W5 Cardiac A Flashcards
(197 cards)
1
Q
What should you revise before continuing with the learning materials for the next two weeks?
A
Cardiac anatomy and physiology, main functions of the cardiovascular system, focused cardiovascular system’s assessment.
2
Q
What are the key components of cardiac anatomy and physiology to review?
A
Cardiac structure and function, cardiac cycle, ECG lead placements.
3
Q
What is the significance of a focused cardiovascular assessment?
A
Vital for providing care, prioritizing tasks, and identifying deterioration.
4
Q
What mnemonic can be used for pain assessment in chest pain?
A
PQRSTU/OLDCARTS.
5
Q
What factors should be assessed regarding dyspnoea?
A
Type and amount of activity causing SOB, comparison to normal, exercise tolerance, pain changes with position.
6
Q
What does orthopnoea refer to?
A
Difficulty breathing while lying down, often needing multiple pillows when sleeping.
7
Q
What should be assessed regarding cough during a cardiovascular assessment?
A
Duration, timing, association with activity or medications.
8
Q
What is the significance of assessing fatigue in a cardiovascular assessment?
A
Determining if the onset is gradual or sudden.
9
Q
What does cyanosis indicate in a cardiovascular assessment?
A
Facial skin turning blue or ashen.
10
Q
What is important to assess regarding oedema?
A
Onset, changes in severity, relief measures, associated symptoms.
11
Q
What does nocturia refer to?
A
Frequent urination during the night.
12
Q
What risk factors should be considered in health and lifestyle management?
A
Smoking, alcohol use, work and social stress, coping patterns, exercise, nutrition.
13
Q
What should be included in the health history for a cardiovascular assessment?
A
History of presenting illness, past health history, surgical treatments.
14
Q
What is included in objective data for a cardiovascular assessment?
A
Primary assessment, secondary assessment, full set of vital signs.
15
Q
What does the acronym DRSABCDE stand for in primary assessment?
A
Danger, Response, Send for help, Airway, Breathing, Circulation, Disability, Exposure.
16
Q
What are the components of a focused cardiovascular assessment?
A
Look, Listen, Feel; Inspect, Auscultate, Percuss, Palpate.
17
Q
What should be assessed in the general appearance during a cardiovascular assessment?
A
Conscious state, posture, skin, nails, speech, affect/mood, eye contact, weight.
18
Q
What should be considered when measuring blood pressure?
A
Assess on both arms, orthostatic BP, review trends.
19
Q
What are the key aspects to assess regarding heart sounds?
A
Identify auscultatory areas, S1 and S2, adventitious sounds, extra heart sounds, murmurs.
20
Q
What peripheral assessments should be conducted?
A
Peripheral oedema, colour, warmth, vascular changes, ulcers, clubbing.
21
Q
Which special populations should be considered in cardiovascular assessments?
A
Paediatrics, pregnant women, older people.
22
Q
What personal cardiac history details should be explored?
A
What/where/how/who manages, changes, tests, pending treatment.
23
Q
What family history factors should be assessed in cardiovascular assessments?
A
Cardiac issues, stroke, obesity, diabetes mellitus, age of onset.
24
Q
What does CVD stand for?
A
Cardiovascular Disease
25
What are the main diseases included under CVD?
* Stroke
* Coronary artery disease
* Acute coronary syndrome
26
What percentage of Australians are affected by some form of CVD?
18%
27
How many Australians have some form of CVD?
More than 4.5 million people
28
What proportion of all reported deaths is attributed to CVD?
1 in 4 deaths
29
How many people die from CVD each day in Australia?
About 118 people
30
How often does a person die from CVD in Australia?
Every 12 minutes
31
Which groups generally have higher incidences of death from CVD?
* Lower socioeconomic groups
* Aboriginal and Torres Strait Islander people
* Those in rural and remote areas
32
What is the annual financial cost of CVD to the healthcare system in Australia?
$5 billion
33
What percentage of total hospital expenditure on admissions does CVD account for?
11%
34
True or False: CVD accounts for 24% of all deaths in Australia.
True
35
What is Coronary Heart Disease (CHD)?
A subcategory of cardiovascular disease (CVD) affecting the coronary arteries, primarily through atherosclerosis
## Footnote
CHD is also known as coronary artery disease (CAD) or ischemic heart disease (IHD).
36
What is atherosclerosis?
The primary cause of CHD characterized by the buildup of fat and fibrin along the arterial walls
## Footnote
Atherosclerosis is a form of arteriosclerosis.
