*FINAL - Patho Chapter 32, 33 & 34- Structure and Function & Alterations of Cardiovascular Function + Children

Which statements are true regarding congenital heart defects? (Select all that apply.) A. Congenital heart disease is the second leading cause of death in infants during the first year of life. B. Incidence of heart defects is high in stillbirths, low-birth-weight babies, and spontaneous abortions. C. Maternal use of drugs during pregnancy has not been shown to increase congenital heart disease. D. The underlying cause of congenital heart disease is known in 30% of cases. E. Infants with trisomy 21 have a high incidence of congenital heart disease.

A, B, E A. Congenital heart disease is the second leading cause of death in infants during the first year of life. B. Incidence of heart defects is high in stillbirths, low-birth-weight babies, and spontaneous abortions. E. Infants with trisomy 21 have a high incidence of congenital heart disease. Congenital heart disease is the leading cause of death, excluding prematurity, in infants during the first year of life. The incidence of heart defects also has been found to be high in stillbirths, low-birth-weight or small-for-gestational-age infants, and spontaneous abortions. The use of some drugs during pregnancy is associated with an above-average incidence of congenital heart disease. Examples of these drugs include thalidomide, lithium, phenytoin (Dilantin), and warfarin. The underlying cause of congenital heart disease is known in only 10% of cases. As many as 50% of infants with trisomy 21 have a congenital heart defect, either an atrioventricular (AV) canal defect or a VSD.

The heart consists of four valves. Which are the semilunar valves? Select all that apply. A. Pulmonary B. Tricuspid C. Aortic D. Mitral

A, C Pulmonary and Aortic Explanation: The heart's semilunar valves are pulmonary and aortic values. The heart's atrioventricular valves are the tricuspid and the mitral.

The heart consists of four valves. Which are the heart's atrioventricular valves? Select all that apply. A. Mitral B. Aortic C. Tricuspid D. Pulmonary

A, C Tricuspid Mitral Explanation: The heart's atrioventricular valves are the tricuspid and the mitral. The semilunar valves are pulmonary and aortic.

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 Explanation: The heart valves control the direction of blood flow from the atria to the ventricles (the AV valves), from the right side of the heart to the lungs (pulmonic valve), and from the left side of the heart to the systemic circulation (aortic valve)

Older children with an unrepaired cardiac septal defect experience cyanosis because of which factor? a. Right-to-left shunts b. Left-to-right shunts c. Obstructive lesions d. Mixed lesions

A. Right-to-left shunts. Older children who have an unrepaired septal defect with a left-to-right shunt may become cyanotic because of pulmonary vascular changes secondary to increased pulmonary blood flow. None of the other options accurately describe the process that results in cyanosis.

When assessing the patient, the nurse notes a palpable precordial thrill. This finding may be caused by A. heart murmurs. B. gallop rhythms. C. pulmonary edema. D. right ventricular hypertrophy.

A. heart murmurs.

When a patient is diagnosed with coronary artery disease, the nurse assesses for myocardial: a. hypertrophy. b. ischemia. c. necrosis. d. inflammation.

ANS: B Ischemia Coronary artery disease leads to myocardial ischemia. Coronary artery disease would not lead to hypertrophy, but not to ischemia, necrosis, or inflammation.

Many valvular stenosis and regurgitation disorders in adults have a common etiology. Which of the following conditions should alert the nurse that the patient may have both types of valve dysfunctions? a. Heart failure b. Connective tissue disorders c. Rheumatic fever or heart disease d. Syphilis infection

ANS: C- Rheumatic fever or heart disease Valvular dysfunction is often related to rheumatic fever. Heart failure decreases cardiac output but does not affect valvular function. It is not due to connective tissue disorders. Syphilis infection could affect valves, but it is not the most common cause.

A 10-year-old male presents with fever, lymphadenopathy, arthralgia, and nosebleeds. He is diagnosed with rheumatic heart disease. The most likely cause of this disease is: a. congenital heart defects. b. human immunodeficiency virus (HIV) infections. c. group A beta-hemolytic streptococcus infections. d. acute pericarditis.

ANS: C- group A beta-hemolytic streptococcus infections. Rheumatic fever is a systemic, inflammatory disease caused by a delayed exaggerated immune response to infection by the group A beta-hemolytic streptococcus, not by congenital heart defects, HIV infections, or acute pericarditis.REF: pp. 628-629

A child who is about to begin school is found to have a crescendo-decrescendo systolic ejection murmur. This finding supports the presence of which cardiac anomaly? A. Mitral valve prolapse B. Atrial septal defect C. Ventricular septal defect D. Congestive heart failure

B. Atrial septal defectAn atrial septal defect may exhibit a crescendo-decrescendo systolic ejection murmur. Mitral valve prolapse is not usually diagnosed in childhood and is identified by an opening click. A ventricular septal defect has a harsh, loud, holosystolic murmur and systolic thrill. A child with congestive heart failure may show changes in feeding, respirations, or lung sounds.

