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Patho cardiac
Patho test 3
| Question | Answer |
|---|---|
| The pericardium is: | a membranous sac that encloses the heart. |
| A function of the pericardium is to: | provide a barrier against extracardial infections. |
| As a result of blockage in the pulmonary artery, blood would first back up into the: | right ventricle. |
| Which chamber of the heart generates the highest pressure? | Left ventricle |
| The internal lining of the cardiovascular system is formed by what tissue? | Endothelium |
| A 20-year-old underwent an echocardiogram to assess chest pain. Results revealed a congenital defect in the papillary muscles. Which of the following would the nurse expect to occur? | Backward expulsion of the atrioventricular valves |
| Which structures act as anchors for the atrioventricular valves? | Chordae tendineae |
| Which statement indicates the nurse understands coronary ostia? The coronary ostia (the openings to the coronary arteries) are found in the: | aorta. |
| What structure conducts action potentials down the atrioventricular septum? | Bundle of His |
| The cardiac electrical impulse normally begins spontaneously in the sinoatrial (SA) node because it: | depolarizes more rapidly than other automatic cells of the heart. |
| Which structures would not receive an electrical impulse when the patient is experiencing a left bundle branch block? | The left ventricle |
| Depolarization of a cardiac muscle cell occurs as the result of: | the rapid movement of ions across the cell membrane. |
| What is the nurse monitoring when observing the QRS complex on the electrocardiogram? | Ventricular activity |
| What term is used to identify the period that follows depolarization of the myocardium and NURSINGTB.COM represents a period during which no new cardiac potential can be propagated? | Absolute refractory |
| The PR interval viewed on a normal electrocardiogram represents: | onset of atrial activation to onset of ventricular activity. |
| What represents the sum of all ventricular muscle cell depolarization? | QRS complex |
| A 13-year-old took a weight loss drug that activated the sympathetic nervous system. Which of the following assessment findings would the nurse expect? | Increased cardiac conduction |
| A 50-year-old received trauma to the chest that caused severe impairment of the primary pacemaker cells of the heart. Which of the following areas received the greatest damage? | Sinoatrial (SA) node |
| A 28-year-old with seizure disorder has a vagus nerve stimulator implanted to help control seizure activity. Which result will the nurse expect to occur? | Decreased cardiac conduction |
| A nurse assesses the heart after acetylcholine because the effect of acetylcholine on the heart is to: | decrease the heart rate. |
| One difference between cardiac muscle and skeletal muscle is that: | cardiac muscle cells are arranged in branching networks. |
| What are the thickened areas of the sarcolemma of myocardial cells that enable electrical impulses to travel in a continuous cell-to-cell fashion called? | Intercalated disks |
| Muscle contractions occur when there is a decreased: | distance between Z lines. |
| The process by which an action potential in the plasma membrane of a myocardial cell triggers the events that directly cause contraction of the myocardial cells is referred to as: | excitation-contraction coupling. |
| The molecule that aids in bonding of the troponin complex to actin and tropomyosin is troponin: | T. |
| A nurse is discussing the pressure generated at the end of diastole. Which term is the nurse describing? | Preload. |
| As stated by the Frank-Starling law, there is a direct relationship between the _____ of the blood in the heart at the end of diastole and the _____ of contraction during the next systole. | Volume. Force |
| Within a normal physiologic range, an increase in left ventricular end-diastolic volume would lead the nurse to monitor for: | an increased force of contraction. |
| A 50-year-old was prescribed a drug that acts as a negative inotrope. Which endogenous substances would be most similar? | Acetylcholine |
| The primary cardiovascular control center is located in the: | Medulla |
| After activation of the Bainbridge reflex in a patient, the nurse assesses for: | increased heart rate. |
| A nurse observes a cardiologist multiplying the heart rate by stroke volume. What is the cardiologist measuring? | Cardiac output |
| Baroreceptors are located in the: | carotid artery. |
| Local myogenic regulation of blood vessel diameter and thus blood flow through a vessel is an example of: | autoregulation. |
| The thoracic lymphatic duct drains into the: | left subclavian vein. |
| Blood flow is affected by: (select all that apply) | blood viscosity. blood vessel diameter. blood pressure. blood vessel length. |
| A nurse is evaluating stroke volume. Which of the following factors affect stroke volume? (select all that apply) | Preload Afterload Contractility |
| A 75-year-old obese female presents to her primary care provider reporting edema in the lower extremities. Physical exam reveals that she has varicose veins. Upon performing the history, which of the following is a possible cause for the varicose veins? | Long periods of standing |
| A 52-year-old male presents with pooling of blood in the veins of the lower extremities and edema. The diagnosis is chronic venous insufficiency, and an expected assessment finding of this disorder is: | skin hyperpigmentation. |
| Superior vena cava syndrome (SVCS), causing venous distention in the upper extremities, is a result of progressive superior vena cava: | occlusion. |
