porth patho final

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

Right sided heart failure

The distensibility of the blood vessel is the major factor in which of the vessel's characteristics?

Compliance

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 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."

As part of pre-surgical teaching for patients who are about to undergo a coronary artery bypass graft, a nurse is performing an education session with a group of surgical candidates. Which of the following teaching points best conveys an aspect of the human circulatory system?

"The blood pressure varies widely between arteries and veins, and between pulmonary and systemic circulation."

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 local athlete is getting prepared for the upcoming national track and field championships. Since this athlete is performing extreme exercise, what would be the most probable cardiac output?

16 to 36 L/minute

The heart is a four-chambered muscular pump. In one day, how many gallons of blood are pumped throughout the body?

1800

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

25% - 30%

A client has suffered chest injuries following a automobile accident. The chest injury has resulted in an increase in intrathoracic pressure. There can be a transient shift from the pulmonary to the systemic circulation of how much blood?

250 mL

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 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.

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

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 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

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

Which of the following blood vessels function without the benefit of having walls comprised of three muscular layers?

Capillaries

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

While intubated for surgery, a patient has inadvertently had his vagus nerve stimulated. What effect would the surgical team expect to observe?

Decreased heart rate as a result of parasympathetic innervation of the heart

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 grandmother, a cook at a nearby school, was recently hospitalized when she lost an extensive amount of blood in a work-related accident. The grandmother tells the nurse that she heard that she would keep feeling faint until the brain made more blood. The nurse knows that when the blood pressure dropped, the pressure in the carotid arteries decreased. This was detected by baroreceptors in the carotid arteries. What did the baroreceptors do?

Increase sympathetic stimulation of the heart and blood vessels

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.

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 suffered damage to his pericardium following a motor vehicle accident. Which consequence could be a possible complication of damaged pericardium that his care providers should assess for?

Impaired regulation of myocardial contraction

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 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 membranous sac that encloses the heart

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

The lymph system correlates with the vascular system without actually being a part of the vascular system. Among other things, the lymph system is the main route for the absorption of fats from the gastrointestinal system. The lymph system empties into the right and left thoracic ducts, which are the points of juncture with the vascular system. What are these points of juncture?

Junctions of the subclavian and internal jugular veins

Which of the following is the correct sequence for the generation of electrical impulses in the heart causing ventricular contraction?

SA node - AV node - bundle of His - bundle branches - Purkinje fibers

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

A nurse is assessing a female client and notes that her left arm is swollen from the shoulder down to the fingers, with non-pitting edema. The right arm is normal. The client had a left-sided mastectomy one year ago. Which of the following does the nurse suspect is the problem?

Lymphedema

Nitroglycerin is the drug of choice in treating angina. What does nitroglycerin release into the vascular smooth muscle of the target tissues?

Nitric oxide

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

Considering the PQRST complex of an electrocardiogram (ECG), which of the following letter designations represents atrial depolarization?

P wave

The nurse assesses the electrocardiogram for depolarization of the atria. What does the nurse expect to assess?

P wave above the baseline

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 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

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:

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

Analysis has shown that a client's right atrial pressure is 30 mmHG. What is the most likely conclusion that the client's care team will draw from this piece of data?

The pressure is excessive given that the right atrium should be at atmospheric pressure.

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 male patient with a history of angina has presented to the emergency department with uncharacteristic chest pain. His subsequent electrocardiogram (ECG) reveals T-wave elevation. This finding suggests an abnormality with which of the following aspects of the cardiac cycle?

Ventricular repolarization

An 80-year-old male client arrives for his yearly physical without any complaints and following the checkup the physician explains that he has noted atrial fibrillation (AF) on the client's ECG. Before the physician can explain the disorder the client becomes very upset and states he thinks he is going to die. The physician explains that atrial fibrillation involves the top chambers of the heart and that:

many people live with atrial fibrillation without even knowing they have it.

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

• Aortic • Pulmonary

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

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

Local control of blood flow is regulated by mechanisms that match blood flow to the metabolic needs of the tissue. Over the short term autoregulation controls flow through the synthesis of vasodilators and vasoconstrictors. Which components of the vascular system are involved in the short term control of blood flow? Select all that apply.

• Tissue • Smooth muscle • Endothelial cells

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

• Tricuspid • Mitral

Select the correct sequence of blood return to the heart.

Capillaries, venules, veins, right atrium

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 client is admitted to the emergency department after experiencing a motor vehicle accident and sustaining multiple injuries with significant blood loss. The nurse predicts that the client will display which of the following?

Decreased urinary output

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.

Resistance to flow is determined by the diameter of the blood vessels and the blood vessel itself. An equation has been developed for understanding the relationship between the diameter of the blood vessel, the viscosity of the blood, and resistance. What is the equation called?

Poiseuille law