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Cardiology II EMT > exam 1 > Flashcards

exam 1 Flashcards

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1
Q

What layer of the heart is responsible for cardiac contraction and efficient ejection of blood?

Select one:

a. Myocardium
b. Pericardium
c. Epicardium
d. Endocardium

A

a. Myocardium

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2
Q

The left main coronary artery subdivides into the:

Select one:

a. right coronary and left posterior descending arteries.
b. left anterior ascending and descending arteries.
c. left posterior ascending and circumflex arteries.
d. left anterior descending and circumflex arteries.

A

d. left anterior descending and circumflex arteries.

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3
Q

The right atrium, right ventricle, and part of the left ventricle are supplied by the:

Select one:

a. circumflex artery.
b. left main coronary artery.
c. left anterior descending artery.
d. right coronary artery.

A

d. right coronary artery.

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4
Q

The S1 heart sound represents:

Select one:

a. closure of the aortic and pulmonic valves.
b. the beginning of atrial contraction.
c. the end of ventricular contraction.
d. closure of the mitral and tricuspid valves.

A

d. closure of the mitral and triscupid valves.

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5
Q

A loud S3 heart sound, when heard in older adults, often signifies:

Select one:

a. valve rupture.
b. pulmonary hypertension.
c. emphysema.
d. heart failure.

A

d. heart failure.

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6
Q

Approximately 70% to 80% of ventricular filling occurs:

Select one:

a. when the AV valves close.
b. when the semilunar valves are open.
c. by gravity.
d. during systole.

A

c. by gravity.

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7
Q

Atrial kick is defined as:

Select one:

a. an attempt of the atria to contract against closed valves.
b. pressure on the AV valves during ventricular contraction.
c. the volume of blood that the atria contract to the ventricles.
d. the blood that flows passively into the ventricles.

A

c. the volume of blood that the atria contract to the ventricles.

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8
Q

Which of the following statements regarding the right side of the heart is correct?

Select one:

a. It pumps against the high resistance of the pulmonary circulation.
b. It receives blood exclusively from the venae cavae.
c. The right side of the heart pumps blood through the pulmonary veins.
d. The right side of the heart is a low-pressure system.

A

d. The right side of the heart is a low-pressure system.

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9
Q

In contrast to the right side of the heart, the left side of the heart:

Select one:

a. is a high-pressure pump that sends blood through the pulmonary circulation and to the lungs.
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 high resistance of the systemic circulation.
d. drives blood out of the heart against the relatively low resistance of the pulmonary circulation.

A

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

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10
Q

Under normal conditions, the strength of cardiac contraction is regulated by:

Select one:

a. the nervous system.
b. physical exertion.
c. the Frank-Starling mechanism.
d. the heart rate.

A

a. the nervous system.

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11
Q

The area of conduction tissue in which electrical activity arises at any given time is called the:

Select one:

a. sinus node.
b. myocyte.
c. bundle of His.
d. pacemaker.

A

d. pacemaker.

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12
Q

Which of the following statements regarding the SA node is correct?

Select one:

a. SA nodal ischemia occurs when the left coronary artery is occluded.
b. Impulses generated by the SA node travel through the right atrium only.
c. The SA node is located in the superior aspect of the right ventricle.
d. The SA node is the dominant cardiac pacemaker in healthy patients.

A

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

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13
Q

The AV junction:

Select one:

a. is composed of the AV node and surrounding tissue.
b. includes the AV node but not the bundle of His.
c. receives its blood supply from the circumflex artery.
d. is the dominant and fastest pacemaker in the heart.

A

a. is composed of the AV node and surrounding tissue.

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14
Q

An electrical impulse is slightly delayed at the AV node so that the:

Select one:

a. bundle of His can depolarize fully.
b. ventricles can contract completely.
c. primary cardiac pacemaker can reset.
d. atria can empty into the ventricles.

A

d. atria can empty into the ventricles.

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15
Q

Thousands of fibrils that are distributed throughout the inner surfaces of the ventricles, which represent the end of the cardiac conduction system, are called the:

Select one:

a. cardiac myocytes.
b. Purkinje fibers.
c. internodal pathways.
d. bundle branches.

A

b. Purkinje fibers.

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16
Q

Depolarization, the process by which muscle fibers are stimulated to contract, occurs when:

Select one:

a. cardiac muscle relaxes in response to a cellular influx of calcium.
b. cell wall permeability changes and sodium rushes into the cell.
c. potassium ions escape from the cell through specialized channels.
d. calcium ions rapidly enter the cell, facilitating contraction.

A

b. cell wall permeability changes and sodium rushes into the cell.

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17
Q

Repolarization begins when:

Select one:

a. calcium ions slowly enter the cardiac cell.
b. the sodium and calcium channels close.
c. the inside of the cell returns to a positive charge.
d. potassium ions rapidly escape fro

A

b. the sodium and calcium channels close.

