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Chapter 21. Cardiovascular System Function,
Assessment, and Therapeutic Measures
Multiple Choice
Identify the choice that best completes the statement or answers the
question.
1. The nurse is reviewing the anatomy and physiology of the
cardiac system with a patient scheduled for pacemaker insertion.
Which chamber of the heart should the nurse instruct has the greatest
workload and usually fails first as a result?
c. Left ventricle
2. The nurse is helping a patient understand why the heartbeat can
change in speed. When doing so, what should the nurse explain as being
the pacemaker of the heart?
b. Sinoatrial node
3. The nurse is using a stethoscope to listen to a patient heart ’s
sounds. The nurse recognizes that the dupp of the characteristic lubb-
dupp heart sound indicates what part of the cardiac cycle?
d. The closure of the aortic and pulmonary semilunar valves
4. The nurse suspects that a patient heart rate is being affected by ’s
parasympathetic influence. What should the nurse recall as the effect
the parasympathetic nervous system has on the heart?
a. Decreases heart rate
5. The nurse is caring for a patient recovering from a cardiac
catheterization with a right femoral artery entry site. Which action should
the nurse take?
c. Avoid movement of the right leg as ordered.
6. The nurse is providing care for a patient whose right atrial
pressure (RAP) is 12 mm Hg. Which action should the nurse take?
b. Listen to breath sounds.
7. A patient is diagnosed with epicarditis. What should the nurse
recall regarding the purpose of the epicardium when caring for this
patient?
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c. Cover the heart muscle and prevent friction.
8. The nurse is explaining the regulation of blood pressure to a patient
newly diagnosed with
hypertension. What tissues within the artery wall help maintain diastolic
blood pressure should the nurse identify for the patient?
a. Smooth muscle and elastic connective tissue
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9. The nurse instructs a patient on beverages to avoid when taking
the prescribed medication warfarin (Coumadin). Which beverage
should the patient state that indicates teaching has been effective?
d. Cranberry juice
10. A patient has sustained damage to the sinoatrial node. Which
heart rates indicate that the patient atrioventricular node has taken ’s
over as the pacemaker for the heart?
c. 40 to 60
11. The nurse is measuring a patient central venous pressure ’s
(CVP). Which patient factors are reflected by this pressure reading?
a. Hydration
12. A patient with type 1 diabetes mellitus arrives for cardiac surgery.
During the assessment, the nurse learns the patient self-administered the
usual insulin dose. Which action should the nurse take?
c. Inform the physician.
13. Upon auscultating a patient heart sounds, the nurse is concerned ’s
that a pericardial friction rub is present. Which health problem should the
nurse suspect is possibly occurring in this patient?
d. Myocardial infarction
14. The nurse reviews the cardiac catheterization procedure with a
patient scheduled for the test in 2 hours. Which patient statement indicates
that teaching has been effective?
c. The table may move while the test is being done.
15. The nurse is caring for a patient who had a cardiac catheterization
using the left femoral site for entry. Which data is most important for the
nurse to monitor?
b. Left pedal pulse
16. A patient is being instructed about a Holter monitor. Which statement
indicates that the patient knows what to do if a symptom occurs while
wearing a Holter monitor?
d. Push the event button
17. A patient will be wearing a Holter monitor for 2 days. What
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should the nurse instruct the patient about bathing while wearing the
monitor?
a. Take a sponge bath.
18. A patient asks the nurse to explain what high levels of low-density
lipoproteins (LDLs) mean. What response by the nurse would be
appropriate?
b. Increased risk for coronary artery disease.
19. The nurse is reinforcing teaching provided to a patient about the
role high-density lipoproteins (HDLs) play in cardiac disease. Which patient
statement indicates the correct understanding of the teaching?
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c. It protects against coronary artery disease.
20. The nurse is collecting data from a patient with hypertension.
Which modifiable cardiovascular risk factor should the nurse identify for
care planning?
d. Activity level
21. The nurse is reinforcing teaching provided to a patient with a high
serum cholesterol level, low HDLs, and high LDLs. What should the nurse
include?
d. Your cholesterol level and LDLs are too high. You need to lower your
intake of saturated fats and increase your level of exercise.
22. The nurse is caring for a patient recovering from a cardiac
catheterization. Which action should the nurse take?
c. Encourage the patient to drink plenty of liquids.
23. The nurse is caring for a patient recovering from a cardiac
catheterization. Which actions for site care should the nurse take?
c. Maintain pressure dressing on the site.
