Jarvis Chapter 20 Heart and Neck Vessels Quiz

Questions and Answers

The sac that surrounds and protects the heart is called the:

Pericardium (correct)

Pleural space

Myocardium

Endocardium

The direction of blood flow through the heart is best described by which of these?

Vena cava right atrium right ventricle lungs pulmonary artery left atrium left ventricle

Right atrium right ventricle pulmonary artery lungs pulmonary vein left atrium left ventricle (correct)

Aorta right atrium right ventricle lungs pulmonary vein left atrium left ventricle vena cava

Right atrium right ventricle pulmonary vein lungs pulmonary artery left atrium left ventricle

Which statement best describes what is meant by atrial kick?

Atrial kick is the pressure exerted against the atria as the ventricles contract during systole.

The atria contract toward the end of diastole and push the remaining blood into the ventricles. (correct)

The atria contract during systole and attempt to push against closed valves.

Contraction of the atria at the beginning of diastole can be felt as a palpitation.

When listening to heart sounds, the valve closures that can be heard best at the base of the heart are:

Aortic and pulmonic Signup and view all the answers

Which of these statements describes the closure of the valves in a normal cardiac cycle?

The tricuspid valve closes slightly later than the mitral valve. Signup and view all the answers

The component of the conduction system referred to as the pacemaker of the heart is the:

Sinoatrial (SA) node Signup and view all the answers

The electrical stimulus of the cardiac cycle follows which sequence?

AV node SA node bundle of His bundle branches Signup and view all the answers

The findings from an assessment of a 70-year-old patient with swelling in his ankles include jugular venous pulsations 5 cm above the sternal angle when the head of his bed is elevated 45 degrees. The nurse knows that this finding indicates:

Elevated pressure related to heart failure Signup and view all the answers

When assessing a newborn infant who is 5 minutes old, the nurse knows which of these statements to be true?

Blood can flow into the left side of the heart through an opening in the atrial septum. Signup and view all the answers

A 25-year-old woman in her fifth month of pregnancy has a blood pressure of 100/70 mm Hg. What does the nurse know to be true about the decline in blood pressure?

This decline in blood pressure is the result of peripheral vasodilatation and is an expected change. Signup and view all the answers

In assessing a 70-year-old man, the nurse finds the following: blood pressure 140/100 mm Hg; heart rate 104 beats per minute and slightly irregular; and the split S2 heart sound. Which of these findings can be explained by expected hemodynamic changes related to age?

Increase in systolic blood pressure Signup and view all the answers

A 45-year-old man is in the clinic for a routine physical examination. During the recording of his health history, the patient states that he has been having difficulty sleeping. What would be the nurse's best response?

Do you have any history of problems with your heart? Signup and view all the answers

In assessing a patient's major risk factors for heart disease, which would the nurse want to include when taking a history?

Smoking, hypertension, obesity, diabetes, and high cholesterol Signup and view all the answers

The mother of a 3-month-old infant states that her baby has not been gaining weight. What other information would the nurse want to have?

Presence of dyspnea or diaphoresis when sucking Signup and view all the answers

In assessing the carotid arteries of an older patient with cardiovascular disease, the nurse would:

Listen with the bell of the stethoscope to assess for bruits. Signup and view all the answers

During an assessment of a 68-year-old man with a recent onset of right-sided weakness, the nurse hears a blowing, swishing sound with the bell of the stethoscope over the left carotid artery. This finding would indicate:

Blood flow turbulence Signup and view all the answers

During an inspection of the precordium of an adult patient, the nurse notices the chest moving in a forceful manner along the sternal border. This finding most likely suggests a(n):

Enlargement of the right ventricle Signup and view all the answers

During an assessment of a healthy adult, where would the nurse expect to palpate the apical impulse?

Fifth left intercostal space at the midclavicular line Signup and view all the answers

The nurse is examining a patient who has possible cardiac enlargement. Which statement about percussion of the heart is true?

Studies show that percussed cardiac borders do not correlate well with the true cardiac border. Signup and view all the answers

The nurse is preparing to auscultate for heart sounds. Which technique is correct?

Listening by inching the stethoscope in a rough Z pattern, from the base of the heart across and down, then over to the apex Signup and view all the answers

While counting the apical pulse on a 16-year-old patient, the nurse notices an irregular rhythm. His rate speeds up on inspiration and slows on expiration. What would be the nurse's response?

No further response is needed because sinus arrhythmia can occur normally. Signup and view all the answers

When listening to heart sounds, the nurse knows that the S1:

Coincides with the carotid artery pulse. Signup and view all the answers

During the cardiac auscultation, the nurse hears a sound immediately occurring after the S2 at the second left intercostal space. To further assess this sound, what should the nurse do?

Watch the patient's respirations while listening for the effect on the sound. Signup and view all the answers

Which of these findings would the nurse expect to notice during a cardiac assessment on a 4-year-old child?

Murmur at the second left intercostal space when supine Signup and view all the answers

While auscultating heart sounds on a 7-year-old child for a routine physical examination, the nurse hears an S3, a soft murmur at the left midsternal border, and a venous hum when the child is standing. What would be a correct interpretation of these findings?

