Chapter 25 PrepU

Which blood vessels function without the benefit of having walls comprised of three muscular layers?

Capillaries

Select the correct sequence of blood return to the heart.

Capillaries, venules, veins, right atrium

The heart controls the direction of blood flow. What is the role of the aortic valve?

Controls the direction of blood flow from the left side of the heart to the systemic circulation

Which factor is the primary factor of local control of blood flow?

Nutritional needs of the tissue involved

The physician states that a client has adequate collateral circulation. The nurse interprets this as:

Long-term compensatory regulation of blood flow

A client with heart disease has the left ventricular ejection fraction measured. What is the normal left ventricular ejection when determined by angiocardiography?

55% - 75%

A local athlete is getting prepared for the upcoming national track and field championships. Since this athlete is performing extreme exercise, what would be the most probable cardiac output?

16 to 36 L/minute

The heart is a four-chambered muscular pump. In one day, how many gallons of blood are pumped throughout the body?

1800

The semilunar valves of the heart open at the onset of the ejection period. Approximately what percentage of the stroke volume is ejected during the first quarter of systole?

60%

Which neurotransmitter is associated with the parasympathetic nervous system?

Acetylcholine

When reviewing diagnostic test results and physical assessment data for a client with a history of stage II hypertension, which of the following would be of most concern to the nurse?

An ejection fraction of 40%

The heart consists of four valves. Which are the semilunar valves? Select all that apply. Aortic Mitral Tricuspid Pulmonary

Aortic Pulmonary

A client is diagnosed with an abdominal aortic aneurysm that the physician just wants to "watch" for now. When teaching the client about signs/symptoms to watch for, the nurse will base the teaching on which physiologic principle?

As the aneurysm grows, more tension is placed on the vessel wall, which increases the risk for rupture.

During a physical examination of a client, the nurse palpates the point of maximal impulse (PMI) in the seventh intercostal space lateral to the left midclavicular line. What is the most appropriate action for the nurse to take?

Assess the client for symptoms of left ventricular hypertrophy.

A nurse is reviewing an echocardiogram for a client with a congenital defect in the papillary muscles of the heart. Based on this result, which assessment should the nurse complete?

Auscultate for a murmur caused by the backward expulsion of blood through the atrioventricular valves.

The heart valves control the direction of blood flow. What is the function of the pulmonic valve?

Controls the direction of blood flow from the right side of the heart to the lungs

A client has just experienced stimulation of the vagus nerve. Which sign would the nurse anticipate the client to manifest?

Decreased heart rate

A client is admitted to the emergency department after experiencing a motor vehicle accident and sustaining multiple injuries with significant blood loss. The nurse predicts that the client will display which of the following?

Decreased urinary output

The school nurse is doing a health class on the functional organization of the circulatory system. What is the function of the capillaries in the circulatory system?

Exchange gases, nutrients, and wastes

The school nurse is doing a health class on the functional organization of the circulatory system. What is the function of the capillaries in the circulatory system? Pump blood Distribute oxygenated blood to the tissues Exchange gases, nutrients, and wastes Collect deoxygenated blood from the tissues

Exchange gases, nutrients, and wastes

Which compensatory mechanism is associated with long term regulation of blood flow?

Fibroblast growth factor

If a client experiences sympathetic nervous stimulation of the heart, the nurse will observe which changes in manifestations?

Increased heart rate and increased contractility

Humoral control of blood flow involves the effect of vasodilator and vasoconstrictor substances in the blood. Select the factor that has a powerful vasodilator effect on arterioles and increases capillary permeability.

Histamine

Release of which humoral factors will result in vasodilation?

Histamine

Which enzyme has a powerful vasodilator effect on arterioles and increases capillary permeability?

Histamine

A grandmother who works as a cook at a nearby school was recently hospitalized when she lost an extensive amount of blood in a work-related accident. The grandmother tells the nurse that she heard that she would keep feeling faint until the brain made more blood. The nurse knows that when the blood pressure dropped, the pressure in the carotid arteries decreased. This was detected by baroreceptors in the carotid arteries. What did the baroreceptors do?

Increase sympathetic stimulation of the heart and blood vessels

Which of the following is true regarding pulmonary circulation?

It is a low-pressure system that allows for improved gas exchange.

The lymph system correlates with the vascular system without actually being a part of the vascular system. Among other things, the lymph system is the main route for the absorption of fats from the gastrointestinal system. The lymph system empties into the right and left thoracic ducts, which are the points of juncture with the vascular system. What are these points of juncture?

Junctions of the subclavian and internal jugular veins

Which of the following blood flow patterns reduces friction, allowing the blood layers to slide smoothly over one another?

Laminar

The heart is a four-chambered pump. Which chamber of the heart pumps blood into the systemic circulation?

Left ventricle

When the semilunar valves open it signals the onset of the ejection period. The aortic pressure reflects changes in the ejection of blood from which part of the heart?

