Archer Cardiovascular Exam Questions and Answers Latest Update Graded A+
The nurse in the emergency department is taking care of a patient diagnosed with left ventricular
failure. The patient presents with fatigue, muscular weakness, and dyspnea. The patient is seen
coughing and sitting in a "three-point position". The nurse understands that manifestations of left-sided
heart failure present themselves as respiratory problems because:
A. There is venous congestion in the liver.
B. There is hypoperfusion of tissue cells.
C. There is pulmonary congestion.
D. Despite the normal cardiac output, the heart is still not able to meet the accelerated demands of the
body.
Submit Answer - Answers Explanation
Choice C is correct. Due to the inability of the left ventricle to pump blood, there is an accumulation of
blood behind it, leading to congestion in the pulmonary veins down to the lungs.
Choice A is incorrect. Venous congestion in the liver occurs because of a decrease in the functioning of
the right ventricle.
Choice B is incorrect. Hypoperfusion of tissues is a consequence of most forms of heart failure. However,
the manifestations of left heart failure occur because of pulmonary congestion.
Choice D is incorrect. The heart being unable to meet the accelerated needs of the body despite its
standard cardiac output is a description of high output heart failure. This occurs in sepsis, Paget's
disease, beriberi, anemia, and other conditions.
Additional Info
Last Updated - 31, Oct 2022
The nurse is caring for a patient with left-sided heart failure. Which of the following signs and symptoms
is related more to right-sided heart failure?
,A. Ascites
B. Tachypnea
C. Cough
D. Crackles and wheezes
Submit Answer - Answers Explanation
Choice A is correct. Ascites is a symptom of right-sided heart failure, not left-sided. Right-sided heart
failure involves congestion in the systemic circulation. Patients with right-sided heart failure may also
experience jugular vein distention, oliguria, weight gain, and peripheral edema.
Choice B is incorrect. Tachypnea, or more frequent than normal respirations, is seen in left-sided heart
failure as breathing becomes more difficult. In left-sided heart failure, fluid backs up into the lungs and
makes breathing more difficult.
Choice C is incorrect. A cough, along with other heart failure symptoms, is a sign of left-sided heart
failure. As fluid backs up in a patient's lungs, the patient may present with a cough.
Choice D is incorrect. Crackles and wheezes upon respiratory auscultation are a sign of left-sided heart
failure. As fluid backs up into the lungs because the heart is unable to pump properly, the lungs sound
wet, wheezy, and may present with crackles.
NCSBN client need Topic: Physiologic integrity, alterations in body systems
Additional Info
The nurse in the post-anesthetic care unit has just received a patient from the OR that has undergone a
coronary artery bypass graft (CABG). The nurse formulates a nursing diagnosis of "decreased cardiac
output related to alterations in preload/afterload/contractility/heart rate." What nursing interventions
should be implemented in the nursing care plan based on the formulated nursing diagnosis?
A. Monitor the patient's arterial blood gas constantly.
B. Monitor the patient's weight daily and calculate the change.
C. Administer prescribed opioids.
D. Monitor mediastinal chest tubes for hourly output.
Submit Answer - Answers Explanation
,Choice B is correct. Monitoring the daily weight of the client and noting any changes gives the nurse a
picture of the client's fluid volume status, which is influenced by the patient's cardiac output.
Choice A is incorrect. Monitoring the patient's arterial blood gas (ABG) is also needed in the care of a
patient post-CABG to detect hypoxemia or acidosis, which may require modification in ventilation
parameters. However, it is not directly related to the nursing diagnosis of decreased cardiac output; it is
an intervention to address the nursing diagnosis of impaired gas exchange.
Choice C is incorrect. Opioids provide pain relief to the client after surgery and should be administered
by the nurse promptly to manage pain. However, opioid administration is not a nursing intervention
related to the care of a patient with a nursing diagnosis of decreased cardiac output.
Choice D is incorrect. Hourly monitoring of mediastinal chest tubes assesses the patient's rate of blood
loss post-surgery. This is a nursing intervention related to risk for illness related to inadequate
hemostasis, not decreased cardiac output.
Last Updated - 14, Jan 2022
When the nurse notes an irregular radial pulse in a client, further evaluation should include assessing for
which of the following?
A. The carotid pulse
B. Diminished peripheral circulation
C. The brachial pulse
D. A pulse deficit
Submit Answer - Answers Explanation
Choice D is correct. Assessing for a pulse deficit provides an indirect evaluation of the heart's ability to
eject enough blood to produce a peripheral pulse. When a pulse deficit is present, the radial pulse is less
than the apical pulse.
Choices A and C are incorrect. If the pulse is irregular, the correct protocol is to assess for a pulse deficit,
which means measuring the apical and radial pulses simultaneously.
Choice B is incorrect. Diminished peripheral circulation is not the correct assessment.
NCSBN Client Need Topic: Physiological Integrity, Subtopic: Reduction of Risk Potential; Pulse
, Last Updated - 03, Feb 2022
The nurse cares for a client with the below tracing on the electrocardiogram. The client is unresponsive
and without a pulse. The nurse should take which priority action based on the tracing?
A. Start cardiopulmonary resuscitation (CPR)
B. Perform immediate defibrillation
C. Initiate intravenous (IV) access
D. Review the client's most recent electrolyte levels
Submit Answer - Answers Explanation
Choice B is correct. This concerning tracing on the electrocardiogram is ventricular fibrillation.
Ventricular fibrillation is electrical chaos in the ventricles that produces no cardiac output. The priority is
to defibrillate the client immediately according to ACLS protocol. If a defibrillator is not readily available,
high-quality CPR must be initiated and continued until the defibrillator arrives.
Choices A, C, and D are incorrect. CPR is a critical intervention in the management of ventricular
fibrillation. However, it is not a higher priority than defibrillation. Defibrillation has been proven to
terminate this lethal arrhythmia and is essential to perform. IV access is essential to obtain to deliver
medications such as epinephrine, but restoring normal cardiac output will not come through IV access.
Ventricular fibrillation may be caused by various conditions, including severe electrolyte disturbances.
However, this client is in distress, and assessment is not the priority.
Additional Info
Ventricular fibrillation causes the ventricles to merely quiver, consuming a tremendous amount of
oxygen. There is no cardiac output or pulse and therefore no cerebral, myocardial, or systemic
perfusion. This rhythm is rapidly fatal if not successfully ended within 3 to 5 minutes. The essential
treatment of ventricular fibrillation is defibrillation, and CPR is merely a life-sustaining measure that
should be used until a defibrillator arrives.
Last Updated - 19, Jun 2022
