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Pathophysiology > exam 3 practice chapter 25-27 > Flashcards

exam 3 practice chapter 25-27 Flashcards

1
Q

which of the following is an accurate statement regarding blood flow through the heart?

A) blood flows from the left ventricle through the bicuspid valve
B) blood flows from the right ventricle through the pulmonic semilunar valve
C) blood flows from the left atrium through the tricuspid valve to the left ventricle
D) blood flows from the right atrium though the aortic valve to the right ventricles

A

B) blood flows from the right ventricle through the pulmonic semilunar valve

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2
Q

Calcium channel blockers (increase or decrease) electrical conduction within the heart and (increase or decrease) the force of contraction

A

decrease

decrease

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3
Q

Potassium channel blockers (increase or decrease) the velocity of action potential transmission which (increase or decrease) contraction

A

decrease

decrease

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4
Q

the definition of preload:

A) the pressure generated at the end of systole
B) the resistance to ejection during systole
C) volume of blood flowing into the system circuit
D)the pressure generated at the end of diastole

A

D)the pressure generated at the end of diastole

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5
Q

the definition of after load is:

A) the pressure generated at the end of systole
B) the resistance to ejection during systole
C) volume of blood flowing into the system circuit
D)the pressure generated at the end of diastole

A

B) the resistance to ejection during systole

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6
Q

what is the Frank-Starling Law of the Heart?

A

the more the heart fills with blood during diastole, the greater the force of contraction during systole

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7
Q

The right atrioventricular valve has (two or three) cusps and is called the (tricuspid or mitral) valve; the left atrioventricular valve has (two or three) cusps and is called the (tricuspid or mitral) valve.

A

three, tricuspid

two, mitral

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8
Q

Norepinephrine action on alpha-adrenergic receptors causes (vasoconstriction or vasodilation)

A

vasoconstriction

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9
Q

Systole is ________ of the muscular wall of cardiac chamber
and
Diastole is the __________ of the muscular wall of cardiac chamber

A

systole = construction

diastole = relaxation

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10
Q

explain intermittent claudication

A

Ischemic pain in the lower extremities that occurs while walking but disappears when resting

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11
Q

select all that apply: stroke volume depends on the force of contraction which is determined by:

A) afterload
B) preload
C) inotropic agents
D) oxygen levels

A

B) preload
C) inotropic agents
D) oxygen levels

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12
Q

veins are the _____ system vs arteries are _____ system

A

capacitance

resistance

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13
Q

what is not a factor that affects blood flow:

A) poiseuille law
B) pressure
C) resistance
D) frank starling law

A

D) frank starling law

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14
Q

a client is diagnosed with increased systemic vascular resistance (SVR). what will be the effect on the heart?

A) left atrium will be required to pump harder
B) left ventricle will be required to pump harder
C) right atrium chamber will become enlarged
D) right ventricle will become ineffective because of increased pressure

A

B) left ventricle will be required to pump harder

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15
Q

How will each of these factors affect arterial size (vasoconstriction or vasodilation) and peripheral vascular resistance (increase or decrease):

  1. epinephrine
  2. adenosine
  3. lactic acid
  4. histamine
  5. heat
  6. cold
  7. no/ endothelium relaxing factor
  8. low PO2
A
  1. epinephrine- constriction/increase
  2. adenosine - dilator/decrease
  3. lactic acid - constriction/increase
  4. histamine - dilator/decrease
  5. heat - dilator/decrease
  6. cold - constrict/increase
  7. no/ endothelium relaxing factor -dilator/decrease
  8. low PO2 -constrict/increase
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16
Q

how would each of the following affect blood pressure (increase or decrease)

  1. vasodilation
  2. decreased stretching of baroreceptors
  3. hypoxemia
  4. inhibiting angiotensin-converting enzyme (ACE)
  5. beta blockers / beta-adrenergic blockers
  6. alpha-2 agonists
  7. calcium channel blockers
A
  1. vasodilation -decrease
  2. decreased stretching of baroreceptors -decrease
  3. hypoxemia -increase
  4. inhibiting angiotensin-converting enzyme (ACE) -decrease
  5. beta blockers / beta-adrenergic blockers - decrease
  6. alpha-2 agonists -decrease
  7. calcium channel blockers -decrease
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17
Q

varicose veins are veins with stasis of venous blood, what is true vs false risk factors:

