Section 6. Cardiovascular Problems
MULTIPLE CHOICE
1. What of the following patients is a candidate for statins?
A.
Jerry is a 55-year-old male with a history of syncope.
B.
Christa is a 65-year-old female with a history of myocardial infarction (MI).
C.
Manny is a 75-year-old male with a 10-year cardiovascular risk of 6.5%.
D.
April is an 80-year-old female with a low-density lipoprotein (LDL) level of 180.
2. Which of the following is a chest wall syndrome?
A.
Myocardial infarction
B.
Angina
C.
Costochondritis
D.
Pericarditis
3. Which of the following may help a clinician to determine whether palpitations are caused by a
potentially lethal cardiac rhythm?
A.
Holter monitoring
B.
Complete blood count (CBC)
C.
Thyroid panel
D.
Computed axial tomography (CAT) scan
4. A blood pressure (BP) of 150/90 is considered:
A.
Stage 2 hypertension
B.
Hypertensive
C.
Normal in healthy older adults
D.
Acceptable if the patient has diabetes mellitus (DM)
5. Lifestyle modifications to manage hypertension (HTN) include:
A.
Maintaining a body mass index of 17
B.
Restricting dietary sodium to 5 grams per day
C.
Engaging in exercise or physical activity for 90 minutes a day
D.
Limiting beer intake to 24 ounces per day
6. Mary has hypertension and previously had a stroke. Which hypertensive drug has been shown
to reduce stroke?
A.
Chlorthalidone
B.
Metoprolol
C.
Amlodipine
D.
Losartan
7. Which high-density lipoprotein (HDL) level is considered cardioprotective?
A.
Greater than 30
B.
Greater than 40
C.
Greater than 50
D.
Greater than 60
8. You are assessing Sigred for metabolic syndrome. Which of her parameters is indicative of
this syndrome?
A.
Her waist is 36 inches.
B.
Her triglyceride level is 140 mg/dL.
C.
Her BP is 128/84.
D.
Her fasting blood sugar (BS) is 108 mg/dL.
9. Which type of angina do you suspect in Harvey, who complains of chest pain that occurs
during sleep and most often in the early morning hours?
A.
Stable angina
B.
Unstable angina
C.
Variant (Prinzmetal’s angina)
D.
Probably not angina but hiatal hernia
10. A patient is undergoing a cardiac stress test. Which of the following parts of their history
could cause a false-positive reading?
A.
Patient is on labetalol.
B.
Patient is a man.
C.
Patient is on amlodipine.
D.
Patient has a potassium level of 4.
11. Which of these patients is at a higher risk for developing deep vein thrombosis?
A.
Jerry, a 64-year-old man with a history of epilepsy
B.
Samantha, a 45-year-old female undergoing a hysterectomy
C.
Diane, a 15-year-old female with type 1 diabetes
D.
Ben, a 23-year-old male with a history of a pneumothorax
12. Claire is a patient complaining that her left leg is cool, pale, smaller than her right, and has
thick toenails. Which condition may she be experiencing?
A.
Peripheral artery disease
B.
Anemia
C.
Deep vein thrombosis
D.
Pulmonary embolism
13. In which type of atrioventricular (AV) block does the pulse rate (PR) interval lengthen until a
beat is dropped?
A.
First-degree AV block
B.
Second-degree Mobitz I AV block
C.
Second-degree Mobitz II AV block
D.
Third-degree AV block
14. What is the term for light-headedness, feeling faint, and muscular weakness with a
cardiovascular origin?
A.
Presyncope
B.
Vertigo
C.
Dizziness
D.
Myocardial infarction
15. A delta wave on the electrocardiogram (ECG) may be present in which condition?
A.
Prinzmetal’s angina
B.
Bundle branch block
C.
Wolff–Parkinson–White syndrome
D.
Aortic stenosis
16. Which heart sound is associated with decreased elasticity of the left ventricle in left
ventricular hypertrophy?
A.
A physiologic split S2
B.
A fixed split S2
C.
S3
D.
S4
17. Samuel is going to the dentist for some work and must take endocarditis prophylaxis because
of his history of:
A.
Severe asthma
B.
A common valvular lesion
C.
Severe hypertension
D.
