Introduction to Cardiovascular Nursing

Self-Study Examination

Instructions: After studying the text answer the following true/false or multiple choice questions. Remember, there's only one answer to each question.

1.	Coronary sinus blood flows to the a. pulmonary artery.

a) left ventricle.
b) right atrium.
c) pulmonary veins.

2.	The right heart chambers are thinner than the left because

a) the valve between them is smaller.
b) the systolic pressure is higher.
c) the workload is not as great.
d) the workload is increased.

3.	Papillary muscles and chordae tendinae control opening and closing of the — valves.

a) mitral and pulmonic
b) tricuspid and mitral
c) pulmonic and aortic
d) aortic and tricuspid

4.	The atrioventricular valves

a) prevent backflow from atria to vena cava during systole.
b) assist forward flow to pulmonary veins during diastole.
c) assist forward flow to the aorta during diastole.
d) prevent backflow from ventricle to atria during systole.

5.	Blood supply to the coronary arteries arises

a) behind the inferior vena cava.
b) within the left ventricle.
c) beyond the pulmonic valve.
d) from the aorta.

6.	The SA and AV nodes receive their blood supply primarily from the

a) right coronary artery.
b) left anterior descending artery.
c) circumflex artery.
d) left main artery.

7.	The smooth layer lining the chambers of the heart and valves is called

a) pericardium.
b) myocardium.
c) epicardium.
d) endocardium.

8.	The heart's normal pacemaker is called the

a) His bundle.
b) sinotrial node.
c) sequential pacer.
d) atrioventricular node.

9.	The network that stimulates the myocardium into contraction is the

a) right bundle branch.
b) His bundle.
c) Purkinje fibers.
d) AV septum.

10.	The largest waveform recorded on the EKG tracing is

a) TUP
b) QRS
c) P.
d) T.

11.	Pain that is intensified by deep breathing and movement is characteristic of

a) pericarditis.
b) tamponade.
c) angina.
d) myocardial infarction.

12.	Temporary loss of consciousness is called

a) stroke out.
b) arrhythmia.
c) sinus arrest.
d) syncope.

13.	Fluid extravasation from intravascular to extravascular spaces produces

a) reduced pulmonary pressure.
b) edema and swelling.
c) elevated ventricular pressure.
d) vertigo and TIAs.

14.	The past medical history should include a question about

a) sibling illnesses.
b) food dislikes.
c) occupation.
d) penicillin allergy.

15.	The PMI of the heart is normally located near the

a) base.
b) anterior portion.
c) apex.
d) left sternal border.

16.	Thrills result from

a) constricted neck veins.
b) early valve closure.
c) ruptured papillary muscle.
d) turbulent blood flow.

17.	The most common symptom of mitral stenosis is

a) an 84 heart sound.
b) a high pitched diastolic murmur.
c) chest palpitations.
d) dyspnea.

18.	The most common etiology of CAD is

a) thrombus.
b) emboli.
c) atherosclerosis.
d) pulmonary emboli.

19.	Atherosclerosis is more commonly found in

a) arterioles and venules.
b) lower extremity vessels.
c) large-sized arteries.
d) the interior vena cava.

20.	The inner layer of an artery wall is called

a) tunica intima.
b) tunica media.
c) tunica adventia.
d) tunica epithelia.

21.	Risk factors for CAD that can be controlled include all except

a) obesity.
b) heredity.
c) health problems.
d) smoking activity.

22.	Angina results from all except

a) coronary artery becomes blocked.
b) discrepancy between O₂ demand and supply occurs.
c) sudden demand is put on a normal heart.
d) lipoprotein deposits appear in the heart.

23.	Diagnosis of variant angina is made with

a) depressed QRS segment on ECG.
b) observation following digitalis injection.
c) cardiac catheterization.
d) elevated ST segment on ECG when pain is present.

24.	AMI results from

a) hypertrophy of the right atrium.
b) elevated left ventricular pressure.
c) reduced blood flow to the myocardium.
d) increased oxygen to the endocardium.

25.	An infarct of the full thickness of the myocardium is called

a) transvenous.
b) subendocardial.
c) transmural.

26.	The classic symptom of AMI is a. nausea and vomiting.

a) crushing chest pain.
b) heaviness in the chest.
c) anxiety and diaphoresis.

27.	A Q wave, T wave inversion, and ST segment elevation are classic ECG findings in

a) Prinzmetal's angina.
b) unstable angina.
c) advanced atherosclerotic disease.
d) AMI

28.	The first cardiac enzyme to rise with AMI is the

a) CPK.
b) SCOT.
c) LDH.
d) SMA.

29.	The enzyme fraction specific to cardiac muscle is

a) MM.
b) MB.
c) BB.

30.	The major cause of cardiac failure is

a) coronary atherosclerosis.
b) myocardial infarction.
c) pulmonary hypertension.
d) cardiac tamponade.

31.	Cardiogenic shock is the most severe form of

a) CAD.
b) cardiac failure.
c) mitral stenosis.
d) aortic insufficiency.

32.	A common symptom of early left ventricular failure as described by patients is

a) paroxysmal nocturnal dyspnea.
b) bradycardia.
c) edema.
d) pulmonary congestion.

33.	Increased stretching of the myofibrils in early cardiac failure results in

a) dyspnea.
b) left ventricular atrophy.
c) myocardial dilatation.
d) decreased filling pressure.

34.	Escape of fluid from the pulmonary vasculature to the alveoli is called

a) pulmonary embolus.
b) dyspnea.
c) paroxysmal nocturnal dyspnea.
d) pulmonary edema.

