Different Symptoms Of Heart Disease

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Different Symptoms Of Heart Disease - Quiz

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Questions and Answers
  • 1. 

    Myra is ordered laboratory tests after she is admitted to the hospitalfor angina. The isoenzyme test that is the most reliable early indicatorof myocardial insult is

    • A.

      CK-MB

    • B.

      SGPT

    • C.

      LDH

    • D.

      AST

    Correct Answer
    A. CK-MB
    Explanation
    The cardiac marker, Creatinine phosphokinase (CPK) isoenzyme levels, especially the MB sub-unit which is cardio-specific, begin to rise in 3-6 hours, peak in 12-18 hours and are elevated 48 hours after the occurrence of the infarct. They are therefore most reliable in assisting
    with early diagnosis. The cardiac markers elevate as a result of
    myocardial tissue damage.

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  • 2. 

    Joey is a 46 year-old radio technician who is admitted because ofmild chest pain. He is 5 feet, 8 inches tall and weighs 190 pounds. He isdiagnosed with a myocardial infarct. Morphine sulfate, Diazepam (Valium)and Lidocaine are prescribed. The physician orders 8 mg of MorphineSulfate to be given IV. The vial on hand is labeled 1 ml/ 10 mg. Thenurse should administer:

    • A.

      12 minims

    • B.

      8 minims

    • C.

      15 minims

    • D.

      10 minims

    Correct Answer
    A. 12 minims
    Explanation
    Using ratio and proportion 8 mg/10 mg = X minims/15 minims 10 X= 120
    X = 12 minims. The nurse will administer 12 minims intravenously
    equivalent to 8mg Morphine Sulfate

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  • 3. 

    An early finding in the EKG of a client with an infarcted mycardiumwould be:

    • A.

      Elevated ST segments

    • B.

      Disappearance of Q waves

    • C.

      Absence of P wave

    • D.

      Flattened T waves

    Correct Answer
    A. Elevated ST segments
    Explanation
    This is a typical early finding after a myocardial infarct because of the
    altered contractility of the heart. The other choices are not typical of MI.

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  • 4. 

    Mr. Ong, a client with CHF, has been receiving a cardiac glycoside, adiuretic, and a vasodilator drug. His apical pulse rate is 44 and he is onbed rest. The nurse concludes that his pulse rate is most likely the resultof the:

    • A.

      Cardiac glycoside

    • B.

      Vasodilator

    • C.

      Diuretic

    • D.

      Bed-rest regimen

    Correct Answer
    A. Cardiac glycoside
    Explanation
    A cardiac glycoside such as digitalis increases force of cardiac contraction, decreases the conduction speed of impulses within the myocardium and slows the heart rate.

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  • 5. 

    After the acute phase of congestive heart failure, the nurse shouldexpect the dietary management of the client to include the restriction of:

    • A.

      Sodium

    • B.

      Potassium

    • C.

      Calcium

    • D.

      Magnesium

    Correct Answer
    A. Sodium
    Explanation
    Restriction of sodium reduces the amount of water retention that reduces
    the cardiac workload

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  • 6. 

    Mr. Ong is admitted to the hospital with a diagnosis of Left-sided CHF.In the assessment, the nurse should expect to find:

    • A.

      Dyspnea on exertion

    • B.

      Jugular vein distention

    • C.

      Extensive peripheral edema

    • D.

      Crushing chest pain

    Correct Answer
    A. Dyspnea on exertion
    Explanation
    Pulmonary congestion and edema occur because of fluid extravasation from
    the pulmonary capillary bed, resulting in difficult breathing. Left-sided heart failure creates a backward effect on the pulmonary system that leads to pulmonary congestion.

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  • 7. 

    What would be the primary goal of therapy for a client withpulmonary edema and heart failure?

    • A.

      Increase cardiac output

    • B.

      Peripheral edema decreased

    • C.

      Enhance comfort

    • D.

      Improve respiratory status

    Correct Answer
    A. Increase cardiac output
    Explanation
    The primary goal of therapy for the client with pulmonary edema or heart failure is increasing cardiac output. Pulmonary edema is an acute medical emergency requiring immediate intervention.

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  • 8. 