A prosthetic heart valve
18. Data from the Framingham Heart Study suggests that individuals who are normotensive at 55
years of age have how much lifetime risk of developing hypertension?
A.
65%
B.
75%
C.
80%
D.
90%
19. Which pain characteristic is usually indicative of angina pectoris?
A.
Fleeting
B.
Moving
C.
Diffuse
D.
Localized
20. Which of the following is the proper way to take a blood pressure measurement?
A.
Patient is in a reverse Trendelenburg position, cuff size has a bladder length of
80% and a width of 40% of arm circumference, patient has rested for 5 minutes
before measurement
B.
Patient is in a sitting position, cuff size has a bladder length of 80% and a width of
40% of arm circumference, patient has rested for 5 minutes before measurement
C.
Patient is in a sitting position, cuff size has a bladder length of 80% and a width of
40% of arm circumference, patient has rested for 3 minutes before measurement
D.
Patient is in a reverse Trendelenburg position, cuff size has a bladder length of
70% and a width of 30% of arm circumference, patient has rested for 5 minutes
before measurement
21. What percentage of patients with angina pectoris will have simultaneous dyspnea, caused by
transient increase in pulmonary venous pressures that accompany ventricular stiffening during
an episode of myocardial ischemia?
A.
About 20%
B.
About 30%
C.
About 50%
D.
Almost all
22. Which of the following patient complaints indicates palpitations are due to increased
catecholamine production?
A.
“I feel like my heart is pounding out of my chest and I have been sitting for an
hour.”
B.
“I feel like my heart is in a vise and I can’t breathe.”
C.
“I feel like my heart is beating strongly after I just worked out.”
D.
“I feel like my heart is skipping beats.”
23. What is the most common presenting complaint in congestive heart failure?
A.
Weight loss
B.
Palpitations
C.
Syncope
D.
Dyspnea
24. Which of the following is true of peripheral edema?
A.
It is always independent of underlying disorders.
B.
Peripheral edema occurs more frequently in men than in women.
C.
When it involves the lower extremities, it may be caused by cardiac conditions.
D.
It is the accumulation of tissue fluid within organ systems.
25. Nitroglycerine (NTG) is given for a patient having ischemic chest pain. One tablet or one
spray should be used under the tongue every 5 minutes for three doses. What should be done
if the pain has not been relieved after three doses?
A.
911 should be called, and the patient should be transported immediately to the
emergency department.
B.
One more dose of NTG may be tried.
C.
The person should be given two aspirin to chew.
D.
A portable defibrillator should be located to ascertain the cardiac rhythm.
26. For the best therapeutic effect after an MI, thrombolytics should be administered within the
first 3 hours (ideally 30 minutes) of symptom onset. Studies have shown, however, that
thrombolytic therapy can be of benefit up to how many hours after the initial presentation of
MI symptoms?
A.
6 hours
B.
8 hours
C.
10 hours
D.
12 hours
27. When teaching post-MI patients about their NTG tablets, the clinician should stress that the
tablets should remain in the light-resistant bottle in which they are packaged and should not be
put in another pill box or remain in areas that are or could become warm and humid. Once
opened, the bottle must be dated and discarded after how many months?
A.
1 month
B.
3 months
C.
6 months
D.
As long as the tablets are kept in this special bottle, they will last forever.
28. There are four stages of heart failure, classified as A to D, that describe the evolution and
progression of disease. In which stage are patients hospitalized or treated with specialized
interventions or hospice care for refractory symptoms of heart failure despite medical therapy?
A.
Stage A
B.
Stage B
C.
Stage C
D.
Stage D
29. There are four stages of heart failure, classified as A to D, that describe the evolution and
progression of disease. In which stage do patients have refractory symptoms of heart failure?
A.
Stage A
B.
Stage B
C.
Stage C
D.
Stage D
30. Which of the following is abundant in the heart and rapidly rises in the bloodstream in the
presence of heart failure, making it a good diagnostic test?
A.
Brain natriuretic peptide
B.
C-reactive protein
C.
Serum albumin
D.
Erythrocyte sedimentation rate
31. If a pulmonary embolus is suspected, which testing should be performed?
A.
Ultrasound
B.
Magnetic resonance imaging (MRI)
C.
V/Q scan
D.
