NURS 5434 FAMILY III MODULE 5 CAD/LIPIDS QUIZ (LATEST 2026/2027 UPDATE) QUESTIONS
AND CORRECT ANSWERS (VERIFIED ANSWERS) PLUS RATIONALES 2026 Q&A |LATEST EXAM
UPDATE 2026/2027UNIVERSITY OF TEXAS, ARLINGTON.
Section One: Questions 1–100
A 52-year-old male presents for a routine physical. His lipid panel reveals a Total Cholesterol of
240 mg/dL, LDL of 165 mg/dL, HDL of 35 mg/dL, and Triglycerides of 200 mg/dL. He has no history
of cardiovascular disease, but his 10-year ASCVD risk is calculated at 8.5%. According to current
ACC/AHA guidelines, what is the most appropriate initial management?
A. Initiate low-intensity statin therapy
B. Initiate moderate-intensity statin therapy
C. Recommend lifestyle modifications only and recheck in 6 months
D. Initiate high-intensity statin therapy
🟢 Correct answer B. Initiate moderate-intensity statin therapy
🔴 RATIONALE: For adults aged 40 to 75 years without clinical ASCVD or diabetes, who have an
LDL-C level between 70 to 189 mg/dL and a 10-year ASCVD risk between 7.5% and less than 20%
(intermediate risk), a moderate-intensity statin should be initiated along with lifestyle modifications
to reduce ASCVD risk.
A patient experiences severe, localized muscle pain and weakness 3 weeks after starting
Atorvastatin 40 mg daily. The clinician suspects statin-induced myalgia. What is the next diagnostic
step to confirm the severity of this condition?
A. Obtain a serum creatinine level
B. Check serum creatine kinase (CK) levels
C. Order an electromyogram (EMG)
D. Perform a liver function panel
🟢 Correct answer B. Check serum creatine kinase (CK) levels
🔴 RATIONALE: When a patient experiences significant muscle symptoms while taking a statin,
,checking serum creatine kinase (CK) levels is necessary to assess for severe myopathy or
rhabdomyolysis, ensuring patient safety before determining whether to discontinue or alter therapy.
During a telehealth consultation, an advanced practice registered nurse (APRN) prescribes a high-
intensity statin to a patient residing in a state where prescriptive authority requires a physician-led
collaborative practice agreement. The APRN fails to document the required physician co-signature
or notification according to state statute. Which legal framework has been violated?
A. Federal Controlled Substances Act
B. State Nursing Practice Act and administrative rules
C. The Joint Commission national patient safety goals
D. HIPAA Privacy Rule regulations
🟢 Correct answer B. State Nursing Practice Act and administrative rules
🔴 RATIONALE: Prescriptive authority and the specific documentation requirements for
collaborative practice agreements are governed directly by individual State Nursing Practice Acts
and state boards of nursing administrative rules. Failure to comply constitutes a regulatory
violation.
A 45-year-old female with a history of heterozygous familial hypercholesterolemia (HeFH) has an
LDL-C of 210 mg/dL despite maximum tolerated doses of Rosuvastatin and Ezetimibe. Which class
of lipid-lowering medication should the clinician consider adding next?
A. Bile acid sequestrants
B. Fibric acid derivatives
C. PCSK9 inhibitors
D. Omega-3 fatty acid concentrates
🟢 Correct answer C. PCSK9 inhibitors
🔴 RATIONALE: PCSK9 inhibitors, such as evolocumab or alirocumab, are highly effective
monoclonal antibodies indicated for patients with familial hypercholesterolemia or clinical ASCVD
,who require additional intensive lowering of LDL-C when maximum tolerated statin and ezetimibe
therapy are insufficient.
A clinician is discussing the initiation of lipid-lowering therapy with a 68-year-old patient. The
patient expresses deep anxiety about developing cognitive decline, citing unverified online articles
claiming statins cause dementia. Which ethical principle is primarily demonstrated when the
clinician thoroughly addresses these concerns to ensure the patient makes an informed choice?
A. Justice
B. Beneficence
C. Autonomy
D. Non-maleficence
🟢 Correct answer C. Autonomy
🔴 RATIONALE: Respect for autonomy requires that providers give patients complete, accurate,
and evidence-based information to help them make voluntary, informed decisions regarding their
healthcare, rather than dismissing their fears or coercing compliance.
A 64-year-old female with type 2 diabetes mellitus and hypertension presents for a follow-up. Her
LDL cholesterol is 92 mg/dL. She is not currently taking a statin. According to current standards of
care, what is the recommended lipid management strategy for this patient?
