A nurse is checking laboratory values on a client who
has crackles in the lower lobes, 2+ pitting edema, and
dyspnea with minimal exertion. Which laboratory
value does the nurse expect to be abnormal?
a) C-reactive protein (CRP)
b) B-type natriuretic peptide (BNP)
c) Platelet count
d) Potassium
B-type natriuretic peptide (BNP)
Explanation:
The client's symptoms suggest heart failure. BNP is a
neurohormone that's released from the ventricles when
the ventricles experience increased pressure and
stretch, such as in heart failure. A BNP level greater
than 51 pg/ml is commonly associated with mild heart
failure. As the BNP level increases, the severity of heart
failure increases. Potassium levels aren't affected by
heart failure. CRP is an indicator of inflammation. It's
used to help predict the risk of coronary artery disease.
There is no indication that the client has an increased
CRP. There is no indication that the client is
experiencing bleeding abnormalities, such as those seen
with an abnormal platelet count.
The electrical conduction system of the heart has
several components, all of which are instrumental in
maintaining polarization, depolarization, and
repolarization of cardiac tissue. Which of the
conductive structures is known as the pacemaker of
the heart?
a) Sinoatrial node
b) Bundle of His
c) Atrioventricular node
d) Bundle branches
Sinoatrial node
Explanation:
The SA node is an area of nerve tissue located in the
posterior wall of the right atrium. The SA node is called
the pacemaker of the heart because it initiates the
electrical impulses that cause the atria and ventricles to
contract.
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*A 60-year-old client is returning to her cardiologist
for the results of her cardiac testing. Her cardiologist
explains that he is concerned about her low cardiac
output, which will increase the workload on her heart.
In his explanation, if the client's workload does not
lessen, via medication, her heart muscle will wear out.
What is the average cardiac output per minute?
a) 8L
b) 10L
c) 5L
d) 6L
5L
Explanation:
In a healthy adult, cardiac output ranges from 4 to 8
L/min (the average is approximately 5 L/min).
During the auscultation of heart, what is revealed by
an atrial gallop?
a) Hypertensive heart disease
b) Diseased heart valves
c) Heart failure
d) Turbulent blood flow
Hypertensive heart disease
Explanation:
Auscultation of the heart requires familiarization with
normal and abnormal heart sounds. An extra sound just
before S1 is an S4 heart sound, or atrial gallop. An S4
sound often is associated with hypertensive heart
disease. A sound that follows S1 and S2 is called an S3
heart sound or a ventricular gallop. An S3 heart sound
is often an indication of heart failure in an adult. In
addition to heart sounds, auscultation may reveal other
abnormal sounds, such as murmurs and clicks, caused
by turbulent blood flow through diseased heart valves.

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- Fall '15
- Cardiology, right ventricle, hypertensive heart disease
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