Question 1

A patient presents with symptoms of shortness of breath on exertion, swelling of abdomen and extremities, decreased appetite and nausea. On examination, raised JVP and tender hepatomegaly were found and the patient was diagnosed to have congestive heart failure. What is the goal of treatment in this patient?

Accepted Answer

The goals of treatment in this patient of congestive heart failure include controlling excess fluid accumulation, improving cardiac function and reducing cardiac workload. This will help the buildup of fluid in the lungs as the heart function decreases.

Question 2

A cardiac nurse is explaining to patients about the routine screening for aneurysms. According to current guidelines, which of the following patients should the nurse advise to undergo routine screening?

Accepted Answer

According to current guidelines the nurse should advise the 70-year old ex-smoker male to undergo routine screening. Patients at high risk for aneurysms should be followed regularly by a cardiothoracic, vascular, or neurological surgeon. Current guideline recommendations suggest that men who are 65 to 75 years old and are ex-smokers should be checked for aneurysms routinely. Men aged 60 and older with a family history of aneurysms should also consider routine screening.

Question 3

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

Accepted Answer

The statement that is not correct about Dressler's Syndrome is it is a result of infection of myocardium which extends to pericardium.
Dressler's syndrome:
Post-MI: acute (direct extension of myocardial inflammation, 1-7 days), Dressler's syndrome (autoimmune, 2-8 weeks).

Question 4

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 5

Which of the following statements about mechanical valves is incorrect?

Accepted Answer

The incorrect statement about mechanical valves is mechanical valves are good for elderly patients. Mechanical valves require lifelong anticoagulation therapy due to risk of thrombosis. Mechanical valves last longer and are typically used for patients under 65 or patients over 65 that have a long life expectancy. Biologic valves deteriorate at a rate inversely proportional to the patient's age (wear out faster in younger patients). Thus, biological valves are typically great for elderly patients in whom the expected lifespan is less than the life of the valve (15-20 years). Women that would like to become pregnant should also have biologic valves placed to avoid long-term teratogenic anticoagulants.

Question 6

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?

Accepted Answer

The nurse should examine the following parameters in the patient for neurological assessment in 1 to 2 hour post-op period: level of consciousness, vocal cord functioning, reflexes, motor strength, level of sensation, pupil size, and reaction to light. Neurological should be made every 1 to 2 hours to ensure the patient is stable.

Question 7

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 8

One of the following is not an acute complication associated with type I and type II diabetes mellitus:

Accepted Answer

Diabetic neuropathy is not an acute complication of type I and type II diabetes mellitus. Diabetic neuropathy is a long term complication of diabetes mellitus. Hyperglycemia, hypoglycemia and nonketotic hyperosmolar coma are acute complication of diabetes mellitus.

Question 9

Which of the following is not one of the five risk factors associated with metabolic syndrome?

Accepted Answer

Hypoglycemia is not one among the five risk factors associated with metabolic syndrome. The five risk factors associated with metabolic syndrome include a large waistline, higher than normal triglyceride levels, lower than normal high-density lipoprotein cholesterol, hypertension, and hyperglycemia. An increased number of risk factors raise an individual's risk of developing complications such as cardiovascular disease, diabetes, and/or stroke.

Question 10

Which of the following is not a symptom of Buerger's disease?

Accepted Answer

Involuntary muscle contraction in limbs is not a symptom of Buerger's disease. Symptoms of Buerger's disease include pain and weakness in extremities, swelling of hands and feet, Raynaud's phenomenon, open sores on digits.

Question 11

The incorrect statement about Buerger's disease is:

Accepted Answer

The incorrect statement about Buerger's disease is "Another name for the disease is Raynaud's disease". Another name for Buerger's disease is Thromboangiitis obliterans. Symptoms of Buerger's disease include pain and weakness in extremities, swelling of hands and feet, Raynaud's phenomenon, open sores on digits.

Question 12

Which of the following statements is true about Buerger's disease?

Accepted Answer

The true statement is "Buerger's disease is also known as thromboangiitis obliterans". Buerger's disease also known as thromboangiitis obliterans is a rare condition resulting in impaired blood flow to the extremities due to clot formation and inflammation in the arteries.