  1. age
  2. pregnancy
  3. height
  4. DVT (deep vein thrombosis)
  5. prior leg injury
  6. family history
  7. male gender
A
  1. age -TRUE
  2. pregnancy -TRUE
  3. height -FALSE, weight is one
  4. DVT (deep vein thrombosis) -TRUE
  5. prior leg injury -TRUE
  6. family history -TRUE
  7. male gender - FALSE, females are more at risk
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18
Q

why are thrombus formation in vein more common than arteries:

A) higher pressure
B) lower pressure
C) larger radius
D) small radius

A

B) lower pressure

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19
Q

Superior vena cava syndrome (SVC) is the progressive occlusion of the superior vena cava that leads to (arterial or venous) distention of upper extremities and head

A

venous

the etiology of SVC is bronchogenic cancer, lymphoma or metastasis of other cancers

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20
Q

what is the difference between primary hypertension and secondary hypertension?

A

primary is caused by complicated interaction of genetics and environment mediated by a host of neurohumoral effects
ex: age, black race, family history, obesity

secondary is caused by an underlying disease process or mediation that raises pulmonary vascular resistance (PVR) or cardiac output (CO)
ex: renal failure, drugs (antihistamines, corticosteroids)

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21
Q

What is orthostatic (postural) hypotension?

A

Decrease in both systolic and diastolic blood pressure upon standing
Lack of normal blood pressure compensation in response to gravitational changes on the circulation

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22
Q

severe and chronic hypertension can lead to which of the following?

A) Anemia
B) Glaucoma
C) Coronary artery disease
D) chronic obstructive pulmonary disease

A

C) Coronary artery disease

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23
Q

embolism can be ____(select all that can apply)____ that is circulating in the blood stream

A) air
B) dislodged thrombus
C) fungi
D) amniotic fluid
E) cancer cells

A

A) air
B) dislodged thrombus
D) amniotic fluid
E) cancer cells

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24
Q

what is the difference between embolus and thrombosis?

A

Thrombosis occurs when a thrombus, or blood clot, develops in a blood vessel and reduces the flow of blood through the vessel.

Embolism occurs when a piece of a blood clot, foreign object, or other bodily substance becomes stuck in a blood vessel and largely obstructs the flow of blood

25
Q

True or false characteristics on thromoangiitis obliterates (Buerger disease)

1) inflammatory disease of the peripheral veins
2) autoimmune
3) associated with alcohol
4) is result in temporary occlusions and obliteration in the feet and sometimes hands

A

1) inflammatory disease of the peripheral veins -False its of the arteries
2) autoimmune -True
3) associated with alcohol -False its with smoking
4) is result in temporary occlusions and obliteration in the feet and sometimes hands -false its permanent

26
Q

pericardial effusion/tamponade

A

effusion(fluid) that accumulation in the pericardial space

its life-threatening slow or rapid compression of the heart

27
Q

list the three different cardiomyopathies

A
  1. dilated
  2. hypertrophic
  3. restrictive
28
Q

what is the difference between dilated and restrictive cardiomyopathy?

A

Dilated cardiomyopathy: the cardiac chambers are enlarged, and myocardium has decreased contractility

Restrictive cardiomyopathy: the cardiac chambers have decreased diastolic volume because the myocardium is rigid and noncompliant

29
Q

thrombus formation risk factors

A
  • intimal injury/inflammation
  • obstruction of flow
  • pooling (stasis)
30
Q

What term should the nurse document for a detached blood clot?

A) Thrombus
B) Embolus
C) Thromboembolus
D) Infarction

A

C) Thromboembolus

31
Q

A 32-year-old female presents with lower leg pain, with swelling and redness. While obtaining the patient’s history, which finding could have caused her condition?

A) Venous thrombus
B) Heart valve damage
C) Bacterial infection
D) Atherosclerosis

A

A) Venous thrombus

A thrombus formation in the vein leads to inflammation that may cause pain and redness with obstruction. Increased pressure in the vein behind the clot may lead to edema of the extremity.

32
Q

what is the greatest concern of a thrombus?

A

turning into a pulmonary embolism

33
Q

Individuals with Raynaud disease need to be counseled to avoid which of the following conditions to prevent severe symptoms?

A) Allergic reactions
B) Cold exposure
C) Hot water immersion
D) Tissue injury

A

B) Cold exposure

Raynaud disease consists of vasospastic attacks triggered by brief exposure to cold.

