In patients with congestive heart failure, ace inhibitor drugs are useful because they: quizlet

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Terms in this set (105)

Uncontrolled hypertension is most likely to cause ischemia and loss of function in the

kidneys, brain & retinas of the eye

Confirmation of the diagnosis of a myocardial infarction would include
1. specific changes in the ECG.
2. marked leukocytosis and increased erythrocyte sedimentation rate (ESR).
3. elevation of cardiac isoenzymes in serum.
4. a pattern of pain.

1, 3

A very rapid heart rate reduces cardiac output because

ventricular filling is reduced

Prophylactic antibacterial drugs such as amoxicillin are given to patients with certain congenital heart defects or damaged heart valves immediately before invasive procedures to prevent

infectious endocarditis

Atherosclerosis in the iliac or femoral arteries is likely to cause which of the following?
1. Gangrenous ulcers in the legs
2. Strong rapid pulses in the legs
3. Intermittent claudication
4. Red, swollen legs

1, 3

Unoxygenated blood enters the systemic circulation in children with tetralogy of Fallot because

pulmonary stenosis changes the ventricular pressures

A prolonged period of shock is likely to cause

damage to, and increased permeability of, pulmonary capillaries

A drug taken in small doses on a continuing basis to reduce platelet adhesion is

acetylsalicylic acid (ASA)

Which of the following causes increased heart rate?

stimulation of the sympathetic nervous system

A dissecting aortic aneurysm develops as

a tear in the intimal lining, which allows blood flow between layers of the aortic wall

In an infant, the initial indication of congestive heart failure is often

feeding problems

The most common factor predisposing to the development of varicose veins is

increased venous pressure

A common adverse effect of many antihypertensive medications is

orthostatic hypotension

Cyanosis occurs in children with tetralogy of Fallot because

a large amount of hemoglobin in the general circulation is unoxygenated

Pericarditis may be caused by
1. infection.
2. abnormal immune responses.
3. injury.
4. malignant neoplasm.

1, 2, 3, 4

Septic shock is frequently caused by infections involving

gram-negative endotoxin-producing bacteria

Common signs of rheumatic fever include all of the following except

arthritis, causing deformity of the small joints in the hands and feet

More extensive permanent damage is likely when a myocardial infarction is caused by

an embolus

Why does anaphylactic shock cause severe hypoxia very quickly?

Bronchoconstriction and bronchial edema reduce airflow

A partial obstruction in a coronary artery will likely cause

angina attacks

What would indicate decompensated acidosis related to shock?

serum pH below normal range

The basic pathophysiology of myocardial infarction is best described as

total obstruction of a coronary artery, which causes myocardial necrosis

The term cardiac arrest refers to which of the following?

the cessation of all cardiac function

A modifiable factor that increases the risk for atherosclerosis is

leading a sedentary lifestyle

Which of the following is considered to be the most dangerous arrhythmia?

ventricular fibrillation

When stroke volume decreases, which of the following could maintain cardiac output?

increased heart rate

What are the early signs of circulatory shock?
1. Pale moist skin
2. Loss of consciousness
3. Anxiety and restlessness
4. Rapid strong pulse

1, 3

The right side of the heart would fail first in the case of
1. severe mitral valve stenosis.
2. uncontrolled essential hypertension.
3. large infarction in the right ventricle
.4. advanced chronic obstructive pulmonary disease (COPD)

3, 4

Excessive fluid in the pericardial space causes

reduced venous return

Which of the following describes the pericardial cavity?

it is a potential space containing a very small amount of serous fluid

A compensation for shock would include

increased heart rate and oliguria

Factors that may precipitate an angina attack include all of the following except

taking a nap

Which of the following describes the blood flow occurring with a ventricular septal defect?

from the left ventricle to the right ventricle

Which of the following factors greatly improves venous return to the heart during strenuous exercise?

contraction & relaxation of skeletal muscle

An atheroma develops from

accumulated lipids, cells, and fibrin where endothelial injury has occurred

Typical early signs or symptoms of myocardial infarction include

persistent chest pain radiating to the left arm, pallor, and rapid, weak pulse

In patients with congestive heart failure, ACE inhibitor drugs are useful because they

reduce renin & aldosterone secretion

The function of the baroreceptors is to

signal the cardiovascular control center of changes in systemic blood pressure

The normal delay in conduction through the AV node is essential for

completing ventricular filing

When comparing angina with myocardial infarction (MI), which statement is true?

Angina pain is relieved by rest and intake of nitroglycerin; the pain of MI is not

Septic emboli, a common complication of infective endocarditis, are a result of the fact that

vegetations are loosely attached and fragile

The most common cause of death immediately following a myocardial infarction is

cardiac arrhythmias & fibrillation

Which of the following applies to subacute infective endocarditis?

A microbe of low virulence attacks abnormal or damaged heart valves

The term arteriosclerosis specifically refers to

degeneration with loss of elasticity and obstruction in small arteries

Shock follows a myocardial infarction when

A large portion of the myocardium is damaged

The cause of essential hypertension is considered to be

idiopathic

Pericarditis causes a reduction in cardiac output as a result of which of the following?

