Cardiac Function Practice Problems
Upon admission assessment, the nurse hears a murmur located at the fifth intercostal space, midclavicular line. The client asks, "What does that mean?" The nurse will base her answer on which physiologic principle?
"You have a heart valve that is diseased."
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."
Which of the following factors affect cardiac performance? Select all that apply.
- Preload - Afterload - Myocardial contractility
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
A client with a history of heart failure has been referred for an echocardiogram. Results of this diagnostic test reveal the following findings: heart rate 80 beats/minute; end-diastolic volume 120 mL; and end-systolic volume 60 mL. What is this client's ejection fraction?
50%
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 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%
A client with aortic insufficiency is experiencing an increase in afterload. The client will experience fatigue and activity intolerance due to:
resistance to ejection of blood from the heart.
In which situation is blood 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 with a diagnosis of secondary hypertension has begun to experience signs and symptoms that are consistent with decreased cardiac output. Which of the following determinants of cardiac output is hypertension most likely to affect directly?
Afterload
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%
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 physiological principle?
As the aneurysm grows, more tension is placed on the vessel wall, which increases the risk for rupture.
A client's echocardiogram identified a narrowed valve that has resulted in a decreased blood flow between the left atria and left ventricle. The nurse would interpret this as the:
Bicuspid valve
The efficiency of the heart as a pump often is measured in the amount of blood the heart pumps per minute. Which is the correct formula to figure out the cardiac output?
CO = SV x HR
A nurse is assessing a client and becomes concerned that the client may be experiencing heart failure. Which of the following would be the best indicator to determine pressure being exerted on the right side of the heart?
Central Venous Pressure
Which mechanism mediates long-term autoregulation of local blood flow in circulation?
Collateral Circulation
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
Following a hypertensive crisis, a client's family asks, "Why are the client's eyes so bloodshot?" The nurse responds that high arterial pressure:
Damages more fragile blood vessels like those in the eyes to the point of rupture
A large increase in heart rate can cause:
Decreased stroke volume
The nurse is assessing the electrical activity of the heart recorded on the ECG. What does the P wave represent?
Depolarization of the sinoarterial node
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 nurse is assessing a client's apical pulse. The nurse is palpating the point of maximum impulse between which ribs?
Fifth and sixth
A nurse is caring for a client following surgery. The central venous pressure (CVP) monitor indicates low pressures. Which action is a priority for the nurse to take?
Increase the IV fluid infusion per protocol.
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
The physician states that a client has adequate collateral circulation. The nurse interprets this as:
Long-term compensatory regulation of blood flow
Which of the following factors represents the amount of blood that the heart must pump with each beat and is determined by the stretch of the cardiac muscle fibers and the actions of the heart prior to cardiac contraction?
Preload
The nurse is teaching a client diagnosed with heart failure about preload. Which of the following would be the most appropriate information to provide?
Preload represents the volume work of the heart.
A nurse is teaching a client the correct technique for taking an arterial pulse. The nurse explains that the pulsations are:
Pressure pulses
Colloidal osmotic pressure acts differently than the osmotic effects of the plasma proteins. What is its action?
Pulls fluid back into the capillary
A nurse is caring for a client with right heart failure caused by pulmonary hypertension. Which hemodynamic parameter is most appropriate for the nurse to monitor?
Pulmonary arterial pressure (PAP)
The heart is a four-chambered pump. What is the function of the right ventricle?
Pumps blood to the lungs
The electrical activity of the heart is recorded on the ECG. What does the T wave on the ECG represent?
Repolarization of the ventricles
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
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
The health care provider is concerned that a client has developed a decrease in cardiac output. Cardiac output may be calculated as:
Stoke volume x heart rate
Which of the following is the difference between the end-diastolic and end-systolic volumes?
Stroke Volume
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 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.
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.
Which statement about vascular compliance is accurate?
Veins can act as a reservoir for storing large quantities of blood.
Preload represents the volume work of the heart and is largely determined by:
Venous blood return
A client has a blood pressure of 68/38 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
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 male client with a history of angina has presented to the emergency department with uncharacteristic chest pain, and his subsequent ECG reveals T-wave elevation. This finding suggests an abnormality with which of the following aspects of the cardiac cycle?
Ventricular repolarization
In the arterial-venous circulatory system, pressure is inversely related to which of the following?
Volume