Exam 2
(MATH) A patient is receiving heparin sodium 25,000 units in 500 mL Dextrose IV at 1,000 units/hour per protocol for acute coronary event. Based on the patient's lab values, the infusion should be decreased by 100 units/hour. The nurse should program the pump to deliver how many mL/hour? (Round to the nearest whole number)
18 mL/hr
A nurse is starting the shift by making rounds. Which patient does the nurse decide to assess first? 42-year-old with anemia who is reporting shortness of breath when ambulating down the hallway. 59-year-old who is receiving heparin to treat a pulmonary embolism and has a nose bleed. 47-year-old who recently had a blood draw and is requesting the nurse to "look at the bruise on my arm". 51-year-old who has just had a bone marrow aspiration and is requesting pain medication.
59-year-old who is receiving heparin to treat a pulmonary embolism and has a nose bleed.
A nurse is giving a presentation to a community group about preventing atherosclerosis. Which of the following should the nurse include as a modifiable risk factor for this disorder? (Select all that apply) A: Hypercholesterolemia B: Genetic predisposition C: Obesity D: Smoking
A, B, D
Which anti-dysrhythmic drug acts by blocking beta-adrenergic receptors in the heart? A: Propranolol (Inderal) B: Verapamil (Calan) C: Amiodarone (Cordarone) D: Digoxin (Lanoxin)
A: Propranolol (Inderal)
What is the physiological effect of atrial and B-type natriuretic peptide (ANP and BNP)? A: Sodium and water excretion by the kidneys, resulting in a decrease in blood volume B: Vasodilation of the systemic arteries, resulting in a decrease in blood pressure C: Increased dilation of the ventricles of the heart, which activates the Frank-Starling Law D: Increased water retention by the kidneys, resulting in an increase in blood pressure
A: Sodium and water excretion by the kidneys, resulting in a decrease in blood volume
The patient says to the nurse, "My neighbor said my antidysrhythmic drug can actually cause me to have irregular heartbeats. How can this be?" What is the nurse's best response? A: "Your medication blocks the flow of the electrolytes in your heart, and this can cause irregular beats." B: "It is better to discuss your medication concerns with a professional, not a lay person like your neighbor." C: "You must take two baby aspirin every other day to avoid irregular heartbeats." D: "Your medication is not the problem; it is when you mix it with over-the-counter (OTC) drugs that you develop irregular beats."
A: "Your medication blocks the flow of the electrolytes in your heart, and this can cause irregular beats."
A 19-year-old student comes to the student health center at the end of the semester complaining that, "My heart is skipping beats." An ECG shows occasional premature ventricular contractions (PVCs). What action should the nurse take? A: Ask the patient about current stress level and caffeine intake B: Start supplemental oxygen at 2-3 L/min via nasal cannula C: Ask the patient about any history of coronary artery disease D: Have the patient taken to the hospital emergency department
A: Ask the patient about current stress level and caffeine intake
Which of the following drugs for high cholesterol works by inhibiting the enzyme HMG-CoA reductase? A: Atorvastatin (Lipitor) B: Cholestyramine (Questran) C: Gemfibrozil (Lopid) D: Nicotinic acid (Niacin)
A: Atorvastatin (Lipitor)
A patient is on warfarin therapy for the prevention of deep vein thrombosis (DVT). The patient should be advised to avoid eating or drinking: A: Broccoli and spinach B: Peppers and onions C: Coffee D: Orange juice
A: Broccoli and spinach
A patient with atrial fibrillation secondary to mitral stenosis is receiving a heparin sodium infusion at 1000 units/hour and warfarin sodium (Coumadin) 7.5 mg at 5:00 pm daily. The morning laboratory results are as follows: aPTT = 32 seconds; INR = 1.3. The nurse should take which action based on the patient's lab results? A: Collaborate with the health care provider to obtain an order to increase the heparin infusion and administer the warfarin as prescribed. B: Collaborate with the health care provider to continue the heparin infusion at the same rate and to discuss the use of dabigatran (Pradaxa) in place of the warfarin (Coumadin). C: Collaborate with the health care provider to discontinue the heparin infusion and administer the warfarin as prescribed. D: Collaborate with the health care provider to withhold the warfarin sodium since the patient is receiving a heparin infusion and the lab values are in the normal range.
