Chapter 25: Structure and Function of the Cardiovascular System

A client with a history of heart failure has the following echocardiogram results: heart rate 80 beats/minute; end-diastolic volume 120 mL; and end-systolic volume 60 mL. What is this client's ejection fraction (EF)?

50%

Vascular smooth muscle cells produce vasoconstriction or dilation of blood vessels. Which local tissue factors are correlated with smooth muscle contraction and relaxation? Select all that apply. -Lack of Oxygen -Lack of carbon dioxide -Decreased Hydrogen Ion Concentrations -Increased hydrogen ion concentrations

-Lack of oxygen -Increased Hydrogen Ion Concentration

A number of clients on an acute cardiac care unit of a hospital have diagnoses of impaired cardiac conduction. Which client is most deserving of immediate medical attention?

A 69-year-old woman who has entered ventricular fibrillation

As part of preoperative teaching for clients who are about to undergo a coronary artery bypass graft, a nurse is performing an education session with a group of surgical candidates. Which teaching point best conveys an aspect of the human circulatory system? A) "The blood pressure varies widely between arteries and veins, and between pulmonary and systemic circulation." B) "Left-sided and right-sided pumping action on each beat of the heart must equal each other to ensure adequate blood distribution." C) "Blood pressure and blood volume roughly mimic one another at any given location in the circulatory system." D) "Only around one-quarter of your blood is in your heart at any given time."

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

Which blood vessels function without the benefit of having walls comprised of three muscular layers? A) Capillaries B) Veins C) Arterioles D) Arteries

A) Capillaries

ECG monitoring has been found to be more sensitive than a client's report of symptoms when identifying transient ongoing myocardial ischemia. Why is this? A) Most ECG-detected ischemic events are clinically silent. B) Most ECG-detected ischemic events cause a great deal of pain. C) ECG monitoring is reliable only when the client remains still. D) The ECG can look at ischemic events from different directions.

A) Most ECG-detected ischemic events are clinically silent.

The health care provider is concerned that a client has developed a decrease in cardiac output. Cardiac output may be calculated as: A) Stroke volume × heart rate B) Blood pressure × heart rate C) Stroke volume × respiratory rate D) Blood pressure × stroke volume

A) Stroke volume × heart rate

Paroxysmal supraventricular tachycardia arises from which form of reentry? A) True B) Atrioventricular (AV) nodal C) Orthodromic D) Bundle of His nodal

B) Atrioventricular (AV) nodal

The circulatory system can be divided into two parts. What does the systemic circulation include? Select all that apply. A) Right Heart B) Capillaries C) Pulmonary Artery D) Aorta

B) Capillaries D) Aorta

Considering the PQRST complex of an electrocardiogram (ECG), which letter designation represents atrial depolarization? A) QRS complex B) P wave C) T wave D) ST segment

B) P wave

A nurse working with a client in heart failure is explaining why the symptoms of the heart failure were not evident for a long period of time. When describing the Frank-Starling mechanism, the nurse will explain: A) the physiologic function of chemoreceptors and baroreceptors. B) the relationship between venous return and stroke volume. C) the molecular structure of actin and myosin and their effect on contraction. D) the high oxygenation needs of cardiac muscle and the role of coronary circulation.

B) the relationship between venous return and stroke volume.

A number of clients on an acute cardiac care unit of a hospital have diagnoses of impaired cardiac conduction. Which client is most deserving of immediate medical attention? A)A 60-year-old man with premature ventricular contractions (PVC) and a history of atrial fibrillation B)A 46-year-old man whose cardiac telemetry shows him to be in ventricular tachycardia C)A 69-year-old woman who has entered ventricular fibrillation D)A 60-year-old woman who has just been diagnosed with a first-degree AV block

C) A 69-year-old woman who has entered ventricular fibrillation

A nurse is caring for four clients. Which client is most at risk for atrial fibrillation (AF)? A) A female adult with diabetes mellitus and hypertension B) A male adult post-carotid endarterectomy C) An older adult man who is 2 days postcoronary artery bypass surgery D) A middle-aged woman with shortness of breath who takes an aspirin daily

