Chapter 12: Cardiovascular Disorders

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. Which finding on the electrocardiogram (ECG) is most conclusive for infarction?

a.	Inverted T-waves
b.	Tall, peaked T-waves
c.	ST-segment depression
d.	Q-waves

 

ANS:   D

On the ECG, evidence of infarction is seen by the presence of pathological Q-waves.

 

DIF:    Cognitive Level: Analysis      REF:    Fig. 12-4

OBJ:    Nursing Process: Assessment TOP:    Cardiovascular Disorders

MSC:   NCLEX: Physiological Integrity: Reduction of Risk Potential

 

2. An inferior wall myocardial infarction (MI) is manifested by ECG changes in:

a.	II, III, aVF
b.	I, aVL
c.	V2 to V4
d.	V5 to V6

 

ANS:   A

Inferior infarctions are manifested by ECG changes in leads II, III, and aVF.

 

DIF:    Cognitive Level: Application REF:    Table 12-5

OBJ:    Nursing Process: Assessment TOP:    Cardiovascular Disorders

MSC:   NCLEX: Physiological Integrity: Reduction of Risk Potential

 

3. The cardiologist has told the patient and family that the diagnosis is hypertrophic cardiomyopathy. Later they ask the nurse what the patient did wrong to cause this condition. The nurse explains:

a.	“This is a result of a high-cholesterol diet and poor exercise habits.”
b.	“The heart has not been getting enough aerobic exercise and has developed this condition. In cardiac rehabilitation they will work with the patient to strengthen his heart through special exercises.”
c.	“This is an inherited condition. You should give serious consideration to having family members screened for it.”
d.	“This is a result of clot formation in the blood vessels in the heart. We will need to use medications to reduce the risk of further clotting.”

 

ANS:   C

Hypertrophic cardiomyopathy is a genetically inherited disease that affects the myocardial sarcomere.

 

DIF:    Cognitive Level: Comprehension       REF:    217

OBJ:    Nursing Process: Implementation       TOP:    Cardiovascular Disorders

MSC:   NCLEX: Physiological Integrity: Physiological Adaptation

 

4. The nurse has reviewed the cardiologist’s reports and is preparing to explain to the patient and family why liver engorgement is related to his restrictive cardiomyopathy. This will include which of the following discussions?

a.	The blood supply to the coronary vessels is restricted, and therefore the heart cannot pump well enough to keep other organs working efficiently.
b.	The heart muscle loses tone, and the effect on pumping is to restrict the volume of blood that fills the chambers. This reduces the circulation to other organs.
c.	The heart chambers are unable to fill with blood properly because of stiffness of the heart. The heart cannot relax normally during diastole and eventually affects other organs because of the inability to pump blood efficiently.
d.	Arrhythmias are causing a restricted volume of blood to be pumped out of the heart, and this produces restricted circulation to other systems of the body.

 

ANS:   C

Restrictive cardiomyopathy results in ventricular wall rigidity as a consequence of myocardial fibrosis. The overall effect is the inhibition of diastolic ventricular filling. Diastolic heart failure, low cardiac output, dyspnea, orthopnea, and liver engorgement are the most common clinical manifestations of restrictive cardiomyopathy.

 

DIF:    Cognitive Level: Comprehension       REF:    218

OBJ:    Nursing Process: Implementation       TOP:    Cardiovascular Disorders

MSC:   NCLEX: Physiological Integrity: Physiological Adaptation

 

5. In assessing the patient’s history for information about the development of dilated cardiomyopathy, the nurse will recognize which of the following as the least likely cause of the condition?

a.	Valvular heart dysfunction
b.	Bacterial infection
c.	Hypertension
d.	Collagen infiltration

 

ANS:   C

There are many acquired causes of dilated cardiomyopathy. Injury can be caused by valvular heart dysfunction that has led to extreme pressure or volume in the chambers; also, viral or bacterial infections such as myocarditis can lead to inflammatory changes that permanently remodel the heart. Other noncardiac causes include infiltration by systemic collagens as in amyloidosis or sarcoidosis.

 

DIF:    Cognitive Level: Comprehension       REF:    218

OBJ:    Nursing Process: Evaluation   TOP:    Cardiovascular Disorders

MSC:   NCLEX: Physiological Integrity: Physiological Adaptation