MCQ Quiz: Introduction to CV Modules

MCQ Quiz: Introduction to CV Modules (Cardiology Self-Care)

Welcome, PharmD students, to this MCQ quiz: Introduction to CV (Cardiovascular) Modules! This quiz focuses on foundational knowledge and self-care principles for common cardiovascular conditions that pharmacists frequently encounter, including hypertension, dyslipidemia, and an overview of heart failure. Understanding how to screen, educate, and counsel patients on lifestyle modifications, self-monitoring, and when to seek medical attention is crucial for managing these chronic conditions. Let’s test your introductory knowledge in cardiology self-care!

1. Hypertension is most accurately defined as:

a) Persistently low blood pressure.
b) Persistently high blood pressure.
c) A temporary increase in heart rate.
d) A condition where blood cholesterol is too high.

Answer: b) Persistently high blood pressure.

2. Blood pressure is recorded as two numbers. The top number (systolic) represents the pressure in the arteries when:

a) The heart is resting between beats.
b) The heart beats and contracts to pump blood.
c) The lungs are fully inflated.
d) The patient is sleeping.

Answer: b) The heart beats and contracts to pump blood.

3. According to recent ACC/AHA guidelines, Stage 1 Hypertension in adults is defined as a blood pressure of:

a) <120/<80 mmHg
b) 120-129/<80 mmHg
c) 130-139 mmHg systolic OR 80-89 mmHg diastolic
d) ≥140 mmHg systolic OR ≥90 mmHg diastolic

Answer: c) 130-139 mmHg systolic OR 80-89 mmHg diastolic

4. Which of the following is a common modifiable risk factor for developing hypertension?

a) Age
b) Family history
c) Ethnicity
d) High sodium intake and physical inactivity

Answer: d) High sodium intake and physical inactivity

5. Non-pharmacological lifestyle modifications recommended for managing hypertension include:

a) Increasing intake of processed foods.
b) Adopting the DASH diet, reducing sodium intake, regular physical activity, and weight management.
c) Increasing alcohol consumption.
d) Starting a smoking habit.

Answer: b) Adopting the DASH diet, reducing sodium intake, regular physical activity, and weight management.

6. Self-monitoring of blood pressure (SMBP) at home can be beneficial for patients with hypertension because it:

a) Replaces the need for all physician visits.
b) Can help improve adherence, detect white coat hypertension, and monitor response to treatment.
c) Is always more accurate than office blood pressure readings.
d) Eliminates the need for lifestyle changes.

Answer: b) Can help improve adherence, detect white coat hypertension, and monitor response to treatment.

7. Dyslipidemia refers to abnormal levels of _______ in the blood.

a) Glucose
b) Lipids (e.g., cholesterol and triglycerides)
c) Uric acid
d) Potassium

Answer: b) Lipids (e.g., cholesterol and triglycerides)

8. Which type of cholesterol is often referred to as “bad cholesterol” because high levels are associated with an increased risk of atherosclerosis?

a) High-Density Lipoprotein (HDL) cholesterol
b) Low-Density Lipoprotein (LDL) cholesterol
c) Very Low-Density Lipoprotein (VLDL) cholesterol
d) Chylomicrons

Answer: b) Low-Density Lipoprotein (LDL) cholesterol

9. Lifestyle modifications for managing dyslipidemia include dietary changes such as:

a) Increasing intake of saturated and trans fats.
b) Reducing intake of saturated fats, trans fats, and cholesterol, and increasing intake of soluble fiber.
c) Consuming a diet high in refined sugars.
d) Avoiding all dietary fats.

Answer: b) Reducing intake of saturated fats, trans fats, and cholesterol, and increasing intake of soluble fiber.

10. Heart failure is a chronic condition where the heart:

a) Beats too fast consistently.
b) Is unable to pump enough blood to meet the body’s metabolic needs.
c) Develops an infection of the heart valves.
d) Stops beating completely.

Answer: b) Is unable to pump enough blood to meet the body’s metabolic needs.