35.	Signs and symptoms of right-sided failure include all except

a) engorged neck veins.
b) edema.
c) abdominal distention.
d) decreased urine output.

36.	On assessment, a commonly found sign of left-sided failure is

a) peripheral edema.
b) elevated CVP.
c) S₃.
d) cough.

37.	One drug used to treat coronary artery spasm is

a) verapamil.
b) NTG.
c) dopamine
d) enifedipine.

38.	Forward failure is also termed

a) left to right shunt.
b) hypovolemic shock.
c) low output failure.
d) essential hypertension.

39.	A pulmonary artery catheter measures the pressures of the

a) aortic artery.
b) left heart.
c) carotid artery.
d) right heart.

40.	Hypovolemia can be diagnosed using a pulmonary artery catheter when

a) pulmonary capillary pressure is high.
b) left diastolic readings are high.
c) right ventricular diastolic readings are high.
d) left-sided pressures are low.

41.	Signs of cardiogenic shock include all except

a) urine output below 30 ml/hour.
b) falling systolic blood pressure.
c) venous collapse.
d) engorged spleen and liver.

42.	Drugs that are used to treat cardiogenic shock because they reduce afterload and preload are called

a) vasoconstrictor.
b) vasodilator.
c) inotropic.
d) chronotropic.

43.	The early stage of hypertension is diagnosed by

a) severe headache.
b) light headedness.
c) cyncopal attacks.
d) none of the above.

44.	A hypertensive state exists when

a) diastolic pressure is less than 90 mm/Hg.
b) systolic pressure exceeds 130 mm/Hg.
c) diastolic pressure exceeds 90 mm/Hg.
d) systolic pressure is less than 160 mm/Hg.

45.	Systolic blood pressure reflects

a) pressure in the pulmonary artery.
b) left atrial pressure in contraction.
c) left ventricular pressure in contraction.
d) right heart pressure.

46.	Secondary hypertension often results from

a) renal parenchymal disease.
b) urinary tract infection.
c) collagen complications.
d) hypophysectomy.

47.	To be classed as hypertensive crisis, the symptoms must include

a) systolic pressure of 210 or over.
b) headache.
c) papilledema.
d) cold extremities.

48.	The valve that is most at risk for bacterial invasion is the

a) mitral.
b) aortic.
c) pulmonic.
d) tricuspid.

49.	The bacterial invader most commonly associated with acute endocarditis is

a) E. coli.
b) Stuphylococcus aureus.
c) Streptococcus viridans.
d) Pseudomonas aeruginosa.

50.	Valve damage may be suspected if a/an — is present.

a) heart murmur
b) S3
c) bruits
d) pulses alterans

51.	Amphotericin B is used to treat which valvular disease?

a) taphylococcal
b) fungal
c) rickettsial
d) streptococcal

52.	An inflammation of the sac covering the heart is called

a) endocarditis.
b) pericarditis.
c) cardiac tamponade.
d) syocarditis.

53.	A friction rub is the classic symptom of

a) cardiac tamponade.
b) myocarditis.
c) endocarditis.
d) pericarditis.

54.	Rheumatic heart disease most frequently attacks which valve?

a) aortic.
b) mitral.
c) pulmonic.
d) tricuspid.

55.	Mitral insufficiency is characterized by

a) hypertension.
b) forward failure.
c) obstructed flow.
d) backflow of blood.

56.	Paradoxical pulse is a diagnostic feature of

a) hypertensive crisis.
b) subacute bacterial endocarditis.
c) cardiac tamponade.
d) aortic insufficiency.

57.	Hypovolemic shock describes a state of

a) pump failure.
b) depleted blood volume.
c) vasovagal venous response.
d) blood pooling in the arterioles.

58.	The shock state in which there is a loss of vasomotor tone is

a) neuropenic.
b) cardiogenic.
c) pulmonary.
d) neurogenic.

59.	Capillary permeability results from the release into the blood stream of all except

a) SRS.
b) bradykinin.
c) serotonin.
d) histamin.

60.	Primary treatment measures for shock include all except

a) correct underlying cause.
b) restore tissue perfusion.
c) vasodilator or vasoconstrictive drugs.
d) use of low-molecular fluid to restore volume.

61.	The first priority for nursing care for the patient with angina pectorus is to

a) provide an adequate supply of NTG.
b) suggest a less stressful work place.
c) relieve the pain.
d) organize an exercise program that is well tolerated.

62.	Nursing management for the AMI patient requires all except

a) document unusual monitor activity.
b) take rectal temperatures to ensure accuracy.
c) provide comfort with adequate pain medication.
d) administer oxygen by cannula or mask.

63.	Objective data that can be collected for the patient with an alteration in comfort status, related to fatigue are

a) overanxious family members.
b) long rest periods.
c) patient reports he is tired.
d) vital signs.

64.	The nurshig diagnosis of alteration in tissue perfusion will lead to all of these nursing interventions except

a) positioning.
b) monitoring sensorium.
c) assessing heart and lung sounds.
d) maintaining a fluid intake of 150 mi/hour.

65.	A high priority for nursing management of the CHF patient is

a) measurement of cardiac output.
b) maintenance of O₂ therapy.
c) patient teaching for altered life-style.
d) the medication regimen.

66.	Nursing assessments for patients at risk for cardiogenic shock include all except

a) blood gas measurement.
b) hourly output report.
c) ventricular workload report.
d) CVP and PA catheter reports.

