Deck 2: Cardiac

Question 1

Which of the following are causes of orthostatic hypotension?

A)Asthma, Addison's disease, alpha blockers
B)Pulmonary edema, COPD, antihistaminics
C)Anxiety, vasculitis, beta agonist
D)Diuretics, pregnancy, burns, excessive heat exposure

Answer 1

Diuretics, pregnancy, burns, excessive heat exposure

Question 2

Which of the phenomena is matched correctly with the relevant of general adaptation syndrome?

A)Alarm stage - initial response to a stressor
B)Stage of exhaustion - point at which the stressor becomes dysfunctional
C)Stage of resistance - individual continues the fight or flight response

Answer 2

Alarm stage - initial response to a stressor

Question 3

An 80-year old hypertensive male is on regular antihypertensive medication, complaints of dizziness, fatigue, syncope or fainting, mental confusion, and lightheadedness after eating meals. The attending nurse records a postprandial fall in blood pressure. What is the appropriate advice to be given by the nurse to help his condition?

A)Stop taking all antihypertensive medications
B)Do heavy exercise after taking meals
C)Stay in lying down position after meals
D)Eat smaller meals low in carbohydrates

Answer 3

Eat smaller meals low in carbohydrates

Question 4

When ventricular fibrillation occurs in the coronary care unit, the immediate action is to:

A)Initiate CPR and administer oxygen
B)Defibrillate the patient
C)Cardiovert by giving 1 shock at 360J
D)Administer Sodium Bicarbonate IV

Question 5

A patient is taking Lisinopril 10mg. The nurse knows that the desired effect for this medication would be to?

A)Relieve abdominal pain
B)Decrease heart rate
C)Decrease blood pressure
D)Decrease body temperature

Question 6

The nurse is assessing a patient suspected to have myocardial infarction. Which of the following questions is a priority?

A)Are you undergoing a lot of stress lately?
B)When did these symptoms start?
C)Did you take any medications recently?
D)All of the above

Question 7

An 80-year-old female patient presents with tender painful knee joints. Which of the following pharmacologic agents may be useful in treatment of her condition?

A)Corticosteroids, hydroxychloroquine, dicyclomine
B)Non-steroidal anti-inflammatory drugs, methotrexate, corticosteroids
C)Anabolic steroid, colchicines, pethidine
D)Non-steroidal anti-inflammatory drugs, aspirin, morphine

Question 8

A 45-year-old male patient has waist circumference of 105 cm. His blood examination shows fasting plasma glucose of 120mg/dL, triglyceride levels 180 mg/dL, high-density lipid cholesterol 30 mg/dL. He is at risk of developing which of the following set of conditions?

A)Fatty liver, hepatitis, anxiety disorder
B)Liver cirrhosis, insomnia, cor pulmonale
C)Cardiomyopathy, hepatitis, pancreatitis
D)Fatty liver, gallstones and sleep apnea

Question 9

A patient presenting with symptoms of shortness of breath on exertion, swelling of abdomen and extremities, decreased appetite, nausea was diagnosed to have congestive heart failure. What should be the goal of treatment in this patient?

A)Controlling excess fluid accumulation, improving cardiac function and reducing cardiac workload
B)Control of symptoms, prevention of disease progression, prevent complications
C)Control of symptoms, treatment of comorbid condition, modify risk factor
D)Reducing cardiac workload, lifestyle modification, reduce the risk of arrhythmia

Question 10

A postoperative surgical patient develops pain, redness, and edema in the calf. These symptoms may potentially indicate which of the following conditions?

A)Arterial embolism
B)Varicose veins
C)Thrombophlebitis
D)Lymphedema

Question 11

A 64-year old male patient was advised to undergo coronary artery bypass surgery after coronary angiogram. What is the correct statement used by the nurse while explaining the objective of coronary artery bypass surgery?

A)Revascularization of selected area of myocardium
B)Complete revascularization of the myocardium
C)Correct the abnormalities of the coronary arteries
D)Remove the diseased part of the coronary artery

Question 12

Choose the statement which is correct about intermittent claudication:

A)Intermittent claudication is defined as pain in muscles during physical activity which resolves once activity is stopped
B)Intermittent claudication arises from occlusion of peripheral arteries
C)It consists of muscle cramps during night which is severe enough to awake the patient
D)It consists of joint pain which resolves when the patient starts walking

Question 13

Which of the following terms correctly defines the character of pericardial friction rub?

A)Rough rumbling sound
B)Soft cooing sound
C)Scratchy sound like velcro
D)Harsh and husky

Question 14

A patient presenting to emergency room with severe dyspnoea is diagnosed to have pulmonary edema. Which of the following drugs should the nurse immediately prepare to give this patient?

