Deck 14: Clinical Presentation and Management of the Cardiac Patient

Question 1

What is the middle layer of a blood vessel called?

A)Tunica media
B)Tunica adventitia
C)Tunica intima
D)Tunica fascia

Answer 1

Tunica media

Question 2

Which of the following is not a sign of unstable angina?

A)Chest pain is more frequent or severe.
B)Chest pain occurs with less exertion or lasts longer than usual.
C)Chest pain does not respond to medications as it did before.
D)Chest pain occurs for shorter periods.

Answer 2

Chest pain occurs for shorter periods.

Question 3

What is the function of the tunica adventitia?

A)Dilate and constrict to maintain homeostasis
B)Keep the vessel open
C)Allow medications to pass through
D)Come in direct contact with the blood

Answer 3

Keep the vessel open

Question 4

Which of the following is one of the primary branches of the right coronary artery and supplies blood to the walls of the right atrium and the right ventricle?

A)Circumflex artery
B)Posterior descending artery
C)Marginal artery
D)Left anterior descending artery

Question 5

Which of the following is one of the primary branches of the right coronary artery, providing blood to the posterior wall of the heart?

A)Circumflex artery
B)Posterior descending artery
C)Left anterior descending artery
D)Anterior interventricular artery

Question 6

What is the function of the tunica media?

A)Dilate and constrict to maintain homeostasis
B)Keep the vessel open
C)Allow medications to pass through
D)Come in direct contact with the blood

Question 7

What is the outermost layer of a blood vessel called?

A)Tunica media
B)Tunica adventitia
C)Tunica intima
D)Tunica fascia

Question 8

Which three groups of patients may present with atypical cardiac complaints or problems?

A)Patients with diabetes, patients who smoke, and patients who abuse drugs
B)Women, the elderly, patients with diabetes
C)African Americans, teenagers, patients who smoke
D)Children, patients with cancer, the elderly

Question 9

Which layer of a blood vessel is prone to disruption when atherosclerotic plaque is ruptured and peels away?

A)Tunica media
B)Tunica adventitia
C)Tunica intima
D)Tunica fascia

Question 10

Which of the following is one of the primary branches of the left coronary artery and supplies blood to both of the ventricles?

A)Circumflex artery
B)Posterior descending artery
C)Marginal artery
D)Left anterior descending artery

Question 11

Which of the following are not symptoms that may occur due to blockage of the coronary arteries?

A)Shortness of breath, sweating, and chest pain
B)Neck pain, cough, and back pain
C)Edema and decreased urinary output
D)Dizziness, nausea, and arm pain

Question 12

Which of the following is one of the primary branches of the left coronary artery and winds around, supplying blood to the lateral wall of the left ventricle?

A)Circumflex artery
B)Posterior descending artery
C)Left anterior descending artery
D)Anterior interventricular artery

Question 13

What is the function of the tunica intima?

A)Dilate and constrict to maintain homeostasis
B)Keep the vessel open
C)Allow medications to pass through
D)Come in direct contact with the blood

Question 14

Approximately how many people in the United States suffer from angina?

A)10,000
B)1 million
C)3 million
D)7 million

Question 15

What is the term for an oppressive pain or pressure in the chest that occurs when the heart muscle does not receive enough oxygen due to partial or complete blockage of a coronary artery?

A)Apnea
B)Asystole
C)Angina
D)Arrhythmia

Question 16

What percentage of women who are having a heart attack never experience chest pain?

A)10%
B)25%
C)37%
D)75%

Question 17

What is the innermost layer of a blood vessel called?

A)Tunica media
B)Tunica adventitia
C)Tunica intima
D)Tunica fascia

Question 18

Which of the following conditions is not a common source of noncardiac chest pain?

A)Inflammation of the lungs
B)Gastric or esophageal irritation
C)Cirrhosis of the liver
D)Gallbladder pain

Question 19

The average person waits how many hours before seeking help for symptoms of a heart attack?

A)1 hour
B)3 hours
C)12 hours
D)24 hours

Question 20

Unstable angina is a warning sign that a patient's cardiac disease has ________.

A)Worsened
B)Remained stable
C)Resulted in decreased cardiac output
D)Developed into a dysrhythmia

Question 21

What is Coumadin used for?

A)To increase the activity of vitamin K
B)To promote the growth of new collateral blood vessels
C)To prevent restenosis of a blood vessel
D)To reduce clot formation in the blood

Question 22

A patient with diabetes is how many times more likely than patients without diabetes to experience a heart attack?

A)Two times
B)Three times
C)Five times
D)Ten times

Question 23

Which of the following are not symptoms of left ventricular failure?

A)Shortness of breath, fatigue, and tachycardia
B)Confusion and anorexia
C)Hypertension and increased thirst
D)Decreased urine production and pallor

Question 24

Approximately what percentage of elderly patients present with atypical cardiac symptoms?