37
What are the two main sub-groups of risk factors for coronary heart disease?
* Modifiable
* Non-modifiable
38
Name three conditions that may increase the risk of CHD.
* Diabetes mellitus
* Kidney function issues
* Familial hypercholesterolemia
39
What is hypertension (HT)?
The most prevalent cardiovascular condition, affecting about 30% of adults over 25 years old in Australia
## Footnote
HT is a major modifiable risk factor for CHD.
40
What blood pressure readings indicate hypertension?
Systolic >140mmHg and/or diastolic >90mmHg
41
How does hypertension contribute to atherosclerosis?
By causing endothelial injury and increasing myocardial oxygen demand
## Footnote
HT increases the risk of myocardial hypertrophy.
42
What is dyslipidaemia?
An imbalance of lipids such as cholesterol and triglycerides that can lead to atherosclerosis
## Footnote
Dyslipidaemia is also referred to as hyperlipidaemia.
43
What are the three layers of the arterial wall?
* Tunica Intima
* Tunica Media
* Tunica Adventitia
44
What is the significance of atherosclerosis narrowing the coronary arteries by 50% or more?
It can impair blood flow enough to interfere with myocardial oxygen delivery and cellular metabolism
45
What are the common clinical manifestations of hypertension?
Elevated blood pressure
## Footnote
Many individuals may be asymptomatic.
46
Fill in the blank: Atherosclerosis begins with the development of a _______.
[fatty streak]
47
What is the role of the sympathetic nervous system in hypertension?
It promotes renal sodium retention and increases heart rate and vasoconstriction, leading to elevated blood pressure
48
What is the impact of dyslipidaemia on arterial walls?
It makes artery walls 'sticky' and can damage the endothelial wall
49
What are some subjective data points to assess in a cardiovascular assessment?
* Current symptoms
* Past health history
* Medications
* Family history
50
What are some objective data points to assess in a cardiovascular assessment?
* Vital signs
* Physical examination findings
* ECG changes
51
What is a major complication of untreated hypertension?
Organ damage can occur long before symptoms are evident
52
What should nursing management for patients with CVD involve?
* Lifestyle modification
* Medication management
* Regular assessment and monitoring
53
True or False: Dyslipidaemia usually presents with noticeable symptoms.
False
54
What is the relationship between obesity and cardiovascular disease?
Obesity is a significant risk factor for developing cardiovascular diseases
55
What is the role of lifestyle modifications in managing cardiovascular disease?
Essential for improving outcomes and managing modifiable risk factors
56
What is the approach to performing a patient assessment in nursing management?
A combination of lifestyle modification, medication management, and regular assessment and monitoring.
57
What is essential for improved outcomes in patients with CVD?
Educating patients about their CVD, risk factors, and the importance of lifestyle modifications and medication adherence.
58
What should be included in medication management for patients with CVD?
Educating patients about prescribed medications, including dosage, indications, timing, and potential side effects.
59
What role does the pharmacist play in medication management for CVD patients?
Educates the patient and/or family about medications and assists with any further questions or concerns after discharge.
60
True or False: All patients with cardiac admission should be referred to cardiac rehabilitation.
True
61
What are the vital components of cardiac rehabilitation?
Physical activity, education about healthy living, and counseling for stress relief and mental health improvement.
62
What are some barriers to medication management that should be identified by nurses?
Access and cost.
63
What are some lifestyle modifications to reduce risk factors for CVD?
* Maintaining a healthy weight
* Healthy dietary choices
* Avoiding tobacco use
* Reducing alcohol intake
* Increasing physical activity
* Managing psychosocial factors
64
Fill in the blank: Cardiac rehabilitation is important for patients recovering from _______.
[acute myocardial infarction, heart failure, or requiring surgery or medical treatment for coronary heart disease]
65
What are the recommended actions for managing hypertension?
* Monitor home BP
* Take prescribed medications
* Reduce salt intake
* Stop tobacco use
* Control weight
* Increase physical activity
66
What dietary changes can help manage elevated serum lipids?
* Reduce total fat intake
* Reduce animal fat intake
* Take prescribed lipid-reducing medications
* Engage in daily physical activity
* Increase complex carbohydrates and fiber
67
What strategies can help someone quit smoking?
* Begin a smoking cessation program
* Change routines associated with smoking
* Substitute activities for smoking
* Seek support from carers
68
What psychological strategies can improve health?
* Increase awareness of harmful behaviors
* Set realistic goals
* Learn stress management strategies
* Seek professional help if needed
69
What is the recommended body mass index range for obesity management?
