Download CPR Question Bank Answered Exam Questions 2023-2024 (100% Verified Answers) and more Exams Nursing in PDF only on Docsity! CPR Question Bank Answered Exam Questions 2023- 2024 (100% Verified Answers) Since voltage-gated Na+ channels inactivate in <5ms, how can the action potential remain depolarized for several hundred milliseconds in ventricular muscle cells? A. The Na+ channels open and close repetitively B. L-type Ca2+ channels sustain Ca2+ influx for a long time C. T-type Ca2+ channels sustain Ca2+ influx for a long time D. Other positively charged ions enter cell - Correct Answers✅ with Rationales ✔ ️B. L-type Ca2+ channels sustain Ca2+ influx for a long time Muscle cells use fast response with L-type Ca2+ channels that have a slow inactivation (stay open for a while). T-type have a fast inactivation and are used for depolarization in the slow response in nodal cells Depolarization of the membrane potential occurs with the influx of both Na+ ions and: A. Influx of Ca2+ ions CPR Question Bank Answered Exam Questions 2023- 2024 (100% Verified Answers) B. Influx of Cl- ions C. Efflux of Ca2+ ions D. Efflux of K+ ions E. None of the above - Correct Answers✅ with Rationales ✔ ️A. Influx of Ca2+ ions Occurs via L-type Ca2+ channels in muscle cells and via T-type Ca2+ channels in nodal cells. B. Influx of Cl- ions. This would repolarize cell C. Efflux of Ca2+ ions. This would repolarize cell D. Efflux of K+ ions. This occurs to help repolarize the cell. Even though the AV node has an intrinsic rate of 40-60 bpm, artificial pacemakers are often implanted when the SA node is damaged. Why? A. Faster rate of depolarization than the AV node can provide is needed in times of stress or exercise. CPR Question Bank Answered Exam Questions 2023- 2024 (100% Verified Answers) B: Decreased Which of the following events occurs immediately BEFORE opening of the mitral valve? A: atrial contraction B: isovolumic ventricular contraction C: isovolumic ventricular relaxation D: P wave - Correct Answers✅ with Rationales ✔ ️C: isovolumic ventricular relaxation Mitral valve in left ventricle, opens during diastole as blood moves from left atrium to left ventricle atrial contraction (AV open) -> isovolumic ventricle contraction (AV close) -> Ejection period (semilunar open) -> isovolumic ventricle relaxation (semilunar close) Which of the following is normally incapable of spontaneous pacemaking? CPR Question Bank Answered Exam Questions 2023- 2024 (100% Verified Answers) A: AV node B: Bundle of His C: Myocardial muscle cell D: Purkinje fiber E: SA node - Correct Answers✅ with Rationales ✔ ️C: Myocardial muscle cell Automaticity usually reserved for nodal cells https://docs.google.com/presentation/d/ 1LMDAi8d5jomeFpJX8PGxofKykhcv0miiGv21Qn9yBSo/edit#slide=id.p In this figure, the upper trace is the membrane electrical potential from a ventricular myocyte and the curves denoted by letters A, B, and C are ionic conductances. Which conductance is tightly linked with cardiac muscle contraction and is blocked by diltiazem? A: Conductance A B: Conductance B CPR Question Bank Answered Exam Questions 2023- 2024 (100% Verified Answers) C: Conductance C - Correct Answers✅ with Rationales ✔ ️C: Conductance C Different ions intracellularly during fast response (muscle cells) A is potassium (K) B is sodium (Na) C is calcium (Ca). Calcium channels are sensitive to diltiazem. Both L-type and T-type Ca2+ channels are inhibited by verapamil and diltiazem (phenylalkylamines). Dihydropyridines do not inhibit T-type so not used to treat arrhythmias. A conduction delay occurs in which of the following part of the cardiac conduction system? A: AV nodal cells B: Internodal conduction fibers C: Purkinje fibers D: SA nodal cells E: The bundle of His - Correct Answers✅ with Rationales ✔ ️A: AV nodal cells CPR Question Bank Answered Exam Questions 2023- 2024 (100% Verified Answers) What factors affect stroke volume? - Correct Answers✅ with Rationales ✔ ️ Preload (stretching force during diastole, EDV) Afterload (force against muscle to contract, arterial P) Contractility (inotropy) Relaxation (lusitropy) https://docs.google.com/presentation/d/ 1LMDAi8d5jomeFpJX8PGxofKykhcv0miiGv21Qn9yBSo/ edit#slide=id.g10ea72fb846_0_1 A: normal sinus rhythm and normal QRS axis B: sinus tachycardia and left axis deviation C: normal sinus rhythm and right axis deviation D: sinus bradycardia and right axis deviation - Correct Answers✅ with Rationales ✔ ️A: normal sinus rhythm and normal QRS axis Rhythm: I and II are positive