Deck 18: Cardiovascular Disorders

Question 1

Modifiable factor that increase the risk for atherosclerosis include:

A) sedentary life style
B) female more than 40 years of age
C) exclusion of saturated fats from the diet
D) familial hypercholesterolemia

Answer 1

sedentary life style

Question 2

Which of the following drugs decrease sodium and fluid retention in the body?

A) warfarin (Coumadin)
B) digoxin (Lanoxin)
C) nitroglycerin (Isordil)
D) hydrochlorothiazide (Hydro DIURIL)

Answer 2

hydrochlorothiazide (Hydro DIURIL)

Question 3

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

Answer 3

increased heart rate

Question 4

Which of the following describes the pericardial cavity correctly?

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.

Question 5

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

Question 6

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 muscle
D) peristalsis in the large veins

Question 7

What does the term preload refer to?

A) volume of venous return
B) peripheral resistance
C) stroke volume
D) cardiac output

Question 8

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

Question 9

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

Question 10

What will a partial obstruction in a coronary artery likely cause?

A) pulmonary embolus
B) hypertension
C) angina attacks
D) myocardial infarction

Question 11

Which event causes the QRS wave on an ECG tracing?

A) atrial depolarization
B) atrial repolarization
C) ventricular depolarization
D) ventricular repolarization

Question 12

Each of the following compares the output of blood from the left and right ventricles with each contraction of a normal heart.Which is correct?

A) Left ventricular output is slightly greater than the right ventricular output.
B) Left ventricular output is approximately double that of right ventricular output.
C) Left ventricular output equals the right ventricular output.
D) Left ventricular output is less than right ventricular output.

Question 13

Which of the following actions causes the atrioventricular 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

Question 14

What does the term arteriosclerosis specifically refer 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

Question 15

Which are the first arteries to branch off the aorta?

A) common carotid arteries
B) pulmonary arteries
C) coronary arteries
D) subclavian arteries

Question 16

What is the function of the baroreceptors? To:

A) stimulate the parasympathetic or sympathetic nervous systems at the 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

Question 17

What is the cardiac reserve?

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

Question 18

Which drug is taken in small doses on a continuing basis to reduce platelet adhesion?

A) acetylsalicylic acid (ASA)
B) streptokinase
C) acetaminophen
D) heparin

Question 19

Which of the following results from 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

Question 20

The normal delay in conduction through the atrioventricular 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

Question 21

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

Question 22

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

Question 23

Which of the following are typical early signs or symptoms of myocardial infarction?

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

Question 24

Which of the following occur as compensation mechanisms for decreased cardiac output in cases of congestive heart failure?

A) slow cardiac contractions
B) increased renin and aldosterone secretions
C) decreased erythropoietin secretion
D) fatigue and cold intolerance

Question 25

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.

Question 26

What is the most common cause of death immediately following a myocardial infarction?

A) cardiac arrhythmias
B) ruptured ventricle
C) congestive heart failure
D) cerebrovascular accident

Question 27

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

Question 28

Which of the following best describes the basic pathophysiology of myocardial infarction?

A) Cardiac output is insufficient to meet the needs of the heart and body.
B) Temporary vasospasm occurs in a coronary artery.
C) Total obstruction of a coronary artery causes myocardial necrosis.
D) Heart rate and force is irregular,reducing blood supply to coronary arteries.

Question 29

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.

Question 30

Which of the following confirms the presence of a myocardial infarction?

A) a full description of the pain
B) the presence of elevated serum cholesterol and triglycerides
C) characteristic patterns for serum isoenzymes and the ECG
D) leukocytosis and elevated C-reactive protein

Question 31

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

Question 32

What does the term cardiac arrest mean?

A) cardiac output is less than the demand
B) decreased circulating blood volume
C) missing a ventricular contraction
D) cessation of all cardiac function

Question 33

Factors that may precipitate an angina attack include all of the following EXCEPT:

A) eating a large meal
B) an angry argument
C) walking down stairs
D) shovelling snow on a cold,windy day

Question 34

Which statement describes a coronary artery bypass procedure?

A) removing the section of an artery containing plaque and thrombus
B) compressing the thrombus with an inflated balloon to provide a larger lumen
C) attaching a section of vein to the coronary artery proximal and distal to the obstruction
D) adding a piece of vein to the end of each coronary artery

Question 35

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

Question 36

What does the term PVC mean?

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.

Question 37

Which of the following are significant signs of right-sided congestive heart failure?

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

Question 38

Paroxysmal nocturnal dyspnea is marked by:

A) hemoptysis and rales
B) distended neck veins and flushed face
C) bradycardia and weak pulse
D) cardiomegaly

Question 39

Which is the best definition of congestive heart failure?