18.5-24.9 kg/m2
70
What are some complementary therapies that may benefit CVD patients?
* Breathing exercises
* Meditation/mindfulness
* Tai chi
* Yoga
* Hypnosis
* Biofeedback
* Acupuncture
* Fish oil supplements (with consultation)
71
What is the impact of high dietary salt intake on cardiovascular health?
72
What is the role of patient advocacy in nursing management?
To ensure patients understand their healthcare journey and assist in transitioning from hospital to discharge.
73
What does Acute Coronary Syndrome (ACS) encompass?
ACS is an umbrella term for conditions affecting the heart related to atherosclerosis that lead to ischaemia or infarction
## Footnote
ACS includes unstable angina, NSTEMI, and STEMI.
74
What is unstable angina (UA)?
UA is characterized by new onset or worsening chest pain with minimal exertion, unpredictable, and may not show cardiac biomarkers
## Footnote
UA is a significant warning sign for potential NSTEMI or STEMI.
75
What characterizes Non-ST elevation myocardial infarction (NSTEMI)?
NSTEMI is caused by prolonged ischaemia leading to myocardial cellular death, with detectable cardiac biomarkers but no ST elevation on ECG.
76
What is ST elevation myocardial infarction (STEMI)?
STEMI is identified by ST segment elevation on the ECG and is considered a life-threatening emergency.
77
List some clinical manifestations of myocardial ischaemia/infarction.
* Chest pain
* Nausea and vomiting
* Dyspnea
* Fatigue
* Diaphoresis
* Syncope
78
What diagnostic tests aid in the diagnosis of ACS?
* ECG
* Cardiac biomarkers
* Coronary angiogram
* Exercise stress test
* Echocardiogram
79
What is the primary cause of angina?
Angina is primarily caused by atherosclerosis leading to inadequate blood flow to the cardiac muscle.
80
What is stable angina?
Stable angina is characterized by predictable chest discomfort triggered by exertion or emotional stress, relieved by rest or medication.
81
What defines chronic stable angina?
Chronic stable angina denotes recurring chest pain with a consistent pattern of onset, duration, and intensity over an extended period.
82
What distinguishes unstable angina from stable angina?
Unstable angina is new in onset, occurs at rest, or has a worsening pattern, indicating impending myocardial infarction.
83
What is the pathophysiology of unstable angina?
Unstable angina involves plaque fissuring, thrombus formation, transient vessel occlusion, and endothelial dysfunction, compromising blood flow.
84
What does the PQRST assessment of chest pain stand for?
* P - Precipitating factors
* Q - Quality of pain
* R - Region/Radiation of pain
* S - Severity of pain
* T - Timing
85
Fill in the blank: Angina typically lasts ______.
3-5 minutes
86
True or False: Atherosclerosis can allow blood flow but may still result in chest pain.
True
87
What happens to myocardial cells during ischaemia?
Myocardial cells receive insufficient oxygen, leading to lactic acid buildup and pain signals.
88
What is the significance of the term 'time is muscle' in relation to chest pain?
The longer an artery is blocked during a heart attack, the more muscle is damaged or dies.
89
What factors should a nurse assess in a patient with chest pain?
* PQRST assessment
* ECG
* Patient/family history
* Medications
* Allergies
* Cardiovascular risk factors
* Vital signs
* IV access and pathology (if applicable)
90
What does ECG stand for?
Electrocardiogram
## Footnote
Also referred to as electrocardiograph(ic) or EKG.
91
What is the purpose of the ECG?
To provide a visual representation of the electrical conduction system of the heart.
92
What is the first deflection of the ECG known as?
P wave
## Footnote
Represents atrial depolarisation.
93
What does the PR interval track?
The impulse from the sinus node discharge to the beginning of ventricular depolarisation.
94
What does the QRS complex represent?
Ventricular depolarisation.
95
What does the ST segment indicate?
The end of ventricular depolarisation and the beginning of repolarisation.
96
What does the T wave represent in an ECG?
Ventricular repolarisation.
97
What is the QT interval measuring?
The duration of ventricular depolarisation and repolarisation.
98
What is sinus rhythm?
The most common rhythm seen in healthy hearts, generated by the SA node.
99
What is atrial fibrillation (AF)?
The most common arrhythmia in Australia and New Zealand, increasing with age.
100
How many people were affected by AF in Australia in 2020?
Approximately 500,000.
101
What can AF be a clinical manifestation of?
Myocardial ischaemia, infarction, heart failure, electrolyte disturbances, thyroid dysfunction, hypovolaemia, and postoperative complications.
