Question 1

An adolescent boy presents with complaints of chest pain that is exacerbated by coughing and deep breathing. During auscultation, the nurse finds that the patient's heart sounds are muffled. What is the most likely cause of his symptoms and the muffled heart sounds?

Accepted Answer

The most likely cause of the patient's symptoms and the muffled heart sounds is pericarditis. In adolescents, pericarditis can be caused by adenovirus or Coxsackie virus.

Question 2

Which of the following complications of pericarditis causes permanent thickening of the pericardium and interferes with the function of heart muscle?

Accepted Answer

Constrictive pericarditis is a complication of pericarditis, and it can interfere with cardiac functioning. Other complications of pericarditis include pericardial effusion, arrhythmias, and cardiac tamponade.

Question 3

Which of the following set of conditions is not associated with vasculitis?

Accepted Answer

Tuberculosis, amyloidosis, and idiopathic thrombocytopenia are not causes of vasculitis. Conditions that are commonly associated with vasculitis include Behçet's syndrome, Buerger's syndrome, Churg-Strauss syndrome, Henoch-Schönlein purpura, Kawasaki disease, microscopic polyangiitis, polymyalgia rheumatica, Sjögren's syndrome, and Takayasu's arteritis.

Question 4

Which of the following pharmacologic agents are used in treatment of vasculitis?

Accepted Answer

Pharmacological agents used to treat vasculitis include corticosteroids such as prednisolone and methylprednisolone to reduce inflammation; cytotoxic drugs such as azathioprine and cyclophosphamide to suppress inflammation; heparin to prevent formation of clots; and nonsteroidal anti-inflammatory agents such as aspirin and ibuprofen to treat mild symptoms.

Question 5

An adult male complains of oliguria and red colored urine. His CT angiogram shows thrombosis of the renal vein. What should be the immediate goals of treatment for this patient?

Accepted Answer

The immediate goal of treatment for a patient of renal vein thrombosis is to decrease the risk of clot formation, prevent progression of current clots, and prevent embolization of formed clots.

Question 6

A two-year-old child has frequent respiratory tract infections, poor weight gain, and lack of appetite. During auscultation the nurse hears a quiet ejection murmur at the left sternal border and a split second heart sound. Which of the following procedures would be useful in making a diagnosis?

Accepted Answer

The patient probably has an atrial septal defect, and diagnostic tools used to determine the presence of atrial septal defect include chest x-ray, echocardiography, and magnetic resonance imaging., A more invasive approach such as cardiac catheterization may also be used.

Question 7

A patient who has swelling, pain, and warmth in his left leg is suspected to have deep vein thrombosis. Which of the following diagnostic modalities are helpful in establishing the presence of deep vein thrombosis (DVT)?

Accepted Answer

Diagnostic modalities that can establish the presence of DVT include nuclear medicine imaging studies, magnetic resonance imaging, impedance plethysmography of leg, and D-dimer blood test.

Question 8

A patient is complaining of throbbing pain in, and discoloration of the skin of her legs and varicose veins. What are the possible complications if this patient is not treated?

Accepted Answer

This patient has venous insufficiency, and complications associated with this condition include deep vein thrombosis, pulmonary embolism, and venous ulcers.

Question 9

Which of the following adverse effects do not match the treatment modalities used for venous insufficiency?

Accepted Answer

The adverse effects of endovenous laser therapy do not include allergic reaction or injury to deep arteries. Potential complications associated with surgical ablation include infection, peripheral nerve damage, and arterial injury. Adverse effects associated with radio frequency ablation include skin burns, injury to adjacent tissues, and injury to deep veins, and adverse effects associated with sclerotherapy include allergic reaction, and cutaneous necrosis.

Question 10

A girl whose mother has valvular heart disease is anxious to know if she has the disease. The diagnostic exam should look for:

Accepted Answer

The diagnostic exam performed on this patient should look for abnormal heart sounds such as murmur, evidence of heart enlargement, and fluid buildup in the lungs.

Question 11

The 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 would include electrocardiogram, echocardiography, and a chest x-ray. Other diagnostic tests such as MRI, cardiac stress testing, and cardiac craterization can be used to detect comorbid cardiovascular conditions.

Question 12

A nurse is caring for a patient who has mitral stenosis. The patient is being released after diagnostic work up and will be receiving medications. What is the role of medications in the treatment of mitral stenosis?

Accepted Answer

Medications are used to relieve symptoms and prevent complications, but they do not cure mitral stenosis. The choice of treatment depends on the extent of disease as well as presence of other comorbid conditions and the individual's overall health.

Question 13

What are the surgical treatments available for a patient who has mitral stenosis associated with mild mitral regurgitation?

Accepted Answer

All of the above. Surgical treatments that can be used for this patient include percutaneous balloon valvuloplasty, valvotomy, and valve replacement.

Question 14

A patient complains of palpitations. The nurse records an EKG which shows varying and /or absent P waves, a varying R-R interval, fibrillatory waves, and a ventricular rate of 140/minute. What are the goals of treatment for this patient?

Accepted Answer

This patient has atrial fibrillation, and the goals treating atrial fibrillation are controlling heart rate and ventricular response, restoring sinus rhythm, and preventing complications such as thromboembolism.

Question 15

A patient who has mitral stenosis complains of dizziness, light headedness, and palpitations. The nurse record an EKG which shows an absence of P waves and an irregular R-R interval. Which of these drugs may be used in the treatment of this patient?

Accepted Answer

Drugs used to treat atrial fibrillation include beta-adrenergic blockers. warfarin, and digitalis. Other drugs that can be used include aspirin, anti-dysrhythmic agents, and calcium channel blockers such as nifedipine, amlodipine, verapamil, and diltiazem.

Question 16

The EKG of a patient complaining of dizziness, light headedness, and palpitations shows absent P waves and fibrillatory waves. Which of the following invasive approaches are not beneficial in treating this patient's arrhythmia?

Accepted Answer

AV node ablation is not used to treat atrial fibrillation: radiofrequency catheter ablation, the surgical maze procedure, and occasionally an implantable defibrillator are used.

Question 17

Which of the following statements is not true regarding cardiac arrhythmias?

Accepted Answer

Some ventricular arrhythmias such s ventricular fibrillation can be life threatening. Sick sinus syndrome definitely causes an arrhythmia. An arrhythmia is defined as a condition that involves dysregulation of cardiac electrical activity. Arrhythmias can cause a slow, rapid, or irregular heartbeat. Tachycardia is a condition in which the heart beats faster than normal; bradycardia is a condition that occurs when the heart beats slower than normal.
There are many types of arrhythmias including premature beats, supraventricular arrhythmias, ventricular arrhythmias, and bradyarrhythmias. Premature beats can originate in both atria and the ventricles. Supraventricular arrhythmias originate in the atria and include atrial fibrillation, atrial flutter, and Wolf-Parkinson-White syndrome.

Question 18

Which of the following statements is not true for atrial fibrillation vs. atrial flutter?

Accepted Answer

Atrial fibrillation can be treated with catheter ablation. Atrial flutter is a condition that is similar to atrial fibrillation. However, compared with atrial fibrillation atrial flutter presents with a more organized and less chaotic heart rate. Atrial flutter may develop into atrial fibrillation, and the reverse is possible as well.
In atrial flutter, the atrial rhythm is generally regular, and the ventricular rhythm may be regular or irregular. In atrial fibrillation, the atrial rhythm and the ventricular rhythms are irregular.
The symptoms, risk factors, and complications of atrial flutter are similar to atrial fibrillation. However, atrial flutter is not as life threatening as atrial fibrillation.

Question 19

The nurse is caring for a patient who has had cardiac surgery, and the nurse notes that the chest tube drainage has decreased, and the patient has muffled heart sounds and pulsus paradoxus. Which of the following echocardiographic findings suggest a diagnosis of cardiac tamponade?

Accepted Answer

An echocardiographic finding of a collapse of the right ventricular outflow tract during early diastole suggests a diagnosis of cardiac tamponade.

Question 20

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

Accepted Answer

Wolff-Parkinson-White syndrome develops because of formation of abnormal conducting tissue in 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.

Quiz 2: Problems