Week 3 Check Your Understanding Assignment

B. mean arterial

Critically ill patients may have parenterally administered vasoactive drugs that are adjusted according to their _____ pressure. A. systolic B. mean arterial C. diastolic D. pulse

D. Septic

Overproduction of nitric oxide is an important aspect of the pathophysiologic process of what type of shock? A. Cardiogenic B. Hypovolemic C. Anaphylactic D. Septic

B. antiplatelet drugs

Patients presenting with symptoms of unstable angina and no ST segment elevation are treated with: A. cardiac catheterization B. antiplatelet drugs C. acute reperfusion therapy D. cardiac biomarkers only

C. mitral regurgitation

A loud pansystolic murmur that radiates to the axilla is most likely a result of: A. aortic regurgitation B. aortic stenosis C. mitral regurgitation D. mitral stenosis

B. cardiac tamponade.

Hypotension, distended neck veins, and muffled heart sounds are classic manifestations of: A. myocardial infarction. B. cardiac tamponade. C. congestive heart failure (CHF). D. cardiomyopathy.

C. systemic vascular resistance.

Improvement in a patient with septic shock is indicated by: A. an increase in cardiac output. B. SvO2. C. systemic vascular resistance. D. serum lactate level.

D. Atrial fibrillation with a ventricular rate of 220 beats/minute

In which dysrhythmias should treatment be instituted immediately? A. Asymptomatic sinus bradycardia at a heart rate of 50 beats/minute B. Fever-induced tachycardia at 122 beats/minute C. Premature atrial complexes occurring every 20 seconds D. Atrial fibrillation with a ventricular rate of 220 beats/minute

B. Class II, Compensated Stage

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 I, Initial Stage B. Class II, Compensated Stage C. Class III, Progressive Stage D. Class IV, Refractory Stage

C. Edema

Increased preload of the cardiac chambers may lead to which patient symptom? A. Decreased heart rate B. Decreased respiratory rate C. Edema D. Excitability

A. pulmonary congestion.

Left-sided heart failure is characterized by: A. pulmonary congestion. B. decreased systemic vascular resistance. C. jugular vein distention. D. peripheral edema.

B. cardiogenic

Low cardiac output in association with high preload is characteristic of ________ shock. A. hypovolemic B. cardiogenic C. anaphylactic D. septic

D. renin

Low cardiac output to the kidneys stimulates the release of _____ from juxtaglomerular cells. A. aldosterone B. norepinephrine C. angiotensinogen D. renin

A. vasodilation.

The effect of nitric oxide on systemic arterioles is: A. vasodilation. B. vasoconstriction. C. not significant. D. opposed by nitrate drugs

D. apoptosis.

The majority of cardiac cells that die after myocardial infarction do so because of: A. cell rupture. B. insufficient glucose. C. thrombus. D. apoptosis.

D. antibiotics

The majority of cases of anaphylactic shock occur when a sensitized individual comes in contact with: A. perfumes. B. incompatible blood products. C. animal proteins or dander. D. antibiotics.

False

The most commonly recognized outcome of hypertension is pulmonary disease: True or False

B. ST-segment elevation.

The most reliable indicator that a person is experiencing an acute myocardial infarction (MI) is: A. severe, crushing chest pain. B. ST-segment elevation. C. dysrhythmias. D. pain radiating to the lower legs.

A. tachycardia.

The progressive stage of hypovolemic shock is characterized by: A. tachycardia. B. hypertension. C. lactic acidosis. D. cardiac failure.

A. Sitting BP 88/60, HR 118

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 110/78, HR 98 D. Sitting BP 120/80, HR 100

A. Elevated CK-MB, troponin I, and troponin T

Which serum biomarker(s) are indicative of irreversible damage to myocardial cells? A. Elevated CK-MB, troponin I, and troponin T B. Markedly decreased CK-MB and troponin I C. Elevated LDL D. Prolonged coagulation time

A. Increased LDL levels are associated with increased risk of coronary artery disease.

While hospitalized, an elderly patient with a history of myocardial infarction was noted to have high levels of low-density lipoproteins (LDLs). What is the significance of this finding? A. Increased LDL levels are associated with increased risk of coronary artery disease. B. Measures to decrease LDL levels in the elderly would be unlikely to affect the progression of this disease. C. Increased LDL levels are indicative of moderate alcohol intake, and patients should be advised to abstain. D. Elevated LDL levels are an expected finding in the elderly and therefore are not particularly significant.

