Deck 13: Heart Disease, Hypertension, Stroke, and Type 2 Diabetes

Question 1

Which of the following job factors has been found to be related to increased risk of CHD?

A) high work demands and low control
B) a discrepancy between one's education level and one's occupation
C) low job security
D) occupational stress in general
E) All of these job factors have been found to be related to an increase risk of CHD.

Answer 1

occupational stress in general

Question 2

Besides chronic stress, what other emerging factor may lead to coronary heart disease?

A) socio-economic status
B) PTSD
C) ethnicity
D) career choice
E) mobile phone use

Answer 2

PTSD

Question 3

Hostility

A) is a potential risk factor for the development of heart disease.
B) is a predictor of survival of heart disease.
C) is implicated in diabetes.
D) has a genetic component.
E) All of these answers are correct.

Answer 3

All of these answers are correct.

Question 4

Cynical hostility is characterized by

A) suspiciousness.
B) little resentment.
C) infrequent angry episodes.
D) trust in others.
E) paranoid schizophrenia.

Question 5

Cognitive behavioural interventions may reduce the drug requirements for the treatment of hypertension.

Question 6

Mild hypertension is defined by a diastolic pressure consistently between 105 and 119.

Question 7

One of the most significant aspects of coronary heart disease is that

A) a number of the deaths that occur each year are premature deaths.
B) it is a disease of lifestyle.
C) it involves modifiable risk factors.
D) it is a non-communicable disease.
E) it is not as serious as most people think.

Question 8

One of the most significant aspects of CHD is that a number of the deaths that occur each year are premature deaths.

Question 9

Across the life span, women seem to be protected against coronary heart disease relative to men.

Question 10

In terms of emotional response, patients with left-brain damage from a stroke seem indifferent to their situation.

Question 11

Depression often is a complication of diabetes.

Question 12

Coronary heart disease (CHD) is the number _____ killer in Canada.

A) one
B) two
C) three
D) four
E) five

Question 13

The personality quality "agency" is associated with _______________, whereas "communion" is associated with _______________.

A) good physical and mental health outcomes; reduced psychological stress
B) good physical and mental health outcomes; few relations to physical and mental health outcomes
C) few relations to physical and mental health outcomes; good physical and mental health outcomes
D) reduced psychological stress; good physical and mental health outcomes
E) they are both related to good physical and mental health outcomes

Question 14

The number two killer in Canada, accounting for more than 20 percent of all deaths, is

A) diabetes.
B) coronary heart disease.
C) hypertension.
D) cancer.
E) parainfluenza.

Question 15

National campaigns to educate Canadians about hypertension have not been very successful in getting people diagnosed and treated.

Question 16

Whereas stress adversely affects adherence to treatment and diet, stress has not been found to directly affect Type I and Type II diabetes.

Question 17

Stroke occurs more often in women than in men.

Question 18

Women

A) show greater increases in cardiovascular, neuroendocrine, and some metabolic responses in response to stress than do men.
B) experience an increased risk of myocardial infarction or CHD-related death after menopause.
C) develop CHD on the average about 15 years earlier than do men.
D) seem to be protected at young ages against CHD due to their lower levels of HDL cholesterol.
E) have not been shown to have different risks for CHD than men.

Question 19

The combination of obesity centered around the waist, high levels of triglycerides, low levels of HDL cholesterol, and difficulty metabolizing blood sugar are symptomatic of

A) inflammation due to C-reactive protein.
B) metabolic syndrome.
C) angina pectoris.
D) cardiac arrest.
E) diabetes.

Question 20

A type of proinflammatory cytokine is implicated in the development of atherosclerosis.

Question 21

As a recommended intervention for the modification of coronary-prone behaviour, exercise can

A) reduce CHD risk factors.
B) enhance psychological well-being.
C) reduce CHD morbidity and mortality.
D) help reduce the anxiety associated with CHD following cardiac events.
E) All of these answers are correct.

Question 22

______________ is/are the most common drug treatment for reducing the incidence of death, heart attack, and stroke.

A) Statins
B) Diuretics
C) Beta-blockers
D) Vitamins
E) Aspirin

Question 23

Beta-blocking agents are used in cardiac rehabilitation

A) to activate the parasympathetic nervous system.
B) to resist the effects of sympathetic nervous system stimulation.
C) to control the pain of angina pectoris.
D) when behavioural stress management interventions fail.
E) to lower levels of LDL cholesterol.

Question 24

Social dominance is related to

A) CHD.
B) all-cause mortality.
C) a pattern of attempting to dominate social interactions.
D) a faster than normal speaking rate.
E) All of these answers are related to social dominance.

