Deck 32: Nursing Assessment: Cardiovascular System

Question 1

While assessing a patient who has just arrived in the emergency department, the nurse notes a pulse deficit. The nurse will anticipate that the patient may require

A) hourly blood pressure (BP) checks.
B) a coronary arteriogram.
C) electrocardiographic (ECG) monitoring.
D) a 2-D echocardiogram.

Answer 1

electrocardiographic (ECG) monitoring.

Question 2

When admitting a patient for a coronary arteriogram and angiogram, the assessment information that will be most important for the nurse to communicate to the health care provider is that the

A) patient had an arteriogram a year ago.
B) patient has not eaten anything yet today.
C) patient is allergic to shellfish.
D) patient's pedal pulses are +1.

Answer 2

patient is allergic to shellfish.

Question 3

When performing an assessment of a newly admitted patient, the nurse notes a thrill along the left sternal border. To obtain more information about the cause of the thrill, which action will the nurse take next?

A) Palpate the quality of the peripheral pulses.
B) Compare the apical and radial pulse rates.
C) Assess for murmurs.
D) Locate the PMI.

Answer 3

Assess for murmurs.

Question 4

The nurse is monitoring a patient with possible coronary artery disease who is undergoing exercise (stress) testing on a treadmill. The symptom that has the most immediate implications for the patient's care during the exercise testing is

A) the BP rising from 134/68 to 150/80 mm Hg.
B) the heart rate (HR) increasing from 80 to 96 beats/min.
C) the patient complaining of feeling short of breath.
D) the ECG indicating the presence of coronary ischemia.

Question 5

A patient is scheduled for a cardiac catheterization with coronary angiography. Before the test, the nurse informs the patient that

A) a catheter will be inserted into a vein in the arm or leg and advanced to the heart.
B) ECG monitoring will be required for 24 hours following the test to detect any dysrhythmias.
C) a feeling of warmth may be experienced as the contrast material is injected into the catheter.
D) it will be important to lie completely still during the coronary angiography procedure.

Question 6

The nurse teaches the patient being evaluated for rhythm disturbances with a Holter monitor to

A) remove the electrodes when taking a shower or tub bath.
B) exercise more than usual while the monitor is in place.
C) keep a diary of daily activities while the monitor is worn.
D) connect the recorder to a telephone transmitter once daily.

Question 7

During a physical examination of a patient, the nurse palpates the PMI in the sixth intercostal space lateral to the midclavicular line. The most appropriate action for the nurse to take next will be to

A) document that the PMI is in the normal location.
B) assess the patient for symptoms of left ventricular hypertrophy.
C) ask the patient about risk factors for coronary artery disease.
D) auscultate both the carotid arteries for a bruit.

Question 8

During physical examination of a thin 72-year-old patient, the nurse observes pulsation of the abdominal aorta in the epigastric area just below the xiphoid process. The nurse teaches the patient that this is

A) a normal assessment finding for a thin individual.
B) likely to be caused by age-related sclerosis and inelasticity of the aorta.
C) an indication that an abdominal aortic aneurysm has probably developed.
D) evidence of elevated systemic arterial pressure.

Question 9

The RN is observing a student nurse who is doing a physical assessment on a patient. The RN will need to intervene immediately if the student nurse

A) presses on the skin over the tibia for 10 seconds to check for edema.
B) palpates both carotid arteries simultaneously to compare pulse quality.
C) places the patient in the left lateral position to check for the PMI.
D) uses the palm of the hand to assess extremity skin temperature.

Question 10

While assessing a patient with heart failure, the nurse notes that the patient has jugular venous distension (JVD) when lying flat in bed. The nurse's next action will be to

A) have the patient perform the Valsalva maneuver and observe the jugular veins.
B) palpate the jugular veins and compare the volume and pressure on the both sides.
C) use a centimeter ruler to measure and document accurately the level of the JVD.
D) elevate the patient gradually to an upright position and examine for continued JVD.

