Quiz 11 - Cardiac A&P/Assessment

Question 1

Cardiac-related chest pain is often palliated by:

A. exertion.

B. mild exercise.

C. stress.

D. nitroglycerin

Answer 1

D. nitroglycerin

Question 2

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

A. primary cardiac pacemaker can reset.

B. atria can empty into the ventricles.

C. ventricles can contract completely.

D. bundle of His can depolarize fully.

Answer 2

B. atria can empty into the ventricles.

Question 3

Changes in cardiac contractility may be induced by medications that have a positive or negative ___________ effect.

A. dromotropic

B. inotropic

C. chronotropic

D. vasoactive

Answer 3

B. inotropic

Question 4

If an increased amount of blood is returned to the heart:

A. the cardiac muscle must stretch to accommodate the larger volume.

B. an increase in stroke volume occurs because the heart rate increases.

C. stroke volume decreases accordingly because of the larger volume.

D. cardiac workload is decreased, resulting in a decreased cardiac output.

Answer 4

A. the cardiac muscle must stretch to accommodate the larger volume.

Question 5

Hypertension is present when the blood pressure:

A. is above 160 mm Hg systolic during strenuous exertion.

B. rises acutely during an emotionally stressful situation.

C. is consistently greater than 140/90 mm Hg while at rest.

D. increases by 20 mm Hg above a person’s normal blood pressure.

Answer 5

C. is consistently greater than 140/90 mm Hg while at rest.

Question 6

Administering a drug that possesses a positive chronotropic effect will have a direct effect on:

A. blood pressure.

B. cardiac output.

C. the heart rate.

D. stroke volume.

Answer 6

C. the heart rate.

Question 7

If the left ventricle contains 80 mL of blood before a contraction and ejects 60 mL during the contraction, the ejection fraction is:

A. 60%.

B. 65%.

C. 70%.

D. 75%.

Answer 7

D. 75%.

Question 8

The presence of dizziness in a patient with a suspected myocardial infarction is MOST likely the result of:

A. a reduction in cardiac output.

B. fear and anxiety.

C. acute left-sided heart failure.

D. the effects of nitroglycerin.

Answer 8

A. a reduction in cardiac output.

Question 9

A patient with orthopnea:

A. prefers a semisitting position to facilitate breathing.

B. experiences dyspnea during periods of exertion.

C. sleeps in a recliner due to severe right heart failure.

D. experiences worsened dyspnea while lying down.

Answer 9

D. experiences worsened dyspnea while lying down.

Question 10

The MOST immediate forms of reperfusion therapy for an injured myocardium are:

A. fibrinolytics and percutaneous coronary intervention.

B. angioplasty and coronary artery bypass grafting.

C. supplemental oxygen and an infusion of nitroglycerin.

D. high-dose aspirin and high-flow supplemental oxygen.

Answer 10

A. fibrinolytics and percutaneous coronary intervention.

Question 11

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

A. cardiac myocytes.

B. bundle branches.

C. Purkinje fibers.

D. internodal pathways

Answer 11

C. Purkinje fibers.

Question 12

The left main coronary artery subdivides into the:

A. left posterior ascending and circumflex arteries.

B. left anterior ascending and descending arteries.

C. left anterior descending and circumflex arteries.

D. right coronary and left posterior descending arteries.

Answer 12

C. left anterior descending and circumflex arteries.

Question 13

Injury to or disease of the ______________ may cause prolapse of a cardiac valve leaflet, allowing blood to regurgitate from the ventricle into the atrium.

A. coronary sinus

B. chordae tendineae

C. coronary sulcus

D. interatrial septum

Answer 13

B. chordae tendineae

Question 14

To increase myocardial contractility and heart rate and to relax the bronchial smooth muscle, you must give a drug that:

A. stimulates beta-1 and beta-2 receptors.

B. stimulates beta-2 and alpha receptors.

C. blocks beta receptors and stimulates alpha receptors.

D. blocks beta-1 and beta-2 receptors

Answer 14

A. stimulates beta-1 and beta-2 receptors.

Question 15

A patient with an elevated cholesterol level would MOST likely take:

A. Altacor.

B. Isordil.

C. Diovan.

D. Inderal.

Answer 15

A. Altacor.

Question 16

Automaticity is defined as the ability of the heart to:

A. spontaneously conduct an electrical impulse between cardiac cells.

B. generate an electrical impulse from the same site every time.

C. increase or decrease its heart rate based on the body’s metabolic needs.

D. generate its own electrical impulses without stimulation from nerves.

Answer 16

D. generate its own electrical impulses without stimulation from nerves.

Question 17

When monitoring a patient’s cardiac rhythm, it is MOST important to remember that:

A. a heart rate below 60 beats per minute must be treated immediately.

B. the presence of a QRS complex correlates with the patient’s pulse.

C. many patients with acute myocardial infarction experience asystole.

D. the ECG does not provide data regarding the patient’s cardiac output.

Answer 17

D. the ECG does not provide data regarding the patient’s cardiac output.

Question 18

Which part of the blood vessel is made up of elastic fibers and muscle, and provides for strength and contractility?

