CMN 574 FINAL EXAM 2026/2027 COMPLETE
QUESTIONS AND CORRECT DETAILED ANSWERS
WITH RATIONALES || 100% GUARANTEED PASS
LATEST VERSION
Question 1
A 68-year-old male with CKD stage 3a presents with new-onset atrial fibrillation. Which
anticoagulant is most appropriate?
A) Warfarin
B) Apixaban
C) Dabigatran
D) Rivaroxaban
Answer: B - Apixaban is partially renally cleared but safe in CKD 3a. Rivaroxaban and
dabigatran have higher renal accumulation; warfarin is effective but requires frequent
monitoring and has more interactions .
Question 2
What is the ECG finding characteristic of atrial fibrillation?
A) Regular rhythm with P waves
B) Irregularly irregular rhythm with NO P waves
C) Regular rhythm with no P waves
D) Irregular rhythm with peaked P waves
Answer: B - Atrial fibrillation is characterized by an irregularly irregular rhythm with no
discernible P waves on ECG .
Question 3
What score is used to assess stroke risk in patients with atrial fibrillation?
,A) Wells score
B) CHA₂DS₂-VASc score
C) HEART score
D) TIMI score
Answer: B - The CHA₂DS₂-VASc score is used to assess stroke risk in patients with atrial
fibrillation. Components include CHF, HTN, Age ≥75 (2 points), DM, Stroke/TIA (2
points), Vascular Disease, Age 65-74, and Female sex .
Question 4
Which factors in the CHA₂DS₂-VASc score are assigned 2 points?
A) CHF and DM
B) Age 75 and history of Stroke/TIA
C) HTN and Vascular Disease
D) Female sex and Age 65-74
Answer: B - Age 75 and history of Stroke/TIA are each assigned 2 points in the
CHA₂DS₂-VASc score. All other components receive 1 point .
Question 5
Resistant hypertension may be caused by which of the following?
A) NSAIDs
B) Oral Contraceptives
C) Obesity
D) All of the above
Answer: D - JNC 7 defines resistant hypertension as the inability to control BP in
patients compliant with an appropriate three-drug regimen including a diuretic. Causes
include nonadherence, NSAIDs, oral contraceptives, adrenal steroids, licorice, obesity,
and excessive alcohol intake .
,Question 6
A female patient at 26 weeks gestation has BP 155/102 with a dull headache. Urine is
negative for protein. What is the best response?
A) "Try yoga and meditation to decrease your blood pressure."
B) Start methyldopa 250 mg PO twice daily.
C) "Monitor your blood pressure at home and call the office if you have swelling."
D) Start metoprolol 100 mg PO twice daily.
Answer: B - Methyldopa has the longest record of safety in pregnancy at a starting
dosage of 250 mg PO BID or TID. The initiation of anti-hypertensive therapy in pregnant
women is indicated if sustained BP is >150/100 or if there is evidence of end-organ
damage .
Question 7
A 62-year-old with HFrEF (EF 30%) on lisinopril, carvedilol, furosemide, and
spironolactone has K+ 5.8 mEq/L. Creatinine 1.4 mg/dL (baseline 1.0). What is the best
next step?
A) Continue all meds, repeat BMP in 1 week
B) Hold spironolactone and lisinopril, monitor potassium
C) Increase furosemide dose
D) Add sodium polystyrene sulfonate
Answer: B - Hyperkalemia with AKI on RAAS blockade + MRA requires holding both
culprit drugs. Furosemide may help but is not the first step alone. Resins are second-line
after stopping offending agents .
Question 8
What ECG changes are associated with STEMI?
A) ST depression and T wave inversion
B) ST elevation and Q waves
C) T wave changes only
D) No ECG changes
, Answer: B - STEMI is characterized by ST elevation and development of Q waves on
ECG. NSTEMI and unstable angina present with ST depression and T wave changes .
Question 9
What is the characteristic murmur of Aortic Stenosis?
A) Harsh systolic murmur radiating to the neck
B) Diastolic murmur along the left sternal border
C) Low-pitched rumbling diastolic murmur
D) Holosystolic murmur at the apex
Answer: A - Aortic stenosis presents with a harsh systolic ejection murmur, sometimes
with a thrill along the left sternal border, often radiating to the neck .
Question 10
What is the murmur associated with Mitral Stenosis?
A) Holosystolic murmur at the apex
B) Opening snap and low-pitched diastolic rumble at the apex
C) Harsh systolic murmur radiating to the neck
D) Diastolic murmur along the left sternal border
Answer: B - Mitral stenosis is characterized by an opening snap and a localized low-
pitched diastolic rumble, best heard at the apex in the left lateral position .
Question 11
What is the characteristic murmur of Tricuspid Regurgitation?
A) Holosystolic murmur that increases with inspiration
B) Low-pitched rumbling diastolic murmur
C) Harsh systolic murmur at the left sternal border
D) Continuous machinery murmur
Answer: A - Tricuspid regurgitation presents as a musical, coarse, or blowing
holosystolic murmur best heard with inspiration .
