NR605 PRACTICUM REVIEW FINAL
EXAM QUESTIONS AND ANSWERS.
VERIFIED
1. A 67-year-old patient with HFrEF and a history of Stage 3 CKD presents for management of
hypertension. Which of the following calcium channel blockers is most appropriate for this
patient?
A. Verapamil
B. Diltiazem
C. Nifedipine ER
D. Amlodipine
Answer: D
Conceptual Explanation: Dihydropyridine CCBs like Amlodipine are preferred in HFrEF if
a CCB is needed for blood pressure, as non-dihydropyridines (Verapamil/Diltiazem) have
negative inotropic effects and are contraindicated.
,2. According to the JNC 8 guidelines, what is the target blood pressure for a 65-year-old
patient with no other co-morbidities?
A. <150/90 mmHg
B. <140/90 mmHg
C. <130/80 mmHg
D. <120/70 mmHg
Answer: A
Conceptual Explanation: For patients aged 60 and older without diabetes or CKD, JNC 8
recommends a blood pressure target of less than 150/90 mmHg.
3. A patient presents with a harsh systolic murmur heard best at the 2nd right intercostal
space that radiates to the carotids. What is the most likely diagnosis?
A. Mitral Stenosis
B. Mitral Regurgitation
C. Aortic Regurgitation
D. Aortic Stenosis
Answer: D
Conceptual Explanation: Aortic Stenosis is characterized by a crescendo-decrescendo
systolic murmur at the right upper sternal border radiating to the carotid arteries.
, 4. In the management of heart failure with reduced ejection fraction (HFrEF), which
medication class is known to decrease mortality and should be started in all patients?
A. Loop Diuretics
B. Digoxin
C. Calcium Channel Blockers
D. ACE Inhibitors
Answer: D
Conceptual Explanation: ACE Inhibitors, along with Beta-blockers and Aldosterone
antagonists, are cornerstone therapies that have been proven to reduce mortality in HFrEF
patients.
5. Which of the following is a symptom of left-sided heart failure rather than right-sided heart
failure?
A. Peripheral edema
B. Jugular venous distention
C. Paroxysmal nocturnal dyspnea
D. Hepatosplenomegaly
Answer: C
Conceptual Explanation: Left-sided heart failure typically presents with pulmonary
symptoms like PND, orthopnea, and crackles due to fluid backing up into the lungs.
EXAM QUESTIONS AND ANSWERS.
VERIFIED
1. A 67-year-old patient with HFrEF and a history of Stage 3 CKD presents for management of
hypertension. Which of the following calcium channel blockers is most appropriate for this
patient?
A. Verapamil
B. Diltiazem
C. Nifedipine ER
D. Amlodipine
Answer: D
Conceptual Explanation: Dihydropyridine CCBs like Amlodipine are preferred in HFrEF if
a CCB is needed for blood pressure, as non-dihydropyridines (Verapamil/Diltiazem) have
negative inotropic effects and are contraindicated.
,2. According to the JNC 8 guidelines, what is the target blood pressure for a 65-year-old
patient with no other co-morbidities?
A. <150/90 mmHg
B. <140/90 mmHg
C. <130/80 mmHg
D. <120/70 mmHg
Answer: A
Conceptual Explanation: For patients aged 60 and older without diabetes or CKD, JNC 8
recommends a blood pressure target of less than 150/90 mmHg.
3. A patient presents with a harsh systolic murmur heard best at the 2nd right intercostal
space that radiates to the carotids. What is the most likely diagnosis?
A. Mitral Stenosis
B. Mitral Regurgitation
C. Aortic Regurgitation
D. Aortic Stenosis
Answer: D
Conceptual Explanation: Aortic Stenosis is characterized by a crescendo-decrescendo
systolic murmur at the right upper sternal border radiating to the carotid arteries.
, 4. In the management of heart failure with reduced ejection fraction (HFrEF), which
medication class is known to decrease mortality and should be started in all patients?
A. Loop Diuretics
B. Digoxin
C. Calcium Channel Blockers
D. ACE Inhibitors
Answer: D
Conceptual Explanation: ACE Inhibitors, along with Beta-blockers and Aldosterone
antagonists, are cornerstone therapies that have been proven to reduce mortality in HFrEF
patients.
5. Which of the following is a symptom of left-sided heart failure rather than right-sided heart
failure?
A. Peripheral edema
B. Jugular venous distention
C. Paroxysmal nocturnal dyspnea
D. Hepatosplenomegaly
Answer: C
Conceptual Explanation: Left-sided heart failure typically presents with pulmonary
symptoms like PND, orthopnea, and crackles due to fluid backing up into the lungs.
