Modifiable risk factors that increase the risk of acute myocardial infarction MI include all of the following except: Hypertension Smoking Food allergies Lack of physical activity 3. The overwhelming majority of strokes are ischemic. Risk of ischemic stroke is reduced among women with all of the following characteristics except: Low BMI Regular exercise Healthy diet Menopause before age 42 6. Transient ischemic attacks TIA are associated with all of the following except: Increased risk of stroke in the first 30 days following the TIA Increased risk of stroke in the first 90 days following the TIA Increased risk of death within one year of the TIA Increased risk of congenital heart disease 7.
High blood pressure is less common among women who: Are age 45 and younger Are obese Use oral contraceptives Are African American 8. By definition, prehypertension is untreated systolic or diastolic pressure ranging from: Systolic pressure of mm Hg or diastolic pressure of mm Hg Systolic pressure of mm Hg or diastolic pressure of mm Hg Systolic pressure of mm Hg or diastolic pressure of mm Hg Systolic pressure of mm Hg and diastolic pressure of mm Hg 9. The most commonly occurring congenital cardiovascular defect is: Tetralogy of Fallot Ventricular septal defects Coarctation of the aorta Hypoplastic left heart syndrome Among postmenopausal women with coronary heart disease the strongest risk factor for heart failure is: First child after age 30 No children Diet low in fruit and vegetables Diabetes Heart disease is the leading cause of death among men and women of all races and ethnic groups, however mortality varies by ethnicity.
Reducing cholesterol and blood pressure may reduce all of the following except: Heart disease mortality Incidence of nonfatal myocardial infarction Risk of developing heart disease Risk of congenital heart disease The most commonly occurring arrhythmia is: Atrial fibrillation Ventricular tachycardia Bradycardia Ventricular fibrillation Symptoms such as shortness of breath, fatigue, weakness, difficulty breathing when recumbent, weight gain, and swelling in the lower extremities may indicate: Atrial fibrillation Heart failure Cardiac arrest Stroke Myocardial infarction Atrial fibrillation Heart failure Sudden cardiac arrest Which of the following groups is not at increased risk of developing endocarditis?
Patients with artificial heart valve or implanted medical devices in the heart or blood vessels Patients with congenital heart defects Persons with poor dental hygiene and gum disease Persons with elevated cholesterol levels Which of the following statement about mitral valve prolapse is false? B Because strokes tend to occur in older persons and women live longer than men, more women die of strokes. Save my name, email, and website in this browser for the next time I comment.
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Options A, B, and D: The circumflex artery supplies the lateral wall, the internal mammary artery supplies the mammary, and the right coronary artery supplies the inferior wall of the heart. Question 2. Question 2 Explanation:. Option B: Although the coronary arteries may receive a minute portion of blood during systole, most of the blood flow to coronary arteries is supplied during diastole.
Option A: Breathing patterns are irrelevant to blood flow. Question 3. Which of the following illnesses is the leading cause of death in the US? Question 3 Explanation:. Question 4. Which of the following conditions most commonly results in CAD? Question 4 Explanation:. Question 5. Question 5 Explanation:. Option B: Arteries, not veins, supply the coronary arteries with oxygen and other nutrients.
Option A: Atherosclerosis is a direct result of plaque formation in the artery. Question 6. Question 6 Explanation:. Option A: Cigarette smoking cessation is a lifestyle change that involves behavior modification. Option B: Diabetes mellitus is a risk factor that can be controlled with diet, exercise, and medication. Question 7. Question 7 Explanation:. They require dietary restriction and perhaps medication. Exercise also helps reduce cholesterol levels.
The other levels listed are all below the nationally accepted levels for cholesterol and carry a lesser risk for CAD. Question 8. Question 8 Explanation:. Option B: Enhancing myocardial oxygenation is always the first priority when a client exhibits signs and symptoms of cardiac compromise.
Without adequate oxygen, the myocardium suffers damage. Options A and D: Although educating the client and decreasing anxiety are important in care delivery, neither are priorities when a client is compromised.
Question 9. Question 9 Explanation:. Option C: Oral medication administration is a noninvasive, medical treatment for coronary artery disease. Options B and D: Coronary artery bypass surgery and percutaneous transluminal coronary angioplasty are invasive, surgical treatments. Question Question 10 Explanation:. Option C: The right coronary artery supplies the right ventricle or the inferior portion of the heart. Therefore, prolonged occlusion could produce an infarction in that area. Which of the following is the most common symptom of myocardial infarction?
Question 11 Explanation:. Option A: The most common symptom of an MI is chest pain, resulting from deprivation of oxygen to the heart. Option B: Dyspnea is the second most common symptom, related to an increase in the metabolic needs of the body during an MI. Option C: Edema is a later sign of heart failure, often seen after an MI. Option D: Palpitations may result from reduced cardiac output, producing arrhythmias.