A)25%
B)50%
C)75%
D)90%

Question 25

Which of the following are not common cardiac symptoms in elderly patients?

A)Shortness of breath and nausea
B)Profuse sweating and pain in the arms
C)Syncope and weakness or fatigue
D)Hypertension and edema

Question 26

What percentage of patients present with STEMI?

A)Less than 10%
B)20% to 25%
C)40% to 50%
D)75% to 80%

Question 27

What is the S-A-M-P-L-E mnemonic used for?

A)Obtaining an insurance referral
B)Gathering information about the patient's family history
C)Gathering additional medical information
D)Determining the patient's pain level

Question 28

Which procedure allows visualization of the coronary arteries and placement of a stent?

A)Echocardiography
B)Enhanced external counter pulsation
C)Coronary artery bypass
D)Cardiac catheterization

Question 29

Which of the following are common cardiac symptoms in women?

A)Migraine headaches
B)Unusual fatigue and cold sweats
C)Leg pain and edema
D)Bloating

Question 30

Why does non-STEMI present a challenge to the health care team?

A)The patient often mistakes the symptoms for indigestion.
B)The ECG tracing looks similar to that of a patient with complete heart block.
C)The ECG tracing does not reflect ST segment deviation or presence of a pathologic Q wave.
D)There is no conclusive method to determine whether an MI has occurred.

Question 31

What is the most common cause of heart failure?

A)Dysrhythmias
B)Ischemia
C)MI
D)Diabetes

Question 32

What is the term for fatty deposits accumulated by elevated glucose levels?

A)Atherosclerotic plaque
B)Antigens
C)Ascites
D)Angiographic plaque

Question 33

What is the term for an abnormal collection of fluid in the lungs due to left ventricular failure?

A)Pulmonary hypertension
B)Pulmonary edema
C)Pulmonary embolism
D)Pulmonary necrosis

Question 34

Which of the following changes does not typically occur in an ECG tracing with a STEMI?

A)Absence of P waves
B)T wave inversion
C)Development of a pathologic Q wave
D)ST segment depression or elevation

Question 35

What condition caused by chronic diabetes impairs sensations or causes a loss of sensation?

A)Neuroblastoma
B)Neuralgia
C)Neuropathy
D)Nephritis

Question 36

The mnemonic O-P-Q-R-S-T helps health care professionals remember the questions to ask when evaluating which of the following?

A)Pain or discomfort the patient is experiencing
B)Additional medical information
C)Patient demographics
D)Patient's family history

Question 37

What causes STEMI?

A)An area of ischemia in the heart tissue
B)Incomplete occlusion of a coronary artery
C)Severe dysrhythmia
D)Complete occlusion of a coronary artery

Question 38

What three symptoms, when presented together, are known as the "clinical triad" and are indicative of right ventricular failure?

A)Shortness of breath, chest pain, and confusion
B)Rales, tachycardia, and anorexia
C)Ascites, edema, and pallor
D)Jugular vein distention, hypotension, and normal breath sounds

Question 39

Which of the following is referred to as the "classic MI"?

A)Acute coronary syndrome MI
B)Non-STEMI
C)STEMI
D)Pathologic Q wave MI

Question 40

What is the term for inadequate flow of arterial blood, typically as a result of left ventricular failure?

A)Cardiogenic shock
B)Anaphylactic shock
C)Hypovolemic shock
D)Neurogenic shock

Question 41

Which of the following foods would be restricted in a patient's diet while he or she is taking Coumadin?

A)Apples
B)Onions
C)Bell peppers
D)Spinach

Question 42

For which of the following conditions might Coumadin be prescribed for a patient?

A)Hypovolemia
B)Hypertension
C)Hypercoagulopathy
D)Hypotension

Question 43

Which of the following is not a common cause of left ventricular heart failure?

A)Right ventricular heart failure
B)Hypertension
C)Atrial fibrillation
D)STEMI

Question 44

Which of the following procedures is a reasonable alternative for a patient who has had heart failure and is not strong enough to withstand heart catheterization?

A)Percutaneous coronary intervention
B)Enhanced external counter pulsation
C)Percutaneous transluminal coronary intervention
D)Coronary artery bypass graft surgery

Question 45

For which of the following patients is fibrinolytic therapy not appropriate?

A)A 44-year-old male patient with suspected coronary occlusion
B)A 52-year-old female patient with a blood pressure of 160/110 mmHg
C)A 36-year-old female cardiac patient who lives in a rural area
D)A 47-year-old male patient with a blood pressure of 110/54 mmHg

Question 46

Which of the following patients is the most likely candidate for a left ventricular assist device (LVAD)?

A)A 42-year-old woman with uncontrolled hypertension
B)A 67-year-old man with partial blockage of two coronary arteries
C)A 49-year-old woman in end-stage heart failure
D)A 56-year-old man with extensive disease in the left main coronary artery

Question 47

When angioplasty is performed on a coronary vessel, a stent is typically inserted to do what?

