Complete Test Bank Chapter.14 Cardiac Patient Management

Electrocardiography for Healthcare Professionals, 5e (Booth)

Chapter 14 Clinical Presentation and Management of the Cardiac Patient

1) Which of the following is one of the primary branches of the right coronary artery, providing blood to the posterior wall of the heart?

A) Circumflex artery

B) Posterior descending artery

C) Left anterior descending artery

D) Anterior interventricular artery

2) Which of the following is one of the primary branches of the left coronary artery and winds around, supplying blood to the lateral wall of the left ventricle?

A) Circumflex artery

B) Posterior descending artery

C) Left anterior descending artery

D) Anterior interventricular artery

3) Which of the following is one of the primary branches of the left coronary artery and supplies blood to both of the ventricles?

A) Circumflex artery

B) Posterior descending artery

C) Marginal artery

D) Left anterior descending artery

4) Which of the following is one of the primary branches of the right coronary artery and supplies blood to the walls of the right atrium and the right ventricle?

A) Circumflex artery

B) Posterior descending artery

C) Marginal artery

D) Left anterior descending artery

5) What is the outermost layer of a blood vessel called?

A) Tunica media

B) Tunica adventitia

C) Tunica intima

D) Tunica fascia

6) What is the function of the tunica adventitia?

A) Dilate and constrict to maintain homeostasis

B) Keep the vessel open

C) Allow medications to pass through

D) Come in direct contact with the blood

7) What is the middle layer of a blood vessel called?

A) Tunica media

B) Tunica adventitia

C) Tunica intima

D) Tunica fascia

8) What is the function of the tunica media?

A) Dilate and constrict to maintain homeostasis

B) Keep the vessel open

C) Allow medications to pass through

D) Come in direct contact with the blood

9) What is the innermost layer of a blood vessel called?

A) Tunica media

B) Tunica adventitia

C) Tunica intima

D) Tunica fascia

10) What is the function of the tunica intima?

A) Dilate and constrict to maintain homeostasis

B) Keep the vessel open

C) Allow medications to pass through

D) Come in direct contact with the blood

11) Which layer of a blood vessel is prone to disruption when atherosclerotic plaque is ruptured and peels away?

A) Tunica media

B) Tunica adventitia

C) Tunica intima

D) Tunica fascia

12) The average person waits how many hours before seeking help for symptoms of a heart attack?

A) 1 hour

B) 3 hours

C) 12 hours

D) 24 hours

13) What is the term for an oppressive pain or pressure in the chest that occurs when the heart muscle does not receive enough oxygen due to partial or complete blockage of a coronary artery?

A) Apnea

B) Asystole

C) Angina

D) Arrhythmia

14) Approximately how many people in the United States suffer from angina?

A) 10,000

B) 1 million

C) 3 million

D) 7 million

15) Which of the following conditions is not a common source of noncardiac chest pain?

A) Inflammation of the lungs

B) Gastric or esophageal irritation

C) Cirrhosis of the liver

D) Gallbladder pain

16) Which of the following are not symptoms that may occur due to blockage of the coronary arteries?

A) Shortness of breath, sweating, and chest pain

B) Neck pain, cough, and back pain

C) Edema and decreased urinary output

D) Dizziness, nausea, and arm pain

17) Unstable angina is a warning sign that a patient's cardiac disease has ________.

A) Worsened

B) Remained stable

C) Resulted in decreased cardiac output

D) Developed into a dysrhythmia

18) Which of the following is not a sign of unstable angina?

A) Chest pain is more frequent or severe.

B) Chest pain occurs with less exertion or lasts longer than usual.

C) Chest pain does not respond to medications as it did before.

D) Chest pain occurs for shorter periods.

19) Which three groups of patients may present with atypical cardiac complaints or problems?

A) Patients with diabetes, patients who smoke, and patients who abuse drugs

B) Women, the elderly, patients with diabetes

C) African Americans, teenagers, patients who smoke

D) Children, patients with cancer, the elderly

20) What percentage of women who are having a heart attack never experience chest pain?

A) 10%

B) 25%

C) 37%

D) 75%

21) Which of the following are common cardiac symptoms in women?

A) Migraine headaches

B) Unusual fatigue and cold sweats

C) Leg pain and edema

D) Bloating

22) A patient with diabetes is how many times more likely than patients without diabetes to experience a heart attack?

A) Two times

B) Three times

C) Five times

D) Ten times

23) What is the term for fatty deposits accumulated by elevated glucose levels?

A) Atherosclerotic plaque

B) Antigens

C) Ascites

D) Angiographic plaque

24) What condition caused by chronic diabetes impairs sensations or causes a loss of sensation?

A) Neuroblastoma

B) Neuralgia

C) Neuropathy

D) Nephritis

25) Which of the following are not common cardiac symptoms in elderly patients?