Question 25

Which type of hostility is most related to CHD?

A) oppositional defiant hostility
B) familial hostility
C) conflictual hostility
D) cynical hostility
E) major depressive hostility

Question 26

Depression may be a risk factor for CHD due to its relationship with

A) C-reactive protein.
B) the metabolic syndrome.
C) both C-reactive protein and the metabolic syndrome.
D) decreased energy levels.
E) Depression is not a risk factor for CHD.

Question 27

Which of the following has NOT been found to be associated with delay before seeking treatment for myocardial infarction?

A) interpretation of symptoms as mild disorders
B) being young and white
C) history of angina or diabetes
D) experiencing an attack during the daytime
E) they have all found to be associated with delay before seeking treatment for myocardial infarction

Question 28

In a study of Canadian-Chinese and American-Chinese women by Satia-Abouta, Patterson, Kristal, Teh, and Tu (2002), the prevalence of hypertension associated with acculturation may be traced to

A) the stress of acculturation.
B) the pressure to change traditional lifestyle practices, including an adopted diet lower in fruit and vegetables.
C) exposure to chronic environmental stressors.
D) anxiety related to learning a new language.
E) There are no health risks associated with acculturation.

Question 29

Cardiac rehabilitation programs involve

A) aerobic exercise.
B) smoking cessation.
C) reduced alcohol consumption.
D) aerobic exercise, smoking cessation, and reduced alcohol consumption.
E) aerobic exercise, smoking cessation only.

Question 30

Diastolic pressure is related to

A) resistance of the blood vessels to blood flow.
B) the amount of force developed during contraction of the heart.
C) the volume of blood leaving the heart.
D) the arteries' elasticity.
E) All of these answers are correct.

Question 31

The role of stress in the development and exacerbation of hypertension

A) is the same for people at risk for hypertension and those who are not at risk.
B) does not change as hypertension progresses.
C) may be different for people at risk for hypertension.
D) has not been studied enough to determine what the role is.
E) is still unclear.

Question 32

The longer immigrants have been living in Canada

A) the more levels of hypertension resemble the general population.
B) the incrementally more chance there is of having hypertension.
C) the less researchers can separate hypertension from socioeconomic variables.
D) the incidence of hypertension drops dramatically.
E) has no effect, hypertension can set in at any time during acculturation.

Question 33

Individuals who are high in hostility

A) have chronically higher blood pressure.
B) show more pronounced heart rate reactivity to laboratory stressors.
C) show more pronounced physiological reactions in response to interpersonal stressors.
D) exhibit a strong antagonistic response to sympathetic activity in response to stress.
E) exhibit higher levels of serotonin.

Question 34

According to a study of hypertension risk factors by Ewart (1991), the family environment that fosters _______________ may then contribute to hypertension.

A) negative affectivity
B) chronic anger
C) excessive competitiveness
D) cynical distrust
E) defensiveness

Question 35

Hostile individuals

A) exhibit a weak antagonistic response to sympathetic activity in response to stress
B) have a prolonged reactivity to stress
C) have larger and longer-lasting blood pressure responses to anger-arousing situations
D) show different patterns of immune activation in response to sympathetic activation
E) All of these answers are correct.

Question 36

In a study of cardiac invalidism (Taylor et al., 1985), wives' perceptions of their husbands' cardiac and physical efficiency were highest when they had

A) been provided information about their husband's medical and psychological condition.
B) observed their husband's performance on a treadmill task.
C) personally experienced the treadmill task themselves.
D) been involved in the decision making process regarding treatment.
E) observed them at home doing everyday tasks.

Question 37

Sudden death from heart attack is most likely to occur

A) at home.
B) at work.
C) on vacation.
D) while the patient is asleep.
E) at a restaurant.

Question 38

Males are at greater risk for hypertension

A) across the life span.
B) before age 40.
C) before age 50.
D) after age 50.
E) after age 60.

Question 39

Higher levels of hostility have been found among

A) men.
B) non-whites.
C) people low in socio-economic status (SES).
D) men, non-whites, and people with low socio-economic status (SES).
E) men and non-whites only, socioeconomic status (SES) does not affect higher hostility levels.

Question 40

Cardiac invalidism occurs when

A) patients and their spouses underestimate the patient's physical abilities.
B) spouses underestimate the extent of disability.
C) patients malinger in order to reap secondary gains associated with the sick role.
D) patients feel that they are unable to control the stressors in their daily lives.
E) spouses overestimate the patient's physical abilities.

Question 41

The correlation between beliefs about level of blood pressure and actual blood pressure is

A) high.
B) moderate.
C) low.
D) zero.
E) > than.8.

