PATHO CH:19

Right-sided heart failure is usually a consequence of (Select all that apply.) a. elevated right ventricular afterload. b. right ventricular infarction. c. tricuspid valve defects. d. congenital anomalies.

a. elevated right ventricular afterload. b. right ventricular infarction.

The most common causes of heart failure are (Select all that apply.) a. myocardial ischemia. b. hypertension. c. dilated cardiomyopathy. d. high-fat diet. e. urinary retention

a. myocardial ischemia. b. hypertension.

Left-sided heart failure is characterized by a. pulmonary congestion. b. decreased systemic vascular resistance. c. jugular vein distention. d. peripheral edema

a. pulmonary congestion.

Lusitropic impairment refers to a. poor contractile force. b. impaired diastolic relaxation. c. altered action potential conduction rate. d. altered automaticity.

b. impaired diastolic relaxation.

The common denominator in all forms of heart failure is a. poor diastolic filling. b. reduced cardiac output. c. pulmonary edema. d. tissue ischemia.

b. reduced cardiac output.

Increased preload of the cardiac chambers may lead to which patient symptom? a. Decreased heart rate b. Decreased respiratory rate c. Edema d. Excitability

c. Edema

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

c. Ventricular escape rhythm

Cor pulmonale refers to a. biventricular failure. b. left ventricular hypertrophy secondary to lung disease. c. right ventricular hypertrophy secondary to pulmonary hypertension. d. right ventricular failure secondary to right ventricular infarction.

c. right ventricular hypertrophy secondary to pulmonary hypertension.

An abnormally wide (more than 0.10 second) QRS complex is characteristic of a. paroxysmal atrial tachycardia. b. supraventricular tachycardia. c. junctional escape rhythm. d. premature ventricular complexes.

d. premature ventricular complexes.

Dysrhythmias are significant since they (Select all that apply.) a. are an indicator of life span. b. can indicate an underlying disorder. c. can impair venous return. d. increase the severity of heart murmurs. e. can impair cardiac output.

b. can indicate an underlying disorder. e. can impair cardiac output.

After sitting in a chair for an hour, an elderly patient develops moderate lower extremity edema. His edema is most likely a consequence of a. arterial obstruction. b. isolated left-sided heart failure. c. right-sided heart failure. d. peripheral vascular disease.

c. right-sided heart failure.

A laboratory test that should be routinely monitored in patients receiving digitalis therapy is a. serum sodium. b. albumin level. c. serum potassium. d. serum calcium.

c. serum potassium.

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

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

Which dysrhythmia is thought to be associated with reentrant mechanisms? a. Second-degree AV block b. Sinus bradycardia c. Junctional escape d. Preexcitation syndrome tachycardia (Wolf-Parkinson-White syndrome)

d. Preexcitation syndrome tachycardia (Wolf-Parkinson-White syndrome)

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. a medication reaction. d. acute cardiogenic pulmonary edema

d. acute cardiogenic pulmonary edema

The therapy that most directly improves cardiac contractility in a patient with systolic heart failure is a. afterload reduction. b. beta-antagonist agents. c. preload reduction. d. digitalis.

d. digitalis.

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.

d. paroxysmal nocturnal dyspnea.

Hypertrophy of the right ventricle is a compensatory response to a. aortic stenosis. b. aortic regurgitation. c. tricuspid stenosis. d. pulmonary stenosis.

d. pulmonary stenosis.

The majority of tachydysrhythmias are believed to occur because of a. triggered activity. b. enhanced automaticity. c. defective gap junctions. d. reentry mechanisms.

d. reentry mechanisms.

Low cardiac output to the kidneys stimulates the release of _____ from juxtaglomerular cells. a. aldosterone b. norepinephrine c. angiotensinogen d. renin

d. renin

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 I b. Class II c. Class III d. Class IV

a. Class I

A patient with forward effects of heart failure may present with which symptoms? (Select all that apply.) a. Impaired memory b. Mental fatigue c. Stupor d. Confusion e. Aggression

a. Impaired memory b. Mental fatigue d. Confusion

Chronic elevation of myocardial wall tension results in atrophy. T/F?

F

A patient's ECG lacks recognizable waveforms and is deemed to be in sinus arrest. The patient's sinus arrest may be a result of (Select all that apply.) a. MI. b. electrical shock. c. electrolyte disturbance. d. acidosis. e. alkalosis.

a. MI. b. electrical shock. c. electrolyte disturbance. d. acidosis.

. A patient is diagnosed with heart failure with normal ejection fraction. This patient is most likely characterized by a(n) a. elderly woman without a previous history of MI. b. middle-aged man with a previous history of MI. c. young female athlete with cardiomegaly. d. young sedentary male with a high-stress job.

a. elderly woman without a previous history of MI.

First-degree heart block is characterized by a. prolonged PR interval. b. absent P waves. c. widened QRS complex. d. variable PR interval.

a. prolonged PR interval.

Which statement is true about the incidence of heart failure? (Select all that apply.) a. Heart failure affects about 2 million Americans. b. Heart failure is the fastest-growing cardiac disorder. c. There are more than 400,000 new cases of heart failure diagnosed each year in the United States. d. The increasing incidence and hospitalization rates of heart failure reflect the aging population in the United States. e. The incidence of heart failure is 10 per 1000 population after age 65.

b. Heart failure is the fastest-growing cardiac disorder. d. The increasing incidence and hospitalization rates of heart failure reflect the aging population in the United States. e. The incidence of heart failure is 10 per 1000 population after age 65.

A patient has heart failure with a normal ejection fraction. Which findings are most likely found in this patient? (Select all that apply.) a. High cardiac output b. Pulmonary congestion c. Edema d. Ejection fraction greater than 50% e. Ejection fraction less than 45%

b. Pulmonary congestion c. Edema d. Ejection fraction greater than 50%

Second-degree heart block type I (Wenckebach) is characterized by a. absent P waves. b. lengthening PR intervals and dropped P wave. c. constant PR interval and dropped QRS complexes. d. no correlation between P waves and QRS complexes.

b. lengthening PR intervals and dropped P wave.

A patient with pure left-sided heart failure is likely to exhibit a. jugular vein distention. b. pulmonary congestion with dyspnea. c. peripheral edema. d. hepatomegaly.

b. pulmonary congestion with dyspnea.

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.

b. reduce cardiac output.