A) Shortness of breath and nausea

B) Profuse sweating and pain in the arms

C) Syncope and weakness or fatigue

D) Hypertension and edema

26) Approximately what percentage of elderly patients present with atypical cardiac symptoms?

A) 25%

B) 50%

C) 75%

D) 90%

27) Which of the following is referred to as the "classic MI"?

A) Acute coronary syndrome MI

B) Non-STEMI

C) STEMI

D) Pathologic Q wave MI

28) What causes STEMI?

A) An area of ischemia in the heart tissue

B) Incomplete occlusion of a coronary artery

C) Severe dysrhythmia

D) Complete occlusion of a coronary artery

29) Which of the following changes does not typically occur in an ECG tracing with a STEMI?

A) Absence of P waves

B) T wave inversion

C) Development of a pathologic Q wave

D) ST segment depression or elevation

30) What percentage of patients present with STEMI?

A) Less than 10%

B) 20% to 25%

C) 40% to 50%

D) 75% to 80%

31) Why does non-STEMI present a challenge to the health care team?

A) The patient often mistakes the symptoms for indigestion.

B) The ECG tracing looks similar to that of a patient with complete heart block.

C) The ECG tracing does not reflect ST segment deviation or presence of a pathologic Q wave.

D) There is no conclusive method to determine whether an MI has occurred.

32) What is the term for inadequate flow of arterial blood, typically as a result of left ventricular failure?

A) Cardiogenic shock

B) Anaphylactic shock

C) Hypovolemic shock

D) Neurogenic shock

33) What is the most common cause of heart failure?

A) Dysrhythmias

B) Ischemia

C) MI

D) Diabetes

34) What is the term for an abnormal collection of fluid in the lungs due to left ventricular failure?

A) Pulmonary hypertension

B) Pulmonary edema

C) Pulmonary embolism

D) Pulmonary necrosis

35) Which of the following are not symptoms of left ventricular failure?

A) Shortness of breath, fatigue, and tachycardia

B) Confusion and anorexia

C) Hypertension and increased thirst

D) Decreased urine production and pallor

36) What three symptoms, when presented together, are known as the "clinical triad" and are indicative of right ventricular failure?

A) Shortness of breath, chest pain, and confusion

B) Rales, tachycardia, and anorexia

C) Ascites, edema, and pallor

D) Jugular vein distention, hypotension, and normal breath sounds

37) The mnemonic O-P-Q-R-S-T helps health care professionals remember the questions to ask when evaluating which of the following?

A) Pain or discomfort the patient is experiencing

B) Additional medical information

C) Patient demographics

D) Patient's family history

38) What is the S-A-M-P-L-E mnemonic used for?

A) Obtaining an insurance referral

B) Gathering information about the patient's family history

C) Gathering additional medical information

D) Determining the patient's pain level

39) Which procedure allows visualization of the coronary arteries and placement of a stent?

A) Echocardiography

B) Enhanced external counter pulsation

C) Coronary artery bypass

D) Cardiac catheterization

40) What is Coumadin used for?

A) To increase the activity of vitamin K

B) To promote the growth of new collateral blood vessels

C) To prevent restenosis of a blood vessel

D) To reduce clot formation in the blood

41) Which of the following is one reason heart disease is slightly more common in men than in women?

A) Women have a faster basal heart rate.

B) Hormones produced during the childbearing years reduce the risk in women.

C) Women generally handle stress better than men.

D) Women are more active and exercise more frequently than men.

42) What is the broad term that refers to STEMI, NSTEMI, and unstable angina?

A) Thrombosis

B) Coronary plaque

C) Acute coronary syndrome

D) Chronic heart failure

43) What is a typical cause of NSTEMI?

A) An incomplete occlusion of a coronary artery

B) Sudden, complete blockage due to thrombosis

C) Chronic left ventricular failure

D) Bundle branch block

44) When might sudden cardiac arrest occur?

A) When a portion of the heart does not receive enough oxygen

B) When the heart's electrical system fails, often without warning

C) When the heart is unable to pump a sufficient amount of blood to body tissues

D) When a coronary artery becomes completely occluded

45) Which of the following is not a common cause of left ventricular heart failure?

A) Right ventricular heart failure

B) Hypertension

C) Atrial fibrillation

D) STEMI

46) Which of the following is a common cause of right ventricular heart failure?

A) Atrial tachycardia

B) Ventricular fibrillation

C) Chronic lung disease

D) Gallbladder disease

47) What minimally invasive procedure is frequently performed to open narrowed or blocked blood vessels?

A) Thromboplastic surgery

B) Angiography

C) Venostasis

D) Angioplasty

48) Emergency test results indicate that Mr. Hartman has had an MI due to 90% occlusion of the right coronary artery. The physician has determined that a procedure needs to be performed immediately to open the artery. Which of the following procedures is the physician most likely to order for Mr. Hartman?

