Cardiovascular Disorders (Exam Mode) By Rnpedia

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  • 1/60 Questions

    What is the term used to describe an enlargement of the heart muscle?

    • Cardiomegaly
    • Myocarditis
    • Myocarditis
    • Pericarditis
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About This Quiz

Mark the letter of the letter of choice then click on the next button. Score will be posted as soon as the you are done with the quiz. You got 72 minutes to finish the exam. Good luck!

Cardiovascular Disorders (Exam Mode) By Rnpedia - Quiz

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  • 2. 

    Which of the following illnesses is the leading cause of death in the US? 

    • Cancer

    • Coronary artery diseas

    • Liver failure

    • Renal failur

    Correct Answer
    A. Coronary artery diseas
    Explanation
    Coronary artery disease accounts for over 50% of all deaths in the US. Cancer accounts for approximately 20%. Liver failure and renal failure account for less than 10% of all deaths in the US.

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  • 3. 

    Which of the following risk factors for coronary artery disease cannot be corrected?

    • Cigarette smoking

    • DM

    • Heredity

    • HPN

    Correct Answer
    A. Heredity
    Explanation
    Because "heredity" refers to our genetic makeup, it can't be changed. Cigarette smoking cessation is a lifestyle change that involves behavior modification. Diabetes mellitus is a risk factor that can be controlled with diet, exercise, and medication. Altering one's diet, exercise, and medication can correct hypertension.

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  • 4. 

    Which of the following is the most common symptom of myocardial infarction? 

    • Chest pain

    • Dyspne

    • Edema

    • Palpitations

    Correct Answer
    A. Chest pain
    Explanation
    The most common symptom of an MI is chest pain, resulting from deprivation of oxygen to the heart. Dyspnea is the second most common symptom, related to an increase in the metabolic needs of the body during an MI. Edema is a later sign of heart failure, often seen after an MI. Palpitations may result from reduced cardiac output, producing arrhythmias.

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  • 5. 

    Which of the following conditions most commonly results in CAD? 

    • Atherosclerosis

    • DM

    • MI

    • Renal failure

    Correct Answer
    A. Atherosclerosis
    Explanation
    Atherosclerosis, or plaque formation, is the leading cause of CAD. DM is a risk factor for CAD but isn't the most common cause. Renal failure doesn't cause CAD, but the two conditions are related. Myocardial infarction is commonly a result of CAD.

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  • 6. 

    A pulsating abdominal mass usually indicates which of the following conditions? 

    • Abdominal aortic aneurysm

    • Enlarged spleen

    • Gastic distention

    • Gastritis

    Correct Answer
    A. Abdominal aortic aneurysm
    Explanation
    The presence of a pulsating mass in the abdomen is an abnormal finding, usually indicating an outpouching in a weakened vessel, as in abdominal aortic aneurysm. The finding, however, can be normal on a thin person. Neither an enlarged spleen, gastritis, nor gastic distention cause pulsation.

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  • 7. 

    Toxicity from which of the following medications may cause a client to see a green halo around lights? 

    • Digoxin

    • Furosemide

    • Metoprolol

    • Enalapri

    Correct Answer
    A. Digoxin
    Explanation
    One of the most common signs of digoxin toxicity is the visual disturbance known as the green halo sign. The other medications aren’t associated with such an effect.

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  • 8. 

    Exceeding which of the following serum cholesterol levels significantly increases the risk of coronary artery disease?

    • 100 mg/dl

    • 150 mg/dl

    • 175 mg/dl

    • 200 mg/dl

    Correct Answer
    A. 200 mg/dl
    Explanation
    Cholesterol levels above 200 mg/dl are considered excessive. They require dietary restriction and perhaps medication. Exercise also helps reduce cholesterol levels. The other levels listed are all below the nationally accepted levels for cholesterol and carry a lesser risk for CAD.

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  • 9. 

    Which of the following landmarks is the corect one for obtaining an apical pulse?

