6531 NRNP Combined midterm and final
review
A health care provider in a clinic finds a patient in a room, unresponsive and pale. Which sign
should be used to identify the need to initiate cardiopulmonary resuscitation (CPR)?
Evaluation of peripheral perfusion and level of consciousness
Obtaining a history of previous myocardial infarction
Determination of pulselessness or bradycardia
Assessment of gasping breaths or not breathing - correct answer Assessment of gasping
breaths or not breathing
An African-American patient who is being treated with a thiazide diuretic for chronic
hypertension reports blurred vision and shortness of breath. The provider notes a blood
pressure of 185/115. What is the recommended action for this patient?
Increase the dose of the thiazide medication
Add a beta blocker to the patient's regimen
Admit to the hospital for evaluation and treatment
Prescribe a calcium channel blocker - correct answer Admit to the hospital for evaluation and
treatment
A patient reports sustained, irregular heart palpitations. What is the most likely cause of these
symptoms?
Atrial fibrillation
Anemia
Extrasystole
Paroxysmal attacks - correct answer Atrial fibrillation
A patient has a cardiac murmur that peaks in midsystole and is best heard along the left sternal
border. The provider determines that the murmur decreases in intensity when the patient
changes from standing to squatting and increases in intensity with the Valsalva maneuver.
Which cause will the provider suspect for this murmur?
Aortic stenosis
Tricuspid regurgitation
,6531 NRNP Combined midterm and final
review
Hypertrophic cardiomyopathy
Mitral valve prolapse - correct answer Hypertrophic cardiomyopathy
A patient is brought to an emergency department with symptoms of acute ST-segment
elevation MI (STEMI). The nearest hospital that can perform percutaneous coronary
intervention (PCI) is 3 hours away. What is the initial treatment for this patient?
Give the patient an oral beta blocker
Transfer to the PCI-capable institution
Administer heparin
Initiate fibrinolytic treatment - correct answer Initiate fibrinolytic treatment
Patients who meet the criteria for statin therapy to help prevent atherosclerotic cardiovascular
disease are those with a history of (Select all that apply.)
previous myocardial infarction.
a low-density lipoprotein (LDL) level >190 mg/dL.
diabetes and an LDL between 40 and 70 mg/dL.
a 10 year risk score of 8% with an LDL of 80 mg/dL.
a 10 year risk score of 5% and an LDL of 165 mg/dL. - correct answer previous myocardial
infarction.
a low-density lipoprotein (LDL) level >190 mg/dL.
a 10 year risk score of 8% with an LDL of 80 mg/dL.
A 75-year-old patient reports pain and a feeling of tiredness in both legs that only relieves after
sitting for 30 minutes or more. What the does provider suspect as the cause for these
symptoms?
Buerger's disease
Cauda equina syndrome
Diabetic neuropathy
Peripheral arterial disease - correct answer Cauda equina syndrome
Which are causes of secondary hypertension? (Select all that apply.)
Oral contraceptives
,6531 NRNP Combined midterm and final
review
Isometic excercises
NSAIDS
Sleep apnea
Increased salt intake - correct answer Oral contraceptives
NSAIDS
Sleep apnea
A young female patient has known mitral valve prolapse. During a routine health maintenance
exam, the provider notes an apical systolic murmur and a midsystolic click on auscultation. The
patient denies chest pain, syncope, or palpitations. What will the provider do?
Reassure the patient that these findings are expected
Continue to monitor the patient every 3 years
Admit the patient to the hospital for evaluation and treatment
Consult with cardiology to determine appropriate diagnostic tests - correct answer Consult
with cardiology to determine appropriate diagnostic tests
A patient reports abdominal and back pain with anorexia and nausea. During an exam, the
provider notes a pulsatile abdominal mass. What is the initial action?
