Exam (elaborations)
Chapter 24 Alterations of Cardiovascular Function
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- Galen College Of Nursing
Chapter 24 Alterations of Cardiovascular Function
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Chapter 24: Alterations of Cardiovascular FunctionMULTIPLE CHOICE
1. A 75-year-old obese female presents to her primary care provider reporting edema in the
lower extremities. Physical exam reveals that she has varicose veins. Upon performing the
history, which of the following is a possible cause for the varicose veins?
a. Extreme exercise
b. Long periods of standing
c. Trauma to the deep veins
d. Ischemia
ANS: B
The probable cause of the patient’s varicose veins is gradual venous distention caused by the
action of gravity on blood in the legs due to long periods of standing. Varicose veins are most
likely due to long periods of standing leading to the action of gravity promoting venous
distention. Exercise would help prevent this. Trauma can occur, but usually this affects the
more superficial veins. Ischemia affects arteries not veins.
REF: p. 598
2. A 52-year-old male presents with pooling of blood in the veins of the lower extremities and
edema. The diagnosis is chronic venous insufficiency, and an expected assessment finding
ofthis disorder is:
N R I G B.C M
a. deep vein thrombus form atio n.
b. skin hyperpigmentation. U S N T O
c. gangrene.
d. edema above the knee.
ANS: B
Symptoms include edema of the lower extremities and hyperpigmentation of the skin of the
feet and ankles but deep vein thrombi do not form. Edema in these areas may extend to the
knees but not above. Gangrene does not occur in veins but in arteries.
REF: p. 598
3. Superior vena cava syndrome (SVCS), causing venous distention in the upper extremities, is a
result of progressive superior vena cava:
a. inflammation.
b. occlusion.
c. distention.
d. sclerosis.
ANS: B
SVCS is a progressive occlusion of the SVC that leads to venous distention in the upper
extremities and head. This distention is not a result of progressive inflammation, distention, or
sclerosis.
REF: p. 599
,4. A 50-year-old male with a 30-year history of smoking was diagnosed with bronchogenic
cancer. He developed edema and venous distention in the upper extremities and face. Which
of the following diagnosis will the nurse observe on the chart?
a. Thromboembolism
b. Deep vein thrombosis
c. Superior vena cava syndrome (SVCS)
d. Chronic venous insufficiency
ANS: C
SVCS is a progressive occlusion of the superior vena cava that leads to venous distention in
the upper extremities and head. Thromboembolism would not lead to the generalized
symptoms described in the patient. Deep vein thrombosis would not lead to upper extremity
symptoms. Chronic venous insufficiency would primarily affect one extremity.
REF: p. 599
5. When a patient is diagnosed with coronary artery disease, the nurse assesses for myocardial:
a. hypertrophy.
b. ischemia.
c. necrosis.
d. inflammation.
ANS: B
Coronary artery disease leads to myocardial ischemia. Coronary artery disease would not
lead to hypertrophy, but not to ischemia, necrosis, or inflammation.
REF: p. 610
6. A nurse takes an adult patient’s blood pressure and determines it to be normal. What
reading did the nurse obtain?
a. Systolic pressure between 140 and 150 mm Hg
b. Systolic pressure less than 120 mm Hg and diastolic pressure less than 80 mm Hg
c. Systolic pressure less than 100 mm Hg regardless of diastolic pressure
d. Systolic pressure greater than 140 mm Hg and a diastolic pressure of 100 mm Hg
ANS: B
Normal blood pressure has a systolic pressure less than 120 mm Hg and diastolic pressure less
than 80 mm Hg. A systolic pressure of 140 mm Hg or more would indicate stage I
hypertension. A systolic pressure of less than 100 mm Hg would indicate low blood pressure.
A diastolic pressure greater than 90 mm Hg would indicate hypertension.
REF: p. 600, Table 24-1
7. Most cases of combined systolic and diastolic hypertension have no known cause and
are documented on the chart as hypertension.
a. primary
b. secondary
c. congenital
d. acquired
ANS: A
, Most cases of hypertension are diagnosed as primary hypertension, not secondary, which is
due to a known cause. Most cases of hypertension are not a result of congenital or acquired
causes.
REF: p. 600
8. A 30-year-old White female was recently diagnosed with primary hypertension. She
reports that she eats fairly well, usually moderate red meat consumption. She also reports
that her father has hypertension as well. A nurse determines which of the following risk
factors is most likely associated with this diagnosis?
a. Race
b. Diet
c. Age
d. Genetic
ANS: D
Genetic factors, such as family history of hypertension, are the number one factor in the
development of hypertension. Race and diet may be factors, but genetic factors are primary.
Age is a factor, but not in this case; since the patient is 30, genetics are a greater factor.
REF: p. 600
9. A 52-year-old is diagnosed with primary hypertension but has no other health problems.
Present treatment would cause the nurse to anticipate administering which drug to the patient?
a. A beta-adrenergic agonist
b. An alpha-adrenergic agonist
c. A diuretic N R I G B.C M
d. A calcium channel agonistU S N T O
ANS: C
Diuretics have been shown to be the safest and most effective medications for lowering blood
pressure and preventing the cardiovascular complications of hypertension. A beta-adrenergic,
an alpha-adrenergic, or a calcium channel agonist drug would be used for patients with other
concurrent health problems.
REF: p. 604
10. When a nurse checks the patient for orthostatic hypotension, what activity did the nurse
have the patient engage in?
a. Physical exertion
b. Eating
c. Standing up
d. Lying down
ANS: C
Orthostatic hypotension refers to a drop in blood pressure when standing up, not a drop
with exertion, eating, or lying down.
REF: p. 604
11. A patient is diagnosed with orthostatic hypotension. Which of the following symptoms would
most likely be reported?
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