Question 1

A nurse assesses a patient with a history of rheumatic fever. Which finding indicates possible mitral stenosis?

Accepted Answer

Answer reason: B. Crackles in lungs and dyspnea on exertion Mitral stenosis (often a late sequela of rheumatic fever) obstructs flow from the left atrium to the left ventricle, increasing left atrial pressure. This pressure backs up into the pulmonary vasculature, leading to pulmonary congestion and interstitial edema, which clinically present as dyspnea on exertion and crackles. Bounding pulses and widened pulse pressure are more consistent with aortic regurgitation/high stroke volume states, while prominent jugular venous distension is more typical of right-sided heart failure or tricuspid pathology.
Category reason: The question tests recognition of clinical manifestations of a specific valvular heart disease (mitral stenosis) as a consequence of rheumatic fever, which is primarily cardiovascular pathophysiology rather than a nursing management/prioritization task.

Question 2

Commonest congenital heart disease is?

Accepted Answer

Answer reason: The core principle is epidemiology of congenital cardiac defects: ventricular septal defects are the most frequent congenital heart lesions identified in infants and children. A VSD results from incomplete formation of the interventricular septum, creating a left-to-right shunt that is commonly detected by murmur screening even when small. ASD and PDA are also common but occur less frequently overall than VSD in standard pediatric cardiology prevalence data. TOF is a classic cyanotic defect but is far less common than isolated septal defects.

Question 3

Which of the following congenital heart defect is classified as cyanotic?

Accepted Answer

Answer reason: Cyanotic congenital heart disease is characterized by right-to-left shunting that reduces pulmonary blood flow and delivers deoxygenated blood to the systemic circulation. This condition includes ventricular septal defect with right ventricular outflow obstruction and overriding aorta, creating a pathway for deoxygenated blood to bypass the lungs and cause hypoxemia and cyanosis. The other listed lesions are typically acyanotic because they primarily cause obstructive left- or right-sided flow without an obligatory right-to-left shunt. Cyanosis in the obstructive lesions would generally only appear late or with complications rather than being a defining classification feature.

Question 4

The valve between right ventricle and pulmonary artery:

Accepted Answer

Answer reason: Cardiac valves ensure one-way blood flow through the heart and into the great vessels. Blood leaves the right ventricle through the outflow tract into the pulmonary artery, and the valve guarding this exit is the semilunar pulmonary valve. The tricuspid valve is between the right atrium and right ventricle, while the mitral valve is between the left atrium and left ventricle. The aortic valve instead regulates flow from the left ventricle into the aorta.

Question 5

The valve between left ventricle and aorta:

Accepted Answer

Answer reason: The aortic valve is the semilunar valve that regulates outflow of oxygenated blood from the left ventricle into the aorta during systole and prevents backflow during diastole. This directly matches the anatomical location asked: between the left ventricle and the aorta. The mitral valve instead lies between the left atrium and left ventricle, while the tricuspid is between the right atrium and right ventricle. The pulmonary valve is between the right ventricle and the pulmonary artery, so it cannot be correct for left-sided outflow.

Question 6

The valve between left atrium and left ventricle:

Accepted Answer

Answer reason: Atrioventricular (AV) valves sit between atria and ventricles and prevent backflow into the atrium during ventricular systole. On the left side of the heart, the AV valve is the mitral (bicuspid) valve, positioned between the left atrium and left ventricle. The aortic valve is instead between the left ventricle and the aorta, making it a semilunar valve rather than an AV valve. The tricuspid valve is the right-sided AV valve, and the pulmonary valve is between the right ventricle and pulmonary artery.

Question 7

The anatomic structure located in the middle of the heart which separates the right and left ventricles is the?

Accepted Answer

Answer reason: The heart’s chambers are divided by septa, which are walls of tissue that prevent mixing of blood between the right and left sides. The specific partition between the right and left ventricles is the interventricular septum. This structure is anatomically located centrally within the heart and contributes to normal pressure separation between systemic and pulmonary circulations. A common distractor is “sputum,” which refers to respiratory secretions and is unrelated to cardiac anatomy.