Scheduling an MRI to evaluate for aortic disease
Immediate referral to a thoracic surgeon
US of the mass to determine size
Ordering CT angiography - correct answer US of the mass to determine size
A patient is brought to an emergency department with symptoms of acute ST-segment
elevations MI (STEMI). The nearest hospital that can perform percutaneous coronary
intervention (PCI) is 3 hours away. What is the initial treatment for this patient?
Give the patient an oral beta blocker
Initiate fibrinolytic treatment
Administer heparin
Transfer to the PCI-capable institution - correct answer Initiate fibrinolytic treatment
, 6531 NRNP Combined midterm and final
review
A 55-year-old patient has a blood pressure of 138/85 on three occasions. The patient denies
headaches, palpitations, snoring, muscle weakness, and nocturia and does not take any
medications. What will the provider do next to evaluate this patient?
Continue to monitor blood pressure at each health maintenance visit
Assess serum cortisol levels
Order urinalysis, CBC, BUN and creatinine
Refer to specialist for sleep study - correct answer Order urinalysis, CBC, BUN and creatinine
A patient is diagnosed with PAD and elects to not have angioplasty after an angiogram reveals
partial obstruction in lower extremity arteries. What will the provider recommend to help with
relief of symptoms in this patient?
Statin therapy with clopidogrel
Walking to the point of pain each day
Daily aspirin therapy to prevent clotting
Walking slowly for 15 to 20 minutes twice daily - correct answer Walking to the point of pain
each day
An adult patient reports frequent episodes of syncope and lightheadedness. The provider notes
a heart rate of 70 beats per minute. What will the provider do next?
Order an electrocardiogram and exercise stress test
Monitor the patient's heart rate while the patient is bearing down
Evaluate the patient's orthostatic vital signs
Reassure the patient that the symptoms are non-cardiac in origin - correct answer Evaluate the
patient's orthostatic vital signs
The AHA recommends early CPR and AED use for adult victims of cardiac arrest outside of a
hospital setting because most victims have which arrhythmia?
Atrial flutter
Ventricular fibrillation
Atrial fibrillation
Ventricular tachycardia - correct answer Ventricular fibrillation
review
A health care provider in a clinic finds a patient in a room, unresponsive and pale. Which sign
should be used to identify the need to initiate cardiopulmonary resuscitation (CPR)?
Evaluation of peripheral perfusion and level of consciousness
Obtaining a history of previous myocardial infarction
Determination of pulselessness or bradycardia
Assessment of gasping breaths or not breathing - correct answer Assessment of gasping
breaths or not breathing
An African-American patient who is being treated with a thiazide diuretic for chronic
hypertension reports blurred vision and shortness of breath. The provider notes a blood
pressure of 185/115. What is the recommended action for this patient?
Increase the dose of the thiazide medication
Add a beta blocker to the patient's regimen
Admit to the hospital for evaluation and treatment
Prescribe a calcium channel blocker - correct answer Admit to the hospital for evaluation and
treatment
A patient reports sustained, irregular heart palpitations. What is the most likely cause of these
symptoms?
Atrial fibrillation
Anemia
Extrasystole
Paroxysmal attacks - correct answer Atrial fibrillation
A patient has a cardiac murmur that peaks in midsystole and is best heard along the left sternal
border. The provider determines that the murmur decreases in intensity when the patient
changes from standing to squatting and increases in intensity with the Valsalva maneuver.
Which cause will the provider suspect for this murmur?
Aortic stenosis
Tricuspid regurgitation
,6531 NRNP Combined midterm and final
review
Hypertrophic cardiomyopathy
Mitral valve prolapse - correct answer Hypertrophic cardiomyopathy
A patient is brought to an emergency department with symptoms of acute ST-segment
elevation MI (STEMI). The nearest hospital that can perform percutaneous coronary
intervention (PCI) is 3 hours away. What is the initial treatment for this patient?