34
Q

Which of the following findings in the patient with Raynaud disease would indicate a need for further teaching?

A) The patient eats bananas twice a day
B) The patient smokes cigarettes.
C) The patient wears mittens outside.
D) The patient takes calcium channel blockers

A

B) The patient smokes cigarettes.

35
Q

A 60-year-old male presents to his primary care provider reporting chest pain. He is diagnosed with atherosclerosis. This disease is caused by:

A) Arterial wall thinning and weakening
B) Abnormally dilated arteries and veins
C) Abnormal thickening and hardening of vessel walls
D) Autonomic nervous system imbalances

A

C) Abnormal thickening and hardening of vessel walls

Atherosclerosis is a form of arteriosclerosis characterized by thickening and hardening of the vessel wall.

36
Q

A patient wants to know what causes atherosclerosis. How should the nurse respond? In general, atherosclerosis is caused by:

A) High serum cholesterol levels
B) Endothelial injury and inflammation
C) An increase in antithrombotic substances
D) Congenital heart disease

A

B) Endothelial injury and inflammation

Atherosclerosis begins with injury to the endothelial cells that line artery walls

37
Q

When a patient asks the nurse what is the most common cause of myocardial ischemia, which statement is the correct response? The most common cause of myocardial ischemia is:

A) Idiopathic vasospasm
B) Arterial emboli from heart valve
C) Atherosclerosis
D) Venous emboli

A

C) Atherosclerosis

The most common cause of myocardial ischemia is atherosclerosis

38
Q

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:

A) Mild to moderate atherosclerosis
B) Impending myocardial infarction (MI)
C) Electrical conduction problems in the heart
D) Decreased myocardial oxygen demand

A

B) Impending myocardial infarction (MI)

Unstable angina is an indication of impending MI.

39
Q

A 51-year-old male presents with recurrent chest pain on exertion. He is diagnosed with angina pectoris. When he asks what causes the pain, how should the nurse respond? The pain occurs when:

A) Cardiac output has fallen below normal levels.
B) The myocardial oxygen supply has fallen below demand.
C) Myocardial stretch has exceeded the upper limits.
D) The vagus nerve is stimulated.

A

B) The myocardial oxygen supply has fallen below demand.

Angina is chest pain caused by myocardial ischemia, which develops if the flow or oxygen content of coronary blood is insufficient to meet the metabolic demands of myocardial cells.

40
Q

A 28-year-old female presents to the ER reporting severe chest pain that worsens with respiration or lying down. She has a fever, tachycardia, and a friction rub. Based upon the assessment findings, the nurse determines the patient is experiencing:

A)Acute pericarditis
B) Myocardial infarction (MI)
C)Stable angina
D) Pericardial effusion

A

A)Acute pericarditis

41
Q

pericardial effusion/tamponade

A

effusion(fluid) that accumulates in the pericardial space

its life-threatening slow or rapid compression of the heart

42
Q

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 dysfunction?

A) Heart failure
B) Connective tissue disorders
C) Rheumatic fever or heart disease
D) Syphilis infection

A

C) Rheumatic fever or heart disease

43
Q

A 10-year-old male presents with fever, lymphadenopathy, arthralgia, and nose bleeds. He is diagnosed with rheumatic heart disease. When a staff member asks what caused the disease, what is the nurse’s most correct response? The most likely cause of this disease is:

A) Congenital heart defects
B) Human immunodeficiency virus (HIV) infections
C) Group A ß-hemolytic streptococcus infections
D) Acute pericarditis

A

C) Group A ß-hemolytic streptococcus infections

44
Q

how is acute rheumatic fever and rheumatic heart disease diagnosed?

A

its based on jones criteria, they need to have major clinical manifestations like carditis, polyartheritis, chorea, erythema marginatum

45
Q

A 35-year-old male presents with pulmonary hypertension. Testing reveals he is in right heart failure. Which of the following is the most likely diagnosis the nurse will see listed on the chart?

A) Aortic stenosis
B) Tricuspid regurgitation
C) Aortic regurgitation
D) Mitral regurgitation

A

B) Tricuspid regurgitation

Tricuspid regurgitation leads to volume overload in the right atrium and ventricle, increased systemic venous blood pressure, and right heart failure

46
Q

Which characteristic changes should the nurse keep in mind while caring for a patient with left heart failure? As left heart failure progresses:

A) Left ventricular preload increases.
B) Systemic vascular resistance decreases.
C) Left end-diastolic volume decreases.
D) Pulmonary vascular resistance decreases

A

A) Left ventricular preload increases

Left ventricular preload increases in left heart failure because less blood is ejected from the left ventricle.

