Chapter_20-_Heart_Failure_and_Circulatory_Shock My Nursing Test Banks

 

1.

The pathophysiology of heart failure involves an interaction between decreased pumping ability and the ________ to maintain cardiac output.

A)

aortic hypertrophy

B)

compensatory mechanisms

C)

electrical conductivity

D)

parasympathetic system

2.

Cardiac output is the ________ each minute.

A)

volume load

B)

blood pumped

C)

stroke volume

D)

force generated

3.

One of the principal mechanisms by which the heart compensates for increased workload is:

A)

myocardial hypertrophy.

B)

sodium and water retention.

C)

endothelin vasoconstrictors.

D)

ventricular wall tension increase.

4.

In right-sided heart failure, peripheral edema is evidenced by:

A)

weight gain.

B)

copious urination.

C)

shortness of breath.

D)

decreased blood pressure.

5.

The most common causes of left-sided heart failure include:

A)

acute myocardial infarction.

B)

chronic pulmonary disease.

C)

impaired renal blood flow.

D)

tricuspid valve regurgitation.

6.

Hypovolemic shock occurs as a result of:

A)

myocardial infarction.

B)

excessive vasoconstriction.

C)

chronic intracellular fluid shift.

D)

acute intravascular volume loss.

7.

In shock, one of the best indicators of blood flow to vital organs is:

A)

warm legs.

B)

urine output.

C)

blood pressure.

D)

consciousness.

8.

Anaphylactic shock is directly associated with:

A)

loss of blood volume.

B)

bacterial blood infection.

C)

failure of the heart as a pump.

D)

type I hypersensitivity response.

9.

Severe shock can be followed by acute lung injury/acute respiratory distress syndrome (ALI/ARDS) characterized by:

A)

hyperventilation.

B)

excessive surfactant.

C)

hyperinflated alveolar sacs.

D)

ventilation-perfusion mismatch.

10.

A common symptom of the ischemia associated with gastrointestinal redistribution of blood flow is:

A)

gastric bleeding.

B)

nausea and vomiting.

C)

irritable bowel syndrome.

D)

copious high volume diarrhea.

11.

A patient has been experiencing increasing fatigue in recent months, a trend that has prompted an echocardiogram. Results of this diagnostic test suggest that the patients end-diastolic volume is insufficient. Which of the following parameters of cardiac performance will directly decrease as a result of this?

A)

Inotropy

B)

Cardiac contractility

C)

Preload

D)

Afterload

12.

Which of the following health problems is associated with heart failure as a result of diastolic dysfunction?

A)

Uncontrolled hypertension

B)

Chronic bradycardia

C)

Ischemic heart disease

D)

Myocardial hypertrophy

13.

Assessment of an elderly female patient reveals the presence of bilateral pitting edema of the patients feet and ankles and pedal pulses that are difficult to palpate. Auscultation of the patients lungs reveals clear air entry to bases, and the patients oxygen saturation level is 93% and vital signs are within reference ranges. What is this patients most likely health problem?

A)

Right-sided heart failure

B)

Left-sided heart failure

C)

Cardiogenic shock

D)

Cor pulmonale

14.

The most recent blood work of a patient with a diagnosis of heart failure indicates increased levels of atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP). What are the most likely effects of these peptides on the patients physiology?

A)

Water retention

B)

Increased tubular sodium reabsorption

C)

Inhibition of the renin-angiotensin-aldosterone system

D)

Sympathetic nervous stimulation

15.

A nurse is performing patient health education with a 68-year-old man who has recently been diagnosed with heart failure. Which of the following statements demonstrates an accurate understanding of his new diagnosis?

A)

Ill be sure to take my beta blocker whenever I feel short of breath.

B)

Im going to avoid as much physical activity as I can so that I preserve my strength.

C)

I know its healthy to drink a lot of water, and Im going to make sure I do this from now on.

D)

Im trying to think of ways that I can cut down the amount of salt that I usually eat.

16.

Electrical burns over a large surface area of a patients body have resulted in hypovolemic shock after the loss of large amounts of blood and plasma. Which of the following mechanisms is the patients body likely to implement to compensate for this loss of fluid?

A)

Increased heart rate

B)

Vasodilation

C)

Diuresis

D)

Inhibition of ADH

17.

A patient who developed a deep vein thrombosis during a prolonged period of bedrest has deteriorated as the clot has dislodged and resulted in a pulmonary embolism. Which of the following types of shock is this patient at risk of experiencing?

A)

Cardiogenic shock

B)

Hypovolemic shock

C)

Obstructive shock

D)

Distributive shock

18.

For which of the following types of shock might intravenous antibiotic therapy be indicated?

A)

Obstructive shock

B)

Distributive shock

C)

Cardiogenic shock

D)

Hypovolemic shock

19.

An 86-year-old male patient is disappointed to learn that he has class II heart failure despite a lifelong commitment to exercise and healthy eating. Which of the following age-related changes predisposes older adults to developing heart failure?

A)

Increased vascular stiffness

B)

Orthostatic hypotension

C)

Increased cardiac contractility

D)

Loss of action potential

20.

A patient with a diagnosis of heart failure has returned from a visit with his primary care provider with a prescription for a change in his daily medication regimen. Which of the following drugs is likely to improve the patients cardiac function by increasing the force and strength of ventricular contractions?

A)

A b-adrenergic blocker

B)

A diuretic

C)

A cardiac glycoside

D)

An ACE inhibitor

Answer Key

1.

B

2.

B

3.

A

4.

A

5.

A

6.

D

7.

B

8.

D

9.

D

10.

A

11.

C

12.

D

13.

A

14.

C

15.

D

16.

A

17.

C

18.

B

19.

A

20.

C

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