Question 8

A white female client is admitted to an acute care facility with a diagnosis of cerebrovascular accident (CVA). Her history reveals bronchial asthma, exogenous obesity, and iron deficiency anemia. Which history finding is a risk factor for CVA?

Accepted Answer

Answer reason: Stroke risk is strongly associated with modifiable vascular risk factors that accelerate atherosclerosis and promote hypertension, diabetes, and dyslipidemia. Excess body weight increases systemic inflammation and endothelial dysfunction, which raises the likelihood of thrombotic and ischemic cerebrovascular events. Among the listed history findings, this one is a well-established, changeable contributor to CVA risk. In contrast, bronchial asthma is not a primary independent risk factor for CVA in standard risk stratification, and the other listed demographics are not drivers of increased risk in the way cardiometabolic factors are.

Question 9

Which cardiac marker raised first in myocardial infarction?

Accepted Answer

Answer reason: Myocardial necrosis releases intracellular proteins into the bloodstream at different times based on size and tissue distribution. Myoglobin is a small cytosolic protein that appears in blood very early after myocardial injury (often within 1–2 hours), making it the earliest commonly taught marker to rise. CK-MB and troponins typically rise later (around 3–6 hours), though troponins are far more specific for cardiac injury. SGOT (AST) is nonspecific and is not preferred for diagnosing acute MI compared with modern cardiac biomarkers.

Question 10

Pulmonary artery carries:

Accepted Answer

Answer reason: The key principle is that pulmonary circulation transports venous blood from the right side of the heart to the lungs for gas exchange. The pulmonary artery specifically carries blood from the right ventricle to the lungs, so its oxygen content is low and CO2 content is high. After oxygenation occurs in pulmonary capillaries, blood returns to the left atrium via the pulmonary veins, which are the vessels that carry oxygenated blood. The common trap is assuming “artery” always means oxygenated blood; in this case, artery refers to direction of flow away from the heart.

Question 11

The blood vessel carrying oxygenated blood from lungs to heart:

Accepted Answer

Answer reason: Pulmonary circulation returns oxygenated blood from the lungs to the left atrium for systemic distribution. The pulmonary veins uniquely carry oxygen-rich blood despite being veins, because they return blood toward the heart. In contrast, the pulmonary artery carries deoxygenated blood from the right ventricle to the lungs. The aorta carries oxygenated blood from the left ventricle to the body, and the vena cava returns deoxygenated blood from the body to the right atrium.

Question 12

The heart is made up of which type of muscle ?

Accepted Answer

Answer reason: The myocardium is composed of specialized striated muscle cells that contract involuntarily to pump blood. These cells are interconnected by intercalated discs with gap junctions, allowing rapid electrical conduction and coordinated contractions across the heart. Skeletal muscle is voluntary and attached to bones, so it does not form the heart wall. Smooth muscle is found in hollow organs and blood vessel walls, but it is not the primary contractile tissue of the heart.

Question 13

Heart Membranous covering of Heart is called?

Accepted Answer

Answer reason: That sac is the pericardium, which includes a fibrous outer layer and a serous inner component. Meninges cover the brain and spinal cord, while peritoneum lines the abdominal cavity and covers many abdominal organs. Therefore the only option that anatomically matches the heart’s covering is the pericardium.

Question 14

Which veins carry oxygenated blood?

Accepted Answer

Answer reason: After gas exchange in the lungs, oxygen-rich blood returns to the left atrium via the pulmonary veins, making them the veins that carry oxygenated blood. In contrast, the jugular veins and brachial veins return deoxygenated blood from the head/upper extremity to the right side of the heart. The inferior vena cava also returns deoxygenated systemic venous blood to the right atrium.

Question 15

The pacemaker of heart is?

Accepted Answer

Answer reason: The sinoatrial node generates impulses at the fastest baseline rate (about 60–100/min), so it sets the heart’s normal sinus rhythm. The AV node primarily delays conduction to allow ventricular filling and serves as a backup pacemaker only if SA activity fails. The Bundle of His and Purkinje system are conduction pathways with slower intrinsic escape rates, not the primary pacemaker.

