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NSG 201H -Assessment of Cardiovascular Function
NSG 201H -Assessment of Cardiovascular Function
Chapter 28: Assessment of Cardiovascular Function
Multiple Choice
Identify the choice that best completes the statement or answers the question.
____ 1. A patient is prescribed to have capillary blood glucose readings every four hours. What should the nurse include when explaining capillaries to the patient?
| 1) | It is a low-pressure vascular circuit. |
| 2) | Capillaries are the largest vessel within the arterial system. |
| 3) | The real work of the vascular system occurs at the capillary level. |
| 4) | They are flexible to adapt to changes in volume without large changes in pressure. |
____ 2. While auscultating a patient’s heart rate the nurse hears scratching sounds. What is most likely causing this sound?
| 1) | Epicardium adhering to the heart surface |
| 2) | Low level of fluid in the pericardial cavity |
| 3) | Parietal pericardium adhering to the sternum |
| 4) | Endocardium adhering to the heart chambers |
____ 3. The nurse is reviewing the anatomy of the heart with a patient scheduled for cardiac surgery. Which patient statement indicates additional teaching is required?
| 1) | “Oxygenated blood returns to the left atrium through the pulmonary vein.” |
| 2) | “The right atrium receives blood from the superior and inferior vena cava.” |
| 3) | “Blood leaves the right ventricle and travels through the pulmonary vein to the lungs.” |
| 4) | “Blood leaves the right ventricle and travels through the pulmonary artery to the lungs.” |
NSG 201H -Assessment of Cardiovascular Function
____ 4. The nurse is preparing teaching about the coronary arteries for a group of patients scheduled for heart surgery. Which information should the nurse include in this teaching?
| 1) | The coronary arteries originate in the cusps of the aortic valve. |
| 2) | The coronary arteries prevent the backflow of blood into the atria. |
| 3) | The coronary arteries respond to changes in pressure within the heart. |
| 4) | The coronary arteries prevent the backflow of blood into the ventricles. |
____ 5. The nurse notes that a patient has a low serum potassium level. Which phase of the cardiac action potential will be most affected by this blood level?
| 1) | Phase 0 |
| 2) | Phase 1 |
| 3) | Phase 3 |
| 4) | Phase 4 |
____ 6. A patient’s QRS complex is becoming increasingly wider. What is occurring within the heart muscle that is reflected on this tracing?
| 1) | The ventricles are repolarizing. |
| 2) | Atrial repolarization is occurring. |
| 3) | Ventricular depolarization is prolonged. |
| 4) | The atria depolarize and the impulse at the AV node is delayed. |
____ 7. A patient with a blood pressure of 88/50 mm Hg has a heart rate of 112 beats per minute. Which mechanism should the nurse realize is occurring in this patient?
| 1) | Positive chronotropic effect |
| 2) | Negative chronotropic effect |
| 3) | Force of the mechanical contraction |
| 4) | Reaction to ventricular volume at the end of diastole |
____ 8. The nurse suspects that a patient is experiencing a release of norepinephrine from the adrenal medulla. Which assessment finding did the nurse use to make this clinical decision?
| 1) | Blood pressure 94/48 mm Hg | 3) | Heart rate 120 beats per minute |
| 2) | Heart rate 68 beats per minute | 4) | Blood pressure 180/100 mm Hg |
____ 9. The nurse is preparing to determine a patient’s cardiac output. Which measurement should be used for preload?
| 1) | Heart rate | 3) | Oxygen saturation |
| 2) | Blood pressure | 4) | Central venous pressure |
____ 10. A patient’s blood pressure is 174/98 mm Hg. Which aspect of cardiac output is most affected by this elevated reading?
| 1) | Preload | 3) | Afterload |
| 2) | Heart rate | 4) | Contractility |
NSG 201H -Assessment of Cardiovascular Function
____ 11. The nurse notes that a patient has bilateral lower extremity edema. For which health problem should the nurse assess further?
| 1) | Pericarditis | 3) | Lymph obstruction |
| 2) | Cardiac tamponade | 4) | Venous insufficiency |
____ 12. After palpating a patient’s radial pulses, the nurse proceeds to palpate the brachial, carotid, femoral, popliteal, and posterior tibial pulses. What condition caused the nurse to make this more thorough physical assessment?