P wave, aVR is negative P wave -> Sinus Rhythm QRS axis: I and aVF axis are both positive -> normal QRS axis CPR Question Bank Answered Exam Questions 2023- 2024 (100% Verified Answers) Assume that a 70 kg healthy adult has a hemorrhage of 500 ml of blood. [Normal total blood volume = 5,000 ml]. How would this affect vasoconstrictor impulses to arterioles? A: increase B: decrease C: remain unchanged - Correct Answers✅ with Rationales ✔ ️A: increase Loss of blood -> hypotension -> try to increase BP via vasoconstriction Which heart valves open at the end of the period of isovolumic contraction? A: Aortic valve B: Aortic valve and pulmonic valve C: Mitral valve D: Pulmonic valve E: Tricuspid valve - Correct Answers✅ with Rationales ✔ ️B: Aortic valve and pulmonic valve CPR Question Bank Answered Exam Questions 2023- 2024 (100% Verified Answers) Isovolumic contraction forces semilunar valves open https://docs.google.com/presentation/d/ 1LMDAi8d5jomeFpJX8PGxofKykhcv0miiGv21Qn9yBSo/ edit#slide=id.g10ea72fb846_0_7 The arrows in the attached micrograph are pointing to which of the following? A: endothelial cells B: fibroblasts C: lymphocytes D: smooth muscle cells - Correct Answers✅ with Rationales ✔ ️A: endothelial cells Statins have which of the following benefits? A: lowering CHOL, lower TG, increasing C-reactive protein CPR Question Bank Answered Exam Questions 2023- 2024 (100% Verified Answers) Baroreceptors work to regulate blood pressure in arteries via vasoconstriction Why do you get tachycardic when you are dehydrated? - Correct Answers✅ with Rationales ✔ ️Small decrease in arterial pressure -> SNS activation -> increase HR to maintain BP Dehydration -> decrease in venous pool -> less preload -> less stroke volume -> SNS activation to increase HR (more strokes to pump needed volume) Why do you get tachycardic when you are febrile? - Correct Answers✅ with Rationales ✔ ️Febrile = higher metabolic rate, increased blood to skin -> decreased systemic vascular resistance -> more flow needed to keep blood pressure https://docs.google.com/presentation/d/ 1LMDAi8d5jomeFpJX8PGxofKykhcv0miiGv21Qn9yBSo/ edit#slide=id.g10f2fc80389_0_1 - Correct Answers✅ with Rationales ✔ ️1. Rate: 300/5 big boxes = ~60bpm 2. Rhythm: P wave in I and II is positive, aVR is negative -> Sinus Rhythm CPR Question Bank Answered Exam Questions 2023- 2024 (100% Verified Answers) 3. Conduction. (A) PR interval about 1 big box (normal), (B) QRS axis: I is positive, aVF is positive, normal. duration is less than 3 small boxes-normal, (C) QT interval. R to R is 4.5 big boxes, QT is about 2 big boxes which is less than 1/2 RR - normal. 4. Chamber enlargement. P wave looks normal, no QRS deviations 5. ST elevations/depressions. None seen https://docs.google.com/presentation/d/ 1LMDAi8d5jomeFpJX8PGxofKykhcv0miiGv21Qn9yBSo/ edit#slide=id.g10f2fc80389_0_8 A 64-year-old woman, with a history of diabetes, comes to your medical office complaining of several episodes of chest tightness for the past two days. You perform a 12-lead electrocardiogram (shown here). Which of the following is the most appropriate management at this point A: Admit the patient to a hospital for a possible non-STEMI/unstable angina B: Change her diabetes medication C: Have her rest at home D: Make an appointment to see a cardiologist the next day CPR Question Bank Answered Exam Questions 2023- 2024 (100% Verified Answers) E: Perform an electrocardiogram during exercise - Correct Answers✅ with Rationales ✔ ️History of angina. Ischemic heart disease -> stable angina, STEMI or NSTEMI. A: Admit the patient to a hospital for a possible non-STEMI/unstable angina Progressing from large arteries to arterioles, which of the following changes occur in the vessel walls? A: An increased proportion of elastin B: An increased proportion of smooth muscle C: An increased number of vasa vasorum D: Disappearance of the endothelial basement membrane - Correct Answers✅ with Rationales ✔ ️B: An increased proportion of smooth muscle Which of the following characteristics of an atherosclerotic plaque makes it LESS LIKELY to rupture? A: Deficiency of smooth muscle cells CPR Question Bank Answered Exam Questions 2023- 2024 (100% Verified Answers) Which normally contain blood? A: 1, 2, 4 B: 1, 3, 5 C: 2, 3, 6 D: 2, 4, 5 E: 3, 4, 6 - Correct Answers✅ with Rationales ✔ ️D: 2,4,5 The pathophysiology of angina pectoris involves the imbalance between myocardial oxygen supply and myocardial oxygen demand. Which of the following is a component of myocardial