A)High flow O2 administration
B)Intravenous morphine
C)Intravenous furosemide at a higher dose
D)Intravenous adenosine

Question 15

An 80-year old male is having end-stage aortic stenosis. Definitive treatment for his condition is aortic valve replacement but he is critically ill and surgery cannot be performed at the moment. Which surgical procedure can be used as a bridge to aortic valve replacement surgery in this patient?

A)Commissurotomy
B)Balloon Valvuloplasty
C)Aortotomy
D)Debridement

Question 16

Which of the following diagnostic tests should be done for a patient who wants to be screened for presence of valvular heart disease?

A)Electrocardiogram, echocardiography, chest x-ray
B)Electrocardiogram, stress echocardiography, chest CT
C)Electrocardiogram, transthoracic echocardiography, ambulatory blood pressure monitoring
D)Electrocardiogram, holter monitoring, thallium scan

Question 17

A nurse is taking care of a patient with post carotid endocardiectomy. What parameters should the nurse examine in the patient for neurological assessment in 1 to 2 hour post-op period?

A)Level of consciousness, response to verbal command, motor reflexes, level of sensation, pupil size, and reaction to light
B)Level of consciousness, vocal cord functioning, reflexes, motor strength, level of sensation, pupil size, and reaction to light
C)Level of consciousness, response to painful stimuli, tendon reflexes, motor strength, pain and temperature sensation, and reaction to light
D)Level of consciousness, vocal cord functioning, reflexes, motor strength, level of sensation, field of vision of both eyes, and reaction to light

Question 18

Which of the following statements about Dressler's syndrome is not correct?

A)Dressler's syndrome is a complication of myocardial infarction
B)It usually develops about one to two week post-MI
C)It is autoimmune in nature
D)It is a result of infection of myocardium which extends to pericardium

Question 19

A child having aortic regurgitation has been advised for valve replacement surgery. The parents are concerned to know about the type of aortic valve prosthesis which is suitable for their child. What is the correct answer given by nurse?

A)Mechanical valve
B)Bioprosthetic valve
C)Pulmonary autograft
D)Aortic homograft

Question 20

A 42-year old male patient is being discharged from hospital after a mitral valve replacement surgery with a metallic valve. He has been prescribed warfarin. Teaching about which of the following things should be given priority by the nurse?

A)He should always take the medicine before meals
B)He should shave with an electric razor and avoid using safety razor
C)If he misses one dose, he should compensate by taking double dose next time
D)It is the responsibility of the doctor to teach the patient about this medication

Question 21

A nurse should prioritize which of the following patients and provide immediate intervention?

A)A fractured shoulder
B)Ventricular fibrillation
C)Head trauma
D)Abdominal pain

Question 22

The nurse records the ECG of a patient presenting with complaints of sudden onset palpitation with ventricular rate of about 200/ minute. ECG shows paroxysmal supraventricular tachycardia. Which of the following drugs the nurse should prepare if this patient is not responding to vagal maneuvers?

A)Digoxin
B)Adenosine
C)Beta blocker
D)Verapamil

Question 23

All of the following group of drugs improve the survival in congestive heart failure as shown by many studies except

A)Beta blockers
B)Spironolactone
C)ACE inhibitor
D)Nitrates

Question 24

Which of the following correctly defines pulse pressure?

A)Mean of systolic blood pressure and diastolic blood pressure
B)Difference of systolic blood pressure and diastolic blood pressure
C)Sum of systolic blood pressure and diastolic blood pressure
D)Mean arterial blood pressure

Question 25

A patient with myocardial infarction on the cardiac telemetry unit suddenly goes into ventricular fibrillation. The advanced cardiac life support team arrives immediately and prepares to defibrillate. Which of the following is correct position for placement of the conductive gel pads?

A)Below the left clavicle and right lower sternum
B)Right of midline below the bottom rib and the left shoulder
C)The upper and lower halves of the sternum
D)The right side of the sternum just below the clavicle and left of the precordium

Question 26

Which of the following surgical corrections is not part of corrective surgery done for Tetralogy of Fallot?

A)Pulmonary valvotomy or pericardial patch enlargement of RV outflow tract
B)RV-PA valved homograft conduit
C)VSD closure with Dacron patch
D)Aortic valve repair

Question 27

Which of the following sets of drugs represent inotropic drugs?

A)Digoxin, dopamine, milrinone
B)Verapamil, digitoxin, isosorbide dinitrate
C)Diltiazem, metoprolol, amrinone
D)Nicorandil, dobutamine, carvedilol

Question 28

Which of the following sentences correctly describes the EKG findings of Wenckebach phenomena?

