Chapter 13: Cardiovascular Therapeutic Management

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. By blocking the conversion of angiotensin I to angiotensin II, angiotensin-converting enzyme inhibitors produce:

a.	competitive inhibition.
b.	vasodilation.
c.	hypoperfusion.
d.	reuptake blockade.

 

ANS:   B

Angiotensin-converting enzyme inhibitors produce vasodilation by blocking the conversion of angiotensin I to angiotensin II.

 

DIF:    Cognitive Level: Comprehension       REF:    264

OBJ:    Nursing Process: Implementation       TOP:    Cardiovascular Therapeutic Management

MSC:   NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

2. The patient’s family heard the doctor say that he was going to perform an atherectomy, but they do not understand what this means. The nurse explains:

a.	“This is a procedure to remove a tumor called an atheroma from the patient’s heart muscle.”
b.	“The surgeon is going to cut out and remove plaque buildup in the patient’s heart vessels with specialized heart catheters.”
c.	“The doctor is going to insert special plastic tubing into the heart vessel to keep it open and functioning.”
d.	“A catheter with a balloon around it will be inserted into the damaged heart vessel to push the cholesterol buildup back and enlarge the inside of the vessel.”

 

ANS:   B

Atherectomy is the excision and removal of the atherosclerotic plaque by cutting, shaving, or grinding, with the use of specialized coronary catheters.

 

DIF:    Cognitive Level: Comprehension       REF:    241

OBJ:    Nursing Process: Implementation       TOP:    Cardiovascular Therapeutic Management

MSC:   NCLEX: Physiological Integrity: Reduction of Risk Potential

 

3. The patient’s family is very worried about the equipment for the intraaortic balloon pump. The nurse works to relieve their anxiety by explaining:

a.	“This is to keep the heart pumping in a healthy rhythm.”
b.	“The pump will increase the amount of blood the heart can pump and improve the balance between the heart muscle’s need for oxygen and available supply.”
c.	“The purpose of the pump is to force blood to circulate for the patient while his heart is unable to do the work for itself.”
d.	“The equipment will pump oxygen into the blood while the heart is unable to get an adequate supply on its own.”

 

ANS:   B

The intraaortic balloon pump (IABP) is the most widely used temporary mechanical circulatory assist device for supporting failing circulation. Its therapeutic effects are based on the hemodynamic principles of diastolic augmentation and afterload reduction. The overall physiological effect of IABP therapy is an improvement in the balance between myocardial oxygen supply and demand.

 

DIF:    Cognitive Level: Comprehension       REF:    255

OBJ:    Nursing Process: Implementation       TOP:    Cardiovascular Therapeutic Management

MSC:   NCLEX: Physiological Integrity: Reduction of Risk Potential

 

4. The nurse has read that the cardiologist recommends the use of class IV drugs to depress sinus and atrioventricular node conduction and terminate supraventricular tachycardias in the patient at this time. The nurse will anticipate orders for which medications?

a.	Verapamil, diltiazem, or amlodipine
b.	Amiodarone, dofetilide, or ibutilide
c.	Telmisartan, losartan, or valsartan
d.	Captopril, enalapril, lisinopril

 

ANS:   A

Class IV agents are calcium channel blockers that inhibit the influx of calcium through slow calcium channels during the plateau phase (phase 2). This effect occurs mainly in tissue in which slow calcium channels predominate, primarily in the sinus and atrioventricular nodes and the atrial tissue.

 

DIF:    Cognitive Level: Application REF:    258

OBJ:    Nursing Process: Implementation       TOP:    Cardiovascular Therapeutic Management

MSC:   NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

5. The nurse has administered a drug that stimulates b₁-adrenergic sites. Following administration of the drug, the nurse will assess for:

a.	increased heart rate.
b.	increased vasoconstriction.
c.	decreased systemic vascular resistance.
d.	decreased conduction.

 

ANS:   A

Stimulation of b₁-receptor sites produces increased heart rate, increased conduction, and increased contractility.

 

DIF:    Cognitive Level: Comprehension       REF:    Table 13-13

OBJ:    Nursing Process: Implementation       TOP:    Cardiovascular Therapeutic Management

MSC:   NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies