Chapter 23 Elseveir

A 60-year-old male presents to his primary care provider reporting chest pain. He is diagnosed with atherosclerosis. This disease is caused by:
Abnormal thickening and hardening of vessel walls
A patient wants to know what causes atherosclerosis. How should the nurse respond? In general, atherosclerosis is caused by:
Endothelial injury and inflammation
A staff member asks a nurse was foam cells are. What is the nurse’s best response? From cells in a fatty streak are:
Macrophages that engulf low-density lipoprotein (LDL)
A nurse takes an adult patient’s blood pressure and determines it to be normal. What reading did the nurse obtain?
Systolic pressure less than 120 mmHg and diastolic pressure less than 80 mmHg
Most cases of combined systolic and diastolic hypertension have no known cause and are documented on the chart as _____ hypertension.
Primary
A 30-year-old Cuacasian female was recently diagnosed with primary hypertension. She reports that she eats fairly well, usually having red meat and potatoes daily. She also reports that her father has hypertension as well. A nurse determines which of the following risk factors is most likely associated with this diagnosis?
Genes
A 65-year-old male presents for a routine checkup. A blood pressure check reveals a systolic pressure of 160 mmHg and a diastolic pressure of 70 mmHg. Which of the following is the most likely cause of this type of pressure evaluation?
Rigidity of the aorta
A 52-year-old male is diagnosed with primary hypertension. He has no other health problems. Present treatment would cause the nurse to anticipate administering which drug to the patient?
A diuretic
A 55-year-old female has undiagnosed hypertension. She presents to her primary care provider reporting impaired vision and chronic edema. Lab tests reveal that she also has renal insufficiency. While planning care, the nurse realizes the most likely cause for these findings is:
End-organ damage
A nurse monitors the patient for _____ when rapid onset of malignant hypertension results.
Encephalopathy
When a nurse checks the patient for orthostatic hypotension, what did the nurse have the patient do?
Stand up
A 50-year-old male is diagnosed with orthostatic hypotension. Which of the following symptoms would he most likely experience?
Syncope and fainting
A 65-year-old female presents to the emergency department reporting difficulty swallowing and shortness of breath. A CT scan would most likely reveal an aneurysm in the:
Throacic aorta
A 60-year-old male is diagnosed with cerebral aneurysm. Where does the nurse suspect the cerebral aneurysm is located?
Circle of Willis
What term should the nurse document for a detached blood clot?
Thromboembolus
A 32-year-old female presents with lower leg pain, with swelling and redness. While obtaining the patient’s history, which finding could have caused her condition?
Venous thrombus
A 28-year-old female presents with severe chest pain and shortness of breath. She is diagnosed with pulmonary embolism, which most likely originated from the:
Deep veins of the leg
Individuals with Raynaud disease need to be counseled to avoid which of the following conditions to prevent severe symptoms?
Cold exposure
A 75-year-old obese female presents to her primary care provider reporting edema in the lower extremities. Physical exam reveals that she has varicose veins. Upon performing the history, which of the following is a possible cause for the varicose veins?
Long periods of standing
A 52-year-old male presents with pooling of blood in the veins and the lower extremities and edema. The diagnosis is chronic venous insufficiency, and an expected assessment finding of this disorder is:
Skin hyperpigmentation
While planning care for a patient with superior vena cava sydrome (SVCS), which principle should the nurse remember? SVCS is a progressive ____ of the superior vena cava (SVC) that leads to venous distention of the upper extremities and head.
Occlusion
A 50-year-old male with a 30-year history of smoking was diagnosed with bronchogenic cancer. He developed edema and venous distention in the upper extremities and face. Which of the following diagnosis will the nurse observe on the chart?
Superior vena cava sydnrome (SVCS)
A 52-year-old female is diagnosed with coronary artery disease. The nurse assesses for myocardial:
Ischemia
A 56-year-old male is diagnosed with coronary artery disease. Which of the following modifiable risk factors would the nurse suggest the patient change?
Smoking cigarettes
A 50-year-old obese male with hypertension and coronary artery disease visits a nutritionist for food counseling. He has an elevated level of low-density lipoprotein (LDL) and low level of high-density lipoprotein (HDL). Which of the following should the nurse advise him to avoid?
Trans fats
When a patient asks the nurse what is the most common cause of myocardial ischemia, which statement is the correct response? The most common cause of myocardial ischemia is:
Atherosclerosis
A 51-year-old male presents with recurrent chest pain on exertion. He is diagnosed with angina pectoris. When he asks what causes the pain, how should the nurse respond? The pain occurs when:
The myocardial oxygen supply has fallen below demand
A 62-year-old male presents to his primary care provider reporting chest pain at rest and with exertion. He does not have a history of coronary artery disease and reports that the pain often occurs at night. He is most likely experiencing which type of angina?
