Cardiovascular system
Which of the following classes of drugs is most widely used in treatment of cardiomyopathy?
Beta-adrenergic blockers
Which of the following parameters is the major determinant of systolic blood pressure?
cardiac outptut
What would a chest x ray reveal on patient with biventricular congestive heart failure?
cardiomegaly and pulmonary congestion
complications of uncontrolled hypertension include
cerebrovascular accidents, ventricular hypertrophy, chronic renal failure
Baroreceptors in the carotid artery walls and aorta respond to which of the following conditions?
changes in blood pressure
The heart controls the direction of blood flow. What is the role of the aortic valve?
controls direction of blood flow from the left side of the heart to the systemic circulation
A client has prominent jugular veins. What type of medical problem is associated with prominent jugular veins?
Right-sided heart failure
The electrical activity of the heart is recorded on the ECG. what does the T wave on the ECG represent?
Repolarization of the ventricles
In essential hypertension, the kidneys contribute to the hypertensive state by
releasing renin in response to decreased renal perfusion
The kidneys help to maintain the hypertensive state by
releasing renin in response to decreased renal perfusion
the diameter of blood vessels MOST directly affects
resistance
Venous return decreases if
right arterial pressure increases
Which sequence is the correct pathway for blood flow through the heart?
right atrium-->tricuspid valve-->right ventricule-->pulmonary artery-->lung-->pulmonary vein-->left atrium-->mitral valve-->left ventricle-->aorta
How does Starling's law apply to heart failure?
An increased venous return dilates the ventricle to a point of impaired contraction
What is the term used to describe an enlargement of the heart muscle?
Cardiomegaly
An increase in venous return most directly affects
stroke volume
Which of the following terms describes the force against which the ventricle must expel blood?
Afterload
What is the function of capillaries in the system?
exchange of gases, nutrients, and wastes
which are the hearts atrioventricular valves?
mitral valve tricuspid valve
What will help to improve respiratory functions of someone with biventricular congestive heart failure?
placing patient in upright position
Which are the semilunar valves?
pulmonary and aortic
Which of the following is a backward effect of left heart failure?
pulmonary edema
The heart is a 4 chamber pump. what is the function of the right ventricle?
pumps blood to the lungs
Activation of the aortic and carotid baroreceptors by increased blood pressure results in
reduced heart rate
Sympathetic nervous system reflex tachycardia is detrimental because it
reduces filling time and stroke volume, therefore decreasing cardiac output
Which of the following terms is used to describe the amount of stretch on the myocardium at the end of diastole?
Preload
As heart rate increases....
. End diastolic volume decreases (because it allows less time for ventricular filling and low venous return)
your patient has a heart rate of 90 bpm, an ejection fraction of 50%, and an end diastolic volume of 100ml. What is his cardiac output?
4500 ml/min
Considering the PQRST complex of an electrocardiogram (ECG), which of the following letter designations represents atrial depolarization?
P wave
Cardiac output (CO) is used to measure efficiency of heart as a pump. What is the equation used to express CO?
CO=SV x HR
Which of the following illnesses is the leading cause of death in the US?
Coronary artery disease
the MOST common cause of heart failure is
Coronary artery disease
when do coronary arteries primarily receive blood flow?
During diastole
Which of the following cardiac conditions does a 4th heart sound (S4) indicate?
Failure of the ventricle to eject all blood during systole, resulting in decreased compliance of ventricle
When the semilunar valve opens it signals onset of ejection period. The aortic pressure reflects changes in the ejection of blood from which part of the heart?
Left ventricle
Atherosclerosis impedes coronary blood flow by which of the following mechanisms?
Plaques obstruct the artery
A physician has ordered the measurement of a cardiac client's electrolyte levels as part of the client's morning blood work. Which statement best captures the importance of potassium in the normal electrical function of the client's heart?
Potassium is central to establishing and maintaining the resting membrane potential of cardiac muscle cells
What is the function of the right atrium?
Receives blood returning to the heart from the systemic circulation
Which of the following correctly describes the reflex responses of the body to decreased cardiac output?
Release of renin by the kidneys to increase blood volume and pressure
What 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
Which of the following is called the pacemaker of the heart?
Sinoatrial (SA) node
Stimulation of the SNS produces which of the following responses?
Tachycardia and increases contractility
The nurse identifies the blood vessel layer that constricts to regulate and control diameter as:
Tunica media
Which statements are correct about the functional organization of the circulatory system?
VENOUS system collects DEOXYGENATED blood FROM tissues ARTERIAL system distributes OXYGENATED blood TO tissues
Preload, the stretch on the heart before contraction, is largely determined by which factor?
Venous blood return
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
What is a peridcardium?
a membraneous sac that encloses around the heart
While intubated for surgery, a client 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
What ways is an ACE inhibitor therapeutic for someone with heart failure?
decreases workload decreases preload decreases myocardial remodeling
When explaining to a client why there was only minimal muscle damage following 99% occlusion of the left anterior descending artery, the nurse will explain that 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
secondary hypertension
has a specific cause that may be treatable
essential hypertension is
idiopathic
If the sympathetic nervous system stimulation of the heart predominates over parasympathetic nervous stimulation, the heart will:
increase its rate and force of contraction
Which of the following phsyiologic changes would increase cardiac work, but not increase cardiac output?
increased afterload
Renal pathology associated with hypertension can be identified by
increased blood, urea, and creatinine levels
The primary pahophysiologic mechanism in heart failure is
ineffectiveness of the heart to pump blood
Backwards effects of right heart failure include all of the following:
jugular venous distension dependent pitting edema hepatomegaly and ascites
Which of the following factors can cause blood pressure to drop to normal levels?
kidneys' excretion of sodium and water
Which of the following arteries primarily feeds the anterior wall of the heart?
left anterior descending artery
Right heart failure is caused by:
left heart failure COPD mitral stenosis ischemic cardiomyopathy
Starling's law concerns the relationship between
length of cardiac muscle and strength of the contraction
The first mode of treatment for a patient with an average blood pressure of 150/96 should be
lifestyle changes
Pregnancy induced hypertension
may rapidly progress to seizure, coma, and death
impulses traveling to the heart that will increase heart rate are conducted by
sympathetic nerves
Expected physical assessment findings of someone with bi ventricular congestive heart failure
tachycardia, tachypnea, and dyspnea (on exertion) pitting edema in the ankles and feet inspiratory fine crackles on chest auscultation
During atrial systole...
the AV valves are open
The diastolic blood pressure represents
the pressure in the aorta when the ventricles are relaxed
in the normal cardiac cycle
the two atria contract simultaneously while the ventricles are relaxed
Which of the following parameters is the major determinant of diastolic blood pressure?
vascular resistance (impedance of blood flow by the arterioles)
