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Advanced Assessment > Chap 10 Cardiovascular > Flashcards

Chap 10 Cardiovascular Flashcards

1
Q

____ 1. Which group would most benefit from statins?
a.
Those with a low density lipoprotein-cholesterol greater than 100 mg/dL
b.
Individuals with clinical arteriosclerotic cardiovascular disease
c.
Individuals with a 10-year risk greater than 10%
d.
Individuals of all ages with diabetes mellitus (DM)

A
  1. B. Individuals with clinical arteriosclerotic cardiovascular disease
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2
Q 
\_\_\_\_	2.	If chest pain can be alleviated with time, analgesics, and heat applications, what might the differential diagnosis be?
a.
Peptic ulcer
b.
Hiatal hernia
c.
Costochondritis
d.
Pericarditis
A
  1. C. costochondritis
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3
Q 
\_\_\_\_	3.	Sandra has palpitations that occur with muscle twitching, paresthesia, and fatigue. What specific diagnostic test might help determine the cause?
a.
Serum calcium
b.
Electrocardiogram (ECG)
c.
Thyroid-stimulating hormone test
d.
Complete blood cell count

____

A
  1. A. Serum Calcium
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4
Q 
\_\_\_\_	4.	A blood pressure (BP) of 150/90 is considered:
a.
Stage 2 hypertension
b.
Hypertensive
c.
Normal in healthy older adults
d.
Acceptable if the patient has DM
A
  1. C. Normal in healthy older adults
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5
Q

____ 5. Lifestyle modifications to manage hypertension (HTN) include:
a.
Maintaining a body mass index of 17
b.
Restricting dietary sodium to 2 grams per day
c.
Engaging in exercise or physical activity for 90 minutes a day
d.
Limiting beer intake to 24 ounces per day

A
  1. D. Limiting beer intake to 24 ounces per day
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6
Q 
‘Mary has hypertension and previously had a stroke. Which hypertensive drug would you order for her?
a.
Angiotensin converting enzyme inhibitor
b.
Calcium channel blocker
c.
Angiotensin II receptor blocker
d.
Beta blocker
A
  1. A. Angiotensin converting enzyme inhibitor
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7
Q 
‘
\_\_\_\_	7.	Which high-density lipoprotein (HDL) level is considered cardioprotective?
a.
Greater than 30
b.
Greater than 40
c.
Greater than 50
d.
Greater than 60
A
  1. D. Greater than 60
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8
Q 
\_\_\_\_	8.	You are assessing Sigred for metabolic syndrome. Which of her parameters is indicative of this syndrome?
a.
Her waist is 36 inches.
b.
Her triglyceride level is 140 mg/dL.
c.
Her BP is 128/84.
d.
Her fasting blood sugar (BS) is 108 mg/dL.
A
  1. A. Her waist is 36 inches
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9
Q 
\_\_\_\_	9.	Which type of angina do you suspect in Harvey, who complains of chest pain that occurs during sleep and most often in the early morning hours?
a.
Stable angina
b.
Unstable angina
c.
Variant (Prinzmetal’s angina)
d.
Probably not angina but hiatal hernia
A
  1. C. Variant (Prinzmetal’s angina)
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10
Q 
\_\_\_\_	10.	Which ECG change is typical of cardiac ischemia?
a.
T-wave inversion
b.
ST-segment elevation
c.
Significant Q wave
d.
U-wave
A
  1. A. T-wave inversion
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11
Q

Which information should be included when you are teaching your patient about the use of nicotine gum?
a.
The gum must be correctly chewed to a softened state and then placed in the buccal mucosa.
b.
Patients should not eat for 30 minutes prior to or during the use of the gum.
c.
Initially, one piece is chewed every 30 minutes while awake.
d.
Acidic foods and beverages should be encouraged during nicotine therapy.

