Nur 107 Chapters 21-27 Cardiovascular/
Brunner & Suddarth's Textbook of
Medical-Surgical Nursing, 15th ed.,
Questions And Verified Answers
A mclient mwith ma mhistory mof mright-sided mheart mfailure mlives min ma mlong-term mcare mfacility. mIn
mthe mdaily massessment, mthe mnurse mis mrequired mto mrecord mthe mlevel mof mthis mclient's
mperipheral medema. mWhich mwould mbe mthe mmain marea mfor mexamination? m- mAnswer m- mCorrect
mresponse:
feet mand mankles
mExplanation:
Edema moccurs mwhen mblood mis mnot mpumped mefficiently mor mplasma mprotein mlevels mare
minadequate mto mmaintain mosmotic mpressure. mWhen mblood mhas mnowhere melse mto mgo, mthe
mextra mfluid menters mthe mtissues. mParticular mareas mfor mexamination mare mthe mdependent mparts
mof mthe mbody, msuch mas mthe mfeet mand mankles. mThe marea mover, mnot mbelow, mthe msacrum mis
manother marea mprone mto medema.
Reference:
Hinkle, mJ.L., m& mCheever, mK.H., mBrunner m& mSuddarth's mTextbook mof mMedical-Surgical mNursing,
m15th med., mPhiladelphia, mWolters mKluwer, m2022, mChapter m21: mAssessment mof mCardiovascular
mFunction, mAssessment mof mthe mSkin mand mExtremities, mp. m664.
Chapter m21: mAssessment mof mCardiovascular mFunction m- mPage m664
It mis mimportant mfor ma mnurse mto munderstand mcardiac mhemodynamics. mFor mblood mto mflow
mfrom mthe mright mventricle mto mthe mpulmonary martery, mthe mfollowing mmust moccur: m- mAnswer m-
mCorrect mresponse:
Right mventricular mpressure mmust mbe mhigher mthan mpulmonary marterial mpressure.
mExplanation:
For mthe mright mventricle mto mpump mblood min mneed mof moxygenation minto mthe mlungs mvia mthe
mpulmonary martery, mright mventricular mpressure mmust mbe mhigher mthan mpulmonary marterial
mpressure.
,Reference:
Hinkle, mJ.L., m& mCheever, mK.H., mBrunner m& mSuddarth's mTextbook mof mMedical-Surgical mNursing,
m15th med., mPhiladelphia, mWolters mKluwer, m2022, mChapter m21: mAssessment mof mCardiovascular
mFunction, mCardiac mHemodynamics, mp. m655.
Chapter m21: mAssessment mof mCardiovascular mFunction m- mPage m655
For mboth moutpatients mand minpatients mscheduled mfor mdiagnostic mprocedures mof mthe
mcardiovascular msystem, mthe mnurse mperforms ma mthorough minitial massessment mto mestablish
maccurate mbaseline mdata. mWhich mdata mis mnecessary mto mcollect mif mthe mclient mis mexperiencing
mchest mpain? m- mAnswer m- mdescription mof mthe mpain
mExplanation:
If mthe mclient mis mexperiencing mchest mpain, ma mhistory mof mits mlocation, mfrequency, mand
mduration mis mnecessary. mA mdescription mof mthe mpain mis malso mneeded, mincluding mif mit mradiates
mto ma mparticular marea, mwhat mprecipitates mits monset, mand mwhat mbrings mrelief. mThe mnurse
mweighs mthe mclient mand mmeasures mvital msigns. mThe mnurse mmay mmeasure mblood mpressure min
mboth marms mand mcompare mfindings. mThe mnurse massesses mapical mand mradial mpulses, mnoting
mrate, mquality, mand mrhythm. mThe mnurse malso mchecks mperipheral mpulses min mthe mlower
mextremities.
Reference:
Hinkle, mJ.L., m& mCheever, mK.H., mBrunner m& mSuddarth's mTextbook mof mMedical-Surgical mNursing,
m15th med., mPhiladelphia, mWolters mKluwer, m2022, mChapter m21: mAssessment mof mCardiovascular
mFunction, mAssessment mof mthe mCardiovascular mSystem, mHealth mHistory, mp. m658.