A)Repair the vessel walls
B)Help prevent restenosis
C)Reroute blood flow away from the surgical site
D)Prevent excess bleeding from the surgical site

Question 48

What is a typical cause of NSTEMI?

A)An incomplete occlusion of a coronary artery
B)Sudden, complete blockage due to thrombosis
C)Chronic left ventricular failure
D)Bundle branch block

Question 49

What is the broad term that refers to STEMI, NSTEMI, and unstable angina?

A)Thrombosis
B)Coronary plaque
C)Acute coronary syndrome
D)Chronic heart failure

Question 50

Which of the following is one reason heart disease is slightly more common in men than in women?

A)Women have a faster basal heart rate.
B)Hormones produced during the childbearing years reduce the risk in women.
C)Women generally handle stress better than men.
D)Women are more active and exercise more frequently than men.

Question 51

A patient is brought to the emergency department by ambulance. He is having severe chest pain that is radiating through his left arm and is having difficulty breathing. You suspect that the patient will be rushed into surgery soon. What must you do before the patient is given narcotics for the pain?

A)Check and record the patient's blood pressure.
B)Inform the patient's family that surgery is likely.
C)Have the patient sign a consent form.
D)Administer oxygen to the patient.

Question 52

You are preparing Mrs. Bayfield for percutaneous coronary intervention. As you explain the procedure to her, she states, "They are going to put a stent in my heart, so why do they need to inject dye in my arm?" What should you tell Mrs. Bayfield?

A)The dye is used to find the exact location of the blockage.
B)The dye contains Coumadin, which will make the blood flow more freely.
C)The dye is a precaution to help the surgeon avoid nearby nerve endings.
D)The dye is an indicator that changes color when blood flow is restored.

Question 53

What is the term for a concentrated amount of medication administered over a short period of time?

A)Stent
B)Catheter
C)Bolus
D)Thrombus

Question 54

Emergency test results indicate that Mr. Hartman has had an MI due to 90% occlusion of the right coronary artery. The physician has determined that a procedure needs to be performed immediately to open the artery. Which of the following procedures is the physician most likely to order for Mr. Hartman?

A)Coronary artery bypass graft surgery
B)Enhanced external counter pulsation therapy
C)Percutaneous transluminal coronary angioplasty
D)Thrombolytic therapy

Question 55

Treatment for hypovolemia may include which of the following therapies?

A)Aspirin administration
B)Nitroglycerin administration
C)Pacemaker insertion
D)IV fluid challenge

Question 56

What minimally invasive procedure is frequently performed to open narrowed or blocked blood vessels?

A)Thromboplastic surgery
B)Angiography
C)Venostasis
D)Angioplasty

Question 57

A patient has been brought to the emergency department complaining of chest pain and dizziness. When assessing this patient, what should the health care professional do?

A)Take extra time to ensure complete accuracy of the information obtained.
B)Gather information quickly and efficiently and report it immediately to the physician.
C)Do a cursory assessment only because the patient needs immediate treatment.
D)Wait to do the assessment until after a stent has been inserted.

Question 58

When might sudden cardiac arrest occur?

A)When a portion of the heart does not receive enough oxygen
B)When the heart's electrical system fails, often without warning
C)When the heart is unable to pump a sufficient amount of blood to body tissues
D)When a coronary artery becomes completely occluded

Question 59

What is the term for a medication that is administered intravenously to convert plasminogen to plasmin, which then breaks down the fibrin in a clot?

A)Thrombolytic agent
B)Anticoagulant
C)Fluorescent dye
D)Bolus

Question 60

Which of the following is a common cause of right ventricular heart failure?

A)Atrial tachycardia
B)Ventricular fibrillation
C)Chronic lung disease
D)Gallbladder disease

Question 61

Which of the following memory tools is useful for gathering information regarding oral intake?

A)ABCDE
B)SAMPLE
C)OPQRST
D)ACLS

Question 62

Which of the following therapeutic measures may be performed on patients with recurrent angina or on heart failure patients who are typically not strong enough to withstand major surgery?

A)CABG
B)Balloon angioplasty and stent
C)Stent only
D)EECP

Question 63

How many 81-mg aspirin are typically ordered for administration to the chest pain patient?

A)None
B)1
C)2-4
D)5-6

Question 64

The patient with chest pain will be going for a cardiac catheterization and the following orders have not been completed. Which one should be done last?

A)administer morphine
B)start an intravenous line
C)administer nitroglycerin
D)obtain a signed content

Question 65

Which of the following memory tools is useful for gathering information regarding pain a patient is experiencing?

A)ABCDE
B)SAMPLE
C)OPQRST
D)ACLS

Question 66

Which chambers or surfaces of the heart are at risk for infarction with a "widow maker"?

A)Right and left ventricles
B)Right ventricle, posterior surface and septum
C)Anterior, lateral and septal surfaces of the left ventricle
D)Left ventricle and both atria