(Exam II Mix:: 2026-2027 Versions)
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2. A 70-year-old male patient has an aortic aneurysm ANS: D
measuring 5.0 cm. The patient has poorly- controlled This patient's aneurysm is less than 5.5 cm and repair is not necessary at
hypertension, and decompensated heart failure. this time. Serial US surveillance is necessary to continue to evaluate size.
What is the recommendation for treatment for this Repair is risky in patients with hypertension and heart failure, so avoiding
patient? procedures if possible is recommended.
a. Endovascular stent grafting of the aneurysm
b. Immediate open surgical repair of the aneurysm
c. No intervention is necessary for this patient
d. Serial ultrasonographic surveillance of the
aneurysm
4/3/2026, 3:14:23 PM 4/3/2026, 3:14:22 PM 4/3/2026
, (Exam II Mix:: 2026-2027 Versions)
1. A patient reports sustained, irregular heart ANS: B
palpitations. What is the most likely cause of these Atrial fibrillation causes palpitations that are irregular and tend to be
symptoms? sustained. Anemia will cause rapid palpitations that are regular.
Extrasystole causes palpitations or an awareness of isolated extra beats
a. Anemia with a pause. Paroxysmal attacks start and terminate abruptly and are
b. Atrial fibrillation usually rapid and regular.
c. Extrasystole
d. Paroxysmal attacks
3. A child with a history of asthma is brought to the ANS: D
clinic with a rapid heart rate. A cardiac monitor shows This child has paroxysmal supraventricular tachycardi
a heart rate of 225 beats per minute. The provider a. Vagal maneuvers or carotid massage may be attempted to slow the
notifies transport to take the child to the emergency ventricular rate. Adenosine is contraindicated in patients with asthm
department. What initial intervention may be a. Medications such as beta blockers and digoxin are not used in
attempted in the clinic? emergency treatment of PSVT.
a. Administration of intravenous adenosine
b. Giving a beta blocker
c. Providing a loading dose of digoxin
d. Using a vagal maneuver or carotid massage
1. According to current research, which are ANS: A, C, E
associated with a decreased incidence of stroke? Individuals without hypertension in Sweden who consumed ≧7 servings of
fruits and vegetables per day had a 19% lower risk of stroke than those
a. ≧7 servings of fruits and vegetables per day consuming only one serving per day. Intensive insulin therapy in patients
b. B-complex vitamin supplements with type 1 diabetes was shown to lower the risk of stroke. Consuming a
c. Intensive insulin therapy in type 1 diabetes Mediterranean diet is associated with a reduced stroke risk. B-complex
d. Low-sugar soda vitamins and low-sugar soda have not shown a
e. Mediterranean diet decreased risk.
2. During a routine health maintenance examination, ANS: A
the provider auscultates a cervical bruit. The patient Carotid duplex ultrasound is the primary diagnostic tool for carotid stenosis.
denies syncope, weakness, or headache. What will A cervical bruit in an asymptomatic patient is an indication for this test.
the provider do, based on this finding? Catheter-based angiography is the criterion-based standard, but has
inherent costs and risks. A neurosurgery referral is not indicated without
a. Order a carotid duplex ultrasound further testing. CTA is used instead of duplex US if the test is not available,
b. Order catheter-based angiography if US results are inconclusive, or further evaluation is needed based on US
c. Refer the patient to a neurosurgeon results.
d. Schedule a computed tomography angiography
1. A patient reports recurrent chest pain that occurs ANS: B
regardless of activity and is not relieved by rest. The Patient with these symptoms who do not respond to nitroglycerin is likely to
provider administers a nitroglycerin tablet which does have microvascular angin
not relieve the discomfort. What is the next action? a. Treatment is effective with beta blockers. These symptoms are not
characteristic of acute MI, so aspirin is not given. A second nitroglycerin
a. Administer a second nitroglycerin tablet tablet is used for classic angin
b. Give the patient a beta blocker medication a. Calcium channel blockers are not indicated.
c. Prescribe a calcium channel blocker mediation
d. Start aspirin therapy and refer the patient to a
cardiologist
2. A patient is brought to an emergency department ANS: C
with symptoms of acute ST-segment elevation MI Fibrinolytic therapy should be administered to any patient with evolving
(STEMI). The nearest hospital that can perform STEMI within 30 minutes of the time of first medical contact. Patients more
percutaneous coronary intervention (PCI) is 3 hours than 120 minutes away from a PCI-capable hospital should be given
away. What is the initial treatment for this patient? fibrinolytic therapy since PCI should be performed within 90 minutes if
possible. Giving heparin or beta blockers is not helpful.