Chapter m21: mAssessment mof mCardiovascular mFunction m- mPage m658
The mclinic mnurse mcaring mfor ma mclient mwith ma mcardiovascular mdisorder mis mperforming man
massessment mof mthe mclient's mpulse. mWhich mof mthe mfollowing msteps mis minvolved min
mdetermining mthe mpulse mdeficit? m- mAnswer m- mCount mthe mheart mrate mat mthe mapex.
mExplanation:
The mnurse mdetermines mthe mpulse mdeficit mby mcounting mthe mheart mrate mthrough mauscultation
mat mthe mapex mwhile ma msecond mnurse msimultaneously mpalpates mand mcounts mthe mradial mpulse
mfor ma mfull mminute. mThe mdifference, mif many, mis mthe mpulse mdeficit. mThe mpulse mquality mrefers
mto mits mpalpated mvolume. mPulse mrhythm mis mthe mpattern mof mthe mpulsations mand mthe mpauses
mbetween mthem.
Reference:
,Hinkle, mJ.L., m& mCheever, mK.H., mBrunner m& mSuddarth's mTextbook mof mMedical-Surgical mNursing,
m15th med., mPhiladelphia, mWolters mKluwer, m2022, mChapter m21: mAssessment mof mCardiovascular
mFunction, mPulse mRhythm, mp. m666.
Chapter m21: mAssessment mof mCardiovascular mFunction m- mPage m666
Within mthe mheart, mseveral mstructures mand mseveral mlayers mall mplay ma mpart min mprotecting mthe
mheart mmuscle mand mmaintaining mcardiac mfunction. mThe minner mlayer mof mthe mheart mis
mcomposed mof ma mthin, msmooth mlayer mof mcells, mthe mfolds mof mwhich mform mheart mvalves.
mWhat mis mthe mname mof mthis mlayer mof mcardiac mtissue? m- mAnswer m- mThe minner mlayer, mthe
mendocardium, mis mcomposed mof ma mthin, msmooth mlayer mof mendothelial mcells. mFolds mof
mendocardium mform mthe mheart mvalves. mThe mmiddle mlayer, mthe mmyocardium, mconsists mof
mmuscle mtissue mand mis mthe mforce mbehind mthe mheart's mpumping maction. mThe mpericardium mis
ma msaclike mstructure mthat msurrounds mand msupports mthe mheart. mThe mouter mlayer, mthe
mepicardium, mis mcomposed mof mfibrous mand mloose mconnective mtissue.
Reference:
Hinkle, mJ.L., m& mCheever, mK.H., mBrunner m& mSuddarth's mTextbook mof mMedical-Surgical mNursing,
m15th med., mPhiladelphia, mWolters mKluwer, m2022, mChapter m21: mAssessment mof mCardiovascular
mFunction, mAnatomy mof mthe mHeart, mp. m651.
Chapter m21: mAssessment mof mCardiovascular mFunction m- mPage m651
The mnurse mworking min mthe memergency mdepartment mplaces ma mclient min manaphylactic mshock
mon ma mcardiac mmonitor mand msees mthe mcardiac mrhythm mshown. mWhich mdysrythmia mshould
mthe mnurse mdocument? m- mAnswer m- mventricular mtachycardia
mExplanation:
The mdysrhythmia mshown mis mventricular mtachycardia mbecause mit mhas mmore mthan m3 mpremature
mventricular mcontractions. mThe mventricular mrate mis m100 mto m200 mbpm; mthe matrial mrate
mdepends mon mthe munderlying mrhythm m(e.g., msinus mrhythm). mThe mQRS mduration mis m0.12
mseconds mor mmore mand mhas man mabnormal mshape. m.
Ventricular masystole mis mcharacterized mby mabsent mQRS mcomplexes; mthis mrhythm mis mreferred mto
mas mflatline.
Normal msinus mrhythm mis mregular mwith mwith ma mventricular mand matrial mrate mof m60 mto m100
mbpm. mThe mP-wave mhas ma mconsistent mshape mand mis malways min mfront mof mthe mQRS. mThe mPR
minterval mis ma mconsistent minterval mbetween m0.12 mand m0.20 mseconds, mand mthe mP:QRS mratio
mis m1:1.
A mjunctional mrhythm mnot mcaused mby ma mcomplete mheart mblock mhas ma mventricular mrate mof m40
mto m60 mbpm mand, mif mP mwaves mare mdiscernible, man matrial mrate mof m40 mto m60 mbpm. mThe
, mventricular mand matrial mrhythm mare mregular. mIf mthe mP-wave mis min mfront mof mthe mQRS, mthe
mPR minterval mis mless mthan m0.12 mseconds. mThe mP:QRS mratio mis m1:1 mor m0:1.
