MSN 622 Week 2 - Cardiac - study for final
exam questions with correct answers
A |patient |with |congestive |heart |failure |is |started |on |furosemide. |They |should |also |be |
prescribed |which |other |medication? |- |CORRECT |ANSWER✔✔-Lisinopril
What |is |the |recommended |management |for |a |patient |with |a |3.5 |cm |abdominal |aortic |
aneurysm? |- |CORRECT |ANSWER✔✔-Ultrasound |every |three |years
A |78-year-old |is |found |to |have |an |asymptomatic |pulsatile |abdominal |mass. |The |ultrasound |
shows |an |abdominal |aortic |aneurysm |measuring |5.5 |cm. |Which |of |the |following |statements |
concerning |this |patient's |condition |is |correct? |- |CORRECT |ANSWER✔✔-Surgery |will |improve |5-
year |survival.
A |65-year-old |male |presents |with |severe |substernal |pain |for |20 |minutes, |radiating |to |the |
upper |left |limb |and |accompanied |by |dyspnea. |He |has |a |history |of |hypertension |and |smokes |30
|cigarettes/day. |His |blood |pressure |is |145/90 |mmHg |and |his |pulse |is |78/min. |Physical |
examination |is |unremarkable. |The |pain |settled |promptly |following |300 |mg |aspirin |orally |and |
800 |mcg |glyceryl |trinitrate |(GTN) |spray |sublingually. |What |is |the |most |common |underlying |
pathological |cause |for |this |patient's |symptoms? |- |CORRECT |ANSWER✔✔-Coronary |artery |
atherosclerosis
A |17-year-old |male |presents |for |a |sports |physical. |He |has |been |healthy |up |to |this |point. |His |
blood |pressure |is |145/95 |mmHg |bilaterally |on |three |separate |occasions. |Lower |extremity |
blood |pressure |is |also |elevated. |The |patient's |father, |uncle, |and |grandfather |all |have |
hypertension, |and |his |father |and |grandfather |have |chronic |kidney |disease |as |well. |Based |on |
this |information, |the |clinician |ordered |an |echocardiogram |and |abdominal |ultrasound. |The |
echocardiogram |was |unremarkable. |What |is |the |most |likely |reason |for |ordering |an |abdominal |
ultrasound? |- |CORRECT |ANSWER✔✔-Polycystic |kidneys
A |65-year-old |man |presents |with |episodic |substernal |pain. |Initially, |he |experienced |chest |pain |
with |physical |activity, |which |remits |with |rest. |But |now |it |occurs |at |rest |too. |He |has |a |history |of
,|hypertension |and |smokes |30 |cigarettes/day. |In |addition, |he |has |aspirin |hypersensitivity. |His |
blood |pressure |is |145/90 |mmHg, |pulse |is |78/min, |and |oxygen |saturation |is |97%. |Physical |
examination |is |unremarkable. |ECG |reveals |mild |ST-segment |depressions |in |V1-V2. |Cardiac |
troponins |are |not |elevated. |Which |of |the |following |is |the |best |option |for |the |management |in |
this |patient? |- |CORRECT |ANSWER✔✔-Clopidogrel
A |65-year-old |female |patient |presents |with |worsening |chest |pain |and |blurring |of |vision. |She |
has |a |history |of |hypertension, |diabetes |mellitus, |hyperlipidemia, |renal |insufficiency, |and |atrial |
fibrillation. |Vital |signs |show |temperature |37.8°C |(100 |F), |heart |rate |98 |bpm, |blood |pressure |
190/110 |mmHg, |respiratory |rate |20 |breaths/min, |and |oxygen |saturation |91%. |Her |complete |
blood |count |shows |a |WBC |of |12.0 |and |hematocrit |30%. |Her |eGFR |is |39 |ml/min/1.73 |m2. |What
|is |the |contraindication |for |cardiac |catheterization |in |this |patient? |- |CORRECT |ANSWER✔✔-
Uncontrolled |malignant |hypertension
A |65-year-old |male |presents |to |the |emergency |department |with |chest |pain |for |the |past |two |
hours. |The |pain |is |located |at |the |precordial |region, |described |as |sharp, |7/10 |intensity, |lasting |
for |20 |minutes, |radiating |to |the |upper |left |upper |limb |and |accompanied |by |dyspnea. |His |past |
medical |history |is |significant |for |hypertension |and |diabetes |mellitus |type |2. |His |blood |pressure
|is |120/80 |mmHg, |the |pulse |rate |72/min; |the |temperature |98 |F. |EKG |reveals |ST-segment |
