Cardiology Basics Quiz

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Questions and Answers

Which of the following accurately describes the sequence of blood flow through the heart?

Left atrium → mitral valve → left ventricle → aortic valve → pulmonary arteries → lungs → pulmonary veins → right atrium → tricuspid valve → right ventricle → pulmonary valve → aorta

Left atrium → tricuspid valve → left ventricle → pulmonary valve → pulmonary arteries → lungs → pulmonary veins → right atrium → mitral valve → right ventricle → aortic valve → aorta

Right atrium → mitral valve → right ventricle → aortic valve → pulmonary arteries → lungs → pulmonary veins → left atrium → tricuspid valve → left ventricle → pulmonary valve → aorta

Right atrium → tricuspid valve → right ventricle → pulmonary valve → pulmonary arteries → lungs → pulmonary veins → left atrium → mitral valve → left ventricle → aortic valve → aorta (correct)

The myocardium is primarily responsible for which function within the heart?

Facilitating the exchange of oxygen and carbon dioxide.

Contracting to pump blood through the heart. (correct)

Generating the electrical impulses for heart rhythm.

Providing a protective outer layer for the heart.

What is the primary role of the pericardial space in the heart?

To regulate blood flow through the heart.

To reduce friction during heart contractions. (correct)

To provide structural support for the myocardium.

To facilitate electrical impulse transmission.

Which of the listed arteries is NOT part of the left coronary artery system?

Right posterior descending artery (B) Signup and view all the answers

If the sinoatrial (SA) node fails, what is the typical heart rate generated by the atrioventricular (AV) node?

40-60 bpm (C) Signup and view all the answers

What is the primary function of the Purkinje fibers within the heart's conduction system?

To depolarize the ventricles, causing them to contract. (C) Signup and view all the answers

The delay in conduction between the SA and AV nodes is most critical for which process to occur efficiently?

Ensuring the atria and ventricles contract sequentially and not simultaneously. (D) Signup and view all the answers

A patient presents with jugular venous distention (JVD) while their head of bed (HOB) is elevated. What does this finding most directly indicate?

Increased pressure in the right atrium. (C) Signup and view all the answers

A patient with heart failure is prescribed an Angiotensin Receptor-Neprilysin Inhibitor (ARNI). Which of the following is a characteristic of this medication?

It increases BNP levels but does not impact NT-proBNP. (C) Signup and view all the answers

A patient exhibiting signs of digoxin toxicity, including confusion and visual disturbances, is likely to also have which of the following?

Hypokalemia and bradycardia or premature ventricular contractions (PVCs). (D) Signup and view all the answers

During the monitoring of a patient in the ICU with an arterial line, which of these statements about mean arterial pressure (MAP) is most accurate?

A MAP of 65 is typically the minimum target, requiring medication titration. (B) Signup and view all the answers

On a standard electrocardiogram (ECG), what does the ST segment represent?

A neutral period between the completion of ventricular depolarization and the beginning of repolarization. (A) Signup and view all the answers

A client with angina is being discharged. Which behavior should the nurse emphasize as the most important to report?

Any noticeable change in the usual pattern or intensity of their chest pain. (B) Signup and view all the answers

When instructing an outpatient about the purpose of a cardiac stress test, which explanation is most accurate?

It will determine how much physical work your heart can handle. (A) Signup and view all the answers

During an exercise stress test, which finding would be most concerning and require immediate attention?

The presence of ST segment depression on the ECG. (D) Signup and view all the answers

A client is unable to achieve their target heart rate during an exercise stress test. What alternative testing method would most likely be used?

A pharmacologic stress test using medication. (B) Signup and view all the answers

Which of the following symptoms experienced during an exercise stress test would be considered abnormal?

The development of ventricular arrhythmias. (D) Signup and view all the answers

A client with known stable angina is preparing for discharge. The nurse should emphasize that which scenario requires immediate reporting to their healthcare provider?

The client needs to take more nitroglycerin, more frequently, to achieve pain relief. (C) Signup and view all the answers

Which of these is a characteristic of unstable angina?

It manifests as unexpected chest pain, even at rest. (D) Signup and view all the answers

What is the fundamental cause of a myocardial infarction?

A sudden blockage of a coronary artery, leading to cardiac tissue death. (C) Signup and view all the answers

During an exercise stress test, which of these assessments is the nurse least likely to perform?

Assessment of their level of peripheral circulation. (A) Signup and view all the answers

A client is undergoing an exercise stress test. At what point should the test be immediately discontinued?

If the client develops chest pain or significant shortness of breath. (D) Signup and view all the answers

A patient's lab results indicate elevated levels of homocysteine. Which of the following is the most likely contributing factor to this finding?

Deficiency in folate and vitamin B12. (B) Signup and view all the answers

A patient with a history of cardiovascular disease is being assessed for a potential myocardial infarction. Which of the following laboratory values would be most indicative of cardiac muscle damage?

Elevated levels of troponin. (D) Signup and view all the answers

A patient's lipid profile reveals elevated total cholesterol and LDL levels, alongside low HDL levels. Which dietary recommendation is most appropriate?

Increase intake of soluble fiber and decrease refined carbohydrates. (A) Signup and view all the answers

A patient is experiencing chest pain that is relieved with rest and nitroglycerin. Based on this information, which type of angina is the patient most likely experiencing?

