3P APEA EXAM
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Difference between varicose vein and arteriosclerosis - (correct Answer) - Is the affected vessel
Arteriosclerosis affects arteries whereas varicose veins affects veins
A patient has poorly controlled hypertension for more than 10 years. Indicate the most likely position of
his point of maximal impulse (PMI) - (correct Answer) - 5th ICS, left of MCL
A 43 year old Hispanic male has an audible diastolic murmur best heard in the mitral listening point.
There is no audible click. His status has been monitored for the past two years. This murmur is probably -
(correct Answer) - mitral stenosis
A patient who has diabetes presents with pain in his lower legs when he walks and pain resolution with
rest. When specifically asked about his pain in his lower leg, he likely will report pain - (correct Answer) -
in the calf muscle
A patient with hypertension describes a previous allergic reaction to a sulfa antibiotic as "sloughing of
skin" and hospitalization. Which medication is contraindicated in this patient? - (correct Answer) -
hydrochlorothiazide
A 75 year old patient who has aortic stenosis wants to know what symptoms indicate worsening of his
stenosis. the NP replies: - (correct Answer) - shortness of breath and syncope
A 74 year old patient has PAD. Which item listed below is an important nonmodifiable risk factor for
PAD? - (correct Answer) - diabetes
Benazepril should be d/c immediately if - (correct Answer) - pregnancy occurs
aortic regurgitation characteristics - (correct Answer) - long asymptomatic period follow by exercise
intolerance, then dyspnea at rest
DVT classic symptoms - (correct Answer) - swelling, pain, and discoloration of lower extremity
Characteristic of ACE-induced cough is that? - (correct Answer) - usually begins two weeks of starting
therapy
Valve most commonly involved in chronic rheumatic heart disease - (correct Answer) - mitral
Medication that can exacerbate HF - (correct Answer) - naproxen
, Patient taking ACE inhibitors should avoid? - (correct Answer) - potassium supplements
Grade 3 murmur indication for a referral - (correct Answer) - a fixed split
Group of meds used to treat HF - (correct Answer) - fosinopril, HCTZ, verapamil
Mr. Smith is a 72-year-old patient who takes warfarin for chronic A-fib. INR today is 4.0. the NP should: -
(correct Answer) - stop the warfarin today and repeat INR tomorrow
According to the NHLBI, which characteristic is a coronary heart disease risk equivalent, that is, which
risk factor places the pt. as a CHD risk similar to a hx of CHD - (correct Answer) - diabetes mellitus
good drug to reduce morbidity and mortality in mild HF - (correct Answer) - metoprolol
A pt. taking atorvastatin newly diagnosed with dyslipidemia complaints of fatigue, weakness, and muscle
aches in his lower back, arms, legs for the past 3 days. it is not improved with rest How should this be
evaluated? - (correct Answer) - Stop the atorvastatin immediately
symptom not indicative of HF - (correct Answer) - headache
What class of meds is preferred to normalized lipid levels and reduce risk of cardiac events - (correct
Answer) - HMG CoA reductase inhibitors
Highest sensitivity in diagnosing HF - (correct Answer) - BNP
The NP is caring for a 74-year-old who had an acute coronary syndrome 6 weeks ago. What medications
should be part of his regimen unless contraindicated - (correct Answer) - ACE, ASA, beta blockers, and
statin
patient with the highest systolic B/P - (correct Answer) - 75-year-old male
test that is most cost effective to screen for abdominal aortic aneurysm - (correct Answer) - abdominal
ultrasound
a 74-year-old patient has had an increase in b/p since the last exam. his b/p has increased from 144/90
to reading in the upper 160's/upper 80's. If medication is to be started on this patient, what would be a
good first choice? - (correct Answer) - Calcium channel blocker
Factor contributing to the development of AAA - (correct Answer) - cigarette smoking
A 40-year-old African-American pt. has a b/p of 175/100 and 170/102. What is a reasonable plan of care
for this pt today? - (correct Answer) - initiate amlodipine 5mg daily
Usual course of treatment for mitral valve prolapse - (correct Answer) - is benign
A 50-year-old patient with hypertension has taken HCTZ 25mg daily for the past 4 weeks. Her b/p has
decreased from 155/95 to 145/90. How should the NP proceed? - (correct Answer) - add another drug
from another class to the daily 25mg HCTZ
A patient with mitral valve prolapse reports chest pain and frequent arrhythmias. In the absence of other
cardiac anomalies, the drug of choice to treat her symptoms is: - (correct Answer) - metoprolol
Save
Difference between varicose vein and arteriosclerosis - (correct Answer) - Is the affected vessel
Arteriosclerosis affects arteries whereas varicose veins affects veins
A patient has poorly controlled hypertension for more than 10 years. Indicate the most likely position of
his point of maximal impulse (PMI) - (correct Answer) - 5th ICS, left of MCL
A 43 year old Hispanic male has an audible diastolic murmur best heard in the mitral listening point.
