Jarvis Chapter 20: Heart and Neck Vessels Flashcards
The first heart sound is produced by the:
A. opening of the AV valves.
B. closure of the atrioventricular (AV) valves.
C. opening of the semilunar valves.
D. closure of the semilunar valves.
B. closure of the atrioventricular (AV) valves.
The first heart sound (S1) occurs with closure of the AV valves.
Which of the following guidelines can be used to identify which heart sound is S1?
A. S1 coincides with the A wave of the jugular venous pulse wave.
B. S1 coincides with the carotid artery pulse.
C. S1 is louder than S2 at the base of the heart.
D. S1 coincides with the Q wave of the QRS complex on electrocardiography (ECG).
B. S1 coincides with the carotid artery pulse.
Which of the following cardiac alterations occurs during pregnancy?
A. An increase in cardiac volume and a decrease in blood pressure
B. An increased heart rate and increased blood pressure
C. An increase in cardiac output and blood pressure
D. An increased stroke volume with decreased cardiac output
A. An increase in cardiac volume and a decrease in blood pressure
During pregnancy, the blood volume increases by 30% to 40%; this creates an increase in stroke volume and cardiac output, and an increased pulse rate of 10 to 15 beats per minute. The arterial blood pressure decreases in pregnancy as a result of peripheral vasodilation.
Which of the following is an appropriate position to have the patient assume when auscultating for extra heart sounds or murmurs?
A. Roll toward the left side
B. Recumbent position
C. Roll toward the right side
D. Trendelenburg’s position
A. Roll toward the left side
After auscultation in the supine position, the nurse should have the patient roll onto the left side; the examiner should listen at the apex with the bell for the presence of any diastolic filling sounds (i.e., S3 or S4) or murmurs that may be heard only in this position. The examiner should have the patient sit up, lean forward and exhale; the examiner should auscultate at the base with the diaphragm for a soft, high-pitched, early diastolic murmur of aortic or pulmonic regurgitation.
The leaflets of the tricuspid and mitral valves are anchored by __________________ to the _________________, which are embedded in the ventricular floor.
A. chordae tendineae; papillary muscles
B. endocardial ligaments; mediastinal muscles
C. pericardial cords; ventricular sheaths
D. AV tendons; pericardial bundles
A. chordae tendineae; papillary muscles
The valves are anchored by collagenous fibres (chordae tendineae) to the papillary muscles, which are embedded in the ventricle floor.
The ability of the heart to contract independently of any signals or stimulation is caused by:
A. conduction.
B. depolarization.
C. automaticity.
D. repolarization.
C. automaticity.
The heart can contract by itself, independent of any signals or stimulation from the body; this property is termed automaticity.
When auscultating the heart of a newborn within 24 hours after birth, the examiner hears a continuous sound that mimics the sound of a machine. This finding most likely indicates:
A. pathology only when accompanied by an increased heart rate.
B. a normal sound because of the thinner chest wall of the newborn.
C. the presence of congenital heart disease.
D. an expected sound caused by nonclosure of the ductus arteriosus.
D. an expected sound caused by nonclosure of the ductus arteriosus.
The murmur of a patent ductus arteriosus is a continuous machinery murmur; the ductus arteriosus usually closes within 10 to 15 hours of birth but may take up to 48 hours.
A bruit heard while auscultating the carotid artery of a 65-year-old patient is caused by:
A. increased viscosity of blood.
B. turbulent blood flow through the carotid artery.
C. decreased velocity of blood flow through the carotid artery.
D. rapid blood flow through the carotid artery.
B. turbulent blood flow through the carotid artery.
A carotid bruit is a blowing, swishing sound indicating blood flow turbulence. A bruit indicates atherosclerotic narrowing of the vessel.
The jugular venous pressure is an indirect reflection of the:
A. cardiac cycle.
B. synchronization of mechanical activity.
C. heart’s efficiency as a pump.
D. conduction effectiveness.
C. heart’s efficiency as a pump.
Jugular venous pressure is a reflection of the heart’s ability to pump blood. If the pressure is elevated, heart failure is suspected.
The semilunar valves separate the:
A. atria from the ventricles.
B. ventricles from the arteries.
C. atria from the veins.
D. right atria from the left atria.
B ventricles from the arteries.
The semilunar valves separate the ventricles from the arteries. The AV valves separate the atria and ventricles.
Five minutes after receiving a preoperative sedative medication by IV injection, a client asks to get up to go to the bathroom to urinate. Which of the following actions is the most appropriate for the nurse to implement?
A. Offer the client to use the urinal/bedpan after explaining the need to maintain safety.
B. Assist the client to the bathroom and stay next to the door to assist the client back to bed when done.
C. Allow the client to go to the bathroom since the onset of the medication will be more than five minutes.
D. Ask the client to hold the urine for a short period since a urinary catheter will be placed in the operating room.
A. Offer the client to use the urinal/bedpan after explaining the need to maintain safety.
The prime issue after administration of either sedative or opioid analgesic medications is safety. Because the medications affect the central nervous system, the client is at risk for falls and should not be allowed out of bed, even with assistance.
Which of the following statements is the primary reason for accurately recording the client’s current medications during a preoperative assessment?
A. Some medications may alter the client’s perceptions about surgery.
B. Many anaesthetics alter renal and hepatic function, causing toxicity of other drugs.
C. Some medications may interact with anaesthetics, altering the potency and effect of the drugs.
D. Routine medications are withheld the day of surgery, requiring dosage and schedule adjustments after surgery.
C. Some medications may interact with anaesthetics, altering the potency and effect of the drugs.
Drug interactions may occur between prescribed medications and anaesthetic agents used during surgery. For this reason, it is important to take a careful medication history and check that they have been communicated to the anaesthesia care provider.
The nurse is preparing a client for surgery and the client refuses to remove a wedding ring. Which of the following actions is the most appropriate for the nurse to implement?
A. Insist the client remove the ring for safety purposes.
B. Explain that the hospital will not be responsible for the ring.
C. Tape the ring securely to the finger and document this on the preoperative checklist.
D. Note the presence of the ring in the nurse’s notes of the chart and on the preoperative checklist.
C. Tape the ring securely to the finger and document this on the preoperative checklist.
It is customary policy to tape a client’s wedding band to the finger and make a notation on the preoperative checklist that the ring is taped in place.
The nurse is performing preoperative teaching and the client asks when she needs to stop drinking water before the surgery. Based on the most recent practice guidelines established by the Canadian Anesthesiologists’ Society, the nurse should teach the client which of the following timeframes?
A. NPO after breakfast
B. NPO after midnight
C. Clear liquids up to 2 hours before surgery
D. Clear liquids up until she is transferred to the OR
C. Clear liquids up to 2 hours before surgery
Practice guidelines for preoperative fasting state that the minimum fasting period for clear liquids is 2 hours. Evidence-informed practice no longer supports the longstanding practice of requiring clients to be NPO after midnight.
The nurse is admitting a client to the same-day-surgery unit. The client tells the nurse that he was so nervous he had to take kava last evening to help him sleep. Which of the following nursing actions would be most appropriate?
A. Tell the client that using kava to help sleep is often helpful.
B. Inform the anaesthesiologist of the client’s recent use of kava.
C. Tell the client that the kava should continue to help him relax before surgery.
D. Inform the client about the dangers of taking herbal medicines without consulting his health care provider.
B. Inform the anaesthesiologist of the client’s recent use of kava.
Kava may prolong the effects of certain anaesthetics. Thus the anaesthesiologist needs to be informed of recent ingestion of this herbal supplement.
