Patho Exam #4 questions!
A patient's blood pressure is persistently in the range of 130-135 mm Hg systolic and 85-88 mm Hg diastolic. The nurse knows that which of the following conditions correctly describes this patient's blood pressure?
Prehypertension
A large increase in heart rate can cause:
decreased stroke volume
Chronic stable angina, associated with inadequate blood flow to meet the metabolic demands of the myocardium, is caused by:
Fixed coronary obstruction
The nurse knows that the primary long term regulation of blood pressure is exerted by which of the following?
The kidneys
A 52-year-old man who is moderately obese has recently been diagnosed with hypertension by his primary care provider. Which of the client's following statements indicates a need for further health promotion teaching
"I'm resolving to eat organic foods from now on and to drink a lot more water."
A nurse is performing client health education with a 68-year-old man who has recently been diagnosed with heart failure. Which of the following statements demonstrates an accurate understanding of his new diagnosis?
"I'm trying to think of ways that I can cut down the amount of salt that I usually eat."
A client with heart failure asks, "Why am I taking a 'water pill' when it's my heart that is having a problem?" While educating the client about the Frank-Starling mechanism, which of the following explanations is most appropriate to share?
"Since your heart is not pumping efficiently, the kidneys are getting less blood flow; therefore, the kidneys are holding on to sodium and water."
The nurse knows that acute regulation of blood pressure involves which physiological processes? Select all that apply.
1. arterial chemoreceptors 2. adrenergic (sympathetic) stimulation
By definition, hypertension is systolic blood pressure of _______ mm Hg or higher or diastolic blood pressure of ______ mm Hg or higher.
140;90
A client has had a myocardial infarction MI that damaged the right atrium, which has interfered with the SA node. The compensatory mechanism, the AV node, becomes the pacemaker of the heart and beats how many times/minute
45 to 50 beats/minute
Which of the following patients is at greatest risk for orthostatic hypotension?
A 66 year old post-surgery patient on bed rest
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.
Which of the following types of aortic aneurysms is the most common?
Abdominal aortic
Heart muscle differs from skeletal muscle tissue by being able to generate:
Action potentials
The most common causes of left-sided heart failure include:
Acute myocardial infarction and hypertension
A client is transported to the emergency department in respiratory distress after eating peanuts. The following interventions are ordered by the health care provider. Which intervention should the nurse complete first?
Administer epinephrine (adrenaline)
Which of the following is a nonmodifiable risk factor for the development of primary hypertension?
African American race
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
Which of the following clients should most likely be assessed for orthostatic hypotension
An 80-year-old elderly client who has experienced two falls since admission while attempting to ambulate to the bathroom
Which of the following patients should most likely be assessed for orthostatic hypotension?
An elderly patient who has experienced two falls since admission while attempting to ambulate to the bathroom.
A post surgical client reports calf pain combined with the emergence of swelling and redness in the area, which have culminated in a diagnosis of deep vein thrombosis. What treatment options will be of greatest benefit to this client
Anticoagulation therapy and elevation of the leg
Following several weeks of increasing fatigue and a subsequent diagnostic workup, a client has been diagnosed with mitral valve regurgitation. Failure of this heart valve would have which of the following consequences?
Backflow from the left ventricle to the left atrium
A nurse is participating in a health fair and is addressing many of the varied factors that can contribute to hypertension. The nurse should be cognizant of the higher incidence and prevalence of hypertension in which groups?
Blacks and South Asians
Cardiac output is used to measure the efficiency of the heart as a pump. What is the equation used to express CO?
CO = SV x HR
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
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
A client is receiving home care for the treatment of a wound on the inside of her lower leg that is 3 cm in diameter with a yellow wound bed and clear exudate. Assessment of the client's legs reveals edema and a darkened pigmentation over the ankles and shins of both legs. What is this client's most likely diagnosis
Chronic venous insufficiency
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
A patient who experienced an ST elevation myocardial infarction (STEMI) received fibrinolytic therapy with streptokinase. Which of the following manifestations alerts the nurse to a developing complication?
