Deck 54: Assessment of the Cardiac System

Question 1

The nurse auscultating heart sounds would recognize that the normal closure of the mitral and tricuspid valves creates the

A) apical pulse.
B) atrial gallop.
C) S₁ heart sound.
D) S₂ heart sound.

Answer 1

S₁ heart sound.

Question 2

The nurse would explain to a client who reports being frequently short of breath that the most common form of dyspnea associated with cardiac disorders is

A) exertional dyspnea.
B) idiopathic dyspnea.
C) orthopnea.
D) paroxysmal nocturnal dyspnea.

Answer 2

exertional dyspnea.

Question 3

The nurse would explain to a client that an exercise ECG is useful as one means of detecting

A) cardiac dysrhythmias.
B) coronary artery disease.
C) heart failure.
D) valvular disorders.

Answer 3

coronary artery disease.

Question 4

During the physical examination of a client, the nurse checks the client for neck vein distention. To perform this assessment properly, the client should be positioned

A) first lying, then sitting, then standing.
B) in a side-lying position with knees flexed.
C) lying supine with head of bed elevated 15-30 degrees.
D) sitting upright with neck flexed slightly forward.

Question 5

A client who had a myocardial infarction has an elevated blood glucose level and is getting insulin. The client asks why this is occurring because the client does not have diabetes. The best answer by the nurse is

A) "I am not sure, but I will ask the doctor and let you know."
B) "It is an expected side effect of the medications we gave you."
C) "The stress of your heart attack makes blood sugar rise."
D) "You probably are a diabetic and weren't diagnosed until now."

Question 6

The nurse would explain to a client that the isoenzyme most useful in the diagnosis of myocardial infarction is

A) CK-MB.
B) CK-MM
C) myoglobin.
D) troponin

Question 7

The nurse establishing teaching priorities for a community health program would rank cardiovascular disease as a cause of death as

A) first.
B) fifth.
C) seventh.
D) tenth.

Question 8

The nurse evaluating the head and neck of a client would assess the carotid arteries by

A) asking the client to bear down and hold the breath while observing the arteries.
B) auscultating the arteries with the diaphragm of the stethoscope.
C) instructing the client to lie down and examining the arteries with oblique lighting.
D) palpating the arteries simultaneously, comparing amplitudes, rates, and rhythms.

Question 9

The nurse performing an admission assessment of a 36-year-old client with cardiac valve disease would know the most relevant fact is that the client has

A) a childhood history of rheumatic fever.
B) a recent rash on the upper extremities.
C) allergies to shellfish.
D) been a smoker for the last 3 years.

Question 10

In evaluating a client's ECG tracing, the nurse notes three small squares between the upstroke and downstroke of the QRS wave. The nurse would record the QRS interval as

A)0.04 second.
B)0.06 second.
C)0.08 second.
D)0.12 second.

Question 11

The nurse palpating the precordium of a 73-year-old client for the point of maximal intensity (PMI) would place the hands

A) at Erb's point in an elderly client.
B) at the level of the sternal manubrium.
C) at the fifth intercostal space, medial to the midclavicular line.
D) to the left of the angle of Louis.

Question 12

The nurse assessing an American Indian client would assess for other cardiovascular risk factors because the prevalence of heart disease in this group is

A) no different from other ethnic groups and all should be assessed.
B) the highest of all ethnic groups in America.
C) the second highest of all ethnic groups in America.
D) varies widely between different geographical locations.

Question 13

The nurse would explain that angina pain usually differs from the pain of a myocardial infarction (MI) in that angina pain

A) is accompanied by palpitations.
B) is seldom relieved by rest.
C) lasts less than 15 minutes.
D) radiates to the arm, jaw, or throat.

Question 14

A nurse understands that the basic premise of an ECG is that it shows

A) altered electrical activity from pathologic changes.
B) damage to the valves inside the heart.
C) the status of the client's coronary arteries.
D) the approximate time since a myocardial infarction occurred.

