NSG 6420 Week 4 Knowledge check
1. Which of the following is the most important question to ask during
cardiovascular health history?
Student
Number of offspring
Answer:
Last physical exam
Sudden death of a family member
Use of caffeine
Instructor The sudden death of a family member is an important question to ask in the health history
Explanation: because it reveals the cardiovascular disease risk of the patient. Sudden death is usually
due to an acute cardiovascular event, such as myocardial infarction, cardiac dysrhythmia,
or stroke.
Family history is particularly important for cardiac assessment because CVD, HTN,
hyperlipidemia, & other vascular diseases often have a familial association that is not
easily ameliorated by lifestyle changes. If there are deaths in the family related to CVD,
determine the age & exact cause of death, because CVD at a young age in the immediate
family carries an increased risk compared with CVD in an elderly family member. Ask
about sudden death, which might indicate a congenital disease such as Marfan's
syndrome. This is especially important to ask during pre-sports physicals because sudden
death in athletes is often related to congenital or familial heart disease. Familial
hyperlipidemia is autosomal dominant & often leads to CAD & MI at a young age.
Family history of obesity & type 2 diabetes are also secondary risk factors for heart
disease because the familial tendency for these is strong. Ask about smoking in the house,
as secondhand smoke is a risk factor for respiratory & cardiac disease. (Goolsby 167-168)
-708354236 MultipleChoice 1 False
Question 2. A key symptom of ischemic heart disease is chest pain. However, angina
equivalents may include exertional dyspnea. Angina equivalents are
important because:
Student Answer:
Women with ischemic heart disease many times do not present with
chest pain
Some patients may have no symptoms or atypical symptoms; diagnosis
may only be made at the time of an actual myocardial infarction
Elderly patients have the most severe symptoms
A & B only
, Instructor The key symptom of IHD is chest pain, but other common symptoms include arm
Explanation: pain, lower jaw pain, shortness of breath, & diaphoresis. These symptoms are
referred to as angina equivalents & can also include fatigue or breathlessness. Some
patients may have no symptoms or atypical ones so that CAD may not be diagnosed
until they experience a myocardial infarction. (Kennedy-Malone 227)
-708354235 MultipleChoice 2 True
Question 3. : A 55-year-old post-menopausal woman with a history of hypertension
complains of jaw pain on heavy exertion. There were no complaints of chest
pain. Her ECG indicates normal sinus rhythm without ST segment
abnormalities. Your plan may include:
Student
Echocardiogram
Answer:
Exercise stress test
Cardiac catheterization
Myocardial perfusion imaging
Instructor Once all the results of the initial laboratory & ECG testing are reviewed, a pretest
Explanation: probability of disease can be generated & additional tests can be ordered.2 The probability
of CAD can be calculated by considering the chosen noninvasive test's sensitivity &
specificity.2 Selection of the proper cardiac test (see Table 115-1) for an individual
depends on the person's risk stratification, age, & tolerable level of activity. The most
common & least invasive test for diagnosis of CAD is the stress test, also called the
exercise tolerance test (ETT) or treadmill exercise. (Buttaro 488)
-708354234 MultipleChoice 3 True
Question 4. Jenny is a 24 year old graduate student that presents to the clinic today with
complaints of fever, midsternal chest pain & generalized fatigue for the past
two days. She denies any cough or sputum production. She states that when
she takes Ibuprofen & rest that the chest pain does seem to ease off. Upon
examination the patient presents looking very ill. She is leaning forward &
states that this is the most comfortable position for her. Temp is 102. BP=
100/70. Heart rate is 120/min & regular. Upon auscultation a friction rub is
audible. Her lung sounds are clear. With these presenting symptoms your
initial diagnosis would be:
Student
Mitral Valve Prolapse
Answer:
Referred Pain from Cholecystitis
Pericarditis
Pulmonary Embolus
Instructor Pericarditis, inflammation of the pericardium, is usually not a solo disease process but is
Explanation: seen in conjunction with other diseases or conditions. Pericarditis may occur as a
1. Which of the following is the most important question to ask during
cardiovascular health history?
