Chapter 19: Coronary Heart Disease and Hypertension Nursing School Test Banks

Chapter 19: Coronary Heart Disease and Hypertension
Test Bank

MULTIPLE CHOICE

1. The underlying pathologic process in coronary heart disease appears to be
a. atrophy of the heart muscle.
b. weakened coronary vessels.
c. fibrous plaques in coronary vessels.
d. inadequate nutrition to the heart muscle.
ANS: C
The underlying pathologic process in coronary heart disease is atherosclerosis. This process is characterized by the formation of fatty fibrous plaques that may begin in childhood and develop into fatty streaks, largely composed of cholesterol, on the inside lining of major blood vessels.

DIF: Cognitive Level: Knowledge REF: 379 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

2. The underlying pathologic process in coronary heart disease is known as
a. angina.
b. atherosclerosis.
c. hypertension.
d. myocardial infarction.
ANS: B
The underlying pathologic process in coronary heart disease is known as atherosclerosis, characterized by the formation of fatty fibrous plaques that may begin in childhood and develop into fatty streaks, largely composed of cholesterol, on the inside lining of major blood vessels.

DIF: Cognitive Level: Knowledge REF: 379 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

3. An infarct in a major artery supplying the brain results in
a. a myocardial infarction.
b. a coma.
c. a cerebrovascular accident.
d. hypertension.
ANS: C
An infarct in a major artery supplying the brain is called a cerebrovascular accident. Cells die when they are deprived of their normal blood supply, and the local area of dead tissue is called an infarct.

DIF: Cognitive Level: Knowledge REF: 379 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

4. A localized area of dying or dead tissue is called a(n)
a. atheroma.
b. infarct.
c. thrombus.
d. lesion.
ANS: B
Cells die when deprived of their normal blood supply. The local area of dying or dead tissue is called an infarct.

DIF: Cognitive Level: Knowledge REF: 379 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

5. A risk factor for coronary heart disease that cannot be controlled is
a. obesity.
b. family history.
c. lack of exercise.
d. smoking.
ANS: B
Risk factors associated with heart disease are sex, age, family history, elevated serum cholesterol, and dietary fat as well as compounding diseases such as diabetes, hypertension, and metabolic syndrome. Family history, age, and sex cannot be controlled.

DIF: Cognitive Level: Knowledge REF: 382-383
TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Reduction of Risk Potential

6. Protection against coronary heart disease is associated with a high-density lipoprotein (HDL) value of at least _____ mg/dL.
a. 30
b. 40
c. 60
d. 80
ANS: C
The optimal level for HDL is 60 mg/dL or greater.

DIF: Cognitive Level: Knowledge REF: 382-383 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

7. A food choice that may be limited in a meal plan controlling fat and cholesterol is
a. pork sausage.
b. baked beans.
c. broiled fish.
d. glazed carrots.
ANS: A
Dietary cholesterol and saturated fat are found in large amounts in foods of animal origin such as meat, dairy, and butter.

DIF: Cognitive Level: Application REF: 384
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

8. The function of lipoproteins is to carry
a. proteins to the liver for metabolism.
b. proteins to the cells for metabolism.
c. fat and cholesterol to the cells for energy and metabolism.
d. cholesterol to adipose tissue for storage.
ANS: C
Because fat is not soluble in water, it is carried in the bloodstream in small wrapped packages of protein called lipoproteins. The function of lipoproteins is to carry fat and cholesterol to the cells for energy and metabolism.

DIF: Cognitive Level: Knowledge REF: 381 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

9. Of the following, an appropriate seasoning choice to use for a sodium-restricted diet would be
a. celery salt.
b. lemon juice.
c. soy sauce.
d. BBQ sauce.
ANS: B
Lemon juice is very low in sodium. Celery salt, soy sauce, and BBQ sauce all contain sodium as a component.

