Complex MS Cardiovascular Exam
Practice Exam for my MS Girls!
- 1.
Injury to the heart muscle will cause the following change in a patient's EKG?
- A.
A large, pronounced Q wave
- B.
A inverted T wave
- C.
A elevated ST segment
- D.
A inverted P wave
Correct Answer
C. A elevated ST segmentExplanation
Inverted T waves are from ischemia, large Q waves are from infarcted muscleRate this question:
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- 2.
What are the signs and symptoms of Angina?
- A.
Chest pain lasting < 15 minutes
- B.
Chest pain radiatin to the Left arm and jaw
- C.
Diaphoresis
- D.
Relief of symptoms with NTG administration
- E.
Brought on by exertion and stress
Correct Answer(s)
A. Chest pain lasting < 15 minutes
D. Relief of symptoms with NTG administration
E. Brought on by exertion and stressExplanation
radiating chest pain past the arm and diaphoresis are signs and symptoms of a MI, not anginaRate this question:
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- 3.
A MI is more lethal to a younger person than an older person
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
Older adults have more collateral circlation giving their hearts more perfusion to survive a MIRate this question:
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- 4.
A woman experiencing a MI's symptoms may differ from a man in what ways?
- A.
More Fatigue
- B.
More nausea
- C.
Back Pain
- D.
Diaphoresis
Correct Answer(s)
A. More Fatigue
C. Back PainExplanation
Women may have a slower build up of plaque in their arteries resulting in more gradual and less severe s/s of MIRate this question:
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- 5.
ST elevations on leads V1, V2, V3 and V4 indicate a:
- A.
Anterior MI
- B.
Lateral MI
- C.
Posterior MI
- D.
Septal MI
Correct Answer
A. Anterior MIExplanation
Leads V1-V4 are close to the anterior surface of the heart and will pick up damaged heart muscle in that areaRate this question:
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- 6.
A lateral MI would be observed in what EKG leads?
- A.
V1-V4
- B.
V5 and V6
- C.
Lead 2
- D.
Lead 1
Correct Answer
B. V5 and V6Explanation
Leads V5 and V6 are on the side of the chest/heart and show damage to the lateral musclesRate this question:
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- 7.
ST elevation in this lead indicates an Inferior MI
- A.
Lead 1
- B.
Lead 2
- C.
V1-V4
- D.
V5 and V6
Correct Answer
B. Lead 2Explanation
Lead 2 is looking "down" from the right shoulder toward the left foot and will more accurately show damage to the bottom part of the heart.Rate this question:
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- 8.
What does the Acronym MONA stand for when referring to care for a MI patient?
Correct Answer
Morphine, Oxygen, NTG, AspirinExplanation
The acronym MONA stands for Morphine, Oxygen, NTG (nitroglycerin), and Aspirin. These are the recommended interventions for providing care to a patient experiencing a myocardial infarction (MI). Morphine helps relieve the pain associated with the MI, while oxygen ensures adequate oxygenation to the heart. NTG helps dilate the blood vessels, improving blood flow, and aspirin helps prevent further blood clotting. Together, these interventions aim to alleviate symptoms, improve blood flow, and reduce the risk of complications in MI patients.Rate this question:
- 9.
Which would be a contraindication for the use of clot busting drugs such as Streptokinase/TPA?
- A.
ST elevation
- B.
Chest pain greater than 30 minutes
- C.
Diabetes
- D.
Recent trauma or surgery in past 10 days
Correct Answer
D. Recent trauma or surgery in past 10 daysExplanation
The clot busting drugs may cause recurrent bleeding from past trauma and surgery. Also pt should not have had a stroke in the past 2 monthsRate this question:
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- 10.
Revascularization of the Coronary Artery after a cardiac cath might cause:
- A.
Abrupt cessation of pain
- B.
More severe pain initially, then reduction of pain within 12 hours
- C.
Sudden onset of dysrhyhtmias
- D.
Resolution of ST elevations
Correct Answer(s)
A. Abrupt cessation of pain
C. Sudden onset of dysrhyhtmias
D. Resolution of ST elevationsExplanation
pain should be resolved b/c blood flow is returned to the heartRate this question:
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- 11.
Non- STEMI patients:
- A.
Should receive clot-busting therapy within 30 minutes of admit to ER
- B.
Should be sent to the cath lab within 120 minutes of admit to ER
- C.
Should receive clot-busting therapy within 90 minutes of admit to ER
- D.
