Nursing Board Exam Reviewer Part 2 of 5

151. Which of the following procedures most specifically describes splitting or separating fused cardiac valve leaflets?

a) Commisurotomy
Commisurotomy is frequently used for mitral stenosis.

b) Annuloplasty
Annuloplasty refers to repair of a cardiac valve’s outer ring.

c) Chordoplasty
Chordoplasty refers to repair of the chordae tendonae of atroventricular valve leaflets.

d) Valvuloplasty
Valvuloplasty is a general term that refers to repair of a stenosed or regurgitant cardiac valve by commisurotomy, annuloplasty, leaflet repair, and/or chordoplasty.

152. Which of the following mitral valve conditions generally produces no symptoms?

a) Prolapse
Mitral valve prolpase is a deformity that usually produces no symptoms and has been diagnosed more frequently in recent years, probably as a result of improved diagnostic methods.

b) Stenosis
Mitral valve stenosis usually causes progressive fatigue.

c) Regurgitation
Mitral valve regurgitation, in its acute stage, usually presents as severe heart failure.

d) Infection
Mitral valve infection, when acute, will produce symptoms typical of infective endocarditis.

153. In which type of cardiomyopathy does the heart muscle actually increase in size and mass weight, especially along the septum?

a) Hypertrophic
Because of the structural changes, hypertrophic cardiomyopathy had also been called idiopathic hypertrophic subaortic stenosis (IHSS) or asymmetric septal hypertrophy (ASH).

b) Dilated
Because of the structural changes, hypertrophic cardiomyopathy had also been called idiopathic hypertrophic subaortic stenosis (IHSS) or asymmetric septal hypertrophy (ASH).

c) Restrictive
Restrictive cardiomyopathy is characterized by diastolic dysfunction caused by rigid ventricular walls that impair ventricular stretch and diastolic filling

d) Arrhythmogenic right ventricular cardiomyopathy
Arrhythmogenic right ventricular cardiomyopathy (ARVC) occurs when the myocardium of the right ventricle is progressively infiltrated and replaced by fibrous scar and adipose tissue

154. Which of the following patient behaviors, if observed by the nurse, would indicate that the cardiac patient’s level of anxiety has decreased?

a) Answers questions regarding status with no problem.
Generally, when anxiety begins to increase, the patient will be less likely to want to discuss prognosis.

b) Discusses prognosis freely.
Open discussion generally indicates some degree of comfort with prognosis.

c) Verbalizes fears and concerns.
Verbalization of fears and concerns indicates some degree of comfort with prognosis.

d) Participates in support groups.
Participation in support groups indicates some degree of comfort with prognosis.

155. The patient with which of the follow characteristics is considered high risk for the development of infective endocarditis?

a) The patient who has complex cyanotic congenital malformations is at high risk for the development of infective endocarditis.

b) Mitral valve prolapse with valvular regurgitation
The patient with mitral valve prolapse with valvular regurgitation is at moderate risk for the development of infective endocarditis.

c) Hypertrophic cardiomyopathy
The patient with hypertrophic cardiomyopathy is at moderate risk for the development of infective endocarditis.

d) Acquired valvular dysfunction
The patient with acquired valvular dysfunction is at moderate risk for the development of infective endocarditis.

156. Which of the following terms indicates the amount of blood pumped out of the ventricle with each contraction of the heart?

a) Stroke volume
Stroke volume is the amount of blood pumped out (ejected) with each contraction of the heart (heart beat). Stroke volume times heart rate equals cardiac output.

b) Afterload
Afterload is the amount of resistance to ejection of blood from a ventricle.

c) Cardiac output
Cardiac output is the amount of blood pumped out of the heart in one minute.

d) Preload
Preload is the pressure created by a volume of blood within a ventricle before contraction.

157. When the balloon on the distal tip of a pulmonary artery catheter is inflated and a pressure is measured, the measurement obtained is referred to as the

a) pulmonary artery wedge pressure.
When the balloon is inflated, the tip of the catheter floats into smaller branches of the pulmonary arty until it can no longer be passed and the pressure is recorded, reflecting left atrial pressure and left ventricular end-diastolic pressure.

b) central venous pressure.
Central venous pressure is measured in the right atrium.

c) pulmonary artery pressure.
Pulmonary artery pressure is measured when the balloon tip is not inflated.

d) cardiac output.
Cardiac output is determined through thermodilution involving injection of fluid into the pulmonary artery catheter.

158. Which of the following medications is categorized as a loop diuretic?

a) Furosemide (Lasix)
Lasix is commonly used in the treatment of cardiac failure.

b) Chlorothiazide (Diuril)
Chlorothiazide is categorized as a thiazide diuretic.

c) Chlorthalidone (Hygroton)
Chlorothalidone is categorized as a thiazide diuretic.

d) Spironolactone (Aldactone)
Spironolactone is categorized as a potassium-sparing diuretic.

159. When the nurse observes that the patient always has difficulty breathing when lying flat, the nurse records that the patient is demonstrating

a) Orthopnea
Patients with orthopnea prefer not to lie flat and will need to maintain their beds in a semi- to high Fowler’s position

b) Dyspnea on exertion.
Dyspnea on exertion refers to difficulty breathing with activity.

c) Hyperpnea.
Hyperpnea refers to increased rate and depth of respiration.

d) Paroxysmal nocturnal dyspnea.
Paroxysmal nocturnal dyspnea refers to orthopnea that occurs only at night.

160. The patient with cardiac failure is taught to report which of the following symptoms to the physician or clinic immediately?

a) Persistent cough
Persistent cough may indicate an onset of left-heart failure.

b) Increased appetite
Loss of appetite should be reported immediately.

c) Weight loss
Weight gain should be reported immediately.

d) Ability to sleep through the night
Frequent urination, causing interruption of sleep, should be reported immediately.

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