Which statement is true regarding myocardial functioning in the normal heart, based upon the Frank Starling law?

An increase in afterload results in decreased systolic pressure, which creates a decreased cardiac output.

A decrease in afterload causes the cardiac muscles to hypertrophy, resulting in increased diastolic volume.

An increase in preload results in greater shortening of myocardial fibers, thereby increasing contractility.

A decrease in preload results in increasing diastolic muscle fiber length, which impedes contractility.

Answer and Explanation

The Correct Answer is C

A) An increase in afterload results in decreased systolic pressure, which creates a decreased cardiac output:

This statement is not consistent with the Frank-Starling law. Afterload refers to the resistance against which the heart must pump blood during systole. An increase in afterload typically results in increased systolic pressure, not decreased, as the heart works harder to overcome the increased resistance. However, increased afterload can lead to decreased cardiac output due to the increased work of the heart.

B) A decrease in afterload causes the cardiac muscles to hypertrophy, resulting in increased diastolic volume:

This statement is not consistent with the Frank-Starling law. Afterload refers to the pressure or resistance against which the heart must pump blood during systole. A decrease in afterload typically reduces the workload on the heart, which may lead to reverse remodeling and a reduction in cardiac hypertrophy. Increased diastolic volume may occur due to reduced afterload, but it's not the direct result of hypertrophy.

C) An increase in preload results in greater shortening of myocardial fibers, thereby increasing contractility:

Correct. According to the Frank-Starling law, an increase in preload (end-diastolic volume or stretch of myocardial fibers) leads to greater overlap of actin and myosin filaments within myocardial fibers during systole. This increased overlap results in stronger myocardial contraction (increased contractility), leading to an increased stroke volume and cardiac output.

D) A decrease in preload results in increasing diastolic muscle fiber length, which impedes contractility:

This statement is not consistent with the Frank-Starling law. Preload refers to the degree of stretch of the myocardial fibers at the end of diastole. A decrease in preload would lead to decreased stretch of the myocardial fibers, not increasing diastolic muscle fiber length. Decreased preload typically results in decreased contractility rather than impediment to contractility due to reduced myocardial stretch.

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Correct Answer is C

Explanation

DKA is a serious complication of diabetes mellitus characterized by hyperglycemia, ketosis, and metabolic acidosis. The laboratory results consistent with DKA include:

Elevated blood glucose level: A blood glucose level of 525 mg/dL (28 mmol/L) is significantly elevated and consistent with DKA.

Low arterial blood pH: A decreased arterial blood pH indicates acidosis, which is characteristic of DKA. Normal arterial blood pH ranges from 7.35 to 7.45.

Low bicarbonate (HCO3-) level: A low bicarbonate level indicates metabolic acidosis, which is also characteristic of DKA. Normal bicarbonate levels range from 21 to 28 mEq/L (21 to 28 mmol/L).

Among the options provided:

A) Arterial blood pH 7.5 and bicarbonate level 32 mEq/L (32 mmol/L):

This pH and bicarbonate level are indicative of alkalosis, which is not consistent with DKA.

B) Arterial blood pH 7.42 and bicarbonate level 18 mEq/L (18 mmol/L):

This pH is within the normal range, and the bicarbonate level is slightly decreased but not indicative of metabolic acidosis consistent with DKA.

C) Arterial blood pH 7.25 and bicarbonate level 10 mEq/L (10 mmol/L):

Correct. This pH is decreased, indicating acidosis, and the bicarbonate level is significantly below the normal range, consistent with metabolic acidosis characteristic of DKA.

D) Arterial blood pH 7.38 and bicarbonate level 29 mEq/L (29 mmol/L):

While the pH is within the normal range, the bicarbonate level is elevated, which is not consistent with metabolic acidosis seen in DKA.

A. Acute pancreatitis. B. Surgical site infection. C. Hepatorenal failure. D. Biliary duct obstruction.

Correct Answer is A

Explanation

The client's symptoms, along with the elevated serum amylase and lipase levels, suggest the development of acute pancreatitis as a postoperative complication. Here's a detailed explanation for why option A is the correct choice:

A) Acute pancreatitis:

Correct. Acute pancreatitis is characterized by inflammation of the pancreas, which can be triggered by various factors, including gallstones, alcohol consumption, and certain medications. In this case, the client's recent cholecystectomy for cholelithiasis (gallstones) may have led to the development of acute pancreatitis. The persistent upper abdominal pain radiating to the back, along with vomiting and fever, are classic symptoms of acute pancreatitis. Elevated serum amylase and lipase levels are common laboratory findings in acute pancreatitis due to pancreatic cell injury and leakage of these enzymes into the bloodstream.

B) Surgical site infection:

While surgical site infections are potential complications of cholecystectomy, the client's symptoms, including upper abdominal pain, vomiting, and fever, are more indicative of a systemic inflammatory process rather than localized infection at the surgical site.

C) Hepatorenal failure:

Hepatorenal failure, also known as hepatorenal syndrome, refers to kidney dysfunction that occurs as a complication of advanced liver disease. The client's symptoms and laboratory findings are not consistent with hepatorenal failure, as there are no signs of significant liver dysfunction or advanced liver disease.

D) Biliary duct obstruction:

While biliary duct obstruction can lead to symptoms similar to those of acute pancreatitis, such as upper abdominal pain and vomiting, the presence of elevated serum amylase and lipase levels strongly suggests pancreatic involvement rather than isolated biliary duct obstruction.

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Which statement is true regarding myocardial functioning in the normal heart, based upon the Frank Starling law?

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Naxlex Comprehensive Predictor Exams

Correct Answer is C

Explanation

Correct Answer is A

Explanation

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