depression. |What |is |the |best |enzyme |assay |to |diagnose |this |condition? |- |CORRECT |
ANSWER✔✔-Troponin
A |65-year-old |male |with |a |history |of |type |2 |diabetes |comes |into |the |provider's |office |
complaining |of |blurry |vision, |nosebleeds, |and |exertional |chest |pain |for |the |past |six |months. |
The |blood |pressure |is |measured |to |be |160/94 |mmHg. |A |CT |angiogram |is |performed, |which |
reveals |partially |occlusive |coronary |artery |plaques. |Which |of |the |following |medication |
regimens |would |be |most |appropriate |for |this |patient? |- |CORRECT |
ANSWER✔✔-Losartan/hydrochlorothiazide |and |atorvastatin
A |75-year-old |man |presents |to |the |emergency |department |with |complaints |of |severe |
abdominal |pain |and |sweating. |The |pain |started |about |an |hour |ago |and |is |becoming |worse |
with |time. |He |has |been |diagnosed |with |hypertension |and |diabetes |and |is |on |amlodipine |and |
metformin, |respectively. |On |presentation, |the |vital |signs |show |blood |pressure |70/40 |mmHg, |
pulse |140/min, |respiratory |rate |32/min, |temperature |38.5 |C |(101.3 |F), |and |oxygen |saturation |
, 87% |at |room |air. |On |physical |examination |of |the |abdomen, |generalized |tenderness |and |
guarding |are |seen. |There |is |a |midline |pulsatile |mass. |What |is |the |next |best |step |in |the |
management |of |this |patient? |- |CORRECT |ANSWER✔✔-Immediate |surgery
A |67-year-old |man |with |a |history |of |hypertension |and |tobacco |use |presents |with |a |two-day |
history |of |hypogastric |pain. |An |examination |reveals |a |5 |cm, |non-tender, |pulsatile |abdominal |
mass |above |the |umbilicus. |Which |of |the |following |type |of |sounds |might |be |heard |upon |
auscultation |at |the |midline, |two |inches |cephalad |to |the |umbilicus? |- |CORRECT |ANSWER✔✔-
Blowing
A |47-year-old |male |presents |to |the |office |for |routine |health |maintenance. |His |blood |pressure |
is |182/138, |with |all |other |vital |signs |within |normal |limits. |The |patient |is |currently |complaining |
of |a |headache |and |blurred |vision |but |denies |chest |pain, |shortness |of |breath, |and |abdominal |
pain. |Under |which |of |the |following |forms |of |hypertension |would |this |patient |be |classified? |- |
CORRECT |ANSWER✔✔-Hypertensive |emergency
A |67-year-old |male |with |a |history |of |hypertension |and |nicotine |dependence |presents |to |the |
emergency |department |with |sudden |onset |of |abdominal |pain |radiating |to |the |back. |There |is |
no |history |of |alcohol |use. |On |examination, |he |is |thin, |pale, |and |diaphoretic. |His |vital |signs |
show |a |blood |pressure |of |110/70 |mmHg |and |a |heart |rate |of |95 |bpm. |Which |of |the |following |is
|most |likely |to |confirm |the |diagnosis? |- |CORRECT |ANSWER✔✔-Abdominal |computed |
tomography
A |68-year-old |male |with |a |past |medical |history |of |type |2 |diabetes |mellitus |and |diabetic |
nephropathy |presented |to |the |clinic |for |a |follow-up |appointment. |His |blood |pressure |on |the |
last |visit |was |150/90 |mmHg. |He |was |called |in |for |a |follow-up |appointment |in |4 |weeks |to |
monitor |his |blood |pressure. |The |blood |pressure |on |this |visit |is |168/105 |mmHg, |and |HbA1c |is |
8.9%. |His |antihypertensive |regimen |was |adjusted, |and |an |ACE |inhibitor |was |added. |He |is |on |
metformin |and |sitagliptin |for |diabetes |mellitus. |One |week |later, |his |blood |pressure |was |130/80
|mmHg, |the |patient's |potassium |was |5.1 |mEq/L, |sodium |was |133 |mEq/L, |and |the |rest |of |the |
renal |panel |was |within |normal |limits. |He |reports |no |symptoms. |What |is |the |next |best |step |in |
his |care? |- |CORRECT |ANSWER✔✔-Reassure |him |that |this |is |expected |from |his |ACE |inhibitor |
and |continue |therapy |with |periodic |monitoring.
