Question 1

PND (Paroxysmal Nocturnal Dyspnea) occurs in?

Accepted Answer

Answer reason: When supine, venous return increases and interstitial fluid re-enters circulation, raising pulmonary capillary hydrostatic pressure and triggering sudden nocturnal dyspnea. The symptom improves with sitting upright because pulmonary venous pressures decrease and lung congestion lessens. Kidney or liver failure can cause fluid overload, but the hallmark association tested for PND is congestive heart failure. Asthma can cause nighttime symptoms, but “asthma only” is incorrect because PND is primarily a cardiac congestion phenomenon.

Question 2

Which of the following is a symptom of a heart attack?

Accepted Answer

Answer reason: This symptom is a classic and high-yield presentation and may radiate to the arm, neck, jaw, or back and be associated with diaphoresis or nausea. Upper respiratory symptoms such as runny nose and sore throat more strongly suggest viral infection rather than cardiac ischemia. Diarrhea is not a typical primary feature of acute coronary syndrome and would not be the best single indicator among the choices.

Question 3

What is the most common cause of secondary hypertension?

Accepted Answer

Answer reason: Reduced renal perfusion activates the renin–angiotensin–aldosterone system, driving vasoconstriction and sodium/water retention, which increases blood pressure. The other choices are recognized etiologies but occur less frequently overall in typical populations. Endocrine causes like catecholamine-secreting tumors are classic but comparatively rare and usually suggested by episodic symptoms and markedly labile pressures.

Question 4

Most common cause of heart failure worldwide is?

Accepted Answer

Answer reason: Because hypertension is highly prevalent globally and often long-standing before treatment, it is a leading upstream driver of clinical heart failure in many populations. Diabetes is an important risk factor that accelerates atherosclerosis and can cause diabetic cardiomyopathy, but it is not the most common primary cause worldwide. Asthma and hypothyroidism can contribute to dyspnea or cardiac dysfunction in specific contexts, yet they are not typical dominant etiologies of heart failure at the population level.

Question 5

A patient presents with dilated tortuous veins of the lower limb and on venous Doppler there is back flow of blood. All are advised expect?

Accepted Answer

Answer reason: Graduated compression stockings are routinely advised to decrease edema and symptoms and to slow progression. Procedural or surgical options (e.g., ligation/stripping/endovenous ablation) may be appropriate when symptoms persist, complications occur, or reflux is significant on Doppler. Antiplatelet therapy is not a standard treatment for uncomplicated varicose veins and does not correct venous valve failure; it is more relevant to arterial thrombosis prevention.

Question 6

Which drug is used to treat acute myocardial infarction?

Accepted Answer

Answer reason: This medication irreversibly inhibits COX-1 in platelets, decreasing thromboxane A2–mediated platelet aggregation and improving outcomes when given early. Metformin is an antihyperglycemic agent and does not address coronary thrombosis in the acute setting. Fluoxetine and prednisone are not indicated for acute coronary occlusion and would not provide the time-critical antithrombotic benefit needed.

Question 7

What is the largest artery in the human body?

Accepted Answer

Answer reason: Its caliber is greatest because it must accommodate the entire stroke volume and dampen pulsatile flow via its elastic wall (Windkessel effect). The femoral and carotid are major branches with smaller diameters, and the pulmonary artery, while large, carries blood only from the right ventricle to the lungs and is still smaller than the systemic outflow trunk. Therefore the most anatomically and physiologically correct choice is the main systemic artery.

Question 8

Which blood vessels carry oxygenated blood?

Accepted Answer

Answer reason: Pulmonary veins uniquely carry oxygen-rich blood from the lungs to the left atrium. Most systemic veins carry deoxygenated blood back to the right heart, and pulmonary arteries are the key exception among arteries because they carry deoxygenated blood to the lungs. Capillaries are exchange vessels and contain blood that transitions from oxygenated to deoxygenated across systemic tissues.

Question 9

The occupational health nurse is counseling an employee who works outdoors during winter. The nurse counsels the employee to always wear warm, dry gloves. Identify the circulatory disorder that may be prevented by wearing warm dry gloves in the winter?

Accepted Answer

Answer reason: Keeping hands warm and dry helps prevent vasospastic/ischemic episodes and tissue injury in distal extremities. This aligns best with thromboangiitis obliterans, a segmental inflammatory-occlusive disorder affecting distal arteries, where avoiding cold is part of symptom prevention. In contrast, acute arterial occlusion is typically embolic/thrombotic and not prevented by glove use, and venous insufficiency is a venous valve problem unrelated to cold-triggered digital ischemia.

Question 10

When planning a class for primigravid clients about the common discomforts of pregnancy, which of the following physiologic changes of pregnancy should the nurse include in the teaching plan?