102
What happens to the ventricular rate in AF?
It can vary greatly, resulting in an irregular pulse.
103
What characterizes the ECG of a patient with atrial fibrillation?
Absence of recognisable P waves.
104
What are the types of atrial fibrillation?
* Occasional (paroxysmal) AF
* Persistent AF
* Permanent AF
105
What can cause atrial fibrillation?
* Excess catecholamines
* Increased atrial automaticity
* Atrial enlargement
* Abnormality of the conduction system
106
What are some risk factors for developing AF?
* Advanced age
* Congenital heart disease
* Other heart diseases
* Endocrine disorders
* Sleep apnoea
* Lifestyle factors
* Genetics
107
What is the impact of cardiac remodelling on AF?
It can lead to structural and electrical changes causing AF.
108
What is the significance of the 'atrial kick'?
It accounts for about 20% of the cardiac output per heartbeat.
109
What can result from stagnant blood in the atrium during AF?
Thrombus formation, which can lead to stroke or other complications.
110
What are some clinical manifestations of atrial fibrillation?
* Fatigue
* Dizziness
* Irregular pulse
* Palpitations
* Hypotension
* Shortness of breath
* Anxiety
111
What is a non-invasive sign that may indicate AF?
An irregular heart rate when palpating the patient's pulse.
112
What does nursing management of AF involve?
* Controlling symptoms
* Preventing complications
* Improving quality of life
113
What should patients with AF be educated about?
* Causes and symptoms of AF
* Treatment options
* Potential complications
* Lifestyle modifications
114
What is the importance of anticoagulant therapy in AF?
It reduces the risk of thromboembolic events.
115
What should be monitored for patients on warfarin?
International Normalised Ratio (INR) levels.
116
What is the primary purpose of anticoagulation therapy?
To reduce the risk of thromboembolic events such as stroke.
## Footnote
Anticoagulation therapy is crucial in managing patients at risk for thromboembolic complications.
117
What should be monitored for patients on warfarin?
International normalised ratio (INR) levels.
## Footnote
INR levels help ensure the effectiveness and safety of warfarin therapy.
118
What time is warfarin typically administered in most health services?
4pm.
## Footnote
Administration requires double checking by two nurses to ensure safety.
119
What is an important education point for patients on anticoagulants?
Increased risk of bleeding and signs to seek medical attention.
## Footnote
Patients must be aware of how to recognize bleeding complications.
120
Name three modifiable risk factors for patients.
* Hypertension
* Diabetes
* Obesity
## Footnote
Modifying these risk factors can significantly improve patient outcomes.
121
What lifestyle changes should patients be educated about?
* Maintaining a healthy weight
* Increasing physical activity
* Moderate-to-no alcohol intake
* Ceasing smoking
## Footnote
These changes can help manage cardiovascular health.
122
Who should healthcare professionals collaborate with for cardiac rehabilitation?
Interprofessional healthcare team including cardiologists and pharmacists.
## Footnote
Collaboration enhances patient care and rehabilitation outcomes.
123
What types of support might patients need beyond education?
* Emotional support
* Connection with support groups
## Footnote
Psychosocial support is essential for comprehensive patient care.
124
List two investigations that may be ordered for diagnosing arrhythmias.
* Electrocardiogram (ECG)
* Echocardiogram
## Footnote
These tests help determine the cause and best treatment options for arrhythmias.
125
What is the role of anti-arrhythmic agents?
To normalise the heart’s rhythm.
## Footnote
These agents are critical in managing arrhythmias.
126
What is electrical cardioversion?
An electrical shock delivered to the heart to restore normal rhythm.
## Footnote
It may only be done if the duration of AF is known and with an echocardiogram to check for thrombus.
127
What is catheter ablation?
An invasive procedure to find and destroy ectopic sites causing arrhythmia.
## Footnote
It is used when other treatments are ineffective.
128
What conditions should be managed alongside arrhythmias?
* Hypertension
* Cardiac failure
* Heart valve disease
* Diabetes mellitus
## Footnote
Co-managing these conditions can improve overall patient health.
129
True or False: Referrals to specialized cardiac services are unnecessary for patients with arrhythmias.
False.
## Footnote
Referrals are often essential for comprehensive management.
130
Fill in the blank: A _______ can electrically stimulate the heart to maintain a regular rhythm.
Pacemaker.
## Footnote
Pacemakers are critical for managing certain types of arrhythmias.
131
What is the purpose of stress tests in cardiac investigations?
