Cardiovascular Test Bank100
A nurse assesses a client who had a myocardial infarction and is hypotensive. Which additional
assessment finding should the nurse expect?
a. Heart rate of 120 beats/min
b. Cool, clammy skin
c. Oxygen saturation of 90%
d. Respiratory rate of 8 breaths/min - ANSWERSANS: A
When a client experiences hypotension, baroreceptors in the aortic arch sense a pressure
decrease in the vessels. The parasympathetic system responds by lessening the inhibitory effect
on the sinoatrial node. This results in an increase in heart rate and respiratory rate. This
tachycardia is an early response and is seen even when blood pressure is not critically low. An
increased heart rate and respiratory rate will compensate for the low blood pressure and
maintain oxygen saturations and perfusion. The client may not be able to compensate for long,
and decreased oxygenation and cool, clammy skin will occur later.
A nurse assesses a client after administering a prescribed beta blocker. Which assessment
should the nurse expect to find?
a. Blood pressure increased from 98/42 mm Hg to 132/60 mm Hg
b. Respiratory rate decreased from 25 breaths/min to 14 breaths/min
c. Oxygen saturation increased from 88% to 96%
,d. Pulse decreased from 100 beats/min to 80 beats/min - ANSWERSANS: D
Beta blockers block the stimulation of beta1-adrenergic receptors. They block the sympathetic
(fight-or-flight) response and decrease the heart rate (HR). The beta blocker will decrease HR
and blood pressure, increasing ventricular filling time. It usually does not have effects on beta2-
adrenergic receptor sites. Cardiac output will drop because of decreased HR.
A nurse assesses clients on a medical-surgical unit. Which client should the nurse identify as
having the greatest risk for cardiovascular disease?
a. An 86-year-old man with a history of asthma
b. A 32-year-old Asian-American man with colorectal cancer
c. A 45-year-old American Indian woman with diabetes mellitus
d. A 53-year-old postmenopausal woman who is on hormone therapy - ANSWERSANS: C
The incidence of coronary artery disease and hypertension is higher in American Indians than in
whites or Asian Americans. Diabetes mellitus increases the risk for hypertension and coronary
artery disease in people of any race or ethnicity. Asthma, colorectal cancer, and hormone
therapy do not increase risk for cardiovascular disease.
A nurse assesses an older adult client who has multiple chronic diseases. The clients heart rate
is 48 beats/min. Which action should the nurse take first?
a. Document the finding in the chart.
,b. Initiate external pacing.
c. Assess the clients medications.
d. Administer 1 mg of atropine. - ANSWERSANS: C
Pacemaker cells in the conduction system decrease in number as a person ages, resulting in
bradycardia. The nurse should check the medication reconciliation for medications that might
cause such a drop in heart rate, then should inform the health care provider. Documentation is
important, but it is not the priority action. The heart rate is not low enough for atropine or an
external pacemaker to be needed.
An emergency room nurse obtains the health history of a client. Which statement by the client
should alert the nurse to the occurrence of heart failure?
a. I get short of breath when I climb stairs.
b. I see halos floating around my head.
c. I have trouble remembering things.
d. I have lost weight over the past month. - ANSWERSANS: A
Dyspnea on exertion is an early manifestation of heart failure and is associated with an activity
such as stair climbing. The other findings are not specific to early occurrence of heart failure.
A nurse obtains the health history of a client who is newly admitted to the medical unit. Which
statement by the client should alert the nurse to the presence of edema?
, a. I wake up to go to the bathroom at night.
b. My shoes fit tighter by the end of the day.
c. I seem to be feeling more anxious lately.
d. I drink at least eight glasses of water a day. - ANSWERSANS: B
Weight gain can result from fluid accumulation in the interstitial spaces. This is known as
edema. The nurse should note whether the client feels that his or her shoes or rings are tight,
and should observe, when present, an indentation around the leg where the socks end. The
other answers do not describe edema.
