Exam 3 Patho, Renal, Patho Ch 32, Pathophysiology II-Chapter 22 Cardiovascular
A 52-year-old male is diagnosed with primary hypertension. He has no other health problems. Present treatment would cause the nurse to anticipate administering which drug to the patient? Question options: A) A beta-adrenergic agonist B) An alpha-adrenergic agonist C) A diuretic D) A calcium channel agonist
C
A 60-year-old female was diagnosed with mitral stenosis. As a result, the nurse realizes the patient has incomplete emptying of the: Question options: A) Right atrium B) Right ventricle C) Left atrium D) Left ventricle
C
A newborn develops a murmur and cyanosis shortly after birth. She is diagnosed with pulmonic stenosis (PS) after an echocardiogram revealed narrowing of the pulmonary: Question options: A) Tree B) Artery C) Valve orifice D) Vein
C
A newborn is diagnosed with congenital heart disease. Which of the following intrauterine factors should the nurse focus on during the history that could have caused this disorder? Question options: A) Diabetes B) Alcohol exposure C) Viral infection D) Dextroamphetamine
C
A nurse is teaching about the heart. Which information should the nurse include? The chamber of the heart that generates the highest pressure is the: Question options: A) Right atrium B) Left atrium C) Left ventricle D) Right ventricle
C
The development of which characteristic is the first sign of puberty in girls? Question options: A) Menarche B) Pubic hair C) Thelarche D) Dysmenorrhea
C
The thoracic lymphatic duct drains into the: Question options: A) Left subclavian artery B) Right atrium C) Right subclavian vein D) Left subclavian vein
C
When a patient with left heart failure starts to have a cough and dyspnea, which principle should the nurse remember? Pulmonary symptoms, common to left heart failure, are a result of: Question options: A) Inflammatory pulmonary edema B) Decreased cardiac output C) Pulmonary vascular congestion D) Bronchoconstriction
C
When a staff member asks what the patent opening between the aorta and pulmonary artery in a fetus is called, how should the nurse reply? It is the: Question options: A) Foramen ovale B) Sinus venosus C) Ductus arteriosus D) Septal defect
C
Which organ should the nurse monitor closely since it is often the first to fail in patients with multiple organ dysfunction syndrome (MODS)? Question options: A) Liver B) Heart C) Lungs D) Pancreas
C
Which patient is most prone to multiple organ dysfunction syndrome (MODS)? In a patient with: Question options: A) Myocardial infarction (MI) B) Pulmonary disease C) Septic shock D) Autoimmune disease
C
Which statement correctly defines Eisenmenger syndrome? Question options: A) Left-to-right shunt B) Oxygenated blood flows into pulmonary circulation C) Deoxygenated blood flows into systemic circulation D) Correction of the VSD
C
Which statement is TRUE regarding sudden infant death syndrome (SIDS)? Question options: A) Peak age is 6 months of age. B) Higher frequency occurs during summer months. C) Young maternal age increases incidence. D) Incidence is unaffected by prenatal care received.
C
Which statement is true regarding gynecomastia in men? Question options: A) It may begin as a palpable mass anywhere on the chest. B) It affects less than 3% of the male population. C) Incidence is greatest among adolescents and older men. D) It generally indicates cancer.
C
Which statement regarding bronchiolitis is TRUE? Question options: A) In adults, it is usually caused by a virus. B) It is most common in chronic bronchitis. C) An inflammatory obstruction of small airways occurs. D) Bacterial infection is a causative agent.
C
Which muscle has a major role in respiration? Select all that apply. Question options: A)Sternocleidomastoid B)Trapezius C)External intercostal D)Diaphragm E)Scalene
C,D
Nephron
+1.2 million nephrons per kidney +Functional unit of the kidney -Superficial cortical nephrons -Midcortical nephrons -Juxtamedullary nephrons You can donate 1 Kidney
Ureters
+30 cm long +Long, intertwining muscle bundles +Pass obliquely though posterior aspect of bladder +Peristaltic activity - Avoid Backflow +Micturition compresses the lower end of the ureter to avoid urine reflux +Bladder is STerile unless you have a cather
Juxtaglomerular apparatus
+Controls RBF, GFR, and renin secrection +Juxtaglomerular cells +Macula densa
Glomerulus
+Filtration - Like Stomping on Grapes to make Wine. +Formation of primary urine - Not the urine you Pea because it hasnt been concentrated yet. +Located in the renal cortex - Outer layer
Glomerular filtration membrane
+Glomerular endothelium +Basement membrane +Capillary epithelium -Also referred to as podocytes or visceral epithelium -Filtration slits
Renal corpuscle
+Glomerulus +Bowman capsule +Mesangial cells- phagocytes
Structures of the Kidney
+Renal cortex +Renal medulla +Renal pyramids +Renal columns +Minor calyx +Major calyx +Renal pelvis
List Parts of the Kidneys
+Retroperitoneal +Renal capsule +Renal fascia +Hilum
A
A nurse recalls the chamber that receives blood from the systemic circulation is the: a. Right atrium b. Right ventricle c. Left atrium d. Left ventricle REF: p. 554 Oxygenated blood flows through the pulmonary veins. Oxygenated blood flows through the pulmonary veins, not the superior vena cava, which carries venous blood. Oxygenated blood flows through the pulmonary veins, not the pulmonary artery, which carries unoxygenated blood to the lungs. Oxygenated blood flows through the pulmonary veins, not the cardiac veins, which carry unoxygenated blood. REF: p. 554 7. A 20-year-old male underwent an echocardiogram to assess chest pain. Results revealed a congenital defect in papillary muscles. Which of the following would the nurse expect to occur? a. Closure of the semilunar valve b. Backward expulsion of the atrioventricular valves c. Closure of the atrioventricular valve d. Backward expulsion of the semilunar valves ANS: B The papillary muscles are extensions of the myocardium that pull the cusps together and downward at the onset of ventricular contraction, thus preventing their backward expulsion into the atria. Defects in the papillary muscles would not affect the semilunar valve closure. Defects in the papillary muscles do not affect the atrioventricular valves. The papillary muscles prevent backward expulsion into the atria. They do not affect the semilunar valves. REF: p. 554 8. A cardiologist is discussing valves with the staff. Which information should the cardiologist include? _____ are the anchors of the atrioventricular valves. a. Chordae tendineae cordis b. Great vessels c. Coronary ostia d. Trabeculae carneae ANS: A The atrioventricular valve openings are attached to the papillary muscles by the chordae tendineae cordis. The atrioventricular valve openings are attached to the papillary muscles by the chordae tendineae cordis. The great vessels are the vessels that bring blood to and out of the heart and are not attached to the chordae tendineae. The atrioventricular valve openings are attached to the