quiz 3
Primary treatment for myocardial infarction (MI) is directed at a. decreasing myocardial oxygen demands. b. activating the parasympathetic system. c. protecting the heart from further ischemia. d. reducing heart rate and blood pressure
a
The progressive stage of hypovolemic shock is characterized by a. tachycardia. b. hypertension. c. cardiac failure. d. lactic acidosis.
a
Which blood pressure reading is considered to be indicative of prehypertension according to the JNC-7 criteria? a. 128/82 b. 118/78 c. 140/88 d. 138/94
a
Beta-blockers are advocated in the management of heart failure because they a. reduce blood flow to the kidneys. b. reduce cardiac output. c. increase cardiac output. d. enhance sodium absorption.
b
Hypertrophy of the right ventricle is a compensatory response to a. aortic stenosis. b. pulmonary stenosis. c. aortic regurgitation. d. tricuspid stenosis.
b
Hypotension associated with neurogenic and anaphylactic shock is because of a. high afterload. b. peripheral pooling of blood. c. hypovolemia. d. poor cardiac contractility.
b
In contrast to all other types of shock, the hyperdynamic phase of septic shock is associated with a. reduced contractility. b. high cardiac output. c. high afterload. d. low cardiac output.
b
In which dysrhythmias should treatment be instituted immediately? a. Premature atrial complexes occurring every 20 seconds b. Atrial fibrillation with a ventricular rate of 220 beats/minute c. Asymptomatic sinus bradycardia at a heart rate of 50 beats/minute d. Fever-induced tachycardia at 122 beats/minute
b
In which dysrhythmias should treatment be instituted immediately? a. Premature atrial complexes occurring every 20 seconds b. Atrial fibrillation with a ventricular rate of 220 beats/minute c. Asymptomatic sinus bradycardia at a heart rate of 50 beats/minute d. Fever-induced tachycardia at 122 beats/minute dizz
b
Mitral stenosis is associated with a. a prominent S4 heart sound. b. a pressure gradient across the mitral valve. c. left ventricular hypertrophy. d. a muffled second heart sound (S2).
b
The common denominator in all forms of heart failure is a. tissue ischemia. b. reduced cardiac output. c. pulmonary edema. d. poor diastolic filling.
b
mprovement in a patient with septic shock is indicated by an increase in a. SvO2. b. systemic vascular resistance. c. serum lactate level. d. cardiac output. 0.125 points
b
After sitting in a chair for an hour, an elderly patient develops moderate lower extremity edema. His edema is most likely a consequence of a. peripheral vascular disease. b. isolated left-sided heart failure. c. right-sided heart failure. d. arterial obstruction.
c
Critically ill patients may have parenterally administered vasoactive drugs that are adjusted according to their _____ pressure. a. pulse b. systolic c. mean arterial d. diastolic
c
Hypotension, distended neck veins, and muffled heart sounds are classic manifestations of a. congestive heart failure (CHF). b. cardiomyopathy. c. cardiac tamponade. d. myocardial infarction.
c
Increased preload of the cardiac chambers may lead to which patient symptom? a. Decreased heart rate b. Decreased respiratory rate c. Edema d. Excitability
c
Low cardiac output to the kidneys stimulates the release of _____ from juxtaglomerular cells. a. norepinephrine b. aldosterone c. renin d. angiotensinogen
c
Patent ductus arteriosus is accurately described as a(n) a. stricture of the aorta that impedes blood flow. b. cyanotic heart defect associated with right-to-left shunt. c. communication between the aorta and the pulmonary artery. d. opening between the atria.
c
Pulse pressure is defined as a. two thirds of systolic pressure + diastolic pressure. b. systolic pressure + diastolic pressure. c. systolic pressure - diastolic pressure. d. systolic pressure × systemic resistance.
c
Rheumatic heart disease is most often a consequence of a. cardiomyopathy. b. chronic intravenous drug abuse. c. β-hemolytic streptococcal infection. d. viral infection with herpesvirus.