Atrial mfibrillation mis mindicated mby man matrial mrate mof m300 mto m600 mbpm; mthe mventricular mrate
mis musually m120 mto m200 mbpm mif muntreated. mBoth mthe mventricular mand matrial mrhythm mare
mhighly mirregular. mP-waves mwill mnot mbe mdiscernible; mirregular mundulating mwaves mthat mvary min
mamplitude mand mshape mare mreferred mto mas mfibrillatory mor mf mwaves. mThe mPR minterval mcannot
mbe mmeasured, mand mthe mP:QRS mratio mis mMany:1.
Reference:
Hinkle, mJ.L., m& mCheever, mK.H., mBrunner m& mSuddarth's mTextbook mof mMedical-Surgical mNursing,
m15th med., mPhiladelphia, mWolters mKluwer, m2022, mChapter m22: mManagement mof mPatients mwith
mArrhythmias mand mConduction mProblems, mTypes mof mArrhythmias, mp. m707.
The mnursing mstudent masks mthe mnurse mhow mto mtell mthe mdifference mbetween mventricular
mtachycardia mand mventricular mfibrillation mon man melectrocardiogram mstrip. mWhat mis mthe mbest
mresponse? m- mAnswer m- mExplanation:
Ventricular mfibrillation mis mirregular mwith mundulating mwaves mand mno mQRS mcomplex, mwhile
mventricular mtachycardia mis musually mregular mand mfast mwith mwide mQRS mcomplexes. mThe
mrhythms mlook mdifferent mon mthe melectrocardiogram mstrip. mThe mQRS mis mwide mand mbizarre mor
mundefined min mventricular mfibrillation. mThe mP-R minterval mis mnot mpresent min mthe mventricular
mdysrhythmias.
Reference:
Hinkle, mJ.L., m& mCheever, mK.H., mBrunner m& mSuddarth's mTextbook mof mMedical-Surgical mNursing,
m15th med., mPhiladelphia, mWolters mKluwer, m2022, mChapter m22: mManagement mof mPatients mwith
mArrhythmias mand mConduction mProblems, mTypes mof mArrhythmias, mpp. m706-707.
Chapter m22: mManagement mof mPatients mwith mArrhythmias mand mConduction mProblems m- mPage
m706-707
The mnurse mis massessing ma mpatient mwith ma mprobable mdiagnosis mof mfirst-degree mAV mblock. mThe
mnurse mis maware mthat mthis mdysrhythmia mis mevident mon man mECG mstrip mby mwhat mindication? m-
mAnswer m- mDelayed mconduction, mproducing ma mprolonged mPR minterval
mExplanation:
Brunner & Suddarth's Textbook of
Medical-Surgical Nursing, 15th ed.,
Questions And Verified Answers
A mclient mwith ma mhistory mof mright-sided mheart mfailure mlives min ma mlong-term mcare mfacility. mIn
mthe mdaily massessment, mthe mnurse mis mrequired mto mrecord mthe mlevel mof mthis mclient's
mperipheral medema. mWhich mwould mbe mthe mmain marea mfor mexamination? m- mAnswer m- mCorrect
mresponse:
feet mand mankles
mExplanation:
Edema moccurs mwhen mblood mis mnot mpumped mefficiently mor mplasma mprotein mlevels mare
minadequate mto mmaintain mosmotic mpressure. mWhen mblood mhas mnowhere melse mto mgo, mthe
mextra mfluid menters mthe mtissues. mParticular mareas mfor mexamination mare mthe mdependent mparts
mof mthe mbody, msuch mas mthe mfeet mand mankles. mThe marea mover, mnot mbelow, mthe msacrum mis
manother marea mprone mto medema.
Reference:
Hinkle, mJ.L., m& mCheever, mK.H., mBrunner m& mSuddarth's mTextbook mof mMedical-Surgical mNursing,
m15th med., mPhiladelphia, mWolters mKluwer, m2022, mChapter m21: mAssessment mof mCardiovascular
mFunction, mAssessment mof mthe mSkin mand mExtremities, mp. m664.
Chapter m21: mAssessment mof mCardiovascular mFunction m- mPage m664
It mis mimportant mfor ma mnurse mto munderstand mcardiac mhemodynamics. mFor mblood mto mflow
mfrom mthe mright mventricle mto mthe mpulmonary martery, mthe mfollowing mmust moccur: m- mAnswer m-
mCorrect mresponse:
Right mventricular mpressure mmust mbe mhigher mthan mpulmonary marterial mpressure.
mExplanation:
For mthe mright mventricle mto mpump mblood min mneed mof moxygenation minto mthe mlungs mvia mthe
mpulmonary martery, mright mventricular mpressure mmust mbe mhigher mthan mpulmonary marterial
mpressure.
