Chapter 22: Structure and Function of the Cardiovascular and Lymphatic Systems My Nursing Test Banks

Huether and McCance: Understanding Pathophysiology, 5th Edition

Chapter 22: Structure and Function of the Cardiovascular and Lymphatic Systems

Test Bank

MULTIPLE CHOICE

1. A 52-year-old female is admitted to the cardiac unit with a diagnosis of pericarditis. She asks the nurse to explain where the infection is. In providing an accurate description, the nurse states that the pericardium is:

a.

The outer muscular layer of the heart

b.

The innermost layer of the heart chambers

c.

A membranous sac that encloses the heart

d.

The hearts fibrous skeleton

ANS: C

The pericardium is the membranous sac that surrounds the heart.

The outer layer of the heart is the myocardium.

The innermost layer of the heart is the endocardium.

The hearts fibrous skeleton is attached to the myocardium.

REF: p. 552

2. A nurse is explaining the function of the heart. Which is a correct response by the nurse? A function of the pericardium is to:

a.

Provide a barrier against extracardial infections.

b.

Improve blood flow through the heart.

c.

Play a role in cardiac conduction.

d.

Assist in cardiac contraction.

ANS: A

A function of the pericardium is to provide a barrier against extracardial infections.

The pericardium does not improve blood flow through the heart as it is on the outside.

The pericardium does not have a role in cardiac conduction. The inner portions of the heart control this.

The pericardium does not assist in contraction. The muscular layers assist with this.

REF: p. 552

3. A 65-year-old male develops blockage in the pulmonary artery. As a result of the blockage, blood would first back up into the:

a.

Aorta

b.

Left ventricle

c.

Pulmonary veins

d.

Right ventricle

ANS: D

Blockage in the pulmonary artery would cause blood to back up into the right ventricle.

Blockage in the pulmonary artery would cause blood to back up into the right ventricle, not the aorta. These two vessels do not communicate.

Blockage in the pulmonary artery would cause blood to back up into the right ventricle, not the left ventricle. This vessel and chamber do not communicate.

Blockage in the pulmonary artery would cause blood to back up into the right ventricle, not the pulmonary vein. The pulmonary vein takes blood to the left atrium.

REF: p. 553

4. A nurse is teaching about the heart. Which information should the nurse include? The chamber of the heart that generates the highest pressure is the:

a.

Right atrium

b.

Left atrium

c.

Left ventricle

d.

Right ventricle

ANS: C

The left ventricle generates the highest pressure.

The left ventricle, not the right atrium, generates the highest pressure.

The left ventricle, not the left atrium, generates the highest pressure.

The left ventricle, not the right ventricle, generates the highest pressure.

REF: p. 553

5. A nurse recalls the chamber that receives blood from the systemic circulation is the:

a.

Right atrium

b.

Right ventricle

c.

Left atrium

d.

Left ventricle

ANS: A

The right atrium receives the blood from the systemic circulation.

The right atrium receives the blood from the systemic circulation; the right ventricle receives blood from the right atrium.

The right atrium receives the blood from the systemic circulation; the left atrium receives blood from the lungs.

The right atrium receives the blood from the systemic circulation; the left ventricle receives blood from the left atrium.

REF: p. 554

6. Which statement indicates the nurse understands blood flow? Oxygenated blood flows through the:

a.

Superior vena cava

b.

Pulmonary veins

c.

Pulmonary artery

d.

Cardiac veins

ANS: B

Oxygenated blood flows through the pulmonary veins.

Oxygenated blood flows through the pulmonary veins, not the superior vena cava, which carries venous blood.

Oxygenated blood flows through the pulmonary veins, not the pulmonary artery, which carries unoxygenated blood to the lungs.

Oxygenated blood flows through the pulmonary veins, not the cardiac veins, which carry unoxygenated blood.

REF: p. 554

7. A 20-year-old male underwent an echocardiogram to assess chest pain. Results revealed a congenital defect in papillary muscles. Which of the following would the nurse expect to occur?

a.

Closure of the semilunar valve

b.

Backward expulsion of the atrioventricular valves

c.

Closure of the atrioventricular valve

d.

Backward expulsion of the semilunar valves

ANS: B

The papillary muscles are extensions of the myocardium that pull the cusps together and downward at the onset of ventricular contraction, thus preventing their backward expulsion into the atria.

Defects in the papillary muscles would not affect the semilunar valve closure.

