patho test 3
Which wave in the electrocardiogram represents ventricular repolarization Select one: a. Q Wave b. P Wave c. S Wave d. T Wave
T Wave
Which elevated serum marker for systemic inflammation is now considered a major risk factor for atherosclerosis and vascular disease? Select one: a. Serum lipoprotein b. Homocysteine c. Leukocytosis d. C-reactive protein
C-reactive protein
A nurse is teaching a client who has cardiovascular disease about the dietary sources of cholesterol and their effects on the body. Which statement made by the client indicates the need for further teaching? Select one: a. "I can have salmon and sardines in my diet." b. "I can have oatmeal and flaxseeds daily." c. "I can use sesame and safflower oil for cooking." d. "I should avoid using peanut and canola oil."
"I should avoid using peanut and canola oil."
Which is the optimal level of low-density lipoprotein (LDL) cholesterol? Select one: a. 170 mg/dL b. 135 mg/dL c. 70 mg/dL d. 110 mg/dL
110 mg/dL
A client reports severe chest pain and a rapid heart rate. A nurse observes a blood pressure difference in the left and right arms. Which difference in blood pressure indicates an aortic dissection? Select one: a. 10 mm Hg b. 15 mm Hg c. 5 mm Hg d. 20 mm Hg
20 mm Hg
A large increase in heart rate can cause: Select one: a. Increased blood viscosity b. Decreased stroke volume c. Reduced cardiac contractility d. Loss of action potential
Decreased stroke volume
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? Select one: a. 21 to 30 beats/minute b. 10 to 20 beats/minute c. 55 to 60 beats/minute d. 45 to 50 beats/minute
45 to 50 beats/minute
Which has a faster spontaneous depolarization rate: AV node or Purkinje fibers
AV node
Which factors should a nurse assess for in a client who has peripheral artery disease (PAD)? Select all that apply. Select one or more: a. Paresthesias in the lower extremities b. Absence of pulsation in the lower extremities c. Throbbing pulse in the lower extremities d. Coolness in the lower extremities e. Increased sensation in the feet
Absence of pulsation in the lower extremities , Coolness in the lower extremities , Paresthesias in the lower extremities
Heart muscle differs from skeletal muscle tissue by being able to generate: Select one: a. Calcium influx b. Sarcomere binding c. Contractions d. Action potentials
Action potentials
Provides one-way flow of blood from the left ventricle into the aorta
Aortic valve
Which is faster: blood flow in a capillary or blood flow in an arteriole
Blood flowing in an arteriole
A client has entered hypovolemic shock after massive blood loss in a car accident. Many of the client's peripheral blood vessels have consequently collapsed. How does the Laplace law account for this pathophysiologic phenomenon? Select one: a. Decreasing vessel radii has caused a decrease in blood pressure. b. Blood pressure is no longer able to overcome vessel wall tension. c. Decreases in wall tension and blood pressure have caused a sudden increase in vessel radii. d. Wall thickness of small vessels has decreased due to hypotension.
Blood pressure is no longer able to overcome vessel wall tension
The parasympathetic nervous system causes a slowing of the heart rate by increasing: a. Cardioinhibitory center b. Vessel constriction c. Smooth muscle tone d. Norepinephrine
Cardioinhibitory center
A nurse is reviewing the ankle-brachial index of four clients who are suspected of having peripheral artery disease (PAD). Client 1 0.6 Client 2 1.0 Client 3 1.3 Client 4 0.95 Which client has developed moderate PAD?
Client 1
A nurse is recording the blood pressure of four clients. Client 1 Client 2 Client 3 Client 4 130/90 mm Hg while lying and 121/90 mm Hg upon standing 118/80 mm Hg while lying and 120/80 mm Hg upon standing 140/90 mm Hg while lying and 130/80 mm Hg upon standing 112/ 76 mm Hg while lying and 112/70 mm Hg upon standing Which client's blood pressure indicates that the client has orthostatic hypotension?