To evaluate heart function under physical stress.
## Footnote
Stress tests help assess the heart's performance in a controlled environment.
132
What is the main focus of cardiovascular pharmacology?
Treatments related to slowing the disease process of the cardiovascular system
133
Which conditions are primarily addressed in cardiovascular pharmacology?
Hypertension, dyslipidaemia, angina
134
List the common classes of drugs used to treat hypertension.
* Diuretics
* Beta-Adrenergic Blockers
* Renin-Angiotensin-Aldosterone Inhibitors (ACE inhibitors)
* Calcium Channel Blockers
135
What do beta-blockers competitively block?
Beta receptors in the heart, peripheral vasculature, bronchi, pancreas, uterus, kidney, brain, and liver
136
What is the common suffix for beta-blockers?
'olols'
137
Name three beta-blockers available for use in Australia.
* Atenolol
* Metoprolol
* Propranolol
138
What is the primary action of ACE inhibitors?
Block the conversion of angiotensin I to angiotensin II
139
What is the common suffix for ACE inhibitors?
'prils'
140
List three ACE inhibitors available in Australia.
* Enalapril
* Lisinopril
* Ramipril
141
What do Angiotensin II Receptor Blockers (ARBs) competitively block?
The binding of angiotensin II to type 1 angiotensin receptors
142
What is the common suffix for ARBs?
'sartans'
143
Name three ARBs available in Australia.
* Losartan
* Valsartan
* Telmisartan
144
What is the primary mechanism of action for Calcium Channel Blockers (CCBs)?
Block the inward current of calcium into cells of vascular smooth muscles and myocardium
145
List two types of CCBs.
* Dihydropyridines
* Non-Dihydropyridines
146
What is the common suffix for dihydropyridine CCBs?
'dipine'
147
What class of drugs is primarily used to reduce intravascular volume?
Diuretics
148
Name two types of diuretics used to treat hypertension.
* Thiazide diuretics (e.g., Hydrochlorothiazide)
* Thiazide-like diuretics (e.g., Indapamide)
149
What is the role of statins in dyslipidaemia?
Inhibit cholesterol production in the liver
150
Name three statins available in Australia.
* Atorvastatin
* Rosuvastatin
* Simvastatin
151
What is the mechanism of action for Ezetimibe?
Inhibits the absorption of cholesterol in the small intestines
152
What is the primary goal of medications for Acute Coronary Syndrome (ACS) and angina?
Dissolving or slowing the development of clots and controlling chest pain symptoms
153
List three medications used for angina.
* Glyceryl trinitrate (GTN)
* Isosorbide dinitrate
* Nicorandil
154
Name one anti-platelet medication.
Aspirin
155
What do direct thrombin inhibitors do?
Inhibit thrombin to prevent clot formation
156
True or False: Fish oil has shown cardiovascular benefits.
False
157
Fill in the blank: The ________ regulates circulating volume, electrolyte balance, and systemic vascular resistance.
Renin-Angiotensin-Aldosterone System (RAAS)
158
Q1: What physiological change in hypertension contributes to increased myocardial oxygen demand?
A. Decreased peripheral resistance
B. Decreased cardiac output
C. Left ventricular hypertrophy
D. Reduced stroke volume
Q1: What physiological change in hypertension contributes to increased myocardial oxygen demand?
A. Decreased peripheral resistance
B. Decreased cardiac output
C. Left ventricular hypertrophy ✅
D. Reduced stroke volume
159
Q2: Which best explains why atrial fibrillation increases the risk of stroke?
A. Decreased ventricular filling
B. Ventricular fibrillation
C. Formation of thrombi due to atrial quivering
D. Enhanced cardiac output
Q2: Which best explains why atrial fibrillation increases the risk of stroke?
A. Decreased ventricular filling
B. Ventricular fibrillation
C. Formation of thrombi due to atrial quivering ✅
D. Enhanced cardiac output
160
Q3: What ECG finding would indicate ST-elevation myocardial infarction (STEMI)?
A. Inverted T waves
B. Prolonged PR interval
C. Elevated ST segment above baseline
D. Absence of P waves
Q3: What ECG finding would indicate ST-elevation myocardial infarction (STEMI)?
A. Inverted T waves
B. Prolonged PR interval
C. Elevated ST segment above baseline ✅
D. Absence of P waves
161
Q4: In the context of ACS, which symptom is most consistent with unstable angina?