A: Collaborate with the health care provider to obtain an order to increase the heparin infusion and administer the warfarin as prescribed.
The nurse explains the purpose of ventricular defibrillation to the new graduate nurse. Which explanation does the nurse provide? A: Defibrillation allows the SA node to resume the role of a pacemaker in the heart B: Defibrillation provides non-emergent treatment for supraventricular dysrhythmias C: Defibrillation delivers a synchronized countershock to the heart D: Defibrillation terminates atrioventricular blocks in the conduction system
A: Defibrillation allows the SA node to resume the role of pacemaker in the heart
What physiologic feature is responsible for the AV nodal delay? A: Fewer gap junctions between the cells of the AV node B: Fewer sodium channels in the cells of the AV node C: An action potential with a longer plateau in the cells of the AV node D: Connective tissue interspersed among the cells of the AV node
A: Fewer gap junctions between the cells of the AV node
What is an indication that the renal carrier molecule for glucose reabsorption is saturated, and has reached the tubular maximum? A: Glucosuria B: Proteinuria C: Hyperglycemia D: Polyuria
A: Glucosuria
Which of the following would cause an increase in right ventricular afterload without affecting left ventricular afterload? A: High pulmonary artery pressure B: Dehydration C: High blood pressure within the systemic arteries D: A stricture (narrowing) at the aortic valve
A: High pulmonary artery pressure
The nurse is caring for a patient with cardiac issues who has been placed on telemetry. The nurse notes that the patient has developed atrial fibrillation and has a ventricular rate of 160 beats/min. The nurse should next assess the patient for which finding? A: Hypotension B: Complaints of nausea C: Increased oxygen saturation D: Flat neck veins
A: Hypotension
Which of the following statements about myocardial cells is incorrect? A: Myocardial cells are glucose-dependent. B: Myocardial cells are entirely dependent on the coronary arteries for oxygen delivery. C: Myocardial cells cannot meet ATP needs for ventricular contraction through anaerobic metabolism. D: Normal myocardial tissue oxygen extraction rates are higher than in other tissues.
A: Myocardial cells are glucose-dependent.
As a class of drugs, diuretics can cause which general adverse effect? A: Orthostatic hypotension B: Hypertension C: Weight gain D: Constipation
A: Orthostatic hypotension
What is the main determinant of plasma oncotic pressure? A: Plasma albumin levels B: Arterial blood pressure C: Plasma sodium levels D: Venous blood pressure
A: Plasma albumin levels
In evaluating a patient's clotting pathways, the nurse understands that which of the following is the primary difference between the extrinsic and intrinsic pathways? A: The intrinsic pathway is activated by injury within the blood vessels; the extrinsic pathway is activated by sources outside the blood vessel. B: The activation of the intrinsic pathway leads to the formation of the fibrin clot. The extrinsic pathway leads to platelet aggregation. C: Prothrombin is not required to coagulation when the extrinsic pathway is activated. D: Thrombin is involved in the extrinsic pathway; prothrombin plays a greater role in the intrinsic.
A: The intrinsic pathway is activated by injury within the blood vessels; the extrinsic pathway is activated by sources outside the blood vessel.
Which of the following statements best describes how atrial contraction occurs? A: When cells in the SA node depolarize, the action potential spreads to all of the other cells via gap junctions, and to the AV node via the internodal pathways. B: Calcium from all of the interconnected capillaries floods into the entire atrial mass, resulting in a coordinated contraction. C: Sympathetic motor neurons innervate every monocyte in the atrium, allowing the muscle mass to contract as a unit. D: The atria are stimulated by ventricular contraction.
A: When cells in the SA node depolarize, the action potential spreads to all of the other cells via gap junctions, and to the AV node via the internodal pathways.
The secretion of renin can be activated by: A: decreased blood pressure sensed in the juxtaglomerular apparatus. B: increased plasma osmolarity sensed by the hypothalamus. C: increased renal blood flow. D: sympathetic stimulation to the juxtaglomerular apparatus.
