patho test 3 pt 2
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. 10 to 20 BPM b. 21 to 30 BPM c. 45 to 50 BPM d. 55 to 60 BPM
45 to 50 bpm
A client with a history of heart failure has been referred for an echocardiogram. Results of this diagnostic test reveals the following findings: heart rate 80 bpm; and diastolic volume 120 mL; and and systolic volume of 60 mL. What is the clients ejection fraction? Select one: a. 180 mL b. 0.80 c. 50% d. 200 mL
50%
When discussing the AV node's role in the electrical conduction of the heart with a client newly diagnosed with AV block, which of the following statements are accurate? Choose all that apply Select one or more: a. The AV node offers a two-way conduction area between the atria and the ventricles b. When there is an AV block, impulses from the atria and the ventricles beat independently of each other so, the heart rhythm is usually chaotic and not regular c. A block at the AV bundle of his interferes with the normal delay of the impulse, thereby interfering with complete injection of blood from the atrium prior to the ventricular contraction d. The velocity of conduction through the AV junctional fibers is very fast, which greatly increases impulse transmission
A block at the AV bundle of his interferes with the normal delay of the impulse, thereby interfering with complete injection of blood from the atrium prior to the ventricular contraction, When there is an AV block, impulses from the atria and the ventricles beat independently of each other so, the heart rhythm is usually chaotic and not regular
The shortness of breath and cyanosis that occurs in clients experiencing acute heart failure syndrome are primarily caused by: choose all that apply Select one or more: a. Myocardial muscle necrosis b. Accumulation of fluid in the alveoli and airways c. Impaired gas exchange d. Worsening renal failure e. Lungs stiffness
Accumulation of fluid in the alveoli and airways, Lungs stiffness, Impaired gas exchange
lient is diagnosed with an abdominal aortic aneurysm that the physician just wants to watch for now. When teaching the client about signs and symptoms to watch for, the nurse will base teaching on which of the following physiological principles? Select one: a. The larger the aneurysm, the less tension placed on the vessel b. The primary cause of rupture relates to increase in abdominal pressure such as straining to have a bowel movement c. As a aneurysm grows, more attention is placed on the vessel wall, which increases the risk of rupture d. Small diameter of this vessel will cause it to rupture more readily
As a aneurysm grows, more attention is placed on the vessel wall, which increases the risk of rupture
Client has been diagnosed with mitral valve regurgitation. Failure of this heart valve would have which of the following consequences? Select one: a. Inhibition of the SA node's normal action potential b. Backup of blood from the right atrium into the superior vena cava c. Backflow from the left ventricle into the left atrium d. Back flow from the right ventricle to the right atrium during systole
Backflow from the left ventricle into the left atrium
A client is receiving home care for the treatment of a wound on the inside of her lower leg that is 3 cm in diameter with a yellow wound bed and clear exudate. Assessment of the client's legs reveals edema and a darkened pigmentation over the ankles and shins of both legs. What is this client's most likely diagnosis? Select one: a. Chronic venous insufficiency b. Varicose veins c. Peripheral arterial disease d. Deep vein thrombosis
Chronic venous insufficiency
A large increase in heart rate can cause: Select one: a. Decreased stroke volume b. Reduce cardiac contractility c. Loss of action potential d. Increase blood viscosity
Decreased stroke volume
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. Select one or more: a. Excess abdominal fluid b. Orthopnea c. Extreme fatigue with activity d. Dyspnea e. Fainting
Dyspnea, Orthopnea, Extreme fatigue with activity
In the days following a tooth cleaning in root canal, the client has developed infection of the thin, three layered membrane that lines the heart and covers the valves. Which is this client's most likely diagnosis? Select one: a. Endocarditis b. Vasculitis c. Myocarditis d. Pericarditis
Endocarditis
The client has just returned from a surgical procedure. During the initial vital sign measurement, the nurse notes that the clients heart rate is 111 bpm and the blood pressure is 100/78. In this early postoperative period, the nurse should be diligently monitoring the client for the development of Select one: a. Pulmonary embolism due to the development of deep vein thrombosis b. Renal failure due to an overdose of medication c. Side effects from verse said administration causing excessive vasoconstriction d. Hypovolemia shock due to acute intravascular volume loss
Hypovolemia shock due to acute intravascular volume loss
A nurse is performing client health education with a 60-year-old man who has recently been diagnosed with heart failure. Which of the following statements demonstrates an accurate understanding of this new diagnosis? Select one: a. I'm going to avoid as much physical activity as I can so I preserve my strength b. I know it's healthy to drink a lot of water, and I'm going to make sure I do this from now on c. I'm trying to think of ways that I can cut down the amount of salt that I usually eat d. I'll be sure to take my beta-blockers whenever I feel short of breath
I'm trying to think of ways that I can cut down the amount of salt that I usually eat
An 86-year-old male client is disappointed to learn that he has class II heart failure despite a lifelong commitment to exercise and healthy eating. Which of the following age-related changes predisposes older adults to developing heart failure? Select one: a. Increase cardiac contractility b. Orthostatic hypotension c. Loss of action potential d. Increase vascular stiffness
Increase vascular stiffness
The most recent blood work of a client with a diagnosis of heart failure indicates increased levels of atrial natriuretic peptide (ANP) and brain nariuretic peptide (BNP). What is the most likely effect of these peptides on the client's physiology? Select one: a. Inhibition of the renin angiotensin aldosterone system b. Water retention c. Increased tubular sodium reabsorption d. Sympathetic nervous stimulation
Inhibition of the renin angiotensin aldosterone system