a. Administer heparin
b. Give the patient an oral beta blocker
c. Initiate fibrinolytic treatment
d. Transfer to the PCI-capable institution
4/3/2026, 3:14:23 PM 4/3/2026, 3:14:22 PM 4/3/2026
, (Exam II Mix:: 2026-2027 Versions)
3. Patients who meet the criteria for statin therapy to ANS: B, C, E
help prevent atherosclerotic cardiovascular disease Patients with previous MI, those with risk scores >8% and an LDL >70
are those with a history of mg/dL, and those with LDL levels >190 mg/dL are candidates for statin
therapy. Patients with a risk score <7.5% with LDL levels between 75 and
a. a 10-year risk score of 5% and an LDL of 165 190 mg/dL are not candidates and patients who have diabetes with LDL
mg/dL. levels <75 mg/dL are not candidates.
b. a 10-year risk score of 8% with an LDL of 80
mg/dL.
c. a low-density lipoprotein (LDL) level >190 mg/dL.
d. diabetes and an LDL between 40 and 70 mg/dL.
e. previous myocardial infarction.
1. A patient who has heart failure with reduced ANS: D
ejection fraction will have which symptoms? Heart failure with reduced ejection fraction results in pump failure from
ventricular systolic dysfunction. Heart failure with preserved ejection
a. Dyspnea and fatigue without volume overload fraction may have milder symptoms and is associated with impairment of
b. Impairment of ventricular filling and relaxation ventricular filling and relaxation.
c. Mild, exertionally related dyspnea
d. Pump failure from left ventricular systolic
dysfunction
2. A patient who has been diagnosed with heart ANS: B
failure for over a year reports being comfortable Patients with Class II heart failure (HF) will have slight limitation of activity
while at rest and experiences palpitations and and will be comfortable at rest with symptoms occurring with ordinary
dyspnea when walking to the bathroom. Which physical activity. Patients with Class I HF do not have limitations and
classification of heart failure is appropriate based on ordinary physical activity does not produce symptoms. With Class III HF,
these symptoms? less than usual activity will produce symptoms. With Class IV HF,
symptoms are present even at rest and all physical activity worsens
a. Class I symptoms.
b. Class II
c. Class III
d. Class IV
3. A patient who has Class II heart failure is taking an ANS: C
ACE inhibitor and reports a recurrent cough that Cough occurs in about 20% of patients who take ACE inhibitors and is not
does not interfere with sleep or activity. What will the dangerous. The patient should be reassured that this is the case. If the
provider do initially to manage this patient? cough is annoying, alternate therapy with an ARB may be considered. It is
not necessary to evaluate electrolytes, renal function, or pulmonary
a. Assess serum potassium and sodium immediately function.
b. Discontinue the ACE inhibitor and prescribe an
ARB
c. Provide reassurance that this is a benign side
effect
d. Withhold the drug and evaluate renal and
pulmonary function
1. Which are causes of secondary hypertension? ANS: C, D, E
NSAIDs and OCPs can both increase the risk of hypertension. Sleep
a. Increased salt intake apnea causes secondary
b. Isometric exercises hypertension. Increased salt intake does not cause HTN, but those with
c. Nonsteroidal anti-inflammatory drugs HTN are more sensitive to sale. Regular isometric exercise can decrease
d. Oral contraceptives blood pressure.
e. Sleep apnea
2. A 55-year-old patient has a blood pressure of ANS: C
138/85 on three occasions. The patient denies This patient has pre-hypertension levels and should be evaluated. UA,
headaches, palpitations, snoring, muscle weakness, CBC, BUN, and creatinine help to evaluate renal function and are in the
and nocturia and does not take any medications. initial workup. Serum cortisol levels are performed if pheochromocytoma is
What will the provider do next to evaluate this suspected, which would cause headache. The patient does not have
patient? snoring, so a sleep study is not indicated at this time. It is not correct to
continue to monitor without assessing possible causes of early
a. Assess serum cortisol levels hypertension.
b. Continue to monitor blood pressure at each health
maintenance visit
c. Order urinalysis, CBC, BUN, and creatinine
d. Refer to a specialist for a sleep study
4/3/2026, 3:14:23 PM 4/3/2026, 3:14:22 PM 4/3/2026
Save
E
x
a
m
II
M
ix
Students
also
studied
Terms in this set (126)
2. A 70-year-old male patient has an aortic aneurysm ANS: D
measuring 5.0 cm. The patient has poorly- controlled This patient's aneurysm is less than 5.5 cm and repair is not necessary at
hypertension, and decompensated heart failure. this time. Serial US surveillance is necessary to continue to evaluate size.
