Deck 13: Diseases of the Cardiovascular System

Question 1

Which factor is associated with primary hypertension?

A) decreased secretion of vasopressin
B) differences in genes that affect sodium retention
C) increased levels of nitrous oxide in the bloodstream
D) decreased production of angiotensinogen
E) type 1 diabetes and diminished insulin production

Answer 1

B

Question 2

How do ACE inhibitors control hypertension? by reducing stroke volume

A) by increasing urinary output to decrease blood volume
B) by blocking beta-receptors in the heart to decrease heart rate and cardiac output
C) by blocking the conversion of angiotensin II into angiotensin I
D) "How many children do you have?"
E) by affecting the movement of calcium, which causes the blood vessels to relax

Answer 2

C

Question 3

Which of the following statements best describes mean arterial pressure (MAP)?

A) It represents the amount of end diastolic volume that is ejected from the heart by contraction of the left ventricle.
B) It represents the force exerted by the blood on the walls of blood vessels during the contraction of the ventricles.
C) It represents the resistance against which the ventricles must contract in order to eject blood into systemic circulation.
D) It represents the depolarization of the AV node that is carried into the ventricles by the atrioventricular bundle.
E) It represents the volume of blood ejected with each contraction of the left ventricle.

Answer 3

C

Question 4

The repeating contraction and relaxation of the heart is termed the:

A) ejection fraction
B) end diastolic volume
C) stroke volume
D) cardiac output
E) cardiac cycle

Question 5

Which is an example of a loop diuretic used in the treatment of hypertension?

A) furosemide
B) hydrochlorothiazide
C) acetazolamide
D) spironolactone
E) methazolamide

Question 6

During the development of atherosclerosis, platelets adhere to the subendothelial surfaces and secrete both adenosine diphosphate (ADP) and:

A) nitric oxide
B) platelet-derived growth factor
C) C-reactive protein
D) plasminogen activator inhibitor
E) thromboxane A2

Question 7

Uncontrolled contractions of the heart ventricle that are often associated with myocardial infarction are known as:

A) ventricular tachycardia
B) ventricular fibrillation
C) ventricular shock arrhythmias
D) atrial fibrillation
E) complete heart block

Question 8

The right atrium and the right ventricle make up the right heart and pump blood through:

A) the left heart
B) the pulmonary circulation
C) the superior vena cava
D) the aortic artery
E) the inferior vena cava

Question 9

As per research, how much daily intake of saturated fat is recommended?

A) no more than 15% of total kcal
B) no more than 12% of total kcal
C) no more than 10% of total kcal
D) no more than 7% of total kcal
E) 0% to no more than 5% of total kcal

Question 10

The DASH eating plan recommends daily servings of various foods including:

A) 1-2 servings of vegetables daily
B) 4-5 servings of fruits daily
C) 4-5 servings of low-fat dairy products daily
D) 4-5 servings of nuts and seeds daily
E) 2-3 servings of sweets daily

Question 11

The protein portion of the lipoprotein that provides structural integrity and allows for receptors to recognize the lipoprotein particle is called:

A) a chylomicron
B) an amino acid receptor
C) bradykinin
D) the fibrinolytic factor
E) an apolipoprotein

Question 12

Which lifestyle change is recommended to control hypertension?

A) engaging in 30 minutes of physical activity per month
B) avoiding consumption of alcohol completely
C) consuming more than 3400 mg of sodium per day
D) increasing fruits, vegetables, and low-fat dairy in the diet
E) maintaining the BMI between 25 and 29.9

Question 13

Gemfibrozil, a generic drug, that is used to reduce VLDL synthesis is classified as:

A) nicotinic acids
B) bile acid sequestrants
C) nitrates
D) fibric acids
E) statins

Question 14

Symptoms of angina may include nausea, pain in the arm and neck, sweating, and:

A) hemorrhage
B) chills
C) edema
D) rash
E) shortness of breath

Question 15

Which of the following medical procedures involves inserting a catheter from an artery in the groin to the site where blood flow is restricted?

A) angioplasty
B) endarterectomy
C) transmyocardial revascularization
D) coronary artery bypass graft
E) radiofrequency ablation

Question 16

The components of metabolic syndrome include elevated triglycerides, low HDL cholesterol, insulin resistance, elevated blood pressure, and:

A) abdominal obesity
B) cerebral edema
C) low exercise tolerance
D) muscle tetany
E) early-onset dementia

Question 17

A dietitian is helping a client with understanding the sodium content of food products to manage her hypertension. The label on a product reads "140 mg or less of sodium per serving." This product would be classified as:

A) sodium free
B) very low sodium
C) low sodium
D) unsalted
E) high in sodium

Question 18

A dietitian is counseling a client with atherosclerosis on how to make therapeutic lifestyle changes. Which food item should the dietitian advise the client to choose less often?