    • Left intercostal space, midaxillary line

    • Left fifth intercostal space, midclavicular line

    • Left second intercostal space, midclavicular line

    • Left seventh intercostal space, midclavicular line

    Correct Answer
    A. Left fifth intercostal space, midclavicular line
    Explanation
    The correct landmark for obtaining an apical pulse is the left intercostal space in the midclavicular line. This is the point of maximum impulse and the location of the left ventricular apex. The left second intercostal space in the midclavicular line is where the pulmonic sounds are auscultated. Normally, heart sounds aren't heard in the midaxillary line or the seventh intercostal space in the midclavicular line.

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  • 10. 

    Atherosclerosis impedes coronary blood flow by which of the following mechanisms

    • Plaques obstruct the vein

    • Plaques obstruct the artery

    • Blood clots form outside the vessel wall

    • Hardened vessels dilate to allow the blood to flow through

    Correct Answer
    A. Plaques obstruct the artery
    Explanation
    Arteries, not veins, supply the coronary arteries with oxygen and other nutrients. Atherosclerosis is a direct result of plaque formation in the artery. Hardened vessels can't dilate properly and, therefore, constrict blood flow

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  • 11. 

    Which of the following blood tests is most indicative of cardiac damage?

    • Lactate dehydrogenase

    • Complete blood count

    • Troponin I

    • Creatine kinase

    Correct Answer
    A. Troponin I
    Explanation
    Troponin I levels rise rapidly and are detectable within 1 hour of myocardial injury. Troponin I levels aren't detectable in people without cardiac injury. Lactate dehydrogenase is present in almost all body tissues and not specific to heart muscle. LDH isoenzymes are useful in diagnosing cardiac injury. CBC is obtained to review blood counts, and a complete chemistry is obtained to review electrolytes. Because CK levels may rise with skeletal muscle injury, CK isoenzymes are required to detect cardiac injury.

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  • 12. 

    After myocardial infarction, serum glucose levels and free fatty acids are both increase. What type of physiologic changes are these? 

    • Electrophysiologic

    • Hematologic

    • Mechanical

    • Metabolic

    Correct Answer
    A. Metabolic
    Explanation
    Both glucose and fatty acids are metabolites whose levels increase after a myocardial infarction. Mechanical changes are those that affect the pumping action of the heart, and electro physiologic changes affect conduction. Hematologic changes would affect the blood.

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  • 13. 

    Which ofthe following symptoms is most commonly associated with left-sided heart failure? 

    • Crackles

    • Arrhythmias

    • Hepatic engorgement

    • Hypotension

    Correct Answer
    A. Crackles
    Explanation
    Crackles in the lungs are a classic sign of left-sided heart failure. These sounds are caused by fluid backing up into the pulmonary system. Arrhythmias can be associated with both right and left-sided heart failure. Left-sided heart failure causes hypertension secondary to an increased workload on the system.

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  • 14. 

    Stimulation of the sympathetic nervous system produces which of the following responses? 

    • Bradycardia

    • Tachycardia

    • Hypotension

    • Decreased myocardial contractility

    Correct Answer
    A. Tachycardia
    Explanation
    Stimulation of the sympathetic nervous system causes tachycardia and increased contractility. The other symptoms listed are related to the parasympathetic nervous system, which is responsible for slowing the heart rate.

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  • 15. 

    What supplemental medication is most frequently ordered in conjuction with furosemide (Lasix)? 

    • Chloride

    • Digoxin

    • Potassium

    • Sodium

    Correct Answer
    A. Potassium
    Explanation
    Supplemental potassium is given with furosemide because of the potassium loss that occurs as a result of this diuretic. Chloride and sodium aren’t loss during diuresis. Digoxin acts to increase contractility but isn’t given routinely with furosemide.

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  • 16. 

    What is the most appropriate nursing response to a myocardial infarction client who is fearful of dying? 

    • "Tell me about your feeling right now."

    • "When the doctor arrives, everything will be fine."

    • "This is a bad situation, but you'll feel better soon."

    • "Please be assured we're doing everything we can to make you feel better."