What is the recommendation for treatment for this Repair is risky in patients with hypertension and heart failure, so avoiding
patient? procedures if possible is recommended.
a. Endovascular stent grafting of the aneurysm
b. Immediate open surgical repair of the aneurysm
c. No intervention is necessary for this patient
d. Serial ultrasonographic surveillance of the
aneurysm
4/3/2026, 3:14:23 PM 4/3/2026, 3:14:22 PM 4/3/2026
, (Exam II Mix:: 2026-2027 Versions)
1. A patient reports sustained, irregular heart ANS: B
palpitations. What is the most likely cause of these Atrial fibrillation causes palpitations that are irregular and tend to be
symptoms? sustained. Anemia will cause rapid palpitations that are regular.
Extrasystole causes palpitations or an awareness of isolated extra beats
a. Anemia with a pause. Paroxysmal attacks start and terminate abruptly and are
b. Atrial fibrillation usually rapid and regular.
c. Extrasystole
d. Paroxysmal attacks
3. A child with a history of asthma is brought to the ANS: D
clinic with a rapid heart rate. A cardiac monitor shows This child has paroxysmal supraventricular tachycardi
a heart rate of 225 beats per minute. The provider a. Vagal maneuvers or carotid massage may be attempted to slow the
notifies transport to take the child to the emergency ventricular rate. Adenosine is contraindicated in patients with asthm
department. What initial intervention may be a. Medications such as beta blockers and digoxin are not used in
attempted in the clinic? emergency treatment of PSVT.
a. Administration of intravenous adenosine
b. Giving a beta blocker
c. Providing a loading dose of digoxin
d. Using a vagal maneuver or carotid massage
1. According to current research, which are ANS: A, C, E
associated with a decreased incidence of stroke? Individuals without hypertension in Sweden who consumed ≧7 servings of
fruits and vegetables per day had a 19% lower risk of stroke than those
a. ≧7 servings of fruits and vegetables per day consuming only one serving per day. Intensive insulin therapy in patients
b. B-complex vitamin supplements with type 1 diabetes was shown to lower the risk of stroke. Consuming a
c. Intensive insulin therapy in type 1 diabetes Mediterranean diet is associated with a reduced stroke risk. B-complex
d. Low-sugar soda vitamins and low-sugar soda have not shown a
e. Mediterranean diet decreased risk.
2. During a routine health maintenance examination, ANS: A
the provider auscultates a cervical bruit. The patient Carotid duplex ultrasound is the primary diagnostic tool for carotid stenosis.
denies syncope, weakness, or headache. What will A cervical bruit in an asymptomatic patient is an indication for this test.
the provider do, based on this finding? Catheter-based angiography is the criterion-based standard, but has
inherent costs and risks. A neurosurgery referral is not indicated without
a. Order a carotid duplex ultrasound further testing. CTA is used instead of duplex US if the test is not available,
b. Order catheter-based angiography if US results are inconclusive, or further evaluation is needed based on US
c. Refer the patient to a neurosurgeon results.
d. Schedule a computed tomography angiography
1. A patient reports recurrent chest pain that occurs ANS: B
regardless of activity and is not relieved by rest. The Patient with these symptoms who do not respond to nitroglycerin is likely to
provider administers a nitroglycerin tablet which does have microvascular angin
not relieve the discomfort. What is the next action? a. Treatment is effective with beta blockers. These symptoms are not
characteristic of acute MI, so aspirin is not given. A second nitroglycerin
a. Administer a second nitroglycerin tablet tablet is used for classic angin
b. Give the patient a beta blocker medication a. Calcium channel blockers are not indicated.
c. Prescribe a calcium channel blocker mediation
d. Start aspirin therapy and refer the patient to a
cardiologist
2. A patient is brought to an emergency department ANS: C
with symptoms of acute ST-segment elevation MI Fibrinolytic therapy should be administered to any patient with evolving
(STEMI). The nearest hospital that can perform STEMI within 30 minutes of the time of first medical contact. Patients more
percutaneous coronary intervention (PCI) is 3 hours than 120 minutes away from a PCI-capable hospital should be given
away. What is the initial treatment for this patient? fibrinolytic therapy since PCI should be performed within 90 minutes if
possible. Giving heparin or beta blockers is not helpful.
