NR 667 PRACTICE EXAM WEEK 2 WITH
CORRECT ANSWERS
Your E50 Eyear-old Emale EAfrican EAmerican E(AA) Epatient Ewas Efound Eto Ehave Ea
Eblood Epressure Eof E160/96 Eupon Earrival Eto Eyour Eclinic. EHe Edoes Enot Ehave Eany
Eother Emedical Econditions. EFor Ethe Efollowing E24 Ehours Eof Eself-reported Evital
Esigns, Eit Eremained Ebetween E160-170 Esystolic Eand E90-100 Ediastolic Ewithout
Etreatment. EAfter Efinding Eall Ebasic Emetabolic Epanel E(BMP) Elab Evalues Eto Ebe
Ewithin Enormal Elimits, Eyour Efirst Echoice Eof Eantihypertensive Eis Emost Elikely Ewhich
Eof Ethe Efollowing Eagents?
carvedilol
metoprolol
amlodipine
lisinopril E- Ecorrect Eanswers E-amlodipine
A Epatient Eis Ebeing Efollowed Efor Etype E2 Ediabetes Emellitus Eand Ehypertension. EHe
Ealso Ehas Ea Ediagnosis Eof Epolycythemia Evera Eand Ehas Eregular Ephlebotomies Efor
Emanagement. EWhich Eof Ethe Efollowing Estatements Eabout Ethis Epatient Eis Ecorrect?
,The Ephlebotomies Ewill Eimprove Ehis Eglycosylated Ehemoglobin Elevels
The Ephlebotomies Ewill Eincrease Ehis Eblood Epressure
He Eshould Eincrease Edietary Eiron Esupplements
He Eshould Eavoid Edietary Eiron Esupplements E- Ecorrect Eanswers E-He Eshould Eavoid
Edietary Eiron Esupplements
As Ethe Enurse Epractitioner Eworking Ein Ea Eprimary Ecare Eclinic, Eyou Ehave Ebeen
Enotified Efrom Ea Ehospitalist Ethat Eyour Elong-term Epatient Ewith Ea Ehistory Eof
EHFrEF E(heart Efailure Ewith Ereduced Eejection Efraction) Ewith Ean Eejection Efraction
Eof E40% Etwo Eyears Eago Ewho Eis Ealso Enot Eon Eoptimal Emedical Etherapy Ehas
Ebeen Ediagnosed Ewith Ea Emyocardial Einfarction Ethis Eadmission Eand Ereceived
Eemergent Eplacement Eof Ea Edrug-eluting Estent Eto Ethe Eleft Eanterior Edescending
Eartery. EAs Ethe Epatient's Emedical Ehome Ewho Ewill Emanage Ethis Epatient Eafter
Edischarge, Ewhich Eof Ethe Efollowing Ewould Eyou Eexpect Eto Ebe Ea Epriority Ein Ethe
Epatient's Ecare Efor Etheir Eheart Efailure Eafter Ean Eacute EMI?
Ordering Ea EHolter Emonitor Efor E7 Edays Epost-discharge
Ordering Ea Enew Etransthoracic Eechocardiogram Eand ELifevest Eif EEF Eis Eless Ethan
E35%
Ordering Easpirin Eand Eclopidogrel Efor E3 Emonths Eat Edischarge
Ordering Ea Enew Etransthoracic Eechocardiogram Eand Eorder Ea ELifevest Eif EEF Eis
Eless Ethan E45% E- Ecorrect Eanswers E-Ordering Ea Enew Etransthoracic
Eechocardiogram Eand ELifevest Eif EEF Eis Eless Ethan E35%
A E70-year-old Eman Ewith Ea Ehistory Eof Eatrial Efibrillation Epresents Ewith Esudden-
onset Eleft-sided Eweakness Eand Eslurred Espeech. EWhat Eis Ethe Emost Elikely
Ediagnosis?