oxygen supply? A: Contractility B: Diastolic perfusion pressure C: Heart rate D: Wall tension - Correct Answers✅ with Rationales ✔ ️B: Diastolic perfusion pressure CPR Question Bank Answered Exam Questions 2023- 2024 (100% Verified Answers) Other options are part of myocardial oxygen demand. Diastolic perfusion pressure relates to coronary arteries as coronary arteries fill during diastole. Coronary arteries provide myocardial oxygen supply A 57 year-old Latino man comes to your clinic for evaluation. You conclude he has Metabolic Syndrome based upon the following findings: abdominal obesity with waist circumference 42 in., elevated triglyceride level 170 mg/dl, low HDL level 29 mg/dl, fasting blood sugar 110 mg/dl, Blood pressure 128/85. Which of the following is the MOST APPROPRIATE initial step in patient care? A: Balanced carbohydrate and protein diet for low glucose and low insulin, regular aerobic exercise at least 3 times weekly, and discussion regarding improving habits that promoted his current health risk B: Low dose statin for primary prevention, krill oil 1000mg, and fibric acid derivative to lower triglycerides C: Low trans-fat diet, low salt diet 2000mg, exercise, fenofibrate for hypertriglyceridemia D: Niacin to increase HDL levels - Correct Answers✅ with Rationales ✔ ️A: Balanced carbohydrate and protein diet for low glucose and low insulin, CPR Question Bank Answered Exam Questions 2023- 2024 (100% Verified Answers) regular aerobic exercise at least 3 times weekly, and discussion regarding improving habits that promoted his current health risk Metabolic syndrome is treated with lifestyle changes A radio nuclear stress test done on a patient with history of chest pain, showed ischemia localized and limited to the lateral wall of the left ventricle. Which of the following coronary arteries is the MOST LIKELY source of the ischemia? A: Circumflex B: Left anterior descending C: Left main D: Posterior descending E: Right - Correct Answers✅ with Rationales ✔ ️A: Circumflex https://docs.google.com/presentation/d/ 1LMDAi8d5jomeFpJX8PGxofKykhcv0miiGv21Qn9yBSo/ CPR Question Bank Answered Exam Questions 2023- 2024 (100% Verified Answers) A: L-type Ca channels B: Na/Ca exchange protein C: plasma membrane Na,K-ATPase D: ryanodine receptor X E: sarcoplasmic reticulum Ca-ATPase - Correct Answers✅ with Rationales ✔ ️C: plasma membrane Na,K-ATPase Cardiac glycosides block the Na/K exchange protein to decrease the Na/Ca exchange protein to decrease amount of Ca leaving the cell during lusitropy - > decreases inotropy. Useful in heart failure to decrease workload of heart. (Digoxin). Has not been shown to decrease mortality. Which of the following is the MOST TYPICAL of right-sided heart failure? A: Dyspnea B: Orthopnea C: Peripheral edema D: Pulmonary crackles E: Tachycardia - Correct Answers✅ with Rationales ✔ ️C: Peripheral edema CPR Question Bank Answered Exam Questions 2023- 2024 (100% Verified Answers) Right sided heart failure -> back up into venous system -> peripheral edema When treating patients with calcium channel blockers, which of the following drugs has an effect on both the AV node and on decreasing arteriole vasoconstriction? A: Amlodipine B: Nicardipine C: Nifedipine D: Felodipine E: Verapamil - Correct Answers✅ with Rationales ✔ ️E: Verapamil Dihydropyridines are only effective on vasoconstriction. Non-dihydrop are also effective on nodal cells. A physician has decided that she is going to treat her patient who has stable angina with a calcium channel blocker. Which of the following activities is common to ALL calcium channel blockers? CPR Question Bank Answered Exam Questions 2023- 2024 (100% Verified Answers) A: Blocking reabsorption of sodium and water in the collecting duct of the kidney B: Reducing afterload C: Reducing preload D: Suppressing electrical conduction of the heart (AV node) - Correct Answers✅ with Rationales ✔ ️B: Reducing afterload Ca channel blockers all decrease vasoconstriction of mostly arterials -> reduce afterload. Only non-dihydrop affect the nodal cells. A 74-year-old man is hospitalized following a large anterior myocardial infarction. He reports having shortness of breath; cardiac auscultation reveals faint heart sounds, but a S3 gallop, with no murmurs. Lung auscultation is positive for bilateral crackles. Which of the following complications is MOST LIKELY responsible for these findings? A: Constrictive pericarditis B: Interventricular septal rupture CPR Question Bank Answered Exam Questions 2023- 2024 (100% Verified