a. Administer heparin
b. Give the patient an oral beta blocker
c. Initiate fibrinolytic treatment
d. Transfer to the PCI-capable institution
4/3/2026, 3:14:23 PM 4/3/2026, 3:14:22 PM 4/3/2026
, (Exam II Mix:: 2026-2027 Versions)
3. Patients who meet the criteria for statin therapy to ANS: B, C, E
help prevent atherosclerotic cardiovascular disease Patients with previous MI, those with risk scores >8% and an LDL >70
are those with a history of mg/dL, and those with LDL levels >190 mg/dL are candidates for statin
therapy. Patients with a risk score <7.5% with LDL levels between 75 and
a. a 10-year risk score of 5% and an LDL of 165 190 mg/dL are not candidates and patients who have diabetes with LDL
mg/dL. levels <75 mg/dL are not candidates.
b. a 10-year risk score of 8% with an LDL of 80
mg/dL.
c. a low-density lipoprotein (LDL) level >190 mg/dL.
d. diabetes and an LDL between 40 and 70 mg/dL.
e. previous myocardial infarction.
1. A patient who has heart failure with reduced ANS: D
ejection fraction will have which symptoms? Heart failure with reduced ejection fraction results in pump failure from
ventricular systolic dysfunction. Heart failure with preserved ejection
a. Dyspnea and fatigue without volume overload fraction may have milder symptoms and is associated with impairment of
b. Impairment of ventricular filling and relaxation ventricular filling and relaxation.
c. Mild, exertionally related dyspnea
d. Pump failure from left ventricular systolic
dysfunction
2. A patient who has been diagnosed with heart ANS: B
failure for over a year reports being comfortable Patients with Class II heart failure (HF) will have slight limitation of activity
while at rest and experiences palpitations and and will be comfortable at rest with symptoms occurring with ordinary
dyspnea when walking to the bathroom. Which physical activity. Patients with Class I HF do not have limitations and
classification of heart failure is appropriate based on ordinary physical activity does not produce symptoms. With Class III HF,
these symptoms? less than usual activity will produce symptoms. With Class IV HF,
symptoms are present even at rest and all physical activity worsens
a. Class I symptoms.
b. Class II
c. Class III
d. Class IV
3. A patient who has Class II heart failure is taking an ANS: C
ACE inhibitor and reports a recurrent cough that Cough occurs in about 20% of patients who take ACE inhibitors and is not
does not interfere with sleep or activity. What will the dangerous. The patient should be reassured that this is the case. If the
provider do initially to manage this patient? cough is annoying, alternate therapy with an ARB may be considered. It is
not necessary to evaluate electrolytes, renal function, or pulmonary
a. Assess serum potassium and sodium immediately function.
b. Discontinue the ACE inhibitor and prescribe an
ARB
c. Provide reassurance that this is a benign side
effect
d. Withhold the drug and evaluate renal and
pulmonary function
1. Which are causes of secondary hypertension? ANS: C, D, E
NSAIDs and OCPs can both increase the risk of hypertension. Sleep
a. Increased salt intake apnea causes secondary
b. Isometric exercises hypertension. Increased salt intake does not cause HTN, but those with
c. Nonsteroidal anti-inflammatory drugs HTN are more sensitive to sale. Regular isometric exercise can decrease
d. Oral contraceptives blood pressure.
e. Sleep apnea
2. A 55-year-old patient has a blood pressure of ANS: C
138/85 on three occasions. The patient denies This patient has pre-hypertension levels and should be evaluated. UA,
headaches, palpitations, snoring, muscle weakness, CBC, BUN, and creatinine help to evaluate renal function and are in the
and nocturia and does not take any medications. initial workup. Serum cortisol levels are performed if pheochromocytoma is
What will the provider do next to evaluate this suspected, which would cause headache. The patient does not have
patient? snoring, so a sleep study is not indicated at this time. It is not correct to
continue to monitor without assessing possible causes of early
a. Assess serum cortisol levels hypertension.
b. Continue to monitor blood pressure at each health
maintenance visit
c. Order urinalysis, CBC, BUN, and creatinine
d. Refer to a specialist for a sleep study
4/3/2026, 3:14:23 PM 4/3/2026, 3:14:22 PM 4/3/2026
