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NUR 104 - Ch. 37 Cardiac problems TB with complete verified solutions.
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NUR 104 - Ch. 37 Cardiac problems TB with complete verified solutions.
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NUR 104 - Ch. 37 Cardiac problemsTB with complete verified solutions
1. A client with heart failure develops an increase in preload. Which
mechanism contributes to this increase?
a. A reduction in sympathetic stimulation
b. Stimulation of coronary baroreceptors
c. Activation of the renin-angiotensin-aldosterone system
d. Arterial vasodilation and subsequent increase in oxygen
consumption - answer -
ANS: C
Activation of the renin-angiotensin-aldosterone system increases
preload by contributing to vasoconstriction and fluid retention,
which in turn reduce the force of contraction and cardiac output.
2. A client is admitted with early-stage heart failure. Which
assessment finding would the nurse expect?
a. Decreased stroke volume, causing decreased urinary output
b. Arterial vasodilation, resulting in pooling of blood in the
extremities
c. Stimulation of adrenergic receptors, causing an increase in heart
rate
d. Myocardial hypertrophy, resulting in an initial increase in oxygen
saturation - answer -
ANS: C
In heart failure, stimulation of the sympathetic nervous system
represents the most immediate response. Adrenergic receptor
stimulation causes an increase in heart rate and respiratory rate.
3. A client is admitted with early-stage heart failure. Which
assessment finding does the nurse expect?
a. A drop in blood pressure and urine output
,b. An increase in creatinine and lower extremity edema
c. An increase in heart rate and respiratory rate
d. An increase in oxygen saturation - answer -
ANS: C
In heart failure, stimulation of the sympathetic nervous system
represents the most immediate response. Adrenergic receptor
stimulation causes an increase in heart rate and respiratory rate.
The blood pressure will remain the same or elevate slightly.
4. A client with systolic dysfunction has an ejection fraction of 38%.
The nurse expects to observe which physiologic change?
a. An increase in stroke volume
b. A decrease in tissue perfusion
c. An increase in oxygen saturation
d. A decrease in arterial vasoconstriction - answer ANS: B
In systolic dysfunction, the ventricle is unable to contract with
enough force to eject blood effectively during systole. As the
ejection fraction decreases (50% to 70% is normal), tissue perfusion
decreases and the client develops activity intolerances.
5. Which client is most at risk of developing left-sided heart failure?
a. Middle-aged woman with aortic stenosis
b. Middle-aged man with pulmonary hypertension
c. Older woman who smokes two packs of cigarettes daily
d. Older man who has had a right ventricular myocardial infarction -
answer : A
Although most individuals with heart failure will have failure that
progresses from left to right, it is possible to have left-sided failure
alone for a short period. It is also possible to have heart failure that
progresses from right to left. Causes of left ventricular failure
include mitral or aortic valve disease, CAD (coronary artery
disease), and hypertension.
, 6. Which client statement alerts the nurse to possible heart failure?
a. "I am drinking more water than usual."
b. "I have been awakened by the need to urinate at night."
c. "I have to stop halfway up the stairs to catch my breath."
d. "I have experienced blurred vision on several occasions." - answer
:C
Clients with left-sided heart failure report weakness or fatigue while
performing normal activities of daily living as well as difficulty
breathing, or "catching their breath." This occurs as fluid moves into
the alveoli.
7. A client with a history of myocardial infarction calls the clinic to
report the onset of a cough that is troublesome only at night. What
direction will the nurse give to the client?
a. "Come to the clinic for evaluation."
b. "Increase fluid intake during waking hours."
c. "Use an over-the-counter cough suppressant before going to
sleep."
d. "Use two pillows to facilitate drainage of postnasal secretions." -
answer : A
The client with a history of myocardial infarction is at risk for
developing heart failure. The onset of nocturnal cough is an early
manifestation of heart failure, and the client needs to be evaluated
as soon as possible.
8. Which statement made by a client would alert the nurse to the
possibility of right-sided heart failure?
a. "I sleep with four pillows at night."
b. "My shoes fit really tight."
c. "I wake up coughing every night."
d. "I have trouble catching my breath." - answer : B
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