Practice questions from class Med surg 1 exam

1. Blood pressure is the product of: ● a.Cardiac output and peripheral resistance b.Cardiac output and preload c.Stroke volume and contractility d.Stroke volume and heart rate

A

1. The dominant function in left sided cardiac failure is: uA. inadequate tissue perfusion uB. ascites uC. hepatomegaly uD. nocturia

A

1. When afterload is increased, cardiac output is decreased. a. True b. False

A

10. Afterload is decreased in the following condition: a.Vasodilation b.Vasoconstriction c.Aortic stenosis d.Pulmonary valve stenosis

A

10. Classic signs of cardiogenic shock include all of the following EXCEPT: uA. bradycardia uB. hypotension uC. oliguria uD. cerebral hypoxia

A

10. The protein produced by the liver in response to systemic inflammation that may play a role in atherosclerosis is: uA. C-reactive protein uB. Plasma protein uC. High density lipoprotein uD. Low density lipoprotein

A

10. The time required for an electric impulse to pass from the SA node through the AV node is denoted by the: a.PR Interval b.QRS duration c.QT interval d.U wave

A

10.One of the most significant concerns for healthcare providers in the management of hypertension involves the noncompliance with recommended therapy. a. True b. False

A

2. A normal QRS interval is: a .06 - .10 sec. c. .04 - .08 sec. b.12 - .20 sec.d..08 - .14 sec

A

3. Hemodynamic monitoring by way of a multilumen pulmonary artery catheter can provide detailed information about: uA. preload uB. afterload uC. blood pressure uD. all of the above

A

3.The nurse responds to the telemetry monitor alarm revealing ventricular tachycardia. Upon entering the room, the patient is found unresponsive. What is the nurse's first action? ● a. Call for help, assess for pulselessness, start CPR b. Defibrillate using the monophasic defibrillator at 360 joules c. Deliver pre-cordial thump and begin CPR d. Assess ABCs, defibrillate at 300 joules, start CPR

A

4. Leads I, II and III differ from each other on the cardiac rhythm strip. This is because: a.The view of the electrical current changes in relation to the lead placement b.Conduction of the heart differs with lead placement c.Electrocardiogram (ECG) equipment has malfunctioned d.The circadian rhythm has changed

A

5.If the sphygmomanometer is too small for the patient, the blood pressure reading will likely be: ● a. Falsely elevated b. Falsely decreased

A

6. Patients with type "A" behavior characteristics may be more likely to develop CAD as a result of the neuroendocrine response. This physical response results in: uA. Increased HR and increased BP uB. Increased HR and decreased BP uC. Decreased HR and increased BP uD. Decreased HR and decreased BP

A

6. The primary underlying disorder of pulmonary edema is: uA. decreased left ventricular pumping uB. decreased right ventricular elasticity uC. increased left atrial contractility uD. increased right atrial resistance

A

7. A "sawtooth" P wave is seen in: a.Atrial flutter b.Atrial fibrillation c.Premature atrial contraction d.Sinus bradycardia

A

7. A primary classification of medications used in the treatment of systolic heart failure is: uA. ACE inhibitors uB. Beta blockers uC. Diuretics uD. Calcium channel blockers

A

7. The difference between the systolic and diastolic blood pressures is called _______ and is normally ______ mmHg. uA. pulse pressure / 30-40 uB. pulsus paradoxus / 30-40 uC. pulse deficit / 20-30 uD. pulse pathology / 20-30

A

8.Treatment of the conscious patient in new onset of ventricular tachycardia includes: a. Assess patient, notify physician, anticipate orders for O2, ECG, electrolytes b. Defibrillate with biphasic defibrillator at 200 joules c. Cardiovert with monophasic defibrillator at 100 joules d. Administer pre-cordial thump after assisting patient to bed

A

9.Of the following, what is the appropriate dosage of epinephrine during an arrest situation? a.Dosage is 1 mg IV every 3-5 minutes b.Dosage is 3 mg IV every 1-3 minutes c.Dosage is 5 mg IV every 3-5 minutes d.Dosage is 7 mg IV every 1-3 minutes

