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Week 2 Patho tri 2

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Tri 2 patho Quiz on Week 2 Patho tri 2, created by Mitch Thornell on 23/07/2018.
Mitch Thornell
Quiz by Mitch Thornell, updated more than 1 year ago
Mitch Thornell
Created by Mitch Thornell over 6 years ago
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Resource summary

Question 1

Question
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?
Answer
  • 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

Question 2

Question
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?
Answer
  • 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

Question 3

Question
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,
Answer
  • 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.

Question 4

Question
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
Answer
  • infective endocarditis
  • vasculitis
  • myocarditis
  • mitral valve stenosis.

Question 5

Question
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?
Answer
  • 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.

Question 6

Question
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?
Answer
  • 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.

Question 7

Question
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?
Answer
  • 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.

Question 8

Question
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?
Answer
  • 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

Question 9

Question
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?
Answer
  • Lisinopril, an ACE inhibitor
  • Lasix, a diuretic
  • Lanoxin, an inotropic
  • Propranolol, a beta-adrenergic blocker

Question 10

Question
The amount of blood pumped by one ventricle in one minute, is called the
Answer
  • ejection fraction.
  • stroke volume.
  • cardiac output.
  • end-diastolic volume.

Question 11

Question
If someone's heart has a stroke volume of 70 ml and a heart rate of 90 beat/minute, the cardiac output would be
Answer
  • 0.77 L/min
  • 6.3 L/min
  • 1.28 ml/min
  • 70 ml/min

Question 12

Question
Any mechanism that increases heart rate is said to have a positive ____ effect.
Answer
  • inotropic
  • feedback
  • chronotropic
  • cholinergic

Question 13

Question
Stroke volume is regulated by all of the following except
Answer
  • peripheral resistance
  • contractility
  • cardiac output
  • end-diastolic volume.

Question 14

Question
The preload acting on a ventricle is equivalent to that chamber's
Answer
  • stroke volume
  • contractility
  • end-diastolic volume
  • ejection fraction

Question 15

Question
The afterload imposed on a ventricle refers to
Answer
  • 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.

Question 16

Question
The Frank-Starling law of the heart describes the proportional relationship between
Answer
  • stroke volume and end-diastolic volume
  • the left and right ventricles
  • stroke volume and cardiac output
  • stroke volume is and total peripheral resistance

Question 17

Question
A positive inotropic agent is something that
Answer
  • 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

Question 18

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

Question 19

Question
Which one of the following is not a pathophysiological change associated with heart failure?
Answer
  • Decreased angiotensin II production.
  • Increased myocardial oxygen demand.
  • Cardiac remodelling.
  • Decreased myocardial contractility.

Question 20

Question
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?
Answer
  • Breathlessness with activity
  • Increased urine output
  • Enlargement of the liver
  • Excessive crying

Question 21

Question
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
Answer
  • 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.

Question 22

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

Question 23

Question
Atrial fibrillation may:
Answer
  • Increase turbulence within the atrial chamber
  • Induce an irregular heart rate
  • increase the risk of thromboembolism
  • All answers are correct

Question 24

Question
By definition, tachycardia describes any heart rate exceeding ______ beats/min
Answer
  • 60
  • 75
  • 95
  • 100

Question 25

Question
Complete cessation of electrical signals from the AV node to the ventricles is known as:
Answer
  • first degree block
  • second degree block
  • Third degree block
  • all answers are correct

Question 26

Question
What changhe results from total heart block
Answer
  • Spontaneous slow ventricular contractions, not coordinated with atrial contraction
  • a wide QRS wabe
  • Periodic omission of a ventricular contraction
  • A prolonged PR interval

Question 27

Question
A 65-year-old male with history of untreated hypertension is now experiencing left heart failure. The most likely reason is
Answer
  • myocardial hypertrophy and ventricular remodelling
  • alterations in alpha and beta receptor function
  • Inhibition of renin and aldosterone
  • ventricular dilation and wall thinning

Question 28

Question
Excess preload can be reduced by
Answer
  • use of diuretics
  • Use of antidiuretics
  • all answers are correct
  • increasing volume intake, that is, drinking more fluid

Question 29

Question
Which of the following would increase the work load of the left ventricle
Answer
  • stenosis of the aortic semilunar valves
  • regurgitating aortic semilunar valves
  • hypertension
  • all answers are correct

Question 30

Question
Paroxysmal nocturnal dyspnea is marked by
Answer
  • haemoptysis and rales
  • cardiomegaly
  • Bradycardia and weak pulse
  • distended neck veins and flushed face

Question 31

Question
A very rapid heart rate reduces cardiac output because:
Answer
  • Ventricular fibrillation develops immediately
  • venous return is increased
  • conduction through the AV node is impaired
  • ventricular filling is reduced

Question 32

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

Question 33

Question
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
Answer
  • 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

Question 34

Question
Clients who have renal impairment are at risk of developing ________ during treatment with ACE inhibitors
Answer
  • Hyperkalaemia
  • Hypernatraemia
  • Hypokalaemia
  • Hyponatraemia

Question 35

Question
Right heart failure will likely cause:
Answer
  • 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

Question 36

Question
Which of the following drugs improves cardiac efficiency by slowing the heart rate and increasing the force of cardiac contractions?
Answer
  • Digoxin
  • epinephrine
  • furosemide
  • Nifedipine

Question 37

Question
Compensation mechanisms for decreased cardiac output in cases of congestive heart failure include:
Answer
  • increased renin and aldosterone secretions
  • Slow cardiac contractions
  • Fatigue and cold intolerance
  • Decreased erythropoietin secretion

Question 38

Question
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?
Answer
  • significant oedema to both lower legs and feet
  • Decreased urine output
  • hypertension
  • pulmonary congestion

Question 39

Question
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?
Answer
  • 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

Question 40

Question
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?
Answer
  • 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

Question 41

Question
Pericarditis may be caused by (choose the most correct answer) 1. infection 2. autoimmune conditions 3. Injury 4. Malignant neoplasm
Answer
  • 1, 2.
  • 1,3, 4
  • 1, 2, 3, 4
  • 3, 4

Question 42

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

Question 43

Question
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.
Answer
  • Bradycardia
  • sudden asytole
  • increased cardiac output
  • ventricular tachycardia

Question 44

Question
Which of the following would you not expect to be administered to a patient suffering heart failure?
Answer
  • Beta-agonist
  • ACE inhibitor
  • digoxin
  • diuretic

Question 45

Question
All but one of the following are signs of congestive heart failure EXCEPT:
Answer
  • Polyuria
  • Muscle fatigue
  • oedema
  • cough

Question 46

Question
In which blood vessels will failure of the left ventricle caused increased hydrostatic pressure?
Answer
  • Pulmonary capillaries
  • Veins of the legs and feet
  • jugular veins
  • blood vessels of the liver and spleen
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