EVOLVE ELSEVIER HESI MED SURG ACTUAL STUDY GUIDE
WITH REAL QUESTIONS AND CORRECT ANSWERS WITH WELL-
ELABORATED RATIONALES/ EVOLVE HESI MEDICAL SURGICAL
LATEST EXAM 2025-2026 (BRAND NEW!!)
Heart as a Pump-
–Systolic contraction
–Diastolic reaction and filling
––receiving function
Heart as an Endocrine organ-–Receptors on heart tissue
responds to hormones produced in the body
–heart also produces its own hormones
–Natriuretic peptides
–Sympathetic nervous System
–renin–Angiotensin–Aldosterone system
–Endothelin–1/Vasopressin/ADH
1|Page
,–Most treatment is directed towards the endocrine aspect of
the heart
Important Features of Normal Blood flow-–Circulation occurs in
series
––matched right and left outputs
–Low pressure in the venous system (below 10)
––need low pressure for exchange of nutrients in capillaries
–high pressure in the arterial system (BP below 60 is
dangerous)
–Series of valves control flow and pressure
–Synergy exists between chambers, allows for coordinated
contraction
–Atrial contraction is 20% of stroke volume, "primes the
pump"
Venous pressure in the body-–Venous pressure is kept low
–Needs to be low to allow for nutrient exchange in the tissues
–Too much pressure in the capillaries results in edema
––fluid is pushed out of the vessels
–Above BP 20, will get congestion
2|Page
,Normal Cardiac Pressures-–LV systolic: 120
–LV diastolic: 8
–RV systolic: 20
–RV diastolic: 4
–Aorta: 120 systolic, 80 diastolic
–Pulmonary artery: 20 systolic, 8 diastolic
–LA: 4–8
–RA: 2–4
Cardiac Pressures-–Atrial pressure is low
–Arterial pressure is high
–Valve closure in the heart allows a pressure difference to be
established between the two chambers
–Valves open and pressure equilibrates
–Equilibration of pressures across an open valve
Principles of Blood Flow-–Blood flows from areas of high
pressure to areas of low pressure
––flows across a pressure gradient
–Blood flow should be laminar
3|Page
, ––all blood moves in the same direction at the same speed
–All elements move at the same velocity
––0.5–1.5 meters per second
–Turbulence results in decreased ability to equilibrate across a
valve
Turbulent blood flow-–Inefficient blood flow
–Can hear as a heart murmur
–Abnormality in the heart system disrupts the normal smooth
laminar flow of blood
–High pressure, high velocity, turbulent blood gives murmurs
–Increased velocity, increased turbulence
–increased diameter of the tube, increased turbulence
–Decreased viscosity, increased turbulence
Systolic Performance of the Heart-–Ejects blood into the
arteries
–Generation of high pressure, sufficient for organ perfusion
–Contraction of the myocardium
4|Page
WITH REAL QUESTIONS AND CORRECT ANSWERS WITH WELL-
ELABORATED RATIONALES/ EVOLVE HESI MEDICAL SURGICAL
LATEST EXAM 2025-2026 (BRAND NEW!!)
Heart as a Pump-
–Systolic contraction
–Diastolic reaction and filling
––receiving function
Heart as an Endocrine organ-–Receptors on heart tissue
responds to hormones produced in the body
–heart also produces its own hormones
–Natriuretic peptides
–Sympathetic nervous System
–renin–Angiotensin–Aldosterone system
–Endothelin–1/Vasopressin/ADH
1|Page
,–Most treatment is directed towards the endocrine aspect of
the heart
Important Features of Normal Blood flow-–Circulation occurs in
series
––matched right and left outputs
–Low pressure in the venous system (below 10)
––need low pressure for exchange of nutrients in capillaries
–high pressure in the arterial system (BP below 60 is
dangerous)
–Series of valves control flow and pressure
–Synergy exists between chambers, allows for coordinated
contraction
–Atrial contraction is 20% of stroke volume, "primes the
pump"
Venous pressure in the body-–Venous pressure is kept low
–Needs to be low to allow for nutrient exchange in the tissues
–Too much pressure in the capillaries results in edema
––fluid is pushed out of the vessels
–Above BP 20, will get congestion
2|Page
,Normal Cardiac Pressures-–LV systolic: 120
–LV diastolic: 8
–RV systolic: 20
–RV diastolic: 4
–Aorta: 120 systolic, 80 diastolic
–Pulmonary artery: 20 systolic, 8 diastolic
–LA: 4–8
–RA: 2–4
Cardiac Pressures-–Atrial pressure is low
–Arterial pressure is high
–Valve closure in the heart allows a pressure difference to be
established between the two chambers
–Valves open and pressure equilibrates
–Equilibration of pressures across an open valve
Principles of Blood Flow-–Blood flows from areas of high
pressure to areas of low pressure
––flows across a pressure gradient
–Blood flow should be laminar
3|Page
, ––all blood moves in the same direction at the same speed
–All elements move at the same velocity
––0.5–1.5 meters per second
–Turbulence results in decreased ability to equilibrate across a
valve
Turbulent blood flow-–Inefficient blood flow
–Can hear as a heart murmur
–Abnormality in the heart system disrupts the normal smooth
laminar flow of blood
–High pressure, high velocity, turbulent blood gives murmurs
–Increased velocity, increased turbulence
–increased diameter of the tube, increased turbulence
–Decreased viscosity, increased turbulence
Systolic Performance of the Heart-–Ejects blood into the
arteries
–Generation of high pressure, sufficient for organ perfusion
–Contraction of the myocardium
4|Page