A: decreased blood pressure sensed in the juxtaglomerular apparatus.
The nurse is administering amiodarone (Cordarone) to a patient and recognizes this drug will block potassium channels, which will then have the following action: A: slow the spread of impulse conduction. B: speed the spread of impulse conduction. C: worsen the dysrhythmia. D: stop the spread of impulse conduction.
A: slow the spread of impulse conduction.
The patient asks why he is taking both hydrochlorothiazide (HCTZ) and spironolactone (Aldactone). The nurse's answer is based on the knowledge that: A: spironolactone (Aldactone) helps retain the potassium that the thiazide diuretic, if taken alone, would excrete from the body. B: multiple diuretics will be more effective than a single one. C: the patient's blood pressure cannot be controlled with one or the other alone. D: when taken together, these two classifications of drug have a synergistic effect.
A: spironolactone (Aldactone) helps retain the potassium that the thiazide diuretic, if taken alone, would excrete from the body.
A direct effect of angiotensin II is to: A: stimulate arterial vasoconstriction. B: stimulate bronchodilation. C: reduce left ventricular afterload. D: increase cardiac output.
A: stimulate arterial vasoconstriction.
Two hormones primarily involved in fluid balance that are also potent vasoconstrictors are: A: vasopressin (ADH) and angiotensin II. B: angiotensin II and aldosterone. C: vasopressin (ADH) and aldosterone. D: epinephrine and angiotensin II.
A: vasopressin (ADH) and angiotensin II.
A nurse is caring for a patient who has deep vein thrombosis and has been on heparin continuous infusion for 5 days. The provider prescribes warfarin PO without discontinuing the heparin. The patient asks the nurse why both anticoagulants are necessary. Which of the following statements should the nurse make? A: "I will call the provider to get an order for discontinuing the IV heparin today." B: "Warfarin takes several days to work, so the IV heparin will be used until the warfarin reaches a therapeutic level." C: "Both heparin and warfarin work together to dissolve the clots." D: "The IV heparin increases the effects of the warfarin and decreases the length of your hospital stay."
B: "Warfarin takes several days to work, so the IV heparin will be used until the warfarin reaches a therapeutic level."
What is the specific effect of aldosterone on the renal tubule? A: Aldosterone inhibits water reabsorption in the distal tubule. B: Aldosterone stimulates sodium reabsorption in the distal tubule. C: Aldosterone stimulates sodium reabsorption in the loop of Henle. D: Aldosterone stimulates potassium reabsorption in the distal tubule.
B: Aldosterone stimulates sodium reabsorption in the distal tubule.
Creatinine is a good measure of glomerular filtration rate because: A: the renal tubules are not permeable to creatinine. B: All of these responses are correct. C: if the tubules do not reabsorb a substance, then clearance equals GFR. D: it is produced at a rate that is constant, and dependent on lean muscle mass.
B: All of these responses are correct.
Vasoconstriction: A: of an arteriole decreases blood flow through that vessel, but increases pressure. B: All of these responses are correct. C: refers to a decrease in the radius of a vessel. D: of a vein increases blood flow through that vessel.
B: All of these responses are correct.
Which type of receptor binds norepinephrine on cardiac muscle cells? A: Alpha-1 B: Beta-1 C: Beta-2 D: Cholinergic
B: Beta-1
Which activity accounts for the "plateau" observed in the action potential of contractile cardiac muscle cells? A: Sodium diffusion into the cytoplasm B: Calcium diffusion into the cytoplasm C: Potassium diffusion into the cytoplasm D: Calcium diffusion out of the cytoplasm
B: Calcium diffusion into the cytoplasm
The nurse understands that the cholesterol component of HDL has which function after it is transported to the liver? A: It is used to build plasma membranes. B: It is broken down to become part of bile. C: It is used to make low-density lipoprotein (LDL) cholesterol. D: It is used as an energy source.
B: It is broken down to become part of bile.
