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chapter 12 > heart > Flashcards

heart Flashcards

1
Q
  1. Which of the following actions causes the atrioventricular (AV) valves to close?
    a. Increased intraventricular pressure
    b. Depolarization at the AV node
    c. Ventricular relaxation and backflow of
    blood
    d. Contraction of the atria
A

a. Increased intraventricular pressure

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2
Q
  1. When stroke volume decreases, which of the following could maintain cardiac output?
    a. Decreased peripheral
    resistance
    b. Increased heart rate
    c. Decreased venous return
    d. General vasodilation
A

b. Increased heart rate

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3
Q
  1. Which of the following describes the pericardial cavity?
    a. It contains sufficient fluid to provide a protective cushion for the heart.
    b. It is a potential space containing a very small amount of serous fluid.
    c. It is lined by the endocardium.
    d. It is located between the double-walled pericardium and the
    epicardium.
A

b. It is a potential space containing a very small amount of serous fluid.

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4
Q
  1. Which of the following factors greatly improves venous return to the heart during strenuous exercise?
    a. Rapid emptying of the right side of the heart
    b. Forceful action of the valves in the veins
    c. Contraction and relaxation of skeletal muscles
    d. Peristalsis in the large veins
A

c. Contraction and relaxation of skeletal muscles

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5
Q
  1. The function of the baroreceptors is to:
    a. stimulate the parasympathetic or sympathetic nervous system at the sinoatrial (SA) node as
    needed.
    b. adjust blood pressure by changing peripheral resistance.
    c. sense a change in blood oxygen and carbon dioxide levels.
    d. signal the cardiovascular control center of changes in systemic blood pressure.
A

d. signal the cardiovascular control center of changes in systemic blood pressure.

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6
Q
  1. The normal delay in conduction through the AV node is essential for:
    a. preventing an excessively rapid heart rate.
    b. limiting the time for a myocardial contraction.
    c. allowing the ventricles to contract before the atria.
    d. completing ventricular filling.
A

d. completing ventricular filling.

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7
Q
  1. Which of the following is a result of increased secretion of epinephrine?
    a. Increased heart rate and force of contraction
    b. Decreased stimulation of the SA node and
    ventricles
    c. Vasoconstriction in skeletal muscles and kidneys
    d. Vasodilation of cutaneous blood vessels
A

a. Increased heart rate and force of contraction

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8
Q
  1. Which of the following causes increased heart rate?
    a. Stimulation of the vagus nerve
    b. Increased renin secretion
    c. Administration of beta-blocking drugs
    d. Stimulation of the sympathetic nervous
    system
A

d. Stimulation of the sympathetic nervous

system

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9
Q
  1. The event that causes the QRS wave on an electrocardiogram (ECG) tracing is:
    a. atrial depolarization.
    b. atrial repolarization.
    c. ventricular depolarization.
    d. ventricular repolarization.
A

c. ventricular depolarization.

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10
Q
  1. The cardiac reserve is:
    a. afterload.
    b. the difference between the apical and radial pulses.
    c. the ability of the heart to increase cardiac output when
    needed.
    d. the extra blood remaining in the heart after it contracts.
A

c. the ability of the heart to increase cardiac output when

needed.

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11
Q
  1. The term preload refers to:
    a. volume of venous
    return.
    b. peripheral resistance.
    c. stroke volume.
    d. cardiac output.
A

a. volume of venous

return.

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12
Q
  1. The first arteries to branch off the aorta are the:
    a. common carotid arteries.
    b. pulmonary arteries.
    c. coronary arteries.
    d. subclavian arteries
A

c. coronary arteries.

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13
Q
  1. Cardiac output refers to:
    a. the amount of blood passing through either of the atria.
    b. the volume of blood ejected by a ventricle in one minute.
    c. the volume of blood ejected by each ventricle in a single
    contraction.
    d. the total number of heartbeats in one minute.
A

b. the volume of blood ejected by a ventricle in one minute.