Accepted Answer

Answer reason: Pregnancy produces major cardiovascular adaptations to meet increased metabolic demands and uteroplacental perfusion, leading to increased blood volume, heart rate, and stroke volume. This drives a typical rise in cardiac output on the order of roughly one-third to one-half above baseline. A key distractor is fibrinogen, which actually increases (hypercoagulable state) rather than decreases. Oxytocin is primarily released from the posterior pituitary (synthesized in the hypothalamus), not the anterior pituitary.

Question 11

What blood vessel carries oxygenated blood from the lungs to the heart?

Accepted Answer

Answer reason: In contrast, the pulmonary artery carries deoxygenated blood from the right ventricle to the lungs for gas exchange. The aorta carries oxygenated blood away from the heart to the systemic circulation, not from the lungs to the heart. Capillaries are exchange vessels and do not serve as the primary conduit returning oxygenated blood to the heart.

Question 12

Heart failure mainly occurs due to?

Accepted Answer

Answer reason: This pump dysfunction leads to reduced forward flow, triggering compensatory neurohormonal activation (SNS/RAAS) that can worsen fluid retention and congestion. Higher oxygen saturation and increased urine output are not primary causes; they are generally opposite of what is expected as perfusion falls and renal blood flow decreases. A higher heart rate can be a compensation, but it is not the defining mechanism and by itself does not explain heart failure.

Question 13

What is the role of the pulmonary artery in circulation?

Accepted Answer

Answer reason: This blood is deoxygenated (low O2, higher CO2) and becomes oxygenated in the pulmonary capillaries around the alveoli. In contrast, oxygenated blood returns to the left atrium via the pulmonary veins, not the pulmonary artery. Supplying the heart muscle is the role of the coronary arteries, and waste removal is primarily performed by organs such as the kidneys and liver, not a specific artery.

Question 14

Which blood vessels carry oxygenated blood away from the heart?

Accepted Answer

Answer reason: In the systemic circulation, arterial blood is typically oxygen-rich after leaving the left ventricle via the aorta. Veins instead return blood to the heart, and capillaries are the exchange vessels where oxygen is delivered to tissues. A common exception is the pulmonary artery, which carries deoxygenated blood away from the heart, but the vessel type that carries blood away from the heart is still arteries.

Question 15

What is the disease characterized by the hardening of arteries?

Accepted Answer

Answer reason: This process narrows the lumen and stiffens vessels, reducing compliance and predisposing to ischemia. Hypertension is elevated blood pressure and can contribute to arterial damage but is not itself the defining disease of arterial hardening. Angina and myocardial infarction are clinical syndromes resulting from coronary ischemia, often secondary to this underlying arterial disease.

Question 16

The clinic nurse reviews the record of a child just seen by a health care provider and diagnosed with suspected aortic stenosis. The nurse expects to note documentation of which clinical manifestation specifically found in this disorder?

Accepted Answer

Answer reason: With exertion, the child cannot meet increased metabolic demands, leading to early fatigue and reduced exercise capacity. This finding is a characteristic manifestation of significant outflow obstruction in pediatric valvular disease. Pallor can occur with many conditions and is not specific to this lesion, while hyperactivity and gastrointestinal disturbances are not typical hallmark features of aortic stenosis.

Question 17

When computing a heart rate from the ECG tracing, you count 15 of the small blocks between the R waves of a patient whose rhythm is regular. From these data, you calculate the patient's heart rate to be what?

Accepted Answer

Answer reason: Each small box is 0.04 seconds at the standard paper speed of 25 mm/s, so 15 small boxes corresponds to 0.6 seconds per beat. Converting to beats per minute gives 60/0.6 = 100 bpm, which matches 1500/15 = 100 bpm. Therefore the correct calculation is 100 bpm, and choosing 150 bpm reflects using an incorrect divisor (e.g., large-box formula without proper box count).

Question 18

Which structure separates the left and right ventricles of the heart?

Accepted Answer

Answer reason: The interventricular (ventricular) septum forms the muscular wall between the left and right ventricles, preventing mixing of oxygenated and deoxygenated blood. By contrast, the atrial septum separates the atria, not the ventricles. The pericardium is the external sac around the heart, and the aortic valve regulates outflow from the left ventricle rather than separating ventricles.

Question 19

What is the most common cause of stroke?

Accepted Answer

Answer reason: Thrombosis from atherosclerotic plaque in cerebral/carotid vessels and emboli (often cardioembolic, e.g., atrial fibrillation) are the dominant mechanisms. Hemorrhagic events account for a smaller proportion of strokes, though they can be more immediately lethal. Infection and tumor can mimic stroke symptoms or contribute indirectly but are not the leading etiologies of acute stroke overall.

Question 20

Which type of blood vessel carries oxygenated blood away from the heart?

