Cardiac Health and Testing Procedures Quiz
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Questions and Answers

What is the normal range for total cholesterol levels in adults aged 20 years and older?

  • 125-200 mg/dL (correct)
  • 150-250 mg/dL
  • 100-150 mg/dL
  • 200-300 mg/dL

    • Which procedure continuously records the heart's electrical activity over 24 hours?

  • Holter Monitoring (correct)
  • Stress Test
  • Echocardiogram
  • Electrocardiogram (ECG)

    • What preparation is recommended prior to conducting a stress test?

  • Fasting for 8 hours
  • Resting adequately and avoiding smoking, alcohol, and caffeine (correct)
  • Eating a heavy meal before the test
  • Taking medication to increase heart rate

    • What is the primary purpose of an echocardiogram?

    <p>To study structural and functional changes of the heart</p> Signup and view all the answers

    Which of the following is NOT a common type of stress test?

    <p>Holter monitoring</p> Signup and view all the answers

    What is a necessary instruction for a client after a pharmacological stress test?

    <p>Avoid taking a hot shower for 10-12 hours</p> Signup and view all the answers

    What is one of the purposes of cardiac catheterization?

    <p>To assess coronary artery patency</p> Signup and view all the answers

    What should be monitored post-cardiac catheterization at the insertion site?

    <p>A and C only</p> Signup and view all the answers

    Which of these is a side effect of Dipyridamole during a pharmacological stress test?

    <p>Flushing of the face</p> Signup and view all the answers

    What is the normal range for Central Venous Pressure (CVP)?

    <p>2 to 6 mmHg</p> Signup and view all the answers

    What pretest instruction should be given regarding fluid intake before cardiac catheterization?

    <p>No food or fluids for 8-12 hours</p> Signup and view all the answers

    What patient experience should be explained during the intra-test phase of cardiac catheterization?

    <p>A fluttery feeling as the catheter passes</p> Signup and view all the answers

    What condition can elevated Central Venous Pressure (CVP) indicate?

    <p>Increased blood volume</p> Signup and view all the answers

    Which laboratory test is primarily used to assist in the diagnosis of myocardial infarction (MI)?

    <p>Troponin I</p> Signup and view all the answers

    What is the normal range for CK-MB levels in patients?

    <p>5-25 IU/L</p> Signup and view all the answers

    In case of an MI, which pattern is typically observed with Lactic Dehydrogenase (LDH) levels?

    <p>LDH1 greater than LDH2</p> Signup and view all the answers

    What indicates the peak elevation time for Myoglobin after myocardial infarction?

    <p>4-12 hours</p> Signup and view all the answers

    How soon can Troponin I be elevated after myocardial infarction onset?

    <p>Within 3-4 hours</p> Signup and view all the answers

    Which diagnostic test is NOT typically performed when assessing cardiac symptoms?

    <p>Complete Blood Count (CBC)</p> Signup and view all the answers

    Which abnormal heart sound is described as a 'harsh, grating' sound and occurs in both systole and diastole?

    <p>Friction rub</p> Signup and view all the answers

    What is the significance of avoiding intramuscular (IM) injections before obtaining blood samples for cardiac enzyme tests?

    <p>It ensures accurate enzymatic measurements</p> Signup and view all the answers

    Which position should a client be placed in to provide optimal elevation during a cardiac assessment?

    <p>Supine with bed elevated at 45 degrees</p> Signup and view all the answers

    What is the recommended practice for the zero point of the Central Venous Pressure (CVP) line?

    <p>At the level of the right atrium</p> Signup and view all the answers

    Which action is essential for promoting gas exchange in a cardiac patient?

    <p>Positioning client in semi-Fowler's position</p> Signup and view all the answers

    What measure should be taken to minimize patient anxiety during cardiac care?

    <p>Encourage verbalization of feelings and answer questions</p> Signup and view all the answers

    Which of the following interventions is NOT recommended for preventing infection in a cardiac patient?

    <p>Changing position infrequently</p> Signup and view all the answers

    What is the primary purpose of a lipid profile test?

    <p>To analyze serum cholesterol, triglycerides, and lipoprotein levels</p> Signup and view all the answers

    Which statement about Holter monitoring is accurate?

