MSN 622 WEEK 2 - CARDIAC - STUDY
FOR FINAL EXAM QUESTIONS WITH
100% CORRECT ANSWERS!!
1 of 69
Term
A 50-year-old man presents to the clinic for routine evaluation. His
systolic blood pressure has persistently been in the 150-160
mmHg range. Treatment with ramipril is initiated. On the next
visit, he
complained of an itchy throat and a dry cough, which is not
distressing for him, but he is concerned that there might be
something serious as he used to smoke but quit 5 years ago. A
chest x-ray is within normal limits. What is the next best step in the
management of this patient?
Give this one a try later!
, Reassurance Tx: Warm Compress
Stress Electrocardiogram Order A Mammogram
Don't know?
2 of 69
Term
A 44-year-old man comes to the clinic for a follow-up. The
patient was found to have elevated blood pressure on his
annual physical exam last week. He was thus asked to keep a
blood pressure diary for one week. Today, the diary reveals an
average blood pressure of between 125-135/80-85 mmHg over the
past week. Which of the
following the best advice to this patient by the nurse?
Give this one a try later!
Sublingual nitroglycerin
Patients with stable angina respond to sublingual nitroglycerin, which helps to
vasodilate heart vessels, improving blood flow to the heart muscles, and
relieving ischemic pain.
Typical angina usually presents as chest discomfort or anginal equivalent
provoked with exertion and alleviated at rest or with nitroglycerin.
Coronary artery stenosis is the most common cause of myocardial ischemia.
During times of increased myocardial oxygen demand, the stenosis
prevents adequate myocardial oxygen supply. This, in turn, results in chest
pain.
Patients who do not respond to nitroglycerin may have unstable angina or
myocardial infarction. Beta-blockers are also used in the treatment of angina
but are not the first-line drug in an emergency.
, Coronary artery calcium scoring
This patient is at intermediate risk for future cardiac events based on her 10-year
ASCVD risk score of 5.3%.
Per the ACC/AHA 2019 Preventative Disease Guidelines, CAC scoring is a class
2A recommendation for further risk stratification in this patient population.
Other options that can be used to assess patient risk in this population further
are Hs-CRP, Lp(a), apoB, and ankle-brachial index.
The new ACCF/ACC guidelines for CAC scanning calls for CAC scoring
consideration among asymptomatic individuals with intermediate global risk
scores and for patients with diabetes older than the age of 40 years. An
abnormal CAC score establishes the presence of underlying CAD and signals
the need for aggressive risk factor management.
150 minutes of moderate-intensity exercise/wk
four categories of HTN: normal blood pressure, prehypertension,
hypertension stage I, and hypertension stage II.
Normal 120/80. Prehypertension: 120-139 mmHg or diastolic blood pressure of
80-89 mmHg. Stage I hypertension is 140-159 mmHg over 90-99 mmHg.
Stage II hypertension is defined as a systolic blood pressure of greater
than 160 mmHg or diastolic blood pressure of greater than 100 mmHg.
In patients with essential hypertension, lifestyle changes alone can account
for up to 15% reduction in all cardiovascular-related events.
A combination of nonpharmacological and dual antihypertensive therapy with
follow-up in 1 month
Don't know?
3 of 69
Term
, 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?
Give this one a try later!
Losartan/hydrochlorothiazide
Sacubitril/valsartan and atorvastatin
Angiotensin-converting enzyme
Amlodipine/atorvastatin inhibitor
Don't know?
4 of 69
Definition
Coronary artery calcium scoring
This patient is at intermediate risk for future cardiac events based on
her 10-year ASCVD risk score of 5.3%.
Per the ACC/AHA 2019 Preventative Disease Guidelines, CAC
scoring is a class 2A recommendation for further risk stratification in
this patient population.
Other options that can be used to assess patient risk in this
population further are Hs-CRP, Lp(a), apoB, and ankle-brachial index.