A. Predictable chest pain relieved by rest
B. Chest pain at rest not relieved by GTN
C. No ECG changes or symptoms
D. ECG showing ST-elevation
Q4: In the context of ACS, which symptom is most consistent with unstable angina?
A. Predictable chest pain relieved by rest
B. Chest pain at rest not relieved by GTN ✅
C. No ECG changes or symptoms
D. ECG showing ST-elevation
162
Q5: Which artery layer is first affected in the development of atherosclerosis?
A. Tunica adventitia
B. Tunica media
C. Tunica intima
D. Endocardium
Q5: Which artery layer is first affected in the development of atherosclerosis?
A. Tunica adventitia
B. Tunica media
C. Tunica intima ✅
D. Endocardium
163
Q6: Which antihypertensive class works by reducing peripheral vascular resistance and heart rate?
A. Diuretics
B. Calcium channel blockers
C. Beta-blockers
D. ACE inhibitors
Q6: Which antihypertensive class works by reducing peripheral vascular resistance and heart rate?
A. Diuretics
B. Calcium channel blockers
C. Beta-blockers ✅
D. ACE inhibitors
164
Q7: What clinical sign may indicate decreased cardiac output in atrial fibrillation?
A. Bounding pulse
B. Regular pulse rhythm
C. Hypotension and syncope
D. Bradycardia
Q7: What clinical sign may indicate decreased cardiac output in atrial fibrillation?
A. Bounding pulse
B. Regular pulse rhythm
C. Hypotension and syncope ✅
D. Bradycardia
165
Q8: What distinguishes NSTEMI from unstable angina?
A. Presence of cardiac biomarkers
B. ST segment elevation
C. Duration of chest pain
D. Predictable chest pain
Q8: What distinguishes NSTEMI from unstable angina?
A. Presence of cardiac biomarkers ✅
B. ST segment elevation
C. Duration of chest pain
D. Predictable chest pain
166
Q9: Which condition is characterised by reduced compliance of arterial walls without fat deposition?
A. Hyaline arteriolosclerosis
B. Atherosclerosis
C. Monckeberg's sclerosis
D. Hyperplastic arteriolosclerosis
Q9: Which condition is characterised by reduced compliance of arterial walls without fat deposition?
A. Hyaline arteriolosclerosis ✅
B. Atherosclerosis
C. Monckeberg's sclerosis
D. Hyperplastic arteriolosclerosis
167
Q10: Which parameter reflects ventricular depolarisation on an ECG?
A. P wave
B. T wave
C. PR interval
D. QRS complex
Q10: Which parameter reflects ventricular depolarisation on an ECG?
A. P wave
B. T wave
C. PR interval
D. QRS complex ✅
168
Q11: What is the primary mechanism of action of statins?
A. Increase bile acid production
B. Enhance HDL receptor sensitivity
C. Inhibit HMG-CoA reductase in the liver
D. Block intestinal lipid absorption
Q11: What is the primary mechanism of action of statins?
A. Increase bile acid production
B. Enhance HDL receptor sensitivity
C. Inhibit HMG-CoA reductase in the liver ✅
D. Block intestinal lipid absorption
169
Q12: What symptom would prompt a MET call in a hypertensive patient despite normal BP range?
A. Pallor with dizziness and altered consciousness
B. BP of 145/90 mmHg
C. Mild headache
D. Anxiety without other symptoms
Q12: What symptom would prompt a MET call in a hypertensive patient despite normal BP range?
A. Pallor with dizziness and altered consciousness ✅
B. BP of 145/90 mmHg
C. Mild headache
D. Anxiety without other symptoms
170
Q13: In PQRST pain assessment, what does "Q" stand for?
A. Quantity
B. Quality of pain
C. Quick onset
D. Quiescent
Q13: In PQRST pain assessment, what does "Q" stand for?
A. Quantity
B. Quality of pain ✅
C. Quick onset
D. Quiescent
171
Q14: What role do baroreceptors play in cardiovascular regulation?
A. Stimulate myocardial contractility
B. Control blood clotting
C. Detect changes in blood pressure
D. Maintain electrolyte balance
Q14: What role do baroreceptors play in cardiovascular regulation?
A. Stimulate myocardial contractility
B. Control blood clotting
C. Detect changes in blood pressure ✅
D. Maintain electrolyte balance
172
Q15: Which ECG finding is characteristic of atrial fibrillation?
A. Regular P waves before each QRS
B. Absent P waves with irregularly irregular rhythm
C. Prolonged QT interval
D. ST depression
Q15: Which ECG finding is characteristic of atrial fibrillation?
