Ultimate NR667 VISE Study Guide | High-Yield
Questions, Verified Answers & Guaranteed Exam
Confidence
Week 1 Full Length Practice Exam
Points 150
Questions 150
Time Limit 180 Minutes
Attempt History
Attempt Time Score
LATEST Attempt 1 171 minutes 144 out of 150
Score for this quiz: 144 out of 150
Submitted Sep 8 at 8:23pm
This attempt took 171 minutes.
Question 1
pts
Effective long-term treatment of systolic heart failure with reduced ejection fraction should include which
of the following?
Correct!
Prescribing valsartan/sacubitril (Entresto) unless contraindicated on discharge
Angiotensin Receptor and Neprilysin Inhibition is considered goal-directed therapy for patients with
reduced systolic heart function as evidence by the PARAGON-HF Trial. Auscultation is an assessment
item, not a treatment. Midazolam does not have any long term benefit for heart failure. Fluid bolus in a
patient with likely fluid overload from systolic heart failure only worsen their presenting symptoms.
Prescribing 500 ml fluid bolus for hypotension
Auscultating lung sounds for rhonchi
Prescribing midazolam to aid with air hunger
Question 2
1/62
, pts
A 45-year-old man presents with chest pain radiating to the left arm, diaphoresis, and shortness of
breath. His ECG shows ST-segment elevation. What is the initial management response?
Administer nitroglycerin sublingually
Start intravenous heparin
, Perform immediate coronary angiography
Correct!
Administer aspirin and call for emergency medical services
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?
You Answered
Deep vein thrombosis
Correct Answer
Acute arterial occlusion
Cellulitis
Peripheral artery disease
Question 4
pts
An older adult female presents for her annual examination. She has been on antihypertensive
medications for over 20 years, with good control. Laboratory values are within normal ranges. The nurse
practitioner is concerned about the patient’s cardiac health risks, due her to weight and her waist
circumference. According to the AHA guidelines, which of the following goals is expected for this patient?
Physical activity for 60 minutes daily, 7 days a week
Correct!
Physical activity for 30 minutes daily, for a minimum of 5 days a week
Physical activity for 30 minutes daily, 7 days a week
Physical activity for 60 minutes daily, for a minimum of 6 days a week
Question 5
pts
Recommendation for lipid check in adolescent with type 1 DM?
10 years
5 years
2 years
Correct!
1 year
3/62
, Remember than with pediatric patients with diabetes, the easiest way to remember the evaluation
schedule is to perform lipid checks is with annual physicals.
Question 6
pts
An adult patient must maintain an International Normalized Ratio (INR) between 2.0 and 3.0. The patient
goes to a clinic for INR determination, and the result is 1.4. Which of the following would be likely to
decrease the effects of warfarin (Coumadin)?
Red Wine
Red meat
Correct!
Broccoli
Grapefruit
It’s important to remember with warfarin (Coumadin) therapy that it is a vitamin K antagonist, and
therefore it can be counteracted by a patient who is eating a dietary intake of vitamin K. Leafy green
vegetables such as broccoli and spinach are notorious for increasing vitamin K levels, and therefore
inhibiting the anticoagulation effect of warfarin. It’s also important to remember that with the direct oral
anticoagulants category, vitamin K is not affected, and therefore no dietary restrictions are required for
this class of medications such as apixaban, rivaroxaban, and edoxaban, which is a distinct benefit over
warfarin as noted above. Also, with warfarin it is important to remember that the effects are based on the
free drug, not the protein bound drug level, so patients who have considerable protein stores will require
more warfarin than those who are emaciated or have low protein levels chronically.
With respect to this particular question, red wine and grapefruit do not have an effect of lowering the
INR, in fact, they will raise it by their unique mechanisms. Grapefruit specifically causes warfarin levels
to rise through the CYP 450 system, and red wine causes the INR to increase by thinning the blood and
and red meat is not likely to have a considerable impact, although it might have some impact if the
protein stores are otherwise low prior to initiating the red meat in the diet. Broccoli is the only option that
has vitamin K and should be an obvious choice for this question.
Question 7
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?
