MSN 622 Final 2026/2027 Exam
Questions and Answers |
Already Graded A+
A 65-year-old woman presents with intermittent, sudden-onset chest
pain and shortness of breath, which radiates to her left jaw and arm. A
history of present illness reveals that the pain initially occurred with
activity, but now it occurs throughout the day. A review of systems is
positive for tiring easily with mild physical activity. Her medical history is
significant for hypertension and type 2 diabetes mellitus. An
electrocardiogram (ECG) and cardiac enzyme markers are ordered.
Which of the following tests will be most helpful in differentiating unstable
,angina from a non-ST segment elevation myocardial infarction
(NSTEMI)? - ANSWER ✔✔Troponin I
A 55-year-old asymptomatic, female smoker, with an extensive family
history of premature coronary artery disease, presents to the office for
further cardiovascular risk stratification. Her 10-year ASCVD risk score
by the pool cohort equation is 5.3%, and she is concerned about testing
for further risk stratification as she is reluctant to take medications.
Which of the following is most appropriate to order to assist in treatment
decision making? - ANSWER ✔✔Coronary artery calcium scoring
A 51-year-old female patient presents with a chief complaint to shortness
of breath, which is present only on exertion. She is a cashier in a local
bank. Her history includes type 1 diabetes mellitus and hypertension.
She is an active smoker for fifteen years and smokes one pack per day.
Her BMI is 32.2. Her current medications include insulin, empagliflozin,
and lisinopril. An EKG is obtained in the office, which shows normal
sinus rhythm with heart rate 77/min. Evidence of left ventricular
hypertrophy is also present on the EKG. An exercise stress test is
scheduled, and the patient gets chest pain on the treadmill soon after it
is started. Her echo shows a left ventricular ejection fraction of 30%.
Cardiac catheterization is performed, which shows 3-vessel coronary
artery disease. Which of the following is the best strategy for this
,patient's mechanical heart disease? - ANSWER ✔✔Coronary artery
bypass graft (CABG)
A 65-year-old man presents for preoperative evaluation. He plans to
undergo bilateral total knee replacement for osteoarthritis, which has
markedly limited his mobility. All conservative measures for osteoarthritis
treatment have failed. He has medical history significant for
hypertension, hyperlipidemia, and smoking. He received one drug-
eluting stent to the left anterior descending artery four months ago for
stable ischemic heart disease. Which of the following is the best step
regarding this patient's clearance for surgery? - ANSWER ✔✔Defer
surgery for at least 2 months.
What is the most appropriate initial intervention for an older male who
complains of leg pain with walking and at night who has weak pulses in
both lower extremities and a reduced ankle-brachial index? -
ANSWER ✔✔Lifestyle modification
A 74-year-old woman smoker with hypertension was found to have weak
right lower extremity pulses with a right ankle-brachial index (ABI) of
0.75. She denies any pain with walking. What is the most appropriate
treatment? - ANSWER ✔✔Smoking cessation
COPYRIGHT©NINJANERD 2025/2026. YEAR PUBLISHED 2026. COMPANY REGISTRATION NUMBER: 619652435. TERMS OF USE. PRIVACY
STATEMENT. ALL RIGHTS RESERVED
3
, A 65-year-old man who is a heavy smoker presents with a complaint of
pain in both legs when he walks. He claims he can only walk half a block
over the past few years without pain. He has been a smoker for 35 years
and also drinks alcohol. He does not have a history of hypertension or
heart disease. The ankle-brachial index in both legs is 0.70. What should
be done to lower this patient's myocardial infarction risk? - ANSWER
✔✔Start patient on aspirin or clopidogrel
A 65-year-old woman presents to the clinic for a 1-year follow-up and
medication management. Her medical history is significant for
congestive heart failure, hypertension, hyperlipidemia, diabetes mellitus
type 2, and chronic obstructive pulmonary disease (COPD). She has
smoked 2 packs of cigarettes for 45 years. She drinks alcohol socially.
Her current medications include lisinopril, hydrochlorothiazide,
atorvastatin, metformin, albuterol, and inhaled fluticasone. Per the
patient, she feels fine other than "some mild tingling in my feet." She
denies chest pain, dyspnea, palpitations, dizziness, and weakness. She
has not had laboratory work done in over 1 year. Her vital signs are
temperature 37 °C (98.6 °F), heart rate 77 bpm, respiratory rate 16
breaths/min, and blood pressure 155/89 mm Hg. A physical exam is
significant for absent bilateral pedal and posterior tibial artery pulses,
Questions and Answers |
Already Graded A+
A 65-year-old woman presents with intermittent, sudden-onset chest
pain and shortness of breath, which radiates to her left jaw and arm. A
history of present illness reveals that the pain initially occurred with
activity, but now it occurs throughout the day. A review of systems is
positive for tiring easily with mild physical activity. Her medical history is
significant for hypertension and type 2 diabetes mellitus. An
electrocardiogram (ECG) and cardiac enzyme markers are ordered.