Question 42

Poor adherence to diabetes treatment seems to be due to

A) situational factors.
B) regional factors.
C) personality factors.
D) family background.
E) socio-economic status.

Question 43

What are the consequences of stroke? What are the rehabilitative interventions used to manage the consequences of stroke?

Question 44

Which of the following would BEST predict compliance with a diabetic treatment regimen?

A) the number of persons in the diabetic's social support network
B) training the diabetic to discriminate when his or her blood glucose level needed to be modified
C) any intervention that focuses on improving a sense of self-efficacy and the ability to independently regulate one's behaviour
D) stress management and relaxation training
E) having a family member present at diagnosis to take notes

Question 45

Explain the relationship of lifestyle factors to coronary heart disease and cardiac rehabilitation.

Question 46

Discuss what we currently know regarding how women experience coronary heart disease including the factors contributing to its development and the consequences for women in comparison to men.

Question 47

Which of the following is NOT one of the rehabilitative interventions used for stroke patients?

A) psychotherapy.
B) cognitive remedial training.
C) family counselling.
D) the use of structured, stimulating environments to challenge the stroke patient's capabilities.
E) training in specific skills development.

Question 48

The risk factors for stroke

A) are independent of those for heart disease.
B) decrease with age.
C) are not subject to modification by lifestyle changes.
D) include cigarette smoking.
E) None of these answers are correct.

Question 49

Stress has been implicated in

A) problems in glucose metabolism.
B) disruption of the performance of preventive health behaviours related to diabetes self-management.
C) adverse effects on adherence to diabetic treatment regimens and diet.
D) the aggravation of both Type I and Type II diabetes after diagnosis.
E) All of these answers are correct.

Question 50

Studies of diabetic control and adherence indicate that the best outcomes are found among adolescents who have

A) individual therapy.
B) family therapy.
C) parents who are actively involved in tasks such as monitoring glucose levels.
D) a dense social support network.
E) parents who allow them to monitor their own glucose levels, giving them a sense of independence and accomplishment.

Question 51

One drug treatment for hypertension, beta-adrenergic blockers, work by

A) decreasing cardiac output and decreasing plasma renin activity.
B) decreasing sympathetic outflow from the central nervous system.
C) depleting catecholamines from the brain and the adrenal medulla.
D) reducing blood volume by promoting the excretion of sodium.
E) decreasing cardiac output and increasing plasma renin activity.

Question 52

Type II (noninsulin-dependent) diabetes

A) develops relatively late in life (after age 40), but is becoming more common in children and adolescents.
B) accounts for 70 percent of all diabetics.
C) occurs when insulin action and secretion is regulated.
D) most commonly occur in women.
E) All of these answers are correct.

Question 53

Predictors of depression in stroke patients include

A) overprotection by a caregiver.
B) site and severity of stroke.
C) poor relation with a caregiver.
D) a caregiver with a negative viewpoint on the caregiving situation.
E) All of these answers are correct.

Question 54

Type I (insulin-dependent) diabetes

A) develops relatively late in life (after age 40).
B) accounts for 90 percent of all diabetics.
C) is characterized by an abrupt onset of symptoms.
D) usually is inherited.
E) is related to obesity.

Question 55

Caffeine restriction is often included as part of the dietary treatment of hypertension because

A) caffeine elevates blood pressure responses among those at risk for or already diagnosed with hypertension
B) caffeine generally contributes to rising levels of hypertension
C) it is an easy and inexpensive treatment
D) caffeine elevates blood pressure, contributes to rising levels of hypertension
E) caffeine restriction is never a recommended part of a dietary treatment for hypertension

Question 56

Cognitive behavioural techniques

A) may substitute for drug treatments in cases of severe hypertension.
B) aggravate sympathetic nervous system activity.
C) are effective but expensive compared to drug treatments for hypertension.
D) designed to control the expression of anger have been unsuccessful in the treatment of hypertension.
E) are effective because they do not require supervision and they have less side effects

Question 57

Explain why adherence to diabetic treatment programs is so difficult for most people to achieve.

Question 58

Small strokes that produce temporary weakness, clumsiness, or loss of feeling in one side or limb are called

A) cerebral hemorrhages.
B) hypertension.
C) CHD.
D) transient ischemic attacks.
E) temporary cerebral attacks.

Question 59

Patients with right-brain damage due to stroke typically suffer

A) communication disorders such as aphasia.
B) impaired performance on cognitive tasks that require the use of short-term memory.
C) difficulty in processing visual feedback.
D) extreme anxiety and depression.
E) impaired performance on tasks that require language generation.

Question 60

What ethnic differences have been found in the incidence of hypertension? What psychosocial factors may be implicated in these ethnic differences?