Should be sent to the cath lab withing 90 minutes of admit to ER
Correct Answer
D. Should be sent to the cath lab withing 90 minutes of admit to ERExplanation
non-STEMIs are not candidates for clot-busting therapy; MI patients should make it to the cath lab within 120 minutes of their fist s/s of chest painRate this question:
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- 12.
What is the priority assessment for a patient following CABG (coronary bypass graft) surgery?
- A.
Blood Pressure
- B.
Pulse
- C.
Respirations
- D.
Temperature
Correct Answer
A. Blood PressureExplanation
If a patient's BP goes too high it can cause the graft to tear- if too low, the graft can collapse (Systolic should be kept above 90)Rate this question:
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- 13.
Why is it important to put a cardiac post-op patient on stool softeners or laxatives?
- A.
Hard stools can cause anal fissures and blood loss
- B.
Constipation can decrease bowel motility, causing fluid back up and edema putting more work on the hear
- C.
Constipation may cause the pt to strain during BMs causing the Valsalva Manuver which could affect the heart
- D.
After surgery pts are put on high doses of opiates causing constipation
Correct Answer
C. Constipation may cause the pt to strain during BMs causing the Valsalva Manuver which could affect the heartExplanation
The Valsalva Manuver is a respose of the Vagus nerve triggered by straining during a BM- this nerve stimulation slows the hart and lowers BP which could cause arrhytmias in a heart surgery pt.Rate this question:
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- 14.
What medication can be given to reduce the retention of water and sodium as a result of aldosterne production which will put less work on the heart?
- A.
Lisinopril (zestril)
- B.
Procardia
- C.
Metoprolol (Lopressor)
- D.
Nitroglycerin
Correct Answer
A. Lisinopril (zestril)Explanation
Lisinopril is an ACE inhibitor (prils=ACE)- low BP activates the kidneys to produce renin which produces angiotensin 1 (not active) ACE (angiotensin converting enzyme) turns angiotensin 1 into angiotensin 2 (active) Angiotensin 2 causes vasoconstriction and stimultes the kidneys to produce aldosterone which causes water and sodium retention. Lisinopril inhibits atn 1-2 preventing vasoconstriction and water retentionRate this question:
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- 15.
What are the signs and symptoms of Left sided heart failure?
- A.
JVD
- B.
Crackles and dyspnea
- C.
Oliguria
- D.
Dependent edema
- E.
Ascites
Correct Answer(s)
B. Crackles and dyspnea
C. OliguriaExplanation
When the left side of the heart fails, blood can't go out to the body so it backs up into the lungs causin respiratory symptomsRate this question:
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- 16.
What are the signs and symptoms of Right sided heart failure?
- A.
JVD
- B.
Crackles and dyspnea
- C.
Oliguria
- D.
Dependent edema
- E.
Ascites
Correct Answer(s)
A. JVD
D. Dependent edema
E. AscitesExplanation
When the right side of the heart fails, blood backs up into the veneous system causing problems with the body verus lungs- circulation decreases to the kidneys, backed up blood causes fluid to leak in liver and blood from the head can't get down to the heart causing JVDRate this question:
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- 17.
What is the hallmark sign of pulmonary edema?
- A.
Crackles in the lungs
- B.
Collapsed lung/atelectasis
- C.
Dyspnea
- D.
Frothy pink tinged sputum
- E.
Use of accessory muscles to breathe
Correct Answer
D. Frothy pink tinged sputumExplanation
all these could be characteristics of pulmonay edema, but the frothy pink sputum is the hallmark sign-Rate this question:
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- 18.
The ejection fraction is the % of blood ejected from the ventricles of the heart with each beat and is used as an assessment of cardiac function. If the ventricles can hold 70 ml of blood but only eject 25 mL of blood, the EJ fraction is _____ which is normal/abnormal
- A.
36 % and normal
- B.
36% and abnormal
- C.
40 % and normal
- D.
40% and abnormal
Correct Answer
B. 36% and abnormalExplanation
Ejection fraction is the amount pumped out over the total volume= 25/70= .357 or 36% If you got 40%, you might have used the formula for finding MAP or mean arterial pressue (2x diastlic + systolic /3) An EF fo 55% is normal so this is an abnormal readingRate this question:
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- 19.
A BNP reading of 90 indicates imminent heart failure
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
A BNP reading under 100 is considered normalRate this question:
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- 20.
