Chapter 16

TESTBANK Chapter Title:
Cardiovascular Disorders
Chapter #: 16
1. Data concerning coronary artery
disease (CAD) and specifc risk factors
has demonstrated:
1. a low correlation of modifable risk
factors to coronary artery disease.
2. the onset of coronary artery disease
in middle age.
. an association between
de!elopment of specifc risk factors
and CAD.
". no decisi!e correlation between risk
factors and CAD.
Topic: Cardio!asc#lar
Cognitive Level: $nowledge
Correct anser:
!ationale: %pidemiologic and
act#arial data ha!e demonstrated an
association between specifc risk factors
and the de!elopment of CAD.
"age !e#erence: &'
2. (hich of the following !al#es) when
ele!ated) places the patient at lowest
risk for CAD*
1. +ery low,density lipoproteins (+-D-)
2. .riglycerides
. -ow,density lipoproteins (-D-)
". /igh,density lipoproteins (/D-)
Cognitive Level: Comprehension
Correct anser: "
!ationale: 0atients with ele!ated /D-
concentrations are tho#ght to be at low
risk for coronary artery disease.
"age !e#erence: &1
. .he ma2or hemodynamic e3ect of CAD
is:
1. decreased left !entric#lar end,
diastolic !ol#me.
2. decreased left !entric#lar end,
diastolic press#re.
. dist#rbance in the balance between
myocardial o4ygen s#pply and
demand.
". increased coronary artery !essel
l#men.
Correct anser:
!ationale: .he ma2or hemodynamic
e3ect of CAD is the dist#rbance in the
delicate balance between myocardial
o4ygen s#pply and demand.
"age !e#erence: &5
". 6ne di3erentiating factor between
stable angina and #nstable angina is that
stable angina:
1. responds predictably well to
!asodilators.
2. is not precipitated by acti!ity.
. has a low correlation to coronary
artery disease.
". is a res#lt of coronary artery spasm.
Cognitive Level: Application
Correct anser: 1
!ationale: 7table angina #s#ally
begins grad#ally and is corrected by the
administration of !asodilators.
"age !e#erence: &&
'. 8#rsing management of the patient
with angina is directed toward:
1. immediate administration of
nitrates.
2. assessment of history of pre!io#s
anginal episodes.
. assessment and doc#mentation of
chest pain episodes.
". administration of prophylactic
lidocaine for !entric#lar ectopy.
Cognitive Level: 7ynthesis
Correct anser:
!ationale: 8#rsing care of the patient
admitted with angina foc#ses on
contin#o#s assessment and
doc#mentation of episodes of chest
pain.
"age !e#erence: "91
1. .he mechanism most responsible for a
myocardial infarction (:;) is:
1. coronary artery thrombi.
2. pla<#e fss#re or hemorrhage.
. coronary artery spasm.
". preinfarction angina.
Correct anser: 1
!ationale: Coronary artery thrombi
are tho#ght to be present in almost all
ac#te occl#sions.
"age !e#erence: "9
=. .he most fre<#ent dysrhythmia seen
initially with s#dden cardiac death is:
1. premat#re !entric#lar contractions.
2. !entric#lar tachycardia.
. !entric#lar fbrillation.
". asystole.
Correct anser: 2
!ationale: .he s#dden death episode
#s#ally begins as !entric#lar
tachycardia.
"age !e#erence: "1
5. Assessment of the patient with
pericarditis may re!eal which of the
following signs and symptoms*
1. +entric#lar gallop> s#bsternal chest
pain
2. 8arrowed p#lse press#re> shortness
of breath
. 0ericardial friction r#b> pain
". 0ericardial tamponade> widened
p#lse press#re
Correct anser:
!ationale: .he most common sign
and symptom of pericarditis is pain and
the presence of a pericardial friction
r#b.
"age !e#erence: "19
&. Clinical manifestations of right,sided
heart fail#re incl#de:
1. ele!ated central !eno#s press#re
and sacral edema.
2. p#lmonary congestion and 2#g#lar
!eno#s distention.
. hypertension and chest pain.
". li!er tenderness and p#lmonary
edema.
Correct anser: 1
!ationale: :anifestations of fail#re of
the right side of the heart are
weakness) peripheral or sacral edema)
2#g#lar !eno#s distention)
hepatomegaly) 2a#ndice) li!er
tenderness) and ele!ated C+0.
"age !e#erence: "1'
19. An essential aspect of teaching that
may pre!ent reocc#rrence of heart
fail#re is:
1. notifying the physician if there is a
2,po#nd weight gain in 2" ho#rs.
2. compliance with di#retic therapy.
. taking nitroglycerin if chest pain
occ#rs.
". assessment of an apical p#lse.
Correct anser: 2
!ationale: ?ed#ction or cessation of
di#retics #s#ally res#lts in sodi#m and
water retention) which may precipitate
heart fail#re.
"age !e#erence: "15
11. Compensatory mechanisms may be
acti!ated when heart fail#re occ#rs. ;n
general) these mechanisms:
1. may worsen the degree of heart
fail#re.
2. are e3ecti!e in maintaining cardiac
o#tp#t for prolonged periods of time.
. assist in decreasing preload and
afterload.
". minimi@e hypertrophic changes in
the !entricles.
Correct anser: 1
!ationale: .he compensatory
mechanisms may s#stain cardiac
f#nction) especially at rest) b#t o!er a
period of time may worsen the degree
of fail#re as the retention of sodi#m and
water leads to o!erdistention of the
!entricles and a conse<#ent decrease in
the force of !entric#lar contraction.
"age !e#erence: "11
12. (hich of the following assessment
fndings is most specifc for ac#te onset
of p#lmonary edema*
1. 0#lmonary crackles
2. 0eripheral edema
. 0ink) frothy sp#t#m
". %le!ated central !eno#s press#re
Correct anser:
!ationale: (ith ac#te onset of
p#lmonary edema) patients are often
e4tremely breathless and an4io#s. .hey
e4pectorate pink) frothy li<#id.
"age !e#erence: "11
1. :edical management of
hypertrophic cardiomyopathy incl#des:
1. beta,blockers.
2. positi!e inotropes.
. intensi!e e4ercise regimen.
". aortic !al!e replacement.
Correct anser: 1
!ationale: :edical management of
hypertrophic cardiomyopathy incl#des
limitation of physical acti!ity) beta,
blockers) calci#m channel blockers)
antidysrhythmic therapy) and treatment
of heart fail#re.
"age !e#erence: "1&
1". 0atient teaching regarding !al!#lar
heart disease sho#ld incl#de which of the
following*
1. ;ncrease A#id intake to increase
cardiac o#tp#t.
2. :onitor and increase sodi#m intake
to replace sodi#m lost with di#retics.
. ;ncrease daily acti!ity #ntil
shortness of breath occ#rs.
". 0rophylactic antibiotics sho#ld be
taken before #ndergoing any in!asi!e
proced#re.
Correct anser: "
!ationale: 0atient teaching incl#des
information related to prophylactic
antibiotics before #ndergoing any
in!asi!e proced#res s#ch as dental
work.
"age !e#erence: "22
1'. (hich medication may be
administered to the patient with
hypertensi!e crisis*
1. Digitalis
2. +asopressin
. +erapamil
". 7odi#m nitropr#sside
Correct anser: "
!ationale: Bre<#ently #sed
medications for hypertensi!e crisis
incl#de f#rosemide) sodi#m
nitropr#sside) nitroglycerine)
phentolamine) labetalol) and clonidine.
"age !e#erence: ""
11. .he classic description of pain
associated with aortic dissection is:
1. s#bsternal press#re.
2. tearing in the chest) abdomen) or
back.
. n#mbness and tingling in the left
arm.
". patient is asymptomatic.
Correct anser: 2
!ationale: .he classic clinical
manifestation of aortic dissection is the
