Unit 5 Practice Questions

During ventricular systole, closure of the atrioventricular (AV) valves coincides with: A) atrial chamber filling. B) aortic valve opening. C) isovolumetric contraction. D) semilunar valves opening.

C) isovolumetric contraction.

The tissue factor that contributes to humoral control of blood flow by causing vasoconstriction is: A) histamine. B) bradykinin. C) serotonin. D) nitric oxide.

C) serotonin.

Which of the following is a nonmodifiable risk factor for the development of primary hypertension? A) African American race B) High salt intake C) Male gender D) Obesity

A) African American race

Coronary artery bypass grafting (CABG) is a relevant treatment modality for which of the following disorders of cardiac function? A) Atherosclerosis with history of MI B) Pericardial effusion and cardiac tamponade C) Dilated cardiomyopathies D) Aortic valve regurgitation and aortic stenosis

A) Atherosclerosis with history of MI

A patient has entered hypovolemic shock after massive blood loss in a car accident. Many of the patients peripheral blood vessels have consequently collapsed. How does the Laplace law account for this pathophysiologic phenomenon? A) Blood pressure is no longer able to overcome vessel wall tension. B) Decreasing vessel radii have caused a decrease in blood pressure. C) Wall thickness of small vessels has decreased due to hypotension. D) Decreases in wall tension and blood pressure have caused a sudden increase in vessel radii.

A) Blood pressure is no longer able to overcome vessel wall tension.

A patients primary care provider has added 20 mg of Lasix (furosemide) to his medication regimen to treat his primary hypertension. How does this diuretic achieve its therapeutic effect? A) By decreasing vascular volume by increasing sodium and water excretion B) By blocking the release of antidiuretic hormone from the posterior pituitary C) By inhibiting the conversion of angiotensin I to angiotensin II. D) By inhibiting the movement of calcium into arterial smooth muscle cells

A) By decreasing vascular volume by increasing sodium and water excretion

A patient is receiving homecare for the treatment of a wound on the inside of her lower leg which is 3 cm in diameter with a yellow wound bed and clear exudate. Assessment of the patients legs reveals edema and a darkened pigmentation over the ankles and shins of both legs. What is this patients most likely diagnosis? A) Chronic venous insufficiency B) Deep vein thrombosis C) Varicose veins D) Peripheral arterial disease

A) Chronic venous insufficiency

Electrical burns over a large surface area of a patients body have resulted in hypovolemic shock after the loss of large amounts of blood and plasma. Which of the following mechanisms is the patients body likely to implement to compensate for this loss of fluid? A) Increased heart rate B) Vasodilation C) Diuresis D) Inhibition of ADH

A) Increased heart rate

An 86-year-old male patient is disappointed to learn that he has class II heart failure despite a lifelong commitment to exercise and healthy eating. Which of the following age-related changes predisposes older adults to developing heart failure? A) Increased vascular stiffness B) Orthostatic hypotension C) Increased cardiac contractility D) Loss of action potential

A) Increased vascular stiffness

An elderly female patient with complaints of increasing fatigue has been diagnosed with aortic stenosis, a disease which her primary care provider believes may have been long-standing. Which of the following compensatory mechanisms has most likely maintained the womans ejection fraction until recently? A) Left ventricular hypertrophy B) Increased blood pressure C) Increased heart rate and stroke volume D) Aortic dilation

A) Left ventricular hypertrophy

Assessment of an elderly female patient reveals the presence of bilateral pitting edema of the patients feet and ankles and pedal pulses that are difficult to palpate. Auscultation of the patients lungs reveals clear air entry to bases, and the patients oxygen saturation level is 93% and vital signs are within reference ranges. What is this patients most likely health problem? A) Right-sided heart failure B) Left-sided heart failure C) Cardiogenic shock D) Cor pulmonale

