Chapter 22 - Structure and Function of The Cardiovascular and Lymphatic Systems - Nursing Test Banks

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Chapter 22: Structure and Function of the

Cardiovascular and Lymphatic Systems
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 heart’s fibrous skeleton
ANS: C
The pericardium is the membranous sac that surrounds the heart.
The outer layer of the heart is the myocardium.

https://boostgrade.info/chapter-22-structure-and-function-of-the-cardiovascular-and-lymphatic-systems/ 1/36
The innermost layer of the heart is the endocardium.
The heart’s 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.
through the AV node, thus decreasing speed of the cardiac cycle.
through the AV node, decreasing contractility.
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.
not a decrease in Z line length.
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.
myocardial contractility (as measured by stroke volume). It does not refer to viscosity.
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
The pressure in the left ventricle must override that of the aorta, not the pulmonary veins, before the
REF: p. 553
35. When a nursing student wants to know where the primary cardiovascular control center is located, what
is the nurse’s 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 nurse’s 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 arterioles, as a response to changes in arterial perfusion pressure. It is not a part of autonomic
regulation.
the arterioles, as a response to changes in arterial perfusion pressure. It is not a part of somatic regulation.
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:
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.

Chapter 22 - Structure and Function of The Cardiovascular and Lymphatic Systems - Nursing Test Banks

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11/12/2019 Chapter 22: Structure and Function of the Cardiovascular and Lymphatic Systems | Nursing Test Banks

Nursing Test Banks

Chapter 22: Structure and Function of the

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 heart’s fibrous skeleton

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 heart’s fibrous skeleton is attached to the myocardium.

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.

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

The left ventricle generates the highest pressure.

a. Superior vena cava

Oxygenated blood flows through the pulmonary veins.

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

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

a. Chordae tendineae cordis

b. Inferior vena cava

The ostia are found on the aorta.

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

c. Left anterior descending

b. Pulmonary artery closure

c. Mitral valve opening

d. Aortic valve closing

a. Superior vena cava

b. Inferior vena cava

a. Decreased myocardial contraction

b. Decreased heart rate

c. Increased cardiac conduction

d. Increased intranodal conduction time

Stimulation of the sympathetic nervous system would increase myocardial contraction.

Stimulation of the sympathetic nervous system would increase heart rate.

a. Atrioventricular (AV) node

b. Sinoatrial (SA) node

The SA node is considered the pacemaker of the heart.

a. Atrioventricular (AV) node

b. Sinoatrial (SA) node

d. The left ventricle

The left bundle branch conducts impulses to the left ventricle.

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

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.

Threshold is related to depolarization.

c. Onset of atrial activation to onset of ventricular activity

d. “Electrical systole” of the ventricles

The P wave represents atrial depolarization.

The QRS complex represents ventricular depolarization.

The QT interval represents “electrical systole” of the ventricles.

The QT interval represents “electrical systole” of the ventricles.

The P wave represents atrial depolarization.

a. Has a superior location in the right atrium