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In auscultating over a peripheral artery, what sound would suggest obstruction of the artery?
- A. Dullness
- B. Tympany
- C. Bruit
- D. Vibrations
Correct Answer: C
Rationale: A bruit is an abnormal sound heard over an artery due to turbulent blood flow, often indicating partial obstruction.
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The most realistic discharge goal for Mrs. G., with a history of compensated congestive heart failure, is
- A. Knowledge of illness and treatment
- B. Absence of signs of congestive failure
- C. Total decompensation for failure
- D. Avoidance of all stress
Correct Answer: B
Rationale: Achieving stability is a practical goal.
Which condition is characterized by an inability to effectively pump blood, leading to fluid buildup and swelling in the body?
- A. Heart failure
- B. Cardiomyopathy
- C. Angina
- D. Myocarditis
Correct Answer: A
Rationale: Step 1: Heart failure is characterized by the heart's inability to effectively pump blood, leading to fluid buildup and swelling.
Step 2: Cardiomyopathy is a disease of the heart muscle, which may contribute to heart failure but is not the direct cause of fluid buildup.
Step 3: Angina is chest pain due to reduced blood flow to the heart, not directly related to fluid buildup.
Step 4: Myocarditis is inflammation of the heart muscle, which can lead to heart failure but is not the primary cause of fluid accumulation.
Summary: Heart failure is the correct answer as it directly relates to the inability of the heart to pump blood effectively, leading to fluid accumulation. Cardiomyopathy, angina, and myocarditis are related to heart health but do not directly cause fluid buildup in the body.
Which of the following is a central vasodilator and peripheral vasoconstrictor?
- A. Sympathetic nervous system
- B. Parasympathetic nervous system
- C. Norepinephrine
- D. Acetylcholine
Correct Answer: A
Rationale: The correct answer is A: Sympathetic nervous system. The sympathetic nervous system releases norepinephrine, which acts as a central vasodilator by dilating blood vessels in the heart and skeletal muscles. It also acts as a peripheral vasoconstrictor by constricting blood vessels in other areas to redirect blood flow to vital organs during fight-or-flight responses.
B: Parasympathetic nervous system is incorrect as it primarily promotes rest and digestion, not vasodilation or vasoconstriction.
C: Norepinephrine is incorrect as it acts as a peripheral vasoconstrictor, not a central vasodilator.
D: Acetylcholine is incorrect as it primarily functions in the parasympathetic nervous system and is not associated with central vasodilation or peripheral vasoconstriction.
At 9:00 pm, you admit a 63-year-old with a diagnosis of acute myocardial infarction (AMI) to the ED. The physician is considering the use of fibrinolytic therapy with tissue plasminogen activator (tPA, alteplase). Which information is most important to communicate to the physician?
- A. The patient was treated with alteplase about 8 months ago.
- B. The patient takes famotidine (Pepcid) for esophageal reflux.
- C. The patient has T wave inversions on the 12-lead ECG.
- D. The patient has had continuous chest pain since 1:00 pM.
Correct Answer: D
Rationale: Continuous chest pain indicates ongoing ischemia, making the patient a candidate for fibrinolytic therapy within the therapeutic window.
Which type of heart disease involves the stiffening of the heart muscle, reducing its ability to relax and fill with blood?
- A. Restrictive cardiomyopathy
- B. Hypertrophic cardiomyopathy
- C. Dilated cardiomyopathy
- D. Ventricular hypertrophy
Correct Answer: A
Rationale: The correct answer is A: Restrictive cardiomyopathy. This type of heart disease involves the stiffening of the heart muscle, leading to decreased ability to relax and fill with blood. Restrictive cardiomyopathy is characterized by abnormal stiffening of the heart muscle, impairing its ability to properly expand and contract during the cardiac cycle. This results in reduced filling of the heart chambers, leading to symptoms of heart failure.
Choice B: Hypertrophic cardiomyopathy involves thickening of the heart muscle, not stiffening.
Choice C: Dilated cardiomyopathy involves enlargement and weakening of the heart chambers, not stiffening.
Choice D: Ventricular hypertrophy is a general term for thickening of the heart muscle, not specific to stiffness.