TESTBANK

Chapter Title: Cardiovascular Disorders

Chapter #: 16

1. Data concerning coronary artery disease (CAD) and specific risk factors has demonstrated: 1. a low correlation of modifiable risk factors to coronary artery disease. 2. the onset of coronary artery disease in middle age. 3. an association between development of specific risk factors and CAD. 4. no decisive correlation between risk factors and CAD. 2. Which of the following values, when elevated, places the patient at lowest risk for CAD? 1. Very low-density lipoproteins (VLDL) 2. Triglycerides 3. Low-density lipoproteins (LDL) 4. High-density lipoproteins (HDL) 3. The major hemodynamic effect of CAD is: 1. decreased left ventricular end-diastolic volume. 2. decreased left ventricular end-diastolic pressure. 3. disturbance in the balance between myocardial oxygen supply and demand. 4. increased coronary artery vessel lumen. 4. One differentiating factor between stable angina and unstable angina is that stable angina: 1. responds predictably well to vasodilators. 2. is not precipitated by activity. 3. has a low correlation to coronary artery disease. 4. is a result of coronary artery spasm. 5. Nursing management of the patient with angina is directed toward: 1. immediate administration of nitrates. 2. assessment of history of previous anginal episodes. 3. assessment and documentation of chest pain episodes. 4. administration of prophylactic lidocaine for ventricular ectopy. 6. The mechanism most responsible for a myocardial infarction (MI) is: 1. coronary artery thrombi. 2. plaque fissure or hemorrhage. 3. coronary artery spasm. 4. preinfarction angina. 7. The most frequent dysrhythmia seen initially with sudden cardiac death is: 1. premature ventricular contractions. 2. ventricular tachycardia. 3. ventricular fibrillation. 4. asystole.

Copyright 2003, Elsevier Science (USA). All rights reserved.

8. Assessment of the patient with pericarditis may reveal which of the following signs and symptoms? 1. Ventricular gallop; substernal chest pain 2. Narrowed pulse pressure; shortness of breath 3. Pericardial friction rub; pain 4. Pericardial tamponade; widened pulse pressure 9. Clinical manifestations of right-sided heart failure include: 1. elevated central venous pressure and sacral edema. 2. pulmonary congestion and jugular venous distention. 3. hypertension and chest pain. 4. liver tenderness and pulmonary edema. 10. An essential aspect of teaching that may prevent reoccurrence of heart failure is: 1. notifying the physician if there is a 2-pound weight gain in 24 hours. 2. compliance with diuretic therapy. 3. taking nitroglycerin if chest pain occurs. 4. assessment of an apical pulse. 11. Compensatory mechanisms may be activated when heart failure occurs. In general, these mechanisms: 1. may worsen the degree of heart failure. 2. are effective in maintaining cardiac output for prolonged periods of time. 3. assist in decreasing preload and afterload. 4. minimize hypertrophic changes in the ventricles. 12. Which of the following assessment findings is most specific for acute onset of pulmonary edema? 1. Pulmonary crackles 2. Peripheral edema 3. Pink, frothy sputum 4. Elevated central venous pressure 13. Medical management of hypertrophic cardiomyopathy includes: 1. beta-blockers. 2. positive inotropes. 3. intensive exercise regimen. 4. aortic valve replacement. 14. Patient teaching regarding valvular heart disease should include which of the following? 1. Increase fluid intake to increase cardiac output. 2. Monitor and increase sodium intake to replace sodium lost with diuretics. 3. Increase daily activity until shortness of breath occurs. 4. Prophylactic antibiotics should be taken before undergoing any invasive procedure. 15. Which medication may be administered to the patient with hypertensive crisis? 1. Digitalis 2. Vasopressin 3. Verapamil 4. Sodium nitroprusside

Copyright 2003, Elsevier Science (USA). All rights reserved.