____

A

A. The gum must be correctly chewed to a softened state and then placed in the buccal mucosa.

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12
Q 
Your patient states he has a strep throat infection. Which of the following symptoms makes you consider a viral etiology instead?
a.
Fever
b.
Headache
c.
Exudative pharyngitis
d.
Rhinorrhea
A

D. Rhinorrhea

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13
Q 
What is the first-line recommended treatment against Group A β-hemolytic streptococci (GABHS), the most common cause of bacterial pharyngitis?
a.
Penicillin
b.
Quinolone
c.
Cephalosporin
d.
Macrolide
A

A. Penicillin

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14
Q 
\_\_\_\_	11.	In which type of arterioventricular (AV) block does the pulse rate (PR) interval lengthen until a beat is dropped?
a.
First-degree AV block
b.
Second-degree Mobitz I AV block
c.
Second-degree Mobitz II AV block
d.
Third-degree AV block
A
    1. ANS: B PTS: 1
Second-degree Mobitz I AV block
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14
Q 
12.	A Delta wave on the ECG may be present in which condition?
a.
Prinzmetal’s angina
b.
Bundle branch block
c.
Wolff-Parkinson-White syndrome
d.
Aortic stenosis
A
  1. ANS: C PTS: 1Wolff-Parkinson-White syndrome
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14
Q 
\_\_\_\_	13.	Which heart sound may be heard with poorly controlled hypertension, angina, and ischemic heart disease?
a.
A physiologic split S2
b.
A fixed split S2
c.
S3
d.
S4

____

A
  1. ANS: D PTS: 1S4
15
Q 
\_\_\_\_	14.	Samuel is going to the dentist for some work and must take endocarditis prophylaxis because of his history of:
a.
Severe asthma
b.
A common valvular lesion
c.
Severe hypertension
d.
A prosthetic heart valve
A
  1. ANS: D PTS: 1A prosthetic heart valve
16
Q 
15.	George, age 64, has cardiovascular disease (CVD), a total cholesterol of 280 mg/dL, and a systolic BP of 158. He is being treated for hypertension. You are doing a Framingham Risk Assessment on him. Which assessment factor would give him the highest number of points on the scale?
a.
His age
b.
His cholesterol level
c.
His systolic BP
d.
The fact that he is on antihypertensiv
A
  1. ANS: B

His cholesterol level

17
Q 
16 \_\_\_\_	16.	Which pain characteristic is usually indicative of cardiac pathology?
a.
Fleeting
b.
Moving
c.
Diffuse
d.
Localized
A
  1. ANS: C PTS: 1Diffuse
18
Q 
17	17.	What percentage of patients with angina pectoris will have simultaneous dyspnea, caused by transient increase in pulmonary venous pressures that accompany ventricular stiffening during an episode of myocardial ischemia?
a.
About 20%
b.
About 30%
c.
About 50%
d.
Almost all
A
  1. ANS: B PTS: 1

About 30%

19
Q

18 ____ 18. Nitroglycerine (NTG) is given for a patient having ischemic chest pain. One tablet or one spray should be used under the tongue every 5 minutes for three doses. What should be done if the pain has not been relieved after three doses?
a.
911 should be called, and the patient should be transported immediately to the emergency department.
b.
One more dose of NTG may be tried.
c.
The person should be given two aspirin to chew.
d.
A portable defibrillator should be located to ascertain the cardiac rhythm.

A
  1. ANS: A PTS: 1

911 should be called, and the patient should be transported immediately to the emergency department.

20
Q 
19
\_\_\_\_	19.	For the best therapeutic effect after a myocardial infarction (MI), thrombolytics should be administered within the first 3 hours (ideally 30 minutes) of symptom onset. Studies have shown, however, that thrombolytic therapy can be of benefit up to how many hours after the initial presentation of MI symptoms?
a.
6 hours
b.
8 hours
c.
10 hours
d.
12 hours
A
  1. ANS: D PTS: 112 hours
21
Q 
20
\_\_\_\_	20.	When teaching post MI patients about their NTG tablets, the clinician should stress that the tablets should remain in the light-resistant bottle in which they are packaged and should not be put in another pill box or remain in areas that are or could become warm and humid. Once opened, the bottle must be dated and discarded after how many months?
a.
1 month
b.
3 months
c.
6 months
d.
As long as the tablets are kept in this special bottle, they will last forever.
A
  1. ANS: C PTS: 1

6 months

22
Q 
21.	There are four stages of heart failure, classified as A to D, that describe the evolution and progression of disease. In which stage are patients hospitalized or treated with specialized interventions or hospice care for refractory symptoms of heart failure despite medical therapy?
a.
Stage A
b.
Stage B
c.
Stage C
d.
Stage D
A
  1. ANS: D PTS: 1