67.	Nursing interventions for the hypertensive patient include a patient education program to discuss all except

a) long-term medication regimen.
b) dietary restrictions.
c) genetic factors.
d) weight control.

68.	A high priority nursing management measure for the patient experiencing pericarditis with an alteration in comfort, pain is:

a) positioning.
b) administering O₂.
c) administering IV morphine.
d) placing pillows under knees.

69.	The dicrotic notch in the waveform of the arterial line is indicative of

a) an aortic aneurysm.
b) pulmonic valve disease.
c) left ventricular diastole.
d) aortic valve closure.

70.	The pulmonary artery catheter provides information primarily about

a) valve activity.
b) right atrium filling pressure.
c) left heart activity.
d) pulmonary artery filling pressure.

71.	Arterial lines distal to the aorta reflect systolic pressures that are

a) higher.
b) the same.
c) lower.

72.	The x waveform seen as the pulmonary artery catheter is passed through the right atrium signifies

a) the dicrotic notch.
b) a rise in atrial pressure.
c) atrial contraction.
d) atrial diastole and beginning ventricular systole.

73.	Normal measurement of the central venous pressure is _ cm HzO.

a) 6-12
b) 4-12
c) 3-9
d) 2-8

74.	A complete dissociation of ventricles and atria with each beating on its own is referred to as

a) third-degree AV block.
b) bundle branch block.
c) hemiblock.
d) Wenckebach.

75.	Conduction blockage of one fascicle of a bundle branch is referred to as

a) 2:1 block.
b) Mobitz II block.
c) right bundle branch block.
d) hemiblock.

76.	The central venous pressure line measures

a) preload of the left ventricle.
b) pulmonary artery wedge pressure.
c) right ventricular systolic pressure.
d) preload of the right heart.

77.	As pressure rises in the right ventricle, the valve forced open is the

a) pulmonic.
b) aortic.
c) tricuspid.
d) mitral.

78.	The cardiac rhythm described as irregularly irregular is

a) sinus tachycardia.
b) sinus rhythm.
c) atrial flutter.
d) atrial fibrillation.

79.	Usually some form of treatment is required for all premature contractions with the exception of

a) couplings.
b) multiforms.
c) singles.
d) salvos.

80.	Elevated right ventricular pressure as recorded by the pulmonary artery line may result from

a) aortic stenosis.
b) pulmonary hypertension.
c) acute myocardial infarction.
d) peripheral vascular disease.

81.	Pulmonary artery diastolic pressure is nearly equal to

a) pulse pressure.
b) central venous pressure.
c) left ventricular end diastolic pressure.
d) right ventricular end diastolic pressure.

82.	A first-degree AV block is

a) hemiblock.
b) Wenckebach
c) 2:1 block.
d) delay in conduction.

83.	A heart rate greater than 100 bpm with the sinus node as the pacemaker is known as

a) sinus bradycardia.
b) sinus arrest.
c) sinus tachycardia.
d) sinus dysrhythmia.

84.	Increasing wedge pressure may be an indicator of

a) heart failure.
b) increased peripheral resistance.
c) pulmonary hypertension.
d) valve disease.

85.	A progressively prolonged PR interval until an impulse is blocked is a

a) 2:1 block.
b) Wenckebach.
c) RBBB.
d) hemiblock.

86.	Pulmonary capillary wedge pressure is normally _ mm/Hg.

a) 12-20
b) 6-12
c) 5-10
d) 2-5

87.	Elevated central venous pressure may result from all except which one of the following?

a) increased afterload
b) decreased contractility
c) hypovolemia
d) increased preload

88.	Asy stole means

a) sinus arrhythmia.
b) cardiac standstill.
c) agonal rhythm.
d) ventricular fibrillation.

89.	The dicrotic notch of the pulmonary artery waveform reflects

a) closure of the pulmonic valve.
b) opening of the aortic valve.
c) closure of the tricuspid valve.
d) opening of the pulmonic valve.

90.	Mean arterial pressure is normally

a) 20-50.
b) 70-90.
c) 90-110.
d) 120-130.

91.	Right ventricular systolic pressure is normally equal to _ pressure.

a) left atrium systolic
b) pulmonary artery systolic
c) pulmonary capillary wedge
d) end diastolic left ventricular

92.	Pulmonic valve closure signals the end of

a) atrial kick.
b) ventricular systole.
c) ventricular diastole.
d) pulmonary artery diastole.

93.	The waveform for the right ventricle is large because it records

a) ventricular systole.
b) pulmonic closure.
c) atrial kick.
d) tricuspid closure.

94.	What is the most serious life-threatening dysrhythmia?

a) premature ventricular contraction
b) premature atrial contraction
c) ventricular fibrillation
d) ventricular tachycardia

95.	A lead placement for lead II has the negative electrode

a) left leg.
b) right arm.
c) left arm.
d) abdomen area.

96.	Preparation for placing electrodes on the skin includes all except which one?

a) Remove dead skin.
b) Check for breaks in conductor leads.
c) Shave the area.
d) Separate electrodes as much as possible on the body.

97.	The more common of the bundle branch blocks is

a) left anterior bundle.
b) trifascicular bundle.
c) left posterior bundle.
d) right bundle.

98.	Bigemeny refers to

a) heart block.
b) Winkebach rhythm.
c) multiform PVCs.
d) a sequence of one normal, one PVC.

99.	An important nursing responsibility when monitoring cardiac patients is to

a) set alarm system.
b) differentiate an artifact from an arrhythmia.
c) document life-threatening arrhythmias.
d) all of the above.