    <p>It records heart activity continuously over 24 hours</p> Signup and view all the answers

    During a stress test, which of the following precautions should be taken before testing?

    <p>The patient should avoid smoking and caffeine</p> Signup and view all the answers

    What is the role of an echocardiogram?

    <p>To assess heart structure and function using ultrasound</p> Signup and view all the answers

    Which type of stress test is most commonly used?

    <p>Treadmill testing</p> Signup and view all the answers

    What is the normal range for heart rate in beats per minute?

    <p>60-100 bpm</p> Signup and view all the answers

    Which system is responsible for increasing heart rate?

    <p>Sympathetic system</p> Signup and view all the answers

    What effect do hormones like ADH and epinephrine have on blood pressure?

    <p>Increase blood pressure</p> Signup and view all the answers

    What is the primary function of the lymphatic system in relation to the vascular system?

    <p>To collect and return excess fluid to blood circulation</p> Signup and view all the answers

    Which of the following is considered a common symptom associated with cardiac issues?

    <p>Chest pain or discomfort</p> Signup and view all the answers

    What are the two types of risk factors in health history assessment related to cardiovascular conditions?

    <p>Non-modifiable and modifiable</p> Signup and view all the answers

    What is the relationship between cardiac output and peripheral resistance?

    <p>Directly proportional</p> Signup and view all the answers

    Which component do baroreceptors monitor to help regulate blood pressure?

    <p>Stretch in arterial walls</p> Signup and view all the answers

    What is the maximum elevation time for CK-MB after a myocardial infarction?

    <p>18 hours</p> Signup and view all the answers

    What abnormal heart sound is associated with turbulent blood flow?

    <p>Murmurs</p> Signup and view all the answers

    What best describes the Troponin I elevation timeline after myocardial infarction?

    <p>Elevates within 3-4 hours and can persist for 7 days to 3 weeks</p> Signup and view all the answers

    Which of the following conditions can lead to elevated myoglobin levels?

    <p>Muscular and renal disease</p> Signup and view all the answers

    What is the typical abnormal LDH pattern observed in myocardial infarction?

    <p>LDH1 greater than LDH2</p> Signup and view all the answers

    What physical examination finding is assessed by palpating the PMI?

    <p>Apical impulse</p> Signup and view all the answers

    Which laboratory procedure is particularly useful in diagnosing myocardial infarction within the first few hours?

    <p>Myoglobin test</p> Signup and view all the answers

    During which phase of heart examination is a thrill most likely to be palpated?

    <p>During palpation</p> Signup and view all the answers

    What is a recommended post-test instruction for a client after a pharmacological stress test?

    <p>Monitor for symptoms of chest pain</p> Signup and view all the answers

    What effects may be experienced during the intra-test phase of cardiac catheterization?

    <p>Fluttery feeling and metallic taste</p> Signup and view all the answers

    Which of the following is NOT part of the pre-test preparation for cardiac catheterization?

    <p>Initiate an intravenous line</p> Signup and view all the answers

    What should be monitored at the insertion site after cardiac catheterization?

    <p>Color and warmth of the extremity</p> Signup and view all the answers

    What can low Central Venous Pressure (CVP) indicate?

    <p>Hypovolemia</p> Signup and view all the answers

    What is one reason to maintain bed rest after cardiac catheterization?

    <p>To ensure the insertion site heals properly</p> Signup and view all the answers

    What dietary instruction should patients follow before a pharmacological stress test?

    <p>Fast for 4 hours</p> Signup and view all the answers

    Which layer of the heart is primarily responsible for its muscular contraction?

    <p>Myocardium</p> Signup and view all the answers

    What structure in the cardiovascular system acts as the primary pacemaker of the heart?

    <p>SA Node</p> Signup and view all the answers

    What is the function of the coronary arteries?

    <p>Supply oxygenated blood to the heart muscle</p> Signup and view all the answers

    Which heart sound is associated with the closure of the atrioventricular valves?

    <p>S1</p> Signup and view all the answers

    What is the role of the pericardial space?

    <p>Contains fluid that reduces friction during heartbeats</p> Signup and view all the answers

    Which artery supplies blood to the posterior left ventricle?

