Cardiovascular Test Bank

Cardiovascular Test Bank Related

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A patient is admitted to your acute coronary care unit with the diagnosis of ACS. The nurse has seen ECG changes that are indicative of an anterior wall infarction and is observing the patient for signs/symptoms of complications. The nurse has noted the following vital sign trends: 1100-HR 92, RR 24, BP 140/88, Cardiac rhythm NSR 1115-HR 96, RR 26, BP 128/82, Cardiac rhythm NSR 1130-HR 104, RR 28, BP 102/68, Cardiac rhythm ST 1145-HR 120, RR 32, BP 80/52, Cardiac rhythm ST with frequent PVC's The nurse should be alert for which of the following complications? Choose all that apply.

  • A. Syncope
  • B. Pericarditis
  • C. Cardiogenic shock
  • D. Cardiac tamponade
Correct Answer: C

Rationale: The correct answer is C: Cardiogenic shock. In this scenario, the patient with ACS is showing vital sign trends of decreasing blood pressure (BP) along with an increase in heart rate (HR) and respiratory rate (RR), indicating poor cardiac output. Cardiogenic shock occurs when the heart cannot pump enough blood to meet the body's demands. The decreasing BP and increasing HR are signs of impending cardiogenic shock, a serious complication of anterior wall infarction due to decreased cardiac output.

Choice A: Syncope is not the most appropriate complication to be alert for in this case, as the vital signs are indicating a more severe condition than just fainting.

Choice B: Pericarditis is unlikely to cause the significant changes in vital signs observed in this scenario. While pericarditis can occur following an MI, the vital sign trends are more indicative of cardiogenic shock.

Choice D: Cardiac tamponade is also unlikely based on the vital sign trends provided. Card

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Which of the following should the nurse monitor for clients with aneurysms to determine the signs of hemorrhage or dissection?

  • A. Nurse monitors for swelling and heaviness of the legs.
  • B. Nurse monitors for chest pain and elevated LDL levels.
  • C. Nurse monitors the BP, hourly urine output, skin color, and level of consciousness.
  • D. Nurse monitors for mild fever and swelling of extremities.
Correct Answer: C

Rationale: Monitoring vital signs, urine output, and neurological status is critical to detect early signs of aneurysm complications.

The nurse prepares a patient for insertion of a pulmonary artery catheter. Preprocedural teaching for this client will include which of the following statements?

  • A. The catheter will assist in directly monitoring your arterial pressure
  • B. The catheter will provide information about your cardiac output
  • C. The catheter will provide information about your left ventricular function
  • D. The catheter will provide information about your cardiac index
Correct Answer: C

Rationale: A pulmonary artery catheter will provide information about the left ventricular function. The catheter does not directly determine the cardiac output or index.

The nurse explains to the patient who is to undergo a coronary artery bypass graft that the procedure most often involves

  • A. Using a synthetic graft as a tube for blood flow from the aorta to a coronary artery distal to an obstruction
  • B. Resecting a stenosed coronary artery and inserting a synthetic arterial tube graft to replace the diseased artery
  • C. Loosening the internal mammary artery from the chest wall and attaching it to a coronary artery distal to a stenosis
  • D. Anastomosing reversed segments of a saphenous vein from the aorta to the coronary artery distal to an obstruction
Correct Answer: C

Rationale: The most common method of coronary artery bypass involves leaving the internal mammary artery attached to its origin from the subclavian artery but dissecting it from the chest wall and anastomosing it distal to an obstruction in a coronary artery.

The client has a resting heart rate of 80 and a regular rhythm. What is the likely source of electrical activity in this client?

  • A. The sino-atrial node
  • B. The atrio-ventricular node
  • C. The Purkinje fibers
  • D. The bundle of HIS
Correct Answer: A

Rationale: The correct answer is A: The sino-atrial node. The SA node is the primary pacemaker of the heart, responsible for initiating the electrical impulses that regulate the heart rate. It is located in the right atrium and typically generates a resting heart rate of around 60-100 beats per minute. In this scenario, with a resting heart rate of 80 and a regular rhythm, the SA node is most likely the source of electrical activity. The other choices (B: AV node, C: Purkinje fibers, D: Bundle of His) are involved in the conduction of electrical impulses within the heart but are not responsible for the initiation of the heartbeat at rest.

A nurse is assessing a client who may be in the early stages of dehydration. Early manifestations of dehydration include:

  • A. Sunken eyeballs and poor skin turgor
  • B. Thirst or confusion
  • C. Increase heart rate with hypotension
  • D. Coma or seizures
Correct Answer: A

Rationale: The correct answer is A: Sunken eyeballs and poor skin turgor. In the early stages of dehydration, the body loses water and the skin loses elasticity, leading to poor skin turgor. Sunken eyeballs are also a common sign of dehydration due to fluid loss. Thirst or confusion (Choice B) are more common in moderate to severe dehydration. Increased heart rate with hypotension (Choice C) typically occurs in moderate to severe dehydration. Coma or seizures (Choice D) are signs of severe dehydration and would not be seen in the early stages. Therefore, A is the correct choice for early manifestations of dehydration.