Week 3: Check Your Understanding

Hypotension, distended neck veins, and muffled heart sounds are classic manifestations of

cardiac tamponade

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.

obstructive

A patient with heart failure who reports intermittent shortness of breath during the night is experiencing

paroxysmal nocturnal dyspnea

In contrast to all other types of shock, the hyperdynamic phase of septic shock is associated with

high cardiac output.

A patient presents to the emergency department with a diastolic blood pressure of 132 mm Hg, retinopathy, and symptoms of an ischemic stroke. This symptomology is likely the result of

hypertensive crisis

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?

Begin antihypertensive drug therapy.

Patent ductus, arteriosus is accurately describes as a

Communication between the aorta and the pulmonary artery

A patient is diagnosed with cardiogenic shock. The patient is hyperventilating and is therefore a risk for the respiratory complication of respiratory acidosis.

False

A patient is diagnosed with cardiogenic shock. The patient is hyperventilating and is therefore at risk for the respiratory complication of respiratory acidosis.

False

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

False

The most commonly recognized outcome of hypertension is pulmonary disease.

False

Which dysrhythmia is thought to be associated with reentrant mechanisms?

Preexcitation syndrome tachycardia (Wolf-Parkinson-White syndrome)

A patient has heart failure with a normal ejection fraction. Which findings are most likely found in this patient? (Select all that apply.)

-Pulmonary congestion -Edema -Ejection fraction less than 45%

Right-sided heart failure is usually a consequence of (Select all that apply.)

-elevated right ventricular afterload. -right ventricular infarction.

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?

Class II, Compensated Stage

Lactated Ringer solution and normal saline are commonly used crystalloid solutions that contain electrolytes

true

What results when systemic blood pressure is increased?

vasoconstriction

Which statement is true about the incidence of heart failure? (Select all that apply.)

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

A patient with forward effects of heart failure may present with which symptoms? (Select all that apply.)

-Impaired memory -Mental fatigue -Confusion

The common denominator in all forms of heart failure is

-myocardial ischemia -hypertension

Which blood pressure reading is considered to be indicative of prehypertension according to the JNC-7 criteria?

128/82

In which dysrhythmias should treatment be instituted immediately?

Atrial fibrillation with a ventricular rate of 220 beats/minute

Increased preload of the cardiac chambers may lead to which patient symptom?

Edema

Which serum biomarker(s) are indicative of irreversible damage to myocardial cells?

Elevated CK-MB, troponin I, and troponin T

The most reliable indicator that a person is experiencing an acute myocardial (MI) infraction is

ST segment elevation

A patient with significant aortic stenosis is likely to experience

Syncope

Mitral stenosis is associated with

a pressure gradient across the mitral valve

High blood pressure increases the workload of the left ventricle because it increases

afterload

High blood pressure increases the workload of the left ventricle, because it increases

afterload

Massive release of histamine with consequent vasodilation and hypotension occurs with what type of shock?

anaphylactic

The majority of cases of anaphylactic shock occur when a sensitized individual comes in contact with

antibiotics

Patients presenting with symptoms of unstable angina and no ST segment elevation are treated with

antiplatelet drugs

The majority of cardiac cells that die, after myocardial infarction do so because of

apoptosis

Patent ductus arteriosus is accurately described as a(n)

communication between the aorta and the pulmonary artery.

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?

continue lifestyle medication only

Administration of which therapy is most appropriate for hypovolemic shock?

crystalloids

Primary treatment for myocardial infarction (MI) is directed at

decreasing myocardial oxygen demands.

Aortic regurgitation is associated with

diastolic murmur

A patient has a history of falls, syncope, dizziness, and blurred vision. The patient's symptomology is most likely related to

hypotension

Lusitropic impairment refers to

impaired diastolic relaxation

Critically ill, patient may have paternally administered vasoactive drugs that are adjusted according to their____ pressure

mean arterial

A loud pansystolic murmur that radiates to the axilla is most likely a result of

mitral regurgitation

Tumor necrosis factor α and interleukin-1 contribute to shock states because they induce production of

nitric oxide

First-degree heart block is characterized by

prolonged PR interval

Hypertrophy of the right ventricle is a compensatory response to

pulmonary stenosis

The majority of tachydysrhythmias are believed to occur because of

re-entry mechanisms

Beta-blockers are advocated in the management of heart failure because they

reduce cardiac output.

Cardiogenic shock is characterized by

reduced cardiac output

Hypertension with a specific, identifiable cause is known as _____ hypertension.

secondary

Hypertension, with a specific identifiable cause, is known as___ hypertension.

secondary

Pulse pressure is defined as

systolic pressure - diastolic pressure

An example of an acyanotic heart defect is

ventricular septal defect

Hypotension associated with neurogenic and anaphylactic shock is because of

peripheral pooling of blood.