24. The nurse is caring for a patient whose troponin I level is elevated.
Which nursing action would be appropriate?
c. Maintain bedrest.
25. The nurse is preparing a patient for an angiogram. What should
be included in data collection for this patient?
d. Ask if the patient is allergic to contrast dyes.
26. During data collection, the nurse learns that a patient with
chronic cardiac problems and diabetes have gained 5 pounds of weight
over 3 days and is experiencing fatigue when climbing stairs. Upon
inspection, the nurse notes edema of the lower extremities. What health
problem do these symptoms suggest that the nurse should report to the
physician?
d. Right-sided heart failure
27. The nurse determines that a patient pulmonary artery wedge ’s
pressure is normal. What range of values did the nurse use to make this
decision?
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d. 4 to 12 mm Hg
28. The nurse is planning to auscultate a patient apical pulse. How ’s
long should the nurse listen to the patient s heart? ’
c. 60 seconds
29. The nurse is documenting information collected about a patient ’s
pulse. How should the nurse document that a peripheral pulse was
normal?
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c. 2+
30. A patient being treated for severe blood loss has a blood pressure
of 90/56 mm Hg and urine output of 10 mL over the last hour. Which
physiological mechanism should the nurse recall is occurring in this
patient?
d. Renin-angiotensin-aldosterone
31. While collecting data a patient expectorates pink frothy sputum.
Which health problem should the nurse consider is occurring in this
patient?
c. Heart failure
32. The nurse notes that a patient lower legs are brown and the feet ’s
are blue when they are in the dependent position. For which health problem
should the nurse collect additional data?
d. Venous blood flow
problems Multiple
Response
Identify one or more choices that best complete the statement or answer the
question.
33. The nurse is preparing to measure a patient for orthostatic
hypotension. Which action should the nurse take to obtain this
information? (Select all that apply.)
a. Use the correct size blood pressure cuff for the patient.
b. Instruct the patient not to eat or drink for 30 minutes before the test.
d. Take pulse and blood pressure readings immediately upon assisting the
patient to stand.
e. Assist the patient to a sitting position, wait 3 minutes, and take the pulse
and blood pressure.
f. Obtain supine reading with the patient lying with the head of the bed
elevated 30 degrees for 30 minutes.
34. The nurse is attempting to detect a pericardial friction rub on a
patient. Which actions will help the nurse in gathering this data during
auscultation? (Select all that apply.)
a. Have the patient sit up.
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c. Have the patient lean forward.
35. The nurse is reinforcing teaching for a patient who is to wear a
Holter monitor. Which of the following should the nurse include? (Select
all that apply.)
c. Push the event button when symptoms occur.
d. Keep an accurate diary of symptoms and activities.
e. Avoid showers or baths while wearing the monitor.
36. The nurse is reviewing the role of atrial natriuretic peptide (ANP) in
blood pressure regulation for a patient with hypertension. What should the
nurse include in this discussion? (Select all that apply.)
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a. It decreases blood volume.
c. It inhibits aldosterone secretion.
f. It increases renal secretion of sodium ions and water.
37. The nurse is caring for a patient who is having an exercise
treadmill test. What interventions would be appropriate for the test?
(Select all that apply.)
b. Monitor vital signs throughout the test.
d. Monitor electrocardiogram before, during, and after the test.
38. The nurse is caring for a patient with peripheral vascular
disease. Which signs or symptoms should the nurse expect to observe
in this patient? (Select all that apply.)
a. Pain
d. Paralysis
f. Pulselessness
39. The nurse notes that a patient being prepared for a cardiac
computed tomography (CT) scan has mild renal insufficiency. What should
the nurse expect to be ordered before and after the procedure for this
patient?
(Select all that apply.)
c. Lactic acid
e. N-acetylcysteine (Mucomyst)
40. A patient with orthostatic hypotension asks why the health problem
is occurring. What should the
nurse include when explaining the causes of orthostatic hypotension to
the patient? (Select all that apply.)
a. Experiencing pain
b. Use of narcotic pain medication
d. Insufficient fluid volume in the body
e. Use of medication that takes fluid out of
the body Completion
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Complete each statement.
41. A patient has a stroke volume of 75 mL and a heart rate of 88. What
should the nurse calculate this patient cardiac output to be? 6000 mL ( ’s
6.6L)
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CH 22
Identify the choice that best completes the statement or answers the
question.
