Brunner and Suddarth's Textbook of
Medical Surgical Nursing -Chapter 29
A cardiac patient's resistance to left ventricular filling has caused blood to back up into the patient's
circulatory system. What health problem is likely to result?
Acute pulmonary edema
Rightsided HF
Right ventricular hypertrophy
Leftsided HF - correct answerAcute pulmonary edema****
Rightsided HF
Right ventricular hypertrophy
Leftsided HF
Feedback: With increased resistance to left ventricular filling, blood backs up into the pulmonary
circulation. The patient quickly develops pulmonary edema from the blood volume overload in the
lungs. When the blood backs up into the pulmonary circulation, rightsided HF, leftsided HF, and right
ventricular hypertrophy do not directly occur.
A cardiovascular patient with a previous history of pulmonary embolism (PE) is experiencing a sudden
onset of dyspnea, rapid breathing, and chest pain. The nurse recognizes the characteristic signs and
symptoms of a PE. What is the nurse's best action?
Rapidly assess the patient's cardiopulmonary status.
Arrange for an ECG.
Increase the height of the patient's bed.
Manage the patient's anxiety. - correct answerRapidly assess the patient's cardiopulmonary status.****
Arrange for an ECG.
,Increase the height of the patient's bed.
Manage the patient's anxiety.
Feedback: Patient management in the event of a PE begins with cardiopulmonary assessment and
intervention. This is a priority over ECG monitoring, management of anxiety, or repositioning of the
patient, even though each of these actions may be appropriate and necessary.
A nurse in the CCU is caring for a patient with HF who has developed an intracardiac thrombus. This
creates a high risk for what sequela?
Stroke
Myocardial infarction (MI)
Hemorrhage
Peripheral edema - correct answerStroke***
Myocardial infarction (MI)
Hemorrhage
Peripheral edema
Feedback: Intracardiac thrombi can become lodged in the cerebral vasculature, causing stroke. There is
no direct risk of MI, hemorrhage, or peripheral edema.
A patient admitted to the medical unit with HF is exhibiting signs and symptoms of pulmonary edema.
The nurse is aware that positioning will promote circulation. How should the nurse best position the
patient?
In a high Fowler's position
On the left sidelying position
In a flat, supine position
In the Trendelenburg position - correct answerIn a high Fowler's position****
On the left sidelying position
, In a flat, supine position
In the Trendelenburg position
Feedback: Proper positioning can help reduce venous return to the heart. The patient is positioned
upright. If the patient is unable to sit with the lower extremities dependent, the patient may be placed
in an upright position in bed. The supine position and Trendelenburg positions will not reduce venous
return, lower the output of the right ventricle, or decrease lung congestion. Similarly, sidelying does not
promote circulation.
A patient presents to the ED complaining of increasing shortness of breath. The nurse assessing the
patient notes a history of leftsided HF. The patient is agitated and occasionally coughing up pinktinged,
foamy sputum. The nurse should recognize the signs and symptoms of what health problem?
Rightsided heart failure
Acute pulmonary edema
Pneumonia
Cardiogenic shock - correct answerRightsided heart failure
Acute pulmonary edema****
Pneumonia
Cardiogenic shock
Feedback: Because of decreased contractility and increased fluid volume and pressure in patients with
HF, fluid may be driven from the pulmonary capillary beds into the alveoli, causing pulmonary edema
and signs and symptoms described. In rightsided heart failure, the patient exhibits hepatomegaly,
jugular vein distention, and peripheral edema. In pneumonia, the patient would have a temperature
spike, and sputum that varies in color. Cardiogenic shock would show signs of hypotension and
tachycardia.
A patient who is at high risk for developing intracardiac thrombi has been placed on longterm
anticoagulation. What aspect of the patient's health history creates a heightened risk of intracardiac
thrombi?
Atrial fibrillation
Medical Surgical Nursing -Chapter 29
A cardiac patient's resistance to left ventricular filling has caused blood to back up into the patient's
circulatory system. What health problem is likely to result?
Acute pulmonary edema
Rightsided HF
Right ventricular hypertrophy
Leftsided HF - correct answerAcute pulmonary edema****
Rightsided HF
Right ventricular hypertrophy
Leftsided HF
Feedback: With increased resistance to left ventricular filling, blood backs up into the pulmonary
circulation. The patient quickly develops pulmonary edema from the blood volume overload in the
lungs. When the blood backs up into the pulmonary circulation, rightsided HF, leftsided HF, and right
ventricular hypertrophy do not directly occur.
A cardiovascular patient with a previous history of pulmonary embolism (PE) is experiencing a sudden
onset of dyspnea, rapid breathing, and chest pain. The nurse recognizes the characteristic signs and
symptoms of a PE. What is the nurse's best action?
Rapidly assess the patient's cardiopulmonary status.
Arrange for an ECG.
Increase the height of the patient's bed.
Manage the patient's anxiety. - correct answerRapidly assess the patient's cardiopulmonary status.****
Arrange for an ECG.
,Increase the height of the patient's bed.
Manage the patient's anxiety.
Feedback: Patient management in the event of a PE begins with cardiopulmonary assessment and
intervention. This is a priority over ECG monitoring, management of anxiety, or repositioning of the
patient, even though each of these actions may be appropriate and necessary.
A nurse in the CCU is caring for a patient with HF who has developed an intracardiac thrombus. This
creates a high risk for what sequela?
Stroke
Myocardial infarction (MI)
Hemorrhage
Peripheral edema - correct answerStroke***
Myocardial infarction (MI)
Hemorrhage
Peripheral edema
Feedback: Intracardiac thrombi can become lodged in the cerebral vasculature, causing stroke. There is
no direct risk of MI, hemorrhage, or peripheral edema.
A patient admitted to the medical unit with HF is exhibiting signs and symptoms of pulmonary edema.
The nurse is aware that positioning will promote circulation. How should the nurse best position the
patient?
In a high Fowler's position
On the left sidelying position
In a flat, supine position
In the Trendelenburg position - correct answerIn a high Fowler's position****
On the left sidelying position
, In a flat, supine position
In the Trendelenburg position
Feedback: Proper positioning can help reduce venous return to the heart. The patient is positioned
upright. If the patient is unable to sit with the lower extremities dependent, the patient may be placed
in an upright position in bed. The supine position and Trendelenburg positions will not reduce venous
return, lower the output of the right ventricle, or decrease lung congestion. Similarly, sidelying does not
promote circulation.
A patient presents to the ED complaining of increasing shortness of breath. The nurse assessing the
patient notes a history of leftsided HF. The patient is agitated and occasionally coughing up pinktinged,
foamy sputum. The nurse should recognize the signs and symptoms of what health problem?
Rightsided heart failure
Acute pulmonary edema
Pneumonia
Cardiogenic shock - correct answerRightsided heart failure
Acute pulmonary edema****
Pneumonia
Cardiogenic shock
Feedback: Because of decreased contractility and increased fluid volume and pressure in patients with
HF, fluid may be driven from the pulmonary capillary beds into the alveoli, causing pulmonary edema
and signs and symptoms described. In rightsided heart failure, the patient exhibits hepatomegaly,
jugular vein distention, and peripheral edema. In pneumonia, the patient would have a temperature
spike, and sputum that varies in color. Cardiogenic shock would show signs of hypotension and
tachycardia.
A patient who is at high risk for developing intracardiac thrombi has been placed on longterm
anticoagulation. What aspect of the patient's health history creates a heightened risk of intracardiac
thrombi?
Atrial fibrillation
