cardiology assessment questions

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depolarization, the process by which muscle fibers are stimulated to contract, occurs when:

A: cell wall permeability changes and sodium rushes into the cell
B: potassium ions escape from the cell though specialized channels
C: cardiac muscle relaxes in response to a cellular influx of calcium
D: calcium ions rapidly enter the cell, facilitating contraction



the right atrium, right ventricle, and part of the left ventricle are supplied by the:

A: left anterior descending artery
B: circumflex artery
C: right coronary artery
D: left main coronary artery



unstable angina:

A: is less frequent but is associated with more pain
B: occurs following periods of strenuous exertion
C: indicates that myocardial necrosis has occured
D: often awakens the patient from his or her sleep



which of the following statements regarding the SA node is correct?

A: the SA node is located in the superior aspect of the right ventricle
B: impulses generated by the SA node travel through the right atrium only
C: the SA node is the dominant cardiac pacemaker in healthy patients
D: SA nodal ischemia occurs when the left coronary artery is occluded



a pulse that alternates in strength from one beat to the next beat is called:

A: pulsus alternans
B: pulsus paradoxus
C: pulse deficit
D: paradoxical pulse



In contrast to the right side of the heart, the left side of the heart:

A: drives blood out of the heart against the relatively high resistance of the systemic circulation
B: is a high pressure pump that sends blood through the pulmonary circulation and to the lungs
C: drives blood out of the heart against the relatively low resistance of the pulmonary circulation
D: is a relatively low pressure pump that must stretch its walls in order to force blood through the aorta



the area of conduction tissue in which electrical activity arises at any given time is called the

A: myocyte
B: pacemaker
C: bundle of His
D: sinus node



the farther removed the conduction tissue is from the SA node

A: the faster its intrinsic rate of firing
B: the longer the PR interval will be
C: the narrower the QRS complex will be
D: the slower its intrinsic rate of firing



the left main coronary artery subdivides into the

A: right coronary and left posterior descending arteries
B: left anterior descending and circumflex arteries
C: left posterior ascending and circumflex arteries
D: left anterior ascending and descending arteries



which of the following electrolytes maintains the depolarization phase?

A: calcium
B: sodium
C: potassium
D: magnesium



acute coronary syndrome is a term used to describe

A: a sudden cardiac rhythm disturbance that causes a decrease in cardiac output
B: acute chest pressure or discomfort that subsides with rest or nitroglycerin
C: a clinical condition in which patients experience chest pain during exertion
D: any group of clinical symptoms consistent with acute myocardial ischemia



common complaints in patients experiencing an acute coronary syndrome include all of the following EXCEPT

A: palpitations
B: headache
C: fatigue
D: chest pain



during the refractory period

A: the heart muscle is depleted of energy and needs to recharge
B: the cell is depolarized or in the process of repolarizing
C: the heart is partially charged, but cannot contract
D: the heart is in a state of partial repolarization



if the hearts secondary pacemaker becomes ischemic and fails to initiate an electrical impulse

A: the P wave and PR interval will have an abnormal appearance
B: you will see a brief period of bradycardia followed by asystole
C: you should expect to see a heart rate slower than 40 beats/min
D: the AV junction will begin pacing at 40 to 60 times/min



in most patients, the SA node is supplied with blood from the

A: left main coronary artery
B: left anterior descending coronary artery
C: right coronary artery
D: left circumflex coronary artery



Nitroglycerin is contraindicated for patients

A: with a systolic BP less than 110
B: with suspected right ventricular infarction
C: who are also taking beta blocker medication
D: with suspected left circumflex artery occlusion



percutaneous coronary interventions involve

A: recanalizing a blocked coronary artery by passing a balloon or stent through a catheter via a peripheral artery
B: using a large vein from one of the lower extremeties to reroute blood flow past an occluded coronary artery
C: passing a guide wire through one of the external jugular veins to directly visualize an occluded coronary artery
D: passing a 2mm catheter through a femoral artery and administering a fibrinolytic agent through the catheter



stable angina

A: typically subsides within 10-15 minutes
B: usually requires both rest and nitroglycerin to subside
C: is characterized by sharp chest pain rather than pressure
D: occurs after a predictable amount of exertion



stimulation of the parasympathetic nervous system

A: slows the SA nodal discharge and decreases conduction through the AV node
B: is characterized by a large P wave and a PR interval that is shorter than normal
C: causes a decrease in production of epinephrine and norepinephrine
D: completely blocks the AV node, preventing ventricular depolarization



sympathetic nerves are regulated primarily by

A: adrenaline
B: cholinesterase
C: epinephrine
D: norepinephrine



a brief pause between the P wave and QRS complex represents

A: a momentary conduction delay at the AV node
B: full dispersal of electricity throughout both atria
C: depolarization of the inferior part of the atria
D; the period of time when the atria are repolarizing



the Levine sign is defined as

A: a subconsciously clenched fist over the fist
B: pushing on the sternum with the fingertips
C: a state of denial in patients with an acute myocardial infarction
D: rubbing the arm to which pain is radiating



the MOST immediate forms of reperfusion therapy for an injured myocardium are

A: high dose aspirin and high flow supplemental O2
B: angioplasty and coronary artery bypass grafting
C: supplemental O2 and infusion of nitroglycerin
D: fibrinolytics and percutaneous coronary intervention



the MOST significant risk associated with the use of fibrinolytic therapy is

A: hemorrhage
B: coagulation
C: anaphylaxis
D: reocclusion



the P wave represents

A: atrial depolarization
B: a delay at the AV node
C: SA nodal discharge
D: contraction of the atria



the presence of dizziness in a patient with a suspected MI is MOST likely the result of

A: acute left sided heart failure
B: effects of nitoglycerin
C: reduction of cardiac output
D: fear and anxiety



thousands of fibrils that are distributed throughout the inner surfaces of the ventricles, which represent the end of the cardiac conduction system, are called the

A: purkinje fibers
B: cardiac myocytes
C: intermodal pathways
D: bundle branches



when administering aspirin to a patient with an acute coronary syndrome, you should

A: first check to make sure the patient is not severely hypertensive
B: administer half the usual dose if the patient has a history of stroke
C: have him or her chew and swallow 160-325mg of baby aspirin
D: give up to 325mg of enteric-coated aspirin for the patient to swallow



which of the following statements regarding O2 administration for a patient experiencing an acute myocardial infarction is correct?

A: in order to prevent hypoxic injury, do not give any patient with acute MI more than 2 L/min of oxygen
B: evidence has shown that higher (greater than 90%) concentrations of oxygen reduce mortality
C: treatment with oxygen should be individualized and titrated to maintain the SpO2 level above 94%
D: any patient experiencing an acute MI should receive high-flow oxygen



Which of the following underlying medical conditions would be of LEAST pertinence when obtaining the past medical history from a patient who complains of chest pain or pressure?

A: cancer
B: diabetes
C: hypertension
D: renal disease



Which of the following would MOST likely cause bradycardia?

A: amphetamines
B: hyperthermia
C: beta blocker use
D: exercise