These findings can all be normal in a child. Signup and view all the answers

During the precordial assessment on a patient who is 8 months pregnant, the nurse palpates the apical impulse at the fourth left intercostal space lateral to the midclavicular line. This finding would indicate:

Displacement of the heart from elevation of the diaphragm. Signup and view all the answers

In assessing for an S4 heart sound with a stethoscope, the nurse would listen with the:

Bell of the stethoscope at the apex with the patient in the left lateral position. Signup and view all the answers

A 70-year-old patient with a history of hypertension has a blood pressure of 180/100 mm Hg and a heart rate of 90 beats per minute. The nurse hears an extra heart sound at the apex immediately before the S1. What is this extra heart sound most likely?

Atrial gallop Signup and view all the answers

The nurse is performing a cardiac assessment on a 65-year-old patient 3 days after her myocardial infarction (MI). Heart sounds are normal when she is supine, but when she is sitting and leaning forward, the nurse hears a high-pitched, scratchy sound with the diaphragm of the stethoscope at the apex. The nurse suspects:

Inflammation of the precordium Signup and view all the answers

The mother of a 10-month-old infant tells the nurse that she has noticed that her son becomes blue when he is crying and that the frequency of this is increasing. What would be the most likely cause of these findings?

Tetralogy of Fallot Signup and view all the answers

A 30-year-old woman with a history of mitral valve problems states that she has been very tired. During the assessment, the nurse palpates a thrill and lift at the fifth left intercostal space midclavicular line. These findings would be most consistent with:

Mitral regurgitation Signup and view all the answers

During a cardiac assessment on a 38-year-old patient in the hospital for chest pain, the nurse finds jugular vein pulsations 4 cm above the sternal angle when the patient is elevated at 45 degrees, along with ankle edema, difficulty breathing when supine, and an S3 on auscultation. Which of these conditions best explains the cause of these findings?

Heart failure Signup and view all the answers

The nurse knows that normal splitting of the S2 is associated with:

Inspiration Signup and view all the answers

During a cardiovascular assessment, the nurse knows that a thrill is:

Vibration that is palpable Signup and view all the answers

During a cardiovascular assessment, the nurse knows that an S4 heart sound is:

Heard at the end of ventricular diastole Signup and view all the answers

During an assessment, the nurse notes that the patient's apical impulse is laterally displaced and is palpable over a wide area. This finding indicates:

Volume overload, as in heart failure. Signup and view all the answers

When the nurse is auscultating the carotid artery for bruits, which of these statements reflects the correct technique?

While lightly applying the bell of the stethoscope over the carotid artery and listening, the patient is asked to take a breath, exhale, and briefly hold it. Signup and view all the answers

The nurse is preparing for a class on risk factors for hypertension and reviews recent statistics. Which racial group has the highest prevalence of hypertension in the world?

Blacks Signup and view all the answers

What is the pulse deficit if the apical pulse is 118 beats per minute and the radial pulse is 105 beats per minute?

13 Signup and view all the answers

In assessing a patient's history of cardiovascular health, which of these are considered modifiable risk factors for myocardial infarction? Select all that apply.

Diabetes Signup and view all the answers

Study Notes

Heart Anatomy and Function

The pericardium surrounds and protects the heart.
Blood flow sequence through the heart: right atrium → right ventricle → pulmonary artery → lungs → pulmonary vein → left atrium → left ventricle.
Atrial kick occurs when atria contract at the end of diastole, pushing blood into ventricles.

Heart Sounds

Valve closures heard best at the base of the heart: aortic and pulmonic valves.
During a normal cardiac cycle, the tricuspid valve closes slightly later than the mitral valve.
S1 heart sound coincides with the carotid pulse and is caused by the closure of atrioventricular valves.

Cardiac Conduction System

The sinoatrial (SA) node is the heart's natural pacemaker.
Electrical stimulus follows this sequence: SA node → AV node → bundle of His → bundle branches.

Clinical Assessments

Jugular venous pulsations above the sternal angle indicate elevated pressure related to heart failure.
Abnormalities such as thrills or lifts may suggest left ventricular enlargement or other cardiac issues.
Carotid artery assessment for bruits uses the bell of the stethoscope to detect blood flow turbulence.

Pediatric Considerations

Blood circulation in newborns includes an atrial septal opening allowing left-sided blood flow.
An S3 heart sound in children can be normal and does not necessarily indicate heart disease.

Risk Factors and Statistics

Major modifiable risk factors for cardiovascular disease include smoking, hypertension, diabetes, and abnormal lipids.
The highest prevalence of hypertension worldwide is among Black individuals.

Heart Sounds and Conditions

An S4 heart sound indicates decreased ventricular compliance and is usually normal in older adults.
Signs of heart failure may include elevated jugular veins upon abdominal pressure in hepatojugular reflux tests.

Pregnancy Effects

Displacement of the heart from diaphragm elevation is common during pregnancy, affecting the apical impulse location.

Pulse Assessment

A pulse deficit is calculated by subtracting the radial pulse from the apical pulse, indicating potential cardiac issues.

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Description

Test your knowledge on the anatomy and physiology of the heart and neck vessels with these flashcards from Jarvis Chapter 20. Focused questions will help you understand key concepts, including blood flow dynamics and protective structures of the heart.