exam questions with correct answers
A |patient |with |congestive |heart |failure |is |started |on |furosemide. |They |should |also |be |
prescribed |which |other |medication? |- |CORRECT |ANSWER✔✔-Lisinopril
What |is |the |recommended |management |for |a |patient |with |a |3.5 |cm |abdominal |aortic |
aneurysm? |- |CORRECT |ANSWER✔✔-Ultrasound |every |three |years
A |78-year-old |is |found |to |have |an |asymptomatic |pulsatile |abdominal |mass. |The |ultrasound |
shows |an |abdominal |aortic |aneurysm |measuring |5.5 |cm. |Which |of |the |following |statements |
concerning |this |patient's |condition |is |correct? |- |CORRECT |ANSWER✔✔-Surgery |will |improve |5-
year |survival.
A |65-year-old |male |presents |with |severe |substernal |pain |for |20 |minutes, |radiating |to |the |
upper |left |limb |and |accompanied |by |dyspnea. |He |has |a |history |of |hypertension |and |smokes |30
|cigarettes/day. |His |blood |pressure |is |145/90 |mmHg |and |his |pulse |is |78/min. |Physical |
examination |is |unremarkable. |The |pain |settled |promptly |following |300 |mg |aspirin |orally |and |
800 |mcg |glyceryl |trinitrate |(GTN) |spray |sublingually. |What |is |the |most |common |underlying |
pathological |cause |for |this |patient's |symptoms? |- |CORRECT |ANSWER✔✔-Coronary |artery |
atherosclerosis
A |17-year-old |male |presents |for |a |sports |physical. |He |has |been |healthy |up |to |this |point. |His |
blood |pressure |is |145/95 |mmHg |bilaterally |on |three |separate |occasions. |Lower |extremity |
blood |pressure |is |also |elevated. |The |patient's |father, |uncle, |and |grandfather |all |have |
hypertension, |and |his |father |and |grandfather |have |chronic |kidney |disease |as |well. |Based |on |
this |information, |the |clinician |ordered |an |echocardiogram |and |abdominal |ultrasound. |The |
echocardiogram |was |unremarkable. |What |is |the |most |likely |reason |for |ordering |an |abdominal |
ultrasound? |- |CORRECT |ANSWER✔✔-Polycystic |kidneys
A |65-year-old |man |presents |with |episodic |substernal |pain. |Initially, |he |experienced |chest |pain |
with |physical |activity, |which |remits |with |rest. |But |now |it |occurs |at |rest |too. |He |has |a |history |of
,|hypertension |and |smokes |30 |cigarettes/day. |In |addition, |he |has |aspirin |hypersensitivity. |His |
blood |pressure |is |145/90 |mmHg, |pulse |is |78/min, |and |oxygen |saturation |is |97%. |Physical |
examination |is |unremarkable. |ECG |reveals |mild |ST-segment |depressions |in |V1-V2. |Cardiac |
troponins |are |not |elevated. |Which |of |the |following |is |the |best |option |for |the |management |in |
this |patient? |- |CORRECT |ANSWER✔✔-Clopidogrel
A |65-year-old |female |patient |presents |with |worsening |chest |pain |and |blurring |of |vision. |She |
has |a |history |of |hypertension, |diabetes |mellitus, |hyperlipidemia, |renal |insufficiency, |and |atrial |
fibrillation. |Vital |signs |show |temperature |37.8°C |(100 |F), |heart |rate |98 |bpm, |blood |pressure |
190/110 |mmHg, |respiratory |rate |20 |breaths/min, |and |oxygen |saturation |91%. |Her |complete |
blood |count |shows |a |WBC |of |12.0 |and |hematocrit |30%. |Her |eGFR |is |39 |ml/min/1.73 |m2. |What
|is |the |contraindication |for |cardiac |catheterization |in |this |patient? |- |CORRECT |ANSWER✔✔-
Uncontrolled |malignant |hypertension
A |65-year-old |male |presents |to |the |emergency |department |with |chest |pain |for |the |past |two |
hours. |The |pain |is |located |at |the |precordial |region, |described |as |sharp, |7/10 |intensity, |lasting |
for |20 |minutes, |radiating |to |the |upper |left |upper |limb |and |accompanied |by |dyspnea. |His |past |
medical |history |is |significant |for |hypertension |and |diabetes |mellitus |type |2. |His |blood |pressure
|is |120/80 |mmHg, |the |pulse |rate |72/min; |the |temperature |98 |F. |EKG |reveals |ST-segment |
