Quiz 3

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

cardiac tamponade.

Patent ductus arteriosus is accurately described as a(n)

communication between the aorta and the pulmonary artery.

Administration of a vasodilator to a patient in shock would be expected to

decrease left ventricular afterload.

Constrictive pericarditis is associated with

impaired cardiac filling.

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

nitric oxide.

An erroneously low blood pressure measurement may be caused by

positioning the arm above the heart level.

A patient with pure left-sided heart failure is likely to exhibit

pulmonary congestion with dyspnea.

Cardiogenic shock is characterized by

reduced cardiac output.

The majority of tachydysrhythmias are believed to occur because of

reentry mechanisms.

Cor pulmonale refers to

right ventricular hypertrophy secondary to pulmonary hypertension.

After sitting in a chair for an hour, an elderly patient develops moderate lower extremity edema. His edema is most likely a consequence of

right-sided heart failure.

The effect of nitric oxide on systemic arterioles is

vasodilation.

An example of an acyanotic heart defect is

ventricular septal defect.

Hypertrophy of the right ventricle is a compensatory response to

pulmonary stenosis.

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

128/82

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.

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

high cardiac output.

Left-sided heart failure is characterized by

pulmonary congestion.

Improvement in a patient with septic shock is indicated by an increase in

systemic vascular resistance.

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?

Ventricular escape rhythm

Angiotensin-converting enzyme (ACE) inhibitors block the

conversion of angiotensin I to angiotensin II.

First-degree heart block is characterized by

prolonged PR interval.

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.

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

Elevated CK-MB, troponin I, and troponin T

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

Chronic elevation of myocardial wall tension results in atrophy.

False (hypertrophy)

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

mitral regurgitation.

While hospitalized, an elderly patient with a history of myocardial infarction was noted to have high levels of low-density lipoproteins (LDLs). What is the significance of this finding?

Increased LDL levels are associated with increased risk of coronary artery disease.

In which dysrhythmias should treatment be instituted immediately?

Atrial fibrillation with a ventricular rate of 220 beats/minute

Angina caused by coronary artery spasm is called _____ angina.

Prinzmetal variant

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

afterload.

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

ST-segment elevation.

A patient presenting with fever, hypotension, and lactic acidosis is most likely to be experiencing what type of shock?

Septic

Overproduction of nitric oxide is an important aspect of the pathophysiologic process of what type of shock?

Septic

Which finding is indicative of orthostatic hypotension in a person with a supine blood pressure (BP) of 110/70 and a heart rate (HR) of 100?

Sitting BP 88/60, HR 118

Restriction of which electrolytes is recommended in the management of high blood pressure?

Sodium

What compensatory sign would be expected during periods of physical exertion in a patient with limited ventricular stroke volume?

Tachycardia

Mitral stenosis is associated with

a pressure gradient across the mitral valve.

Sepsis has been recently redefined as

a systemic inflammatory response to infection.

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

acute cardiogenic pulmonary edema.

Tachycardia is an early sign of low cardiac output that occurs because of

baroreceptor activity.

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

Myocarditis should be suspected in a patient who presents with

acute onset of left ventricular dysfunction.

A laboratory test that should be routinely monitored in patients receiving digitalis therapy is

serum potassium.

A patient with a history of myocardial infarction continues to complain of intermittent chest pain brought on by exertion and relieved by rest. The likely cause of this pain is

stable angina.

Patients with structural evidence of heart failure who exhibit no signs or symptoms are classified into which New York Heart Association heart failure class?

Class I

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

True

The ingestion of certain drugs, foods, or chemicals can lead to secondary hypertension.

True

What results when systemic blood pressure is increased?

Vasoconstriction

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.

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.

Hypertension is closely linked to

obstructive sleep apnea.

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

paroxysmal nocturnal dyspnea.

Low cardiac output to the kidneys stimulates the release of _____ from juxtaglomerular cells.

renin

A patient with significant aortic stenosis is likely to experience

syncope.