Decreased level of consciousness
A client consistently has an elevated systolic BP greater than 150 mm Hg but a diastolic pressure in the 80s. The health care provider should be assessing for which of the following complications?
Crackles in bilateral lung bases caused by left-sided heart failure
Which manifestation of left-sided heart failure can be diagnosed by examination of the lips and mucous membranes?
Cyanosis
The client has been diagnosed with impaired blood flow in the deep venous channels of her legs. The nurse explains that which of the following is the most common cause of this condition?
DVT
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
The client is immobilized following a hip injury and has begun demonstrating lower leg discoloration with edema, pain, tenderness, and increased warmth in the midcalf area. He has many of the manifestations of
Deep vein thrombosis
Which term describes an object which has been carried in the bloodstream to lodge in a vessel causing an obstruction
Embolus
In the days following a tooth cleaning and root canal, a client has developed an infection of the thin, three-layered membrane that lines the heart and covers the valves. What is this client's most likely diagnosis?
Endocarditis
The nurse is teaching a class on reduction of cardiovascular disease. Which of the following demonstrates an intervention that is cognizant of the modifiable risk factors for hyperlipidemia?
Going for a brisk walk with a friend and talking to him about continuing to exercise regularly.
Nearly everyone with pericarditis has chest pain. With acute pericarditis, the pain is abrupt in onset, sharp, and radiates to the neck, back, abdomen, or sides. What can be done to ease the pain of acute pericarditis?
Have the client sit up and lean forward.
A patient has developed atherosclerosis. The nurse knows that a major cause for this disorder is which of the following?
Hypertension
A patient's blood pressure reading is 142/91 mm Hg. How should the nurse classify the BP
Hypertension, stage I
A patient reports a recent onset of pain in the calf when climbing stairs. The pain is relieved when the patient sits and rests for about 2 minutes. The patient is then able to resume activities. The nurse suspects what condition
Intermittent claudication
Which of the following is true regarding pulmonary circulation?
It is a low-pressure system that allows for improved gas exchange.
The heart is a four-chambered pump. Which chamber of the heart pumps blood into the systemic circulation?
Left ventricle
The client with emphysema should be educated about changes in lung tissue that may include which of the following changes? Select all that apply.
Loss of elastic recoil. Difficulty exhaling due to inability to recoil. Increased lung compliance.
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.
One of the principal mechanisms by which the heart compensates for increased workload is:
Myocardial hypertrophy
Part of the ECG that indicates atrial depolarization
P wave
Part of the ECG that indicates the time it takes for the electrical signal to travel from the atrium to the ventricle
P-R interval
A patient with intermittent claudication experiences pain in the leg muscles while exercising that resolves within 10 minutes after stopping. The nurse recognizes that the ischemic pain is a result what disease?
Peripheral artery disease
Which of the following occurs during repolarization?
Positively charged K+ moves outward across the cell membrane
The heart is a four-chambered pump. What is the function of the right ventricle?
Pumps blood to the lungs
The rapidly conducting fibers that innervate the ventricles are:
Purkinje fibers
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
Assessment of an elderly female client reveals the presence of bilateral pitting edema of the client's feet and ankles and pedal pulses that are difficult to palpate. Auscultation of the client's lungs reveals clear air entry to bases, and the client's oxygen saturation level is 93%, and vital signs are within reference ranges. What is this client's most likely health problem
Right-sided heart failure
Which of the following is called the pacemaker of the heart?
Sinoatrial Node (SA)
A client who lives with angina pectoris has taken a sublingual dose of nitroglycerin to treat the chest pain he experiences while mowing his lawn. This drug facilitates release of nitric oxide, which will have what physiologic effect?
Smooth muscle relaxation of vessels
Venous thrombosis most commonly occurs in the lower extremities. Risk factors for venous thrombosis include which of the following?