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14
Q
  1. Vasodilation in the skin and viscera results directly from:
    a. decreased blood pressure.
    b. increased parasympathetic stimulation.
    c. relaxation of smooth muscle in the arterioles.
    d. increased stimulation of alpha-adrenergic
    receptors.
A

c. relaxation of smooth muscle in the arterioles

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15
Q
  1. Which of the following drugs decrease sodium and fluid retention in the body?
    a. warfarin (Coumadin)
    b. digoxin (Lanoxin)
    c. nitroglycerin (Isordil)
    d. hydrochlorothiazide
    (HydroDIURIL)
A

d. hydrochlorothiazide

HydroDIURIL

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16
Q
  1. Which of the following are predisposing factors to thrombus formation in the circulation?
  2. Decreased viscosity of the blood
  3. Damaged blood vessel walls
  4. Immobility
  5. Prosthetic valves
    a. 1, 3
    b. 2, 4
    c. 1, 3, 4
    d. 2, 3, 4
A

d. 2, 3, 4

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17
Q
  1. A drug taken in small doses on a continuing basis to reduce platelet adhesion is:
    a. acetylsalicylic acid (ASA).
    b. streptokinase.
    c. acetaminophen.
    d. heparin.
A

a. acetylsalicylic acid (ASA).

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18
Q
  1. A partial obstruction in a coronary artery will likely cause:
    a. pulmonary embolus.
    b. hypertension.
    c. angina attacks.
    d. myocardial infarction.
A

c. angina attacks.

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19
Q
  1. Cigarette smoking is a risk factor in coronary artery disease because smoking:
    a. reduces vasoconstriction and peripheral
    resistance.
    b. decreases serum lipid levels.
    c. promotes platelet adhesion.
    d. increases serum HDL levels.
A

c. promotes platelet adhesion.

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20
Q
  1. The term arteriosclerosis specifically refers to:
    a. development of atheromas in large arteries.
    b. intermittent vasospasm in coronary arteries.
    c. degeneration with loss of elasticity and obstruction in small
    arteries.
    d. ischemia and necrosis in the brain, kidneys, and heart.
A

c. degeneration with loss of elasticity and obstruction in small
arteries

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21
Q
  1. A modifiable factor that increases the risk for atherosclerosis is:
    a. leading a sedentary lifestyle.
    b. being female and older than 40 years of
    age.
    c. excluding saturated fats from the diet.
    d. familial hypercholesterolemia.
A

a. leading a sedentary lifestyle.

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22
Q
  1. An atheroma develops from:
    a. a torn arterial wall and blood clots.
    b. accumulated lipids, cells, and fibrin where endothelial injury has
    occurred.
    c. thrombus forming on damaged walls of veins.
    d. repeated vasospasms.
A

b. accumulated lipids, cells, and fibrin where endothelial injury has
occurred.

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23
Q
  1. Low-density lipoproteins (LDL):
    a. promote atheroma development.
    b. contain only small amounts of cholesterol.
    c. transport cholesterol from cells to the liver for
    excretion.
    d. are associated with low intake of saturated fats.
A

a. promote atheroma development.

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24
Q
  1. Factors that may precipitate an angina attack include all of the following EXCEPT:
    a. eating a large meal.
    b. engaging in an angry argument.
    c. taking a nap.
    d. shoveling snow on a cold, windy
    day.
A

c. taking a nap.

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25
Q
  1. When comparing angina with myocardial infarction (MI), which statement is true?
    a. Both angina and MI cause tissue necrosis.
    b. Angina often occurs at rest; MI occurs during a stressful time.
    c. Pain is more severe and lasts longer with angina than with MI.
    d. Angina pain is relieved by rest and intake of nitroglycerin; the pain of MI is
    not.
A

d. Angina pain is relieved by rest and intake of nitroglycerin; the pain of MI is
not.

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26
Q
  1. The basic pathophysiology of myocardial infarction is best described as:
    a. cardiac output that is insufficient to meet the needs of the heart and
    body.
    b. temporary vasospasm that occurs in a coronary artery.
    c. total obstruction of a coronary artery, which causes myocardial necrosis.
    d. irregular heart rate and force, reducing blood supply to coronary arteries.
A

c. total obstruction of a coronary artery, which causes myocardial necrosis

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27
Q
  1. Typical early signs or symptoms of myocardial infarction include:
    a. brief, substernal pain radiating to the right arm, with labored breathing.
    b. persistent chest pain radiating to the left arm, pallor, and rapid, weak
    pulse.
    c. bradycardia, increased blood pressure, and severe dyspnea.
    d. flushed face, rapid respirations, left-side weakness, and numbness.
A

b. persistent chest pain radiating to the left arm, pallor, and rapid, weak
pulse.

