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MCQ for Mid-term Review
- Which of the following actions is the first priority of care for a patient exhibiting signs and symptoms of coronary artery disease? a. Decrease anxiety b. Enhance myocardial oxygenation c. Administer sublingual nitroglycerin d. Educate the patient about his symptoms
- Medical treatment of coronary artery disease includes which of the following procedures? a. Cardiac catheterization b. Coronary artery bypass surgery c. Oral medical therapy d. Percutaneous transluminal coronary angioplasty
- Which of the following is the most common symptom of myocardial infarction (MI)? a. Chest pain b. Dyspnea c. Edema d. Palpitations
- Which of the following symptoms is the most likely origin of pain the patient described as knifelike chest pain that increases in intensity with inspiration? a. Cardiac b. Gastrointestinal c. Musculoskeletal d. Pulmonary
- Which of the following blood tests is most indicative of cardiac damage? a. Lactate dehydrogenase b. Complete blood count (CBC) c. Troponin I d. Creatine Kinase
- What is the primary reason for administering morphine to a client with an Myocardial Infarction a. To sedate the patient
b. To decrease the patient’s pain c. To decrease the patient’s anxiety d. To decrease oxygen demand on the patient’s heart
- Which of the following conditions is most commonly responsible for myocardial infarction? a. Aneurysm b. Heart failure c. Coronary artery thrombosi s d. Renal failure
- Which of the following complications is indicated by a third heart sound (S3). a. Ventricular dilation b. Systemic hypertension c. Aortic valve malfunction d. Increased atrial contractions
- After an anterior wall myocardial infarction, which of the following problems is indicated by auscultation of crackles in the lungs? a. Left-sided heart failure b. Pulmonic valve malfunction c. Right-sided heart failure d. Tricuspid valve malfunction
- What is the first intervention for a patient experiencing MI? a. Administer morphine b. Administer oxygen c. Administer sublingual nitroglycerin d. Obtain an ECG
- Which of the following classes of medications protects the ischemic myocardium by blocking catecholamines and sympathetic nerve stimulation? a. Beta-adrenergic blockers b. Calcium channel blockers c. Narcotics d. Nitrates
- What is the most common complication of an MI? a. Cardiogenic shock
b. Calcium channel blockers c. Diuretics d. Inotropic agents
- Stimulation of the sympathetic nervous system produces which of the following responses? a. Bradycardia b. Tachycardia c. Hypotension d. Decreased myocardial contractility
- Which of the following conditions is most closely associated with weight gain, nausea, and a decrease in urine output? a. Angina pectoris b. Cardiomyopathy c. Left-sided heart failure d. right-sided heart failure
- Which of the following heart muscle diseases is unrelated to other cardiovascular diseases? a. Cardiomyopathy b. Coronary artery disease c. Myocardial infarction d. Pericardial effusion
- Which of the following types of cardiomyopathy can be associated with childbirth? a. Dilated b. Hypertrophic c. Myocarditis d. restrictive
- Septal involvement occurs in which type of cardiomyopathy? a. Congestive b. Dilated c. Hypertrophic d. Restrictive
- Which of the following recurring conditions most commonly occurs in patients with cardiomyopathy? a. Heart failure
b. Diabetes c. MI d. Pericardial effusion
- Dyspnea, cough, expectoration, weakness and edema are classic signs and symptoms of which of the following conditions? a. Pericarditis b. Hypertension c. MI d. Heart failure
- In which of the following types of cardiomyopathy does cardiac output remain normal? a. Dilated b. Hypertrophic c. Obliterative d. Restrictive
- Which of the following cardiac conditions does a fourth heart sound (S4) indicate? a. Dilated aorta b. Normally functioning heart c. Decreased myocardial contractility d. Failure of the ventricle to receive all of the blood during diastole
- Which of the following classes of drugs is most widely used in treatment of cardiomyopathy? a. Antihypertensives b. Beta-adrenergic blockers c. Calcium channel blockers d. Nitrates
- If medical treatment fails, which of the following invasive procedures is necessary for treating cardiomyopathy? a. Cardiac catheterization b. Coronary artery bypass graft (CABG) c. Heart transplantation d. Intra-aortic balloon pump (IABP)
- Which of the following conditions is associated with a predictable level of pain that occurs as a result of physical or emotional stress?
