. Which of the following is NOT one of the factors that promotes deep venous thrombosis? A. Venous stasis B.

Venous endothelial damage C. Polycythemia D. Hypercoagulable states Polycythemia is not one of the three factors that promote venous thrombosis. Points Earned: 1/1 Correct Answer: C Your Response: C 2. Which of the following terms describes this condition of an occlusion in a blood vessel from a bolus of circulating matter in the bloodstream? A. Thrombus B. Embolus C. Thrombophlebitis D. Foam cell A thrombus is a blood clot that remains attached to the vessel wall. An embolus circulates. Thrombophlebitis is the inflammation caused by a thrombus. Foam cells are lipid-laden cells that contribute to fatty streaks. Points Earned: 1/1 Correct Answer: B Your Response: B 3. Which of the following is a factor that leads to aortic aneurysm? A. Lack of atherosclerosis B. Deficiencies in wall collagen C. Excessive elastin D. Decreased oxygen radicals Atherosclerosis is a common cause of aneurysms. Aortic aneurysms are associated with genetic markers, deficiencies in wall collagen, elastin failure, inflammation, increased oxygen radicals, and mechanical shear forces. Points Earned: 0/1 Correct Answer: B Your Response: C 4. A young woman presents with pallor, numbness, and a sensation of cold temperature of her digits. Which of the following is the most likely cause? A. Raynaud phenomenon B. Thromboangiitis obliterans C. Peripheral vascular disease D. Varicose veins

Raynaud phenomenon is characterized by attacks of vasospasm in the small arteries of the fingers. It is characterized by cold, numb digits. Thromboangiitis obliterans tends to occur in young men who are heavy smokers; it is an inflammatory disease of the peripheral arteries. Arteries occlude in the feet and hands. Peripheral vascular disease is a result of atherosclerosis. Varicose veins have pooled blood. Points Earned: 1/1 Correct Answer: A Your Response: A 5. Which of the following is WRONG regarding hypertension? A. Approximately 65% of Americans older than the age of 60 have hypertension. B. Less than two thirds of those with hypertension have it controlled. C. It is defined as a systolic pressure of greater than 90 mmHg. D. It is systolic pressure of 140 mmHg or greater. Approximately 65% of Americans older than the age of 60 have hypertension and less than two thirds of those have adequately controlled hypertension. Hypertension is defined as a diastolic pressure of 90 mmHg or greater or a systolic pressure of 140 mmHg or greater. Points Earned: 0/1 Correct Answer: D Your Response: B 6. A person experiences an elevated systolic pressure accompanied by normal diastolic pressure (less than 90 mmHg). Which of the following is the correct term for this condition? A. Primary hypertension B. Secondary hypertension C. Tertiary hypertension D. Isolated systolic hypertension Isolated systolic hypertension is an elevated systolic pressure with a normal diastolic pressure. Primary hypertension has no known cause. Secondary hypertension is caused by altered hemodynamics associated with a primary disease. There is no tertiary hypertension. Points Earned: 1/1 Correct Answer: D Your Response: D 7. Which of the following is NOT associated with hypertension? A. Family history positive for hypertension B. Asian race C. High dietary sodium D. Glucose intolerance Hypertension is associated with positive family history, gender (men younger than 55 and women after menopause), black race, high dietary sodium, glucose intolerance, cigarette smoking, obesity, heavy alcohol consumption, and low dietary intake of minerals. Points Earned: 1/1 Correct Answer: B