    Correct Answer
    A. "Tell me about your feeling right now."
    Explanation
    Validation of the client’s feelings is the most appropriate response. It gives the client a feeling of comfort and safety. The other three responses give the client false hope. No one can determine if a client experiencing MI will feel or get better and therefore, these responses are inappropriate.

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  • 17. 

    Which of the following parameters should be checked before administering digoxin? 

    • Apical pulse

    • Blood pressure

    • Radial pulse

    • Respiratory rate

    Correct Answer
    A. Apical pulse
    Explanation
    An apical pulse is essential or accurately assessing the client’s heart rate before administering digoxin. The apical pulse is the most accurate point in the body. Blood pressure is usually only affected if the heart rate is too low, in which case the nurse would withhold digoxin. The radial pulse can be affected by cardiac and vascular disease and therefore, won’t always accurately depict the heart rate. Digoxin has no effect on respiratory function.

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  • 18. 

    After an anterior wall  myocardial infarction, which of the following problems is indicated by auscultation of crackles in the lungs? 

    • Left-sided heart failure

    • Pulmonic valve malfunction

    • Right-sided heart failure

    • Tricuspid valve malfunction

    Correct Answer
    A. Left-sided heart failure
    Explanation
    The left ventricle is responsible for the most of the cardiac output. An anterior wall MI may result in a decrease in left ventricular function. When the left ventricle doesn’t function properly, resulting in left-sided heart failure, fluid accumulates in the interstitial and alveolar spaces in the lungs and causes crackles. Pulmonic and tricuspid valve malfunction causes right-sided heart failure.

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  • 19. 

    With which of the following disorders is jugular vein distention most prominent?

    • Abdominal aortic aneurysm

    • Heart failure

    • Myocardial infarction

    • Pneumothorax

    Correct Answer
    A. Heart failure
    Explanation
    Elevated venous pressure, exhibited as jugular vein distention, indicates a failure of the heart to pump. Jugular vein distention isn’t a symptom of abdominal aortic aneurysm or pneumothorax. An MI, if severe enough, can progress to heart failure; however, in and of itself, an MI doesn’t cause jugular vein distention.

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  • 20. 

    Which of the following sounds is distinctly heard on auscultation over the abdominal region of an abdominal aortic aneurysm client?

    • Bruit

    • Crackles

    • Dullness

    • Friction rubs

    Correct Answer
    A. Bruit
    Explanation
    A bruit, a vascular sound resembling heart murmur, suggests partial arterial occlusion. Crackles are indicative of fluid in the lungs. Dullness is heard over solid organs, such as the liver. Friction rubs indicate inflammation of the peritoneal surface.

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  • 21. 

    Which of the followng conditions is most commonly responsible for myocardial infarction? 

    • Aneurysm

    • Heart failure

    • Coronary artery thrombosis

    • Renal failure

    Correct Answer
    A. Coronary artery thrombosis
    Explanation
    Coronary artery thrombosis causes occlusion of the artery, leading to myocardial death. An aneurysm is an outpouching of a vessel and doesn't cause an MI. Renal failure can be associated with MI but isn't a direct cause. Heart failure is usually the result of an MI.

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  • 22. 

    In which of the following disorders would the nurse expect to assess sacral eddema in bedridden client? 

    • DM

    • Pulmonary emboli

    • Renal failure

    • Right-sided heart failure

    Correct Answer
    A. Right-sided heart failure
    Explanation
    The most accurate area on the body to assed dependent edema in a bedridden client is the sacral area. Sacral, or dependent, edema is secondary to right-sided heart failure. Diabetes mellitus, pulmonary emboli, and renal disease aren’t directly linked to sacral edema.

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  • 23. 

    Which of the following cardiac conditions does a fourth heart sound (S4) indicate? 

    • Dilated aorta

    • Normally functioning heart

    • Decreased myocardial contractility

    • Failure of the ventricle to eject all the blood during systole

    Correct Answer
    A. Failure of the ventricle to eject all the blood during systole
    Explanation
    An S4 occurs as a result of increased resistance to ventricular filling adterl atrial contraction. This increased resistance is related to decrease compliance of the ventricle. A dilated aorta doesn’t cause an extra heart sound, though it does cause a murmur. Decreased myocardial contractility is heard as a third heart sound. An s4 isn’t heard in a normally functioning heart.