Question 16

Good cholesterol in blood is?

Accepted Answer

Answer reason: This anti-atherogenic function is associated with lower risk of coronary artery disease when levels are higher. In contrast, LDL and VLDL are more atherogenic because they deliver cholesterol and triglyceride-rich particles to tissues and can promote plaque formation. Triglycerides are a lipid measure but are not classified as “cholesterol” carriers in the same way as lipoproteins.

Question 17

Normal amount of pericardial fluid?

Accepted Answer

Answer reason: Standard anatomy/physiology references commonly cite a physiologic range around 15–50 mL, so a range that includes ~20 mL is most consistent with normal. Smaller ranges like 5–10 mL or 10–15 mL are below typical adult estimates and can underrepresent the expected baseline. Larger pathologic accumulations are discussed in pericardial effusion/tamponade rather than normal physiology, making this mid-range option the best fit.

Question 18

Normal ECG paper speed?

Accepted Answer

Answer reason: The routine recording speed used for diagnostic 12‑lead ECGs is 25 mm/s, where each small box equals 0.04 seconds and each large box equals 0.20 seconds. This calibration underpins accurate rhythm interpretation and interval-based diagnoses such as conduction delays or QT prolongation. Alternative speeds like 50 mm/s may be used in special cases to spread out fast rhythms, but they are not the normal default.

Question 19

Cardiac Enzyme elevated after MI :-

Accepted Answer

Answer reason: Troponins (I/T) are highly cardiac-specific and rise early, remaining elevated for days, making them the preferred diagnostic marker. CK (particularly CK-MB within total CPK) also increases after MI and is useful for detecting reinfarction because it normalizes sooner. LDH can rise after tissue injury including MI (historically used before troponin became standard), so all listed markers can be elevated.

Question 20

Largest vein is ?

Accepted Answer

Answer reason: Its large caliber is necessary to accommodate high flow from the lower limbs, pelvis, and abdominal organs. The superior vena cava is large but smaller than the inferior vena cava because it drains only the upper body. The saphenous and jugular veins are major peripheral veins but are much smaller than the central venae cavae.

Question 21

Total number of chambers in human heart is?

Accepted Answer

Answer reason: It has two atria that receive blood (right from systemic veins, left from pulmonary veins) and two ventricles that eject blood (right to the pulmonary artery, left to the aorta). This arrangement maintains one-way flow via valves and allows different pressures in the right vs left sides. Options with fewer chambers describe other organisms or incomplete separation and do not match normal human cardiac anatomy.

Question 22

Total number of ECG lead in ECG machine?

Accepted Answer

Answer reason: It is derived from 10 electrodes placed on the patient (4 limb electrodes and 6 precordial chest electrodes) to generate 12 leads (I, II, III, aVR, aVL, aVF, V1–V6). This setup is the routine baseline for evaluating ischemia/infarction, conduction abnormalities, and rhythm interpretation in most clinical settings. Options like 9 or 10 confuse the count of electrodes with the number of leads recorded, and 14 is not the standard configuration for routine ECG acquisition.

Question 23

Slowest conduction is in ?

Accepted Answer

Answer reason: This nodal delay is due to smaller fibers and fewer gap junctions, producing lower conduction velocity than other parts of the conduction system. In contrast, Purkinje fibers are specialized for very rapid conduction to synchronize ventricular activation. Therefore the slowest conduction occurs at the AV node.

Question 24

The endothelium is located in the?

Accepted Answer

Answer reason: This lining is part of the tunica intima (also called the tunica interna), along with a thin subendothelial connective tissue layer. The tunica media is primarily smooth muscle and elastic tissue responsible for vasoconstriction/vasodilation, not the endothelial lining. The tunica externa (adventitia) is connective tissue on the outside of the vessel, and the vasa vasorum are small vessels that supply the walls of large arteries/veins rather than forming the lumen lining.

Question 25

Commonest cause of cerebral infraction?