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28
Q
  1. The most common cause of a myocardial infarction is:
    a. an imbalance in calcium ions.
    b. an infection of the heart muscle.
    c. atherosclerosis involving an attached
    thrombus.
    d. a disruption of the heart conduction system.
A

c. atherosclerosis involving an attached

thrombus.

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29
Q
  1. Calcium-channel blocking drugs are effective in:
    a. reducing the risk of blood clotting.
    b. decreasing the attraction of cholesterol into lipid
    plaques.
    c. reducing cardiac and smooth muscle contractions.
    d. decreasing all types of cardiac arrhythmias.
A

c. reducing cardiac and smooth muscle contractions.

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30
Q
  1. Which of the following confirms the presence of a myocardial infarction?
    a. A full description of the pain, including the sequence of
    development
    b. The presence of elevated serum cholesterol and triglycerides
    c. Serum isoenzymes released from necrotic cells and an ECG
    d. Leukocytosis and elevated C-reactive protein
A

c. Serum isoenzymes released from necrotic cells and an ECG

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31
Q
  1. The size of the necrotic area resulting from myocardial infarction may be minimized by all of the following
    EXCEPT:
    a. previously established collateral circulation.
    b. immediate administration of thrombolytic drugs.
    c. maintaining maximum oxygen supply to the myocardium.
    d. removing the predisposing factors to atheroma
    development.
A

d. removing the predisposing factors to atheroma

development.

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32
Q
  1. The most common cause of death immediately following a myocardial infarction is:
    a. cardiac arrhythmias and fibrillation.
    b. ruptured ventricle or aorta.
    c. congestive heart failure.
    d. cerebrovascular accident.
A

a. cardiac arrhythmias and fibrillation.

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33
Q

Why does ventricular fibrillation result in cardiac arrest?
a. Delayed conduction through the AV node blocks ventricular
stimulation.
b. Insufficient blood is supplied to the myocardium.
c. The ventricles contract before the atria.
d. Parasympathetic stimulation depresses the SA node.

A

b. Insufficient blood is supplied to the myocardium.

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34
Q
  1. The term cardiac arrest refers to which of the following?
    a. Condition where cardiac output is less than the
    demand
    b. A decreased circulating blood volume
    c. Missing a ventricular contraction
    d. The cessation of all cardiac function
A

d. The cessation of all cardiac function

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35
Q
  1. Which change results from total heart block?
    a. A prolonged PR interval
    b. Periodic omission of a ventricular contraction
    c. A wide QRS wave
    d. Spontaneous slow ventricular contractions, not coordinated with atrial
    contraction
A

d. Spontaneous slow ventricular contractions, not coordinated with atrial
contraction

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36
Q
  1. The term premature ventricular contraction refers to the condition where:
    a. atrial muscle cells are stimulating additional cardiac contractions.
    b. the ventricles contract spontaneously following a period without a
    stimulus.
    c. additional contractions arise from ectopic foci in the ventricular muscle.
    d. increased heart rate causes palpitations.
A

c. additional contractions arise from ectopic foci in the ventricular muscle

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37
Q
  1. Which of the following is most likely to cause left-sided congestive heart failure?
    a. Incompetent tricuspid heart valve
    b. Chronic pulmonary disease
    c. Infarction in the right atrium
    d. Uncontrolled essential
    hypertension
A

d. Uncontrolled essential

hypertension

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38
Q
  1. The definition of congestive heart failure is:
    a. cessation of all cardiac activity.
    b. inability of the heart to pump enough blood to meet the metabolic needs of the
    body.
    c. insufficient circulating blood in the body.
    d. the demand for oxygen by the heart is greater than the supply.
A

b. inability of the heart to pump enough blood to meet the metabolic needs of the
body.

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39
Q
  1. Significant signs of right-sided congestive heart failure include:
    a. severe chest pain and tachycardia.
    b. edematous feet and legs with hepatomegaly.
    c. frequent cough with blood-streaked frothy
    sputum.
    d. orthopnea, fatigue, increased blood pressure.
A

b. edematous feet and legs with hepatomegaly.

