Free CMC Certification Cardio Vascular Questions and Answers — Questions and Answers
Question 1: Which of the following describes diastolic heart failure?
- decreased ability of the ventricle to contract
- dilation of the ventricular chambers
- inability of the heart muscle to relax (Correct answer)
- increased filling of the left ventricle
Correct answer: inability of the heart muscle to relax
Diastolic heart failure, also known as heart failure with preserved ejection fraction (HFpEF), occurs when the heart muscle becomes stiff and less compliant. This stiffness impairs the ventricle's ability to relax and fill properly during diastole, leading to elevated filling pressures and symptoms of heart failure despite a normal or near-normal ejection fraction.
Question 2: The nurse is examining the treatment plan for a patient with systolic heart failure who has been prescribed carvedilol (Coreg), metoprolol (Lopressor), furosemide (Lasix), and enalapril (Vasotec). What intervention will offer the MOST ACCURATE evaluation of the regimen?
- daily weights (Correct answer)
- serial chest x-rays
- strict intake and output
- basic metabolic panel every morning
Correct answer: daily weights
Daily weights are the most accurate and sensitive indicator of fluid status in patients with heart failure. A sudden increase in weight (e.g., 2-3 lbs in 24 hours or 5 lbs in a week) often signifies fluid retention and worsening heart failure. This provides a crucial and early assessment of the effectiveness of diuretic and other heart failure medications in managing fluid balance.
Question 3: A pacemaker is surgically implanted before a patient is safely extubated. The patient becomes tachypneic and dyspneic three hours later. Crackles in the posterior lobes are audible to the nurse and are most likely caused by
- atelectasis
- pulmonary embolus
- pulmonary edema (Correct answer)
- anesthesia-induced asthma
Correct answer: pulmonary edema
The symptoms of tachypnea, dyspnea, and crackles in the posterior lobes, especially after a cardiac procedure and extubation, are highly suggestive of pulmonary edema. This condition involves fluid accumulation in the lungs, often due to fluid overload, left ventricular dysfunction, or increased cardiac workload post-procedure, leading to impaired gas exchange and respiratory distress.
Question 4: Which evaluation result should the nurse anticipate for a patient who has been admitted with arterial occlusion of the limb?
- pale extremity, pain, diminished or absent pulses (Correct answer)
- pale extremity, swollen extremity, +2 pedal pulse that bounds when limb is elevated
- reddened extremity, pain, +2 pedal pulse that becomes non-palpable when limb is elevated
- reddened extremity, no complaint of pain, no pedal pulses
Correct answer: pale extremity, pain, diminished or absent pulses
Arterial occlusion restricts blood flow to the limb, leading to classic signs of ischemia. These include pallor (pale extremity) due to lack of blood, severe pain, and diminished or absent pulses distal to the occlusion, as blood flow is severely compromised. The affected limb will also typically feel cool to the touch.
Question 5: Acute thrombosis-related occlusion symptoms include severe pain that comes on suddenly, loss of pulse, collapse of superficial veins, pallor, and decreased motor and sensory function.
- coronary artery restenosis following PCI
- recurrent ventricular tachycardia refractory to cardioversion
- recurrent atrial fibrillation refractory to drug therapy (Correct answer)
- cardiomyopathy with an EF less than 20%
Correct answer: recurrent atrial fibrillation refractory to drug therapy
The described symptoms of acute limb ischemia (severe pain, loss of pulse, pallor, decreased motor/sensory function) are caused by a sudden blockage of an artery, often by a thrombus or embolus. Recurrent atrial fibrillation is a significant risk factor for embolic events, as blood can pool and clot in the atria, dislodge, and travel to peripheral arteries, causing acute occlusion.
Question 6: A patient who has ST-segment elevation in leads II, III, and aVF with high troponin is hospitalized. Which medicine administration should the nurse initially prepare for?
- streptokinase (Streptase)
- Reteplase (Retavase) (Correct answer)
- enoxaparin (Lovenox)
- alteplase (Activase)
Correct answer: Reteplase (Retavase)
ST-segment elevation in leads II, III, and aVF, along with elevated troponin, indicates an acute inferior wall myocardial infarction (STEMI). For STEMI, immediate reperfusion therapy is critical to restore blood flow. Reteplase (Retavase) is a thrombolytic agent used to dissolve the clot causing the MI, making it an appropriate initial medication to prepare for in this emergency scenario.
Question 7: With each inspiration by the patient, the nurse observes a significant reduction in the arterial line waveform. Which complication should the nurse monitor for as it develops?
- pulmonary embolus
- atrial fibrillation
- acute MI
- cardiac tamponade (Correct answer)
Correct answer: cardiac tamponade
A significant reduction in the arterial line waveform with inspiration, known as pulsus paradoxus, is a classic sign of cardiac tamponade. In cardiac tamponade, fluid accumulation in the pericardial sac compresses the heart, impairing ventricular filling. During inspiration, increased negative intrathoracic pressure further impedes right ventricular filling, leading to a noticeable drop in systolic blood pressure and a diminished arterial waveform.
Free CMC Certification Cardio Vascular Questions and Answers
Which of the following describes diastolic heart failure?