On a normal ECG, a wave for repolarization of the atria is not recorded. Why not? A: It does not travel through body fluids. B: It occurs simultaneously with ventricular depolarization and is masked by the QRS complex. C: No repolarization of the atria occurs normally. D: The electrodes are not placed in a position to pick it up.
B: It occurs simultaneously with ventricular depolarization and is masked by the QRS complex.
To measure whether there is a delay in impulse conduction through the atria, the nurse will measure the duration of the patient's: A: P wave B: P-R interval C: Q wave D: QRS complex
B: P-R interval
A patient is being treated for moderate to severe hypertension and has been taking diltiazem (Cardizem) for several months. After some episodes of chest pain, the patient is diagnosed with angina. The nurse understands that the medication will provide which therapeutic effect for this new diagnosis? A: Increases oxygen demands within the myocardium B: Prevents influx of calcium ions in vascular smooth muscle C: Increases the force of contraction of ventricular tissues D: Leads to an increase in calcium absorption in the vascular smooth muscle
B: Prevents influx of calcium ions in vascular smooth muscle
The nurse assesses the client with prolonged or uncontrolled hypertension for the development of which of the following conditions? A: Cirrhosis of the liver B: Renal failure C: Gastroesophageal reflux disorder D: Emphysema
B: Renal failure
The nurse is reviewing the laboratory test results for a patient who has recently been diagnosed with hypertension. Which result is the most important to communicate to the health care provider? A: Serum potassium of 4.5 mEq/L B: Serum creatinine 2.8 mg/dL C: Serum hemoglobin of 14.7 g/dL D: Blood glucose of 96 mg/dL
B: Serum creatinine 2.8 mg/dL
A patient with no history of heart disease has experienced acute myocardial infarction and has been given thrombolytic therapy with tissue plasminogen activator (tPA). What assessment finding should the nurse identify as the most likely indicator that the patient is experiencing complications of this therapy? A: Nausea and vomiting B: Tarry stools C: Decreased urine output D: Orange-colored urine
B: Tarry stools
The most appropriate food for the patient taking loop diuretics is: A: yogurt. B: bananas. C: meat. D: cheese.
B: bananas.
Afferent arteriole vasoconstriction _____ blood flow into the glomerulus, which causes the glomerular capillary hydrostatic pressure to _____, leading to a(n) _____ in the net filtration pressure and a resultant _____ in the GFR. A: decreases; decrease; increase; increase B: decreases; decrease; decrease; decrease C: increases; increase; decrease; decrease D: increases; increase; increase; increase
B: decreases; decrease; decrease; decrease
A patient has frequent runs of ventricular tachycardia on the cardiac monitor. A nurse is most concerned with this dysrhythmia because: A: it is almost impossible to convert to normal sinus rhythm. B: it can develop into ventricular fibrillation at any time. C: it produces a high cardiac output that quickly leads to cerebral and myocardial ischemia. D: it is uncomfortable for the patient, giving a sense of impending doom.
B: it can develop into ventricular fibrillation at any time.
The wall of the left ventricle is thicker than the wall of the right ventricle because the: A:left ventricle must pump much more blood than the right ventricle, so it must have stronger walls. B: left ventricle must pump the same amount of blood into the high-resistance, high-pressure systemic circulation as does the right ventricle into the low-resistance, low-pressure pulmonary system. C:right ventricle must pump much more blood than the left ventricle, so it has a larger chamber to accommodate the blood and correspondingly thinner wall. D: left ventricle must pump oxygenated blood, which requires more energy than pumping non-oxygenated blood.
B: left ventricle must pump the same amount of blood into the high-resistance, high-pressure systemic circulation as does the right ventricle into the low-resistance, low-pressure pulmonary system.
Most cases of combined systolic and diastolic hypertension have no known cause and are documented on the chart as _______ hypertension. A: secondary B: primary C: acquired D: congenital
B: primary
The client has been in bed for several hours. When the client sits on the side of the bed, the blood pressure drops slightly and the heart rate increases. The regulatory mechanism responsible for this response is: A: suppression of chemoreceptors. B: stimulation of the baroreceptors. C: activation of chemoreceptors. D: parasympathetic nervous system stimulation.