QUESTIONS AND CORRECT DETAILED ANSWERS
WITH RATIONALES || 100% GUARANTEED PASS
LATEST VERSION
Question 1
A 68-year-old male with CKD stage 3a presents with new-onset atrial fibrillation. Which
anticoagulant is most appropriate?
A) Warfarin
B) Apixaban
C) Dabigatran
D) Rivaroxaban
Answer: B - Apixaban is partially renally cleared but safe in CKD 3a. Rivaroxaban and
dabigatran have higher renal accumulation; warfarin is effective but requires frequent
monitoring and has more interactions .
Question 2
What is the ECG finding characteristic of atrial fibrillation?
A) Regular rhythm with P waves
B) Irregularly irregular rhythm with NO P waves
C) Regular rhythm with no P waves
D) Irregular rhythm with peaked P waves
Answer: B - Atrial fibrillation is characterized by an irregularly irregular rhythm with no
discernible P waves on ECG .
Question 3
What score is used to assess stroke risk in patients with atrial fibrillation?
,A) Wells score
B) CHA₂DS₂-VASc score
C) HEART score
D) TIMI score
Answer: B - The CHA₂DS₂-VASc score is used to assess stroke risk in patients with atrial
fibrillation. Components include CHF, HTN, Age ≥75 (2 points), DM, Stroke/TIA (2
points), Vascular Disease, Age 65-74, and Female sex .
Question 4
Which factors in the CHA₂DS₂-VASc score are assigned 2 points?
A) CHF and DM
B) Age 75 and history of Stroke/TIA
C) HTN and Vascular Disease
D) Female sex and Age 65-74
Answer: B - Age 75 and history of Stroke/TIA are each assigned 2 points in the
CHA₂DS₂-VASc score. All other components receive 1 point .
Question 5
Resistant hypertension may be caused by which of the following?
A) NSAIDs
B) Oral Contraceptives
C) Obesity
D) All of the above
Answer: D - JNC 7 defines resistant hypertension as the inability to control BP in
patients compliant with an appropriate three-drug regimen including a diuretic. Causes
include nonadherence, NSAIDs, oral contraceptives, adrenal steroids, licorice, obesity,
and excessive alcohol intake .
,Question 6
A female patient at 26 weeks gestation has BP 155/102 with a dull headache. Urine is
negative for protein. What is the best response?
A) "Try yoga and meditation to decrease your blood pressure."
B) Start methyldopa 250 mg PO twice daily.
C) "Monitor your blood pressure at home and call the office if you have swelling."
D) Start metoprolol 100 mg PO twice daily.
Answer: B - Methyldopa has the longest record of safety in pregnancy at a starting
dosage of 250 mg PO BID or TID. The initiation of anti-hypertensive therapy in pregnant
women is indicated if sustained BP is >150/100 or if there is evidence of end-organ
damage .
Question 7
A 62-year-old with HFrEF (EF 30%) on lisinopril, carvedilol, furosemide, and
spironolactone has K+ 5.8 mEq/L. Creatinine 1.4 mg/dL (baseline 1.0). What is the best
next step?
A) Continue all meds, repeat BMP in 1 week
B) Hold spironolactone and lisinopril, monitor potassium
C) Increase furosemide dose
D) Add sodium polystyrene sulfonate
Answer: B - Hyperkalemia with AKI on RAAS blockade + MRA requires holding both
culprit drugs. Furosemide may help but is not the first step alone. Resins are second-line
after stopping offending agents .
Question 8
What ECG changes are associated with STEMI?
A) ST depression and T wave inversion
B) ST elevation and Q waves
C) T wave changes only
D) No ECG changes
, Answer: B - STEMI is characterized by ST elevation and development of Q waves on
ECG. NSTEMI and unstable angina present with ST depression and T wave changes .
Question 9
What is the characteristic murmur of Aortic Stenosis?
A) Harsh systolic murmur radiating to the neck
B) Diastolic murmur along the left sternal border
C) Low-pitched rumbling diastolic murmur
D) Holosystolic murmur at the apex
Answer: A - Aortic stenosis presents with a harsh systolic ejection murmur, sometimes
with a thrill along the left sternal border, often radiating to the neck .
Question 10
What is the murmur associated with Mitral Stenosis?
A) Holosystolic murmur at the apex
B) Opening snap and low-pitched diastolic rumble at the apex
C) Harsh systolic murmur radiating to the neck
D) Diastolic murmur along the left sternal border
Answer: B - Mitral stenosis is characterized by an opening snap and a localized low-
pitched diastolic rumble, best heard at the apex in the left lateral position .
Question 11
What is the characteristic murmur of Tricuspid Regurgitation?
A) Holosystolic murmur that increases with inspiration
B) Low-pitched rumbling diastolic murmur
C) Harsh systolic murmur at the left sternal border
D) Continuous machinery murmur
Answer: A - Tricuspid regurgitation presents as a musical, coarse, or blowing
holosystolic murmur best heard with inspiration .