Question 11

The nurse is obtaining a health history for a new patient with possible coronary artery disease. Which question would the nurse use when obtaining subjective data related to the patient's health perception-health management functional health pattern?

A) "Do you every have any discomfort or indigestion resulting from exercise or activity?"
B) "Have you had any recent episodes of sore throat, fever, or streptococcal infections?"
C) "How frequently do you have your cholesterol level and blood pressure checked?"
D) "Are there any symptoms that seem to occur when you are feeling very stressed?"

Question 12

When auscultating over the patient's abdominal aorta, the nurse hears a humming sound. The nurse documents this finding as a

A) thrill.
B) bruit.
C) heave.
D) murmur.

Question 13

The nurse hears a murmur between the S₁ and S₂ heart sounds at the patient's left 5th intercostal space and midclavicular line. The best way to record this information is

A) "systolic murmur heard at mitral area."
B) "diastolic murmur heard at aortic area."
C) "systolic murmur heard at Erb's point."
D) "diastolic murmur heard at tricuspid area."

Question 14

Which information obtained by the nurse who is admitting the patient for magnetic resonance imaging (MRI) will be most important to report to the health care provider before the MRI?

A) The patient has a history of coronary artery disease.
B) The patient took all the prescribed cardiac medications today.
C) The patient has an allergy to shellfish and iodine.
D) The patient has a permanent ventricular pacemaker in place.

Question 15

The nurse has received the laboratory results for a patient who developed chest pain 2 hours ago and may be having a myocardial infarction. The most important laboratory result to review will be

A) troponins T and I.
B) creatine kinase-MB.
C) LDL cholesterol.
D) C-reactive protein.

Question 16

A patient with syncope is scheduled for Holter monitoring. When teaching the patient about the purpose of the procedure, the nurse will explain that Holder monitoring provides information about the

A) ventricular ejection fraction during usual daily activities.
B) cardiovascular response to high-intensity exercise.
C) changes in cardiac output when the patient is resting.
D) HR and rhythm during normal patient activities.

Question 17

When reviewing the 12-lead ECG for a healthy 86-year-old patient who is having an annual physical examination, which of these observations will be of most concern to the nurse?

A) The PR interval is 0.21 seconds.
B) The HR is 43 beats/min.
C) There is a right bundle-branch block.
D) There is a QRS duration of 0.13 seconds.

Question 18

To auscultate for S₃ or S₄ gallops in the mitral area, the nurse listens with the

A) diaphragm of the stethoscope with the patient in a reclining position.
B) diaphragm of the stethoscope with the patient lying flat on the left side.
C) bell of the stethoscope with the patient in the left lateral position.
D) bell of the stethoscope with the patient sitting and leaning forward.

Question 19

The standard orders on the cardiac unit state, "Notify the health care provider for mean arterial pressure (MAP) less than 70 mm Hg." The nurse will need to call the health care provider about

A) the patient with left ventricular failure who has a BP of 110/70.
B) the patient with a myocardial infarction who has a BP of 114/50.
C) the postoperative patient with a BP 116/42.
D) the newly admitted patient with a BP of 122/60.

Question 20

A transesophageal echocardiogram (TEE) is ordered for a patient with possible endocarditis. Which of these actions included in the standard TEE orders will the nurse need to accomplish first?

A) Make the patient NPO.
B) Start a large-gauge IV line.
C) Administer O₂ per mask.
D) Give lorazepam (Ativan) 1 mg IV.

Question 21

When assessing a 76-year-old woman, the nurse finds the following results: BP 146/102, resting HR 104, slightly irregular S₄ heart sound, and a grade I/VI aortic systolic murmur. The nurse recognizes that common effects of aging may be responsible for the (Select all that apply.)

A) HR.
B) irregular pulse.
C) S₄ heart sound.
D) systolic BP.
E) diastolic BP.
F) grade I/VI aortic systolic murmur.