Excess fluid in the pericardial cavity, which decreases ventricular filling

In the period immediately following a myocardial infarction, the manifestations of pallor and diaphoresis, rapid pulse, and anxiety result from

onset of circulatory shock

Calcium-channel blocking drugs are effective in

reducing cardiac and smooth muscle contractions

The initial effect on the heart in cases of rheumatic fever is

acute inflammation in all layers of the heart due to abnormal immune response

Significant signs of right-sided congestive heart failure include

edematous feet & legs w hepatomegaly

An incompetent mitral valve would cause

decreased output from the left ventricle

Which of the following compensations that develop in patients with congestive heart failure eventually increase the workload of the heart?

(A, B, C)
faster heart rate & cardiomegaly
peripheral vasoconstriction
increased secretion of renin

Which factor predisposes to varicose veins during pregnancy?

compressed pelvic veins

Neurogenic (vasogenic) shock results from systemic vasodilation due to

increased capacity of the vascular system & reduced venous return

Why does ventricular fibrillation result in cardiac arrest?

insufficient blood is supplied to the myocardium

Compensation mechanisms for decreased cardiac output in cases of congestive heart failure include

increased renin & aldosterone secretions

The term intermittent claudication refers to

ischemic muscle pain in the legs, particularly with exercise

Which of the following are predisposing factors to thrombus formation in the circulation?
1. Decreased viscosity of the blood
2. Damaged blood vessel walls
3. Immobility
4. Prosthetic valves

2, 3, 4

Varicose ulcers may develop and be slow to heal because

edema reduces arterial blood supply to the area

The most common cause of a myocardial infarction is

artherosclerosis involving an attached thrombus

The cardiac reserve is

the ability of the heart to increase cardiac output when needed

Rheumatic heart disease usually manifests in later years as

cardiac arrhythmias & heart murmurs

The first arteries to branch off the aorta are the

coronary arteries

Which of the following is NOT true of the drug nitroglycerin?

it strengthens the myocardial contraction

Effects that may be expected from a beta-adrenergic blocking drug include

decreased sympathetic stimulation of the heart

Heart block, in which a conduction delay at the AV node results in intermittent missed ventricular contractions, is called

second-degree block

In which blood vessels will failure of the left ventricle cause increased hydrostatic pressure?

pulmonary capillaries

The term premature ventricular contraction refers to the condition where

additional contractions arise from ectopic foci in the ventricular muscle

Phlebothrombosis is more likely to cause pulmonary emboli than is thrombophlebitis because

thrombus forms in a vein & is less firmly attached

Aortic stenosis means the aortic valve

cannot fully open during systole

Paroxysmal nocturnal dyspnea is marked by

hemoptysis and rales

Shock is defined as

decreased circulating blood and tissue perfusion

When is a diagnosis of essential hypertension likely to be considered in young or middle-aged individuals?

blood pressure remains consistently above 140/90

Which of the following confirms the presence of a myocardial infarction?

Serum isoenzymes released from necrotic cells and an ECG

In a child with acute rheumatic fever, arrhythmias may develop due to the presence of

myocarditis

An echocardiogram is used to demonstrate any abnormal

movement of the heart valves

The definition of congestive heart failure is

inability of the heart to pump enough blood to meet the metabolic needs of the body

Vasodilation in the skin and viscera results directly from

relaxation of smooth muscle in the arterioles

Which of the following is most likely to cause left-sided congestive heart failure?

uncontrolled essential hypertension

In a child with ventricular septal defect, altered blood flow

is called a left-to-right shunt

A friction rub is associated with

pericarditis

A sign of aortic stenosis is

heart murmur

Which statement applies to paroxysmal nocturnal dyspnea?

It is caused by increased blood in the lungs when lying in a supine position

The basic pathophysiological change associated with essential hypertension is

increased systemic vasoconstriction

Which of the following is a result of increased secretion of epinephrine?

Increased heart rate and force of contraction

Cardiac output refers to

volume of blood ejected by a ventricle in one minute

Septic shock differs from hypovolemic shock in that it is frequently manifested by

fever & flushed face

Which of the following drugs decreases sodium and fluid retention in the body?

hydrochlorothiazide (HydroDIURIL)

Which of the following statements regarding aneurysms is true?

Manifestations of aneurysms result from compression of adjacent structures

With shock, anaerobic cell metabolism and decreased renal blood flow cause

metabolic acidosis

The term preload refers to

volume of venous return

The event that causes the QRS wave on an electrocardiogram (ECG) tracing is

ventricular depolarization

A source of an embolus causing an obstruction in the brain could be the

carotid artery

The size of the necrotic area resulting from myocardial infarction may be minimized by all of the following except

removing the predisposing factors to atheroma development

Shock develops in patients with severe burns as a result of

pain & loss of plasma

The outcome for many aortic aneurysms is

rupture & hemorrhage

A cardiac pacemaker would most likely be inserted in cases of

heart block

Which change results from total heart block?

spontaneous slow ventricular contractions, not coordinated with atrial contraction

Which of the following drugs improves cardiac efficiency by slowing the heart rate and increasing the force of cardiac contractions?

digoxin

The classic early manifestation(s) of left-sided congestive heart failure is/are ____, whereas the early indicator(s) of right-sided failure is/are _______

shortness of breath on exertion or lying down; swelling of the ankles

What is the primary reason for amputation of gangrenous toes or feet in patients with peripheral vascular disease?

It prevents spread of infection and reduces pain.

Low-density lipoproteins (LDL)

promote atheroma development

Cigarette smoking is a risk factor in coronary artery disease because smoking

promotes platelet adhesion

Which of the following actions causes the atrioventricular (AV) valves to close?

increased intraventricular pressure

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