Question 1

You are caring for a client with a damaged tricuspid valve. You know that the tricuspid valve is held in place by which of the following?

Accepted Answer

The tricuspid valve is held in place by the chordae tendineae which attach to the papillary muscles in the right ventricle. This prevents the valve from prolapsing (flipping back into the right atrium) during ventricular contraction.

Question 2

You are discharging a client after a cardiac catheterization. What would you include in your discharge teaching?

Accepted Answer

It is important for the client to report any signs of complications such as numbness, tingling, or sharp pain in the extremity which may indicate bleeding or blood clots at the catheter insertion site. Option A is not necessary as there are no restrictions on diet after cardiac catheterization. Option C is also incorrect as the client should be encouraged to drink plenty of fluids to flush out the dye from their system. Option D is incorrect as the client should be advised to take it easy and avoid heavy lifting or strenuous activities for a few days after the procedure.

Question 3

You are teaching a group of nursing students about adventitious heart sounds. You explain that auscultation of the heart requires familiarization with normal and abnormal heart sounds. What would you tell these students a ventricular gallop indicates in an adult?

Accepted Answer

A ventricular gallop (S3) is an abnormal third heart sound and is associated with decreased ventricular compliance, which is often seen in heart failure.

Question 4

You are working on a telemetry unit. Your client was admitted with a cardiac event and is now on a cardiac monitor. You know a cardiac monitor reveals the heart's electrical but not its mechanical activity. How would you assess the mechanical activity of the client's heart?

Accepted Answer

Palpating a peripheral pulse is the best choice to assess the mechanical activity of the heart. While a cardiac monitor shows the electrical activity of the heart, palpating a pulse assesses the mechanical activity and can provide information about the strength and rhythm of the heartbeat. It is a quick, noninvasive way to monitor the client's cardiac function. The other options (taking blood pressure, auscultating the carotid artery, and percussing the perimeter of the heart) may provide some additional information, but they are not as direct or reliable in assessing the mechanical activity of the heart.

Question 5

A student nurse is caring for a client with suspected cardiovascular disease. The nursing instructor asks the student what side effects a client may experience when undergoing a magnetic resonance imaging (MRI) test. What should the student respond?

Accepted Answer

Rapid heart rate is a possible side effect of an MRI due to the loud noises produced by the machine. Swollen feet, sweating, and sluggishness are not common side effects of an MRI.

Question 6

One of your students asks what the consequences of uncorrected, left-sided heart failure would be. What would be your best response?

Accepted Answer

Left-sided heart failure can lead to a backup of fluid and pressure in the lungs, but over time, it can also cause strain on the right side of the heart, leading to right-sided heart failure. This occurs as the weakened left ventricle cannot pump out enough blood, causing blood to back up into the left atrium and then into the pulmonary veins and lungs. The increased pressure in the lungs then creates back pressure on the right side of the heart, leading to right-sided heart failure. Distention of the jugular vein and blood congestion in neck veins are more commonly associated with right-sided heart failure, while effort to lie down to breathe is a symptom of left-sided heart failure.

Question 7

A student nurse asks if anticipatory anxiety can be reduced in a client undergoing a diagnostic procedure of the cardiovascular system. How should the instructor respond?

Accepted Answer

By giving the client a time frame about the test, it helps to reduce anticipatory anxiety by providing a sense of predictability and control. Using medical terms may increase confusion and anxiety, allowing for increased activity may not be appropriate depending on the client's health status, and not informing the client about unexpected delays may lead to further anxiety and frustration.

Question 8

You are assessing the skin of a client with a cardiovascular disorder and find sparse hair growth on the legs and thick toenails. What does this indicate?

Accepted Answer

Sparse hair growth and thick toenails are both signs of poor circulation, which is commonly associated with cardiovascular disorders. The reduced blood flow to the area affects the hair growth and can lead to thickened nails due to decreased oxygen and nutrients.

Question 9

The instructor is teaching a pre-nursing anatomy and physiology class. The class is studying the cardiovascular system. What does the instructor tell the class safeguards the heart from infectious microorganisms?

Accepted Answer

The parietal pericardium is part of the pericardium that surrounds the heart, providing a protective barrier against infection and physical damage. It is not directly in contact with the heart itself but forms an outer layer that helps to safeguard the heart from infectious microorganisms.

Question 10

Your client is being prepared for echocardiography when they ask you why they need to have this test. What would be your best response?

Accepted Answer

The answer of Your client is being prepared for echocardiography...

