Cardiac & Respiratory Exam 2 Patho Test Bank 2023 QUESTIONS WITH COMPLETE SOLUTIONS (provides full explanations and criteria)

In which of the following patient situations would a physician be most justified in preliminarily ruling out pericarditis as a contributing pathology to the patient's health problems? - ANSWER A 77-year-old with diminished S3 and S4 heart tones, irregular heart rate and history of a-fib Following cardiac surgery, the nurse suspects the patient may be developing a cardiac tamponade. Which of the following clinical manifestations would support this diagnosis? - ANSWER Muffled heart tones, narrowed pulse pressure and low BP 84/60 Cardiac tamponade results in increased intracardiac pressure, progressive limitation of ventricular diastolic filling and decrease SV and CO Which of the following phenomena would be most likely to accompany increased myocardial oxygen demand? - ANSWER Increased aortic pressure Results in rise in afterload, wall tension, ultimately MVO2 Which of the following teaching points would be most appropriate for a group of older adults who are concerned about their cardiac health? - ANSWER The plaque that builds up in your heart vessels obstructs the normal flow of blood and can even break loose and lodge itself in a vessel Stable plaque is associated with obstruction of blood flow, while unstable plaque may dislodge and result in thrombus formation Four patients were admitted to the emergency department with severe chest pain. All were given preliminary treatment with aspirin, morphine, oxygen, and nitrates and were monitored by ECG. Which patient most likely experienced myocardial infarction? - ANSWER An 80-year-old woman whose pain started at 6am shortly after awakening and was not relieved by nitrates or rest; the ECG showed St-segment elevation with inverted T waves and abnormal Q waves; levels of cardiac markers subsequently rose The chest pain of MI does not respond to rest or nitrates Which of the following statements provides blood work results and rationale that would be most closely associated with acute coronary syndrome? - ANSWER Elevated creatinine kinase and troponin, both of which normally exist intracellularly rather than in circulation Myocardial necrosis releases creatinine kinase and troponin that normally exist intracellularly A number of clients have presented to the emergency department in the last 32 hours with complaints that preliminarily indicative of MI, which of the following clients is least likely to have a STEMI? - ANSWER A 71-year-old man who has most skin, fever and chest pain that is excruciating when he moves but relieved when at rest