C) An older adult man who is 2 days postcoronary artery bypass surgery

Which cardiac drug classification decreases sympathetic outflow to the heart and is the is the cornerstone of therapy for catecholaminergic polymorphic ventricular tachycardia (CPVT)? A) Sodium channel blockers B) Calcium channel blockers C) Beta-adrenergic blockers D) Potassium blockers

C) Beta-adrenergic blockers

A client with a history of renal insufficiency arrives at the emergency room complaining of severe shortness of breath (SOB), fatigue, and dizziness. The triage nurse immediately draws blood and attaches a cardiac monitor. As the shift continues, the nurse notes the above change in the ECG tracing. What should the nurse do first? A) Auscultate the client's lungs. B) Call the code blue. C) Place an IV catheter. D) Check the lab results.

D) Check the lab results

If a client experiences sympathetic nervous stimulation of the heart, the nurse will observe which changes in manifestations? A) Decreased contractility and decreased heart rate B) Decreased rate and force of contraction C) Increased heart rate and decreased contractility D) Increased heart rate and increased contractility

D) Increased heart rate and increased contractility

Which sequence is the correct pathway for blood flow through the heart?

right atrium - tricuspid valve - right ventricle - pulmonary artery - lungs - pulmonary vein - left atrium - mitral valve - left ventricle - aorta

Which related circulatory complication can result from surgical treatment for metastatic breast cancer?

Lymphedema in the affected arm

An intensive care unit nurse is caring for a client who suffered a myocardial infarction involving the anterior wall, and notes a change in the cardiac rhythm. The rhythm has a PR interval that does not change, but there are twice as many P waves as there are R waves. The nurse prepares for a temporary pacemaker insertion because the client has developed: A) second-degree, Mobitz type I. B) second-degree, type 2 AV block. C) a benign second-degree AV block. D) complete, third-degree heart block.

B) second-degree, type 2 AV block.

A client with a new automatic implantable cardioverter-defibrillator (AICD) asks the nurse what happens if he goes into that deadly heart rhythm again. The nurse will base her response knowing the AICD will: A) periodically fire just to test for lead placement and battery life. B) remove scar tissue and aneurysm during placement of electrodes and then will shock if paradoxical ventricular movement is located. C) use radiofrequency energy to deliver an electrical shock through the site where the lethal rhythm originates. D) respond to ventricular tachydysrhythmia by delivering a shock within 10-20 seconds of its onset.

D) respond to ventricular tachydysrhythmia by delivering a shock within 10-20 seconds of its onset.

The nurse is assisting a client who had a myocardial infarction 2 days ago during a bath. The client suddenly lost consciousness and the nurse was unable to feel a pulse. Cardiopulmonary resuscitation was begun and the client was connected to the monitor with a gross disorganization without identifiable waveforms or intervals observed. What is a priority intervention at this time?

Immediate defibrillation

A monitored hospitalized client with a pulmonary embolism has been in atrial fibrillation (AF) for 4 days. The nurse observes the rhythm spontaneously convert to a normal sinus rhythm. Which form of AF is this?

Paroxysmal

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.

The difference between the end-diastolic and end-systolic volumes is called what? A) Cardiac output B) Stroke volume C) Cardiac reserve D) Ejection fraction

B) Stroke volume

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. A) Histamine B) Prostaglandins C) Norepinephrine D) Serotonin

A) Histamine

The nurse is reviewing the circulatory system. Which statements are correct about the functional organization of the circulatory system? Select all that apply. A)The capillaries pump blood. B)The venous system collects deoxygenated blood from the tissues. C)The arterial system distributes oxygenated blood to the tissues. D)The heart exchanges gases, nutrients, and wastes.

B) The venous system collects deoxygenated blood from the tissues. C) The arterial system distributes oxygenated blood to the tissues.

