Deck 13: Diseases of the Cardiovascular System

Question 1

A patient's ECG was abnormal and the physician determined that a pacemaker was necessary Which of the following best describes the normal electrical functioning of the heart?

A)Electrical activity is initiated by the SA node and depolarization is carried from the ventricle by the AV node.
B)Electrical activity is initiated by the AV node and depolarization is carried from the atria by the SA node.
C)As the resting membrane potential decreases the SA node will reach its depolarization threshold.
D)As the resting membrane potential increases the AV node will reach its depolarization threshold.

Answer 1

C

Question 2

When the fibers of the _____ nervous system are stimulated, they release norepinephrine, which _____ heart rate

A)parasympathetic, increases
B)sympathetic, increases
C)parasympathetic, decreases
D)sympathetic, decreases

Answer 2

B

Question 3

Which of the following is consistent with the DASH diet?

A)increased fruits and vegetables
B)decreased monounsaturated fat
C)increased amounts of processed foods
D)strict restriction of NaCl to less than 2 g/day

Answer 3

A

Question 4

The middle layer of the heart is called the _____ and is responsible for _____

A)epicardium, contractions
B)myocardium, contractions
C)endocardium, thermoregulation
D)myocardium, thermoregulation

Question 5

Beta-adrenergic blocking agents (such as atenolol) work to:

A)decrease heart rate.
B)block vascular muscle action.
C)reduce vasoconstriction.
D)suppress the action of aldosterone.

Question 6

Relaxation of the ventricle as it fills with blood is referred to as

A)diastole.
B)systole.
C)tachycardia.
D)arrhythmia.

Question 7

At Mr Jones's annual examination, his blood pressure was 165/80 What category would this put him in?

A)high-normal BP
B)stage 1 hypertension
C)stage 2 hypertension
D)stage 3 hypertension

Question 8

Gas exchange occurs in the body's:

A)endocardium.
B)arteries.
C)capillaries.
D)arterioles.

Question 9

Within the cardiac cycle, contraction of the ventricle and ejection of the blood is referred to as

A)diastole.
B)systole.
C)tachycardia.
D)arrhythmia.

Question 10

Which of the following is an example of a medication that works as a vasodilator?

A)aspirin
B)nitroglycerin
C)verapamil

Question 11

You have a patient who is taking a medication to control hypertension He mentioned that his doctor described this medicine as "blocking the enzyme that converts angiotensin" Which medication is he taking?

A)calcium channel blocker
B)beta adrenergic blocking agent
C)ACE inhibitor
D)carbonic anhydrase inhibitor

Question 12

Which of the following is not high in sodium?

A)Alka-Seltzer
B)broth
C)MSG
D)frozen vegetables

Question 13

Which of the following ethnic and gender groups shows the highest prevalence of hypertension?

A)Mexican females
B)Black males
C)White males
D)Hispanic males

Question 14

The etiology of secondary hypertension may be:

A)excessive sodium intake.
B)obesity.
C)genetics.
D)renal artery disease.

Question 15

We say that most cases of hypertension are considered to be essential hypertension What does this mean?

A)it is a very serious disease
B)it is caused by a dietary factor
C)the etiology is unknown

Question 16

Which part of the heart pumps blood to the systemic circulation?

A)left ventricle
B)right ventricle
C)left atria
D)right atria

Question 17

Which of the following is not one of the basic components of the nutrition therapy for hypertension?

A)weight reduction, if needed
B)low potassium intake
C)reduced NaCl intake
D)high calcium intake

Question 18

Which of the following minerals does not have a positive effect on blood pressure?

A)Mn
B)Ca
C)Mg
D)K

Question 19

ACE Inhibitors work to control blood pressure by

A)increasing urine excretion.
B)blocking an enzyme that causes vasodilation.
C)blocking receptors in heart that in turn decreases rate and cardiac output.
D)preventing conversion of angiotensin I into angiotensin II.

Question 20

The MAP is regulated by all of the following except:

A)smooth muscle tissue.
B)the renin-angiotensin system.
C)the kidneys.
D)the sympathetic nervous system.

Question 21

You have instructed your patients to look for "Light in Sodium" on certain food labels This means:

A)the food only contains 5 mg of sodium.
B)the food contains 50% less sodium than the regular version.
C)the food contains 25% less sodium than the regular version.
D)the food has 140 mg or less of sodium per serving.

Question 22

Someone who has suffered an MI:

A)has elevated total and LDL cholesterol.
B)has ventricular tachycardia.
C)has necrosis of the myocardial cells.
D)will show decreased CK-MB levels.

Question 23

The name of the lipoprotein with the highest triglyceride content is:

A)VLDL.
B)LDL.
C)IDL.
D)HDL.