A)No relationship between p-wave and QRS complex
B)Progressive lengthening of PR interval followed by a p wave without an associated QRS complex
C)Prolonged PR interval with narrow QRS complex
D)Prolonged PR interval with wide QRS complex

Question 29

The nurse calculates the ankle-brachial index of a patient as 0.65. Patient is concerned to know about the significance of this value. What is the correct answer given by the nurse?

A)Ankle-brachial index gives the percentage of blockage in the artery of foot
B)Ankle-brachial index is calculated to estimate the degree of arterial occlusion in patients suspected of having peripheral arterial disease. Values between 0.5 to 0.8 suggest moderate arterial disease
C)Ankle-brachial index gives the estimate of power in the muscles of lower limb
D)Ankle-brachial index gives an idea about the oxygenation of tissues

Question 30

Calcium channel blockers act by antagonizing the L-type calcium channels in vascular smooth muscle. What are the effects on cardiac muscle?

A)Increased cardiac muscle contractility, increased SA pacemaker rate, and increased atrioventricular conduction velocity in cardiac tissue
B)Increased cardiac muscle contractility, increased SA pacemaker rate, and decreased atrioventricular conduction velocity in cardiac tissue
C)Reduced cardiac muscle contractility, increased SA pacemaker rate, and increased atrioventricular conduction velocity in cardiac tissue
D)Reduced cardiac muscle contractility, decreased SA pacemaker rate, and decreased atrioventricular conduction velocity in cardiac tissue

Question 31

How many positions have been included in generic pacemaker code?

A)1
B)3
C)5
D)7

Question 32

Which of the following surgical corrections do not match correctly with the type of surgery performed to correct the type of aortic stenosis?

A)Supravalvular aortic stenosis - myectomy of hypertrophied ventricular septum
B)Supravalvular aortic stenosis - patch augmentation of ascending aorta
C)Subaortic stenosis - resection of fibrous membrane
D)Valvular aortic stenosis - percuateneous balloon valvotomy or valve replacement

Question 33

Which of the following degree of heart block may be an incidental finding in asymptomatic individuals and is not associated with an increase in mortality and morbidity?

A)Third-degree heart block
B)Mobitz type I second-degree heart block
C)First-degree heart block
D)Mobitz type II second-degree heart block

Question 34

Which of the following statements is true about Wolff-Parkinson-White syndrome?

A)Wolff-Parkinson-White syndrome occurs due to formation of extra circuit inside heart
B)Wolff-Parkinson-White syndrome is common in elderly patients
C)Wolff-Parkinson-White syndrome occurs more commonly in women
D)Incidence of Wolff-Parkinson-White syndrome is highest in people of age group 60 to70

Question 35

Which of the following arrhythmias is most common?

A)Atrial flutter
B)Atrial fibrillation
C)Paroxysmal supraventricular tachycardia
D)Ventricular tachycardia

Question 36

Diagnostic work up for a patient who wants to be screened for presence of valvular heart disease should include which of the following diagnostic tools?

A)Electrocardiogram, echocardiography, chest x-ray
B)Electrocardiogram, stress echocardiography, chest CT
C)Electrocardiogram, treadmill test, holter monitoring
D)Electrocardiogram, ambulatory blood pressure monitoring

Question 37

Which of the following statements is not true about ventricular fibrillation?

A)Ventricular fibrillation is a serious condition that may lead to sudden death
B)Individuals with an acute ventricular fibrillation episode become unconscious suddenly
C)Patients having acute ventricular fibrillation present with rapid and undetectable heart rate
D)Post hospital stay survival rate of patient with ventricular fibrillation is very high

Question 38

A patient presents with complaints of shortness of breath, palpitation and pink, frothy sputum. The chest x-ray suggests pulmonary edema. What are the characteristic features of pulmonary edema?

A)Decreased cardiac output, inadequate tissue perfusion, acute pulmonary congestion
B)Decreased blood pressure, inadequate tissue perfusion, cardiac arrest
C)Hypertension, rapid breathing, respiratory failure
D)Hypertension, respiratory arrest, cardiac arrhythmia

Question 39

Which of the following symptoms is characteristic of Shy-Drager syndrome?

A)Severe uncontrolled hypertension
B)Severe hypotension when standing and severe hypertension when lying down
C)Problems with coordination and speech
D)Severe hypotension and muscle tremor

Question 40

The prevalence of intermittent claudication is estimated to be about 4.5 million. How many of these individuals need surgical intervention?

