Chapter 33: Assessment of the Cardiovascular System Ignatavicius: Medical-Surgical Nursing, 8th Edition (100% Correct Solutions)
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Medical surgical
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HAVARD UNIVERSITY
Chapter 33: Assessment of the Cardiovascular System Ignatavicius: Medical-Surgical Nursing, 8th Edition MULTIPLE CHOICE 1. A nurse assesses a client who had a myocardial infarction and is hypote nsive. Which additional assessment finding should the nurse expect? a. Heart rate of 120 beats/min b. Co...
1 a nurse assesses a client who had a myocardial infarction and is hypotensive which additional assessment finding should the nurse expect
2 a nurse assesses a client after administering a prescri
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Chapter 33: Assessment of the Cardiovascular System
Ignatavicius: Medical-Surgical Nursing, 8th Edition
MULTIPLE CHOICE
1. A nurse assesses a client who had a myocardial infarction and is
hypotensive. Which additional assessment finding should the nurse expect?
a. Heart rate of 120 beats/min
b. Cool, clammy skin
c. Oxygen saturation of 90%
d. Respiratory rate of 8 breaths/min
ANS: A
When a client experiences hypotension, baroreceptors in the aortic arch sense a pressure
decrease in the vessels. The parasympathetic system responds by lessening the inhibitory
effect on the sinoatrial node. This results in an increase in heart rate and respiratory rate.
This tachycardia is an early response and is seen even when blood pressure is not
critically low. An increased heart rate and respiratory rate will compensate for the low
blood pressure and maintain oxygen saturations and perfusion. The client may not be able
to compensate for long, and decreased oxygenation and cool, clammy skin will occur
later.
2. A nurse assesses a client after administering a prescribed beta blocker.
Which assessment should the nurse expect to find?
a. Blood pressure increased from 98/42 mm
Hg to 132/60 mm Hg
b. Respiratory rate decreased from 25
breaths/min to 14 breaths/min
c. Oxygen saturation increased from 88% to
96%
d. Pulse decreased from 100 beats/min to 80
beats/min
ANS: D
Beta blockers block the stimulation of beta1-adrenergic receptors. They block the
sympathetic (fight-or-flight) response and decrease the heart rate (HR). The beta blocker
will decrease HR and blood pressure, increasing ventricular filling time. It usually does
not have effects on beta2-adrenergic receptor sites. Cardiac output will drop because of
3. A nurse assesses clients on a medical-surgical unit. Which client should
the nurse identify as having the greatest risk for cardiovascular disease?
a. An 86-year-old man with a history of
asthma
b. A 32-year-old Asian-American man with
colorectal cancer
c. A 45-year-old American Indian woman
with diabetes mellitus
d. A 53-year-old postmenopausal woman
who is on hormone therapy
ANS: C
The incidence of coronary artery disease and hypertension is higher in American Indians
than in whites or Asian Americans. Diabetes mellitus increases the risk for hypertension
and coronary artery disease in people of any race or ethnicity. Asthma, colorectal cancer,
and hormone therapy do not increase risk for cardiovascular disease.
DIF: Understanding/Comprehension REF: 632 KEY: Health
screening
MSC: Integrated Process: Nursing Process: Assessment
NOT: Client Needs Category: Safe and Effective Care Environment: Management of
Care
4. A nurse assesses an older adult client who has multiple chronic diseases.
The client’s heart rate is 48 beats/min. Which action should the nurse take first?
a. Document the finding in the chart.
b. Initiate external pacing.
c. Assess the client’s medications.
d. Administer 1 mg of atropine.
ANS: C
Pacemaker cells in the conduction system decrease in number as a person ages, resulting
in bradycardia. The nurse should check the medication reconciliation for medications that
might cause such a drop in heart rate, then should inform the health care provider.
Documentation is important, but it is not the priority action. The heart rate is not low
enough for atropine or an external pacemaker to be needed.
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