Cardiovascular System | Coronary Artery Disease & Hypertension NCLEX Quiz 5

1. The nurse teaches the client with angina about the common expected side effects of nitroglycerin. including:

Headache

High blood pressure

Shortness of breath

Stomach cramps

Because of the widespread vasodilating effects. nitroglycerin often produces such side effects as headache. hypotension. and dizziness. The client should lie or sit down to avoid fainting. Nitro does not cause shortness of breath or stomach cramps.

Explanation

Because of the widespread vasodilating effects. nitroglycerin often produces such side effects as headache. hypotension. and dizziness. The client should lie or sit down to avoid fainting. Nitro does not cause shortness of breath or stomach cramps.

2. Sublingual nitroglycerin tablets begin to work within 1 to 2 minutes. How should the nurse instruct the client to use the drug when chest pain occurs?

Take one (1) tablet every two (2) to five (5) minutes until the pain stops.

Take one (1) tablet and rest for ten (10) minutes. Call the physician if pain persists after ten (10) minutes.

The correct protocol for nitroglycerin used involves immediate administration. with subsequent doses taken at 5-minute intervals as needed. for a total dose of three (3) tablets. Sublingual nitroglycerin appears in the bloodstream within two (2) to three (3) minutes and is metabolized within about 10 minutes.

Explanation

The correct protocol for nitroglycerin used involves immediate administration. with subsequent doses taken at 5-minute intervals as needed. for a total dose of three (3) tablets. Sublingual nitroglycerin appears in the bloodstream within two (2) to three (3) minutes and is metabolized within about 10 minutes.

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

Lactate dehydrogenase

Complete blood count (CBC)

Troponin I

Creatine kinase (CK)

Troponin I levels rise rapidly and are detectable within 1 hour of myocardial injury. Troponin levels aren’t detectable in people without cardiac injury.

Explanation

Troponin I levels rise rapidly and are detectable within 1 hour of myocardial injury. Troponin levels aren’t detectable in people without cardiac injury.

4. As an initial step in treating a client with angina. the physician prescribes nitroglycerin tablets. 0.3mg given sublingually. This drug's principal effects are produced by:

Antispasmodic effect on the pericardium

Causing an increased myocardial oxygen demand

Vasodilation of peripheral vasculature

Improved conductivity in the myocardium

Nitroglycerin produces peripheral vasodilation. which reduces myocardial oxygen consumption and demand. Vasodilation in coronary arteries and collateral vessels may also increase blood flow to the ischemic areas of the heart. Nitroglycerin decreases myocardial oxygen demand. Nitroglycerin does not have an effect on pericardial spasticity or conductivity in the myocardium.

Explanation

Nitroglycerin produces peripheral vasodilation. which reduces myocardial oxygen consumption and demand. Vasodilation in coronary arteries and collateral vessels may also increase blood flow to the ischemic areas of the heart. Nitroglycerin decreases myocardial oxygen demand. Nitroglycerin does not have an effect on pericardial spasticity or conductivity in the myocardium.

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

Cardiac catheterization

Cardiac enzymes

Echocardiogram

Electrocardiogram (ECG)

The ECG is the quickest. most accurate. and most widely used tool to determine the location of myocardial infarction.Option A: 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.Option B: Cardiac enzymes are used to diagnose MI but can’t determine the location.Option C: An echocardiogram is used most widely to view myocardial wall function after an MI has been diagnosed.

Explanation

The ECG is the quickest. most accurate. and most widely used tool to determine the location of myocardial infarction.Option A: 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.Option B: Cardiac enzymes are used to diagnose MI but can’t determine the location.Option C: An echocardiogram is used most widely to view myocardial wall function after an MI has been diagnosed.

6. 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

The left anterior descending artery is the primary source of blood flow for the anterior wall of the heart.Options A. B. and D: The circumflex artery supplies the lateral wall. the internal mammary supplies the mammary. and the right coronary artery supplies the inferior wall of the heart.

Explanation

The left anterior descending artery is the primary source of blood flow for the anterior wall of the heart.Options A. B. and D: The circumflex artery supplies the lateral wall. the internal mammary supplies the mammary. and the right coronary artery supplies the inferior wall of the heart.

7. When do coronary arteries primarily receive blood flow?

During inspiration

During diastolic

During expiration

During systole

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.

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.

8. Prolonged occlusion of the right coronary artery produces an infarction in which of the following areas of the heart?

Inferior

Lateral

The right coronary artery supplies the right ventricle or the inferior portion of the heart. Therefore. prolonged occlusion could produce an infarction in that area. The right coronary artery doesn’t supply the anterior portion (left ventricle).Options A. B. and D: The right coronary artery doesn’t supply the anterior portion (left ventricle). lateral portion (some of the left ventricle and the left atrium). or the apical portion (left ventricle) of the heart.

Explanation

The right coronary artery supplies the right ventricle or the inferior portion of the heart. Therefore. prolonged occlusion could produce an infarction in that area. The right coronary artery doesn’t supply the anterior portion (left ventricle).Options A. B. and D: The right coronary artery doesn’t supply the anterior portion (left ventricle). lateral portion (some of the left ventricle and the left atrium). or the apical portion (left ventricle) of the heart.

9. Which of the following types of pain is most characteristic of angina?

Knifelike

Sharp

Shooting

Tightness

The pain of angina usually ranges from a vague feeling of tightness to heavy. intense pain. Pain impulses originate in the most visceral muscles and may move to such areas as the chest. neck. and arms.

Explanation

The pain of angina usually ranges from a vague feeling of tightness to heavy. intense pain. Pain impulses originate in the most visceral muscles and may move to such areas as the chest. neck. and arms.

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

Aortic

Mitral

Pulmonic

Tricuspid

Abnormalities of the pulmonic valve are auscultated at the second left intercostal space along the left sternal border.Option A: Aortic valve abnormalities are heard at the second intercostal space. to the right of the sternum.Option B: Mitral valve abnormalities are heard at the fifth intercostal space in the midclavicular line.Option D: Tricuspid valve abnormalities are heard at the 3rd and 4th intercostal spaces along the sternal border.

Explanation

Abnormalities of the pulmonic valve are auscultated at the second left intercostal space along the left sternal border.Option A: Aortic valve abnormalities are heard at the second intercostal space. to the right of the sternum.Option B: Mitral valve abnormalities are heard at the fifth intercostal space in the midclavicular line.Option D: Tricuspid valve abnormalities are heard at the 3rd and 4th intercostal spaces along the sternal border.