Stasis of blood, hypercoagulability, vessel wall injury
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
Part of the ECG that represents ventricular repolarization
T wave
When lecturing to a group of students about the pathophysiological principles behind heart failure, the instructor explains that cardiac output represents:
The amount of blood the heart pumps each minute
The most important complication of atherosclerosis that may cause occlusion of small heart vessels is:
Thrombosis
Congenital heart defects can cause a right heart-to-left heart shunting of blood that results in increased:
Unoxygenated blood flow
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
A patient with chronic stable angina has received a prescription for sublingual (SL) nitroglycerin. The nurse tells the patient that orthostatic hypotension is a side effect of the drug. What should the nurse include in the patient's teaching about preventing complications associated with the side effect
avoid sudden changes in position after taking nitroglycerin to prevent falls
Select the response that best describes the pressure-sensitive receptors that respond to changes in the stretch of the vessel wall.
baroreceptors
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
Atherosclerotic peripheral vascular disease is symptomatic with at least 50% occlusion. The primary peripheral symptom, due to ischemia, is:
calf pain
The nursing instructor is teaching her nursing students about cardiac function and different heart diseases. Which of the following disease does she tell the students is caused by calcified scar tissue that develops between the visceral and parietal layers of the serous pericardium?
constrictive pericarditis
The client is immobilized following a hip injury and has begun demonstrating lower leg discoloration with edema, pain, tenderness, and increased warmth in the midcalf area. He has many of the manifestations of:
deep vein thrombosis
The health care provider is reviewing lab results of a client diagnosed with heart failure. The provider notes that the client's ANP and BNP levels have been increasing and remain significantly elevated. These results would be interpreted as:
he condition is getting progressively worse.
A client who has suffered a myocardial infarction is being treated in the emergency room. His pain remains severe even though he was given nitrates and oxygen. The physician now orders morphine for the pain. What method should the nurse to administer the morphine?
intravenous
While studying the heart the nursing instructor teaches about pericarditis. Which of the following does she tell the student best defines this disease?
it is an inflammatory process
The layer of the heart responsible for contraction is the
myocardium
Assessment of an elderly female client reveals the presence of bilateral pitting edema of the client's feet and ankles and pedal pulses that are difficult to palpate. Auscultation of the client's lungs reveals clear air entry to bases, and the client's oxygen saturation level is 93%, and vital signs are within reference ranges. What is this client's most likely health problem?
right sided heart failure
The plaques in a client's coronary arteries are plentiful, and most have small- to moderate-sized lipid cores with thick fibrous caps. This form of atherosclerosis is most closely associated with which of the following diagnoses?
stable angina
Which of the following vessel layers is made primarily of muscle?
tunica media
What is the cause of the heart sounds "lubb dubb"
vibrations caused by closure of the valves
When discussing the AV node's role in the electrical conduction of the heart with a client newly diagnosed with an AV block, which of the following statements are accurate? Select all that apply.
-A block at the AV bundle of His interferes with the normal delay of the impulse, thereby interfering with complete ejection of blood from the atria prior to ventricular contraction. -When there is an AV block, impulses from the atria and ventricles beat independently of each other so, the heart rhythm is usually chaotic and not regular.
A postsurgical client reports calf pain combined with the emergence of swelling and redness in the area, which have culminated in a diagnosis of deep vein thrombosis. What treatment options will be of greatest benefit to this client?
Anticoagulation therapy and elevation of the leg
A 56-year-old male patient has been diagnosed with hypercholesterolemia. Which of the following are the lab results that support this diagnosis?
Cholesterol 250 mg/dL and HDL 32 mg/dL
While teaching a client with new-onset right-sided heart failure, the nurse should educate the client to monitor for fluid accumulation by:
Weighing every day at the same time with same type of clothing
Which of the following clients would be considered at high risk for developing pneumonia (both community and hospital setting)? Select all that apply.
-A young adult in motorcycle accident with head injury requiring tracheostomy and mechanical ventilation. -A HIV-positive client with a WBC count of 2000 who has been camping near a commercial farm raising chickens for food. -A school-aged child with severe asthma controlled by steroids admitted for an exacerbation.
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 of the following physiologic principles?
you have a heart valve that is diseased
