Question 1

How many positions does the generic pacemaker code have?

Accepted Answer

A generic pacemaker code has 5 positions. Pacemakers are classified using a 5-position code, which describes the different types of pacemakers and their function. Position one (I) indicates the chamber(s) being paced. Position two (II) indicates the chamber(s) being sensed. Position three (III) indicates the device's response to sensing. Position four (IV) indicates the programmability and rate of modulation function. Position five (V) is only used for tachycardia functions.

Question 2

Which of the following statements is true about Marfan's syndrome?

Accepted Answer

The true statement about Marfan's syndrome is the patient generally has characteristics like being tall and thin with tapering fingers, high arched palate, long arms and legs. Marfan's syndrome is a congenital heart disease.
According to the NIH, Marfan syndrome is a condition some people are born with. This condition affects a protein known as Fibrillin-1 in the body that helps build healthy connective tissues. Connective tissues support the bones, muscles, and organs in your body and allow your skin, blood vessels, and ligaments to stretch.
People who have Marfan syndrome may be tall and thin and have long arms, legs, fingers, and toes, as well as flexible joints. The most serious associated health problems occur when Marfan's Syndrome affects the heart and blood vessels.

Question 3

Which of the following is not a route for temporary pacing?

Accepted Answer

Transarterial is not a route for temporary pacing. The types of pacemakers include permanent pacemakers and temporary pacemakers. Temporary pace makers include transvenous pacing, transcutaneous pacing, epicardial pacing, and transthoracic pacing. In transvenous pacing, vascular access is gained by percutaneous puncture of the internal jugular, subclavian, antecubital or femoral vein. Access can also be gained by venous cut down in an antecubital vein.
A bipolar, transvenous pacing lead is usually placed and maintained. Transcutaneous pacing requires a nonsurgical approach where electrodes are attached to the anterior and posterior chest walls and connected to an external generator. This approach is typically used during emergency situations. In transthoracic pacing, a long needle is used to then connected to an external generator. This approach is reserved for emergency situations.

Question 4

Which of the following anti-dysrhythmic class of drugs is not correctly matched with its mechanism of action?

Accepted Answer

Class II - Potassium channel openers is not a correct match. Class I anti-dysrhythmic agents inhibit sodium channels. Class II drugs include beta-adrenergic receptor antagonists, which slow heart rate and increase cardiac muscle contraction. Class III drugs inhibit potassium efflux during repolarization. Class IV agents include calcium channel blocker. Unclassified agents such as digoxin decrease conduction velocity and adenosine activates adenosine receptors that play a role in potassium conductance.

Question 5

Which of the following set of drugs are not vasodilators?

Accepted Answer

Dopamine, dobutamine, furosemide are not vasodilators. Classes of agents include in the vasodilator group include beta-blockers such as acebutolol, atenolol, betaxolol, bisoprolol, carteolol, carvedilol, esmolol, labetalol, metoprolol, nadolol, penbutolol, pindolol, propranolol, sotalol, and timolol; nitrates/nitrites, also known as anti-anginal vasodilators, such as amyl nitrate, isosorbide dinitrate, isosorbide mononitrate, and nitroglycerin; anti-hypertensive vasodilators such as diazoxide, minoxidil, fenoldopam, nitroprusside, hydralazine, and tolazoline; and calcium channel blockers such as amlodipine, bepridil, diltiazem, felodipine, isradipine, nicardipine, nifedipine, nimodipine, nisoldipine, and verapamil

Question 6

Which of the following is not a correct match between the anticoagulant and its mechanism of action?

Accepted Answer

"Low molecular weight heparins - prevents conversion of fibrinogen to fibrin" is not a correct match. Heparin is a protein that inhibits the conversion of prothrombin to thrombin, which prevents fibrinogen being converted to fibrin. Lepirudin directly inhibits thrombin formation, while low molecular weight heparins block factors Xa and IIa, which inhibit thrombus and clot formation. Warfarin prevents clot formation by interfering with formation of vitamin K dependent clotting factors in the liver.

Question 7

The fibrinolytic mechanism of streptokinase and urokinase are:

Accepted Answer

Both inhibit the formation of fibrin by disrupting the conversion of plasminogen to plasmin. Specifically, streptokinase, urokinase, and anistreplase inhibit the formation of fibrin by disrupting the conversion of plasminogen to plasmin. Alteplase, tenecteplase, and reteplase activate the conversion of fibrin-bound plasminogen to plasmin.

Question 8

Which of the following is not a part of major criteria for diagnosis of Marfan's syndrome?

Accepted Answer

Presence of peripheral vascular disease is not major criteria for diagnosis of Marfan's syndrome. The major criteria for Marfan's syndrome include an enlarged aorta, with or without aortic dissection; aortic dissection affecting ascending aorta; dislocation of the lens of an eye; dural ectasia; at least 4 skeletal problems such as chest deformities, long thin arms and legs, flat footedness and scoliosis; family history; and/or having an abnormal gene for Marfan's syndrome. Minor criteria are symptoms and signs that occur in both patients with the disease as well as in the general population.