Question 24

Atherosclerosis is negatively associated with:

A)chylomicrons.
B)VLDL cholesterol.
C)LDL cholesterol.
D)HDL cholesterol.

Question 25

If a patient develops heart failure, which of the following is not a possible etiological factor?

A)LV hypertrophy
B)arterial aneurysm
C)renal disease
D)dilated cardiomyopathy

Question 26

Atherosclerosis begins as a _____, and progresses to a(n) _____

A)foam cell, fibrous plaque
B)fatty streak, foam cell
C)fibrous plaque, aneurysm
D)clot, complicated lesion

Question 27

A desirable LDL level is less than:

A)160 mg/dL.
B)140 mg/dL.
C)100 mg/dL.
D)200 mg/dL.

Question 28

All of the following may be incorporated into plaque formation except:

A)collagen.
B)NO.
C)connective tissue.
D)smooth muscle cells.

Question 29

The name of a lipid neutral fatty acid (ie, one that does not seem to affect LDL levels) is:

A)oleic.
B)linolenic.
C)stearic.
D)myristic.

Question 30

Abnormal findings commonly seen in metabolic syndrome include:

A)increased TG, HDL, and BP.
B)decreased MCHC and HgbA1c.
C)increased TG, wt, and BP.
D)decreased HDL, TG, and BP.

Question 31

You have a patient with a thrombus that has occluded the lumen of the artery in his leg Which type of intervention would be necessary?

A)lifestyle modifications
B)increase his bile acid sequestrant medication
C)help him to increase his HDL cholesterol
D)surgery

Question 32

Good advice for a dietitian working with clients who have cardiac disease is:

A)focus on the cumulative effect of diet and lifestyle changes.
B)focus on increasing fiber because research shows a positive effect on cholesterol levels.
C)always obtain a full lipid profile.
D)assess the level of physical activity the patient is at and counsel towards meeting the recommendations of the American Heart Association.

Question 33

Which of the following statements is true?

A)Risk factors for atherosclerosis are similar to those for IHD.
B)Plaque build-up is usually on the non-branching portions of the artery.
C)CRP is only useful when a coronary event has taken place.
D)Lifestyle modifications as interventions have not yet been proven in the research.

Question 34

Occlusion of an artery that does not permit blood flow is _____, whereas cell death due to the resulting lack of oxygen is termed _____

A)ischemia, infarction
B)angina, infarction
C)ischemia, angina
D)infarction, ischemia

Question 35

Which lipoprotein is responsible for the transport of lipids that are consumed by mouth?

A)chylomicrons
B)LDL
C)VLDL
D)ILDL

Question 36

The difference between an aneurysm and an embolism is:

A)atherosclerosis vs.ballooning artery wall.
B)wandering clot vs.ruptured artery wall.
C)ballooning artery wall vs.wandering clot.
D)narrowing artery wall vs.ruptured artery wall.

Question 37

The term used to describe substernal pain experienced when the workload of the heart is increased due to physical or emotional stress is:

A)ventricle fibrillation.
B)PVD.
C)stable angina.
D)unstable angina.

Question 38

Which of the following fats is associated with increased risk of myocardial infarction and increased inflammatory response?

A)PUFA
B)trans fats
C)MUFA
D)dietary cholesterol

Question 39

Which of the following people has the highest risk for developing heart disease?

A)someone who eats a high amount of cholesterol each day
B)someone who has a family history of hypertension
C)someone who is diabetic
D)someone who has a low HDL

Question 40

Which type of oil has the highest monounsaturated content?

A)corn oil
B)canola oil
C)any vegetable oil
D)soybean oil

Question 41

TR is a 75 yo M admitted into the hospital with heart failure.He complains of shortness of breath and orthopnea and has not eaten for several days.He has a history of hypertension, which has gone uncontrolled for several decades.His typical intake is:
B Scrambled eggs D 1 12-oz can tomato soup
Bacon 1 slice meat loaf
Grits 20 oz lemonade
16 oz orange juice
Banana
L Pastrami sandwich on rye bread
Potato salad
1 12-oz can of clam chowder
20 oz water
For which medication likely to be prescribed to TR should he receive education on drug-nutrient interactions?

A)ACE inhibitors
B)diuretics
C)nitrates
D)calcium channel blockers

Question 42

Case Study Multiple Choice
PT is a 65 yo M who comes to the emergency room complaining of chest pain.Several diagnostic tests conclude that he has suffered an MI.The registered dietitian is consulted for nutrition education.PT reports that he has gained 30 pounds in the previous year due to his hectic work schedule, which forces him to eat out often.In addition, he is physically inactive.PT also reports that he has a family history of heart disease and his father died of an MI.
HT: 5'9 WT: 190# Waist Circumference: 105 cm BP: 140/93
Cholesterol: 259
LDL: 180
HDL: 58
TG: 234
Diet Hx:
B Egg and sausage muffin D Chicken breast
Coffee Mashed potatoes
Iced tea
L Ham and cheese sandwich on white bread Cheesecake
Potato chips
Soda
Which of the following fortified foods, when consumed twice daily, can have therapeutic effects on cholesterol?