papillary muscles by the chordae tendineae cordis, not the coronary ostia, which are openings in the aorta for the coronary arteries. The atrioventricular valve openings are attached to the papillary muscles by the chordae tendineae cordis, not the trabeculae carneae, which are a portion of the myocardium. REF: p. 554 9. Which statement indicates the nurse understands coronary ostia? The coronary ostia (the openings to the coronary arteries) are found in the: a. Left ventricle b. Inferior vena cava c. Coronary sinus d. Aorta ANS: D The ostia are found on the aorta. The ostia are found on the aorta, not the ventricle. The ostia are found on the aorta, not the vena cava. The ostia are found on the aorta, not the coronary sinus. REF: p. 556 10. The nurse is planning care for a patient with heart problems. Which information should the nurse remember? The _____ artery travels down the interventricular septum and delivers blood to portions of the left and right ventricle. a. Right coronary b. Circumflex c. Left anterior descending d. Cardiac ANS: C The left anterior descending artery delivers blood to the left and right ventricle. The left anterior descending artery, not the right coronary artery, delivers blood to the left and right ventricle. The left anterior descending artery, not the circumflex, delivers blood to the left and right ventricle. The left anterior descending artery, not the cardiac artery, delivers blood to the left and right ventricle. REF: p. 557 11. A 65-year-old male is transported to the ER for chest pain. An electrocardiogram reveals a prolonged QRS interval. What is the nurse monitoring when the nurse observes the QRS complex on the electrocardiogram? The QRS complex reflects: a. Ventricular activity b. Pulmonary artery closure c. Mitral valve opening d. Aortic valve closing ANS: A The QRS complex represents the sum of all ventricular muscle cell depolarizations. The QRS complex represents the sum of all ventricular muscle cell depolarizations, not the pulmonary artery. The QRS complex represents the sum of all ventricular muscle cell depolarizations; it does not reflect mitral opening. The QRS complex represents the sum of all ventricular muscle cell depolarizations; it does not reflect activity of the aortic valve. REF: p. 559 12. When a staff member asks where venous blood from the coronary circulation drains into, what is the best response by the nurse? The: a. Superior vena cava b. Inferior vena cava c. Right atrium d. Reft atrium ANS: C Unoxygenated blood from the coronary veins enters the right atrium through the coronary sinus. Unoxygenated blood from the coronary veins enters the right atrium through the coronary sinus. It does not flow into the superior vena cava. Unoxygenated blood from the coronary veins enters the right atrium through the coronary sinus. It does not flow into the inferior vena cava. Unoxygenated blood from the coronary veins enters the right atrium, not the left, through the coronary sinus. REF: p. 557 13. While viewing the electrocardiogram, the nurse recalls the _____ conducts action potentials down the atrioventricular septum. a. Bachmann bundle b. Bundle of His c. Sinoatrial node d. Atrioventricular node ANS: B The bundle of His conducts action potentials down the atrioventricular septum. The bundle of His conducts action potentials down the atrioventricular septum, not the Bachmann bundle. The bundle of His conducts action potentials down the atrioventricular septum; the sinoatrial node conducts the potential along the atria. The bundle of His conducts action potentials down the atrioventricular septum; the atrioventricular node conducts impulses to the ventricles. REF: p. 557 14. A 13-year-old female took a weight loss drug that activated the sympathetic nervous system. Which of the following assessment findings would the nurse expect? a. Decreased myocardial contraction b. Decreased heart rate c. Increased cardiac conduction d. Increased intranodal conduction time ANS: C Stimulation of the SA node by the sympathetic nervous system rapidly increases cardiac conduction. Stimulation of the sympathetic nervous system would increase myocardial contraction. Stimulation of the sympathetic nervous system would increase heart rate. Stimulation of the sympathetic nervous system would not affect conduction time within the node. These are inherent rates. REF: p. 560 15. A 50-year-old female received trauma to the chest that caused severe impairment of the primary pacemaker cells of the heart. Which of the following areas received the greatest damage? a. Atrioventricular (AV) node b. Sinoatrial (SA) node c. Bundle of His d. Ventricles ANS: B The SA node is considered the pacemaker of the heart. The SA node, not the AV node, is considered the pacemaker of the heart. The SA node is considered the pacemaker of the heart; the bundle of His is not involved. The SA node is considered the pacemaker of the heart; the ventricles are not involved. REF: p. 560 16. A 54-year-old male is diagnosed with left bundle branch block. Which of the following structures would not receive an electrical impulse? a. Atrioventricular (AV) node b. Sinoatrial (SA) node c. Bundle of His d. The left ventricle ANS: D The left bundle branch conducts impulses to the left ventricle. The left bundle branch conducts impulses to the left ventricle; the AV node feeds conduction of the bundles. The left bundle branch conducts impulses to the left ventricle; the SA node initiates conduction. The left bundle branch conducts impulses to the left ventricle; the bundle of His precedes the division of the left and right bundles. REF: p. 557 17. Which information by the nurse indicates a good understanding of depolarization? Depolarization of a cardiac muscle cell occurs as the result of: a. A decrease in the permeability of the cell membrane to ions b. The rapid movement of ions across the cell membrane c. A blockade by calcium ions d. Stimuli instigated during the refractory period ANS: B Depolarization is caused by the movement of electrically charged solutes (ions) across cardiac cell membranes. Permeability must be increased for movement to occur. A blockage of calcium ions would decrease depolarization. No cardiac action potential can be initiated in the refractory period. REF: p. 558 18. A cardiologist is teaching about the period that follows depolarization of the myocardium and represents a period during which no new cardiac potential can be propagated. What is the cardiologist describing? a. Absolute refractory b. Hyperpolarization c. Resting d. Threshold ANS: A A refractory period is the time during which no new cardiac action potential can be initiated by a stimulus. It follows depolarization. A refractory period is the time, not hyperpolarization, during which no new cardiac action potential can be initiated by a stimulus. It follows depolarization. Cardiac potential does rest, but the period is termed the refractory period. Threshold is related to depolarization. REF: p. 559 19. The nurse is reviewing a normal electrocardiogram. The