In the circulatory system, pressure is inversely related to which factor? A) Volume B) Velocity C) Viscosity D) Tension

B) Volume

A grandmother who works as 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? A) Inhibit renin release from the kidneys to promote fluid retention B) Stimulate the brain to form new red blood cells C) Increase sympathetic stimulation of the heart and blood vessels D) Increase parasympathetic stimulation of the heart and blood vessels

C) Increase sympathetic stimulation of the heart and blood vessels

During a sleep study in the laboratory, the health care provider notices one client has a prolonged period of asystole. Which term will the nurse use to describe this event in the documentation? A) Junctional rhythm B) Bradycardia-tachycardia syndrome C) Sinus arrest D) Long QT syndrome

C) Sinus arrest

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

During an assessment of a client with ankle swelling, the nurse observes jugular venous pulsations 5 cm above the sternal angle when the head of his bed is elevated 45 degrees. What is the correct interpretation of this finding? A) The client has stenosis of the jugular veins. B) The client has an increased cardiac output. C) The client has decreased fluid volume. D) The client has increased pressure related to right-sided heart failure.

D) The client has increased pressure related to right-sided heart failure.

A client with a history of angina presents with uncharacteristic chest pain. The subsequent electrocardiogram (ECG) reveals T-wave elevation. This finding suggests an abnormality with which aspects of the cardiac cycle? A)Ventricular depolarization B)Depolarization of the atrioventricular node, bundle branches, and Purkinje system C)Atrial depolarization D)Ventricular repolarization

D) Ventricular repolarization

A client reports severe indigestion that has been intermittent; however, the pain is now constant and feels like a vise. The nurse does an ECG and recognizes that the situation is possibly emergent due to ST-segment elevation, which could indicate: A) benign late repolarization. B) decreased intracranial pressure. C) advanced hypokalemia. D) myocardial infarction.

D) myocardial infarction.

The heart is a four-chambered pump. What is the function of the right ventricle?

Pumps blood to the lungs

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

Right-sided heart failure

The heart valves control the direction of blood flow. What is the function of the pulmonic valve? A) Controls the direction of blood flow from the right side of the heart to the lungs B) Controls the direction of blood flow from the right side of the heart to the systemic circulation C) Controls the direction of blood flow from the left side of the heart to the systemic circulation D) Controls the direction of blood flow from the left side of the heart to the lungs

A) Controls the direction of blood flow from the right side of the heart to the lungs

Downstream peripheral pulses have a higher pulse pressure because the pressure wave travels faster than the blood itself. What occurs in peripheral arterial disease? A) The reflected wave is transmitted more rapidly through the aorta. B) Downstream peripheral pulses are increased even more than normal. C) The pulse decreases, rather than increases, in amplitude. D) Downstream peripheral pulses are greater than upstream pulses.

C) The pulse decreases, rather than increases, in amplitude.

A client has had an acute myocardial infarction (MI). The brother of the client has a history of angina. The client asks how he will know if his brother's pain is angina or if the brother is actually having an MI. Which statement is correct? A) Chest pain with angina only occurs during the day; MI pain is more likely at night. B) Chest pain with angina only occurs at rest; MI pain occurs during a stressful time. C) Rest and intake of nitroglycerin relieve chest pain with angina; they do not relieve chest pain with an MI. D) Pain is more severe and lasts longer with angina than with an MI.

C)Rest and intake of nitroglycerin relieve chest pain with angina; they do not relieve chest pain with an MI.

Nursing students who are studying for their upcoming cardiac exam are discussing how the heart could possibly continue to beat once removed from the body. One of the students explains that this phenomenon is directly related to automaticity. What is automaticity? A) Inherent low-impulse conductivity B) Inherent discharge rate of 60-80 C) Inherent discharge rate of 40-60 D) Inherent spontaneous action-potential

D) Inherent spontaneous action-potential

Torsade de pointes is a specific type of polymorphic ventricular tachycardia in which the polarity of the QRS complex swings between positive and negative, often on a beat-to-beat basis. It is the result of the long QT syndrome and can cause sudden cardiac death. Which medication is not linked to torsade de pointes as a causative agent? A) Digitalis B) Procainamide C) Verapamil D) Tetracycline

D) Tetracycline

A client's heart rate increased from 75 beats/min to 120 beats/min. Which statement accurately expresses what occurs within the heart structure? A)The amount of time spent in diastole decreases. B) Time spent in diastole and systole decrease equally. C)The time spent in systole and diastole remain equal. D) The amount of time spent in systole increases.

D) The amount of time spent in diastole decreases.