A

2. Stroke volume is primarily affected by all of the following EXCEPT: a. Contractility b. Heart rate c. Afterload d. Preload

B

3. Complications of Acute Myocardial Infarction (AMI) include: uA. Nausea and shortness of breath uB. Dysrhythmias and heart failure uC. Anxiety and restlessness uD. Diaphoresis and fatigue

B

4. The first heart sound is generated by: a.Closure of the aortic valve b.Closure of the atrioventricular valves c.Opening of the atrioventricular valves d.Opening of the pulmonic valve

B

4.The nurse notes the patient has no pulse, and tells someone to get the Code Cart and call the hospital's code team. CPR is begun. Upon arrival of the defibrillator, the nurse sets the biphasic defibrillator for _____ joules? a. 100 c. 250 b. 120 d. 300

B

5. Which of the following describes atrial fibrillation: a.Sawtooth P waves b.Irregular rhythm - no pattern c.Patient requires immediate defibrillation d.Prolonged PR interval

B

7. The pericardial space is: a.The space between the endocardium and the myocardium b.The space between the visceral pericardium and the parietal pericardium c.The space between the myocardium and the visceral pericardium d.The space between the endocardium and the parietal pericardium

B

7.Following defibrillation, the nurse notes that the patient is in NSR with frequent premature ventricular contractions (PVCs). Of the following, a likely cause of frequent PVCs might be? ● a. Serum potassium of 4.0 meq/L c. Oxygen saturation of 94% b. Serum potassium of 2.5 meq/L d. Serum sodium of 140 mEq/L

B

8.Structural and functional changes that occur among the elderly and predispose the patient to hypertension includes: ● a.Macular degeneration b.Impaired vasodilation c.Ventricular muscle atrophy d.Increased tissue around SA node

B

9. The neurohormone that is secreted from the ventricles in response to increased preload and helps to regulate BP and fluid volume is called: uA. Troponin T uB. Brain (B-type) Natriuretic Peptide uC. C-Reactive Protein uD. Homocysteine

B

1. The ECG component that reflects ventricular depolarization and repolarization is called: a. ST segment c. QT interval b. QRS complex d. TP interval

C

1.A patient is experiencing premature ventricular contractions (PVCs) every third beat. This is called: a. Couplets c. Trigeminy b. Bigeminy d. Ventricular tachycardia

C

10.Cardioversion is used to terminate dysrhythmias. With cardioversion, the: a. Amount of voltage used should exceed 400 ws b. Electrical impulse can be discharged during the T wave c. Defibrillator should be set to deliver a shock during the QRS complex d. All of the above are true

C

2. All of the following are true EXCEPT: uA. The severity and duration of chest pain does not correlate with the seriousness of its cause uB. Diabetics and the elderly may not experience angina due to neuropathies uC. Men are more likely than women to present with atypical symptoms uD. The location of the chest pain is not well correlated with the cause of the pain

C

3. An example of a beta-blocker that is administered to decrease automaticity is: a. Cardizem c. Metoprolol b. Cordarone d. Rythmol

C

3. The drug of choice to treat symptomatic sinus bradycardia is: a. Amiodarone c. Atropine b. Metoprolol d. Lidocaine

C

4. The primary cause of heart failure is: uA. pulmonary hypertension uB. arterial hypertension uC. coronary atherosclerosis uD. valvular dysfunction

C

4.The following ACE inhibitor is a common first line medication in the treatment of hypertension: ● a. Metoprolol c. Lisinopril b. Digoxin d. Diltiazem

C

5. So that blood may flow from the right ventricle to the pulmonary artery, which is NOT required? a.The atrioventricular valves must be closed b.The pulmonic valve must be open c.Right ventricular pressure must be < pulmonary arterial pressure d.Right ventricular pressure must rise with systole

C

5. The following are examples of platelet inhibiting medications: uA. Heparin and Coumadin uB. Alteplase and Reteplase uC. Clopidogrel and ASA uD. Lovenox and daltaparen

C

5. The patient who denies symptoms of heart failure at rest, but reports symptoms of heart failure while getting dressed, would have a heart failure classification of: uA. I uB. II uC. III uD. IV

