Introductory Medical Surgical Nursing 11th Edition by Barbara K. Tim
Introductory Medical Surgical Nursing 11th Edition by Barbara K. Tim
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Chapter 22, Introduction to the Cardiovascular System
Complete Chapter Questions With Answers
Sample Questions Are Posted Below
| 221. | You are caring for a client with right-sided heart failure. When assessing the respiratory rate of this client, what is an indication that the client is having difficulty breathing? |
| A) | Not using the abdominal muscles during breathing |
| B) | Using accessory muscles during respiration |
| C) | Barely palpable, thready pulse volume |
| D) | Combination of noisy and quiet respiration |
| Ans: | B |
| Feedback: | |
| When assessing the respiratory rate of a client with a cardiovascular disorder, the nurse observes the character of the respirations, noting whether the client’s breathing is easy, labored, or dyspneic; deep or shallow; and noisy or quiet. The use of accessory muscles such as neck or abdominal muscles during respiration is an indication that the client is having difficulty breathing. Pulse volume is described as feeling full, weak, or thready, meaning barely palpable. |
| 2. | You are teaching a group of nursing students about adventitious heart sounds. You explain that auscultation of the heart requires familiarization with normal and abnormal heart sounds. What would you tell these students a ventricular gallop indicates in an adult? |
| A) | Heart failure |
| B) | Hypertensive heart disease |
| C) | Normal functioning |
| D) | Pericarditis |
| Ans: | A |
| Feedback: | |
| A sound that follows S1 and S2 is called an S3 heart sound or a ventricular gallop. An S3, normal in children, often is an indication of heart failure in an adult. An extra sound before S1 is an S4 heart sound, or atrial gallop. An S4 sound often is associated with hypertensive heart disease. A friction rub may cause a rough, grating, or scratchy sound that is an indication of pericarditis or inflammation of the pericardium. |
| 3. | One of your students asks what the consequences of uncorrected, left-sided heart failure would be. What would be your best response? |
| A) | Distention of the jugular vein |
| B) | Effort to lie down to breathe |
| C) | Right-sided heart failure |
| D) | Blood congestion in neck veins |
| Ans: | C |
| Feedback: | |
| If uncorrected, left-sided heart failure is followed by right-sided heart failure because the circulatory system is a continuous loop. With left-sided congestive heart failure, auscultation reveals a crackling sound, wheezes, and gurgles. Wet lung sounds are accompanied by dyspnea and an effort to sit up to breathe. If the right side of the heart fails to pump efficiently, blood becomes congested in the neck veins, and the nurse may inspect the distention of external jugular vein. |
| 4. | A student nurse is caring for a client with suspected cardiovascular disease. The nursing instructor asks the student what side effects a client may experience when undergoing a magnetic resonance imaging (MRI) test. What should the student respond? |
| A) | Swollen feet |
| B) | Sweating |
| C) | Rapid heart rate |
| D) | Sluggishness |
| Ans: | C |
| Feedback: | |
| Side effects that a client may experience when undergoing an MRI test include chest pressure, rapid heart rate, and hypotension. Swollen feet, sweating, and sluggishness are not the side effects of an MRI test. |
| 5. | The nurse notes that the client has had a change in mental status. Why would it be important for the nurse to report extremes in the thought process of a client with cardiovascular disorder to the physician? |
| A) | It is an indication of an impending heart failure. |
| B) | The client may develop anxiety disorder. |
| C) | It may indicate a problem with oxygenation. |
| D) | It creates anxiety during the diagnostic testing. |
| Ans: | C |
| Feedback: | |
| The nurse should report extremes in thought processes to the physician because such effects may interfere with the client’s safety and prescribed therapy. Chest pain and impaired breathing may create anxiety. Extremes of emotions or disturbances in thought processes are not the indications of an impending heart failure. The client will not develop any anxiety disorder. |
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