NURS 487 MIDTERM 1 QUESTIONS AND ANSWERS
Cardiac Output - CORRECT ANSWER✅✅•what's coming out of the heart in one minute (5 L/min)
Stroke volume - CORRECT ANSWER✅✅•amount of blood in one beat in ml) (preload, afterload,
contractility) x HR bpm
•Ventricles fill with blood (end diastolic volume), the ventricles don't eject out all the blood during
systole, some amount is always left in the ventricle after contraction (end systolic volume). The amount
ejected is the stroke volume (EDV - ESV).
Preload - CORRECT ANSWER✅✅•EDV or how much fluid is going in, also described as how stretched
the myocytes are when the ventricle is full of blood (think of a balloon full of air - when its full of air it
has a lot of force, when its not full of air, not as much force)
Afterload - CORRECT ANSWER✅✅the resistance the ventricle must overcome to eject blood. If there is
a lot of pressure it takes a lot of force to open valves. This may reduce the amount of blood ejected.
Stenotic (narrowed) valves reduces blood output = low CO.
contractility - CORRECT ANSWER✅✅•how much squeeze the heart has, the more force the more it
ejects
•Heart rate is increased if CO is reduced; if heart rate is decreased this may also decrease CO if the SV
doesn't increase
Fatty Streak - CORRECT ANSWER✅✅lipids accumulate and migrate into smooth muscle cells
fibrous plaque - CORRECT ANSWER✅✅- collagen covers the fatty streak
- vessel lumen is narrowed
- blood flow is reduced
- fissures can develop
complicated lesion - CORRECT ANSWER✅✅- plaque rupture
- thrombus formation
,-further narrowing or total occlusion of vessel
collateral circulation - CORRECT ANSWER✅✅circulation by secondary channels after obstruction of the
principal channel supplying the heart (grows new vessels to bypass blockage)
Embolus - CORRECT ANSWER✅✅travelling clot that occludes an artery (atrial fibrillation, infective
endocarditis, PCI)
Vasculitis - CORRECT ANSWER✅✅inflammation of blood vessel- Kawasaki disease, aneurysm
Vasospasm - CORRECT ANSWER✅✅vessels constricts, reduces blood flow
ventricular fibrillation * - CORRECT ANSWER✅✅the rapid, irregular, and useless contractions of the
ventricles (quivering) - need to start CPR
angiogram - CORRECT ANSWER✅✅The radiographic visualization of blood vessels after the injection of
radiopaque substance. - shows you blocked vessels
Angina - CORRECT ANSWER✅✅•Ischemia from not enough oxygen
•Angina = Chest pain
Chronic Stable Angina - CORRECT ANSWER✅✅chest pain that occurs intermittently over a long period
with the same pattern of onset, duration, and intensity of symptoms - occurs when oxygen demand
increases (demand ischemia)
-** goes away at rest
What causes pain with angina? - CORRECT ANSWER✅✅anaerobic metabolism creates lactic acid = pain
Ischemia - CORRECT ANSWER✅✅Lack of blood supply
, unstable angina - CORRECT ANSWER✅✅rupture of thickened plaque, exposing thrombogenic surface
•UA: New onset, occurs at rest (different from stable angina that goes away at rest), worsening pattern
•Unpredictable and requires immediate attention
•Easily provoked (minimal to no exertion)
•Common symptoms in females include fatigue, SOB, indigestion, anxiety
•Remember in UA there is no ST elevation and cardiac enzymes are normal
(There may be ST depression or T wave inversion which indicates ischemia but not infarct)
A 65 y/o female presents with chest pain with activity and is diagnosed with chronic stable angina. The
pain occurs when - CORRECT ANSWER✅✅myocardial oxygen supply has fallen below the demand
Acute Coronary Syndrome - CORRECT ANSWER✅✅sudden symptoms of insufficient blood supply to the
heart indicating unstable angina or acute myocardial infarction
Myocardial Infarction (NSTEMI or STEMI) - CORRECT ANSWER✅✅•Interruption of blood supply to the
cardiac muscle resulting in sustained ischemia and irreversible myocardial cell death
•Location of the infarction correlates with the involved coronary circulation
•The longer the area is deprived of oxygen the greater chance of cell death
•Causes altered contraction and heart function
•Sub-endocardium is affected first and necrosis will progress through entire thickness of the heart
muscle in 4-6 hrs
NSTEMI - CORRECT ANSWER✅✅non-ST elevation myocardial infarction
- partial occlusion to vessel
STEMI - CORRECT ANSWER✅✅ST elevation MI, real-time ongoing death of heart tissue due to ischemia
- complete occlusion to heart vessel
- reflected by reduced CO ECG changes and ruse in troponins
Infarct - CORRECT ANSWER✅✅Area of dead tissue after a lack of blood supply - gets worse and worse
Cardiac Output - CORRECT ANSWER✅✅•what's coming out of the heart in one minute (5 L/min)
Stroke volume - CORRECT ANSWER✅✅•amount of blood in one beat in ml) (preload, afterload,
contractility) x HR bpm
•Ventricles fill with blood (end diastolic volume), the ventricles don't eject out all the blood during
systole, some amount is always left in the ventricle after contraction (end systolic volume). The amount
ejected is the stroke volume (EDV - ESV).