1. A patient on antihypertensive medication has no insurance, three
children, and reports feeling great and exercising daily. What should the
nurse include in this patient s teaching plan to promote compliance? ’
c. Refer the patient for financial assistance.
2. A patient current blood pressure reading is 144/94 mm Hg. A ’s
reading of 150/96 mm Hg was obtained on a prior occasion. Which type of
hypertension should the nurse recognize that this patient is experiencing?
b. Stage 1
3. The nurse is caring for a patient who is prescribed a thiazide
diuretic. What instructions should the nurse provide this patient who
reports fatigue due to sleep deprivation?
b. Take your medication early in the day.
4. The nurse measuring blood repressurizing a screening clinic.
Which participant statement indicates that teaching about blood pressure
has been effective?
a. My blood pressure is 118/68, which is normal.
5. The nurse measures blood pressure during a screening clinic.
For which blood pressure reading should the nurse instruct a patient to
have a follow-up in one year?
b. 132/88 mm Hg
6. The nurse is measuring blood pressure during a screening clinic.
Which recommended follow-up time frame should the nurse suggest to a
patient for a blood pressure reading of 118/72 mm Hg?
d. 2 years
7. The nurse measures a blood pressure of 166/100 mm Hg on a
participant of a screening clinic. Which follow-up should the nurse
recommend to this participant?
a. 1 month
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8. The nurse is planning care for patients with hypertension. Which
ethnic group should the nurse understand is most sensitive to the effects
of the beta blocker propranolol (Inderal)?
c. African Americans
9. The nurse is planning care for a group of patients. Which individual
should the nurse identify as being at the highest risk for developing
hypertension?
b. A 56-year-old African American woman
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10. A patient asks the nurse what the doctor meant by the phrase,
hypertensive emergency. Which explanation should the nurse provide?
b. It refers to an episode of very high blood pressure.
11. The nurse is monitoring a patient with hypertensive urgency. Which
manifestation should the nurse expect to find?
c. Severe headaches
12. The nurse is reinforcing teaching for a patient with hypertension. If a
patient states, I understand that if I do not eat or cook with salt, my
hypertension will go away. What is the nurse best response? ’s
d. Some patients’ blood pressure may not respond to salt restriction alone.
13. The nurse is reinforcing teaching for a patient with hypertension.
Which activity should the nurse include to help control hypertension?
a. Walk regularly.
14. The nurse is reinforcing teaching provided to a patient who has been
taught ways to decrease blood pressure. Which patient statement
indicates a need for further teaching?
a. I eat fried foods three times a week.
15. A patient is prescribed furosemide (Lasix) for hypertension and heart
failure. Which statement should the nurse use to explain the purpose of this
medication to the patient?
c. By removing excess water, blood pressure and then cardiac workload
are lowered so the heart doesn work so hard. ’t
blood pressure is lowered.
16. The nurse is caring for a patient who is receiving furosemide (Lasix) for
the treatment of hypertension. Which laboratory test should the nurse
carefully monitor?
b. Potassium
17. The nurse provides dietary teaching to a patient who has been
prescribed bumetanide (Bumex). Which food should the patient name as
important to ingest while taking this medication?
c. Broccoli
18. The nurse is obtaining a health history from an individual at a blood
pressure screening clinic. Which information in the patient history should ’s
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the nurse identify as a modifiable risk factor for hypertension?
c. Cigarette smoking
19. The nurse is measuring blood pressure at a screening clinic. For
which blood pressure reading should the nurse provide the patient with
instructions for a follow-up in 2 months?
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b. 148/96 mm Hg
20. The nurse is reinforcing teaching provided to a patient on the
pathophysiology of hypertension. Which patient statement indicates an
understanding of this teaching?
a. High blood pressure can cause serious problems.
21. The nurse obtains a blood pressure reading from a patient who is
being treated with lifestyle modifications and drug therapy for stage 1
hypertension. Which reading indicates that the treatment is having the
desired effect?
a. 88/42 mm Hg
22. A patient who has unsuccessfully implemented lifestyle modifications
for high blood pressure asks what else can be done. How should the
nurse respond to this patient?
d. Your doctor may discuss medication with you.
23. The nurse is caring for a patient who has possible kidney damage from
high blood pressure. Which action should the nurse take?
d. Review creatinine level.