d. Aortic stenosis
- Which of the following statements is true? a. Arterial thrombi are white and non-occlusive (mural) where as venous thrombi are red and occlusive b. Arterial thrombi produce ischemia and infarction whereas cardiac and venous thrombi cause embolism c. Venous thrombi are soft, red and gelatinous whereas arterial thrombi are firm and white d. All of the above
- Major site of atherosclerosis a. Thoracic aorta b. Coronary artery c. Abdominal aorta d. Internal carotid artery e. All of the above
- Active hyperemia is seen in? a. Muscles during exercise b. Inflammation c. Blushing d. All of the above (an excess of blood in the vessels supplying an organ or other part of the body.)
- Caissons disease is caused by: a. Amniotic fluid embolism b. Tumor embolism c. Hyper coagulability d. Air or gas embolism
- Thrombosis due to hypercoagulability is seen in? a. Severe trauma or burns b. Cardiac failure
c. Women taking oral contraceptives d. All of the above
- Both pale or red infarcts may be seen in a. Lung b. Kidney c. Brain d. Spleen
- Edema may be caused by any of the following EXCEPT? a. A n increase in the plasma protein concentration b. An increase in the capillary hydrostatic pressure c. An increase in the capillary permeability d. Lymphatic obstruction
- The most common site of origin for venous thrombi leading to pulmonary embolism is: a. Ascending aorta b. Portal vein c. Deep leg veins d. Right atrium
- Anasarca means? a. Abnormal inflammatory process b. Severe generalized swelling c. Absence of proliferation of vessels following inflammation d. Presence of pus
- Edema is due to? a. Blood vessel permeability increased b. Decreased albumin in blood c. decreased osmotic pressure of the blood d. None of the above e. All of the above
- Which of the following is common in all forms of shock? a. Sepsis b. Hypovolemia
- Shock is a circulatory disturbance characterized by? a. Increased blood pressure b. Decreased volume of circulating blood c. Elevated body temperature d. Decreased volume of interstitial fluid
- Which of the following statement is incorrect a. HDL contains the highest cholesterol content b. Low density lipoproteins has maximum association with atherosclerosis c. Poly unsaturated fats lowers plasma cholesterol levels d. High density lipoproteins have protective role in atherosclerosis
- Which of the following symptomatic atherosclerotic diseases is correct? a. Lower extremities-claudication gangrene b. Aorta-aneurysm, thromboembolism c. heart-MI, Ischemic heart disease d. All of the above
- The major factors predisposing to thrombogenesis include all of the following except? a. Altered blood flow b. Endothelial injury c. Urinary functionality d. Hypercoagulability of blood
- Which of the following is not indicative of hemorrhage? a. Ecchymosis b. Petechiae c. Melanosis d. Malena
- Which of the following is the most frequent site of thrombus? a. Hepatic vein b. Pulmonary vein c. Portal vein d. Veins of lower extremities
- Ascites seen in alcoholic liver cirrhosis result from: a. Decreased protein production by liver
b. Due to increased portal hypertension c. Due to obstruction of bile duct d. All of them
- An infarct is most frequently characterized by what type of necrosis? a. Caseous b. Coagulative c. Fatty d. Gangrenous
- The most reliable post mortem feature of left sided cardiac failure is? a. Systemic venous congestion b. Chronic venous congestion of lungs c. Enlargement of spleen and liver d. Edematous ankles
- Which of the following is correctly matched with the forms of extravasation hemorrhages? a. Petechiae b. Purpura -small area (1 cm) of hemorrhage into the skin and mucous membrane c. Ecchymosis - large extravasation of blood into the skin and mucous membrane d. All of the above
- Extravasation of blood into the tissues with resulting swelling is called? a. Hemoperitoneum b. Hematoma c. Hemopericardium d. hemothorax
- Risk factors for atherosclerosis a. Hypertension b. Diabetes c. Smoking d. All of them
- The client has S-T segment depression on electrocardiogram (ECG). The doctor concludes that this ECG finding is consistent with which of the following changes?