Your Response: B 8. Which of the following complications occurs secondary to hypertension? A. Cardiovascular muscle atrophy B. Hypoglycemia C. Congestive heart failure D. Decreased demand for coronary perfusion Complications of hypertension include left ventricular hypertrophy, angina pectoris (CHEST PAIN) , congestive heart failure, coronary artery disease, myocardial infarction, and sudden death. Points Earned: 0/1 Correct Answer: C Your Response: A 9. Which of the following is TRUE regarding atherosclerosis? A. Atherosclerosis is an acute process of heart muscle degeneration. B. Atherosclerosis is thickening and hardening of the vessel wall. C. A plaque is caused by neutrophils. D. Fatty streaks and foam cells are identical. Arteriosclerosis is a chronic degeneration of blood vessel walls. A plaque is caused by collagen over a fatty streak. Fatty streaks are composed of a large number of lipid-laden foam cells that deposit on the vessel wall. Points Earned: 0/1 Correct Answer: B Your Response: C 10. Which of the following pairs regarding dyslipidemia is correct? A. High-density lipoproteintriglycerides and fat packages B. Very low-density lipoproteinstriglycerides and proteins C. Low-density lipoproteinsphospholipids and proteins D. Chylomicronstriglycerides and phospholipids VLDL is associated with triglycerides and protein. LDL is associated with cholesterol and protein. HDL is phospholipids and protein. Chylomicrons are dietary fat packages. Points Earned: 0/1 Correct Answer: B Your Response: A 11. A woman presents with chest pain that occurs at rest. She is found to have abnormal vasospasm of her coronary arteries. Which of the following is the BEST description of this case? A. Stable angina B. Prinzmetal angina C. Silent ischemia D. Angina pectoris

Prinzmetal angina is an abnormal vasospasm of the coronary vessels. It typically produces pain at rest and is common in women. Stable angina occurs with activity and is often limited and resolves with rest. Silent ischemia is occlusion of the coronary arteries without pain. Angina pectoris is chest pain, usually substernal chest discomfort. Points Earned: 0/1 Correct Answer: B Your Response: D 12. Which of the following is NOT a sign of atherosclerosis? A. Xanthelasmas B. Arcus senilis C. Atrial septal defect D. Extra-rapid heart sounds Xanthelasmas are small fat deposits around the eyes. Arcus senilis is a yellow lipid ring around the cornea. These both suggest dyslipidemia, which is associated with atherosclerosis. Extrarapid heart sounds such as a left ventricular gallop indicate impaired left ventricular function during an ischemic attack. Points Earned: 0/1 Correct Answer: C Your Response: A 13. Which of the following is TRUE regarding cellular injury of the myocardium? A. Cardiac cells can withstand ischemic conditions for about 60 minutes. B. ECG changes are visible after approximately 120 seconds. C. Myocardial cells remain viable if blood flow returns within 20 minutes. D. After 20 seconds of decreased blood flow, myocardial cells become cooler. Cardiac cells can withstand ischemic conditions for about 20 minutes. ECG changes are visible after 30 to 60 seconds of hypoxia. After 8 to 10 seconds of blood flow, the myocardial cells are already cyanotic and cooler. Points Earned: 1/1 Correct Answer: C Your Response: C 14. Which of the following is NOT a functional change expected from acute myocardial infarction? A. Decreased contractility B. Decreased stroke volume C. Increased ejection fraction D. Increased left ventricular compliance There is a decreased ejection fraction. Points Earned: 0/1 Correct Answer: C Your Response: D

15. A person is being transferred from another medical facility with a diagnosis of acute myocardial infarction. Which of the following is NOT a typical symptom of acute myocardial infarction? A. Cough B. Diaphoresis C. Absence of pain D. Crushing pain A person may experience substernal chest pressure or pain. Some have no pain at all. Nausea, vomiting, abdominal pain, or indigestion also may occur. Sweating and cool and clammy skin are typical. Points Earned: 0/1 Correct Answer: A Your Response: C 16. Which of the following is NOT an enzyme released by the myocardial muscle? A. CK-MB B. LDH C. AST D. Troponin I AST is a liver enzyme that indicates damage to the liver cells. The other three are indicators of myocardial damage. Although LDH is also measured in liver function, it also has a purpose for acute myocardial infarction. Points Earned: 0/1 Correct Answer: C Your Response: 17. Which of the following is the MOST common complication of AMI? A. Dressler postinfarction syndrome B. Dysrhythmia C. Pericarditis D. Congestive heart failure All of these choices are true complications of AMI; however, the most common is dysrhythmia. Points Earned: 0/1 Correct Answer: B Your Response: D 18. An individual is experiencing an acute myocardial infarction. Which of the following medications would NOT be expected on the admission orders? A. Beta-blockers B. Aspirin C. Nitrates D. Calcium chloride