    <p>Circumflex artery</p> Signup and view all the answers

    Which part of the conduction system has the slowest conduction speed?

    <p>AV Node</p> Signup and view all the answers

    How many chambers does the heart contain?

    <p>Four</p> Signup and view all the answers

    Study Notes

    Nursing Board Review - Cardiovascular System

    • The heart is located in the center of the thorax.
    • The heart has three layers: epicardium, myocardium, and endocardium.
    • The epicardium covers the outer surface of the heart.
    • The myocardium is the middle muscular layer of the heart.
    • The endocardium lines the chambers and valves of the heart.
    • The pericardium is the layer that covers the heart.
    • The pericardium has two parts: parietal and visceral pericardium.
    • The pericardial space is the space between the two pericardial layers.
    • The heart has four chambers: two atria and two ventricles.
    • The left atrium and the right atrium receive blood.
    • The left ventricle and the right ventricle pump blood.
    • The heart chambers are guarded by valves.
    • The atrioventricular valves are the tricuspid and bicuspid valves.
    • The semilunar valves are the pulmonic and aortic valves.
    • The coronary arteries supply blood to the heart.
    • The right coronary artery supplies the right atrium and ventricle, as well as the inferior portion of the left ventricle and posterior septal wall.
    • The left coronary artery supplies the anterior wall of the left ventricle, the anterior septum, and the apex of the left ventricle.
    • The left circumflex branch supplies the left atrium and posterior left ventricle.
    • The conduction system of the heart consists of the SA node, AV node, bundle of His, right and left bundle branches, and Purkinje fibers.
    • The SA node is the pacemaker.
    • The AV node is the slowest conduction.
    • The SA node initiates the heartbeat.
    • The bundle of His is the pathway for electrical impulses from the AV to to the bundle branches.
    • The bundle branches carry the electrical impulses through the ventricles.
    • The Purkinje fibers are the fastest conduction.
    • The heart sounds (S1 and S2) are due to the closure of heart valves.
      • S1 is the closure of the atrioventricular valves (tricuspid and mitral).
      • S2 is the closure of the semilunar valves (pulmonic and aortic).
    • S3 is due to increased ventricular filling.
    • S4 is due to forceful atrial contraction.
    • Normal heart rate is 60-100 beats per minute.
    • Tachycardia is a heart rate greater than 100 bpm.
    • Bradycardia is a heart rate less than 60 bpm.
    • The sympathetic system increases heart rate.
    • The parasympathetic system (vagus) decreases heart rate.
    • Blood pressure is controlled by cardiac output and peripheral resistance.
    • Baroreceptors in the carotid and aorta detect blood pressure changes.
    • Hormones like ADH, aldosterone, and epinephrine increase blood pressure.
    • ANF decreases blood pressure.
    • The vascular system consists of arteries, veins, and capillaries.
    • Arteries carry blood away from the heart.
    • Veins carry blood to the heart.
    • Capillaries connect arteries and veins, and are lined with squamous cells.
    • The lymphatic system is part of the vascular system.
    • The lymphatic system collects extravasated fluid from tissues and returns it to the blood.

    Cardiac Assessment

      1. Health History
      • Obtain a description of the present illness and chief complaint (e.g., chest pain, shortness of breath, edema).
      • Assess risk factors (e.g., ethnic background, socioeconomic status).
    • Common Symptoms
      • Chest pain/discomfort, pain/discomfort in other upper body areas, shortness of breath, peripheral edema, weight gain, abdominal distention, palpitations, unusual fatigue, dizziness, syncope.

    Assessment of the Skin and Extremities (detailed)

    • Physical findings
      • Clubbing of the fingers or toes — Thickening of skin under the fingers/toes; may indicate chronic pulmonary diseases, congenital heart disease, etc.
      • Cool/cold skin and diaphoresis — A sign of decreased peripheral blood flow or low cardiac output (like in shock).
      • Cold, pain, pallor of the fingertips or toes — A symptom associated with Raynaud disease (intermittent arteriolar vasoconstriction).
      • Cyanosis (central or peripheral) — Bluish tinge of the skin. Central cyanosis points to issues with oxygenation in the heart; while peripheral cyanosis arises because venous blood stagnates while circulating through the periphery.
      • Ecchymosis or bruising — Purplish-blue discoloration fading to various colors. This could be due to blood leaking outside blood vessels
      • Edema — Swelling due to fluid accumulation; often in the lower extremities.
      • Hematoma — Collection of clotted blood in tissues.
      • Generalized pallor — Decreased skin color; may point to anemia, shock, or low cardiac output..
      • Rubor — Reddish-blue discoloration of extremities. Observed after elevation for a few seconds; usually associated with arterial perfusion issues.

