Chapter 33: Syncope Buttaro: Primary Care: A Collaborative Practice, 6th Edition

Multiple Choice

1. A healthy 20-year-old patient reports having had 1 or 2 episodes of syncope without loss of consciousness. Which is the most likely type of syncope in this patient?

a. Cardiac b. Neurogenic c. Orthostatic hypotensive d. Reflex syncope

ANS: D a. Cardiac enzyme levels b. Electroencephalogram c. Fasting blood glucose d. Orthostatic blood pressures

Neurally mediated or reflex syncope is the most common cause of syncope and is primarily seen in young adults. Cardiac, neurogenic, and orthostatic syncope are generally seen in older adults.

2. An elderly patient reports experiencing syncope each morning when getting out of bed. Which assessment will the health care provider perform first to evaluate this patient’s symptoms?

ANS: D

Orthostatic blood pressures should be measured first since this patient reports problems associated with rising from a supine position. The other tests are performed as part of the diagnostic workup only if indicated by associated symptoms or suspected causes.

Multiple Response

NURSINGTB.COM a. 12-lead electrocardiogram b. Cardiac enzyme levels c. Complete blood count d. Electroencephalogram e. Serum glucose testing

1. Which tests are indicated as part of the initial evaluation for women of childbearing age who report syncope? (Select all that apply.)

ANS: A, C, E

Initial evaluation for all patients reporting syncope should include a standard 12-lead ECG. Women of childbearing age should have a CBC, serum pregnancy test, and serum glucose testing. Cardiac enzyme levels are obtained if the patient has cardiac risk factors. EEG is performed only if there is a concern for seizure disorder.