100.	Factors influencing CVP include all of the following except

a) preload.
b) LVEDP.
c) afterload.
d) contractility.

101.	As systole begins, pressure in the right ventricle

a) drops below PA pressure.
b) forces the tricuspid valve open.
c) exceeds PA diastolic pressure.
d) forces the pulmonic valve to close.

102.	Thrombosis refers to

a) a floating blood clot.
b) rupture of a vein wall.
c) the formation of a blood clot.
d) a pulsatile arterial mass.

103.	When falling blood pressure is sensed by the baroreceptors

a) there is no response.
b) sympathetic activity is decreased.
c) parasympathetic activity is increased.
d) sympathetic activity is increased.

104.	The most difficult peripheral pulse to palpate is usually

a) brachial.
b) posterior tibial.
c) dorsalis pedis.
d) popliteal.

105.	On a scale of 0-4, the +3 refers to

a) slight impairment.
b) absent pulse.
c) moderate impairment.
d) normal pulse.

106.	Raynaud's phenomenon is dysfunction of the

a) large arteries in the arm.
b) capillaries in the toes.
c) arterioles in the fingers.
d) venules in the hands.

107.	Baroreceptors respond to

a) sound.
b) bruits.
c) oxygen.
d) pressure.

108.	Edema in both arms suggests

a) lymph node occlusion.
b) obstruction of the superior vena cava.
c) occlusion in the aorta.
d) brachial artery disease.

109.	Alien's test determines occlusion of the

a) radial artery.
b) saphenous vein.
c) brachial artery.
d) femoral vein.

110.	The most common cause of varicosities of the saphenous vein is

a) fistulas between superficial and deep veins.
b) elevated peripheral vascular pressure.
c) sclerosed veins.
d) incompetent valves.

111.	The 10th cranial nerve is a message carrier to the brain stem from the

a) aorta.
b) carotid.
c) subclavian.
d) jugular.

112.	The most common early symptom of Buerger's disease is

a) pulmonary embolus.
b) intermittent claudication.
c) rainbow phenomenon.
d) pain at rest.

113.	Blood pressure is dependent on

a) unidirectional flow and capillary lumen.
b) aortic valve closure and vascular reception.
c) cardiac output and peripheral resistance.
d) pulse pressure and diastolic ejection.

114.	An aneurysm may be defined as

a) a floating blood clot.
b) the dilated atria.
c) the constricted arteriole.
d) a dilatation of an arterial wall.

115.	A positive Romans' sign is

a) pain in the calf with dorsiflexion.
b) development of a tic in leg muscle.
c) redness along a vein line.
d) cold toe temperature.

116.	Rebound action of arterial walls

a) forces blood from the pulmonary artery into the left atrium.
b) propels blood through the circulatory system.
c) forces blood in a retrograde fashion.
d) propels blood between superficial and deep veins.

117.	The difference between an apical and a peripheral pulse is

a) pulsus paradoxsus.
b) pulsus alternans.
c) pulse deficit.
d) bigeminal pulse.

118.	Hypovolemic states lead to a reduction of

a) peripheral vascular pressure.
b) pulse pressure.
c) heart rate.
d) systolic blood pressure.

119.	A false aneurysm is one in which

a) fluid collects in surrounding tissue.
b) an atriovenous fistula occurs.
c) there is an intact wall.
d) a syphilitic lesion ruptures.

120.	The diameter of veins and arteries is controlled by the

a) central nervous system.
b) volume of blood pumped by the aorta.
c) autonomic nervous system.
d) size of the lumen.

121.	With feet in the dependent position, normal venous filling time is

a) 10 seconds.
b) 15 seconds.
c) 20 seconds.
d) 30 seconds.

122.	The arterial system in a ____ system.

a) low volume/high pressure
b) high volume/high pressure
c) low volume/low pressure
d) high volume/low pressure

123.	Clot formation without initial vein wall inflammation is called

a) embolic phlebitis.
b) phlebothrombosis.
c) thrombophlebitis.
d) endothelial embolus.

124.	Arterioles change diameter in response to the

a) tissues being perfused.
b) demand of the aorta.
c) oncotic pressure.
d) blood volume.

125.	Intermittent claudication in thighs and hips is associated with

a) Buerger's disease.
b) Leriche's syndrome.
c) Raynaud's disease.
d) Battle's sign.

126.	Baroreceptors are found in the

a) arterioles.
b) walls of arteries.
c) arch of the aorta.
d) iliac crest.

127.	The occlusive arterial disease associated with tobacco smoking is

a) thromboangiitis obliterans.
b) arteriosclerosis obliterans.
c) Raynaud's phenomenon.
d) Femorosis obliterans.

128.	Systemic vascular resistance is determined primarily by

a) elastic ability of vessel wall.
b) changes in arterioles and their sphincters.
c) amount of blood passing through the vessel.
d) the number of vessels.

129.	The smallest part of the peripheral vascular system is the

a) venule.
b) capillary.
c) arteriole.
d) prevenule.

130.	A dissecting aneurysm is one in which

a) one side of the wall is involved.
b) the sac communicates with the artery wall.
c) blood is forced between artery layers.
d) the cause is localized stretching.

131.	An attack of Raynaud's can be precipitated by putting a

a) toe into a warm swimming pool.
b) glove on one hand.
c) person into a sudden rainfall.
d) hand into a freezer compartment.

132.	A positive Homans' sign usually means

a) aneurysm.
b) phlebitis.
c) varicose veins.
d) bruits.