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40
Q
  1. Paroxysmal nocturnal dyspnea is marked by:
    a. hemoptysis and rales.
    b. distended neck veins and flushed
    face.
    c. bradycardia and weak pulse.
    d. cardiomegaly.
A

a. hemoptysis and rales.

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41
Q
  1. Compensation mechanisms for decreased cardiac output in cases of congestive heart failure include:
    a. slow cardiac contractions.
    b. increased renin and aldosterone
    secretions.
    c. decreased erythropoietin secretion.
    d. fatigue and cold intolerance.
A

b. increased renin and aldosterone

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42
Q
  1. In which blood vessels will failure of the left ventricle cause increased hydrostatic pressure?
    a. Veins of the legs and feet
    b. Jugular veins
    c. Pulmonary capillaries
    d. Blood vessels of the liver and
    spleen
A

c. Pulmonary capillaries

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43
Q 
43. Which of the following drugs improves cardiac efficiency by slowing the heart rate and increasing the
force of cardiac contractions?
a. Furosemide
b. Digoxin
c. Epinephrine
d. Nifedipine
A

b. Digoxin

44
Q
  1. In an infant, the initial indication of congestive heart failure is often:
    a. distended neck veins.
    b. feeding problems.
    c. low-grade fever and
    lethargy.
    d. frequent vomiting.
A

b. feeding problems.

45
Q
  1. Effects that may be expected from a beta-adrenergic blocking drug include:
    a. increasing systemic vasoconstriction.
    b. decreased sympathetic stimulation of the
    heart.
    c. blockage of an angiotensin receptor site.
    d. increased release of renin.
A

b. decreased sympathetic stimulation of the

heart.

46
Q
  1. A sign of aortic stenosis is:
    a. increased cardiac output.
    b. congestion in the liver, spleen, and legs.
    c. flushed face and headache.
    d. a heart murmur.
A

d. a heart murmur.

47
Q
  1. An incompetent mitral valve would cause:
    a. increased blood to remain in the right atrium.
    b. hypertrophy of the right ventricle.
    c. decreased output from the left ventricle.
    d. decreased pressure in the left atrium.
A

c. decreased output from the left ventricle.

48
Q
  1. Which of the following describes the blood flow occurring with a ventricular septal defect?
    a. From the left ventricle to the right ventricle
    b. From the right ventricle to the left ventricle
    c. Increased cardiac output from the left ventricle
    d. Mixed oxygenated and unoxygenated blood in the systemic
    circulation
A

a. From the left ventricle to the right ventricle

49
Q
  1. Unoxygenated blood enters the systemic circulation in children with tetralogy of Fallot because:
    a. the aorta and pulmonary artery have exchanged positions.
    b. pulmonary stenosis changes the ventricular pressures.
    c. the left ventricular wall has hypertrophied.
    d. the septal defect allows exchange of blood between the
    atria.
A

b. pulmonary stenosis changes the ventricular pressures.

50
Q
  1. Cyanosis occurs in children with tetralogy of Fallot because:
    a. more carbon dioxide is present in the circulating blood.
    b. a large amount of hemoglobin in the general circulation is
    unoxygenated.
    c. the pulmonary circulation is overloaded and congested.
    d. the circulation is sluggish (slow) throughout the system.
A

b. a large amount of hemoglobin in the general circulation is
unoxygenated.

51
Q
  1. The initial effect on the heart in cases of rheumatic fever is:
    a. infection in the heart by hemolytic streptococci.
    b. highly virulent microbes causing vegetations on the heart valves.
    c. septic emboli obstructing coronary arteries.
    d. acute inflammation in all layers of the heart due to abnormal immune
    response.
A

d. acute inflammation in all layers of the heart due to abnormal immune
response.

52
Q
  1. Common signs of rheumatic fever include all of the following EXCEPT:
    a. arthritis, causing deformity of the small joints in the hands and
    feet.
    b. erythematous skin rash and subcutaneous nodules.
    c. epistaxis, tachycardia, and fever.
    d. elevated ASO titer and leukocytosis.
A

a. arthritis, causing deformity of the small joints in the hands and
feet.

