MN 551 PATHO CORRECT EXAMINATION
QUESTIONS AND ANSWERS SURE A+
✔✔A 6-year-old boy has been brought to the emergency department by ambulance
after his mother discovered that his heart rate was "so fast I couldn't even count it." The
child was determined to be in atrial flutter and his mother is seeking an explanation from
the health care team. Which of the following points should underlie an explanation to the
mother? - ✔✔The child is experiencing a reentry rhythm in his right atrium.
✔✔A 68-year-old male complains to his nurse practitioner that when he tests his blood
pressure using a machine at his pharmacy, his heart rate is nearly always very low. At
other times, he feels that his heart is racing, and it also seems to pause at times. The
man has also occasionally had lightheadedness and a recent syncopal episode. What is
this patient's most likely diagnosis and the phenomenon underlying it? - ✔✔Sick sinus
syndrome as a result of a disease of his sinus node and atrial or junctional arrhythmias
✔✔A 54-year-old man with a long-standing diagnosis of essential hypertension is
meeting with his nurse practitioner. The patient's nurse practitioner would anticipate that
which of the following phenomena is most likely occurring? - ✔✔The conversion of
angiotensin I to angiotensin II in his lungs causes increases in blood pressure and
sodium reabsorption.
✔✔A 72-year-old woman with a recent onset of syncopal episodes has been referred to
a cardiology group by her family physician. As part of the patient's diagnostic workup,
the nurse practitioner conducting the intake assessment has ordered a Holter monitor
for 24 hours. Which of the following statements best captures an aspect of Holter
monitoring? - ✔✔Accurate interpretation of the results requires correlating the findings
with the activity that the woman was doing at the time of recording.
✔✔A nurse practitioner is teaching a student NP about the physiologic basis for
damage to the circulatory and neurological systems that can accompany hypotension.
,Which of the following responses by the student would warrant correction by the nurse
practitioner? - ✔✔"Tension and vessel thickness increase proportionately."
✔✔An autopsy is being performed on a 44-year-old female who died unexpectedly of
heart failure. Which of the following components of the pathologist's report is most
suggestive of a possible history of poorly controlled blood pressure? - ✔✔"Arterial
sclerosis of subcortical brain regions noted."
✔✔A patient has suffered damage to his pericardium following a motor vehicle accident.
Which of the following consequences should the nurse practitioner be most likely to rule
out? - ✔✔Impaired regulation of myocardial contraction
✔✔A 31-year-old woman with a congenital heart defect reports episodes of
lightheadedness and syncope, with occasional palpitations. A resting electrocardiogram
reveals sinus bradycardia and she is suspected of having sick sinus syndrome. Which
of the following diagnostic methods is the best choice to investigate the suspicion? -
✔✔Holter monitoring
✔✔In which of the following patient situations would a nurse practitioner be most
justified in preliminarily ruling out pericarditis as a contributing pathology to the patient's
health problems? - ✔✔A 77-year-old with diminished S3 and S4 sounds, an irregular
heart rate, and a history of atrial fibrillation
✔✔A 70-year-old male patient presents to the emergency department complaining of
pain in his calf that is exacerbated when he walks. His pedal and popliteal pulses are
faintly palpable and his leg distal to the pain is noticeably reddened. What would his
care provider's preliminary diagnosis and anticipated treatment most likely be? -
✔✔Atherosclerotic occlusive disease necessitating thrombolytic therapy
✔✔A nurse practitioner has ordered the measurement of a cardiac patient's electrolyte
levels as part of the patient's morning blood work. Which of the following statements
best captures the importance of potassium in the normal electrical function of the
patient's heart? - ✔✔Potassium is central to establishing and maintaining the resting
membrane potential of cardiac muscle cells.
✔✔A number of patients have presented to the emergency department in the last 24
hours with complaints that are preliminarily indicative of myocardial infarction. Which of
the following patients is least likely to have an ST-segment myocardial infarction
(STEMI)? - ✔✔A 71-year-old man who has moist skin, fever, and chest pain that is
excruciating when he moves but relieved when at rest
✔✔An 81-year-old male resident of a long-term care facility has a long-standing
diagnosis of heart failure. Which of the following short-term and longer-term
,compensatory mechanisms is least likely to decrease the symptoms of his heart failure?