133.	The tunica media is composed of ____ tissue.

a) endothelial
b) elastic and muscular
c) connective
d) collagen

134.	Deformed toenails and dry shiny skin are characteristic of

a) aortic atherosclerosis.
b) increased venous return.
c) femoral ischemia.
d) decreased extremity arterial blood flow.

135.	____ dispersal system (Match the subsystem to its function:)

a) capillaries and venules
b) arterioles
c) aorta-large artery
d) veins

136.	____ collecting system (Match the subsystem to its function:)

a) capillaries and venules
b) arterioles
c) aorta-large artery
d) veins

137.	____ tissue exchange system (Match the subsystem to its function:)

a) capillaries and venules
b) arterioles
c) aorta-large artery
d) veins

138.	____ resistance (Match the subsystem to its function:)

a) capillaries and venules
b) arterioles
c) aorta-large artery
d) veins

139.	Thrombi are

a) limited to artery walls.
b) in venous or arterial walls.
c) in the aorta exclusively.
d) limited to the left ventricle.

140.	Reduced lower-extremity arterial perfusion is suspected with all except

a) shiny appearance.
b) diminished hair growth.
c) edema.
d) bruit.

141.	The most common symptom of arteriosclerosis obliterans is

a) rainbow phenomenon.
b) intermittent claudication.
c) pulsatile bruit.
d) pulsus altemans.

142.	Rainbow phenomenon described

a) the pain of intermittent claudication.
b) ruber coloring of venous stasis.
c) finger color changes of Raynaud's phenomenon.
d) cyanosis of arterial occlusion.

143.	Pain that occurs at rest indicates that

a) the patient is too active.
b) tissue perfusion is very limited.
c) oxygen supply exceeds demand.
d) an extremity is ischemic.

144.	"A thin, semipermeable membrane in a single layer" describes which part of the systemic vasculature?

a) arterioles
b) capillaries
c) venules
d) prearterioles

145.	Arterial emboli

a) begin in the pulmonary artery.
b) originate in the inferior vena cava.
c) result from trauma to the saphenous vein.
d) originate in the left heart.

146.	The chief complaint in systemic vascular disease is

a) numbness/tingling.
b) paresthesia.
c) pain.
d) pallor.

147.	Hoarseness may be a symptom of thoracic aneurysm resulting from compression of the

a) main bronchus.
b) 12th cranial nerve.
c) spines of the intercostal nerves.
d) recurrent laryngeal nerve.

148.	The five P's are symptoms of

a) reduced cellular nutrition.
b) slow venous return.
c) diminished capillary filling.
d) reduced artery flow.

149.	Main arterial pressure refers to

a) the difference between systolic and diastolic pressure.
b) an average pressure required to pump blood through the system.
c) the pressure at the aorta to prevent backflow.
d) pressure produced by a stenotic valve.

150.	In the presence of peripheral arterial disease, walking produces

a) pronounced pallor of feet.
b) ruber coloring of legs and thighs.
c) dyanotic appearance of ankles.
d) circumoral pallor.

151.	Inflammation of the lining of a vein wall is called

a) embolic phlebitis.
b) phlebothrombosis.
c) thrombophlebitis.
d) endothelial embolus.

152.	Common sites for acute peripheral artery disease include all except the

a) femoral artery.
b) aorta.
c) iliac artery.
d) saphenous vein.

153.	A pulsatile abdominal mass may indicate

a) pulmonary embolus.
b) cerebral aneurysm.
c) abdominal aneurysm.
d) arteriosclerosis obliterans.

154.	Bed rest puts a patient at risk for

a) intermittent claudication.
b) venous occlusive disease.
c) saccular aneurysm.
d) Buerger's disease.

155.	A common finding in Leriche's syndrome is

a) water-hammer pulse.
b) Battle's sign.
c) sciatic pain.
d) impotence.

156.	Venous emboli frequently lodge in

a) pulmonary circulation.
b) cerebral arteries.
c) muscles of the thigh.
d) renal circulation.

157.	A nursing care priority for a patient with peripheral vascular disease is

a) administer anticoagulants.
b) encourage exercise.
c) provide comfort measures.
d) suggest diuretic therapy.

158.	Nurses may effect treatment for the patient with Buerger's disease by

a) encouraging membership in a STOP SMOKING program.
b) encouraging weight loss.
c) arranging for short walking periods.
d) suggesting surgical correction.

159.	Varicose veins require surgical intervention when

a) they become cosmetically unsightly.
b) the vein becomes superficial.
c) recurrent attacks of thrombophlebitis occur.
d) the veins do not lie in straight channels.

160.	A Class IV femoral-popliteal occlusive disease involves occlusion of

a) superficial femoral, popliteal, more than one distal vessel.
b) one segment of the superficial femoral.
c) superficial femoral, popliteal, one distal vessel.
d) superficial femoral, popliteal, popliteal segments.

161.	Acquired valvular disease is uncommon in the

a) mitral.
b) tricuspid.
c) pulmonic.
d) aortic.

162.	A transvenous pacemaker serves as an anatomic marker for

a) valve replacement.
b) angioplasty.
c) bypass surgery.
d) aneurysm repair.

163.	Portal hypertension is relieved by

a) performing lobectomy and anastomosis.
b) shunting blood to the aorta.
c) sclerosing esophageal varicies.
d) diverting some of portal blood flow.

164.	Leg edema is a frequent problem following

a) descending aorta reconstruction.
b) porta-caval shunt.
c) axillofemoral bypass.
d) femoral-popliteal bypass.

