What is the initiating event that leads to the development of atherosclerosis?
1. What is the initiating event that leads to the development of atherosclerosis?
a. Release of the inflammatory cytokines
b. Macrophages adhere to vessel walls.
c. Injury to the endothelial cells that line the artery walls
d. Release of the platelet-deprived growth factor
2. When endothelial cells are injured, what alteration contributes to atherosclerosis?
a. The release of toxic oxygen radicals that oxidize low-density lipoproteins (LDLs)
b. Cells are unable to make the normal amount of vasodilating cytokines.
c. Cells produce an increased amount of antithrombotic cytokines.
d. Cells develop a hypersensitivity to homocysteine and lipids.
3. Which factor is responsible for the hypertrophy of the myocardium associated with hypertension?
a. Increased norepinephrine
b. Adducin
c. Angiotensin II
d. Insulin resistance
4. What pathologic change occurs to the kidney’s glomeruli as a result of hypertension?
a. Compression of the renal tubules
b. Ischemia of the tubule
c. Increased pressure from within the tubule
d. Obstruction of the renal tubule
5. What effect does atherosclerosis have on the development of an aneurysm?
a. Atherosclerosis causes ischemia of the intima.
b. It increases nitric oxide.
c. Atherosclerosis erodes the vessel wall.
d. It obstructs the vessel.
6. Regarding the endothelium, what is the difference between healthy vessel walls and those that promote clot formation?
a. Inflammation and roughening of the endothelium of the artery are present.
b. Hypertrophy and vasoconstriction of the endothelium of the artery are present.
c. Excessive clot formation and lipid accumulation in the endothelium of the artery are present.
d. Evidence of age-related changes that weaken the endothelium of the artery is present.
7. A healthcare professional is caring for four patients. Which patient does the professional assess for pulmonary emboli (PE) as the priority?
a. Deep venous thrombosis
b. Endocarditis
c. Valvular disease
d. Left heart failure
8. Which factor can trigger an immune response in the bloodstream that may result in an embolus?
a. Amniotic fluid
b. Fat
c. Bacteria
d. Air
9. Which statement best describes thromboangiitis obliterans (Buerger disease)?
a. Inflammatory disorder of small- and medium-size arteries in the feet and sometimes in the hands
b. Vasospastic disorder of the small arteries and arterioles of the fingers and, less commonly, of the toes
c. Autoimmune disorder of the large arteries and veins of the upper and lower extremities
d. Neoplastic disorder of the lining of the arteries and veins of the upper extremities
10. A patient has been diagnosed with Raynaud disease and asks for an explanation. What statement by the healthcare professional is best?
a. Inflammatory disorder of small- and medium-size arteries in the feet and sometimes in the hands
b. Neoplastic disorder of the lining of the arteries and veins of the upper extremities
c. Vasospastic disorder of the small arteries and arterioles of the fingers and, less commonly, of the toes
d. Autoimmune disorder of the large arteries and veins of the upper and lower extremities
11. A patient who has lung cancer calls the clinic reports facial and neck swelling severe enough so that shirts no longer fit. What question by the healthcare professional there would be most appropriate?
a. “Have you gained weight recently?”
b. “Are your feet and ankles swollen?”
c. “Does your voice sound hoarse?”
d. “When was your last chemotherapy?”
12. What term is used to identify when a cell is temporarily deprived of blood supply?
a. Infarction
b. Ischemia
c. Necrosis
d. Inflammation
13. A person wishes to reduce the risk of developing coronary artery disease. This person has a normal lipid panel. What risk factor reduction would the healthcare professional advise for this person?