,Reference:
Hinkle, mJ.L., m& mCheever, mK.H., mBrunner m& mSuddarth's mTextbook mof mMedical-Surgical mNursing,
m15th med., mPhiladelphia, mWolters mKluwer, m2022, mChapter m21: mAssessment mof mCardiovascular
mFunction, mCardiac mHemodynamics, mp. m655.
Chapter m21: mAssessment mof mCardiovascular mFunction m- mPage m655
For mboth moutpatients mand minpatients mscheduled mfor mdiagnostic mprocedures mof mthe
mcardiovascular msystem, mthe mnurse mperforms ma mthorough minitial massessment mto mestablish
maccurate mbaseline mdata. mWhich mdata mis mnecessary mto mcollect mif mthe mclient mis mexperiencing
mchest mpain? m- mAnswer m- mdescription mof mthe mpain
mExplanation:
If mthe mclient mis mexperiencing mchest mpain, ma mhistory mof mits mlocation, mfrequency, mand
mduration mis mnecessary. mA mdescription mof mthe mpain mis malso mneeded, mincluding mif mit mradiates
mto ma mparticular marea, mwhat mprecipitates mits monset, mand mwhat mbrings mrelief. mThe mnurse
mweighs mthe mclient mand mmeasures mvital msigns. mThe mnurse mmay mmeasure mblood mpressure min
mboth marms mand mcompare mfindings. mThe mnurse massesses mapical mand mradial mpulses, mnoting
mrate, mquality, mand mrhythm. mThe mnurse malso mchecks mperipheral mpulses min mthe mlower
mextremities.
Reference:
Hinkle, mJ.L., m& mCheever, mK.H., mBrunner m& mSuddarth's mTextbook mof mMedical-Surgical mNursing,
m15th med., mPhiladelphia, mWolters mKluwer, m2022, mChapter m21: mAssessment mof mCardiovascular
mFunction, mAssessment mof mthe mCardiovascular mSystem, mHealth mHistory, mp. m658.
Chapter m21: mAssessment mof mCardiovascular mFunction m- mPage m658
The mclinic mnurse mcaring mfor ma mclient mwith ma mcardiovascular mdisorder mis mperforming man
massessment mof mthe mclient's mpulse. mWhich mof mthe mfollowing msteps mis minvolved min
mdetermining mthe mpulse mdeficit? m- mAnswer m- mCount mthe mheart mrate mat mthe mapex.
mExplanation:
The mnurse mdetermines mthe mpulse mdeficit mby mcounting mthe mheart mrate mthrough mauscultation
mat mthe mapex mwhile ma msecond mnurse msimultaneously mpalpates mand mcounts mthe mradial mpulse
mfor ma mfull mminute. mThe mdifference, mif many, mis mthe mpulse mdeficit. mThe mpulse mquality mrefers
mto mits mpalpated mvolume. mPulse mrhythm mis mthe mpattern mof mthe mpulsations mand mthe mpauses
mbetween mthem.
Reference:
,Hinkle, mJ.L., m& mCheever, mK.H., mBrunner m& mSuddarth's mTextbook mof mMedical-Surgical mNursing,
m15th med., mPhiladelphia, mWolters mKluwer, m2022, mChapter m21: mAssessment mof mCardiovascular
mFunction, mPulse mRhythm, mp. m666.
Chapter m21: mAssessment mof mCardiovascular mFunction m- mPage m666
Within mthe mheart, mseveral mstructures mand mseveral mlayers mall mplay ma mpart min mprotecting mthe
mheart mmuscle mand mmaintaining mcardiac mfunction. mThe minner mlayer mof mthe mheart mis
mcomposed mof ma mthin, msmooth mlayer mof mcells, mthe mfolds mof mwhich mform mheart mvalves.
mWhat mis mthe mname mof mthis mlayer mof mcardiac mtissue? m- mAnswer m- mThe minner mlayer, mthe
mendocardium, mis mcomposed mof ma mthin, msmooth mlayer mof mendothelial mcells. mFolds mof
mendocardium mform mthe mheart mvalves. mThe mmiddle mlayer, mthe mmyocardium, mconsists mof
mmuscle mtissue mand mis mthe mforce mbehind mthe mheart's mpumping maction. mThe mpericardium mis
ma msaclike mstructure mthat msurrounds mand msupports mthe mheart. mThe mouter mlayer, mthe
mepicardium, mis mcomposed mof mfibrous mand mloose mconnective mtissue.
Reference:
Hinkle, mJ.L., m& mCheever, mK.H., mBrunner m& mSuddarth's mTextbook mof mMedical-Surgical mNursing,
m15th med., mPhiladelphia, mWolters mKluwer, m2022, mChapter m21: mAssessment mof mCardiovascular
mFunction, mAnatomy mof mthe mHeart, mp. m651.
