Check Your Understanding Assignment 3

Patients with structural evidence of heart failure who exhibit no signs or symptoms are classified into which New York Heart Association heart failure class? a. Class III b. Class II c. Class I d. Class IV

c. Class I

A patient with significant aortic stenosis is likely to experience a. hypertension. b. peripheral edema. c. syncope. d. increased pulse pressure.

c. syncope.

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? a. Class IV, Refractory Stage b. Class III, Progressive Stage c. Class I, Initial Stage d. Class II, Compensated Stage

d. Class II, Compensated Stage

High blood pressure increases the workload of the left ventricle, because it increases a. stroke volume. b. preload. c. blood volume. d. afterload.

d. afterload.

Administration of a vasodilator to a patient in shock would be expected to a. increase contractility. b. increase tissue perfusion. c. decrease vascular resistance. d. decrease left ventricular afterload.

d. decrease left ventricular afterload.

Primary treatment for myocardial infarction (MI) is directed at a. reducing heart rate and blood pressure. b. activating the parasympathetic system. c. protecting the heart from further ischemia. d. decreasing myocardial oxygen demands.

d. decreasing myocardial oxygen demands.

The effect of nitric oxide on systemic arterioles is a. vasodilation. b. vasoconstriction. c. opposed by nitrate drugs. d. not significant.

a. vasodilation.

Atherosclerotic plaques with large lipid cores are prone to a. binding. b. rupture. c. attachment. d. dislodgement.

b. rupture.

Mitral stenosis is associated with a. left ventricular hypertrophy. b. a muffled second heart sound (S2). c. a pressure gradient across the mitral valve. d. a prominent S4 heart sound.

c. a pressure gradient across the mitral valve.

New-organ damage is a function of both the stage of hypertension and its duration. a. True b. False

b. False

Restriction of which electrolytes is recommended in the management of high blood pressure? a. Potassium b. Sodium c. Magnesium d. Calcium

b. Sodium

What compensatory sign would be expected during periods of physical exertion in a patient with limited ventricular stroke volume? a. Aortic regurgitation b. Tachycardia c. Hypotension d. Bradycardia

b. Tachycardia

Lactated Ringer solution and normal saline are commonly used crystalloid solutions that contain electrolytes. a. False b. True

b. True

Myocarditis should be suspected in a patient who presents with a. chest pain and ST elevation. b. murmur and abnormal valves on echocardiogram. c. acute onset of left ventricular dysfunction. d. family history of cardiomyopathy.

c. acute onset of left ventricular dysfunction.

Tachycardia is an early sign of low cardiac output that occurs because of a. tissue hypoxia. b. acidosis. c. baroreceptor activity. d. anxiety.

c. baroreceptor activity.

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? a. Third-degree heart block b. Ventricular escape rhythm c. Junctional tachycardia d. Sinus bradycardia

b. Ventricular escape rhythm

A loud pansystolic murmur that radiates to the axilla is most likely a result of a. mitral stenosis. b. aortic stenosis. c. mitral regurgitation. d. aortic regurgitation.

c. mitral regurgitation.

Administration of which therapy is most appropriate for hypovolemic shock? a. Crystalloids b. 5% dextrose in water c. Inotropic agents d. Vasoconstrictor agents

a. Crystalloids

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

a. False

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? a. Continue lifestyle modifications plus b-blocker therapy. b. Continue lifestyle modifications only. c. Continue lifestyle modifications plus ACE inhibitor therapy. d. Continue lifestyle modifications plus diuretic therapy.

b. Continue lifestyle modifications only.

Overproduction of nitric oxide is an important aspect of the pathophysiologic process of what type of shock? a. Septic b. Anaphylactic c. Hypovolemic d. Cardiogenic

a. Septic

Increased preload of the cardiac chambers may lead to which patient symptom? a. Decreased respiratory rate b. Edema c. Excitability d. Decreased heart rate

b. Edema

Massive release of histamine with consequent vasodilation and hypotension occurs with what type of shock? a. Neurogenic b. Cardiogenic c. Hypovolemic d. Anaphylactic

d. Anaphylactic

Disseminated intravascular coagulation is a serious complication of septic shock characterized by abnormal clot formation in the microvasculature throughout the body. a. True b. False

a. True

The majority of cases of anaphylactic shock occur when a sensitized individual comes in contact with a. antibiotics. b. animal proteins or dander. c. perfumes. d. incompatible blood products.

a. antibiotics.

patent ductus arteriosus is accurately described as a(n) a. communication between the aorta and the pulmonary artery. b. stricture of the aorta that impedes blood flow. c. opening between the atria. d. cyanotic heart defect associated with right-to-left shunt.

a. communication between the aorta and the pulmonary artery.

Lusitropic impairment refers to a. impaired diastolic relaxation. b. poor contractile force. c. altered automaticity. d. altered action potential conduction rate.

a. impaired diastolic relaxation.

An abnormally wide (more than 0.10 second) QRS complex is characteristic of a. premature ventricular complexes. b. supraventricular tachycardia. c. paroxysmal atrial tachycardia. d. junctional escape rhythm.

a. premature ventricular complexes.

The common denominator in all forms of heart failure is a. reduced cardiac output. b. tissue ischemia. c. pulmonary edema. d. poor diastolic filling.

a. reduced cardiac output.

Cor pulmonale refers to a. right ventricular hypertrophy secondary to pulmonary hypertension. b. right ventricular failure secondary to right ventricular infarction. c. biventricular failure. d. left ventricular hypertrophy secondary to lung disease.

a. right ventricular hypertrophy secondary to pulmonary hypertension.

A patient with cold and edematous extremities, low cardiac output, and profound hypotension is likely to be experiencing a progressive stage of ________ shock. a. septic b. hypovolemic c. obstructive d. cardiogenic

a. septic

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 a. stable angina. b. unstable angina. c. myocardial infarction. d. coronary vasospasm.

a. stable angina.

Pulse pressure is defined as a. systolic pressure - diastolic pressure. b. two thirds of systolic pressure + diastolic pressure. c. systolic pressure + diastolic pressure. d. systolic pressure × systemic resistance.

a. systolic pressure - diastolic pressure.

The ingestion of certain drugs, foods, or chemicals can lead to secondary hypertension. a. False b. True

b. True

What results when systemic blood pressure is increased? a. Decreased cardiac output b. Vasoconstriction c. Decreased vascular resistance d. Hypovolemia

b. Vasoconstriction

The prevalence of high blood pressure is higher in a. Asian children. b. non-Hispanic black adults. c. non-Hispanic white adults. d. Mexican-American adults.

b. non-Hispanic black adults.

Hypotension associated with neurogenic and anaphylactic shock is because of a. hypovolemia. b. peripheral pooling of blood. c. poor cardiac contractility. d. high afterload.

b. peripheral pooling of blood.

An erroneously low blood pressure measurement may be caused by a. positioning the arm at heart level. b. positioning the arm above the heart level. c. using a cuff that is too small. d. measuring blood pressure after exercise.

b. positioning the arm above the heart level.

A laboratory test that should be routinely monitored in patients receiving digitalis therapy is a. albumin level. b. serum sodium. c. serum potassium. d. serum calcium.

c. serum potassium.

Tumor necrosis factor α and interleukin-1 contribute to shock states because they induce production of a. clotting factors. b. vasopressin. c. catecholamines. d. nitric oxide.

d. nitric oxide.