A nurse reviewing the anatomy and physiologic functioning of the heart. The nurse should recognize that which statement best describes the atrial kick?

The atria contract toward the end of diastole and push the remaining blood into the ventricles

Contraction the atria at the beginning of diastole can be felt as a click

The ventricles contract during systole and attempt to push against closed atria

Atrial kick is the pressure exerted against the atria as the ventricles contract during systole

Answer and Explanation

The Correct Answer is A

A) The atria contract toward the end of diastole and push the remaining blood into the ventricles:
This is the correct definition of the atrial kick. The atrial kick refers to the contraction of the atria just before the ventricles contract, which occurs late in diastole. During this phase, the atria contract to push the remaining blood into the ventricles, ensuring that the ventricles are as filled as possible before the next ventricular contraction. This action contributes to about 20–30% of the ventricular filling, especially important in situations where the heart rate is fast, as there may be less time for passive filling during diastole.

B) Contraction of the atria at the beginning of diastole can be felt as a click:
This statement is incorrect. Atria contract at the end of diastole, not the beginning. The atrial contraction is not typically felt as a "click." If there is a "click" sound, it could indicate an abnormal heart valve sound, such as from a mitral valve prolapse, rather than the normal atrial contraction. The atrial kick itself is not associated with any audible click but may be heard as part of the S4 heart sound, especially in conditions with stiff ventricles (such as hypertension or heart failure).

C) The ventricles contract during systole and attempt to push against closed atria:
This is not an accurate description of the atrial kick. During systole, the ventricles contract and push blood into the aorta and pulmonary artery through the open semilunar valves, not against the atria. The atrial kick is a part of diastole, not systole, and involves the atria pushing blood into the ventricles, not the ventricles pushing against the atria.

D) Atrial kick is the pressure exerted against the atria as the ventricles contract during systole:
This description is incorrect. The atrial kick occurs when the atria contract near the end of diastole, not during systole. During systole, the ventricles contract and pump blood out of the heart, but this is not related to the atrial kick. Instead, the atrial kick is the contribution of atrial contraction to the final phase of ventricular filling, just before the ventricles contract.

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Correct Answer is C

Explanation

A) The best time to perform BSE is immediately prior to the menstrual cycle:
Performing a breast self-examination (BSE) immediately prior to the menstrual cycle is not ideal because hormonal changes leading up to menstruation can cause the breasts to become swollen, tender, and lumpy. These changes could make it difficult to detect subtle lumps or changes in the breast tissue. For the most accurate assessment, it's recommended that women avoid performing BSE during the premenstrual phase when the breast tissue is most likely to be affected by hormonal fluctuations.

B) If pregnancy is suspected, BSE should not be performed until post-delivery:
This statement is incorrect. There is no contraindication to performing a breast self-examination during pregnancy, and it is important for pregnant women to continue self-monitoring for any changes in breast tissue. In fact, BSE should be performed regularly during pregnancy, as the breast tissue can undergo changes due to hormonal shifts, and early detection of any abnormalities is key to successful management.

C) The best time to perform BSE is 4 to 7 days after the first day of the menstrual period:
This is the correct recommendation. The best time to perform a BSE is 4 to 7 days after the first day of the menstrual period because the breasts are least likely to be swollen or tender during this time. Hormonal levels are more stable at this point in the menstrual cycle, and any lumps or changes in the tissue are more likely to be noticeable. Performing BSE during this time increases the likelihood of detecting potential abnormalities.

D) The woman with diagnosed fibrocystic breast tissue should not rely on BSE:
While it is true that women with fibrocystic breast changes may experience lumpy, tender tissue, they should still perform BSE regularly. Fibrocystic tissue can sometimes make it more difficult to distinguish between normal and abnormal changes, but BSE remains an important tool for detecting significant changes, such as new lumps or changes in size, shape, or consistency. Women with fibrocystic breast tissue should be taught to perform BSE regularly and to report any unusual changes to their healthcare provider. Relying solely on BSE for breast cancer detection is not recommended, but it is an essential part of breast health awareness.

A. Suprasternal notch B. Xiphoid process C. Costal angle D. Sternal angle

Correct Answer is D

Explanation

A) Suprasternal notch:
This is incorrect. The suprasternal notch is a depression located at the top of the sternum, just above the manubrium. While this is an important landmark for palpating the trachea and assessing other structures in the thoracic region, it is not the point where the trachea bifurcates.

B) Xiphoid process:
This is incorrect. The xiphoid process is the small, pointed lower portion of the sternum. It is located at the inferior end of the sternum and does not play a role in the bifurcation of the trachea. The trachea bifurcates much higher in the thoracic region.

C) Costal angle:
This is incorrect. The costal angle is formed by the meeting of the costal margins of the ribs at the lower end of the ribcage. While it is an important anatomical landmark, it is not related to the bifurcation of the trachea.

D) Sternal angle:
This is the correct answer. The sternal angle (also known as the angle of Louis) is located at the junction between the manubrium and the body of the sternum, approximately at the level of the second rib. This is the anatomical landmark where the trachea bifurcates into the right and left mainstem bronchi, usually around the level of the T4 to T5 vertebrae. It is an important reference point during respiratory assessments.

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A nurse reviewing the anatomy and physiologic functioning of the heart. The nurse should recognize that which statement best describes the atrial kick?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

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Correct Answer is D

Explanation

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