Chapter 42, Introduction to the Cardiovascular System

10. A client is admitted to the cardiac unit with a diagnosis of a myocardial infarction (MI). The nurse notes that the client is having regular premature ventricular contractions (PVCs). What would concern the nurse? A) Blood is not efficiently pumped from the heart with PVCs. B) Healing of the myocardium will be disrupted. C) PVCs usually cause severe pain. D) PVCs make it difficult to make a definitive diagnosis.

A

11. The nurse is caring for a client who is experiencing a backflow of blood from the left ventricle to the left atrium. How should the nurse best interpret this finding? A) The client's mitral valve is incompetent. B) The client is likely having premature ventricular contractions (PVCs). C) The client has increased preload. D) There is a deficit involving the tricuspid valve.

A

21. The nurse explains to a client that when sodium gates open along the cardiac cell membrane and sodium rushes into the cell, it results in the membrane no longer having a positive or negative side but being electrically the same on both sides. How does the nurse describe this period of the cardiac cycle to the client? A) depolarization B) repolarization C) polarity D) action potential

A

26. How does the nurse describe the cardiac action potential to a client? A) the cycle of depolarization and repolarization B) the time it takes from the firing of the sinoatrial (SA) node to the contraction of the ventricles C) the time between the contraction of the atria and the contraction of the ventricles D) the cycle of the firing of the atrioventricular (AV) node and the contraction of the myocardium

A

28. The nurse explains how the myocardium receives oxygen to a client in the constant care unit. The nurse explains to the client that the coronary arteries receive blood when? A) during diastole B) during systole C) when the heart is refractory D) when the aortic valve is open

A

29. A client asks the nurse to explain why the left ventricle is so much larger than the right ventricle. Which explanation will the nurse provide? A) "The left ventricle needs to pump blood through the entire body." B) "The left ventricle needs to pump blood through both lungs." C) "The right ventricle pumps blood through the entire body." D) "The right ventricle pulls blood back into the heart from the lungs."

A

30. The nurse is caring for a client with hypertension and recognizes this will have what impact on afterload? A) increased afterload B) reduced afterload C) unchanged afterload D) initial increase and then decrease in afterload

A

32. The client has an excessive production of antidiuretic hormone (ADH). The nurse expects what change in the client's blood pressure? A) Increase in the blood volume which will then cause an increase in the blood pressure. B) Increase in water and sodium excretion which will then cause a decrease in the blood volume. C) Increase in ADH production which will then cause an increase in renin production and hypertension. D) Increase in ADH production which will then decrease angiotensin production and hypotension.

A

6. A client, diagnosed with heart failure, would like the nurse to explain what the diagnosis means. How should the nurse explain heart failure? A) The heart muscle cannot pump as effectively as normal, causing a backup of blood. B) The hydrostatic pressure pushing fluid out of the capillaries is lower than the oncotic pressure. C) The decrease in venous pressure from the backup of blood increases hydrostatic pressure. D) Increased protein leads to reduced oncotic pressure and inability to pull fluid into the system.

A

16. The nurse is providing health education to a client who has been newly diagnosed with hypertension. When explaining the need for vigilant blood pressure control, the nurse should describe what potential consequence of hypertension? Select all that apply. A) risk for damage to vessel walls B) heart valve failure C) arrhythmias D) increased cardiac workload E) impaired coronary circulation

A,D

18. The nurse is caring for a client who has been diagnosed with coronary artery disease (CAD) and hypertension. The nurse explains to the client that CAD disables what process that controls blood pressure? A) capacitance system B) ability of the arterioles to increase or decrease resistance C) oncotic pressure D) ability of the venules to return blood to the veins

B

31. The client's blood pressure is low due to shock and vasodilation of the blood vessels. The nurse recognizes this will have what impact on preload? A) Preload will increase. B) Preload will decrease. C) Preload will depend on afterload. D) Preload will vary with activity of the client.

B

8. The nurse is caring for a client with traumatic injuries who is hypotensive. What pathophysiologic change could be the cause of the client's health problem? A) activation of the renin-angiotensin-aldosterone system B) insufficient antidiuretic hormone (ADH) C) deficient natriuretic peptides D) increased tissue oxygen demand

B

27. The nurse teaches a group of clients on the systems that control blood pressure. Which system will the nurse include in the discussion? Select all that apply. A) the capacitance system B) aldosterone-antidiuretic hormone (ADH) system C) difference between the systolic and the diastolic readings D) stimulus from the sympathetic system E) reflex control of blood volume

B, D, E

14. The nurse is caring for a client who has been diagnosed with severe coronary artery disease (CAD) and is experiencing chest pain. What forces could potentially be lowered to reduce oxygen consumption? Select all that apply. A) pulse pressure B) afterload C) stretch on the ventricles D) heart rate E) preload

B,C,D,E

12. A client's blood pressure is 161/106 mmHg. How would the nurse explain how this blood pressure will affect the client's cardiac workload? A) Increased systolic pressure will increase the client's heart rate. B) The increased blood pressure causes an increase in preload and cardiac workload. C) Increased afterload creates increased oxygen consumption. D) The heart will have to pump harder to overcome the mitral and tricuspid valves.