| 1) | Skin warm and dry | 3) | Edema of the left lower extremity |
| 2) | Various skin temperatures | 4) | Respiratory rate of 24 and labored |
____ 13. The nurse is preparing to auscultate the heart sounds of a patient with mitral valve regurgitation. Which sound should the nurse expect to hear?
| 1) | Rub | 3) | Murmur |
| 2) | Click | 4) | Atrial gallop |
____ 14. A patient is being assessed for heart disease. For which laboratory test should the nurse instruct to avoid eating and drinking fluids for 12 hours?
| 1) | Lipid panel | 3) | C-reactive protein |
| 2) | Homocysteine | 4) | Partial thromboplastin time |
____ 15. The nurse notes that a patient is scheduled for a brain natriuretic peptide level to be drawn. What patient teaching should the nurse prepare for this patient?
| 1) | Low-fat diet | 3) | Symptoms of a heart attack |
| 2) | Signs of heart failure | 4) | Lung versus heart problems |
____ 16. A patient is scheduled for a transesophageal echocardiogram (TEE). What information should the nurse expect to be provided from this test?
| 1) | Cardiac filling pressures | 3) | Heart function during stress |
| 2) | Integrity of cardiac arteries | 4) | Presence of clots in the atria |
____ 17. A patient is recovering from a cardiac catheterization. For which finding should the nurse notify the health-care provider?
| 1) | Warm right foot | 3) | Discomfort lying flat for six hours |
| 2) | Urine output 250 mL/2 hours | 4) | Hematoma formation at puncture site |
____ 18. An older patient is being evaluated for a cardiac click audible upon auscultation. Which age-related change should the nurse realize might be causing this heart sound?
| 1) | Hypertension | 3) | Atrial fibrillation |
| 2) | Valve stenosis | 4) | Congestive heart failure |
NSG 201H -Assessment of Cardiovascular Function
____ 19. The nurse notes that an older patient’s point of maximum impulse is displaced to the left. What age-related change should the nurse suspect as causing this assessment finding?
| 1) | Valvular stenosis | 3) | Arterial wall narrowing |
| 2) | Left ventricular atrophy | 4) | Fibrosis of heart chambers |
____ 20. The nurse is reviewing data collected during the assessment of an older patient. Which finding should the nurse consider as being an age-related change of the cardiovascular system?
| 1) | First heart sound louder | 3) | Heart rate 64 and regular |
| 2) | Friction rub auscultated | 4) | Blood pressure 168/96 mm Hg |
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Completion
Complete each statement.
- The nurse is preparing a teaching tool about the cardiac electrical conduction system. In which order should the nurse explain the route of the action potential? (Enter the number of each step in the proper sequence; do not use punctuation or spaces. Example: 1234)
1) Impulse travels to the bundle of His
2) Sinoatrial node fires in the right atrium
3) Impulse extends through Purkinje fibers
4) Impulse travels through bundle branches
5) Impulse travels to the atrioventricular node
6) Impulse spreads through atrial myocardium
- The clinical trainer is reviewing the renin-angiotensin-aldosterone system with graduate nurses during orientation to the telemetry unit. In which order should the trainer discuss this system? (Enter the number of each step in the proper sequence; do not use punctuation or spaces. Example: 1234)
1) Sodium and water reabsorbed in the kidneys
2) Renin reacts with angiotensin to create angiotensin 1
3) Angiotensin I is converted to angiotensin II in the lungs
4) Kidneys release renin in response to a drop in blood pressure
5) Angiotensin II influences adrenal glands to release aldosterone
- A patient is prescribed a 12-lead electrocardiogram. In which order should the nurse apply the V leads? (Enter the number of each step in the proper sequence; do not use punctuation or spaces. Example: 1234)
1) Midaxillary line
2) Between V2 and V4
3) Midclavicular line 5th intercostal space
4) 4th intercostal space left of the sternum
5) 4th intercostal space right of the sternum
6) Between V4 and V6 anterior axillary line
Multiple Response
Identify one or more choices that best complete the statement or answer the question.
____ 24. The nurse is preparing content for a community health fair on risk factors for heart disease. What should the nurse include as nonmodifiable risk factors? Select all that apply.
| 1) | Age |
| 2) | Weight |
| 3) | Alcohol intake |
| 4) | Ethnic background |
| 5) | Parents’ health history |
____ 25. Which information should the nurse include when documenting the findings of a patient’s heart sounds? Select all that apply.
| 1) | Pitch |
| 2) | Clicks |
| 3) | Quality |
| 4) | Intensity |
| 5) | Location |