B: stimulation of the baroreceptors.
The descending loop of Henle primarily allows for: A: hydrogen ion reabsorption. B: water reabsorption. C: sodium secretion. D: potassium secretion.
B: water reabsorption.
A patient is receiving doxazosin (Cardura) for hypertension. He asks the nurse how the medication works. What is the nurse's best response? A: "It works by decreasing the release of your stress hormone." B: "It works by making your heart work more efficiently." C: "It works by making your blood vessels expand." D: "It works by causing your kidneys to excrete more urine."
C: "It works by making your blood vessels expand."
The nurse realizes that client teaching regarding the cause of angina pain was effective when the client states: A: "The heart is not pumping enough blood out with each beat because of narrowed arteries." B: "The pain comes from the heart beating irregularly because of narrowed arteries." C: "The pain comes from a lack of oxygen getting to the heart, which is caused by narrowed arteries." D: "The pain is related to remodeling of the heart muscle caused by narrowed arteries."
C: "The pain comes from a lack of oxygen getting to the heart, which is caused by narrowed arteries."
Furosemide is administered intravenously to the patient with heart failure. How soon after administration should the nurse begin to see evidence of the drug's desired effect? A: 2 to 4 hours B: 30-60 minutes C: 5 to 10 minutes D: 6 to 8 hours
C: 5 to 10 minutes
In the baroreceptor reflex, what is the body's response to decreased blood pressure sensed by the carotid and aortic bodies? A: Inhibition of the autonomic nervous system B: Release of renin from the kidneys C: Activation of the sympathetic nervous system D: Activation of the parasympathetic nervous system
C: Activation of the sympathetic nervous system
A nurse is caring for a patient who is taking lisinopril. Which of the following outcomes indicates a therapeutic effect of the medication? A: Increased HDL cholesterol B: Prevention of bipolar manic episodes C: Decreased blood pressure D: Improved sexual function
C: Decreased blood pressure
A nurse is explaining to a nursing student that which of the following is the term used to describe the physiological process that occurred when bleeding is stopped? A: Coagulation cascade B: None of these responses is correct. C: Hemostasis D: Coagulation
C: Hemostasis
Which information should the nurse include when teaching a patient newly diagnosed with hypertension? A: Hypertension is usually asymptomatic until target organ damage occurs B: Increasing physical activity will control blood pressure for most patients C: Most patients are able to control blood pressure through dietary changes D: Daily BP checks must be done in the provider's office to monitor efficacy of treatment
C: Most patients are able to control blood pressure through dietary changes
Stimulation of which of the following receptors on the SA node cells will result in a decrease in heart rate? A: Alpha-1 B: Beta-1 C: Muscarinic D: Beta-2
C: Muscarinic
When administering a beta blocker to a patient with a dysrhythmia, the nurse understands that the drug will have which effect? A: Positive inotropic effect B: Positive chronotropic effect C: Negative inotropic effect D: Negative chronotropic effect
C: Negative inotropic effect
A patient is post-operative, and at risk for developing venous thromboembolism (VTE). The nurse should review which of the following lab values to monitor for a therapeutic effect of warfarin? A: Hemoglobin (Hgb) B: Bleeding time C: Prothrombin time (PT) D: Activated partial thromboplastin time (aPTT)
C: Prothrombin time (PT)
A patient is diagnosed with orthostatic hypotension. Which of the following symptoms would most likely be reported? A: Headache and blurred vision B: Chest pain and palpitations C: Syncope and fainting D: Nausea and vomiting
C: Syncope and fainting
The nurse is monitoring a patient who is on telemetry. Which of the following findings on the ECG strip should the nurse recognize as normal sinus rhythm? A: The T-wave is in the inverted position. B: The QRS complex duration is 0.20 seconds. C: The P wave falls before the QRS complex. D: The P-R interval measures 0.22 seconds.
C: The P wave falls before the QRS complex.
