NURSING 6005 CHAPTER 43: REVIEW OF HEMODYNAMICS

NURSING 6005 CHAPTER 43: REVIEW OF HEMODYNAMICS Test Bank MULTIPLE CHOICE 1. A patient is taking a beta1-adrenergic drug to improve the stroke volume of the heart. The nurse caring for this patient knows that this drug acts by increasing: a. cardiac afterload. b. cardiac preload. c. myocardial contractility. d. venous return. ANS: C Beta1-adrenergic agents help increase the heart’s stroke volume by increasing myocardial contractility. Cardiac afterload is determined primarily by the degree of peripheral resistance caused by constriction of arterioles; increasing afterload would decrease stroke volume. Beta1-adrenergic agents do not affect afterload. Cardiac preload is the amount of stretch applied to the cardiac muscle before contraction and is determined by the amount of venous return. Beta1-adrenergic agents do not affect cardiac preload. Venous return is determined by the systemic filling pressure and auxiliary muscle pumps and is not affected by beta1-adrenergic agents. DIF: Cognitive Level: Analysis REF: Regulation of Cardiac Output | Determinants of Cardiac Output | Stroke Volume TOP: Nursing Process: Evaluation MSC: NCLEX Client Needs Category: Physiologic Integrity: Physiologic Adaptation 2. A nurse is caring for a patient who is receiving a drug that causes constriction of arterioles. The nurse expects to observe which effect from this drug? a. Decreased stroke volume b. Increased stroke volume c. Decreased myocardial contractility d. Increased myocardial contractility ANS: A Constriction of arterioles increases the load against which the heart must pump to eject blood. Increased constriction of arterioles would decrease, not increase, the stroke volume of the heart. Myocardial contractility is determined by the sympathetic nervous system, acting through beta1-adrenergic receptors in the myocardium. DIF: Cognitive Level: Analysis REF: Regulation of Cardiac Output | Determinants of Cardiac Output TOP: Nursing Process: Assessment MSC: NCLEX Client Needs Category: Physiologic Integrity: Physiologic Adaptation 3. A patient with a history of hypertension is admitted for a procedure. If the patient’s arterial pressure decreases, which clinical manifestation would the nurse expect to see? a. Decreased heart rate