Q.1 Which of the following is the most common cause of myocardial infarction?
Aortic stenosis
Coronary artery atherosclerosis
Myocarditis
Pericarditis
Explanation - Myocardial infarction (heart attack) most commonly occurs due to blockage of coronary arteries by atherosclerotic plaque leading to ischemia and necrosis of myocardial tissue.
Correct answer is: Coronary artery atherosclerosis
Q.2 Which symptom is considered classic for left-sided heart failure?
Peripheral edema
Dyspnea on exertion
Hepatomegaly
Jugular venous distention
Explanation - Left-sided heart failure often causes pulmonary congestion, leading to shortness of breath, especially during exertion.
Correct answer is: Dyspnea on exertion
Q.3 A patient presents with crushing chest pain radiating to the left arm. Which immediate intervention is essential?
Administer oxygen and call for emergency help
Give antipyretics
Apply a heat pack to the chest
Encourage the patient to walk
Explanation - Crushing chest pain radiating to the left arm is suggestive of acute myocardial infarction; immediate oxygen and emergency response are critical.
Correct answer is: Administer oxygen and call for emergency help
Q.4 Which lab test is most specific for diagnosing myocardial infarction?
Creatine kinase (CK)
Troponin I
Myoglobin
Lactate dehydrogenase (LDH)
Explanation - Troponin I is highly specific and sensitive for myocardial injury and is considered the gold standard for MI diagnosis.
Correct answer is: Troponin I
Q.5 Which type of hypertension is more common and has no identifiable cause?
Secondary hypertension
Essential hypertension
Malignant hypertension
Isolated systolic hypertension
Explanation - Essential (primary) hypertension accounts for 90-95% of cases and has no identifiable cause, unlike secondary hypertension which is caused by another medical condition.
Correct answer is: Essential hypertension
Q.6 Which medication class is first-line therapy for chronic heart failure to improve survival?
Loop diuretics
Beta-blockers
Calcium channel blockers
Nitrates
Explanation - Beta-blockers reduce mortality in chronic heart failure by decreasing sympathetic nervous system activity and improving cardiac function over time.
Correct answer is: Beta-blockers
Q.7 Which ECG change is characteristic of acute myocardial infarction?
Peaked T waves
ST-segment elevation
Prolonged QT interval
Flattened P waves
Explanation - ST-segment elevation on ECG is indicative of acute myocardial injury, often seen in STEMI (ST-Elevation Myocardial Infarction).
Correct answer is: ST-segment elevation
Q.8 A patient with peripheral arterial disease is most likely to report which symptom?
Resting tachycardia
Intermittent claudication
Orthopnea
Frequent urination
Explanation - Intermittent claudication, which is pain in the legs during exercise relieved by rest, is a hallmark symptom of peripheral arterial disease.
Correct answer is: Intermittent claudication
Q.9 Which is a modifiable risk factor for coronary artery disease?
Age
Gender
Hypertension
Family history
Explanation - Hypertension is a controllable risk factor for CAD, whereas age, gender, and family history are non-modifiable.
Correct answer is: Hypertension
Q.10 Which type of shock is caused by severe blood loss?
Cardiogenic shock
Hypovolemic shock
Septic shock
Neurogenic shock
Explanation - Hypovolemic shock occurs due to a significant loss of blood or fluid, reducing circulating volume and leading to inadequate tissue perfusion.
Correct answer is: Hypovolemic shock
Q.11 Which dietary recommendation is most appropriate for a patient with hypertension?
High sodium intake
Low sodium, high potassium diet
High cholesterol diet
High sugar diet
Explanation - Reducing sodium intake and increasing potassium helps lower blood pressure and reduce cardiovascular risk.
Correct answer is: Low sodium, high potassium diet
Q.12 Which clinical feature differentiates stable angina from unstable angina?
Pain is relieved with rest in stable angina
Pain occurs at rest in stable angina
Pain is severe and unrelieved in stable angina
Pain radiates to the jaw in unstable angina only
Explanation - Stable angina occurs predictably with exertion and is relieved by rest or nitroglycerin, whereas unstable angina may occur at rest and is unpredictable.