Defects in the papillary muscles do not affect the atrioventricular valves.

The papillary muscles prevent backward expulsion into the atria. They do not affect the semilunar valves.

REF: p. 554

8. A cardiologist is discussing valves with the staff. Which information should the cardiologist include? _____ are the anchors of the atrioventricular valves.

a.

Chordae tendineae cordis

b.

Great vessels

c.

Coronary ostia

d.

Trabeculae carneae

ANS: A

The atrioventricular valve openings are attached to the papillary muscles by the chordae tendineae cordis.

The atrioventricular valve openings are attached to the papillary muscles by the chordae tendineae cordis. The great vessels are the vessels that bring blood to and out of the heart and are not attached to the chordae tendineae.

The atrioventricular valve openings are attached to the papillary muscles by the chordae tendineae cordis, not the coronary ostia, which are openings in the aorta for the coronary arteries.

The atrioventricular valve openings are attached to the papillary muscles by the chordae tendineae cordis, not the trabeculae carneae, which are a portion of the myocardium.

REF: p. 554

9. Which statement indicates the nurse understands coronary ostia? The coronary ostia (the openings to the coronary arteries) are found in the:

a.

Left ventricle

b.

Inferior vena cava

c.

Coronary sinus

d.

Aorta

ANS: D

The ostia are found on the aorta.

The ostia are found on the aorta, not the ventricle.

The ostia are found on the aorta, not the vena cava.

The ostia are found on the aorta, not the coronary sinus.

REF: p. 556

10. The nurse is planning care for a patient with heart problems. Which information should the nurse remember? The _____ artery travels down the interventricular septum and delivers blood to portions of the left and right ventricle.

a.

Right coronary

b.

Circumflex

c.

Left anterior descending

d.

Cardiac

ANS: C

The left anterior descending artery delivers blood to the left and right ventricle.

The left anterior descending artery, not the right coronary artery, delivers blood to the left and right ventricle.

The left anterior descending artery, not the circumflex, delivers blood to the left and right ventricle.

The left anterior descending artery, not the cardiac artery, delivers blood to the left and right ventricle.

REF: p. 557

11. A 65-year-old male is transported to the ER for chest pain. An electrocardiogram reveals a prolonged QRS interval. What is the nurse monitoring when the nurse observes the QRS complex on the electrocardiogram? The QRS complex reflects:

a.

Ventricular activity

b.

Pulmonary artery closure

c.

Mitral valve opening

d.

Aortic valve closing

ANS: A

The QRS complex represents the sum of all ventricular muscle cell depolarizations.

The QRS complex represents the sum of all ventricular muscle cell depolarizations, not the pulmonary artery.

The QRS complex represents the sum of all ventricular muscle cell depolarizations; it does not reflect mitral opening.

The QRS complex represents the sum of all ventricular muscle cell depolarizations; it does not reflect activity of the aortic valve.

REF: p. 559

12. When a staff member asks where venous blood from the coronary circulation drains into, what is the best response by the nurse? The:

a.

Superior vena cava

b.

Inferior vena cava

c.

Right atrium

d.

Reft atrium

ANS: C

Unoxygenated blood from the coronary veins enters the right atrium through the coronary sinus.

Unoxygenated blood from the coronary veins enters the right atrium through the coronary sinus. It does not flow into the superior vena cava.

Unoxygenated blood from the coronary veins enters the right atrium through the coronary sinus. It does not flow into the inferior vena cava.

Unoxygenated blood from the coronary veins enters the right atrium, not the left, through the coronary sinus.

REF: p. 557

13. While viewing the electrocardiogram, the nurse recalls the _____ conducts action potentials down the atrioventricular septum.

a.

Bachmann bundle

b.

Bundle of His

c.

Sinoatrial node

d.

Atrioventricular node

ANS: B

The bundle of His conducts action potentials down the atrioventricular septum.

The bundle of His conducts action potentials down the atrioventricular septum, not the Bachmann bundle.

The bundle of His conducts action potentials down the atrioventricular septum; the sinoatrial node conducts the potential along the atria.

The bundle of His conducts action potentials down the atrioventricular septum; the atrioventricular node conducts impulses to the ventricles.

REF: p. 557

14. A 13-year-old female took a weight loss drug that activated the sympathetic nervous system. Which of the following assessment findings would the nurse expect?

a.

Decreased myocardial contraction

b.

Decreased heart rate

c.

Increased cardiac conduction

d.

