Chapter 14 - Cardiovascular Emergencies

Question 1

A 66-year-old woman presents with a stabbing pain in the middle of her chest that radiates to her back. She tells you that the pain suddenly began about 30 minutes ago and has been severe since the onset. She has a history of hypertension, but admits to not being compliant with her regimen of antihypertensive medications. During the primary assessment, you find that her blood pressure is significantly higher in her left arm than it is in her right arm. What do these signs and symptoms MOST likely indicate?
Select one:
A. AMI
B. dissecting aortic aneurysm
C. unstable angina
D. hypertensive emergency

Answer 1

B. dissecting aortic aneurysm

Question 2

A 67-year-old woman presents with difficulty breathing and chest discomfort that awakened her from her sleep. She states that she has congestive heart failure, has had two previous heart attacks, and has prescribed nitroglycerin. She is conscious and alert with adequate breathing. Her blood pressure is 94/64 mm Hg and her heart rate is 120 beats/min. Treatment for this patient includes:
Select one:
A. oxygen at 4 L/min via nasal cannula.
B. ventilations with a bag-mask device.
C. placing her in an upright position.
D. nitroglycerin for her chest pain.

Answer 2

C. placing her in an upright position.

Question 3

A patient with atherosclerotic heart disease experiences chest pain during exertion because the:
Select one:
A. lumen of the coronary artery is narrowed and cannot accommodate increased blood flow.
B. tissues of the myocardium undergo necrosis secondary to a prolonged absence of oxygen.
C. ragged edge of a tear in the coronary artery lumen causes local blood clotting and arterial narrowing.
D. coronary arteries suddenly spasm and cause a marked reduction in myocardial blood flow.

Answer 3

A. lumen of the coronary artery is narrowed and cannot accommodate increased blood flow.

Question 4

A percutaneous transluminal coronary angioplasty (PTCA) restores blood flow to the ischemic myocardium by:
Select one:
A. scraping fatty deposits off of the lumen of the coronary artery.
B. placing a stent inside the coronary artery to keep it from narrowing.
C. bypassing the coronary artery with a vessel from the chest or leg.
D. dilating the affected coronary artery with a small inflatable balloon.

Answer 4

D. dilating the affected coronary artery with a small inflatable balloon.

Question 5

Blood that is ejected from the right ventricle:
Select one:
A. enters the systemic circulation.
B. flows into the pulmonary arteries.
C. has a high concentration of oxygen.
D. was received directly from the aorta.

Answer 5

B. flows into the pulmonary arteries.

Question 6

Common signs and symptoms of AMI include all of the following, EXCEPT:
Select one:
A. pain exacerbated by breathing.
B. shortness of breath or dyspnea.
C. an irregular heartbeat.
D. sudden unexplained sweating.

Answer 6

A. pain exacerbated by breathing.

Question 7

Rapid, labored breathing in a patient with signs and symptoms of AMI should make you suspect:
Select one:
A. congestive heart failure.
B. significant hypotension.
C. a cardiac arrhythmia. 
D. right ventricular failure.

Answer 7

A. congestive heart failure.

Question 8

Signs and symptoms of a hypertensive emergency would MOST likely be delayed in patients who:
Select one:
A. are older than 40 years of age.
B. have had a stroke in the past.
C. have chronic hypertension.
D. regularly take illegal drugs.

Answer 8

C. have chronic hypertension.

Question 9

Sudden death following an AMI is MOST often caused by:
Select one:
A. severe bradycardia.
B. congestive heart failure.
C. cariogenic shock.
D. ventricular fibrillation.

Answer 9

D. ventricular fibrillation.

Question 10

The ability of cardiac muscle cells to contract spontaneously without a stimulus from a nerve source is called:
Select one:
A. automaticity.
B. excitability.
C. impulsivity. 
D. contractility.

Answer 10

A. automaticity.

Question 11

The descending aorta divides into the two iliac arteries at the level of the:
Select one:
A. nipple line.
B. iliac crest. 
C. umbilicus.
D. pubic symphysis.

Answer 11

C. umbilicus.

Question 12

The myocardium receives oxygenated blood from the \_\_\_\_\_\_\_\_\_\_, which originate(s) from the \_\_\_\_\_\_\_\_\_\_.
Select one:
A. aorta, inferior vena cava
B. vena cava, coronary veins
C. coronary sinus, vena cava
D. coronary arteries, aorta

Answer 12

D. coronary arteries, aorta

Question 13

Which of the following is LEAST important when obtaining a medical history from a patient with a chief complaint of chest discomfort?
Select one:
A. history of previous heart attack
B. history of cigarette smoking
C. presence of personal risk factors
D. family history of hypertension

Answer 13

D. family history of hypertension

Question 14

Which of the following statements regarding nitroglycerin is correct?
Select one:
A. Nitroglycerin should be administered between the cheek and gum.
B. A maximum of five nitroglycerin doses should be given to a patient. Incorrect
C. Nitroglycerin usually relieves anginal chest pain within 5 minutes.
D. The potency of nitroglycerin is increased when exposed to light.

Answer 14

C. Nitroglycerin usually relieves anginal chest pain within 5 minutes.