Chapter m21: mAssessment mof mCardiovascular mFunction m- mPage m651
The mnurse mworking min mthe memergency mdepartment mplaces ma mclient min manaphylactic mshock
mon ma mcardiac mmonitor mand msees mthe mcardiac mrhythm mshown. mWhich mdysrythmia mshould
mthe mnurse mdocument? m- mAnswer m- mventricular mtachycardia
mExplanation:
The mdysrhythmia mshown mis mventricular mtachycardia mbecause mit mhas mmore mthan m3 mpremature
mventricular mcontractions. mThe mventricular mrate mis m100 mto m200 mbpm; mthe matrial mrate
mdepends mon mthe munderlying mrhythm m(e.g., msinus mrhythm). mThe mQRS mduration mis m0.12
mseconds mor mmore mand mhas man mabnormal mshape. m.
Ventricular masystole mis mcharacterized mby mabsent mQRS mcomplexes; mthis mrhythm mis mreferred mto
mas mflatline.
Normal msinus mrhythm mis mregular mwith mwith ma mventricular mand matrial mrate mof m60 mto m100
mbpm. mThe mP-wave mhas ma mconsistent mshape mand mis malways min mfront mof mthe mQRS. mThe mPR
minterval mis ma mconsistent minterval mbetween m0.12 mand m0.20 mseconds, mand mthe mP:QRS mratio
mis m1:1.
A mjunctional mrhythm mnot mcaused mby ma mcomplete mheart mblock mhas ma mventricular mrate mof m40
mto m60 mbpm mand, mif mP mwaves mare mdiscernible, man matrial mrate mof m40 mto m60 mbpm. mThe
, mventricular mand matrial mrhythm mare mregular. mIf mthe mP-wave mis min mfront mof mthe mQRS, mthe
mPR minterval mis mless mthan m0.12 mseconds. mThe mP:QRS mratio mis m1:1 mor m0:1.
Atrial mfibrillation mis mindicated mby man matrial mrate mof m300 mto m600 mbpm; mthe mventricular mrate
mis musually m120 mto m200 mbpm mif muntreated. mBoth mthe mventricular mand matrial mrhythm mare
mhighly mirregular. mP-waves mwill mnot mbe mdiscernible; mirregular mundulating mwaves mthat mvary min
mamplitude mand mshape mare mreferred mto mas mfibrillatory mor mf mwaves. mThe mPR minterval mcannot
mbe mmeasured, mand mthe mP:QRS mratio mis mMany:1.
Reference:
Hinkle, mJ.L., m& mCheever, mK.H., mBrunner m& mSuddarth's mTextbook mof mMedical-Surgical mNursing,
m15th med., mPhiladelphia, mWolters mKluwer, m2022, mChapter m22: mManagement mof mPatients mwith
mArrhythmias mand mConduction mProblems, mTypes mof mArrhythmias, mp. m707.
The mnursing mstudent masks mthe mnurse mhow mto mtell mthe mdifference mbetween mventricular
mtachycardia mand mventricular mfibrillation mon man melectrocardiogram mstrip. mWhat mis mthe mbest
mresponse? m- mAnswer m- mExplanation:
Ventricular mfibrillation mis mirregular mwith mundulating mwaves mand mno mQRS mcomplex, mwhile
mventricular mtachycardia mis musually mregular mand mfast mwith mwide mQRS mcomplexes. mThe
mrhythms mlook mdifferent mon mthe melectrocardiogram mstrip. mThe mQRS mis mwide mand mbizarre mor
mundefined min mventricular mfibrillation. mThe mP-R minterval mis mnot mpresent min mthe mventricular
mdysrhythmias.
Reference:
Hinkle, mJ.L., m& mCheever, mK.H., mBrunner m& mSuddarth's mTextbook mof mMedical-Surgical mNursing,
m15th med., mPhiladelphia, mWolters mKluwer, m2022, mChapter m22: mManagement mof mPatients mwith
mArrhythmias mand mConduction mProblems, mTypes mof mArrhythmias, mpp. m706-707.
Chapter m22: mManagement mof mPatients mwith mArrhythmias mand mConduction mProblems m- mPage
m706-707
The mnurse mis massessing ma mpatient mwith ma mprobable mdiagnosis mof mfirst-degree mAV mblock. mThe
mnurse mis maware mthat mthis mdysrhythmia mis mevident mon man mECG mstrip mby mwhat mindication? m-
mAnswer m- mDelayed mconduction, mproducing ma mprolonged mPR minterval
mExplanation:
