Question 1

Which of the following statements are not true about sick sinus syndrome?

Accepted Answer

The statement not true about sick sinus syndrome (SSS) is "It may present as complete heart block". Causes of sick sinus syndrome are structural SA node disease, autonomic abnormalities, or both; bradycardia may be punctuated by episodes of SVT, especially atrial fibrillation or atrial flutter (tachy-brady syndrome). Treatment is pacing for bradycardia and medicines for tachycardia.

Question 2

A patient presents with complaints of palpitations and loss of weight. Blood investigations show thyrotoxicosis. Which of the following murmurs are expected to be heard on auscultation?

Accepted Answer

The murmur expected to be heard on auscultation in a patient with thyrotoxicosis is flow murmurs. High output or "flow" murmurs can be heard in conditions such as anemia, thyrotoxicosis, pregnancy, arteriovenous fistula, children and fever.

Question 3

The bypass pathway known as bundle of Kent is present in Wolf-Parkinson-White syndrome. Which anatomical structures are connected via the bundle of Kent?

Accepted Answer

The bundle of Kent connects the two anatomical structures of heart, the atria and the ventricle. Wolf-Parkinson-White syndrome develops because of the formation of extra electrical circuits within the heart. The condition leads to rapid heart rate and abnormal electrocardiogram. Wolf-Parkinson-White syndrome is a syndrome, and by definition, an identifiable external cause is not known. It is caused by an accessory pathway in the cardiac conduction system that causes arrhythmias in some individuals. The condition is congenital and there are no risk factors.

Question 4

Jones criteria are for diagnosis of which of the following diseases?

Accepted Answer

Jones criteria is for diagnosis of rheumatic fever. Nowadays the criteria has been modified and known as modified Jones criteria.
Modified Jones criteria:
Major criteria
•Pancarditis
•Polyarthritis
•Sydenham's chorea
•Erythema marginatum
•Subcutaneous nodules
Minor criteria
•Previous history of rheumatic fever or rheumatic heart disease
•Polyarthralgia
•Increased ESR or c-reactive protein (CRP)
•Increased pr interval (first degree heart block)
•Fever

Question 5

Which of the following pharmacologic agents are not used for treatment of metabolic syndrome?

Accepted Answer

Antibiotics are not used for treatment of metabolic syndrome. Pharmacologic agents used to treat metabolic syndrome include lipid-lowering agents, antihypertensives, anticoagulants and diabetic agents such as oral agents and insulin.

Question 6

Which of the following is not a part of major criteria of the modified Jones criteria for diagnosis of rheumatic fever?

Accepted Answer

Polyarthralgia is not a part of major criteria of the modified Jones major criteria for diagnosis of rheumatic fever. The major criteria of the modified Jones criteria includes :
•Pancarditis
•Polyarthritis
•Sydenham's chorea
•Erythema marginatum
•Subcutaneous nodules

Question 7

A patient presenting to emergency room was diagnosed to have acute myocardial infarction. Which of the following measures should the nurse be prepared to take in the emergency room?

Accepted Answer

The nurse should be prepared to take the following measures in emergency room are: ECASA 325 mg chewed stat, oxygen, sublingual nitroglycerine, morphine for pain relief, sedation, venodilation and ß blockers to reduce heart rate if not contraindicated.

Question 8

The vascular changes of acute inflammation consist of the following:

Accepted Answer

Acute inflammation is characterized by vascular changes including vasodilation, increased permeability, and/or reduced blood flow. This allows for cytokines and other immune regulators to enter the area of inflammation causing swelling of the tissue.

Question 9

Which of the following set of symptoms is correctly matched with the location of the aneurysm?

Accepted Answer

"Brain - severe headache, blurred vision, pain around eye" symptoms match correctly with the location of the aneurysm. Associated symptoms vary by location of the aneurysm. Aneurysms located closer to the surface of body may present with swelling and pain; however, most aneurysms within the body are asymptomatic. Aneurysms in the brain can present with symptoms of localized severe headache, intense pressure, nausea and vomiting, neck pain, blurred or double vision, pain in or around the eye, dilated pupils, sensitivity to light, and loss of sensation. Aneurysms in the abdomen may present with a deep dull penetrating pain in the lower back or abdomen that lasts for days to hours. Signs and symptoms of a peripheral aneurysm may include leg or arm cramping, coldness, and numbness or tingling in the feet due to blocked flow to the peripheral arteries.

Question 10

Which of the following sets of medications is used in treatment of Raynaud's disease?

Accepted Answer

Medications used in the treatment of Raynaud's phenomenon include calcium channel blockers to dilate blood vessels, alpha-blockers to counteract the constriction of blood vessels as well as vasodilators to dilate and relax blood vessels.

Question 11

The false statement about stroke is:

Accepted Answer

The false statement about stroke is "Embolic stroke occurs when a blood clot forms in arteries supplying the brain". Ischemic strokes include thrombotic strokes, which occur when a blood clot forms in arteries supplying the brain, and embolic stroke, which occurs when a blood clot (or other embolus, like a cholesterol plaque) formed in the cardiovascular system dislodges and blocks more distal arteries. Hemorrhagic stroke occurs when a blood vessel ruptures and leaks into the brain.

Question 12

Which of the following sets of conditions during pregnancy increases the risk of developing atrial septal defect in fetus?

Accepted Answer

Rubella infection, poorly controlled diabetes, and illicit drug or alcohol abuse during pregnancy increase the risk of developing atrial septal defect in fetus. The following conditions during pregnancy may increase the risk of an offspring having a congenital heart defect such as atrial septal defects:
•Rubella infection
•Poorly controlled diabetes
•Illicit drug and/or alcohol abuse

Question 13

The nurse is taking care of a 50-year old patient who has undergone mitral valve replacement surgery. Patient suffers from perioperative myocardial infarction, doctor recommends continuous intravenous infusion of nitroglycerine. About which of the following parameters should the nurse be closely watchful?

Accepted Answer

The nurse should be closely watchful about frequent monitoring of blood pressure if the patient is receiving intravenous nitroglycerine. Intravenous infusion of nitroglycerine may result in fall of blood pressure.

Question 14

Which of the following cardiac arrhythmias is most serious, and for which emergency defibrillation is often necessary to prevent sudden death?

Accepted Answer

Ventricular fibrillation is the most serious arrhythmia among these and emergency defibrillation is often necessary to prevent sudden death. Ventricular fibrillation is an emergency condition that requires immediate attention and emergency defibrillation is often necessary to prevent serious complications like congestive heart failure and sudden death.

Question 15

Which of the following statements is not true about Wolf-Parkinson-White syndrome?

Accepted Answer

"Wolf-Parkinson-White syndrome is common in elderly patients" is not true about Wolf-Parkinson-White syndrome. Wolf-Parkinson-White syndrome develops because of formation of extra electrical circuits within the heart. Wolf-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 16

A nurse is examining a patient with constrictive pericarditis. Which of the following findings is not expected in this patient?

Accepted Answer

Slow "y" descent is not expected in this patient.
Signs of constrictive pericarditis:
•General examination - mimics CHF (especially right-sided HF) - ascites, hepatosplenomegaly, edema
•Increased JVP, Kussmaul's sign (paradoxical increase in JVP with inspiration), Friedrich's sign (prominent "y" descent > "x" descent)
•Pressures: BP normal to decreased, +/- pulsus paradoxus
•Precordial examination: +/- pericardial knock (early diastolic sound)

Question 17

Which of the following does not correctly match the site of peripheral thromboembolectomy with the appropriate surgical approach?

Accepted Answer

The statement that does not matches correctly with the site of peripheral thromboembolectomy and the surgical approach is femoral occlusions - bilateral ventricle groin incisions. For aortic or iliac occlusions, bilateral ventricle groin incisions followed by embolectomy balloon catheter approach is typically performed. The procedure can be performed on both legs once the initial clot is removed from the occlusion. For femoral and popliteal occlusions, incisions in the distal common femoral artery followed by embolectomy balloon catheter approach are typically performed.

Question 18

Which of the following is not a correct pair of the signs of chronic aortic regurgitation and the organ where it is demonstrated?

Accepted Answer

Mueller sign - liver is not a correct match.
Signs of chronic AR:
•Quincke's sign - pulsatile blushing of nail beds
•Corrigan's pulse - visible carotid pulse
•Hill's test:- femoral-brachial SBP difference > 20 (greater differences correlate with more severe AR)
•Duroziez's test: light proximal compression of femoral artery produces systolic-diastolic murmur over femoral artery
•Other - pulsating uvula (Mueller), liver (Rosenbach), pupil (Gandolfi), or spleen (Gerhard)

Question 19

Which of the following sets of drugs might slow the conduction through AV node and cause second degree heart block?

Accepted Answer

Digoxin, beta-blockers, and calcium channel blockers might slow the conduction through AV node and cause second degree heart block. Pharmacologic agents that slow conduction through the atrioventricular node have been shown to cause second-degree atrioventricular block type I. These agents include cardioactive drugs such as digoxin, beta-blockers, calcium channel blockers, and certain antiarrhythmia drugs such as sodium channel blockers (procainamide).

Question 20

A patient who has been diagnosed with aneurysm in femoral artery during routine screening wants to know about the available treatment options. What the nurse should explain this patient regarding treatment?

Accepted Answer

The nurse should tell this patient that as the aneurysm is located in the extremity and is asymptomatic, no treatment is necessary. Peripheral aneurysms in the extremities are typically asymptomatic and do not require treatment due to their low risk of rupture. Treatment of peripheral aneurysms depends on the presence of symptoms, the location of the aneurysm, and whether the blood flow through the artery is blocked.

Quiz 3: AACN Cardiac Vascular Nursing