Chapter 18: Alterations in Cardiac Function

Chapter 18: Alterations in Cardiac Function

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE
1. The most reliable indicator that a person is experiencing an acute myocardial infarction (MI) is
a. severe, crushing chest pain.
b. ST-segment elevation.
c. dysrhythmias.
d. pain radiating to the lower legs.
ANS: B
Injuries to cardiac tissue caused by myocardial ischemia and infarction are indicated on the ECG by ST-segment changes.
ST-segment elevation on the ECG indicates that ischemic injury is ongoing and that efforts to improve perfusion or reduce oxygen
demand may be effective in preserving myocardial muscle. In some instances, an MI is entirely asymptomatic. Dysrhythmiasthat
accompany MI are attributed to injured and ischemic cells that have not yet become necrotic. Pain radiating to the jaw and neck, not
the lower legs, is symptomatic of an MI.
REF: Pg. 388
2. Primary treatment for myocardial infarction (MI) is directed at
a. protecting the heart from further ischemia.
b. decreasing myocardial oxygen demands.
c. reducing heart rate and blood pressure.
d. activating the parasympathetic system.
ANS: B
Reducing oxygen demand may be effective in preserving myocardial muscle. Decreasing demand increases myocardial oxygen
supply. Once the cardiac muscle has been damaged, it is more important to preserve remaining muscle and prevent further loss of
the myocardium. Reduction in the heart rate and blood pressure is not the primary treatment goal in MI care. Parasympathetic
activation is not the primary treatment for myocardial infarction.
REF: Pg. 390
3. Rheumatic heart disease is most often a consequence of
a. chronic intravenous drug abuse.
b. viral infection with herpes virus.
c. -hemolytic streptococcal infection.
d. cardiomyopathy.
ANS: C
Rheumatic heart disease is an uncommon but serious consequence of rheumatic fever. Rheumatic fever is an acute inflammatory
disease that follows infection with group A -hemolytic streptococci. Rheumatic heart disease is not associated with chronic IV
drug abuse. Rheumatic fever is an acute inflammatory infectious disease. Cardiomyopathy does not cause rheumatic heart disease.
REF: Pg. 395
4. Patients presenting with symptoms of unstable angina and no ST segment elevation are treated with
a. cardiac catheterization.
b. antiplatelet drugs.
c. acute reperfusion therapy.
d. cardiac biomarkers only.
ANS: B
Patients presenting with symptoms of unstable angina and no ST elevation on the ECG would be treated with antiplatelet drugs as a
cornerstone of therapy. Coronary angiography may be used as an additional method of diagnosis but would not be the primary
option. The patient with symptoms of unstable angina would not benefit from reperfusion strategies. Cardiac biomarkers may be
assessed in the unstable angina patient, but are not the primary indicator.
REF: Pg. 386
5. An example of an acyanotic heart defect is
a. tetralogy of Fallot.
b. transposition of the great arteries.
c. ventricular septal defect.
d. all right-to-left shunt defects.
ANS: C
An example of an acyanotic heart defect is a ventricular septal defect. In this condition, blood from the left ventricle leaks into the
right ventricle due to a defect in the ventricular wall. This leakage causes extra pressure in the right ventricle resulting in pulmonary
hypertension. Tetralogy of Fallot is a cyanotic congenital defect. Transposition of the great vessels is a cyanotic congenital defect.
The category of cyanotic congenital defects refers to those that are right-to-left shunts.