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Clinical Guidelines in Primary Care 4th Edition Hollier Test Bank (With a New Update) 2024 $13.49
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Clinical Guidelines in Primary Care 4th Edition Hollier Test Bank (With a New Update) 2024
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Clinical Guidelines in Primary Care 4th Edition Hollier Test Bank (With a New Update) 2024

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  • 20 août 2024
  • 217
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  • clinical guidelines in primary care 4th edition

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Clinical Guidelines in j j




j PrimaryCare 4th Edition Test j j j j




bank/StudyGuide
j



Chapter 1 Cardiovascular Disorders
j j j




MULTIPLE CHOICE j




1.The nurse is aware that the muscle layer of the heart, which is responsible for the
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heartscontraction, is the:
j j j j




a. endocardium.
b. pericardium.
c. mediastinum.
d. myocardium.

ANS: D j




The myocardium is the specialized muscle layer that allows the heart to
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contract.2.The nurse clarifies that the master pacemaker of the heart is the:
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a. left ventricle. j



b. atrioventricular (AV) node. j j



c. sinoatrial (SA) node. j j



d. bundle of His. j j




ANS: C j




The SA node is the master pacemaker of the heart.
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3. The nurse is aware that the symptoms of an impending myocardial infarction (MI) differ in
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women because acute chest pain is not present. Women are frequently misdiagnosed as having:
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a. hepatitis A. j



b. indigestion.
c. urinary infection. j



d. menopausal complications. j

,ANS: B j




Indigestion, gallbladder attack, anxiety attack, and depression are frequent misdiagnoses
j j j j j j j j j


forwomen having an MI.
j j j j j




4. The nurse identifies the LUBB sound of the LUBB/DUBB of the cardiac cycle as the sound
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ofthe:
j j




a. AV valves closing. j j



b. closure of the semilunar valves. j j j j



c. contraction of the papillary muscles. j j j j



d. contraction of the ventricles. j j j




ANS: A j




The LUBB is the first sound of a low pitch heard when the AV valves close.
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5.A patient is admitted from the emergency department. The emergency department
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physician notes the patient has a diagnosis of heart failure with a New York Heart Association
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(NYHA)classification of IV. This indicates the patients condition as:
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a. moderate heart failure. j j



b. severe heart failure. j j



c. congestive heart failure. j j



d. negligible heart failure. j j




ANS: B j




Class IV: Severe; patient unable to perform any physical activity without discomfort. Angina
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orsymptoms of cardiac inefficiency may develop at rest.
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6. The nurse assesses that the home health patient has no signs or symptoms of heart failure,
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butdoes have a history of rheumatic fever and has been recently diagnosed with diabetes
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mellitus.The nurse is aware that using the American College of Cardiology and the American
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Heart Association (ACC/AHA) staging, this patient would be a:
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a. stage A. j



b. stage B. j



c. stage C. j



d. stage D. j




ANS: A j




The ACC/AHA staging describes stage A as a person without symptoms of heart failure,
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butwith primary conditions associated with the development of the disease.
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,7. The nurse caring for a patient recovering from a myocardial infarct who is on remote
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telemetryrecognizes the need for added instruction when the patient says:
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a. I can ambulate in the hallway with this gadget on.
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b. I always take off the telemetry device when I shower.
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c. MyEKG is being watched by one of the nurses in CCU on the home unit.
j j j j j j j j j j j j j j j



d. I am able to sleep just fine with this device on.
j j j j j j j j j j




ANS: B j




Remote telemetry allows the patient to be on a separate unit, but be monitored in a
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centrallocation. The patients can be ambulatory and can sleep with the monitor on. They
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should not remove the monitor to shower.
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8. The nurse assesses pitting edema that can be depressed approximately inch and refills in
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15seconds. The nurse would document this assessment as:
j j j j j j j j j




a. +1 edema. j



b. +2 edema. j



c. +3 edema. j



d. +4 edema. j




ANS: B j




A +2 edema can be documented if the skin can be depressed inch and respond within
j j j j j j j j j j j j j j j


15seconds.
j j




9. What do dark or cold spots on a thallium scan indicate?
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a. Tissue with adequate blood supply j j j j



b. Dilated vessels j



c. Areas of neoplastic growth j j j



d. Tissue that has inadequate perfusion j j j j




ANS: D j




Thallium scans show adequate perfused areas by the collection of thallium. Dark spots or
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coldspots indicate tissues that have inadequate perfusion.
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10. The nurse recognizes the echocardiogram report that shows an ejection factor of 42% as
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j anindication of:
j j




a. normal heart action. j j



b. mild heart failure. j j



c. moderate heart failure. j j

, d. severe heart failure. j j




ANS: C j




An ejection factor (cardiac output) of 42% indicates moderate heart failure.
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11. The nurse takes into consideration that age-related changes can affect the
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peripheralcirculation because of:
j j j j




a. sclerosed blood vessels. j j



b. hypotension.
c. inactivity.
d. poor nutrition. j




ANS: A j




Aging causes sclerotic changes in the blood vessels that lead to decreased elasticity
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andnarrowing of the vessel lumen.
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12. The nurse assessing a cardiac monitor notes that the cardiac complexes each have a P
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wavefollowed by a QRS and a T. The rate is 120. The nurse recognizes this arrhythmia as:
j j j j j j j j j j j j j j j j j j




a. sinus bradycardia. j



b. atrial fibrillation. j



c. sinus tachycardia. j



d. ventricular tachycardia. j




ANS: C j




Sinus tachycardia has a P wave followed by the QRS and the T. All the components of
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thecomplex are present and in the correct order, but the rate is over 100 beats a minute.
j j j j j j j j j j j j j j j j j j




13. After an influenza-like illness, the patient complains of chills and small petechiae in
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hismouth and his legs. A heart murmur is detectable. These are characteristic signs of:
j j j j j j j j j j j j j j j




a. congestive heart failure. j j



b. heart block. j



c. aortic stenosis. j



d. infective endocarditis. j




ANS: D j




Collection of subjective data includes noting patient complaints of influenza-like symptoms
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withrecurrent fever, undue fatigue, chest pain, and chills. Objective data may reveal the significant
j j j j j j j j j j j j j j j

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