Accepted Answer

Answer reason: In systemic circulation, this blood is typically oxygenated (e.g., aorta and its branches) as it is delivered to tissues. Veins return blood to the heart, and capillaries are exchange vessels rather than primary transport away from the heart. A key exception is the pulmonary artery, which carries deoxygenated blood away from the heart to the lungs, but it is still an artery based on flow direction.

Question 21

The natural Pacemaker in the Human Heart is located in the SA node which is present in which among the following chambers?

Accepted Answer

Answer reason: “Right auricle” refers to the right atrial appendage and is commonly used in exam wording to represent the right atrial region where the SA node resides. Ventricles do not contain the primary pacemaker tissue; they rely on conduction from atrial pacemaker and downstream nodes/His-Purkinje system. Thus the chamber associated with the SA node is the right atrial/auricular area.

Question 22

A 58-year-old client, who is 5'5" and weighs 220 pounds, tells you she smokes 2 ppd and doesn’t get much exercise. Her blood pressure is 190/98 and she is a Type-2 diabetic. How many risk factors does she have for cardiac disease?

Accepted Answer

Answer reason: This client has age >55 (nonmodifiable), obesity (220 lb at 5'5" implies obesity), cigarette smoking (2 packs/day), sedentary lifestyle (little exercise), hypertension (190/98), and diabetes mellitus type 2. However, obesity is commonly considered a contributing factor that overlaps with inactivity and metabolic risk; many exam frameworks count the major traditional risks here as age, smoking, inactivity, hypertension, and diabetes. That yields a best count of five from the provided choices, whereas higher counts depend on double-counting closely related metabolic contributors.

Question 23

Which statement best describes the electrical activity of the heart represented by measuring the PR interval on the ECG?

Accepted Answer

Answer reason: It is measured from the start of the P wave to the start of the QRS complex, representing impulse transmission from the atria (initiated at the SA node) through the AV node and His-Purkinje system up to, but not including, ventricular depolarization. Option A describes only atrial depolarization (primarily the P wave duration), not the interval. Option C extends the concept beyond what the PR interval specifically captures, because it would imply full conduction to Purkinje fibers rather than the AV nodal/AV conduction time emphasized by PR.

Question 24

The nurse obtains a rhythm strip on a patient who has had a myocardial infarction and makes the following analysis: no visible P waves, P-R interval not measurable, ventricular rate 162, R-R interval regular, and QRS complex wide and distorted, QRS duration 0.18 second. The nurse interprets the patient's cardiac rhythm as?

Accepted Answer

Answer reason: A regular, rapid rhythm with wide (≥0.12 s) and bizarre QRS complexes and absent discernible P waves indicates a ventricular-origin tachyarrhythmia due to abnormal ventricular depolarization. The rate of 162 bpm with a regular R-R interval strongly supports monomorphic VT rather than chaotic ventricular activity. After myocardial infarction, scar/ischemia commonly creates reentry circuits that precipitate VT. Ventricular fibrillation would be irregular and disorganized without identifiable QRS complexes, and sinus tachycardia would have normal narrow QRS complexes with P waves preceding each beat.

Question 25

The nurse is caring for a newborn with patent ductus arteriosus. Which assessment finding should the nurse expect?

Accepted Answer

Answer reason: This classically sounds “machinery-like,” often best heard at the left infraclavicular/upper left sternal border, and may be accompanied by bounding pulses and widened pulse pressure. A purely systolic ejection murmur is more typical of outflow tract lesions (e.g., aortic or pulmonic stenosis) rather than a continuous shunt. A soft diastolic murmur points toward diastolic flow abnormalities (e.g., aortic regurgitation) and does not match PDA’s hallmark finding.

Question 26

Eisenmenger syndrome develops due to?

Accepted Answer

Answer reason: g., VSD/ASD/PDA) causing chronically increased pulmonary blood flow. Over time this leads to pulmonary vascular remodeling and irreversible pulmonary hypertension with rising pulmonary vascular resistance. Once pulmonary pressures exceed systemic pressures, the shunt reverses direction, producing right-to-left flow and cyanosis. A key distinction is that it is not a cyanotic lesion from birth; cyanosis develops after the shunt reverses due to pulmonary hypertension.

Question 27

What is the primary function of the circulatory system?

Accepted Answer

Answer reason: This includes delivering oxygen, nutrients, and hormones to cells and carrying carbon dioxide and other wastes to organs responsible for elimination. Gas exchange itself occurs primarily across the alveolar-capillary membrane in the respiratory system, not within the cardiovascular system. Temperature regulation is a supportive function through changes in skin blood flow, but it is not the primary purpose compared with systemic transport.

Question 28

A nurse notes that the patient’s ECG shows a prolonged QT interval. This finding indicates a delay in which cardiac phase?