Primary cause of death in persons older than age 65: A. Diabetes B. Cardiovascular Disease C. Obesity D. Cancer

B. Cardiovascular Disease

What is the most common cardiovascular disease condition? A. Coronary artherosclerosis B. Hypertension C. Aneurysm D. Coronary Artery Disease

B. Hypertension

Which event triggers congenital heart defects that cause acyanotic congestive heart failure? a. Right-to-left shunts b. Left-to-right shunts c. Obstructive lesions d. Mixed lesions

B. Left-to-right shunts. Congenital heart defects that cause acyanotic congestive heart failure usually involve left-to-right shunts (see Table 33-4). Acyanotic congestive heart failure does not involve any of the other options.

The nurse is reviewing the anatomy and physiology of the heart. What is the function of the right atrium? A. Pumps blood to the lungs B. Receives blood returning to the heart from the systemic circulation C. Pumps blood into the systemic circulation D. Receives oxygenated blood from the lungs

B. Receives blood returning to the heart from the systemic circulation Explanation: The right atrium receives blood returning to the heart from the system circulation. The left atrium receives oxygenated blood from the lungs. The right ventricle pumps blood to the lungs. The left ventricle pumps blood into the systemic circulation.

Which sequence is the correct pathway for blood flow through the heart? A. Left atrium - bicuspid valve - left ventricle - pulmonary artery - lungs - pulmonary vein - right atrium - tricuspid valve - right ventricle - aorta. B. Right atrium - tricuspid valve - right ventricle - pulmonary artery - lungs - pulmonary vein - left atrium - mitral valve - left ventricle - aorta. C. Right atrium - bicuspid valve - right ventricle - pulmonary artery - lungs - pulmonary vein - left atrium - tricuspid valve - left ventricle - aorta. D. Left atrium - tricuspid valve - left ventricle - pulmonary artery - lungs - pulmonary vein - right atrium - mitral valve - right ventricle - aorta.

B. Right atrium - tricuspid valve - right ventricle - pulmonary artery - lungs - pulmonary vein - left atrium - mitral valve - left ventricle - aorta Explanation: The correct pathway for blood flow through the heart in the right atrium - tricuspid valve - right ventricle - pulmonary artery - lungs - pulmonary vein - left atrium - mitral valve - the left ventricle - aorta.

Which statement accurately describes blood flow through the heart? A. Blood flows from the left atrium through the tricuspid valve to the left ventricle. B. Blood flows from the right atrium through the aortic valve to the right ventricle. C. Blood flows from the right ventricle through the pulmonic semilunar valve. D. Blood flows from the left ventricle through the bicuspid valve.

C. Blood flows from the right ventricle through the pulmonic semilunar valve.Blood flows from the right atrium through the tricuspid valve to the right ventricle. Blood then travels from the right ventricle through the pulmonic semilunar valve to the pulmonary circulation. Once in the pulmonary circulation, it is oxygenated and travels to the left atrium through the bicuspid valve to the left ventricle. Blood leaves the left ventricle through the aortic valve and enters the systemic circulation.

Select the correct sequence of blood return to the heart. A. Capillaries, arterioles, veins, left atrium B. Capillaries, arterioles, arteries, right atrium C. Capillaries, venules, veins, right atrium D. Capillaries, venules, veins, left atrium

C. Capillaries, venules, veins, right atrium Explanation: The correct pathway for blood returning back to the heart is the capillaries, venules, veins, and right atrium. The other options do not support normal blood flow.

The school nurse is doing a health class on the functional organization of the circulatory system. What is the function of the capillaries in the circulatory system? A. Distribute oxygenated blood to the tissues B. Pump blood C. Exchange gases, nutrients, and wastes D. Collect deoxygenated blood from the tissues

C. Exchange gases, nutrients, and wastes Explanation: The circulatory system consists of the heart, which pumps blood; the arterial system, which distributes oxygenated blood to the tissues; the venous system, which collects deoxygenated blood from the tissues and returns it to the heart; and the capillaries, where the exchange of gases, nutrients, and waste takes place.

Which of the following is true regarding pulmonary circulation? A. The system functions with an increased arterial pressure to circulate through the distal parts of the body. B. It is the larger of the two circulatory systems. C. It is a low-pressure system that allows for improved gas exchange. D. It consists of the left side of the heart, the aorta, and its branches.

C. It is a low-pressure system that allows for improved gas exchange. Explanation: The pulmonary circulation consists of the right heart and the pulmonary artery, capillaries, and veins. It is the smaller of the systems and functions at a lower pressure to assist with gas exchange.

