Chapter 42: Review of Hemodynamics

Chapter 42: Review of Hemodynamics

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

1. A nurse is attending a class on the monitoring of hemodynamics. The instructor asks the nurse to list the primary functions of the circulatory system. The nurse would be correct to list which of the following functions? (Select all that apply.)

a.	Delivery of oxygen to the cells
b.	Delivery of carbon dioxide to the cells
c.	Removal of electrolytes from the cells
d.	Delivery of hormones to the cells
e.	Removal of metabolic wastes from the cells

 

 

ANS:   A, D, E

The circulatory system has two primary functions: delivery of oxygen, nutrients, hormones, electrolytes, and other essentials to the cells; and removal of carbon dioxide, metabolic wastes, and other detritus from cells.

The circulatory system removes carbon dioxide from the cells.

The circulatory system delivers electrolytes to the cells.

 

DIF:    Cognitive Level: Comprehension      REF:    p. 460

TOP:    Nursing Process: Diagnosis

MSC:   NCLEX Client Needs Category: Physiological Integrity: Physiological Adaptation

 

2. A nurse is teaching a class on the cardiovascular system to nurses from the unit. The nurse asks the class what factors largely determine stroke volume. Which response from a member of the class demonstrates a need for further teaching?

a.	Myocardial contractility
b.	Viscosity of the blood
c.	Cardiac afterload
d.	Cardiac preload

 

 

ANS:   B

Viscosity of the blood affects resistance to flow; this response indicates that further teaching is required.

Stroke volume is determined largely by three factors: myocardial contractility, cardiac afterload, and cardiac preload; no further teaching is required with these answers.

 

DIF:    Cognitive Level: Analysis                  REF:    p. 462

TOP:    Nursing Process: Evaluation

MSC:   NCLEX Client Needs Category: Physiological Integrity: Physiological Adaptation

 

3. A nurse is performing a physical assessment on a patient with heart failure. If Starling’s law were to break down, what is the most significant clinical manifestation the patient could display?

a.	Increased heart rate
b.	Decreased blood volume
c.	Increased blood pressure
d.	Shortness of breath

 

 

ANS:   D

In a failing heart, Starling’s law breaks down. The force of contraction no longer increases in proportion to increased ventricular filling. Blood backs up behind the failing ventricle, which causes blood to back up in the pulmonary circulation. This leads to respiratory symptoms, including dyspnea, or shortness of breath.

An increased heart rate would be expected because of the increase in volume; however, this would not be the most significant finding related to heart failure.

The patient would not have a decrease in blood volume.

An increase in blood pressure probably would be expected, but this would not be the most significant finding related to heart failure.

 

DIF:    Cognitive Level: Analysis                  REF:    p. 463

TOP:    Nursing Process: Assessment

MSC:   NCLEX Client Needs Category: Physiological Integrity: Physiological Adaptation

 

4. A patient with a history of hypertension is admitted for a procedure. If the patient’s arterial pressure decreases, which clinical manifestation would the nurse expect to see?

a.	Decreased heart rate
b.	Increased heart rate
c.	Decreased blood pressure
d.	Syncope

 

 

ANS:   B

When arterial pressure decreases, the vasoconstrictor center causes constriction of nearly all arterioles, leading to an increase in peripheral resistance, constriction of veins, increasing venous return, and subsequent acceleration of the heart rate.

A decrease in arterial pressure would not cause a decrease in the heart rate or blood pressure, nor would it cause syncope.

 

DIF:    Cognitive Level: Application             REF:    p. 463

TOP:    Nursing Process: Assessment

MSC:   NCLEX Client Needs Category: Physiological Integrity: Physiological Adaptation