- ✔✔AV node pacemaking activity and vagal nerve suppression
✔✔A 22-year-old male is experiencing hypovolemic shock following a fight in which his
carotid artery was cut with a broken bottle. What immediate treatments are likely to
most benefit the man? - ✔✔Infusion of normal saline of Ringer lactate to maintain the
vascular space
✔✔A nurse practitioner is providing care for several patients on a medical unit of a
hospital. In which of the following patient situations would the nurse practitioner be most
likely to rule out hypertension as a contributing factor? - ✔✔A 61-year-old man who has
a heart valve infection and recurrent fever
✔✔An older adult female patient has presented with a new onset of shortness of breath,
and the patient's nurse practitioner has ordered measurement of her BNP levels along
with other diagnostic tests. What is the most accurate rationale for the nurse
practitioner's choice of blood work? - ✔✔BNP is released as a compensatory
mechanism during heart failure and measuring it can help differentiate the patient's
dyspnea from a respiratory pathology.
✔✔A formerly normotensive woman, pregnant for the first time, develops hypertension
and headaches at 26 weeks' gestation. Her blood pressure is 154/110 mm Hg and she
has proteinuria. What other labs should be ordered for her? - ✔✔Platelet count, serum
creatinine, and liver enzymes
✔✔A patient in the intensive care unit has a blood pressure of 87/39 and has warm,
flushed skin accompanying his sudden decline in level of consciousness. The patient
also has arterial and venous dilation and a decrease in systemic vascular resistance.
What is this patient's most likely diagnosis? - ✔✔Septic shock
✔✔A nurse practitioner is instructing a group of older adults about the risks associated
with high cholesterol. Which of the following teaching points should the participants try
to integrate into their lifestyle after the teaching session? - ✔✔"Your family history of
hypercholesterolemia is important, but there are things you can do to compensate for a
high inherited risk."
✔✔A 66-year-old obese man with a diagnosis of ischemic heart disease has been
diagnosed with heart failure that his care team has characterized as attributable to
systolic dysfunction. Which of the following assessment findings is inconsistent with his
diagnosis? - ✔✔Ventricular dilation and wall tension are significantly lower than normal.
✔✔A physical assessment of a 28-year-old female patient indicates that her blood
pressure in her legs is lower than that in her arms and that her brachial pulse is weaker
in her left arm than in her right. In addition, her femoral pulses are weak bilaterally.
, Which of the following possibilities would her care provider be most likely to suspect? -
✔✔Coarctation of the aorta
✔✔The nurse practitioner for a cardiology practice is responsible for providing
presurgical teaching for patients who are about to undergo a coronary artery bypass
graft. Which of the following teaching points best conveys an aspect of the human
circulatory system? - ✔✔"Your blood pressure varies widely between arteries and veins,
and between pulmonary and systemic circulation."
✔✔During a routine physical examination of a 66-year-old woman, her nurse
practitioner notes a pulsating abdominal mass and refers the woman for further
treatment. The nurse practitioner is explaining the diagnosis to the patient, who is
unfamiliar with aneurysms. Which of the following aspects of the pathophysiology of
aneurysms would underlie the explanation the nurse provides? - ✔✔Hypertension is a
frequent modifiable contributor to aneurysms.
✔✔cardiac reserve - ✔✔Ability to increase cardiac output during increased activity
✔✔preload - ✔✔volume of blood in ventricles at end of diastole
✔✔afterload - ✔✔The force or resistance against which the heart pumps.
✔✔Frank-Starling Mechanism - ✔✔A mechanism by which the stroke volume of the
heart is increased by increasing the venous return of the heart (thus stretching the
ventricular muscle).
✔✔Inotrophy - ✔✔myocardial contractility
✔✔Which of the following statements best conveys an aspect of the respiratory
pressures that govern ventilation?
Question options: - ✔✔Negative intrapleural pressure holds the lungs against the chest
wall
✔✔A 51-year-old female patient who is 2 days postoperative on a surgical unit of a
hospital is at risk for developing atelectasis as a result of being largely immobile. Which
of the following teaching points by her nurse practitioner is most appropriate?
Question options: - ✔✔"You should breathe deeply and cough to help your lungs
expand as much as possible while you're in bed."
✔✔As a result of dehydration, a patient's epithelial cells are producing insufficient
amounts of mucus. Consequently, the patient's mucociliary blanket is compromised.