Left ventricle

A nurse is assessing a female client and notes that her left arm is swollen from the shoulder down to the fingers, with non-pitting edema. The right arm is normal. The client had a left-sided mastectomy 1 year ago. What does the nurse suspect is the problem?

Lymphedema

Which related circulatory complication can result from surgical treatment for metastatic breast cancer?

Lymphedema in the affected arm

The heart consists of four valves. Which are the heart's atrioventricular valves? Select all that apply. Mitral Pulmonary Aortic Tricuspid

Mitral Tricuspid

A client comes to the emergency department reporting a "racing" heart and feeling "anxious." On a heart monitor, the nurse notes a heart rate of 134 and proceeds to monitor for which complications related to tachycardia? Select all that apply. Risk for angina Increase in cardiac output Decrease in oxygen levels Decrease in stroke volume Decrease in blood pressure

Risk for angina Decrease in oxygen levels Decrease in stroke volume Decrease in blood pressure

The heart is a four-chambered pump. What is the function of the right ventricle?

Pumps blood to the lungs

The nurse is reviewing the anatomy and physiology of the heart. What is the function of the right atrium?

Receives blood returning to the heart from the systemic circulation

The electrical activity of the heart is recorded on the ECG. What does the T wave on the ECG represent?

Repolarization of the ventricles

A client has had an acute myocardial infarction (MI). The brother of the client has a history of angina. The client asks how he will know if his brother's pain is angina or if the brother is actually having an MI. Which statement is correct?

Rest and intake of nitroglycerin relieve chest pain with angina; they do not relieve chest pain with an MI.

If the parasympathetic neurotransmitter releases acetylcholine, the nurse should anticipate observing what changes in the ECG pattern?

Slowing of heart rate to below 60 beats/minute

A client says that when the hospital checked his blood pressure after he lost a lot of blood in a work-related accident, the top number (systolic pressure) was lower than usual but the bottom number (diastolic pressure) was about the same. Why is this?

Systemic vasoconstriction maintained the diastolic pressure.

During an assessment of a client with ankle swelling, the nurse observes jugular venous pulsations 5 cm above the sternal angle when the head of his bed is elevated 45 degrees. What is the correct interpretation of this finding?

The client has increased pressure related to right-sided heart failure.

Downstream peripheral pulses have a higher pulse pressure because the pressure wave travels faster than the blood itself. What occurs in peripheral arterial disease?

The pulse decreases, rather than increases, in amplitude.

The nurse is reviewing the circulatory system. Which statements are correct about the functional organization of the circulatory system? Select all that apply. The venous system collects deoxygenated blood from the tissues. The capillaries pump blood. The heart exchanges gases, nutrients, and wastes. The arterial system distributes oxygenated blood to the tissues.

The venous system collects deoxygenated blood from the tissues. The arterial system distributes oxygenated blood to the tissues.

The cardiac cycle describes the pumping action of the heart. Which statement is correct about systole?

Ventricles contract and blood is ejected from the heart.

A nurse working with a client in heart failure is explaining why the symptoms of the heart failure were not evident for a long period of time. When describing the Frank-Starling mechanism, the nurse will explain:

the relationship between venous return and stroke volume.

Which sequence is the correct pathway for blood flow through the heart?

right atrium - tricuspid valve - right ventricle - pulmonary artery - lungs - pulmonary vein - left atrium - mitral valve - left ventricle - aorta

The difference between the end-diastolic and end-systolic volumes is called what?

stroke volume

In the circulatory system, pressure is inversely related to which factor?

volume

A client asks why he has not had major heart damage since his cardiac catheterization revealed he has 98% blockage of the right coronary artery. The nurse's best response is:

"You have small channels between some of your arteries, so you can get blood from a patent artery to one severely blocked."

A client took a weight loss drug that activated the alpha-adrenergic receptors in the sympathetic nervous system. Which manifestations would the nurse expect to occur? Select all that apply. Increased blood pressure of cardiac contraction Decreased myocardial contraction Increased cardiac cycle speed Decrease in respiration rate

Increased blood pressure of cardiac contraction Increased cardiac cycle speed

A client has a blood pressure of 68/38 mm Hg and fainted after donating a unit of blood. The client is experiencing low preload from loss of blood volume. What is preload?

Venous return to the heart

A client is lying in a recumbent position. In this client, approximately how much total blood volume is in the central circulation?

25% - 30%

A client with a history of heart failure has the following echocardiogram results: heart rate 80 beats/minute; end-diastolic volume 120 mL; and end-systolic volume 60 mL. What is this client's ejection fraction (EF)?

50%

Nitroglycerin is the drug of choice in treating angina. What does nitroglycerin release into the vascular smooth muscle of the target tissues?

Nitric oxide

A client has prominent jugular veins. What type of medical problem is associated with prominent jugular veins?

Right-sided heart failure

The nurse identifies the blood vessel layer that constricts to regulate and control diameter as:

Tunica media

Preload, the stretch on the heart before contraction, is largely determined by which factor?

Venous blood return