- Necrosis
- Injury 3. Ischemia
- Bradycardia
- A client undergoing cardiac monitoring by ECG has sinus rhythm with a heart rate of 54 beats per minute. The doctor appropriately documents which cardiac rhythm? 1. Sinus bradycardia
- Sinus tachycardia
- Sinus arrhythmia
- Accelerated nodal rhythm
- A client with a history of unstable angina is being assessed in the emergency department. The client demonstrates significant Q waves on the electrocardiogram (ECG) compared with an ECG taken 1 week ago. This is indicative of which problem?
- Gangrene
- Ischemia
- Infection 4. Infarction
- The client in the emergency department who is diagnosed with acute myocardial infarction (MI) asks the doctor to explain what this is. The doctor responds that an MI usually occurs because of which of the following? 1. Obstruction of a coronary artery with death of tissue distal to the blockage
- Spasm of a coronary artery causing temporary decreased blood supply
- A slow heart rate leading to decreased blood supply to myocardium
- Dilation of the ventricular wall causing decreased blood supply
- The client arrives in the emergency department with a heart rate of 130. The client appears anxious and is tachypneic. The doctor interprets that what physiological mechanism is most likely responsible for the increased heart rate?
- Parasympathetic nervous system (PNS) activity 2. Sympathetic nervous system (SNS) activity
- Increase in circulating acetylcholine
- Decrease in circulating catecholamines
- The client arrives in the emergency department with a diagnosis of right-sided heart failure. What clinical manifestations should the doctor expect to assess in this client? Which is nott apply.
- Distended neck veins
- Pitting edema in the feet and ankles
- No crackles in the lungs
- Abdominal ascites 5. Reflex bradycardia with activity
- The client presents to the emergency department with substernal chest pain and is diagnosed with a subendocardial myocardial infarction (MI). The client asks the doctor what that means. What information should the doctor include when responding to the client about the myocardial damage?
- It is located on the anterior wall of the left ventricle.
- It is located on the posterior wall of the left ventricle.
- It involves the full thickness of the wall. 4. It involves the inner layer of the heart.
- The client is admitted to the coronary care unit (CCU) with a diagnosis of left-sided heart failure. When listening to lung sounds, the doctor hears crackles bilaterally. The doctor concludes that this is an expected finding because left-ventricular failure leads to which of the following?
- Increased coronary artery perfusion
- Pulmonary emboli
- Increased peripheral resistance 4. Pulmonary congestion
- The doctor anticipates that left ventricular failure can result in which of the following problems in the client? Select all that apply.
- Right ventricular failure
- Diminished left atrial pressure
- Higher pulmonary pressures (pulmonary hypertension) 4. Pulmonary edema
- Increased peripheral circulation and perfusion to the brain
- The life span of thrombocytes is? a. 4 to 5 weeks b. 3 to 7 weeks
- The formation of erythrocytes in the fetus takes place in? a. liver and spleen b. red bone marrow c. blood plasma d. all of these
- In a healthy adult man, the commonest smallest type of leukocytes are? a. Lymphocytes b. basophils c. eosinophils d. all of these
- The production of red blood cells in bone marrow is regulated by? a. Renin b. Rennin c. erythropoietin d. calcium
90.Major and frequent influence for thrombus formation is? a. Fatty streak b. Hypercoagulability c. Endothelial damage d. Alteration in blood flow
91.Sickle cell disease occurs when a person inherits abnormal copies of the β-globin gene that makes hemoglobin, which changes the red blood cells into sickle-like shape under certain circumstances. a. True b. False
92.Major site of atherosclerosis a. Thoracic aorta b. Coronary artery c. Abdominal aorta d. Internal carotid artery
93.Active hyperemia is seen in a. Muscles during exercise b. Inflammation c. Blushing d. All of the above
94.Edema may be caused by any of the following EXCEPT? a.