Increased intranodal conduction time

ANS: C

Stimulation of the SA node by the sympathetic nervous system rapidly increases cardiac conduction.

Stimulation of the sympathetic nervous system would increase myocardial contraction.

Stimulation of the sympathetic nervous system would increase heart rate.

Stimulation of the sympathetic nervous system would not affect conduction time within the node. These are inherent rates.

REF: p. 560

15. A 50-year-old female 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?

a.

Atrioventricular (AV) node

b.

Sinoatrial (SA) node

c.

Bundle of His

d.

Ventricles

ANS: B

The SA node is considered the pacemaker of the heart.

The SA node, not the AV node, is considered the pacemaker of the heart.

The SA node is considered the pacemaker of the heart; the bundle of His is not involved.

The SA node is considered the pacemaker of the heart; the ventricles are not involved.

REF: p. 560

16. A 54-year-old male is diagnosed with left bundle branch block. Which of the following structures would not receive an electrical impulse?

a.

Atrioventricular (AV) node

b.

Sinoatrial (SA) node

c.

Bundle of His

d.

The left ventricle

ANS: D

The left bundle branch conducts impulses to the left ventricle.

The left bundle branch conducts impulses to the left ventricle; the AV node feeds conduction of the bundles.

The left bundle branch conducts impulses to the left ventricle; the SA node initiates conduction.

The left bundle branch conducts impulses to the left ventricle; the bundle of His precedes the division of the left and right bundles.

REF: p. 557

17. Which information by the nurse indicates a good understanding of depolarization? Depolarization of a cardiac muscle cell occurs as the result of:

a.

A decrease in the permeability of the cell membrane to ions

b.

The rapid movement of ions across the cell membrane

c.

A blockade by calcium ions

d.

Stimuli instigated during the refractory period

ANS: B

Depolarization is caused by the movement of electrically charged solutes (ions) across cardiac cell membranes.

Permeability must be increased for movement to occur.

A blockage of calcium ions would decrease depolarization.

No cardiac action potential can be initiated in the refractory period.

REF: p. 558

18. A cardiologist is teaching about the period that follows depolarization of the myocardium and represents a period during which no new cardiac potential can be propagated. What is the cardiologist describing?

a.

Absolute refractory

b.

Hyperpolarization

c.

Resting

d.

Threshold

ANS: A

A refractory period is the time during which no new cardiac action potential can be initiated by a stimulus. It follows depolarization.

A refractory period is the time, not hyperpolarization, during which no new cardiac action potential can be initiated by a stimulus. It follows depolarization.

Cardiac potential does rest, but the period is termed the refractory period.

Threshold is related to depolarization.

REF: p. 559

19. The nurse is reviewing a normal electrocardiogram. The nurse assesses the PR interval because it represents:

a.

Atrial depolarization

b.

Ventricular depolarization

c.

Onset of atrial activation to onset of ventricular activity

d.

Electrical systole of the ventricles

ANS: C

The PR interval represents the onset of atrial activation to the onset of ventricular activity.

The P wave represents atrial depolarization.

The QRS complex represents ventricular depolarization.

The QT interval represents electrical systole of the ventricles.

REF: p. 559

20. The _____ represents the sum of all ventricular muscle cell depolarization.

a.

PR interval

b.

QRS complex

c.

QT interval

d.

P wave

ANS: B

The QRS complex represents the sum of all ventricular muscle cell depolarizations.

The PR interval represents the onset of atrial activation to the onset of ventricular activity.

The QT interval represents electrical systole of the ventricles.

The P wave represents atrial depolarization.

REF: p. 559

21. When a student nurse asks the nurse how the cardiac electrical impulse normally begins, what is the most correct response? The cardiac electrical impulse normally begins spontaneously in the sinoatrial (SA) node because it:

a.

Has a superior location in the right atrium

b.

Is the only area of the heart capable of spontaneous depolarization

c.

Has rich sympathetic innervation via the vagus nerve

d.

Depolarizes more rapidly than other automatic cells of the heart

ANS: D

The electrical impulse normally begins in the SA node because its cells depolarize more rapidly than other automatic cells.

Cardiac impulses occur in the SA node because its cells depolarize more rapidly than other automatic cells, not because of its superior location.

Cardiac impulses occur in the SA node because its cells depolarize more rapidly than other automatic cells. The SA node is not the only area of the heart capable of spontaneous depolarization.