A) soft or liquid margarine
B) buttermilk
C) whole eggs
D) cottage cheese
E) pasta

Question 19

Which is an example of a polyunsaturated fat source?

A) butter
B) corn oil
C) lard
D) coconut oil
E) palm oil

Question 20

A dietitian is using the CAGE questions to assess the intakes of saturated fat and cholesterol in a client's diet. The "C" in CAGE stands for:

A) convenience
B) calories
C) calcium
D) caffeine
E) cheese

Question 21

PT, a 65-year-old male, 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. Height: 5'9"
Weight: 190 lbs
Waist circumference: 105 cm
BP: 140/93
Cholesterol: 259 mg/dL
LDL: 180 mg/dL
HDL: 58 mg/dL
TG: 234 mg/dL
Diet routine:
Breakfast: Egg and sausage muffin
            Coffee
Lunch: Ham and cheese sandwich on white bread
         Potato chips
         Soda
Dinner: Chicken breast
        Mashed potatoes
          Iced tea
        Cheesecake
Based on the available clinical data, what additional diagnosis might be made in this case?

A) hyperhomocysteinemia
B) heart failure
C) peripheral vascular disease
D) metabolic syndrome
E) atrial fibrillation

Question 22

Which information about fluid restriction is essential as part of educating a client with the risk of heart failure?

A) Increase sodium intake to offset fluid loss.
B) Count all beverages and foods such as soups, sherbet, and gelatin within the fluid allowance.
C) Use warm or hot foods to control thirst.
D) Check body weight 3 times daily.
E) Limit fluid intake to 4 quarts per day.

Question 23

What is the recommended amount of protein intake during the initial phase after a heart transplant?

A) 0.8-1.0 g/kg
B) 1.0-1.5 g/kg
C) 1.5-2.0 g/kg
D) 2.0-2.4 g/kg
E) 2.5-3.0 g/kg

Question 24

Which of the following statements is true of an echocardiogram?

A) It involves attaching radionucleotides to red blood cells to allow the visualization of a beating heart.
B) It involves measuring vital signs after a session of prescribed exercise on a treadmill.
C) It involves the graphic recording of the heart's electrical activity.
D) It involves inserting a catheter from an appropriate artery or vein into the ventricle.
E) It involves documenting the anatomy and function of the heart using sound waves.

Question 25

Which is a true statement regarding a heart transplant?

A) Most transplant surgeries are performed on patients younger than 40 years old.
B) A heart-lung bypass machine is hooked up in order to provide blood to the patient's body after surgery.
C) The aorta and pulmonary arteries are not replaced as part of the surgery.
D) Aldosterone antagonists are administered after surgery to prevent rejection.
E) Recovery often involves 3 months in the hospital and 6 months of monitoring by the transplant team for organ rejection.

Question 26

A dietitian is educating a client on how to prevent infection after a heart transplant. Which foods would the dietitian counsel the client to avoid?

A) pasteurized milk
B) homemade eggnog
C) canned fish
D) cooked sprouts
E) hard cheese

Question 27

Which medication is recommended for a patient with atrial fibrillation?

A) warfarin
B) vitamin A
C) dabigatran
D) aspirin
E) rivaroxaban

Question 28

Patients who have structural heart disease but demonstrate no symptoms of heart failure are classified as having which stage of the disease?

A) A
B) B
C) C
D) D
E) E

Question 29

Which of the following describes a noninvasive test used in patients with symptoms of PAD that measures the blood pressure in the ankles and compares it with the blood pressure in the arms at rest and after exercise?

A) magnetic resonance angiography
B) ankle dorsiflexion test
C) positron emission tomography
D) ankle-brachial index
E) CT angiography

Question 30

Immediate nutrition goals after a heart transplant are to supply adequate nutrients so the body can heal and:

A) reduce fluid buildup
B) prevent potassium loss
C) increase energy intake
D) prepare for cardiac rehabilitation
E) fight infections

Question 31

The most common cause of heart failure in women is:

A) hypertension
B) ischemic heart disease
C) peripheral arterial disease
D) myocardial infarction
E) acute coronary syndrome

Question 32

PT, a 65-year-old male, 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. Height: 5'9"
Weight: 190 lbs
Waist circumference: 105 cm
BP: 140/93
Cholesterol: 259 mg/dL
LDL: 180 mg/dL
HDL: 58 mg/dL
TG: 234 mg/dL
Diet routine:
Breakfast: Egg and sausage muffin
            Coffee
Lunch: Ham and cheese sandwich on white bread
         Potato chips
         Soda
Dinner: Chicken breast
        Mashed potatoes
          Iced tea
        Cheesecake
A registered dietitian may recommend which of the following additions to PT's diet to help decrease the absorption of cholesterol?