Question 13

Which of the following is true about atherosclerotic plaque formation?

Accepted Answer

The true statement about "Plaque formation is caused by a chronic inflammatory response and epithelial injury where lipids, cholesterol, and calcium build up in the arteries". Atherosclerotic plaque formation is caused by a chronic inflammatory response and endothelial dysfunction where lipids, cholesterol, calcium, and other substances build up in the arteries. There is an imbalance between deposition of plaque and removal by low-density lipoproteins in smooth muscle cells.

Question 14

Which of the following groups of patients is at high risk of developing aneurysms?

Accepted Answer

Hypertension, diabetes and pheochromocytoma patients are at high risk of developing aneurysms. Factors that put individuals at high risk for aneurysms that cannot always be prevented or controlled include family history of aneurysms, hypertension or high cholesterol, natural aging, and diabetes. Secondary types of hypertension that could put an individual at high risk for aneurysms include renal disease, pheochromocytoma, Cushing syndrome, thyroid or pituitary dysfunction, and/or pregnancy.

Question 15

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.

Question 16

Which of the following approaches are used for treatment of cerebral aneurysms?

Accepted Answer

Currently, there are two surgical approaches for brain aneurysms including surgical clipping or endovascular coiling. No other options are currently supported for treatment of cerebral aneurysms.

Question 17

The guideline for treatment of aneurysm is based on:

Accepted Answer

The guideline for treatment of aneurysm depends on size of aneurysm and symptoms of the patient.
•Treatment by aneurysm size:
For patients with an abdominal or thoracic aortic aneurysm with a diameter less than 3 cm without symptoms, follow-up screening should be conducted within 5 to 10 years. For patients with an aorta of 3 to 4 cm in diameter, follow-up screening should be performed on a yearly basis. For patients with a diameter of greater than 4 cm, careful follow-up needs to be performed on a bi-yearly basis. If a patient presents with an aorta with a diameter greater than 5 cm, surgery is recommended, which would include abdominal or open chest repair.
•Treatment by aneurysm location:
Treatment of cerebral aneurysms is dependent on the size and location of the aneurysm in the brain. If the aneurysm is small and not causing symptoms, follow-up screening is recommended. However, surgery is recommended for large, symptomatic aneurysms due to their risk of rupture and stroke. For thoracic or abdominal aneurysms less than 5 cm in diameter and not causing symptoms, pharmacologic approaches are typically used in combination with continuous monitoring. Surgical options are reserved for large unruptured aneurysm. Treatment of peripheral aneurysms depends on the presence of symptoms, the location of aneurysm, and whether the blood flow through the artery is blocked.

Question 18

A patient has been diagnosed with aortic aneurysm of abdominal aorta having a diameter of 3.5 cm. What advice should the nurse give this patient about follow-up?

Accepted Answer

The nurse should advise the patient with abdominal or thoracic of size 3 to 4 cm to come for follow up every year. For patients with an abdominal or thoracic aortic aneurysm with a diameter less than 3 cm without symptoms, follow-up screening should be conducted within 5 to 10 years. For patients with an aorta of 3 to 4 cm in diameter, follow-up screening should be performed on a yearly basis. For patients with a diameter of greater than 4 cm, careful follow-up needs to be performed on a bi-yearly basis. If a patient presents with an aorta with a diameter greater than 5 cm, surgery is recommended, which would include abdominal or open chest repair.

Question 19

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

Accepted Answer

Electrocardiogram, echocardiography and chest x-ray should be done to screen a patient for presence of valvular heart disease. Diagnostic tools used to screening for valvular diseases include electrocardiogram, echocardiography, magnetic resonance imaging, and chest x-ray. Other diagnostic tests to rule out any other co-morbid cardiovascular conditions include cardiac stress testing and cardiac catheterization.

Question 20

Which of the following statement is not true for atrial fibrillation versus atrial flutter?

Accepted Answer

The statement not true for atrial fibrillation versus atrial flutter is patients diagnosed with atrial fibrillation respond better to catheter ablation than patients diagnosed with atrial flutter. Atrial fibrillation and atrial flutter are both arrhythmias of the atrium caused by inappropriate electrical signals in the heart.

Quiz 1: Cardiac Medicine