Week 2 Patho tri 2

Question 1 of 46

1

A 34-year-old man who is an intravenous drug user has presented to the emergency department with malaise, abdominal pain, and lethargy. The health care team wants to rule out endocarditis as a diagnosis. Staff of the department would most realistically anticipate which of the following sets of diagnostics?

Select one of the following:

CT of the heart, chest x-ray, and ECG
ECG, blood pressure, and stress test
Cardiac catheterization, chest x-ray, electrolyte measurement, and white cell count
Echocardiogram, blood cultures, and temperature

Explanation

Question 2 of 46

1

A client has been diagnosed with mitral valve stenosis following his recovery from rheumatic fever. Which of the following teaching points would be most accurate to convey to the client?

Select one of the following:

Your mitral valve isn't opening up enough for blood to flow into the part of your heart that sends blood into circulation
The valve between your left ventricle and left atria is infected and isn't allowing enough blood through.
Your heart's mitral valve isn't closing properly so blood is flowing backward in your heart and eventually into your lungs.
The normal tissue that makes up the valve between the right sides of your heart has stiffened

Explanation

Question 3 of 46

1

On a routine physical exam visit, the physician mentions that he hears a new murmur. The patient gets worried and asks, What does this mean? The physician responds,

Select one of the following:

It would be caused by stress. Let's keep our eye on it and see if it goes away with your next visit.
This may make you a little more fatigued than usual. Let me know if you start getting dizzy or light-headed.
This could be caused by an infection. Have you been feeling well the past few weeks?
One of your heart valves is not opening properly. We need to do an echocardiogram to see which valve is having problem.

Explanation

Question 4 of 46

1

A 13-year-old boy has had a sore throat for at least a week and has been vomiting for 2 days. His glands are swollen, and he moves stiffly because his joints hurt. Throat cultures show infection with group A streptococci. This child is at high risk for

Select one of the following:

infective endocarditis
vasculitis
myocarditis
mitral valve stenosis.

Explanation

Question 5 of 46

1

A physician has ordered the measurement of a cardiac patient's electrolyte levels as part of the client's morning blood work. Which of the following statements best captures the importance of potassium in the normal electrical function of the patient's heart?

Select one of the following:

The reciprocal movement of one potassium ion for one sodium ion across the cell membrane results in the production of an action potential.
The impermeability of cardiac cell membranes to potassium allows for action potentials achieved by the flow of sodium ions.
Potassium is central to establishing and maintaining the resting membrane potential of cardiac muscle cells.
Potassium catalyzes the metabolism of ATP, producing the gradient that results in electrical stimulation.

Explanation

Question 6 of 46

1

A 63-year-old male client has been diagnosed with a bundle branch block. How will this client's care team most likely expect his condition to be expressed diagnostically?

Select one of the following:

His ECG will show a flattened P wave as a result of impaired atrial depolarization.
Conduction from the Purkinje fibers to the bundle branches is compromised by inadequate conduction
His ECG will show an inordinately wide QRS complex because impulses are bypassing the normal conduction tissue.
His AV node will be performing the primary pacemaker role due to inadequacy of the SA node.

Explanation

Question 7 of 46

1

A client has been diagnosed with mitral valve stenosis following his recovery from rheumatic fever. Which of the following teaching points would be most accurate to convey to the client?

Select one of the following:

The valve between your left ventricle and left atria is infected and isn't allowing enough blood through.
Your heart's mitral valve isn't closing properly so blood is flowing backward in your heart and eventually into your lungs.
Your mitral valve isn't opening up enough for blood to flow into the part of your heart that sends blood into circulation.
The normal tissue that makes up the valve between the right sides of your heart has stiffened.

Explanation

Question 8 of 46

1

You are looking after a 61-year-old male client in the hospital who has presented with a new onset of atrial fibrillation. Which of the following courses of treatment would you most likely expect the attending physician to initiate?

Select one of the following:

Antihypertensives and constant cardiac monitoring in a high acuity unit
Immediate cardioversion followed by surgery to correct the atrial defect
Anticoagulants and beta-blockers to control rate
Diuretics, total bed rest, and cardioversion if necessary

Explanation

Question 9 of 46

1

The initial medical management for a symptomatic patient with obstructive hypertrophic cardiomyopathy (HCM) would be administering a medication to block the effects of catecholamines. The nurse will anticipate administering which of the following medications?

Select one of the following:

Lisinopril, an ACE inhibitor
Lasix, a diuretic
Lanoxin, an inotropic
Propranolol, a beta-adrenergic blocker

Explanation

Question 10 of 46

1

The amount of blood pumped by one ventricle in one minute, is called the

Select one of the following:

ejection fraction.
stroke volume.
cardiac output.
end-diastolic volume.