s#dden onset of intense) se!ere) tearing
pain that may be locali@ed initially in
the chest) abdomen) or back.
"age !e#erence: "25
1=. (hich of the following clinical
manifestations is #s#ally the frst
symptom of arterial peripheral !asc#lar
disease*
1. ;ntermittent cla#dication
2. .hrombophlebitis
. 0#lmonary embolism
". Cordlike !eins
Correct anser: 1
!ationale: ;ntermittent cla#dication
(cramping) aching pain d#ring
amb#lation) #s#ally is the frst symptom
of arterial peripheral !asc#lar disease.
"age !e#erence: "25
15. Co# are teaching a patient with Topic: Cardio!asc#lar
endocarditis abo#t his diagnosis. (hich
statement below is correct*
1. %ndocarditis is a !iral infection that
is easily treated with antibiotics.
2. .he risk of this diagnosis is
occl#sion of the coronary arteries.
. A long co#rse of antibiotics is
needed to treat this disorder.
". Complications are rare once
antibiotics ha!e been started.
Correct anser:
!ationale: %ndocarditis re<#ires a
prolonged co#rse of intra!eno#s
antibiotics.
"age !e#erence: "21,"22
1&. D#estions 1&,22 refer to the
following sit#ation. :r. :. is a 11,year,old
man admitted to the coronary care #nit
with a diagnosis of ac#te inferior
myocardial infarction.
A 12,lead %CE is taken to !alidate the
area of infarction. (hich fnding on the
%CE is most concl#si!e for infarction*
1. ;n!erted . wa!es
2. .all) peaked . wa!es
. 7.,segment depression
". D wa!es
Correct anser: "
!ationale: 6n the %CE) e!idence of
infarction is seen by the presence of
pathologic D wa!es.
"age !e#erence: "9
29. (hich leads on :r. :.Fs %CE
correlate with an inferior wall :;*
1. ;;) ;;;) a+B
2. ;) a+-
. +2,+"
". +',+1
Correct anser: 1
!ationale: ;nferior infarctions are
manifested by %CE changes in leads ;;)
;;;) and a+B.
"age !e#erence: "9'
21. Complications post,:; are common.
.he n#rse sho#ld anticipate which of the
following as the most common
complication*
1. 0#lmonary edema
2. Cardiogenic shock
. Dysrhythmias
". 7#dden cardiac death
Correct anser:
!ationale: Almost all patients who
e4perience a myocardial infarction will
ha!e dysrhythmias.
"age !e#erence: "9=
22. (hich classifcation of dysrhythmia
is most common following an inferior
wall myocardial infarction*
1. 7in#s tachycardia
2. 0remat#re atrial contractions
. Atrial fbrillation
". A+ heart block
Correct anser: "
!ationale: A+ heart block most
fre<#ently follows an inferior wall
myocardial infarction.
"age !e#erence: "9&
2. (hich of the following cholesterol
!al#es indicate a heightened risk for the
de!elopment of coronary artery disease*
1. .otal cholesterol le!el of 1=9 mgGd-
2. /D-,C le!el of 9 mgGd-
. .riglyceride le!el of 129 mgGd-
". -D-,C le!el of &9 mgGd-
Correct anser: 2
!ationale: .he higher the /D-,C) or
good cholesterol) the lower the risk of
CAD.
"age !e#erence: &1
2". A patient with known CAD in the CCH
with chest pain is s#ddenly awakened
with se!ere chest pain. .hree 8.E
s#bling#al tablets are administered '
Correct anser:
min#tes apart witho#t relief. A 12,lead
%CE re!eals non,specifc 7. segment
ele!ation. .his patient is probably
s#3ering from which of the following*
1. 7ilent ischemia
2. 7table angina
. Hnstable angina
". 0rin@metalFs angina
!ationale: .hese are hallmark signs
and symptoms of #nstable angina.
"age !e#erence: &&
2'. A patient has been newly diagnosed
with stable angina. /e tells yo# he knows
a lot abo#t his diagnosis already beca#se
his father had the same thing 1' years
ago. Co# ask him to tell yo# what he
already knows abo#t angina. (hich of
