NR 667 / NR667 VISE Practice Questions &
Answers | 100% Correct, Exam-Focused
Nursing Review Week 1 Full Length Practice
Exam Results for Fox, Amber
Score for this quiz: 130 out of 150
Submitted Jan 12 at 4:31pm
This attempt took 177 minutes.
Question 1
pts
A patient has been complaining of palpitations for the past week and presents to you at
an urgent care clinic for evaluation. You perform a 12 lead EKG and identify atrial
fibrillation with a hear rate of 122 beats per minute. What is your next order?
Apply a Holter monitor
Administer 5mg of warfarin
Order a stat transthoracic (2D) echocardiogram and prepare the patient for trasnport to
the closest appropriate hospital for inpatient evaluation
A wearable monitor does not provide you with actionable information until it is read, and the
patient is already identified as being in atrial fibrillation. Warfarin without bridging will take
several days to achieve a therapeutic INR and without bridging (as it is not mentioned) would
potentially increase prothrombotic state for first few days due to inhibition of protein C and S.
Amiodarone is a rhythm conversion medication and should not be given unless first identifying
any evidence of clot burden with an echocardiogram.
Administer 150mg of amiodarone IV bolus
Question 2
pts
Which of the following do not represent possible causes of a prothrombotic state?
Inhibition of factor Xa
,Protein C and S are the body’s natural anticoagulants and a deficit of these would make the
patient more prone to clot. Factor V Leyden is a genetic mutation that makes the blood more
prone to clot. Factor X when activated (Xa) is the beginning of stable clot formation. Inhibition of
this would represent an anticoagulated state. (Oral anticoagulants such as rivaroxaban and
apixaban use this mechanism).
Deficiency of protein S
Presence of factor V Leyden
Deficiency of protein C
Question 3
pts
An 80-year-old man with a history of atrial fibrillation presents with sudden-onset
unilateral leg pain and pallor. What is the most likely diagnosis?
Deep vein thrombosis
Cellulitis
Correct Answer
Acute arterial occlusion
Peripheral artery disease
Question 4
pts
A 65-year-old woman presents for a follow-up examination. She is a smoker, and her
hypertension is now adequately controlled with medication. Her mother died at age 40
from a heart attack. The fasting lipid profile shows cholesterol = 240 mg/dL, HDL = 30,
,and LDL = 200. In addition to starting therapeutic lifestyle changes, the nurse
practitioner should start the patient on:
bile acid sequestrant.
low-dose aspirin.
a cholesterol absorption inhibitor.
a statin drug.
Bile acid sequestrants and cholesterol absorption inhibitors may be useful in reducing
ASVD risk, but for a patient who is an active smoker with premature coronary disease
history (less than age 65 for women), has hypertension and is far from an LDL goal, this
patient is most certainly a candidate for statin therapy, which represents the most
aggressive therapy option of these four listed.
Question 5
pts
Your patient has been diagnosed with a 4.5cm ascending aortic aneurysm. Which
medical imaging is considered standard of care for serial surveillance?
Transesophageal Echocardiogram
CT PE rule-out protocol
CT angiography of the chest
CT angiography is considered the standard of care for measuring vascular luminal dimensions
with contrast. CT PE protocol is not timed properly for the aorta (it’s timed for the pulmonary
artery). Although a plain film is able to catch large aneurysms at times, they are not able to
provide multi-axis reconstruction needed to accurately measure the size. Transesophageal echo
, is not needed to accurately measure the aorta and requires the patient to undergo sedation
which is unnecessary.
Plain film chest X-ray (CXR)
Question 6
pts
Preventive cardiac care should focus primarily on addressing all the following except?
Genetic predisposition
Smoking cessation, exercise, and medication compliance all represent modifiable risk factors and
should be the focus of preventive care. Non-modifiable risk factors such as age, gender,
genetic/family history should not be the primary focus of prevention.
