©SIRJOEL EXAM SOLUTIONS
10/14/2024 11:14 PM
Lewis's Medical-Surgical Nursing, 11th
Edition Chapter 31 - 37 Review Questions
And Correct Answers
Which aspect of the heart's action does the QRS complex on the ECG represent?
Depolarization of the atria
Repolarization of the ventricles
Depolarization from atrioventricular (AV) node throughout ventricles
The length of time it takes for the impulse to travel from the atria to the ventricles -
answer✔Depolarization from atrioventricular (AV) node throughout ventricles
Rationale:
The QRS recorded on the ECG represents depolarization from the AV node throughout the
ventricles. The P wave represents depolarization of the atria. The T wave represents
repolarization of the ventricles. The interval between the PR and QRS represents the length of
time it takes for the impulse to travel from the atria to the ventricles.
, ©SIRJOEL EXAM SOLUTIONS
10/14/2024 11:14 PM
The patient tells the nurse that he does not understand how there can be a blockage in the left
anterior descending artery (LAD), but there is damage to the right ventricle. What is the best
response by the nurse?
"One coronary vessel curves around and supplies the entire heart muscle."
"The LAD supplies blood to the left side of the heart and part of the right ventricle."
"The right ventricle is supplied during systole primarily by the right coronary artery."
"It is actually on the right side of the heart, but we call it the left anterior descending vessel." -
answer✔"The LAD supplies blood to the left side of the heart and part of the right ventricle."
Rationale:
The best response is explaining that the lower portion of the right ventricle receives blood flow
from the left anterior descending artery as well as the right coronary artery during diastole.
Which anatomic feature of the heart directly stimulates ventricular contractions?
SA node
AV node
Bundle of His
Purkinje fibers - answer✔Purkinje fibers
, ©SIRJOEL EXAM SOLUTIONS
10/14/2024 11:14 PM
Rationale:
The Purkinje fibers move the electrical impulse or action potential through the walls of both
ventricles triggering synchronized right and left ventricular contraction. The sinoatrial (SA) node
initiates the electrical impulse that results in atrial contraction. The atrioventricular (AV) node
receives the electrical impulse through internodal pathways. The bundle of His receives the
impulse from the AV node.
The nurse is providing care for a patient who has decreased cardiac output due to heart failure.
As a basis for planning care, what should the nurse understand about cardiac output (CO)?
CO is calculated by multiplying the patient's stroke volume by the heart rate.
CO is the average amount of blood ejected during one complete cardiac cycle.
CO is determined by measuring the electrical activity of the heart and the heart rate.
CO is the patient's average resting heart rate multiplied by the mean arterial blood pressure. -
answer✔CO is calculated by multiplying the patient's stroke volume by the heart rate.
Rationale:
Cardiac output is determined by multiplying the patient's stroke volume by heart rate, thus
identifying how much blood is pumped by the heart over a 1-minute period. Electrical activity of
the heart and blood pressure are not direct components of cardiac output.
, ©SIRJOEL EXAM SOLUTIONS
10/14/2024 11:14 PM
The nurse is performing an assessment for a patient with fatigue and shortness of breath.
Auscultation reveals a heart murmur. What does this assessment finding indicate?
Increased viscosity of the patient's blood
Turbulent blood flow across a heart valve
Friction between the heart and the myocardium
A deficit in conductivity impairs normal contractility - answer✔Turbulent blood flow across a
heart valve
Rationale:
Turbulent blood flow across the affected valve results in a murmur. A murmur is not a direct
result of variances in blood viscosity, conductivity, or friction between the heart and
myocardium.
A nurse is preparing to teach a group of women in a community volunteer group about heart
disease. What should the nurse include in the teaching plan?
Women are less likely to delay seeking treatment than men.
Women are more likely to have noncardiac symptoms of heart disease.
Women are often less ill when presenting for treatment of heart disease.
10/14/2024 11:14 PM
Lewis's Medical-Surgical Nursing, 11th
Edition Chapter 31 - 37 Review Questions
And Correct Answers
Which aspect of the heart's action does the QRS complex on the ECG represent?
Depolarization of the atria
Repolarization of the ventricles
Depolarization from atrioventricular (AV) node throughout ventricles
The length of time it takes for the impulse to travel from the atria to the ventricles -
answer✔Depolarization from atrioventricular (AV) node throughout ventricles
Rationale:
The QRS recorded on the ECG represents depolarization from the AV node throughout the
ventricles. The P wave represents depolarization of the atria. The T wave represents
repolarization of the ventricles. The interval between the PR and QRS represents the length of
time it takes for the impulse to travel from the atria to the ventricles.
, ©SIRJOEL EXAM SOLUTIONS
10/14/2024 11:14 PM
The patient tells the nurse that he does not understand how there can be a blockage in the left
anterior descending artery (LAD), but there is damage to the right ventricle. What is the best
response by the nurse?
"One coronary vessel curves around and supplies the entire heart muscle."
"The LAD supplies blood to the left side of the heart and part of the right ventricle."
"The right ventricle is supplied during systole primarily by the right coronary artery."
"It is actually on the right side of the heart, but we call it the left anterior descending vessel." -
answer✔"The LAD supplies blood to the left side of the heart and part of the right ventricle."
Rationale:
The best response is explaining that the lower portion of the right ventricle receives blood flow
from the left anterior descending artery as well as the right coronary artery during diastole.
Which anatomic feature of the heart directly stimulates ventricular contractions?
SA node
AV node
Bundle of His
Purkinje fibers - answer✔Purkinje fibers
, ©SIRJOEL EXAM SOLUTIONS
10/14/2024 11:14 PM
Rationale:
The Purkinje fibers move the electrical impulse or action potential through the walls of both
ventricles triggering synchronized right and left ventricular contraction. The sinoatrial (SA) node
initiates the electrical impulse that results in atrial contraction. The atrioventricular (AV) node
receives the electrical impulse through internodal pathways. The bundle of His receives the
impulse from the AV node.
The nurse is providing care for a patient who has decreased cardiac output due to heart failure.
As a basis for planning care, what should the nurse understand about cardiac output (CO)?
CO is calculated by multiplying the patient's stroke volume by the heart rate.
CO is the average amount of blood ejected during one complete cardiac cycle.
CO is determined by measuring the electrical activity of the heart and the heart rate.
CO is the patient's average resting heart rate multiplied by the mean arterial blood pressure. -
answer✔CO is calculated by multiplying the patient's stroke volume by the heart rate.
Rationale:
Cardiac output is determined by multiplying the patient's stroke volume by heart rate, thus
identifying how much blood is pumped by the heart over a 1-minute period. Electrical activity of
the heart and blood pressure are not direct components of cardiac output.
, ©SIRJOEL EXAM SOLUTIONS
10/14/2024 11:14 PM
The nurse is performing an assessment for a patient with fatigue and shortness of breath.
Auscultation reveals a heart murmur. What does this assessment finding indicate?
Increased viscosity of the patient's blood
Turbulent blood flow across a heart valve
Friction between the heart and the myocardium
A deficit in conductivity impairs normal contractility - answer✔Turbulent blood flow across a
heart valve
Rationale:
Turbulent blood flow across the affected valve results in a murmur. A murmur is not a direct
result of variances in blood viscosity, conductivity, or friction between the heart and
myocardium.
A nurse is preparing to teach a group of women in a community volunteer group about heart
disease. What should the nurse include in the teaching plan?
Women are less likely to delay seeking treatment than men.
Women are more likely to have noncardiac symptoms of heart disease.
Women are often less ill when presenting for treatment of heart disease.
