cardiology assessment questions

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1

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

A

2

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

C

3

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

D

4

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

C

5

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

A

6

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

A

7

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

B

8

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

D

9

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

B

10

which of the following electrolytes maintains the depolarization phase?

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

A

11

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

D

12

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

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

B

13

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

B

14

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

C

15

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

C

16

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

B

17

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

A

18

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

D

19

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

A

20

sympathetic nerves are regulated primarily by

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

D

21

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

A

22

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

A

23

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

D

24

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

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

A

25

the P wave represents

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

A

26

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

C

27

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

A

28

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

C

29

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

C

30

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

A

31

Which of the following would MOST likely cause bradycardia?

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

C