Prinzmetal
A 51-year-old male is at the health clinic for an annual physical exam. After walking from the car to the clinic, he developed substernal pain. He also reported discomfort in his left shoulder and his jaw, lasting 2 to 3 minutes and then subsiding with rest. He indicates that this has occurred frequently over the past few months with similar exertion. The nurse suspects he is most likely experiencing:
Stable angina
A 49-year-old male presents to his primary care provider reporting chest pain. EKG reveals ST elevation. He is diagnosed with myocardial ischemia. Which of the following interventions would be most beneficial?
Apply oxygen to increase myocardial oxygen supply
A 68-year-old male presents to the ER reporting chest pain. He has a history of stable angina that now appears to be unstable. He most likely has:
Impending myocardial infarction (MI)
A 55-year-old male died of a myocardial infarction. Autopsy would most likely reveal:
Platelet aggregation within the atherosclerotic coronary artery
A 60-year-old female has a myocardial infarction. She was brought to the hospital 30 minutes later. She survived, but now the nurse is providing care for impaired ventricular function because:
The resulting ischemia leads to hypoxic injury and myocardial cell death.
A 75-year-old male has severe chest pain and dials 911. Lab tests at the hospital reveal elevated levels of cardiac troponins I and T. Based upon the lab findings, the nurse suspects which of the following has occurred?
Myocardial infarction (MI)
A 28-year-old female presents to the ER reporting severe chest pain that worsens with respirations or lying down. She has a fever, tachycardia, and a friction rub. Based upon the assessment findings, the nurse determines the patient is experiencing:
Acute pericarditis
A 56-year-old male presents to his primary care provider for a checkup. Physical exam reveals edema, hepatomegaly, and muffled heart sounds. Which of the following is of greatest concern to the nurse?
Tamponade
A 42-year-old female is diagnosed with constrictive pericarditis. The nurse assesses the blood pressure for decreased cardiac output because of:
Fibrosis and calcification of the pericardial layers
Many valvular stenosis and regurgitation disorders in adults have a common etiology. Which of the following conditions should alert the nurse that the patient may have both types of valve dysfunction?
Rheumatic fever or heart disease
While planning care, the nurse remembers which principle? In valvular ____, the valve opening is constricted and narrowed because the valve leaflets, or cusps, fail to open completely.
Stenosis
A 67-year-old female was previously diagnosed with rheumatic heart disease. Tests reveal lipoprotein deposition with chronic inflammation that impairs blood flow from the left ventricle into the aorta. Which of the following is the most likely diagnosis recorded on the chart?
Aortic stenosis
A 60-year-old female was diagnosed with mitral stenosis. As a result, the nurse realizes the patient has incomplete emptying of the:
Left atrium
A 72-year-old female has a history of hypertension and atherosclerosis. An echocardiogram reveals backflow of blood into the left ventricle. Which of the following is the most likely diagnosis documented on the chart?
Aortic regurgitation
Upon assessment of the patient, the nurse finds a widened pulse pressure and throbbing peripheral pulses. Which valve disorder does the nurse suspect?
Aortic regurgitation
A 35-year-old male presents with pulmonary hypertension. Testing reveals he is in right heart failure. Which of the following is the most likely diagnosis the nurse will see listed on the chart?
Tricuspid regurgitation
A nurse recalls the most common cardiac valve disease in the United States, which tends to be most prevalent in young women, is:
Mitral valve prolapse
A 10-year-old male presents with fever, lymphadenopathy, arthralgia, and nose bleeds. He is diagnosed with rheumatic heart disease. When a staff member asks what caused the disease, what is the nurse’s most correct response? The most likely cause of this disease is:
Group A ?-hemolytic streptococcus infections
A 10-year-old male presents with fever, lymphadenopathy, arthralgia, and nose bleeds. He is diagnosed with rheumatic heart disease. While planning care, which characteristic changes should the nurse remember?
Antigens that bind to the valvular lining, triggering an autoimmune response
A 30-year-old female presents to her primary care provider with fever, cardiac murmur, and petechial skin lesions. She is diagnosed with infective endocarditis. When the patient wants to know what caused the disease, what is the nurse’s best response? the most likely cause of the disease is:
Bacteria
A nurse is teaching staff about endocarditis. Which information should the nurse include? Inflammatory cells have difficulty limiting the colonization of microorganisms in infective endocarditis because the:
Microorganisms are sequestered in a fibrin clot
A 50-year-old male visits the cardiologist for an EKG. Results indicate that he has no PR interval and a variable QRS rate with rhythm irregularity. Which of the following is the most likely diagnosis to be recorded on the chart?