11. Common symptoms of heart failure include:

a) Persistent dry cough and itchy skin.
b) Shortness of breath (dyspnea), fatigue, and fluid retention (edema).
c) High fever and severe headache.
d) Numbness in the extremities and blurred vision.

Answer: b) Shortness of breath (dyspnea), fatigue, and fluid retention (edema).

12. For diagnosed, stable heart failure patients, important self-care measures often include:

a) Increasing daily sodium and fluid intake.
b) Monitoring daily weights, adhering to prescribed medications, and recognizing symptoms of worsening HF.
c) Engaging in strenuous, unmonitored exercise.
d) Discontinuing all prescribed medications if feeling well.

Answer: b) Monitoring daily weights, adhering to prescribed medications, and recognizing symptoms of worsening HF.

13. A patient with diagnosed heart failure who experiences a sudden weight gain of 3-5 pounds in a few days should:

a) Assume it’s normal and do nothing.
b) Increase their fluid intake.
c) Contact their healthcare provider, as this could indicate worsening fluid retention.
d) Start a new exercise program immediately.

Answer: c) Contact their healthcare provider, as this could indicate worsening fluid retention.

14. Which of the following is a pharmacist’s role in the self-care aspect of hypertension?

a) Prescribing antihypertensive medications independently.
b) Educating patients on lifestyle modifications, proper use of home blood pressure monitors, and adherence to prescribed therapy.
c) Performing cardiac catheterization.
d) Diagnosing new cases of severe hypertension without referral.

Answer: b) Educating patients on lifestyle modifications, proper use of home blood pressure monitors, and adherence to prescribed therapy.

15. The DASH (Dietary Approaches to Stop Hypertension) diet emphasizes increased intake of:

a) Red meat, sweets, and sodium.
b) Fruits, vegetables, whole grains, and low-fat dairy products, while limiting saturated fat, cholesterol, and sodium.
c) Processed foods and sugary drinks.
d) Only high-protein foods.

Answer: b) Fruits, vegetables, whole grains, and low-fat dairy products, while limiting saturated fat, cholesterol, and sodium.

16. A key counseling point for patients using a home blood pressure monitor is to:

a) Take readings only when feeling stressed.
b) Ensure proper cuff size and placement, rest for 5 minutes before measurement, and keep a log of readings.
c) Always take readings immediately after vigorous exercise.
d) Calibrate the monitor daily with a mercury sphygmomanometer.

Answer: b) Ensure proper cuff size and placement, rest for 5 minutes before measurement, and keep a log of readings.

17. Which type of dietary fat is generally considered heart-healthy and can help improve cholesterol levels when consumed in moderation, replacing saturated fats?

a) Trans fats
b) Saturated fats
c) Monounsaturated and polyunsaturated fats (e.g., found in olive oil, avocados, nuts, fatty fish)
d) Animal lard

Answer: c) Monounsaturated and polyunsaturated fats (e.g., found in olive oil, avocados, nuts, fatty fish)

18. For a patient with hypertension, a blood pressure reading consistently above _______ would generally indicate a need for medical follow-up or adjustment of therapy.

a) 110/70 mmHg
b) Their individualized target blood pressure goal set by their physician.
c) 90/60 mmHg
d) 120/80 mmHg (unless their target is lower)

Answer: b) Their individualized target blood pressure goal set by their physician.

19. Which over-the-counter product category may potentially increase blood pressure and should be used cautiously by patients with hypertension?

a) Saline nasal sprays
b) Artificial tears
c) Oral decongestants (e.g., pseudoephedrine, phenylephrine) and some NSAIDs.
d) Calcium supplements

Answer: c) Oral decongestants (e.g., pseudoephedrine, phenylephrine) and some NSAIDs.

20. Regular physical activity can help lower blood pressure and improve lipid profiles. General recommendations often include at least:

a) 30 minutes of moderate-intensity aerobic exercise once a month.
b) 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity aerobic exercise per week.
c) 10 minutes of light stretching daily.
d) Vigorous weightlifting only.

Answer: b) 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity aerobic exercise per week.

