8-13
1. The most common cause of myocardial
ischemia is:
◦
◦
◦
◦
A. obesity
B. cigarette smoking
C. atherosclerosis
D. hypertension
8-13
1.The most common cause of myocardial
ischemia is:
◦
◦
◦
◦
A. obesity
B. cigarette smoking
C. atherosclerosis
D. hypertension
8-13
2. The age advantage that women have over
men in the development of CHD is most likely
related to
A. better lifestyle habits
B. the protective effects of estrogen
C. a lower incidence of hypertension
D. a lower incidence of diabetes
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2. The age advantage that women have over
men in the development of CHD is most likely
related to
A. better lifestyle habits
B. the protective effects of estrogen
C. a lower incidence of hypertension
D. a lower incidence of diabetes
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
3. Cigarette smoking contributes to the
development of coronary artery disease in all
of the following ways except one. Which one
is the exception?
◦ A. Tobacco use accelerates the development of
coronary plaques.
◦ B. Tobacco use promotes plaque rupture
◦ C. Tobacco use promotes coronary thrombosis
◦ D. Tobacco use causes vasodilatation and
hypotension.
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
3. Cigarette smoking contributes to the
development of coronary artery disease in all
of the following ways except one. Which one
is the exception?
◦ A. Tobacco use accelerates the development of
coronary plaques.
◦ B. Tobacco use promotes plaque rupture
◦ C. Tobacco use promotes coronary thrombosis
◦ D. Tobacco use causes vasodilatation and
hypotension.
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
4. In individuals over the age of 50, systolic
blood pressure greater than ______ is a more
important risk factor than diastolic blood
pressure.
◦
◦
◦
◦
A. 150 mmHg
B. 130 mmHg
C. 140 mmHg
D. 125 mmHg
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
4. In individuals over the age of 50, systolic
blood pressure greater than ______ is a more
important risk factor than diastolic blood
pressure.
◦
◦
◦
◦
A. 150 mmHg
B. 130 mmHg
C. 140 mmHg
D. 125 mmHg
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
5. If a patient with angina has had no
changes in the cause, frequency, or duration
of anginal symptoms in the previous 60 days,
he or she is considered to have
◦
◦
◦
◦
A. unstable angina
B. stable angina
C. vasoplastic angina
D. variant angina
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
5. If a patient with angina has had no
changes in the cause, frequency, or duration
of anginal symptoms in the previous 60 days,
he or she is considered to have
◦
◦
◦
◦
A. unstable angina
B. stable angina
C. vasoplastic angina
D. variant angina
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
6. A sharp, stabbing chest pain that can be
localized and is aggravated by movement or
breathing is symptomatic of
◦
◦
◦
◦
A. variant angina
B. unstable angina
C. non-cardiac related chest pain
D. an acute myocardial infarction
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
6. A sharp, stabbing chest pain that can be
localized and is aggravated by movement or
breathing is symptomatic of
◦
◦
◦
◦
A. variant angina
B. unstable angina
C. non-cardiac related chest pain
D. an acute myocardial infarction
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
7. Patients who present to the dental office
with unstable angina
◦ A. can be treated in the dental office if their vital
signs are monitored throughout the appointment
◦ B. can receive emergency dental treatment after
consultation with a physician and preferably in a
hospital setting
◦ C. can receive a local anesthetic with epinephrine
safely
◦ D. can receive a local anesthetic with epinephrine
but the maximum dose of the vasoconstrictor
should not exceed o.o4 mg.
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
7. Patients who present to the dental office
with unstable angina
◦ A. can be treated in the dental office if their vital
signs are monitored throughout the appointment
◦ B. can receive emergency dental treatment after
consultation with a physician and preferably in a
hospital setting
◦ C. can receive a local anesthetic with epinephrine
safely
◦ D. can receive a local anesthetic with epinephrine
but the maximum dose of the vasoconstrictor
should not exceed o.o4 mg.
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
8. The protocol for management of a patient
with no history of angina and who is
experiencing anginal-like chest pain includes
◦ A. administering three doses of nitroglycerin over
15 minutes prior to activating the EMS system
◦ B. administering one dose of nitroglycerin and
activation of the EMS system if the pain continues
for two minutes or longer
◦ C. immediately administering 81 mg of aspirin
◦ D. positioning the patient in a Trandelenburg
position because he or she is probably having an
anxiety attack.
8-13