A. Delay statin therapy until LDL exceeds 100 mg/dL
B. Initiate a high-intensity statin regardless of baseline LDL
C. Initiate at least a moderate-intensity statin
D. Implement lifestyle modifications only since her LDL is under 100 mg/dL
🟢 Correct answer C. Initiate at least a moderate-intensity statin
🔴 RATIONALE: Guidelines state that patients aged 40 to 75 with diabetes mellitus should be
started on at least a moderate-intensity statin for primary prevention, regardless of their calculated
, 10-year ASCVD risk or baseline LDL level (provided it is between 70-189 mg/dL), due to their
inherently high cardiovascular risk.
Which of the following best describes the core pathophysiological mechanism of an acute
myocardial infarction (AMI)?
A. Gradual concentric narrowing of the coronary lumen by a stable calcified plaque
B. Coronary artery vasospasm induced by localized endothelial nitric oxide excess
C. Rupture or erosion of an unstable lipid-rich fibrous plaque leading to thrombosis
D. Embolization of a deep vein thrombus through a patent ductus arteriosus
🟢 Correct answer C. Rupture or erosion of an unstable lipid-rich fibrous plaque leading to
thrombosis
🔴 RATIONALE: Acute myocardial infarctions are most commonly triggered by the structural
disruption (rupture or erosion) of a vulnerable, thin-cap fibroatheroma. This exposes highly
thrombogenic lipid core contents to the bloodstream, causing rapid platelet aggregation and
occlusive thrombus formation.
A patient is prescribed extended-release Niacin to help optimize their lipid profile. The clinician
advises the patient to take 325 mg of aspirin 30 minutes before the niacin dose. What is the
pharmacological rationale for this intervention?
A. To enhance the absorption of niacin in the gastrointestinal tract
B. To suppress prostaglandin-mediated cutaneous vasodilation and flushing
C. To prevent localized gastric ulceration caused by niacin acidity
D. To provide synergistic antiplatelet activity for secondary prevention
🟢 Correct answer B. To suppress prostaglandin-mediated cutaneous vasodilation and flushing
🔴 RATIONALE: Niacin causes cutaneous flushing via a prostaglandin-mediated pathway that
induces peripheral vasodilation. Pre-medicating with aspirin, a cyclooxygenase inhibitor, decreases
prostaglandin synthesis and significantly mitigates this common, distressing side effect.
AND CORRECT ANSWERS (VERIFIED ANSWERS) PLUS RATIONALES 2026 Q&A |LATEST EXAM
UPDATE 2026/2027UNIVERSITY OF TEXAS, ARLINGTON.
Section One: Questions 1–100
A 52-year-old male presents for a routine physical. His lipid panel reveals a Total Cholesterol of
240 mg/dL, LDL of 165 mg/dL, HDL of 35 mg/dL, and Triglycerides of 200 mg/dL. He has no history
of cardiovascular disease, but his 10-year ASCVD risk is calculated at 8.5%. According to current
ACC/AHA guidelines, what is the most appropriate initial management?
A. Initiate low-intensity statin therapy
B. Initiate moderate-intensity statin therapy
C. Recommend lifestyle modifications only and recheck in 6 months
D. Initiate high-intensity statin therapy
🟢 Correct answer B. Initiate moderate-intensity statin therapy
🔴 RATIONALE: For adults aged 40 to 75 years without clinical ASCVD or diabetes, who have an
LDL-C level between 70 to 189 mg/dL and a 10-year ASCVD risk between 7.5% and less than 20%
(intermediate risk), a moderate-intensity statin should be initiated along with lifestyle modifications
to reduce ASCVD risk.
A patient experiences severe, localized muscle pain and weakness 3 weeks after starting
Atorvastatin 40 mg daily. The clinician suspects statin-induced myalgia. What is the next diagnostic
step to confirm the severity of this condition?
A. Obtain a serum creatinine level
B. Check serum creatine kinase (CK) levels
C. Order an electromyogram (EMG)
D. Perform a liver function panel
🟢 Correct answer B. Check serum creatine kinase (CK) levels
🔴 RATIONALE: When a patient experiences significant muscle symptoms while taking a statin,
,checking serum creatine kinase (CK) levels is necessary to assess for severe myopathy or
rhabdomyolysis, ensuring patient safety before determining whether to discontinue or alter therapy.
During a telehealth consultation, an advanced practice registered nurse (APRN) prescribes a high-
intensity statin to a patient residing in a state where prescriptive authority requires a physician-led
collaborative practice agreement. The APRN fails to document the required physician co-signature
or notification according to state statute. Which legal framework has been violated?
