HV3 Practice Quiz #1 & 2 PDF

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HV3 practice exam questions from 2020...

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HV3 Practice Quiz #1 1. a) b) c) d)

Compensatory mechanisms that result in hypertension are Increased sympathetic nervous system activity & aldosterone secretion Decreased sympathetic nervous system activity & vasoconstriction Suppression of renin & aldosterone secretion Increased aldosterone secretion & vasodilation

2. Diets high in saturated fat increase the removal of LDLs by body cells a) False b) True 3. a) b) c) d)

A modifiable risk factor of coronary artery disease is: Family history of heart disease Male gender Hypertension Advanced age 60+

4. a) b) c) d)

All of the following factors trigger an increased in renin secretion except: B-Adrenergic inhibitors A drop in BP A drop in blood flow Low potassium concentrations in the plasma

5. ________ regulates systemic blood pressure, renal blood flow & glomerular filtration rate a) Baroreceptors b) Chemoreceptors c) Renin-angiotensin-aldosterone system d) Sympathetic nervous system 6. a) b) c) d)

Diagnostic tool used to determine the location of myocardial damage is ECG Echocardiogram Cardiac catheterisation Pace maker

7. a) b) c) d)

Aetiology (cause) of systolic heart failure includes: Cardiomyopathy Infection Vascular disease All of the above

8. a) b) c) d)

In which group of anti-hypertensive medication is Captopril found? Beta-blockers Angiotensin II receptor blockers Alpha-1 blocker Angiotensin converting-enzyme inhibitor

9. a) b) c) d)

Increased salt intake causes hypertension because it Weight gain Increases intravascular volume Increases sympathetic nervous activity Increase cardiac output

10. In heart failure, the loop-diuretic, Frusemide (Lasix) is used to decrease a) Preload b) Aldosterone release c) Myocardial contractility d) Afterload 11. A biomarker that is released from the myocardium in response to volume or pressure overload is a) Troponin b) B-type Natriuretic peptide c) Creatinine d) C-reactive protein 12. Left-sided heart failure may lead to right-sided heart failure as a result of a) Excessive volume retention b) Poor perfusion of the right coronary artery c) Increased right ventricular afterload d) Arterial hypotension 13. If untreated, a serious complication of hypertension could be a) Diabetes mellitus b) Stroke c) Acute kidney disease d) Retinopathy 14. The QRS complex in the PQRST is described as a) Ventricle relaxation b) Atrial contraction c) Depolarization of the inter ventricular septum d) Ventricle contraction

15. Mechanism of action of Enalapril is to a) Block calcium channels b) Stimulate beta 1 receptors on the myocardium c) Open potassium channels d) Inhibit conversion of angiotensin I into angiotensin II 16. Beta antagonist drugs act to lower BP by a) Increasing sodium & water excretion b) Decreasing cardiac output c) Blocking conversion of angiotensin I to angiotensin II d) Blocking calcium channels in the myocardium 17. The primary determinants of BP are a) Cardiac output & peripheral vascular resistance b) Heart rate & peripheral vascular resistance c) Cardiac output & temperature d) Intravascular volume & peripheral resistance 18. Movement of fluid into the lungs in a patient with heart failure is result of a) Increased osmotic pressure in the pulmonary capillaries b) Decreased osmotic pressure in the pulmonary capillaries c) Increased hydrostatic pressure in the pulmonary capillaries d) Decreased hydrostatic pressure in the capillaries 19. In which area of the heart will an infarction occur if there is an occlusion of the right coronary artery? a) Anterior b) Inferior c) Lateral d) Septal 20. Baroreceptors are a) Located in the aortic arch & carotid arteries b) Cause water retention c) Stimulated by hypoxia d) Stimulated by the low pH 21. Chemoreceptors detect a) An increase in peripheral vascular resistance & blood volume b) Respond to changes in smooth muscle fibre length c) A drop in arterial oxygen concentration or a fall in pH levels d) Drop in BP & blood volume