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  • 24. 

    Which of the following conditions is most closely associated with weight gain, nausea, and a decrease in urine output?

    • Angina pectoris

    • Cardiomyopathy

    • Left-sided heart failure

    • Right-sided heart failure

    Correct Answer
    A. Right-sided heart failure
    Explanation
    Weight gain, nausea, and a decrease in urine output are secondary effects of right-sided heart failure. Cardiomyopathy is usually identified as a symptom of left-sided heart failure. Left-sided heart failure causes primarily pulmonary symptoms rather than systemic ones. Angina pectoris doesn’t cause weight gain, nausea, or a decrease in urine output.

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  • 25. 

    What is the most common symptom in a client with abdominal aortic aneurysm? 

    • Abdominal pain

    • Diaphoresis

    • Headache

    • Upper back pain

    Correct Answer
    A. Abdominal pain
    Explanation
    Abdominal pain in a client with an abdominal aortic aneurysm results from the disruption of normal circulation in the abdominal region. Lower back pain, not upper, is a common symptom, usually signifying expansion and impending rupture of the aneurysm. Headache and diaphoresis aren’t associated with abdominal aortic aneurysm.

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  • 26. 

    Which of the following complications is of greatest concern when caring for a preoperative abdominal aneurysm client? 

    • HPN

    • Aneurysm rupture

    • Cardiac arrythmias

    • Diminished pedal pulses

    Correct Answer
    A. Aneurysm rupture
    Explanation
    Rupture of the aneurysm is a life-threatening emergency and is of the greatest concern for the nurse caring for this type of client. Hypertension should be avoided and controlled because it can cause the weakened vessel to rupture. Diminished pedal pulses, a sign of poor circulation to the lower extremities, are associated with an aneurysm but isn’t life threatening. Cardiac arrhythmias aren’t directly linked to an aneurysm.

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  • 27. 

    Which of the following actions is the first priority care for a client exhibiting signs and symptoms of coronary artery disease?

    • Decrease anxiety

    • Enhance myocardial oxygenatio

    • Administer sublignual nitroglycerin

    • Educate the client about his symptoms

    Correct Answer
    A. Enhance myocardial oxygenatio
    Explanation
    Enhancing mocardial oxygenation is always the first priority when a client exhibits signs and symptoms of cardiac compromise. Without adequate oxygen, the myocardium suffers damage. Sublingual nitorglycerin is administered to treat acute angina, but its administration isn't the first priority. Although educating the client and decreasing anxiety are important in care delivery, nether are priorities when a client is compromise

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  • 28. 

    Which of the following symptoms might a client with right-sided heart failure exhibit? 

    • Adequate urine output

    • Polyuria

    • Oliguria

    • Polydipsia

    Correct Answer
    A. Oliguria
    Explanation
    Inadequate deactivation of aldosterone by the liver after right-sided heart failure leads to fluid retention, which causes oliguria. Adequate urine output, polyuria, and polydipsia aren’t associated with right-sided heart failure.

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  • 29. 

    What is the first intervention for a client experiencing myocardial infarction? 

    • Administer morphine

    • Administer oxygen

    • Administer sublingual nitroglycerin

    • Obtain an electrocardiogram

    Correct Answer
    A. Administer oxygen
    Explanation
    Administering supplemental oxygen to the client is the first priority of care. The myocardium is deprived of oxygen during an infarction, so additional oxygen is administered to assist in oxygenation and prevent further damage. Morphine and sublingual nitroglycerin are also used to treat MI, but they’re more commonly administered after the oxygen. An ECG is the most common diagnostic tool used to evaluate MI.

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  • 30. 

    Which of the following classes of medications protects the ischemic myocardium by blocking catecholamines and sympathetic nerve stimulation? 

