Title: Quiz: Cardiac Disorders
Course: PRN 0092 Practical Nursing II > Section: Nursing Care of Clients with Cardiovascular Disorders

Q: The heart valves are arranged with the:
- mitral and pulmonary semilunar valves on the right side of the heart
- bicuspid and aortic semilunar valves on the right side of the heart
- tricuspid and pulmonary semilunar valves on the right side of the heart
- tricuspid and aortic semilunar valves on the left side of the heart
A: tricuspid and pulmonary semilunar valves on the right side of the heart

Q: When the left ventricle contracts, it pushes blood through a valve to the:
- aorta
- pulmonary artery
- pulmonary vein
- inferior vena cava
A: aorta

Q: The pulmonary vein returns oxygen-rich blood to the:
- right atrium
- right ventricle
- left atrium
- left ventricle
A: left atrium

Q: The heart is supplied with blood by:
- diffusion through the heart wall
- the right and left cardiac arteries
- arteries that branch directly from the pulmonary artery
- arteries that branch directly from the aorta
A: arteries that branch directly from the aorta

Q: The blood vessels that carry blood away from the heart are the:
- veins
- venules
- arteries
- capillaries
A: arteries

Q: The blood vessels that carry blood toward the heart are the:
- veins
- arteries
- arterioles
- capillaries
A: veins

Q: The tricuspid valve is located between the:
- left atrium and left ventricle
- right atrium and right ventricle
- right ventricle and the pulmonary artery
- left ventricle and the aorta
A: right atrium and right ventricle

Q: Blood that has just passed through the bicuspid valve is in the:
- aorta
- right ventricle
- left ventricle
- pulmonary artery
A: left ventricle

Q: Another name for a heart attack is a(n)
- embolism
- angina pectoris
- myocardial infarction
- none of the above
A: myocardial infarction

Q: Modifiable risk factors for coronary artery disease (CAD) include which group?
- Diabetes, family history
- Family history, smoking
- Smoking, heredity
- High cholesterol, obesity
A: High cholesterol, obesity
If right: Modifiable factors include smoking, hyperlipidemia, hypertension, diabetes mellitus, and obesity.
If wrong: Modifiable factors include smoking, hyperlipidemia, hypertension, diabetes mellitus, and obesity.

Q: The patient has right-sided heart failure. She will probably be comfortable in which position?
- Dorsal recumbent
- Trendelenburg
- Supine
- Orthopneic
A: Dorsal recumbent
If right: Restful sleep may be possible only in the sitting position or with the aid of extra pillows.
If wrong: Restful sleep may be possible only in the sitting position or with the aid of extra pillows.

Q: A 53-year-old patient with a history of dysrhythmias is to wear a Holter monitor. The nurse should explain that Holter monitoring
- is a form of stress test.
- amplifies heart sounds.
- is a portable electrocardiographic device.
- regulates heart rate.
A: is a portable electrocardiographic device.
If right: A Holter monitor (a small portable recorder) is attached to the patient by one to four leads, with a 2-pound tape recorder carried on a belt or shoulder strap.
If wrong: A Holter monitor (a small portable recorder) is attached to the patient by one to four leads, with a 2-pound tape recorder carried on a belt or shoulder strap.

Q: Dependent edema of the extremities, enlargement of the liver, oliguria, jugular vein distention, and abdominal distention are signs and symptoms of
- right-sided heart failure.
- left-sided heart failure.
- cardiac dysrhythmias.
- valvular heart disease.
A: right-sided heart failure.
If right: Inability of the right ventricle to pump blood forward into the lungs results in peripheral congestion. Edema is a sign of increased fluid in interstitial tissue and appears in dependent areas of the body such as the sacrum when supine and the feet and ankles while in an upright position.
If wrong: Inability of the right ventricle to pump blood forward into the lungs results in peripheral congestion. Edema is a sign of increased fluid in interstitial tissue and appears in dependent areas of the body such as the sacrum when supine and the feet and ankles while in an upright position.