Cardiac impulses occur in the SA node because its cells depolarize more rapidly than other automatic cells. It does have rich innervations, but by parasympathetic innervation from the vagus nerve.

REF: p. 557

22. A 28-year-old female with seizure disorder has a vagus nerve stimulator implanted to help control seizure activity. Which of the following would the nurse also expect to occur?

a.

Increased speed of cardiac cycle

b.

Increased cardiac contractility

c.

Decreased vasodilation

d.

Decreased cardiac conduction

ANS: D

The vagus nerve releases acetylcholine. Acetylcholine causes decreased heart rate and slows conduction through the atrioventricular (AV) node.

The vagus nerve releases acetylcholine. Acetylcholine causes decreased heart rate and slows conduction through the AV node, thus decreasing speed of the cardiac cycle.

The vagus nerve releases acetylcholine. Acetylcholine causes decreased heart rate and slows conduction through the AV node, decreasing contractility.

The vagus nerve releases acetylcholine. Acetylcholine causes decreased heart rate and slows conduction through the AV node; it does not cause vasodilation.

REF: p. 560

23. A new drug is released to aid in weight loss. It stimulates the sympathetic system. The nurse monitors for an increased heart rate. The sympathetic system causes this by:

a.

Inhibiting the release of catecholamines

b.

Altering the threshold potential

c.

Decreasing the conduction time through the atrioventricular (AV) node

d.

Increasing the influx of calcium

ANS: B

The sympathetic system increases heart rate by altering the threshold potential.

The sympathetic system increases heart rate by altering the threshold potential. It does not inhibit the release of catecholamines.

The sympathetic system increases heart rate by altering the threshold potential. It does not decrease conduction through the AV node.

The sympathetic system increases heart rate by altering the threshold potential. It does not increase the influx of calcium.

REF: p. 560

24. A nurse assesses the heart after acetylcholine because the effect of acetylcholine on the heart is to:

a.

Decrease the refractory period

b.

Increase calcium influx

c.

Increase the strength of myocardial contraction

d.

Decrease the heart rate

ANS: D

Acetylcholine causes decreased heart rate and slows conduction through the atrioventricular (AV) node.

Acetylcholine causes decreased heart rate and slows conduction through the AV node; it does not decrease the refractory period.

It decreases calcium influx.

Acetylcholine causes decreased heart rate and slows conduction through the AV node; it does not increase the strength of myocardial contraction.

REF: p. 560

25. To help a nursing student differentiate cardiac muscle from skeletal muscle, which characteristic should the nurse use? One difference between cardiac muscle and skeletal muscle is that:

a.

Cardiac muscle cells are arranged in branching networks.

b.

Skeletal muscle cells have only one nucleus.

c.

Cardiac muscle cells appear striped.

d.

Skeletal muscle cells contain sarcomeres.

ANS: A

Cardiac cells are arranged in branching networks throughout the myocardium, whereas skeletal muscle cells tend to be arranged in parallel units throughout the length of the muscle.

Cardiac muscle cells have only one nucleus, whereas skeletal muscle cells have many nuclei.

Both cardiac and muscle cells appear striped.

Both cardiac and muscle cells contain sarcomeres.

REF: p. 560

26. A cardiologist is teaching about myocardial cells. Which information should the cardiologist include? _____ are thickened areas of the sarcolemma of myocardial cells that enable electrical impulses to travel in a continuous cell-to-cell fashion.

a.

Myosins

b.

Intercalated disks

c.

Troponin Ts

d.

I bands

ANS: B

Intercalated discs allow electrical impulses to be transmitted rapidly from cardiac fiber to cardiac fiber because the network of fibers is connected at these discs.

Myosins are filaments that are a part of cardiac tissue. They do not play a role in conduction.

Troponin Ts are involved in contraction, but are not part of the sarcolemma.

I bands are a part of the filaments bud, which do not conduct impulses in a cell-to-cell fashion.

REF: p. 560

27. _____ is 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.

a.

Electrocontraction

b.

Intercalated communication

c.

Excitation-contraction coupling

d.

Myosin communication

ANS: C

Excitation-contraction coupling is the process by which an action potential in the plasma membrane of the muscle fiber triggers the cycle, leading to cross-bridge activity and contraction.

Excitation-contraction coupling, not electrocontraction, is the process by which an action potential in the plasma membrane of the muscle fiber triggers the cycle, leading to cross-bridge activity and contraction.