DIF: Cognitive Level: Application REF: 389
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

10. Appropriate snacks for a patient with hypertension would include
a. corn chips and salsa.
b. pretzel rings and cheese dip.
c. orange juice with whole wheat toast.
d. french fries with apple slices.
ANS: C
Orange juice with whole wheat toast contains the least sodium. Nutrition therapy for hypertension includes sodium control to control fluid accumulation. High potassium foods such as orange juice may also be helpful.

DIF: Cognitive Level: Application REF: 389-393
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

11. Dietary guidelines from the American Heart Association for foods to limit or consume in moderation include
a. avoid all foods that contain cholesterol and animal fats.
b. cut back on foods that contain partially hydrogenated vegetable oils.
c. aim to eat less than 100 mg of cholesterol each day.
d. do not consume foods with dairy fat.
ANS: B
Foods to limit or consume in moderation include cutting back on those that contain partially hydrogenated vegetable oils to reduce trans fats in the diet, cutting back on foods that are high in dietary cholesterol, and aiming to eat less than 300 mg of cholesterol each day.

DIF: Cognitive Level: Knowledge REF: 384 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

12. Dietary modifications during the first 24 to 48 hours after myocardial infarction include
a. increasing fiber intake.
b. avoiding cholesterol.
c. reducing energy intake.
d. reducing fluid intake.
ANS: C
All care after a myocardial infarction is aimed at ensuring cardiac rest so that the damaged heart can be restored to normal functioning. Energy restriction reduces metabolism and therefore reduces the workload for the heart.

DIF: Cognitive Level: Application REF: 387
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

13. Heart failure results in
a. difficulty breathing.
b. anemia.
c. dehydration.
d. myocardial infarction.
ANS: A
In heart failure the progressively weakened heart muscle is unable to maintain an adequate cardiac output to sustain normal blood circulation. The resulting fluid imbalances cause edema, which makes breathing difficult and places more stress on the laboring heart.

DIF: Cognitive Level: Knowledge REF: 388 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

14. The Therapeutic Lifestyle Changes (TLC) diet recommends limiting daily cholesterol intake to no more than _____ mg daily.
a. 200
b. 300
c. 400
d. 600
ANS: A
The TLC diet includes not exceeding a total of 200 mg dietary cholesterol daily.

DIF: Cognitive Level: Knowledge REF: 385 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

15. The greatest proportion of dietary fatty acids should be
a. saturated.
b. polyunsaturated.
c. monounsaturated.
d. fish oil.
ANS: C
The greatest proportion of dietary fatty acids should be monounsaturated fat and should not exceed 20% of the total fat intake of 25% to 35% of total calories.

DIF: Cognitive Level: Knowledge REF: 385 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

16. A food that should be limited by patients with heart failure is
a. shredded wheat cereal
b. salted potato chips
c. tofu
d. angel food cake
ANS: B
Because of sodiums role in tissue fluid balance, high-sodium foods such as salted potato chips are restricted in the treatment of cardiac edema.

DIF: Cognitive Level: Application REF: 388-389
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

17. The cause of essential hypertension is
a. coronary heart disease.
b. stress.
c. hormone imbalance.
d. unknown.
ANS: D
The cause of essential hypertension is unknown, although injury to the inner lining of the blood vessel wall appears to be an underlying link.

DIF: Cognitive Level: Knowledge REF: 389 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

18. A patients blood pressure reading is 150/92 mm Hg. This would be considered
a. hypotension.
b. stage 1 hypertension.
c. normotension.
d. stage 2 hypertension.
ANS: B
A blood pressure reading greater than 140/90 mm Hg indicates the presence of stage 1 hypertension.

DIF: Cognitive Level: Application REF: 390
TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

19. The diagnosis of stages 1 and 2 hypertension is based on the _____ blood pressure.
a. systolic
b. diastolic
c. systolic and diastolic
d. resting
ANS: C
Current hypertension screening and treatment programs identify persons with hypertension according to the severity of the systolic and diastolic blood pressures.

DIF: Cognitive Level: Knowledge REF: 390-391 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

20. The main source of dietary sodium in food is
a. processed foods.
b. found naturally in foods.
c. found in cooking compounds.
d. found as a mineral in drinking water.
ANS: A
The main source of dietary sodium comes from processed foods, fast food, and some types of restaurant foods.