165.	Thoracic aneurysms are usually

a) sacciform.
b) suspension.
c) false.
d) dissecting.

166.	The procedure of choice to restore blood flow to a leg with diminished blood flow is

a) femoral-popliteal bypass.
b) aortoiliac endarterectomy.
c) patch grafting.
d) extra-anatomical graft.

167.	The pain associated with rupture of the aorta is described as

a) crushing, intense.
b) retrosternal and intrascapular.
c) pulsatile.
d) pericardial and substernal.

168.	The successful vena-caval interruption procedure

a) diverts emboli to the pulmonary veins.
b) destroys thromboemboli in the microcirculation.
c) uses heparin solution as anticoagulant.
d) filters clots but retains vena-caval patency.

169.	Heparin rebound occurs following injection of

a) prostigmine.
b) coumadin.
c) insulin.
d) protamine.

170.	The surgical intervention frequently required to repair an ascending aorta aneurysm is

a) aortic valve replacement.
b) bypass graft.
c) heart transplant.
d) extra-anatomical graft.

171.	The drug of choice in percutaneous transluminal coronary revascularization is

a) heparin.
b) dicumarol.
c) urikinase.
d) streptokinase.

172.	Removal of thromboemboli from an artery is called

a) endarterectomy.
b) umbrella.
c) embolectomy.
d) shunt.

173.	The pacemaker with the longest history of successful use is the

a) asynchronous.
b) fixed rate.
c) demand.
d) dual chamber.

174.	A dissecting thoracic aneurysm may initially be confused with

a) acute myocardial infarction.
b) acute angina.
c) hypertensive crisis.
d) indigestion.

175.	A sequential graft is

a) two vessels anastomosed to provide a graft.
b) several vessels to bypass a large occlusion.
c) one vessel to bypass several areas.
d) a second vein graft piggybacking.

176.	Ligation of the vena cava for thromboemboli is a technique no longer used because

a) collateral circulation produced emboli.
b) necrosis occurred in nearby veins.
c) large clots formed in the ligated section.
d) CHF followed the ligation.

177.	The letters VVI describe a pacemaker that is

a) ventricle-stimulated and paced; the absence of R wave triggers it.
b) ventricle-stimulated, atrial-sensed; no response.
c) atrium-stimulated, ventricle-sensed; response is inhibited.

178.	The proximal site for CABG is the

a) artery to be bypassed.
b) myocardium.
c) descending aorta.
d) closest aorta site.

179.	Impotence is male patients may follow

a) femoral-femoral bypass.
b) aortoiliac reconstruction.
c) femoral-popliteal bypass.
d) axillofemoral bypass.

180.	Prevention of injury to the spinal cord is a consideration in ____ aneurysm repair.

a) ventricular
b) aorta arch
c) aortoiliac
d) descending aorta

181.	A True ventrieular aneurysm will bulge

a) infrequently.
b) during diastole.
c) during systole.
d) during systole and diastole.

182.	A frequent finding when a thoracic aneurysm occurs is

a) localized bleeds.
b) expanding medastinum on x-ray.
c) compression of adjacent structures.
d) cardiac tamponade.

183.	Percutaneous transluminal coronary angioplasty is a method of treatment for

a) occluded peripheral vasculature.
b) diseased coronary arteries.
c) valve disease.
d) dissecting aneurysm.

184.	Dissecting aneurysm refers to

a) subclavian tear.
b) outpouch on one side.
c) splitting of the intima.
d) false aneurysm.

185.	The most common cause of aortic penetrating trauma is

a) vehicular accident.
b) stab wound.
c) "steering wheel" syndrome.
d) gunshot wound.

186.	Cardioplegia has been refined to be induced with

a) potassium in D_51/2 NS solution.
b) sodium in 6°C solution.
c) Ringer's solution with bicarbonate.
d) D₅W at 47°C.

187.	The major cause of acquired mitral valve lesions is

a) ruptured chordae.
b) syphilis.
c) rheumatic fever.
d) chicken pox.

188.	Aortoiliac bypass grafting is the procedure of choice for

a) abdominal aneurysm repair.
b) intraluminal atheromatous plaque removal.
c) restoration of blood flow to extremities.
d) extensive occlusive disease repair.

189.	The artery sometimes used for CABG is the

a) greater saphenous.
b) extrafemoral.
c) internal mammary.
d) external carotid.

190.	The purpose of a pacemaker is to

a) bypass the SA node.
b) augment the AV node.
c) supplant the conduction system.
d) stimulate the myocardium to contract.

191.	When aortic rupture occurs, the blood pressure of the lower extremities is

a) muffled.
b) elevated.
c) accentuated.
d) decreased.

192.	The coronary artery involved in a coronary endarterectomy is the

a) left main.
b) right.
c) left anterior descending.
d) circumflex.

193.	Candidates for repair of ventricular aneurysm present with all except

a) ventricular fibrillation.
b) congestive failure.
c) systemic emboli.
d) ventricular tachycardia.

194.	The preferred vein for the performance of a coronary artery bypass graft is the

a) saphenous.
b) cephalic.
c) basilic.
d) femoral.

195.	A common finding of an aneurysm in the ascending aorta is

a) decreased blood pressure.
b) aortic regurgitation.
c) pulmonary edema.
d) aortic stenosis.

196.	A porta-caval shunt diverts blood from the

a) portal vein to the superior vena cava.
b) portal vein to the inferior vena cava.
c) portal artery to the distal splenic bed.
d) portal artery to the superior mesenteric.