Excitation-contraction coupling, not intercalated communication, is the process by which an action potential in the plasma membrane of the muscle fiber triggers the cycle, leading to cross-bridge activity and contraction.

Excitation-contraction coupling, not myosin communication, is the process by which an action potential in the plasma membrane of the muscle fiber triggers the cycle, leading to cross-bridge activity and contraction.

REF: p. 562

28. The molecule that aids in bonding of the troponin complex to actin and tropomyosin is troponin:

a.

C

b.

I

c.

T

d.

M

ANS: C

Troponin T aids in the binding of the troponin complex to actin and tropomyosin.

Troponin C contains binding sites for the calcium ions involved in contraction.

Troponin I inhibits the ATPase of actomyosin.

Troponin M is not a substance.

REF: p. 563

29. A patient has searched on the internet for muscle contractions. Which information indicates a good understanding? Muscle contractions occur when there is a decreased:

a.

Distance between Z lines

b.

A band length

c.

Z line length

d.

H zone distance

ANS: A

Anatomically, contraction occurs when the sarcomere shortens, so adjacent Z lines move closer together.

Anatomically, contraction occurs when the sarcomere shortens, so adjacent Z lines move closer together, not a decrease in A band length.

Anatomically, contraction occurs when the sarcomere shortens, so adjacent Z lines move closer together, not a decrease in Z line length.

Anatomically, contraction occurs when the sarcomere shortens, so adjacent Z lines move closer together, not a decrease in H zone distance.

REF: p. 561

30. A nurse is discussing the pressure generated at the end of diastole. Which term is the nurse describing?

a.

Preload

b.

Afterload

c.

Systemic vascular resistance

d.

Total peripheral resistance

ANS: B

Preload is the volume and associated pressure generated in the ventricle at the end of diastole.

B Preload, not afterload, is the volume and associated pressure generated in the ventricle at the end of diastole. Afterload is the resistance to ejection of blood from the left ventricle.

Systemic vascular resistance is related to afterload.

Total peripheral resistance increases afterload.

REF: p. 563

31. Which principle should the nurse remember when planning nursing care for a patient with heart problems? 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.

a.

Pressure, duration

b.

Volume, force

c.

Viscosity, force

d.

Viscosity, duration

ANS: B

The Frank-Starling law of the heart describes the length-tension relationship of ventricular end-diastolic volume (VEDV) (preload) to myocardial contractility (as measured by stroke volume).

The Frank-Starling law of the heart describes the length-tension relationship of VEDV (preload) to myocardial contractility (as measured by stroke volume). It does not refer to duration.

The Frank-Starling law of the heart describes the length-tension relationship of VEDV (preload) to myocardial contractility (as measured by stroke volume). It does not refer to viscosity.

The Frank-Starling law of the heart describes the length-tension relationship of VEDV (preload) to myocardial contractility (as measured by stroke volume). It does not refer to duration.

REF: p. 563

32. Within a normal physiologic range, an increase in left ventricular end-diastolic volume would lead the nurse to monitor for:

a.

An increased force of contraction

b.

A decrease in cardiac output

c.

An increase in heart rate

d.

Heart failure

ANS: A

An increase in end-diastolic volume leads to an increased force of contraction because fibers are stretched to handle increased volume.

Cardiac output would increase.

Although volume increases, heart rate does not respond accordingly.

An increase in end-diastolic volume would not lead to heart failure. Failure results in output decrease.

REF: p. 563

33. While planning care for a heart patient, which principle should the nurse recall? Right ventricular afterload is affected by:

a.

Vascular resistance in the systemic vessels

b.

Right end-diastolic pressure

c.

Pressures in the vena cava

d.

Pulmonary vascular resistance

ANS: D

Right ventricular afterload is affected by pulmonary vascular resistance because this is the pressure the ventricle must pump against.

Systemic resistance affects left-sided afterload.

Right end-diastolic pressure is a measurement of the pressure at diastole, but does not determine afterload.

Pressures in the vena cava do not affect right ventricle afterload directly.

REF: p. 564

34. Which principle should the nurse remember while planning care for a cardiac patient? Pressure in the left ventricle must exceed pressure in the _____ before the left ventricle can eject blood.

a.

Coronary arteries

b.

Aorta

c.

Inferior vena cava

d.

Pulmonary veins

ANS: B

The pressure in the left ventricle must override that of the aorta before the ventricle can eject blood.

The pressure in the left ventricle must override that of the aorta, not the coronary arteries, before the ventricle can eject blood.