a. Eating a low-fat diet
b. Controlling the blood pressure
c. Avoiding air pollution
d. Moderate alcohol use
14. Nicotine increases atherosclerosis by the release of which neurotransmitter?
a. Histamine
b. Nitric oxide
c. Angiotensin II
d. Epinephrine
15. Which substance primarily contains cholesterol and protein?
a. Very low-density lipoproteins (VLDLs)
b. Low-density lipoproteins (LDLs)
c. High-density lipoproteins (HDLs)
d. Triglycerides
16. Which elevated value may be protective of the development of atherosclerosis?
a. Very low-density lipoproteins (VLDLs)
b. Low-density lipoproteins (LDLs)
c. High-density lipoproteins (HDLs
d. Triglycerides
17. Which laboratory test is an indirect measure of atherosclerotic plaque?
a. Homocysteine
b. Low-density lipoprotein (LDL)
c. Erythrocyte sedimentation rate (ESR)
d. C-reactive protein (CRP)
18. Cardiac cells can withstand ischemic conditions and still return to a viable state for how many minutes?
a. 10
b. 15
c. 20
d. 25
19. A patient reports chest pain that occurs most often during sleep. What treatment does the healthcare professional discuss with the patient?
a. Treatment of obstructive sleep apnea
b. Short-acting nitroglycerin tablets
c. A low-dose aspirin regimen
d. Oral calcium channel blockers
20. A patient who had a myocardial infarction is going to cardiac rehabilitation where progressive exercise is monitored by health care professionals. When would this patient be most vulnerable to injury and complications?
a. Between 5 and 9 days
b. Between 10 and 14 days
c. Between 15 and 20 days
d. Between 20 and 30 days
21. A patient in the Emergency department is suspected of having a myocardial infarction (MI). The initial cardiac troponin 1 level was negative. What action by the healthcare professional is best?
a. Prepare the patient for thrombolytic therapy.
b. Dismiss the patient because the lab was negative.
c. Schedule repeat lab within a few hours.
d. Give the patient oxygen and pain medication.
22. What electrocardiogram (ECG) change would the healthcare professional assess for when a patient’s myocardial infarction extends through the myocardium from the endocardium to the epicardium?
a. Prolonged QT interval
b. ST elevation
c. ST depression
d. Prolonged PR interval
23. How does angiotensin II increase the workload of the heart after a myocardial infarction (MI)?
a. By increasing the peripheral vasoconstriction
b. By causing dysrhythmias as a result of hyperkalemia
c. By reducing the contractility of the myocardium
d. By stimulating the sympathetic nervous system
24. A healthcare provider is assessing a patient who has a pericardial effusion and notes a pulsus paradoxus. A student asks for an explanation of how this occurs. What description by the professional is best?
a. Diastolic filling pressures of the right ventricle and reduction of blood volume in both ventricles
b. Blood ejected from the right atrium and reduction of blood volume in the right ventricle
c. Blood ejected from the left atrium and reduction of blood volume in the left ventricle
d. Diastolic filling pressures of the left ventricle and reduction of blood volume in all four heart chambers
25. A patient reports sudden onset of severe chest pain that radiates to the back and worsens with breathing and when lying down. What action by the healthcare professional is most appropriate?
a. Prepare to assist with an immediate pericardiocentesis.
b. Inform the patient about the side effects of diuretics.
c. Facilitate the patient getting an immediate ECG.
d. Teach the patient about a course of antiinflammatory medications.
26. A disproportionate thickening of the interventricular septum is the hallmark of which form of cardiomyopathy?
a. Dystrophic
b. Hypertrophic
c. Restrictive
d. Dilated
27. Amyloidosis, hemochromatosis, or glycogen storage disease usually causes which form of cardiomyopathy?
a. Infiltrative
b. Restrictive
c. Septal
d. Hypertrophic
28. Which condition is a cause of acquired aortic regurgitation?
a. Congenital malformation
b. Cardiac failure
c. Rheumatic fever
d. Coronary artery disease (CAD)
29. A patient in the clinic reports fever, arthralgia, a rash, and nosebleeds. What other information should the healthcare professional elicit from this patient?