c
Second-degree heart block type I (Wenckebach) is characterized by a. absent P waves. b. no correlation between P waves and QRS complexes. c. lengthening PR intervals and dropped P wave. d. constant PR interval and dropped QRS complexes.
c
The prevalence of high blood pressure is higher in a. Mexican-American adults. b. Asian children. c. non-Hispanic black adults. d. non-Hispanic white adults.
c
The therapy that most directly improves cardiac contractility in a patient with systolic heart failure is a. preload reduction. b. β-antagonist agents. c. digitalis. d. afterload reduction.
c
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? a. Sitting BP 120/80, HR 100 b. Sitting BP 110/78, HR 98 c. Sitting BP 88/60, HR 118 d. Sitting BP 108/68, HR 102
c
Low cardiac output in association with high preload is characteristic of ________ shock.
cardiogenic
A patient presenting with fever, hypotension, and lactic acidosis is most likely to be experiencing what type of shock? a. Neurogenic b. Anaphylactic c. Cardiogenic d. Septic
d
An abnormally wide (more than 0.10 second) QRS complex is characteristic of a. paroxysmal atrial tachycardia. b. supraventricular tachycardia. c. junctional escape rhythm. d. premature ventricular complexes.
d
An elderly patient's blood pressure is measured at 160/98. How would the patient's left ventricular function be affected by this level of blood pressure? a. High blood pressure enhances left ventricular perfusion during systole. b. High-pressure workload leads to left ventricular atrophy. c. This is an expected blood pressure in the elderly and has little effect on left ventricular function. d. Left ventricular workload is increased with high afterload.
d
Overproduction of nitric oxide is an important aspect of the pathophysiologic process of what type of shock? a. Septic b. Hypovolemic c. Cardiogenic d. Anaphylactic
d
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 IV d. Class I
d
Sepsis has been recently redefined as a. severe hypotension in an infected patient. b. a systemic inflammatory response to ischemia. c. a systemic infection with viable organisms in the bloodstream. d. a systemic inflammatory response to infection.
d
Tachycardia is an early sign of low cardiac output that occurs because of a. anxiety. b. acidosis. c. tissue hypoxia. d. baroreceptor activity.
d
The effect of nitric oxide on systemic arterioles is a. not significant. b. vasoconstriction. c. opposed by nitrate drugs. d. vasodilation.
d
Administration of a vasodilator to a patient in shock would be expected to
decrease left ventricular afterload
Primary treatment for myocardial infarction (MI) is directed at
decreasing myocardial oxygen demands.
Aortic regurgitation is associated with
diastolic murmur.
The most commonly recognized outcome of hypertension is pulmonary disease. a. False b. True
f
Chronic elevation of myocardial wall tension results in atrophy. a. False b. True
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 alk.
New-organ damage is a function of both the stage of hypertension and its duration.
false end damage
A type of shock that includes brain trauma that results in depression of the vasomotor center is cardiogenic.
false neurogenic shock.
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 patient has a history of falls, syncope, dizziness, and blurred vision. The patient's symptomology is most likely related to
hypotension
Constrictive pericarditis is associated with
impaired cardiac filling.
Lusitropic impairment refers to
impaired diastolic relaxation.
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.
Hypertension is closely linked to
obstructive sleep apnea.
An erroneously low blood pressure measurement may be caused by
positioning the arm above the heart level.
First-degree heart block is characterized by
prolonged PR interval.
A patient with pure left-sided heart failure is likely to exhibit
pulmonary congestion with dyspnea.
Left-sided heart failure is characterized by
pulmonary congestion.
Cor pulmonale refers to
right ventricular failure secondary to right ventricular infarction.
Atherosclerotic plaques with large lipid cores are prone to
rupture.