Explanation

Question 11 of 46

1

If someone's heart has a stroke volume of 70 ml and a heart rate of 90 beat/minute, the cardiac output would be

Select one of the following:

0.77 L/min
6.3 L/min
1.28 ml/min
70 ml/min

Explanation

Question 12 of 46

1

Any mechanism that increases heart rate is said to have a positive ____ effect.

Select one of the following:

inotropic
feedback
chronotropic
cholinergic

Explanation

Question 13 of 46

1

Stroke volume is regulated by all of the following except

Select one of the following:

peripheral resistance
contractility
cardiac output
end-diastolic volume.

Explanation

Question 14 of 46

1

The preload acting on a ventricle is equivalent to that chamber's

Select one of the following:

stroke volume
contractility
end-diastolic volume
ejection fraction

Explanation

Question 15 of 46

1

The afterload imposed on a ventricle refers to

Select one of the following:

the amount of blood added to a ventricle by atrial systole
the ejection fraction, or percentage of EDV ejected by ventricular systole
Its end-systolic volume, the blood left after contraction is complete
the total peripheral resistance opposing the ejection of blood.

Explanation

Question 16 of 46

1

The Frank-Starling law of the heart describes the proportional relationship between

Select one of the following:

stroke volume and end-diastolic volume
the left and right ventricles
stroke volume and cardiac output
stroke volume is and total peripheral resistance

Explanation

Question 17 of 46

1

A positive inotropic agent is something that

Select one of the following:

increases the heart rate in positive feedback loop
decreases the contractility of myocardial fibers
increases the contractility of myocardial fibers
reduces the heart rate in positive feedback loop

Explanation

Question 18 of 46

1

The nurse working in the ICU knows that chronic elevation of left ventricular end-diastolic pressure will result in the patient displaying which of the following clinical manifestations?

Select one of the following:

Dyspnoea and crackles in bilateral lung bases
Muscle cramping and cyanosis in the feet
Chest pain and intermittent ventricular tachycardia
Petechia and spontaneous bleeding

Explanation

Question 19 of 46

1

Which one of the following is not a pathophysiological change associated with heart failure?

Select one of the following:

Decreased angiotensin II production.
Increased myocardial oxygen demand.
Cardiac remodelling.
Decreased myocardial contractility.

Explanation

Question 20 of 46

1

A 3-year-old child with right-sided heart failure has been admitted for worsening of his condition. Which of the following assessments would be considered one of the earliest signs of systemic venous congestion in this toddler?

Select one of the following:

Breathlessness with activity
Increased urine output
Enlargement of the liver
Excessive crying

Explanation

Question 21 of 46

1

A nurse will be providing care for a female patient who has a diagnosis of heart failure that has been characterized as being primarily right sided. Which of the following statements best describes the presentation that the nurse should anticipate? The client

Select one of the following:

has cyanotic lips and extremities, low urine output, and low blood pressure.
complains of dyspnea and has adventitious breath sounds on auscultation (listening).
has a distended bladder, facial edema, and nighttime difficulty breathing.
has pitting edema to the ankles and feet bilaterally, decreased activity tolerance, and occasional upper right quadrant pain.

Explanation

Question 22 of 46

1

A nurse is administering morning medications to a number of patients on a medical unit. Which of the following medication regimens is most suggestive that the patient has a diagnosis of heart failure?

Select one of the following:

Anticoagulant, antihypertensive, calcium supplement
Beta-blocker, potassium supplement, anticoagulant
Diuretic, ACE inhibitor, beta-blocker
Antihypertensive, diuretic, antiplatelet aggregator

Explanation

Question 23 of 46

1

Atrial fibrillation may:

Select one of the following:

Increase turbulence within the atrial chamber
Induce an irregular heart rate
increase the risk of thromboembolism
All answers are correct

Explanation

Question 24 of 46

1

By definition, tachycardia describes any heart rate exceeding ______ beats/min

Select one of the following:

60
75
95
100

Explanation

Question 25 of 46

1

Complete cessation of electrical signals from the AV node to the ventricles is known as:

Select one of the following:

first degree block
second degree block
Third degree block
all answers are correct

Explanation

Question 26 of 46

1

What changhe results from total heart block

Select one of the following:

Spontaneous slow ventricular contractions, not coordinated with atrial contraction
a wide QRS wabe
Periodic omission of a ventricular contraction
A prolonged PR interval

Explanation

Question 27 of 46

1

A 65-year-old male with history of untreated hypertension is now experiencing left heart failure. The most likely reason is