    During the second day of hospitalization of the client aftera Myocardial Infarction. Which of thefollowing is an expected outcome?

    • A.

      Able to perform self-care activities without pain

    • B.

      Can Participate in cardiac rehabilitation walking program

    • C.

      Severe chest pain

    • D.

      Can recognize the risk factors of Myocardial Infarction

    Correct Answer
    A. Able to perform self-care activities without pain
    Explanation
    By the second day of hospitalization after suffering
    a Myocardial Infarction, Clients are able to perform care without chest pain

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  • 9. 

    Upon admission to an intensive care unit, a client diagnosed with anacute myocardialinfarction is ordered oxygen. The nurse knows that the major reason thatoxygen

    • A.

      Increase oxygen level in the myocardium

    • B.

      Relieve dyspnea

    • C.

      Saturate the red blood cells

    • D.

      Decrease cyanosis

    Correct Answer
    A. Increase oxygen level in the myocardium
    Explanation
    Anoxia of the myocardium occurs in myocardial infarction. Oxygen administration will help relieve dyspnea and cyanosis associated with the condition but the major purpose is to increase the oxygen concentration in the damaged myocardial tissue.

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  • 10. 

    A 66 year-old client is admitted for mitral valve replacement surgery.The client has ahistory of mitral valve regurgitation and mitral stenosis since her teenageyears. During theadmission assessment, the nurse should ask the client if as a child shehad

    • A.

      Rheumatic fever

    • B.

      Measles

    • C.

      Hay fever

    • D.

      Encephalitis

    Correct Answer
    A. Rheumatic fever
    Explanation
    Clients that present with mitral stenosis often have a history
    of rheumatic fever or bacterial endocarditis

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  • 11. 

    Electrocardiogarphy (ECG) is a diagnostic tool used to evaluate theelectrical activity of the heart. Which of the following ECG results wouldreveal that there is myocardial ischemia? 

    • A.

      ST segment elevation and inverted T wave

    • B.

      ST segment elevation and peaked T wave

    • C.

      ST segment depression and abnormal Q wave

    • D.

      ST segment depression and peaked T wave

    Correct Answer
    A. ST segment elevation and inverted T wave
    Explanation
    The ECG reading of a client who had myocardial ischemia would reveal an inverted T wave and ST segment elevation. The ECG tracing of a client with myocardial injury is characterized by a symmetric and peaked T wave and at least 1 mm ST segment elevation while myocardial infarction will show an abnormal or pathologic Q wave that develops within 1-3 days after MI.

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  • 12. 

    A client has been diagnosed with hypertension. The nurse prioritynursing diagnosis would be

    • A.

      Ineffective health maintenance

    • B.

      Impaired Skin Integrity

    • C.

      Pain

    • D.

      Deficient Fluid Volume

    Correct Answer
    A. Ineffective health maintenance
    Explanation
    Managing hypertension is the priority for the client with hypertension. Clients with hypertension frequently do not experience pain, deficient volume or impaired skin integrity. It is the asymptomatic nature of hypertension that makes it so difficult to treat.

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  • 13. 

    Which of the following represents a significant risk immediately aftersurgery for repair of aortic aneurysm? 

    • A.

      Potential alteration in renal perfusion

    • B.

      Potential electrolyte imbalance

    • C.

      Potential wound infection

    • D.

      Potential ineffective coping

    Correct Answer
    A. Potential alteration in renal perfusion
    Explanation
    There is a potential alteration in renal perfusion manifested by decreased urine output. The altered renal perfusion may be related to renal artery embolism, prolonged hypotension, or prolonged aortic cross clamping during the surgery.

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  • 14. 

    The following are lipid abnormalities. Which of the following is a riskfactor for the development of atherosclerosis and PVD? 

    • A.

      High levels of low density lipid (LDL) cholesterol

    • B.

      High levels of high density lipid (HDL) cholesterol

    • C.

      Low concentration triglycerides

    • D.

      Low levels of LDL cholesterol.

    Correct Answer
    A. High levels of low density lipid (LDL) cholesterol
    Explanation
    An increased in LDL cholesterol concentration has been documented at risk factor for the development of atherosclerosis. LDL cholesterol is not broken down into the liver but is deposited into the wall of the blood vessels.

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  • 15. 

    Patrick who is hospitalized following a myocardial infarction asksthe nurse why he is taking morphine. The nurse explains that morphine: 

    • A.

      Prevents shock and relieves pain

    • B.

      Decrease anxiety and restlessness

    • C.

      Helps prevent fibrillation of the heart

    • D.

      Dilates coronary blood vessels

    Correct Answer
    A. Prevents shock and relieves pain
    Explanation
    Morphine is a central nervous system depressant used to relieve the pain associated with myocardial infarction, it also decreases apprehension and prevents cardiogenic shock.

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  • 16. 

    Nurse Trisha teaches a client with heart failure to take oralFurosemide in the morning. The reason for this is to help. 

    • A.

      Prevents sleep disturbances during night

    • B.

      Excrete excessive fluids accumulated at night

    • C.

      Retard rapid drug absorption

    • D.

      Prevention of electrolyte imbalance

    Correct Answer
    A. Prevents sleep disturbances during night
    Explanation
    When diuretics are taken in the morning, client will void frequently during daytime and will not need to void frequently at night.

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  • 17. 

    Dr. Marquez orders a continuous intravenous nitroglycerin infusion forthe client suffering from myocardial infarction. Which of the following isthe most essential nursing action? 

    • A.

      Obtaining infusion pump for the medication

    • B.

      Obtaining serum potassium levels daily

    • C.

      Monitoring blood pressure every 4 hours

    • D.

      Monitoring urine output frequently

    Correct Answer
    A. Obtaining infusion pump for the medication
    Explanation
    Administration of Intravenous Nitroglycerin infusion requires
    pump for accurate control of medication

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  • 18. 

    Nurse Maureen would expect the client with mitral stenosis woulddemonstrate symptoms associated with congestion in the: 

    • A.

      Pulmonary

    • B.

      Aorta

    • C.

      Superior vena cava

    • D.

      Right atrium

    Correct Answer
    A. Pulmonary
    Explanation
    When mitral stenosis is present, the left atrium has difficulty
    emptying its contents into the left ventricle because there is no valve to
    prevent back ward flow into the pulmonary vein; the pulmonary
    circulation is under pressure

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  • 19. 

    A client who has been diagnosed of hypertension is being taught torestrict intake of sodium. The nurse would know that the teachings areeffective if the client states that…

    • A.

      I can eat shredded wheat cereal

    • B.

      I can eat spaghetti on rye bread

    • C.

      I can eat broiled scallops

    • D.

      I can eat celery sticks and carrots

    Correct Answer
    A. I can eat shredded wheat cereal
    Explanation
    Wheat cereal has low sodium content.

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  • 20. 

    Which of the following should the nurse teach the client about thesigns of digitalis toxicity? 

    • A.

      Visual disturbances such as seeing yellow spots

    • B.

      Skin rash over the chest and back

    • C.

      Elevated blood pressure

    • D.

      Increased appetite

    Correct Answer
    A. Visual disturbances such as seeing yellow spots
    Explanation
    Seeing yellow spots and colored vision are common symptoms of
    digitalis toxicity

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  • 21. 

    A client received digoxin (Lanoxin) therapy o treat the irregularbeating of his heart. The nurse knows that the therapy has beeneffective when the client with atrial fibrillation has an ECG tracingshowing: 

    • A.

      A heart rate of 70 beats per minute

    • B.

      A heart rate of 105 beats per minute

    • C.

      Mobitz II heart block

    • D.

      A heart rate of 50 beats per minute

    Correct Answer
    A. A heart rate of 70 beats per minute
    Explanation
    When the heart rate is above 60 beats per minute and below
    10 beats per minute, digoxin therapy is deemed effective. However, if too
    much digoxin was administered to the client, Mobitz II heart block may
    be present.

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  • 22. 

    Cardiomyopathy is a serious disease in which the heart muscleweakens and there is an evident change in the cardiac structure. Thereare three types of cardiomyopathy namely: dilated, hypertonic andrestrictive. When assessing a client with left-sided heart failure, thenurse would observe: 

    • A.

      Air hunger and tachypnea

    • B.

      Jugular vein distention and neck vein distention

    • C.

      Pitting edema and pulmonary congestion

    • D.

