Nur 265 - Cardiovascular test 3 UPDATED
ACTUAL Questions and CORRECT
Answers
Acute Coronary Syndrome (ACS) - CORRECT ANSWER A way of describing the
disorders and manifestations that make up unstable Angina and Myocardial Infarction.
• Describe any conditions characterized by signs and symptoms of sudden myocardial ischemia
Afterload - CORRECT ANSWER The force that the ventricles must develop to eject
blood into circulation
• The amount of resistance against which the hearty must pump to get blood into systemic
circulation
Contractility - CORRECT ANSWER The force of contraction of the heart muscle
Coronary Artery Disease (CAD) - CORRECT ANSWER Myocardial impairment caused
by an imbalance between coronary blood flow and myocardial oxygen requirements as a result of
obstructed blood flow through the coronary arteries.
• Can lead to myocardial ischemia
• Atherosclerosis is most common cause
Coronary Artery Disease - CORRECT ANSWER 4 primary risk factors: smoking, DM
(especially in women), HTN, high cholesterol
• LDL greater than 100
• Patho:
- localized accumulation of lipids and fibrous tissue within coronary arteries.
- Narrowing of lumen.
- Increased myocardial oxygen demand, ischemia, chance of MI
• Results of myocardial ischemia - angina pectoris, acute MI and death
• ACS - unstable angina and MI
,Preload - CORRECT ANSWER The volume of blood distending the ventricles at end-
diastole
• The amount of blood waiting to be pumped into systemic circulation
• S&S of elevated preload: anorexia, nausea, abdominal pain
Starling's Law - CORRECT ANSWER States that the cardiac muscle fibers stretch to a
certain point
• This stretching allows for a more forceful contraction, thus increasing the stroke volume and
venous return to the heart
• Causes a temporary improvement in cardiac output.
• However, once the cardiac fibers stretch beyond a certain point then the cardiac output
decreases
• Relates to preload
Stroke Volume - CORRECT ANSWER The amount of blood ejected by the heart with
each beat
Transmural Myocardial Infarction - CORRECT ANSWER A MI which involves the entire
thickness of the cardiac muscles
Heart Disease S&S in Women - CORRECT ANSWER • Fatigue, lethargy,
• Heaviness or squeezing pain left chest, abdomen, mid back, arm, shoulder without midchest
pain
• Palpitations, ingestion, nausea, indigestion
• Numbness of hands, sharp fleeting pain, chest discomfort during rest or sleep or with other
symptoms during exertion.
• Chest discomfort includes burning stabbing tingling
Diagnostic Test - CORRECT ANSWER • EKG: detects myocardial ischemia.
,- T wave and ST segment changes occur when patient is symptomatic.
- Returns to normal when patient is free of symptoms
• Exercise Electrocardiography (stress test) - Evaluates functional capacity of heart
- Evokes symptoms under controlled conditions to progressively increase O2 demand
- Treadmill or bike
- If positive then patient is experiencing symptoms
- EKG hangers, chest pain, vertigo, sob, BP changes
Diagnostic Test Testing Women - CORRECT ANSWER • EKG less likely to have
concurrent st segment elevation
• Stress test false positive more common
• Exercise echocardiography more reliable
• Heart cath with angiography most reliable but due to invasive nature should only be used if
strong suspicion is present
Blood Pressure - CORRECT ANSWER Is controlled by blood flow and peripheral
vascular resistance
• Blood flow is affected by heart rate and amount of blood ejected by heart with each beat (SV).
- Faster heart beat = less perfusion
• Peripheral Vascular Resistance affected by viscosity of blood (anticoagulant, synthetic
hormones thicken blood (birth control) and dilation or constriction of blood vessel
• Internal mechanisms that affect dilation/constriction of vessels: baroreceptors, SNS, renin-
angiotensin aldosterone system
Blood Pressure values - CORRECT ANSWER • Normal BP: systolic 120 or less, diastolic
80 or less
• Pre HTN: 120-139, 80-89.
- Prehypertensive patients face twice the risk of HTN than those that fall in normal category
• Stage 1 HTN: 140-159/90-99
• Stage 2 HTN: 160 or higher/100 or higher
, • Patients with diabetes or renal disease should have readings less than 130/80.
Hypertension (HTN) - CORRECT ANSWER A disorder that is characterized by systolic
blood pressure that is persistently 140 mmHg or above and a diastolic pressure that is
persistently 90 mmHg or above
• Is based on 2 or more elevated findings
• The blood pressure is elevated for a sustained period of time
• Both don't have to be elevated to diagnose HTN
Hypertension: Essential (Primary/Idiopathic) - CORRECT ANSWER • Has no identifiable
cause
• Accounts for 90-95% if all types of hypertension
• Physiological factors commonly seen: Hyperactivity of sympathetic nervous system,
hyperactivity of the renin-angiotension aldosterone system, endothelial dysfunction
Hypertension: Essential - CORRECT ANSWER Associated Risk Factors
• Age greater than 60
• Family history of hypertension
• Excessive calorie consumption
• Physical inactivity
• Excessive alcohol intake
• Hyperlipidemia
• African-American
Hypertension: Secondary - CORRECT ANSWER • There is known cause
• Accounts for 5-10% of all cases
• Is the direct result of another problem
- e.g. artery stenosis, pheochromcytoma, medications, etc
ACTUAL Questions and CORRECT
Answers
Acute Coronary Syndrome (ACS) - CORRECT ANSWER A way of describing the
disorders and manifestations that make up unstable Angina and Myocardial Infarction.