Which of the following tests will be most helpful in differentiating unstable
,angina from a non-ST segment elevation myocardial infarction
(NSTEMI)? - ANSWER ✔✔Troponin I
A 55-year-old asymptomatic, female smoker, with an extensive family
history of premature coronary artery disease, presents to the office for
further cardiovascular risk stratification. Her 10-year ASCVD risk score
by the pool cohort equation is 5.3%, and she is concerned about testing
for further risk stratification as she is reluctant to take medications.
Which of the following is most appropriate to order to assist in treatment
decision making? - ANSWER ✔✔Coronary artery calcium scoring
A 51-year-old female patient presents with a chief complaint to shortness
of breath, which is present only on exertion. She is a cashier in a local
bank. Her history includes type 1 diabetes mellitus and hypertension.
She is an active smoker for fifteen years and smokes one pack per day.
Her BMI is 32.2. Her current medications include insulin, empagliflozin,
and lisinopril. An EKG is obtained in the office, which shows normal
sinus rhythm with heart rate 77/min. Evidence of left ventricular
hypertrophy is also present on the EKG. An exercise stress test is
scheduled, and the patient gets chest pain on the treadmill soon after it
is started. Her echo shows a left ventricular ejection fraction of 30%.
Cardiac catheterization is performed, which shows 3-vessel coronary
artery disease. Which of the following is the best strategy for this
,patient's mechanical heart disease? - ANSWER ✔✔Coronary artery
bypass graft (CABG)
A 65-year-old man presents for preoperative evaluation. He plans to
undergo bilateral total knee replacement for osteoarthritis, which has
markedly limited his mobility. All conservative measures for osteoarthritis
treatment have failed. He has medical history significant for
hypertension, hyperlipidemia, and smoking. He received one drug-
eluting stent to the left anterior descending artery four months ago for
stable ischemic heart disease. Which of the following is the best step
regarding this patient's clearance for surgery? - ANSWER ✔✔Defer
surgery for at least 2 months.
What is the most appropriate initial intervention for an older male who
complains of leg pain with walking and at night who has weak pulses in
both lower extremities and a reduced ankle-brachial index? -
ANSWER ✔✔Lifestyle modification
A 74-year-old woman smoker with hypertension was found to have weak
right lower extremity pulses with a right ankle-brachial index (ABI) of
0.75. She denies any pain with walking. What is the most appropriate
treatment? - ANSWER ✔✔Smoking cessation
COPYRIGHT©NINJANERD 2025/2026. YEAR PUBLISHED 2026. COMPANY REGISTRATION NUMBER: 619652435. TERMS OF USE. PRIVACY
STATEMENT. ALL RIGHTS RESERVED
3
, A 65-year-old man who is a heavy smoker presents with a complaint of
pain in both legs when he walks. He claims he can only walk half a block
over the past few years without pain. He has been a smoker for 35 years
and also drinks alcohol. He does not have a history of hypertension or
heart disease. The ankle-brachial index in both legs is 0.70. What should
be done to lower this patient's myocardial infarction risk? - ANSWER
✔✔Start patient on aspirin or clopidogrel
A 65-year-old woman presents to the clinic for a 1-year follow-up and
medication management. Her medical history is significant for
congestive heart failure, hypertension, hyperlipidemia, diabetes mellitus
type 2, and chronic obstructive pulmonary disease (COPD). She has
smoked 2 packs of cigarettes for 45 years. She drinks alcohol socially.
Her current medications include lisinopril, hydrochlorothiazide,
atorvastatin, metformin, albuterol, and inhaled fluticasone. Per the
patient, she feels fine other than "some mild tingling in my feet." She
denies chest pain, dyspnea, palpitations, dizziness, and weakness. She
has not had laboratory work done in over 1 year. Her vital signs are
temperature 37 °C (98.6 °F), heart rate 77 bpm, respiratory rate 16
breaths/min, and blood pressure 155/89 mm Hg. A physical exam is
significant for absent bilateral pedal and posterior tibial artery pulses,