53
Q
  1. Rheumatic heart disease usually manifests in later years as:
    a. swollen heart valves and fever.
    b. cardiac arrhythmias and heart murmurs.
    c. thrombus formation and septic emboli.
    d. petechial hemorrhages of the skin and
    mucosa.
A

b. cardiac arrhythmias and heart murmurs.

54
Q
  1. Septic emboli, a common complication of infective endocarditis, are a result of the fact that:
    a. vegetations are loosely attached and fragile.
    b. the valves are no longer competent.
    c. cardiac output is reduced.
    d. heart contractions are irregular.
A

a. vegetations are loosely attached and fragile.

55
Q
  1. Which of the following applies to subacute infective endocarditis?
    a. A microbe of low virulence attacks abnormal or damaged heart
    valves.
    b. Virulent microbes invade normal heart valves.
    c. No permanent damage occurs to the valves.
    d. Prophylactic medication does not prevent infection.
A

a. A microbe of low virulence attacks abnormal or damaged heart
valves.

56
Q
  1. Pericarditis causes a reduction in cardiac output as a result of which of the following?
    a. Delays in the conduction system, interfering with cardiac rhythm
    b. Weak myocardial contractions due to friction rub
    c. Excess fluid in the pericardial cavity, which decreases ventricular
    filling
    d. Incompetent valves, which allow regurgitation of blood
A

c. Excess fluid in the pericardial cavity, which decreases ventricular
filling

57
Q
  1. Pericarditis may be caused by:
  2. infection.
  3. abnormal immune responses.
  4. injury.
  5. malignant neoplasm.
    a. 1, 2
    b. 3, 4
    c. 1, 3, 4
    d. 1, 2, 3, 4
A

d. 1, 2, 3, 4

58
Q
  1. A source of an embolus causing an obstruction in the brain could be the:
    a. femoral vein.
    b. pulmonary vein.
    c. carotid artery.
A

c. carotid artery.

59
Q
  1. The basic pathophysiological change associated with essential hypertension is:
    a. development of lipid plaques in large arteries.
    b. recurrent inflammation and fibrosis in peripheral
    arteries.
    c. degeneration and loss of elasticity in arteries.
    d. increased systemic vasoconstriction.
A

a. development of lipid plaques in large arteries

60
Q
  1. Uncontrolled hypertension is most likely to cause ischemia and loss of function in the:
    a. kidneys, brain, and retinas of the
    eye.
    b. peripheral arteries in the legs.
    c. aorta and coronary arteries.
    d. liver, spleen, and stomach.
A

a. kidneys, brain, and retinas of the

eye.

61
Q
  1. When is a diagnosis of essential hypertension likely to be considered in young or middle-aged individuals?
    a. Blood pressure remains consistently above 140/90
    b. Blood pressure fluctuates between 130/85 and 180/105
    c. Blood pressure increases rapidly and is unresponsive to medication
    d. Chronic kidney disease leads to consistently elevated blood
    pressure
A

a. Blood pressure remains consistently above 140/90

62
Q
  1. Atherosclerosis in the iliac or femoral arteries is likely to cause which of the following?
  2. Gangrenous ulcers in the legs
  3. Strong rapid pulses in the legs
  4. Intermittent claudication
  5. Red, swollen legs
    a. 1, 2
    b. 1, 3
    c. 2, 3
    d. 2, 4
A

b. 1, 3

63
Q
  1. The term intermittent claudication refers to:
    a. sensory deficit in the legs due to damage to nerves.
    b. chest pain related to ischemia.
    c. ischemic muscle pain in the legs, particularly with
    exercise.
    d. dry, cyanotic skin with superficial ulcers.
A

c. ischemic muscle pain in the legs, particularly with

exercise.

64
Q
  1. What is the primary reason for amputation of gangrenous toes or feet in patients with peripheral vascular
    disease?
    a. It promotes more rapid healing of ulcerated
    areas.
    b. It improves circulation to other areas.
    c. It prevents spread of infection and reduces pain.
    d. It reduces swelling in the peripheral areas.
A

c. It prevents spread of infection and reduces pain.