The new ACCF/ACC guidelines for CAC scanning calls for CAC
scoring consideration among asymptomatic individuals with
FOR FINAL EXAM QUESTIONS WITH
100% CORRECT ANSWERS!!
1 of 69
Term
A 50-year-old man presents to the clinic for routine evaluation. His
systolic blood pressure has persistently been in the 150-160
mmHg range. Treatment with ramipril is initiated. On the next
visit, he
complained of an itchy throat and a dry cough, which is not
distressing for him, but he is concerned that there might be
something serious as he used to smoke but quit 5 years ago. A
chest x-ray is within normal limits. What is the next best step in the
management of this patient?
Give this one a try later!
, Reassurance Tx: Warm Compress
Stress Electrocardiogram Order A Mammogram
Don't know?
2 of 69
Term
A 44-year-old man comes to the clinic for a follow-up. The
patient was found to have elevated blood pressure on his
annual physical exam last week. He was thus asked to keep a
blood pressure diary for one week. Today, the diary reveals an
average blood pressure of between 125-135/80-85 mmHg over the
past week. Which of the
following the best advice to this patient by the nurse?
Give this one a try later!
Sublingual nitroglycerin
Patients with stable angina respond to sublingual nitroglycerin, which helps to
vasodilate heart vessels, improving blood flow to the heart muscles, and
relieving ischemic pain.
Typical angina usually presents as chest discomfort or anginal equivalent
provoked with exertion and alleviated at rest or with nitroglycerin.
Coronary artery stenosis is the most common cause of myocardial ischemia.
During times of increased myocardial oxygen demand, the stenosis
prevents adequate myocardial oxygen supply. This, in turn, results in chest
pain.
Patients who do not respond to nitroglycerin may have unstable angina or
myocardial infarction. Beta-blockers are also used in the treatment of angina
but are not the first-line drug in an emergency.
, Coronary artery calcium scoring
This patient is at intermediate risk for future cardiac events based on her 10-year
ASCVD risk score of 5.3%.
Per the ACC/AHA 2019 Preventative Disease Guidelines, CAC scoring is a class
2A recommendation for further risk stratification in this patient population.
Other options that can be used to assess patient risk in this population further
are Hs-CRP, Lp(a), apoB, and ankle-brachial index.
The new ACCF/ACC guidelines for CAC scanning calls for CAC scoring
consideration among asymptomatic individuals with intermediate global risk
scores and for patients with diabetes older than the age of 40 years. An
abnormal CAC score establishes the presence of underlying CAD and signals
the need for aggressive risk factor management.
150 minutes of moderate-intensity exercise/wk
four categories of HTN: normal blood pressure, prehypertension,
hypertension stage I, and hypertension stage II.
Normal 120/80. Prehypertension: 120-139 mmHg or diastolic blood pressure of
80-89 mmHg. Stage I hypertension is 140-159 mmHg over 90-99 mmHg.
Stage II hypertension is defined as a systolic blood pressure of greater
than 160 mmHg or diastolic blood pressure of greater than 100 mmHg.
In patients with essential hypertension, lifestyle changes alone can account
for up to 15% reduction in all cardiovascular-related events.
A combination of nonpharmacological and dual antihypertensive therapy with
follow-up in 1 month
Don't know?
3 of 69
Term
, 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?
Give this one a try later!
Losartan/hydrochlorothiazide
Sacubitril/valsartan and atorvastatin
Angiotensin-converting enzyme
Amlodipine/atorvastatin inhibitor
Don't know?
4 of 69
Definition
Coronary artery calcium scoring
This patient is at intermediate risk for future cardiac events based on
her 10-year ASCVD risk score of 5.3%.
Per the ACC/AHA 2019 Preventative Disease Guidelines, CAC
scoring is a class 2A recommendation for further risk stratification in
this patient population.
Other options that can be used to assess patient risk in this
population further are Hs-CRP, Lp(a), apoB, and ankle-brachial index.
The new ACCF/ACC guidelines for CAC scanning calls for CAC
scoring consideration among asymptomatic individuals with