nurse assesses the PR interval because it represents: a. Atrial depolarization b. Ventricular depolarization c. Onset of atrial activation to onset of ventricular activity d. "Electrical systole" of the ventricles ANS: C The PR interval represents the onset of atrial activation to the onset of ventricular activity. The P wave represents atrial depolarization. The QRS complex represents ventricular depolarization. The QT interval represents "electrical systole" of the ventricles. REF: p. 559 20. The _____ represents the sum of all ventricular muscle cell depolarization. a. PR interval b. QRS complex c. QT interval d. P wave ANS: B The QRS complex represents the sum of all ventricular muscle cell depolarizations. The PR interval represents the onset of atrial activation to the onset of ventricular activity. The QT interval represents "electrical systole" of the ventricles. The P wave represents atrial depolarization. REF: p. 559 21. When a student nurse asks the nurse how the cardiac electrical impulse normally begins, what is the most correct response? The cardiac electrical impulse normally begins spontaneously in the sinoatrial (SA) node because it: a. Has a superior location in the right atrium b. Is the only area of the heart capable of spontaneous depolarization c. Has rich sympathetic innervation via the vagus nerve d. Depolarizes more rapidly than other automatic cells of the heart ANS: D The electrical impulse normally begins in the SA node because its cells depolarize more rapidly than other automatic cells. Cardiac impulses occur in the SA node because its cells depolarize more rapidly than other automatic cells, not because of its superior location. Cardiac impulses occur in the SA node because its cells depolarize more rapidly than other automatic cells. The SA node is not the only area of the heart capable of spontaneous depolarization. Cardiac impulses occur in the SA node because its cells depolarize more rapidly than other automatic cells. It does have rich innervations, but by parasympathetic innervation from the vagus nerve. REF: p. 557 22. A 28-year-old female with seizure disorder has a vagus nerve stimulator implanted to help control seizure activity. Which of the following would the nurse also expect to occur? a. Increased speed of cardiac cycle b. Increased cardiac contractility c. Decreased vasodilation d. Decreased cardiac conduction ANS: D The vagus nerve releases acetylcholine. Acetylcholine causes decreased heart rate and slows conduction through the atrioventricular (AV) node. The vagus nerve releases acetylcholine. Acetylcholine causes decreased heart rate and slows conduction through the AV node, thus decreasing speed of the cardiac cycle. The vagus nerve releases acetylcholine. Acetylcholine causes decreased heart rate and slows conduction through the AV node, decreasing contractility. The vagus nerve releases acetylcholine. Acetylcholine causes decreased heart rate and slows conduction through the AV node; it does not cause vasodilation. REF: p. 560 23. A new drug is released to aid in weight loss. It stimulates the sympathetic system. The nurse monitors for an increased heart rate. The sympathetic system causes this by: a. Inhibiting the release of catecholamines b. Altering the threshold potential c. Decreasing the conduction time through the atrioventricular (AV) node d. Increasing the influx of calcium ANS: B The sympathetic system increases heart rate by altering the threshold potential. The sympathetic system increases heart rate by altering the threshold potential. It does not inhibit the release of catecholamines. The sympathetic system increases heart rate by altering the threshold potential. It does not decrease conduction through the AV node. The sympathetic system increases heart rate by altering the threshold potential. It does not increase the influx of calcium. REF: p. 560 24. A nurse assesses the heart after acetylcholine because the effect of acetylcholine on the heart is to: a. Decrease the refractory period b. Increase calcium influx c. Increase the strength of myocardial contraction d. Decrease the heart rate ANS: D Acetylcholine causes decreased heart rate and slows conduction through the atrioventricular (AV) node. Acetylcholine causes decreased heart rate and slows conduction through the AV node; it does not decrease the refractory period. It decreases calcium influx. Acetylcholine causes decreased heart rate and slows conduction through the AV node; it does not increase the strength of myocardial contraction. REF: p. 560 25. To help a nursing student differentiate cardiac muscle from skeletal muscle, which characteristic should the nurse use? One difference between cardiac muscle and skeletal muscle is that: a. Cardiac muscle cells are arranged in branching networks. b. Skeletal muscle cells have only one nucleus. c. Cardiac muscle cells appear striped. d. Skeletal muscle cells contain sarcomeres. ANS: A Cardiac cells are arranged in branching networks throughout the myocardium, whereas skeletal muscle cells tend to be arranged in parallel units throughout the length of the muscle. Cardiac muscle cells have only one nucleus, whereas skeletal muscle cells have many nuclei. Both cardiac and muscle cells appear striped. Both cardiac and muscle cells contain sarcomeres. REF: p. 560 26. A cardiologist is teaching about myocardial cells. Which information should the cardiologist include? _____ are thickened areas of the sarcolemma of myocardial cells that enable electrical impulses to travel in a continuous cell-to-cell fashion. a. Myosins b. Intercalated disks c. Troponin Ts d. I bands ANS: B Intercalated discs allow electrical impulses to be transmitted rapidly from cardiac fiber to cardiac fiber because the network of fibers is connected at these discs. Myosins are filaments that are a part of cardiac tissue. They do not play a role in conduction. Troponin Ts are involved in contraction, but are not part of the sarcolemma. I bands are a part of the filaments bud, which do not conduct impulses in a cell-to-cell fashion. REF: p. 560 27. _____ is the process by which an action potential in the plasma membrane of a myocardial cell triggers the events that directly cause contraction of the myocardial cells. a. Electrocontraction b. Intercalated communication c. Excitation-contraction coupling d. Myosin communication ANS: C Excitation-contraction coupling is the process by which an action potential in the plasma membrane of the muscle fiber triggers the cycle, leading to cross-bridge activity and contraction. Excitation-contraction coupling, not electrocontraction, is the process by which an action potential in the plasma membrane of the muscle fiber triggers the cycle, leading to cross-bridge activity and contraction. Excitation-contraction coupling, not intercalated communication, is the process by which an action potential in the plasma membrane of the muscle fiber triggers the cycle, leading to cross-bridge activity and contraction. Excitation-contraction coupling, not myosin communication, is