A. Regular P waves before each QRS
B. Absent P waves with irregularly irregular rhythm ✅
C. Prolonged QT interval
D. ST depression
173
Q16: What mechanism explains orthopnoea in CVD patients?
A. Vagal stimulation
B. Pulmonary venous congestion when supine
C. Decreased cardiac preload
D. Increased capillary refill
Q16: What mechanism explains orthopnoea in CVD patients?
A. Vagal stimulation
B. Pulmonary venous congestion when supine ✅
C. Decreased cardiac preload
D. Increased capillary refill
174
Q17: Which medication is most likely prescribed to prevent thrombus formation in AF?
A. Digoxin
B. Metoprolol
C. Apixaban
D. GTN
Q17: Which medication is most likely prescribed to prevent thrombus formation in AF?
A. Digoxin
B. Metoprolol
C. Apixaban ✅
D. GTN
175
Q18: What is the correct order of cardiac conduction?
A. AV node → SA node → Purkinje fibres
B. SA node → AV node → Bundle of His → Purkinje fibres
C. Purkinje fibres → AV node → SA node
D. AV node → Bundle of His → SA node
Q18: What is the correct order of cardiac conduction?
A. AV node → SA node → Purkinje fibres
B. SA node → AV node → Bundle of His → Purkinje fibres ✅
C. Purkinje fibres → AV node → SA node
D. AV node → Bundle of His → SA node
176
Q19: What is the main cause of pain in stable angina?
A. Coronary artery rupture
B. Myocardial necrosis
C. Lactic acid buildup from ischaemia
D. Inflammation of the endocardium
Q19: What is the main cause of pain in stable angina?
A. Coronary artery rupture
B. Myocardial necrosis
C. Lactic acid buildup from ischaemia ✅
D. Inflammation of the endocardium
177
Q20: Which of the following is an example of a non-dihydropyridine calcium channel blocker?
A. Amlodipine
B. Felodipine
C. Verapamil
D. Lercanidipine
Q20: Which of the following is an example of a non-dihydropyridine calcium channel blocker?
A. Amlodipine
B. Felodipine
C. Verapamil ✅
D. Lercanidipine
178
Q21: Which parameter measures time from atrial to ventricular depolarisation on ECG?
A. QRS duration
B. QT interval
C. ST segment
D. PR interval
Q21: Which parameter measures time from atrial to ventricular depolarisation on ECG?
A. QRS duration
B. QT interval
C. ST segment
D. PR interval ✅
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Q22: What is the term for heart sound caused by turbulent blood flow?
A. Gallop
B. Murmur
C. Thrill
D. Rub
Q22: What is the term for heart sound caused by turbulent blood flow?
A. Gallop
B. Murmur ✅
C. Thrill
D. Rub
180
Q23: What would a nurse assess for in a patient with potential peripheral vascular disease?
A. Apical pulse only
B. Jugular vein distension
C. Peripheral pulses, colour, and warmth
D. Lung crackles
Q23: What would a nurse assess for in a patient with potential peripheral vascular disease?
A. Apical pulse only
B. Jugular vein distension
C. Peripheral pulses, colour, and warmth ✅
D. Lung crackles
181
Q24: Which antihypertensive class works by inhibiting angiotensin II binding to receptors?
A. ACE inhibitors
B. ARBs
C. Beta-blockers
D. Diuretics
Q24: Which antihypertensive class works by inhibiting angiotensin II binding to receptors?
A. ACE inhibitors
B. ARBs ✅
C. Beta-blockers
D. Diuretics
182
Q25: Which cardiac medication primarily causes systemic vasodilation to relieve angina?
A. Aspirin
B. Isosorbide mononitrate
C. Apixaban
D. Clopidogrel
Q25: Which cardiac medication primarily causes systemic vasodilation to relieve angina?
A. Aspirin
B. Isosorbide mononitrate ✅
C. Apixaban
D. Clopidogrel
183
Q26: Which of the following may be elevated in dyslipidaemia?
A. HDL
B. Troponin
C. LDL
D. Creatinine
Q26: Which of the following may be elevated in dyslipidaemia?
A. HDL
B. Troponin
C. LDL ✅
D. Creatinine
184
Q27: Why is cardiac rehabilitation considered essential after ACS?
A. Prevents medication errors
B. Reduces risk of readmission and improves outcomes
C. Increases medication compliance only
D. Focuses solely on physical therapy
Q27: Why is cardiac rehabilitation considered essential after ACS?