    Cardiac Implementation

      1. Assess cardiopulmonary status (VS, BP, cardiac assessment)
      1. Enhance cardiac output (establish IV line to administer fluids)
      1. Promote gas exchange (administer O2, position client in semi-Fowler's, encourage coughing and deep breathing exercises).
      1. Increase client activity tolerance (balance rest and activity, assist in daily activities).
      1. Promote client comfort (assess pain, administer medications).
      1. Promote adequate sleep
      1. Prevent infection (monitor skin, assess skin site, monitor fever, change patient's position)
      1. Minimize patient anxiety (encourage verbalization, answer questions, provide information about procedures and medications)

    Laboratory Procedures (detailed)

    • Cardiac Catheterization

      • Insertion of a catheter into the heart and surrounding vessels.
      • Used to diagnose CAD, assess coronary artery patency, determine extent of atherosclerosis.
      • Pretest requirements: consent, allergy assessment (seafood, iodine), NPO, weight, height, baseline VS, blood tests, peripheral pulse documentation.
      • Intra-test: inform patient of possible fluttering feelings, warmth, and metallic taste if dye is used.
      • Post-test: monitor VS, cardiac rhythm, peripheral pulses, color, warmth and sensation of the extremity distal to the insertion site, maintain sandbag, monitor bleeding/hematoma.
      • Posttest instructions: maintain strict bedrest for 6-12 hours, turn from side to side, but not elevate more than 30 degrees; legs always straight, and encourage fluid intake to flush out dye. Monitor also for dye allergy

    • Cardiac Proteins & Enzymes:

      • CK-MB (creatin kinase): Elevates during MI within 4 hours, peaks in 18 hours, and then declines to normal values in 3 days. Normal value – 5-25 IU/L.
      • LDH (Lactate Dehydrogenase): Elevates within 24 hours of MI; peaks in 48-72 hours. Normal LDH1 is less than LDH2 values. (flipped LDH pattern) — Normal value is 70-200 IU/L.
      • Myoglobin: Rises within 1-3 hours of MI, peaks in 4-12 hours, and returns to normal within a day. (Also elevated in muscular/renal disease)
      • Troponin I & T: Used frequently for MI diagnosis; elevates within 3-4 hours of onset, peaks in 4-24 hours, and persists for 7-3 weeks. Normal value for Troponin I is less than 0.04 ng/mL.

    • Serum Lipids:

      • Lipid profile - measures cholesterol, triglycerides, and lipoprotein levels. Cholesterol values are 125-200 mg/dL for ages 20 and older; and triglycerides are 40-150 mg/dL; HDL = 30-70 mg/dL; and LDL< 100 mg/dL. NPO is required usually for 12 hours after midnight.

    • ECG (Electrocardiogram)

      • Non-invasive procedure to assess electrical activity of the heart; electrodes & wires attached to patient.

    • Stress Test

      • Treadmill testing - most common stress test used to determine CAD, chest pain causes, drug effects and dysrhythmias in exercise;
      • Pharmacologic stress test - Uses medication (e.g., Dipyridamole) to evaluate blood flow in the heart, including coronary arteries (which are often maximally dilated.) Side effect often involves skin flushing.
      • Pretest/Post-test instructions for stress tests

    • Holter Monitoring

      • Non-invasive ECG monitoring of a patient over 24 hours.
      • Pre-test/Post-test instructions for this test.

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    Cardiovascular System - Nursing Board Review PDF

    Description

    Test your knowledge on cardiac health topics, including cholesterol levels, stress tests, echocardiograms, and catheterization. This quiz covers important preparation steps, monitoring procedures, and understanding of various tests related to heart health. Perfect for students and professionals in the medical field.

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