Medical Surgical Nursing Patient Centered Collaborative Care, 7th Edition by Donna D.
Medical Surgical Nursing Patient Centered Collaborative Care, 7th Edition by Donna D.
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Chapter 37: Care of Patients with Cardiac Problems
Complete Chapter Questions With Answers
Sample Questions Are Posted Below
MULTIPLE CHOICE
| a. | A decrease in blood pressure and urine output |
| b. | An increase in creatinine and extremity edema |
| c. | An increase in heart rate and respiratory rate |
| d. | A decrease in respirations and oxygen saturation |
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. Blood pressure will remain the same or will elevate slightly. Changes in creatinine occur when kidney damage has occurred, which is a later manifestation. Other later manifestations may include edema, increased respiratory rate, and lowered oxygen saturation readings.
DIF: Cognitive Level: Comprehension/Understanding REF: p. 746
TOP: Client Needs Category: Physiological Integrity (Physiological Adaptation—Pathophysiology)
MSC: Integrated Process: Nursing Process (Assessment)
| a. | Increase in stroke volume |
| b. | Decrease in tissue perfusion |
| c. | Increase in oxygen saturation |
| d. | Decrease in arterial vasoconstriction |
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 intolerance. Stroke volume and oxygen saturation do not increase with a low ejection fraction.
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)
| a. | Middle-aged woman with aortic stenosis |
| b. | Middle-aged man with pulmonary hypertension |
| c. | Older woman who smokes cigarettes daily |
| d. | Older man who has had a myocardial infarction |
ANS: A
Although most people 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, coronary artery disease (CAD), and hypertension.
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)
| a. | “I have been 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.” |
ANS: 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. Nocturia is often seen with right-sided heart failure. Thirst and blurred vision are not related to heart failure.
DIF: Cognitive Level: Comprehension/Understanding REF: p. 748
TOP: Client Needs Category: Health Promotion and Maintenance (Health Screening)
MSC: Integrated Process: Nursing Process (Assessment)
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