week 1 med/surg CH32 Cardiovascular

Question 1

what happens with released B1 Adrenergic stimulation?

Answer 1

Increased: C/O,Vasc resistance, VASOCONSTRICTION, Rate and contractility, Periph. art. vasoconstriction & Stimulation of Renin that starts the RAAS system.

Question 2

When palpating the patient’s popliteal pulse, the nurse feels a vibration at the site. How should the nurse record this finding?

Answer 2

d. Thrill of the popliteal artery

Question 3

What can be auscultated in a patient with cardiac valve problems ( a. Arterial bruit b. Pulsus alternans c. Cardiac murmurs d. Third heart sound (S3) e. Pericardial friction rub f. Fourth heart sound (S4)

Answer 3

c. Cardiac murmurs d. Third heart sound (S3) f. Fourth heart sound (S4)

Question 4

Which arteries are the major providers of coronary circulation (select all that apply)?

Answer 4

Left circumflex artery, Right coronary artery, Left anterior descending artery

Question 5

Number in sequence the path of the action potential along the conduction system of the heart:

Answer 5

1.Sinoatrial (SA) node, 2.Right and left atrial cells, 3.Internodal pathways, Atrioventricular (AV) node, 4.Bundle of His 5.Right and left bundle branches, 6.Purkinje fibers, 7.Ventricular cells,

Question 6

Measured from beginning of P wave to beginning of QRS complex?

Answer 6

PR interval

Question 7

Repolarization of the ventricles?

Answer 7

T wave

Question 8

what is measured as 0.12 to 0.20 sec

Answer 8

PR interval

Question 9

measured at 0.16 sec?

Answer 9

T wave

Question 10

Time of depolarization and repolarization of ventricles

Answer 10

QT interval

Question 11

measured at

Answer 11

QRS interval

Question 12

Depolarization from the AV node throughout ventricles

Answer 12

QRS interval

Question 13

0.06 to 0.12 sec

Answer 13

P wave

Question 14

valsalva maneuver affects what?

Answer 14

Pre-load and Decrease of: Stroke volume factor & Decrease Cardiac Output

Question 15

Venous dilation affects what?

Answer 15

Pre-load and Decrease of: Stroke volume factor & Decrease Cardiac Output

Question 16

Hypertension affects what?

Answer 16

After-load and Increase of: Stroke volume factor & Decrease Cardiac Output

Question 17

Administration of epinephrine affects what?

Answer 17

Contractility and Increase of: Stroke volume factor & Cardiac Output

Question 18

Obstruction of pulmonary artery affects what?.

Answer 18

Pre-load and Decrease of: Stroke volume factor & Decrease Cardiac Output

Question 19

Hemorrhage affects what?

Answer 19

Pre-load and Decrease of: Stroke volume factor & Decrease Cardiac Output

Question 20

What are the age-related physiologic changes that occur in the older adult that result in the following cardiovascular problems?…..Widened pulse pressure

Answer 20

long vascular distensibility and elastic recoil during systole

Question 21

What are the age-related physiologic changes that occur in the older adult that result in the following cardiovascular problems?…..Decreased cardiac reserve

Answer 21

increased callogen and decreased elastin

Question 22

What are the age-related physiologic changes that occur in the older adult that result in the following cardiovascular problems?…Increased cardiac dysrhythmias

Answer 22

decrease in SA node cells, conduction cells in the intermodal tracts, bundle off his, bundle branches

Question 23

What are the age-related physiologic changes that occur in the older adult that result in the following cardiovascular problems?.. Decreased response to sympathetic stimulation

Answer 23

decreased number of function of B-Adrenergic receptors

Question 24

What are the age-related physiologic changes that occur in the older adult that result in the following cardiovascular problems?..Aortic or mitral valve murmurs

Answer 24

Valvular lipid accumulation and calcification

Question 25

What is a significant finding in the health history of a patient during an assessment of the cardiovascular system?

Answer 25

Frequent use of recreational drugs……rationale: Recreational or abused drugs, especially stimulants such as cocaine and methamphetamine, are a growing cause of cardiac dysrhythmias and problems associated with tachycardia and IV injection of abused drugs is a risk factor for inflammatory and infectious conditions of the heart. Although calcium is involved in the contraction of muscles, calcium supplementation is not a significant factor in heart disease, nor is metastatic cancer. Streptococcal, but not viral, pharyngitis is a risk factor for rheumatic heart disease.

Question 26

When palpating the patient’s popliteal pulse, the nurse feels a vibration at the site. How should the nurse record this finding?

Answer 26

Thrill of the popliteal artery….remeber a thrill is palpabale

Question 27

Indicate whether the following are characteristic of the first heart sound (S1) or the second heart sound (S2). -Soft lub sound -Sharp dup sound -Indicates beginning of systole -Indicates the onset of diastole -Loudest at pulmonic and aortic areas -Loudest at tricuspid and mitral areas

Answer 27

a. Angle of Louis; b. Aortic area; c. Mitral area (apex) and PMI; d. Tricuspid area; e. Erb’s point; f. Pulmonic area

Question 28

What can be auscultated in a patient with cardiac valve problems (select all that apply)? a. Arterial bruit b. Pulsus alternans c. Cardiac murmurs d. Third heart sound (S3) e. Pericardial friction rub f. Fourth heart sound (S4)

Answer 28

a. S1; b. S2; c. S1; d. S2; e. S2; f. S

Question 29

The nursing student is seeking assistance in hearing the patient’s abnormal heart sounds. What should the nurse tell the student to do for a more effective assessment

Answer 29

Use the bell of the stethoscope with the patient leaning forward

Question 30

Which finding is associated with a blue tinge around the lips and conjunctiva?

Answer 30

Central cyanosis

Question 31

A patient is scheduled for exercise nuclear imaging stress testing. The nurse explains to the patient that this test involves

Answer 31

IV administration of a radioisotope at the maximum heart rate during exercise to identify the heart’s response to physical stress.

Question 32

Priority Decision: The nurse caring for a patient immediately following a transesophageal echocardiogram (TEE) should consider which action the highest priority? a. Monitor the ECG b. Monitor pulse oximetry c. Assess vital signs (BP, HR, RR, temperature) d. Maintain NPO status until gag reflex has returned

Answer 32

d. Maintain NPO status until gag reflex has returned

Question 33

Which method is used to evaluate the ECG responses to normal activity over a period of 1 or 2 days?

Answer 33

Holter monitoring

Question 34

When caring for a patient after a cardiac catheterization with coronary angiography, which finding would be of most concern to the nurse?

Answer 34

Absence of pulses distal to the catheter insertion site

Question 35

A female patient has a total cholesterol level of 232 mg/dL (6.0 mmol/L) and a high-density lipoprotein (HDL) of 65 mg/dL (1.68 mmol/L). A male patient has a total cholesterol level of 200 mg/dL and an HDL of 32 mg/dL. Based on these findings, which patient has the highest cardiac risk? a. The man, because his HDL is lower b. The woman, because her HDL is higher c. The woman, because her cholesterol is higher d. The man, because his cholesterol-to-HDL ratio is high

Answer 35

d. The man, because his cholesterol-to-HDL ratio is high

Question 36

Increases in which factors are predictors of an increased risk for coronary artery disease or evidence of myocardial injury (select all that apply)? a. Creatine kinase (CK)-MM b. Cardiac troponin T (cTnT) c. B-type natriuretic peptide (BNP) d. High-sensitivity C-reactive protein e. Lipoprotein-associated phospholipase A2

Answer 36

b. Cardiac troponin T (cTnT) d. High-sensitivity C-reactive protein e. Lipoprotein-associated phospholipase A2