8. The protocol for management of a patient
with no history of angina and who is
experiencing anginal-like chest pain includes
◦ A. administering three doses of nitroglycerin over
15 minutes prior to activating the EMS system
◦ B. administering one dose of nitroglycerin and
activation of the EMS system if the pain continues
for two minutes or longer
◦ C. immediately administering 81 mg of aspirin
◦ D. positioning the patient in a Trandelenburg
position because he or she is probably having an
anxiety attack.
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
9. During the first one to two hours following
the onset of symptoms of an AMI, the
greatest risk for death is the development of
◦
◦
◦
◦
A. cardiac dysrhythmias
B. dyspnea
C. diaphoresis
D. pulmonary edema
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
9. During the first one to two hours following
the onset of symptoms of an AMI, the
greatest risk for death is the development of
◦
◦
◦
◦
A. cardiac dysrhythmias
B. dyspnea
C. diaphoresis
D. pulmonary edema
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
10. It is recommended that out-of-hospital
AMI victims begin fibrinolysis as soon as the
symptoms are recognized. The recommended
drug is
◦
◦
◦
◦
A. 5 mg of warfarin
B. 7 mg of Coumadin
C. 162 to 325 mg of acetylsalicylic acid
D. 50 mg of aspirin
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
10. It is recommended that out-of-hospital
AMI victims begin fibrinolysis as soon as the
symptoms are recognized. The recommended
drug is
◦
◦
◦
◦
A. 5 mg of warfarin
B. 7 mg of Coumadin
C. 162 to 325 mg of acetylsalicylic acid
D. 50 mg of aspirin
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8-13

1. Left ventricular heart failure results in
◦
◦
◦
◦
A. respiratory distress
B. peripheral edema
C. distended jugular veins while lying or sitting
D. nocturia
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
1. Left ventricular heart failure results in
◦
◦
◦
◦
A. respiratory distress
B. peripheral edema
C. distended jugular veins while lying or sitting
D. nocturia
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
2. All of the following symptoms are observed
in late stage heart failure except one. Which
symptom is the exception?
◦
◦
◦
◦
A. cyanosis of the lips and/or nail beds
B. cardiac cachexia
C. mental confusion and anxiety
D. stabbing chest pain lasting less than 30 seconds
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
2. All of the following symptoms are observed
in late stage heart failure except one. Which
symptom is the exception?
◦
◦
◦
◦
A. cyanosis of the lips and/or nail beds
B. cardiac cachexia
C. mental confusion and anxiety
D. stabbing chest pain lasting less than 30 seconds
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
3. Right ventricular heart failure usually
develops before left ventricular heart failure.
The major clinical symptom of RV heart
failure is pulmonary edema.
◦
◦
◦
◦
A. The 1st statement is true, 2nd is false
B. The 1st statement is false, the 2nd true
C. Both statements are true
D. Both statements are false
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
3. Right ventricular heart failure usually
develops before left ventricular heart failure.
The major clinical symptom of RV heart
failure is pulmonary edema.
◦
◦
◦
◦
A. The 1st statement is true, 2nd is false
B. The 1st statement is false, the 2nd true
C. Both statements are true
D. Both statements are false
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
4. Symptoms of right heart failure include all
of the following except one. Which one is the
exception?
◦
◦
◦
◦
A. distended jugular veins
B. peripheral edema with pitting
C. nocturia
D. carpopedal spasms
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4. Symptoms of right heart failure
include all of the following except
one. Which one is the exception?
A. distended jugular veins
B. peripheral edema with pitting
C. nocturia
D. carpopedal spasms
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
5. A bloodless phlebotomy
◦ A. should only be performed in a hospital setting on
patients suffering from heart failure
◦ B. could be performed in the dental setting to help
reduce peripheral edema in heart failure patients
◦ C. could be performed in a dental setting to help
manage lung congestion in patients suffering from
acute pulmonary edema.
◦ D. is never a treatment option for patients
experiencing acute pulmonary edema.
8-13

5. A bloodless phlebotomy
◦ A. should only be performed in a hospital setting on
patients suffering from heart failure
◦ B. could be performed in the dental setting to help
reduce peripheral edema in heart failure patients
◦ C. could be performed in a dental setting to help
manage lung congestion in patients suffering from
acute pulmonary edema.
◦ D. is never a treatment option for patients
experiencing acute pulmonary edema.
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
6. The administration of nitroglycerin is
indicated in the management of acute
pulmonary edema and heart failure. The
administration of nitroglycerin is
contraindicated in patients with a systolic
pressure lower than 100 mmHg.
◦
◦
◦
◦
A. The 1st statement is true, the 2nd false
B. The 1st statement is false, the 2nd true
C. Both statements are true
D. Both statements are false
8-13

6. The administration of nitroglycerin is
indicated in the management of acute
pulmonary edema and heart failure. The
administration of nitroglycerin is
contraindicated in patients with a systolic
pressure lower than 100 mmHg.
◦
◦
◦
◦
A. The 1st statement is true, the 2nd false
B. The 1st statement is false, the 2nd true
C. Both statements are true
D. Both statements are false
8-13

7. Prominent jugular veins while seated in an
upright position is indicative of
◦
◦
◦
◦
A. left heart failure
B. right heart failure
C. pulmonary embolism
D. acute myocardial infarction
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




7. Prominent jugular veins while seated in an
upright position is indicative of
A. left heart failure
B. right heart failure
C. pulmonary embolism
D. acute myocardial infarction
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
8. The most frequent etiology of heart failure
is
◦
◦
◦
◦
A. cerebrovascular accident
B. diabetes
C. myocardial infarction
D. cardiac valve abnormalities
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


8. The most frequent etiology of heart failure
is
A. cerebrovascular accident
B. diabetes

C. myocardial infarction

D. cardiac valve abnormalities
8-13
8-13

1. Which of the following should not be used
on patients with a pacemaker or ICD?
◦
◦
◦
◦
A. dental handpieces
B. composite curing light
C. magnetostrictive ultrasonic scaler
D. dental radiographs
8-13

1. Which of the following should not be used
on patients with a pacemaker or ICD?
◦
◦
◦
◦
A. dental handpieces
B. composite curing light
C. magnetostrictive ultrasonic scaler
D. dental radiographs
8-13

2. The most common use for an implantable
cardioverter defibrillator is
◦
◦
◦
◦
A. tachyarrhythmia
B. syncope
C. severe hypertension
D. none of the above
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
2. The most common use for an implantable
cardioverter defibrillator is
◦
◦
◦
◦
A. tachyarrhythmia
B. syncope
C. severe hypertension
D. none of the above
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
3. The portion of the pacemaker that contains
the electronic circuitry and powers the device
is the
◦
◦
◦
◦
A. lead
B. defibrillator
C. copper stem
D. generator
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
3. The portion of the pacemaker that contains
the electronic circuitry and powers the device
is the
◦
◦
◦
◦
A. lead
B. defibrillator
C. copper stem
D. generator
8-13

4. All of the following are symptoms of an
individual suffering from a pacemaker
malfunction except one. Which one is the
exception?
◦
◦
◦
◦
A. dizziness
B. hiccoughing
C. swelling of the extremities
D. wheezing
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
4. All of the following are symptoms of an
individual suffering from a pacemaker
malfunction except one. Which one is the
exception?
◦
◦
◦
◦
A. dizziness
B. hiccoughing
C. swelling of the extremities
D. wheezing
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
5. The most important vital sign to monitor
on a patient suspected of having a pacemaker
malfunction is the
◦
◦
◦
◦
A. pulse
B. respiration
C. blood pressure
D. temperature
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
5. The most important vital sign to monitor
on a patient suspected of having a pacemaker
malfunction is the
◦
◦
◦
◦
A. pulse
B. respiration
C. blood pressure
D. temperature
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
6. Local anesthetics with vasoconstrictors
should be used with caution on patients with
pacemakers and ICDs.
◦ A. True
◦ B. False
8-13

6. Local anesthetics with vasoconstrictors
should be used with caution on patients with
pacemakers and ICDs.

A. True

B. False
8-13

7. The factor that causes the greatest risk of
malfunction with pacemakers or ICDs is
◦
◦
◦
◦
A. electromagnetic interference
B. solar interference
C. radiation interference
D. sonar interference
8-13





7. The factor that causes the greatest risk of
malfunction with pacemakers or ICDs is
A. electromagnetic interference
B. solar interference
C. radiation interference
D. sonar interference
8-13

8. The first step in the treatment of suspected
pacemaker malfunction is to
◦
◦
◦
◦
A. remove the cause of the interference
B. use the AED to regain appropriate heart rate
C. administer one table of nitroglycerin sublingually
D. contact the manufacturer of the pacemaker for
advice.
8-13





8. The first step in the treatment of suspected
pacemaker malfunction is to
A. remove the cause of the interference
B. use the AED to regain appropriate heart
rate
C. administer one table of nitroglycerin
sublingually
D. contact the manufacturer of the
pacemaker for advice.
8-13