NRSG 3420 Exam 2 Questions With Complete Solutions
A client with angina has been prescribed nitroglycerin. Before administering the drug, the nurse should
inform the client about what potential adverse effects?
A) Nervousness or paresthesia
B)Throbbing headache or dizziness
C) Drowsiness or blurred vision
D) Tinnitus or diplopia - (ANSWER)Correct response:
Throbbing headache or dizziness
Explanation:
Headache and dizziness commonly occur when nitroglycerin is taken at the beginning of therapy.
Nervousness, paresthesia, drowsiness, blurred vision, tinnitus, and diplopia do not typically occur as a
result of nitroglycerin therapy.
Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing,
14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 27: Management of Patients with Coronary
Vascular Disorders, Chart 27-3, p. 759.
Chapter 27: Management of Patients with Coronary Vascular Disorders - Page 759
The physical therapist notifies the nurse that a client with coronary artery disease (CAD) experiences a
much greater-than-average increase in heart rate during physical therapy. The nurse recognizes that an
increase in heart rate in a client with CAD may result in what?
A) Development of an atrial-septal defect
B) Myocardial ischemia
C) Formation of a pulmonary embolism
D) Release of potassium ions from cardiac cells - (ANSWER)Correct response:
Myocardial ischemia
,NRSG 3420 Exam 2 Questions With Complete Solutions
Explanation:
Unlike other arteries, the coronary arteries are perfused during diastole. An increase in heart rate
shortens diastole and can decrease myocardial perfusion. Clients, particularly those with CAD, can
develop myocardial ischemia. An increase in heart rate will not usually result in a pulmonary embolism
or create electrolyte imbalances. Atrial-septal defects are congenital.
Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing,
14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 25: Assessment of Cardiovascular Function,
Coronary Arteries, p. 675.
Chapter 25: Assessment of Cardiovascular Function - Page 675
The nurse is providing care for a client with high cholesterol and triglyceride values. In teaching the
client about therapeutic lifestyle changes such as diet and exercise, the nurse realizes that the desired
goal for cholesterol levels is which of the following?
A) High HDL values and high triglyceride values
B) Absence of detectable total cholesterol levels
C) Elevated blood lipids, fasting glucose less than 100
D) Low LDL values and high HDL values - (ANSWER)Correct response:
Low LDL values and high HDL values
Explanation:
The desired goal for cholesterol readings is for a client to have low LDL and high HDL values. LDL exerts a
harmful effect on the coronary vasculature because the small LDL particles can be easily transported
into the vessel lining. In contrast, HDL promotes the use of total cholesterol by transporting LDL to the
liver, where it is excreted. Elevated triglycerides are also a major risk factor for cardiovascular disease. A
goal is also to keep triglyceride levels less than 150 mg/dL. All individuals possess detectable levels of
total cholesterol.
,NRSG 3420 Exam 2 Questions With Complete Solutions
Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing,
14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 27: Management of Patients with Coronary
Vascular Disorders, Controlling Cholesterol Abnormalities, p. 753.
Chapter 27: Management of Patients with Coronary Vascular Disorders - Page 753
The health care provider has placed a central venous pressure (CVP) monitoring line in an acutely ill
client so right ventricular function and venous blood return can be closely monitored. The results show
decreased CVP. What does this indicate?
A) Possible hypovolemia
B) Possible myocardial infarction (MI)
C) Left-sided heart failure
D) Aortic valve regurgitation - (ANSWER)Correct response:
Possible hypovolemia
Explanation:
Hypovolemia may cause a decreased CVP. MI, valve regurgitation and heart failure are less likely causes
of decreased CVP.
Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing,
14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 25: Assessment of Cardiovascular Function,
Central Venous Pressure Monitoring, p. 706.
Chapter 25: Assessment of Cardiovascular Function - Page 706
The nursing instructor is teaching nursing students about myocardial contractility and ejection fractions.
What diagnostic tests can determine client ejection fractions? Select all that apply.
A) Echocardiogram
B) Cardiac catheterization
, NRSG 3420 Exam 2 Questions With Complete Solutions
C) Magnetic resonance imaging
D) Positron emission tomography scan
E) Troponin levels - (ANSWER)Correct response:
Echocardiogram
Cardiac catheterization
Magnetic resonance imaging
Explanation:
Echocardiogram, cardiac catheterization, and magnetic resonance imaging can provide ejection fraction
estimates. The positron emission tomography scan reveals areas of decreased blood flow in the heart.
Troponin levels are cardiac markers and do not measure ejection fractions.
Reference:
Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed.,
Philadelphia, Wolters Kluwer, 2018, Chapter 25: Assessment of Cardiovascular Function, Effect of Stroke
Volume on Cardiac Output, p. 678.
Chapter 25: Assessment of Cardiovascular Function - Page 678
A client with a strong family history of coronary artery disease asks the nurse how to reduce the risk of
developing the disorder. Which is the best response by the nurse?
A) "Moderation is the key to everything."
B) "Ask your physician to prescribe the new reverse lipid drug."
C) "Increase the soy in your diet."
D) "Exercise, keep your blood sugar in check, and manage your stress." - (ANSWER)Correct response:
"Exercise, keep your blood sugar in check, and manage your stress."
