Chapter 17- Patient Assessment- Cardiovascular System My Nursing Test Banks

 

1.

The patient is complaining of chest pain. The nurse asks several questions to determine the likelihood that this pain is cardiac in origin. What patient response is most likely to indicate cardiac pain?

A)

Started suddenly and was at maximum intensity from the start

B)

Accompanied by no other symptoms, such as nausea

C)

Painful area is the size of a clenched fist and substernal.

D)

Described as stabbing and knifelike pain

2.

As part of the general physical assessment of a patient with cardiac disease, the nurse assesses central and peripheral pulses. What is the most accurate statement about pulse assessment?

A)

All pulses should be assessed bilaterally at the same time.

B)

A pulse that is weak and thready would be scaled +4.

C)

Pulsus alternans varies in intensity with every other beat.

D)

Absence of posterior tibial pulses is a normal variant.

3.

The nurse is auscultating a patients heart sounds. What best describes a normal finding?

A)

S2 is heard best at the second intercostal space to the right of the sternum.

B)

S2 is heard equally at all areas across the precordium and apex.

C)

S1 usually disappears after 25 to 35 years of age.

D)

S3 is caused by retrograde blood flow though an incompetent valve.

4.

A patient has been determined to have a new heart murmur. The best description of the cause of a cardiac murmur is what?

A)

The patient had rheumatic heart disease as a child.

B)

A murmur is caused by the flow of blood through a narrow or incompetent valve or septum.

C)

A murmur indicates a ruptured ventricular septum from myocardial disease or infarction.

D)

A murmur occurs normally secondary to turbulent blood flow in children and young adults.

5.

The patient is to undergo a diagnostic electrophysiology study. The nurse should tell the patient and family that the purpose of this study is what?

A)

Identify blockages of coronary arteries.

B)

Measure volumes and pressures in cardiac chambers.

C)

Evaluate the efficacy of antiarrhythmic drugs and devices.

D)

Evaluate patient response to pharmacologically elevated heart rates.

6.

The patient is undergoing an echocardiogram for diagnosis of cardiac valve dysfunction. What factor is most likely to result in an accurate echocardiogram?

A)

The patient has chronic obstructive pulmonary disease (COPD).

B)

The technologist performing the test is very experienced.

C)

The patient is very obese, with large pendulous breasts.

D)

The echocardiogram machine is several years old.

7.

The nurse is caring for a patient using a 5-lead continuous cardiac monitor system. To monitor lead V6, where does the nurse place the chest electrode?

A)

Fourth intercostal space on right sternal border

B)

Right shoulder on muscle tissue close to bone

C)

Left shoulder on muscle tissue close to bone

D)

Fifth intercostal space on left mid-axillary line

8.

The nurse is applying electrodes to the patients chest for use in continuous cardiac rhythm monitoring. When applying these electrodes, what placement will the nurse use to ensure maximum accuracy?

A)

In the fold beneath the breast tissue

B)

Directly over the clavicle

C)

In the intercostal spaces

D)

Over the clavicle/humerus joint

9.

A patient is on continuous cardiac rhythm monitoring. The nurse notices that the low-rate alarm is sounding frequently. What nursing action takes the highest priority?

A)

Assess monitor alarm limits for appropriate setting.

B)

Check contact with skin for all electrodes.

C)

Assess patients level of consciousness and vital signs.

D)

Check connections between lead wires and electrodes.

10.

The nurse is using the cardiac monitor tracing to evaluate cardiac function. The QRS interval is 0.14 seconds in width. How does the nurse interpret this finding?

A)

Normal rate and rhythm

B)

Slowed conduction through the atria

C)

Left ventricular bundle branch block

D)

Slowed ventricular depolarization

11.

A patient in the CCU is suspected of having coronary artery disease (CAD) following myocardial infarction. Which blood test or tests would be most pertinent in evaluating this patients condition? Select all that apply.

