Patho Exam 3 Ch 17
The heart is a four-chambered pump. What is the function of the right ventricle?
Pumps blood to the lungs.
A physician is teaching a group of medical students about the physiological basis for damage to the circulatory and neurological system that can accompany hypotension. Which of the following responses by a student would warrant correction by the physician?
"Tension and vessel thickness increase proportionately."
A nurse educator is teaching a group of nurses at a long term care facility about atrial fibrillation in light of its prevalence in older adults. Which of the following statements by the nurses would the educator most want to correct?
"The contraction of the ventricles and the atria can range from 400-600 beats per minute."
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 the 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 is lying in a recumbent position. In this patient approximately how much total blood volume is in the central circulation?
25%-30%.
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 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.
Of the following factors, which one represents the contractile force used by the muscle in order to move blood into the aorta?
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'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.
Select the correct sequence of blood return to the heart.
Capillaries, venules, veins, right atrium.
Which of the following blood vessels function without the benefit of having walls comprised of three muscular layers?
Capillaries.
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.
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 client comes to the emergency department with symptoms of a "racing" heart and feeling "anxious." The nurse places the client on a heart monitor and observes a heart rate of 134. The nurse monitors for which of the following complications related to tachycardia? Select all that apply.
Decrease in blood pressure, decrease in oxygen levels, decrease in stroke volume, and risk for angina.
A nurse is monitoring a patient with a consistent and regular heart rate of 128 beats/min. Which of the following physiologic alterations would be consistent with this finding?
Decrease in ventricular filling time and blood pressure.
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.
During a physiology lecture, a nursing student hears about the different forms of muscle tissue. Which description best describes vascular smooth muscle?
Depolarization of smooth muscle relies largely on extracellular calcium.
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.
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.
Which of the following enzymes has a powerful vasodilator effect on arterioles and increases capillary permeability?
Histamine.
The nurse is assisting a patient who had a myocardial infarction 2 days ago during a bath. The patient suddenly lost consciousness and the nurse was unable to feel a pulse. Cardiopulmonary resuscitation was begun and the patient was connected to the monitor with a gross disorganization without identifiable waveforms or intervals observed. Which of the following is a priority intervention at this time?
Immediate defibrillation.
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 the greatest diagnostic limitation of an electrocardiogram (ECG)?
It documents only current cardiac function.
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.
The heart is a four-chambered pump. Which chamber of the heart pumps blood into the systemic circulation?
Left ventricle.
The physician states that a client has adequate collateral circulation. The nurse interprets this as:
Long-term compensatory regulation of blood flow.
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 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.
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 x 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.
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, and the venous system collects deoxygenated blood from the tissues.
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.
The circulatory system is a closed system that is divided into two parts. Which statement is correct about the closed system?
The low pressure pulmonary circulation links circulation and gas exchange in the lungs.
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 cardiac nurse is describing to a colleague the relationship between the law of Laplace and a client's peripheral vascular disease. To express the law of Laplace in an equation, the nurses need to know which values? Select all that apply.
The tension that exists in the walls of a blood vessel, The radius of a particular blood vessel, and The pressure that exists in the lumen of a vessel.
A client is visiting the primary physician and appears extremely nervous. The intake nurse does his vital signs and notes an increase in both his heart rate and blood pressure. In an effort to better understand the client's presenting signs and symptoms the nurse asks the client about his concerns and the client states that the person who performed his pre-visit told him that he had an arrhythmia. Which is the most therapeutic response about cardiac arrhythmias that the nurse can make?
They can occur in diseased or healthy hearts.
The heart consists of four valves. Which are the heart's atrioventricular valves? Select all that apply.
Tricuspid and mitral.
The nurse identifies the blood vessel layer that constricts to regulate and control diameter as which of the following?
Tunica media.
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.
Which of the following arrhythmias is considered to be the most fatal and requires immediate treatment?
Ventricular fibrillation.
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.
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%.
Blood flow in the circulatory system depends on a blood volume that is sufficient to fill the blood vessels and a pressure difference across the system that provides the force to move blood forward. What is the total blood volume in an adult?
70 to 75 mL/kg.
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.
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 heart consists of four valves. Which are the semilunar values? Select all that apply.
Pulmonary and Aortic.
