NRNP 6531 Fred O Macintyre iHuman Case
Study Actual Exam 2026/2027 – Complete
Cardiovascular Assessment with Detailed
Rationales | 100% Verified | Pass Guaranteed –
A+ Graded
Section A: Patient Profile, History of Presenting Illness, & Chief
Complaint
Q1: Fred O Macintyre, a 62-year-old male, presents with a two-month history of chest
pressure. Using the OLDCARTS mnemonic, the nurse practitioner documents that the
"C" (Character) is BEST described as:
A. Sharp, stabbing pain worsened by deep breathing
B. Burning epigastric discomfort after meals
C. Squeezing pressure radiating to the throat and jaw [CORRECT]
D. Localized tenderness reproducible with palpation
Correct Answer: C
Rationale: Cardiac ischemia typically presents as squeezing, pressure, or crushing
substernal pain with radiation to the throat, jaw, shoulder, or arm. Sharp pleuritic pain
suggests pericarditis or musculoskeletal causes, burning epigastric pain suggests
GERD, and reproducible tenderness indicates costochondritis.
,Q2: Fred reports chest pressure when climbing stairs and during stressful meetings,
with relief after sitting down for 5–10 minutes. This pain pattern is MOST consistent
with:
A. Unstable angina
B. Stable angina [CORRECT]
C. Variant (Prinzmetal's) angina
D. Non-cardiac chest pain
Correct Answer: B
Rationale: Chest pain with exertion or emotional stress that is predictably relieved by
rest is classic for stable angina due to reversible myocardial ischemia. Unstable angina
occurs at rest or with increasing frequency, and variant angina occurs at rest due to
coronary vasospasm.
Q3: Fred's father died of myocardial infarction at age 58. The nurse practitioner
recognizes this family history as a:
A. Modifiable risk factor
B. Non-modifiable risk factor [CORRECT]
C. Contraindication to exercise stress testing
D. Primary indication for prophylactic aspirin therapy alone
Correct Answer: B
, Rationale: Family history of premature coronary artery disease is a non-modifiable risk
factor that increases Fred's baseline cardiovascular risk. It does not contraindicate
diagnostic testing, and aspirin primary prevention decisions require comprehensive
ASCVD risk calculation.
Q4: During the review of systems, Fred denies dysuria but reports increased nocturia. In
the context of his cardiovascular presentation, nocturia may indicate:
A. Benign prostatic hyperplasia only
B. Nocturnal angina
C. Heart failure with fluid redistribution during recumbency [CORRECT]
D. Chronic kidney disease from hypertension
Correct Answer: C
Rationale: Nocturia in patients with cardiovascular disease may indicate heart failure, as
recumbency redistributes fluid from dependent tissues, increasing renal perfusion and
urine production. While BPH and CKD are possible, nocturia warrants evaluation for
heart failure in this high-risk patient.
Q5: The nurse practitioner auscultates a right carotid bruit and left femoral bruit. These
findings suggest:
A. Normal age-related vascular sounds
B. Turbulent blood flow due to atherosclerotic stenosis [CORRECT]
C. Aortic regurgitation
Study Actual Exam 2026/2027 – Complete
Cardiovascular Assessment with Detailed
Rationales | 100% Verified | Pass Guaranteed –
A+ Graded
Section A: Patient Profile, History of Presenting Illness, & Chief
Complaint
Q1: Fred O Macintyre, a 62-year-old male, presents with a two-month history of chest
pressure. Using the OLDCARTS mnemonic, the nurse practitioner documents that the
"C" (Character) is BEST described as:
A. Sharp, stabbing pain worsened by deep breathing
B. Burning epigastric discomfort after meals
C. Squeezing pressure radiating to the throat and jaw [CORRECT]
D. Localized tenderness reproducible with palpation
Correct Answer: C
Rationale: Cardiac ischemia typically presents as squeezing, pressure, or crushing
substernal pain with radiation to the throat, jaw, shoulder, or arm. Sharp pleuritic pain
suggests pericarditis or musculoskeletal causes, burning epigastric pain suggests
GERD, and reproducible tenderness indicates costochondritis.
,Q2: Fred reports chest pressure when climbing stairs and during stressful meetings,
with relief after sitting down for 5–10 minutes. This pain pattern is MOST consistent
with:
A. Unstable angina
B. Stable angina [CORRECT]
C. Variant (Prinzmetal's) angina
D. Non-cardiac chest pain
Correct Answer: B
Rationale: Chest pain with exertion or emotional stress that is predictably relieved by
rest is classic for stable angina due to reversible myocardial ischemia. Unstable angina
occurs at rest or with increasing frequency, and variant angina occurs at rest due to
coronary vasospasm.
Q3: Fred's father died of myocardial infarction at age 58. The nurse practitioner
recognizes this family history as a:
A. Modifiable risk factor
B. Non-modifiable risk factor [CORRECT]
C. Contraindication to exercise stress testing
D. Primary indication for prophylactic aspirin therapy alone
Correct Answer: B
, Rationale: Family history of premature coronary artery disease is a non-modifiable risk
factor that increases Fred's baseline cardiovascular risk. It does not contraindicate
diagnostic testing, and aspirin primary prevention decisions require comprehensive
ASCVD risk calculation.
Q4: During the review of systems, Fred denies dysuria but reports increased nocturia. In
the context of his cardiovascular presentation, nocturia may indicate:
A. Benign prostatic hyperplasia only
B. Nocturnal angina
C. Heart failure with fluid redistribution during recumbency [CORRECT]
D. Chronic kidney disease from hypertension
Correct Answer: C
Rationale: Nocturia in patients with cardiovascular disease may indicate heart failure, as
recumbency redistributes fluid from dependent tissues, increasing renal perfusion and
urine production. While BPH and CKD are possible, nocturia warrants evaluation for
heart failure in this high-risk patient.
Q5: The nurse practitioner auscultates a right carotid bruit and left femoral bruit. These
findings suggest:
A. Normal age-related vascular sounds
B. Turbulent blood flow due to atherosclerotic stenosis [CORRECT]
C. Aortic regurgitation
