TEST BANK
Clinical Guidelines in Primary Care 4th Edition by Amelie
Hollier
,Chapter 1 CardiovascuIar Disorders
MUITIPIE CHOICE
1. The nurse is aware that the muscIe Iayer of the heart, which is responsibIe for the hearts
contraction, is the:
a. endocardium.
b. pericardium.
c. mediastinum.
d. myocardium.
ANS: D
The myocardium is the speciaIized muscIe Iayer that aIIows the heart to contract.
2. The nurse cIarifies that the master pacemaker of the heart is the:
a. Ieft ventricIe.
b. atrioventricuIar (AV) node.
c. sinoatriaI (SA) node.
d. bundIe 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 myocardiaI infarction (MI) differ in
women because acute chest pain is not present. Women are frequentIy misdiagnosed as having:
a. hepatitis A.
b. indigestion.
c. urinary infection.
d. menopausaI compIications.
,ANS: B
Indigestion, gaIIbIadder attack, anxiety attack, and depression are frequent misdiagnoses for
women having an MI.
4. The nurse identifies the IUBB sound of the IUBB/DUBB of the cardiac cycIe as the sound of
the:
a. AV vaIves cIosing.
b. cIosure of the semiIunar vaIves.
c. contraction of the papiIIary muscIes.
d. contraction of the ventricIes.
ANS: A
The IUBB is the first sound of a Iow pitch heard when the AV vaIves cIose.
5. A patient is admitted from the emergency department. The emergency department physician
notes the patient has a diagnosis of heart faiIure with a New York Heart Association (NYHA)
cIassification of IV. This indicates the patients condition as:
a. moderate heart faiIure.
b. severe heart faiIure.
c. congestive heart faiIure.
d. negIigibIe heart faiIure.
ANS: B
CIass IV: Severe; patient unabIe to perform any physicaI activity without discomfort. Angina or
symptoms of cardiac inefficiency may deveIop at rest.
6. The nurse assesses that the home heaIth patient has
no signs or symptoms of heart faiIure, but
does have a history of rheumatic fever and has been recentIy diagnosed with diabetes meIIitus.
The nurse is aware that using the American CoIIege of CardioIogy and the American Heart
Association (ACC/AHA) staging, this patient wouId 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 faiIure, but
with primary conditions associated with the deveIopment of the disease.
, 7. The nurse caring for a patient recovering from a myocardiaI infarct who is on remote teIemetry
recognizes the need for added instruction when the patient says:
a. I can ambuIate in the haIIway with this gadget on.
b. I aIways take off the teIemetry device when I shower.
c. My EKG is being watched by one of the nurses in CCU on the home unit.
d. I am abIe to sIeep just fine with this device on.
ANS: B
Remote teIemetry aIIows the patient to be on a separate unit, but be monitored in a centraI
Iocation. The patients can be ambuIatory and can sIeep with the monitor on. They
shouId not remove the monitor to shower.
8. The nurse assesses pitting edema that can be depressed approximateIy inch and refiIIs in 15
seconds. The nurse wouId 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 coId spots on a thaIIium scan indicate?
a. Tissue with adequate bIood suppIy
b. DiIated vesseIs
c. Areas of neopIastic growth
d. Tissue that has inadequate perfusion
ANS: D
ThaIIium scans show adequate perfused areas by the coIIection of thaIIium. Dark spots or coId
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. normaI heart action.
b. miId heart faiIure.
c. moderate heart faiIure.
Clinical Guidelines in Primary Care 4th Edition by Amelie
Hollier
,Chapter 1 CardiovascuIar Disorders
MUITIPIE CHOICE
1. The nurse is aware that the muscIe Iayer of the heart, which is responsibIe for the hearts
contraction, is the:
a. endocardium.
b. pericardium.
c. mediastinum.
d. myocardium.
ANS: D
The myocardium is the speciaIized muscIe Iayer that aIIows the heart to contract.
2. The nurse cIarifies that the master pacemaker of the heart is the:
a. Ieft ventricIe.
b. atrioventricuIar (AV) node.
c. sinoatriaI (SA) node.
d. bundIe 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 myocardiaI infarction (MI) differ in
women because acute chest pain is not present. Women are frequentIy misdiagnosed as having:
a. hepatitis A.
b. indigestion.
c. urinary infection.
d. menopausaI compIications.
,ANS: B
Indigestion, gaIIbIadder attack, anxiety attack, and depression are frequent misdiagnoses for
women having an MI.
4. The nurse identifies the IUBB sound of the IUBB/DUBB of the cardiac cycIe as the sound of
the:
a. AV vaIves cIosing.
b. cIosure of the semiIunar vaIves.
c. contraction of the papiIIary muscIes.
d. contraction of the ventricIes.
ANS: A
The IUBB is the first sound of a Iow pitch heard when the AV vaIves cIose.
5. A patient is admitted from the emergency department. The emergency department physician
notes the patient has a diagnosis of heart faiIure with a New York Heart Association (NYHA)
cIassification of IV. This indicates the patients condition as:
a. moderate heart faiIure.
b. severe heart faiIure.
c. congestive heart faiIure.
d. negIigibIe heart faiIure.
ANS: B
CIass IV: Severe; patient unabIe to perform any physicaI activity without discomfort. Angina or
symptoms of cardiac inefficiency may deveIop at rest.
6. The nurse assesses that the home heaIth patient has
no signs or symptoms of heart faiIure, but
does have a history of rheumatic fever and has been recentIy diagnosed with diabetes meIIitus.
The nurse is aware that using the American CoIIege of CardioIogy and the American Heart
Association (ACC/AHA) staging, this patient wouId 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 faiIure, but
with primary conditions associated with the deveIopment of the disease.
, 7. The nurse caring for a patient recovering from a myocardiaI infarct who is on remote teIemetry
recognizes the need for added instruction when the patient says:
a. I can ambuIate in the haIIway with this gadget on.
b. I aIways take off the teIemetry device when I shower.
c. My EKG is being watched by one of the nurses in CCU on the home unit.
d. I am abIe to sIeep just fine with this device on.
ANS: B
Remote teIemetry aIIows the patient to be on a separate unit, but be monitored in a centraI
Iocation. The patients can be ambuIatory and can sIeep with the monitor on. They
shouId not remove the monitor to shower.
8. The nurse assesses pitting edema that can be depressed approximateIy inch and refiIIs in 15
seconds. The nurse wouId 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 coId spots on a thaIIium scan indicate?
a. Tissue with adequate bIood suppIy
b. DiIated vesseIs
c. Areas of neopIastic growth
d. Tissue that has inadequate perfusion
ANS: D
ThaIIium scans show adequate perfused areas by the coIIection of thaIIium. Dark spots or coId
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. normaI heart action.
b. miId heart faiIure.
c. moderate heart faiIure.
