Cardiovascular System Practice Test Questions

1) A patient being treated with chlorothiazide to control hypertension may require supplementation with which of the following?

2) Which of the following refers to coronary artery spasm that occurs while the patient is at rest?

3) Which of the following is the primary drug class of choice for treatment of chronic angina?

4) Which of the following is the drug of choice for the prevention of pulmonary embolism?

5) A 60-year-old male presents to his PCP for a routine physical. Current medications include Atenolol 50 mg and HCTZ 12.5 mg. He has a 40 packs/year history of smoking. Examination reveals a pulsatile mass in the epigastrium. What is the most important NEXT step?

6) A child is in need of emergency intravenous medication. The child’s veins are inaccessible. What route of administration should be used to administer the medication?

7) A patient is diagnosed with left ventricular heart failure. Which of the following types of medication is the most appropriate intervention for this condition?

8) Which of the following is appropriate treatment for individuals with acute coronary syndrome?

9) Which of the following is the major side effect of angiotensin-converting enzyme (ACE) inhibitors?

10) A 57-year-old female with known coronary artery disease presents to her PCP for a regular physical. She states that since an MI three years ago, she has retrosternal chest pain radiating to the jaw that lasts for 5 minutes and is alleviated by rest and nitroglycerine. She always has the pain when walking up the steps to her office. She denies any lower extremity edema, cough, orthopnea, nausea, or vomiting. Examination is unchanged from her last visit. What is the most likely diagnosis?

11) Which of the following refers to spasms of the blood vessels in the fingers and toes?

12) A 45-year-old male presents to the ER after experiencing chest pain and dyspnea. EKG shows a prominent S wave in lead 1 and a Q wave and inverted T wave in lead 3. What is the most important NEXT test?

13) A 55-year-old male with a long history of alcoholism presents to the emergency room complaining of dyspnea on exertion, lower extremity edema, and orthopnea. Examination reveals jugular venous distention, a III/VI systolic murmur heard loudest at the apex, bibasilar rales, hepatomegaly, and 3+ pedal edema. What is the most likely diagnosis?

14) A 65-year-old woman with hypertension presents to the emergency room after experiencing weakness and paresthesias in the left arm that lasted for 20 minutes. Current medications include hydrochlorothiazide. Examination reveals a II/VI systolic murmur heard loudest at the apex, a normal neurologic exam, and a BP of 130/80. Non-contrast CT of the brain is negative for ischemia. Which of the following medications is most appropriate?

15) Which can decrease the effectiveness of Warfarin (Coumadin)?

16) A 57-year-old male with HTN and a 50 packs/year smoking history presents to his PCP with a complaint of intermittent “cramps” in his left leg. He works for the local cable company and his job includes quite a bit of walking. The pain in his left leg starts after walking about 50 feet. He states that he first noticed the pain about six months ago, but, at that time, he could walk at least a mile before the “cramp” began. The pain resolves with rest. Which of the following is NOT appropriate management of the patient’s condition?

17) Which of the following is a loop diuretic used in the treatment of chronic hypertension?

18) A 45-year-old high school teacher is brought to the emergency room by paramedics. She states that she was standing for 2 hours at a parade. She states that she felt “woozy,” and bystanders report that she lost consciousness and fell to the ground. She was unconscious for only 2 or 3 minutes and had no confusion upon recovery. The paramedics report that the bystanders denied any seizure-like activity on the part of the patient. There is no history of prior episodes or any other medical problems. The physical examination is normal. What is the next step in the evaluation of the patient?

19) Increasing the intake of fluids and dietary sodium can help to treat which of the following?

20) A 70-year-old female with diabetes and CHF presents to her PCP complaining of fatigue and a “racing heart beat.” Examination reveals BP 150/80. Pulse is irregularly irregular at 170 bpm. Cardiac exam reveals tachycardia and an irregularly irregular rhythm. EKG shows tachycardia, left axis deviation, and a wavy baseline with no defined P wave. Which of the following is the most likely diagnosis?