A. Tunica intima

B. Tunica media

C. Tunica adventitia

D. Arterial lumen

Answer 18

B. Tunica media

Question 19

Which of the following medications would be the MOST acceptable alternative to morphine for analgesia in patients with an acute coronary syndrome?

A. Fentanyl

B. Ibuprofen

C. Versed

D. Diazepam

Answer 19

A. Fentanyl

Question 20

The numerous connections among the arterioles of the various coronary arteries, which allow for the development of alternate routes of blood flow if a larger coronary artery begins to narrow, are called:

A. the coronary sinus.

B. collateral circulation.

C. coronary microcirculation.

D. cardiac myocytes

Answer 20

B. collateral circulation.

Question 21

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

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

B. cardiac muscle relaxes in response to a cellular influx of calcium.

C. calcium ions rapidly enter the cell, facilitating contraction.

D. potassium ions escape from the cell through specialized channels.

Answer 21

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

Question 22

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

A. moves calcium and potassium ions back into the cell by a process called passive transport.

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

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

D. moves three sodium ions and three potassium ions back into the cell.

Answer 22

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

Question 23

The point of maximal impulse usually can be felt on the:

A. left lateral chest, in the midaxillary line, at the fourth intercostal space.

B. left anterior chest, in the midaxillary line, at the fifth intercostal space.

C. medial aspect of the chest, just below the third intercostal space.

D. left anterior chest, in the midclavicular line, at the fifth intercostal space.

Answer 23

D. left anterior chest, in the midclavicular line, at the fifth intercostal space.

Question 24

Which of the following medications is a calcium channel blocker?

A. Tenormin

B. Capoten

C. Cardizem

D. Lanoxin

Answer 24

C. Cardizem

Question 25

When administering aspirin to a patient with an acute coronary syndrome, you should:

A. administer half the usual dose if the patient has a history of stroke.

B. give up to 325 mg of enteric-coated aspirin for the patient to swallow.

C. first check to make sure the patient is not severely hypertensive.

D. have him or her chew and swallow 160 to 325 mg of baby aspirin.

Answer 25

D. have him or her chew and swallow 160 to 325 mg of baby aspirin.

Question 26

The heart’s anatomic location is MOST accurately described as being:

A. hemithoracic.

B. submediastinal.

C. retrosternal.

D. supradiaphragmatic.

Answer 26

C. retrosternal.

Question 27

Paroxysmal nocturnal dyspnea is defined as:

A. dyspnea that is brought on by excessive movement during sleep.

B. acute shortness of breath that suddenly awakens a person from sleep.

C. sitting upright in a chair in order to facilitate effective breathing.

D. the inability to function at night due to severe difficulty breathing.

Answer 27

B. acute shortness of breath that suddenly awakens a person from sleep.

Question 28

Atrial kick is defined as:

A. increased preload pressure as a result of atrial contraction.

B. the blood that flows passively into the ventricles.

C. pressure on the AV valves during ventricular contraction.

D. an attempt of the atria to contract against closed valves.

Answer 28

A. increased preload pressure as a result of atrial contraction.

Question 29

The Levine sign is defined as:

A. pushing on the sternum with the fingertips.

B. a subconsciously clenched fist over the chest.

C. rubbing the arm to which pain is radiating.

D. a state of denial in patients with an acute myocardial infarction.

Answer 29

B. a subconsciously clenched fist over the chest.

Question 30

Cardiac output is influenced by:

A. stroke volume.

B. heart rate.

C. heart rate and/or stroke volume.

D. ejection fraction and heart rate.

Answer 30

C. heart rate and/or stroke volume.

Question 31

A pulse that alternates in strength from one beat to the next beat is called:

A. pulse deficit.

B. pulsus paradoxus.

C. paradoxical pulse.

D. pulsus alternans.

Answer 31

D. pulsus alternans.

Question 32

Which of the following electrolytes maintains the depolarization phase?

A. Calcium

B. Potassium

C. Sodium

D. Magnesium

Answer 32

A. Calcium

Question 33

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

A. you will see a brief period of bradycardia followed by asystole.

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

C. the P wave and PR interval will have an abnormal appearance.

D. the AV junction will begin pacing at 40 to 60 times/min.

Answer 33

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

Question 34

What prevents the backflow of blood during ventricular contraction?

A. Semilunar valves

B. The pulmonic valve

C. AV valves

D. The aortic valve

Answer 34

C. AV valves

Question 35

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

D. a sudden cardiac rhythm disturbance that causes a decrease in cardiac output.

Answer 35

C. any group of clinical symptoms consistent with acute myocardial ischemia.