There is no audible click. His status has been monitored for the past two years. This murmur is probably -
(correct Answer) - mitral stenosis
A patient who has diabetes presents with pain in his lower legs when he walks and pain resolution with
rest. When specifically asked about his pain in his lower leg, he likely will report pain - (correct Answer) -
in the calf muscle
A patient with hypertension describes a previous allergic reaction to a sulfa antibiotic as "sloughing of
skin" and hospitalization. Which medication is contraindicated in this patient? - (correct Answer) -
hydrochlorothiazide
A 75 year old patient who has aortic stenosis wants to know what symptoms indicate worsening of his
stenosis. the NP replies: - (correct Answer) - shortness of breath and syncope
A 74 year old patient has PAD. Which item listed below is an important nonmodifiable risk factor for
PAD? - (correct Answer) - diabetes
Benazepril should be d/c immediately if - (correct Answer) - pregnancy occurs
aortic regurgitation characteristics - (correct Answer) - long asymptomatic period follow by exercise
intolerance, then dyspnea at rest
DVT classic symptoms - (correct Answer) - swelling, pain, and discoloration of lower extremity
Characteristic of ACE-induced cough is that? - (correct Answer) - usually begins two weeks of starting
therapy
Valve most commonly involved in chronic rheumatic heart disease - (correct Answer) - mitral
Medication that can exacerbate HF - (correct Answer) - naproxen
, Patient taking ACE inhibitors should avoid? - (correct Answer) - potassium supplements
Grade 3 murmur indication for a referral - (correct Answer) - a fixed split
Group of meds used to treat HF - (correct Answer) - fosinopril, HCTZ, verapamil
Mr. Smith is a 72-year-old patient who takes warfarin for chronic A-fib. INR today is 4.0. the NP should: -
(correct Answer) - stop the warfarin today and repeat INR tomorrow
According to the NHLBI, which characteristic is a coronary heart disease risk equivalent, that is, which
risk factor places the pt. as a CHD risk similar to a hx of CHD - (correct Answer) - diabetes mellitus
good drug to reduce morbidity and mortality in mild HF - (correct Answer) - metoprolol
A pt. taking atorvastatin newly diagnosed with dyslipidemia complaints of fatigue, weakness, and muscle
aches in his lower back, arms, legs for the past 3 days. it is not improved with rest How should this be
evaluated? - (correct Answer) - Stop the atorvastatin immediately
symptom not indicative of HF - (correct Answer) - headache
What class of meds is preferred to normalized lipid levels and reduce risk of cardiac events - (correct
Answer) - HMG CoA reductase inhibitors
Highest sensitivity in diagnosing HF - (correct Answer) - BNP
The NP is caring for a 74-year-old who had an acute coronary syndrome 6 weeks ago. What medications
should be part of his regimen unless contraindicated - (correct Answer) - ACE, ASA, beta blockers, and
statin
patient with the highest systolic B/P - (correct Answer) - 75-year-old male
test that is most cost effective to screen for abdominal aortic aneurysm - (correct Answer) - abdominal
ultrasound
a 74-year-old patient has had an increase in b/p since the last exam. his b/p has increased from 144/90
to reading in the upper 160's/upper 80's. If medication is to be started on this patient, what would be a
good first choice? - (correct Answer) - Calcium channel blocker
Factor contributing to the development of AAA - (correct Answer) - cigarette smoking
A 40-year-old African-American pt. has a b/p of 175/100 and 170/102. What is a reasonable plan of care
for this pt today? - (correct Answer) - initiate amlodipine 5mg daily
Usual course of treatment for mitral valve prolapse - (correct Answer) - is benign
A 50-year-old patient with hypertension has taken HCTZ 25mg daily for the past 4 weeks. Her b/p has
decreased from 155/95 to 145/90. How should the NP proceed? - (correct Answer) - add another drug
from another class to the daily 25mg HCTZ
A patient with mitral valve prolapse reports chest pain and frequent arrhythmias. In the absence of other
cardiac anomalies, the drug of choice to treat her symptoms is: - (correct Answer) - metoprolol