47
Q

A 59-year-old female is diagnosed with left ventricular failure. If a decrease in kidney perfusion occurs, the nurse knows this would ultimately cause:

A) Decreased left ventricular preload
B) Increased pulmonary capillary permeability
C) Increased systemic vascular resistance
D) Decreased cardiac oxygen demand

A

C) Increased systemic vascular resistance

With a decrease in kidney perfusion, renin is released with the ultimate outcome of increased systemic vascular resistance to raise blood pressure to increase blood flow to the kidney.

48
Q

When a patient with left heart failure starts to have a cough and dyspnea, which principle should the nurse remember? Pulmonary symptoms, common to left heart failure, are a result of:

A) Inflammatory pulmonary edema
B) Decreased cardiac output
C) Pulmonary vascular congestion
D) Bronchoconstriction

A

C) Pulmonary vascular congestion

The clinical manifestations of left heart failure are the result of pulmonary vascular congestion and inadequate perfusion of the systemic circulation.

49
Q

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?

A) Right heart failure
B) Left heart failure
C) Low-output failure
D) High-output failure

A

A) Right heart failure

Right-sided failure occurs when the patient experiences chronic pulmonary disease and elevated pulmonary vascular resistance because the blood has difficulty overcoming the pressure and blood builds up in the right side of the heart.

50
Q

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?

A) Significant edema to both lower legs and feet
B) Hypertension
C) Decreased urine output
D) Dyspnea upon exertion

A

A) Significant edema to both lower legs and feet

Right-sided failure allows blood to back up into the systemic circulation, leading to peripheral edema.

51
Q

When a person is in shock, a nurse remembers impairment in cellular metabolism is cause by:

A) Release of toxic substances
B) Free radical formation
C) Inadequate tissue perfusion
D) Lack of nervous or endocrine stimulation

A

C) Inadequate tissue perfusion

In shock, impaired cellular metabolism is caused by inadequate tissue perfusion.

52
Q

A nurse is planning care for a patient in shock. Which principle should the nurse remember? During shock states, glucose uptake is usually:

A) Enhanced
B) Normal
C) Impaired
D) Energy intensive

A

C) Impaired

53
Q

An 82-year-old female was admitted to the hospital with confusion and severe hypotension. Her body’s compensatory mechanisms are increased heart rate, vasoconstriction, and movement of large volumes of interstitial fluid to the vascular compartment. What kind of shock does the nurse suspect the patient is experiencing?

A) Anaphylactic
B) Hypovolemic
C) Neurogenic
D) Septic

A

B) Hypovolemic

In hypovolemic shock, heart rate and SVR increase, boosting both cardiac output and tissue perfusion pressures. Interstitial fluid moves into the vascular compartment.

54
Q

What factors make a patient prone to neurogenic shock? Neurogenic shock can be caused by any factor that inhibits the:

A) Parasympathetic nervous system
B) Sympathetic nervous system
C) Somatic nervous system
D) Thalamus

A

B) Sympathetic nervous system

Neurogenic shock is caused by any factor that inhibits the sympathetic nervous system.

55
Q

For an infection to progress to septic shock, which of the following factors should the nurse determine occurred?

A) The individual must be immunosuppressed.
B) The myocardium must be impaired.
C) The infection must be gram negative.
D) Bacteria must enter the bloodstream

A

D) Bacteria must enter the bloodstream

56
Q

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?

A) Bradycardia, palpitations, confusion, truncal rash
B) Severe respiratory distress, jugular venous distention, chest pain
C) Low blood pressure, tachycardia, generalized edema
D) Reduced cardiac output, increased systemic vascular resistance, moist cough

A

C) Low blood pressure, tachycardia, generalized edema

57
Q

Which patient is most prone to multiple organ dysfunction syndrome (MODS)? In a patient with:
A) Myocardial infarction (MI)
B) Pulmonary disease
C) Septic shock
D) Autoimmune disease

A

C) Septic shock

The most common cause of MODS is septic shock.

58
Q

pulmonic stenosis is the narrowing of the pulmonary valve causing resistance to flow from (left or right) ventricle to pulmonary artery

A

right

causing cyanosis from right to left shunt

Pathophysiology (25 decks)

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