Accepted Answer

Answer reason: Most cerebral infarctions are ischemic strokes caused by occlusion of an artery supplying brain tissue, and the most common underlying mechanism is thrombosis over an atherosclerotic plaque in a cerebral or carotid artery. This produces gradual or sudden reduction in perfusion with subsequent neuronal ischemia and infarction. Embolism is an important cause (e.g., atrial fibrillation) but overall accounts for fewer cases than in-situ arterial thrombosis in broad population terms. Venous thrombosis usually causes cerebral venous sinus thrombosis with different clinical patterns, and aneurysm is more classically linked to hemorrhagic stroke rather than infarction.

Question 26

What is the silent killer disease?

Accepted Answer

Answer reason: Persistently elevated arterial pressure accelerates atherosclerosis and leads to complications such as stroke, myocardial infarction, heart failure, and chronic kidney disease without early warning signs. The other options typically present with more recognizable symptomatic illness (e.g., TB with cough/fever/weight loss, diarrheal disease with acute GI symptoms), making them less fitting for this classic label. Therefore the best answer is elevated blood pressure/hypertension.

Question 27

Which of the following is not a risk factor for hypertension?

Accepted Answer

Answer reason: Being young is generally protective rather than a predisposing factor for primary (essential) hypertension in population risk profiling. In contrast, obesity increases sympathetic tone and activates RAAS, promoting sodium retention and higher cardiac output, and smoking contributes to endothelial dysfunction and vascular damage. Family history/genetics also meaningfully increases baseline susceptibility, making it a recognized nonmodifiable risk factor.

Question 28

Blood supply to the heart is maintained by the ?

Accepted Answer

Answer reason: This dedicated circulation is what maintains the heart’s tissue-level blood supply and supports continuous contractile function. The aorta is the main systemic outflow vessel, but it does not directly nourish the myocardium except through the coronary ostia. Pulmonary vessels are primarily involved in gas exchange and return of oxygenated blood to the left atrium, not direct myocardial perfusion.

Question 29

What is the most common cause of an abdominal aortic aneurysm?

Accepted Answer

Answer reason: Plaque-driven inflammation and proteolytic degradation of elastin/collagen reduce tensile strength, allowing progressive dilation under systemic pressure. Hypertension is an important risk factor that accelerates expansion and rupture risk, but it is not the primary underlying cause. Syphilis classically causes aneurysms of the ascending thoracic aorta (vasa vasorum endarteritis), making it a less likely cause for abdominal aneurysms. Diabetes mellitus is generally not a primary cause and is not the typical etiologic driver tested for AAA.

Question 30

Q-What is the pacemaker of heart called?

Accepted Answer

Answer reason: S.A node The heart’s normal rhythm is initiated by the structure with the highest intrinsic automaticity, which spontaneously depolarizes fastest under normal conditions. The sinoatrial node in the right atrium generates the initial impulse that sets the baseline heart rate (normal sinus rhythm). The AV node primarily delays conduction to allow ventricular filling rather than serving as the primary pacemaker. The bundle of His and Purkinje fibers are downstream conduction pathways that can act as slower escape pacemakers if higher-level pacing fails.

Question 31

Turner syndrome associated with

Accepted Answer

Answer reason: The most characteristic association tested is coarctation due to abnormal development of the aortic arch, often alongside bicuspid aortic valve. Pulmonic stenosis is more typical of conditions like Noonan syndrome rather than Turner. Although aortic dissection risk is increased in Turner (especially with bicuspid valve/coarctation and hypertension), it is a complication rather than the hallmark congenital association asked in most exam stems.

Question 32

The largest Artery of human body is ?

Accepted Answer

Answer reason: It has the greatest diameter and elastic tissue content to buffer pulsatile ejection and maintain continuous downstream perfusion. Other named arteries like the carotid and subclavian are major branches but are smaller-caliber distribution vessels. The pulmonary artery carries a large flow but operates at lower pressure and is still smaller in caliber than the systemic outflow vessel.

Question 33

Longest vein in human heart..?