21. Elevated triglyceride levels are a component of dyslipidemia. High triglycerides can be associated with:

a) Diets very low in carbohydrates.
b) Diets high in refined carbohydrates and sugars, excessive alcohol intake, and obesity.
c) Excessive intake of soluble fiber.
d) Regular fish oil supplementation.

Answer: b) Diets high in refined carbohydrates and sugars, excessive alcohol intake, and obesity.

22. While pharmacists do not diagnose heart failure, they play a role in recognizing symptoms that might suggest undiagnosed or worsening heart failure. A key symptom requiring referral is:

a) Occasional mild fatigue after exertion.
b) New or worsening shortness of breath, especially at rest or with minimal exertion, or orthopnea/PND.
c) A single episode of indigestion.
d) Dry mouth.

Answer: b) New or worsening shortness of breath, especially at rest or with minimal exertion, or orthopnea/PND.

23. The term “orthopnea” in heart failure refers to:

a) Difficulty breathing when standing up.
b) Difficulty breathing when lying flat, requiring elevation with pillows.
c) Rapid breathing.
d) Palpitations.

Answer: b) Difficulty breathing when lying flat, requiring elevation with pillows.

24. The primary goal of lifestyle changes for dyslipidemia is to:

a) Increase LDL cholesterol and decrease HDL cholesterol.
b) Lower LDL cholesterol, lower triglycerides (if elevated), and potentially raise HDL cholesterol.
c) Eliminate all fats from the diet.
d) Only lose weight.

Answer: b) Lower LDL cholesterol, lower triglycerides (if elevated), and potentially raise HDL cholesterol.

25. Which of the following is a major, potentially life-threatening complication of untreated or poorly controlled hypertension?

a) Improved kidney function.
b) Stroke, heart attack, heart failure, and kidney disease.
c) Stronger bones.
d) Enhanced vision.

Answer: b) Stroke, heart attack, heart failure, and kidney disease.

26. A patient with hypertension asks if they can stop their medication because their blood pressure readings have been normal for a month. The pharmacist should advise them to:

a) Stop the medication immediately as it’s no longer needed.
b) Continue taking their medication as prescribed and discuss any changes with their physician, as hypertension is often a chronic condition requiring lifelong management.
c) Double the dose to ensure it stays normal.
d) Switch to an herbal supplement.

Answer: b) Continue taking their medication as prescribed and discuss any changes with their physician, as hypertension is often a chronic condition requiring lifelong management.

27. For a patient with dyslipidemia, what is the significance of HDL cholesterol?

a) It is the primary cholesterol that clogs arteries.
b) Higher levels are generally considered protective against heart disease (“good cholesterol”).
c) It should be as low as possible.
d) It is only found in plant-based foods.

Answer: b) Higher levels are generally considered protective against heart disease (“good cholesterol”).

28. A pharmacist counseling a patient newly diagnosed with heart failure should emphasize the importance of:

a) Discontinuing all other chronic medications.
b) Strict adherence to their prescribed heart failure medications, dietary sodium/fluid restrictions, and daily weight monitoring.
c) Starting a high-intensity exercise program immediately.
d) Only monitoring blood pressure.

Answer: b) Strict adherence to their prescribed heart failure medications, dietary sodium/fluid restrictions, and daily weight monitoring.

29. Which of these is a common symptom that might indicate worsening heart failure and requires prompt medical attention?

a) Decreased urination despite adequate fluid intake.
b) Sudden onset of shortness of breath or waking up at night breathless.
c) Increased swelling in the legs, ankles, or abdomen.
d) All of the above.

Answer: d) All of the above.

30. “White coat hypertension” refers to a phenomenon where a patient’s:

a) Blood pressure is lower in the clinical setting than at home.
b) Blood pressure is elevated in the clinical setting but normal when measured at home or with ambulatory monitoring.
c) Blood pressure is always normal.
d) Coat turns white when their blood pressure is high.

Answer: b) Blood pressure is elevated in the clinical setting but normal when measured at home or with ambulatory monitoring.

31. Excessive alcohol consumption can contribute to:

a) Lowering blood pressure and improving lipid profiles.
b) Raising blood pressure, increasing triglycerides, and contributing to weight gain.
c) Preventing heart failure.
d) Only improving social interactions.