24. The nurse is reinforcing teaching provided to a patient with
hypertension. Which food should the nurse include if the patient is
prescribed a diet low in cholesterol and saturated fat?
d. Grilled Chicken
25. A patient with a history of hypertension used to take prescribed
antihypertensive medication for headaches, however, stopped when the
headaches disappeared. Now the patient blood pressure is 198/110 ’s
mmHg. What should the nurse emphasize when teaching this patient?
b. Symptoms may not always be present.
26. The nurse is contributing to the plan of care for a 76-year-old patient
with hypertension. Which guideline should be used when following
physician orders to treat elevated blood pressure?
c. Reduce blood pressure slowly.
27. The nurse is caring for a patient with stage 1 hypertension. Which
medication should the nurse expect to be prescribed for this patient?
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d. Hydrochlorothiazide (HydroDIURIL)
28. A patient with essential hypertension asks the nurse to explain the
cause of the disorder. How should the nurse respond to the patient?
a. The cause is unknown.
29. The nurse is contributing to a teaching session about hypertension.
Which patient should the nurse identify as having the greatest risk for
hypertension?
b. A 40-year-old man whose brother has hypertension
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30. The nurse is reinforcing teaching provided to a patient about the
complications of hypertension. Which organ should the patient state is
at risk of damage from hypertension?
a. Eyes
31. The nurse determines that the teaching provided to a patient about the
medication bumetanide (Bumex) was not effective. What did the patient say
that caused the nurse to come to this conclusion?
b. I should limit my potassium intake.
32. A patient with mild hypertension is prescribed spironolactone
(Aldactone). Which patient statement indicates that teaching about this
medication was effective?
d. I will avoid potassium-rich foods such as bananas and take medication
after meals.
33. The nurse caring for a patient with newly diagnosed mild hypertension.
Which medications should the nurse expect to be ordered for this
patient?
d. Hydrochlorothiazide (HydroDIURIL)
34. The nurse is caring for a patient in a hypertensive emergency. What
should the nurse expect to be the goal when treatment is provided for this
patient?
d. Reduce blood pressure by 25% in one hour
35. A patient with hypertension has been following the Mediterranean diet
however blood pressure has not been any lower. What additional
information should the nurse obtain from the patient?
a. amount of exercise each day
36. The nurse becomes concerned that a male patient s blood pressure is ’
168/98 mm Hg after 6 months on antihypertensive medication. What
question should the nurse ask after measuring this blood pressure?
a. Is the patient taking the
medication? Multiple
Response
Identify one or more choices that best complete the statement or answer the
question.
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37. The nurse is contributing to the teaching plan for a patient taking
antihypertensives to control blood pressure who is on a 2000-calorie
DASH diet. What should be included in the teaching about this diet?
(Select all that apply.)
a. Eat four or five servings of vegetables a day.
c. Consume four or five servings of fruit each day.
e. Eat two or fewer servings of lean meat, poultry, or fish each day.
f. Consume two to three servings of low-fat or nonfat dairy products.
38. The nurse is contributing to a staff education program about
hypertension. Which factors should be included as possibly playing a role
in the development of hypertension? (Select all that apply.)
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a. Changes in kidney function
b. Increases in aldosterone levels
c. Increased baroreceptor sensitivity
d. Sympathetic nervous system overstimulation
f. Increased arteriolar premature ventricular contraction
39. The nurse reinforced the teaching provided to a patient about
complications of hypertension. Which organs if identified by a patient
indicate the correct understanding of the organs most likely to be
damaged from uncontrolled hypertension? (Select all that apply.)
a. Eyes
b. Brain
c. Heart
f. Kidneys
40. The infection control nurse observes a nurse in a cardiac unit. Which
actions by the nurse would require intervention by the infection control
nurse? (Select all that apply.)
a. Wipes the stethoscope with a soft cloth before each patient use
e. Takes own stethoscope into the room of a patient on contact precautions
41. The nurse is preparing to measure a patient s blood pressure. What ’
should the nurse do to ensure that the reading obtained is accurate?
(Select all that apply.)
a. The patient is seated.
b. The patient s arm is at the level of the heart. ’
42. A patient is being considered for medication therapy to treat high blood
pressure. Before beginning medication, the nurse should prepare to
schedule the patient for which diagnostic tests. (Select all that apply.)
a. Hematocrit
b. Electrocardiogram
d. Blood glucose level
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e. Cholesterol and triglycerides
43. After completing a family history, the nurse is concerned that a patient is
at risk for developing high blood pressure. What information did the nurse
obtain to come to this conclusion? (Select all that apply.)
b. Mother had type 2 diabetes mellitus.
d. Father died of morbid obesity at age 55.