The nurse is monitoring a patient who is taking propranolol (Inderal). Which assessment data indicates a potential serious complication associated with this medication? A: The development of complaints of insomnia B: A baseline resting heart rate of 88 bpm followed by a resting heart rate of 72 bpm after two doses of the medication C: The development of audible expiratory wheezes D: A baseline blood pressure of 150/80 mm Hg, followed by a blood pressure of 138/72 mm Hg after two doses of the medication
C: The development of audible expiratory wheezes
Propranolol (Inderal) is prescribed for a patient diagnosed with hypertension. The nurse should consult with the health care provider before giving this medication when the patient reveals a history of: A: peptic ulcer disease. B: daily alcohol use. C: asthma. D: myocardial infarction.
C: asthma.
At the arterial end of capillaries, fluid moves from the intravascular space into the interstitial space because the: A: capillary oncotic pressure is lower than the interstitial hydrostatic pressure. B: interstitial hydrostatic pressure is higher than the capillary hydrostatic pressure. C: capillary hydrostatic pressure is higher than the capillary oncotic pressure. D: interstitial oncotic pressure is higher than the interstitial hydrostatic pressure.
C: capillary hydrostatic pressure is higher than the capillary oncotic pressure.
The patient asks how the cardiac glycoside, digoxin, is different than propranolol (Inderal), a beta blocker. The nurse replies that beta-blockers: A: increase the strength of myocardial contraction. B: increase afterload by causing vasodilation. C: decrease myocardial oxygen demand and contractility. D: increase myocardial oxygen demand.
C: decrease myocardial oxygen demand and contractility.
The nurse's best explanation to the patient about the action of clopidogrel (Plavix) would be that the drug acts by: A: dissolving clots. B: reducing the viscosity of red blood cells. C: decreasing platelet aggregation. D: increasing platelet production.
C: decreasing platelet aggregation.
The QRS complex represents: A: depolarization of the atria. B: the time during which the heart is contracting. C: depolarization of the ventricles. D: the AV nodal delay.
C: depolarization of the ventricles.
The purpose of the AV nodal delay is to: A: There is no AV nodal delay. B: ensure cardiac muscle does not have tetanic contraction. C: ensure the atria contract and empty their contents prior to the ventricular systole. D: ensure the ventricles contract prior to atrial systole.
C: ensure the atria contract and empty their contents prior to the ventricular systole.
Loop diuretics: A: promote excretion of water by adding sodium to the filtrate. B: block sodium in the distal and proximal loops. C: inhibit reabsorption of sodium and chloride in the nephron ansa. D: block aldosterone.
C: inhibit reabsorption of sodium and chloride in the nephron ansa.
The action of nitrates is: A: vasoconstriction. B: increased preload. C: smooth muscle relaxation. D: smooth muscle contraction.
C: smooth muscle relaxation.
Renal secretion is a process in which: A: molecules selectively leak across the glomerular membrane. B: filtered ions are returned to the peritubular capillaries. C: substances are added to the urine filtrate in the renal tubules and then excreted. D: hormones are released by the renal tubules.
C: substances are added to the urine filtrate in the renal tubules and then excreted.
The nurse recognizes the following class of drugs would not be helpful in the treatment of a client with a dysrhythmia. A: Potassium channel blockers B: Sodium channel blockers C: Calcium channel blockers D: Alpha-adrenergic blockers
D: Alpha-adrenergic blockers
An increase in the force of ventricular contraction would result from stimulating: A: Alpha-1 receptors. B: Muscarinic receptors. C: Beta-s receptors. D: Beta-1 receptors.
D: Beta-1 receptors.
A patient with a history of hypertension treated with a diuretic and an angiotensin-converting enzyme (ACE) inhibitor arrives in the emergency department complaining of a severe headache and nausea, and has a blood pressure of 238/118 mm Hg. Which question should the nurse ask first? A: "Did you take any acetaminophen (Tylenol) today?" B: "Have there been any recent stressful events in your life?" C: "Have you recently taken any antihistamine medications?" D: "Have you been consistently taking your medication?"
D: "Have you been consistently taking your medication?"