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18
Q

In order to ensure proper electrolyte distribution and maintain the polarity of the cell membrane, the sodium-potassium pump:

Select one:

a. moves three sodium ions and three potassium ions back into the cell.
b. moves calcium and potassium ions back into the cell by a process called passive transport.
c. moves two potassium ions into the cell for every three sodium ions it moves out of the cell.
d. moves two sodium ions into the cell for every three potassium ions it moves out of the cell.

A

c. moves two potassium ions into the cell for every three sodium ions it moves out of the cell.

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19
Q

During the refractory period:

Select one:

a. the heart is in a state of partial repolarization.
b. the cell is depolarized or in the process of repolarizing.
c. the heart is partially charged, but cannot contract.
d. the heart muscle is depleted of energy and needs to recharge.

A

b. the cell is depolarized or in the process of repolarizing.

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20
Q

In most patients, the SA node is supplied with blood from the:

Select one:

a. left circumflex coronary artery.
b. right coronary artery.
c. left anterior descending coronary artery.
d. left main coronary artery.

A

b. right coronary artery.

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21
Q

The farther removed the conduction tissue is from the SA node:

Select one:

a. the slower its intrinsic rate of firing.
b. the longer the PR interval will be.
c. the narrower the QRS complex will be.
d. the faster its intrinsic rate of firing.

A

a. the slower its intrinsic rate of firing.

22
Q

If the heart’s secondary pacemaker becomes ischemic and fails to initiate an electrical impulse:

Select one:

a. you will see a brief period of bradycardia followed by asystole.
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 should expect to see a heart rate slower than 40 beats/min.

A

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

23
Q

The P wave represents:

Select one:

a. a delay at the AV node.
b. SA nodal discharge.
c. atrial depolarization.
d. contraction of the atria.

A

c. atrial depolarization.

24
Q

The brief pause between the P wave and QRS complex represents:

Select one:

a. full dispersal of electricity throughout both atria.
b. depolarization of the inferior part of the atria.
c. a momentary conduction delay at the AV node.
d. the period of time when the atria are repolarizing.

A

c. a momentary conduction delay at the AV node.

25
Q

Which of the following ECG waveforms represents ventricular depolarization?

Select one:

a. U wave
b. QRS complex
c. ST segment
d. T wave

A

b. QRS complex

26
Q

The PR interval should be no shorter than ____ seconds and no longer than ____ seconds in duration.

Select one:

a. 0.18, 2.0
b. 0.14, 0.30
c. 0.16, 0.40
d. 0.12, 0.20

A

d. 0.12, 0.20

27
Q

Stimulation of the parasympathetic nervous system:

Select one:

a. is characterized by a large P wave and a PR interval that is shorter than normal.
b. slows SA nodal discharge and decreases conduction through the AV node.
c. causes a decrease in the production of epinephrine and norepinephrine.
d. completely blocks the AV node, preventing ventricular depolarization.

A

b. slows SA nodal discharge and decreases conduction through the AV node.

28
Q

Sympathetic nerves are regulated primarily by:

Select one:

a. cholinesterase.
b. norepinephrine.
c. adrenaline.
d. epinephrine.

A

b. norepinephrine.

29
Q

Myocardial ischemia occurs when the heart muscle:

Select one:

a. undergoes necrosis because of prolonged oxygen deprivation.
b. is deprived of oxygen because of a blocked coronary artery.
c. suffers oxygen deprivation secondary to coronary vasodilation.
d. experiences a decreased oxygen demand and an increased supply.

A

b. is deprived of oxygen because of a blocked coronary artery.

30
Q
  1. An electrical wave moving in the direction of a positive electrode will:
    Select one:
    a. cause a positive deflection on the ECG.
    b. produce a significant amount of artifact.
    c. cause a negative deflection on the ECG.
    d. manifest with narrow QRS complexes.
A

a. cause a positive deflection on the ECG.

31
Q 
103. When applying the limb leads, the negative lead should be placed on the:
Select one:
a. left arm.
b. left leg.
c. right arm. 
d. right leg.
A

c. right arm.

32
Q
  1. According to the Einthoven triangle, lead II is assessed by placing the:
    Select one:
    a. negative lead on the left arm and the positive lead on the left leg.
    b. positive lead on the left leg and the negative lead on the right arm.
    c. positive lead on the left arm and the negative lead on the right arm.
    d. negative lead on the right arm and the positive lead on the left leg.
A

d. negative lead on the right arm and the positive lead on the left leg.

33
Q 
105. On the ECG graph paper, amplitude is measured in \_\_\_\_\_\_\_\_\_\_\_\_\_ and width is measure in \_\_\_\_\_\_\_\_\_\_\_\_.
Select one:
a. centimeters, seconds
b. milliseconds, millimeters
c. seconds, centimeters
d. millimeters, milliseconds
A

d. millimeters, milliseconds

34
Q 
107. If a particular interval on the ECG graph paper is 1.5 small boxes in width, the interval would be measured as:
Select one:
a. 0.06 seconds. 
b. 2 millimeters.
c. 45 milliseconds.
d. 600 milliseconds.
A

a. 0.06 seconds.