the following responses by the patient
ha!e a so#nd scientifc basis*
1. /e can not drink iced) cold
be!erages.
2. /e can no longer drink colas or
co3ee.
. /e can no longer get a strong back
massage.
". /e sho#ld not strain when going to
the bathroom.
Correct anser:
!ationale: .he +alsal!a mane#!er
is contraindicated in cardiac
patients.
"age !e#erence: "92
21. A patient presents with se!ere
s#bsternal chest pain. .he patient states)
I.his is the most se!ere pain ; ha!e e!er
feltJK .he patient reports that the pain
came on s#ddenly abo#t 2 ho#rs ago and
that three 8.E s#bling#al tablets ha!e
not relie!ed the pain. .he 12,lead %CE
re!eals only the following abnormalities:
.,wa!e in!ersion in leads ;) a+-) +" and +'
0athologic D,wa!es in leads ;;) ;;;) and
a+B
7. segment ele!ation in leads +1) +2) +)
+"
(hich of the following is probably
acc#rate abo#t this patient*
1. .his patient has had an old lateral
wall infarction.
2. .his patient is ha!ing an inferior
wall infarction.
. .his patient is ha!ing an ac#te
anterior wall infarction.
". .his patient is ha!ing a posterior
wall infarction.
Cognitive Level: Analysis
Correct anser:
!ationale: .he D wa!es indicate an
old inferior wall :;) and the . wa!e
in!ersions and 7. segment
ele!ations indicate an ac#te anterior
wall :;.
"age !e#erence: "9"
2=. A patient) days following an
anterior wall :;) is in the CCH. 7he is
c#rrently recei!ing) 62 at " -Gmin !ia
nasal cann#la) 8.E paste 1K <1 ho#rs)
and the beta blocker -opressor 2' mg 06
<12 ho#rs. .he monitor shows that she
begins to ha!e 0+Cs. 6!er the co#rse of
the ne4t se!eral ho#rs) the 0+Cs
Cognitive Level: Analysis
Correct anser:
!ationale: .he potassi#m le!el is
within normal limits and
replacement is not warranted. All
other inter!entions listed are
appropriate for this patient.
increase in fre<#ency) to more than 1'
per min#te) with occasional r#ns of
m#ltifocal bigeminal 0+CFs. .he patientLs
!ital signs are: /? 5" 7? with described
0+CFs) M0 12"G15) ?? 29) 7p62 &2N.
-aboratory !al#es are blood p/ =."")
potassi#m ".") and magnesi#m 1.2.
(hich of the following) if ordered) wo#ld
be inappropriate for this patient*
1. -idocaine 199 mg ;+0
2. ;ncrease 62 to 1 -Gmin !ia nasal
cann#la
. 0otassi#m chloride "9 m%< in 2'9
cc 9.&N saline ;+0M o!er " ho#rs
". :agnesi#m s#lfate 2 gm ;+0M o!er
2 ho#rs
"age !e#erence: "11,"12
25. A "',year,old patient is admitted to
the CCH with a diagnosis of ac#te
myocardial infarction. 8itroglycerin is
inf#sing at 19 mcgGmin and heparin at
1999 #nitsGhr. (hich of the following
statements wo#ld be appropriate at this
time*
1. Co# will be able to res#me normal
se4#al acti!ity when yo# are
discharged.
2. Co# will need to decrease yo#r fat
intake to red#ce the risk of another
heart attack
. Co# ha!e been admitted to the
critical care #nit beca#se there has
been damage to yo#r heart m#scle.
". Angina is #s#ally relie!ed by rest)
b#t a heart attack isnFt.
Correct anser:
!ationale: Meca#se the window of
time has passed when the
myocardi#m co#ld be sa!ed) the
patient is ed#cated to clarify the
reasons for admission to the critical
care #nit.
"age !e#erence: "1

Chapter 16

Diunggah oleh

Informasi Dokumen

Hak Cipta

Format Tersedia

Bagikan dokumen Ini

Bagikan atau Tanam Dokumen

Opsi Berbagi

Apakah menurut Anda dokumen ini bermanfaat?

Apakah konten ini tidak pantas?

Hak Cipta:

Format Tersedia

Chapter 16

Diunggah oleh

Hak Cipta:

Format Tersedia

TESTBANK Chapter Title:

Anda mungkin juga menyukai