Explanation:
A client with angina has been prescribed nitroglycerin. Before administering the drug, the nurse should
inform the client about what potential adverse effects?
A) Nervousness or paresthesia
B)Throbbing headache or dizziness
C) Drowsiness or blurred vision
D) Tinnitus or diplopia - (ANSWER)Correct response:
Throbbing headache or dizziness
Explanation:
Headache and dizziness commonly occur when nitroglycerin is taken at the beginning of therapy.
Nervousness, paresthesia, drowsiness, blurred vision, tinnitus, and diplopia do not typically occur as a
result of nitroglycerin therapy.
Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing,
14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 27: Management of Patients with Coronary
Vascular Disorders, Chart 27-3, p. 759.
Chapter 27: Management of Patients with Coronary Vascular Disorders - Page 759
The physical therapist notifies the nurse that a client with coronary artery disease (CAD) experiences a
much greater-than-average increase in heart rate during physical therapy. The nurse recognizes that an
increase in heart rate in a client with CAD may result in what?
A) Development of an atrial-septal defect
B) Myocardial ischemia
C) Formation of a pulmonary embolism
D) Release of potassium ions from cardiac cells - (ANSWER)Correct response:
Myocardial ischemia
,NRSG 3420 Exam 2 Questions With Complete Solutions
Explanation:
Unlike other arteries, the coronary arteries are perfused during diastole. An increase in heart rate
shortens diastole and can decrease myocardial perfusion. Clients, particularly those with CAD, can
develop myocardial ischemia. An increase in heart rate will not usually result in a pulmonary embolism
or create electrolyte imbalances. Atrial-septal defects are congenital.
Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing,
14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 25: Assessment of Cardiovascular Function,
Coronary Arteries, p. 675.
Chapter 25: Assessment of Cardiovascular Function - Page 675
The nurse is providing care for a client with high cholesterol and triglyceride values. In teaching the
client about therapeutic lifestyle changes such as diet and exercise, the nurse realizes that the desired
goal for cholesterol levels is which of the following?
A) High HDL values and high triglyceride values
B) Absence of detectable total cholesterol levels
C) Elevated blood lipids, fasting glucose less than 100
D) Low LDL values and high HDL values - (ANSWER)Correct response:
Low LDL values and high HDL values
Explanation:
The desired goal for cholesterol readings is for a client to have low LDL and high HDL values. LDL exerts a
harmful effect on the coronary vasculature because the small LDL particles can be easily transported
into the vessel lining. In contrast, HDL promotes the use of total cholesterol by transporting LDL to the
liver, where it is excreted. Elevated triglycerides are also a major risk factor for cardiovascular disease. A
goal is also to keep triglyceride levels less than 150 mg/dL. All individuals possess detectable levels of
total cholesterol.
,NRSG 3420 Exam 2 Questions With Complete Solutions
Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing,
14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 27: Management of Patients with Coronary
Vascular Disorders, Controlling Cholesterol Abnormalities, p. 753.
Chapter 27: Management of Patients with Coronary Vascular Disorders - Page 753
The health care provider has placed a central venous pressure (CVP) monitoring line in an acutely ill
client so right ventricular function and venous blood return can be closely monitored. The results show
decreased CVP. What does this indicate?
A) Possible hypovolemia
B) Possible myocardial infarction (MI)
C) Left-sided heart failure
D) Aortic valve regurgitation - (ANSWER)Correct response:
Possible hypovolemia
Explanation:
Hypovolemia may cause a decreased CVP. MI, valve regurgitation and heart failure are less likely causes
of decreased CVP.
Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing,
14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 25: Assessment of Cardiovascular Function,
Central Venous Pressure Monitoring, p. 706.
Chapter 25: Assessment of Cardiovascular Function - Page 706
The nursing instructor is teaching nursing students about myocardial contractility and ejection fractions.
What diagnostic tests can determine client ejection fractions? Select all that apply.
A) Echocardiogram
B) Cardiac catheterization
, NRSG 3420 Exam 2 Questions With Complete Solutions
C) Magnetic resonance imaging
D) Positron emission tomography scan
E) Troponin levels - (ANSWER)Correct response:
Echocardiogram
Cardiac catheterization
Magnetic resonance imaging
Explanation:
Echocardiogram, cardiac catheterization, and magnetic resonance imaging can provide ejection fraction
estimates. The positron emission tomography scan reveals areas of decreased blood flow in the heart.
Troponin levels are cardiac markers and do not measure ejection fractions.
Reference:
Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed.,
Philadelphia, Wolters Kluwer, 2018, Chapter 25: Assessment of Cardiovascular Function, Effect of Stroke
Volume on Cardiac Output, p. 678.
Chapter 25: Assessment of Cardiovascular Function - Page 678
A client with a strong family history of coronary artery disease asks the nurse how to reduce the risk of
developing the disorder. Which is the best response by the nurse?
A) "Moderation is the key to everything."
B) "Ask your physician to prescribe the new reverse lipid drug."
C) "Increase the soy in your diet."
D) "Exercise, keep your blood sugar in check, and manage your stress." - (ANSWER)Correct response:
"Exercise, keep your blood sugar in check, and manage your stress."
Explanation:
