Patho Quiz 4 (Cardiac)

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? A. "Since your heart is not pumping efficiently, the kidneys are getting less blood flow; therefore, the kidneys are holding on to sodium and water." B. "Your heart muscle is overstretched, so it's not able to pump all the blood out. The prescribed 'water pills' help by decreasing your weight." C. "Since your heart function is impaired, the lungs are not able to oxygenate the blood and your kidneys are wearing out." D. "You must be drinking way too many liquids. Your kidneys cannot filter all that you are drinking during the day."

A. "Since your heart is not pumping efficiently, the kidneys are getting less blood flow; therefore, the kidneys are holding on to sodium and water."

A heart failure client has an echocardiogram performed revealing an ejection fraction (EF) of 40%. The nurse knows this EF is below normal and explains to the client: A. "This means your heart is not pumping as much blood out of the heart with each beat." B. "You need to increase the amount of exercise you do to get your heart muscle back in shape." C. "This means you have a lot of pressure built-up inside your heart." D. "Your ventricular muscle is getting too stiff to beat normally."

A. "This means your heart is not pumping as much blood out of the heart with each beat."

Which of the following clients would be at high risk for developing primary varicose veins? Select all that apply. A. A morbidly obese (>100 pounds overweight) male who works behind the counter of a convenience store 10 hours/day, 5 days/week B. A 47-year-old waitress who works 12-hour shifts three or four times/week C. A new peritoneal dialysis client who has been utilizing a home machine and performing dialysis every evening beginning at 8 PM D. A Marathon runner who has completed three marathons in the past 3 months E. A 56-year-old male who has been immobile due to back surgery and has developed a deep vein thrombosis

A. A morbidly obese (>100 pounds overweight) male who works behind the counter of a convenience store 10 hours/day, 5 days/week B. A 47-year-old waitress who works 12-hour shifts three or four times/week

The most common causes of left-sided heart failure include: A. Acute myocardial infarction B. Impaired renal blood flow C. Chronic pulmonary disease D. Tricuspid valve regurgitation

A. Acute myocardial infarction

Which of the following clients should most likely be assessed for orthostatic hypotension? A. An 80-year-old elderly client who has experienced two falls since admission while attempting to ambulate to the bathroom B. A 78-year-old woman who has begun complaining of frequent headaches unrelieved by over-the-counter analgesics C. A 65-year-old client whose vision has become much less acute in recent months and who has noticed swelling in her ankles D. A 42-year-old client who has a history of poorly controlled type 1 diabetes

A. An 80-year-old elderly client who has experienced two falls since admission while attempting to ambulate to the bathroom

A client is admitted with dilated cardiomyopathy with left ventricular dysfunction. The nurse should assess for which of the following clinical manifestations? Select all that apply. A. Extreme fatigue with activity B. Orthopnea C. Dyspnea D. Fainting E. Excess abdominal fluid

A. Extreme fatigue with activity B. Orthopnea C. Dyspnea

Football fans at a college have been shocked to learn of the sudden death of a star player, an event that was attributed in the media to "an enlarged heart." Which of the following disorders was the player's most likely cause of death? A. Takotsubo cardiomyopathy B. Hypertrophic cardiomyopathy (HCM) C. Dilated cardiomyopathy (DCM) D. Arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D)

B. Hypertrophic cardiomyopathy (HCM)

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? A. "Your heart has enlarged, so naturally your valves had to enlarge as well." B. "You heart has been pumping your blood so hard, that the pressure has damaged your valves." C. "You have a heart valve that is diseased." D. "You have been exposed to an infection that went into your blood stream."

C. "You have a heart valve that is diseased."

Which of the following is a nonmodifiable risk factor for the development of primary hypertension? A. Obesity B. High salt intake C. African American race D. Smoking

C. African American race

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: A. Primary varicose veins B. Stasis ulcerations C. Deep vein thrombosis D. Arterial insufficiency

C. Deep vein thrombosis

Which of the following lab results strongly suggest an immunologic response in the client with possible rheumatic heart disease? A. High C-reactive protein levels B. Elevated white blood cell count C. Group A (β-hemolytic) streptococcal antibodies D. Elevated erythrocyte sedimentation rate (ESR)

C. Group A (β-hemolytic) streptococcal antibodies

While lecturing on blood pressure, the nurse will emphasize that the body maintains its blood pressure by adjusting the cardiac output to compensate for changes in which of the following physiologic processes? A. Electrical impulses in the heart B. Rigidity of the ventricular walls C. Peripheral vascular resistance D. Release of stress hormones

C. Peripheral vascular resistance

If the parasympathetic neurotransmitter releases acetylcholine, the nurse should anticipate observing what changes in the ECG pattern? A. Disorganized ventricular fibrillation B. Complete cardiac standstill C. Slowing of heart rate to below 60 beats/minute D. Heart rate 150 beats/minute, labeled as supraventricular tachycardia

C. Slowing of heart rate to below 60 beats/minute

When lecturing to a group of students about the pathophysiological principles behind heart failure, the instructor explains that cardiac output represents: A. The volume of blood stretching the heart muscle at the end of diastole B. The amount of blood pumped out of the heart with each beat C. The amount of blood the heart pumps each minute D. Strength of the right ventricular pump to move blood

C. The amount of blood the heart pumps each minute

The most important complication of atherosclerosis that may cause occlusion of small heart vessels is: A. Fatty streaks B. Fibrous plaque C. Thrombosis D. Ulceration

C. Thrombosis

Endocarditis and rheumatic heart disease are both cardiac complications of systemic infections. Characteristics include a new or changed heart murmur caused by: A. Myocardial inflammation B. Left ventricle hypertrophy C. Vegetative valve destruction D. Chronic atrial fibrillation

C. Vegetative valve destruction

A father experienced the onset of chest pain and dies suddenly. The family asks, "What caused him to die so suddenly?" The health care provider's reply that is most appropriate would be, "There's a high probability that your loved one developed an acute heart attack and experienced: A. Hypertrophic cardiomyopathy." B. Acute myocarditis." C. High troponin levels." D. Acute ventricular arrhythmia."

D. Acute ventricular arrhythmia."

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? A. Backup of blood from the right atrium into the superior vena cava B. Inhibition of the SA node's normal action potential C. Backflow from the right ventricle to the right atrium during systole D. Backflow from the left ventricle to the left atrium

D. Backflow from the left ventricle to the left atrium

One of the principal mechanisms by which the heart compensates for increased workload is: A. Endothelin vasoconstrictors B. Ventricular wall tension increase C. Sodium and water retention D. Myocardial hypertrophy

D. Myocardial hypertrophy

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? A. Atrial depolarization B. Depolarization of the AV node C. Ventricular depolarization D. Ventricular repolarization

D. Ventricular repolarization