| A 50-year-old male with a 30-year history of smoking was diagnosed with bronchogenic cancer. He developed edema and venous distention in the upper extremities and face. Which of the following diagnosis will the nurse observe on the chart? | Superior vena cava syndrome (SVCS) |
| When a patient is diagnosed with coronary artery disease, the nurse assesses for myocardial: | ischemia. |
| A nurse takes an adult patient’s blood pressure and determines it to be normal. What reading did the nurse obtain? | Systolic pressure less than 120 mm Hg and diastolic pressure less than 80 mm Hg |
| Most cases of combined systolic and diastolic hypertension have no known cause and are documented on the chart as _____ hypertension. | Primary |
| A 30-year-old White female was recently diagnosed with primary hypertension. She also reports that her father has hypertension as well. A nurse determines which of the following risk factors is most likely associated with this diagnosis? | Genetic |
| A 52-year-old is diagnosed with primary hypertension but has no other health problems. Present treatment would cause the nurse to anticipate administering which drug to the patient? | A diuretic |
| When a nurse checks the patient for orthostatic hypotension, what activity did the nurse have the patient engage in? | Standing up |
| A patient is diagnosed with orthostatic hypotension. Which of the following symptoms would most likely be reported? | Syncope and fainting |
| A patient presents to the emergency department reporting difficulty swallowing and shortness of breath. A CT scan would most likely reveal an aneurysm in the: | thoracic aorta. |
| An older adult is diagnosed with cerebral aneurysm. Where does the nurse suspect the cerebral aneurysm is located? | Circle of Willis |
| What term should the nurse use to document a detached blood clot? | Thromboembolus |
| A patient presents with severe chest pain and shortness of breath and is diagnosed with pulmonary embolism. The embolism most likely originated from the: | deep veins of the leg. |
| Individuals with Raynaud disease need to be counseled to avoid which of the following conditions to prevent severe symptoms? | Cold exposure |
| A patient is diagnosed with coronary artery disease. Which of the following modifiable risk factors would the nurse suggest the patient change? | Smoking cigarettes |
| A patient presents to a primary care provider reporting chest pain and is diagnosed with atherosclerosis. This disease is caused by: | abnormal thickening and hardening of vessel walls. |
| Foam cells in a fatty streak are: | macrophages that engulf low-density lipoprotein (LDL). |
| The most common cause of myocardial ischemia is: | atherosclerosis. |
| A 51-year-old male presents with recurrent chest pain on exertion and is diagnosed with angina pectoris. The pain occurs when: | the myocardial oxygen supply has fallen below demand. |
| A 62-year-old male presents to his primary care provider reporting chest pain at rest and with exertion. reports that the pain often occurs at night. He is most likely experiencing which type of angina? | Prinzmetal |
| 51-year-old m is at the health clinic.. After walking from the car to the clinic, he developed substernal pain. 2-3 minutes and then subsiding with rest. He indicates that this has occurred frequently over the past few months with similar exertion. | Stable angina |
| A 49-year-old male presents reporting chest pain. EKG reveals ST elevation. He is diagnosed with myocardial ischemia. Which of the following interventions would be most beneficial? | Apply oxygen to increase myocardial oxygen supply. |
| A 68-year-old male presents to the ER reporting chest pain. He has a history of stable angina that now appears to be unstable. He most likely has: | impending myocardial infarction (MI). |
| A 55-year-old male died of a myocardial infarction. Autopsy would most likely reveal: | platelet aggregation within the atherosclerotic coronary artery. |
| A 75-year-old male has severe chest pain and dials 911. Based upon the lab findings indicating a patient has elevated levels of cardiac troponins I and T, the nurse suspects which of the following has occurred? | Myocardial infarction (MI) |
| A 28-year-old presents to the ER reporting severe chest pain that worsens with respirations or lying down. Other signs include a fever, tachycardia, and a friction rub. Assessment findings support which medical diagnosis? | Acute pericarditis |
| A 56-year-old presents to his primary care provider for a checkup. Physical exam reveals edema, hepatomegaly, and muffled heart sounds. Which of the following is of greatest concern to the nurse? | Tamponade |
| A 42-year-old is diagnosed with constrictive pericarditis. The nurse assesses the blood pressure for decreased cardiac output because of: | fibrosis and calcification of the pericardial layers. |
| A 60-year-old female has survived a myocardial infarction. The nurse is providing care for impaired ventricular function because: | the resulting ischemia leads to hypoxic injury and myocardial cell death. |
| 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? | Rheumatic fever or heart disease |
| Which valvular condition is characterized by the valve opening being constricted and narrowed, causing the valve leaflets, or cusps, to fail to open completely? | Stenosis |
| A 67-year-old was previously diagnosed with rheumatic heart disease. Tests now reveal lipoprotein deposition with chronic inflammation that impairs blood flow from the left ventricle into the aorta. Which diagnosis does this history support? | Aortic stenosis |