Administer 5mg of warfarin
Questions, Verified Answers & Guaranteed Exam
Confidence
Week 1 Full Length Practice Exam
Points 150
Questions 150
Time Limit 180 Minutes
Attempt History
Attempt Time Score
LATEST Attempt 1 171 minutes 144 out of 150
Score for this quiz: 144 out of 150
Submitted Sep 8 at 8:23pm
This attempt took 171 minutes.
Question 1
pts
Effective long-term treatment of systolic heart failure with reduced ejection fraction should include which
of the following?
Correct!
Prescribing valsartan/sacubitril (Entresto) unless contraindicated on discharge
Angiotensin Receptor and Neprilysin Inhibition is considered goal-directed therapy for patients with
reduced systolic heart function as evidence by the PARAGON-HF Trial. Auscultation is an assessment
item, not a treatment. Midazolam does not have any long term benefit for heart failure. Fluid bolus in a
patient with likely fluid overload from systolic heart failure only worsen their presenting symptoms.
Prescribing 500 ml fluid bolus for hypotension
Auscultating lung sounds for rhonchi
Prescribing midazolam to aid with air hunger
Question 2
1/62
, pts
A 45-year-old man presents with chest pain radiating to the left arm, diaphoresis, and shortness of
breath. His ECG shows ST-segment elevation. What is the initial management response?
Administer nitroglycerin sublingually
Start intravenous heparin
, Perform immediate coronary angiography
Correct!
Administer aspirin and call for emergency medical services
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?
You Answered
Deep vein thrombosis
Correct Answer
Acute arterial occlusion
Cellulitis
Peripheral artery disease
Question 4
pts
An older adult female presents for her annual examination. She has been on antihypertensive
medications for over 20 years, with good control. Laboratory values are within normal ranges. The nurse
practitioner is concerned about the patient’s cardiac health risks, due her to weight and her waist
circumference. According to the AHA guidelines, which of the following goals is expected for this patient?
Physical activity for 60 minutes daily, 7 days a week
Correct!
Physical activity for 30 minutes daily, for a minimum of 5 days a week
Physical activity for 30 minutes daily, 7 days a week
Physical activity for 60 minutes daily, for a minimum of 6 days a week
Question 5
pts
Recommendation for lipid check in adolescent with type 1 DM?
10 years
5 years
2 years
Correct!
1 year
3/62
, Remember than with pediatric patients with diabetes, the easiest way to remember the evaluation
schedule is to perform lipid checks is with annual physicals.
Question 6
pts
An adult patient must maintain an International Normalized Ratio (INR) between 2.0 and 3.0. The patient
goes to a clinic for INR determination, and the result is 1.4. Which of the following would be likely to
decrease the effects of warfarin (Coumadin)?
Red Wine
Red meat
Correct!
Broccoli
Grapefruit
It’s important to remember with warfarin (Coumadin) therapy that it is a vitamin K antagonist, and
therefore it can be counteracted by a patient who is eating a dietary intake of vitamin K. Leafy green
vegetables such as broccoli and spinach are notorious for increasing vitamin K levels, and therefore
inhibiting the anticoagulation effect of warfarin. It’s also important to remember that with the direct oral
anticoagulants category, vitamin K is not affected, and therefore no dietary restrictions are required for
this class of medications such as apixaban, rivaroxaban, and edoxaban, which is a distinct benefit over
warfarin as noted above. Also, with warfarin it is important to remember that the effects are based on the
free drug, not the protein bound drug level, so patients who have considerable protein stores will require
more warfarin than those who are emaciated or have low protein levels chronically.
With respect to this particular question, red wine and grapefruit do not have an effect of lowering the
INR, in fact, they will raise it by their unique mechanisms. Grapefruit specifically causes warfarin levels
to rise through the CYP 450 system, and red wine causes the INR to increase by thinning the blood and
and red meat is not likely to have a considerable impact, although it might have some impact if the
protein stores are otherwise low prior to initiating the red meat in the diet. Broccoli is the only option that
has vitamin K and should be an obvious choice for this question.
Question 7
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?
Administer 5mg of warfarin