A)nuts
B)folate
C)vitamin B6
D)plant stanols

Question 43

Clients with edema associated with congestive heart failure usually have orders for:

A)cholesterol restriction and bile acid sequestrants.
B)saturated fat restriction and corticosteroids.
C)sodium restriction, fluid restriction, and diuretics.
D)carbohydrate restriction and insulin.

Question 44

Case Study Multiple Choice
PT is a 65 yo M who comes to the emergency room complaining of chest pain.Several diagnostic tests conclude that he has suffered an MI.The registered dietitian is consulted for nutrition education.PT reports that he has gained 30 pounds in the previous year due to his hectic work schedule, which forces him to eat out often.In addition, he is physically inactive.PT also reports that he has a family history of heart disease and his father died of an MI.
HT: 5'9 WT: 190# Waist Circumference: 105 cm BP: 140/93
Cholesterol: 259
LDL: 180
HDL: 58
TG: 234
Diet Hx:
B Egg and sausage muffin D Chicken breast
Coffee Mashed potatoes
Iced tea
L Ham and cheese sandwich on white bread Cheesecake
Potato chips
Soda
The registered dietitian may recommend which of the following additions to PT's diet to help decrease the absorption of lipids and increase their excretion?

A)nuts
B)soluble fiber
C)folate
D)complex carbohydrates

Question 45

TR is a 75 yo M admitted into the hospital with heart failure.He complains of shortness of breath and orthopnea and has not eaten for several days.He has a history of hypertension, which has gone uncontrolled for several decades.His typical intake is:
B Scrambled eggs D 1 12-oz can tomato soup
Bacon 1 slice meat loaf
Grits 20 oz lemonade
16 oz orange juice
Banana
L Pastrami sandwich on rye bread
Potato salad
1 12-oz can of clam chowder
20 oz water
TR is at risk for developing which condition?

A)cardiac cachexia
B)metabolic syndrome
C)ischemic heart disease
D)atherosclerosis

Question 46

TR is a 75 yo M admitted into the hospital with heart failure.He complains of shortness of breath and orthopnea and has not eaten for several days.He has a history of hypertension, which has gone uncontrolled for several decades.His typical intake is:
B Scrambled eggs D 1 12-oz can tomato soup
Bacon 1 slice meat loaf
Grits 20 oz lemonade
16 oz orange juice
Banana
L Pastrami sandwich on rye bread
Potato salad
1 12-oz can of clam chowder
20 oz water
Which is the likely cause of his heart failure?

A)age
B)hypertension
C)high consumption of fat
D)gender

Question 47

TR is a 75 yo M admitted into the hospital with heart failure.He complains of shortness of breath and orthopnea and has not eaten for several days.He has a history of hypertension, which has gone uncontrolled for several decades.His typical intake is:
B Scrambled eggs D 1 12-oz can tomato soup
Bacon 1 slice meat loaf
Grits 20 oz lemonade
16 oz orange juice
Banana
L Pastrami sandwich on rye bread
Potato salad
1 12-oz can of clam chowder
20 oz water
Which of the following foods is contributing the most sodium to his diet?

A)rye bread
B)canned soup
C)meat loaf
D)eggs

Question 48

The term for protein-energy malnutrition associated with congestive heart failure is:

A)anorexia nervosa.
B)cardiac cachexia.
C)dyspnea.
D)tachycardia.

Question 49

Over time as the heart is unable to deliver oxygen to the tissues, the condition of _____ develops

A)congestive heart failure
B)high blood pressure
C)cardiac arrhythmia

Question 50

Case Study Multiple Choice
PT is a 65 yo M who comes to the emergency room complaining of chest pain.Several diagnostic tests conclude that he has suffered an MI.The registered dietitian is consulted for nutrition education.PT reports that he has gained 30 pounds in the previous year due to his hectic work schedule, which forces him to eat out often.In addition, he is physically inactive.PT also reports that he has a family history of heart disease and his father died of an MI.
HT: 5'9 WT: 190# Waist Circumference: 105 cm BP: 140/93
Cholesterol: 259
LDL: 180
HDL: 58
TG: 234
Diet Hx:
B Egg and sausage muffin D Chicken breast
Coffee Mashed potatoes
Iced tea
L Ham and cheese sandwich on white bread Cheesecake
Potato chips
Soda
In addition to suffering an MI, what other diagnosis can the MD make based on the available clinical data?

