Exam (elaborations)
Chapter 27 Palpitations
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- Osu Institute Of Technology
Chapter 27 Palpitations
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Chapter 27 PalpitationsYour 35-year-old female patient complains of feeling palpitations on occasion. The
1.
clinician should recognize that palpitations are often a sign of:
A. Anemia
B. Anxiety
C. Hyperthyroidism
D. All of the above
ANS: D
Palpitations sensed by the patient are commonly indicative of atrial fibrillation, tachycardia, or premature
ventricular contractions. Anemia, anxiety, and hyperthyroidism are all possible etiologies of these cardiac
rhythm disturbances.
n atrial septal defect (ASD) causes a left to right shunt, which enlarges the right atrium. Because of this effect,
which of the following conditions often occur with ASD?
A. Asthma
B. Jugular venous distension
C. Atrial fibrillation
D. B & C
ANS: D
ASD is a congenital abnormality in which oxygenated blood is shunted from a higher-pressured left atrium
to a lower-pressured right atrium through an abnormal opening in the atrial septum. Atrial arrhythmias,
especially atrial fibrillation, are common in the adult population with ASD. ASDs are often accompanied by
other congenital heart defects, but in an uncomplicated lesion, patients are often asymptomatic until early
adulthood, when they present with dyspnea on exertion or palpitations resulting from atrial arrhythmia.
Because patients may be asymptomatic for many years, right HF can be the first sign, and patients may
present with jugular venous distension, edema, and ascites.
2. The nurse is reviewing the anatomy and physiologic functioning of the heart. Which statement
best describes what is meant by atrial kick?
a. The atria contract during systole and attempt to push against closed valves.
b. Contraction of the atria at the beginning of diastole can be felt as a palpitation.
c. Atrial kick is the pressure exerted against the atria as the ventricles contract during systole.
d. The atria contract toward the end of diastole and push the remaining blood into the ventricles.
ANS: D
Toward the end of diastole, the atria contract and push the last amount of blood (approximately
25% of stroke volume) into the ventricles. This active filling phase is called presystole, or atrial
systole, or sometimes theatrial kick.
3. Which one of the following is the most likely etiology for a patient's symptoms of palpitations?
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