A) Right-sided heart failure

A patient who lives with a diagnosis of angina pectoris has taken a sublingual dose of nitroglycerin to treat the chest pain he experienced while mowing his lawn. This drug has resulted in a release of nitric oxide, which will have what effect? A) Smooth muscle relaxation of vessels B) Decreased heart rate and increased stroke volume C) Increased preload D) Reduction of cardiac refractory periods

A) Smooth muscle relaxation of vessels

The plaques in a patients coronary arteries are plentiful and most have small- to moderate-sized lipid cores with thick fibrous caps. This form of atherosclerosis is most closely associated with which of the following diagnoses? A) Stable angina B) Non-ST-segment elevation MI C) ST-Segment elevation MI D) Unstable angina

A) Stable angina

A 29-year-old woman who considers herself active and health conscious is surprised to have been diagnosed with preeclampsia-eclampsia in her second trimester. What should her care provider teach her about this change in her health status? A) We don't really understand why some women get high blood pressure when they're pregnant. B) This is likely a result of your nervous system getting overstimulated by pregnancy. C) Hypertension is a common result of all the hormonal changes that happen during pregnancy. D) Even though you're a healthy person, it could be that you have an underlying heart condition.

A) We don't really understand why some women get high blood pressure when they're pregnant.

The most common causes of left-sided heart failure include: A) acute myocardial infarction. B) chronic pulmonary disease. C) impaired renal blood flow. D) tricuspid valve regurgitation.

A) acute myocardial infarction.

Long-term autoregulation of local blood flow in the microcirculation is mediated by: A) collateral circulation. B) arteriovenous shunting. C) autonomic nervous system. D) metabolic needs of the tissues.

A) collateral circulation.

Chronic stable angina, associated with inadequate blood flow to meet the metabolic demands of the myocardium, is caused by: A) fixed coronary obstruction. B) increased collateral circulation. C) intermittent vessel vasospasms. D) excessive endothelial relaxing factors.

A) fixed coronary obstruction.

A common symptom of the ischemia associated with gastrointestinal redistribution of blood flow is: A) gastric bleeding. B) nausea and vomiting. C) irritable bowel syndrome. D) copious high volume diarrhea.

A) gastric bleeding.

A major cause of secondary hyperlipoproteinemia is _______, which increases the production of VLDL and conversion to LDL. A) high-calorie diet B) diabetes mellitus C) bile-binding resin D) cholesterol ingestion

A) high-calorie diet

Turbulent blood flow can be caused by a number of factors, including: A) increased velocity. B) short vessel length. C) high blood viscosity. D) layering of blood cells.

A) increased velocity.

One of the principal mechanisms by which the heart compensates for increased workload is: A) myocardial hypertrophy. B) sodium and water retention. C) endothelin vasoconstrictors. D) ventricular wall tension increase.

A) myocardial hypertrophy.

The difference between the end-diastolic and end-systolic volumes is the: A) stroke volume. B) cardiac output. C) ejection fraction. D) cardiac reserve.

A) stroke volume.

Preload represents the volume work of the heart and is largely determined by: A) venous blood return. B) vascular resistance. C) force of contraction. D) ventricular emptying.

A) venous blood return.

In right-sided heart failure, peripheral edema is evidenced by: A) weight gain. B) copious urination. C) shortness of breath. D) decreased blood pressure.

A) weight gain.

A patient with a history of heart failure has been referred for an echocardiogram. Results of this diagnostic test reveal the following findings: heart rate 80 beats per minute; end-diastolic volume 120 mL; end-systolic volume 60 mL. What is this patients ejection fraction? A) 200 mL B) 50% C) .80 D) 180 mL

B) 50%

Which of the following individuals is suffering the effects of acute coronary syndrome (ACS)? A) A patient whose most recent ECG indicates that silent myocardial ischemia has occurred B) A patient who occasionally experiences persistent and severe chest pain when at rest C) A patient who sometimes experiences chest pain when climbing stairs D) A patient who has recently been diagnosed with variant (vasospastic) angina

B) A patient who occasionally experiences persistent and severe chest pain when at rest