Which of the following changes would a care provider most reasonably anticipate as a
direct result of this change? - ✔✔Increased amounts of bacteria in the lungs. The
primary role of the mucociliary blanket is to trap foreign particles and bacteria and thus
QUESTIONS AND ANSWERS SURE A+
✔✔A 6-year-old boy has been brought to the emergency department by ambulance
after his mother discovered that his heart rate was "so fast I couldn't even count it." The
child was determined to be in atrial flutter and his mother is seeking an explanation from
the health care team. Which of the following points should underlie an explanation to the
mother? - ✔✔The child is experiencing a reentry rhythm in his right atrium.
✔✔A 68-year-old male complains to his nurse practitioner that when he tests his blood
pressure using a machine at his pharmacy, his heart rate is nearly always very low. At
other times, he feels that his heart is racing, and it also seems to pause at times. The
man has also occasionally had lightheadedness and a recent syncopal episode. What is
this patient's most likely diagnosis and the phenomenon underlying it? - ✔✔Sick sinus
syndrome as a result of a disease of his sinus node and atrial or junctional arrhythmias
✔✔A 54-year-old man with a long-standing diagnosis of essential hypertension is
meeting with his nurse practitioner. The patient's nurse practitioner would anticipate that
which of the following phenomena is most likely occurring? - ✔✔The conversion of
angiotensin I to angiotensin II in his lungs causes increases in blood pressure and
sodium reabsorption.
✔✔A 72-year-old woman with a recent onset of syncopal episodes has been referred to
a cardiology group by her family physician. As part of the patient's diagnostic workup,
the nurse practitioner conducting the intake assessment has ordered a Holter monitor
for 24 hours. Which of the following statements best captures an aspect of Holter
monitoring? - ✔✔Accurate interpretation of the results requires correlating the findings
with the activity that the woman was doing at the time of recording.
✔✔A nurse practitioner is teaching a student NP about the physiologic basis for
damage to the circulatory and neurological systems that can accompany hypotension.
,Which of the following responses by the student would warrant correction by the nurse
practitioner? - ✔✔"Tension and vessel thickness increase proportionately."
✔✔An autopsy is being performed on a 44-year-old female who died unexpectedly of
heart failure. Which of the following components of the pathologist's report is most
suggestive of a possible history of poorly controlled blood pressure? - ✔✔"Arterial
sclerosis of subcortical brain regions noted."
✔✔A patient has suffered damage to his pericardium following a motor vehicle accident.
Which of the following consequences should the nurse practitioner be most likely to rule
out? - ✔✔Impaired regulation of myocardial contraction
✔✔A 31-year-old woman with a congenital heart defect reports episodes of
lightheadedness and syncope, with occasional palpitations. A resting electrocardiogram
reveals sinus bradycardia and she is suspected of having sick sinus syndrome. Which
of the following diagnostic methods is the best choice to investigate the suspicion? -
✔✔Holter monitoring
✔✔In which of the following patient situations would a nurse practitioner be most
justified in preliminarily ruling out pericarditis as a contributing pathology to the patient's
health problems? - ✔✔A 77-year-old with diminished S3 and S4 sounds, an irregular
heart rate, and a history of atrial fibrillation
✔✔A 70-year-old male patient presents to the emergency department complaining of
pain in his calf that is exacerbated when he walks. His pedal and popliteal pulses are
faintly palpable and his leg distal to the pain is noticeably reddened. What would his
care provider's preliminary diagnosis and anticipated treatment most likely be? -
✔✔Atherosclerotic occlusive disease necessitating thrombolytic therapy
✔✔A nurse practitioner has ordered the measurement of a cardiac patient's electrolyte
levels as part of the patient's morning blood work. Which of the following statements
best captures the importance of potassium in the normal electrical function of the
patient's heart? - ✔✔Potassium is central to establishing and maintaining the resting
membrane potential of cardiac muscle cells.
✔✔A number of patients have presented to the emergency department in the last 24
hours with complaints that are preliminarily indicative of myocardial infarction. Which of
the following patients is least likely to have an ST-segment myocardial infarction
(STEMI)? - ✔✔A 71-year-old man who has moist skin, fever, and chest pain that is
excruciating when he moves but relieved when at rest
✔✔An 81-year-old male resident of a long-term care facility has a long-standing
diagnosis of heart failure. Which of the following short-term and longer-term
,compensatory mechanisms is least likely to decrease the symptoms of his heart failure?