      Ascites and orthopnea

    Correct Answer
    A. Air hunger and tachypnea
    Explanation
    The client with left-sided heart failure usually has pulmonary
    congestion, orthopnea, hemoptysis and experiences dyspnea and coughing.
    Right sided heart failure is characterized by hepatomegaly, edema, ascites
    and distended neck veins. Right sided heart failure is another complication
    of cardiomyopathy.

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  • 23. 

    You are providing care for a patient with Arterial Occlusive Disease,and writing a Nursing Care Plan. One of your interventions is to positionthe patient's legs below the level of the heart. From which of thefollowing Nursing Diagnoses is the above intervention MOST LIKELY derivedfrom:

    • A.

      Altered Tissue Perfusion

    • B.

      Potential for Altered Respiratory Function

    • C.

      High risk for pain

    • D.

      Potential for Activity Intolerance

    Correct Answer
    A. Altered Tissue Perfusion
    Explanation
    Patients with Arterial Occlusive Disease have decreased
    perfusion of tissues. By placing the patient in a dependent position,
    blood flow to the lower extremities is enhanced, and, therefore, the
    nursing diagnosis for this intervention would be Altered Tissue Perfusion

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  • 24. 

    An 18 month old with Tetralogy of Fallot has a "tet" spell afterhaving an invasive procedure. To improve the child's cardiac statuswhich of the following interventions should the nurse do initially:

    • A.

      Place the child in a knee chest position

    • B.

      Begin chest compressions

    • C.

      Administer oxygen

    • D.

      Position with HOB elevated

    Correct Answer
    A. Place the child in a knee chest position
    Explanation
    A "tet" spell is when the child is having difficulty meeting
    oxygen demands. The knee chest position reduces venous blood return from
    the lower extremities and increases vascular resistance to divert blood
    flow to the pulmonary artery.

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  • 25. 

    A patient has received thromboembolytic therapy following aMyocardial Infarction with Streoptokinase. Which of the following drugsshould the nurse have on hand if the patient develops excessive bleedingor hemorrhage?

    • A.

      Aminocaproic Acid (Amicar)

    • B.

      Protamine Sulfate

    • C.

      Vitamin K

    • D.

      Heparin

    Correct Answer
    A. Aminocaproic Acid (Amicar)
    Explanation
    The major complication of thromboembolytic therapy is
    hemorrhage, and the antidote for this is Amicar, which aids in the
    stoppage of bleeding by inhibiting plasminogen, which inhibits
    thrombolysis. This drug should be available for any patient on this type
    of thromboembolytic therapy. Protamine Sulfate and Vitamin K are the
    antidotes for Heparin and Coumadin, respectively. Heparin is not correct,
    as it is an anticoagulant.

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  • 26. 

    Valsalva maneuver can result in bradycardia. Which of the followingactivities will not stimulate Valsalva’s maneuver?

    • A.

      Use of stool softeners

    • B.

      Enema administration

    • C.

      Gagging while toothbrushing.

    • D.

      Lifting heavy objects

    Correct Answer
    A. Use of stool softeners
    Explanation
    Straining or bearing down activities can cause vagal stimulation
    that leads to bradycardia. Use of stool softeners promote easy bowel
    evacuation that prevents straining or the valsalva maneuver.

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  • 27. 

    A 66 year-old client is admitted for mitral valve replacement surgery.The client has ahistory of mitral valve regurgitation and mitral stenosis since her teenageyears. During theadmission assessment, the nurse should ask the client if as a child shehad

    • A.

      Rheumatic fever

    • B.

      Hay fever

    • C.

      Measles

    • D.

      Encephalitis

    Correct Answer
    A. Rheumatic fever
    Explanation
    Clients that present with mitral stenosis often have a history
    of rheumatic fever or bacterial endocarditis.

    Rate this question:

  • 28. 

    A woman in her third trimester complains of severe heartburn. Whatis appropriate teaching by the nurse to help the woman alleviate thesesymptoms? 

    • A.

      Sleep with head propped on several pillows

    • B.

      Take sodium bicarbonate after each meal

    • C.

      Eat the evening meal just before retiring

    • D.