depression. |What |is |the |best |enzyme |assay |to |diagnose |this |condition? |- |CORRECT |
ANSWER✔✔-Troponin
A |65-year-old |male |with |a |history |of |type |2 |diabetes |comes |into |the |provider's |office |
complaining |of |blurry |vision, |nosebleeds, |and |exertional |chest |pain |for |the |past |six |months. |
The |blood |pressure |is |measured |to |be |160/94 |mmHg. |A |CT |angiogram |is |performed, |which |
reveals |partially |occlusive |coronary |artery |plaques. |Which |of |the |following |medication |
regimens |would |be |most |appropriate |for |this |patient? |- |CORRECT |
ANSWER✔✔-Losartan/hydrochlorothiazide |and |atorvastatin
A |75-year-old |man |presents |to |the |emergency |department |with |complaints |of |severe |
abdominal |pain |and |sweating. |The |pain |started |about |an |hour |ago |and |is |becoming |worse |
with |time. |He |has |been |diagnosed |with |hypertension |and |diabetes |and |is |on |amlodipine |and |
metformin, |respectively. |On |presentation, |the |vital |signs |show |blood |pressure |70/40 |mmHg, |
pulse |140/min, |respiratory |rate |32/min, |temperature |38.5 |C |(101.3 |F), |and |oxygen |saturation |
, 87% |at |room |air. |On |physical |examination |of |the |abdomen, |generalized |tenderness |and |
guarding |are |seen. |There |is |a |midline |pulsatile |mass. |What |is |the |next |best |step |in |the |
management |of |this |patient? |- |CORRECT |ANSWER✔✔-Immediate |surgery
A |67-year-old |man |with |a |history |of |hypertension |and |tobacco |use |presents |with |a |two-day |
history |of |hypogastric |pain. |An |examination |reveals |a |5 |cm, |non-tender, |pulsatile |abdominal |
mass |above |the |umbilicus. |Which |of |the |following |type |of |sounds |might |be |heard |upon |
auscultation |at |the |midline, |two |inches |cephalad |to |the |umbilicus? |- |CORRECT |ANSWER✔✔-
Blowing
A |47-year-old |male |presents |to |the |office |for |routine |health |maintenance. |His |blood |pressure |
is |182/138, |with |all |other |vital |signs |within |normal |limits. |The |patient |is |currently |complaining |
of |a |headache |and |blurred |vision |but |denies |chest |pain, |shortness |of |breath, |and |abdominal |
pain. |Under |which |of |the |following |forms |of |hypertension |would |this |patient |be |classified? |- |
CORRECT |ANSWER✔✔-Hypertensive |emergency
A |67-year-old |male |with |a |history |of |hypertension |and |nicotine |dependence |presents |to |the |
emergency |department |with |sudden |onset |of |abdominal |pain |radiating |to |the |back. |There |is |
no |history |of |alcohol |use. |On |examination, |he |is |thin, |pale, |and |diaphoretic. |His |vital |signs |
show |a |blood |pressure |of |110/70 |mmHg |and |a |heart |rate |of |95 |bpm. |Which |of |the |following |is
|most |likely |to |confirm |the |diagnosis? |- |CORRECT |ANSWER✔✔-Abdominal |computed |
tomography
A |68-year-old |male |with |a |past |medical |history |of |type |2 |diabetes |mellitus |and |diabetic |
nephropathy |presented |to |the |clinic |for |a |follow-up |appointment. |His |blood |pressure |on |the |
last |visit |was |150/90 |mmHg. |He |was |called |in |for |a |follow-up |appointment |in |4 |weeks |to |
monitor |his |blood |pressure. |The |blood |pressure |on |this |visit |is |168/105 |mmHg, |and |HbA1c |is |
8.9%. |His |antihypertensive |regimen |was |adjusted, |and |an |ACE |inhibitor |was |added. |He |is |on |
metformin |and |sitagliptin |for |diabetes |mellitus. |One |week |later, |his |blood |pressure |was |130/80
|mmHg, |the |patient's |potassium |was |5.1 |mEq/L, |sodium |was |133 |mEq/L, |and |the |rest |of |the |
renal |panel |was |within |normal |limits. |He |reports |no |symptoms. |What |is |the |next |best |step |in |
his |care? |- |CORRECT |ANSWER✔✔-Reassure |him |that |this |is |expected |from |his |ACE |inhibitor |
and |continue |therapy |with |periodic |monitoring.
