Chapter 35: Assessment of the Cardiovascular System

Chapter 35: Assessment of the Cardiovascular System

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. The nurse is caring for a client who has had a recent myocardial infarction involving the left ventricle. Which assessment finding is expected?

a.	Faint S1 and S2 sounds
b.	Decreased cardiac output
c.	Increased blood pressure
d.	Absent peripheral pulses

 

 

ANS:  B

The myocardium is the layer responsible for the contractile force of the heart. Damage to this layer can result in decreased cardiac output. This most likely would result in decreased blood pressure and strength of peripheral pulses. Absent peripheral pulses would be caused by an arterial occlusion. S₁ and S₂ most likely would not be affected.

 

DIF:    Cognitive Level: Application/Applying or higher               REF:   N/A

TOP:   Client Needs Category: Physiological Integrity (Physiological Adaptation—Pathophysiology)

MSC:  Integrated Process: Nursing Process (Assessment)

 

2. The nurse is caring for a client with coronary artery disease. What assessment finding does the nurse expect if the client’s mean arterial blood pressure decreases below 60 mm Hg?

a.	Increased cardiac output
b.	Hypertension
c.	Chest pain
d.	Decreased heart rate

 

 

ANS:  C

Coronary artery blood flow occurs primarily during diastole. Mean arterial pressure (MAP) of 60 mg Hg is necessary for adequate blood flow to coronary arteries, and MAP of 60 to 70 mm Hg is necessary for adequate perfusion to major body organs. If MAP decreases to below 60 mm Hg, the client with cardiac disease may have chest pain. Cardiac output most likely would decrease, and blood pressure also would decrease. Heart rate may increase as the body initiates compensatory mechanisms.

 

DIF:    Cognitive Level: Application/Applying or higher               REF:   N/A

TOP:   Client Needs Category: Physiological Integrity (Physiological Adaptation—Pathophysiology)

MSC:  Integrated Process: Nursing Process (Assessment)

 

3. The nurse is assessing a client following a myocardial infarction. The client is hypotensive. What additional assessment finding does the nurse expect?

a.	Heart rate of 120 beats/min
b.	Cool, clammy skin
c.	Oxygen saturation of 90%
d.	Respiratory rate of 8 breaths/min

 

 

ANS:  A

When a client experiences hypotension, baroreceptors in the aortic arch sense a pressure decrease in the vessels. The parasympathetic system responds by lessening the inhibitory effect on the sinoatrial (SA) node. This results in an increase in heart rate. This tachycardia is an early response and is seen even when blood pressure is not critically low.

 

DIF:    Cognitive Level: Application/Applying or higher               REF:   N/A

TOP:   Client Needs Category: Physiological Integrity (Physiological Adaptation—Pathophysiology)

MSC:  Integrated Process: Nursing Process (Assessment)

 

4. The nurse administers a beta blocker to a client after a myocardial infarction. What assessment finding does the nurse expect?

a.	Blood pressure increase of 10%
b.	Increasing respiratory rate
c.	Increased cardiac output
d.	Pulse decrease from 100 to 80 beats/min

 

 

ANS:  D

Beta blockers block the stimulation of beta₁-adrenergic receptors. They block the sympathetic (fight-or-flight) response and decrease the heart rate (HR). The beta blocker will decrease HR and blood pressure, increasing ventricular filling time. It usually does not have effects on beta₂-adrenergic receptor sites. Cardiac output will drop because of decreased heart rate.

 

DIF:    Cognitive Level: Application/Applying or higher               REF:   N/A

TOP:   Client Needs Category: Physiological Integrity (Pharmacological and Parenteral Therapies—Expected Actions/Outcomes)    MSC:  Integrated Process: Nursing Process (Assessment)