Review Med surg exam (cni college)

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Med surg exam (cni college)

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Total Questions : 55

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Question 1:

What is the term used to describe Right-sided heart failure that is caused by increased pressure in the lungs?

A. Ventricular dysfunction B. Orthopnea C. Cor Pulmonale D. Congestive HF

Answer and Explanation

Choice A:

This is a general term that can refer to problems with either the left or right ventricle of the heart. It doesn't specifically address the relationship between lung pressure and right-sided heart failure.

Choice B:

This is a symptom of heart failure, specifically difficulty breathing when lying down. It's not a diagnostic term for the condition itself.

Choice C:

It specifically refers to right-sided heart failure that is caused by increased pressure in the lungs (pulmonary hypertension).

Choice D:

This is a general term for heart failure where the heart is unable to pump blood effectively, leading to congestion in various parts of the body. While it can include right-sided heart failure, it doesn't specifically address the underlying cause of increased lung pressure.

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Question 2:

All of the following are common signs/symptoms of Hyperglycemia?

A. Excessive hunger B. Increased thirst C. Sweaty skin D. Increased urine production

Answer and Explanation

Choice A:

Excessive hunger is more commonly associated with hypoglycemia (low blood sugar), not hyperglycemia.

Choice B:

When blood sugar levels are high, the kidneys work overtime to filter out the excess glucose, leading to increased urination and dehydration. This causes increased thirst.

Choice C:

Sweaty skin is more often associated with hypoglycemia or other conditions like anxiety.

Choice D:

As mentioned above, the kidneys work harder to eliminate excess glucose, leading to increased urine production.

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Question 3:

What two diseases comprise COPD?

A. Chronic Bronchitis & Emphysema B. Acute Bronchitis & Emphysema C. Polycythemia & Emphysema D. Asthma & Emphysema

Answer and Explanation

Choice A:

These are the two primary conditions that constitute COPD. Chronic bronchitis is characterized by persistent cough with mucus production, while emphysema involves the destruction of lung tissue.

Choice B:

Acute bronchitis is a short-term infection, while COPD is a chronic condition. Therefore, this combination is incorrect.

Choice C:

Polycythemia is an increase in red blood cells, unrelated to lung conditions.

Choice D:

While asthma and COPD can share some symptoms, they are distinct conditions. Asthma is reversible airway obstruction, while COPD is progressive and irreversible.

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Question 4:

Which of the following would be expected findings in a patient experiencing Right-sided heart failure? (Select all that Apply)

A. JVD B. Crackles in the lungs C. Pink, Frothy sputum D. Paroxysmal nocturnal dyspnea E. Pitting edema

Answer and Explanation

Choice A:

When the right ventricle is failing, blood can back up into the jugular veins in the neck, causing them to become swollen and visible.

Choice B:

Crackles in the lungs are a sign of fluid buildup in the lungs, which is a common finding in left-sided heart failure, but not typically in right-sided heart failure.

Choice C:

Pink, Frothy sputum: Pink, frothy sputum can be a sign of pulmonary edema, which is a buildup of fluid in the lungs. However, this is more commonly associated with left-sided heart failure than right- sided heart failure.

Choice D:

Paroxysmal nocturnal dyspnea (PND): PND is a symptom of heart failure that causes shortness of breath that occurs at night, often waking the person from sleep. It can occur in both right-sided and left- sided heart failure.

Choice E:

In right sided heart failure, fluid can also build up in the legs and ankles, causing swelling that is tender to the touch

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Question 5:

Your patient asks you what the purpose of the Hgb A1C test is. The BEST answer is:

A. It tells us your average blood Sugar levels over the last 4 months B. It tells us if your pancreas is producing the hormone insulin C. It tells us your blood sugar levels without regard to your last food intake D. It tells us how much sugar you have been eating over the last few months

Answer and Explanation

Choice A:

The Hgb A1c test provides a snapshot of your average blood sugar levels over the past 2-3 months.

Choice B:

The Hgb A1c test does not measure insulin production. It measures the amount of glucose attached to hemoglobin in red blood cells.

Choice C:

While the Hgb A1c test is not affected by recent food intake, it doesn't provide a snapshot of your current blood sugar level. It reflects an average over several months.

Choice D:

The Hgb A1c test measures blood sugar levels, not directly sugar intake. While diet affects blood sugar, the test does not isolate sugar consumption.

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Question 6:

Which of the following would be expected findings in a patient experiencing Left-sided heart failure?

