CEA FNP Board Certification Prep Exam Questions and Answers Graded A
flow of blood in body - AnswersLung --> pulm vein --> L atrium --> bicuspid valve --> L ventricle
--> aorta --> body --> vena cava --> R atrium --> tricuspid valve --> R ventricle --> pulmonary
arteries --> lungs
blood flow complications- contractility - AnswersEF, CAD, LVH, cardiomyopathy
blood flow complications- preload - Answerscentral fluid volume status
blood flow complications- afterload - Answersarterial back pressure on outflow
HTN - Answers-guidelines JNC8
-140/90
->60 (buffer for 150/90)
-DM & CKD (ACE or ARB)
-Black (CCB)
HTN & HF drug choice - Answerscoreg or labetolol
relax afterload and decrease HR
what is bad for glomerus in kidneys? - Answerssugar, protein and HTN
HFrEF - AnswersEF <40%
tx: entresto, loop diuretics, coreg, ACE or ARB
HFpEF - AnswersEF >40%
tx: diuretics
HF functional classes - Answers1: asymptomatic
2: sx when exceeding ADLs
3: sx with ADLs
4: SOB and fatigue at rest
what should you do daily with HF - Answerscheck daily weights
concern if gain >3lbs/day or 5lbs/week
,Identifying HF - Answers-sx: SOB, fatigue, exertional dyspnea, edema, low activity tolerance,
abdominal bloating, orthopnea
-cause: ischemic heart disease, valve disease, MI, cardiomyopathy
-tx: ACE/ARB, B-blocker, diuretics, thiazide diuretic, fluid/Na restrict, daily weights
-goals: minimize exacerbations/hospital; maintain current functional status and medication
regimen
Lipid management - AnswersASCVD risk sore --> 10 year risk score (low, moderate, high,
demonstrated disease) --> statins (take @ bedtime) ---> secondary (ezetimibe) ---> statin
intolerant (PCSK9s)-documented myalgia or intolerance or rhabdo
statin therapy - Answershigh intensity statin
-crestor (20-40)
-lipitor (40-80)
COQ10
aortic stenosis - Answers-narrowing of outflow to aortic root through aortic valve due to
calcification
-auscultate over aortic area
-sx: syncope or near syncope
-aortic murmur will radiate up to neck & can listen there
murmurs - Answers-aorta tends to radiate up to neck
-mitral tends to radiate to lateral chest
-L side dysfunction back up to lungs
aortic layers - Answers-tunica intima (smooth) inner most
-tunica media (middle layer) sticky
-tunica externa
aneurysm - Answers-keep BP down (120/80)
-avoid fluoroquinolones
-rupture: triad of sx (abdominal pain, abdominal distention, hemodynamically unstable)
aneurysm management - Answers-congenital concern: marfan or ED
,-other cause: atherosclerosis, vasculitis, uncontrolled HTN
-supportive management: avoid heavy lifting, BP control, avoidance of fluoroquinolones
PE - Answerspresent with SOB
EKG
provoked PE - Answersanesthesia
immobility
pregnancy
hypercoagulable state
DVT
cancer
hormone replacement therapy (estrogen)
treatment at least 3 months
unprovoked PE - Answersidiopathic
tx for 3 months, but may be lifelong
DVT - Answers-virchows triad: venous stasis, hypercoagulability, endothelial injury
PAD - Answers-cannot get blood flow down
-blood does not move --> clot
-pale, waxy, hairless legs
-pain with ambulation, cessation at rest
-dx: angio
-tx: stents, antiplt agents (clopidogrel, aspirin); statins for lipid management; smoking cessation;
daily ambulation and exercise
intermittent claudication - Answers-walk through pain
-antiplt/aspirin
-tx underlying cause: smoking, HTN, HLD, DM
pericardial effusion - Answers-fluid around the heart inside the pericardium
, -normally small volume
-could use anti-inflamm (NSAID or colchicine)
-tx underlying cause (hypothyroidism)
a. fib - Answers-irregularly irregular
-INR goal (2-3)
-ablation
-watchmen procedure (block off L appendage in heart)
-typically clot get trapped in L appendage off L atrium
a. flutter - Answerssaw tooth
intrinsic anticoag pathway - Answers-inside blood vessel
(12 --> 11 --> 9 --> 10)
-extrinsic
(7 --> 8 --> 10)
10a (prothrombin --> thrombin)
anticoagulation bridging - Answers-immediate protection when initiating warfarin
-inhibition of protein C/S during first few days of warfarin therapy to induce prothrombin state
-typically required until INR is 2.0
MUST bridge if there is an active clot
lovenox - Answers1mg/kg BID for bridging therapy
STEMI - Answersfull thickness damage
elevation seen on EKG + enzyme changes
NSTEMI - Answerspartial thickness damage
just enzyme elevation
conduction system of heart-cardiac sysynctum - Answerssqueeze all at same time
MI EKG changes - AnswersI SEE ALL LEADS
inferior, septal, anterior, lateral
flow of blood in body - AnswersLung --> pulm vein --> L atrium --> bicuspid valve --> L ventricle
--> aorta --> body --> vena cava --> R atrium --> tricuspid valve --> R ventricle --> pulmonary
arteries --> lungs
blood flow complications- contractility - AnswersEF, CAD, LVH, cardiomyopathy
blood flow complications- preload - Answerscentral fluid volume status
blood flow complications- afterload - Answersarterial back pressure on outflow
HTN - Answers-guidelines JNC8
-140/90
->60 (buffer for 150/90)
-DM & CKD (ACE or ARB)
-Black (CCB)
HTN & HF drug choice - Answerscoreg or labetolol
relax afterload and decrease HR
what is bad for glomerus in kidneys? - Answerssugar, protein and HTN
HFrEF - AnswersEF <40%
tx: entresto, loop diuretics, coreg, ACE or ARB
HFpEF - AnswersEF >40%
tx: diuretics
HF functional classes - Answers1: asymptomatic
2: sx when exceeding ADLs
3: sx with ADLs
4: SOB and fatigue at rest
what should you do daily with HF - Answerscheck daily weights
concern if gain >3lbs/day or 5lbs/week
,Identifying HF - Answers-sx: SOB, fatigue, exertional dyspnea, edema, low activity tolerance,
abdominal bloating, orthopnea
-cause: ischemic heart disease, valve disease, MI, cardiomyopathy
-tx: ACE/ARB, B-blocker, diuretics, thiazide diuretic, fluid/Na restrict, daily weights
-goals: minimize exacerbations/hospital; maintain current functional status and medication
regimen
Lipid management - AnswersASCVD risk sore --> 10 year risk score (low, moderate, high,
demonstrated disease) --> statins (take @ bedtime) ---> secondary (ezetimibe) ---> statin
intolerant (PCSK9s)-documented myalgia or intolerance or rhabdo
statin therapy - Answershigh intensity statin
-crestor (20-40)
-lipitor (40-80)
COQ10
aortic stenosis - Answers-narrowing of outflow to aortic root through aortic valve due to
calcification
-auscultate over aortic area
-sx: syncope or near syncope
-aortic murmur will radiate up to neck & can listen there
murmurs - Answers-aorta tends to radiate up to neck
-mitral tends to radiate to lateral chest
-L side dysfunction back up to lungs
aortic layers - Answers-tunica intima (smooth) inner most
-tunica media (middle layer) sticky
-tunica externa
aneurysm - Answers-keep BP down (120/80)
-avoid fluoroquinolones
-rupture: triad of sx (abdominal pain, abdominal distention, hemodynamically unstable)
aneurysm management - Answers-congenital concern: marfan or ED
,-other cause: atherosclerosis, vasculitis, uncontrolled HTN
-supportive management: avoid heavy lifting, BP control, avoidance of fluoroquinolones
PE - Answerspresent with SOB
EKG
provoked PE - Answersanesthesia
immobility
pregnancy
hypercoagulable state
DVT
cancer
hormone replacement therapy (estrogen)
treatment at least 3 months
unprovoked PE - Answersidiopathic
tx for 3 months, but may be lifelong
DVT - Answers-virchows triad: venous stasis, hypercoagulability, endothelial injury
PAD - Answers-cannot get blood flow down
-blood does not move --> clot
-pale, waxy, hairless legs
-pain with ambulation, cessation at rest
-dx: angio
-tx: stents, antiplt agents (clopidogrel, aspirin); statins for lipid management; smoking cessation;
daily ambulation and exercise
intermittent claudication - Answers-walk through pain
-antiplt/aspirin
-tx underlying cause: smoking, HTN, HLD, DM
pericardial effusion - Answers-fluid around the heart inside the pericardium
, -normally small volume
-could use anti-inflamm (NSAID or colchicine)
-tx underlying cause (hypothyroidism)
a. fib - Answers-irregularly irregular
-INR goal (2-3)
-ablation
-watchmen procedure (block off L appendage in heart)
-typically clot get trapped in L appendage off L atrium
a. flutter - Answerssaw tooth
intrinsic anticoag pathway - Answers-inside blood vessel
(12 --> 11 --> 9 --> 10)
-extrinsic
(7 --> 8 --> 10)
10a (prothrombin --> thrombin)
anticoagulation bridging - Answers-immediate protection when initiating warfarin
-inhibition of protein C/S during first few days of warfarin therapy to induce prothrombin state
-typically required until INR is 2.0
MUST bridge if there is an active clot
lovenox - Answers1mg/kg BID for bridging therapy
STEMI - Answersfull thickness damage
elevation seen on EKG + enzyme changes
NSTEMI - Answerspartial thickness damage
just enzyme elevation
conduction system of heart-cardiac sysynctum - Answerssqueeze all at same time
MI EKG changes - AnswersI SEE ALL LEADS
inferior, septal, anterior, lateral
