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?

<p>Right posterior descending artery (B)</p> Signup and view all the answers

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

<p>40-60 bpm (C)</p> Signup and view all the answers

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

<p>To depolarize the ventricles, causing them to contract. (C)</p> 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?

<p>Ensuring the atria and ventricles contract sequentially and not simultaneously. (D)</p> 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?

<p>Increased pressure in the right atrium. (C)</p> 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?

<p>It increases BNP levels but does not impact NT-proBNP. (C)</p> 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?

<p>Hypokalemia and bradycardia or premature ventricular contractions (PVCs). (D)</p> 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?

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

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

<p>A neutral period between the completion of ventricular depolarization and the beginning of repolarization. (A)</p> 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?

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

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

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

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

<p>The presence of ST segment depression on the ECG. (D)</p> 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?

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

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

<p>The development of ventricular arrhythmias. (D)</p> 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?

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

Which of these is a characteristic of unstable angina?

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

What is the fundamental cause of a myocardial infarction?

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

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

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

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

<p>If the client develops chest pain or significant shortness of breath. (D)</p> 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?

<p>Deficiency in folate and vitamin B12. (B)</p> 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?

<p>Elevated levels of troponin. (D)</p> 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?

<p>Increase intake of soluble fiber and decrease refined carbohydrates. (A)</p> 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?

<p>Stable angina (B)</p> Signup and view all the answers

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

<p>Rupture of atherosclerotic plaque, leading to blood flow obstruction. (D)</p> 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?

<p>Decreased estrogen levels in postmenopausal women (D)</p> 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?

<p>Abnormal levels of potassium and magnesium. (A)</p> 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?

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

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

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

Which of the following best describes afterload?

<p>The resistance the heart must overcome to eject blood during systole. (D)</p> 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?

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

What formula accurately represents how to calculate stroke volume?

<p>End-diastolic volume - end-systolic volume (C)</p> Signup and view all the answers

What does preload primarily reflect?

<p>The stretch of the cardiac muscle at the end of diastole. (C)</p> 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?

<p>Approximately 58% (B)</p> Signup and view all the answers

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

<p>Indication of systolic heart failure (C)</p> Signup and view all the answers

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

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

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

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

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

<p>Pulmonary congestion and pulmonary edema. (B)</p> 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?

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

Flashcards

Epicardium

The external layer of the heart.

Myocardium

The muscular layer of the heart responsible for contraction.

Endocardium

The inner lining of the heart, including the valves, composed of epithelial tissue.

Interventricular Septum

A thick wall separating the right and left ventricles.

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Pericardium

The sac surrounding the heart, consisting of two layers: visceral and parietal.

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Pericardial Space

The space between the visceral and parietal layers of the pericardium, containing about 20 ml of fluid to prevent friction.

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SA Node

The natural pacemaker of the heart, located in the right atrium, responsible for the rhythm.

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Atherosclerosis

The buildup of plaque within the coronary artery that can worsen over time, potentially blocking the vessel or causing a blood clot.

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Lipid Profile

A series of tests to assess a person's cardiovascular health, including levels of LDL, HDL, total cholesterol, and triglycerides.

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C-reactive Protein

A marker of inflammation in the body, particularly associated with atherosclerosis in blood vessels.

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Brain Natriuretic peptide (BNP)

A hormone released primarily by the heart in response to stretching of the heart chambers, commonly used to assess heart failure.

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Troponin

The enzyme released by damaged heart muscle cells, used as a marker for heart attack.

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Homocysteine

An amino acid that can contribute to inflammation and damage to the endothelial layer of blood vessels, increasing the risk of atherosclerosis.

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High LDL Cholesterol

A critical risk factor for coronary artery disease. It is associated with low levels of HDL cholesterol and high total cholesterol levels.

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Hypertension

A critical risk factor for coronary artery disease, characterized by persistently elevated blood pressure.

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Diabetes

A condition where the body cannot effectively regulate blood sugar levels leading to increased risk of CVD.

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Stable Angina

Chest pain that occurs during exercise and resolves with rest or nitroglycerin.

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Unstable Angina

Chest pain that occurs unexpectedly, even at rest, often caused by narrowed coronary arteries (atherosclerosis).

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Myocardial Infarction (MI)

A blockage in a coronary artery leading to death of heart tissue.

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Cardiac Stress Test

A test to assess the heart's ability to tolerate a workload, often used to diagnose angina and other cardiovascular conditions.

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Exercise Stress Test

A type of cardiac stress test that involves walking or running on a treadmill or stationary bike.

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Pharmacologic Stress Test

A type of cardiac stress test that uses medication to simulate exercise, used for people who cannot exercise sufficiently.

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Pain Following Sexual Activity

Pain that occurs following sexual activity.

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Pain After Large Meal

Pain that occurs after eating a large meal.

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Change in Character of Pain

A change in the character of chest pain.

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Headache After Nitroglycerin

A headache after taking nitroglycerin.

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Hemodynamics

The study of how blood circulates through the body's vessels.

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Cardiac Output

The amount of blood ejected by the ventricles each minute, calculated as stroke volume (SV) multiplied by heart rate (HR).

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Afterload

The pressure the heart must overcome during systole to pump blood out of the ventricles. It's influenced by blood pressure and vessel constriction.

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End-diastolic Volume (EDV)

The amount of blood in the ventricles at the end of diastole (the 'full' state).

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Stroke Volume (SV)

The amount of blood ejected with each heartbeat. Calculated as end-diastolic volume minus end-systolic volume.

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Ejection Fraction

The percentage of blood ejected from the heart with each contraction.

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Preload

The stretch of the myocardium at the end of diastole (the 'full' state). It's influenced by blood volume.

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Echocardiogram

An ultrasound imaging technique used to visualize the heart and vessels.

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Heart Failure

A clinical syndrome where the heart cannot pump enough blood to meet the body's needs.

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Systolic Heart Failure

Type of heart failure where the ejection fraction is reduced (less than 40%) due to decreased contractility or increased afterload.

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Mean Arterial Pressure (MAP)

A measurement of the pressure in the arteries during a heartbeat cycle, reflecting the workload on the heart.

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ACE-I or ARBs

A group of medications addressing the renin-angiotensin-aldosterone system (RAAS) to manage high blood pressure and improve heart health.

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Central Venous Pressure (CVP)

The pressure in the right atrium that reflects the preload (blood volume) in the heart.

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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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