Q: A patient, age 72, was admitted to the medical unit with a diagnosis of angina pectoris. Characteristic signs and symptoms of angina pectoris include
- substernal pain that radiates down the left arm.
- epigastric pain that radiates to the jaw.
- indigestion, nausea, and eructation.
- fatigue, shortness of breath, and dyspnea.
A: substernal pain that radiates down the left arm.
If right: The pain often radiates down the left inner arm to the little finger and also upward to the shoulder and jaw.
If wrong: The pain often radiates down the left inner arm to the little finger and also upward to the shoulder and jaw.

Q: The patient, age 26, is hospitalized with cardiomyopathy. While obtaining a nursing history from her, the nurse recognizes that the increased incidence of cardiomyopathy in young adults who have minimal risk factors for cardiovascular disease is related to
- cocaine use.
- viral infections.
- vitamin B_1 deficiencies.
- pregnancy.
A: cocaine use.
If right: Cardiomyopathy caused by cocaine abuse is seen more frequently than ever before. Cocaine also causes high circulating levels of catecholamines, which may further damage myocardial cells, leading to ischemic or dilated cardiomyopathy. The cardiomyopathy produced is difficult to treat. Interventions deal mainly with the HF that ensues.
If wrong: Cardiomyopathy caused by cocaine abuse is seen more frequently than ever before. Cocaine also causes high circulating levels of catecholamines, which may further damage myocardial cells, leading to ischemic or dilated cardiomyopathy. The cardiomyopathy produced is difficult to treat. Interventions deal mainly with the HF that ensues.

Q: Restlessness, diaphoresis, severe dyspnea, tachypnea, hemoptysis, audible wheezing, and crackles are signs and symptoms of
- heart failure.
- respiratory failure.
- pulmonary edema.
- peripheral edema.
A: pulmonary edema.
If right: Signs and symptoms of pulmonary edema are restlessness; vague uneasiness; agitation; disorientation; diaphoresis; severe dyspnea; tachypnea; tachycardia; pallor or cyanosis; cough producing large quantities of blood-tinged, frothy sputum; audible wheezing and crackles; cold extremities.
If wrong: Signs and symptoms of pulmonary edema are restlessness; vague uneasiness; agitation; disorientation; diaphoresis; severe dyspnea; tachypnea; tachycardia; pallor or cyanosis; cough producing large quantities of blood-tinged, frothy sputum; audible wheezing and crackles; cold extremities.

Q: The nurse identifies the problem of a potential complication—pulmonary edema—for a patient in acute congestive heart failure (CHF). For which early symptom of this problem does the nurse assess?
- Pink, frothy sputum
- Lethargy and faintness
- Decreased urinary output
- Bradycardia
A: Pink, frothy sputum
If right: Frothy sputum is produced from air mixing with the fluid in the alveoli; the sputum is blood-tinged from blood cells that have exuded into the alveoli.
If wrong: Frothy sputum is produced from air mixing with the fluid in the alveoli; the sputum is blood-tinged from blood cells that have exuded into the alveoli.

Q: When providing discharge teaching to a patient with endocarditis regarding prevention of infections, what would the nurse stress?
- Avoid crowds.
- Take antibiotics as prescribed.
- Use only aspirin for mild pain.
- Weigh yourself daily.
A: Take antibiotics as prescribed.
If right: Patient teaching focuses on identifying causes, infective endocarditis precautions, dietary requirements, and gradually increasing activity levels, as well as teaching the need for prophylactic antibiotics before any invasive procedure if the patient has preexisting valvular heart disease.
If wrong: Patient teaching focuses on identifying causes, infective endocarditis precautions, dietary requirements, and gradually increasing activity levels, as well as teaching the need for prophylactic antibiotics before any invasive procedure if the patient has preexisting valvular heart disease.

