Patho- Chapter 19

19. Persistent cyanosis has led an infant's care team to suspect a congenital heart defect. Which of the following assessment findings would suggest coarctation of the infant's 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 child's legs is lower than in the arms.

D) Blood pressure in the child's legs is lower than in the arms.

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

B) thinning.

12. The plaques in a patient's 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

14. 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

18. 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 woman's 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

1. 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.

13. 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

7. 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.

5. 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.

2. 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.

11. 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

17. A child's 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 -adrenergic blockers C) Antibiotics and anti-inflammatories D) Pain control and oxygen therapy

C) Antibiotics and anti-inflammatories

16. 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)

15. 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 player's 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)

4. 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.

6. 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.

10. 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.

20. 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 infant's pulmonary outflow channel is narrowed. C) The child has right ventricular hypertrophy. D) The infant's aorta is narrowed.

D) The infant's aorta is narrowed.

3. 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

9. 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.