35
Q 
11. Under normal conditions, the strength of cardiac contraction is regulated by:
Select one:
a. the heart rate.
b. the nervous system. 
c. physical exertion.
d. the Frank-Starling mechanism.
A

b. the nervous system.

36
Q 
110. The duration of the QRS complex should be \_\_\_\_ milliseconds or less in a healthy adult.
Select one:
a. 100
b. 110
c. 120
d. 130
A

b. 110

37
Q
  1. A wide QRS complex that is preceded by a normal P wave indicates:
    Select one:
    a. that the rhythm is ventricular in origin.
    b. rapid conduction through the ventricles.
    c. a delay in conduction at the AV junction.
    d. an abnormality in ventricular conduction.
A

d. an abnormality in ventricular conduction.

38
Q 
120. If the R-R interval spans more than \_\_\_\_ large boxes on the ECG graph paper, the heart rate is less than 60/min.
Select one:
a. 1.5
b. 2
c. 3.5
d. 5
A

d. 5

39
Q
  1. Normal sinus rhythm is characterized by all of the following, EXCEPT:
    Select one:
    a. minimal variation between the R-R intervals.
    b. QRS complexes that are up to 140 milliseconds.
    c. consistent PR intervals and upright P waves.
    d. a consistent heart rate between 60 and 100 beats/min.
A

b. QRS complexes that are up to 140 milliseconds.

40
Q 
123. In sinus bradycardia, the:
Select one:
a. heart rate is less than 70 beats/min.
b. pacemaker site is the SA node. 
c. QRS complexes are often wide.
d. P waves are consistently upright.
A

b. pacemaker site is the SA node.

41
Q
  1. Which of the following statements regarding the SA node is correct?
    Select one:
    a. The SA node is the dominant cardiac pacemaker in healthy patients.
    b. SA nodal ischemia occurs when the left coronary artery is occluded.
    c. The SA node is located in the superior aspect of the right ventricle.
    d. Impulses generated by the SA node travel through the right atrium only.
A

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

42
Q
  1. The AV junction:
    Select one:
    a. includes the AV node but not the bundle of His.
    b. is the dominant and fastest pacemaker in the heart.
    c. receives its blood supply from the circumflex artery.
    d. is composed of the AV node and surrounding tissue.
A

d. is composed of the AV node and surrounding tissue.

43
Q
  1. Why do patients with cardiac compromise have chest pain?
    Select one:
    a. The patient is working too hard to breathe.
    b. The heart rate increases too rapidly.
    c. There is not enough oxygen to the heart.
    d. Blood supply is diminished to the lung tissue.
A

c. There is not enough oxygen to the heart.

44
Q
  1. A major complication associated with atrial fibrillation is:
    Select one:
    a. clot formation in the fibrillating atria.
    b. a significant reduction in atrial filling.
    c. pulmonary congestion and hypoxemia.
    d. a profound increase in the atrial kick.
A

a. clot formation in the fibrillating atria.

45
Q
  1. If an impulse generated by the AV node begins moving upward through the atria before the other part of it enters the ventricles:
    Select one:
    a. the PR intervals will be greater than 0.20 seconds.
    b. an upright P wave will appear after the QRS complex.
    c. an inverted P wave will appear before the QRS complex.
    d. a small inverted P wave will be buried in the QRS complex.
A

c. an inverted P wave will appear before the QRS complex.

46
Q 
144. A regular rhythm with inverted P waves before each QRS complex, a ventricular rate of 70 beats/min, narrow QRS complexes, and a PR interval of 0.16 seconds should be interpreted as aNo:
Select one:
a. ectopic atrial rhythm.
b. junctional escape rhythm.
c. supraventricular tachycardia.
d. accelerated junctional rhythm.
A

d. accelerated junctional rhythm.

47
Q 
176. The precordial leads do NOT view the \_\_\_\_\_\_\_\_\_\_ wall of the heart.
Select one:
a. septal
b. inferior 
c. anterior
d. lateral
A

b. inferior

48
Q 
177. When viewing leads V3 and V4, you are looking at the \_\_\_\_\_\_\_\_\_ wall of the \_\_\_\_\_\_\_\_\_.
Select one:
a. septal, heart.
b. lateral, left ventricle.
c. anterior, left ventricle. 
d. inferior, right ventricle.
A

c. anterior, left ventricle.

49
Q 
179. Leads V1 to V3 allow you to view the \_\_\_\_\_\_\_\_ wall of the left ventricle.
Select one:
a. septal
b. lateral
c. anterior 
d. anteroseptal
A

d. anteroseptal

50
Q
  1. Repolarization begins when:
    Select one:
    a. the sodium and calcium channels close.
    b. calcium ions slowly enter the cardiac cell.
    c. potassium ions rapidly escape from the cell.
    d. the inside of the cell returns to a positive charge.
A

a. the sodium and calcium channels close.

Cardiology II EMT (6 decks)

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