Answer: b) Raising blood pressure, increasing triglycerides, and contributing to weight gain.

32. For patients with hypertension, stress management techniques can be beneficial because stress can:

a) Permanently cure hypertension.
b) Temporarily increase blood pressure.
c) Lower cholesterol levels.
d) Improve kidney function directly.

Answer: b) Temporarily increase blood pressure.

33. Which of the following is NOT typically a direct focus of “self-care” for undiagnosed dyslipidemia, but rather a public health recommendation leading to screening?

a) Adopting a heart-healthy diet.
b) Engaging in regular physical activity.
c) Self-prescribing high-dose statin therapy.
d) Weight management.

Answer: c) Self-prescribing high-dose statin therapy. (Diagnosis and prescription medication are physician-led).

34. The pharmacist’s role in counseling patients about fish oil supplements for dyslipidemia (if appropriate and discussed with a doctor) would include discussing:

a) That all fish oil supplements are equally effective and pure.
b) The potential benefits for triglyceride lowering (at adequate EPA/DHA doses), possible side effects (e.g., fishy aftertaste, bleeding risk at high doses), and the importance of product quality.
c) That fish oil cures atherosclerosis.
d) That they should stop all their other cholesterol medications.

Answer: b) The potential benefits for triglyceride lowering (at adequate EPA/DHA doses), possible side effects (e.g., fishy aftertaste, bleeding risk at high doses), and the importance of product quality.

35. One of the key components of the “Introduction to Cardiology Self Care” module (PHA5781) is to help future pharmacists:

a) Perform cardiac surgery.
b) Identify patients with common cardiovascular risk factors or conditions who may benefit from self-care interventions, education, or referral.
c) Prescribe complex antiarrhythmic drugs.
d) Only interpret electrocardiograms (ECGs).

Answer: b) Identify patients with common cardiovascular risk factors or conditions who may benefit from self-care interventions, education, or referral.

36. A patient reports their home blood pressure monitor consistently gives readings that are much higher than those in the doctor’s office. The pharmacist might suggest:

a) The patient has resistant hypertension.
b) The home monitor is definitely more accurate.
c) Checking the cuff size, patient technique, and potentially having the monitor validated against a calibrated device.
d) Discontinuing all blood pressure medication.

Answer: c) Checking the cuff size, patient technique, and potentially having the monitor validated against a calibrated device.

37. Which of these dietary components is most directly linked to raising LDL cholesterol levels?

a) Soluble fiber
b) Monounsaturated fats
c) Saturated fats and trans fats
d) Omega-3 fatty acids

Answer: c) Saturated fats and trans fats

38. The primary purpose of restricting sodium intake in patients with heart failure or hypertension is to:

a) Improve the taste of food.
b) Help manage fluid balance and reduce blood pressure or fluid retention.
c) Increase potassium levels.
d) Prevent osteoporosis.

Answer: b) Help manage fluid balance and reduce blood pressure or fluid retention.

39. A pharmacist is screening a patient using a cardiovascular risk assessment tool. This tool likely incorporates information about:

a) Only blood pressure.
b) Multiple risk factors such as age, smoking status, cholesterol levels, blood pressure, and diabetes status.
c) Only family history.
d) The patient’s favorite type of exercise.

Answer: b) Multiple risk factors such as age, smoking status, cholesterol levels, blood pressure, and diabetes status.

40. Which statement is TRUE regarding self-care for heart failure?

a) Self-care can cure heart failure.
b) It is primarily focused on lifestyle changes that patients (diagnosed with HF) can implement to manage their condition and recognize worsening symptoms, in conjunction with medical therapy.
c) It means patients should adjust their own medication doses frequently.
d) It is only for patients awaiting a heart transplant.

Answer: b) It is primarily focused on lifestyle changes that patients (diagnosed with HF) can implement to manage their condition and recognize worsening symptoms, in conjunction with medical therapy.

41. When counseling on lifestyle changes for hypertension or dyslipidemia, it is important for the pharmacist to:

a) Provide a very strict and complex plan that is difficult to follow.
b) Encourage small, gradual, and sustainable changes, and set realistic goals with the patient.
c) Tell the patient that medications are never necessary if lifestyle changes are made.
d) Only provide written information without discussion.

