Pathophys 3: CH 16, 18, 19 20
Patients presenting with symptoms of unstable angina and no ST segment elevation are treated with a. antiplatelet drugs. b. cardiac catheterization. c. acute reperfusion therapy. d. cardiac biomarkers only.
a
Which finding is indicative of orthostatic hypotension in a person with a supine blood pressure (BP) of 110/70 and a heart rate (HR) of 100? a. Sitting BP 88/60, HR 118 b. Sitting BP 108/68, HR 102 c. Sitting BP 120/80, HR 100 d. Sitting BP 110/78, HR 98
a
Hypotension, distended neck veins, and muffled heart sounds are classic manifestations of a. cardiomyopathy. b. cardiac tamponade. c. myocardial infarction. d. congestive heart failure (CHF).
b
In which stage of shock is a patient who has lost 1200 mL of blood, who has normal blood pressure when supine, but who experiences orthostatic hypotension upon standing? a. Class III, Progressive Stage b. Class II, Compensated Stage c. Class I, Initial Stage d. Class IV, Refractory Stage
b
Patients with structural evidence of heart failure who exhibit no signs or symptoms are classified into which New York Heart Association heart failure class? a. Class II b. Class I c. Class IV d. Class III
b
Restriction of which electrolytes is recommended in the management of high blood pressure? a. Potassium b. Sodium c. Calcium d. Magnesium
b
What results when systemic blood pressure is increased? a. Decreased cardiac output b. Vasoconstriction c. Hypovolemia d. Decreased vascular resistance
b
Aortic regurgitation is associated with a. elevated left ventricular/aortic systolic pressure gradient. b. elevated systemic diastolic blood pressure. c. diastolic murmur. d. shortened ventricular ejection phase.
c
Beta-blockers are advocated in the management of heart failure because they a. increase cardiac output. b. reduce blood flow to the kidneys. c. reduce cardiac output. d. enhance sodium absorption.
c
Hypertrophy of the right ventricle is a compensatory response to a. aortic regurgitation. b. aortic stenosis. c. pulmonary stenosis. d. tricuspid stenosis.
c
Massive release of histamine with consequent vasodilation and hypotension occurs with what type of shock? a. Hypovolemic b. Cardiogenic c. Anaphylactic d. Neurogenic
c
Pulse pressure is defined as a. systolic pressure + diastolic pressure. b. systolic pressure × systemic resistance. c. systolic pressure - diastolic pressure. d. two thirds of systolic pressure + diastolic pressure.
c
The effect of nitric oxide on systemic arterioles is a. opposed by nitrate drugs. b. vasoconstriction. c. vasodilation. d. not significant.
c
The therapy that most directly improves cardiac contractility in a patient with systolic heart failure is a. afterload reduction. b. β-antagonist agents. c. digitalis. d. preload reduction.
c
Hypertension is closely linked to a. urinary tract infection. b. de Quervain syndrome. c. spinal stenosis. d. obstructive sleep apnea.
d
The common denominator in all forms of heart failure is a. pulmonary edema. b. tissue ischemia. c. poor diastolic filling. d. reduced cardiac output.
d
Which dysrhythmia is thought to be associated with reentrant mechanisms? a. Junctional escape b. Preexcitation syndrome tachycardia (Wolf-Parkinson-White syndrome) c. Second-degree AV block d. Sinus bradycardia
b
Low cardiac output to the kidneys stimulates the release of _____ from juxtaglomerular cells. a. aldosterone b. angiotensinogen c. norepinephrine d. renin
d
Tachycardia is an early sign of low cardiac output that occurs because of a. baroreceptor activity. b. anxiety. c. tissue hypoxia. d. acidosis.
a
The majority of cases of anaphylactic shock occur when a sensitized individual comes in contact with a. antibiotics. b. incompatible blood products. c. animal proteins or dander. d. perfumes.
a
The most reliable indicator that a person is experiencing an acute myocardial infarction (MI) is a. ST-segment elevation. b. severe, crushing chest pain. c. pain radiating to the lower legs. d. dysrhythmias.
