Nurse Practitioners in Primary
Care I
Wilkes University
NSG554/NSG 554 Exam 3
Questions & Answers Plus
Detailed Rationales
Latest 2026 | PDF
THIS EXAM CONTAINS:
✓100% Pass
✓Multiple Choice ( A-D)
✓Detailed Rationales For Each Question
✓Correct Answers For Each Question
✓100 Qs & Answers
,SECTION 1: Cardiovascular Disorders (Questions 1-15)
Question 1
A 60-year-old man reports bilateral lower extremity edema,
worsening dyspnea on exertion, and a 5-pound weight gain over
one week. He has a known history of HFrEF. Which finding would
be most concerning for acute decompensation requiring urgent
intervention?
A. Trace pedal edema improved with elevation
B. New orthopnea and paroxysmal nocturnal dyspnea
C. Stable weight compared to last visit
D. Mild fatigue after a long walk
Answer: B. New orthopnea and paroxysmal nocturnal
dyspnea
Rationale: New orthopnea and paroxysmal nocturnal dyspnea
(PND) are hallmark symptoms of worsening pulmonary
congestion in heart failure and, combined with rapid weight gain,
suggest acute decompensation requiring urgent evaluation, likely
diuretic adjustment or hospitalization. Trace edema that
improves with elevation and stable weight are reassuring
findings. Mild exertional fatigue is nonspecific and less concerning
than new orthopnea/PND in this context.
Question 2
Which lipid panel result would most strongly indicate a need to
screen for familial hypercholesterolemia in a 30-year-old patient?
,A. LDL of 110 mg/dL with normal triglycerides
B. LDL of 220 mg/dL with family history of premature CAD
C. HDL of 65 mg/dL
D. Triglycerides of 140 mg/dL
Answer: B. LDL of 220 mg/dL with family history of
premature CAD
Rationale: An LDL ≥190 mg/dL in a young adult, particularly
with a family history of premature coronary artery disease, raises
strong suspicion for familial hypercholesterolemia and warrants
further evaluation and aggressive lipid management.
Question 3
When is an exercise stress test indicated?
A. For detection of ischemia in asymptomatic patients with no
history of revascularization
B. To assess CAD in patients with chest pain or dyspnea on
exertion with intermediate risk of ACS
C. For routine screening of all patients over age 50
D. To evaluate all patients with diabetes
Answer: B. To assess CAD in patients with chest pain or
dyspnea on exertion with intermediate risk of ACS
Rationale: An exercise stress test is NOT used for detection of
ischemia in asymptomatic patients with no history of
revascularization. It IS used to assess CAD in patients with chest
pain or dyspnea on exertion with intermediate risk of ACS. It also
shows the patient's functional capacity, which is a predictor of
future cardiac events.
, Question 4
Which medications can make an exercise stress test less
diagnostic?
A. Beta-blockers, digoxin, calcium channel blockers, and
antihypertensives
B. Statins and aspirin
C. ACE inhibitors only
D. Diuretics only
Answer: A. Beta-blockers, digoxin, calcium channel blockers,
and antihypertensives
Rationale: Beta-blockers, digoxin, calcium channel blockers, and
antihypertensives can make an exercise stress test less diagnostic.
Consultation with cardiology should be obtained if these
medications should be withheld before the test.
Question 5
When should nuclear or ultrasound imaging be added to an
exercise tolerance test?
A. For all patients undergoing stress testing
B. For patients with LV hypertrophy with ST and T abnormalities
on resting electrocardiography
C. Only for patients over age 70
D. For patients with normal resting EKG
Answer: B. For patients with LV hypertrophy with ST and T
abnormalities on resting electrocardiography
Care I
Wilkes University
NSG554/NSG 554 Exam 3
Questions & Answers Plus
Detailed Rationales
Latest 2026 | PDF
THIS EXAM CONTAINS:
✓100% Pass
✓Multiple Choice ( A-D)
✓Detailed Rationales For Each Question
✓Correct Answers For Each Question
✓100 Qs & Answers
,SECTION 1: Cardiovascular Disorders (Questions 1-15)
Question 1
A 60-year-old man reports bilateral lower extremity edema,
worsening dyspnea on exertion, and a 5-pound weight gain over
one week. He has a known history of HFrEF. Which finding would
be most concerning for acute decompensation requiring urgent
intervention?
A. Trace pedal edema improved with elevation
B. New orthopnea and paroxysmal nocturnal dyspnea
C. Stable weight compared to last visit
D. Mild fatigue after a long walk
Answer: B. New orthopnea and paroxysmal nocturnal
dyspnea
Rationale: New orthopnea and paroxysmal nocturnal dyspnea
(PND) are hallmark symptoms of worsening pulmonary
congestion in heart failure and, combined with rapid weight gain,
suggest acute decompensation requiring urgent evaluation, likely
diuretic adjustment or hospitalization. Trace edema that
improves with elevation and stable weight are reassuring
findings. Mild exertional fatigue is nonspecific and less concerning
than new orthopnea/PND in this context.
Question 2
Which lipid panel result would most strongly indicate a need to
screen for familial hypercholesterolemia in a 30-year-old patient?
,A. LDL of 110 mg/dL with normal triglycerides
B. LDL of 220 mg/dL with family history of premature CAD
C. HDL of 65 mg/dL
D. Triglycerides of 140 mg/dL
Answer: B. LDL of 220 mg/dL with family history of
premature CAD
Rationale: An LDL ≥190 mg/dL in a young adult, particularly
with a family history of premature coronary artery disease, raises
strong suspicion for familial hypercholesterolemia and warrants
further evaluation and aggressive lipid management.
Question 3
When is an exercise stress test indicated?
A. For detection of ischemia in asymptomatic patients with no
history of revascularization
B. To assess CAD in patients with chest pain or dyspnea on
exertion with intermediate risk of ACS
C. For routine screening of all patients over age 50
D. To evaluate all patients with diabetes
Answer: B. To assess CAD in patients with chest pain or
dyspnea on exertion with intermediate risk of ACS
Rationale: An exercise stress test is NOT used for detection of
ischemia in asymptomatic patients with no history of
revascularization. It IS used to assess CAD in patients with chest
pain or dyspnea on exertion with intermediate risk of ACS. It also
shows the patient's functional capacity, which is a predictor of
future cardiac events.
, Question 4
Which medications can make an exercise stress test less
diagnostic?
A. Beta-blockers, digoxin, calcium channel blockers, and
antihypertensives
B. Statins and aspirin
C. ACE inhibitors only
D. Diuretics only
Answer: A. Beta-blockers, digoxin, calcium channel blockers,
and antihypertensives
Rationale: Beta-blockers, digoxin, calcium channel blockers, and
antihypertensives can make an exercise stress test less diagnostic.
Consultation with cardiology should be obtained if these
medications should be withheld before the test.
Question 5
When should nuclear or ultrasound imaging be added to an
exercise tolerance test?
A. For all patients undergoing stress testing
B. For patients with LV hypertrophy with ST and T abnormalities
on resting electrocardiography
C. Only for patients over age 70
D. For patients with normal resting EKG
Answer: B. For patients with LV hypertrophy with ST and T
abnormalities on resting electrocardiography