Stroke
Transient Eischemic Eattack E(TIA)
Myocardial Einfarction E(MI)
Seizure E- Ecorrect Eanswers E-Stroke
A E55 Eyear-old Efemale Epatient Ewith Eno Eprevious Ecardiac Ehistory Eand Eno Efamily
Ehistory Eof Ehyperlipidemia Ewith Ean Eacute Emyocardial Einfarction Eis Etreated
Esuccessfully Ewith Ea Edrug-eluting Estent Eduring Ea Erecent Ehospitalization. EAs Etheir
Elong-term Ecare Eprovider, Eyou Eanticipate Ethey Ewere Emost Elikely Eto Ebe Ealso
Estarted Eon Ewhich Eof Ethe Efollowing Elipid-lowering Eagents Eat Edischarge?
Ezetimibe Eprior Eto Einitiating Estatin Etherapy
PCSK9 Einhibitor Etherapy
High Eintensity Estatin Etherapy
Moderate Eintensity Estatin Etherapy E- Ecorrect Eanswers E-High Eintensity Estatin
Etherapy
Which Eof Ethe Efollowing Emedications Eis Enot Econsidered Epart Eof Eoptimal Emedical
Etherapy Efor Ea E54 Eyear-old Emale Epatient Ewith Ea Ediagnosis Eof Eheart Efailure Ewith
, Ereduced Eejection Efraction E(HFrEF) Ewith Ean EEF Eof E30%, Eknown Ecoronary Eartery
Edisease, Eand Enormal Erenal Efunction?
Aspirin
Carvedilol E(Coreg)
Diltiazem E(Cardizem)
Spironolactone E(Aldactone) E- Ecorrect Eanswers E-Diltiazem E(Cardizem)
An Eolder Eadult Ewith Ediabetes Emellitus Epresents Ewith Eleg Ecramps. EShe Estates
Ethat Ethe Ecramps Ewere Eworst Ewhen Ewalking Eto Ethe Esupermarket. EIf Eshe Estops
Eto Erest, Ethe Epain Esubsides. EThe Enurse Epractitioner Eknows Ethat Ethis Epatient
Eneeds Ea Eworkup Efor:
Popliteal Eaneurism
Deep Evein Ethrombosis
Benign Enocturnal Eleg Ecramps
Intermittent Eclaudication E- Ecorrect Eanswers E-Intermittent Eclaudication
What Eis Ethe Ekey Elong-term Ebenefit Eof Eusing Ecarvedilol Efor Epatients Ewith
Ecoronary Eartery Edisease Eand Eheart Efailure Ewith Ereduced Eejection Efraction
E(HFrEF)?
Baseline Ereduction Eof Eblood Epressure
Increase Ein Elibido
Potential Eincrease Ein Eejection Efraction
Reduce Ein Ecardiac Eoutput E- Ecorrect Eanswers E-Potential Eincrease Ein Eejection
Efraction
An Eotherwise Ehealthy Epatient Ereports Eepisodes Eof Epalpitations Elasting Eless Ethan
E5 Eminutes Eand Eoccurring E3-5 Etimes Edaily. EThe Epatient Edescribes Ea Esubsternal
Eflip-flop Esensation Ewith Ea Esudden Erapid Eheart Erate, Eending Ewith Ea Eforceful
Ebeat. EHolter Emonitoring Ewould Emost Elikely Edocument:
Premature Eventricular Econtraction E(extrasystole)
Paroxysmal Esupraventricular Etachycardia
Sinus Etachycardia
Atrial Eflutter E- Ecorrect Eanswers E-Paroxysmal Esupraventricular Etachycardia
Which Eof Ethe Efollowing Epeople Egroups Erepresent Ethe Eleast Erisk Eof Ecardiac
Edisease?
Native EHawaiians
American EIndians
Caucasians
African EAmericans E- Ecorrect Eanswers E-Caucasians
An Eadult Efemale Epresents Ewith Ea Echief Ecomplaint Eof Efatigue Eand Eweight Egain.
EShe Estates Ethat Eshe Edoesn't Efeel Elike Eherself. EA Ediagnosis Eof Ehypothyroidism
Eis Esuspected. EWhich Eof Ethe Efollowing Ephysical Efindings Ewould Esupport Ethis
Ediagnosis?