65
Q
  1. An echocardiogram is used to demonstrate any abnormal:
    a. activity in the conduction system.
    b. movement of the heart valves.
    c. change in central venous
    pressure.
    d. blood flow in coronary arteries.
A

b. movement of the heart valves.

66
Q
  1. A friction rub is associated with:
    a. infectious endocarditis.
    b. arrhythmias.
    c. pericarditis.
    d. an incompetent aortic
    valve.
A

c. pericarditis.
Refers to inflammation of the pericardium, two thin layers of a sac-like tissue that surround the heart, hold it in place and help it work. A small amount of fluid keeps the layers separate so that there’s no friction between them.

67
Q
  1. A dissecting aortic aneurysm develops as:
    a. a dilation or bulge that develops at one point on the aortic wall.
    b. a thrombus that accumulates at a point in the aortic wall.
    c. a section of the aorta that weakens and dilates in all directions.
    d. a tear in the intimal lining, which allows blood flow between layers of the aortic
    wall.
A

d. a tear in the intimal lining, which allows blood flow between layers of the aortic
wall.

68
Q
  1. The outcome for many aortic aneurysms is:
    a. early diagnosis and repair.
    b. thrombus formation and pulmonary
    embolus.
    c. rupture and hemorrhage.
    d. pressure on adjacent organs or structures.
A

c. rupture and hemorrhage.

69
Q
  1. Which factor predisposes to varicose veins during pregnancy?
    a. Compressed pelvic veins
    b. Stenotic valves in leg veins
    c. Thrombus formation
    d. Insufficient muscle support for veins
A

a. Compressed pelvic veins

70
Q
  1. Phlebothrombosis is more likely to cause pulmonary emboli than is thrombophlebitis because:
    a. platelets attach to the inflamed wall.
    b. thrombus forms in a vein and is less firmly
    attached.
    c. leg cramps require massage.
    d. systemic signs of inflammation require treatment.
A

b. thrombus forms in a vein and is less firmly

attached.

71
Q
  1. Shock is defined as:
    a. failure of the heart to supply sufficient blood to body
    cells.
    b. general hypoxia, causing damage to various organs.
    c. decreased circulating blood and tissue perfusion.
    d. loss of blood, causing severe hypoxia.
A

c. decreased circulating blood and tissue perfusion.

72
Q
  1. Shock follows a myocardial infarction when:
    a. the stress response causes general
    vasodilation.
    b. fluid is lost into ischemic tissues.
    c. heart valves are damaged.
    d. a large portion of the myocardium is damaged.
A

d. a large portion of the myocardium is damaged.

73
Q
  1. What are the early signs of circulatory shock?
  2. Pale moist skin
  3. Loss of consciousness
  4. Anxiety and restlessness
  5. Rapid strong pulse
    a. 1, 2
    b. 1, 3
    c. 1, 4
    d. 3, 4
A

b. 1, 3

74
Q
  1. A compensation for shock would include:
    a. increased heart rate and oliguria.
    b. lethargy and decreased
    responsiveness.
    c. warm, dry, flushed skin.
    d. weak, thready pulse.
A

a. increased heart rate and oliguria

75
Q
  1. Why does anaphylactic shock cause severe hypoxia very quickly?
    a. Generalized vasoconstriction reduces venous return.
    b. Bronchoconstriction and bronchial edema reduce
    airflow.
    c. Heart rate and contractility are reduced.
    d. Metabolic rate is greatly increased.
A

b. Bronchoconstriction and bronchial edema reduce

airflow.

76
Q
  1. Neurogenic (vasogenic) shock results from systemic vasodilation due to:
    a. increased peripheral resistance and less blood in the microcirculation.
    b. increased permeability of all the blood vessels, leading to
    hypovolemia.
    c. slower, less forceful cardiac contractions.
    d. increased capacity of the vascular system and reduced venous return.
A

d. increased capacity of the vascular system and reduced venous return.

77
Q
  1. A prolonged period of shock is likely to cause:
    a. damage to, and increased permeability of, pulmonary capillaries.
    b. increased permeability of the glomerular capillaries of the
    kidneys.
    c. increased pH of blood and body fluids.
    d. increased systemic vasoconstriction.
A

a. damage to, and increased permeability of, pulmonary capillaries.