A)A)50%
B)30%
C)10%
D)70%

Question 41

What is the investigation protocol for a follow-up patient of post percutaneous transluminal angioplasty of carotid artery?

A)Doppler ultrasound and Magnetic resonance imaging every 6 months
B)Examination 1-week post-procedure to check neurological status, Doppler ultrasound every 3-6 months then every year, Magnetic resonance imaging 3-months post-procedure
C)Echocardiography, Doppler ultrasound 1-week post-procedure and then every 6 months
D)Echocardiography, Doppler ultrasound and Magnetic resonance imaging at 1-week post-procedure and then every year

Question 42

The nurse is going to assist the interventionist during percutaneous transluminal coronary angioplasty. Which drugs should the nurse prepare to administer to the patient?

A)Heparin, Streptokinase
B)Heparin, Nitroglycerin, Abciximab
C)Heparin, Warfarin
D)Heparin, warfarin, Aspirin

Question 43

Which of the following options are available for prevention of development of aneurysm?

A)Regular use of aspirin, taking proper rest and ensuring enough sleep
B)Proper control of blood pressure, avoid smoking, avoid straining, maintain proper cholesterol level, exercise regularly
C)Regular anticoagulation and maintain proper cholesterol level
D)Proper control of blood pressure and use of stimulant drugs

Question 44

Which is the most common type of cardiomyopathy?

A)Restrictive cardiomyopathy
B)Dilated cardiomyopathy
C)Hypertrophic cardiomyopathy
D)Arrhythmogenic right ventricular dysplasia

Question 45

According to current guidelines, to which of the following patients should the nurse explain the routine screening for aneuryms?

A)70-year-old non-smoker male patient
B)62-year-old male patient whose father died of aneurysmal rupture
C)65-year-old diabetic female patient
D)55-year-old male patient with family history of aneurysm

Question 46

The 3 domains of adult learning include which of the following?

A)Cognitive learning, sensory learning, motor learning,
B)Cognitive learning, psychomotor learning, affective learning
C)Psychomotor learning, psychosocial learning, behavioral learning
D)Cognitive learning, psychosocial learning, motor learning

Question 47

An intensive care nurse answers a rapid response call for a 54 year old female patient on the pre-surgery floor who is scheduled to have a left partial knee replacement later today. When the nurse arrives, she notes the ashen color of the woman's face and profuse sweating. The monitor shows a blood pressure of 170/90, a heart rate of 122 and an oxygen saturation of 92% on 1 liter of oxygen. The admitting nurse states that the woman had been complaining of nausea. What is the most likely cause of the patient's condition?

A)Pulmonary embolism
B)Myocardial infarction
C)Cardiac tamponade
D)Anxiety attack

Question 48

Among different methods of stress reduction, use of repetitive verbal phases and concentrating on sensation for deep relaxation is used in which method?

A)Meditation
B)Imagery
C)Autogenics
D)Cognitive restructuring

Question 49

Which leadership style involves minimal guidance from a leader and provides little feedback to team members?

A)Autocratic
B)Laissez-faire
C)Transactional
D)Transformational

Question 50

In rate modulated pacing, pacing of atria and ventricles are based on:

A)Intrinsic heart rate
B)Physiological stress with increased heart rate
C)Pacing only when demand of body increases during exercise
D)Keep pacing at a constant rate

Question 51

The nurse is recording blood pressure and counting pulse rate of a patient who uses cocaine. What is the expected finding in this patient?

A)Hypertension and decreased heart rate
B)Hypertension and increased heart rate
C)Hypotension and increased heart rate
D)Hypotension and decreased heart rate

Question 52

When the patient is being monitored for cardiogenic shock with one of the devices like extracorporeal life support, left ventricular assist device, or intraaortic balloon pump, what lab value must be monitored to prevent these devices from becoming clotted?

A)Potassium and sodium
B)Prothrombin time, International Normalized Ratio (INR)
C)Cardiac markers and Troponin
D)B-type Natriuretic Peptide

Question 53

Which one of the listed statements correctly describes the flow of blood in an individual with an atrial septal defect who develops Eisenmenger's syndrome?

A)Aorta to pulmonary artery to lungs to left atrium to left ventricle to aorta
B)Left atrium to right atrium to right ventricle to lungs to left atrium
C)Left ventricle to right ventricle to lungs to left atrium to right ventricle
D)Right atrium to left atrium to left ventricle to aorta to right atrium

Question 54

Which of the following is NOT a characteristic of tetralogy of fallot?

A)Large ventricular septal defect
B)Right ventricular outflow obstruction
C)Right ventricular hypertrophy
D)A left to right cardiac shunt