Which of the following landmarks is the correct one for obtaining an apical pulse? Left fifth intercostal space, midclavicular line. Left second intercostal space, midclavicular line. Question 12 Explanation:. Option B: The correct landmark for obtaining an apical pulse is the left intercostal space in the midclavicular line. This is the point of maximum impulse and the location of the left ventricular apex.
Option C: The left second intercostal space in the midclavicular line is where the pulmonic sounds are auscultated. Question 13 Explanation:. Option D: Pulmonary pain is generally described by these symptoms. Option C: Musculoskeletal pain only increases with movement.
Heart Failure NCLEX Questions
Question 14 Explanation:. Option C: Abnormalities of the pulmonic valve are auscultated at the second left intercostal space along the left sternal border. Option A: Aortic valve abnormalities are heard at the second intercostal space, to the right of the sternum. Option B: Mitral valve abnormalities are heard at the fifth intercostal space in the midclavicular line. Option D: Tricuspid valve abnormalities are heard at the third and fourth intercostal spaces along the sternal border.
Which of the following blood tests is most indicative of cardiac damage? Question 15 Explanation:. Option C: Troponin I levels rise rapidly and are detectable within 1 hour of myocardial injury. Option A: Lactate dehydrogenase is present in almost all body tissues and not specific to heart muscle. LDH isoenzymes are useful in diagnosing cardiac injury. Option B: CBC is obtained to review blood counts, and a complete chemistry is obtained to review electrolytes.
Option D: Because CK levels may rise with skeletal muscle injury, CK isoenzymes are required to detect cardiac injury. Question 16 Explanation:. Option D: Morphine is administered because it decreases myocardial oxygen demand. Which of the following conditions is most commonly responsible for myocardial infarction? Question 17 Explanation:.
Option C: Coronary artery thrombosis causes occlusion of the artery, leading to myocardial death. Option B: Heart failure is usually the result of an MI. Question 18 Explanation:. Option C: Supplemental potassium is given with furosemide because of the potassium loss that occurs as a result of this diuretic. Question 19 Explanation:. Option D: Both glucose and fatty acids are metabolites whose levels increase after a myocardial infarction. Options A and C: Mechanical changes are those that affect the pumping action of the heart, and electrophysiologic changes affect conduction.
Option B: Hematologic changes would affect the blood. Question 20 Explanation:. Option A: Rapid filling of the ventricles causes vasodilation that is auscultated as S3. Option B and D: Increased atrial contraction or systemic hypertension can result is a fourth heart sound. Option C: Aortic valve malfunction is heard as a murmur. Question 21 Explanation:. Option A: The left ventricle is responsible for the most of the cardiac output.
NCLEX: Cardiovascular disorders - Brilliant Nurse®
An anterior wall MI may result in a decrease in left ventricular function. Options B, C, and D: Pulmonic and tricuspid valve malfunction cause right-sided heart failure. Question 22 Explanation:. Option D: The ECG is the quickest, most accurate, and most widely used tool to determine the location of myocardial infarction. Option C: An echocardiogram is used most widely to view myocardial wall function after an MI has been diagnosed.
Option A: Cardiac catheterization is an invasive study for determining coronary artery disease and may also indicate the location of myocardial damage, but the study may not be performed immediately. Question 23 Explanation:. Option B: Administering supplemental oxygen to the client is the first priority of care. The myocardium is deprived of oxygen during an infarction, so additional oxygen is administered to assist in oxygenation and prevent further damage. Question 24 Explanation:. It gives the client a feeling of comfort and safety. Options B, C, and D: The other three responses give the client false hope.
No one can determine if a client experiencing MI will feel or get better and therefore, these responses are inappropriate. Question 25 Explanation:. Option A: Beta-adrenergic blockers work by blocking beta receptors in the myocardium, reducing the response to catecholamines and sympathetic nerve stimulation. They protect the myocardium, helping to reduce the risk of another infarction by decreasing the workload of the heart and decreasing myocardial oxygen demand.
Option B: Calcium channel blockers reduce the workload of the heart by decreasing the heart rate. Option C: Narcotics reduce myocardial oxygen demand, promote vasodilation, and decreased anxiety. Option D: Nitrates reduce myocardial oxygen consumption by decreasing left ventricular end-diastolic pressure preload and systemic vascular resistance afterload. What is the most common complication of a myocardial infarction? Question 26 Explanation:. Option C: Arrhythmias, caused by oxygen deprivation to the myocardium, are the most common complication of an MI.
Option A: Cardiogenic shock, another complication of MI, is defined as the end stage of left ventricular dysfunction. Option B: Because the pumping function of the heart is compromised by an MI, heart failure is the second most common complication. Option D: Pericarditis most commonly results from a bacterial or viral infection but may occur after MI. Question 27 Explanation:. Option B: Elevated venous pressure, exhibited as jugular vein distention, indicates a failure of the heart to pump.
Question 28 Explanation:. Option C: Jugular venous pressure is measured with a centimeter ruler to obtain the vertical distance between the sternal angle and the point of highest pulsation with the head of the bed inclined between 15 and 30 degrees. Question 29 Explanation:.
