prep u ch 17

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

Long-term compensatory regulation of blood flow

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

• Mitral • Tricuspid

Which of the following factors affect cardiac performance? Select all that apply.

• Preload • Afterload • Myocardial contractility

As part of their orientation to a cardiac care unit, a group of recent nursing graduates is receiving a refresher in cardiac physiology from the unit educator. Which of the following teaching points best captures a component of cardiac function?

"The diastolic phase is characterized by relaxation of ventricles and their filling with blood."

The cardiologist just informed a patient that they have a reentry circuit in the electrical conduction system in their heart. This arrhythmia is called Wolff-Parkinson-White (WPW) syndrome. After the physician has left the room, the patient asks the nurse to explain this to them. Which of the following statements most accurately describes what is happening?

"There is an extra, abnormal electrical pathway in the heart that leads to impulses traveling around the heart very quickly, in a circular pattern, causing the heart to beat too fast."

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

25% - 30%

The venous system is a low pressure system that returns blood to the heart. What is the normal right atrial pressure?

0mm Hg

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%

The stroke volume is the amount of blood ejected with every contraction of the ventricle. It is broken down into quarters. What is the approximate amount of the stroke volume per quarter?

60%, 20%, 20%, and little blood

A number of patients on an acute cardiac care unit of a hospital have diagnoses of impaired cardiac conduction. Which of the following patients is most deserving of immediate medical attention?

A 69-year-old woman who has entered ventricular fibrillation.

In which of the following situations would blood be most likely to be rapidly relocated from central circulation to the lower extremities?

A client is helped out of bed and stands up.

A client is admitted to the cardiac unit with a diagnosis of pericarditis. The nurse is teaching the patient about the anatomical location of the infection. The nurse evaluates the effectiveness of the teaching when the client correctly identifies which of the following as the location of the pericardium?

A membranous sac that encloses the heart

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 of the following assessments should the nurse complete?

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

Which of the following 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

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 patient's electrocardiogram monitor begins to sound an alarm and shows sustained ventricular fibrillation. The patient is unconscious and without a pulse. Which of the following priority interventions should the nurse take?

Defibrillate the patient

When explaining to a patient why they only had minimal muscle damage following 99% occlusion of the left anterior descending artery, the nurse will explain this is primarily due to:

Development of collateral circulation that build channels between some of the smaller arteries usually when the flow is decreased gradually.

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

A 72 year old female has been told by her physician that she has a new heart murmur that requires her to go visit a cardiologist. Upon examination, the cardiologist informs the patient that she has aortic stenosis. After the cardiologist has left the room, the patient asks, "What caused this [aortic stenosis] to happen now?" The clinic nurse responds:

Heart murmurs result from tumultuous flow through a diseased heart valve that is too narrow and stiff. This flow causes a vibration called a murmur.

Which of the following enzymes has a powerful vasodilator effect on arterioles and increases capillary permeability?

Histamine

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 client has experienced sympathetic nervous stimulation of the heart. The nurse is aware that the client may manifest which of the following?

Increased heart rate and increased contractility

A nursing instructor is explaining arterial circulation to a group of nursing students. Which of the following is the most appropriate information for the nurse to provide?

It contains one sixth of the total blood volume.

Which of the following is true regarding pulmonary circulation?

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

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

Laminar

ECG monitoring has been found to be more sensitive than a client's report of symptoms when identifying transient ongoing myocardial ischemia. Why is this?

Most ECG-detected ischemic events are clinically silent.

The pericardium is a tri-layer sac. Which layer prevents acute dilation of the heart chambers and exerts a restraining effect on the left ventricle?

Outer fibrous layer

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

A client has had an acute myocardial infarction. The brother of the client has a history of angina. The client asks how they will know if the 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.

Which of the following is the correct sequence for blood flow through the heart?

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

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

Right sided heart failure

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

When trying to explain to a new dialysis patient the movement of substances through the capillary pores, the nurse will explain that in the kidneys, the glomerular capillaries have:

Small openings that allow large amounts of smaller molecular substances to filter through the gomeruli.

The health care provider is concerned that a client has developed a decrease in cardiac output. Cardiac output may be calculated as:

Stroke volume × heart rate

A 20-year-old college student, with no past medical history, arrives at the emergency room complaining of severe palpitations and dizziness that started this morning following a night of studying. The student is very upset that this is happening because the final exams are the following day. The cardiac monitor shows a heart rate of 110, regular rhythm with occasional premature ventricular complexes. The nurse explains to the student that this can happen in healthy hearts and is usually caused by stimulation of which of the following?

Sympathetic nervous system

A pathologist is examining histological (tissue) samples from a client with an autoimmune disease. Which of the following characteristics of muscle samples would signal the pathologist that the samples are cardiac rather than skeletal muscle?

The cells have a poorly defined sarcoplasmic reticulum.

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.

A group of nurses is taking a critical care course in cardiac electrophysiology. The instructor is reviewing action potential and the risk of arrhythmias and states that if an electrical impulse fires just after the relative refractory period, during the supernormal excitatory period, cardiac arrhythmias could result. Locate the supernormal excitatory period on the first complex on the rhythm strip.

The supernormal excitatory period, which occurs during the "T" wave on the ECG, is a vulnerable time during the cardiac action potential when even a weak stimulus can initiate potentially lethal cardiac arrhythmias. The ability to accurately evaluate cardiac rhythms and identify potential rhythm concerns may prevent the development of arrhythmias and improve client outcomes.

Hypoxia is said to have a negative inotropic effect on the heart, which means:

There will be interference in the generation of ATP, which is needed for muscle contraction

The nurse identifies the blood vessel layer that constricts to regulate and control diameter as which of the following?

Tunica media

Which of the following arrhythmias is considered to be the most fatal and requires immediate treatment?

Ventricular fibrillation

The nurse is reviewing the circulatory system. Which statements are correct about the functional organization of the circulatory system? Select all that apply.

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

Valves in the veins prevent retrograde flow. In which veins are there no valves? Select all that apply.

• Abdominal • Thoracic

As the needs of the body change, the heart's ability to increase output needs to change too. This ability in the heart depends on what factors? (Select all that apply.)

• Cardiac contractility • Heart rate • Preload • Afterload

The heart consists of four valves. Which are the semilunar values? Select all that apply.

• Pulmonary • Aortic