78
Q
  1. What would indicate decompensated acidosis related to shock?
    a. Serum bicarbonate level below
    normal
    b. PCO2 above normal
    c. Serum pH below normal range
    d. Urine pH of 4.5
A

c. Serum pH below normal range

79
Q
  1. With shock, anaerobic cell metabolism and decreased renal blood flow cause:
    a. metabolic alkalosis.
    b. metabolic acidosis.
    c. decreased serum potassium.
    d. increased serum bicarbonate.
A

b. metabolic acidosis.

80
Q
  1. Shock develops in patients with severe burns as a result of:
    a. extensive hemorrhage.
    b. pain and loss of plasma.
    c. direct damage to the heart.
    d. extensive hemolysis of
    erythrocytes.
A

b. pain and loss of plasma.

81
Q
  1. The classic early manifestation(s) of left-sided congestive heart failure is/are ____, whereas the earlyindicator(s) of right-sided failure is/are _______.
    a. palpitations and periodic chest pain; shortness of breath on exertion
    b. swelling of the ankles and abdomen; chest pain
    c. shortness of breath on exertion or lying down; swelling of the
    ankles
    d. coughing up frothy sputum; hepatomegaly and splenomegaly
A

c. shortness of breath on exertion or lying down; swelling of the
ankles

82
Q
  1. A common adverse effect of many antihypertensive medications is:
    a. orthostatic hypotension.
    b. bradycardia.
    c. altered blood coagulation.
    d. peripheral edema.
A

a. orthostatic hypotension.

83
Q
  1. The cause of essential hypertension is considered to be:
    a. chronic renal disease.
    b. excessive intake of saturated fats and
    salt.
    c. sedentary lifestyle.
    d. idiopathic.
A

d. idiopathic.

84
Q
  1. A cardiac pacemaker would most likely be inserted in cases of:
    a. angina pectoris.
    b. heart block.
    c. congestive heart failure.
    d. ventricular fibrillation.
A

b. heart block.

85
Q
  1. Which of the following is considered to be the most dangerous arrhythmia?
    a. Tachycardia
    b. Bradycardia
    c. Ventricular fibrillation
    d. Second-degree heart block
A

c. Ventricular fibrillation

86
Q
  1. Which of the following is NOT true of the drug nitroglycerin?
    a. It decreases myocardial workload by causing systemic vasodilation.
    b. It may be administered sublingually, transdermally, or by oral
    spray.
    c. Dizziness or syncope may follow a sublingual dose.
    d. It strengthens the myocardial contraction.
A

d. It strengthens the myocardial contraction.

87
Q
  1. Confirmation of the diagnosis of a myocardial infarction would include:
  2. specific changes in the ECG.
  3. marked leukocytosis and increased erythrocyte sedimentation rate (ESR).
  4. elevation of cardiac isoenzymes in serum.
  5. a pattern of pain.
    a. 1, 2
    b. 1, 3
    c. 2, 4
    d. 3, 4
A

b. 1, 3

88
Q
  1. Which of the following statements regarding aneurysms is true?
    a. Aneurysms are always caused by congenital malformations.
    b. The greatest danger with aneurysms is thrombus formation.
    c. Manifestations of aneurysms result from compression of adjacent
    structures.
    d. Aneurysms involve a defect in the tunica media of veins.
A

c. Manifestations of aneurysms result from compression of adjacent
structures.

89
Q
  1. The most common factor predisposing to the development of varicose veins is:
    a. trauma.
    b. congenital valve defect in the abdominal
    veins.
    c. infection.
    d. increased venous pressure.
A

d. increased venous pressure.

90
Q
  1. Septic shock differs from hypovolemic shock in that it is frequently manifested by:
    a. fever and flushed face.
    b. elevated blood pressure.
    c. increased urinary
    output.
    d. slow bounding pulse.
A

a. fever and flushed face.

91
Q 
92. Heart block, in which a conduction delay at the AV node results in intermittent missed ventricular
contractions, is called:
a. first-degree block.
b. second-degree block.
c. bundle-branch block.
d. total heart block.
A

b. second-degree block.

