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66 notecards = 17 pages (4 cards per page)

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CH 16, 18-20

front 1

An abnormally wide (more than 0.10 second) QRS complex is characteristic of

back 1

premature ventricular complexes.

front 2

Improvement in a patient with septic shock is indicated by an increase in

back 2

systemic vascular resistance.

front 3

The majority of cases of anaphylactic shock occur when a sensitized individual comes in contact with

back 3

antibiotics.

front 4

Tumor necrosis factor α and interleukin-1 contribute to shock states because they induce production of

back 4

nitric oxide.

front 5

A patient presents to the emergency department with a diastolic blood pressure of 132 mm Hg, retinopathy, and symptoms of an ischemic stroke. This symptomology is likely the result of

back 5

hypertensive crisis.

front 6

A type of shock that includes brain trauma that results in depression of the vasomotor center is cardiogenic.

back 6

False

A type of shock that includes brain trauma that results in depression of the vasomotor center is neurogenic shock.

front 7

A middle-aged patient has a follow up visit for a recorded blood pressure of 162/96 mm Hg taken 3 weeks ago. The patient has no significant past medical history and takes no medications, but smokes 1 1/2 packs of cigarettes per day, drinks alcohol regularly, and exercises infrequently. The patient is about 40 lbs. overweight and admits to a high-fat, high-calorie diet. At the office visit today, the patient’s blood pressure is 150/92 mm Hg. What is the least appropriate intervention for this patient at this time?

back 7

Begin antihypertensive drug therapy.

front 8

Overproduction of nitric oxide is an important aspect of the pathophysiologic process of what type of shock?

back 8

Septic

front 9

Aortic regurgitation is associated with

back 9

diastolic murmur.

front 10

Low cardiac output in association with high preload is characteristic of ________ shock.

back 10

cardiogenic

front 11

The prevalence of high blood pressure is higher in

back 11

non-Hispanic black adults.

front 12

A patient with heart failure who reports intermittent shortness of breath during the night is experiencing

back 12

paroxysmal nocturnal dyspnea.

front 13

Tachycardia is an early sign of low cardiac output that occurs because of

back 13

baroreceptor activity.

front 14

The effect of nitric oxide on systemic arterioles is

back 14

vasodilation.

front 15

A patient is diagnosed with heart failure with normal ejection fraction. This patient is most likely characterized by a(n)

back 15

elderly woman without a previous history of MI.

front 16

The therapy that most directly improves cardiac contractility in a patient with systolic heart failure is

back 16

digitalis.

front 17

Hypertension is closely linked to

back 17

obstructive sleep apnea.

front 18

After being diagnosed with hypertension, a patient returns to the clinic 6 weeks later. The patient reports “moderate” adherence to the recommended lifestyle changes and has experienced a decreased from 165/96 to 148/90 mm Hg in blood pressure. What is the most appropriate intervention for this patient at this time?

back 18

Continue lifestyle modifications only.

front 19

Low cardiac output to the kidneys stimulates the release of _____ from juxtaglomerular cells.

back 19

renin

front 20

A patient presenting with fever, hypotension, and lactic acidosis is most likely to be experiencing what type of shock?

back 20

Septic

front 21

Chronic elevation of myocardial wall tension results in atrophy.

back 21

False

Chronic elevation of myocardial wall tension results in hypertrophy

front 22

Myocarditis should be suspected in a patient who presents with

back 22

acute onset of left ventricular dysfunction.

front 23

Disseminated intravascular coagulation is a serious complication of septic shock characterized by abnormal clot formation in the microvasculature throughout the body.

back 23

True

Acute myocarditis is commonly characterized by left ventricular dysfunction or general dilation of all four heart chambers. Chest pain and ST elevation is indicative of myocardial infarction. Myocarditis is associated with viral infections. Dilated cardiomyopathy runs in families and has a genetic basis.

front 24

Second-degree heart block type I (Wenckebach) is characterized by

back 24

lengthening PR intervals and dropped P wave.

front 25

Increased preload of the cardiac chambers may lead to which patient symptom?

back 25

Edema

front 26

An erroneously low blood pressure measurement may be caused by

back 26

positioning the arm above the heart level.

front 27

In which dysrhythmias should treatment be instituted immediately?

back 27

Atrial fibrillation with a ventricular rate of 220 beats/minute

front 28

First-degree heart block is characterized by

back 28

prolonged PR interval.

front 29

Atherosclerotic plaques with large lipid cores are prone to

back 29

rupture.

front 30

Left-sided heart failure is characterized by

back 30

pulmonary congestion.

front 31

A patient is diagnosed with cardiogenic shock. The patient is hyperventilating and is therefore at risk for the respiratory complication of respiratory acidosis.

back 31

False

A patient diagnosed with cardiogenic shock who is hyperventilating is at risk for respiratory alkalosis.

front 32

The most commonly recognized outcome of hypertension is pulmonary disease.

