Deck 20: Control of Cardiac Output and Hemodynamic

Question 1

Which of the following are the major vascular factors that determine venous return and cardiac output?
I.Right atrial pressure
II.Mean filling pressure of the systemic circulation
III.Vascular resistance to blood flow between the peripheral vessels and the right atrium
IV.Capillary pressure

A) I, II
B) III, IV
C) I, II, III, IV
D) I, II, III

Answer 1

I, II, III

Question 2

Which of the following pressures is an indicator of afterload?

A) RAP
B) MPAP
C) PCWP
D) CVP

Answer 2

MPAP

Question 3

Which of the following mechanisms are responsible for compensating heart failure?
I.Improved contractility
II.Vasoconstriction
III.Fluid retention
IV.Vasodilation

A) I, II, IV
B) I, II, III
C) III, IV
D) II, III, IV

Answer 3

I, II, III

Question 4

Where is the Swan-Ganz catheter placed if a waveform shows a clear, sharp upstroke on the left, falling to a distinct notch in the downstroke on the right?

A) Left atrium
B) Right ventricle
C) Pulmonary artery
D) Right atrium

Question 5

Which of the following factors restrict ventricular expansion during diastole?
I.An already overstretched, distended ventricle
II.Pericardial tamponade
III.Myocardial infarction
IV.The increased pressure surrounding the heart during positive pressure mechanical ventilation, especially in the presence of high levels of PEEP

A) I, II, III
B) I, III
C) II, III, IV
D) I, II, III, IV

Question 6

Which of the following statements are true of ejection fraction?
I.It is a measure of ventricular contractility.
II.The heart's normal ejection fraction is approximately 60% of the end-diastolic volume under resting conditions.
III.The heart's normal ejection fraction is approximately 90% of the end-diastolic volume in strenuous exercise.
IV.The heart's normal ejection fraction is approximately 80% of the end-diastolic volume under resting conditions.

A) I, II
B) I, III, IV
C) I, II, III, IV
D) I, II, III

Question 7

Which of the following are signs and symptoms of left ventricular failure?
I.High systemic blood pressure
II.Dyspnea
III.Skin cool and clammy
IV.Fine crackles

A) I, II, IV
B) I, II, III
C) II, III, IV
D) I, II, III, IV

Question 8

Stroke volume is determined by which of the following factors?
I.Preload
II.Afterload
III.Contractility
IV.Conduction rate

A) I, II, III
B) III, IV
C) I, II, III, IV
D) II, III

Question 9

What is considered the hallmark of cardiac contractility?

A) Preload pressure
B) Afterload pressure
C) Mean arterial blood pressure
D) Conduction rate

Question 10

Increased sympathetic activity is associated with which of the following cardiac events?
I.Increased cardiac output
II.Low RAP
III.Increased venous return
IV.Increased cardiac contractility

A) I, II, IV
B) II, III
C) I, III, IV
D) I, II, III, IV

Question 11

Which of the following measurements is associated with increased afterload and with increased myocardial work and oxygen consumption for a given cardiac output?

A) LVEDP
B) CVP
C) PCWP
D) MAP

Question 12

Which of the following are the main clinical reasons for measuring PCWP?
I.To measure pulmonary capillary hydrostatic pressure
II.To estimate cardiac output
III.To estimate the filling pressure of the left ventricle
IV.To estimate the filling pressure of the right ventricle

A) I, II, III
B) I, III
C) II, III, IV
D) I, II, III, IV

Question 13

Which of the following parameters is the most important in controlling cardiac output in healthy people?

A) Pumping ability
B) Heart rate
C) Conduction rate
D) Venous return

Question 14

Which of the following is still considered the gold standard method of measuring hemodynamic variables such as cardiac output?

A) Peripheral arterial catheter
B) Central venous line
C) Swan-Ganz catheter
D) Femoral vein catheter

Question 15

Which of the following pressures is a clinical indicator of ventricular afterload?

A) LVEDP
B) CVP
C) PCWP
D) MAP

Question 16

A PCWP > 18 mm Hg and a CI < 2.2 L/min/m² is consistent with which of the following conditions?

A) Left ventricular failure
B) Blood volume loss
C) Pulmonary edema
D) Peripheral hypoperfusion

Question 17

A PCWP of 5 mm Hg and a CI of 1.5 L/min/m² is consistent with which of the following conditions?

A) Left ventricular failure
B) Blood volume loss
C) Pulmonary edema
D) Peripheral hypoperfusion

Question 18

Which of the following is considered a preload pressure?

A) LVEDP
B) CVP
C) PCWP
D) MAP

Question 19

When the balloon-tipped catheter wedges in a small pulmonary arteriole, the blood pressure measured through the distal lumen is approximately the same as which of the following?

A) Right atrium
B) Right ventricle
C) Left atrium
D) Left ventricle

Question 20

Which of the following statements are true of PCWP?
I.Normally its force is 6 to 12 mm Hg.
II.When the PCWP rises above 18 mm Hg, early clinical signs of pulmonary edema appear on the chest x-ray image.
III.Above 25 mm Hg the chest x-ray film shows obvious evidence of pulmonary edema.
IV.PCWP is a valuable clinical tool for monitoring the effects of intravenous fluid infusions in hemodynamically unstable patients.

A) I, II, III
B) I, III
C) II, III, IV
D) I, II, III, IV

Question 21

Which pharmacologic agent should be administered to a patient with abnormally low vascular resistance?

A) Inotropes
B) IV fluids
C) Vasopressors
D) Oxygen

Question 22

How soon after coronary artery occlusion should fibrinolytics be administered to improve survival?

A) Within 5 minutes
B) Within 1 hour
C) Within 2 hours
D) Within 24 hours

Question 23

A PCWP of 25 mm Hg and a CI of 1.5 L/min/m² is consistent with which of the following conditions?

A) Left ventricular failure
B) Blood volume loss
C) Pulmonary edema
D) Peripheral hypoperfusion

Question 24

What is a major concern in the administration of inotropic drugs for myocardial infarction?

A) They produce vasodilation.
B) They increase heart rate.
C) They produce reactive vasoconstriction.
D) They increase myocardial work and oxygen demand.