Stable angina (B) Signup and view all the answers

Which of the following best describes the mechanism by which atherosclerosis contributes to acute coronary syndrome (ACS)?

Rupture of atherosclerotic plaque, leading to blood flow obstruction. (D) Signup and view all the answers

A patient has an increased risk of cardiovascular disease, specifically related to a hormonal imbalance. Which hormonal change is most likely contributing to this increased risk?

Decreased estrogen levels in postmenopausal women (D) Signup and view all the answers

A patient is admitted with heart rhythm abnormalities. Which of the following electrolyte imbalances is most likely contributing to this condition?

Abnormal levels of potassium and magnesium. (A) Signup and view all the answers

A patient has just been diagnosed with a STEMI. What diagnostic test was most likely used to arrive at this diagnosis?

An EKG showing ST segment elevation. (C) Signup and view all the answers

Which of the following scenarios would most strongly suggest a patient has coronary artery disease?

A biological male over 45 with elevated LDL cholesterol and consistently high blood pressure. (B) Signup and view all the answers

Which of the following best describes afterload?

The resistance the heart must overcome to eject blood during systole. (D) Signup and view all the answers

A patient has a mean arterial pressure (MAP) of 55. Which of the following is the most accurate assessment?

The patient is at risk for inadequate cerebral perfusion. (D) Signup and view all the answers

What formula accurately represents how to calculate stroke volume?

End-diastolic volume - end-systolic volume (C) Signup and view all the answers

What does preload primarily reflect?

The stretch of the cardiac muscle at the end of diastole. (C) Signup and view all the answers

A patient's echocardiogram shows the following: End-diastolic volume (EDV) of 120 mL and end-systolic volume (ESV) of 50 mL. What is the patient's ejection fraction?

Approximately 58% (B) Signup and view all the answers

A patient's ejection fraction is calculated at 30%. Which of the following best describes this finding?

Indication of systolic heart failure (C) Signup and view all the answers

Which of the following is a typical cause of diastolic heart failure?

Impaired ventricular filling due to conditions like fibrosis. (B) Signup and view all the answers

What is the most common cause of right-sided heart failure?

Left-sided heart failure causing back up of blood into the right side. (C) Signup and view all the answers

Which of the following indicates a potential complication related to left-sided heart failure?

Pulmonary congestion and pulmonary edema. (B) Signup and view all the answers

What is a unique characteristic of cor pulmonale, in differentiating it from right sided heart failure caused by left sided heart failure?

It results from pulmonary hypertension, pulmonary fibrosis, or other lung issues. (D) Signup and view all the answers

Study Notes

Cardio A - Blood Flow and Anatomy

Blood enters the right atrium via the superior and inferior vena cava.
It flows through the tricuspid valve to the right ventricle.
Then, it passes through the pulmonary valve into the pulmonary arteries.
These arteries carry deoxygenated blood to the lungs.
In the lungs, CO2 is exchanged for O2.
Oxygenated blood returns to the left atrium via the pulmonary veins.
Next, it passes through the mitral valve to the left ventricle.
The blood then flows through the aortic valve into the aorta.
The aorta distributes blood to the body.

Cardiac Layers

Epicardium: The outermost layer of the heart.
Myocardium: The muscular layer that pumps/contracts the heart.
Endocardium: The inner lining layer of the heart and valves.
Pericardium: The external sac surrounding the heart, made of two layers (visceral against epicardium, parietal surrounding visceral).

Coronary Circulation

Aortic sinuses lead to coronary arteries supplying blood to the heart's tissues.
The right coronary artery supplies the right ventricle, right atrium, SA node, and AV node.
It also extends to the right posterior descending artery.
The left coronary artery supplies the left ventricle, left atrium, and the anterior left side of the heart, extending to the left anterior descending and circumflex arteries.

Conduction System

The SA node (pacemaker) initiates the heartbeat at 60-100 bpm.
The internodal pathway carries the signal to depolarize the atria.
The AV node introduces a delay, allowing the atria to contract completely before ventricular contraction.
This impulse then travels through the bundle of His, left and right bundle branches, and Purkinje fibers.
Finally, the ventricles contract.
The AV node fires at 40-60 bpm if the SA node fails.

Cardiac Enzymes and Electrolytes

Cardiac enzymes (CK, CK-MB, myoglobin, troponin) aid in diagnosing myocardial damage.
Electrolyte imbalances (K+, Mg2+, Ca2+) can impact heart function and rhythms.
Lipid profiles are usually checked to assess risk of atherosclerosis and/or CVD (high LDL, total cholesterol, triglycerides, a low HDL is considered unhealthy)
Other labs related to CVD include C-reactive protein, Homocysteine and NT-proBNP.

Cardiac Stress Testing

Stress tests evaluate the heart's response to physical or pharmacological exertion.
Exercise or medication stress the heart to assess for ischemia and blood flow issues.
A variety of tests are performed to measure blood pressure, heart rate, ECG, skin temperature, physical appearance and/or perceived exertion.

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Description

Test your knowledge on the anatomy and physiology of the heart with this quiz. Questions cover blood flow, the conduction system, and clinical implications related to heart failure and medications. Ideal for students in medical or nursing programs.