92
Q
  1. More extensive permanent damage is likely when a myocardial infarction is caused by:
    a. a hemorrhage.
    b. an embolus.
    c. a thrombus.
    d. an arrhythmia.
A

b. an embolus.
a blood clot, air bubble, piece of fatty deposit, or other object which has been carried in the bloodstream to lodge in a vessel and cause an embolism.

93
Q

a. venous return is increased.
b. ventricular fibrillation develops
immediately.
c. conduction through the AV node is impaired.
d. ventricular filling is reduced.

A

d. ventricular filling is reduced.

94
Q
  1. The right side of the heart would fail first in the case of:
  2. severe mitral valve stenosis.
  3. uncontrolled essential hypertension.
  4. large infarction in the right ventricle.
  5. advanced chronic obstructive pulmonary disease (COPD).
    a. 1, 2
    b. 2, 3
    c. 1, 4
    d. 3, 4
A

d. 3, 4

95
Q 
96. Which of the following compensations that develop in patients with congestive heart failure eventually
increase the workload of the heart?
a. Faster heart rate and
cardiomegaly
b. Peripheral vasoconstriction
c. Increased secretion of renin
d. A and C
e. A, B, and C
A

e. A, B, and C

96
Q
  1. Which statement applies to paroxysmal nocturnal dyspnea?
    a. It indicates decreased CO2 diffusion in the lungs.
    b. It indicates swelling in the bronchioles and bronchi.
    c. It is caused by increased blood in the lungs when lying in a supine
    position.
    d. It results from pleural effusion.
A

c. It is caused by increased blood in the lungs when lying in a supine
position

97
Q
  1. In a child with ventricular septal defect, altered blood flow:
    a. leads to increased stroke volume from the left ventricle.
    b. results in unoxygenated blood in the systemic
    circulation.
    c. is called a right-to-left shunt.
    d. is called a left-to-right shunt.
A

d. is called a left-to-right shunt.

98
Q
  1. In a child with acute rheumatic fever, arrhythmias may develop due to the presence of:
    a. endocarditis.
    b. myocarditis.
    c. pericarditis.
    d. congestive heart failure.
A

b. Myocarditis is an inflammation of the heart muscle (myocardium). Myocarditis can affect your heart muscle and your heart’s electrical system, reducing your heart’s ability to pump and causing rapid or abnormal heart rhythms (arrhythmias).

99
Q
  1. Prophylactic antibacterial drugs such as amoxicillin are given to patients with certain congenital heart
    defects or damaged heart valves immediately before invasive procedures to prevent:
    a. formation of septic
    thrombi.
    b. infectious endocarditis.
    c. abscess formation.
    d. myocarditis.
A

b. infectious endocarditis.

100
Q
  1. Varicose ulcers may develop and be slow to heal because:
    a. leg muscles are painful, restricting movement.
    b. edema reduces arterial blood supply to the area.
    c. emboli form in damaged veins, leading to local
    ischemia.
    d. valves in veins restrict blood flow.
A

b. edema reduces arterial blood supply to the area.

101
Q
  1. Excessive fluid in the pericardial space causes:
a. increased cardiac
output.
b. myocardial infarction.
c. reduced venous return.
d. friction rub.
A

c. reduced venous return.

102
Q
  1. Aortic stenosis means the aortic valve:
    a. allows blood to leak back into the left ventricle during
    diastole.
    b. cannot fully open during systole.
    c. functions to increase stroke volume.
    d. does not respond to the cardiac cycle.
A

b. cannot fully open during systole.

103
Q
  1. Septic shock is frequently caused by infections involving:
    a. gram-negative endotoxin-producing bacteria.
    b. spore-forming saprophytic fungi.
    c. free-swimming, motile parasitic protozoa.
    d. parasitic nematodes.
A

a. gram-negative endotoxin-producing bacteria.

104
Q

______________ ensure that the muscle fibers of the two atria contract together at the same time.

a.	 Desmosomes

b.	 Semilunar valves

c.	 Baroreceptors

d.	 Electrodes
A

a.

Desmosomes

105
Q

Which enzyme is most specific indicator of cardiac muscle damage?

a.	 AST

b.	 CK-MB

c.	 Troponin

d.	 LDH-1
A

c.

Troponin

chapter 12 (4 decks)

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