Chapter 11: Cardiovascular Clinical Assessment and Diagnostic Procedures

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. Which of the following laboratory studies is used to assist with the diagnosis of acute myocardial infarction?

a.	Serum potassium
b.	Cardiac troponin I (cTnI)
c.	Brain natriuretic peptide (BNP)
d.	Low-density lipoprotein to high-density lipoprotein ratio

 

ANS:   B

Cardiac biomarkers are proteins that are released from severely damaged myocardial tissue cells. When myocardial cells are damaged, they release detectable proteins into the bloodstream so that a rise in biomarkers can be correlated with myocardial cellular damage. The biomarkers that are routinely measured include cardiac troponin I (cTnI), cardiac troponin T (cTnT), and CK-MB.

 

DIF:    Cognitive Level: Application REF:    173

OBJ:    Nursing Process: Assessment TOP:    Cardiovascular Laboratory Studies

MSC:   NCLEX: Physiological Integrity: Reduction of Risk Potential

 

2. The resistance against which the left ventricle must pump to eject its volume is:

a.	end-diastolic pressure.
b.	systemic vascular resistance.
c.	ejection fraction.
d.	pulmonary vascular resistance.

 

ANS:   B

Systemic vascular resistance is mean pressure difference across the systemic vascular bed, divided by blood flow. Systemic vascular resistance represents the resistance against which the left ventricle must pump to eject its volume.

 

DIF:    Cognitive Level: Comprehension       REF:    Table 11-4

OBJ:    Nursing Process: N/A TOP:    Cardiovascular Bedside Monitoring

MSC:   NCLEX: Physiological Integrity: Physiological Adaptation

 

3. When the tricuspid valve is open, central venous pressure reflects the filling pressure in the:

a.	left atrium.
b.	right atrium.
c.	left ventricle.
d.	right ventricle.

 

ANS:   D

Pressure is created by the volume in the right side of the heart. When the tricuspid valve is open, the central venous pressure reflects filling pressures in the right ventricle. Clinically, the central venous pressure is often used as a guide to overall fluid balance.

 

DIF:    Cognitive Level: Knowledge REF:    Table 11-4

OBJ:    Nursing Process: N/A TOP:    Cardiovascular Bedside Monitoring

MSC:   NCLEX: Physiological Integrity: Physiological Adaptation

 

4. Tachycardia is dangerous for the patient with ischemic heart disease because of:

a.	increased ventricular filling time.
b.	increased stroke volume.
c.	compromised cardiac output.
d.	decreased myocardial oxygen demand.

 

ANS:   C

Tachycardia is detrimental to anyone with ischemic heart disease because it decreases the time for ventricular filling, decreases stroke volume, and thus compromises cardiac output and myocardial oxygenation.

 

DIF:    Cognitive Level: Analysis      REF:    156

OBJ:    Nursing Process: Evaluation   TOP:    Cardiovascular Bedside Monitoring

MSC:   NCLEX: Physiological Integrity: Physiological Adaptation

 

5. Before calculating indices such as the cardiac index and stroke volume index, the nurse will need to determine:

a.	cardiac output.
b.	ejection fraction.
c.	body surface area.
d.	mean arterial pressure.

 

ANS:   C

For the patient with a thermodilution pulmonary artery (PA) catheter in place, additional hemodynamic information can be calculated using values derived from the PA catheter, blood pressure, cardiac output, and body surface area.

 

DIF:    Cognitive Level: Comprehension       REF:    148

OBJ:    Nursing Process: Assessment TOP:    Cardiovascular Bedside Monitoring

MSC:   NCLEX: Physiological Integrity: Physiological Adaptation