NSG 6020 MIDTERM/ FINAL EXAM
NEWEST 2 LATEST VERSIONS
(VERSION A AND B) ACTUAL EXAM
COMPLETE QUESTIONS AND CORRECT
DETAILED ANSWERS
which of the following is the most important question to ask during cardiovascular health history
- ANSWER sudden death of a family member
a key symptom of ischemic heart disease is chest pain. However, angina equivalents may include
exertional dyspnea. Angina equivalenstare important because - ANSWER A and B
(Women with ischemic heart disease/some patients may have no symptoms)
A 55 year old post menopausal woman with a history of hypertension complains of jaw pain on
heavy exertion. There were no complaints of chest pain. Her ECG indicates normal sinus rhythm
without ST segment abnormalities. Your plan may include - ANSWER exercise test
Jenny is a 24 year old graduate student that presents to the clinic today with complaints of fever,
mid sternal chest pain and generalized fatigue for the past two days. She denies any cough or
sputum production. She states that when she takes ibuprofen and rest that the chest pain does
seem to ease off. Upon examination the patient presents looking very ill. She is leaning forward
and states that this is the most comfortable position for her. Temp is 102, BP 100/70, heart rate is
120/min and regular. Upon auscultation a friction rub is audible. Her lungs sounds clear. With
these presenting symptoms your initial diagnosis would be - ANSWER pericarditis
which symptom is more characteristic of non-cardiac chest pain - ANSWER pain tends
to occur with movement stretching or palpation
,what is the most common valvular heart disease in the older adult - ANSWER aortic
stenosis
1. Jeff, 48 years old, presents to the clinic complaining of fleeting chest pain, fatigue,
palpitations, lightheadedness, and shortness of breath. The pain comes and goes and is not
associated with activity or exertion. Food does not exacerbate or relieve the pain. The pain is
usually located under the left nipple. Jeff is concerned because his father has cardiac disease and
underwent a CABG at age 65. The ANP examines Jeff and hears a mid-systolic click at the 4th
ICS mid-clavicular area. The ANP knows that this is a hallmark sign of: - ANSWER
mitral valve prolapse
The aging process causes what normal physiological changes in the heart? - ANSWER
the heart valve thickens and becomes rigid, secondary to fibrosis and sclerosis
Dan G., a 65-year-old man, presents to your primary care office for the evaluation of chest pain
and left-sided shoulder pain. Pain begins after strenuous activity, including walking. Pain is
characterized as dull, aching; 8/10 during activity, otherwise 0/10. Began a few months ago,
intermittent, aggravated by exercise, and relieved by rest. Has occasional nausea. Pain is
retrosternal, radiating to left shoulder, definitely affects quality of life by limiting activity. Pain is
worse today; did not go away after he stopped walking. BP 120/80. Pulse 72 and regular. Normal
heart sounds, S1 and S2, no murmurs. Which of the following differential diagnoses would be
most likely - ANSWER Coronary artery disease with angina pectoris
a common auscultatory finding in advanced CHF is - ANSWER S3 gallop rhythm
Your 35-year-old female patient complains of feeling palpitations on occasion. The clinician
should recognize that palpitations are often a sign of - ANSWER all of the above
The best way to diagnose structural heart disease/dysfunction non-invasively is - ANSWER
echocardiogram
, During auscultation of the chest, your exam reveals a loud grating sound at the lower
anterolateral lung fields, at full inspiration and early expiration. This finding is consistent with: -
ANSWER A and B (pneumonia/pleuritis)
A 75-year-old patient complains of pain and paresthesias in the right foot that worsens with
exercise and is relieved by rest. On physical examination you note pallor of the right foot,
capillary refill of 4 seconds in the right foot, +1 dorsalis pedis pulse in the right foot, and +2
pulse in left foot. Which of the following is a likely cause of the signs and symptoms? -
ANSWER arterial insufficiency
Your patient complains of a feeling of heaviness in the lower legs daily. You note varicosities,
edema, and dusky color of both ankles and feet. Which of the following is the most likely cause
for these symptoms? - ANSWER venous insufficiency
Your 54 year old patient, Mr. A, presents to your clinic with a 2 day history of severe shoulder
pain. On initial assessment you note that in addition to shoulder findings his blood pressure on
the 'good' arm is 162/100. You review his history and on his last visit his blood pressure was
120/70. He has a medical history of sleep apnea and has used anabolic steroids when body
building as a younger adult. In addition to caring for Mr. A's chief complaint of shoulder pain,
you also - ANSWER Schedule a follow up appointment after pain has subsided to take
additional blood pressure readings
You decide to order labs today to help with the diagnosis and management of hypertension in
Mr. A. Which of the following labs are indicated to assist in the medical management of Mr. A if
he meets the diagnostic criteria for hypertension? - ANSWER fasting serum cholesterol
panel
Lifestyle modifications reduce blood pressure, enhance antihypertensive medication efficacy,
and decrease cardiovascular risks. Which lifestyle change will decrease blood pressure the most?
- ANSWER weight reduction
Mr. A returns to your clinic and a diagnosis of hypertension is made. He is started on a diuretic
and counseled on lifestyle modifications including increasing activity and smoking cessation. On
his next visit you note that his blood pressure remains elevated. Before referring to a specialist
NEWEST 2 LATEST VERSIONS
(VERSION A AND B) ACTUAL EXAM
COMPLETE QUESTIONS AND CORRECT
DETAILED ANSWERS
which of the following is the most important question to ask during cardiovascular health history
- ANSWER sudden death of a family member
a key symptom of ischemic heart disease is chest pain. However, angina equivalents may include
exertional dyspnea. Angina equivalenstare important because - ANSWER A and B
(Women with ischemic heart disease/some patients may have no symptoms)
A 55 year old post menopausal woman with a history of hypertension complains of jaw pain on
heavy exertion. There were no complaints of chest pain. Her ECG indicates normal sinus rhythm
without ST segment abnormalities. Your plan may include - ANSWER exercise test
Jenny is a 24 year old graduate student that presents to the clinic today with complaints of fever,
mid sternal chest pain and generalized fatigue for the past two days. She denies any cough or
sputum production. She states that when she takes ibuprofen and rest that the chest pain does
seem to ease off. Upon examination the patient presents looking very ill. She is leaning forward
and states that this is the most comfortable position for her. Temp is 102, BP 100/70, heart rate is
120/min and regular. Upon auscultation a friction rub is audible. Her lungs sounds clear. With
these presenting symptoms your initial diagnosis would be - ANSWER pericarditis
which symptom is more characteristic of non-cardiac chest pain - ANSWER pain tends
to occur with movement stretching or palpation
,what is the most common valvular heart disease in the older adult - ANSWER aortic
stenosis
1. Jeff, 48 years old, presents to the clinic complaining of fleeting chest pain, fatigue,
palpitations, lightheadedness, and shortness of breath. The pain comes and goes and is not
associated with activity or exertion. Food does not exacerbate or relieve the pain. The pain is
usually located under the left nipple. Jeff is concerned because his father has cardiac disease and
underwent a CABG at age 65. The ANP examines Jeff and hears a mid-systolic click at the 4th
ICS mid-clavicular area. The ANP knows that this is a hallmark sign of: - ANSWER
mitral valve prolapse
The aging process causes what normal physiological changes in the heart? - ANSWER
the heart valve thickens and becomes rigid, secondary to fibrosis and sclerosis
Dan G., a 65-year-old man, presents to your primary care office for the evaluation of chest pain
and left-sided shoulder pain. Pain begins after strenuous activity, including walking. Pain is
characterized as dull, aching; 8/10 during activity, otherwise 0/10. Began a few months ago,
intermittent, aggravated by exercise, and relieved by rest. Has occasional nausea. Pain is
retrosternal, radiating to left shoulder, definitely affects quality of life by limiting activity. Pain is
worse today; did not go away after he stopped walking. BP 120/80. Pulse 72 and regular. Normal
heart sounds, S1 and S2, no murmurs. Which of the following differential diagnoses would be
most likely - ANSWER Coronary artery disease with angina pectoris
a common auscultatory finding in advanced CHF is - ANSWER S3 gallop rhythm
Your 35-year-old female patient complains of feeling palpitations on occasion. The clinician
should recognize that palpitations are often a sign of - ANSWER all of the above
The best way to diagnose structural heart disease/dysfunction non-invasively is - ANSWER
echocardiogram
, During auscultation of the chest, your exam reveals a loud grating sound at the lower
anterolateral lung fields, at full inspiration and early expiration. This finding is consistent with: -
ANSWER A and B (pneumonia/pleuritis)
A 75-year-old patient complains of pain and paresthesias in the right foot that worsens with
exercise and is relieved by rest. On physical examination you note pallor of the right foot,
capillary refill of 4 seconds in the right foot, +1 dorsalis pedis pulse in the right foot, and +2
pulse in left foot. Which of the following is a likely cause of the signs and symptoms? -
ANSWER arterial insufficiency
Your patient complains of a feeling of heaviness in the lower legs daily. You note varicosities,
edema, and dusky color of both ankles and feet. Which of the following is the most likely cause
for these symptoms? - ANSWER venous insufficiency
Your 54 year old patient, Mr. A, presents to your clinic with a 2 day history of severe shoulder
pain. On initial assessment you note that in addition to shoulder findings his blood pressure on
the 'good' arm is 162/100. You review his history and on his last visit his blood pressure was
120/70. He has a medical history of sleep apnea and has used anabolic steroids when body
building as a younger adult. In addition to caring for Mr. A's chief complaint of shoulder pain,
you also - ANSWER Schedule a follow up appointment after pain has subsided to take
additional blood pressure readings
You decide to order labs today to help with the diagnosis and management of hypertension in
Mr. A. Which of the following labs are indicated to assist in the medical management of Mr. A if
he meets the diagnostic criteria for hypertension? - ANSWER fasting serum cholesterol
panel
Lifestyle modifications reduce blood pressure, enhance antihypertensive medication efficacy,
and decrease cardiovascular risks. Which lifestyle change will decrease blood pressure the most?
- ANSWER weight reduction
Mr. A returns to your clinic and a diagnosis of hypertension is made. He is started on a diuretic
and counseled on lifestyle modifications including increasing activity and smoking cessation. On
his next visit you note that his blood pressure remains elevated. Before referring to a specialist