Accepted Answer

Answer reason: Among the listed choices, it is the only vein classically recognized as the longest. Basilic and pulmonary veins are not the longest and have more limited anatomic courses. “Arteries Vein” is not an anatomically valid vessel name and is therefore not a plausible correct choice.

Question 34

One cardiac cycle completes in

Accepted Answer

Answer reason: At a normal resting heart rate of about 75 beats/min, the duration of one heartbeat (one cardiac cycle) is approximately 60/75 minutes, which equals 0.8 seconds. This standard value is commonly used to describe the timing of systole and diastole in basic cardiovascular physiology. Options like 0.12 seconds are far too short to allow normal ventricular filling and ejection. While the cycle length varies with heart rate, 0.8 seconds best matches the typical resting adult value tested in exams.

Question 35

Osler's Nodes are a feature of?

Accepted Answer

Answer reason: Their presence supports a systemic embolic/immunologic phenomenon arising from infected valvular vegetations. In contrast, pericarditis primarily presents with pleuritic chest pain, friction rub, and diffuse ST elevation rather than peripheral nodular lesions. Myocarditis and rheumatic carditis can cause cardiac dysfunction or murmurs but do not classically produce Osler nodes as a hallmark finding.

Question 36

The innermost layer of the heart is?

Accepted Answer

Answer reason: The inner surface that directly lines the cardiac chambers and covers the valves is the endocardium, providing a smooth, non-thrombogenic lining for blood flow. The myocardium is the thick muscular middle layer responsible for contraction, so it cannot be the innermost lining. The pericardium is an external sac surrounding the heart rather than a layer forming the inner lining of the chambers.

Question 37

Blood supply to the heart is by?

Accepted Answer

Answer reason: Both the left coronary artery (giving rise to the LAD and circumflex branches) and the right coronary artery contribute to perfusing heart muscle. Therefore, stating only one side would be incomplete for overall cardiac blood supply. Pulmonary veins return oxygenated blood to the left atrium and do not directly perfuse the myocardial tissue.

Question 38

The only artery which supplies deoxygenated blood?

Accepted Answer

Answer reason: In adult circulation, the pulmonary artery uniquely carries oxygen-poor blood from the right ventricle to the lungs for gas exchange. Most other systemic arteries (e.g., hepatic, gastric, renal) deliver oxygenated blood to tissues. A common confusion is mixing this with veins; the pulmonary veins are the exception on the venous side because they carry oxygenated blood back to the left atrium.

Question 39

Which Blood vessel carries blood from lungs to heart?

Accepted Answer

Answer reason: This is a key exception to the general rule that veins carry deoxygenated blood, because pulmonary veins specifically carry oxygen-rich blood. In contrast, the pulmonary arteries carry deoxygenated blood from the right ventricle to the lungs for gas exchange. The superior vena cava returns systemic venous blood from the upper body to the right atrium, while the aorta carries oxygenated blood from the left ventricle to the body.

Question 40

Which of layer of the artery contains smooth muscles?

Accepted Answer

Answer reason: The tunica media contains concentric layers of smooth muscle (and elastic fibers), enabling vasoconstriction and vasodilation to regulate blood pressure and tissue perfusion. By contrast, the tunica interna is primarily endothelium and subendothelial connective tissue, and the tunica externa is mainly connective tissue for structural support and anchoring. “Tunica alba” is not a standard arterial wall layer (it refers to structures like the tunica albuginea in testes/ovary), making it an incorrect distractor.

Question 41

Right coronary artery supplies all; EXCEPT :-

Accepted Answer

Answer reason: That makes the conduction system (especially SA node) and the posterior one-third of the interventricular septum commonly supplied by the right coronary circulation, and the interatrial septum can receive right coronary contributions as well. The cardiac apex, however, is primarily formed by the left ventricle and is most typically perfused by the left anterior descending artery (a branch of the left coronary artery), not the right coronary artery. Therefore the apex is the structure not classically supplied by the right coronary artery.

Question 42

Most common site to monitor ABG analysis?