Smoking cessation
Daily exercise
Medication compliance
Question 7
pts
The suggested International Normalized Ratio (INR) range in a patient being treated for
atrial fibrillation is:
3.0-4.0
4.0-5.0
Answers | 100% Correct, Exam-Focused
Nursing Review Week 1 Full Length Practice
Exam Results for Fox, Amber
Score for this quiz: 130 out of 150
Submitted Jan 12 at 4:31pm
This attempt took 177 minutes.
Question 1
pts
A patient has been complaining of palpitations for the past week and presents to you at
an urgent care clinic for evaluation. You perform a 12 lead EKG and identify atrial
fibrillation with a hear rate of 122 beats per minute. What is your next order?
Apply a Holter monitor
Administer 5mg of warfarin
Order a stat transthoracic (2D) echocardiogram and prepare the patient for trasnport to
the closest appropriate hospital for inpatient evaluation
A wearable monitor does not provide you with actionable information until it is read, and the
patient is already identified as being in atrial fibrillation. Warfarin without bridging will take
several days to achieve a therapeutic INR and without bridging (as it is not mentioned) would
potentially increase prothrombotic state for first few days due to inhibition of protein C and S.
Amiodarone is a rhythm conversion medication and should not be given unless first identifying
any evidence of clot burden with an echocardiogram.
Administer 150mg of amiodarone IV bolus
Question 2
pts
Which of the following do not represent possible causes of a prothrombotic state?
Inhibition of factor Xa
,Protein C and S are the body’s natural anticoagulants and a deficit of these would make the
patient more prone to clot. Factor V Leyden is a genetic mutation that makes the blood more
prone to clot. Factor X when activated (Xa) is the beginning of stable clot formation. Inhibition of
this would represent an anticoagulated state. (Oral anticoagulants such as rivaroxaban and
apixaban use this mechanism).
Deficiency of protein S
Presence of factor V Leyden
Deficiency of protein C
Question 3
pts
An 80-year-old man with a history of atrial fibrillation presents with sudden-onset
unilateral leg pain and pallor. What is the most likely diagnosis?
Deep vein thrombosis
Cellulitis
Correct Answer
Acute arterial occlusion
Peripheral artery disease
Question 4
pts
A 65-year-old woman presents for a follow-up examination. She is a smoker, and her
hypertension is now adequately controlled with medication. Her mother died at age 40
from a heart attack. The fasting lipid profile shows cholesterol = 240 mg/dL, HDL = 30,
,and LDL = 200. In addition to starting therapeutic lifestyle changes, the nurse
practitioner should start the patient on:
bile acid sequestrant.
low-dose aspirin.
a cholesterol absorption inhibitor.
a statin drug.
Bile acid sequestrants and cholesterol absorption inhibitors may be useful in reducing
ASVD risk, but for a patient who is an active smoker with premature coronary disease
history (less than age 65 for women), has hypertension and is far from an LDL goal, this
patient is most certainly a candidate for statin therapy, which represents the most
aggressive therapy option of these four listed.
Question 5
pts
Your patient has been diagnosed with a 4.5cm ascending aortic aneurysm. Which
medical imaging is considered standard of care for serial surveillance?
Transesophageal Echocardiogram
CT PE rule-out protocol
CT angiography of the chest
CT angiography is considered the standard of care for measuring vascular luminal dimensions
with contrast. CT PE protocol is not timed properly for the aorta (it’s timed for the pulmonary
artery). Although a plain film is able to catch large aneurysms at times, they are not able to
provide multi-axis reconstruction needed to accurately measure the size. Transesophageal echo
, is not needed to accurately measure the aorta and requires the patient to undergo sedation
which is unnecessary.
Plain film chest X-ray (CXR)
Question 6
pts
Preventive cardiac care should focus primarily on addressing all the following except?
Genetic predisposition
Smoking cessation, exercise, and medication compliance all represent modifiable risk factors and
should be the focus of preventive care. Non-modifiable risk factors such as age, gender,
genetic/family history should not be the primary focus of prevention.
Smoking cessation
Daily exercise
Medication compliance
Question 7
pts
The suggested International Normalized Ratio (INR) range in a patient being treated for
atrial fibrillation is:
3.0-4.0
4.0-5.0
