PREMIUM STUDY GUIDE A+
COMPREHENSIVE NURS 5463 MODULE
1 QUESTIONS AND ANSWERS GRADED
A+
⩥ An 84-year-old woman has diabetes and congestive heart failure that
is refractory to medical treatment. A right carotid bruit is detected on
physical examination. A duplex study suggests a 50% to 75% right
carotid stenosis. Which of the following is the most appropriate
treatment? Answer: A. Medical management
⩥ Which of the following statements regarding carotid artery stenting is
most accurate? Answer: A. CREST study suggests that older patients
have increased combined stroke and death rates in comparison to
younger patients
⩥ Which of the following does NOT need to be instituted for a patient
following carotid endarterectomy? Answer: A. Coumadin to target an
INR of 2 to 3
⩥ For which of the following patients is a left carotid endarterectomy
most indicated? Answer: A. A 70-year-old man with transient loss of
vision in the left eye that recovered after 20 minutes, and he has 75% left
carotid stenosis
1
,PREMIUM STUDY GUIDE A+
⩥ A 73-year-old woman is evaluated in the ED and transferred to the
ICU because of chest pain of 4 hours' duration. Her medical history
includes a 20-year history of hypertension and Type II diabetes mellitus.
Her medications include metformin, atenolol, and ASA. On physical
examination, her blood pressure is 130/84 mm Hg, and her heart rate is
87 beats/min and regular. Her jugular vein is distended to 5 cm while the
patient is upright. She has a faint left carotid bruit and bibasilar crackles
to one quarter up from the lung bases. A normal S1 and S2 is heard, with
a grade II/VI holosystolic murmur heard best at the apex to the axilla.
An electrocardiogram from six months ago was normal. The ECG was
seen during the chest pain. The initial serum troponin measurement is
elevated. She is now admitted to the ICU for an MI. She is free of chest
pain while on IV nitroglycerin, and her vital signs are stable. Which of
the fol Answer: A. Left bundle branch block with normal sinus rhythm
⩥ A 55-year-old man in the ICU has ACS, with 2 mm of ST elevation on
the leads II, III, and aVF. The troponins are positive. The blood pressure
is 130/70 mm Hg on a nitroglycerin drip at 5 μg/kg/min keeping the
patient chest pain free, but ECG changes persist and only 1 mm of ST
elevation is seen. There is no lower extremity edema. The patient was
given ASA upon entry into the ED. What is/are the next best steps in the
management of this patient? Answer: Anticoagulation, IV β-blocker,
ACE inhibitor, nitro-glycerine, and alert catheterization lab
⩥ A 65-year-old man with history of diabetes presents to the Emergency
Department stating he has had substernal chest pain and diaphoresis for
45 minutes. Which is the most important next step in management?
Answer: Aspirin to chew
2
, PREMIUM STUDY GUIDE A+
⩥ In the initial evaluation of a patient with chest pain, which is the most
important diagnostic test? Answer: ECG
⩥ A 54-year-old man is seen at a rural ED with 1 hour of nausea and
substernal chest pain radiating to his jaw. The ECG shows STEMI. PCI
is not performed at this hospital and only performed at a hospital 2 1/2
hours away. Which of the following statements is most accurate?
Answer: C Administer thrombolytics, then transfer to PCI centre.
⩥ Which of the following is NOT an accurate description of
hypothermia therapy for post-cardiac arrest patients? Answer: B
Therapeutic hypothermia has a proven effect in reducing the rate of
recurrent ventricular fibrillation
⩥ A 64-year-old man who was being treated in the hospital for acute
cholecystitis is found to be unresponsive. He was noted to be in VF and
underwent chest compressions for several minutes in addition to
cardioversion. The patient has return of spontaneous rhythm and vital
signs. Which of the following is an important treatment for this patient?
Answer: A Percutaneous coronary angiography
⩥ Which of the following statements regarding out-of-hospital sudden
cardiac arrest (SCA) is true? Answer: E Therapeutic hypothermia
improves neurological outcome after SCA in patients with depressed
mental status after resuscitation.
3
COMPREHENSIVE NURS 5463 MODULE
1 QUESTIONS AND ANSWERS GRADED
A+
⩥ An 84-year-old woman has diabetes and congestive heart failure that
is refractory to medical treatment. A right carotid bruit is detected on
physical examination. A duplex study suggests a 50% to 75% right
carotid stenosis. Which of the following is the most appropriate
treatment? Answer: A. Medical management
⩥ Which of the following statements regarding carotid artery stenting is
most accurate? Answer: A. CREST study suggests that older patients
have increased combined stroke and death rates in comparison to
younger patients
⩥ Which of the following does NOT need to be instituted for a patient
following carotid endarterectomy? Answer: A. Coumadin to target an
INR of 2 to 3
⩥ For which of the following patients is a left carotid endarterectomy
most indicated? Answer: A. A 70-year-old man with transient loss of
vision in the left eye that recovered after 20 minutes, and he has 75% left
carotid stenosis
1
,PREMIUM STUDY GUIDE A+
⩥ A 73-year-old woman is evaluated in the ED and transferred to the
ICU because of chest pain of 4 hours' duration. Her medical history
includes a 20-year history of hypertension and Type II diabetes mellitus.
Her medications include metformin, atenolol, and ASA. On physical
examination, her blood pressure is 130/84 mm Hg, and her heart rate is
87 beats/min and regular. Her jugular vein is distended to 5 cm while the
patient is upright. She has a faint left carotid bruit and bibasilar crackles
to one quarter up from the lung bases. A normal S1 and S2 is heard, with
a grade II/VI holosystolic murmur heard best at the apex to the axilla.
An electrocardiogram from six months ago was normal. The ECG was
seen during the chest pain. The initial serum troponin measurement is
elevated. She is now admitted to the ICU for an MI. She is free of chest
pain while on IV nitroglycerin, and her vital signs are stable. Which of
the fol Answer: A. Left bundle branch block with normal sinus rhythm
⩥ A 55-year-old man in the ICU has ACS, with 2 mm of ST elevation on
the leads II, III, and aVF. The troponins are positive. The blood pressure
is 130/70 mm Hg on a nitroglycerin drip at 5 μg/kg/min keeping the
patient chest pain free, but ECG changes persist and only 1 mm of ST
elevation is seen. There is no lower extremity edema. The patient was
given ASA upon entry into the ED. What is/are the next best steps in the
management of this patient? Answer: Anticoagulation, IV β-blocker,
ACE inhibitor, nitro-glycerine, and alert catheterization lab
⩥ A 65-year-old man with history of diabetes presents to the Emergency
Department stating he has had substernal chest pain and diaphoresis for
45 minutes. Which is the most important next step in management?
Answer: Aspirin to chew
2
, PREMIUM STUDY GUIDE A+
⩥ In the initial evaluation of a patient with chest pain, which is the most
important diagnostic test? Answer: ECG
⩥ A 54-year-old man is seen at a rural ED with 1 hour of nausea and
substernal chest pain radiating to his jaw. The ECG shows STEMI. PCI
is not performed at this hospital and only performed at a hospital 2 1/2
hours away. Which of the following statements is most accurate?
Answer: C Administer thrombolytics, then transfer to PCI centre.
⩥ Which of the following is NOT an accurate description of
hypothermia therapy for post-cardiac arrest patients? Answer: B
Therapeutic hypothermia has a proven effect in reducing the rate of
recurrent ventricular fibrillation
⩥ A 64-year-old man who was being treated in the hospital for acute
cholecystitis is found to be unresponsive. He was noted to be in VF and
underwent chest compressions for several minutes in addition to
cardioversion. The patient has return of spontaneous rhythm and vital
signs. Which of the following is an important treatment for this patient?
Answer: A Percutaneous coronary angiography
⩥ Which of the following statements regarding out-of-hospital sudden
cardiac arrest (SCA) is true? Answer: E Therapeutic hypothermia
improves neurological outcome after SCA in patients with depressed
mental status after resuscitation.
3