Student
Number of offspring
Answer:
Last physical exam
Sudden death of a family member
Use of caffeine
Instructor The sudden death of a family member is an important question to ask in the health history
Explanation: because it reveals the cardiovascular disease risk of the patient. Sudden death is usually
due to an acute cardiovascular event, such as myocardial infarction, cardiac dysrhythmia,
or stroke.
Family history is particularly important for cardiac assessment because CVD, HTN,
hyperlipidemia, & other vascular diseases often have a familial association that is not
easily ameliorated by lifestyle changes. If there are deaths in the family related to CVD,
determine the age & exact cause of death, because CVD at a young age in the immediate
family carries an increased risk compared with CVD in an elderly family member. Ask
about sudden death, which might indicate a congenital disease such as Marfan's
syndrome. This is especially important to ask during pre-sports physicals because sudden
death in athletes is often related to congenital or familial heart disease. Familial
hyperlipidemia is autosomal dominant & often leads to CAD & MI at a young age.
Family history of obesity & type 2 diabetes are also secondary risk factors for heart
disease because the familial tendency for these is strong. Ask about smoking in the house,
as secondhand smoke is a risk factor for respiratory & cardiac disease. (Goolsby 167-168)
-708354236 MultipleChoice 1 False
Question 2. A key symptom of ischemic heart disease is chest pain. However, angina
equivalents may include exertional dyspnea. Angina equivalents are
important because:
Student Answer:
Women with ischemic heart disease many times do not present with
chest pain
Some patients may have no symptoms or atypical symptoms; diagnosis
may only be made at the time of an actual myocardial infarction
Elderly patients have the most severe symptoms
A & B only
, Instructor The key symptom of IHD is chest pain, but other common symptoms include arm
Explanation: pain, lower jaw pain, shortness of breath, & diaphoresis. These symptoms are
referred to as angina equivalents & can also include fatigue or breathlessness. Some
patients may have no symptoms or atypical ones so that CAD may not be diagnosed
until they experience a myocardial infarction. (Kennedy-Malone 227)
-708354235 MultipleChoice 2 True
Question 3. : A 55-year-old post-menopausal woman with a history of hypertension
complains of jaw pain on heavy exertion. There were no complaints of chest
pain. Her ECG indicates normal sinus rhythm without ST segment
abnormalities. Your plan may include:
Student
Echocardiogram
Answer:
Exercise stress test
Cardiac catheterization
Myocardial perfusion imaging
Instructor Once all the results of the initial laboratory & ECG testing are reviewed, a pretest
Explanation: probability of disease can be generated & additional tests can be ordered.2 The probability
of CAD can be calculated by considering the chosen noninvasive test's sensitivity &
specificity.2 Selection of the proper cardiac test (see Table 115-1) for an individual
depends on the person's risk stratification, age, & tolerable level of activity. The most
common & least invasive test for diagnosis of CAD is the stress test, also called the
exercise tolerance test (ETT) or treadmill exercise. (Buttaro 488)
-708354234 MultipleChoice 3 True
Question 4. Jenny is a 24 year old graduate student that presents to the clinic today with
complaints of fever, midsternal chest pain & generalized fatigue for the past
two days. She denies any cough or sputum production. She states that when
she takes Ibuprofen & rest that the chest pain does seem to ease off. Upon
examination the patient presents looking very ill. She is leaning forward &
states that this is the most comfortable position for her. Temp is 102. BP=
100/70. Heart rate is 120/min & regular. Upon auscultation a friction rub is
audible. Her lung sounds are clear. With these presenting symptoms your
initial diagnosis would be:
Student
Mitral Valve Prolapse
Answer:
Referred Pain from Cholecystitis
Pericarditis
Pulmonary Embolus
Instructor Pericarditis, inflammation of the pericardium, is usually not a solo disease process but is
Explanation: seen in conjunction with other diseases or conditions. Pericarditis may occur as a