DIF: Cognitive Level: Knowledge REF: 389 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

21. Nutrition therapy for those with heart failure restricts sodium to
a. 1.0 gram per day.
b. 1.5 grams per day.
c. 2.0 grams per day.
d. 2.5 grams per day
ANS: C
A 2 g/day sodium restriction is recommended for those with heart failure.

DIF: Cognitive Level: Knowledge REF: 389 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

22. An example of a food that is recommended with the DASH eating plan is
a. lemonade.
b. a fresh orange.
c. a bread roll.
d. bottled water.
ANS: B
A diet rich in fruits (such as oranges), vegetables, and low-fat dairy products with a reduced content of saturated and total fat is recommended with the DASH eating plan.

DIF: Cognitive Level: Application REF: 392-393 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Reduction of Risk Potential

23. Hypertension is common in some ethnic groups, including
a. Europeans.
b. Asians.
c. African Americans.
d. Native Americans.
ANS: C
There is a high incidence of hypertension in African Americans, with the highest incidence among older African American women.

DIF: Cognitive Level: Knowledge REF: 389 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

24. The best way to control coronary heart disease is
a. by early diagnosis.
b. to meet regularly with a dietitian.
c. to eliminate fat from the diet.
d. to develop a heart-healthy lifestyle during childhood.
ANS: D
Developing a heart-healthy lifestyle during childhood may be the best way to control heart disease.

DIF: Cognitive Level: Application REF: 383-385 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Reduction of Risk Potential

25. Examples of foods high in soluble dietary fiber are
a. whole-wheat bread and crackers.
b. pureed fruits and vegetables.
c. potatoes and yams.
d. oat bran and legumes.
ANS: D
Foods high in soluble fiber include oat bran and legumes.

DIF: Cognitive Level: Application REF: 385 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

26. The Dietary Approaches to Stop Hypertension (DASH) diet encourages intake of
a. foods high in monounsaturated fats.
b. foods high in soluble fiber.
c. fruits, vegetables, and low-fat dairy products.
d. breads, cereals, rice, and pasta.
ANS: C
The DASH diet recommends eating four to six servings of fruits, four to six servings of vegetables, and two to three servings of low-fat dairy foods per day.

DIF: Cognitive Level: Knowledge REF: 392-393 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Reduction of Risk Potential, Health Promotion and Maintenance

27. Appropriate food choices for a breakfast while following the DASH diet may include
a. fried egg, biscuit and gravy.
b. hash brown casserole and sausage.
c. whole grain toast with a banana.
d. chipped beef and a croissant with butter.
ANS: C
Whole grain toast with a banana provides whole grains and fruit. The DASH diet recommends eating four to six servings of fruits, four to six servings of vegetables, and two to three servings of low-fat dairy foods per day in addition to lean meats and high-fiber grains.

DIF: Cognitive Level: Application REF: 392-393
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

28. An example of a low-sodium food is
a. canned salmon.
b. a peanut butter sandwich.
c. a biscuit.
d. shredded wheat cereal.
ANS: D
Low-sodium foods include shredded wheat cereal. Processed foods such as canned, frozen, and baked products contain higher amounts of sodium.

DIF: Cognitive Level: Application REF: 389 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

29. An example of a food that is a good source of calcium is
a. olive oil.
b. skim milk.
c. oatmeal.
d. lemonade.
ANS: B
Milk is a good source of calcium.

DIF: Cognitive Level: Application REF: 392 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

30. A food that can be used freely on a sodium-restricted diet is
a. canned salmon.
b. a peanut butter sandwich.
c. a biscuit.
d. a fresh apple.
ANS: D
Fruits contain negligible amounts of sodium in their natural state. Processed foods, including canned, frozen, and other packaged items, contain various amounts of sodium.

DIF: Cognitive Level: Application REF: 389 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Reduction of Risk Potential

Leave a Reply