Q: In older adults, rapid infusion of fluids can lead to
- Hypotension
- Thrombophlebitis
- Mitral insufficiency
- Heart failure
A: Heart failure
If right: Heart failure can result from rapid infusion of intravenous fluids in older adults.
If wrong: Heart failure can result from rapid infusion of intravenous fluids in older adults.

Q: Edema and pulmonary congestion are treated with:
- Unlimited activity, high protein diet, weights weekly
- Bed rest, normal diet, weights four times daily
- Increase in fluids, no activity restrictions
- Diuretics, restriction of sodium diet and fluid intake
A: Diuretics, restriction of sodium diet and fluid intake
If right: Edema and pulmonary congestion are treated with diuretics, a sodium-restricted diet, and restriction of fluid intake. Weigh the patient daily to monitor fluid retention.
If wrong: Edema and pulmonary congestion are treated with diuretics, a sodium-restricted diet, and restriction of fluid intake. Weigh the patient daily to monitor fluid retention.

Q: A 63-year-old patient with an acute myocardial infarction is on a cardiac monitor and begins to show some dysrhythmias. The physician will probably prescribe which intravenous medication?
- Nitroglycerin
- Digitalis
- Lidocaine
- Amyl nitrite
A: Lidocaine
If right: Management of dysrhythmias is accomplished by suppressing the impulse that triggers dysrhythmias.
If wrong: Management of dysrhythmias is accomplished by suppressing the impulse that triggers dysrhythmias.

Q: A patient admitted from the emergency room with a diagnosis of heart failure and a NYHA classification of IV is requesting ambulation to the bathroom. Which nursing intervention would be appropriate for this patient?
- Assist the patient to the bathroom.
- Obtain a bedside commode.
- Offer a urinal or bedpan.
- Obtain assistance of another nurse and ambulate the patient to the bathroom.
A: Offer a urinal or bedpan.
If right: Class IV: Severe: patient unable to perform any physical activity without discomfort.
If wrong: Class IV: Severe: patient unable to perform any physical activity without discomfort.

Q: An old term defined as the condition in which the patient suffers peripheral or pulmonary congestion is called
- pneumonia.
- peripheral edema.
- pulmonary edema.
- congestive heart failure.
A: congestive heart failure.
If right: Because many patients suffer pulmonary or systemic congestion with HF, the syndrome was once called congestive heart failure.
If wrong: Because many patients suffer pulmonary or systemic congestion with HF, the syndrome was once called congestive heart failure.

Q: What is defined as a distended dilated segment of an artery?
- Embolism
- Aneurysm
- Angina
- Adhesion
A: Aneurysm
If right: An aneurysm is an enlarged, dilated portion of an artery.
If wrong: An aneurysm is an enlarged, dilated portion of an artery.

Q: A patient, age 65, has chronic angina pectoris. Her daughter had questions about the proper use of nitroglycerin for pain management. She was unsure about how many times she should take nitroglycerin for an episode of angina. The best reply the nurse could make is
- “Continue to take nitroglycerin sublingually at 5-minute intervals until the pain is relieved.”
- “If the pain is not relieved after three doses of nitroglycerin at 5-minute intervals, call your physician and come to the hospital.”
- “When nitroglycerin is not relieving the pain, lie down and rest.”
- “Use oxygen at home to relieve pain when nitroglycerin is not successful.”
A: “If the pain is not relieved after three doses of nitroglycerin at 5-minute intervals, call your physician and come to the hospital.”
If right: Administer prescribed nitroglycerin. Repeat every 5 minutes, three times. If pain is unrelieved, notify the physician. Nitroglycerin administered sublingually usually relieves angina symptoms but does not relieve the pain from an MI. Administering nitro more than three times will probably not relieve the pain.
If wrong: Administer prescribed nitroglycerin. Repeat every 5 minutes, three times. If pain is unrelieved, notify the physician. Nitroglycerin administered sublingually usually relieves angina symptoms but does not relieve the pain from an MI. Administering nitro more than three times will probably not relieve the pain.