1
NURS 6560 Comprehensive Exam Review: 200
Practice Questions with Clinical Rationales for
Midterm and Final Success
NURS 6560 Midterm & Final Exam: 200
Practice Questions with Rationales
Cardiology Questions (1-15)
Question 1
A 59-year-old female with a history of aortic
regurgitation has been lost to follow-up for 16
months. She now presents with activity
intolerance and weight gain. Physical
examination reveals a grade IV/VI diastolic
aortic murmur and 2+ lower extremity edema
to the midcalf. The AGACNP considers which
management strategy?
,2
• A. Serial echocardiography every 6 months
• B. Begin a calcium channel antagonist
• C. Begin an angiotensin converting enzyme
(ACE) inhibitor
• D. Surgical consultation and intervention
Correct ☑VERIFIED ANSWER: C. Begin an
angiotensin converting enzyme (ACE) inhibitor
Rationale: The patient is exhibiting symptoms
of worsening aortic regurgitation with heart
failure (activity intolerance, edema). ACE
inhibitors provide afterload reduction,
decreasing left ventricular workload and
managing symptoms. Surgery is reserved for
severe regurgitation with symptoms refractory
to medical therapy, evidence of LV dysfunction,
or when valves are significantly damaged/leaky.
,3
Question 2
An ascending thoracic aneurysm of >5.5 cm is
universally considered an indication for
surgical repair. Regardless of size, all of the
following are additional indications for
immediate operation EXCEPT:
• A. Comorbid Marfan's syndrome
• B. Enlargement of >1 cm since diagnosis
• C. Crushing chest pain
• D. History of giant cell arteritis
Correct ☑VERIFIED ANSWER: C. Crushing chest
pain
Rationale: While Marfan's syndrome, rapid
enlargement (>0.5 cm/year), and giant cell
arteritis history warrant surgical repair
regardless of size, crushing chest pain alone is
not an independent surgical indication.
, 4
Prophylactic surgery is recommended at 5.5 cm
diameter, for Marfan syndrome/bicuspid aortic
valve patients, enlargement >0.5 cm, or with
giant cell arteritis history.
Question 3
The AGACNP is managing a patient in the ICU
being treated for a pulmonary embolus.
Initially stable, the patient has become
increasingly lethargic. Vital signs: BP 88/54,
Pulse 110, RR 22, SaO2 93% on 50% mask, SVR
1600 dynes∙sec/cm5, Cardiac Index 1.3 L/min,
PCWP 8 mmHg. This clinical picture is most
consistent with which shock state?
• A. Hypovolemic
• B. Cardiogenic
• C. Distributive
NURS 6560 Comprehensive Exam Review: 200
Practice Questions with Clinical Rationales for
Midterm and Final Success
NURS 6560 Midterm & Final Exam: 200
Practice Questions with Rationales
Cardiology Questions (1-15)
Question 1
A 59-year-old female with a history of aortic
regurgitation has been lost to follow-up for 16
months. She now presents with activity
intolerance and weight gain. Physical
examination reveals a grade IV/VI diastolic
aortic murmur and 2+ lower extremity edema
to the midcalf. The AGACNP considers which
management strategy?
,2
• A. Serial echocardiography every 6 months
• B. Begin a calcium channel antagonist
• C. Begin an angiotensin converting enzyme
(ACE) inhibitor
• D. Surgical consultation and intervention
Correct ☑VERIFIED ANSWER: C. Begin an
angiotensin converting enzyme (ACE) inhibitor
Rationale: The patient is exhibiting symptoms
of worsening aortic regurgitation with heart
failure (activity intolerance, edema). ACE
inhibitors provide afterload reduction,
decreasing left ventricular workload and
managing symptoms. Surgery is reserved for
severe regurgitation with symptoms refractory
to medical therapy, evidence of LV dysfunction,
or when valves are significantly damaged/leaky.
,3
Question 2
An ascending thoracic aneurysm of >5.5 cm is
universally considered an indication for
surgical repair. Regardless of size, all of the
following are additional indications for
immediate operation EXCEPT:
• A. Comorbid Marfan's syndrome
• B. Enlargement of >1 cm since diagnosis
• C. Crushing chest pain
• D. History of giant cell arteritis
Correct ☑VERIFIED ANSWER: C. Crushing chest
pain
Rationale: While Marfan's syndrome, rapid
enlargement (>0.5 cm/year), and giant cell
arteritis history warrant surgical repair
regardless of size, crushing chest pain alone is
not an independent surgical indication.
, 4
Prophylactic surgery is recommended at 5.5 cm
diameter, for Marfan syndrome/bicuspid aortic
valve patients, enlargement >0.5 cm, or with
giant cell arteritis history.
Question 3
The AGACNP is managing a patient in the ICU
being treated for a pulmonary embolus.
Initially stable, the patient has become
increasingly lethargic. Vital signs: BP 88/54,
Pulse 110, RR 22, SaO2 93% on 50% mask, SVR
1600 dynes∙sec/cm5, Cardiac Index 1.3 L/min,
PCWP 8 mmHg. This clinical picture is most
consistent with which shock state?
• A. Hypovolemic
• B. Cardiogenic
• C. Distributive
