Cardiology Quiz 1

Question 1

During the refractory period:
A) the cell is depolarized or in the process of repolarizing.
B) the heart is in a state of partial repolarization.
C) the heart muscle is depleted of energy and needs to recharge.
D) the heart is partially charged, but cannot contract.

Answer 1

A) the cell is depolarized or in the process of repolarizing.

Question 2

If the heart’s secondary pacemaker becomes ischemic and fails to initiate an electrical impulse:
A) you should expect to see a heart rate slower than 40 beats/min.
B) the P wave and PR interval will have an abnormal appearance.
C) the AV junction will begin pacing at 40 to 60 times/min.
D) you will see a brief period of bradycardia followed by asystole.

Answer 2

A) you should expect to see a heart rate slower than 40 beats/min.

Question 3

In most patients, the SA node is supplied with blood from the:
A) left circumflex coronary artery.
B) left anterior descending coronary artery.
C) right coronary artery.
D) left main coronary artery.

Answer 3

C) right coronary artery.

Question 4

The circumflex branch of the left coronary artery supplies the _________ wall of the left ventricle.
A) septal
B) inferior
C) anterior
D) lateral

Answer 4

D) lateral

Question 5

Under normal conditions, the strength of cardiac contraction is regulated by:
A) the nervous system.
B) physical exertion.
C) the Frank-Starling mechanism.
D) the heart rate.

Answer 5

A) the nervous system.

Question 6

An electrical impulse is slightly delayed at the AV node so that the:
A) ventricles can contract completely.
B) primary cardiac pacemaker can reset.
C) atria can empty into the ventricles.
D) bundle of His can depolarize fully.

Answer 6

C) atria can empty into the ventricles.

Question 7

In contrast to the right side of the heart, the left side of the heart:
A) drives blood out of the heart against the relatively high resistance of the systemic circulation.
B) is a relatively low-pressure pump that must stretch its walls in order to force blood through
the aorta.
C) drives blood out of the heart against the relatively low resistance of the pulmonary
circulation.
D) is a high-pressure pump that sends blood through the pulmonary circulation and to the
lungs.

Answer 7

A) drives blood out of the heart against the relatively high resistance of the systemic circulation.

Question 8

The area of conduction tissue in which electrical activity arises at any given time is called the:
A) bundle of His.
B) pacemaker.
C) sinus node.
D) myocyte.

Answer 8

B) pacemaker.

Question 9

The farther removed the conduction tissue is from the SA node:
A) the longer the PR interval will be.
B) the faster its intrinsic rate of firing.
C) the narrower the QRS complex will be.
D) the slower its intrinsic rate of firing.

Answer 9

D) the slower its intrinsic rate of firing.

Question 10

The left main coronary artery subdivides into the:
A) left posterior ascending and circumflex arteries.
B) left anterior ascending and descending arteries.
C) right coronary and left posterior descending arteries.
D) left anterior descending and circumflex arteries.

Answer 10

D) left anterior descending and circumflex arteries.

Question 11

Which of the following electrolytes maintains the depolarization phase?
A) Sodium
B) Potassium
C) Calcium
D) Magnesium

Answer 11

C) Calcium

Question 12

A loud S 3 heart sound, when heard in older adults, often signifies:
A) valve rupture.
B) heart failure.
C) emphysema.
D) pulmonary hypertension.

Answer 12

B) heart failure.

Question 13

Depolarization, the process by which muscle fibers are stimulated to contract, occurs when:
A) calcium ions rapidly enter the cell, facilitating contraction.
B) cell wall permeability changes and sodium rushes into the cell.
C) cardiac muscle relaxes in response to a cellular influx of calcium.
D) potassium ions escape from the cell through specialized channels.

Answer 13

B) cell wall permeability changes and sodium rushes into the cell.

Question 14

The right atrium, right ventricle, and part of the left ventricle are supplied by the:
A) left main coronary artery.
B) right coronary artery.
C) left anterior descending artery.
D) circumflex artery.

Answer 14

C) left anterior descending artery.

Question 15

Which of the following statements regarding the SA node is correct?
A) The SA node is the dominant cardiac pacemaker in healthy patients.
B) The SA node is located in the superior aspect of the right ventricle.
C) Impulses generated by the SA node travel through the right atrium only.
D) SA nodal ischemia occurs when the left coronary artery is occluded.

Answer 15

A) The SA node is the dominant cardiac pacemaker in healthy patients.

Question 16

Name the different parts of the heart in order:

Answer 16

1. Right Atrium
2. Tricuspid Valve
3. Right Ventricle
4. Pulmonic Valve
5. Left Atrium
6. Mitral Valve
7. Left Ventricle
8. Aortic Valve

Question 17

What is the longest phase, known as the plateau phase during the cardiac action potential?
A) 3
B) 0
C) 2
D) 1

Answer 17

C) 2

Question 18

What electrolyte does not play a direct part in the cardiac action potential?
A) Calcium
B) Sodium
C) Potassium
D) Magnesium

Answer 18

D) Magnesium

Question 19

S1 sounds represent what?
A) ventricles relaxing
B) pulmonic and aortic valves closing
C) ventricles contracting
D) tricuspid and mitral valves closing

Answer 19

D) tricuspid and mitral valves closing

Question 20

List out the three main coronary arteries

Answer 20

Left main, right main, circumflex coronary

Question 21

Describe five different complaints that need a cardiac assessment completed.