Correct answer is: Pain is relieved with rest in stable angina
Q.13 Which heart valve is most commonly affected in rheumatic heart disease?
Aortic valve
Mitral valve
Pulmonary valve
Tricuspid valve
Explanation - Rheumatic heart disease most commonly affects the mitral valve, leading to stenosis or regurgitation due to chronic inflammation.
Correct answer is: Mitral valve
Q.14 Which clinical sign is characteristic of right-sided heart failure?
Pulmonary edema
Dyspnea on exertion
Peripheral edema and hepatomegaly
Orthopnea
Explanation - Right-sided heart failure causes systemic venous congestion, resulting in peripheral edema, ascites, and enlarged liver.
Correct answer is: Peripheral edema and hepatomegaly
Q.15 Which antihypertensive drug class is contraindicated in pregnancy?
Methyldopa
Hydralazine
ACE inhibitors
Labetalol
Explanation - ACE inhibitors can cause fetal renal damage and are contraindicated in pregnancy. Methyldopa, hydralazine, and labetalol are considered safer options.
Correct answer is: ACE inhibitors
Q.16 Which lipid abnormality is most strongly associated with atherosclerosis?
High HDL
Low LDL
High LDL
Low triglycerides
Explanation - Elevated LDL cholesterol contributes to plaque formation in arteries, increasing the risk of atherosclerosis and cardiovascular disease.
Correct answer is: High LDL
Q.17 Which diagnostic test measures the percentage of blood ejected from the left ventricle?
Cardiac catheterization
Ejection fraction via echocardiography
ECG
Chest X-ray
Explanation - Echocardiography can measure the ejection fraction, indicating the pumping efficiency of the left ventricle, important in heart failure assessment.
Correct answer is: Ejection fraction via echocardiography
Q.18 Which of the following is a common side effect of beta-blockers?
Tachycardia
Bradycardia
Hypertension
Hyperglycemia
Explanation - Beta-blockers slow the heart rate by blocking sympathetic stimulation, leading to bradycardia as a common side effect.
Correct answer is: Bradycardia
Q.19 Which condition is characterized by sudden, severe chest pain relieved by leaning forward?
Myocardial infarction
Pericarditis
Stable angina
Pulmonary embolism
Explanation - Acute pericarditis often causes sharp, pleuritic chest pain that improves when the patient leans forward.
Correct answer is: Pericarditis
Q.20 Which is the earliest clinical sign of hypovolemic shock?
Bradycardia
Tachycardia
Hypotension
Pulmonary edema
Explanation - Tachycardia is an early compensatory response to maintain cardiac output when blood volume decreases in hypovolemic shock.
Correct answer is: Tachycardia
Q.21 Which assessment finding is expected in a patient with chronic venous insufficiency?
Pale, cool legs
Shiny skin with hair loss
Edema and hyperpigmentation
Weak or absent pulses
Explanation - Chronic venous insufficiency leads to fluid pooling in the lower extremities, causing edema and brownish skin pigmentation.
Correct answer is: Edema and hyperpigmentation
Q.22 Which procedure is indicated for severe coronary artery disease not amenable to medication?
Percutaneous coronary intervention (PCI)
Cardioversion
Pacemaker insertion
Coronary artery bypass grafting (CABG)
Explanation - CABG is a surgical procedure to bypass blocked coronary arteries and restore adequate blood flow to the myocardium.
Correct answer is: Coronary artery bypass grafting (CABG)
Q.23 Which condition is caused by a defective heart valve leading to backward flow of blood?
Stenosis
Regurgitation
Myocardial infarction
Arrhythmia
Explanation - Valvular regurgitation occurs when a valve does not close properly, allowing blood to flow backward instead of forward.
Correct answer is: Regurgitation
Q.24 Which nursing intervention is priority for a patient experiencing acute chest pain?
Monitor vital signs every 4 hours
Administer prescribed nitroglycerin and assess pain
Encourage ambulation
Provide high-calorie diet
Explanation - Nitroglycerin can relieve ischemic chest pain, and continuous assessment is crucial for detecting deterioration or complications.
Correct answer is: Administer prescribed nitroglycerin and assess pain