Atrial fibrillation
Which characteristic changes should the nurse keep in mind while caring for a patient with left heart failure? As left heart failure progresses:
Left ventricular preload increases
A 65-year-old male with a history of untreated hypertension is now experiencing left heart failure. A nurse recalls his untreated hypertension led to:
Myocardial hypertrophy and ventricular remodeling
A 59-year-old female is diagnosed with left ventricular failure. If a decrease in kidney perfusion occurs, the nurse knows this would ultimately cause:
Increased systemic vascular resistance
A 68-year-old female is experiencing left heart failure. Physical exam reveals elevated blood pressure. The nurse understands this is most likely caused by:
Sympathetic nervous system compensation for decreased cardiac output
When a patient with left heart failure starts to have a cough and dyspnea, which principle should the nurse remember? Pulmonary symptoms, common to left heart failure, are a result of:
Pulmonary vascular congestion
A 73-year-old female has increased pulmonary pressure resulting in right heart failure. The nurse should monitor for a possible complication because a potential cause for her heart to fail is:
Left heart failure
A 65-year-old male is diagnosed with chronic pulmonary disease and elevated pulmonary vascular resistance. Which of the following heart failures should the nurse assess for in this patient?
Right heart failure
A 72-year-old female has a history of a right heart failure caused by a right ventricular myocardial infarction. Which of the following symptoms are specifically related to her right heart failure?
Significant edema to both lower legs and feet
Which condition should cause the nurse to assess for high-output failure in a patient?
Anemia
When a person is in shock, a nurse remembers impairment in cellular metabolism is caused by:
Inadequate tissue perfusion
One consequence of switching from aerobic to anaerobic cellular metabolism during shock states is:
Decrease adenosine triphosphate (ATP) production
A nurse is planning care for a patient in shock. Which principle should the nurse remember? During shock states, glucose uptake is usually:
Impaired
A 50-year-old male was admitted to the intensive care unit with a diagnosis of acute myocardial infarction (MI). He is being treated for shock. His cardiopulmonary symptoms include low blood pressure, tachycardia, and tachypnea. His skin is pale and cool. The primary cause of his shock is most likely:
Decreased cardiac contractility
An 82-year-old female was admitted to the hospital with confusion and severe hypotension. Her body’s compensatory mechanisms are increased heart rate, vasoconstriction, and movement of large volumes of interstitial fluid to the vascular compartment. What kind of shock does the nurse suspect the patient is experiencing?
Hypovolemic
A 27-year-old male is admitted to a neurologic unit with a complete C-5 spinal cord transection. On initial assessment, he is bradycardic, hypotensive, and hyperventilating. He appears to be going into shock. The most likely mechanism of his shock is:
Vasodilation caused by a decrease in sympathetic stimulation
What factors make a patient prone to neurogenic shock? Neurogenic shock can be caused by any factor that inhibits the:
Sympathetic nervous system
A 15-year-old male who is allergic to peanuts eats a peanut butter cup. He then goes into anaphylactic shock. Which assessment findings will the nurse asses for?
Bronchoconstriction, hives or edema, and hypotension
A nurse is teaching a patient about anaphylactic shock. Which information should the nurse include? The onset of anaphylactic shock is usually:
Immediate and life threatening
For an infection to progress to septic shock, which of the following factors should the nurse determine occurred?
Bacteria must enter the bloodstream
A 20-year-old female is being admitted to the hospital with fever and septic shock. Which set of assessment findings would the nurse expect the patient to exhibit?
Low blood pressure, tachycardia, generalized edema
The hypotensive state seen in septic shock can lead to:
Gut lining disruption and the translocation of bacteria into the bloodstream
Which patient is most prone to multiple organ dysfunction syndrome (MODS)? In a patient with:
Septic shock
A 75-year-old female has been critically ill with multiple organ dysfunction syndrome (MODS) for longer than a week and has developed a severe oxygen supply and demand imbalance. The statement that best describes this imbalance is which of the following?
The reserve has been exhausted, and the amount of oxygen consumed depends on the amount the circulation is able to deliver?
Which organ should the nurse monitor closely since it is often the first to fail in patients with multiple organ dysfunction syndrome (MODS)?
Lungs
Which of the following findings in the patient with Raynaud disease would indicate a need for further teaching?
The patient smokes cigarettes
Which of the following lab tests will the nurse check to help diagnose heart failure and provide insight into its severity?
Brain natriuretic
A nurse recalls acute orthostatic hypotension can be caused by (select all that apply):
– Prolonged immobility
– Drug action
– Starvation
– Volume depletion
A patient has been researching cardiac cells on the internet. Which information indicates the patient has a good understanding? Cardiac cells can withstand ischemic conditions for ___ minutes before irreversible cell injury occurs.
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