Give the patient an oral beta blocker
Transfer to the PCI-capable institution
Administer heparin
Initiate fibrinolytic treatment - correct answer Initiate fibrinolytic treatment
Patients who meet the criteria for statin therapy to help prevent atherosclerotic cardiovascular
disease are those with a history of (Select all that apply.)
previous myocardial infarction.
a low-density lipoprotein (LDL) level >190 mg/dL.
diabetes and an LDL between 40 and 70 mg/dL.
a 10 year risk score of 8% with an LDL of 80 mg/dL.
a 10 year risk score of 5% and an LDL of 165 mg/dL. - correct answer previous myocardial
infarction.
a low-density lipoprotein (LDL) level >190 mg/dL.
a 10 year risk score of 8% with an LDL of 80 mg/dL.
A 75-year-old patient reports pain and a feeling of tiredness in both legs that only relieves after
sitting for 30 minutes or more. What the does provider suspect as the cause for these
symptoms?
Buerger's disease
Cauda equina syndrome
Diabetic neuropathy
Peripheral arterial disease - correct answer Cauda equina syndrome
Which are causes of secondary hypertension? (Select all that apply.)
Oral contraceptives
,6531 NRNP Combined midterm and final
review
Isometic excercises
NSAIDS
Sleep apnea
Increased salt intake - correct answer Oral contraceptives
NSAIDS
Sleep apnea
A young female patient has known mitral valve prolapse. During a routine health maintenance
exam, the provider notes an apical systolic murmur and a midsystolic click on auscultation. The
patient denies chest pain, syncope, or palpitations. What will the provider do?
Reassure the patient that these findings are expected
Continue to monitor the patient every 3 years
Admit the patient to the hospital for evaluation and treatment
Consult with cardiology to determine appropriate diagnostic tests - correct answer Consult
with cardiology to determine appropriate diagnostic tests
A patient reports abdominal and back pain with anorexia and nausea. During an exam, the
provider notes a pulsatile abdominal mass. What is the initial action?
Scheduling an MRI to evaluate for aortic disease
Immediate referral to a thoracic surgeon
US of the mass to determine size
Ordering CT angiography - correct answer US of the mass to determine size
A patient is brought to an emergency department with symptoms of acute ST-segment
elevations MI (STEMI). The nearest hospital that can perform percutaneous coronary
intervention (PCI) is 3 hours away. What is the initial treatment for this patient?
Give the patient an oral beta blocker
Initiate fibrinolytic treatment
Administer heparin
Transfer to the PCI-capable institution - correct answer Initiate fibrinolytic treatment
, 6531 NRNP Combined midterm and final
review
A 55-year-old patient has a blood pressure of 138/85 on three occasions. The patient denies
headaches, palpitations, snoring, muscle weakness, and nocturia and does not take any
medications. What will the provider do next to evaluate this patient?
Continue to monitor blood pressure at each health maintenance visit
Assess serum cortisol levels
Order urinalysis, CBC, BUN and creatinine
Refer to specialist for sleep study - correct answer Order urinalysis, CBC, BUN and creatinine
A patient is diagnosed with PAD and elects to not have angioplasty after an angiogram reveals
partial obstruction in lower extremity arteries. What will the provider recommend to help with
relief of symptoms in this patient?
Statin therapy with clopidogrel
Walking to the point of pain each day
Daily aspirin therapy to prevent clotting
Walking slowly for 15 to 20 minutes twice daily - correct answer Walking to the point of pain
each day
An adult patient reports frequent episodes of syncope and lightheadedness. The provider notes
a heart rate of 70 beats per minute. What will the provider do next?
Order an electrocardiogram and exercise stress test
Monitor the patient's heart rate while the patient is bearing down
Evaluate the patient's orthostatic vital signs
Reassure the patient that the symptoms are non-cardiac in origin - correct answer Evaluate the
patient's orthostatic vital signs
The AHA recommends early CPR and AED use for adult victims of cardiac arrest outside of a
hospital setting because most victims have which arrhythmia?
Atrial flutter
Ventricular fibrillation
Atrial fibrillation
Ventricular tachycardia - correct answer Ventricular fibrillation