A) Coronary artery bypass graft surgery

B) Enhanced external counter pulsation therapy

C) Percutaneous transluminal coronary angioplasty

D) Thrombolytic therapy

49) When angioplasty is performed on a coronary vessel, a stent is typically inserted to do what?

A) Repair the vessel walls

B) Help prevent restenosis

C) Reroute blood flow away from the surgical site

D) Prevent excess bleeding from the surgical site

50) You are preparing Mrs. Bayfield for percutaneous coronary intervention. As you explain the procedure to her, she states, "They are going to put a stent in my heart, so why do they need to inject dye in my arm?" What should you tell Mrs. Bayfield?

A) The dye is used to find the exact location of the blockage.

B) The dye contains Coumadin, which will make the blood flow more freely.

C) The dye is a precaution to help the surgeon avoid nearby nerve endings.

D) The dye is an indicator that changes color when blood flow is restored.

51) A patient has been brought to the emergency department complaining of chest pain and dizziness. When assessing this patient, what should the health care professional do?

A) Take extra time to ensure complete accuracy of the information obtained.

B) Gather information quickly and efficiently and report it immediately to the physician.

C) Do a cursory assessment only because the patient needs immediate treatment.

D) Wait to do the assessment until after a stent has been inserted.

52) A patient is brought to the emergency department by ambulance. He is having severe chest pain that is radiating through his left arm and is having difficulty breathing. You suspect that the patient will be rushed into surgery soon. What must you do before the patient is given narcotics for the pain?

A) Check and record the patient's blood pressure.

B) Inform the patient's family that surgery is likely.

C) Have the patient sign a consent form.

D) Administer oxygen to the patient.

53) Treatment for hypovolemia may include which of the following therapies?

A) Aspirin administration

B) Nitroglycerin administration

C) Pacemaker insertion

D) IV fluid challenge

54) What is the term for a concentrated amount of medication administered over a short period of time?

A) Stent

B) Catheter

C) Bolus

D) Thrombus

55) What is the term for a medication that is administered intravenously to convert plasminogen to plasmin, which then breaks down the fibrin in a clot?

A) Thrombolytic agent

B) Anticoagulant

C) Fluorescent dye

D) Bolus

56) For which of the following patients is fibrinolytic therapy not appropriate?

A) A 44-year-old male patient with suspected coronary occlusion

B) A 52-year-old female patient with a blood pressure of 160/110 mmHg

C) A 36-year-old female cardiac patient who lives in a rural area

D) A 47-year-old male patient with a blood pressure of 110/54 mmHg

57) For which of the following conditions might Coumadin be prescribed for a patient?

A) Hypovolemia

B) Hypertension

C) Hypercoagulopathy

D) Hypotension

58) Which of the following foods would be restricted in a patient's diet while he or she is taking Coumadin?

A) Apples

B) Onions

C) Bell peppers

D) Spinach

59) Which of the following procedures is a reasonable alternative for a patient who has had heart failure and is not strong enough to withstand heart catheterization?

A) Percutaneous coronary intervention

B) Enhanced external counter pulsation

C) Percutaneous transluminal coronary intervention

D) Coronary artery bypass graft surgery

60) Which of the following patients is the most likely candidate for a left ventricular assist device (LVAD)?

A) A 42-year-old woman with uncontrolled hypertension

B) A 67-year-old man with partial blockage of two coronary arteries

C) A 49-year-old woman in end-stage heart failure

D) A 56-year-old man with extensive disease in the left main coronary artery

61) Which of the following memory tools is useful for gathering information regarding pain a patient is experiencing?

A) ABCDE 

B) SAMPLE 

C) OPQRST

D) ACLS

62) Which of the following memory tools is useful for gathering information regarding oral intake?

A) ABCDE 

B) SAMPLE 

C) OPQRST

D) ACLS

63) How many 81-mg aspirin are typically ordered for administration to the chest pain patient?

A) None

B) 1

C) 2-4

D) 5-6

64) The patient with chest pain will be going for a cardiac catheterization and the following orders have not been completed. Which one should be done last?

A) administer morphine

B) start an intravenous line

C) administer nitroglycerin

D) obtain a signed content

65) Which chambers or surfaces of the heart are at risk for infarction with a "widow maker"? 

A) Right and left ventricles

B) Right ventricle, posterior surface and septum

C) Anterior, lateral and septal surfaces of the left ventricle 

D) Left ventricle and both atria 

66) Which of the following therapeutic measures may be performed on patients with recurrent angina or on heart failure patients who are typically not strong enough to withstand major surgery? 

A) CABG 

B) Balloon angioplasty and stent

C) Stent only

D) EECP