Dry Eskin, Ebradycardia, Eand Ehypoactive Edeep Etendon Ereflexes
CORRECT ANSWERS
Your E50 Eyear-old Emale EAfrican EAmerican E(AA) Epatient Ewas Efound Eto Ehave Ea
Eblood Epressure Eof E160/96 Eupon Earrival Eto Eyour Eclinic. EHe Edoes Enot Ehave Eany
Eother Emedical Econditions. EFor Ethe Efollowing E24 Ehours Eof Eself-reported Evital
Esigns, Eit Eremained Ebetween E160-170 Esystolic Eand E90-100 Ediastolic Ewithout
Etreatment. EAfter Efinding Eall Ebasic Emetabolic Epanel E(BMP) Elab Evalues Eto Ebe
Ewithin Enormal Elimits, Eyour Efirst Echoice Eof Eantihypertensive Eis Emost Elikely Ewhich
Eof Ethe Efollowing Eagents?
carvedilol
metoprolol
amlodipine
lisinopril E- Ecorrect Eanswers E-amlodipine
A Epatient Eis Ebeing Efollowed Efor Etype E2 Ediabetes Emellitus Eand Ehypertension. EHe
Ealso Ehas Ea Ediagnosis Eof Epolycythemia Evera Eand Ehas Eregular Ephlebotomies Efor
Emanagement. EWhich Eof Ethe Efollowing Estatements Eabout Ethis Epatient Eis Ecorrect?
,The Ephlebotomies Ewill Eimprove Ehis Eglycosylated Ehemoglobin Elevels
The Ephlebotomies Ewill Eincrease Ehis Eblood Epressure
He Eshould Eincrease Edietary Eiron Esupplements
He Eshould Eavoid Edietary Eiron Esupplements E- Ecorrect Eanswers E-He Eshould Eavoid
Edietary Eiron Esupplements
As Ethe Enurse Epractitioner Eworking Ein Ea Eprimary Ecare Eclinic, Eyou Ehave Ebeen
Enotified Efrom Ea Ehospitalist Ethat Eyour Elong-term Epatient Ewith Ea Ehistory Eof
EHFrEF E(heart Efailure Ewith Ereduced Eejection Efraction) Ewith Ean Eejection Efraction
Eof E40% Etwo Eyears Eago Ewho Eis Ealso Enot Eon Eoptimal Emedical Etherapy Ehas
Ebeen Ediagnosed Ewith Ea Emyocardial Einfarction Ethis Eadmission Eand Ereceived
Eemergent Eplacement Eof Ea Edrug-eluting Estent Eto Ethe Eleft Eanterior Edescending
Eartery. EAs Ethe Epatient's Emedical Ehome Ewho Ewill Emanage Ethis Epatient Eafter
Edischarge, Ewhich Eof Ethe Efollowing Ewould Eyou Eexpect Eto Ebe Ea Epriority Ein Ethe
Epatient's Ecare Efor Etheir Eheart Efailure Eafter Ean Eacute EMI?
Ordering Ea EHolter Emonitor Efor E7 Edays Epost-discharge
Ordering Ea Enew Etransthoracic Eechocardiogram Eand ELifevest Eif EEF Eis Eless Ethan
E35%
Ordering Easpirin Eand Eclopidogrel Efor E3 Emonths Eat Edischarge
Ordering Ea Enew Etransthoracic Eechocardiogram Eand Eorder Ea ELifevest Eif EEF Eis
Eless Ethan E45% E- Ecorrect Eanswers E-Ordering Ea Enew Etransthoracic
Eechocardiogram Eand ELifevest Eif EEF Eis Eless Ethan E35%
A E70-year-old Eman Ewith Ea Ehistory Eof Eatrial Efibrillation Epresents Ewith Esudden-
onset Eleft-sided Eweakness Eand Eslurred Espeech. EWhat Eis Ethe Emost Elikely
Ediagnosis?