the process by which an action potential in the plasma membrane of the muscle fiber triggers the cycle, leading to cross-bridge activity and contraction. REF: p. 562 28. The molecule that aids in bonding of the troponin complex to actin and tropomyosin is troponin: a. C b. I c. T d. M ANS: C Troponin T aids in the binding of the troponin complex to actin and tropomyosin. Troponin C contains binding sites for the calcium ions involved in contraction. Troponin I inhibits the ATPase of actomyosin. Troponin M is not a substance. REF: p. 563 29. A patient has searched on the internet for muscle contractions. Which information indicates a good understanding? Muscle contractions occur when there is a decreased: a. Distance between Z lines b. A band length c. Z line length d. H zone distance ANS: A Anatomically, contraction occurs when the sarcomere shortens, so adjacent Z lines move closer together. Anatomically, contraction occurs when the sarcomere shortens, so adjacent Z lines move closer together, not a decrease in A band length. Anatomically, contraction occurs when the sarcomere shortens, so adjacent Z lines move closer together, not a decrease in Z line length. Anatomically, contraction occurs when the sarcomere shortens, so adjacent Z lines move closer together, not a decrease in H zone distance. REF: p. 561 30. A nurse is discussing the pressure generated at the end of diastole. Which term is the nurse describing? a. Preload b. Afterload c. Systemic vascular resistance d. Total peripheral resistance ANS: B Preload is the volume and associated pressure generated in the ventricle at the end of diastole. B Preload, not afterload, is the volume and associated pressure generated in the ventricle at the end of diastole. Afterload is the resistance to ejection of blood from the left ventricle. Systemic vascular resistance is related to afterload. Total peripheral resistance increases afterload. REF: p. 563 31. Which principle should the nurse remember when planning nursing care for a patient with heart problems? As stated by the Frank-Starling law, there is a direct relationship between the _____ of the blood in the heart at the end of diastole and the _____ of contraction during the next systole. a. Pressure, duration b. Volume, force c. Viscosity, force d. Viscosity, duration ANS: B The Frank-Starling law of the heart describes the length-tension relationship of ventricular end-diastolic volume (VEDV) (preload) to myocardial contractility (as measured by stroke volume). The Frank-Starling law of the heart describes the length-tension relationship of VEDV (preload) to myocardial contractility (as measured by stroke volume). It does not refer to duration. The Frank-Starling law of the heart describes the length-tension relationship of VEDV (preload) to myocardial contractility (as measured by stroke volume). It does not refer to viscosity. The Frank-Starling law of the heart describes the length-tension relationship of VEDV (preload) to myocardial contractility (as measured by stroke volume). It does not refer to duration. REF: p. 563 32. Within a normal physiologic range, an increase in left ventricular end-diastolic volume would lead the nurse to monitor for: a. An increased force of contraction b. A decrease in cardiac output c. An increase in heart rate d. Heart failure ANS: A An increase in end-diastolic volume leads to an increased force of contraction because fibers are stretched to handle increased volume. Cardiac output would increase. Although volume increases, heart rate does not respond accordingly. An increase in end-diastolic volume would not lead to heart failure. Failure results in output decrease. REF: p. 563 33. While planning care for a heart patient, which principle should the nurse recall? Right ventricular afterload is affected by: a. Vascular resistance in the systemic vessels b. Right end-diastolic pressure c. Pressures in the vena cava d. Pulmonary vascular resistance ANS: D Right ventricular afterload is affected by pulmonary vascular resistance because this is the pressure the ventricle must pump against. Systemic resistance affects left-sided afterload. Right end-diastolic pressure is a measurement of the pressure at diastole, but does not determine afterload. Pressures in the vena cava do not affect right ventricle afterload directly. REF: p. 564 34. Which principle should the nurse remember while planning care for a cardiac patient? Pressure in the left ventricle must exceed pressure in the _____ before the left ventricle can eject blood. a. Coronary arteries b. Aorta c. Inferior vena cava d. Pulmonary veins ANS: B The pressure in the left ventricle must override that of the aorta before the ventricle can eject blood. The pressure in the left ventricle must override that of the aorta, not the coronary arteries, before the ventricle can eject blood. The pressure in the left ventricle must override that of the aorta, not the inferior vena cava, before the ventricle can eject blood. The pressure in the left ventricle must override that of the aorta, not the pulmonary veins, before the ventricle can eject blood. REF: p. 553 35. When a nursing student wants to know where the primary cardiovascular control center is located, what is the nurse's best response? In the: a. Cerebral cortex b. Midbrain c. Medulla d. Cervical spinal cord ANS: C The cardiovascular control center is in the brainstem in the medulla. The cardiovascular control center is in the brainstem in the medulla, not the cerebral cortex. The cardiovascular control center is in the brainstem in the medulla, not the midbrain. The cardiovascular control center is in the brainstem in the medulla, not in the cervical spinal cord. REF: p. 565 36. A 50-year-old female was prescribed a drug that acts as a negative inotrope. Which of the following endogenous substances would be most similar? a. Acetylcholine b. Dopamine c. Epinephrine d. Thyroid hormone ANS: A The most important negative inotropic agent is acetylcholine. The most important negative inotropic agent is acetylcholine, not dopamine, which is a positive inotrope. The most important negative inotropic agent is acetylcholine, not epinephrine, which is a positive inotrope. The most important negative inotropic agent is acetylcholine, not thyroid hormone, which is a positive inotrope. REF: p. 564 37. After activation of the Bainbridge reflex in a patient, the nurse assesses for: a. Increased heart rate b. Decreased blood pressure c. Increased rate and depth of respirations d. Decreased myocardial contractility ANS: A Activation of the Bainbridge reflex increases heart rate. Activation of the Bainbridge reflex increases heart rate; it does not decrease blood pressure. Activation of the Bainbridge reflex increases heart rate; it does not increase rate and depth of respirations. Activation of the Bainbridge reflex increases heart rate; it does not decrease myocardial contractility. REF: p. 565 38. A 50-year-old female presents with a low heart rate and low blood pressure. She is given an intravenous (IV) infusion