An 81-year-old female client of a long-term care facility has a ...

[wenmo]

An 81-year-old female client of a long-term care facility has a history of congestive heart failure.
 
  The nurse practitioner caring for the client has positioned her sitting up at an angle in bed and is observing her jugular venous distention. Why is jugular venous distention a useful indicator for the assessment of the client's condition?
  A)
  Increased cardiac demand causes engorgement of systemic blood vessels, of which the jugular vein is one of the largest.
  B)
  Blood backs up into the jugular vein because there are no valves at the point of entry into the heart.
  C)
  Peripheral dilation is associated with decreased stroke volume and ejection fraction.
  D)
  Heart valves are not capable of preventing backflow in cases of atrial congestion.

Question 2

A pathologist is examining histological (tissue) samples from a client with an autoimmune disease. Which of the following characteristics of muscle samples would signal the pathologist that the samples are cardiac rather than skeletal muscle?
 
  A)
  The cell samples lack intercalated disks.
  B)
  The muscle cells have small and a few mitochondria.
  C)
  The cells have a poorly defined sarcoplasmic reticulum.
  D)
  The muscles are striated and composed of sarcomeres.

[xthemafja]

Answer to Question 1

Ans:
B

Feedback:

Because there are no valves at the entry points to the atria, congestion can result in engorgement of the jugular veins, which are proximal to the heart. Increased cardiac demand is not associated with engorgement of vessels or peripheral dilation.

Answer to Question 2

Ans:
C

Feedback:

Cardiac cells have a less clearly defined sarcoplasmic reticulum than do skeletal muscles. They also have intercalated disks and large, numerous mitochondria. Both types of muscles are striated and composed of sarcomeres.

[wenmo]

Excellent

[samiel-sayed]

TYSM