Stroke
Transient Eischemic Eattack E(TIA)
Myocardial Einfarction E(MI)
Seizure E- Ecorrect Eanswers E-Stroke
A E55 Eyear-old Efemale Epatient Ewith Eno Eprevious Ecardiac Ehistory Eand Eno Efamily
Ehistory Eof Ehyperlipidemia Ewith Ean Eacute Emyocardial Einfarction Eis Etreated
Esuccessfully Ewith Ea Edrug-eluting Estent Eduring Ea Erecent Ehospitalization. EAs Etheir
Elong-term Ecare Eprovider, Eyou Eanticipate Ethey Ewere Emost Elikely Eto Ebe Ealso
Estarted Eon Ewhich Eof Ethe Efollowing Elipid-lowering Eagents Eat Edischarge?
Ezetimibe Eprior Eto Einitiating Estatin Etherapy
PCSK9 Einhibitor Etherapy
High Eintensity Estatin Etherapy
Moderate Eintensity Estatin Etherapy E- Ecorrect Eanswers E-High Eintensity Estatin
Etherapy
Which Eof Ethe Efollowing Emedications Eis Enot Econsidered Epart Eof Eoptimal Emedical
Etherapy Efor Ea E54 Eyear-old Emale Epatient Ewith Ea Ediagnosis Eof Eheart Efailure Ewith
, Ereduced Eejection Efraction E(HFrEF) Ewith Ean EEF Eof E30%, Eknown Ecoronary Eartery
Edisease, Eand Enormal Erenal Efunction?
Aspirin
Carvedilol E(Coreg)
Diltiazem E(Cardizem)
Spironolactone E(Aldactone) E- Ecorrect Eanswers E-Diltiazem E(Cardizem)
An Eolder Eadult Ewith Ediabetes Emellitus Epresents Ewith Eleg Ecramps. EShe Estates
Ethat Ethe Ecramps Ewere Eworst Ewhen Ewalking Eto Ethe Esupermarket. EIf Eshe Estops
Eto Erest, Ethe Epain Esubsides. EThe Enurse Epractitioner Eknows Ethat Ethis Epatient
Eneeds Ea Eworkup Efor:
Popliteal Eaneurism
Deep Evein Ethrombosis
Benign Enocturnal Eleg Ecramps
Intermittent Eclaudication E- Ecorrect Eanswers E-Intermittent Eclaudication
What Eis Ethe Ekey Elong-term Ebenefit Eof Eusing Ecarvedilol Efor Epatients Ewith
Ecoronary Eartery Edisease Eand Eheart Efailure Ewith Ereduced Eejection Efraction
E(HFrEF)?
Baseline Ereduction Eof Eblood Epressure
Increase Ein Elibido
Potential Eincrease Ein Eejection Efraction
Reduce Ein Ecardiac Eoutput E- Ecorrect Eanswers E-Potential Eincrease Ein Eejection
Efraction
An Eotherwise Ehealthy Epatient Ereports Eepisodes Eof Epalpitations Elasting Eless Ethan
E5 Eminutes Eand Eoccurring E3-5 Etimes Edaily. EThe Epatient Edescribes Ea Esubsternal
Eflip-flop Esensation Ewith Ea Esudden Erapid Eheart Erate, Eending Ewith Ea Eforceful
Ebeat. EHolter Emonitoring Ewould Emost Elikely Edocument:
Premature Eventricular Econtraction E(extrasystole)
Paroxysmal Esupraventricular Etachycardia
Sinus Etachycardia
Atrial Eflutter E- Ecorrect Eanswers E-Paroxysmal Esupraventricular Etachycardia
Which Eof Ethe Efollowing Epeople Egroups Erepresent Ethe Eleast Erisk Eof Ecardiac
Edisease?
Native EHawaiians
American EIndians
Caucasians
African EAmericans E- Ecorrect Eanswers E-Caucasians
An Eadult Efemale Epresents Ewith Ea Echief Ecomplaint Eof Efatigue Eand Eweight Egain.
EShe Estates Ethat Eshe Edoesn't Efeel Elike Eherself. EA Ediagnosis Eof Ehypothyroidism
Eis Esuspected. EWhich Eof Ethe Efollowing Ephysical Efindings Ewould Esupport Ethis
Ediagnosis?
Dry Eskin, Ebradycardia, Eand Ehypoactive Edeep Etendon Ereflexes