Question 9

A nurse is taking care of a patient who has undergone pacemaker implantation. What investigations should the nurse order for this patient?

Accepted Answer

The nurse should order electrocardiogram, echocardiogram, chest X-ray for this patient. Post permanent pacemaker implantation, the clinician should perform an electrocardiogram, echocardiogram, perform a physical assessment, monitor peripheral blood flow and look for swelling and evaluate cardiac pain. Chest X-ray should also be performed pre and post pacemaker placement.

Question 10

A 28-year old male patient complaining of sharp chest pain radiating to the back and relieved by sitting up forward was diagnosed to suffer from pericarditis. What lifestyle modification should the nurse suggest to this patient?

Accepted Answer

The nurse should suggest to this patient to reduce the physical activity and increase rest and relaxation. Lifestyle modifications in patients with pericarditis include reduction of physical activity as well as increased rest and relaxation until the condition resolves.

Question 11

Which of the following statements is correct about pericardiectomy?

Accepted Answer

The correct statement about pericardiectomy is "the procedure is reserved for patients with constrictive pericarditis". Pericardiectomy involves removal of the entire pericardium. This procedure is typically reserved for patients with constrictive pericarditis.

Question 12

Which of the following visual complication is not associated with Marfan's syndrome?

Accepted Answer

Retinal vein thrombosis is not associated with Marfan's syndrome. Vision complications associated with Marfan's syndrome includes shifting or dislocation, extreme nearsightedness, glaucoma, cataract and/or detachment or tear in the retina.

Question 13

What is the basis of pacing of atria and ventricles in rate modulated pacing?

Accepted Answer

Basis of pacing in rate modulated pacing is increased heart rate with physiological stress. Rate modulated pacing involves the pacing of the atria and ventricles based on physiological stress with increased heart rate. This type of pacing uses sensors to modulate pacing.

Question 14

Which of the following techniques is used for stress management?

Accepted Answer

Cognitive restructuring is used for stress management. Stress management techniques include autogenic training, cognitive restructuring, imagery, progressive muscle relaxation, meditation and aerobic exercise.

Question 15

Which of the following is not a maladaptive response to coping?

Accepted Answer

Adjusting to discomfort is not a maladaptive response to coping. Maladaptive responses to coping include anxiety, anger, depression, denial and dependence.

Question 16

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

Accepted Answer

The correct match is Alarm stage - initial response to a stressor. The alarm stage is the initial response to a stressor, which is the fight or flight syndrome. The stage of resistance or adaptation is the process whereby the individual continues the fight or flight response. The stage of exhaustion is the point at which the stressor becomes dysfunctional and can lead to disease or illness.

Question 17

Which of the following hormones is released during alarm stage?

Accepted Answer

The hormone ACTH is released during alarm stage. Growth hormone stimulates growth, cell reproduction and regeneration. Parathyroid increases concentration of calcium in blood. Thyroid hormone acts on various cells of the body. It increases basal metabolic rate, protein synthesis, regulates bone growth and helps in neuronal maturation.

Question 18

Which of the following is not a possible disciplinary action measure which can be taken if a nurse is found guilty of misconduct?

Accepted Answer

Prosecution is not a possible disciplinary action to be taken if nurse is found guilty of misconduct. Possible disciplinary action measures taken if found guilty include revocation of license, suspension of license for a specified period of time, suspension of license for a program of study or treatment, and/or prohibition of work in specified settings.

Question 19

A 45-year old male presents with complaints of daytime somnolence and forgetfulness. His wife reports that her husband snores loudly during night with intermittent periods of breath holding. Which of the following is a most likely diagnosis?

Accepted Answer

Most likely diagnosis is obstructive sleep apnea. Symptoms of obstructive sleep apnea are daytime somnolence, headache, depression, forgetfulness, overweight, and impotence. An electrocardiogram may indicate bradydysrhythmia during apnea and tachydysrhythmia during respiration. Erythrocytosis, hypertension, and heart failure are common. Narcolepsy is characterized by brief, sudden episodes of falling asleep, loss of muscle tone, and sleep paralysis. Cushing's syndrome will have its other typical feature.

Question 20

Which of the following are causes of orthostatic hypotension?

Accepted Answer

Diuretics, pregnancy, burns, excessive heat exposure are causes of orthostatic hypotension. The causes of orthostatic hypotension include dehydration, prolonged bed rest, pregnancy, diabetes, heart problems, burns, excessive heat exposure, large varicose veins, and certain neurological disorders. Drugs that can lead to orthostatic hypotension include diuretics, beta-blockers, calcium channel blockers, angiotensin-converting enzyme inhibitors and antidepressant.

Quiz 1: Cardiac Medicine