A. Prevents medication errors
B. Reduces risk of readmission and improves outcomes ✅
C. Increases medication compliance only
D. Focuses solely on physical therapy
185
Q28: Which population group is at higher risk of CVD in Australia?
A. Urban residents
B. Younger adults
C. Aboriginal and Torres Strait Islander people
D. Athletes
Q28: Which population group is at higher risk of CVD in Australia?
A. Urban residents
B. Younger adults
C. Aboriginal and Torres Strait Islander people ✅
D. Athletes
186
Q29: What causes the irregular ventricular response in AF?
A. Complete AV block
B. Failure of AV node to fire
C. Chaotic atrial signals intermittently passing through the AV node
D. SA node failure
Q29: What causes the irregular ventricular response in AF?
A. Complete AV block
B. Failure of AV node to fire
C. Chaotic atrial signals intermittently passing through the AV node ✅
D. SA node failure
187
Q30: Which lab result supports a diagnosis of NSTEMI?
A. Elevated CRP
B. Elevated cardiac troponin
C. Normal serum cholesterol
D. Decreased INR
Q30: Which lab result supports a diagnosis of NSTEMI?
A. Elevated CRP
B. Elevated cardiac troponin ✅
C. Normal serum cholesterol
D. Decreased INR
188
Q31: What structural cardiac change is associated with chronic hypertension?
A. Atrial dilation
B. Ventricular septal defect
C. Left ventricular hypertrophy
D. Pericardial effusion
Q31: What structural cardiac change is associated with chronic hypertension?
A. Atrial dilation
B. Ventricular septal defect
C. Left ventricular hypertrophy ✅
D. Pericardial effusion
189
Q32: Which symptom best differentiates unstable angina from stable angina?
A. Diaphoresis
B. Predictable pain on exertion
C. Pain at rest
D. Nausea
Q32: Which symptom best differentiates unstable angina from stable angina?
A. Diaphoresis
B. Predictable pain on exertion
C. Pain at rest ✅
D. Nausea
190
Q33: What is a late complication of uncontrolled AF?
A. Ventricular septal defect
B. Heart failure
C. Hyperthyroidism
D. Pulmonary embolism
Q33: What is a late complication of uncontrolled AF?
A. Ventricular septal defect
B. Heart failure ✅
C. Hyperthyroidism
D. Pulmonary embolism
191
Q34: Which value indicates systolic hypertension?
A. 120 mmHg
B. 130 mmHg
C. 140 mmHg
D. 90 mmHg
Q34: Which value indicates systolic hypertension?
A. 120 mmHg
B. 130 mmHg
C. 140 mmHg ✅
D. 90 mmHg
192
Q35: Why might auscultation of carotid arteries be necessary in a CVD assessment?
A. To assess oxygen saturation
B. To detect bruits suggestive of turbulent flow
C. To monitor murmurs
D. To measure pulse rate
Q35: Why might auscultation of carotid arteries be necessary in a CVD assessment?
A. To assess oxygen saturation
B. To detect bruits suggestive of turbulent flow ✅
C. To monitor murmurs
D. To measure pulse rate
193
Q36: Which cardiac enzyme rises first after myocardial infarction?
A. Troponin I
B. CK-MB
C. Myoglobin
D. ALT
Q36: Which cardiac enzyme rises first after myocardial infarction?
A. Troponin I ✅
B. CK-MB
C. Myoglobin
D. ALT
194
Q37: Which antihypertensive medication reduces calcium influx into vascular smooth muscle?
A. Ramipril
B. Amlodipine
C. Atenolol
D. Enalapril
Q37: Which antihypertensive medication reduces calcium influx into vascular smooth muscle?
A. Ramipril
B. Amlodipine ✅
C. Atenolol
D. Enalapril
195
Q38: What feature is typical of Monckeberg’s arteriosclerosis?
A. Fatty deposits
B. Calcium deposits in tunica media
C. Protein deposits
D. Fibrotic thickening
Q38: What feature is typical of Monckeberg’s arteriosclerosis?
A. Fatty deposits
B. Calcium deposits in tunica media ✅
C. Protein deposits
D. Fibrotic thickening
196
Q39: What nursing action is appropriate if a patient with angina reports increased chest pain unrelieved by rest?
A. Document and reassess in 30 mins
B. Call MET or escalate for immediate review
C. Check for a fever
D. Encourage deep breathing
Q39: What nursing action is appropriate if a patient with angina reports increased chest pain unrelieved by rest?
A. Document and reassess in 30 mins
B. Call MET or escalate for immediate review ✅
C. Check for a fever
D. Encourage deep breathing
197
