Which of the following conditions is associated with a predictable level of pain that occurs as a result of physical or emotional stress?
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Solution
Stable angina
The pain of stable angina is predictable in nature, builds gradually, and quickly reaches maximum intensity.
Option C: Unstable angina doesn’t always need a trigger, is more intense, and lasts longer than stable angina.
Option D: Variant angina usually occurs at rest—not as a result of exercise or stress.
If medical treatments fail, which of the following invasive procedures is necessary for treating cardiomyopathy?
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Solution
Heart transplantation
The only definitive treatment for cardiomyopathy that can’t be controlled medically is a heart transplant because the damage to the heart muscle is irreversible.
Which of the following classes of drugs is most widely used in the treatment of cardiomyopathy?
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Solution
Beta-adrenergic blockers
By decreasing the heart rate and contractility, beta-blockers improve myocardial filling and cardiac output, which are primary goals in the treatment of cardiomyopathy.
Option A: Antihypertensives aren’t usually indicated because they would decrease cardiac output in clients who are already hypotensive.
Option C: Calcium channel blockers are sometimes used for the same reasons as beta-blockers; however, they aren’t as effective as beta-blockers and cause increased hypotension.
Option D: Nitrates aren’t used because of their dilating effects, which would further compromise the myocardium.
Which of the following cardiac conditions does a fourth heart sound (S4) indicate?
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Solution
Failure of the ventricle to eject all of the blood during systole
An S4 occurs as a result of increased resistance to ventricular filling after atrial contraction. The increased resistance is related to decreased compliance of the ventricle.
Option A: A dilated aorta doesn’t cause an extra heart sound, though it does cause a murmur.
Option B: An S4 isn’t heard in a normally functioning heart.
Option C: Decreased myocardial contractility is heard as a third heart sound.
In which of the following types of cardiomyopathy does cardiac output remain normal?
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Solution
Hypertrophic
Cardiac output isn’t affected by hypertrophic cardiomyopathy because the size of the ventricle remains relatively unchanged. All of the rest decrease cardiac output.
Dyspnea, cough, expectoration, weakness, and edema are classic signs and symptoms of which of the following conditions?
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Solution
Heart failure
These are the classic signs of failure.
Option A: Pericarditis is exhibited by a feeling of fullness in the chest and auscultation of a pericardial friction rub.
Option B: Hypertension is usually exhibited by headaches, visual disturbances, and a flushed face.
Option D: MI causes heart failure but isn’t related to these symptoms.
Which of the following recurring conditions most commonly occurs in clients with cardiomyopathy?
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Solution
Heart failure
Because the structure and function of the heart muscle is affected, heart failure most commonly occurs in clients with cardiomyopathy.
Option C: MI results from prolonged myocardial ischemia due to reduced blood flow through one of the coronary arteries.
Option D: Pericardial effusion is most predominant in clients with pericarditis.
Septal involvement occurs in whichRestrictive type of cardiomyopathy?
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Solution
Hypertrophic
In hypertrophic cardiomyopathy, hypertrophy of the ventricular septum—not the ventricle chambers—is apparent. This abnormality isn’t seen in other types of cardiomyopathy.
Which of the following types of cardiomyopathy can be associated with childbirth?
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Solution
Dilated
Although the cause isn’t entirely known, cardiac dilation and heart failure may develop during the last month of pregnancy or the first few months after birth. The condition may result from a preexisting cardiomyopathy not apparent prior to pregnancy.
Option B: Hypertrophic cardiomyopathy is an abnormal symmetry of the ventricles that has an unknown etiology but a strong familial tendency.
Option C: Myocarditis isn’t specifically associated with childbirth.
Option D: Restrictive cardiomyopathy indicates constrictive pericarditis; the underlying cause is usually myocardial.
Which of the following heart muscle diseases is unrelated to other cardiovascular disease?
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Solution
Cardiomyopathy
Cardiomyopathy isn’t usually related to an underlying heart disease such as atherosclerosis. The etiology in most cases is unknown.
Options B and C: CAD and MI are directly related to atherosclerosis.
Option D:Pericardial effusion is the escape of fluid into the pericardial sac, a condition associated with Pericarditis and advanced heart failure.