A patient with a diagnosis of chronic renal failure secondary to diabetes has seen a gradual increase in her blood pressure over the past several months, culminating in a diagnosis of secondary hypertension. Which of the following has most likely resulted in the patients increased blood pressure? A) Increased levels of adrenocortical hormones B) Activation of the renin-angiotensin-aldosterone mechanism C) Increased sympathetic stimulation by the autonomic nervous system (ANS) D) Coarctation of the patients aorta

B) Activation of the renin-angiotensin-aldosterone mechanism

A patient with a diagnosis of secondary hypertension has begun to experience signs and symptoms that are ultimately suggestive of decreased cardiac output. Which of the following factors that determine cardiac output is hypertension likely to affect most directly? A) Preload B) Afterload C) Contractility D) Heart rate

B) Afterload

For which of the following types of shock might intravenous antibiotic therapy be indicated? A) Obstructive shock B) Distributive shock C) Cardiogenic shock D) Hypovolemic shock

B) Distributive shock

Patients with ischemic coronary vessel disease and acute coronary syndrome (ACS) are classified as low or high risk for acute myocardial infarction based on characteristics that include significant: A) heart murmurs. B) ECG changes. C) pulmonary disease. D) pericardial effusion.

B) ECG changes.

In the days following a tooth cleaning and root canal, a patient has developed an infection of the thin, three-layered membrane that lines the heart and covers the valves. What is this patients most likely diagnosis? A) Pericarditis B) Endocarditis C) Myocarditis D) Vasculitis

B) Endocarditis

Which of the following factors is the primary governor of the local control of blood flow? A) Action potential B) The nutritional needs of the tissue involved C) Cardiac contractility and preload D) Feedback from arterial baroreceptors and chemoreceptors

B) The nutritional needs of the tissue involved

On the second or third day after an acute myocardial infarction, the area of necrosis is: A) soft and yellow. B) acutely inflamed. C) granulation tissue. D) fibrous scar tissue.

B) acutely inflamed.

Cardiac output is the ________ each minute. A) volume load B) blood pumped C) stroke volume D) force generated

B) blood pumped

Atherosclerotic peripheral vascular disease is symptomatic with at least 50% occlusion. The primary peripheral symptom, due to ischemia, is: A) edema. B) calf pain. C) varicosities. D) strong pulse.

B) calf pain.

The pathophysiology of heart failure involves an interaction between decreased pumping ability and the ________ to maintain cardiac output. A) aortic hypertrophy B) compensatory mechanisms C) electrical conductivity D) parasympathetic system

B) compensatory mechanisms

Atherosclerotic plaque is most likely to be unstable and vulnerable to rupture when the plaque has a thin fibrous cap over a: A) red thrombus. B) large lipid core. C) calcified lesion. D) vessel wall injury.

B) large lipid core.

Dilated cardiomyopathy with left ventricular dysfunction is characterized by increased wall: A) rigidity. B) thinning. C) thickness. D) contractility.

B) thinning.

The most important complication of atherosclerosis is _________, which may cause occlusion of small heart vessels. A) ulceration B) thrombosis C) fatty streaks D) fibrous plaque

B) thrombosis

In shock, one of the best indicators of blood flow to vital organs is: A) warm legs. B) urine output. C) blood pressure. D) consciousness.

B) urine output.

In the arterial-venous circulatory system, pressure is inversely related to: A) velocity. B) volume. C) tension. D) viscosity.

B) volume.