D-dimer
32. Which of the following doses of statins decrease LDL by up to 50% on average?
A.
Pravastatin 40 mg
B.
Simvastatin 20 mg
C.
Atorvastatin 80 mg
D.
Fluvastatin 40 mg
33. What is true regarding the treatment of cilostazol?
A.
It causes vasoconstriction.
B.
It can be used when a patient has a degree of heart failure.
C.
It is used to treat leg pain due to blockages in the leg veins.
D.
It causes platelet aggregation.
34. Which of the following medications can cause hyperlipidemia?
A.
High dose diuretics
B.
Exercising 30 minutes every day
C.
Hyperthyroidism
D.
Angiotensin II receptor blocker (ARB) use
35. Which of the following complementary therapies may be helpful if a patient has orthostatic
hypotension?
A.
Magnesium
B.
Beta-glucan
C.
Selenium
D.
Hawthorn
36. In the CHADS2 Index for the stroke risk score for AF, the “A” stands for:
A.
Anticoagulation
B.
Autoimmune disease
C.
Age
D.
Antihypertension
37. Which of these murmurs is also called a 50/50 murmur?
A.
Aortic sclerosis
B.
Hemic murmur
C.
Systolic ejection murmur
D.
Diastolic murmur
38. Which of the following statements about dabigatran is true?
A.
It is difficult to keep the patient in therapeutic range.
B.
Anticoagulation cannot be immediately reversed.
C.
This agent is for the management of valvular atrial fibrillation.
D.
It has a longer half-life than warfarin.
39. What value on the ankle-brachial index diagnoses peripheral artery disease?
A.
Less than 0.25
B.
Less than 0.50
C.
Less than 0.90
D.
Greater than 1
40. Your patient with permanent atrial fibrillation asks what other options he has to warfarin. You
tell him:
A.
There is a permanent implantable device, but you will have to continue the
warfarin when you have it.
B.
We could try dabigatran, but it would require more laboratory monitoring.
C.
Rivaroxaban is a good alternative because it has an established antidote.
D.
Apixaban is an alternative medication because it does not necessitate dose titration.
41. You just started Martha on HTN therapy. The Eighth Joint National Committee recommends
that if her goal BP is not reached in what length of time, you should increase the initial drug
or add a second drug to it?
A.
1 month
B.
3 months
C.
6 months
D.
1 year
42. Janice is a 65-year-old Caucasian female with a history of osteoporosis and new-onset
hypertension. Which of the following medications is appropriate as first line for Janice’s
hypertension?
A.
Benazepril
B.
Hydrochlorothiazide
C.
Amlodipine
D.
Clonidine
43. Fred is a 76-year-old man with a history of hypertension who recently suffered a
post-myocardial infarction. Which of the following antihypertensive medications is
appropriate?
A.
Hydrochlorothiazide
B.
Furosemide
C.
Spironolactone
D.
Lisinopril
44. The care provider is assessing an ECG electrical axis, which shows a negative complex in
lead I and a positive complex in augmented vector foot (aVF). Which describes this axis
deviation?
A.
Normal axis
B.
Left axis deviation
C.
Right axis deviation
D.
Extreme right axis deviation
45. Which of the following results might you see in a physical examination of a male patient with
hypertension?
A.
S2 heart sound
B.
Distended neck veins
C.
Rhonchi
D.
Waist measurement 36 inches
46. In which patient do premature ventricular contractions NOT need to be treated?
A.
Kelly, a 25-year-old female with an allergy to bee stings
B.
Mary, a 50-year-old female with a history of untreated anxiety
C.
Randy, a 45-year-old male with a history of hypotension
D.
Bill, a 65-year-old male with a history of angina
47. What is the most common form of heart disease in a patient with atrial fibrillation?
A.
Hypertension
B.
Rheumatic heart disease
C.
Angina
D.
Coronary artery disease associated with heart failure
48. What does digitalis compete with at binding sites on the cell membrane?
A.
Magnesium
B.
Potassium
C.
Sodium
D.
Calcium
49. Which of the following will help a provider determine whether a patient is experiencing
paroxysmal supraventricular tachycardia (PSVT) or ventricular tachycardia (VT)?
A.
An obstructed P wave
B.
Ability to calculate PR interval
C.
Frog sign
D.
Chvostek’s sign