Question 11

The nurse notes that their client has had a change in mental status. Why would it be important for the nurse to report extremes of emotions or disturbances in the thought process of a client with cardiovascular disorder to the physician?

Accepted Answer

Changes in mental status can interfere with diagnostic testing and prescribed therapy, making it important for the physician to be aware of these changes to adjust treatment plans accordingly.

Question 12

The nurse caring for a client who is suspected of having cardiovascular disease has a stress test ordered. The client has a co-morbidity of multiple sclerosis, so the nurse knows the stress test will be drug-induced. What drug will be used to dilate the coronary arteries?

Accepted Answer

Dobutrex is a drug that is commonly used for pharmacologic stress testing to simulate exercise on the heart. It works by increasing heart rate, cardiac output, and oxygen demand, which helps to identify any areas of the heart that may have decreased blood flow. It also dilates the coronary arteries, which allows for better visualization of the heart on imaging tests. Thallium is a radioactive tracer that is used during the stress test to help visualize blood flow to the heart muscle, but it does not dilate coronary arteries. Ativan and Diazepam are benzodiazepines that are used for anxiety and sedation, respectively, and are not used in stress testing.

Question 13

You are evaluating the expected outcomes on a client who is recovering from a cardiac catheterization. What is an expected outcome that you would evaluate?

Accepted Answer

Understanding discharge instructions is a key expected outcome for a client recovering from a cardiac catheterization, as it ensures they know how to care for themselves post-procedure.

Question 14

You are the clinic nurse doing assessments on your clients before they have outpatient diagnostic testing done. What would you document when assessing the client's pulse?

Accepted Answer

When assessing a client's pulse, the nurse should document the rate (number of pulses in one minute), quality (strength, amplitude), and rhythm (pattern of beats). These are the most important aspects to assess and document in order to evaluate the client's cardiovascular function. Pressure and volume are not typically assessed when checking a pulse.

Question 15

What is considered the pacemaker of the heart?

Accepted Answer

The SA (sinoatrial) node is considered the "natural pacemaker" of the heart because it generates electrical impulses that initiate each heartbeat. The other choices play important roles in the conduction of electrical impulses through the heart, but they do not have the same pacemaker function as the SA node.

Question 16

Students are drawing pictures of the cardiac circulation. Where should they place the coronary ostia?

Accepted Answer

The coronary ostia are located at the base of the aorta, where it arises from the left ventricle. This is the site where coronary blood flow is delivered to the heart muscle via the left and right coronary arteries.

Question 17

The clinic nurse caring for a client with a cardiovascular disorder is performing an assessment of the client's pulse. Which of the following steps is involved in determining the pulse deficit?

Accepted Answer

To determine a pulse deficit, the nurse or healthcare provider must compare the apical pulse (heart rate at the apex of the heart) with the radial pulse. This involves counting the heart rate directly over the heart (apical pulse) and comparing it with the pulse felt at the radial artery. A difference between these two rates indicates a pulse deficit, which can suggest a lack of perfusion or an irregular heartbeat.

Question 18

You are caring for a client with right-sided heart failure. When assessing the respiratory rate of this client, what is an indication that the client is having difficulty breathing?

Accepted Answer

Using accessory muscles during respiration is an indication that the client is having difficulty breathing. In right-sided heart failure, fluid builds up in the lungs, making it harder for the client to breathe. Using accessory muscles to compensate means the respiratory muscles are working harder to breathe, which can indicate difficulty.

Question 19

The nurse is caring for a client scheduled for an angiocardiography. Which of the following interventions does the nurse implement during client preparation?

Accepted Answer

Angiocardiography is a test that examines the heart and the blood vessels that supply it with blood. To prepare for this test, the nurse should recommend that the client fast for at least 3 hours before the test. This is done to reduce the risk of aspiration during the procedure. Additionally, there is no need to stop administering antihistaminic medication or draw arterial blood samples for blood gas analysis before the test. Restricting client activity for about 12 hours before the test is not necessary as well.

Question 20

Your students are studying various laboratory tests, such as blood chemistries, that may be used as part of the diagnostic analysis for a client with a cardiovascular disorder. What do hyperglycemia and hypertriglyceridemia indicate?

Accepted Answer

Hyperglycemia (high blood sugar levels) and hypertriglyceridemia (high levels of triglycerides in the blood) indicate uncontrolled diabetes mellitus. These are common laboratory findings in individuals with diabetes, and can indicate poor glycemic control and increased risk for cardiovascular disease.

Quiz 22: Introduction to the Cardio Vascular System