197.	Right or left coronary artery dominance is a factor in

a) anastomotic sites.
b) choice of bypass material.
c) aneurysm repair.
d) cardiopulmonary bypass.

198.	One complication of an axillofemoral graft is

a) abdominal aorta calcification
b) edema in graft site.
c) reduced flow to recipient extremity following arm exercise.
d) reduced patency rate after 3 years.

199.	Blood is diverted from the heart for surgery by

a) aortic clamp.
b) cardioplegia.
c) cardiopulmonary bypass.
d) pulmonic clamp.

200.	The type of valve frequently used for aortic valve replacement is

a) cadaveric.
b) porcine.
c) bovine pericardium.
d) dura mater.

201.	Most thromboemboli originate

a) in the pulmonary vasculature.
b) below the level of the vena cava.
c) in the aortoiliac circulation.
d) above the descending aorta.

202.	Mitral valve replacement includes excision of all EXCEPT

a) atrial septum.
b) mitral leaflets.
c) papillary muscle.
d) chordae tendineae.

203.	Thoracic aorta repair has been helped by the invention of

a) aorta clamps.
b) oxygenators for bypass machine.
c) heparin-coated bypass shunts.
d) emergency repair kits.

204.	Postoperative nursing management for arterial reconstruction includes all EXCEPT

a) document response to medication.
b) monitor hemodynamic status.
c) administer 2000 ml Ringer's Lactate.
d) complete physical assessment.

205.	With a nursing diagnosis of alteration in tissue perfusion, nursing interventions will include

a) weights recorded daily.
b) frequent assessment of peripheral pulses.
c) neurologic status monitoring.
d) all of the above.

206.	Thiazides are ____ drugs.

a) antianginal
b) beta blocker
c) antihemolytic
d) diuretic

207.	The drug of choice to prevent recurrence of su-praventricular tachyarrhythmias is

a) lidoflazine.
b) quinidine.
c) diltiazem.
d) lidocaine.

208.	A nursing priority in the management for the patient beginning therapy with a calcium blocking agent is

a) ensure that the patient remains on bed rest.
b) inform the patient about increased angina pain.
c) administer the agent after meals.
d) discontinue beta blocking agents.

209.	Intrinsic sympathomimetic activity of some of the beta blockers

a) reduces the cardioselectivity.
b) increases the beta blockade.
c) adds an element of inotropic activity.
d) protects against prolonged AV conduction time.

210.	Thiazide diuretics

a) act primarily in the distal loop.
b) increase absorption of water.
c) inhibit Na and Cl reabsorption.
d) all of the above.

211.	Class I antiarrhythmic drugs are

a) quinidine-like.
b) calcium blockers.
c) beta blockers.
d) alpha agonists.

212.	An antihistamine effect causing sedation occurs with the administration of

a) timolol.
b) gallopamil.
c) cinnarizine.
d) isordil.

213.	Dobutamine is a cardioselective

a) agonist.
b) antagonist.

214.	Betai receptors are those that affect

a) pulmonary airways.
b) vascular smooth muscle.
c) coronary stimulation.
d) peripheral circulation.

215.	Information to be included by nurses instructing patients about administration of enalapril includes all except

a) onset of effect is delayed.
b) it may be taken with other antihypertensive drugs.
c) take it with meals.
d) maximum daily dose is 20 mg.

216.	The Type 1 (papaverine derivates) calcium channel blockers include all except

a) diltiazem.
b) gallopamil.
c) tiapamil.
d) verapamil.

217.	A high priority for nursing management of a patient receiving flecainide is

a) record intake and output.
b) monitor pulse.
c) monitor ECG.
d) assess for dyspnea.

218.	A hypertensive crisis may be precipitated if ____ is withdrawn suddenly.

a) hyperstat
b) clonidine
c) nifedipine
d) lidocaine

219.	Abrupt withdrawal syndrome has been reported with

a) atropine.
b) lidocaine.
c) clonidine.
d) nitroprusside.

220.	Effective treatment for nonlethal PVCs has been achieved with

a) labetalol.
b) tocainide.
c) mexiletine.
d) ethmozine.

221.	An example of a drug that blocks the slow channel is

a) atenolol.
b) nifedipine.
c) epinephrine.
d) hydralazine.

222.	A nursing management priority for patients treated with amiodarone is

a) instruct patient about symptoms to be reported.
b) explain lengthened period of onset of activity.
c) discuss side effects.
d) all of the above.

223.	An example of a calcium channel blocking agent with cardiac and vascular effects is

a) cinnarizine.
b) gallopamil.
c) diltiazem.
d) nifedipine.

224.	Quinidine is the prototype of ____ drugs.

a) Class I
b) Class II
c) Class III
d) Class IV

225.	The "old standby" for angina treatment is

a) nitroglycerin.
b) dipyridamole.
c) nifedipine.
d) heparin.

226.	The concept of lengthening the action potential duration and the refractoriness of cardiac muscle is of primary significance to ____ agents.

a) Class I
b) Class II
c) Class III
d) Class IV

227.	Sodium bicarbonate precipitates when mixed with

a) nifedipine.
b) epinephrine.
c) atropine.
d) calcium chloride.

228.	A nursing instruction for the patient receiving be-pridil is

a) take the pulse.
b) avoid sunlight.
c) take with food.
d) avoid exercise.

229.	Propranolol is noncardioselective and is therefore not the proper drug choice for patients with

a) angina.
b) CHF.
c) asthma.
d) gallbladder disease.