C

5.If initial defibrillations are unsuccessful, which of the following may be used in this situation? a. Atropine c. Epinephrine b. Cardizem d. Dopamine

C

6. The ejection fraction is: a.The percentage of end diastolic blood ejected from the atria b.The percentage of blood left in the ventricle at the end of systole c.Normally about 55 - 65% d.Normally about 75 - 85%

C

8. Preload is increased by all of the following EXCEPT: a.Hypervolemia b.Vasoconstriction c.Blood loss d.Administration of hypertonic fluids

C

8. The dysrhythmia described by patients as "my heart skipped a beat" is: a.Atrial flutter b.Sinus tachycardia c.Premature Atrial Contraction (PAC) d.Sinus bradycardia

C

9. All of the following may be a cause of sinus tachycardia EXCEPT: a. Fever c. Sympatholytic drugs b. Hypovolemia d. Sympathomimetic drugs

C

9.Of the following conditions, all may evolve into a hypertensive emergency and require prompt lowering of the B.P. EXCEPT: ● a.Intracranial hemorrhage b.Hypertension of pregnancy c.Ischemic stroke d.Dissecting aortic aneurysm

C

1. A serious manifestation of Coronary Artery Disease (CAD) is called Acute Coronary Syndrome (ACS). ACS occurs when uA. A patient experiences unrelenting chest pain uB. A patient experiences vasospasm of a coronary artery uC. A coronary artery dissects and leads to cardiac tamponade uD. An atheromatous plaque ruptures and forms an obstructive clot

D

2. Nursing measures involved in intra-arterial monitoring include assessing for localized ischemia caused by inadequate arterial blood flow. As a result, the nurse would assess the involved extremity for the following: uA. pulse rate uB. capillary refill uC. color and temperature uD. all of the above

D

2.Stage 1 hypertension is defined as a persistent blood pressure level greater than: a. 110/60 b. 120/80 C.130/90 d. 140/90

D

2.Ventricular fibrillation is associated with an absence of: ● a. Heart rate c. Palpable pulse b. Respirations d. All of the above

D

3.Renal disease associated with essential hypertension can best be identified by: a.U/O > 2,000 ml/24 hours b.U/O > 3,000 ml/24 hours c.Decreased urine osmolality d.Increased BUN & creatinine

D

4. A precipitating factor of angina is: uA. physical exertion uB. emotional upset uC. exposure to extreme temperatures uD. all of the above

D

6. Stimulation of the parasympathetic system results in: a. Positive dromotropy c. Positive chronotropy b. Increased blood pressure d. Negative inotropy

D

6.Postural hypotension is a drop of at least _____ mm/Hg in the systolic BP reading from supine to sitting. ● a. 5 B. 10 C. 15 d. 20

D

6.Precautions that should be taken prior to defibrillation include all of the following EXCEPT: a. Ensure "all clear" 3 times. b. Charge defibrillator only when ready to administer defibrillation c. Exert 20-25 pounds of pressure when performing manual defibrillation d. Ensure defibrillator is in "Sync" mode

D

7.All of the following are consequences of prolonged, uncontrolled hypertension EXCEPT: ● a.Left ventricular hypertrophy b.Cerebrovascular Accident c.Myocardial Infarction d.Pulmonary hypertension

D

8. A commonly prescribed diuretic that is given intravenously to produce rapid diuresis is: uA. Zaroxolyn uB. Lisinopril uC. Hydrochlorothiazide uD. Furosemide (Lasix)

D

8. The PMI (Point of Maximal Impulse) is located: uA. 4th ICS (intercostal space) at left sternal border uB. 4th ICS at right sternal border uC. 5th ICS at right sternal border uD. 5th ICS at midclavicular line

D

9. Cardiogenic shock is pump failure that occurs primarily as a result of: uA. coronary artery stenosis uB. right atrial flutter uC. myocardial ischemia uD. left ventricular damage

D

9. Heart rate is increased by all of the following EXCEPT: a.Excess thyroid hormone b.Increased levels of circulating catecholamines c.The sympathetic nervous system d.The vagus nerve

D