Accepted Answer

Answer reason: The radial artery is the most common site because it is accessible at the wrist and can be assessed with an Allen test to confirm ulnar collateral flow. Brachial and axillary sites are deeper and carry higher complication risk (e.g., hematoma, nerve injury) and are generally used when radial access is not feasible. The ulnar artery is less commonly used due to more variable access and greater concern for compromising hand perfusion if collateral flow is inadequate.

Question 43

The primary pacemaker in the Mammalian heart is ?

Accepted Answer

Answer reason: The SA node has the highest spontaneous firing rate in the heart, so it sets the sinus rhythm and drives atrial depolarization first. The AV node primarily delays conduction to allow ventricular filling rather than serving as the dominant rhythm source under normal conditions. The Bundle of His and Purkinje system are downstream rapid-conduction pathways and have slower intrinsic pacemaker rates, so they only take over if higher pacemakers fail.

Question 44

Which of the following can cause MI of heart?

Accepted Answer

Answer reason: Elevated LDL cholesterol promotes atherosclerosis by depositing cholesterol in the arterial intima, driving inflammation and plaque growth. This directly increases the risk of coronary artery disease and subsequent MI. While high blood sugar (diabetes) is also a risk factor, it is not as direct a single causal substrate for plaque formation in the way hypercholesterolemia is, and the other listed choices are not established causes of MI.

Question 45

True about lab values in RHD?

Accepted Answer

Answer reason: CRP and ESR are acute-phase reactants that increase with inflammation and help support the diagnosis and monitor activity. Leukocytosis (raised total leukocyte count) can also be present as part of the systemic inflammatory response. Therefore, the combined statement that all listed values can be increased is the best choice.

Question 46

Which of the following diagnostic tools is most commonly used to determine the location of myocardial damage?

Accepted Answer

Answer reason: g., inferior vs anterior vs lateral territories). ST-segment elevation/depression, T-wave inversions, and pathologic Q waves in contiguous leads help identify the likely infarct location and the involved coronary distribution. Cardiac enzymes confirm myocardial necrosis and help with diagnosis/timing but do not localize the affected wall. Echocardiography can show regional wall-motion abnormalities but is not the most commonly used first-line tool for localization in acute evaluation compared with the rapid, ubiquitous 12-lead ECG.

Question 47

Normal blood pressure is?

Accepted Answer

Answer reason: Among the provided choices, the only one approximating the standard systolic value of 120 is option A, while the other options list markedly elevated systolic values. Although the diastolic values shown in all options are inconsistent with normal physiology, exam convention indicates the intended normal reference is 120/80. Therefore, the best available answer is the choice starting with 120.

Question 48

A nurse is reviewing the electrocardiogram (ECG) of a patient and notices the following rhythm: irregular R-R intervals, no distinct P waves, and a narrow QRS complex. The nurse recognizes this as?

Accepted Answer

Answer reason: Because ventricular activation still proceeds through the AV node and His-Purkinje system, the QRS complex is typically narrow. This pattern differentiates it from ventricular tachycardia, which usually produces a wide QRS due to ventricular-origin conduction. It also differs from third-degree heart block, where P waves are present but dissociated from QRS complexes, and from sinus bradycardia, which retains regular rhythm with visible P waves before each QRS.

Question 49

CABG stands for:

Accepted Answer

Answer reason: The operation creates an alternate route for blood to reach heart muscle by grafting vessels (commonly internal mammary artery or saphenous vein) to bypass the blocked coronary segments. The other options incorrectly reference cranial/cerebral/cerebellar circulation, which are not the target vessels in this common cardiac surgery term. Recognizing common procedure abbreviations is essential because they convey the involved organ system, risks, and typical perioperative care considerations.

Question 50

Year old smoker with gangrenous toe most probably suffers from:

Accepted Answer

Answer reason: In a younger patient, ischemic ulcers and distal gangrene (toes) are classic for Buerger disease rather than age-related plaque disease. Raynaud’s typically causes episodic color changes and pain from vasospasm without progressing to frank gangrene unless severe secondary disease is present. An arteriovenous fistula would more often produce high-flow findings (bruit/thrill, venous engorgement) rather than distal ischemic necrosis.

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