22. The p-wave on an ECG represents a) The firing of the A-V node & depolarization of the ventricles b) Time taken for the electrical signal to travel through the A-V node c) Depolarization of the intraventricular septum d) The firing of the sino-atrial node & depolarization of the atrium 23. Which of the following best describes Toponin? a) Vasoactive peptide that results in natriuretic, diuresis & vasodilation b) Body’s endogenous defence against hypervolaemia c) An n-terminal pro-btype natriuretic peptide d) Proteins found in skeletal cardiac muscles fibres, regulate contractions 24. Afterload is a) End diastolic volume b) The volume of blood ejected from the left ventricle with each contraction c) The pressure against which the ventricle ejects blood from the heart d) The amount of circulating blood volume in one minute 25. An increase in pulmonary interstitial fluid is likely to manifest as a) Bibasal crackles b) Swollen hands & feet c) HTN d) Oliguria 26. Atrial fibrillation is characterised by which of the following: a) Loss of synchrony in the electrical activity between atria & ventricles b) Cause & consequence of heart failure c) Quivering of the upper chambers at a rate of 300-600 times per minute d) All of the above 27. Clinical manifestations of left-sided heart failure include a) Cyanosis & cough b) Peripheral oedema & orthopnoea c) Hepatomegaly & anorexia d) Oedema of legs & ascites 28. The Circle of Willis is important because it a) Can spasm during cerebral ischaemia & worsen function outcomes b) Decreases blood flow to the brain to reduce swelling & ischaemia c) Is the main site of bleeding in a patient presenting with haemorrhage d) Provides collateral circulation to brain tissue when there is a blockage 29. In which group of anti-hypertensive medication if Captopril found? a) Beta-blockers b) Angiotensin converting-enzyme inhibitor c) Angiotensin II receptor blockers d) Alpha-1 blockers

30. B-type natriuretic peptide (BNP) is a natriuretic peptide that causes a) Decreased SNS activity & decreased hydrostatic pressure b) Increased SNS activity & decreased contractility c) Vasodilation, natriuesis & diuresis d) Increased peripheral vascular resistance & decreased glomerular 31. The most common complication following a myocardial infarction is a) Right ventricular hypertrophy b) Hyperkalaemia c) Left ventricular hypertrophy d) Cardiac dysrhythmia 32. When performing a physical examination on a patient with acute left-sided heart failure, the nurse is likely to find: a) A basal crepitations on auscultation b) Hyper resonance on chest percussion c) Bronchial breath sounds on auscultation d) Trachea shifted from the midline 33. Following a myocardial infarction, the purpose of thrombolysis (streptokinase or tPA) is to: a) Prevent further clots from developing b) Insert a stent into the blocked coronary artery & reestablishes blood flow c) Dissolve clots blocking the coronary artery & reestablishes blood flow d) Bypass the blocked coronary artery & reestablishes blood flow 34. ________ blocks absorption of sodium, chloride & water from, filtered fluid in kidneys & thus increase urine output a) Transdermal Glyceryl Trinitrate b) Captopril c) Bisoprolol d) Furosemide 35. Clinical manifestations of pulmonary embolism include: a) Fever, diarrhoea & lethargy b) Fever, haemoptysis & swollen joints c) Clinical signs of DVT, hypoxia & pain radiation down left arm d) Pleuritic chest pain, tachycardia & hypoxia 36. Which of the following drugs relieve pulmonary congestion by venodilation? a) Morphine b) Transdermal Glyceryl Trinitrate c) Bisoprolol d) Captopril