A) nuts
B) magnesium
C) folate
D) soluble fiber
E) protein

Question 33

PT, a 65-year-old male, 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. Height: 5'9"
Weight: 190 lbs
Waist circumference: 105 cm
BP: 140/93
Cholesterol: 259 mg/dL
LDL: 180 mg/dL
HDL: 58 mg/dL
TG: 234 mg/dL
Diet routine:
Breakfast: Egg and sausage muffin
            Coffee
Lunch: Ham and cheese sandwich on white bread
         Potato chips
         Soda
Dinner: Chicken breast
        Mashed potatoes
          Iced tea
        Cheesecake
Which compound, when consumed twice daily, provides therapeutic effects against heart diseases?

A) nuts
B) folate
C) vitamin B6
D) plant stanols
E) vitamin B12

Question 34

A long-term complication of heart transplant might be:

A) cancer
B) hypokalemia
C) weight gain
D) migraine headaches
E) hyponatremia

Question 35

Signs of right-sided heart failure include distended neck veins, flushed face, and:

A) dry mouth
B) ascites
C) sunken eyes
D) decreased urine output
E) constipation

Question 36

PT, a 65-year-old male, 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. Height: 5'9"
Weight: 190 lbs
Waist circumference: 105 cm
BP: 140/93
Cholesterol: 259 mg/dL
LDL: 180 mg/dL
HDL: 58 mg/dL
TG: 234 mg/dL
Diet routine:
Breakfast: Egg and sausage muffin
            Coffee
Lunch: Ham and cheese sandwich on white bread
         Potato chips
         Soda
Dinner: Chicken breast
        Mashed potatoes
          Iced tea
        Cheesecake
Which is an example of a modifiable risk factor that contributed to PT's condition?

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

Question 37

Identify the pharmacologic therapy that is used to control symptoms of heart failure and limit damage to the heart.

A) restricting dietary sodium
B) treatment of comorbidities
C) using inotropic agents
D) restricting fluid weight gain
E) prevention of malnutrition

Question 38

Which of the following is a physiologic contributor to intestinal ischemia?

A) decreased level of dehydroepiandrosterone sulfate
B) increased level of norepinephrine
C) exposure to endotoxin and inflammatory cytokine release
D) nausea and early satiety from gut or hepatic edema
E) increased level of insulin-like growth factor-1

Question 39

Which best describes surgical ventricular restoration?

A) An implant is placed in the chest when the right and left sides of the heart do not contract at the same time .
B) A device mechanically pumps blood from the left side of the heart to the rest of the body .
C) A procedure that restores the normal geometry of the left ventricle by removing scarred areas of heart tissue .
D) A person's failing heart is replaced with a healthy heart from a suitable deceased donor .
E) Sensors are placed in the ventricles to regulate electrical impulses coming from the SA node .

Question 40

PT, a 65-year-old male, 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. Height: 5'9"
Weight: 190 lbs
Waist circumference: 105 cm
BP: 140/93
Cholesterol: 259 mg/dL
LDL: 180 mg/dL
HDL: 58 mg/dL
TG: 234 mg/dL
Diet routine:
Breakfast: Egg and sausage muffin
            Coffee
Lunch: Ham and cheese sandwich on white bread
         Potato chips
         Soda
Dinner: Chicken breast
        Mashed potatoes
          Iced tea
        Cheesecake
PT's diet is high in which component?

A) polyunsaturated fat
B) saturated fat
C) vitamin D
D) monounsaturated fat
E) potassium

Question 41

Clients with atrial fibrillation should be educated on foods that are high in vitamin K and how to check product labels for vitamin K contents.

Question 42

An individual who is currently taking antihypertensive medication is not considered to have hypertension if the blood pressure normalizes as a result of the medication.

Question 43

Since the intakes of magnesium and calcium can directly impact the progression and management of HF, accurate assessment of both of these nutrients is essential.