Accepted Answer

Answer reason: When QT is prolonged, it reflects delayed ventricular repolarization and an overall lengthening of ventricular action potential duration. Among the choices, the phase most directly tied to the QT’s onset is the QRS complex, which corresponds to ventricular depolarization. Atrial depolarization is reflected by the P wave, and SA node conduction is not measured by the QT interval, making them less applicable.

Question 29

Which type of blood vessel carries oxygenated blood away from the heart to the rest of the body?

Accepted Answer

Answer reason: Their thicker muscular and elastic walls support this high-pressure delivery and help maintain pulsatile flow. Veins return blood toward the heart and generally carry deoxygenated blood in the systemic circuit. Capillaries are primarily the exchange vessels where oxygen and nutrients diffuse into tissues rather than serving as the main conduits away from the heart.

Question 30

Which system is responsible for transporting oxygen in humans?

Accepted Answer

Answer reason: The cardiovascular components (heart, blood vessels, and blood) provide the transport network that distributes oxygenated blood systemically. The respiratory system is essential for gas exchange in the lungs, but it does not perform the body-wide delivery to organs and cells. Digestive and nervous systems do not have a primary role in oxygen transport.

Question 31

In the human circulatory system, which blood vessels carry oxygenated blood away from the heart?

Accepted Answer

Answer reason: In systemic circulation, this blood is oxygen-rich as it leaves the left ventricle (e.g., via the aorta) to supply tissues. Veins and venules return blood toward the heart, and capillaries are the exchange vessels rather than primary conduits away from the heart. A common exception to “arteries carry oxygenated blood” exists in pulmonary arteries, but the question specifies oxygenated blood away from the heart in the human circulatory system, which aligns with systemic arteries.

Question 32

Assessing the neck vessels in a stable patient with heart failure is done to determine which of the following?

Accepted Answer

Answer reason: Measuring the vertical height/maximum level of jugular venous pulsation above the sternal angle provides the clinically useful value used to judge congestion and monitor response to diuresis. In contrast, auscultating for bruits and checking carotid pulses assess carotid arterial disease and perfusion rather than venous congestion. “Strength of the jugular veins” is not a standard, quantifiable parameter; the exam focuses on the height/level of venous pulsation.

Question 33

In the human circulatory system, which blood vessel carries deoxygenated blood from the heart to the lungs?

Accepted Answer

Answer reason: In pulmonary circulation, blood leaving the right ventricle travels to the lungs for gas exchange, so this vessel must carry deoxygenated blood. The pulmonary veins are the exception in the opposite direction, returning oxygenated blood from the lungs to the left atrium. The aorta distributes oxygenated blood systemically, while the vena cavae return deoxygenated blood to the right atrium rather than to the lungs.

Question 34

According to the American Heart Association (AHA), what is normal blood pressure in adults?

Accepted Answer

Answer reason: Under the AHA/ACC classification, “normal” is systolic less than 120 mmHg and diastolic less than 80 mmHg. A systolic of 120–129 with diastolic still

Question 35

A pulsating abdominal mass usually indicates which of the following conditions?

Accepted Answer

Answer reason: An abdominal aortic aneurysm commonly presents with a palpable, expansile pulsation above the umbilicus, especially in thin patients. Splenomegaly typically produces a firm, nonpulsatile mass in the left upper quadrant, and gastric distention may cause abdominal fullness without an expansile arterial pulse. Gastritis causes epigastric pain/dyspepsia rather than a palpable pulsating mass.

Question 36

In presenting a workshop on parameters of cardiac function, which conditions should a nurse list as those most likely to lead to a decrease in preload?

Accepted Answer

Answer reason: Third spacing shifts fluid out of the vascular compartment, lowering effective circulating volume and venous return. Diuresis reduces intravascular volume, directly decreasing venous return and filling pressures. In heart failure—especially with reduced forward flow—reduced effective cardiac output can impair venous return dynamics and effective filling, making a decrease in preload more likely than choices that include fluid overload, which generally increases preload.

Question 37

In the human heart, which chamber is responsible for pumping oxygenated blood to the rest of the body?

Accepted Answer

Answer reason: Oxygenated blood returns from the lungs to the left side of the heart and must be pumped into systemic circulation at high pressure. The left ventricle has the thickest myocardium to generate the force needed to eject blood through the aortic valve into the aorta. The left atrium primarily receives oxygenated blood from the pulmonary veins and functions as a reservoir/primer pump rather than the main systemic pump. In contrast, the right ventricle pumps deoxygenated blood to the lungs via the pulmonary artery, not to the rest of the body.

Question 38

The normal systolic pressure in human beings is?

Accepted Answer

Answer reason: This value represents typical resting hemodynamics in a healthy adult and is used as the reference point for defining elevated blood pressure ranges. Values like 80 or 100 mmHg are generally low for systolic pressure and may suggest hypotension depending on context. A systolic pressure of 140 mmHg aligns more with hypertension thresholds rather than normal resting pressure.

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