Which cardiac chamber has the thickest wall? A. Left atrium B. Right atrium C. Left ventricle D. Right ventricle

C. Left ventricle The atria are approximately 1 to 2 mm thick. The right ventricle is 4 to 5 mm thick, and the left ventricle, the most muscular chamber, is approximately 12 to 15 mm thick.

A murmur is heard at the second left intercostal space along the left sternal border. Which valve is this? A. Aortic B. Mitral C. Pulmonic D. Tricupsid

C. Pulmonic valve Abnormalities of the pulmonic valve are auscultated at the second left intercostal space along the left sternal border. Aortic valve abnormalities are heard at the second intercostal space, to the right of the sternum. Mitral valve abnormalities are heard at the fifth intercostal space in the midclavicular line. Tricuspid valve abnormalities are heard at the 3rd and 4th intercostal spaces along the sternal border.

In teaching a patient about coronary artery disease, the nurse explains that the changes that occur in this disorder involve A. diffuse involvement of plaque formation in coronary veins. B. formation of fibrous tissue around coronary artery orifices. C. accumulation of lipid and fibrous tissue within the coronary arteries. D. chronic vasoconstriction of coronary arteries leading to permanent vasospasm.

C. accumulation of lipid and fibrous tissue within the coronary arteries.

A child has been noted to have hypertension with decreased pulses in the lower extremities. What is the most likely congenital cause for this finding? A. Tricuspid atresia B. Atrial septal defect C. Pulmonary stenosis D. Coarctation of the aorta

D. Coarctation of the aorta Coarctation of the aorta is a narrowing of the lumen of the aorta that impedes blood flow. Children may have cool, mottled skin and occasionally leg cramps during exercise. A systolic ejection murmur, heard best at the left interscapular area, is caused by rapid blood flow through the narrowed area, which is often found with hypertension. Children with pulmonary stenosis may have a systolic ejection murmur and possibly exertional dyspnea and fatigability. Atrial septal defects have a murmur. Cyanosis, growth failure, and dyspnea may occur with tricuspid atresia.

The heart controls the direction of blood flow. What is the role of the aortic valve? A. Controls the direction of blood flow from the atria to the ventricles B. Controls the direction of blood flow from the ventricles to the atria C. Controls the direction of blood flow from the left side of the heart to the lungs D. 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 systemic circulation Explanation: The heart valves control the direction of blood flow from the atria to the ventricles (the AV valves), from the right side of the heart to the lungs (pulmonic valves), and from the left side of the heart to the systemic circulation (aortic valve).

The heart is a four-chambered pump. What is the function of the right ventricle? A. Receives blood returning to the heart from the systemic circulation B. Pumps blood into the systemic circulation C. Receives oxygenated blood from the lungs D. Pumps blood to the lungs

D. Pumps blood to the lungs Explanation: The right ventricle pumps blood to the lungs. The right atrium receives blood returning to the heart from the system circulation. The left atrium receives oxygenated blood from the lungs. The left ventricle pumps blood into the systemic circulation.

The nurse is reviewing the anatomy and physiology of the heart. What is the function of the right atrium? A. Receives oxygenated blood from the lungs B. Pumps blood to the lungs C. Pumps blood into the systemic circulation D. Receives blood returning to the heart from the systemic circulation

D. Receives blood returning to the heart from the systemic circulation Explanation: The right atrium receives blood returning to the heart from the system circulation. The left atrium receives oxygenated blood from the lungs. The right ventricle pumps blood to the lungs. The left ventricle pumps blood into the systemic circulation.

What are the structural changes that happens with cardiovascular system with aging?

Decreased myocardial cells, aortic distensibility, and vascular tone Increased heart weight, myocardial cell size, left ventricle wall thickens, artery stiffness, elastin levels, collagen levels, and left atrium size

Which of the following risk factors is associated with coronary artery disease (CAD)? a.Diabetes mellitus b.Hypertension c.Obesity d.High alcohol consumption

a- Diabetes mellitus because of alteration of hepatitic lipoprotein

Which disorder causes a transitory truncal rash that is nonpruritic and pink with erythematous macules that may fade in the center, making them appear as ringworm? a.Fat emboli b.Rheumatic fever c.Bacterial endocarditis d.Myocarditis of acquired immunodeficiency syndrome

b- Rheumatic fever

The risk of developing coronary artery disease is increased up to threefold by: a.diabetes mellitus. b.hypertension. c.obesity. d.high alcohol consumption.

b- hypertension

Aortic and mitral regurgitation, as well as mitral stenosis, are caused by: a.congenital malformation. b.cardiac failure. c.rheumatic fever. d.coronary artery disease.

c- rheumatic fever.

Which of the following does not significantly affect heart rate? a. temperature b. age c. presence of heart murmur d. Na+ and K+ ions

c. presence of heart murmur