Question 1

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

Accepted Answer

The nurse should prioritize the patient with ventricular fibrillation because this is an emergency situation. A fractured shoulder, head trauma and abdominal pain can wait after the patient with VF has been stabilized.

Question 2

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?

Accepted Answer

The nurse should prepare adenosine if the patient is not responding to vagal maneuvers. Adenosine is the first choice in acute paroxysmal supraventricular tachycardia, if unresponsive to vagal maneuvers. If no response, try metoprolol, digoxin, verapamil; DC shock if signs of cardiogenic shock, angina, or CHF.

Question 3

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

Accepted Answer

Nitrates do not improve the survival in patients of congestive heart failure. The drugs which offer mortality benefit to the patients of cardiac failure are: spironolactone, ACE inhibitor, Angiotensin receptor blocker and beta-blockers. Nitrates are used for symptom control but do not increase survival.

Question 4

Which of the following correctly defines pulse pressure?

Accepted Answer

Pulse pressure (PP) is defined as the difference of systolic blood pressure and diastolic blood pressure (PP = systolic BP (SBP) - diastolic PB (DBP)).

Question 5

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?

Accepted Answer

The correct placement of gel pads is one gel pad to be placed to the right of the sternum, just below the clavicle and the other just left of the precordium. To defibrillate, the paddles are placed over the pads. The other options do not correspond with the position of the heart and are therefore not correct.

Question 6

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

Accepted Answer

Surgical procedures done for Tetralogy of Fallot: pulmonary valvotomy or pericardial patch enlargement of RV outflow tract or RV-PA valved homograft conduit + closure of VSD with Dacron patch

Question 7

Which of the following sets of drugs represent inotropic drugs?

Accepted Answer

The classes of agents included in the ionotropic group of drugs include cardiac glycosides such as digitalis, digitoxin, and digoxin; phosphodiesterase inhibitors such as amrinone and milrinone; and sympathomimetics such as dopamine, dobutamine, isoproterenol, metaraminol, epinephrine and norepinephrine.

Question 8

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

Accepted Answer

Second-degree atrioventricular block type I, also known as Wenckebach or Mobitz I, is an asymptomatic dysrhythmia typically diagnosed on electrocardiogram which shows progressive lengthening of PR interval followed by a p wave without an associated QRS complex.

Question 9

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?

Accepted Answer

Ankle-brachial index (ABI): measure brachial pressure bilaterally (use highest pressure) and measure pressure at ankle.
An abnormal ABI is defined as an index < 0.90. Values between 0.8 to 0.9 suggest some arterial disease. Values between 0.5 to 0.8 suggest moderate arterial disease. Values less than 0.5 is suggestive of severe arterial disease
Rest pain usually appears at an ABI < 0.3.
Solution: Trans-cutaneous oxygen studies to measure tissue oxygenation (30 mmHg necessary for primary wound healing). Doppler flow studies and real-time Duplex scanning

Question 10

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

Accepted Answer

Calcium channel blockers act by antagonizing L-type calcium channels in vascular smooth muscle, which leads to reduced cardiac muscle contractility, decreased SA pacemaker rate, and decreased atrioventricular conduction velocity in cardiac tissue.

Question 11

How many positions have been included in generic pacemaker code?

Accepted Answer

Generic pacemaker code
Pacemakers are classified using a 5-position code, which describes the different types of pacemakers and their functions.

Question 12

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

Accepted Answer

Aortic stenosis
• may occur at 3 levels: subaortic (fibrous membrane or tunnel stenosis), valvar (unicuspid or fusion bicuspid valve), or supravalvar (fibrous ridge or hypoplasia of ascending aorta)
• indications for surgery: infants with critical aortic stenosis (severe low output states, cyanosis by right-to-left ductal shunting), older children with symptoms or peak gradient > 50 mmHg
Surgical procedures
• subaortic stenosis relieved by resection of fibrous membrane or myectomy of hypertrophied ventricular septum
• valvular aortic stenosis relieved by percuateneous balloon valvotomy or valve replacement
• supravalvular aortic stenosis relieved by patch augmentation of ascending aorta

Question 13

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?

Accepted Answer

First-degree atrioventricular block is defined as a delay in conduction of impulses from sinoatrial (SA) node to the atrioventricular (AV) node. The condition is typically asymptomatic and undiagnosed. It can occur in individuals of all ages. The disease is typically benign and not associated with an increase in the mortality and morbidity.

Question 14

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

Accepted Answer

Wolff-Parkinson-White syndrome develops because of formation of extra electrical circuits within the heart. Wolff-Parkinson-White syndrome is the most common cause of tachycardia in young children, toddlers and infants. The syndrome is more common in men than women, with 60% to 70% of cases in men. However, the syndrome can occur in individuals of all ages and ethnic/racial descents. The highest incidence occurs in individuals between the ages of 30 to 40.

Question 15

Which of the following arrhythmias is most common?

Accepted Answer

The incidence of Atrial Fibrillation increases with age and the most common form is dysrhythmia. The condition occurs in approximately 20% to 30% of individuals undergoing coronary artery bypass surgery.

Question 16

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?

Accepted Answer

Diagnostic tools used to screen for valvular diseases include electrocardiogram, echocardiography, magnetic resonance imaging, and chest x-ray. Other diagnostic tests to rule out any other comorbid cardiovascular conditions include cardiac stress testing and cardiac catheterization.

Question 17

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

Accepted Answer

Ventricular fibrillation is a serious medical condition that should be treated as a medical emergency. Individuals with an acute ventricular fibrillation episode typically present by fainting or suddenly collapsing and/or becoming unconscious. They also typically present with very rapid or undetectable heart rate. The prognosis of patient who experience ventricular fibrillation depends on the length the patient was in fibrillation. However, for those patients who survive an acute ventricular fibrillation episode, the survival rate averages between 2% to 25% post hospital stay.

Question 18

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?

Accepted Answer

Decreased cardiac output, inadequate tissue perfusion, and acute pulmonary congestion are characteristic of pulmonary edema.

Question 19

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

Accepted Answer

The main characteristic of Shy-Drager syndrome is severe hypotension when standing and severe hypertension when lying down. Other symptoms of the disease include muscle tremors, slowed movement, problems with coordination and speech, and incontinence. The disease is progressive, with few treatment approaches, and usually leads to death within 7 to 10 years from time of diagnosis.

Question 20

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

Accepted Answer

The estimated prevalence of intermittent claudication is approximately 4.5 million individuals. It has been estimated that 60% to 70% of individuals with intermittent claudication have persistent symptoms, 20% to 25% symptoms get worse, and 10% require surgical intervention.

Quiz 2: Cardiac