Client 3
Anchors the valve cusps to the papillary muscles to prevent valve prolapse
Cordae Tendinea
A large increase in heart rate can cause Select one: a. Loss of action potential b. Increased blood viscosity c. Reduced cardiac contractility d. Decreased stroke volume
Decreased stroke volume
Clients with ischemic coronary vessel disease and acute coronary syndrome (ACS) are classified as low or high risk for acute myocardial infarction based on characteristics that include significant: Select one: a. Heart murmurs b. Pulmonary disease c. Pericardial effusion d. ECG changes
ECG changes
Chronic stable angina, associated with inadequate blood flow to meet the metabolic demands of the myocardium, is caused by: Select one: a. Intermittent vessel vasospasms b. Increased collateral circulation c. Excessive endothelial relaxing factors d. Fixed coronary obstruction
Fixed coronary obstruction
Conveys deoxygenated blood from trunk and lower extremities to the right atrium
Inferior vena cava
Separates the right and left ventricles
Intraventricular septum
During ventricular systole, closure of the atrioventricular (AV) valves coincides with: Select one: a. Isovolumetric contraction b. Atrial chamber filling c. Semilunar valves opening d. Aortic valve opening
Isovolumetric contraction
Transport deoxygenated blood from the right ventricle to the left lung
Left pulmonary artery
Provides one-way flow of blood from the right ventricle into the pulmonary artery
Pulmonary valve
Transports deoxygenated blood from the right ventricle to the right lung
Right pulmonary artery
Which has a faster spontaneous depolarization rate: SA node or AV node
SA node
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? Select one: a. Non-ST-segment elevation MI b. ST-segment elevation MI c. Stable angina d. Unstable angina
Stable angina
Which causes a faster heart rate: stimulation of cardiac beta-1 receptors or cardiac beta-3 receptors →
Stimulation of cardiac beta-1 receptors
Which causes a faster heart rate: sympathetic nerve firing or parasympathetic nerve firing
Sympathetic nerve firing
A nurse hears a bruit while assessing the carotid artery of a client. What could be the reason behind the bruit? Select one: a. Decreased blood flow in the artery b. None of the above c. Problems in the tricuspid valve d. Turbulent blood flow in the artery
Turbulent blood flow in the artery
Which of the following statements about vascular compliance is accurate? a. Veins can act as a reservoir for storing large quantities of blood. b. Arteries have thick muscular walls that constrict tightly, thereby ejecting blood without storing it for later use. c. Arteries are much more distensible than veins. d. A continuous flow through the capillaries occurs primarily during systole.
Veins can act as a reservoir for storing large quantities of blood.
Preload represents the volume work of the heart and is largely determined by: Select one: a. Vascular resistance b. Force of contraction c. Ventricular emptying d. Venous blood return
Venous blood return
Preload represents the volume work of the heart and is largely determined by: Select one: a. Vascular resistance b. Venous blood return c. Ventricular emptying d. Force of contraction
Venous blood return
A client asks why he has not had major heart damage since his cardiac catheterization revealed he has 98% blockage of the right coronary artery. The nurse's best response is: a. You are just a lucky person since most people would have had a massive heart attack by now b. You must have been taking a blood thinner for a long time c. With this amount of blockage, your red blood cells get through the vessel one-by-one and supply oxygen to the muscle d. You have small channels between some of your arteries, so you can get blood from a patent artery to one severely blocked
You have small channels between some of your arteries, so you can get blood from a patent artery to one severely blocked
A client asks why he has not had major heart damage since his cardiac catheterization revealed he has 98% blockage of the right coronary artery. The nurse's best response is: Select one: a. With this amount of blockage, your red blood cells get through the vessel one-by-one and supply oxygen to the muscle. b. You are just a lucky person since most people would have had a massive heart attack by now. c. You have small channels between some of your arteries, so you can get blood from a patent artery to one severely blocked. d. You must have been taking a blood thinner for a long time.
You have small channels between some of your arteries, so you can get blood from a patent artery to one severely blocked.