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

Question 40

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

Question 41

In children with tetralogy of Fallot,why does unoxygenated blood enter the systemic circulation?

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.

Question 42

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

Question 43

In an infant,which of the following is frequently the initial indication of congestive heart failure?

A) distended neck veins
B) feeding problems
C) low-grade fever and lethargy
D) frequent vomiting

Question 44

Why does pericarditis cause a reduction in cardiac output?

A) Delays in the conduction system interfere with cardiac rhythm.
B) Due to friction rub,the myocardial contractions are weak.
C) Excess fluid in the pericardial cavity decreases ventricular filling.
D) Incompetent valves allow regurgitation of blood.

Question 45

Why does cyanosis occur in children with tetralogy of Fallot?

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.

Question 46

Which of the following represent(s)the pathophysiologic changes in the heart in cases of rheumatic fever?

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) an abnormal immune response,causing acute inflammation in all layers of the heart

Question 47

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

Question 48

Where is uncontrolled hypertension most likely to cause ischemia and loss of function?

A) kidneys,brain,and retinas of the eye
B) peripheral arteries in the legs
C) aorta and coronary arteries
D) liver,spleen,and stomach

Question 49

Which of the following apply 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.

Question 50

Why are septic emboli a common complication of infective endocarditis?

A) Vegetations are loosely attached and fragile.
B) The valves are no longer competent.
C) Cardiac output is reduced.
D) Heart contractions are irregular.

Question 51

What does the term intermittent claudication refer 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

Question 52

Which of the following could be the source of an embolus causing an obstruction in the brain?

A) femoral vein
B) pulmonary vein
C) carotid artery
D) coronary artery

Question 53

What is considered to be the basic pathophysiologic change in essential hypertension?

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

Question 54

How does rheumatic heart disease usually manifest in later years?

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

Question 55

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

Question 56

Which of the following is a sign of aortic stenosis?

A) increased cardiac output
B) congestion in the liver,spleen,and legs
C) flushed face and headache
D) a heart murmur

Question 57

What would an incompetent mitral valve 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

Question 58

Which of the following effects may be expected from a beta-adrenergic blocking drug?

A) increasing systemic vasoconstriction
B) decreased sympathetic stimulation of the heart
C) blockage of an angiotensin receptor site
D) increased release of renin

Question 59

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

Question 60

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

Question 61

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.

Question 62

A friction rub is associated with:

A) infectious endocarditis
B) arrhythmias
C) pericarditis
D) an incompetent aortic valve

Question 63

How does a dissecting aortic aneurysm develop?

A) A dilation or bulge develops at one point on the aortic wall.
B) Thrombus accumulates at a point in the aortic wall.
C) A section of the aorta weakens and dilates in all directions.
D) A tear in the intimal lining allows blood flow between layers of the aortic wall.

Question 64

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

Question 65

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

Question 66

When does shock follow myocardial infarction?

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.

Question 67

What indicates compensation for shock?

A) increased heart rate and oliguria
B) lethargy and decreased responsiveness
C) warm,dry,flushed skin
D) weak,thready pulse

Question 68

What is the primary reason for amputation of gangrenous toes or feet in patients with peripheral vascular disease?

A) promotes more rapid healing of ulcerated areas
B) improves circulation to other areas
C) prevents spread of infection and reduces pain
D) reduces swelling in the peripheral areas

Question 69

Why does neurogenic (vasogenic) shock result from systemic vasodilation?

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

Question 70

Which is a common adverse effect of many antihypertensive medications?

A) orthostatic hypotension
B) bradycardia
C) altered blood coagulation
D) peripheral edema

Question 71

What is a prolonged period of shock likely to cause?

A) damage 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

Question 72

Why does shock develop in patients with severe burns?

A) extensive hemorrhage
B) pain and loss of plasma
C) direct damage to the heart
D) extensive hemolysis of erythrocytes

Question 73

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

Question 74

The classic early manifestation(s)of left-sided congestive heart failure are ____,whereas the early indicator(s)of right-sided failure 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

Question 75

For which of the following would a cardiac pacemaker likely be inserted?

A) angina pectoris
B) heart block
C) congestive heart failure
D) ventricular fibrillation

Question 76

How is shock defined?

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

Question 77

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

Question 78

What is the outcome for many aortic aneurysms?

A) early diagnosis and repair
B) thrombus formation and pulmonary embolus
C) rupture and hemorrhage
D) pressure on adjacent organs or structures

Question 79

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

Question 80

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 asymptomatic
C) leg cramps require massage
D) systemic signs of inflammation require treatment