A male client with a history of angina has presented to the emergency department with uncharacteristic chest pain, and his subsequent EKG reveals T-wave elevation. This finding suggests an abnormality with which of the following aspects of the cardiac cycle? Select one: a. Iso volumetric contractions b. Atrial depolarization c. Aortic valve opening d. Semilunar valve openings
Iso volumetric contractions
A client with heart failure asked, "why am I taking a water pill when it's my heart that it is having a problem?" While educating the client about the Frank Starling mechanism, which of the following explanations is most appropriate to share? Select one: a. Since your heart is not pumping effectively, your kidneys are getting less blood flow; therefore, the kidneys are holding onto sodium and water b. Since your heart function is impaired the lungs are not able to oxygenate the blood in your kidneys are wearing out c. Your heart muscle is overstretched, so it's not able to pump all the blood out the prescribed water pill will help you decrease your weight d. You must be drinking way too much liquids your kidneys cannot filter all that you are drinking during the day
Since your heart is not pumping effectively, your kidneys are getting less blood flow; therefore, the kidneys are holding onto sodium and water
If the parasympathetic neurotransmitter releases acetylcholine, the nurse should anticipate observing what changes in the EKG pattern Select one: a. Complete cardiac standstill b. Partnering 150 bpm, labeled as supra ventricular tachycardia c. Disorganized ventricular fibrillation d. Slowing of heart rate below 60 bpm
Slowing of heart rate below 60 bpm
When lecturing to a group of students about pathophysiological principles behind heart failure, the instructor explains that cardiac output represents: Select one: a. The amount of blood pumped out of the hard with each beat b. The amount of blood the heart pumps each minute c. The volume of blood stretching the heart muscles at the end of diastole d. Strength of the right ventricular, to move blood
The amount of blood the heart pumps each minute
One of the principal mechanisms by which the heart compensates for increased workload is: Select one: a. Endothelium vasoconstrictors b. Sodium and water retention c. Ventricular wall tension increase d. Myocardial hypertrophy
myocardial hypertrophy
Mine is diagnosed with an abdominal aortic aneurysm data physician just wants to "watch" for now. When teaching the client about signs/symptoms to watch for, the nurse will base in teaching on which of the following physiologic principles? Select one: a. The primary cause of rupture relates to an increase in abdominal pressure such as straining to have a bowel movement b. As a aneurysm grows, more attention is placed on the vessel wall, which increases the risk for rupture c. The larger the aneurysm, the less tension placed on the vessel d. Small diameter of this vessel will cause it to rupture more readily
The correct answer is: As a aneurysm grows, more attention is placed on the vessel wall, which increases the risk for rupture
Hypoxia is said to have a negative financial effect on the heart, which means: Select one: a. The hiring will slow down, so the atria and the ventricles can fill better b. The cardiac output will decrease to cause less work for the heart c. There will be interference in the generation of ATP, which is needed for muscle contraction d. The heart will adjust so that less time will be spent in diastole and filling of the ventricles will shorten
There will be interference in the generation of ATP, which is needed for muscle contraction
A heart failure client has an echocardiogram performed revealing an ejection fraction of 40%. The nurse knows that this EF is below normal and explained to the client: Select one: a. This means you have a lot of pressure built up inside your heart b. You need to increase the amount of exercise you do to get your heart muscle back in shape c. This means your heart is not pumping as much blood out of the heart with each beat d. Your ventricular muscle is getting too stiff to be normally
This means your heart is not pumping as much blood out of the heart with each beat
Which of the following statements about vascular compliance is accurate? Select one: a. Arteries have thick muscular walls that constrict tightly, by injecting blood without storing it for later use b. A continuous flow through the capillaries occurs primarily during systole c. Veins can act as a reservoir for storing large quantities of blood d. Arteries are much more distensible than veins
Veins can act as a reservoir for storing large quantities of blood
Which of the statements about vascular compliance is accurate Select one: a. Arteries have thick muscular walls that constrict tightly, there by injecting blood without storing it for later use b. A continuous flow through the capillaries occurs primarily during systole c. Veins can act as a reservoir for storing large quantities of blood d. Arteries are much more distended will and veins
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. Venous blood return b. Vascular resistance c. Force of contraction d. Ventricular emptying
Venous blood return
Upon admission assessment, the nurse hears a murmur located at the fifth intercostal space, and clavicular line. The client asked, (what does this mean?) The nurse will base her answer on which of the following physiologic principles Select one: a. Your heart has enlarged, so naturally her valves had to enlarge as well b. You have a heart valve that is diseased c. You have been exposed to an infection that went into your bloodstream d. Your heart has been pumping your blood so hard, that the pressure has damaged your valves
You have a heart valve that is diseased
Heart muscle differs from skeletal muscle tissue by being able to generate: Select one: a. Contractions b. Sarcomere binding c. Calcium influx d. Action potentials
action potentials
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 determines of cardiac output is hypertension most likely to affect directly? Select one: a. Preload b. Heart rate c. Afterload d. Contractility
afterload
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: Select one: a. Stasis ulcerations b. Arterial insufficiency c. Deep vein thrombosis d. Primary varicose veins
deep vein thrombosis
The client is experiencing increased fatigue in recent months, a trend that has prompted an echocardiogram. Results of this diagnostic tests suggests that the client and diastolic volume is insufficient. Which of the following parameters of cardiac performance will directly decrease as a result of this? Select one: a. Preload b. Inotropy c. Cardiac contractility d. Afterload
preload
