Assessment of the Cardiovascular System (Concepts for Interprofessional Collaborative Care College Test

Assessment of the Cardiovascular System (Concepts for Interprofessional Collaborative Care College Test
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 b
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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 decreased HR.
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 o
any race or ethnicity. Asthma, colorectal cancer, and hormone therapy do not increase risk for cardiovascular
disease.

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