The therapeutic serum levels for Lanoxin (digoxin) are
Correct Answer
0.8-1.2Explanation
The therapeutic serum levels for Lanoxin (digoxin) are 0.8-1.2. These levels indicate the range of digoxin concentration in the blood that is considered effective and safe for treating certain heart conditions. Maintaining digoxin levels within this range helps ensure that the medication is providing its desired therapeutic effects without causing toxicity or side effects.Rate this question:
- 21.
What are the differences betwen Heart Failure and Cardiogenic Shock?
- A.
Increase in preload and afterload
- B.
Decrease in tissue perfusion
- C.
Decrease in CO
- D.
Decrease in contractility
- E.
Ischemia to organs
Correct Answer(s)
B. Decrease in tissue perfusion
E. Ischemia to organsExplanation
HF does not result in decreased tissue perfusion or organ ischemia- these are specific to Cardiogenic ShockRate this question:
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- 22.
Your patient has a BP of 100/50. Their MAP is ______ which is/isn't sufficent for proper tissue perfusion
- A.
50, is sufficient
- B.
50, is not sufficient
- C.
67, is sufficient
- D.
67, is not sufficient
Correct Answer
C. 67, is sufficientExplanation
Mean Arterial pressure is calculated by diastolic x2 + systolic/3. A MAP of 65 or above is sufficient for tissue perfusionRate this question:
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- 23.
Physicians use a Swan-Ganz catheter to measure the pulmonary artery pressure on your patient. The readings are: SPAP: 28, DPAP: 12. Your patient has_____________ and needs______________
- A.
A normal PAP and just needs to be monitored
- B.
Pulmonary hypotension and needs a fluid bolus
- C.
Pulmonary hypertension and treatment with NTG and diuretics
Correct Answer
A. A normal PAP and just needs to be monitoredExplanation
normal PAP is between 15/5 and 28/16Rate this question:
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- 24.
You can administer medications through a Swan-Ganz catheter
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
The Swan Ganz catheter goes directly into the heart allowing for even distribution of medications-NEVER ADMINISTER MEDS through a arterial line catheterRate this question:
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- 25.
During Hemodynamic Monitoring, you notice the PAP go to 10/4. Your initial itervenion is:
- A.
Sit the patient upright at 30 degrees
- B.
Administer dopamin 5-20mcg/kg/min to cause vasocontriction
- C.
Administer a fluid bolus
- D.
Administer NTG
Correct Answer
C. Administer a fluid bolusExplanation
a fluid bolus should always be administered first for DFV or LBP before vasoconstrictors b/c a dehydrated patient may experience dangerous tachycardia if put on meds without being hydratedRate this question:
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- 26.
Levophed (norepinepherine) is a vasoconstrictor used to increase blood pressure. What advantage does this drug have over dopamine?
- A.
It can be administered via IV for quicker results
- B.
It does not cause tachycardia
- C.
It does not cause hypertension
- D.
It does not constrict the CA so angina is not a side effect
Correct Answer
D. It does not constrict the CA so angina is not a side effectExplanation
dopamine constricts all blood vessels including the CA which decreases blood to the heart causin angina as a SE- levophed does not.Rate this question:
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- 27.
Why would a patient be perscribed Dobutmine (dobutrex)?
- A.
Hypertension
- B.
Pulmonary edema
- C.
Cardiogenic shock
- D.
Angina
Correct Answer
C. Cardiogenic shockExplanation
dobutrex increases cardiac contractility and is used to treat HF and cardiogenic shockRate this question:
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- 28.
Nitroglycerin acts by decreasing ____________ and increasing ____________
- A.
Preload, contractility
- B.
Afterload, contratility
- C.
Preload, cardiac output
- D.
Afterload, cardiac output
Correct Answer
C. Preload, cardiac outputExplanation
NTG causes vasodilation which decreases preload; a decrease in preload increases cardiac output. Lanoxin and dobutrex increase contractilityRate this question:
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- 29.
A patient is on arterial pressre monitoring. The nurse notices the patiens systolic BP increases by between 10 and 15 mm of Hg upon exhalation. This could indicate:
- A.
Pulmonay edema
- B.
MI
- C.
Cardiogenic shock
- D.
Cardiac tamponade
Correct Answer
D. Cardiac tamponadeExplanation
the increase of systolic BP on expiration is called pulsus paradoxus- if it is 10 or over, cardiac tamponade should be suspectedRate this question:
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- 30.
The following signs and symptoms are possible with cardiac tampoade
- A.
JVD
- B.
Hypotension
- C.
Muffled heart sounds
- D.
Paradoxical pulse
- E.