37. Which class of drugs can decrease oxygen demands on the heart by blocking catecholamines & sympathetic nerve stimulati a) Nitrates b) Calcium channel blockers c) Beta-adrenergic blockers d) Opioids 38. The most likely cause of myocardial ischaemia is a) Occlusion of the coronary artery by a thrombus b) Cardiac tissue necrosis c) Excessive myocardial oxygen demand d) Reduced coronary artery blood flow 39. In evaluating the therapeutic effect of Glyceryl Trinitrate (Anginine) the nurse should monitor for a) Relief of chest pain b) Decreased HR c) An increase in BP d) Fewer cardiac dysrhymias 40. Heparin is a common medication used to prevent venothromboembolism. The mechanism of action of heparin is a) Inhibits the activity of Thrombin b) Inhibits the activity of Factor Xa c) Inhibits the activity of Thrombin & Factor Xa d) Inhibits the activity of platelets 41. You note that your patient’s BP is low. The most likely cause would be a) Reduced stroke volume due to tachycardia b) Increased left-ventricular end-diastolic volume c) Reduced contractility due to myocardial ischaemia d) Increase pulmonary pressure & left-atrial pressure 42. Vagal stimulation of the heart is mediated by a) Adrenaline b) Dopamine c) Glutamine d) Acetylcholine 43. Modifiable risk factors for heart disease could include smoking, a) Diet, being female, & physical activity b) Diet, having diabetes, & physical activity c) Poor diet, lack of exercise & high cholesterol d) Poor diet, a family history of heart disease & high cholesterol

44. Systolic heart failure is characterised by which of the following? a) Structural abnormality or cardiac dysfunction that impairs the LV b) Structural abnormality or cardiac dysfunction that impairs the RV c) Structural abnormality or cardiac dysfunction that impairs the myocardium d) Ascites, peripheral oedema, heptomegaly & JVT 45. Cause of decreased contractility includes which of the following? a) Myocarditis b) Cardiomyopathies c) Ventricular remodelling d) All of the above 46. A common adverse effect of captopril associated with the accumulation of kinins & prostaglandins is: a) Hyperkalemia b) Unproductive cough c) Decreased white cell count d) Increased red blood cell count 47. According to Virchow’s triad, there are 3 possible contributors to clot formation. These are a) Hypocoagulability, major trauma & hyperlipidemia b) Venous stasis, vessel wall injury & hypercoagulability c) Hypertension, high cholesterol & hypercoagulability d) Pelvic fractures, immobilisation & malignancy 48. Preload is characterised by a) End diastolic volume b) End systolic volume c) Aortic valvular function d) Aortic pressure 49. Increased afterload is most commonly a result of increased a) Preload b) Contractility c) Peripheral Vascular Resistance d) End-Diastolic volume 50. A drug used to restore blood flow in patients with ischaemic stroke is a) Glycerol Trinitrate (GTN) b) Salbutamol c) Alteplase (TPA) d) Magnesium sulfate

51. The major goal of treatment in patients presenting with ischaemic stroke is to a) Salvage the penumbra b) Prevent chest infections c) Minimise length of hospital stay d) Reduce deep vein thrombosis 52. During the acute stage of a ruptured intracranial aneurysm the patient will be nursed a) In high fowlers position to promote basal expansion b) In the left lateral position with the bed flat to prevent aspiration c) With the head of the bed elevated 30 degrees to promote venous drainage d) Prone to prevent extension of the haemorrhage 53. Diagnosis of subarachnoid haemorrhage includes a) 6 minute walk test b) Pupillary reaction, Babinski reflex & MRI c) Clinical presentation, CT scan & lumbar puncture d) Arm weakness on the contralateral side, dysphasia & severe head 54. Best indication for the use of Morphine in CHF is: a) Reduce preload, HR & possibly afterload b) Reduce pain associated with CHF c) Inhibits the production of angiotensin II d) To relax both peripheral arteries & veins 55. The functional unit of the kidney is the a) Pyramid b) Glomerulus c) Major calyx d) Nephron 56. Water balance, secretion of toxins, regulation of pH, electrolytes & blood pressure regulation is done by the a) Spleen b) Liver c) Thymus gland d) Kidneys 57. The p-wave on an ECG indicates a) Atrial depolarization b) Ventricular depolarization c) Atrial repolarization d) Ventricular repolarization