a
A patient is diagnosed with heart failure with normal ejection fraction. This patient is most likely characterized by a(n) a. young sedentary male with a high-stress job. b. middle-aged man with a previous history of MI. c. elderly woman without a previous history of MI. d. young female athlete with cardiomegaly.
c
A patient presents to the emergency department with a diastolic blood pressure of 132 mm Hg, retinopathy, and symptoms of an ischemic stroke. This symptomology is likely the result of a. myocardial infarction. b. angina. c. arthrosclerosis. d. hypertensive crisis.
d
Atherosclerotic plaques with large lipid cores are prone to a. rupture. b. dislodgement. c. attachment. d. binding.
a
A patient with significant aortic stenosis is likely to experience a. hypertension. b. increased pulse pressure. c. peripheral edema. d. syncope.
d
In which dysrhythmias should treatment be instituted immediately? a. Premature atrial complexes occurring every 20 seconds b. Asymptomatic sinus bradycardia at a heart rate of 50 beats/minute c. Fever-induced tachycardia at 122 beats/minute d. Atrial fibrillation with a ventricular rate of 220 beats/minute
d
A loud pansystolic murmur that radiates to the axilla is most likely a result of a. mitral regurgitation. b. aortic regurgitation. c. aortic stenosis. d. mitral stenosis.
a
A patient presenting with fever, hypotension, and lactic acidosis is most likely to be experiencing what type of shock? a. Septic b. Anaphylactic c. Cardiogenic d. Neurogenic
a
A patient is exhibiting severe dyspnea and anxiety. The patient also has bubbly crackles in all lung fields with pink, frothy sputum. This patient is most likely experiencing a. right-sided heart failure. b. cardiomyopathy. c. acute cardiogenic pulmonary edema. d. a medication reaction.
c
Myocarditis should be suspected in a patient who presents with a. family history of cardiomyopathy. b. chest pain and ST elevation. c. murmur and abnormal valves on echocardiogram. d. acute onset of left ventricular dysfunction.
d
Primary treatment for myocardial infarction (MI) is directed at a. reducing heart rate and blood pressure. b. protecting the heart from further ischemia. c. activating the parasympathetic system. d. decreasing myocardial oxygen demands.
d
The majority of cardiac cells that die after myocardial infarction do so because of a. cell rupture. b. thrombus. c. insufficient glucose. d. apoptosis.
d
Hypotension associated with neurogenic and anaphylactic shock is because of a. peripheral pooling of blood. b. poor cardiac contractility. c. high afterload. d. hypovolemia.
a
New-organ damage is a function of both the stage of hypertension and its duration. a. False b. True
a (end-organ)
A middle-aged patient has a follow up visit for a recorded blood pressure of 162/96 mm Hg taken 3 weeks ago. The patient has no significant past medical history and takes no medications, but smokes 1 1/2 packs of cigarettes per day, drinks alcohol regularly, and exercises infrequently. The patient is about 40 lbs. overweight and admits to a high-fat, high-calorie diet. At the office visit today, the patient's blood pressure is 150/92 mm Hg. What is the least appropriate intervention for this patient at this time? a. Begin antihypertensive drug therapy. b. Recheck blood pressure in 4 to 6 weeks. c. Encourage smoking cessation. d. Begin lifestyle modifications.
a
A patient with cold and edematous extremities, low cardiac output, and profound hypotension is likely to be experiencing a progressive stage of ________ shock. a. septic b. cardiogenic c. hypovolemic d. obstructive
a
Administration of which therapy is most appropriate for hypovolemic shock? a. Crystalloids b. Inotropic agents c. 5% dextrose in water d. Vasoconstrictor agents
a
An erroneously low blood pressure measurement may be caused by a. positioning the arm above the heart level. b. using a cuff that is too small. c. positioning the arm at heart level. d. measuring blood pressure after exercise.
a
A patient with a history of myocardial infarction continues to complain of intermittent chest pain brought on by exertion and relieved by rest. The likely cause of this pain is a. coronary vasospasm. b. stable angina. c. myocardial infarction. d. unstable angina.
b
A patient has a history of falls, syncope, dizziness, and blurred vision. The patient's symptomology is most likely related to a. angina. b. deep vein thrombosis. c. hypotension. d. hypertension.
c