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The nurse identifies the 'lub' sound of the 'lub/dub' of the cardiac cycle as the sound of which event?
- A. AV valves closing.
- B. closure of the semilunar valves.
- C. contraction of the papillary muscles.
- D. contraction of the ventricles.
Correct Answer: A
Rationale: The lub is the first sound of a low pitch heard when the AV valves close.
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The nurse reminds the patient that the American Heart Association recommends a lipid study how frequently?
- A. Every 2 years
- B. Every 2 to 3 years
- C. At least every 4 years
- D. Every 4 to 6 years
Correct Answer: D
Rationale: The American Heart Association recommends a lipid study every 4 to 6 years for all Americans over the age of 20.
A patient with atrial fibrillation may experience decreased cardiac output, due to
Correct Answer: Incomplete ventricular filling
Rationale: Since the atria quiver, rather than contract, the normal atrial kick is lost, leading to a decrease in the cardiac output.
Which intervention is appropriate for a patient who is experiencing an acute attack of Raynaud's disease?
- A. Vigorously rub both the hands in ice or snow.
- B. Place the hands in ice water to observe for pallor.
- C. Apply hot water over both the hands to rapidly warm the hands.
- D. Place mittens on the hands and encourage the patient to move fingers.
Correct Answer: D
Rationale: For an acute attack, the patient should wear layers such as mittens, and move the fingers and hands to improve circulation. Placing the hands in ice, snow or ice water would worsen the arterial constriction. Applying hot water would cause serious burns.
The nurse would assess closely for which sign of right-sided heart failure?
- A. cough.
- B. increasing abdominal girth.
- C. shortness of breath.
- D. edema of feet and ankles.
- E. distended jugular veins.
- F. orthopnea.
Correct Answer: B,D,E
Rationale: Indicators of right-sided heart failure are distended jugular veins, anorexia, abdominal distention from ascites, liver enlargement with right upper quadrant pain, and edema of feet and ankles.
A patient admitted to the emergency room with a possible myocardial infarction (MI) has reports back from the laboratory. Which laboratory report is specific for myocardial damage?
- A. CK-MB
- B. Elevated white count
- C. Elevated sedimentation rate
- D. Low level of sodium
Correct Answer: A
Rationale: The CK-MB is elevated when there is infarcted myocardial muscle. The elevated white count, low sodium, and ESR are nonspecific.