16. The classic description of pain associated with aortic dissection is: 1. substernal pressure. 2. tearing in the chest, abdomen, or back. 3. numbness and tingling in the left arm. 4. patient is asymptomatic. 17. Which of the following clinical manifestations is usually the first symptom of arterial peripheral vascular disease? 1. Intermittent claudication 2. Thrombophlebitis 3. Pulmonary embolism 4. Cordlike veins 18. You are teaching a patient with endocarditis about his diagnosis. Which statement below is correct? 1. Endocarditis is a viral infection that is easily treated with antibiotics. 2. The risk of this diagnosis is occlusion of the coronary arteries. 3. A long course of antibiotics is needed to treat this disorder. 4. Complications are rare once antibiotics have been started. 19. Questions 19-22 refer to the following situation. Mr. M. is a 66-year-old man admitted to the coronary care unit with a
diagnosis of acute inferior myocardial infarction. A 12-lead ECG is taken to validate the area of infarction. Which finding on the ECG is most conclusive for infarction? 1. Inverted T waves 2. Tall, peaked T waves 3. ST-segment depression 4. Q waves

20. Which leads on Mr. M.s ECG correlate with an inferior wall MI? 1. II, III, aVF 2. I, aVL 3. V2-V4 4. V5-V6 21. Complications post-MI are common. The nurse should anticipate which of the following as the most common complication? 1. Pulmonary edema 2. Cardiogenic shock 3. Dysrhythmias 4. Sudden cardiac death 22. Which classification of dysrhythmia is most common following an inferior wall myocardial infarction? 1. Sinus tachycardia 2. Premature atrial contractions 3. Atrial fibrillation 4. AV heart block 23. Which of the following cholesterol values indicate a heightened risk for the development of coronary artery disease? 1. Total cholesterol level of 170 mg/dL 2. HDL-C level of 30 mg/dL 3. Triglyceride level of 120 mg/dL 4. LDL-C level of 90 mg/dL

Copyright 2003, Elsevier Science (USA). All rights reserved.

24. A patient with known CAD in the CCU with chest pain is suddenly awakened with severe chest pain. Three NTG sublingual
tablets are administered 5 minutes apart without relief. A 12-lead ECG reveals non-specific ST segment elevation. This patient is probably suffering from which of the following? 1. Silent ischemia 2. Stable angina 3. Unstable angina 4. Prinzmetals angina

25. A patient has been newly diagnosed with stable angina. He tells you he knows a lot about his diagnosis already because his
father had the same thing 15 years ago. You ask him to tell you what he already knows about angina. Which of the following responses by the patient have a sound scientific basis? 1. He can not drink iced, cold beverages. 2. He can no longer drink colas or coffee. 3. He can no longer get a strong back massage. 4. He should not strain when going to the bathroom.

26. A patient presents with severe substernal chest pain. The patient states, This is the most severe pain I have ever felt! The
patient reports that the pain came on suddenly about 2 hours ago and that three NTG sublingual tablets have not relieved the pain. The 12-lead ECG reveals only the following abnormalities: T-wave inversion in leads I, aVL, V4 and V5 Pathologic Q-waves in leads II, III, and aVF ST segment elevation in leads V1, V2, V3, V4 Which of the following is probably accurate about this patient? 1. This patient has had an old lateral wall infarction. 2. This patient is having an inferior wall infarction. 3. This patient is having an acute anterior wall infarction. 4. This patient is having a posterior wall infarction.

27. A patient, 3 days following an anterior wall MI, is in the CCU. She is currently receiving, O2 at 4 L/min via nasal cannula,
NTG paste 1 q6 hours, and the beta blocker Lopressor 25 mg PO q12 hours. The monitor shows that she begins to have PVCs. Over the course of the next several hours, the PVCs increase in frequency, to more than 15 per minute, with occasional runs of multifocal bigeminal PVCs. The patient's vital signs are: HR 84 SR with described PVCs, BP 124/68, RR 20, SpO2 92%. Laboratory values are blood pH 7.44, potassium 4.4, and magnesium 1.2. Which of the following, if ordered, would be inappropriate for this patient? 1. Lidocaine 100 mg IVP 2. Increase O2 to 6 L/min via nasal cannula 3. Potassium chloride 40 mEq in 250 cc 0.9% saline IVPB over 4 hours 4. Magnesium sulfate 2 gm IVPB over 2 hours

28. A 45-year-old patient is admitted to the CCU with a diagnosis of acute myocardial infarction. Nitroglycerin is infusing at 10
mcg/min and heparin at 1000 units/hr. Which of the following statements would be appropriate at this time? 1. You will be able to resume normal sexual activity when you are discharged. 2. You will need to decrease your fat intake to reduce the risk of another heart attack 3. You have been admitted to the critical care unit because there has been damage to your heart muscle. 4. Angina is usually relieved by rest, but a heart attack isnt.

Copyright 2003, Elsevier Science (USA). All rights reserved.