Nokea
The nurse is caring for a client with an elevated blood pressure and no previous history of hypertension. At 0900, the blood pressure was 158/90 mm Hg. At 0930, the blood pressure is 142/82 mm Hg. The nurse is most correct when relating the fall in blood pressure to which structure?
- A. Chemoreceptors
- B. Sympathetic nerve fibers
- C. Baroreceptors
- D. Vagus nerve
Correct Answer: C
Rationale: Baroreceptors sense pressure in nerve endings in the walls of the atria and major blood vessels. The baroreceptors respond accordingly to raise or lower the pressure. Chemoreceptors are sensitive to pH, CO2, and O2 in the blood. Sympathetic nerve fibers increase the heart rate. The vagus nerve slows the heart rate.
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The nurse is caring for a client with a damaged tricuspid valve. The nurse knows that the tricuspid valve is held in place by which of the following?
- A. Chordae tendineae
- B. Atrioventricular tendons
- C. Semilunar tendineae
- D. Papillary tendons
Correct Answer: A
Rationale: Attached to the mitral and tricuspid valves are cordlike structures known as chordae tendineae, which in turn attach to papillary muscles, two major muscular projections from the ventricles. Neither atrioventricular tendons, semilunar tendineae, nor papillary tendons hold the tricuspid valve in place.
The nurse is caring for a client with nursing diagnosis of ineffective tissue perfusion. Which area of the heart would the nurse anticipate being compromised?
- A. Right atrium
- B. Pulmonary artery
- C. Right ventricle
- D. Aorta
Correct Answer: C
Rationale: There are four chambers to the heart. The right and left ventricles are the heart's major pumping chamber. The right ventricle pumps to the lungs to oxygenate the blood. The left ventricle pumps blood to the tissues and cells. The pulmonary artery and aorta are not of the heart.
The nurse is reviewing lab work for a client whose blood CO2 level is elevated. The nurse is most correct to suspect an impairment of which?
- A. Alveoli
- B. Bronchi
- C. The pulmonary artery
- D. The pulmonary vein
Correct Answer: A
Rationale: Gas exchange occurs in the lung where oxygen in inspired air exchanges for CO2 in the venous blood. The CO2 is then transferred to the alveoli to be exhaled. No gas exchange occurs in the bronchi. The pulmonary artery carries deoxygenated blood to the lungs, and the pulmonary vein brings oxygenated blood back to the heart to be pumped to the tissues.
While being prepared for echocardiography, the client asks nurse why this test is necessary. What would be the nurse's best response?
- A. This test will find any congenital heart defects.
- B. This test can tell us a lot about your heart.
- C. Echocardiography is a way of determining the functioning of the left ventricle of your heart.
- D. Echocardiography will tell your doctor if you have cancer of the heart.
Correct Answer: C
Rationale: Echocardiography uses ultrasound waves to determine the functioning of the left ventricle and to detect cardiac tumors, congenital defects, and changes in the tissue layers of the heart. Explaining the procedure is the best answer because it addresses the client's question without making the client anxious or minimizing the question.
The nurse provides care for a client who is diagnosed with an infarction of the posterior wall of the right atrium. Which clinical finding should the nurse anticipate relating to the infarction location?
- A. Jugular vein distention
- B. Irregular heart rate
- C. Peripheral edema
- D. Fever
Correct Answer: B
Rationale: The posterior wall of the right atrium is the location of the sinoatrial node (SA node), which is the pacemaker of the heart. Damage to this location may result in an irregular heart rate due to a disturbance of electrical pulse initiation. Jugular vein distension and peripheral edema are anticipated for the client who is experiencing heart failure, not myocardial infarction (MI). Although fever can increase the client's heart rate, this is not an expected finding with an MI.