The pressure in the left ventricle must override that of the aorta, not the inferior vena cava, before the ventricle can eject blood.

The pressure in the left ventricle must override that of the aorta, not the pulmonary veins, before the ventricle can eject blood.

REF: p. 553

35. When a nursing student wants to know where the primary cardiovascular control center is located, what is the nurses best response? In the:

a.

Cerebral cortex

b.

Midbrain

c.

Medulla

d.

Cervical spinal cord

ANS: C

The cardiovascular control center is in the brainstem in the medulla.

The cardiovascular control center is in the brainstem in the medulla, not the cerebral cortex. The cardiovascular control center is in the brainstem in the medulla, not the midbrain.

The cardiovascular control center is in the brainstem in the medulla, not in the cervical spinal cord.

REF: p. 565

36. A 50-year-old female was prescribed a drug that acts as a negative inotrope. Which of the following endogenous substances would be most similar?

a.

Acetylcholine

b.

Dopamine

c.

Epinephrine

d.

Thyroid hormone

ANS: A

The most important negative inotropic agent is acetylcholine.

The most important negative inotropic agent is acetylcholine, not dopamine, which is a positive inotrope.

The most important negative inotropic agent is acetylcholine, not epinephrine, which is a positive inotrope.

The most important negative inotropic agent is acetylcholine, not thyroid hormone, which is a positive inotrope.

REF: p. 564

37. After activation of the Bainbridge reflex in a patient, the nurse assesses for:

a.

Increased heart rate

b.

Decreased blood pressure

c.

Increased rate and depth of respirations

d.

Decreased myocardial contractility

ANS: A

Activation of the Bainbridge reflex increases heart rate.

Activation of the Bainbridge reflex increases heart rate; it does not decrease blood pressure.

Activation of the Bainbridge reflex increases heart rate; it does not increase rate and depth of respirations.

Activation of the Bainbridge reflex increases heart rate; it does not decrease myocardial contractility.

REF: p. 565

38. A 50-year-old female presents with a low heart rate and low blood pressure. She is given an intravenous (IV) infusion of fluids. The increase in atrial distension results in:

a.

Renal retention of fluids

b.

Depressed myocardial contractility

c.

Release of acetylcholine

d.

Increased heart rate

ANS: D

IV fluids increase intravascular volume, distending the atria and increasing the heart rate.

IV fluids increase intravascular volume, distending the atria and increasing the heart rate; it does not result in renal retention of fluids.

IV fluids increase intravascular volume, distending the atria and increasing the heart rate; it does not depress myocardial contractility.

IV fluids increase intravascular volume, distending the atria and increasing the heart rate; it does not result in the release of acetylcholine.

REF: p. 565

39. A nurse observes a cardiologist multiplying the heart rate by stroke volume. What is the cardiologist measuring?

a.

Vascular resistance

b.

Preload

c.

Cardiac output

d.

Ejection fraction

ANS: C

Cardiac output is found by multiplying the heart rate times stroke volume.

Vascular resistance is not a factor in the calculation of cardiac output; it does play a role in blood pressure.

Preload affects cardiac output but is not the result of heart rate times stroke volume.

Ejection fraction is the amount ejected per beat.

REF: p. 565

40. A nurse recalls the internal lining of the cardiovascular system is formed by what tissue?

a.

Tunica adventitia

b.

Connective

c.

Mesothelium

d.

Endothelium

ANS: D

The endothelium is the lining of blood vessels.

The endothelium, not the tunica adventitia, is the lining of blood vessels.

Connective tissues help make up arterial walls but are not the lining of blood vessels.

The mesothelium is a part of the pericardial cavity.

REF: p. 553

41. A patient researches baroreceptors online. Which information indicates a good understanding? Baroreceptors are located in the:

a.

Renal artery

b.

Superior vena cava

c.

Carotid sinus

d.

Circle of Willis

ANS: C

Baroreceptors are found in the carotid sinus.

Baroreceptors are not found in the renal artery, but in the carotid sinus.

Baroreceptors are not found in the superior vena cava, but in the carotid sinus.

Baroreceptors are not found in the circle of Willis, but in the carotid sinus.

REF: p. 574

42. A nurse is evaluating the direct end effect of the renin-angiotensin-aldosterone system. Which principle should the nurse remember?

a.

Angiotensin II causes systemic vasoconstriction.

b.