b. An increase in the plasma protein concentration c. An increase in the capillary hydrostatic pressure d. An increase in the capillary permeability e. Lymphatic obstruction
95.The most common site of origin for venous thrombosis leading to pulmonary embolism is: a. Ascending aorta b. Portal vein c. Deep leg veins d. Right atrium
96.Anasarca means? a. Abnormal inflammatory process b. Severe generalized swelling c. Absence of proliferation of vessels following inflammation d. Presence of pus
97.Edema is due to? a. Increased albumin in blood and decreased globin b. Decreased albumin in blood c. Increased osmotic pressure d. None of the above
98.Normal Fluid Homeostasis is maintained by? a. Vessel wall integrity b. Intravascular pressure c. Osmolarity d. All of the above
99.Edema is caused by? a. Increased hydrostatic pressure b. Imparied vascular structure c. Reduced plasma osmotic pressure (hypo-proteinemia) d. All of the above
100.Which disease can cause edema? a. Lymphatic obstruction: Neoplastic, or postsurgical b. Sodium Retention: excessive salt intake with renal insufficiency c. Inflammation: acute inflammation, chronic inflammation d. All of the above
101.Disseminated intravascular coagulation (DIC) is a rare but serious condition that first causes abnormal blood clotting, then bleeding throughout the body’s blood vessels. It can be caused by another disease or condition, such as a shock, an infection or injury, that makes the body’s normal blood clotting process become overactive. a. True
b. Arterial thrombi produce ischemia and infarction whereas cardiac and venous thrombi cause embolism c. Arterial thrombi are soft, red and gelatinous whereas venous thrombi are firm and white d. All of the above
110.The type of embolism seen in fractures of long bones: a. Thromboembolism b. Air embolism c. Fat embolism d. Amniotic fluid embolism
111.Which of the following is the most frequent site of thrombus? a. Hepatic vein b. Pulmonary vein c. Portal vein d. Veins of lower extremities
112.An infarct is most frequently characterized by what type of necrosis? a. Caseous b. Coagulative c. Fatty d. Gangrenous
113.Risk factors for atherosclerosis a. Hypertension b. Diabetes c. Smoking d. All of them
114.The commonest site of thrombosis is? a. Heart b. Arteries c. Veins d. Capillaries
- Which of the following can be classified as Cardiovascular diseases (CVD)? a. Thrombosis b. Angina pectoris c. Heart attack (myocardial infarction MI) d. All of the above
116.Coronary heart disease (CHD), or coronary artery disease, develops when the coronary arteries become too open. a. True b. False
117.Acute coronary syndrome (ACS) is a syndrome (set of signs and symptoms) due to decreased blood flow in the coronary arteries, symptoms may include? a. chest pain, b. often radiating to the left shoulder or angle of the jaw, c. crushing, associated with nausea and sweating, d. All of the above
118.According to the appearance of the electrocardiogram (ECG), acute coronary syndrome (ACS) can be demonstrated as? a. ST elevation myocardial infarction (STEMI, 30%), b. non-ST elevation myocardial infarction (NSTEMI, 25%), c. Unstable angina (38%). d. All of the above
119.In diagnosis of myocardial infarction (MI), ECG is more sensitive than specific markers in blood. a. True b. False
120.Cardiac troponin is a sensitive marker for diagnosis of MI? a. True b. False
121.Which of the following is the most common symptom of myocardial infarction (MI)? a. Chest pain b. Dyspnea c. Edema d. Palpitations
122.Which of the following blood tests is most indicative of cardiac damage? a. Lactate dehydrogenase b. Complete blood count (CBC) c. Troponin I d. Creatine Kinase
123.Which of the following symptoms is most commonly associated with left-sided heart failure? a. Crackles b. Arrhythmias c. Hepatic engorgement d. Hypotension
