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| 1 | The _______ arteries provide a continuous supply of oxygen and nutrients to the myocardial cells. |
 | A) | cerebral |
| B) | systemic |
| C) | cephalic |
| D) | coronary |
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| 2 | The right main coronary artery: |
| A) | divides into the anterior descending and circumflex branches |
| B) | originates from the left side of the aorta |
| C) | divides into two branches, the marginal artery and the posterior interventricular artery |
| D) | it supplies blood to the majority of the right bundle branch |
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| 3 | The left coronary artery: |
| A) | originates from the right side of the aorta and passes along the atrioventricular sulcus between the right atrium and right ventricle |
| B) | divides into the anterior descending and circumflex branches |
| C) | it supplies the right atrium, right ventricle, inferior and posterior walls of the left ventricle, and posterior one-third of the interventricular septum with blood |
| D) | transports blood back to the right atrium via the coronary sinus |
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| 4 | Coronary perfusion occurs: |
| A) | during diastole when the heart is relaxed |
| B) | during systole when the heart is contracting |
| C) | just as the heart finishes filling with blood |
| D) | just as the heart finishes ejecting the blood from the ventricles |
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| 5 | Which of the following is true regarding myocardial oxygenation? |
| A) | The resting heart extracts most of the oxygen from the coronary blood as it flows through the heart muscle. |
| B) | Increased oxygen demands of the myocardium that result from exercise or emotional stress can only be satisfied by faster coronary blood flow. |
| C) | The need for oxygen in local heart tissue causes the coronary arteries to constrict which increases coronary pressure and myocardial perfusion. |
| D) | Stimulation of the alpha receptors leads to vasodilation which increases coronary blood flow |
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| 6 | The _______ can be used as a baseline from which to evaluate depression or elevation of the ST segment. |
| A) | QT interval |
| B) | P wave |
| C) | J point |
| D) | PR segment |
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| 7 | The Q wave: |
| A) | is the first part of the QRS complex and represents depolarization of the interventricular septum |
| B) | is clinically insignificant when it is present and normal |
| C) | is normally less than 25% the amplitude of the R wave in that lead |
| D) | all of the above |
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| 8 | The ST segment: |
| A) | begins at the most negative point of the S wave |
| B) | represents the last portion of ventricular depolarization |
| C) | is the line that follows the QRS complex and connects it to the T wave |
| D) | normally appears as a thin line that slopes upward to the flat line that precedes the T wave |
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| 9 | The T wave represents the: |
| A) | completion of ventricular repolarization |
| B) | completion of ventricular depolarization |
| C) | beginning of ventricular repolarization |
| D) | movement of electrical activity through the ventricles |
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| 10 | Myocardial ischemia: |
| A) | is not usually accompanied by chest pain |
| B) | is due to a permanent shortage of oxygen to the myocardium brought on by exertion, emotional stress, or even the stress of cold weather |
| C) | reflects actual cellular damage |
| D) | is a deprivation of oxygen and nutrients to the myocardium |
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| 11 | Myocardial __________ is the death of myocardial cells. |
| A) | infarction |
| B) | injury |
| C) | angina |
| D) | thrombus |
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| 12 | Two characteristic signs of myocardial ischemia are: |
| A) | pathologic Q waves, elevated ST segments |
| B) | inverted T waves, ST segment depression |
| C) | ST segment elevation, inverted T waves |
| D) | flat depression of the ST segment, inverted P waves |
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| 13 | Subendocardial infarction results in: |
| A) | A flat depression of the ST segment |
| B) | elevation of the ST segment |
| C) | tall, peaked T waves |
| D) | inverted, symmetrical T waves |
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| 14 | ST segment elevation: |
| A) | is a sign of irreversible myocardial damage |
| B) | is the earliest sign of angina |
| C) | occurs with myocardial injury |
| D) | indicates a past myocardial infarction |
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| 15 | Pathologic Q waves: |
| A) | always occur in myocardial infarction |
| B) | are a characteristic sign of myocardial injury |
| C) | disappear after the first couple hours following the beginning of an infarction |
| D) | indicate the presence of irreversible myocardial damage or a past myocardial infarction |
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| 16 | You are assessing the ECG of a patient who is complaining of crushing substernal chest pain. You see a regular rhythm with heart rate of 54 beats per minute and each upright P wave is followed by a narrow QRS complex. The PR intervals are 0.14 seconds in duration. You note the presence of ST depression and inverted T waves in leads V1, V2 and V3. This represents: |
| A) | anterior myocardial ischemia |
| B) | lateral myocardial infarction |
| C) | posterior myocardial injury |
| D) | inferior myocardial infarction |
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| 17 | You are assessing the ECG of a patient who describes having a dull aching pain in his chest. You see a regular rhythm with a heart rate of 76 beats per minute. The P waves are round and upright. In leads I, aVL, V5, and V6 you note the presence of elevated ST segments and pathological Q waves. The PR intervals are 0.12 seconds in duration. This condition is: |
| A) | anterior myocardial infarction |
| B) | lateral myocardial infarction |
| C) | posterior myocardial infarction |
| D) | inferior myocardial infarction |
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| 18 | Your 48-year-old patient has been experiencing nausea and shortness of breath. You attach her to an ECG and see a regular rhythm that has a heart rate of 64 beats per minute. There are upright P waves that are each followed by a QRS complex. The duration of the PR intervals is 0.18 seconds in duration. There is ST segment elevation in II, III, and aVF. This condition is: |
| A) | anterior myocardial ischemia |
| B) | lateral myocardial injury |
| C) | posterior myocardial infarction |
| D) | inferior myocardial injury |
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| 19 | Your 51-year-old patient has been brought to the hospital by ambulance. She is complaining of a dull, aching pain that radiates to her neck and shoulder. You attach her to an ECG and see a regular rhythm that has a heart rate of 84 beats per minute. There are upright P waves that are each followed by a QRS complex. The duration of the PR intervals is 0.10 seconds. You also note unusually large R waves, ST elevation and upright T waves in leads V1. This condition is: |
| A) | anterior infarction |
| B) | lateral myocardial infarction |
| C) | posterior myocardial infarction |
| D) | inferior myocardial infarction |
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| 20 | Branches of the anterior descending artery, the diagonal artery and the septal perforators, help supply blood to the lateral walls of the left ventricle. |
| A) | True |
| B) | False |
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| 21 | The Q wave is always present on the ECG. |
| A) | True |
| B) | False |
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| 22 | Myocardial ischemia is usually relieved within 2 to 10 minutes of rest or by administration of a medicine, such as nitroglycerin that dilates the coronary arteries and allows the needed blood to flow to the myocardium. |
| A) | True |
| B) | False |
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| 23 | The ECG is of little help in identifying the presence of ischemia, injury, and/or infarction of the heart muscle. |
| A) | True |
| B) | False |
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| 24 | Leads V1, V2, V3, and V4 provide the best view for identifying lateral myocardial infarction. |
| A) | True |
| B) | False |
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| 25 | Inferior infarction is determined by ECG changes such as ST segment elevation; T wave inversion; and the development of significant Q waves in leads II, III, and aVF. |
| A) | True |
| B) | False |