A feeling of fulless in the chest
Correct Answer(s)
A. JVD
B. Hypotension
C. Muffled heart sounds
D. Paradoxical pulse
E. A feeling of fulless in the chestExplanation
all of these are s/s of cardiac tamponadeRate this question:
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- 31.
What would be an appropriate treatment for Cardiac Tamponade?
- A.
Thoracentesis
- B.
Administer diuretics
- C.
ACE inhibitors
- D.
Performing a pericardial window procedure
Correct Answer
D. Performing a pericardial window procedureExplanation
Cardiac tamponade is a medical emergency- fluid must be pulled off the heart immediately so the pericardial window would be correctRate this question:
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- 32.
The most common cause of thoracic and abdominal aneurysms is hyperlipidemia
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
artherosclerosis is the most common cause of aneurysms followed by HTN and smokingRate this question:
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- 33.
The following are s/s of thoracic aneurysms
- A.
Cough/ loss of voice
- B.
Pain
- C.
Hypovolemic shock
- D.
Pulsating mass under skin
- E.
Dyspnea
Correct Answer(s)
A. Cough/ loss of voice
B. Pain
C. Hypovolemic shock
D. Pulsating mass under skin
E. DyspneaExplanation
The given answer is a list of signs and symptoms of thoracic aneurysms. These symptoms include cough/loss of voice, pain, hypovolemic shock, pulsating mass under the skin, and dyspnea. A thoracic aneurysm is a condition where there is a bulging or ballooning in the wall of the aorta, the main blood vessel that carries blood from the heart to the rest of the body. The symptoms listed in the answer are commonly associated with thoracic aneurysms and can help in identifying and diagnosing the condition.Rate this question:
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- 34.
The blood pressure of a pt who has come out of surgery from a thoracic aneurysm should be between ________ and _______
Correct Answer(s)
100, 120Explanation
After undergoing surgery for a thoracic aneurysm, it is important for the patient's blood pressure to be within the range of 100 to 120. This range is considered normal for a post-surgery patient and indicates that the blood pressure is stable and within a healthy range. Maintaining blood pressure within this range helps to ensure proper healing and recovery from the surgery, while also reducing the risk of complications such as bleeding or damage to the repaired area.Rate this question:
- 35.
More than half of the patiets diagnosed with abdominal aneurysms use tobacco
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
over half have HTNRate this question:
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- 36.
A patients systolic blood pressure must be kept below ________ to decrease the risk of aneurysm ruputure
- A.
120
- B.
110
- C.
100
Correct Answer
C. 100Explanation
To decrease the risk of aneurysm rupture, a patient's systolic blood pressure must be kept below 100. High blood pressure puts strain on the walls of blood vessels, including aneurysms, which are weakened areas. Keeping the blood pressure below 100 helps to reduce the stress on the aneurysm, decreasing the likelihood of it rupturing.Rate this question:
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- 37.
A dissecting aorta may be difficult to diagnose because its signs and symptoms mimic a
- A.
Angina attack
- B.
Hypertensive crisis
- C.
MI
- D.
Stroke
Correct Answer
C. MIExplanation
pain onset is severe and sudden and is near the heart; pt may also have diaphoresis, pain, pallor and tachycardia which are all s/s of a MIRate this question:
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- 38.
When doing hemodynamic monitoring, you know you are getting a good PAP reading by observing:
- A.
A good rhythm
- B.
The dicrotic notch in the waves
- C.
Your patient's vital signs remain stable
- D.
Don't remember
Correct Answer
B. The dicrotic notch in the wavesExplanation
The dicrotic notch indicates the opening and closing of the atria which means the catheter is placed properlyRate this question:
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- 39.
During hemodynamic monitoring, the transducer that transmits the PAP to an electrical signal should be placed
- A.
At heart level
- B.
Higher than the heart
- C.
Lower than the heart
- D.
I was in the bathroom when she talked about that
Correct Answer
A. At heart levelExplanation
The correct answer is "at heart level". When performing hemodynamic monitoring, it is important to place the transducer at heart level to accurately measure the pulmonary artery pressure (PAP). Placing the transducer at heart level ensures that the pressure measurements are not affected by gravity, as placing it higher or lower than the heart can result in inaccurate readings. Therefore, positioning the transducer at heart level allows for the most accurate transmission of PAP to an electrical signal.Rate this question:
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- 40.
The antidote for digoxin toxicity is
- A.
Digibind
- B.
Protamine sulfate
- C.
Vitamin K
- D.