230.	Nifedipine is used in drug regimens to treat all except

a) coronary artery spasm.
b) systemic hypertension.
c) variant angina.
d) hypertensive crisis.

231.	Central-acting antihypertensive drugs reduce blood pressure by action on the

a) arterioles and venules.
b) peripheral vascular system only.
c) brain stem and peripheral vasculature.
d) central nervous system.

232.	A drug used to reverse bradycardia is

a) apresoline.
b) bretylium.
c) chlorothiazide.
d) atropine.

233.	The drug of choice to reverse acidosis of an arrest is

a) calcium chloride.
b) sodium bicarbonate.
c) lidocaine.
d) atropine.

234.	Digitalis drugs are called

a) aminoglycosides.
b) positive inotropes.
c) loading dose drugs.
d) antiarrhythmics.

235.	Renal blood flow is maintained, and arterial and smooth muscle is relaxed with the use of

a) nitroprusside.
b) thiazides.
c) prazosin.
d) dopamine.

236.	A new drug used to treat arrhythmias assodated with W-P-W is

a) bretylium.
b) ajmaline.
c) flecainide.
d) atenolol.

237.	A drug used to reduce blood lipids is

a) probucol.
b) pronestyl.
c) furosemide.
d) ethacrynic acid.

238.	A drug for the treatment of acute thromboembo-lic disease is

a) heparin.
b) protamine.
c) streptokinase.
d) edecrin.

239.	The drug of choice to terminate an acute episode of SVT is

a) naldolol.
b) lidocaine.
c) nifedipine.
d) verapamil.

240.	A high-priority item in the nursing management for the patient receiving a beta blocking agent is

a) identify cardioselectivity of the drug.
b) determine renal status of the patient.
c) teach patient to monitor pulse.
d) instruct patient about daily medical regimen.

241.	An example of a drug with ACE inhibition properties is

a) doxazocin.
b) minoxidil.
c) captopril.
d) clonidine.

242.	A transdermal type of NTG is administered

a) q.i.d.
b) q. 12 h.
c) x 1 daily.
d) x 1 weekly.

243.	The beta blockers are considered ____ antiar-rhythmic agents.

a) Class IV
b) Class III
c) Class II
d) Class I

244.	Beta adrenoreceptor blockers compete with ____ for the adrenoreceptors of the heart.

a) catecholamines
b) ACE blockers
c) calcium channel blockers
d) diuretics

245.	Hydralazine lowers total peripheral resistance, affecting the ____ to a greater degree.

a) arteries
b) veins
c) capillaries
d) arterioles

246.	____ , related to the thiazides, dilates resistance vessels but not capacitance vessels.

a) Hydralazine
b) Digitalis
c) Diazoxide
d) Prazosin

247.	Hirsutism is reported with use of

a) minoxidil.
b) hydralazine.
c) enalapril.
d) nitroprusside.

248.	A drug that acts to increase intracellular calcium ion is

a) atropine.
b) apresoline.
c) digitalis.
d) heparin.

249.	Guanethidine is an example of a drug that

a) stores epinephrine.
b) causes diuresis.
c) depletes norepinephrine.
d) blocks the calcium channel.

250.	Timolol may be a better drug than propranolol because it is

a) less toxic.
b) a renin agonist.
c) cardioselective.
d) many times more potent.

251.	Hypertensive crisis is treated with

a) nitroprusside.
b) thiazoxide.
c) minoxidil.
d) quanethidine

252.	The preferred diuretic used during hypertensive crisis treatment is

a) triamterene.
b) hydrochlorothiazide.
c) bumetanide.
d) furosemide.

253.	A drug with a direct negative inotropic effect is

a) digoxin.
b) NTG.
c) lorelco.
d) nifedipine.

254.	The drug of choice for CHF in patients refractory to digitalis and diuretics is

a) dopamine.
b) nitroprusside.
c) prazosm.
d) minoxidil.

255.	Trimazosin is an example of a

a) beta blocking agent.
b) diuretic.
c) positive inotropic agent.
d) vasodilator.

256.	A high-priority nursing responsibility during a code is

a) record drugs used.
b) prepare drugs in the order they will be used.
c) record time of code.
d) all of the above.

257.	Pentoxifylline is a new medication used to treat

a) angina pectoris.
b) intermittent claudication.
c) renal failure.
d) arrhythmias.

258.	Nicotinic acid, a member of the B vitamin group, is used in large doses to

a) suppress fatty acid influx to liver.
b) increase production of HDLs.
c) augment activity of diuretic therapy.
d) suppress nonlethal PVCs.

259.	Severe hypotension, tachycardia, and sympathetic activity limit this vasodilator's use:

a) phentolamine.
b) diazoxide.
c) minoxidil.
d) captopril.

260.	A high priority in the nursing care of patients receiving diuretic therapy is

a) evaluate loss of K+.
b) treat nausea and vomiting.
c) give medication at noon.
d) assess sensorium and fatigue levels.

261.	Alpha adrenoreceptor blocking agents produce results by

a) inhibiting vasoconstriction.
b) directing vasodilatation.
c) decreasing heart rate.
d) inhibiting norepinephrine release.

262.	A new, investigational, precapillary vasodilator agent that reduces blood pressure is

a) bretylium.
b) pinacidil.
c) diltiazem.
d) minoxidil.

263.	The renin-angiotensin system blocking agents are effective in treatment of

a) myocardial infarct.
b) arrhythmias.
c) angina.
d) hypertension.