Cardiovascular Test Mix

From the Nursing Center CE collection
http://www.nursingcenter.com/prodev/static.asp?pageid=597015

Gender, Ethnicity, and Cardiovascular Disease Specialty CE Collections, August 2005
Get the Edge on Deep Vein Thrombosis Specialty CE Collections, August 2005
New High Blood Pressure Guidelines Create New At-Risk Classification: Changes in Blood Pressure Classification by JNC 7 Specialty CE Collections, August 2005
Sparing a Few Minutes for Tobacco Cessation Specialty CE Collections, August 2005
1.
Questions 1-15 are associated with the article, "Gender, Ethnicity, and Cardiovascular Disease."
What is the authors' view regarding the amount of research that has been conducted examining gender and ethnicity in relation to cardiovascular disease (CVD)?
a. These topics have received excessive attention by the media.
b. These topics have been understudied.
c. Research nurses have made little contribution in these areas.
d. Research in these areas has been funded almost exclusively by pharmaceutical companies.

2.
According to the 2000 Institute of Medicine (IOM) report, all of the following should be a basis for how the term sex is used except
a. biochemical characteristics.
b. gonadal characteristics.
c. social role characteristics.
d. physical characteristics.

3.
According to the 2000 IOM report, what does the term gender refer to?
a. social roles that are independent of sex
b. biophysical characteristics
c. chromosomal characteristics
d. social roles that are related to sex

4.
How does the IOM regard the concepts of race and ethnicity?
a. They distinguish the two and find the concept of race to be more useful.
b. They distinguish the two and find the concept of ethnicity to be more useful.
c. They distinguish the two and find both to be equally useful.
d. They equate the two and find both to be equally useful.

5.
Which of the following is not part of the ethnicity concept as viewed by the IOM?
a. skin color
b. language
c. material culture
d. religion

6.
Which of the following do the authors view as one very positive contribution of nursing science in the study of gender and ethnicity?
a. a focus on genetic factors
b. a focus on language
c. a focus on cultural context
d. a focus on phenotype

7.
In the epidemiological research of Dr. Miyong Kim, what was found to be the leading CVD risk factor?
a. high blood cholesterol
b. obesity
c. cigarette smoking
d. high blood pressure

8.
Which of the following is a part of African American culture that has been used as a mechanism for CVD risk factor reduction?
a. rap music
b. churches
c. sports
d. language

9.
In what way was Dr. Martha Hill's program of research on blood pressure control among inner city African Americans culturally sensitive?
a. It provided assistance with life priorities such as job training and housing.
b. It emphasized antihypertensive medications that are most effective among African Americans.
c. It involved having ministers discuss blood pressure in their sermons.
d. The health team visited with participants in their churches.

10.
According to recent research, which of the following is the most common prodromal symptom of myocardial infarction among women?
a. sleep disturbance
b. shortness of breath
c. unusual fatigue
d. indigestion

11.
What did the IOM conclude regarding racial and ethnic disparities in cardiovascular care?
a. They found no such differences.
b. They found that such disparities could be explained by overuse of services by whites.
c. They found that such disparities could be explained by differences in disease prevalence.
d. They found that such disparities could not be explained by confounding factors.

12.
What findings were obtained by Dr. Julie Zerwic in her research on sex and race differences in delay in seeking treatment for acute MI?
a. African Americans were less likely to seek treatment within the first hour after symptom onset.
b. Women delayed longer than men across all ethnic groups.
c. Non-Hispanic whites delayed longer than African Americans.
d. African American women delayed longer than Hispanic men.

13.
What was a notable feature of the findings reported by Dr. Debra Moser based on her study of anxiety early after acute MI?
a. Only married women reported greater anxiety than men.
b. Only unmarried women reported greater anxiety than men.
c. The pattern of sex differences varied widely across countries.
d. The same pattern was seen across countries and could not be explained.

14.
According to the authors' own research, what are the rates of participation in outpatient cardiac rehabilitation in women and men?
a. 25% to 30% in women compared to 35% to 41% in men
b. 15% to 20% in women compared to 35% to 41% in men
c. 15% to 20% in women compared to 25% to 31% in men
d. 5% to 10% in women compared to 25% to 31% in men

15.
What recommendation do the authors make regarding the analysis and reporting of data on gender and ethnicity in research on cardiovascular disease?
a. Differential outcome data should focus on disparities across gender and ethnic groups.
b. Statistical power should be sufficient to allow statistical analysis of differential outcomes.
c. Differential outcome data should not be reported unless it is analyzed statistically.
d. Differential outcome data should be made available even if it is not analyzed statistically.