| The nurse realizes the patient diagnosed with mitral stenosis has incomplete emptying of the: | left atrium. |
| A 72-year-old has a history of hypertension and atherosclerosis. An echocardiogram reveals backflow of blood into the left ventricle. Which of the following is the most likely diagnosis documented on the chart? | Aortic regurgitation |
| Upon assessment of the patient, the nurse finds a widened pulse pressure and throbbing peripheral pulses. Which valve disorder does the nurse suspect? | Aortic regurgitation |
| A 35-year-old presents with pulmonary hypertension and is diagnosed as being in right heart failure. Which is the most likely cause of this condition? | Tricuspid regurgitation |
| A nurse recalls the most common cardiac valve disease in the United States is: | mitral valve prolapse. |
| 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: | group A beta-hemolytic streptococcus infections. |
| A 10-year-old male presents with fever, lymphadenopathy, arthralgia, and nosebleeds and is diagnosed with rheumatic heart disease. While planning care, which characteristic changes should the nurse remember? | Antigens that bind to the valvular lining, triggering an autoimmune response |
| A 30-year-old female presents to her primary care provider with fever, cardiac murmur, and petechial skin lesions and is diagnosed with infective endocarditis. The most likely cause of the disease is: | bacteria. |
| Inflammatory cells have difficulty limiting the colonization of microorganisms in infective endocarditis because the: | microorganisms are sequestered in a fibrin clot. |
| Which characteristic changes should the nurse keep in mind while caring for a patient with left heart failure? As left heart failure progresses: | left ventricular preload increases. |
| A 65-year-old male with a history of untreated hypertension is now experiencing left heart failure. A nurse recalls his untreated hypertension led to: | myocardial hypertrophy and ventricular remodeling. |
| A patient with left heart failure starts to have a cough and dyspnea. Pulmonary symptoms common to left heart failure are a result of: | pulmonary vascular congestion. |
| A patient was admitted to the intensive care unit with a diagnosis of acute myocardial infarction (MI) and is being treated for shock. The primary cause of shock is most likely: | decreased cardiac contractility. |
| A 73-year-old has increased pulmonary pressure resulting in right heart failure. A potential cause for the right heart to fail is: | Left heart failure. |
| A 65-year-old male is diagnosed with chronic pulmonary disease and elevated pulmonary vascular resistance. Which of the following heart failures should the nurse assess for in this patient? | Right heart. |
| A 72-year-old female has a history of right heart failure caused by a right ventricular myocardial infarction. Which of the following symptoms are specifically related to her right heart failure? | Significant edema to both lower legs and feet |
| Which condition should cause the nurse to assess for high-output failure in a patient? | Anemia. |
| When a person is in shock, a nurse remembers impairment in cellular metabolism is caused by: | inadequate tissue perfusion. |
| One consequence of switching from aerobic to anaerobic cellular metabolism during shock states is: | decreased adenosine triphosphate (ATP) production. |
| During shock states, glucose uptake is usually: | Impaired. |
| A 20-year-old female is being admitted to the hospital with fever and septic shock. Which set of assessment findings would the nurse expect the patient to exhibit? | Low blood pressure and tachycardia |
| An 82-year-old female was admitted to the hospital with confusion and severe hypotension. increased heart rate, vasoconstriction, and movement of large volumes of interstitial fluid to the vascular comp. What kind of shock is patient experiencing? | Hypovolemic. |
| A 27-year-old male is admitted to a neurologic unit with a complete C-5 spinal cord transection. On initial assessment, he is bradycardic, hypotensive, and hyperventilating. He appears to be going into shock. The most likely mechanism of his shock is: | vasodilation caused by a decrease in sympathetic stimulation. |
| Neurogenic shock can be caused by any factor that inhibits the: | sympathetic nervous system. |
| A 15-year-old male who is allergic to peanuts eats a peanut butter cup. He then goes into anaphylactic shock. Which assessment findings will the nurse assess for? | Bronchoconstriction, hives or edema, and hypotension |
| The onset of anaphylactic shock is usually: | sudden and life threatening. |
| For an infection to progress to septic shock, what must occur? | The bacteria must enter the blood stream. |
| A patient most prone to multiple organ dysfunction syndrome (MODS) is a a patient with: | septic shock. |
| A 75-year-old female has been critically ill with multiple organ dysfunction syndrome (MODS) for longer than a week and has developed a severe oxygen supply and demand imbalance. The statement that best describes this imbalance is which of the following? | The reserve has been exhausted, and the amount of oxygen consumed depends on the amount the circulation is able to deliver. |
| Which of the following findings in the patient with Raynaud disease would indicate a need for further teaching? | The patient smokes cigarettes. |
| A nurse recalls acute orthostatic hypotension can be caused by: (select all that apply) | prolonged immobility. drug action. starvation. volume depletion. |
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