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The electrical stimulus of the cardiac cycle follows

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7.The electrical stimulus of the cardiac cycle follows which sequence?a.AV node SA node bundle of Hisb.Bundle of His AV node SA nodec.SA node AV node bundle of His bundle branchesd.AV node SA node bundle of His bundle branchesANS: DSpecialized cells in the SA node near the superior vena cava initiate an electrical impulse. Thecurrent flows in an orderly sequence, first across the atria to the AV node low in the atrialseptum. There it is delayed slightly, allowing the atria the time to contract before the ventriclesare stimulated. Then the impulse travels to the bundle of His, the right and left bundle branches,and then through the ventricles.DIF: Cognitive Level: Understanding (Comprehension) REF: p. 464MSC: Client Needs: General8.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 45degrees. The nurse knows that this finding indicates:a.Decreased fluid volume.b.Increased cardiac output.c.Narrowing of jugular veins.d.Elevated pressure related to heart failure.ANS: DBecause no cardiac valve exists to separate the superior vena cava from the right atrium, thejugular veins give information about the activity on the right side of the heart. They reflect fillingpressures and volume changes. Normal jugular venous pulsation is 2 cm or less above the sternalangle. Elevated pressure is more than 3 cm above the sternal angle at 45 degrees and occurs withheart failure.DIF: Cognitive Level: Analyzing (Analysis) REF: pp. 466-467MSC: Client Needs: Physiologic Integrity: Physiologic Adaptation9.When assessing a newborn infant who is 5 minutes old, the nurse knows which of thesestatements to betrue?a.The left ventricle is larger and weighs more than the right ventricle.b.The circulation of a newborn is identical to that of an adult.c.Blood can flow into the left side of the heart through an opening in the atrialseptum.d.The foramen ovale closes just minutes before birth, and the ductus arteriosuscloses immediately after.ANS: CFirst, approximately two thirds of the blood is shunted through an opening in the atrial septum,the foramen ovale, into the left side of the heart, where it is pumped out through the aorta. Theforamen ovale closes within the first hour after birth because the pressure in the right side of theheart is now lower than in the left side.DIF: Cognitive Level: Applying (Application) REF: p. 467MSC: Client Needs: Health Promotion and Maintenance

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