    • Beta-adrenergic blockers

    • Calcium channel blocker

    • Narcotics

    • Nitrate

    Correct Answer
    A. Beta-adrenergic blockers
    Explanation
    Beta-adrenergic blockers work by blocking beta receptors in the myocardium, reducing the response to catecholamines and sympathetic nerve stimulation. They protect the myocardium, helping to reduce the risk of another infarction by decreasing the workload of the heart and decreasing myocardial oxygen demand. Calcium channel blockers reduce the workload of the heart by decreasing the heart rate. Narcotics reduce myocardial oxygen demand, promote vasodilation, and decreased anxiety. Nitrates reduce myocardial oxygen consumption by decreasing left ventricular end-diastolic pressure (preload) and systemic vascular resistance (afterload).

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  • 31. 

    Which of the following complications of an abdominal aortic repair is indicated by detection of a hematoma in the perineal area?

    • Hernia

    • Stage 1 pressure ulcer

    • Retroperitoneal rupture at the repair site

    • Rapid expansion of the aneurysm

    Correct Answer
    A. Retroperitoneal rupture at the repair site
    Explanation
    Blood collects in the retroperitoneal space and is exhibited as a hematoma in the perineal area. This rupture is most commonly caused by leakage at the repair site. A hernia doesn’t cause vascular disturbances, nor does a pressure ulcer. Because no bleeding occurs with rapid expansion of the aneurysm, a hematoma won’t form.

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  • 32. 

    Which of the following conditions is linked to more than 50% of clients with abdominal aortic aneurysms? 

    • DM

    • HPN

    • PVD

    • Syphilis

    Correct Answer
    A. HPN
    Explanation
    Continuous pressure on the vessel walls from hypertension causes the walls to weaken and an aneurysm to occur. Atherosclerotic changes can occur with peripheral vascular diseases and are linked to aneurysms, but the link isn’t as strong as it is with hypertension. Only 1% of clients with syphilis experience an aneurysm. Diabetes mellitus doesn’t have direct link to aneurysm.

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  • 33. 

    When do coronary arteries primarily receive blood flow? 

    • During inspiration

    • During diastole

    • During expiration

    • During systole

    Correct Answer
    A. During diastole
    Explanation
    Although the coronary arteries may receive a minute portion of blood during systole, most of the blood flow to coronary arteries is supplied during diastole. Breathing patterns are irrelevant to blood flow

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  • 34. 

    Which of the following classes of medications maximizes cardiac performance in clients with heat failure by increasing ventricular contractility? 

    • Beta-adrenergic blockers

    • Calcium channel blockers

    • Diuretics

    • Inotropic agents

    Correct Answer
    A. Inotropic agents
    Explanation
    Inotropic agents are administered to increase the force of the heart’s contractions, thereby increasing ventricular contractility and ultimately increasing cardiac output. Beta-adrenergic blockers and calcium channel blockers decrease the heart rate and ultimately decrease the workload of the heart. Diuretics are administered to decrease the overall vascular volume, also decreasing the workload of the heart.

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  • 35. 

    Which of the following recurring conditions most commonly occurs in clients with cardiomyopathy? 

    • Heart failure

    • MI

    • MI

    • Pericardial effusion

    Correct Answer
    A. Heart failure
    Explanation
    Because the structure and function of the heart muscle is affected, heart failure most commonly occurs in clients with cardiomyopathy. Myocardial infarction results from prolonged myocardial ischemia due to reduced blood flow through one of the coronary arteries. Pericardial effusion is most predominant in clients with percarditis. Diabetes mellitus is unrelated to cardiomyopathy.

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  • 36. 

    What is the primary reason for administering morphine to a client with myocardial infarction? 

    • To sedate the clien

    • To decrease the client's pain

    • To decrease the client's anxiet

    • To decrease oxygen demand on the client's heart

    Correct Answer
    A. To decrease oxygen demand on the client's heart
    Explanation
    Morphine is administered because it decreases myocardial oxygen demand. Morphine will also decrease pain and anxiety while causing sedation, but isn't primarily given for those reasons.

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  • 37. 