C

17. The nurse is caring for an older adult client who is displaying alterations in the conduction of impulses in the SA node. What assessment finding is most likely? A) cardiac gallop B) tachycardia C) dysrhythmia D) heart murmur

C

19. The nurse is explaining cardiac function to a client. What will the nurse indicate is a necessary property for the muscle to function efficiently when it is acting as a pump? A) antagonistic contraction B) antagonistic relaxation C) simultaneous contraction D) simultaneous relaxation

C

23. The client has had a myocardial infarction. The nurse realizes the significance of this injury is damage to what layer of the heart? A) endocardium B) pericardium C) myocardium D) epicardium

C

24. The nurse is caring for a client with decreased blood flow to the kidneys. The client's blood pressure has been in the range of 150/100 mmHg for several days. What is the most likely cause of this client's hypertension? A) lack of antidiuretic hormone (ADH) B) vasodilation C) release of renin D) increased natriuretic peptide levels

C

3. A client is scheduled to have a pacemaker implanted. The nurse knows this intervention will compensate for what cardiac deficit? A) increased preload B) increased afterload C) dysfunction of the SA node D) absence of sarcomeres

C

33. A dysfunction of a client's autonomic nervous system has resulted in the arterial resistance system performing inadequately. What assessment will the nurse perform to monitor the client's condition? A) heart rate B) heart rhythm C) blood pressure D) level of consciousness

C

4. The nurse is describing some of the key characteristics of cardiac cells to a client. What action does the nurse use to explain cardiac cells' performance? A) Synthesize a small amount of glucose in order to prolong their survival. B) Survive in an ischemic state for four to six times longer than skeletal muscle cells. C) Spontaneously generate an action potential. D) Produce neurotransmitters that stimulate electrical impulses independent of external stimulation.

C

9. The nurse is caring for a client whose blood pressure is 120/78 mmHg. What would the nurse document as the client's pulse pressure? A) 120 mmHg B) 99 mmHg C) 42 mmHg D) 198 mmHg

C

1. Which structure should the nurse identify as separating the client's right half of the heart from the left? A) auricle B) bundle of His C) syncytia D) septum

D

13. The nurse takes the client's pulse and finds a regular rate at 44 beats/min. What area of the heart is controlling this client's heart rate? A) the atrioventricular (AV) node B) the bundle of His C) the Purkinje fibers D) the sinoatrial (SA) node

D

15. The client has bilateral ankle edema resulting from heart failure (HF). The nurse interprets this as indicating what likely cause? A) The client's pulse pressure is less than 30 mmHg. B) The oxygen demand of the client's heart exceeds oxygen supply. C) Fluid pressure is forcing plasma in the client's interstitial space. D) Hydrostatic pressure is exceeding oncotic pressure.

D

2. A nurse is caring for a neonate born with a congenital heart anomaly. To better help the parents understand the impact of this disorder, the nurse begins by describing the usual flow of blood through the heart. What course should the nurse describe? A) Deoxygenated blood from the lungs enters the left atrium through the pulmonary artery. B) Oxygenated blood from the lungs enters the right atrium through the pulmonary veins. C) Deoxygenated blood from the lungs enters the right atrium through pulmonary veins. D) Oxygenated blood from the lungs enters the left atrium through the pulmonary veins.

D

25. The nurse is assigned to watch the cardiac monitors in the constant care unit and notes four different clients displaying arrhythmias. Which arrhythmia is the nurse's highest priority? A) sinus bradycardia at a rate of 54 beats/min B) atrial flutter C) sinus tachycardia at a rate of 108 beats/min D) ventricular fibrillation

D

5. A client has developed left-sided heart failure. What assessment finding should the nurse attribute to this health problem? A) increased abdominal girth B) irregular heart rhythm C) pitting edema to the ankles and feet D) shortness of breath

D

7. A client who is on a ventilator has been declared brain dead. A family member asks the nurse how the heart can still function if the client's brain is dead. What statement is an appropriate response by the nurse? A) "Death of the heart will follow brain death in a few hours." B) "The heart is controlled by the brainstem, not the upper levels of the brain." C) "The cardiovascular center in the medulla is not be reflected in any tests." D) "The heart is self-controlled and does not depend on the brain to beat."

D

22. The nurse explains the normal conduction pathway to a client who has been diagnosed with dysrhythmia. Place these parts of the heart in the current sequence of cardiac conduction. Use each option once. A) bundle of His B) AV node C) Purkinje fibers D) SA node

D, B, A, C

20. The nurse is providing care for a client with a recent cardiac diagnosis and is explaining the structure and function of the heart. Place the events of circulation in the correct sequence, beginning with the entry of blood into the right atrium. Use each item once. A) Oxygenated blood enters the left atrium. B) Blood passes through the tricuspid valve. C) Blood is pumped from the right ventricle to the lungs. D) Blood passes through the mitral valve. E) Deoxygenated blood returns to the heart from the venous system. F) Oxygenated blood is pumped into circulation.

E, B, C, A, D, F