      Drink small amounts of liquids frequently

    Correct Answer
    A. Sleep with head propped on several pillows
    Explanation
    Heartburn is a burning sensation caused by regurgitation of
    gastric contents that is best relieved by sleeping position, eating small
    meals, and not eating before bedtime.

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  • 29. 

    A nurse is caring for a 2 year-old child after corrective surgery forTetralogy of Fallot. The mother reports that the child has suddenly begunseizing. The nurse recognizes this problem is probably due to

    • A.

      A cerebral vascular accident

    • B.

      Postoperative meningitis

    • C.

      Medication reaction

    • D.

      Metabolic alkalosis

    Correct Answer
    A. A cerebral vascular accident
    Explanation
    Polycythemia occurs as a physiological reaction to chronic
    hypoxemia which commonly occurs in clients with Tetralogy of Fallot.
    Polycythemia and the resultant increased viscosity of the blood increase
    the risk of thromboembolic events. Cerebrovascular accidents may occur.
    Signs and symptoms include sudden paralysis, altered speech, extreme
    irritability or fatigue, and seizures.

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  • 30. 

    A client is scheduled for a percutaneous transluminal coronaryangioplasty (PTCA). The nurse knows that a PTCA is the

    • A.

      Procedure that compresses plaque against the wall of the diseased coronary artery to improve blood flow

    • B.

      Non-invasive radiographic examination of the heart

    • C.

      Placement of an automatic internal cardiac defibrillator

    • D.

      Surgical repair of a diseased coronary artery

    Correct Answer
    A. Procedure that compresses plaque against the wall of the diseased coronary artery to improve blood flow
    Explanation
    PTCA (percutaneous transluminal coronary angioplasty) is
    performed to improve coronary artery blood flow in a diseased artery. It
    is performed during a cardiac catheterization. Aorta coronary bypass
    Graft is the surgical procedure to repair a diseased coronary artery.

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  • 31. 

    To prevent a valsalva maneuver in a client recovering from an acutemyocardial infarction, the nurse would

    • A.

      Administer stool softeners every day as ordered

    • B.

      Assist the client to use the bedside commode

    • C.

      Administer antidysrhythmics prn as ordered

    • D.

      Maintain the client on strict bed rest

    Correct Answer
    A. Administer stool softeners every day as ordered
    Explanation
    Administering stool softeners every day will prevent straining
    on defecation which causes the Valsalva maneuver. If constipation occurs
    then laxatives would be necessary to prevent straining. If straining on
    defecation produced the valsalva maneuver and rhythm disturbances
    resulted then antidysrhythmics would be appropriate.

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  • 32. 

    Which of the ff. statements by the client to the nurse indicates arisk factor for CAD?

    • A.

      “I smoke 1 1/2 packs of cigarettes per day.”

    • B.

      “My cholesterol is 180.”

    • C.

      “My father died of Myasthenia Gravis.”

    • D.

      “I exercise every other day.”

    Correct Answer
    A. “I smoke 1 1/2 packs of cigarettes per day.”
    Explanation
    “I smoke 1 1/2 packs of cigarettes per day.” Smoking has
    been considered as one of the major modifiable risk factors for coronary
    artery disease. Exercise and maintaining normal serum cholesterol levels
    help in its prevention.

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  • 33. 

    The nurse is teaching the patient regarding his permanent artificialpacemaker. Which information given by the nurse shows her knowledgedeficit about the artificial cardiac pacemaker?. 

    • A.

      May engage in contact sports

    • B.

      Have regular follow up care

    • C.

      May be allowed to use electrical appliances

    • D.

      Take the pulse rate once a day, in the morning upon awakening

    Correct Answer
    A. May engage in contact sports
    Explanation
    The client should be advised by the nurse to avoid contact
    sports. This will prevent trauma to the area of the pacemaker generator.

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  • 34. 

    A client with chronic heart failure has been placed on a dietrestricted to 2000mg. of sodium per day. The client demonstratesadequate knowledge if behaviors are evident such as not salting food andavoidance of which food?

    • A.

      Canned sardines

    • B.

      Whole milk

    • C.

      Plain nuts

    • D.

      Eggs

    Correct Answer
    A. Canned sardines
    Explanation
    Canned foods are generally rich in sodium content as salt is
    used as the main preservative.

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