1. The nurse is explaining to a patient with dysrhythmia how the heart conducts impulses that cause myocardial cells to contract simultaneously. The patient asks what structure allows this conduction from cell to cell. Which structure should the nurse mention?
A) Intercalated disks
2. A nurse is explaining to a cardiac patient how mechanical contraction takes place in the myocardial cells in the heart. The nurse should explain that which of the following is needed for contraction? Select all that apply.
3. Which of the following statements is true of cell membrane depolarization? Select all that apply.
A) In the resting myocardial cell, there are more potassium ions outside than inside the cell.
B) In the depolarized state, the cell membrane is positively charged.
C) Excitability is the term used to describe the ability of a cell to depolarize in response to a given stimulus.
D) Pumps move sodium out of the cell and potassium into the cell.
4. What is the role of the atrioventricular node in a person with normal heart rate (60 to 100 bpm) and why?
A) Acts as primary pacemaker, to establish the heart rate
B) Accelerates conduction of atrial action potentials so that all ventricular cells contract almost simultaneously
C) Delays conduction of atrial action potentials so that all ventricular cells contract almost simultaneously
D) Pumps sodium out of the myocardial cell and potassium into it to cause cell membrane depolarization
5. A nurse is working with a cardiac patient who is anxious about his upcoming surgery. At his request, the nurse hands him his MP3 player. After the patient listens to his MP3 player for a few moments, the nurse notices on the patients heart rate monitor that his heart rate has decreased somewhat. What physiological response would explain this decrease in heart rate?
A) Stimulation of the sympathetic nervous system and the subsequent release of norepinephrine
B) Release of epinephrine from the adrenal medulla
C) Release of norepinephrine from the adrenal medulla
D) Stimulation of the parasympathetic nervous system and the subsequent release of acetylcholine
6. The demand for oxygen in heart cells as a result of inotropic action is known as which of the following?
7. Which of the following statements regarding coronary circulation is correct?
A) In about 90% of the population, the right coronary artery is source of blood flow to the atrioventricular node.
B) In about 100% of the population, the left circumflex artery is the source of blood flow to the sinoatrial node.
C) The right coronary artery is the source of blood flow to the bundle branches.
D) The left anterior descending artery is the source of blood to the left atrium.
8. A patient has inadequate perfusion to her extremities. Which of the following could explain this phenomenon?
A) Increased diastolic pressure
B) Arteriole dilation
C) Decreased vascular resistance
D) Decreased blood viscosity
9. A patient has an irregular heartbeat. What is the most likely cause of this?
A) Excitability in cardiac tissue
B) Contractility in cardiac muscle
C) Automaticity in cardiac muscle cells
D) Conductivity in the AV node
10. The double-layered sac that surrounds the heart is known as which of the following?
11. A patient has been prescribed calcium blockers. The nurse should expect these medications to have what effect on the patient?
A) Decreased blood volume
B) Irregular heartbeat
C) Decreased arterial pressure
12. In evaluating the cardiac function of a patient, the nurse understands that cardiac muscle cells have unique properties that are not found in skeletal muscle. What is the best example of such a unique property?
13. While teaching a patient, the nurse explains that cardiac functioning has both a mechanical and an electrical component. What is the best way to assess the mechanical function of the heart?
A) Blood pressure
C) Membrane potential
D) Cardiac monitor pattern
14. Part of cardiac function involves the movement of ions in and out of cells, resulting in changes in the polarity of the cell membrane. As part of a teaching plan, the nurse explains that the term depolarized means that the cardiac cell membrane is what?
A) In transition
B) Electrically neutral
C) Negatively charged
D) Positively charged
15. Part of understanding cardiac electrical function is understanding the normal conduction system of the heart. List the following parts in normal functional order.
A) Bundle of His
B) Intranodal pathways
C) Atrioventricular node
D) Left bundle branches
E) Sinoatrial node
F) Purkinje fibers
16. A patient has compromised cardiac output. What parameters would the nurse assess to monitor cardiac output most fully?
A) Stroke volume and blood pressure
B) Heart rate and stroke volume
C) Stroke volume and pulse pressure
D) Heart rate and contractility
17. The patient is receiving a beta-receptor antagonist medication. What is the most significant effect on cardiac function that the nurse should be monitoring for?
A) Decreased cardiac output
B) Supraventricular tachycardia
C) Increased stroke volume
D) Increased blood pressure
18. The nurse is evaluating a patients cardiac output. What situation would be most indicative of increased preload?
A) Sinus tachycardia
B) Elevated central venous pressure
C) Elevated blood pressure
D) Evidence of myocardial infarction
19. The nurse is caring for a patient in cardiac failure who has very high afterload. What is the most direct adverse effect on cardiac function that the nurse would anticipate?
A) Increased cardiac output
B) Decreased heart rate
C) Decreased stroke volume
D) Increased heart rate
20. The patient has been diagnosed with a severe blockage of the proximal left anterior descending artery. What cardiac disturbance does the nurse anticipate as most likely?
A) Arrhythmias from the sinoatrial node
B) Arrhythmias from the atrioventricular node
C) Atrial muscle dysfunction and failure
D) Disturbance in bundle branch conduction
21. A patients heart rate is 45 bpm and regular. What part of the conduction system is most likely initiating the rhythm?
A) Sinoatrial node
B) Atrial muscle tissue
C) Atrioventricular node
D) Purkinje fibers
22. The patient has a heart rate of 80 bpm, blood pressure of 140/80 mmHg, and stroke volume of 100 mL/beat. The nurse calculates the patients cardiac output as ____ L/min?
23. The patient has a peripheral capillary refill time of less than 2 seconds. What relationship between blood volume and peripheral resistance would the nurse expect to find?
A) Elevated preload and blood pressure measurements
B) Normal preload and blood pressure measurements
C) Diminished preload and blood pressure measurements
D) No relationship between preload and blood pressure
2. A, B
3. C, D
15. E, B, C, A, D, F
22. 8 L/min
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