A. Crystalloids

Administration of which therapy is most appropriate for hypovolemic shock? A. Crystalloids B. Vasoconstrictor agents C. Inotropic agents D. 5% dextrose in water

False

Chronic elevation of myocardial wall tension results in atrophy. True or False

C. Sodium

Restriction of which electrolytes is recommended in the management of high blood pressure? A. Calcium B. Potassium C. Sodium D. Magnesium

B. Begin antihypertensive drug therapy

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 lifestyle modifications. B. Begin antihypertensive drug therapy. C. Recheck blood pressure in 4 to 6 weeks. D. Encourage smoking cessation.

B. hypotension.

A patient has a history of falls, syncope, dizziness, and blurred vision. The patient's symptomology is most likely related to: A. hypertension. B. hypotension. C. deep vein thrombosis. D. angina.

C. Ventricular escape rhythm

A patient who reports dizziness and who has absent P waves, wide QRS complexes, and a heart rate of 38 beats/minute on an ECG is most likely in which rhythm? A. Third-degree heart block B. Junctional tachycardia C. Ventricular escape rhythm D. Sinus bradycardia

B. obstructive

A patient who was involved in a fall from a tree becomes short of breath. The lung sounds are absent on one side. This patient is experiencing ________ shock. A. cardiogenic B. obstructive C. hypovolemic D. distributive

D. septic

A patient with cold and edematous extremities, low cardiac output, and profound hypotension is likely to be experiencing a progressive stage of ________ shock. A. cardiogenic B. hypovolemic C. obstructive D. septic

D. paroxysmal nocturnal dyspnea.

A patient with heart failure who reports intermittent shortness of breath during the night is experiencing: A. orthopnea. B. paroxysmal atrial tachycardia. C. sleep apnea. D. paroxysmal nocturnal dyspnea.

False

A type of shock that includes brain trauma that results in depression of the vasomotor center is cardiogenic. True or False

A. Continue lifestyle modifications only

After being diagnosed with hypertension, a patient returns to the clinic 6 weeks later. The patient reports "moderate" adherence to the recommended lifestyle changes and has experienced a decreased from 165/96 to 148/90 mm Hg in blood pressure. What is the most appropriate intervention for this patient at this time? A. Continue lifestyle modifications only. B. Continue lifestyle modifications plus diuretic therapy. C. Continue lifestyle modifications plus ACE inhibitor therapy. D. Continue lifestyle modifications plus b-blocker therapy

A. diastolic murmur

Aortic regurgitation is associated with: A. diastolic murmur B. elevated left ventricular/aortic systolic pressure gradient C. elevated systemic diastolic blood pressure D. shortened ventricular ejection phase

B. reduce cardiac output.

Beta-blockers are advocated in the management of heart failure because they: A. increase cardiac output. B. reduce cardiac output. C. enhance sodium absorption. D. reduce blood flow to the kidneys.

A. impaired cardiac filling.

Constrictive pericarditis is associated with: A. impaired cardiac filling. B. cardiac hypertrophy. C. increased cardiac preload. D. elevated myocardial oxygen consumption.

False

New-organ damage is a function of both the stage of hypertension and its duration. True or False

C. communication between the aorta and the pulmonary artery

Patent ductus arteriosus is accurately described as a(n): A. opening between the atria. B. stricture of the aorta that impedes blood flow. C. communication between the aorta and the pulmonary artery. D. cyanotic heart defect associated with right-to-left shunt.

B. decreasing myocardial oxygen demands.

Primary treatment for myocardial infarction (MI) is directed at: A. protecting the heart from further ischemia. B. decreasing myocardial oxygen demands. C. reducing heart rate and blood pressure. D. activating the parasympathetic system.

C. systolic pressure - diastolic pressure.

Pulse pressure is defined as: A. two thirds of systolic pressure + diastolic pressure. B. systolic pressure + diastolic pressure. C. systolic pressure - diastolic pressure. D. systolic pressure × systemic resistance.

C. a systemic inflammatory response to infection.

Sepsis has been recently redefined as: A. a systemic infection with viable organisms in the bloodstream. B. a systemic inflammatory response to ischemia. C. a systemic inflammatory response to infection. D. severe hypotension in an infected patient.