By definition, hypertension is systolic blood pressure of ____ mm Hg or higher or diastolic blood pressure of ____ mm Hg or higher. A) 129; 85 B) 138; 89 C) 140; 90 D) 155; 95

C) 140; 90

Which of the following assessment findings of a cardiac patient would be suggestive of cardiac tamponade? A) Increasing PaCO2 and decreasing PaO2 B) Audible crackles on chest auscultation and presence of frothy sputum C) 20 mm Hg Drop in systolic blood pressure during respiration D) Normal ECG combined with complaints of chest pain and shortness of breath

C) 20 mm Hg Drop in systolic blood pressure during respiration

A patient with a diagnosis of heart failure has returned from a visit with his primary care provider with a prescription for a change in his daily medication regimen. Which of the following drugs is likely to improve the patients cardiac function by increasing the force and strength of ventricular contractions? A) A b-adrenergic blocker B) A diuretic C) A cardiac glycoside D) An ACE inhibitor

C) A cardiac glycoside

Which of the following patients should most likely be assessed for orthostatic hypotension? A) A 78-year-old woman who has begun complaining of frequent headaches unrelieved by over-the-counter analgesics. B) A patient whose vision has become much less acute in recent months and who has noticed swelling in her ankles. C) An elderly patient who has experienced two falls since admission while attempting to ambulate to the bathroom. D) A patient who has a history of poorly controlled type 1 diabetes.

C) An elderly patient who has experienced two falls since admission while attempting to ambulate to the bathroom.

A childs history of a recurrent sore throat followed by severe knee and ankle pain has resulted in a diagnostic workup and a diagnosis of rheumatic fever. What are the treatment priorities for this child? A) Cardiac catheterization and corticosteroid therapy B) Implanted pacemaker and b-adrenergic blockers C) Antibiotics and anti-inflammatories D) Pain control and oxygen therapy

C) Antibiotics and anti-inflammatories

Implantation of a pacemaker is most likely to benefit a patient with which of the following cardiomyopathies? A) Myocarditis B) Takotsubo cardiomyopathy C) Dilated cardiomyopathy (DCM) D) Primary restrictive cardiomyopathy

C) Dilated cardiomyopathy (DCM)

Football fans at a college have been shocked to learn of the sudden death of a star player, an event that was attributed in the media to an enlarged heart. Which of the following disorders was the players most likely cause of death? A) Takotsubo cardiomyopathy B) Arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D) C) Hypertrophic cardiomyopathy (HCM) D) Dilated cardiomyopathy (DCM)

C) Hypertrophic cardiomyopathy (HCM)

A large increase in heart rate can cause: A) increased blood viscosity. B) loss of action potential. C) decreased stroke volume. D) reduced cardiac contractility.

C) decreased stroke volume.

A 52-year-old man who is moderately obese has recently been diagnosed with hypertension by his primary care provider. Which of the patients following statements indicates a need for further health-promotion teaching? A) I've started going to the gym before work three times a week. B) I'm trying to cut back on the amount of salt that I cook with and add to my food. C) I'm resolving to eat organic foods from now on and to drink a lot more water. D) I'm planning to lose 15 pounds before the end of this year.

C) I'm resolving to eat organic foods from now on and to drink a lot more water.

The most recent blood work of a patient with a diagnosis of heart failure indicates increased levels of atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP). What are the most likely effects of these peptides on the patients physiology? A) Water retention B) Increased tubular sodium reabsorption C) Inhibition of the renin-angiotensin-aldosterone system D) Sympathetic nervous stimulation

C) Inhibition of the renin-angiotensin-aldosterone system

Because cholesterol is insoluble in plasma, it is mainly carried by the lipoprotein: A) IDL. B) HDL. C) LDL. D) VLDL.

C) LDL.

A patient who developed a deep vein thrombosis during a prolonged period of bedrest has deteriorated as the clot has dislodged and resulted in a pulmonary embolism. Which of the following types of shock is this patient at risk of experiencing? A) Cardiogenic shock B) Hypovolemic shock C) Obstructive shock D) Distributive shock

C) Obstructive shock

Harmful effects on cardiac action potential are most likely to result from a deficit of which of the following electrolytes? A) Magnesium (Mg2+) B) Chloride (Cl) C) Potassium (K+) D) Hydrogen carbonate (HCO3)

C) Potassium (K+)

