Deck 12: Cardiovascular System Disorders

Question 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.

Answer 1

relaxation of smooth muscle in the arterioles.

Question 2

A partial obstruction in a coronary artery will likely cause:

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

Answer 2

angina attacks.

Question 3

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.

Answer 3

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

Question 4

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

Question 5

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)

Question 6

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.

Question 7

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 8

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.

Question 9

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.

Question 10

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 11

The first arteries to branch off the aorta are the:

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

Question 12

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.

Question 13

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.

Question 14

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.

Question 15

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

Question 16

The term preload refers to:

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

Question 17

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.

Question 18

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

Question 19

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 20

Which of the following are predisposing factors to thrombus formation in the circulation?
1) Decreased viscosity of the blood
2) Damaged blood vessel walls
3) Immobility
4) Prosthetic valves

A)1, 3
B)2, 4
C)1, 3, 4
D)2, 3, 4

Question 21

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.

Question 22

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.

Question 23

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.

Question 24

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.

Question 25

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.

Question 26

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.

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

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

Question 29

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 30

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 31

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 32

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 33

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 34

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.

Question 35

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 36

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

Question 37

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 38

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 39

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.

Question 40

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.

Question 41

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.

Question 42

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.

Question 43

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.

Question 44

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.

Question 45

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 46

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.

Question 47

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.

Question 48

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.

Question 49

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 50

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.

Question 51

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.

Question 52

A source of an embolus causing an obstruction in the brain could be the:

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

Question 53

Pericarditis may be caused by:
1) infection.
2) abnormal immune responses.
3) injury.
4) malignant neoplasm.

A)1, 2
B)3, 4
C)1, 3, 4
D)1, 2, 3, 4

Question 54

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.

Question 55

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.

Question 56

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.

Question 57

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

Question 58

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 59

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 60

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.

Question 61

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 62

Atherosclerosis in the iliac or femoral arteries is likely to cause which of the following?
1) Gangrenous ulcers in the legs
2) Strong rapid pulses in the legs
3) Intermittent claudication
4) Red, swollen legs

A)1, 2
B)1, 3
C)2, 3
D)2, 4

Question 63

A friction rub is associated with:

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

Question 64

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.

Question 65

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 66

What are the early signs of circulatory shock?
1) Pale moist skin
2) Loss of consciousness
3) Anxiety and restlessness
4) Rapid strong pulse

A)1, 2
B)1, 3
C)1, 4
D)3, 4

Question 67

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 68

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 69

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.

Question 70

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.

Question 71

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.

Question 72

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 73

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 74

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.

Question 75

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.

Question 76

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.

Question 77

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.

Question 78

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.

Question 79

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.

Question 80

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.