Preload - CORRECT ANSWER✅✅•EDV or how much fluid is going in, also described as how stretched
the myocytes are when the ventricle is full of blood (think of a balloon full of air - when its full of air it
has a lot of force, when its not full of air, not as much force)
Afterload - CORRECT ANSWER✅✅the resistance the ventricle must overcome to eject blood. If there is
a lot of pressure it takes a lot of force to open valves. This may reduce the amount of blood ejected.
Stenotic (narrowed) valves reduces blood output = low CO.
contractility - CORRECT ANSWER✅✅•how much squeeze the heart has, the more force the more it
ejects
•Heart rate is increased if CO is reduced; if heart rate is decreased this may also decrease CO if the SV
doesn't increase
Fatty Streak - CORRECT ANSWER✅✅lipids accumulate and migrate into smooth muscle cells
fibrous plaque - CORRECT ANSWER✅✅- collagen covers the fatty streak
- vessel lumen is narrowed
- blood flow is reduced
- fissures can develop
complicated lesion - CORRECT ANSWER✅✅- plaque rupture
- thrombus formation
,-further narrowing or total occlusion of vessel
collateral circulation - CORRECT ANSWER✅✅circulation by secondary channels after obstruction of the
principal channel supplying the heart (grows new vessels to bypass blockage)
Embolus - CORRECT ANSWER✅✅travelling clot that occludes an artery (atrial fibrillation, infective
endocarditis, PCI)
Vasculitis - CORRECT ANSWER✅✅inflammation of blood vessel- Kawasaki disease, aneurysm
Vasospasm - CORRECT ANSWER✅✅vessels constricts, reduces blood flow
ventricular fibrillation * - CORRECT ANSWER✅✅the rapid, irregular, and useless contractions of the
ventricles (quivering) - need to start CPR
angiogram - CORRECT ANSWER✅✅The radiographic visualization of blood vessels after the injection of
radiopaque substance. - shows you blocked vessels
Angina - CORRECT ANSWER✅✅•Ischemia from not enough oxygen
•Angina = Chest pain
Chronic Stable Angina - CORRECT ANSWER✅✅chest pain that occurs intermittently over a long period
with the same pattern of onset, duration, and intensity of symptoms - occurs when oxygen demand
increases (demand ischemia)
-** goes away at rest
What causes pain with angina? - CORRECT ANSWER✅✅anaerobic metabolism creates lactic acid = pain
Ischemia - CORRECT ANSWER✅✅Lack of blood supply
, unstable angina - CORRECT ANSWER✅✅rupture of thickened plaque, exposing thrombogenic surface
•UA: New onset, occurs at rest (different from stable angina that goes away at rest), worsening pattern
•Unpredictable and requires immediate attention
•Easily provoked (minimal to no exertion)
•Common symptoms in females include fatigue, SOB, indigestion, anxiety
•Remember in UA there is no ST elevation and cardiac enzymes are normal
(There may be ST depression or T wave inversion which indicates ischemia but not infarct)
A 65 y/o female presents with chest pain with activity and is diagnosed with chronic stable angina. The
pain occurs when - CORRECT ANSWER✅✅myocardial oxygen supply has fallen below the demand
Acute Coronary Syndrome - CORRECT ANSWER✅✅sudden symptoms of insufficient blood supply to the
heart indicating unstable angina or acute myocardial infarction
Myocardial Infarction (NSTEMI or STEMI) - CORRECT ANSWER✅✅•Interruption of blood supply to the
cardiac muscle resulting in sustained ischemia and irreversible myocardial cell death
•Location of the infarction correlates with the involved coronary circulation
•The longer the area is deprived of oxygen the greater chance of cell death
•Causes altered contraction and heart function
•Sub-endocardium is affected first and necrosis will progress through entire thickness of the heart
muscle in 4-6 hrs
NSTEMI - CORRECT ANSWER✅✅non-ST elevation myocardial infarction
- partial occlusion to vessel
STEMI - CORRECT ANSWER✅✅ST elevation MI, real-time ongoing death of heart tissue due to ischemia
- complete occlusion to heart vessel
- reflected by reduced CO ECG changes and ruse in troponins
Infarct - CORRECT ANSWER✅✅Area of dead tissue after a lack of blood supply - gets worse and worse