Answer 21

Jaw pain
Left arm pain
SOB
Pressure in the chest
diaphoretic

Question 22

A 48-year-old man with a history of hypertension presents with a severe headache, tinnitus, and blurred vision. He is conscious and alert and denies any other symptoms. His BP is 204/120mm Hg, his pulse rate is 100 beats/min, and his oxygen saturation is 96%. The closest appropriate facility is 20 minutes away. You should:
A) keep him in a supine position and transport.
B) start an IV line and administer labetalol.
C) monitor his cardiac rhythm and transport.
D) administer high-flow oxygen and transport.

Answer 22

C) monitor his cardiac rhythm and transport.

Question 23

A 67-year-old woman presents with severe dyspnea, coarse crackles to all lung fields, and anxiety. She has a history of several myocardial infarctions and hypertension. Which of the following interventions will have the MOST immediate and positive effect?
A) IV or IO access and 20 to 40 mg of furosemide
B) 0.4 mg sublingual nitroglycerin, up to three doses
C) Positive end-expiratory pressure ventilation
D) Supplemental oxygen via nonrebreathing mask

Answer 23

C) Positive end-expiratory pressure ventilation

Question 24

Acute coronary syndrome is a term used to describe:
A) a clinical condition in which patients experience chest pain during exertion.
B) acute chest pressure or discomfort that subsides with rest or nitroglycerin.
C) a sudden cardiac rhythm disturbance that causes a decrease in cardiac output.
D) any group of clinical symptoms consistent with acute myocardial ischemia.

Answer 24

D) any group of clinical symptoms consistent with acute myocardial ischemia.

Question 25

Common complaints in patients experiencing an acute coronary syndrome include all of the
following, EXCEPT:
A) palpitations.
B) fatigue.
C) headache.
D) chest pain.

Answer 25

C) headache.

Question 26

The MOST important initial pieces of equipment to bring to the side of an unresponsive
patient are the:
A) drug kit and stretcher with a long backboard.
B) defibrillator and airway management equipment.
C) intubation kit and equipment for vascular access.
D) pocket face mask and equipment for intubation.

Answer 26

B) defibrillator and airway management equipment.

Question 27

Which of the following underlying medical conditions would be of LEAST pertinence when obtaining the past medical history from a patient who complains of acute chest pain or pressure?
A) Renal disease
B) Cancer
C) Diabetes
D) Hypertension

Answer 27

B) Cancer

Question 28

List the physical exam you want to perform on the chest for a cardiac assessment.

Answer 28

I would exam the chest for any signs of a pacemaker, surgical scars indicating open heart surgery, any signs of trauma, any medication patches that would help identify any other medical conditions. I would be looking for any signs of edema or pulsating masses. I would also listen to heart tones and lung sounds

Question 29

What is the difference between a pacemaker and defibrillator?

Answer 29

A pacemaker takes over the part of the SA node and keeps the rhythm and pace of the heart. A defibrillator initiates a shock to correct a rhythm that is not correct.

Question 30

Where should we be assessing heart tones at?

Answer 30

At the 2nd, 3rd, 4th, 5th intercostal spaces

Question 31

Describe phase 0:

Answer 31

Sodium goes in

Question 31

Describe phase 1:

Answer 31

Potassium goes out

Question 32

Describe phase 2:

Answer 32

Calcium comes in through calcium channel

Question 33

Describe phase 3:

Answer 33

Potassium leaves through the potassium channel

Question 34

Describe phase 4:

Answer 34

Leaky potassium channels

Question 35

What drug class affects Phase 0?

Answer 35

Class 1, Na+ channel blockers (e.g. Lidocaine 1-1.5mg/kg IV)

Question 36

What drug class affects Phase 2?

Answer 36

Class 4, Ca2+ channel blockers (e.g. Diltiazem 0.25mg/kg IV)

Question 37

What drug class affects Phase 3?

Answer 37

Class 3, K+ channel blockers (e.g. Amiodarone 300mg IV/IO, 150mg IV over 10 mins)

Question 38

What drug class affects phase 4?

Answer 38

Class 2, beta blockers (e.g. Metoprolol 5mg IV max 15mg)

Question 39

Describe how Thiazide diuretics work:

Answer 39

Inhibit sodium and chloride channels in the kidneys

Question 40

Describe how Calcium channels blockers work:

Answer 40

prevent calcium from entering the cells of the heart

Question 41

Describe how Beta blockers work

Answer 41

Block the effects of the hormone epinephrine to reduce heart rate

Question 42

Describe how ACE inhibitors work

Answer 42

Prevents angiotensin-converting enzyme in the lungs from combining with angiotensin I to produce angiotensin II to raise blood pressure

Question 43

Describe how Angiotensin II receptor antagonists (ARBs)

Answer 43

by blocking angiotensin II receptors that the hormone acts on to raise blood pressure