Answer: b) Encourage small, gradual, and sustainable changes, and set realistic goals with the patient.

42. A patient presents with symptoms of fatigue, bilateral ankle swelling, and shortness of breath on exertion. While referral is needed, these symptoms are most suggestive of which introductory CV condition?

a) Acute myocardial infarction.
b) Heart failure.
c) Uncomplicated hypertension.
d) Stable angina.

Answer: b) Heart failure.

43. The “A” in SCHOLAR-MAC, when assessing a patient with symptoms potentially related to a CV condition, would involve asking about:

a) Their age.
b) What makes their symptoms worse (Aggravating factors).
c) Their allergies and adverse drug reactions.
d) All medications they are taking (Medications).

Answer: c) Their allergies and adverse drug reactions. (Aggravating factors is also ‘A’, but given the context of M-A-C, Allergies is key).

44. What is a primary reason for pharmacists to be knowledgeable about self-monitoring devices for blood pressure?

a) To sell the most expensive models.
b) To help patients select appropriate devices, learn correct technique, and interpret their readings in context with their physician’s advice.
c) To calibrate these devices for home use.
d) To use them for diagnosing hypertension in the pharmacy.

Answer: b) To help patients select appropriate devices, learn correct technique, and interpret their readings in context with their physician’s advice.

45. Introduction to cardiology self-care emphasizes that untreated dyslipidemia can lead to:

a) Improved cardiovascular health.
b) Atherosclerosis, which can increase the risk of heart attack and stroke.
c) Stronger bones.
d) Better lung function.

Answer: b) Atherosclerosis, which can increase the risk of heart attack and stroke.

46. When a patient asks for advice on an OTC product for “water retention,” and they have a history of heart failure, the pharmacist should:

a) Immediately recommend the strongest available OTC diuretic.
b) Assess if this is a new or worsening symptom of their heart failure and advise them to contact their physician promptly, as self-treatment of HF edema is inappropriate.
c) Suggest they drink more water.
d) Tell them all water retention is normal.

Answer: b) Assess if this is a new or worsening symptom of their heart failure and advise them to contact their physician promptly, as self-treatment of HF edema is inappropriate.

47. Which lifestyle factor has a significant impact on all three conditions: hypertension, dyslipidemia, and risk of heart failure?

a) Reading books
b) Regular physical activity and maintaining a healthy weight
c) Drinking coffee
d) Getting a new pet

Answer: b) Regular physical activity and maintaining a healthy weight

48. The concept of “patient empowerment” in the self-care of chronic cardiovascular conditions like hypertension involves:

a) The pharmacist making all decisions for the patient.
b) Providing patients with the knowledge, skills, and confidence to actively participate in managing their condition.
c) Discouraging patients from asking questions.
d) Ensuring patients only follow advice found online.

Answer: b) Providing patients with the knowledge, skills, and confidence to actively participate in managing their condition.

49. A pharmacist’s initial interaction with a patient seeking self-care advice for a potential cardiovascular issue (e.g., consistently high home BP readings) should always include:

a) Immediately recommending an OTC medication.
b) A thorough assessment to determine the urgency and appropriateness of self-care versus medical referral.
c) Sharing personal experiences with similar conditions.
d) Guaranteeing a cure with lifestyle changes alone.

Answer: b) A thorough assessment to determine the urgency and appropriateness of self-care versus medical referral.

50. The overall goal of the “Introduction to Cardiology Self Care” module for PharmD students is to equip them to:

a) Perform cardiac stress tests.
b) Counsel patients effectively on preventative measures, adherence, self-monitoring, and recognizing warning signs for common cardiovascular conditions, and to facilitate appropriate medical follow-up.
c) Prescribe medications for hypertension and dyslipidemia.
d) Only focus on the most expensive treatment options.

Answer: b) Counsel patients effectively on preventative measures, adherence, self-monitoring, and recognizing warning signs for common cardiovascular conditions, and to facilitate appropriate medical follow-up.

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