Select one of the following:

myocardial hypertrophy and ventricular remodelling
alterations in alpha and beta receptor function
Inhibition of renin and aldosterone
ventricular dilation and wall thinning

Explanation

Question 28 of 46

1

Excess preload can be reduced by

Select one of the following:

use of diuretics
Use of antidiuretics
all answers are correct
increasing volume intake, that is, drinking more fluid

Explanation

Question 29 of 46

1

Which of the following would increase the work load of the left ventricle

Select one of the following:

stenosis of the aortic semilunar valves
regurgitating aortic semilunar valves
hypertension
all answers are correct

Explanation

Question 30 of 46

1

Paroxysmal nocturnal dyspnea is marked by

Select one of the following:

haemoptysis and rales
cardiomegaly
Bradycardia and weak pulse
distended neck veins and flushed face

Explanation

Question 31 of 46

1

A very rapid heart rate reduces cardiac output because:

Select one of the following:

Ventricular fibrillation develops immediately
venous return is increased
conduction through the AV node is impaired
ventricular filling is reduced

Explanation

Question 32 of 46

1

Pericarditis causes a reduction in cardiac output as a result of which of the following

Select one of the following:

delays in the conduction system, interfering with a cardiac rhythm
Excess fluid in the pericardial cavity, which decreases ventricular filling
Incompetent valves, which allow regurgitation of blood
Weak myocardial contractions due to friction rub

Explanation

Question 33 of 46

1

A 63-year-old male client has been diagnosed with bundle branch block. how will this clients care team most likely expect his condition to be expressed diagnostically

Select one of the following:

his ECG will show an inordinately wide QRS complex because impulses are bypassing the normal conduction tissue
His AV node will be performing the primary pacemaker role due to inadequacy of the SA node
Conduction from the purkinje fibers to the bundle branches is compromised by inadequate conduction
His ECG will show a flattened P wave as a result of impaired atrial depolarization

Explanation

Question 34 of 46

1

Clients who have renal impairment are at risk of developing ________ during treatment with ACE inhibitors

Select one of the following:

Hyperkalaemia
Hypernatraemia
Hypokalaemia
Hyponatraemia

Explanation

Question 35 of 46

1

Right heart failure will likely cause:

Select one of the following:

Pitting oedema in the lower legs resulting from increased venous pressure
non-pitting oedema in the arms, resulting from decreased arterial pressure
pulmonary oedema from increased left ventricular filling
all answers are correct

Explanation

Question 36 of 46

1

Which of the following drugs improves cardiac efficiency by slowing the heart rate and increasing the force of cardiac contractions?

Select one of the following:

Digoxin
epinephrine
furosemide
Nifedipine

Explanation

Question 37 of 46

1

Compensation mechanisms for decreased cardiac output in cases of congestive heart failure include:

Select one of the following:

increased renin and aldosterone secretions
Slow cardiac contractions
Fatigue and cold intolerance
Decreased erythropoietin secretion

Explanation

Question 38 of 46

1

A 72-year-old female has history of right heart failure caused by a right ventricular myocardial infarction. which of the following symptoms are directly related to her heart failure?

Select one of the following:

significant oedema to both lower legs and feet
Decreased urine output
hypertension
pulmonary congestion

Explanation

Question 39 of 46

1

You are looking after a 61-year-old male who has presented with a new onset of atrial fibrilation. which of the following courses of treatment would you most likely expect the attending physician to initiate?

Select one of the following:

Intermediate cardioversion followed by surgery to correct the atrial defect
anticoagulants and beta-blockers to control rate
Anti hypertensives and constant cardiac monitoring in a high acuity unit
Calcium channel blockers and beta blockers to prolong QRS complex

Explanation

Question 40 of 46

1

A number of patients in an acute cardiac care unit of a hospital have diagnoses of impaired cardiac conduction. Which of the following patients is most deserving of immediate medical attention?

Select one of the following:

A 69-year-old who has entered ventricular fibrillation
a 60-year-old women who has just been diagnosed with a first degree AV block
A 60-Year-Old male with premature ventricular contractions (PVC) and a history of atrial fibrillation
A 46-year-old man whose ECG shows him to be in ventricular tachycardia

Explanation

Question 41 of 46

1

Pericarditis may be caused by (choose the most correct answer)

1. infection
2. autoimmune conditions
3. Injury
4. Malignant neoplasm

Select one of the following:

1, 2.
1,3, 4
1, 2, 3, 4
3, 4

Explanation

Question 42 of 46

1

Pericarditis causes a reduction in cardiac output as a result of the following?