A nurse assesses an older adult client who is experiencing a myocardial infarction. Which clinical
manifestation should the nurse expect?
a. Excruciating pain on inspiration
b. Left lateral chest wall pain
c. Disorientation and confusion
d. Numbness and tingling of the arm - ANSWERSANS: C
In older adults, disorientation or confusion may be the major manifestation of myocardial
infarction caused by poor cardiac output. Pain manifestations and numbness and tingling of the
A nurse assesses a client who had a myocardial infarction and is hypotensive. Which additional
assessment finding should the nurse expect?
a. Heart rate of 120 beats/min
b. Cool, clammy skin
c. Oxygen saturation of 90%
d. Respiratory rate of 8 breaths/min - ANSWERSANS: A
When a client experiences hypotension, baroreceptors in the aortic arch sense a pressure
decrease in the vessels. The parasympathetic system responds by lessening the inhibitory effect
on the sinoatrial node. This results in an increase in heart rate and respiratory rate. This
tachycardia is an early response and is seen even when blood pressure is not critically low. An
increased heart rate and respiratory rate will compensate for the low blood pressure and
maintain oxygen saturations and perfusion. The client may not be able to compensate for long,
and decreased oxygenation and cool, clammy skin will occur later.
A nurse assesses a client after administering a prescribed beta blocker. Which assessment
should the nurse expect to find?
a. Blood pressure increased from 98/42 mm Hg to 132/60 mm Hg
b. Respiratory rate decreased from 25 breaths/min to 14 breaths/min
c. Oxygen saturation increased from 88% to 96%
,d. Pulse decreased from 100 beats/min to 80 beats/min - ANSWERSANS: D
Beta blockers block the stimulation of beta1-adrenergic receptors. They block the sympathetic
(fight-or-flight) response and decrease the heart rate (HR). The beta blocker will decrease HR
and blood pressure, increasing ventricular filling time. It usually does not have effects on beta2-
adrenergic receptor sites. Cardiac output will drop because of decreased HR.
A nurse assesses clients on a medical-surgical unit. Which client should the nurse identify as
having the greatest risk for cardiovascular disease?
a. An 86-year-old man with a history of asthma
b. A 32-year-old Asian-American man with colorectal cancer
c. A 45-year-old American Indian woman with diabetes mellitus
d. A 53-year-old postmenopausal woman who is on hormone therapy - ANSWERSANS: C
The incidence of coronary artery disease and hypertension is higher in American Indians than in
whites or Asian Americans. Diabetes mellitus increases the risk for hypertension and coronary
artery disease in people of any race or ethnicity. Asthma, colorectal cancer, and hormone
therapy do not increase risk for cardiovascular disease.
A nurse assesses an older adult client who has multiple chronic diseases. The clients heart rate
is 48 beats/min. Which action should the nurse take first?
a. Document the finding in the chart.
,b. Initiate external pacing.
c. Assess the clients medications.
d. Administer 1 mg of atropine. - ANSWERSANS: C
Pacemaker cells in the conduction system decrease in number as a person ages, resulting in
bradycardia. The nurse should check the medication reconciliation for medications that might
cause such a drop in heart rate, then should inform the health care provider. Documentation is
important, but it is not the priority action. The heart rate is not low enough for atropine or an
external pacemaker to be needed.
An emergency room nurse obtains the health history of a client. Which statement by the client
should alert the nurse to the occurrence of heart failure?
a. I get short of breath when I climb stairs.
b. I see halos floating around my head.
c. I have trouble remembering things.
d. I have lost weight over the past month. - ANSWERSANS: A
Dyspnea on exertion is an early manifestation of heart failure and is associated with an activity
such as stair climbing. The other findings are not specific to early occurrence of heart failure.
A nurse obtains the health history of a client who is newly admitted to the medical unit. Which
statement by the client should alert the nurse to the presence of edema?
, a. I wake up to go to the bathroom at night.
b. My shoes fit tighter by the end of the day.
c. I seem to be feeling more anxious lately.
d. I drink at least eight glasses of water a day. - ANSWERSANS: B
Weight gain can result from fluid accumulation in the interstitial spaces. This is known as
edema. The nurse should note whether the client feels that his or her shoes or rings are tight,
and should observe, when present, an indentation around the leg where the socks end. The
other answers do not describe edema.
A nurse assesses an older adult client who is experiencing a myocardial infarction. Which clinical
manifestation should the nurse expect?
a. Excruciating pain on inspiration
b. Left lateral chest wall pain
c. Disorientation and confusion
d. Numbness and tingling of the arm - ANSWERSANS: C
In older adults, disorientation or confusion may be the major manifestation of myocardial
infarction caused by poor cardiac output. Pain manifestations and numbness and tingling of the