of fluids. The increase in atrial distension results in: a. Renal retention of fluids b. Depressed myocardial contractility c. Release of acetylcholine d. Increased heart rate ANS: D IV fluids increase intravascular volume, distending the atria and increasing the heart rate. IV fluids increase intravascular volume, distending the atria and increasing the heart rate; it does not result in renal retention of fluids. IV fluids increase intravascular volume, distending the atria and increasing the heart rate; it does not depress myocardial contractility. IV fluids increase intravascular volume, distending the atria and increasing the heart rate; it does not result in the release of acetylcholine. REF: p. 565 39. A nurse observes a cardiologist multiplying the heart rate by stroke volume. What is the cardiologist measuring? a. Vascular resistance b. Preload c. Cardiac output d. Ejection fraction ANS: C Cardiac output is found by multiplying the heart rate times stroke volume. Vascular resistance is not a factor in the calculation of cardiac output; it does play a role in blood pressure. Preload affects cardiac output but is not the result of heart rate times stroke volume. Ejection fraction is the amount ejected per beat. REF: p. 565 40. A nurse recalls the internal lining of the cardiovascular system is formed by what tissue? a. Tunica adventitia b. Connective c. Mesothelium d. Endothelium ANS: D The endothelium is the lining of blood vessels. The endothelium, not the tunica adventitia, is the lining of blood vessels. Connective tissues help make up arterial walls but are not the lining of blood vessels. The mesothelium is a part of the pericardial cavity. REF: p. 553 41. A patient researches baroreceptors online. Which information indicates a good understanding? Baroreceptors are located in the: a. Renal artery b. Superior vena cava c. Carotid sinus d. Circle of Willis ANS: C Baroreceptors are found in the carotid sinus. Baroreceptors are not found in the renal artery, but in the carotid sinus. Baroreceptors are not found in the superior vena cava, but in the carotid sinus. Baroreceptors are not found in the circle of Willis, but in the carotid sinus. REF: p. 574 42. A nurse is evaluating the direct end effect of the renin-angiotensin-aldosterone system. Which principle should the nurse remember? a. Angiotensin II causes systemic vasoconstriction. b. Renin promotes the excretion of sodium and water in the renal tubules. c. Aldosterone increases renal retention of water only. d. Angiotensin I promotes sodium and water reabsorption by the kidneys. ANS: A Angiotensin II is a potent vasoconstrictor. Renin promotes the retention of sodium and water. Aldosterone increases retention of water and sodium. Angiotensin I does not have an effect on the kidneys. REF: p. 574 43. When a patient wants to know about the renin-angiotensin-aldosterone system, what is the nurse's best response? Conversion of angiotensin I to angiotensin II happens in the: a. Lungs b. Liver c. Kidneys d. Heart ANS: A Angiotensin I is converted to angiotensin II by angiotensin converting enzyme in the lungs. The liver synthesizes angiotensinogen rather than assisting with the conversion of angiotensin I to II. The kidneys release renin, which initiates the process; it is not involved in the conversion of angiotensin I to II The heart does not assist in the conversion of angiotensin I to II. REF: p. 574 44. A nurse is discussing the different types of regulation. Which regulation is the nurse describing? Local myogenic regulation of blood vessel diameter and thus blood flow through a vessel is an example of: a. Autonomic regulation b. Somatic regulation c. Autoregulation d. Metabolic regulation ANS: C The myogenic hypothesis proposes that autoregulation originates in vascular smooth muscle, presumably of the arterioles, as a response to changes in arterial perfusion pressure. The myogenic hypothesis proposes that autoregulation originates in vascular smooth muscle, presumably of the arterioles, as a response to changes in arterial perfusion pressure. It is not a part of autonomic regulation. The myogenic hypothesis proposes that autoregulation originates in vascular smooth muscle, presumably of the arterioles, as a response to changes in arterial perfusion pressure. It is not a part of somatic regulation. The myogenic hypothesis proposes that autoregulation originates in vascular smooth muscle, presumably of the arterioles, as a response to changes in arterial perfusion pressure. It is not part of metabolic regulation. REF: p. 579 45. The thoracic lymphatic duct drains into the: a. Left subclavian artery b. Right atrium c. Right subclavian vein d. Left subclavian vein ANS: D The thoracic duct drains lymph into the left subclavian vein. The thoracic duct drains lymph into the left subclavian vein, not artery; the right lymphatic duct drains into the right subclavian vein, not artery. The thoracic duct drains lymph into the left subclavian vein, not the right atrium. The thoracic duct drains lymph into the left subclavian vein, not the right subclavian vein REF: p. 580 MULTIPLE RESPONSE 1. Increases in which of the following would cause the nurse to assess for decreased blood flow? (Select all that apply.) a. Blood viscosity b. Blood vessel diameter c. Blood pressure d. Blood vessel length ANS: A, C, D Resistance to flow is generally greater in longer tubes because resistance increases with length. Blood flow varies inversely with the viscosity of the fluid. Thick fluids move more slowly and experience greater resistance to flow than thin fluids. Increased blood pressure decreases blood flow because resistance in increased. REF: p. 572 2. Important mechanisms for maintaining venous return to the right atrium include (elect all that apply): a. Cardiac output b. Atrioventricular (AV) valves c. Skeletal muscle contraction d. Blood volume e. Vascular tone ANS: A, B, C, D Venous return is dependent on blood volume and flow through the venous system and the AV valves. Skeletal muscle function assists the flow of blood toward the heart. This important mechanism of venous return is called the muscle pump. Vascular tone must be maintained to facilitate return. REF: p. 578 3. A nurse is evaluating stroke volume. Which of the following factors affect stroke volume? (Select all that apply.) a. Preload b. Peripheral vascular resistance c. Afterload d. Ejection fraction e. Contractility ANS: A, C, E Preload, afterload, and contractility affect stroke volume. REF: p. 563 COMPLETION 1. The nu ANS:2. A nurse is assessing the heart rate. The nurse obtains a normal heart rate. The average heart rate in a healthy adult is _____ beats per minute. ANS: 70 seventy REF: p. 565
Which statement regarding croup is TRUE? Question options: A) Children between the ages of 6 months and 5 years of age are at greatest risk. B) It is generally a result of a bacterial infection. C) There is no research data to show any relationship to a family history of the disorder. D) It is seen more frequently in female children.