Select one of the following:

Weak myocardial contractions due to friction rub.
Delays in the conduction system interfering with cardiac rhythm
Excess fluid in the pericardial cavity, which decreases ventricular filling
incompetent valves,, which affect regurgitation of blood

Explanation

Question 43 of 46

1

A patient who is experiencing some angina associated with tachycardia has been placed on verapamil, a calcium channel blocker. Knowing the mechanism of action of this medication, you should assess the patient for which of the following adverse reactions.

Select one of the following:

Bradycardia
sudden asytole
increased cardiac output
ventricular tachycardia

Explanation

Question 44 of 46

1

Which of the following would you not expect to be administered to a patient suffering heart failure?

Select one of the following:

Beta-agonist
ACE inhibitor
digoxin
diuretic

Explanation

Question 45 of 46

1

All but one of the following are signs of congestive heart failure EXCEPT:

Select one of the following:

Polyuria
Muscle fatigue
oedema
cough

Explanation

Question 46 of 46

1

In which blood vessels will failure of the left ventricle caused increased hydrostatic pressure?

Select one of the following:

Pulmonary capillaries
Veins of the legs and feet
jugular veins
blood vessels of the liver and spleen

	Created by Mitch Thornell over 6 years ago

Tri 2 patho Quiz on Week 2 Patho tri 2, created by Mitch Thornell on 23/07/2018.

Week 2 Patho tri 2

Question 1 of 46

Select one of the following:

Explanation

Question 2 of 46

A client has been diagnosed with mitral valve stenosis following his recovery from rheumatic fever. Which of the following teaching points would be most accurate to convey to the client?

Select one of the following:

Explanation

Question 3 of 46

On a routine physical exam visit, the physician mentions that he hears a new murmur. The patient gets worried and asks, What does this mean? The physician responds,

Select one of the following:

Explanation

Question 4 of 46

A 13-year-old boy has had a sore throat for at least a week and has been vomiting for 2 days. His glands are swollen, and he moves stiffly because his joints hurt. Throat cultures show infection with group A streptococci. This child is at high risk for

Select one of the following:

Explanation

Question 5 of 46

A physician has ordered the measurement of a cardiac patient's electrolyte levels as part of the client's morning blood work. Which of the following statements best captures the importance of potassium in the normal electrical function of the patient's heart?

Select one of the following:

Explanation

Question 6 of 46

A 63-year-old male client has been diagnosed with a bundle branch block. How will this client's care team most likely expect his condition to be expressed diagnostically?

Select one of the following:

Explanation

Question 7 of 46

A client has been diagnosed with mitral valve stenosis following his recovery from rheumatic fever. Which of the following teaching points would be most accurate to convey to the client?

Select one of the following:

Explanation

Question 8 of 46

You are looking after a 61-year-old male client in the hospital who has presented with a new onset of atrial fibrillation. Which of the following courses of treatment would you most likely expect the attending physician to initiate?

Select one of the following:

Explanation

Question 9 of 46

The initial medical management for a symptomatic patient with obstructive hypertrophic cardiomyopathy (HCM) would be administering a medication to block the effects of catecholamines. The nurse will anticipate administering which of the following medications?

Select one of the following:

Explanation

Question 10 of 46

The amount of blood pumped by one ventricle in one minute, is called the

Select one of the following:

Explanation

Question 11 of 46

If someone's heart has a stroke volume of 70 ml and a heart rate of 90 beat/minute, the cardiac output would be

Select one of the following:

Explanation

Question 12 of 46

Any mechanism that increases heart rate is said to have a positive ____ effect.

Select one of the following:

Explanation

Question 13 of 46

Stroke volume is regulated by all of the following except

Select one of the following:

Explanation

Question 14 of 46

The preload acting on a ventricle is equivalent to that chamber's

Select one of the following:

Explanation

Question 15 of 46

The afterload imposed on a ventricle refers to

Select one of the following:

Explanation

Question 16 of 46

The Frank-Starling law of the heart describes the proportional relationship between

Select one of the following:

Explanation

Question 17 of 46

A positive inotropic agent is something that

Select one of the following:

Explanation

Question 18 of 46

The nurse working in the ICU knows that chronic elevation of left ventricular end-diastolic pressure will result in the patient displaying which of the following clinical manifestations?

Select one of the following:

Explanation

Question 19 of 46

Which one of the following is not a pathophysiological change associated with heart failure?

Select one of the following:

Explanation

Question 20 of 46

A 3-year-old child with right-sided heart failure has been admitted for worsening of his condition. Which of the following assessments would be considered one of the earliest signs of systemic venous congestion in this toddler?

Select one of the following: