Chapter 12: Heart and Peripheral Vascular System

Chapter 12: Heart and Peripheral Vascular System

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. A nurse informs a patient that her blood pressure is 128/78. The patient asks what the number 128 means. What is the nurse’s appropriate response? The 128 represents the pressure in your blood vessels when:

a.	“The ventricles relax and the aortic and pulmonic valves open.”
b.	“The ventricles contract and the mitral and tricuspid valves close.”
c.	“The ventricles contract and the mitral and tricuspid valves open.”
d.	“The ventricles relax and the aortic and pulmonic valves close.”

 

 

ANS:  B

 

	Feedback
A	The aortic and pulmonic valves open during systole, but ventricles fill during diastole.
B	During systole the ventricles contract, creating a pressure that closes the atrioventricular (AV) valves (mitral and tricuspid).
C	During systole the ventricles contract, creating a pressure that closes the AV valves (mitral and tricuspid).
D	The ventricles are relaxed and the aortic and pulmonic valves close during diastole, rather than systole.

 

 

DIF:    Cognitive Level: Understand            REF:   225

TOP:   Nursing Process: Assessment

MSC:  NCLEX Patient Needs: Physiologic Integrity: Reduction of Risk Potential: System Specific Assessments

 

2. A nurse determines that a patient has a heart rate of 42 beats per minute. What might be a cause of this heart rate?

a.	Sinoatrial (SA) node failure
b.	Atrial bradycardia
c.	A well-conditioned heart muscle
d.	Left ventricular hypertrophy

 

 

ANS:  A

 

	Feedback
A	If the SA node is ineffective, the atrioventricular  node may initiate contraction, but at a rate of 40 to 60 beats/min.
B	The heart rate reflects the ventricular rate rather than the atrial rate.
C	Although well-conditioned athletes may have slower heart rates, this rate is too slow for even an athlete.
D	Left ventricular hypertrophy alters the strength of contraction rather than the heart rate.

 

 

DIF:    Cognitive Level: Apply                   REF:   226

TOP:   Nursing Process: Assessment

MSC:  NCLEX Patient Needs: Physiologic Integrity: Physiologic Adaptation: Alterations in Body Systems

 

3. While taking a history, a nurse learns that a patient had rheumatic heart disease as a child. Based on this information, what abnormal data might this nurse expect to find during an examination?

a.	An extra beat just before the S2 heart sound heard during auscultation
b.	A raspy machine-like or blowing sound heard during auscultation
c.	A prominent thrust of the heart against the chest wall felt on palpation
d.	A visible indentation of pericardial tissue noted during inspection

 

 

ANS:  B

 

	Feedback
A	An extra beat just before the S1 heart sound heard during auscultation is a description of the S4 heart sound that occurs when there is hypertrophy of the ventricle.
B	A raspy machine-like or blowing sound heard during auscultation is a description of a murmur that can develop after rheumatic heart disease.
C	A prominent thrust of the heart against the chest wall felt on palpation is a description of a heave, which may occur from left ventricular hypertrophy due to increased workload.
D	A visible indentation of pericardial tissue noted during inspection is a description of a retraction that begins in the intercostal spaces and occurs with increased respiratory effort.

 

 

DIF:    Cognitive Level: Analyze                REF:   229| 259

TOP:   Nursing Process: Assessment

MSC:  NCLEX Patient Needs: Physiologic Integrity: Physiologic Adaptation: Alteration in Body Systems

 

4. A nurse is completing a symptom analysis with a patient complaining of chest pain. When asked what makes the chest pain worse, the patient reports that coughing and sneezing increase the chest pain. Based on these data, what does the nurse suspect as the cause of this patient’s chest pain?

a.	Stable angina
b.	Esophageal reflux disease
c.	Mitral valve prolapse
d.	Costochondritis

 

 

ANS:  D

 

	Feedback
A	Physical exertion, emotional stress, and cold worsen the chest pain associated with stable angina.
B	A spicy or acidic meal, alcohol, or lying supine may worsen the chest pain associated with esophageal reflux.
C	Only occasional position changes worsen the chest pain associated with mitral valve prolapse.
D	Coughing, deep breathing, laughing, and sneezing worsen the chest pain associated with costochondritis.

 

 

DIF:    Cognitive Level: Apply                   REF:   230-231

TOP:   Nursing Process: Assessment

MSC:  NCLEX Patient Needs: Physiologic Integrity: Physiologic Adaptation: Alteration in Body Systems