A nurse is caring for a patient who has thrombophlebitis and is receiving heparin by continuous IV infusion. The patient asks the nurse how long it will take for the heparin to dissolve the clot. Which of the following responses should the nurse give? A: "A pharmacist is the person to answer that question." B: "The oral medication you take after this IV will dissolve the clot." C: "It usually takes heparin at least 2 to 3 days to reach a therapeutic blood level." D: "Heparin does not dissolve clots. It stops new clots from forming."
D: "Heparin does not dissolve clots. It stops new clots from forming."
The nurse is providing group education about lipids to patients who have been diagnosed with hyperlipidemia. What does the best instruction include? A: "High density lipoprotein (HDL) decreases, bad cholesterol (low density lipoprotein, or LDL), and promotes excretion of it through the kidneys." B: "High density lipoprotein (HDL) is called "good cholesterol" because it increases the oxygen content in the arteries and reduces the amount of plaque build-up." C: "High density lipoprotein (HDL) decreases low-density lipoprotein (LDL) and prevents it from converting to very-low-density lipoprotein (VLDL), which is the worst kind of cholesterol in the body." D: "High density lipoprotein (HDL) is called "good cholesterol" because it removes cholesterol from the body and gets rid of it through the liver."
D: "High density lipoprotein (HDL) is called "good cholesterol" because it removes cholesterol from the body and gets rid of it through the liver."
The client asks the nurse, "What is VLDL? I've never heard of that." The nurse provides the simple explanation that: A: "Diets low in cholesterol result in more LDL being converted into VLDL." B: "Because VLDL is a very-low-density lipoprotein, it is good for preventing heart disease." C: "VLDL is the "best" cholesterol because it has the lowest density." D: "Very-low-density lipoprotein (VLDL) is used to carry triglycerides through the body."
D: "Very-low-density lipoprotein (VLDL) is used to carry triglycerides through the body."
Vasodilation of the coronary arteries in response to myocardial hypoxia is accomplished by which of the following mechanisms? A: Atrial stretch feedback B: Frank-Starling Law C: Stimulation of the coronary arteries by the vagus nerve D: Adenosine release by the myocardial cells
D: Adenosine release by the myocardial cells
A nurse is caring for a patient who has lost a significant amount of blood as a result of complications of a surgical procedure. The nurse understands that which patient assessment will provide the earliest indication of new decreases in fluid volume? A: Lung auscultation for crackles B: Assessment for edema C: Blood pressure (BP) D: Heart rate
D: Heart rate
A nurse is assessing a patient with an abdominal aortic aneurysm. Which assessment finding by the nurse is most likely unrelated to the aneurysm? A: Pulsatile abdominal mass visible when patient is supine B: Systolic bruit over the area of the mass C: Subjective sensation of "heart beats" in the abdomen D: Hyperactive bowel sounds in the area
D: Hyperactive bowel sounds in the area
A patient has had a stroke to the pituitary gland. What is the effect of decreased antidiuretic hormone (ADH) secretion by the posterior pituitary? A: Hypertension B: Sodium and water loss by the kidney C: Sodium retention by the kidney D: Hypovolemia
D: Hypovolemia
A client with new-onset atrial fibrillation had a baseline prothrombin time (PT) of 15 seconds before starting 2.5 mg of warfarin daily. The nurse reviews the client's coagulation panel. She expects the warfarin dose to continue at 2.5 mg per day when finding which of the following laboratory date? A: PT=60 seconds; INR=5 B: PT=14 seconds; INR=1 C: PTT=30 D: INR=2.5; PT=31 seconds
D: INR=2.5; PT=31 seconds
Which of the following changes will increase the myocardial workload (i.e. increased demand for ATP) of the heart? A: Decreased systemic vascular resistance B: Parasympathetic stimulation C: Decreased oxygen supply D: Increased afterload
D: Increased afterload
The nurse is assessing an older adult patient who is receiving digoxin. The nurse should recognize that which of the following findings is a manifestation of digoxin toxicity? A: Anorexia B: Ataxia C: Jaundice D: Photosensitivity/auras
D: Photosensitivity/auras
A nurse is caring for a patient who is receiving heparin by continuous IV infusion. Which of the following medications should the nurse plan to administer in the event of an overdose? A: Iron B: Vitamin K C: Glucagon D: Protamine
D: Protamine
The nurse understands that when medications in the urine filtrate pass across the wall of the nephron to re-enter the bloodstream, they are using what process? A: Tubular secretion B: Metabolism C: Absorption D: Reabsorption
D: Reabsorption
Procainamide (Procan), an anti-dysrhythmic agent for supraventricular tachycardia, prolongs repolarization by blocking the removal of which of the following electrolytes from the cell? A: Chloride B: Calcium C: Potassium D: Sodium
D: Sodium
A person with a heart rate of 170 bpm and a normal QRS duration would most likely be experiencing a: A: Tachydysrhythmia originating from the Purkinje fibers. B: Tachydysrhythmia originating from the ventricles. C: Tachydysrhythmia originating from the bundle branches. D: Tachydysrhythmia originating from the atria.