A
Which term is appropriate when describing painful menstruation associated with the release of prostaglandins in ovulatory cycles? Question options: A) Primary dysmenorrhea B) Primary amenorrhea C) Secondary dysmenorrhea D) Secondary amenorrhea
A
parathyroid gland secretes which hormone? A)parathyroid B)ADH C) TSH
A
What are the functions of the pericardium? The pericardium: (select all that apply) A)prevents displacement of the heart during gravitational acceleration/deceleration. B)acts as a physical barrier that protects the heart against infection and inflammation. C)contains pain receptors and mechanoreceptors that affect blood pressure. D)provides a continuous lining of the arteries, veins, and capillaries of the body. E)brings about the force required to normalize blood pressure.
A,B,E
Which childhood population is associated with a high risk for asthma? Select all that apply. Question options: A)African-American B)Females C)Hispanic D)Urban dwellers E)Middle socioeconomic class
A,C,D
Which statement is correct and should be included in information regarding the function of surfactant? Surfactant: Select all that apply. Question options: A)is a lipid protein mix produced by type II cells. B)functions to inhibit normal gas exchange. C)is found in the lining of the alveoli. D)reduces surface tension. E)prevents the collapse of air cells during inhalation.
A,C,E
A 65-year-old male is transported to the ER for chest pain. An electrocardiogram reveals a prolonged QRS interval. What is the nurse monitoring when the nurse observes the QRS complex on the electrocardiogram? The QRS complex reflects: Question options: A) Ventricular activity B) Pulmonary artery closure C) Mitral valve opening D) Aortic valve closing
A.
Which term describes the "thick filaments of myosin that constitute a central dark band"? A.A band B.I band C.Z line D. M line
A. A band
Which classification of drugs decreases the strength of cardiac contraction? A. Calcium channel blockers B.Narcotics (morphine) C.Adenosine D.Aspirin
A. Calcium channel blockers
Which artery travels in the coronary sulcus between the left atrium and the left ventricle of the heart? Incorrect A. Left anterior descending B. Circumflex C.Right coronary D.Left coronary
A. Left anterior descending
Which item is a characteristic of the Frank-Starling law of the heart? A.Resting sarcomere length to tension generation B. Resting sarcomere length to end-diastolic volume C.Tension generation and diastolic filling pressures
A. Resting sarcomere length to tension generation
Which of the following findings in the patient with Raynaud disease would indicate a need for further teaching? Question options: A) The patient eats bananas twice a day. B) The patient smokes cigarettes. C) The patient wears mittens outside. D) The patient takes calcium channel blockers.
B
Which of the following would shift the oxyhemoglobin dissociation curve to the left? Question options: A) Acidosis B) Hypocapnia C) Increased H+ ion D) Increased metabolic activity
B
Which pathology most commonly results in pulmonary edema? Question options: A) The inhalation of organic particles causing an inflammatory response B) Increasing pressure in the left chambers of the heart C) Inflammatory obstruction of small airways D) The permanent enlargement of acini
B
Which structure is a part of the upper airway? Question options: A) Trachea B) Nasopharynx C) Larynx D) Bronchi
B
While viewing the electrocardiogram, the nurse recalls the _____ conducts action potentials down the atrioventricular septum. Question options: A) Bachmann bundle B) Bundle of His C) Sinoatrial node D) Atrioventricular node
B
Which is TRUE regarding the thoracic duct? The thoracic duct: A)is a major source of venous return to the heart. B)receives lymph from most of the body. C)collects lymph from the right arm, head, and thorax. D)dumps blood into the right atrium.
B)receives lymph from most of the body
What situation is characteristic of tricuspid atresia? Select all that apply. Question options: A)No pathway between the right health chambers B)A decrease in pulmonary blood flow C)The mixing of unoxygenated and oxygenated bloods D)Cyanosis in the newborn experiencing this disorder E) Children at a risk for endocarditis
B,C,D,E
Which structures are considered part of the acinus? Select all that apply. Question options: A)Trachea B)Respiratory bronchioles C)Alveolar ducts D)Alveoli E)Nare
B,C,D,E
Which statements regarding autoregulation are TRUE? (select all that apply) A)Blood vessels regulate their own blood flow. B)In coronary circulation, pressure is between 60 and 180 mm Hg. C)Mechanism is well documented and is related to the sympathetic system. D)Autoregulation ensures constant coronary blood flow. E)It is proposed that this process originates in vascular smooth muscles of the arterioles.
B,D,E
What factor has been identified as one that affects the process of female menopause? Select all that apply. Question options: A)Age B)Family history C)Onset of menarche D)Use of oral contraception E)History of tobacco smoking
B,E
Which describes the cardio-inhibitory center? Question options: A) Sympathetic excitatory neurons B) Parasympathetic excitatory neurons C) Bainbridge reflex D) Baroreceptor reflex
B.
Which statement regarding the epidemiology of congenital heart defects in children is TRUE? Question options: A) There are 95 types of congenital heart disease. B) Congenital heart disease is the leading cause of death in the first year of life other than prematurity. C) Fifty percent of deaths due to congenital heart disease occur in the first year of life. D) The underlying cause of congenital heart defect is known in 90% of cases.
B.