Question 15

The finding during a routine assessment that would most strongly suggest to the nurse the presence of serious heart or lung disease is

A) blanching of nail beds when compressed.
B) broken vessels in the legs.
C) duskiness of the buccal mucosa.
D) pulse rate greater than 90 beats/min.

Question 16

The nurse would explain to a client that the benefit of a Holter monitor over an ECG is that the Holter monitor

A) does not require a lengthy hospital stay.
B) is a continuous recording, often for 24 hours.
C) is less expensive than the traditional ECG.
D) provides a two-dimensional view of the coronary arteries.

Question 17

The nurse would explain to a client that an electrical representation of the cardiac cycle shows that a normal PR interval is between 0.12 second and

A)0.15 second.
B)0.16 second.
C)0.18 second.
D)0.20 second.

Question 18

A client's record contains a notation that the client is orthopneic. Which question by the nurse would obtain the most useful information?

A) "About how far can you walk before it occurs?"
B) "Does anyone else in your family have this too?"
C) "How many pillows do you need to sleep on?"
D) "When did you first notice this problem?"

Question 19

In doing a breath sound assessment on a client who has left ventricular failure, the nurse would anticipates the finding of

A) audible S3 and S4.
B) crackles in the lung bases.
C) inspiratory wheeze.
D) pericardial friction rub.

Question 20

The nurse is attempting to identify the timing of a murmur detected in a client. The additional activity necessary to make this assessment would be

A) assessment of blood pressure.
B) estimation of the client's fluid status.
C) evaluation of peripheral pulses.
D) identification of S1 and S2.

Question 21

Important information the nurse should collect when a client complains of chest pain includes (Select all that apply)

A) aggravating and relieving factors.
B) associated manifestations.
C) characteristics.
D) duration.
E) location.

Question 22

The critical piece of information related to the client's myocardium that is obtained through a PET scan is

A) electrical activity of the heart.
B) myocardial viability.
C) patency of coronary arteries.
D) status of valves.

Question 23

The nurse planning a secondary prevention program for risk reduction would focus on clients who

A) already have a diagnosis of cardiovascular disease.
B) do not yet have cardiovascular disease and wish to prevent it.
C) have two or more family members with cardiovascular disease.
D) want information about cardiovascular disease.

Question 24

To best facilitate a client's understanding of an electrophysiologic study, the nurse would explain that this study will

A) enable the physician to reproduce dysrhythmias and evaluate antidysrhythmic drugs.
B) evaluate the relationship of the atrium to the ventricles during contractions.
C) increase the understanding of the strength of the muscles in the ventricles.
D) interrupt blood flow to coronary arteries and assess the heart's electrical system.

Question 25

A nurse explains the purpose of echocardiography to a client as

A) a picture of both the structures in the heart and their motion.
B) an image of the heart and great vessels from a posterior view.
C) hemodynamic pressure monitoring and analysis of oxygenation.
D) the use of extra contrast dye to visualize pulmonary arteries.

Question 26

A client has an elevated level of C-reactive protein. The nurse explains the significance of this finding as

A) an indication of an inflammatory process like atherosclerosis.
B) not related to future cardiac events such as myocardial infarction.
C) suggestive of a recent pulmonary embolus.
D) worrisome because it signals possible myocardial irritability.

Question 27

The nurse providing education at a community forum on obesity and heart disease informs the group that "obese" is described as a body mass index greater than

A) 15 kg/m2.
B) 20 kg/m2.
C) 25 kg/m2.
D) 30 kg/m2.

Question 28

Women with heart disease often present with which symptom? (Select all that apply.)

A) Chest pain
B) Dyspnea
C) Fatigue
D) Nausea
E) Palpitations

Question 29

A client is taking the herbal supplements bilberry and evening primrose. The nurse would specifically question the client about manifestations of

A) angina.
B) dyspnea.
C) hypertension.
D) palpitations.

Question 30

In developing a standard teaching plan for the outpatient unit where stress testing is performed, the nurse would include information that the

A) test may cause chest pain and may need to be stopped.
B) test should not be interrupted for any reason.
C) client should attempt to exercise before arriving for the test.
D) client's balance must be good for performance of this test.