Test Bank for Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 15th Edition
NOT: Multiple Choice
36. A client with an ICD calls the cardiologist's office and talks to the nurse. The client is
concerned about being defibrillated too often. The nurse tells the client to come to the
office to be evaluated because the nurse knows that the most frequent complication of
ICD therapy is what issue?
A. Infection
B. Failure to capture
C. Premature battery depletion
D. Oversensing of dysrhythmias
ANS: D
Rationale: Inappropriate delivery of ICD therapy, usually due to oversensing of atrial and
sinus tachycardias with a rapid ventricular rate response, is the most frequent
complication of ICD. Infections, failure to capture, and premature battery failure are less
common.
PTS: 1 REF: p. 718
NAT: Client Needs: Physiological Integrity: Physiological Adaptation
TOP: Chapter 22: Management of Clients with Arrhythmias and Conduction Disorders
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand
NOT: Multiple Choice
,Test Bank for Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 15th Edition
Chapter 23: Management of Patients with Coronary Vascular
Disorders
1. The nurse is caring for a client who has been diagnosed with an elevated cholesterol
level. The nurse is aware that plaque on the inner lumen of arteries is composed chiefly
of what?
A. Lipids and fibrous tissue
B. White blood cells
C. Lipoproteins
D. High-density cholesterol
ANS: A
Rationale: As T-lymphocytes and monocytes infiltrate to ingest lipids on the arterial wall
and then die, a fibrous tissue develops. This causes plaques to form on the inner lumen
of arterial walls. These plaques do not consist of white cells, lipoproteins, or high-density
cholesterol.
PTS: 1 REF: p. 726
NAT: Client Needs: Safe, Effective Care Environment: Management of Care | Client
Needs: Physiological Integrity: Physiological Adaptation
TOP: Chapter 23: Management of Clients with Coronary Vascular Disorders
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand
NOT: Multiple Choice
2. A client presents to the clinic reporting intermittent chest pain on exertion, which is
eventually attributed to angina. The nurse should inform the client that angina is most
often attributable to what cause?
A. Decreased cardiac output
B. Decreased cardiac contractility
C. Infarction of the myocardium
D. Coronary arteriosclerosis
,Test Bank for Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 15th Edition
ANS: D
Rationale: In most cases, angina pectoris is due to arteriosclerosis. The disease is not a
result of impaired cardiac output or contractility. Infarction may result from untreated
angina, but it is not a cause of the disease.
PTS: 1 REF: p. 726
NAT: Client Needs: Physiological Integrity: Physiological Adaptation
TOP: Chapter 23: Management of Clients with Coronary Vascular Disorders
KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Apply
NOT: Multiple Choice
3. The nurse is caring for an adult client who had symptoms of unstable angina upon
admission to the hospital. What nursing diagnosis underlies the discomfort associated
with angina?
A. Ineffective breathing pattern related to decreased cardiac output
B. Anxiety related to fear of death
C. Ineffective cardiopulmonary tissue perfusion related to coronary artery disease
(CAD)
D. Impaired skin integrity related to CAD
ANS: C
Rationale: Ineffective cardiopulmonary tissue perfusion directly results in the symptoms
of discomfort associated with angina. Anxiety and ineffective breathing may result from
angina chest pain, but they are not the causes. Skin integrity is not impaired by the
effects of angina.
PTS: 1 REF: p. 742
NAT: Client Needs: Safe, Effective Care Environment: Management of Care
TOP: Chapter 23: Management of Clients with Coronary Vascular Disorders
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply
NOT: Multiple Choice
, Test Bank for Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 15th Edition
4. The triage nurse in the ED assesses an adult client who presents with reports of
midsternal chest pain that has lasted for the last 5 hours. If the client's symptoms are due
to an MI, what will have happened to the myocardium?
A. It may have developed an increased area of infarction during the time without
treatment.
B. It will probably not have more damage than if the client came in immediately.
C. It may be responsive to restoration of the area of dead cells with proper
treatment.
D. It has been irreparably damaged, so immediate treatment is no longer
necessary.
ANS: A
Rationale: When the client experiences lack of oxygen to myocardium cells during an MI,
the sooner treatment is initiated, the more likely the treatment will prevent or minimize
myocardial tissue necrosis. Delays in treatment equate with increased myocardial
damage. Despite the length of time the symptoms have been present, treatment needs
to be initiated immediately to minimize further damage. Dead cells cannot be restored by
any means.
PTS: 1 REF: p. 737
NAT: Client Needs: Physiological Integrity: Physiological Adaptation
TOP: Chapter 23: Management of Clients with Coronary Vascular Disorders
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Analyze
NOT: Multiple Choice
5. Family members bring a client to the ED with pale cool skin, sudden midsternal chest
pain unrelieved with rest, and a history of CAD. How should the nurse best interpret
these initial data?
A. The symptoms indicate angina and should be treated as such.
B. The symptoms indicate a pulmonary etiology rather than a cardiac etiology.
C. The symptoms indicate an acute coronary episode and should be treated as
such.