A)

Red blood cell count

B)

Low-density lipoproteins

C)

Prothrombin time

D)

Triglycerides

E)

White blood cell count

F)

High-density lipoproteins

12.

A patient in the CCU is suspected to have had a myocardial infarction. His blood work results have arrived, and the nurse is reviewing them. Which results would indicate myocardial infarction? Select all that apply.

A)

Elevated troponins

B)

CK-MB isoenzyme at 10% of total creatine kinase

C)

C-reactive protein serum value of 6 mg/dL

D)

Decreased levels of D-dimer

13.

A patient is being discharged from the CCU, and the cardiologist would like to monitor her cardiac activity over the coming month. This patient typically experiences infrequent dysrhythmias and is willing to wear electrodes, carry a recorder, and keep a diary. Which type of cardiac monitoring would be most appropriate for this patient?

A)

Holter monitoring

B)

Event (continuous loop) monitoring

C)

Implantable loop monitoring

D)

Signal-averaged electrocardiography

14.

A patient in the CCU must perform exercise stress testing. Which of the following would be the most appropriate intervention for the nurse to make in preparing the patient for this test?

A)

Provide the patient with a cup of coffee to help him be alert during the testing.

B)

Continue the patient on beta blockers throughout the test.

C)

Explain to the patient that he may have to continue exercising after angina develops.

D)

Feed the patient an hour before the test so that he has plenty of energy.

15.

A patient in the CCU will undergo a diagnostic electrophysiology study. Which complication should the nurse monitor for during this procedure?

A)

Bleeding

B)

Vascular damage

C)

Lethal dysrhythmias

D)

Cardiac arrest

16.

A nurse in the CCU must assess a patients cardiac rhythm strip. Which of the following represents the first three steps in this assessment in correct order?

A)

Look for P waves, measure the PR interval, evaluate the QRS interval.

B)

Evaluate the QRS complex, examine the ST segment, identify the rhythm.

C)

Determine atrial and ventricular heart rates, examine the rhythm to see if it is regular, look for P waves.

D)

Look for P waves, examine the rhythm to see if it is regular, determine atrial and ventricular heart rates.

17.

A patient in the CCU who is undergoing ECG monitoring has impulses originating at the sinoatrial node at a rate of 75 bpm, a shortest RR interval of 0.69 seconds, and a longest RR interval of 0.84 seconds. The P wave is regular. Which sinus rhythm does this patient exhibit?

A)

Sinus tachycardia

B)

Sinus bradycardia

C)

Sinus dysrhythmia

D)

Sinus arrest

18.

A patient in the CCU has been found on examination by ECG to have a bundle branch block. Which of the following should the nurse expect to see on this patients ECG?

A)

Tall, pointed P waves in leads II, III, and aVF

B)

Broad, notched P waves in leads I, II, and aVL

C)

A tall R wave in V1 and progressively smaller R waves through V6

D)

A broad QRS complex with two peaks (RSR)

19.

A patient in the CCU exhibits a tall, narrow, and peaked T wave on ECG. The nurse recognizes that this is most likely an early sign of which of the following?

A)

Hypokalemia

B)

Hyperkalemia

C)

Hypocalcemia

D)

Hypercalcemia

20.

A patient in the CCU is undergoing arterial pressure monitoring, and the bedside physiological monitor alarm sounds. Which of the following should the nurse do? Select all that apply.

A)

Check to see whether the catheter is kinked.

B)

Check to see whether the stopcocks are turned the wrong way.

C)

Add IV solution through the arterial pressure monitoring system.

D)

Make sure that there is sufficient pressure in the pressure bag.

Answer Key

1.

C

2.

C

3.

A

4.

B

5.

C

6.

B

7.

D

8.

C

9.

C

10.

D

11.

B, D, F

12.

A, B, C

13.

B

14.

C

15.

A

16.

C

17.

C

18.

D

19.

B

20.

A, B, D

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