A. Pitting edema B. Paroxysmal noctural dyspnea C. JVD D. Crackles in the lungs E. Pink, Frothy sputum

Answer and Explanation

Choice A:

Pitting edema is more commonly associated with right-sided heart failure, where blood backs up in the systemic venous system, leading to fluid accumulation in the extremities. While it can occur in left- sided heart failure due to secondary effects on right-sided heart function, it is not a primary feature.

Choice B:

This is a common symptom of left-sided heart failure. It refers to sudden, severe shortness of breath that occurs at night, often causing the patient to wake up gasping for air. It is due to fluid accumulation in the lungs when lying flat, which worsens the patient’s breathing.

Choice C:

JVD is typically associated with right-sided heart failure. It occurs when blood backs up into the veins of the neck. In left-sided heart failure, this is not a primary symptom, though it can appear if left-sided heart failure progresses to affect the right side of the heart.

Choice D:

Crackles (or rales) are often heard during auscultation of the lungs in patients with left-sided heart failure. They are caused by fluid accumulation in the alveoli and are a direct result of pulmonary congestion.

Choice E:

This is a classic and severe symptom of left-sided heart failure, specifically associated with acute pulmonary edema. It occurs due to significant fluid leakage from the capillaries into the alveoli, mixing with air to create the pink, frothy appearance.

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Question 7:

What is the term used to describe the total amount of blood ejected from the Ventricle over 1 minute?

A. Stroke Volume B. Ejection Fraction C. Systemic Vascular Resistance D. Cardiac Output

Answer and Explanation

Choice A:

This is the amount of blood pumped out of the left ventricle with each heartbeat.

Choice B:

This is the percentage of blood pumped out of the left ventricle with each heartbeat compared to the total amount of blood in the ventricle before the beat.

Choice C:

This refers to the total resistance the blood encounters as it flows through the circulatory system.

Choice D:

This is the total amount of blood pumped out of the left ventricle per minute. It is calculated by multiplying stroke volume by heart rate.

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Question 8:

Your STEMI patient returns from the Cath lab, after having Balloon Angioplasty percutaneously through their femoral artery. Which of the following Signs and Symptoms would be indicative of Cardiac Tamponade?

A. Low blood pressure B. Bounding peripheral pulses C. Beck's Triad D. Clear S1, S2 heart sounds E. Jugular veins are distended

Answer and Explanation

Choice A:

As the heart's ability to pump blood is compromised, blood pressure decreases.

Choice B:

Bounding pulses are associated with increased cardiac output, which is opposite to what occurs in cardiac tamponade.

Choice C:

Beck's Triad: This classic triad includes hypotension, muffled heart sounds, and jugular venous distention, all indicative of cardiac tamponade.

Choice D:

Muffled heart sounds are a characteristic of cardiac tamponade due to the fluid accumulation around the heart.

Choice E:

Jugular veins are distended: The increased pressure in the right atrium due to impaired ventricular filling leads to distended jugular veins.

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Question 9:

Your patient in the Emergency Room reports having severe chest pain and you suspect a heart attack. Which of the following laboratory tests would be best to confirm your suspicions?

A. Troponin I & T B. Myoglobin C. BNP D. CK-MB isoenzymes

Answer and Explanation

Choice A:

These are the most specific and sensitive markers for diagnosing a heart attack. They are released into the bloodstream when heart muscle is damaged.

Choice B:

Myoglobin is an early marker of heart muscle damage, but it is less specific than troponin and can be elevated in other conditions.

Choice C:

B-type natriuretic peptide is a hormone primarily used to diagnose heart failure, not acute myocardial infarction (heart attack).

Choice D:

Creatine kinase-MB is an older marker for heart damage, but it is less specific than troponin and takes longer to rise in the blood.

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Question 10:

Your patient states that he experiences chest pain that increases with activity and decreases with rest. He is most likely describing which type of Angina?

A. Unstable B. Variant C. Stable D. Prinzmetal

Answer and Explanation

Choice A:

This is unpredictable chest pain that occurs at rest or with minimal exertion. It's a more serious condition and often a precursor to a heart attack.

Choice B:

Also known as Prinzmetal angina, this occurs at rest due to coronary artery spasms.

Choice C:

This is characterized by chest pain that occurs predictably with exertion and is relieved by rest. It's the most common type of angina.

Choice D:

This is another name for variant angina.

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Med surg exam (cni college)

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