58. What type of drug is Amiodarone? a) Antiarrhythmic b) Beta-blocker c) Calcium channel blocker d) ACE inhibitor 59. Which best describes the mechanism of action of Amiodarone? a) A potent vasodilator used to decrease the heart rate b) Relieves pulmonary congestion through venodilation c) Used to treat a wide range of cardiac tachyarrhythmias d) Inhibits the production of angiotensin II 60. Which is not a nursing clinical consideration for the administration of Amiodarone? a) Phlebitis b) Pulmonary function monitoring c) Thyroid functioning monitoring d) Respiratory depression 61. Which of the following group of drug would be most effective in lowering the risk of stroke associated with hypertension a) Anti-platelets b) Antihypertensives c) Statins d) Diuretics 62. Which diagnostic test is used to definitely diagnose heart failure? a) ECG b) Chest x-ray c) Arterial blood gas analysis d) Echocardiogram 63. A patient with hypertension has a) High cholesterol b) A high risk of stroke & heart attack c) A risk of erratic heart beats d) May experience chronic back pain 64. Patient continues to have ventricular ectopic beats. The nurse is concerned with this dysrhythmia because it a) Is uncomfortable for the patient b) Can develop into ventricular fibrillation c) Produces high cardiac output increasing myocardial oxygen demand d) Cannot be converted to a normal sinus rhythm

65. The most common early complication of myocardial infarction is a) Congestive heart failure b) Dysrhythmias c) Cardiogenic shock d) Rupture of the myocardium 66. Alteplase (Cathflo Activase), a tissue plasminogen activator (tPA) is administered to a patient with an acute MI to: a) Restore blood flow to the ischaemic myocardium b) Prevent the formation of blood clots c) Reduce blood pressure that could cause clot rupture d) Repair damaged heart tissue 67. Acute coronary syndromes (ACS) myocardial infarction (MI) & unstable angina (UA) are the result of a) A modifiable life-style factors b) Strong family history of CVD c) Poor diet & lack of exercise d) Transient or permanent occlusion of coronary arteries 68. Which of the following is a significant complication with thrombolytic therapy? a) Air embolus b) Cerebral haemorrhage c) Expansion of the clot d) Resolution of the clot 69. Elevated creatinine levels in chronic kidney disease occur because: a) Decreased glomerular filtration rate b) Excessive creatinine release from muscles c) Sodium & water retention d) Increased glomerular function 70. In end-stage renal disease requiring dialysis, the glomerular filtration rate (GFR) a) Falls to 60-89 mL/min b) Is between 45-59 mL/min c) Is less than 15 mL/min d) Between 30-44 mL/min 71. Erythropoietin is given to patients with CKD because it a) Elevate the white blood cell count b) Enhance maturation of thrombocytes c) Increase the production of platelets d) Stimulate the synthesis of red blood cells

72. Renal Osteodystrophy can be prevented by giving a) Erythropoietin b) Salbutamol c) Methotrexate d) Calcitriol 73. What joint is most likely to have septic arthritis in patients who are intravenous drug users? a) Metacarpal b) Knee c) Mandible d) Sternoclavicular joint 74. Afterload refers to a) The blood remaining in the ventricle after ventricular contraction b) The volume of blood added to the ventricle after atrial systole c) The force the left ventricle must overcome to eject blood d) The percentage of blood ejected during ventricular systole 75. The normal percentage of blood ejected from the ventricle each contraction (ejection fraction) a) 45-50% b) 55-70% c) 90-95% d) 100% 76. In heart failure, the cardiac glycoside, Digoxin (Lanoxin) can be used to increase a) Preload b) Afterload c) Myocardial contractility d) Aldosterone release 77. Patient’s 12 lead ECG indicates STEMI. The first drug that is usually given is a) Aspirin b) Nitroglycerin c) Morphine d) Propanolol 78. The action of nitroglycerin is to a) Slow contraction of the heart b) Increase preload c) Dilate coronary blood vessels d) Strengthen cardiac contractions

