Deck 19: Heart Failure and Dysrhythmias: Common Sequelae of Cardiac

Question 1

$\beta$ -Adrenergic blocking drugs are contraindicated in heart failure.

Answer 1

False

Question 2

Digitalis therapy may improve symptoms of CHF, but it doesn't alter survival.

Answer 2

True

Question 3

An ejection fraction of 0.40 or higher is considered normal.

Answer 3

False

Question 4

Lusitropic impairment refers to

A) poor contractile force.
B) impaired diastolic relaxation.
C) altered action potential conduction rate.
D) altered automaticity.

Question 5

Systolic failure is associated with a low cardiac output and low ejection fraction.

Question 6

Loss of functional myocardial cells is the principal cause of heart failure.

Question 7

Second-degree heart block type I (Wenckebach) is characterized by

A) absent P waves.
B) variable PR interval and dropped QRS complexes.
C) constant PR interval and dropped QRS complexes.
D) no correlation between P waves and QRS complexes.

Question 8

In which of the following dysrhythmias should treatment be instituted immediately?

A) Asymptomatic sinus bradycardia at a heart rate of 50 beats/min
B) Fever-induced tachycardia at 122 beats/min
C) Premature atrial complexes occurring every 20 seconds
D) Atrial fibrillation with a ventricular rate of 220 beats/min

Question 9

Cor pulmonale refers to

A) biventricular failure.
B) left ventricular hypertrophy secondary to lung disease.
C) right ventricular hypertrophy secondary to pulmonary hypertension.
D) right ventricular failure secondary to right ventricular infarction.

Question 10

The therapy that most directly improves cardiac contractility in a patient with systolic heart failure is

A) afterload reduction.
B) . $\beta$ -antagonist agents.
C) preload reduction.
D) digitalis.

Question 11

Left-sided heart failure is characterized by

A) pulmonary congestion.
B) decreased systemic vascular resistance.
C) jugular vein distention.
D) peripheral edema.

Question 12

Angiotensin-converting enzyme (ACE) inhibitor therapy is avoided in heart failure because a drop in preload may reduce cardiac output.

Question 13

Hypertrophy of the right ventricle is a compensatory response to

A) aortic stenosis.
B) aortic regurgitation.
C) tricuspid stenosis.
D) pulmonary stenosis.

Question 14

The common denominator in all forms of heart failure is

A) poor diastolic filling.
B) reduced cardiac output.
C) pulmonary edema.
D) tissue ischemia.

Question 15

Most cases of heart failure are a consequence of coronary heart disease or systemic hypertension.

Question 16

All of the following dysrhythmias are thought to be associated with reentrant mechanisms except

A) second-degree AV block.
B) atrial fibrillation.
C) premature ventricular complexes.
D) preexcitation syndrome tachycardia (Wolf-Parkinson-White syndrome).

Question 17

The overall 5-year survival rate after onset of heart failure is about 50%.

Question 18

First-degree heart block is characterized by

A) prolonged PR interval.
B) absent P waves.
C) widened QRS complex.
D) variable PR interval.

Question 19

Oversecretion of B-type natriuretic peptide by the heart contributes to the volume overload of congestive heart failure (CHF).

Question 20

The principal difference between systolic failure and diastolic failure is the ejection fraction.

Question 21

After sitting in a chair for an hour, an elderly patient develops moderate lower extremity edema. His edema is most likely a consequence of

A) arterial obstruction.
B) isolated left-sided heart failure.
C) right-sided heart failure.
D) peripheral vascular disease.

Question 22

A patient who complains of dizziness and who has absent P waves, regular QRS complexes, and a heart rate of 48 beats/min on an ECG is most likely in which rhythm?

A) Third-degree heart block
B) Junctional tachycardia
C) Junctional escape rhythm
D) Sinus bradycardia

Question 23

Patients with structural evidence of heart failure who exhibit no signs or symptoms are classified into which New York Heart Association heart failure class?

A) Class I
B) Class II
C) Class III
D) Class IV

Question 24

A laboratory test that should be routinely monitored in patients receiving digitalis therapy is

A) serum sodium.
B) albumin level.
C) serum potassium.
D) serum calcium.

Question 25

Morphine and nitrates may be used in the management of acute pulmonary edema to

A) increase cardiac output.
B) reduce cardiac preload.
C) improve ventilation.
D) decrease anxiety.

Question 26

A patient with pure left-sided heart failure is likely to exhibit

A) jugular vein distention.
B) pulmonary congestion with dyspnea.
C) peripheral edema.
D) hepatomegaly.

Question 27

Right-sided heart failure usually is a consequence of

A) elevated right ventricular afterload.
B) right ventricular infarction.
C) tricuspid valve defects.
D) congenital anomalies.

Question 28

Low cardiac output to the kidneys stimulates the release of _____ from juxtaglomerular cells.

A) aldosterone
B) norepinephrine
C) angiotensinogen
D) renin

Question 29

The majority of dysrhythmias are believed to occur because of

A) triggered activity.
B) enhanced automaticity.
C) defective gap junctions.
D) reentry mechanisms.

Question 30

A patient with heart failure who complains of intermittent shortness of breath during the night is experiencing

A) orthopnea.
B) paroxysmal atrial tachycardia.
C) sleep apnea.
D) paroxysmal nocturnal dyspnea.

Question 31

A patient receives an ACE-inhibiting agent to manage his cardiovascular disease. Which of the following is not an expected result of ACE inhibitor therapy?

A) Diuresis
B) Afterload reduction
C) Enhanced sodium excretion
D) Increased cardiac preload

Question 32

An abnormally wide (more than 1.0 msec) QRS complex is characteristic of

A) paroxysmal atrial tachycardia.
B) supraventricular tachycardia.
C) junctional escape rhythm.
D) premature ventricular complexes.

Question 33

Cardiac hypertrophy is stimulated by all of the following except

A) angiotensin II.
B) norepinephrine.
C) increased myocardial wall tension.
D) atrial natriuretic peptide.