In the distal tubule, which cells reabsorb sodium and water but secrete potassium? A. Distal cells B. Proximal cells C. Principal cells D. Intercalated cells
Principal cells reabsorb sodium and water and secrete potassium. Intercalated cells secrete either hydrogen or bicarbonate and reabsorb potassium. Distal and proximal refer to the tubules.C
Which is the most common type of congenital heart defect the nurse should assess for in infants? Question options: A) Atrial septal defect (ASD) B) Ventricular septal defect (VSD) C) Tetralogy of Fallot D) Atrioventricular canal defect
B
Thyroid gland hormones are? A)T4,T3,TSH B) T4,T3,calcitonin C) T4,T3,cortisol
B
Which is the MOST common complication of an AMI? Question options: A) Dressler syndrome B) Arrhythmia C) Pericarditis D) Heart failure
B
A 22-year-old pregnant female presents for a fetal echocardiogram. Tests reveal small left atrium and mitral valve and an absent left ventricle and aortic valve. The diagnosis is hypoplastic left heart syndrome (HLHS). The nurse will anticipate that the treatment for this defect is: Question options: A) An indication for neonatal heart transplant B) Rarely fatal C) Easily repaired D) Asymptomatic
A
A cardiologist is discussing valves with the staff. Which information should the cardiologist include? _____ are the anchors of the atrioventricular valves. Question options: A) Chordae tendineae cordis B) Great vessels C) Coronary ostia D) Trabeculae carneae
A
A nurse is explaining the function of the heart. Which is a correct response by the nurse? A function of the pericardium is to: Question options: A) Provide a barrier against extracardial infections. B) Improve blood flow through the heart. C) Play a role in cardiac conduction. D) Assist in cardiac contraction.
A
A patient has been diagnosed with a moderately large cystocele. What information would the nurse include in the client's teaching plan? Question options: A) Lying in a prone position may help relieve some of the symptoms. B) The symptoms will increase during menstruation. C) The condition causes urinary stress incontinence. D) This condition contributes to chronic constipation.
A
Posterior pitiuitary hormones are: A) ADH, oxytocin B) ADH, MSH C) ADH, GH D) oxytocin, GH
A
Which statement regarding chronic bronchitis is TRUE? Question options: A) Hypersecretion of mucus is a characteristic. B) It features a chronic productive cough that lasts at least 6 months. C) Symptoms occur for at least 5 consecutive years. D) Is one of the few respiratory diseases not exacerbated by smoking.
A
An increase in the release of renin is the result of which event? A)Decrease in blood pressure at the renal artery B) Decrease in the amount of sodium delivered to the kidney C)β-Adrenergic stimuli D)Low potassium concentration
A) Decrease in blood pressure at the renal artery
pineal gland secretes
A)melatonin B)TSH C)ADH
Which factor helps to maintain the self-cleansing action of the vagina? Select all that apply. Question options: A)Acid-base balance of the vagina B)Thickness of the vaginal epithelium C)Low levels of estrogen in the vagina D)Excess lactobacillus acidophilus in the vagina E)Physical shape of the vagina
A,B
adrenal medulla hormones: Select all that apply A) epinephrine B)norepinephrine C) cortisol D) aldosterone
A,B
Which of the following are types of nephron? (select all that apply) A)Superficial cortical B)Midcortical C)Juxtamedullary D)Glomerular E)Mesangial
A,B,C
adrenal cortex produce: Select all that apply A)aldosterone B)cortisol C)adrenal androgens D) calcitonin
A,B,C
Which statement regarding respiratory distress syndrome (RDS) of the newborn is TRUE? Select all that apply. Question options: A)The major predisposing factor is birth prior to 36 weeks. B)There is increased incidence in American newborns. C)It is more frequently seen in infants of diabetic mothers. D)Birth by elective cesarean section increases risk. E)It is more commonly observed in newborn females.
A,B,C,D
Hypothalamus secretes select all that apply A) CRH B) TRH C)GHRH D)somatostatin E)GnRH F)PRF
A,B,C,D,E,F
anterior pituitary gland hormones select all that apply: A)ACTH B)MSH C)TSH D)GH E) LH F) FSH G)prolactin
A,B,C,D,E,F,G
What factor will be influential in the development of aspiration pneumonia? Select all that apply. Question options: A)The amount of aspirate B)pH of the material aspirated C)Size of the particles aspirated D)Protein content of the aspirate E)Bacterial content present in the aspirate
A,B,C,E
Which items are components of the heart's anatomy? Select all that apply. Question options: A)Two atria B)Two atrioventricular valves C)Two ventricles D)Two-layer heart wall E)Two semilunar valves
A,B,C,E
Which of the following genes have been linked with the development of breast cancer? Select all that apply. Question options: A)BRCA1 B)BRCA2 C)p53 D)PSA E)Her-2/neu
A,B,C,E
The respiratory center is correctly identified as: Select all that apply. Question options: A)being located in the brain stem. B)affecting the respiratory muscles' ability to contract and relax. C)containing one major type of neuron. D)transmitting impulses that bring about the physical act of breathing. E)being influenced by emotions and pain.