16.
Questions 16-34 are associated with the article, "Get the Edge on Deep Vein Thrombosis."
Which of the following patients has the greatest risk of developing a deep vein thrombosis (DVT)?
a. a 15-year-old post appendectomy
b. a 20-year-old post pulmonary wedge resection
c. a 50-year-old post cholecystectomy
d. a 60-year-old post hip replacement

17.
Which of the following is a classic assessment finding in a patient who has a DVT in the leg?
a. tachycardia
b. absent pedal pulse
c. coolness of the extremity
d. pain in the extremity

18.
Which of the following is the preferred diagnostic procedure to identify a DVT?
a. I-fibrinogen scan
b. magnetic resonance direct thrombus imaging
c. D-Dimer assay
d. venous duplex ultrasonography

19.
Which of the following diagnostic test can be used to detect filling defects in a deep vein?
a. venous duplex ultrasonography
b. venography with contrast media
c. magnetic resonance direct thrombus imaging
d. D-Dimer assay

20.
To prevent a venous thromboembolism (VTE) in a low-risk patient, the nurse should expect to use which of the following preventive measures?
a. encourage ambulation
b. apply elastic compression stockings
c. use an intermittent pneumatic compression device
d. administer heparin

21.
In which of the following patients would the half-life of heparin be prolonged?
a. a 55-year-old post total knee replacement
b. a 60-year-old with a history of cirrhosis
c. a 65-year-old with multiple sclerosis
d. a 70-year-old with a history of MI

22.
In a patient receiving UFH, the activated partial thromboplastin time ratio should be maintained at
a. 0.5 to 1.5.
b. 1.5 to 2.5.
c. 2.5 to 3.5.
d. 3.5 to 4.5.

23.
Heparin would be recommended for a patient who has had a
a. pulmonary lobectomy.
b. total hip replacement.
c. total knee replacement.
d. spinal cord injury.

24.
Low molecular weight heparin (LMWH) must be administered via which route?
a. by mouth
b. subcutaneous injection
c. intramuscular injection
d. intravenous infusion

25.
A patient receiving warfarin therapy should be advised not to increase consumption of foods that are rich in
a. vitamin A.
b. vitamin B.
c. vitamin C.
d. vitamin K.

26.
For which of the following patients is it safe to administer warfarin?
a. A patient who has a bleeding gastric ulcer.
b. A hemophiliac patient who has hemarthrosis.
c. A woman who's pregnant.
d. A woman who's lactating.

27.
One advantage of using LMWH for a VTE recurrence is that
a. daily blood work can be done in the home.
b. it's administered orally.
c. it may not require hospitalization.
d. treatment lasts for 3 days.

28.
A patient may require a higher dosage of warfarin if she's also receiving
a. nafcillin.
b. ketoconazole.
c. metronidazole.
d. tamoxifen.

29.
Which of the following laboratory tests is used to assess the therapeutic effect of warfarin in a patient who has a VTE?
a. platelet count
b. activated partial thromboplastin time
c. international normalized ratio
d. prothrombin time

30.
Which of the following international normalized ratio values indicates a therapeutic maintenance level of warfarin?
a. 1.0 to 2.0
b. 2.0 to 3.0
c. 3.0 to 4.0
d. 4.0 to 5.0

31.
Which of the following medications is used as a heparin antagonist?
a. phytonadione
b. vitamin K
c. protamine sulfate
d. AquaMEPHYTON

32.
Administration of protamine sulfate in less than 3 minutes may lead to which of the following side effects?
a. bradycardia
b. hypertension
c. tachypnea
d. elevated temperature

33.
Anaphylaxis to protamine sulfate is often associated with
a. an increased heparin dosage.
b. a decreased white blood count.
c. previous exposure to the drug.
d. a prolonged prothrombin time.

34.
Post-thrombotic syndrome may be helped by
a. administering steroids.
b. stopping heparin administration.
c. limiting foods high in vitamin K
d. encouraging exercise.

35.
Questions 35-50 are associated with the article, "New High Blood Pressure Guidelines Create New At-Risk Classification: Changes in Blood Pressure Classification by JNC 7."
According to the new guidelines of the Seventh Report of the Joint National Committee on the Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7), what is now considered normal blood pressure (BP) is what was previously considered
a. low.
b. normal.
c. optimal.
d. high-normal.

36.
A primary goal of the JNC 7 report was to make the classification of BP more
a. outcome-driven.
b. detailed.
c. stringent.
d. simple.

37.
The new prehypertension category includes a
a. systolic BP of 120 to 139 mm Hg.
b. systolic BP of 130 to 149 mm Hg.
c. diastolic BP of 70 to 89 mm Hg.
d. diastolic BP of 80 to 99 mm Hg.

38.
According to recent data from the Framingham Heart Study, what is the probability of nonhypertensive adults at age 55 developing hypertension in their lifetime?
a. 60%
b. 70%
c. 80%
d. 90%

39.
Consistent with the Framingham Heart Study is another report that indicates that the risk of cardiovascular disease doubles for each BP increment of
a. 10/05 mm Hg.
b. 10/10 mm Hg.
c. 20/10 mm Hg.
d. 25/15 mm Hg.

40.
All individuals now identified as prehypertensive should
a. eliminate alcohol consumption immediately.
b. start taking an antihypertensive medication.
c. begin a weight-loss program immediately.
d. reduce dietary sodium intake to < 100 mmol/d.

41.
An essential focus of the Dietary Attempts to Stop Hypertension (DASH) diet is
a. increased intake of fruits and vegetables.
b. decreased intake of protein.
c. increased intake of dairy products.
d. decreased intake of carbohydrates.