a. Family history of Marfan’s disease
b. History of a recent bacterial infection
c. History of any recent chest trauma
d. Any illnesses in family members
30. What is the most common cause of infective endocarditis?
a. Virus
b. Fungus
c. Bacterium
d. Rickettsiae
31. A patient is diagnosed with chronic obstructive pulmonary disease (COPD) and has elevated pulmonary vascular resistance. Which complication would the health care professional assess the patient for?
a. Right heart failure
b. Left heart failure
c. Restrictive cardiomyopathy
d. Hypertrophic cardiomyopathy
32. What cardiac pathologic condition contributes to ventricular remodeling?
a. Left ventricular hypertrophy
b. Right ventricular failure
c. Myocardial ischemia
d. Contractile dysfunction
33. In systolic heart failure, what effect does the renin-angiotensin-aldosterone system (RAAS) have on stroke volume?
a. Increases preload and decreases afterload
b. Increases preload and increases afterload
c. Decreases preload and increases afterload
d. Decreases preload and decreases afterload
34. What is the cause of the dyspnea resulting from a thoracic aneurysm?
a. Pressure on surrounding organs
b. Poor oxygenation
c. Formation of atherosclerotic lesions
d. Impaired blood flow
35. Which statement is true concerning the cells’ ability to synthesize cholesterol?
a. Cell production of cholesterol is affected by the aging process.
b. Cells produce cholesterol only when dietary fat intake is low.
c. Most body cells are capable of producing cholesterol.
d. Most cholesterol produced by the cells is converted to the low-density form.
36. What is the trigger for angina pectoris?
a. Atherosclerotic lesions
b. Hyperlipidemia
c. Myocardial necrosis
d. Myocardial ischemia
MULTIPLE RESPONSE
1. Which information regarding fatty streaks does the pathophysiology student learn? (Select all that apply.)
a. Fatty streaks progressively damage vessel walls.
b. Fatty streaks are capable of producing toxic oxygen radials.
c. When present, inflammatory changes occur to the vessel walls.
d. Oxidized low-density lipoproteins (LDLs) are involved in their formation.
e. Fatty streaks are formed by killer T cells filled with oxidized LDLs.
2. What factors contribute to the development of orthostatic hypotension? (Select all that apply.)
a. Altered body chemistry
b. Drug action of certain antihypertensive agents
c. Prolonged immobility
d. Effects of aging on postural reflexes
e. Any condition that produces volume overload
3. Which assessment findings would the health care professional correlate with aortic stenosis?
(Select all that apply.)
a. Jugular vein distention
b. Bounding pulses
c. Hypotension
d. Angina
e. Syncope
4. A patient has infective endocarditis. Which risk factors should the healthcare professional assess this patient for? (Select all that apply.)
a. Rheumatic fever
b. Intravenous drug use
c. Prosthetic heart valve
d. Aortic regurgitation
e. Heart valve disease
5. A person wishes to reduce the risk of developing varicose veins. What does the health care professional advise this person? (Select all that apply.)
a. Avoid standing for long periods of time.
b. Maintain a healthy weight.
c. Drink plenty of fluids.
d. Wear compression stockings.
e. Choose a job that involves sitting.
6. A person with diabetes mellitus does not realize that this disease contributes to coronary artery disease and asks the healthcare professional to explain. What information does the professional provide? (Select all that apply.)
a. “High blood glucose directly attacks the heart cells.”
b. “Diabetes is associated with impaired lipid metabolism.”
c. “It can lead to more vasoconstriction in the blood vessels.”
d. “Diabetes can damage the inside of your blood vessel.”
e. “It causes inflammation and cells to clump together in the vessels.”
7. A healthcare professions student learns which facts about mitral valve stenosis? (Select all that apply.)
a. It is an uncommon valvular disorder.
b. It mostly affects women.
c. May result from genetic factors
d. Most cases are asymptomatic.
e. Symptoms tend to be vague.
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