A. Federal Controlled Substances Act
B. State Nursing Practice Act and administrative rules
C. The Joint Commission national patient safety goals
D. HIPAA Privacy Rule regulations
🟢 Correct answer B. State Nursing Practice Act and administrative rules
🔴 RATIONALE: Prescriptive authority and the specific documentation requirements for
collaborative practice agreements are governed directly by individual State Nursing Practice Acts
and state boards of nursing administrative rules. Failure to comply constitutes a regulatory
violation.
A 45-year-old female with a history of heterozygous familial hypercholesterolemia (HeFH) has an
LDL-C of 210 mg/dL despite maximum tolerated doses of Rosuvastatin and Ezetimibe. Which class
of lipid-lowering medication should the clinician consider adding next?
A. Bile acid sequestrants
B. Fibric acid derivatives
C. PCSK9 inhibitors
D. Omega-3 fatty acid concentrates
🟢 Correct answer C. PCSK9 inhibitors
🔴 RATIONALE: PCSK9 inhibitors, such as evolocumab or alirocumab, are highly effective
monoclonal antibodies indicated for patients with familial hypercholesterolemia or clinical ASCVD
,who require additional intensive lowering of LDL-C when maximum tolerated statin and ezetimibe
therapy are insufficient.
A clinician is discussing the initiation of lipid-lowering therapy with a 68-year-old patient. The
patient expresses deep anxiety about developing cognitive decline, citing unverified online articles
claiming statins cause dementia. Which ethical principle is primarily demonstrated when the
clinician thoroughly addresses these concerns to ensure the patient makes an informed choice?
A. Justice
B. Beneficence
C. Autonomy
D. Non-maleficence
🟢 Correct answer C. Autonomy
🔴 RATIONALE: Respect for autonomy requires that providers give patients complete, accurate,
and evidence-based information to help them make voluntary, informed decisions regarding their
healthcare, rather than dismissing their fears or coercing compliance.
A 64-year-old female with type 2 diabetes mellitus and hypertension presents for a follow-up. Her
LDL cholesterol is 92 mg/dL. She is not currently taking a statin. According to current standards of
care, what is the recommended lipid management strategy for this patient?
A. Delay statin therapy until LDL exceeds 100 mg/dL
B. Initiate a high-intensity statin regardless of baseline LDL
C. Initiate at least a moderate-intensity statin
D. Implement lifestyle modifications only since her LDL is under 100 mg/dL
🟢 Correct answer C. Initiate at least a moderate-intensity statin
🔴 RATIONALE: Guidelines state that patients aged 40 to 75 with diabetes mellitus should be
started on at least a moderate-intensity statin for primary prevention, regardless of their calculated
, 10-year ASCVD risk or baseline LDL level (provided it is between 70-189 mg/dL), due to their
inherently high cardiovascular risk.
Which of the following best describes the core pathophysiological mechanism of an acute
myocardial infarction (AMI)?
A. Gradual concentric narrowing of the coronary lumen by a stable calcified plaque
B. Coronary artery vasospasm induced by localized endothelial nitric oxide excess
C. Rupture or erosion of an unstable lipid-rich fibrous plaque leading to thrombosis
D. Embolization of a deep vein thrombus through a patent ductus arteriosus
🟢 Correct answer C. Rupture or erosion of an unstable lipid-rich fibrous plaque leading to
thrombosis
🔴 RATIONALE: Acute myocardial infarctions are most commonly triggered by the structural
disruption (rupture or erosion) of a vulnerable, thin-cap fibroatheroma. This exposes highly
thrombogenic lipid core contents to the bloodstream, causing rapid platelet aggregation and
occlusive thrombus formation.
A patient is prescribed extended-release Niacin to help optimize their lipid profile. The clinician
advises the patient to take 325 mg of aspirin 30 minutes before the niacin dose. What is the
pharmacological rationale for this intervention?
A. To enhance the absorption of niacin in the gastrointestinal tract
B. To suppress prostaglandin-mediated cutaneous vasodilation and flushing
C. To prevent localized gastric ulceration caused by niacin acidity
D. To provide synergistic antiplatelet activity for secondary prevention
🟢 Correct answer B. To suppress prostaglandin-mediated cutaneous vasodilation and flushing
🔴 RATIONALE: Niacin causes cutaneous flushing via a prostaglandin-mediated pathway that
induces peripheral vasodilation. Pre-medicating with aspirin, a cyclooxygenase inhibitor, decreases
prostaglandin synthesis and significantly mitigates this common, distressing side effect.