D: Tachydysrhythmia originating from the atria.
Which of the following explanations about the international normalized ratio (INR) test is correct? A: The INR is only needed twice a month B: The INR is the only test available for anticoagulant therapy monitoring. C: The INR monitors heparin therapy. D: The INR is a standardized test that estimates the variations between laboratories in prothrombin times.
D: The INR is a standardized test that estimates the variations between laboratories in prothrombin times.
What anti-dysrhythmic agent also acts to dilate coronary arteries and so is frequently used to treat angina? A: Procainamide (Procan) B: Adenosine (Adenocard) C: Lidocaine (Xylocaine) D: Verapamil (Calan)
D: Verapamil (Calan)
According to the Frank-Starling Law related to the heart, within a normal physiologic range, an increase in left ventricular end-diastolic pressure leads to: A: an increase in heart rate. B: a decreased force of contraction. C: vasoconstriction of the systemic arteries. D: an increase in stroke volume.
D: an increase in stroke volume.
Glomerular filtration: A: occurs in the loop of Henle. B: All of these responses are correct. C: is the process by which a substance is transported from tubular fluid to the peritubular capillaries. D: is the process by which plasma, water, electrolytes and small molecules, which enter Bowman's capsule, are separated from blood cells and protein, which remain in the glomerular capillaries.
D: is the process by which plasma, water, electrolytes and small molecules, which enter Bowman's capsule, are separated from blood cells and protein, which remain in the glomerular capillaries.
Foam cells in the "fatty streak" that marks development of atherosclerosis are: A: deposited adipose cells. B: injured neutrophils. C: lipid-laden HDL molecules. D: macrophages that engulf low-density lipoproteins.
D: macrophages that engulf low-density lipoproteins.
The cardiac muscle: A: receives its blood supply primarily during ventricular systole when blood is forced into vessels supplying the heart. B: receives its blood supply as the blood returning to the heart from the lung passes through the cardiac circulation before being pumped to the systemic circulation. C: extracts oxygen and nutrients from the blood within its chambers. D: receives most of its blood supply during ventricular diastole by means of the coronary circulation.
D: receives most of its blood supply during ventricular diastole by means of the coronary circulation.
Which of the following statements regarding tubular reabsorption is incorrect? Tubular reabsorption: A: is important for the conservation of substances imported to the body, such as Na+, Cl-, and glucose. B: refers to the movement of a substance from the tubular fluids to the peritubular capillary blood. C: can occur by active or passive transport. D: takes place only in the proximal tubules.
D: takes place only in the proximal tubules. rational: reabsorption happens in the proximal and distal tubules
An important effect of beta-2 receptor stimulation is: A: vasodilation of the major (large) arteries. B: vasoconstriction of the arterioles to the skin. C: an increase in the strength of myocardial contraction. D: vasodilation of the coronary arteries.
D: vasodilation of the coronary arteries.
Secretion of antidiuretic hormone (ADH) and perception of thirst are stimulated by a(n): decrease in serum sodium. increase in plasma osmolality. decrease in baroreceptor stimulation. increase in glomerular filtration rate.
increase in plasma osmolality.