Stage D

23
Q 
22
\_\_\_\_	22.	Which of the following is abundant in the heart and rapidly rises in the bloodstream in the presence of heart failure, making it a good diagnostic test?
a.
B-type natriuretic peptide
b.
C-reactive protein
c.
Serum albumin
d.
Erythrocyte sedimentation rate
A
  1. ANS: A PTS: 1B-type natriuretic peptide
24
Q

23

\_\_\_\_	23.	Which test has long been considered the gold standard for a diagnosis of venous thromboembolism?
a.
Ultrasound
b.
Magnetic resonance imaging (MRI)
c.
Ascending venogram
d.
D-dimer
A
  1. ANS: C PTS: 1

Ascending venogram

25
Q 
24
\_\_\_\_	24.	Statins are approved for which age group?
a.
Children over the age of 2
b.
Children over the age of 6
c.
Children over the age of 10
d.
Only adolescents and adults
A
  1. ANS: C PTS: 1Children over the age of 10
26
Q

25
____ 25. The American College of Cardiology/American Heart Association states which of the following regarding the use of non-statin lipid-lowering agents?
a.
Nicotinic acid derivatives are effective for lowering LDL and triglycerides (TGs).
b.
Bile acid sequestrates increase HDL.
c.
Cholesterol absorption inhibitors decrease LDL.
d.
There is no sufficient evidence to use non-statin lipid-drugs.

A
  1. ANS: D PTS: 1There is no sufficient evidence to use non-statin lipid-drugs.
27
Q 
26
\_\_\_\_	26.	Which of the following medications can cause hyperlipidemia?
a.
Diuretics
b.
NSAIDs
c.
Opioids
d.
Insulin
A

Diuretics

26. ANS: A PTS: 1

28
Q 
27
\_\_\_\_	27.	Jamie, age 55, has just started on a statin after having his liver function tests (LFTs) come back normal. He now asks you how often he has to have the LFTs repeated. What do you tell him?
a.
Initially in 6 weeks
b.
Every 3 months
c.
Every 6 months
d.
It’s no longer necessary for his statin regimen.
A
  1. ANS: D PTS: 1It’s no longer necessary for his statin regimen.
29
Q 
28
28.	In the CHADS2 Index for the stroke risk score for AF, the ‘A’ stands for:
a.
Anticoagulation
b.
Autoimmune disease
c.
Age
d.
Antihypertension
A
  1. ANS: C PTS: 1

Age

30
Q

29
____ 29. Which murmurs are usually ‘watch and wait’?
a.
Systolic murmurs
b.
Diastolic murmurs
c.
They both are dangerous and need immediate attention.
d.
You can ‘watch and wait’ for both of them.

A
  1. ANS: A PTS: 1

Systolic murmurs

31
Q
  1. Which of the following statements about dabigatran is true?
    a.
    It is difficult to keep the patient in therapeutic range.
    b.
    Anticoagulation cannot be immediately reversed.
    c.
    It allows for the use of tPA if the patient has a stroke despite anticoagulation.
    d.
    None of the statements are true.
A
  1. ANS: B PTS: 1

Anticoagulation cannot be immediately reversed.

32
Q 
\_\_\_\_	31.	What value on the ankle-brachial index diagnoses peripheral artery disease?
a.
Less than 0.25
b.
Less than 0.50
c.
Less than 0.90
d.
Greater than 1
A
  1. ANS: C PTS: 1

Less than 0.90

33
Q 
32
32.	Your patient with permanent afib asks when he can discontinue his warfarin. You tell him:
a.
When your internalized normalized ratio reaches 3.0, you can stop taking your warfarin permanently.
b.
When you no longer feel ill
c.
One month after your symptoms dissipate
d.
You’ll probably be on it indefinitely.
A
  1. ANS: D PTS: 1You’ll probably be on it indefinitely.
34
Q 
\_\_\_\_	33.	You just started Martha on HTN therapy. The Eighth Joint National Committee recommends that if her goal BP is not reached in what length of time, you should increase the initial drug or add a second drug to it?
a.
1 month
b.
3 months
c.
6 months
d.
1 year
A
  1. ANS: A

1 month

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