42.
To help reduce blood pressure, which nutrient should be included specifically in adequate amounts in the diet daily?
a. calcium
b. potassium
c. magnesium
d. fish oil

43.
As reported in JNC 7, the most significant reduction in systolic BP was achieved with
a. reduced alcohol consumption.
b. the DASH diet.
c. regular exercise.
d. weight reduction.

44.
To reduce blood pressure, regular aerobic physical activity is recommended for
a. 20 minutes a day 5 days a week.
b. 20 minutes a day every day.
c. 30 minutes a day most days of the week.
d. 40 minutes a day 5 days a week.

45.
Women who need to reduce blood pressure should have
a. no alcohol at all.
b. no more than one drink per day.
c. 2 glasses of red wine per day.
d. no more than 3 drinks per week.

46.
To prevent and manage hypertension, dietary sodium consumption should be limited to less than how many grams per day?
a. 10
b. 8.2
c. 4.2
d. 2.4

47.
According to the new JNC 7 blood pressure classification, a systolic BP of 140 would be considered
a. normal.
b. prehypertension.
c. stage 1 hypertension.
d. stage 2 hypertension.

48.
According to the new JNC 7 blood pressure classification, a systolic BP of 160 would be considered
a. normal.
b. prehypertension.
c. stage 1 hypertension.
d. stage 2 hypertension.

49.
In the PREMIER clinical trial, nonhypertensive participants who incorporated lifestyle interventions and were given information on the DASH diet
a. showed no significant change in systolic BP.
b. reduced systolic BP by 3.6 mm Hg.
c. reduced systolic BP by more than 6 mm Hg.
d. reduced diastolic BP by 8.9 mm Hg.

50.
For primary prevention of hypertension and management of hypertension, it is recommended that individuals maintain a body mass index
a. from 18 to 24.9.
b. below 22.
c. from 21 to 30.
d. below 26.

51.
Questions 51-65 are associated with the article, "Sparing a Few Minutes for Tobacco Cessation."
Over the past 4 decades, cigarette smoking in the United States has declined by about
a. one-quarter.
b. one-third.
c. one-half.
d. two-thirds.

52.
Smoking prevalence is highest among adults ages
a. 18 to 24 years.
b. 25 to 35 years.
c. 36 to 50 years.
d. 51 to 65 years.

53.
Adolescent girls tend to associate being an established smoker with
a. attracting boys.
b. peer approval.
c. defying authority.
d. staying thin.

54.
A common nicotine withdrawal symptom is
a. headache.
b. joint pain.
c. dry mouth.
d. photosensitivity.

55.
The United States Public Health Service (USPHS) recommends that all patients have their smoking status documented
a. at each provider encounter.
b. every 5 years.
c. at least once a year.
d. only if they're willing to quit.

56.
A smoker who quits decreases his risk of heart attack
a. immediately.
b. 24 hours after quitting.
c. 1 week after quitting.
d. 3 months after quitting.

57.
A recommendation for a smoker who is trying to quit and who typically smokes after dinner is to
a. skip dinner.
b. eat more than usual at dinner.
c. brush his teeth immediately after eating dinner.
d. have a cup of coffee after dinner.

58.
According to estimates, what percentage of nurses smoke?
a. 3%
b. 16%
c. 23%
d. 26%

59.
Which nicotine replacement therapy is known for causing hiccups?
a. lozenges
b. inhaler
c. nasal spray
d. transdermal patch

60.
The best response to a patient who says that she became ill the last time she tried to quit is explaining that
a. withdrawal symptoms are nothing compared with symptoms of lung cancer.
b. quitting has many health benefits, so she must have become ill from a virus.
c. nutrition will help improve her resistance to illness, so she should eat more after she quits.
d. when a smoker quits, paralyzed cilia recover by rejecting debris through a temporary cough.

61.
What is the best response to a nurse colleague who says that she doesn't have time to help patients quit smoking?
a. "You can't really think about the time when you could be saving lives."
b. "They expect so much of us in so little time, but we have to set priorities."
c. "It only takes a minute to refer them to a telephone quit line or hand them a brochure."
d. "I don't mind making the time, if you'll just tell me which patients of yours smoke."

62.
The Joint Commission on Accreditation of Healthcare Organizations and the Centers for Medicare and Medicaid Services require hospitals to submit data on cessation counseling provided to smokers hospitalized for
a. chronic bronchitis.
b. community-acquired pneumonia.
c. emphysema.
d. lung cancer.

63.
As part of step 1 of the smoking intervention implemented at Greenwich Hospital, the nurses assess the patient for all of the following except whether or not he
a. has ever smoked.
b. currently smokes.
c. has smoked in the past 12 months.
d. lives with others who smoke.

64.
Once the nurses at Greenwich Hospital identify a smoker willing to quit, they
a. advise and assist him in quitting.
b. discuss the rewards of quitting.
c. teach the relevance of quitting.
d. understand the roadblocks to quitting.

65.
At Greenwich Hospital, plans are under way to offer the same guidelines and pocket reference cards for smoking cessation to the
a. physicians.
b. nursing assistants.
c. respiratory therapists.
d. nonclinical staff.