Renin promotes the excretion of sodium and water in the renal tubules.

c.

Aldosterone increases renal retention of water only.

d.

Angiotensin I promotes sodium and water reabsorption by the kidneys.

ANS: A

Angiotensin II is a potent vasoconstrictor.

Renin promotes the retention of sodium and water.

Aldosterone increases retention of water and sodium.

Angiotensin I does not have an effect on the kidneys.

REF: p. 574

43. When a patient wants to know about the renin-angiotensin-aldosterone system, what is the nurses best response? Conversion of angiotensin I to angiotensin II happens in the:

a.

Lungs

b.

Liver

c.

Kidneys

d.

Heart

ANS: A

Angiotensin I is converted to angiotensin II by angiotensin converting enzyme in the lungs.

The liver synthesizes angiotensinogen rather than assisting with the conversion of angiotensin I to II.

The kidneys release renin, which initiates the process; it is not involved in the conversion of angiotensin I to II

The heart does not assist in the conversion of angiotensin I to II.

REF: p. 574

44. A nurse is discussing the different types of regulation. Which regulation is the nurse describing? Local myogenic regulation of blood vessel diameter and thus blood flow through a vessel is an example of:

a.

Autonomic regulation

b.

Somatic regulation

c.

Autoregulation

d.

Metabolic regulation

ANS: C

The myogenic hypothesis proposes that autoregulation originates in vascular smooth muscle, presumably of the arterioles, as a response to changes in arterial perfusion pressure.

The myogenic hypothesis proposes that autoregulation originates in vascular smooth muscle, presumably of the arterioles, as a response to changes in arterial perfusion pressure. It is not a part of autonomic regulation.

The myogenic hypothesis proposes that autoregulation originates in vascular smooth muscle, presumably of the arterioles, as a response to changes in arterial perfusion pressure. It is not a part of somatic regulation.

The myogenic hypothesis proposes that autoregulation originates in vascular smooth muscle, presumably of the arterioles, as a response to changes in arterial perfusion pressure. It is not part of metabolic regulation.

REF: p. 579

45. The thoracic lymphatic duct drains into the:

a.

Left subclavian artery

b.

Right atrium

c.

Right subclavian vein

d.

Left subclavian vein

ANS: D

The thoracic duct drains lymph into the left subclavian vein.

The thoracic duct drains lymph into the left subclavian vein, not artery; the right lymphatic duct drains into the right subclavian vein, not artery.

The thoracic duct drains lymph into the left subclavian vein, not the right atrium.

The thoracic duct drains lymph into the left subclavian vein, not the right subclavian vein

REF: p. 580

MULTIPLE RESPONSE

1. Increases in which of the following would cause the nurse to assess for decreased blood flow? (Select all that apply.)

a.

Blood viscosity

b.

Blood vessel diameter

c.

Blood pressure

d.

Blood vessel length

ANS: A, C, D

Resistance to flow is generally greater in longer tubes because resistance increases with length. Blood flow varies inversely with the viscosity of the fluid. Thick fluids move more slowly and experience greater resistance to flow than thin fluids. Increased blood pressure decreases blood flow because resistance in increased.

REF: p. 572

2. Important mechanisms for maintaining venous return to the right atrium include (elect all that apply):

a.

Cardiac output

b.

Atrioventricular (AV) valves

c.

Skeletal muscle contraction

d.

Blood volume

e.

Vascular tone

ANS: A, B, C, D

Venous return is dependent on blood volume and flow through the venous system and the AV valves. Skeletal muscle function assists the flow of blood toward the heart. This important mechanism of venous return is called the muscle pump. Vascular tone must be maintained to facilitate return.

REF: p. 578

3. A nurse is evaluating stroke volume. Which of the following factors affect stroke volume? (Select all that apply.)

a.

Preload

b.

Peripheral vascular resistance

c.

Afterload

d.

Ejection fraction

e.

Contractility

ANS: A, C, E

Preload, afterload, and contractility affect stroke volume.

REF: p. 563

COMPLETION

1. The nurse is measuring cardiac output in a resting patient. the normal baseline for cardiac output in this patient is _____ L/min.

ANS:

5

five

REF: p. 563

2. A nurse is assessing the heart rate. The nurse obtains a normal heart rate. The average heart rate in a healthy adult is _____ beats per minute.

ANS:

70

seventy

REF: p. 565

Mosby items and derived items 2012 Mosby, Inc., an imprint of Elsevier Inc.

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