    What position should the nurse place the head of the bed in to obtain the most accurate reading of jugular vein distention?

    • High-fowler's

    • Raised 10 degrees

    • Raised 30 degree

    • Supine position

    Correct Answer
    A. Raised 30 degree
    Explanation
    Jugular venous pressure is measured with a centimeter ruler to obtain the vertical distance between the sternal angle and the point of highest pulsation with the head of the bed inclined between 15 and 30 degrees. Inclined pressure can’t be seen when the client is supine or when the head of the bed is raised 10 degrees because the point that marks the pressure level is above the jaw (therefore, not visible). In high Fowler’s position, the veins would be barely discernible above the clavicle

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  • 38. 

    What is the most common cause of abdominal aortic aneurysm? 

    • Atherosclerosis

    • DM

    • HPN

    • Syphilis

    Correct Answer
    A. Atherosclerosis
    Explanation
    Atherosclerosis accounts for 75% of all abdominal aortic aneurysms. Plaques build up on the wall of the vessel and weaken it, causing an aneurysm. Although the other conditions are related to the development of an aneurysm, none is a direct cause.

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  • 39. 

    Which of the following groups of symptoms indicated a ruptured abdominal aneurysm?

    • Lower back pain, increased BP, decreased RBC, increased WBC

    • Severe lower back pain, decreased BP, decreased RBC, increased WBC

    • Severe lower back pain, decreased BP, decreased RBC, decreased WBC

    • Intermittent lower back pain, decreased BP, decreased RBC, increased WBC

    Correct Answer
    A. Severe lower back pain, decreased BP, decreased RBC, increased WBC
    Explanation
    Severe lower back pain indicates an aneurysm rupture, secondary to pressure being applied within the abdominal cavity. When rupture occurs, the pain is constant because it can’t be alleviated until the aneurysm is repaired. Blood pressure decreases due to the loss of blood. After the aneurysm ruptures, the vasculature is interrupted and blood volume is lost, so blood pressure wouldn’t increase. For the same reason, the RBC count is decreased – not increase. The WBC count increases as cells migrate to the site of injury.

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  • 40. 

    Which of the following arteries primarily feeds the anterior wall of the heart?

    • Circumflex artery

    • Internal mammary artery

    • Left anterior descending artery

    • Right coronary artery

    Correct Answer
    A. Left anterior descending artery
    Explanation
    The left anterior descending artery is the primary source of blood for the anterior wall of the heart. The circumflex artery supplies the lateral wall, the internal mammary artery supplies the mammary, and the right coronary artery supplies the inferior wall of the heart.

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  • 41. 

    Which hereditary disease is most closely linked to aneurysm? 

    • Cystic fibrosis

    • Lupus erythematosus

    • Marfan's syndrome

    • Myocardial infarction

    Correct Answer
    A. Marfan's syndrome
    Explanation
    Marfan’s syndrome results in the degeneration of the elastic fibers of the aortic media. Therefore, clients with the syndrome are more likely to develop an aortic aneurysm. Although cystic fibrosis is hereditary, it hasn’t been linked to aneurysms. Lupus erythematosus isn’t hereditary. Myocardial infarction is neither hereditary nor a disease.

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  • 42. 

    Which of the following classes of drugs is most widely used in the treatment of cardiomyopathy? 

    • Antihypertensive

    • Beta-adrenergic blockers

    • Calcium channel blockers

    • Nitrates

    Correct Answer
    A. Beta-adrenergic blockers
    Explanation
    By decreasing the heart rate and contractility, beta-adrenergic blockers improve myocardial filling and cardiac output, which are primary goals in the treatment of cardiomyopathy. Antihypertensives aren’t usually indicated because they would decrease cardiac output in clients who are often already hypotensive. Calcium channel blockers are sometimes used for the same reasons as beta-adrenergic blockers; however, they aren’t as effective as beta-adrenergic blockers and cause increase hypotension. Nitrates aren’t’ used because of their dilating effects, which would further compromise the myocardium.

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  • 43. 