A patient has been experiencing increasing fatigue in recent months, a trend that has prompted an echocardiogram. Results of this diagnostic test suggest that the patients end-diastolic volume is insufficient. Which of the following parameters of cardiac performance will directly decrease as a result of this? A) Inotropy B) Cardiac contractility C) Preload D) Afterload

C) Preload

Which of the following physiologic processes contributes most to the long-term regulation of blood pressure? A) Actions of the renin-angiotensin-aldosterone system B) Release of antidiuretic hormone (vasopressin) by the posterior pituitary C) Renal monitoring and adjustment of extracellular fluid volume D) Integration and modulation of autonomic nervous system (ANS)

C) Renal monitoring and adjustment of extracellular fluid volume

A male patient with a history of angina has presented to the emergency department with uncharacteristic chest pain and his subsequent ECG reveals T-wave elevation. This finding suggests an abnormality with which of the following aspects of the cardiac cycle? A) Atrial depolarization B) Ventricular depolarization C) Ventricular repolarization D) Depolarization of the AV node, bundle branches, and Purkinje system

C) Ventricular repolarization

A patient with persistent, primary hypertension remains apathetic about his high blood pressure, stating, I dont feel sick, and it doesnt seem to be causing me any problems that I can tell. How could a clinician best respond to this patients statement? A) Actually, high blood pressure makes you very susceptible to getting diabetes in the future. B) Thats true, but its an indicator that youre not taking very good care of yourself. C) You may not sense any problems, but it really increases your risk of heart disease and stroke. D) Youre right, but its still worthwhile to monitor it in case you do develop problems.

C) You may not sense any problems, but it really increases your risk of heart disease and stroke.

Because of its location, the presence of an abdominal aortic aneurysm may first be noticed as: A) constipation. B) indigestion. C) a pulsating mass. D) mid-abdominal pain.

C) a pulsating mass.

Heart muscle differs from skeletal muscle tissue by being able to generate: A) contractions. B) calcium influx. C) action potentials. D) sarcomere binding.

C) action potentials.

In adults, sudden death from an acute myocardial infarction is usually caused by: A) acute myocarditis. B) high troponin levels. C) acute ventricular arrhythmia. D) hypertrophic cardiomyopathy.

C) acute ventricular arrhythmia.

In aortic regurgitation, failure of aortic valve closure during diastole causes an abnormal drop in diastolic pressure. This change in pressure causes decreased: A) stroke volume. B) left ventricular size. C) coronary perfusion. D) arterial pulse pressure.

C) coronary perfusion.

Congenital heart defects can cause a right heart to left heart shunting of blood that results in increased: A) pulmonary blood volume. B) right ventricle workload. C) unoxygenated blood flow. D) right atrial blood volume.

C) unoxygenated blood flow.

The parasympathetic nervous system causes a slowing of the heart rate by increasing: A) norepinephrine. B) vessel constriction. C) vagus nerve activity. D) smooth muscle tone.

C) vagus nerve activity.

A postsurgical patients complaints of calf pain combined with the emergence of swelling and redness in the area have culminated in a diagnosis of deep vein thrombosis. What treatment options will be of greatest benefit to this patient? A) Analgesics and use of a pneumatic compression device B) Massage followed by vascular surgery C) Frequent ambulation and the use of compression stockings D) Anticoagulation therapy and elevation of the leg

D) Anticoagulation therapy and elevation of the leg

Following several weeks of increasing fatigue and a subsequent diagnostic work-up, a patient has been diagnosed with mitral valve regurgitation. Failure of this heart valve would have which of the following consequences? A) Backup of blood from the right atrium into the superior vena cava B) Backflow from the right ventricle to the right atrium during systole C) Inhibition of the SA nodes normal action potential D) Backflow from the left ventricle to left atrium

D) Backflow from the left ventricle to left atrium

Persistent cyanosis has led an infants care team to suspect a congenital heart defect. Which of the following assessment findings would suggest coarctation of the infants aorta? A) The child has a split S2 heart sound on auscultation. B) ECG reveals atrial fibrillation. C) The child experiences apneic spells after feeding. D) Blood pressure in the childs legs is lower than in the arms.

