.
b. I always take off the telemetry device when I shower.
c. My EKG is being watched by one of the nurses in CCU on the home unit.
d. I am able to sleep just fine with this device on.
ANS: B
Remote telemetry allows the patient to be on a separate unit, but be monitored in a central
location. The patients can be ambulatory and can sleep with the monitor on. They
should not remove the monitor to shower.
8. The nurse assesses pitting edema that can be depressed approximately inch and refills in 15
seconds. The nurse would document this assessment as:
a. +1 edema.
b. +2 edema.
c. +3 edema.
d. +4 edema.
ANS: B
A +2 edema can be documented if the skin can be depressed inch and respond within 15
seconds.
9. What do dark or cold spots on a thallium scan indicate?
a. Tissue with adequate blood supply
b. Dilated vessels
c. Areas of neoplastic growth
d. Tissue that has inadequate perfusion
ANS: D
Thallium scans show adequate perfused areas by the collection of thallium. Dark spots or cold
spots indicate tissues that have inadequate perfusion.
10. The nurse recognizes the echocardiogram report that shows an ejection factor of 42% as an
indication of:
a. normal heart action.
b. mild heart failure.
c. moderate heart failure.
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, Page 4 Clinical Guidelines in Primary Care 5th Edition Testbank Hollier Test Bank 9781565332737 Page 4 of 217
d. severe heart failure.
ANS: C
An ejection factor (cardiac output) of 42% indicates moderate heart failure.
11. The nurse takes into consideration that age-related changes can affect the peripheral
circulation because of:
a. sclerosed blood vessels.
b. hypotension.
c. inactivity.
d. poor nutrition.
ANS: A
Aging causes sclerotic changes in the blood vessels that lead to decreased elasticity and
narrowing of the vessel lumen.
12. The nurse assessing a cardiac monitor notes that the cardiac complexes each have a P wave
followed by a QRS and a T. The rate is 120. The nurse recognizes this arrhythmia as:
a. sinus bradycardia.
b. atrial fibrillation.
c. sinus tachycardia.
d. ventricular tachycardia.
ANS: C
Sinus tachycardia has a P wave followed by the QRS and the T. All the components of the
complex are present and in the correct order, but the rate is over 100 beats a minute.
13. After an influenza-like illness, the patient complains of chills and small petechiae in his
mouth and his legs. A heart murmur is detectable. These are characteristic signs of:
a. congestive heart failure.
b. heart block.
c. aortic stenosis.
d. infective endocarditis.
ANS: D
Collection of subjective data includes noting patient complaints of influenza-like symptoms with
recurrent fever, undue fatigue, chest pain, and chills. Objective data may reveal the significant
2/5/2026 https://www.stuvia.com/dashboard
Clinical Guidelines in Primary
Care 4th Edition Testbank
Hollier Test Bank/StudyGuide
Chapter 1 Cardiovascular Disorders
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.
2/5/2026 https://www.stuvia.com/dashboard
,Page 2 Clinical Guidelines in Primary Care 5th Edition Testbank Hollier Test Bank 9781565332737 Page 2 of 217
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.
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,Page 3 Clinical Guidelines in Primary Care 5th Edition Testbank Hollier Test Bank 9781565332737 Page 3 of 217
7. The nurse caring for a patient recovering from a myocardial infarct who is on remote telemetry
recognizes the need for added instruction when the patient says:
a. I can ambulate in the hallway with this gadget on.
b. I always take off the telemetry device when I shower.
c. My EKG is being watched by one of the nurses in CCU on the home unit.
d. I am able to sleep just fine with this device on.
ANS: B
Remote telemetry allows the patient to be on a separate unit, but be monitored in a central
location. The patients can be ambulatory and can sleep with the monitor on. They
should not remove the monitor to shower.
8. The nurse assesses pitting edema that can be depressed approximately inch and refills in 15
seconds. The nurse would document this assessment as:
a. +1 edema.
b. +2 edema.
c. +3 edema.
d. +4 edema.
ANS: B
A +2 edema can be documented if the skin can be depressed inch and respond within 15
seconds.
9. What do dark or cold spots on a thallium scan indicate?
a. Tissue with adequate blood supply
b. Dilated vessels
c. Areas of neoplastic growth
d. Tissue that has inadequate perfusion
ANS: D
Thallium scans show adequate perfused areas by the collection of thallium. Dark spots or cold
spots indicate tissues that have inadequate perfusion.
10. The nurse recognizes the echocardiogram report that shows an ejection factor of 42% as an
indication of:
a. normal heart action.
b. mild heart failure.
c. moderate heart failure.
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, Page 4 Clinical Guidelines in Primary Care 5th Edition Testbank Hollier Test Bank 9781565332737 Page 4 of 217
d. severe heart failure.
ANS: C
An ejection factor (cardiac output) of 42% indicates moderate heart failure.
11. The nurse takes into consideration that age-related changes can affect the peripheral
circulation because of:
a. sclerosed blood vessels.
b. hypotension.
c. inactivity.
d. poor nutrition.
ANS: A
Aging causes sclerotic changes in the blood vessels that lead to decreased elasticity and
narrowing of the vessel lumen.
12. The nurse assessing a cardiac monitor notes that the cardiac complexes each have a P wave
followed by a QRS and a T. The rate is 120. The nurse recognizes this arrhythmia as:
a. sinus bradycardia.
b. atrial fibrillation.
c. sinus tachycardia.
d. ventricular tachycardia.
ANS: C
Sinus tachycardia has a P wave followed by the QRS and the T. All the components of the
complex are present and in the correct order, but the rate is over 100 beats a minute.
13. After an influenza-like illness, the patient complains of chills and small petechiae in his
mouth and his legs. A heart murmur is detectable. These are characteristic signs of:
a. congestive heart failure.
b. heart block.
c. aortic stenosis.
d. infective endocarditis.
ANS: D
Collection of subjective data includes noting patient complaints of influenza-like symptoms with
recurrent fever, undue fatigue, chest pain, and chills. Objective data may reveal the significant
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