    Which of the following types of cardiomyopathy can be associated with childbirth? 

    • Dilated

    • Myocarditis

    • Myocarditis

    • Restrictive

    Correct Answer
    A. Dilated
    Explanation
    Although the cause isn’t entirely known, cardiac dilation and heart failure may develop during the last month of pregnancy of the first few months after birth. The condition may result from a preexisting cardiomyopathy not apparent prior to pregnancy. Hypertrophic cardiomyopathy is an abnormal symmetry of the ventricles that has an unknown etiology but a strong familial tendency. Myocarditis isn’t specifically associated with childbirth. Restrictive cardiomyopathy indicates constrictive pericarditis; the underlying cause is usually myocardial.

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  • 44. 

    Which of the following systems is the most likely origin of pain the client describes as knifelike chest pain that increases in intensity with inspiration? 

    • Cardiac

    • Gastrointestinal

    • Musculoskeletal

    • Pulmonary

    Correct Answer
    A. Pulmonary
    Explanation
    Pulmonary pain is generally described by these symptoms. Musculoskeletal pain only increase with movement. Cardiac and GI pains don't change with respiration.

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  • 45. 

    A murmur is heard at the second left intercostal space along the left sternal border. Which valve area is this

    • Aortic

    • Mitral

    • Pulmonic

    • Tricuspid

    Correct Answer
    A. Pulmonic
    Explanation
    Abnormalities of the pulmonic valve are auscultated at the second left intercostal space along the left sternal border. Aortic valve abnormalities are heard at the second intercostal space, to the right of the sternum. Mitral valve abnormalities are heard at the fifth intercostal space in the midclavicular line. Tricuspid valve abnormalities are heard at the third and fourth intercostal spaces along the sternal border.

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  • 46. 

    Which of the following symptoms usually signifies rapid expansion and impending rupture of an abdominal aortic aneurysm? 

    • Abdominal pain

    • Absent pedal pulses

    • Angina

    • Lower back pain

    Correct Answer
    A. Lower back pain
    Explanation
    Lower back pain results from expansion of the aneurysm. The expansion applies pressure in the abdominal cavity, and the pain is referred to the lower back. Abdominal pain is most common symptom resulting from impaired circulation. Absent pedal pulses are a sign of no circulation and would occur after a ruptured aneurysm or in peripheral vascular disease. Angina is associated with atherosclerosis of the coronary arteries.

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  • 47. 

    What is the definitive test used to diagnose an abdominal aortic aneurysm?

    • Abdominal X-ray

    • Arteriogram

    • CT scan

    • Ultrasound

    Correct Answer
    A. Arteriogram
    Explanation
    An arteriogram accurately and directly depicts the vasculature; therefore, it clearly delineates the vessels and any abnormalities. An abdominal aneurysm would only be visible on an X-ray if it were calcified. CT scan and ultrasound don’t give a direct view of the vessels and don’t yield as accurate a diagnosis as the arteriogram.

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  • 48. 

    Which of the following diagnostic tools is most commonly used to determine the location of myocardial damage?

    • Cardiac catheterization

    • Cardiac enzyme

    • Echocardiogram

    • Electrocardiogram

    Correct Answer
    A. Electrocardiogram
    Explanation
    The ECG is the quickest, most accurate, and most widely used tool to determine the location of myocardial infarction. Cardiac enzymes are used to diagnose MI but can’t determine the location. An echocardiogram is used most widely to view myocardial wall function after an MI has been diagnosed. Cardiac catheterization is an invasive study for determining coronary artery disease and may also indicate the location of myocardial damage, but the study may not be performed immediately.

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  • 49. 

    When assessing a client for an abdominal aortic aneurysm, which area of the abdomen is most commonly palpated? 

    • Right upper quadrant

    • Directly over the umbilicus

    • Middle lower abdomen to the left of the midline

    • Midline lower abdomen to the right of the midline

    Correct Answer
    A. Middle lower abdomen to the left of the midline
    Explanation
    The aorta lies directly left of the umbilicus; therefore, any other region is inappropriate for palpation.

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