A)PVD
B)metabolic syndrome
C)hyperhomocysteinemia
D)CHF

Question 51

Case Study Multiple Choice
PT is a 65 yo M who comes to the emergency room complaining of chest pain.Several diagnostic tests conclude that he has suffered an MI.The registered dietitian is consulted for nutrition education.PT reports that he has gained 30 pounds in the previous year due to his hectic work schedule, which forces him to eat out often.In addition, he is physically inactive.PT also reports that he has a family history of heart disease and his father died of an MI.
HT: 5'9 WT: 190# Waist Circumference: 105 cm BP: 140/93
Cholesterol: 259
LDL: 180
HDL: 58
TG: 234
Diet Hx:
B Egg and sausage muffin D Chicken breast
Coffee Mashed potatoes
Iced tea
L Ham and cheese sandwich on white bread Cheesecake
Potato chips
Soda
PT's diet is high in which nutrient?

A)saturated fat
B)polyunsaturated fat
C)monounsaturated fat
D)vitamins

Question 52

TR is a 75 yo M admitted into the hospital with heart failure.He complains of shortness of breath and orthopnea and has not eaten for several days.He has a history of hypertension, which has gone uncontrolled for several decades.His typical intake is:
B Scrambled eggs D 1 12-oz can tomato soup
Bacon 1 slice meat loaf
Grits 20 oz lemonade
16 oz orange juice
Banana
L Pastrami sandwich on rye bread
Potato salad
1 12-oz can of clam chowder
20 oz water
If TR had visited a registered dietitian and was placed on the DASH diet, which food from his diet would be recommended for its contribution of beneficial minerals?

A)eggs
B)grits
C)banana
D)rye bread

Question 53

When the heart is unable to pump hard enough, blood may diffuse into the surrounding tissues How does the kidney respond to this change in fluid volume?

A)releases renin, causing conversion of angiotensin I to angiotensin II
B)reduces blood pressure
C)excretes excessive fluid
D)the kidney does not respond

Question 54

If heart failure originates on the left side of the heart, the patient will most likely present with:

A)pulmonary edema.
B)ascites.
C)peripheral edema.

Question 55

Case Study Multiple Choice
PT is a 65 yo M who comes to the emergency room complaining of chest pain.Several diagnostic tests conclude that he has suffered an MI.The registered dietitian is consulted for nutrition education.PT reports that he has gained 30 pounds in the previous year due to his hectic work schedule, which forces him to eat out often.In addition, he is physically inactive.PT also reports that he has a family history of heart disease and his father died of an MI.
HT: 5'9 WT: 190# Waist Circumference: 105 cm BP: 140/93
Cholesterol: 259
LDL: 180
HDL: 58
TG: 234
Diet Hx:
B Egg and sausage muffin D Chicken breast
Coffee Mashed potatoes
Iced tea
L Ham and cheese sandwich on white bread Cheesecake
Potato chips
Soda
Which of the following is an alterable risk factor that contributed to his condition?

A)obesity
B)family history
C)age
D)gender

Question 56

Case Study Multiple Choice
PT is a 65 yo M who comes to the emergency room complaining of chest pain.Several diagnostic tests conclude that he has suffered an MI.The registered dietitian is consulted for nutrition education.PT reports that he has gained 30 pounds in the previous year due to his hectic work schedule, which forces him to eat out often.In addition, he is physically inactive.PT also reports that he has a family history of heart disease and his father died of an MI.
HT: 5'9 WT: 190# Waist Circumference: 105 cm BP: 140/93
Cholesterol: 259
LDL: 180
HDL: 58
TG: 234
Diet Hx:
B Egg and sausage muffin D Chicken breast
Coffee Mashed potatoes
Iced tea
L Ham and cheese sandwich on white bread Cheesecake
Potato chips
Soda
Should the MD decide to put PT on medication to lower his cholesterol, what would be an optimal LDL level for him to achieve?

A)150
B)130
C)100
D)120

Question 57

TR is a 75 yo M admitted into the hospital with heart failure.He complains of shortness of breath and orthopnea and has not eaten for several days.He has a history of hypertension, which has gone uncontrolled for several decades.His typical intake is:
B Scrambled eggs D 1 12-oz can tomato soup
Bacon 1 slice meat loaf
Grits 20 oz lemonade
16 oz orange juice
Banana
L Pastrami sandwich on rye bread
Potato salad
1 12-oz can of clam chowder
20 oz water
Due to his diagnosis and symptoms, what will he have to limit?

A)saturated fat
B)fiber
C)cholesterol
D)fluids