- ✔✔AV node pacemaking activity and vagal nerve suppression
✔✔A 22-year-old male is experiencing hypovolemic shock following a fight in which his
carotid artery was cut with a broken bottle. What immediate treatments are likely to
most benefit the man? - ✔✔Infusion of normal saline of Ringer lactate to maintain the
vascular space
✔✔A nurse practitioner is providing care for several patients on a medical unit of a
hospital. In which of the following patient situations would the nurse practitioner be most
likely to rule out hypertension as a contributing factor? - ✔✔A 61-year-old man who has
a heart valve infection and recurrent fever
✔✔An older adult female patient has presented with a new onset of shortness of breath,
and the patient's nurse practitioner has ordered measurement of her BNP levels along
with other diagnostic tests. What is the most accurate rationale for the nurse
practitioner's choice of blood work? - ✔✔BNP is released as a compensatory
mechanism during heart failure and measuring it can help differentiate the patient's
dyspnea from a respiratory pathology.
✔✔A formerly normotensive woman, pregnant for the first time, develops hypertension
and headaches at 26 weeks' gestation. Her blood pressure is 154/110 mm Hg and she
has proteinuria. What other labs should be ordered for her? - ✔✔Platelet count, serum
creatinine, and liver enzymes
✔✔A patient in the intensive care unit has a blood pressure of 87/39 and has warm,
flushed skin accompanying his sudden decline in level of consciousness. The patient
also has arterial and venous dilation and a decrease in systemic vascular resistance.
What is this patient's most likely diagnosis? - ✔✔Septic shock
✔✔A nurse practitioner is instructing a group of older adults about the risks associated
with high cholesterol. Which of the following teaching points should the participants try
to integrate into their lifestyle after the teaching session? - ✔✔"Your family history of
hypercholesterolemia is important, but there are things you can do to compensate for a
high inherited risk."
✔✔A 66-year-old obese man with a diagnosis of ischemic heart disease has been
diagnosed with heart failure that his care team has characterized as attributable to
systolic dysfunction. Which of the following assessment findings is inconsistent with his
diagnosis? - ✔✔Ventricular dilation and wall tension are significantly lower than normal.
✔✔A physical assessment of a 28-year-old female patient indicates that her blood
pressure in her legs is lower than that in her arms and that her brachial pulse is weaker
in her left arm than in her right. In addition, her femoral pulses are weak bilaterally.
, Which of the following possibilities would her care provider be most likely to suspect? -
✔✔Coarctation of the aorta
✔✔The nurse practitioner for a cardiology practice is responsible for providing
presurgical teaching for patients who are about to undergo a coronary artery bypass
graft. Which of the following teaching points best conveys an aspect of the human
circulatory system? - ✔✔"Your blood pressure varies widely between arteries and veins,
and between pulmonary and systemic circulation."
✔✔During a routine physical examination of a 66-year-old woman, her nurse
practitioner notes a pulsating abdominal mass and refers the woman for further
treatment. The nurse practitioner is explaining the diagnosis to the patient, who is
unfamiliar with aneurysms. Which of the following aspects of the pathophysiology of
aneurysms would underlie the explanation the nurse provides? - ✔✔Hypertension is a
frequent modifiable contributor to aneurysms.
✔✔cardiac reserve - ✔✔Ability to increase cardiac output during increased activity
✔✔preload - ✔✔volume of blood in ventricles at end of diastole
✔✔afterload - ✔✔The force or resistance against which the heart pumps.
✔✔Frank-Starling Mechanism - ✔✔A mechanism by which the stroke volume of the
heart is increased by increasing the venous return of the heart (thus stretching the
ventricular muscle).
✔✔Inotrophy - ✔✔myocardial contractility
✔✔Which of the following statements best conveys an aspect of the respiratory
pressures that govern ventilation?
Question options: - ✔✔Negative intrapleural pressure holds the lungs against the chest
wall
✔✔A 51-year-old female patient who is 2 days postoperative on a surgical unit of a
hospital is at risk for developing atelectasis as a result of being largely immobile. Which
of the following teaching points by her nurse practitioner is most appropriate?
Question options: - ✔✔"You should breathe deeply and cough to help your lungs
expand as much as possible while you're in bed."
✔✔As a result of dehydration, a patient's epithelial cells are producing insufficient
amounts of mucus. Consequently, the patient's mucociliary blanket is compromised.
Which of the following changes would a care provider most reasonably anticipate as a
direct result of this change? - ✔✔Increased amounts of bacteria in the lungs. The
primary role of the mucociliary blanket is to trap foreign particles and bacteria and thus
