Chapter 19 Cardiovascular and Respiratory Disorders

Chapter 19  Cardiovascular and Respiratory Disorders

Complete Chapter Questions And Answers
 

Sample Questions

MULTIPLE CHOICE

1. Which of the following is a true statement about heart disease in older adults?
a.
Myocardial infarction (MI) has many of the same symptoms in older patients as in middle-aged persons.
b.
Both excessive urination at night and decreased urination can be signs of heart failure (HF).
c.
Any exertion on the part of an older adult patient with heart disease can bring on another heart attack.
d.
A person with HF is likely to have trouble breathing, except when lying down.

ANS: B
Because the heart is an ineffective pump in HF, both excessive urination at night and decreased urination can occur when older adults have an MI. Nocturia occurs in HF when the heart is unable to maintain adequate renal blood flow in the performance of daily activities; then, during the night when the patient’s lower extremities are elevated for sleep, the heart is able to perfuse the kidneys with the assistance of increased venous return owing to the elevated extremities. Inadequate urine production is due to inadequate perfusion from an ineffective pump.
The classic presentation of angina pectoris in older patients is often absent in what is known as a silent MI, with only mild discomfort, perhaps even limited to nausea or “heartburn” as the only symptom. Failure to engage in cardiac rehabilitation exercises is more likely to result in another MI or be an aggravation of HF than ordinary exertion. A person with HF is more likely to have difficulty breathing except when the trunk is upright (orthopnea).

PTS: 1 DIF: Understand REF: 3-8
TOP: Nursing Process: Assessment MSC: Physiological Integrity

2. An older man in a cardiac rehabilitation exercise class refuses to participate in the cool-down phase of the activity; consequently, 2 minutes later, he passes out but quickly regains consciousness. Which instruction does the nurse include in patient teaching to reinforce the importance of cooling down after exercising to this man?
a.
Cardiac output diminishes with age.
b.
Mobility capacity decreases with age.
c.
Baroreceptor function diminishes with age.
d.
Sensory perception diminishes with age.

ANS: C
During exercise, the body shunts blood to the skeletal muscles to supply enough oxygen to meet the increased metabolic demands of the muscles. If the exercise is suddenly withdrawn, however, the blood temporarily pools in the skeletal muscles, and the older adult loses consciousness from transient hypotension. Baroreceptor responsiveness declines with age; therefore the body does not respond as readily to the need for changes in blood pressure. The cool-down period compensates for this effect.
An acute problem such as losing consciousness as a result of decreased cardiac output should appear during the “real” exercise. The man is mobile enough to participate in the exercise program. Gradual sensory alteration does not account for the acute episode.

PTS: 1 DIF: Apply REF: 3-14 TOP: Teaching/Learning
MSC: Physiological Integrity

3. Which of the following is a true statement about heart disease in older men and women?
a.
More women than men die from MIs.
b.
Cardiac care for men and women is equally aggressive.
c.
Cardiac medications have been tested on men and women equally.
d.
Women generally receive less aggressive treatment than men do.

ANS: D
Women generally receive less aggressive treatment than men; this stereotype has led to a relative neglect of women’s cardiac problems. Men usually receive more aggressive treatment. Testing in the past has focused on male patients. Women receive less aggressive treatment and less effective instruction for cardiac disease, which is potentially due to the atypical presentations women have for cardiac disease and MIs.

PTS: 1 DIF: Remember REF: 3-14
TOP: Nursing Process: Assessment MSC: Physiological Integrity

4. Which condition is a COPD?
a.
Bronchial asthma
c.
Bacterial pneumonia
b.
Histoplasmosis
d.
Mycobacterium tuberculosis

ANS: A
COPD includes asthma, chronic bronchitis, and emphysema. Pneumonia, an acute pulmonary infection, is not a chronic obstructive lung disorder.

PTS: 1 DIF: Remember REF: 10-15
TOP: Nursing Process: Assessment MSC: Physiological Integrity