Beta-blockers, aspirin, nitrates, and some calcium channel blockers are appropriate inpatient orders. Calcium chloride is not routinely used in AMI. Points Earned: 1/1 Correct Answer: D Your Response: D 19. A person sustained a ruptured myocardial wall. Which of the following is accurate regarding the cause of this rupture? A. Thickening of the myocardial wall B. Increased collateral flow C. Shearing effect against stiffened necrotic tissue D. Softened, elastic area of muscle The facts surrounding a ruptured myocardial wall include decreased mass of muscle, poor collateral flow, shearing effect of muscle contraction, stiffened necrotic muscle, necrosis at the terminal blood supply, and aging of the myocardium with laceration of the myocardial microstructure. Points Earned: 0/1 Correct Answer: C Your Response: D 20. A 23-year-old presents with severe chest pain that worsens with respiratory movements and with lying down. On exam, there is a friction rub. Which of the following treatments is the most appropriate for this condition? A. Analgesics B. Percutaneous coronary intervention C. CABG D. Beta-blockers Analgesics are the correct choice; this individual has pericarditis. The other choices are appropriate for AMI. Points Earned: 0/1 Correct Answer: A Your Response: C 21. A person has been diagnosed with a pericardial effusion that is frank blood. Which of the following is associated with a bloody effusion? A. Tuberculosis B. Coagulation defect C. Neoplasm D. Left heart failure Coagulation defect, trauma, and aneurysms are associated with bloody effusion. Points Earned: 0/1 Correct Answer: B Your Response: D

22. Which of the following medical conditions is NOT associated with pericardial effusion? A. Renal failure B. Breast cancer C. Aortic stenosis D. Open heart surgery Renal failure, cancer, radiation therapy, certain medications, and previous open heart surgery have been associated with pericardial effusion. Points Earned: 0/1 Correct Answer: C Your Response: D 23. Which of the following is a result of dilated cardiomyopathy? A. Increased ejection fraction B. Decreased end-diastolic volume C. Increased stroke volume D. Biventricular failure There is decreased ejection fraction and increased end-diastolic volume. The stroke volume is decreased. Biventricular failure is associated with dilated cardiomyopathy. Points Earned: 0/1 Correct Answer: D Your Response: C 24. Which of the following medications is used in dilated cardiomyopathy? A. Digitalis B. Calcium channel blockers C. Beta-blockers D. Fibrinolytics Inotropic agents, vasodilators, and diuretics have been used in dilated cardiomyopathy. Points Earned: 0/1 Correct Answer: A Your Response: B 25. Which of the following is NOT one of the three common causes of aortic stenosis? A. Inflammatory damage caused by rheumatic heart disease B. Acute myocardial infarction C. Congenital malformation of the bicuspid valve D. Degeneration with aging Acute myocardial infarction is not a cause of aortic stenosis. Points Earned: 0/1 Correct Answer: B

Your Response: D 26. A person has impaired blood flow from the left atrium to the left ventricle. Which of the following valvular problems does this describe? A. Mitral stenosis B. Mitral regurgitation C. Aortic stenosis D. Aortic regurgitation Mitral stenosis is due to a mitral valve that inhibits adequate blood flow from the left atrium to the left ventricle. Mitral regurgitation occurs secondary to blood flowing backward from the left ventricle to the left atrium. Aortic stenosis results in diminished blood flow from the left ventricle into the aorta. Aortic regurgitation results from blood from the aorta flowing back into the left ventricle during diastole. Points Earned: 1/1 Correct Answer: A Your Response: A 27. A person has a loud pansystolic murmur that radiates to the back and axilla. Which of the following valvular abnormalities is this describing? A. Mitral stenosis B. Mitral regurgitation C. Aortic stenosis D. Aortic regurgitation Mitral regurgitation is characteristic of these findings. Aortic regurgitation is associated with a water-hammer pulse. Aortic stenosis has a crescendo-decrescendo murmur. Mitral stenosis has a rumbling decrescendo murmur. Points Earned: 0/1 Correct Answer: B Your Response: D 28. A man has rheumatic fever. Which of the following valves is most commonly affected? A. Aortic B. Tricuspid C. Pulmonic D. Mitral The mitral valve is the most commonly affected in rheumatic heart disease. Points Earned: 0/1 Correct Answer: D Your Response: A
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