Cardiovascular Physiology
Which chamber of the heart has the thickest myocardium because it pumps blood to the entire body?
A. Right atrium
B. Right ventricle
C. Left atrium
D. Left ventricle
Answer:
D. Left ventricle
Rationale:
The left ventricle generates the highest pressure to pump blood throughout the body.
Which diagnostic test records the electrical activity of the heart?
A. Echocardiogram
B. Chest X-ray
C. Electrocardiogram (EKG)
D. Cardiac catheterization
Answer:
C. Electrocardiogram (EKG)
Rationale:
An EKG records the heart's electrical activity and can identify arrhythmias and signs of ischemia.
Which body system is responsible for the body's "fight-or-flight" response?
The sympathetic nervous system.
Rationale:
It increases heart rate, contractility, and blood pressure to improve perfusion.
Which medication is a positive inotrope that increases the strength of the heart's contraction?
A. Metoprolol
B. Digoxin
C. Diltiazem
D. Verapamil
B. Digoxin
Rationale:
Digoxin increases contractility, allowing the heart to pump more effectively.
Which assessment finding suggests a patient is experiencing decreased cardiac output?
A. Warm, dry skin
B. BP 118/76 mmHg
C. Confusion and hypotension
D. Capillary refill less than 2 seconds
Answer:
C. Confusion and hypotension
Rationale:
Poor cardiac output decreases blood flow to the brain and lowers blood pressure.
Coronary arteries receive most of their blood flow during which phase of the cardiac cycle?
A. Systole
B. Diastole
C. Ventricular contraction
D. Atrial contraction
Answer:
B. Diastole
Rationale:
During systole, the contracting myocardium compresses the coronary arteries. They fill during ventricular relaxation (diastole).
A nurse is preparing a patient for a transesophageal echocardiogram (TEE). Which instruction is most important?
A. Drink extra fluids before the procedure.
B. Remain NPO for at least 6 hours.
C. Walk for 30 minutes before the test.
D. Hold all blood pressure medications.
B. Remain NPO for at least 6 hours.
Rationale:
Patients are kept NPO to reduce the risk of aspiration during sedation
Which receptor increases heart rate and contractility when stimulated?
A. Alpha 1
B. Beta 1
C. Beta 2
D. Cholinergic
A patient has prolonged hypotension from dehydration. Which body system responds by increasing blood volume and causing vasoconstriction?
A patient is taking metoprolol. What effect should the nurse expect?
A. Increased heart rate
B. Increased contractility
C. Decreased heart rate and contractility
D. Vasoconstriction
Answer:
C. Decreased heart rate and contractility
Rationale:
Metoprolol is a beta blocker that decreases the heart's workload.
A patient returns from a cardiac catheterization. Which assessment finding requires the nurse's immediate intervention?
A. Small bruise at the insertion site
B. Warm flushed feeling after contrast
C. Absent pedal pulse on the affected leg
D. Mild soreness at the insertion site
Answer:
C. Absent pedal pulse on the affected leg
An absent pulse may mean blood flow to the leg has been blocked. This is an emergency because the tissue is not being perfused and can become ischemic.
A patient's ejection fraction is 30%. What does this indicate?
A. The heart is pumping normally.
B. The heart is pumping too much blood.
C. The heart has decreased pumping ability.
D. The patient has increased cardiac reserve.
C. The heart has decreased pumping ability.
Rationale:
A low ejection fraction indicates weak ventricular contraction and reduced cardiac output.
A patient has an elevated BNP level. What condition does this most strongly suggest?
A. Pulmonary embolism
B. Heart failure
C. Myocardial infarction
D. Hyperlipidemia
Answer:
B. Heart failure
Rationale:
BNP is released when the ventricles are stretched from fluid overload.
A patient has prolonged hypotension from dehydration. Which body system responds by increasing blood volume and causing vasoconstriction?
A. Parasympathetic nervous system
B. RAAS
C. Beta₂ receptors
D. Cholinergic system
Answer:
B. RAAS
Rationale:
RAAS increases blood pressure by causing vasoconstriction and retaining sodium and water.
A patient with hypertension and fluid volume excess is prescribed lisinopril and furosemide (Lasix). How do these medications work together to improve perfusion?
Lisinopril causes vasodilation, reducing afterload, while Lasix removes excess fluid, decreasing preload and the heart's workload.
Rationale:
Both medications reduce the work the heart must do, improving cardiac output and tissue perfusion.
Which patient should the nurse assess FIRST?
A. BNP 450 pg/mL with mild ankle edema
B. Troponin 0.04 ng/mL with no chest pain
C. Chest pain with diaphoresis and shortness of breath
D. BP 148/86 during a routine physical
C. Chest pain with diaphoresis and shortness of breath
Rationale:
Possible acute myocardial infarction requires immediate assessment.
A patient has severe hypertension. Which component of cardiac function is increased?
A. Preload
B. Afterload
C. Cardiac reserve
D. Stroke volume
B. Afterload
Rationale:
High blood pressure increases the resistance the left ventricle must pump against.
A patient has chest pain that began 8 hours ago. Which cardiac biomarker would be the most specific for myocardial injury?
What is troponin?
Rationale:
Troponin is the most specific marker for myocardial damage.
Which pairing is correct?
A. Alpha₁ → Vasoconstriction
B. Beta₁ → Bronchodilation
C. Beta₂ → Increased contractility
D. Chemoreceptors → Detect blood pressure
Answer:
✅Rationale:
A patient has a blood pressure of 188/96 mmHg, making it difficult for the heart to pump blood forward. Which medication class would directly reduce afterload?
A. Positive inotropes
B. ACE inhibitors
C. Anticoagulants
D. Antiplatelet agents
B. ACE inhibitors
Rationale:
ACE inhibitors cause vasodilation, reducing afterload and making it easier for the heart to pump blood.
Four patients arrive at the emergency department. Which patient should the nurse see FIRST?
A. BP 170/92 with no symptoms
B. Painful leg when walking that resolves with rest
C. Sudden confusion, facial droop, and slurred speech
D. BNP 700 with bilateral ankle edema
Answer:
C. Sudden confusion, facial droop, and slurred speech
Rationale:
Suspected acute stroke is a time-sensitive emergency because decreased cerebral perfusion can rapidly lead to irreversible brain injury.
A patient is dehydrated, tachycardic, and hypotensive after several days of vomiting. Which component of cardiac performance is most directly decreased first?
What is preload?
Rationale:
Fluid loss decreases venous return, reducing ventricular filling.
A patient has chest pain and an elevated D-dimer. What should the nurse expect the provider to order next?
A. Repeat lipid panel
B. CT angiography or Doppler ultrasound
C. Echocardiogram
D. Stress test
B. CT angiography or Doppler ultrasound
Rationale:
A positive D-dimer suggests a possible blood clot but does not diagnose one. Additional imaging is needed to confirm the diagnosis.
A patient's blood pressure suddenly falls when standing. Which receptor detects this change first?
What are baroreceptors?
Rationale:
Baroreceptors rapidly detect changes in blood pressure.
A patient with hypertension is prescribed lisinopril. Which substance will decrease as a direct result of this medication?
What is angiotensin II?
Rationale:
ACE inhibitors block conversion of angiotensin I to angiotensin II.
A nurse is assessing peripheral perfusion. Which finding requires immediate follow-up?
A. Capillary refill of 1 second
B. Warm, pink skin
C. Cool, pale foot with no palpable pulse
D. 2+ dorsalis pedis pulse
C. Cool, pale foot with no palpable pulse
Rationale:
This indicates severely impaired tissue perfusion and possible arterial occlusion.