CMN 574 FINAL EXAM 2025/2026 QUESTIONS
AND CORRECT ANSWERS GRADED A+
What is the 3rd most common cause of chest pain?
Psych
What are some risk factors for psych as the cause of chest pain?
Acute stress (home, workplace, school)
Hx of panic disorder
Hx of depression
A patient presents with chest pain. Hx of depression. What might this patient
describe their chest pain as?
heaviness that is either sudden or gradual
A patient presents with chest pain. Hx of anxiety. What might this patient look
like?
Hyperventilating, numbness or tingling to BILATERAL extremities
What 2 screening questions are IMPORTANT when assessing a patient with chest
pain to help your differential in psych being the cause?
In the last 6 months, have you experienced either of the following:
,- Spell or attack of feeling anxious
- Felt like your heart was racing or felt faint?
If patient responds with YES to EITHER question, SUSPECT PSYCH and
investigate further
What risk factors place the patient at risk for a respiratory cause of chest pain?
Recent immobility
Recent pregnancy
Pelvic or femur trauma (fracture, surgery)
Hypercoagulability
Estrogen use (HRT) or birth control
Are they a smoker
Hx or current cancer
A patient was recently dx with pneumonia. What chest pain symptoms might this
patient report?
dull ache (could have no pain at all)
A patient presents to clinic with c/o pain worse with inspiration, characterized as
stabbing to posterior LL lobe. Vitals reveal tachycardia of 101hr. What do you
suspect?
What should be included in your assessment of this patient?
,PE (pulmonary embolism).
You should perform a Wells score to determine imaging.
What Wells score indicates low risk? What would be your next NP action?
<2 you would order a d-dimer
Depending on patient complaint, may order a lower extremity US to rule out DVT
What Wells score indicates high risk? What would be your next NP action?
>6 you would order a CT scan and LE US
If a clot is found, begin anticoagulation.
Patient presents to clinic with cough, fever, and increased shortness of breath with
exertion.
What do you suspect in this patient? What would you order to rule in / out?
Pneumonia
Order a 2-view CXR
Treat with antibiotics
, Woman presents to clinic for annual exam. Constitutional: healthy, thin,
cooperative. CV: pansystolic murmur with mid-systolic click. Spine: pectus
excavatum.
What cardiac issue do you suspect in this patient? How do you diagnose
definitively?
What is treatment?
Mitral Valve Prolapse
Diagnose: Echo
Treatment: None required UNLESS symptomatic - this would be a beta-blocker
"olol"
Patient presents to clinic with c/o abrupt onset of stabbing / ripping chest pain that
is radiating to his back. Hx of smoker. Patient appears anxious upon exam.
What assessment technique is important to perform? What do you suspect? What is
your treatment?
BP in left and right arm
Difference in BP >15mmHg = positive
assessment
Diff Dx: Abdominal aortic aneurysm
Diagnostics: Stat CT
TX:prayer, surgery
AND CORRECT ANSWERS GRADED A+
What is the 3rd most common cause of chest pain?
Psych
What are some risk factors for psych as the cause of chest pain?
Acute stress (home, workplace, school)
Hx of panic disorder
Hx of depression
A patient presents with chest pain. Hx of depression. What might this patient
describe their chest pain as?
heaviness that is either sudden or gradual
A patient presents with chest pain. Hx of anxiety. What might this patient look
like?
Hyperventilating, numbness or tingling to BILATERAL extremities
What 2 screening questions are IMPORTANT when assessing a patient with chest
pain to help your differential in psych being the cause?
In the last 6 months, have you experienced either of the following:
,- Spell or attack of feeling anxious
- Felt like your heart was racing or felt faint?
If patient responds with YES to EITHER question, SUSPECT PSYCH and
investigate further
What risk factors place the patient at risk for a respiratory cause of chest pain?
Recent immobility
Recent pregnancy
Pelvic or femur trauma (fracture, surgery)
Hypercoagulability
Estrogen use (HRT) or birth control
Are they a smoker
Hx or current cancer
A patient was recently dx with pneumonia. What chest pain symptoms might this
patient report?
dull ache (could have no pain at all)
A patient presents to clinic with c/o pain worse with inspiration, characterized as
stabbing to posterior LL lobe. Vitals reveal tachycardia of 101hr. What do you
suspect?
What should be included in your assessment of this patient?
,PE (pulmonary embolism).
You should perform a Wells score to determine imaging.
What Wells score indicates low risk? What would be your next NP action?
<2 you would order a d-dimer
Depending on patient complaint, may order a lower extremity US to rule out DVT
What Wells score indicates high risk? What would be your next NP action?
>6 you would order a CT scan and LE US
If a clot is found, begin anticoagulation.
Patient presents to clinic with cough, fever, and increased shortness of breath with
exertion.
What do you suspect in this patient? What would you order to rule in / out?
Pneumonia
Order a 2-view CXR
Treat with antibiotics
, Woman presents to clinic for annual exam. Constitutional: healthy, thin,
cooperative. CV: pansystolic murmur with mid-systolic click. Spine: pectus
excavatum.
What cardiac issue do you suspect in this patient? How do you diagnose
definitively?
What is treatment?
Mitral Valve Prolapse
Diagnose: Echo
Treatment: None required UNLESS symptomatic - this would be a beta-blocker
"olol"
Patient presents to clinic with c/o abrupt onset of stabbing / ripping chest pain that
is radiating to his back. Hx of smoker. Patient appears anxious upon exam.
What assessment technique is important to perform? What do you suspect? What is
your treatment?
BP in left and right arm
Difference in BP >15mmHg = positive
assessment
Diff Dx: Abdominal aortic aneurysm
Diagnostics: Stat CT
TX:prayer, surgery