NOT: Multiple Choice
36. A client with an ICD calls the cardiologist's office and talks to the nurse. The client is
concerned about being defibrillated too often. The nurse tells the client to come to the
office to be evaluated because the nurse knows that the most frequent complication of
ICD therapy is what issue?
A. Infection
B. Failure to capture
C. Premature battery depletion
D. Oversensing of dysrhythmias
ANS: D
Rationale: Inappropriate delivery of ICD therapy, usually due to oversensing of atrial and
sinus tachycardias with a rapid ventricular rate response, is the most frequent
complication of ICD. Infections, failure to capture, and premature battery failure are less
common.
PTS: 1 REF: p. 718
NAT: Client Needs: Physiological Integrity: Physiological Adaptation
TOP: Chapter 22: Management of Clients with Arrhythmias and Conduction Disorders
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand
NOT: Multiple Choice
,Test Bank for Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 15th Edition
Chapter 23: Management of Patients with Coronary Vascular
Disorders
1. The nurse is caring for a client who has been diagnosed with an elevated cholesterol
level. The nurse is aware that plaque on the inner lumen of arteries is composed chiefly
of what?
A. Lipids and fibrous tissue
B. White blood cells
C. Lipoproteins
D. High-density cholesterol
ANS: A
Rationale: As T-lymphocytes and monocytes infiltrate to ingest lipids on the arterial wall
and then die, a fibrous tissue develops. This causes plaques to form on the inner lumen
of arterial walls. These plaques do not consist of white cells, lipoproteins, or high-density
cholesterol.
PTS: 1 REF: p. 726
NAT: Client Needs: Safe, Effective Care Environment: Management of Care | Client
Needs: Physiological Integrity: Physiological Adaptation
TOP: Chapter 23: Management of Clients with Coronary Vascular Disorders
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand
NOT: Multiple Choice
2. A client presents to the clinic reporting intermittent chest pain on exertion, which is
eventually attributed to angina. The nurse should inform the client that angina is most
often attributable to what cause?
A. Decreased cardiac output
B. Decreased cardiac contractility
C. Infarction of the myocardium
D. Coronary arteriosclerosis
,Test Bank for Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 15th Edition
ANS: D
Rationale: In most cases, angina pectoris is due to arteriosclerosis. The disease is not a
result of impaired cardiac output or contractility. Infarction may result from untreated
angina, but it is not a cause of the disease.
PTS: 1 REF: p. 726
NAT: Client Needs: Physiological Integrity: Physiological Adaptation
TOP: Chapter 23: Management of Clients with Coronary Vascular Disorders
KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Apply
NOT: Multiple Choice
3. The nurse is caring for an adult client who had symptoms of unstable angina upon
admission to the hospital. What nursing diagnosis underlies the discomfort associated
with angina?
A. Ineffective breathing pattern related to decreased cardiac output
B. Anxiety related to fear of death
C. Ineffective cardiopulmonary tissue perfusion related to coronary artery disease
(CAD)
D. Impaired skin integrity related to CAD
ANS: C
Rationale: Ineffective cardiopulmonary tissue perfusion directly results in the symptoms
of discomfort associated with angina. Anxiety and ineffective breathing may result from
angina chest pain, but they are not the causes. Skin integrity is not impaired by the
effects of angina.
PTS: 1 REF: p. 742
NAT: Client Needs: Safe, Effective Care Environment: Management of Care
TOP: Chapter 23: Management of Clients with Coronary Vascular Disorders
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply
NOT: Multiple Choice
, Test Bank for Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 15th Edition
4. The triage nurse in the ED assesses an adult client who presents with reports of
midsternal chest pain that has lasted for the last 5 hours. If the client's symptoms are due
to an MI, what will have happened to the myocardium?
A. It may have developed an increased area of infarction during the time without
treatment.
B. It will probably not have more damage than if the client came in immediately.
C. It may be responsive to restoration of the area of dead cells with proper
treatment.
D. It has been irreparably damaged, so immediate treatment is no longer
necessary.
ANS: A
Rationale: When the client experiences lack of oxygen to myocardium cells during an MI,
the sooner treatment is initiated, the more likely the treatment will prevent or minimize
myocardial tissue necrosis. Delays in treatment equate with increased myocardial
damage. Despite the length of time the symptoms have been present, treatment needs
to be initiated immediately to minimize further damage. Dead cells cannot be restored by
any means.
PTS: 1 REF: p. 737
NAT: Client Needs: Physiological Integrity: Physiological Adaptation
TOP: Chapter 23: Management of Clients with Coronary Vascular Disorders
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Analyze
NOT: Multiple Choice
5. Family members bring a client to the ED with pale cool skin, sudden midsternal chest
pain unrelieved with rest, and a history of CAD. How should the nurse best interpret
these initial data?
A. The symptoms indicate angina and should be treated as such.
B. The symptoms indicate a pulmonary etiology rather than a cardiac etiology.
C. The symptoms indicate an acute coronary episode and should be treated as
such.