• Describe any conditions characterized by signs and symptoms of sudden myocardial ischemia
Afterload - CORRECT ANSWER The force that the ventricles must develop to eject
blood into circulation
• The amount of resistance against which the hearty must pump to get blood into systemic
circulation
Contractility - CORRECT ANSWER The force of contraction of the heart muscle
Coronary Artery Disease (CAD) - CORRECT ANSWER Myocardial impairment caused
by an imbalance between coronary blood flow and myocardial oxygen requirements as a result of
obstructed blood flow through the coronary arteries.
• Can lead to myocardial ischemia
• Atherosclerosis is most common cause
Coronary Artery Disease - CORRECT ANSWER 4 primary risk factors: smoking, DM
(especially in women), HTN, high cholesterol
• LDL greater than 100
• Patho:
- localized accumulation of lipids and fibrous tissue within coronary arteries.
- Narrowing of lumen.
- Increased myocardial oxygen demand, ischemia, chance of MI
• Results of myocardial ischemia - angina pectoris, acute MI and death
• ACS - unstable angina and MI
,Preload - CORRECT ANSWER The volume of blood distending the ventricles at end-
diastole
• The amount of blood waiting to be pumped into systemic circulation
• S&S of elevated preload: anorexia, nausea, abdominal pain
Starling's Law - CORRECT ANSWER States that the cardiac muscle fibers stretch to a
certain point
• This stretching allows for a more forceful contraction, thus increasing the stroke volume and
venous return to the heart
• Causes a temporary improvement in cardiac output.
• However, once the cardiac fibers stretch beyond a certain point then the cardiac output
decreases
• Relates to preload
Stroke Volume - CORRECT ANSWER The amount of blood ejected by the heart with
each beat
Transmural Myocardial Infarction - CORRECT ANSWER A MI which involves the entire
thickness of the cardiac muscles
Heart Disease S&S in Women - CORRECT ANSWER • Fatigue, lethargy,
• Heaviness or squeezing pain left chest, abdomen, mid back, arm, shoulder without midchest
pain
• Palpitations, ingestion, nausea, indigestion
• Numbness of hands, sharp fleeting pain, chest discomfort during rest or sleep or with other
symptoms during exertion.
• Chest discomfort includes burning stabbing tingling
Diagnostic Test - CORRECT ANSWER • EKG: detects myocardial ischemia.
,- T wave and ST segment changes occur when patient is symptomatic.
- Returns to normal when patient is free of symptoms
• Exercise Electrocardiography (stress test) - Evaluates functional capacity of heart
- Evokes symptoms under controlled conditions to progressively increase O2 demand
- Treadmill or bike
- If positive then patient is experiencing symptoms
- EKG hangers, chest pain, vertigo, sob, BP changes
Diagnostic Test Testing Women - CORRECT ANSWER • EKG less likely to have
concurrent st segment elevation
• Stress test false positive more common
• Exercise echocardiography more reliable
• Heart cath with angiography most reliable but due to invasive nature should only be used if
strong suspicion is present
Blood Pressure - CORRECT ANSWER Is controlled by blood flow and peripheral
vascular resistance
• Blood flow is affected by heart rate and amount of blood ejected by heart with each beat (SV).
- Faster heart beat = less perfusion
• Peripheral Vascular Resistance affected by viscosity of blood (anticoagulant, synthetic
hormones thicken blood (birth control) and dilation or constriction of blood vessel
• Internal mechanisms that affect dilation/constriction of vessels: baroreceptors, SNS, renin-
angiotensin aldosterone system
Blood Pressure values - CORRECT ANSWER • Normal BP: systolic 120 or less, diastolic
80 or less
• Pre HTN: 120-139, 80-89.
- Prehypertensive patients face twice the risk of HTN than those that fall in normal category
• Stage 1 HTN: 140-159/90-99
• Stage 2 HTN: 160 or higher/100 or higher
, • Patients with diabetes or renal disease should have readings less than 130/80.
Hypertension (HTN) - CORRECT ANSWER A disorder that is characterized by systolic
blood pressure that is persistently 140 mmHg or above and a diastolic pressure that is
persistently 90 mmHg or above
• Is based on 2 or more elevated findings
• The blood pressure is elevated for a sustained period of time
• Both don't have to be elevated to diagnose HTN
Hypertension: Essential (Primary/Idiopathic) - CORRECT ANSWER • Has no identifiable
cause
• Accounts for 90-95% if all types of hypertension
• Physiological factors commonly seen: Hyperactivity of sympathetic nervous system,
hyperactivity of the renin-angiotension aldosterone system, endothelial dysfunction
Hypertension: Essential - CORRECT ANSWER Associated Risk Factors
• Age greater than 60
• Family history of hypertension
• Excessive calorie consumption
• Physical inactivity
• Excessive alcohol intake
• Hyperlipidemia
• African-American
Hypertension: Secondary - CORRECT ANSWER • There is known cause
• Accounts for 5-10% of all cases
• Is the direct result of another problem
- e.g. artery stenosis, pheochromcytoma, medications, etc