NCLEX Practice Exam 21 (60 Questions)
The apical pulse is the most accurate point in the body. Option B: Blood pressure is usually only affected if the heart rate is too low, in which case the nurse would withhold digoxin. Option D: Digoxin has no effect on respiratory function. Question 30 Explanation:. Option A: One of the most common signs of digoxin toxicity is the visual disturbance known as the green halo sign.
Question 31 Explanation:. Option A: Crackles in the lungs are a classic sign of left-sided heart failure. These sounds are caused by fluid backing up into the pulmonary system. Option B: Arrhythmias can be associated with both right and left-sided heart failure. Left-sided heart failure causes hypertension secondary to an increased workload on the system. Question 32 Explanation:. Option D: The most accurate area of the body to assess dependent edema in a bedridden client is the sacral area.
Sacral, or dependent, edema is secondary to right-sided heart failure.
NCLEX Practice Questions for Heart Failure
Question 33 Explanation:. Option C: Inadequate deactivation of aldosterone by the liver after right-sided heart failure leads to fluid retention, which causes oliguria. Question 34 Explanation:. Options A and B: Beta-adrenergic blockers and calcium channel blockers decrease the heart rate and ultimately decrease the workload of the heart. Option C: Diuretics are administered to decrease the overall vascular volume, also decreasing the workload of the heart.
Question 35 Explanation:. Option B: Stimulation of the sympathetic nervous system causes tachycardia and increased contractility. Options A, C, and D: The other symptoms listed are related to the parasympathetic nervous system, which is responsible for slowing the heart rate. Which of the following conditions is most closely associated with weight gain, nausea, and a decrease in urine output?
Question 36 Explanation:. Option D: Weight gain, nausea, and a decrease in urine output are secondary effects of right-sided heart failure. Option B: Cardiomyopathy is usually identified as a symptom of left-sided heart failure. Option C: Left-sided heart failure causes primarily pulmonary symptoms rather than systemic ones. What is the most common cause of abdominal aortic aneurysm? Question 37 Explanation:. Plaques build up on the wall of the vessel and weaken it, causing an aneurysm.
Options B, C, and D: Although the other conditions are related to the development of an aneurysm, none is a direct cause. Question 38 Explanation:. Option A: Distal to the iliac arteries, the vessel is again surrounded by stable vasculature, making this an uncommon site for an aneurysm. Option C: There is no area adjacent to the aortic arch, which bends into the thoracic descending aorta. Question 39 Explanation:. Option A: The presence of a pulsating mass in the abdomen is an abnormal finding, usually indicating an outpouching in a weakened vessel, as in abdominal aortic aneurysm.
The finding, however, can be normal on a thin person. Options B, C, and D: Neither an enlarged spleen, gastritis, nor gastric distention cause pulsation. What is the most common symptom in a client with abdominal aortic aneurysm? Question 40 Explanation:. Option A: Abdominal pain in a client with an abdominal aortic aneurysm results from the disruption of normal circulation in the abdominal region. Option D: Lower back pain, not upper, is a common symptom, usually signifying expansion and impending rupture of the aneurysm. Question 41 Explanation:. Option D: Lower back pain results from expansion of an aneurysm.
The expansion applies pressure in the abdominal cavity, and the pain is referred to the lower back. Option A: Abdominal pain is most common symptom resulting from impaired circulation. Option B: Absent pedal pulses are a sign of no circulation and would occur after a ruptured aneurysm or in peripheral vascular disease. Option C: Angina is associated with atherosclerosis of the coronary arteries.
What is the definitive test used to diagnose an abdominal aortic aneurysm? Question 42 Explanation:. Option B: An arteriogram accurately and directly depicts the vasculature; therefore, it clearly delineates the vessels and any abnormalities. Option A: An abdominal aneurysm would only be visible on an X-ray if it were calcified. Question 43 Explanation:. Option B: Rupture of an aneurysm is a life-threatening emergency and is of the greatest concern for the nurse caring for this type of client.
Option A: Hypertension should be avoided and controlled because it can cause the weakened vessel to rupture. Question 44 Explanation:. Option C: The factor common to all types of aneurysms is a damaged media. Options A, B, and D: The interna and externa are generally no damaged in an aneurysm. Middle lower abdomen to the left of the midline. Question 45 Explanation:. Option C: The aorta lies directly left of the umbilicus; therefore, any other region is inappropriate for palpation.
Question 46 Explanation:. Option B: Continuous pressure on the vessel walls from hypertension causes the walls to weaken and an aneurysm to occur. Question 47 Explanation:. Option A: A bruit, a vascular sound resembling heart murmur, suggests partial arterial occlusion.
Option B: Crackles are indicative of fluid in the lungs.
Option C: Dullness is heard over solid organs, such as the liver. Option D: Friction rubs indicate inflammation of the peritoneal surface. Question 48 Explanation:. Option B: Severe lower back pain indicates an aneurysm rupture, secondary to pressure being applied within the abdominal cavity.
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