Answers) A: Atherosclerosis B: Bacterial infection C: Marfan syndrome D: Vasculitis E: Venous malformation - Correct Answers✅ with Rationales ✔ ️A: Atherosclerosis pulsatile mass + bruits -> abdominal aorta aneurysm which are normally caused by atherosclerosis A 28-year-old male non-smoker develops fatigue, occasional myalgia and abdominal pain, and increasing numbness of his left hand. Physical examination is unremarkable, although laboratory workup reveals a leukocytosis on CBC and the presence of moderate hematuria on urinalysis. Renal biopsy reveals sharply segmental fibrinoid necrosis of several medium- sized arteries with heavy PMN transmural infiltration. These findings are MOST CONSISTENT with which of the following diagnoses? A: Hyaline arteriosclerosis CPR Question Bank Answered Exam Questions 2023- 2024 (100% Verified Answers) B: Hyperplastic arteriolosclerosis C: Polyarteritis nodosa D: Takayasu arteritis E: Granulomatosis with polyangiitis - Correct Answers✅ with Rationales ✔ ️C: Polyarteritis nodosa medium sized arteries with PMN and transmural infiltration and fibrinoid necrosis all point to polyarteritis nodosa. Often also hep B surface antigen https://docs.google.com/presentation/d/ 1LMDAi8d5jomeFpJX8PGxofKykhcv0miiGv21Qn9yBSo/ edit#slide=id.g1113016fc01_0_0 A 38-year-old woman has congestive heart failure, premature ventricular contractions, and repeated episodes of ventricular tachycardia. Her blood pressure is normal. Her heart is enlarged. There are no murmurs and coronary angiography is normal. A biopsy was taken with representative histology shown in the images (H&E and trichrome stained). The MOST LIKELY diagnosis is which of the following? CPR Question Bank Answered Exam Questions 2023- 2024 (100% Verified Answers) A: acute rheumatic fever B: dilated cardiomyopathy C: fibroelastosis D: hypertrophic cardiomyopathy E: myocardial infarction - Correct Answers✅ with Rationales ✔ ️B: dilated cardiomyopathy No murmurs -> not valve issue normal coronary -> not atherosclerosis Large heart -> cardiomyopathy A 72-year-old anthropologist with long-standing hypertension visits your office for a routine exam. You notice an abnormality on his laboratory results caused by his regimen of captopril and spironolactone. What abnormality did you MOST LIKELY find? A: Anemia B: Hypercalcemia C: Hyperkalemia CPR Question Bank Answered Exam Questions 2023- 2024 (100% Verified Answers) In which type of primary cardiomyopathy does a sarcomeric mutation cause fiber disarray, muscle thickening, diastolic impairment, and potential obstruction to the outflow of the heart? A: Anthracycline cardiomyopathy B: Dilated Cardiomyopathy C: Hypertrophic Cardiomyopathy D: Restrictive Cardiomyopathy - Correct Answers✅ with Rationales ✔ ️C: Hypertrophic Cardiomyopathy https://docs.google.com/presentation/d/ 1LMDAi8d5jomeFpJX8PGxofKykhcv0miiGv21Qn9yBSo/ edit#slide=id.g1113016fc01_0_6 This diagram shows the relationship between stroke volume and end diastolic volume in the normal heart, the compensated heart, and the heart in failure. Letter A represents the position on the Frank Starling curve for a patient with congestive heart failure before treatment. Which of the lettered items best represents the expected shift based on the therapeutic action(s) of a diuretic drug such as furosemide: CPR Question Bank Answered Exam Questions 2023- 2024 (100% Verified Answers) A: A to B B: A to C C: A to D D: A to E E: A to F - Correct Answers✅ with Rationales ✔ ️A: A to B Diuretic decrease preload. travel left along same Frank Starling line In patients with severe HFrEF an increase in Afterload will result in which of the following? A: Decreased Blood Pressure B: Decreased Heart Rate C: Decreased Stroke Volume D: Increased Contractility - Correct Answers✅ with Rationales ✔ ️C: Decreased Stroke Volume (BAD) CPR Question Bank Answered Exam Questions 2023- 2024 (100% Verified Answers) Thrombolytic agents facilitate the breakdown of formed clots via activation of which of the following pathways? A: Factor X to Factor Xa B: Fibrinogen to fibrin C: Plasminogen to plasmin D: Prothrombin to thrombin - Correct Answers✅ with Rationales ✔ ️C: Plasminogen to plasmin 67 yo M presents with flu-like symptoms, joint pain, and visual disturbances. His erythrocyte sedimentation rate (ESR) is elevated over 100 and giant cells are seen on biopsy. Diagnosis? Which artery? Would a negative biopsy exclude disease? Treatment? Risk w/o treatment? - Correct Answers✅ with Rationales ✔ ️Temporal Giant Cell Arteritis