79. Initial management of suspected AMI. The action of aspirin is to a) Thin the blood b) Inhibit synthesis of thromboxane thereby preventing platelet aggregation c) Breakdown the clot that is occurring the coronary artery d) Inhibit Vitamin K dependent clotting factors 80. The most common bacteria found from synovial fluid aspiration is a) Propionibacterium acne b) Escherichia coli c) Staphylococcus aureus d) Haemophilus influenzae 81. Risk factors for septic arthritis include a) Young age & history of HIV b) Increased consumption of alcohol & hypocalcaemia c) Immunosuppression, reduction in size of thymus & poor hygiene d) History of IV drug use, Increased alcohol, recurrent skin infections & poor hygiene 82. What pharmacological approach is the most appropriate for patients with septic arthritis? a) Antibiotics b) Analgesia c) Anti-hypertensives d) Corticosteroids 83. Which of the following findings incidcate that the patient is progressing toward septic shock? a) BP 20bpm & elevated CK-MB b) Serum lactate 4mmol/L, SBP 24bpm & BP 150/78mHg 84. If synovial fluid culture has been identified as Methicillin-resistant staphylococcus aureus (MRSA), it would a) Red gram negative stain b) Violet crystalline stain c) Gram crystal violet positive stain d) Red hemochromatosis stain 85. Bacterial seeding can lead to a) Decreased intra-articular pressure & synovial ischaemia b) Dilation of synovial vessels causing synovial tissue becoming oedematous c) Decreased production of the host white blood d) Stimulation of RANK activity & suppression of osteoprotegrin production

86. A compensatory response to a decreased cardiac output is a) Decreased BP & diuresis b) Decreased BP & bradycardia c) Vasoconstriction & fluid retention d) Increased blood pressure & vasodilation 87. Which is a more likely cause for the progression of Atrial Fibrillation? a) Structural & neurohormonal changes in heart failure (Reduced/preserve EF) b) Hypotension c) Underactive thyroid gland or another metabolic imbalance d) Smoking 88. Which system directly contributes to the remodelling of the heart leading to arrhythmias? a) RAAS b) Androgenic system c) Sympathetic nervous system d) Parasympathetic nervous system 89. Which of the following promotes HF through a number of established mechanisms associated with Atrial Fibrillation? a) Impaired LV filling decreasing cardiac output by 25% b) Irregular and/or rapid ventricular conduction leads to LV dysfunction c) Tachycardia-induced myopathy d) All of the above 90. When should oxygen be administered for a person experiencing an acute HF stage? a) Oxygen saturation below 95% b) Oxygen saturation below 94% c) Oxygen saturation below 96% with a patient experiencing dyspnoea d) Oxygen saturation below 98% with a patient experiencing dyspnoea 91. What hormone is useful for the diagnosis of patients with suspected heart failure? a) Aldosterone b) Troponin c) B-Type Natriuretic Peptide d) Adrenaline 92. What is the role of Captopril & Bisoprolol for the long-term management of Chronic Heart Failure? a) Reduce the risk of HF development, hospitalisation & death b) Improve the survival of patients with HF c) Recommended for the treatment of patients with HF with a reduced ejection fraction d) All of the above

93. What is the acronym used to diagnose stroke? a) FACE b) FAST c) MATH d) RACE 94. What is not used to clinically diagnose a stroke? a) Cerebral angiography b) Cerebral CT c) PET scan d) MRI 95. What is the rationale for ordering a Brain imaging (CT/MRI) in an embolic stroke? a) Baseline Hb to detect any sub-clinical bleeding b) To rule out hypoglycaemia c) To determine if there is cerebral ischaemia or intracranial haemorrhage d) To identify any cerebral lesions 96. Which is not an indication that the Right-brain has been damaged from a stroke? a) Special perceptual deficit b) Speech language deficit c) Memory deficit d) Quick impulsive behavioural style 97. Which is not an indication that the Left-brain has been damaged from a stroke? a) Paralysed on the right-hand side b) Paralysed on the left-hand side c) Memory deficit d) Speech language defici...