A patient presenting with fever, hypotension, and lactic acidosis is most likely to be experiencing what type of shock?
septic
A patient with significant aortic stenosis is likely to experience
syncope
Improvement in a patient with septic shock is indicated by an increase in
systemic vascular resistance.
Lactated Ringer solution and normal saline are commonly used crystalloid solutions that contain electrolytes. a. True b. False
t
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. a. False b. True
true
An example of an acyanotic heart defect is
ventricular septal defect.
Hypertension with a specific, identifiable cause is known as _____ hypertension.
2ndary
The majority of cases of anaphylactic shock occur when a sensitized individual comes in contact with
antibiotics
A patient is diagnosed with heart failure with normal ejection fraction. This patient is most likely characterized by a(n) a. young female athlete with cardiomegaly. b. elderly woman without a previous history of MI. c. middle-aged man with a previous history of MI. d. young sedentary male with a high-stress job.
b
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. Junctional tachycardia b. Ventricular escape rhythm c. Third-degree heart block d. Sinus bradycardia
b
An example of an acyanotic heart defect is a. transposition of the great arteries. b. ventricular septal defect. c. all right-to-left shunt defects. d. tetralogy of Fallot.
b
Angina caused by coronary artery spasm is called _____ angina. a. unstable b. Prinzmetal variant c. classic d. stable
b
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 infarction (MI) is
. ST-segment elevation.
Angiotensin-converting enzyme (ACE) inhibitors block the
. conversion of angiotensin I to angiotensin II.
What results when systemic blood pressure is increased?
Vasoconstriction
Myocarditis should be suspected in a patient who presents with
acute onset of left ventricular dysfunction.
Massive release of histamine with consequent vasodilation and hypotension occurs with what type of shock?
Anaphylactic
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 modifications only.
Administration of which therapy is most appropriate for hypovolemic shock?
Crystalloids
High blood pressure increases the workload of the left ventricle, because it increases
afterload.
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
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. coronary vasospasm. d. myocardial infarction.
a
Administration of a vasodilator to a patient in shock would be expected to a. decrease left ventricular afterload. b. increase tissue perfusion. c. increase contractility. d. decrease vascular resistance.
a
Cardiogenic shock is characterized by a. reduced cardiac output. b. reduced systemic vascular resistance. c. elevated SvO2. d. hypovolemia.
a
Constrictive pericarditis is associated with a. impaired cardiac filling. b. increased cardiac preload. c. elevated myocardial oxygen consumption. d. cardiac hypertrophy.
a
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
Massive release of histamine with consequent vasodilation and hypotension occurs with what type of shock? a. Anaphylactic b. Cardiogenic c. Hypovolemic d. Neurogenic
a
Myocarditis should be suspected in a patient who presents with a. acute onset of left ventricular dysfunction. b. chest pain and ST elevation. c. family history of cardiomyopathy. d. murmur and abnormal valves on echocardiogram.
a
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? a. Increased LDL levels are associated with increased risk of coronary artery disease. b. Measures to decrease LDL levels in the elderly would be unlikely to affect the progression of his disease. c. Increased LDL levels are indicative of moderate alcohol intake, and patients should be advised to abstain. d. Elevated LDL levels are an expected finding in the elderly and therefore not particularly significant.
a
Mitral stenosis is associated with
a pressure gradient across the mitral valve
Sepsis has been recently redefined as
a systemic inflammatory response to infection.
Tachycardia is an early sign of low cardiac output that occurs because of
baroreceptor activity.
A laboratory test that should be routinely monitored in patients receiving digitalis therapy is a. serum sodium. b. albumin level. c. serum potassium. d. serum calcium.
c
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. a. cardiogenic b. hypovolemic c. obstructive d. distributive
c
A patient with heart failure who reports intermittent shortness of breath during the night is experiencing a. paroxysmal atrial tachycardia. b. orthopnea. c. paroxysmal nocturnal dyspnea. d. sleep apnea.
c