PATHOPHYSIOLOGY, 6TH EDITION Chapter 18: Alterations in Cardiac Function
MULTIPLE CHOICE
1. The most reliable indicator that a person is
... [Show More] experiencing an acute myocardial infarction (MI) is
a. severe, crushing chest pain.
b. ST-segment elevation.
c. dysrhythmias.
d. pain radiating to the lower legs. ANS: B
Injuries to cardiac tissue caused by myocardial ischemia and infarction are indicated on the ECG by STsegment
changes. ST-segment elevation on the ECG indicates that ischemic injury is ongoing and that
efforts to improve perfusion or reduce oxygen demand may be effective in preserving myocardial
muscle. In some instances, an MI is entirely asymptomatic. Dysrhythmias that accompany MI are
attributed to injured and ischemic cells that have not yet become necrotic. Pain radiating to the jaw and
neck, not the lower legs, is symptomatic of an MI.
2. Primary treatment for myocardial infarction (MI) is directed at
a. protecting the heart from further ischemia.
b. decreasing myocardial oxygen demands.
c. reducing heart rate and blood pressure.
d. activating the parasympathetic system.
ANS: B
Reducing oxygen demand may be effective in preserving myocardial muscle. Decreasing demand
increases myocardial oxygen supply. Once the cardiac muscle has been damaged, it is more important to
preserve remaining muscle and prevent further loss of the myocardium.
Reduction in the heart rate and blood pressure is not the primary treatment goal in MI care.
Parasympathetic activation is not the primary treatment for myocardial infarction.
3. Rheumatic heart disease is most often a consequence of
a. chronic intravenous drug abuse.
b. viral infection with herpesvirus.
c. -hemolytic streptococcal infection.
d. cardiomyopathy.
ANS: C
Rheumatic heart disease is an uncommon but serious consequence of rheumatic fever. Rheumatic fever
is an acute inflammatory disease that follows infection with group A
-hemolytic streptococci. Rheumatic heart disease is not associated with chronic IV drug abuse.
Rheumatic fever is an acute inflammatory infectious disease. Cardiomyopathy does not cause rheumatic
heart disease.
4. Patients presenting with symptoms of unstable angina and no ST segment elevation are treated
with
a. cardiac catheterization.
b. antiplatelet drugs.
c. acute reperfusion therapy.
d. cardiac biomarkers only. ANS: B
Patients presenting with symptoms of unstable angina and no ST elevation on the ECG would be treated
with antiplatelet drugs as a cornerstone of therapy. Coronary angiography may be used as an additional
method of diagnosis but would not be the primary option. The patient with symptoms of unstable
angina would not benefit from reperfusion strategies. Cardiac biomarkers may be assessed in the
unstable angina patient, but are not the primary indicator.
5. An example of an acyanotic heart defect is
a. tetralogy of Fallot.
b. transposition of the great arteries.
c. ventricular septal defect.
d. all right-to-left shunt defects. ANS: C
An example of an acyanotic heart defect is a ventricular septal defect. In this condition, blood from the
left ventricle leaks into the right ventricle because of a defect in the ventricular wall. This leakage causes
extra pressure in the right ventricle resulting in pulmonary hypertension. Tetralogy of Fallot is a cyanotic
congenital defect. Transposition of the great vessels is a cyanotic congenital defect. The category of
cyanotic congenital defects refers to those that are right-to-left shunts.
6. Patent ductus arteriosus is accurately described as a(n)
a. opening between the atria.
b. stricture of the aorta that impedes blood flow.
c. communication between the aorta and the pulmonary artery.
d. cyanotic heart defect associated with right-to-left shunt. ANS: C [Show Less]