back 32

False

The most commonly recognized outcome of hypertension is cardiovascular disease.

front 33

While hospitalized, an elderly patient with a history of myocardial infarction was noted to have high levels of low-density lipoproteins (LDLs). What is the significance of this finding?

back 33

Increased LDL levels are associated with increased risk of coronary artery disease

front 34

Restriction of which electrolytes is recommended in the management of high blood pressure?

back 34

Sodium

front 35

A patient who reports dizziness and who has absent P waves, wide QRS complexes, and a heart rate of 38 beats/minute on an ECG is most likely in which rhythm?

back 35

Ventricular escape rhythm

front 36

A patient with cold and edematous extremities, low cardiac output, and profound hypotension is likely to be experiencing a progressive stage of ________ shock.

back 36

septic

In the progressive stage of septic shock, some patients deteriorate to a hypodynamic state. This is characterized by decreased cardiac output and cold, clammy skin as a result of narrowed pulse pressure. Profound hypotension generally occurs which is unresponsive to treatment. Cardiogenic shock is evidenced by decreased cardiac output, elevated left ventricular end-diastolic pressure, S 3 heart sounds, and pulmonary edema. Hypotension occurs with hypovolemic shock, but extremities are not likely to be cold and edematous. Cold edematous extremities along with low cardiac output and profound hypotension are not manifestations of obstructive shock.

front 37

A loud pansystolic murmur that radiates to the axilla is most likely a result of

back 37

mitral regurgitation.

front 38

A patient with significant aortic stenosis is likely to experience

back 38

syncope.

front 39

Hypertension with a specific, identifiable cause is known as _____ hypertension.

back 39

secondary

front 40

Which serum biomarker(s) are indicative of irreversible damage to myocardial cells?

back 40

Elevated CK-MB, troponin I, and troponin T

front 41

A patient with a history of myocardial infarction continues to complain of intermittent chest pain brought on by exertion and relieved by rest. The likely cause of this pain is

back 41

stable angina.

front 42

Cardiogenic shock is characterized by

back 42

reduced cardiac output.

front 43

The common denominator in all forms of heart failure is

back 43

reduced cardiac output.

front 44

An example of an acyanotic heart defect is

back 44

ventricular septal defect.

front 45

Massive release of histamine with consequent vasodilation and hypotension occurs with what type of shock?

back 45

Anaphylactic

front 46

Sepsis has been recently redefined as

back 46

a systemic inflammatory response to infection.

front 47

An elderly patient's blood pressure is measured at 160/98. How would the patient's left ventricular function be affected by this level of blood pressure?

back 47

Left ventricular workload is increased with high afterload

front 48

After sitting in a chair for an hour, an elderly patient develops moderate lower extremity edema. His edema is most likely a consequence of

back 48

right-sided heart failure.

front 49

Tumor necrosis factor α and interleukin-1 contribute to shock states because they induce production of

back 49

nitric oxide

front 50

Patients presenting with symptoms of unstable angina and no ST segment elevation are treated with

back 50

antiplatelet drugs.

front 51

Cor pulmonale refers to

back 51

right ventricular hypertrophy secondary to pulmonary hypertension.

front 52

The majority of cardiac cells that die after myocardial infarction do so because of

back 52

apoptosis.

front 53

The most reliable indicator that a person is experiencing an acute myocardial infarction (MI) is

back 53

ST-segment elevation.

front 54

A laboratory test that should be routinely monitored in patients receiving digitalis therapy is

back 54

serum potassium

front 55

Angina caused by coronary artery spasm is called

back 55

Prinzmetal angina

front 56

Beta-blockers are advocated in the management of heart failure because they

back 56

reduce cardiac output.

front 57

Hypotension associated with neurogenic and anaphylactic shock is because of

back 57

peripheral pooling of blood.

front 58

A patient has a history of falls, syncope, dizziness, and blurred vision. The patient's symptomology is most likely related to

back 58

hypotension.

front 59

Which dysrhythmia is thought to be associated with reentrant mechanisms?

back 59

Preexcitation syndrome tachycardia (Wolf-Parkinson-White syndrome)

front 60

A patient is exhibiting severe dyspnea and anxiety. The patient also has bubbly crackles in all lung fields with pink, frothy sputum. This patient is most likely experiencing

back 60

acute cardiogenic pulmonary edema

front 61

Constrictive pericarditis is associated with:

back 61

Impaired cardiac filling

front 62

Hypotension, distended neck veins, and muffled heart sounds are classic manifestations of

back 62

Cardiac tamponade

front 63

Pulse pressure is defined as

back 63

Systolic - Diastolic

front 64

Angiotensin-converting enzyme (ACE) inhibitors block the:

back 64

Conversion of angiotensin I to angiotensin II

front 65

A patient who was involved in a fall from a tree becomes short of breath. The lung sounds are absent on one side. This patient is experiencing ________ shock

back 65

obstructive

front 66

Constrictive pericarditis is associated with

back 66

impaired cardiac filling.