A,B,D,E
Which client has an increased risk for developing a pulmonary embolus (PE)? Select all that apply. Question options: A)The adult in traction for a fractured femur B)The woman taking birth control pills C)The child with exercise-induced asthma D)The teenager receiving intravenous chemotherapy E)The man with a prothrombin gene mutation
A,B,D,E
Which symptom would be characteristic of cystic fibrosis (CF)? Select all that apply. Question options: A)Persistent cough B)Pneumonia C)Meconium stool D)Barrel chest E)Wheezing
A,B,D,E
Which substance controls final urine concentration? A. Antidiuretic hormone B. Renin C. Angiotensin I D. Urea
Antidiuretic hormone is secreted from the posterior pituitary; it increases water permeability in the last segment of the distal tubule. Renin stimulates the renin-angiotensin-aldosterone system, which can increase systemic arterial pressure and change renal blood flow. Renin forms angiotensin I that is converted to angiotensin II, which stimulates the secretion of aldosterone.A
A 22-year-old pregnant woman presents to her OB/GYN for a prenatal checkup. The heartbeat sounds irregular, and a fetal echocardiogram reveals an atrioventricular canal (AVC) defect. This defect is the result of: Question options: A) Failure of the ductus arteriosus to close B) Fusion of the endocardial cushions C) A patent foramen ovale D) A right-to-left shunt
B
A 50-year-old female received trauma to the chest that caused severe impairment of the primary pacemaker cells of the heart. Which of the following areas received the greatest damage? Question options: A) Atrioventricular (AV) node B) Sinoatrial (SA) node C) Bundle of His D) Ventricles
B
A 7-month-old male presents with cystic fibrosis (CF) accompanied by failure to thrive and frequent, loose, and oily stools. Sweat testing reveals increased chloride. Which of the following should the nurse observe for that would accompany this disease? Question options: A) Autoantibodies that target the lungs and pancreas B) A thick mucus C) Enzymes that degrade surfactant in the alveoli D) A toxic amount of electrolytes from secretory glands
B
A patient experiences spinal cord damage following a motorcycle accident. Which type of shock would most likely result? Question options: A) Hypovolemic B) Vasogenic C) Anaphylactic D) Septic
B
A patient has a loud pansystolic murmur that radiates to the back and axilla. Which valvular abnormality is this describing? Question options: A) Mitral stenosis B) Mitral regurgitation C) Aortic stenosis D) Aortic regurgitation
B
A patient is diagnosed with early puberty. Which condition has been linked with this condition? Question options: A) Underweight B) Obesity C) Decreased growth hormone D) Decreased FSH
B
A patient has been diagnosed with cervical dysplasia. Which anatomical location is a common site for this type of cancer? Question options: A) Perimetrium B) Myometrium C) Endometrium D) Squamous-columnar junction
D
For an infection to progress to septic shock, which of the following factors should the nurse determine occurred? Question options: A) The individual must be immunosuppressed. B) The myocardium must be impaired. C) The infection must be gram negative. D) Bacteria must enter the bloodstream.
D
In the female reproductive system, which term is used to identify the "thin perforate membrane that covers the vaginal introitus"? Question options: A) Mons pubis B) Labia majora C) Vulva D) Hymen
D
Which pathogen is consistent associated with nosocomial pneumonia? Question options: A) Streptococcus pneumoniae B) Mycoplasma pneumoniae C) Haemophilus influenzae D) Pseudomonas aeruginosa
D
Which receptor monitors pH, PaCO2, and PaO2 of arterial blood? Question options: A) Stretch receptors B) Irritant receptor C) J receptors D) Chemoreceptors
D
Which statement regarding the zones of the lung is accurate? Question options: A) Zone 1 is above the level of the left atrium. B) In zone 2, alveolar pressure exceeds pulmonary arterial and venous pressures. C) Zone 2 is a small part of the lung at the apex. D) Zone 3 is in the base of the lung.
D
Which peptide regulates sodium and water balance? A)Atrial natriuretic peptide (ANP) B)Brain natriuretic peptide (BNP) C)C-type natriuretic peptide D) Urodilatin peptide
D) Urodilatin peptide
Which hormone is released from heart tissue in response to increases in blood volume? Question options: A) Epinephrine B) Norepinephrine C) Thyroid hormone D) Natriuretic peptide
D.
Which structure is the source of nutrients for the blood vessels? Question options: A) Tunica intima B) Tunica media C) Adventitia D) Vasa vasorum
D.
Which is a characteristic of cardiac preload? A.Impedance to ejection of blood from the left ventricle B.Wall tension related to internal blood vessel radius C.A lower than normal tension curve D.Pressure generated by the end-diastolic volume
D.Pressure generated by the end-diastolic volume
A person experiences hypotension. Which of the following enzymes is primarily released? A. Renin B. Angiotensin I C. Angiotensin II D. Angiotensin III
Primarily, renin is released, which starts a cascade of events that leads to the angiotensins.A
Which of the following is NOT one of the three kinds of nephrons? A. Superficial cortical nephrons B. Midcortical nephrons C. Juxtamedullary nephrons D. Glomerular nephrons
Nephrons are the functional units of the kidney. The three types include superficial, midcortical, and juxtamedullaryD
Renal tubules
Proximal tubule Loop of Henle Distal tubule Collecting duct Principal cells Intercalated cells
Which statement regarding the lower airway is accurate? Question options: A) The trachea bifurcates at the larynx. B) The trachea has no supportive structure. C) The right and left main bronchi enter the lungs at the hila. D) The goblet cells are air-filled cells.
c
Which of the following is TRUE regarding renal blood flow? A. The kidneys are highly vascular organs and receive 1000 to 1200 ml of blood per minute. B. The kidneys receive 50% of cardiac output. C. The GFR is not related to renal blood flow. D. No autoregulation is found in renal blood flow.
The kidneys are vascular organs and receive 1000 to 1200 ml of blood per minute and 20% to 25% of cardiac output. The GFR is related to renal blood flow, and autoregulation is found in renal blood flow.A
Which of the following is a correct finding in a normal urinalysis? A. pH <5 B. Dark yellow urine C. Specific gravity 1.016 to 1.022 D. Two to five red blood cells
The pH is generally 5 to 6.5, the urine is light yellow, the specific gravity is 1.016 to 1.022, and there are no white or red blood cells.C
Which muscle lies between the two openings of the ureter and urethra? A. Micturition B. Detrusor C. Trigone D. Urethra
The trigone is a smooth triangular area in the bladder that lies between the openings of the two ureters and the urethra. The detrusor muscle distends as the bladder fills with urine and is composed of smooth muscle fibers that weave around the bladder bag. Micturition is another term for urination. Urethra is the term for the tube that connects the bladder to the outside of the body.C
True or False the pancreas secretes these four hormones: Insulin, glucagon, amylin, somatostatin.
True
What is the appropriate term for when fluid moves from the tubular lumen to the peritubular capillary plasma? A. Ultrafiltration B. Tubular reabsorption C. Tubular secretion D. Excretion
Tubular reabsorption is the movement of fluids and solute from the tubular lumen to the peritubular capillary plasma. Ultrafiltration is the process of filtration across the glomerular capillaries to form a filtrate of protein-free plasma. Tubular secretion refers to substances moving from the plasma of the capillary to the tubular lumen. Excretion is the elimination of the substance in the final urine.B
Which muscle lies between the two openings of the ureter and urethra? Question options: A) Micturition B) Detrusor C) Trigone D) Urethra
c