Question 44

At the onset of atherosclerotic lesion formation, the damaged endothelial layer attracts platelets to the site of damage to form a small clot termed a _______________.

Question 45

In the diet, _______________ appear to behave similarly to saturated fatty acids in that they increase total cholesterol and LDL levels and perhaps lower HDL levels.

Question 46

_______________ are medications that affect the movement of calcium, which causes the blood vessels to relax and therefore reduces vasoconstriction.

Question 47

Ischemic heart disease (IHD) is often misdiagnosed or undiagnosed in females because they tend to experience angina pain differently than men.

Question 48

The veins from the upper part of the body drain into the _______________ vena cava.

Question 49

Atherosclerosis in the leg can result in _______________ and possibly the tissue death associated with gangrene and even loss of a limb.

Question 50

_______________ produced in the endothelial cells controls the normal relaxation of smooth muscle in the arteries and arterioles.

Question 51

Current recommendations include maintenance of dietary fat intake within 10%-15% of total caloric intake for patients with atherosclerosis.

Question 52

As the atherosclerotic plaque grows, the artery at first compensates by expanding inward and decreasing the size of the lumen.

Question 53

Though many myocardial cells have the capability of generating spontaneous electrical activity, electrical activity is initiated at the atrioventricular (AV) node.

Question 54

_______________ hypertension occurs as a result of another primary problem, such as kidney disease, other cardiovascular diseases, endocrine disorders, or neurogenic disorders.

Question 55

The prevailing theory for the pathophysiology of atherosclerosis is that the disease begins as a response to injury that results in an inflammatory process.

Question 56

The force exerted by the blood on the walls of blood vessels during the contraction of the ventricles is termed _______________.

Question 57

A comprehensive approach that addresses multiple lifestyle factors has the most significant effect on blood pressure control for hypertensive individuals.

Question 58

A surgical procedure that typically uses the saphenous vein or internal mammary artery to "bypass" the blocked vessel is known as a(n) _______________.

Question 59

The causes of an acute MI or unstable angina are plaque erosion, rupture of a plaque resulting in formation of a thrombus, and vasoconstriction.

Question 60

_______________ geometries are subject to more abnormalities in blood flow and are more likely to suffer endothelial damage.

Question 61

Describe each of the components of nutrition intervention for heart failure, including sodium restriction, energy and protein requirements, fluid intake, and drug-nutrient interactions.

Question 62

List examples of food items to choose and to avoid in the given categories to avoid cardiovascular disease: dairy products, fats and oils, and breads and cereals.

Question 63

Name and briefly describe the stages of heart failure.

Question 64

A(n) _______________ is defined as a nonhealing break in the skin. Inadequate perfusion to the tissues (i.e., lack of oxygen) is the primary etiology for skin breakdown.

Question 65

A _______________ mg sodium diet is a standard initial recommendation for individuals with heart failure.

Question 66

Write down the formula used for calculating blood flow and resistance.

Question 67

A(n) _______________ is a surgical procedure in which a person's failing heart is replaced with a healthy heart from a suitable deceased donor.

Question 68

List the components of the guide to medical nutrition therapy for cardiovascular disease and dyslipidemias with examples.

Question 69

The procedure that is used for the treatment of cardiac arrhythmias is called _______________.

Question 70

It is not unusual for individuals to experience episodes of _______________ in response to an increase in cardiac workload.

Question 71

Describe the components of the rapid eating assessment for patients (REAP) and give an example of a question applicable to each category of the assessment.

Question 72

Describe the "5 A's" of nutrition counseling for hypertension.

Question 73

_______________ is used to determine the dosage of anticoagulant medication for patients with atrial fibrillation.

Question 74

List risk factors that are common in the development of coronary heart disease, peripheral vascular disease, and cerebrovascular accidents.

Question 75

_______________ is a term used to describe the condition of persons who present with either an acute MI or unstable angina.

Question 76

A(n) _______________ is a medical device that mechanically pumps blood from the left side of the heart to the rest of the body in case of heart failure.

Question 77

List the classifications of complications that can occur in a person who suffers a myocardial infarction.

Question 78

Typically, heart failure begins with the _______________, the heart's primary pumping chamber.

Question 79

Discuss each of the following components when evaluating clinical hypertension: classification of blood pressure, major cardiovascular disease risk factors, and identifiable causes of secondary hypertension.

Question 80

Postsurgery education on basic food safety after heart transplant should be provided since transplant patients are more susceptible to _______________ due to immunosuppressant therapy.