Narcan
Correct Answer
A. DigibindExplanation
Digibind is the correct answer because it is an antidote specifically used to treat digoxin toxicity. Digoxin is a medication commonly used to treat heart conditions, but an overdose or toxicity can occur, leading to symptoms such as irregular heart rhythm, nausea, and confusion. Digibind works by binding to the excess digoxin in the body and preventing it from causing harm. Other options like protamine sulfate, vitamin K, and narcan are not used to treat digoxin toxicity.Rate this question:
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- 41.
Beta blockers should be used cautiously in patients with
- A.
History of stroke
- B.
Asthma
- C.
Cancer
- D.
HTN
Correct Answer
B. AsthmaExplanation
Beta blockers should be used cautiously in patients with asthma because beta blockers can potentially trigger bronchospasm and worsen asthma symptoms. These medications block the action of beta receptors, which can lead to constriction of the airways and narrowing of the bronchial tubes. As a result, patients with asthma, who already have compromised lung function, may experience difficulty breathing and increased wheezing. Therefore, it is important to monitor these patients closely and consider alternative medications or lower doses if beta blockers are necessary for their treatment.Rate this question:
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- 42.
What drug can cause hyperkalemia?
- A.
Beta blockers
- B.
Calcium channel blockers
- C.
Nitrates
- D.
ACE inhibitors
Correct Answer
D. ACE inhibitorsExplanation
ACE inhibitors can cause hyperkalemia because they block the action of an enzyme called angiotensin-converting enzyme (ACE), which is responsible for converting angiotensin I to angiotensin II. This leads to decreased aldosterone production, which in turn reduces the excretion of potassium by the kidneys. As a result, potassium levels in the blood can rise, leading to hyperkalemia.Rate this question:
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- 43.
Common indications for using a intra-aortic balloon pump are
- A.
Pt awaiting a cardiac transplant
- B.
Recovery from a MI
- C.
Cardiogenic shock
- D.
HTN
Correct Answer(s)
A. Pt awaiting a cardiac transplant
B. Recovery from a MI
C. Cardiogenic shockExplanation
The common indications for using an intra-aortic balloon pump include a patient awaiting a cardiac transplant, recovery from a myocardial infarction (MI), and cardiogenic shock. These conditions can all lead to decreased cardiac function and compromised circulation, which can be supported and improved with the use of an intra-aortic balloon pump.Rate this question:
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- 44.
The IABP is placed in the ascending aorta
- A.
True
- B.
Fase
Correct Answer
B. FaseExplanation
descending aortaRate this question:
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- 45.
What would be the main post procedure assessment after having a IABP inserted?
- A.
Bleeding at the site of insertion
- B.
UO
- C.
Pulse assessments
- D.
BP
Correct Answer
A. Bleeding at the site of insertionExplanation
ABC'sRate this question:
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- 46.
What date is the pinning ceremony this year?
- A.
December 10th
- B.
December 12th
- C.
December 17th
- D.
Who cares?
Correct Answer
C. December 17thExplanation
The correct answer is December 17th. This is the date for the pinning ceremony this year.Rate this question:
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- 47.
Krispen is the most amazing test creator in the universe
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
The given statement states that Krispen is the most amazing test creator in the universe. The word "amazing" indicates that Krispen is exceptionally good at creating tests. Since there is no information provided to contradict this statement, it can be assumed to be true. Therefore, the correct answer is True.Rate this question:
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- 48.
The pericardial sac usually contains less than 50 mL of fluid
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
The pericardial sac is a double-layered membrane that surrounds the heart. It contains a small amount of fluid called pericardial fluid, which acts as a lubricant to reduce friction between the heart and the surrounding structures. Normally, the pericardial sac contains less than 50 mL of this fluid. Therefore, the statement "The pericardial sac usually contains less than 50 mL of fluid" is true.Rate this question:
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- 49.
Normal urine output is _______mL and hour
Correct Answer
30Explanation
The normal urine output is 30 mL per hour. This means that on average, a person should produce around 30 mL of urine every hour. This is considered to be within the normal range for urine output and indicates that the kidneys are functioning properly.Rate this question:
- 50.
Oxygen is a drug
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
Oxygen is considered a drug because it is a medication that is prescribed and administered to patients in specific doses and for specific purposes. It is used to treat conditions such as hypoxemia, respiratory distress, and chronic obstructive pulmonary disease (COPD). Oxygen therapy is a medical intervention that requires careful monitoring and regulation by healthcare professionals to ensure its safe and effective use. Therefore, the statement "oxygen is a drug" is true.Rate this question:
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Mar 17, 2023Quiz Edited by
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