Cardiovascular System | Myocardial Infarction And Heart Failure NCLEX Quiz 15

1. Which of the following types of angina is most closely related with an impending MI?

Angina decubitus

Chronic stable angina

Nocturnal angina

Unstable angina

Unstable angina progressively increases in frequency. intensity. and duration and is related to an increased risk of MI within 3 to 18 months.

Explanation

Unstable angina progressively increases in frequency. intensity. and duration and is related to an increased risk of MI within 3 to 18 months.

2. Which of the following conditions is the predominant cause of angina?

Increased preload

Decreased afterload

Coronary artery spasm

Inadequate oxygen supply to the myocardium

Inadequate oxygen supply to the myocardium is responsible for the pain accompanying angina.Option A: Increased preload would be responsible for right-sided heart failure.Option B: Decreased afterload causes increased cardiac output.Option C: Coronary artery spasm is responsible for variant angina.

Explanation

Inadequate oxygen supply to the myocardium is responsible for the pain accompanying angina.Option A: Increased preload would be responsible for right-sided heart failure.Option B: Decreased afterload causes increased cardiac output.Option C: Coronary artery spasm is responsible for variant angina.

3. Which of the following interventions should be the first priority when treating a client experiencing chest pain while walking?

Sit the client down

Get the client back to bed

Obtain an ECG

Administer sublingual nitroglycerin

The initial priority is to decrease the oxygen consumption; this would be achieved by sitting the client down.Option B and D: After the ECG. sublingual nitro would be administered. When the client’s condition is stabilized. he can be returned to bed.Option C: An ECG can be obtained after the client is sitting down.

Explanation

The initial priority is to decrease the oxygen consumption; this would be achieved by sitting the client down.Option B and D: After the ECG. sublingual nitro would be administered. When the client’s condition is stabilized. he can be returned to bed.Option C: An ECG can be obtained after the client is sitting down.

4. Which of the following tests is used most often to diagnose angina?

Chest x-ray

Echocardiogram

Cardiac catheterization

12-lead electrocardiogram (ECG)

The 12-lead ECG will indicate ischemia. showing T-wave inversion. In addition. with variant angina. the ECG shows ST-segment elevation.Option A: A chest x-ray will show heart enlargement or signs of heart failure. but isn’t used to diagnose angina.

Explanation

The 12-lead ECG will indicate ischemia. showing T-wave inversion. In addition. with variant angina. the ECG shows ST-segment elevation.Option A: A chest x-ray will show heart enlargement or signs of heart failure. but isn’t used to diagnose angina.

5. Which of the following positions would best aid breathing for a client with acute pulmonary edema?

Lying flat in bed

Left side-lying

In high Fowler’s position

In semi-Fowler’s position

A high Fowler’s position promotes ventilation and facilitates breathing by reducing venous return.Options A and B: Lying flat and side-lying positions worsen the breathing and increase the workload of the heart.Option D: Semi-Fowler’s position won’t reduce the workload of the heart as well as the Fowler’s position will.

Explanation

A high Fowler’s position promotes ventilation and facilitates breathing by reducing venous return.Options A and B: Lying flat and side-lying positions worsen the breathing and increase the workload of the heart.Option D: Semi-Fowler’s position won’t reduce the workload of the heart as well as the Fowler’s position will.

6. Myocardial oxygen consumption increases as which of the following parameters increase?

Preload. afterload. and cerebral blood flow

Preload. afterload. and renal blood flow

Preload. afterload. contractility. and heart rate.

Preload. afterload. cerebral blood flow. and heart rate.

Myocardial oxygen consumption increases as preload. afterload. renal contractility. and heart rate increase. Cerebral blood flow doesn’t directly affect myocardial oxygen consumption.

Explanation

Myocardial oxygen consumption increases as preload. afterload. renal contractility. and heart rate increase. Cerebral blood flow doesn’t directly affect myocardial oxygen consumption.

7. Which of the following is a compensatory response to decreased cardiac output?

Decreased BP

Alteration in LOC

Decreased BP and diuresis

Increased BP and fluid retention

The body compensates for a decrease in cardiac output with a rise in BP. due to the stimulation of the sympathetic NS and an increase in blood volume as the kidneys retain sodium and water.Option A: Blood pressure doesn’t initially drop in response to the compensatory mechanism of the body.Option B: Alteration in LOC will occur only if the decreased cardiac output persists.

Explanation

The body compensates for a decrease in cardiac output with a rise in BP. due to the stimulation of the sympathetic NS and an increase in blood volume as the kidneys retain sodium and water.Option A: Blood pressure doesn’t initially drop in response to the compensatory mechanism of the body.Option B: Alteration in LOC will occur only if the decreased cardiac output persists.

8. Which of the following results is the primary treatment goal for angina?

Reversal of ischemia

Reversal of infarction

Reduction of stress and anxiety

Reduction of associated risk factors

Reversal of the ischemia is the primary goal. achieved by reducing oxygen consumption and increasing oxygen supply.Option B: An infarction is permanent and can’t be reversed.

Explanation

Reversal of the ischemia is the primary goal. achieved by reducing oxygen consumption and increasing oxygen supply.Option B: An infarction is permanent and can’t be reversed.

9. Which of the following blood gas abnormalities is initially most suggestive of pulmonary edema?

Anoxia

Hypercapnia

Hyperoxygenation

Hypocapnia

In an attempt to compensate for increased work of breathing due to hyperventilation. carbon dioxide decreases. causing hypocapnea. If the condition persists. CO2 retention occurs and hypercapnia results.

Explanation

In an attempt to compensate for increased work of breathing due to hyperventilation. carbon dioxide decreases. causing hypocapnea. If the condition persists. CO2 retention occurs and hypercapnia results.

10. Which of the following actions is the appropriate initial response to a client coughing up pink. frothy sputum?

Call for help

Call the physician

Start an I.V. line

Suction the client

Production of pink. frothy sputum is a classic sign of acute pulmonary edema. Because the client is at high risk for decompensation. the nurse should call for help but not leave the room. The other three interventions would immediately follow.

Explanation

Production of pink. frothy sputum is a classic sign of acute pulmonary edema. Because the client is at high risk for decompensation. the nurse should call for help but not leave the room. The other three interventions would immediately follow.