Pathophysiology

A client comes to the emergency room with reports of chest pain. When the nurse reads his ECG she sees changes which include T-wave inversion, ST-segment elevation, and an abnormal Q wave. What should she suspect?

Acute myocardial infarction

The scar tissue that occurs between the layers of the pericardium becomes rigid and constrictive from scar tissue in constrictive pericarditis. What is a physiologic sign of constrictive pericarditis?

Kussmaul sign

A nurse educator on a geriatric medicine unit of a hospital is teaching a group of new graduates specific assessment criteria related to heart failure. Which of the following assessment criteria should the nurses prioritize in their practice?

Measurement of urine output and mental status assessment

An emergency department client arrives after two days of "chest pressure" and "tightness" that was unrelieved with antacids. Following angioplasty for a massive myocardial infarction (MI), the client asks why so much muscle was damaged if only the left circumflex vessel was blocked. Which response by the nurse is most accurate?

"If a major artery like the circumflex is occluded, the smaller vessels supplied by that vessel cannot restore the blood flow."

A client is admitted to the hospital with severe bradycardia, heart rate in low to upper 40s, after contracting Lyme disease. She asks the nurse why the heart rate is so slow. The most accurate response would be a possible disassociation between the atria and ventricles due to:

AV nodal block

The nursing instructor teaches the students that when a client is suffering from pericarditis he/she will have a friction rub. Which description best describes a friction rub?

An audible medical sign that is high-pitched and results from the rubbing and friction between the inflamed pericardial surfaces

A client is admitted to the intensive care unit suspected of having infective endocarditis. Which test is the most definitive diagnostic procedure that is done and used to guide treatment for this type of client?

Blood culture

In pregnancy, which diagnostic findings are characteristic for preeclampsia-eclampsia?

Blood pressure 160/100 mm Hg and platelet count 25,000/μL (25 ×109/L)

A client is admitted to the emergency department after experiencing a motor vehicle accident and sustaining multiple injuries with significant blood loss. The nurse predicts that the client will display which of the following?

Decreased urinary output

A 3-year-old child with right-sided heart failure has been admitted for worsening of their condition. Which assessment would be considered one of the earliest signs of systemic venous congestion in this toddler?

Enlargement of liver

A nurse is assessing a client's apical pulse. The nurse is palpating the point of maximum impulse between which ribs?

Fifth and sixth

A client who has just been diagnosed with dilated cardiomyopathy asks the nurse what caused the condition. The most appropriate response would be:

Genetic abnormalities

Which lab result strongly suggests an immunologic response in the client with possible rheumatic heart disease?

Group A (β-hemolytic) streptococcal antibodies

A client with heart failure tells the nurse that he is frustrated and is unable to get "a good night's rest." The client relates that he falls asleep and is suddenly awakened and feels as though he is having a hard time breathing and is suffocating. The nurse recognizes this assessment as:

Paroxysmal nocturnal dyspnea

Cardiac tamponade is a serious, life-threatening condition that can arise from a number of other conditions. What is a key diagnostic finding in cardiac tamponade?

Pulsus paradoxus

The health care provider is preparing to assess a client who has been diagnosed with hypertrophic cardiomyopathy. The provider anticipates the assessment data will include which finding?

Reduced chamber size

A client is experiencing circulatory shock. The nurse is aware that compensation will occur with stimulation of the beta-2 (β2) receptors. The nurse anticipates the client will experience which physiologic response?

Relaxation of the bronchioles

A client is admitted to the outpatient diagnostic unit for further testing to identity the cause of the uncontrolled secondary hypertension. In preparation, the nurse should anticipate that which diagnostic procedure will provide the most definitive diagnosis?

Renal arteriography

A client says that when the hospital checked his blood pressure after he lost a lot of blood in a work-related accident, the top number (systolic pressure) was lower than usual but the bottom number (diastolic pressure) was about the same. Why is this?

Systemic vasoconstriction maintained the diastolic pressure

A physician is explaining to a group of medical students the concept of Virchow's triad as it applies to venous thrombosis. Which clinical observation of a 50-year-old male client is most likely unrelated to a component of Virchow's triad?

The man has decreased cardiac output and an ejection fraction of 30%.

In infective endocarditis, vegetative lesions grow on the valves of the heart. These vegetative lesions consist of a collection of infectious organisms and cellular debris enmeshed in the fibrin strands of clotted blood. What are the possible systemic effects of these vegetative lesions?

They can fragment and cause cerebral emboli

A client has a blood pressure of 68/38 mm Hg and fainted after donating a unit of blood. The client is experiencing low preload from loss of blood volume. What is preload?

Venous return to the heart

A nursing student is studying the properties of cardiac rhythm to better understand what causes dysrhythmias to occur. The student begins to understand that there is a programmed ability for certain cells to conduct impulses. Interruption in this ability can result in abnormalities of cardiac rate and rhythm; this property would be:

conductivity

A group of nursing students is discussing ventricular dysrhythmias and one student is unsure why a client with frequent premature ventricular complexes (PVCs) has an irregular radial pulse. One of the other students explains that premature ventricular complexes often do not produce a palpable pulse due to:

decreased ventricular filling time

A client with aortic insufficiency is experiencing an increase in afterload. The client will experience fatigue and activity intolerance due to:

resistance to ejection of blood from the heart