D) Blood pressure in the childs legs is lower than in the arms.

A serum marker for systemic inflammation, _______, is now considered a major risk factor marker for atherosclerosis, and vascular disease. A) leukocytosis B) homocysteine C) serum lipoprotein D) C-reactive protein

D) C-reactive protein

Release of which of the following humoral factors will result in vasodilation? A) Norepinephrine B) Angiotensin II C) Serotonin D) Histamine

D) Histamine

A nurse is performing patient health education with a 68-year-old man who has recently been diagnosed with heart failure. Which of the following statements demonstrates an accurate understanding of his new diagnosis? A) I'll be sure to take my beta blocker whenever I feel short of breath. B) I'm going to avoid as much physical activity as I can so that I preserve my strength. C) I know its healthy to drink a lot of water, and I'm going to make sure I do this from now on. D) I'm trying to think of ways that I can cut down the amount of salt that I usually eat.

D) I'm trying to think of ways that I can cut down the amount of salt that I usually eat.

Which of the following health problems is associated with heart failure as a result of diastolic dysfunction? A) Uncontrolled hypertension B) Chronic bradycardia C) Ischemic heart disease D) Myocardial hypertrophy

D) Myocardial hypertrophy

Which of the following assessment findings of a cyanotic infant is incongruent with a diagnosis of tetralogy of Fallot? A) The child has ventricular septal defect. B) The infants pulmonary outflow channel is narrowed. C) The child has right ventricular hypertrophy. D) The infants aorta is narrowed.

D) The infants aorta is narrowed.

Hypovolemic shock occurs as a result of: A) myocardial infarction. B) excessive vasoconstriction. C) chronic intracellular fluid shift. D) acute intravascular volume loss.

D) acute intravascular volume loss.

The patient is immobilized following a hip injury and has begun demonstrating lower leg discoloration with edema, pain, tenderness, and increased warmth in the mid-calf area. He has many of the manifestations of: A) stasis ulcerations. B) arterial insufficiency. C) primary varicose veins. D) deep vein thrombosis.

D) deep vein thrombosis.

Cardiac tamponade and pericardial effusion can be life-threatening when the pericardial sac _______ and ______ the heart. A) ruptures; releases B) thickens; stretches C) contracts; friction rubs D) fills rapidly; compresses

D) fills rapidly; compresses

Small-vessel vasculitides, a group of vascular disorders that cause vasculitis, are mainly mediated by: A) infectious agents. B) tissue necrosis. C) mononuclear cells. D) hypersensitivity reactions.

D) hypersensitivity reactions.

Anaphylactic shock is directly associated with: A) loss of blood volume. B) bacterial blood infection. C) failure of the heart as a pump. D) type I hypersensitivity response.

D) type I hypersensitivity response.

Although both are characterized by ischemia, Raynaud phenomenon is caused by _________, and thromboangiitis obliterans is caused by: A) occlusion; compression. B) thrombi; vasoconstriction. C) vasculitides; hypertension. D) vasospasm; inflammation.

D) vasospasm; inflammation.

Endocarditis and rheumatic heart disease are both cardiac complications of systemic infections. Characteristics include a new or changed heart murmur caused by: A) chronic atrial fibrillation. B) myocardial inflammation. C) left ventricle hypertrophy. D) vegetative valve destruction.

D) vegetative valve destruction.

Severe shock can be followed by acute lung injury/acute respiratory distress syndrome (ALI/ARDS) characterized by: A) hyperventilation. B) excessive surfactant. C) hyperinflated alveolar sacs. D) ventilation-perfusion mismatch.

D) ventilation-perfusion mismatch.

Primary (essential) hypertension is characterized by chronic elevation in blood pressure that results from some other disorder, such as kidney disease. True or False?

False

Most abdominal aneurysms are asymptomatic. True or False?

True