21) Which of the following is a cyanotic type of congenital heart defect?

22) Which of the following is a cyanotic type of congenital heart defect?

23) A 60-year-old male presents to his PCP for a routine physical. Current medications include Atenolol 50 mg and HCTZ 12.5 mg. He has a 40 packs/year history of smoking. Examination reveals a pulsatile mass in the epigastrium. What is the most likely diagnosis?

24) A cardiac patient who experiences discomfort upon performing any physical activity is most likely experiencing which of the following functional classes of heart disease?

25) A 65-year-old female presents to the emergency room with complaints of dyspnea on exertion, orthopnea, and bilateral lower extremity edema. Examination reveals a chronically ill-appearing female whose head bobs rhythmically. PMI is laterally displaced and enlarged. There is a high-pitched blowing decrescendo murmur heard in diastole and loudest at the left sternal border. What is the most likely diagnosis?

26) An 80-year-old female presents to her PCP complaining of chest discomfort and shortness of breath. Her daughter brought her in because she fainted at a family reunion. Examination reveals a IV/VI systolic crescendo-decrescendo murmur heard loudest at the right sternal border. What is the most likely diagnosis?

27) A 45-year-old female with systemic lupus erythematosus presents for a routine check-up. Examination reveals a IV/VI systolic blowing holosystolic murmur that radiates to the axilla. There is a thrill palpated at the apex. What is the most likely diagnosis?

28) A 25-year-old female presents for a well check. Examination reveals a holosystolic murmur at the apex radiating to the axilla with an associated click. Which of the following would be the most appropriate diagnosis?

29) Which of the following is most common etiology of ischemic heart disease?

30) A 55-year-old African American male with a 30 packs/year history of smoking presents to his PCP with a complaint of swelling in the right lower leg. The patient reports that he recently returned from a 15-hour road trip from New York, which he proudly states he made in a “straight shot.” On examination, his BP is 140/90. Cardiac and pulmonary examinations are essentially normal. Examination of the extremities reveals 2+ pitting edema in the right leg and positive “Homan’s sign.” What is the most appropriate next test to order in this patient?

31) A 55-year-old male with DM presents to the emergency room with a complaint of malaise, shortness of breath, nausea, and “indigestion.” He states that he has had nausea and “cold sweats” when walking for the past several months. Examination reveals BP 80/50 and a pulse of 50. EKG reveals ST elevation in leads II, III, and aVF. What is the most likely diagnosis?

32) A 70-year-old female with diabetes and CHF presents to her PCP complaining of fatigue and “racing heart beat.” Examination reveals BP 150/80. Pulse is irregularly irregular at 170 bpm. Cardiac exam reveals tachycardia and an irregularly irregular rhythm. EKG shows tachycardia, left axis deviation, and a wavy baseline with no defined P wave. Which of the following is NOT an appropriate intervention for this patient?

33) A 72-year-old male presents to his PCP complaining of dyspnea and fatigue. Examination reveals an opening snap and a rumbling diastolic murmur heard loudest at the apex. What is the most likely diagnosis?

34) A patient presents to his PCP with suspected peripheral arterial disease. After physical exam, what is the most important next test to confirm this diagnosis?

35) Which of the following may exacerbate heart failure by reducing oxygen flow to the heart?

36) A 30-year-old male with a history of IV drug use presents to the emergency room. The chart reveals that he is a “frequent flyer” with multiple requests for narcotics. Examination reveals a holosystolic murmur heard loudest at the left sternal border that increases with inspiration. Examination of the liver reveals hepatojugular reflux. What is the most likely diagnosis?

37) Which of the following medications is commonly administered for the prevention of deep venous thromboses?

38) Which of the following should be administered to prevent atherothrombosis in patients with diabetes mellitus type 2?

39) Which of the following medications is one of the first lines of treatment for stable angina pectoris?

40) Which of the following types of medications is the most appropriate intervention in conjunction with nitroglycerin for conditions related to coronary artery spasms?