A client asks, "Why do I have clogged arteries but my neighbor has higher 'bad cholesterol' levels and yet he is just fine?"The health care provider bases the reply on which of the following physiological principles about lipoprotein? a. You must have a genetic predisposition to having clogged arteries b. Your neighbor has larger 'bad cholesterol' particles that can move into blood vessels but park in joints/tendons. c. You more than likely have small, dense type of 'bad cholesterol' (LDL) d. Your neighbor probably has higher amounts of good cholesterol (HDL) as well
You more than likely have small, dense type of 'bad cholesterol' (LDL)
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? Select one: a. heart rate b. preload c. afterload d. contractility
afterload
Resistance to ejection during systole
afterload
transport oxygenated blood from the left ventricle to the systemic circulation
aorta
Ability to generate spontaneous depolarization to threshold potential
automaticity
Volume of blood flowing into the systemic (or pulmonary) circuit in 1 minute
cardiac output
Disseminated intravascular coagulation (DIC) can be initiated by an external event such as trauma. Once that event happens, what is the first pathological body change that would indicate the presence of DIC? Select one: a. blood glucose levels immediately elevate b. macrophages travel to the area of the initial trauma c. clots form throughout the body, especially in small vessels d. large amounts of bleeding occur
clots form throughout the body, especially in small vessels
Ability of the heart muscle to shorten, generating force; change in developed tension at a given resting fiber length
contractility
Your grandmother, a cook at a nearby school, was recently hospitalized when she lost an extensive amount of blood in a work-related accident. She tells you that she heard the nurse say that she would keep feeling faint until her brain made more blood. You recognize that when her blood pressure dropped, the pressure in her carotid arteries decreased. This was detected by baroreceptors in the carotid arteries, which acted then to: Select one: a. stimulate the brain to form new red blood cells b. inhibit renin release from the kidneys to promote fluid retention c. increase sympathetic stimulation of the heart and blood vessels d. increase parasympathetic stimulation of the heart and blood vessels
increase sympathetic stimulation of the heart and blood vessels
Your brother is a smoker. You are concerned because you learned in class that cigarette smoking increases the risk for heart disease. You encourage him to quit because smoking: Select one: a. promotes vasodilation and decreases peripheral resistance, thereby increasing cardiac workload b. decreases serum lipid levels and increases inflammation, thereby promoting hyperlipidemia c. increases serum HDL levels, thereby promoting fat oxidation d. injures the endothelial cells lining the blood vessels, thereby promoting thrombus development
injures the endothelial cells lining the blood vessels, thereby promoting thrombus development
Atherosclerotic plaque is most likely to be unstable and vulnerable to rupture when the plaque has a thin fibrous cap over a: Select one: a. Large lipid coreI b. Vessel wall injury c. Calcified lesion d. Red thrombus
large lipid coreI
transports oxygenated blood from left lung to left atrium
mitral valve
Causing a decreased heart rate
negative chronotropic effect
Causing decreased myocardial
negative inotropic effect
The pressure generated at the end of diastole
preload
Factors that affect cardiac performance include Select one: a. preload b. afterload c. all of the above d. contractility
preload, after load, contractility
You attend a health fair and have your serum cholesterol checked. You have a high low-density lipoprotein level (LDL). You understand that you have a risk factor for coronary artery disease because you know that LDL: Select one: a. has low cholesterol content b. is associated with a low intake of saturated fats c. promotes atheromas and plaque development d. transports cholesterol away from cells to the liver for excretion
promotes atheromas and plaque development
ability to generate action potential in a regular person
rhythmicity
Conveys deoxygenated blood from head and upper extremities to the right atrium
superior vena cava
Your grandmother says that when they checked her blood pressure in the hospital, the top number (systolic pressure) was lower than usual but the bottom number (diastolic pressure) was about the same. Why is this? Select one: a. systemic vasoconstriction has maintained the diastolic pressure b. you have no idea and you keep reminding your grandma that you haven't even finished your pathophysiology class yet c. her heart rate increased with blood loss d. her stroke volume increased with blood loss
systemic vasoconstriction has maintained the diastolic pressure
Altered cardiac tissue perfusion can result from all of the following except: Select one: a. the development of collateral circulation b. imbalances of oxygen supply and demand c. blood flow obstruction to the cardiac tissue d. reduced cardiac stroke volume
the development of collateral circulation
The most important complication of atherosclerosis that may cause occlusion of small heart vessels is: Select one: a. Fibrous plaque b. Ulceration c. Thrombosis d. Fatty streaks
thrombosis
Provides one-way flow of blood from the right atrium into the right ventricle
tricuspid valve
You are concerned about your parents' health. You decide to do teaching over Christmas break about the modifiable risk factors for atherosclerosis. Which of the following demonstrates an intervention that is cognizant of the modifiable risk factors? Select one: a. You go for a brisk walk with your parents and talk to them about continuing to exercise regularly b. You encourage your mom not to take estrogen supplements after menopause c. You talk to your mom about using more saturated and less unsaturated fats when cooking d. You encourage your parents to be tested for familial hypercholesterolemia
you go for a brisk walk with your parents and talk to them about continuing to exercise regularly