NR 508 MIDTERM EXAM 2026/2027 | 150 HIGH-
YIELD QUESTIONS & VERIFIED ANSWERS |
LATEST TEST PREP | RECENT & MOST
TESTED TOPICS | A+ PREPARATION
An elderly person has been prescribed lactulose for treatment of chronic constipation.
Monitoring with long-term treatment would include:
1. Electrolytes, including potassium and chloride
2. Bone mineral density for osteoporosis
3. Magnesium level
4. Liver function - correct answer-1. Electrolytes, including potassium and chloride
Angina is produced by an imbalance between myocardial oxygen supply (MOS) and demand
(MOD) in the myocardium. Which of the following drugs help to correct this imbalance by
increasing MOS?
1. Calcium channel blockers
2. Beta blockers
3. Angiotensin-converting-enzyme (ACE) inhibitors
4. Aspirin - correct answer-3. Angiotensin-converting-enzyme (ACE) inhibitors
Not all chest pain is caused by myocardial ischemia. Noncardiac causes of chest pain include:
1. Pulmonary embolism
2. Pneumonia
3. Gastroesophageal reflux
4. All of the above - correct answer-4. All of the above
,Angiotensin-converting-enzyme (ACE) inhibitors are a central part of the treatment of heart failure
because they have more than one action to address the pathological changes in this disorder. Which
of the following pathological changes in heart failure is NOT addressed by ACE inhibitors?
1. Changes in the structure of the left ventricle so that it dilates, hypertrophies, and uses energy less
efficiently.
2. Reduced formation of cross-bridges so that contractile force decreases.
3. Activation of the sympathetic nervous system that increases heart rate and preload.
4. Decreased renal blood flow that decreases oxygen supply to the kidneys. - correct answer-3.
Activation of the sympathetic nervous system that increases heart rate and preload.
One of the three types of heart failure involves systolic dysfunction. Potential causes of this most
common form of heart failure include:
1. Myocardial ischemia and injury secondary to myocardial infarction
2. Inadequate relaxation and loss of muscle fiber secondary to valvular dysfunction
3. Increased demands of the heart beyond its ability to adapt secondary to anemia
4. Slower filling rate and elevated systolic pressures secondary to uncontrolled hypertension -
correct answer-1. Myocardial ischemia and injury secondary to myocardial infarction
The American Heart Association and the American College of Cardiology have devised a classification
system for heart failure that can be used to direct treatment. Patients with symptoms and
underlying disease are classified as stage:
1. A
2. B
3. C
4. D - correct answer-3. C
Diagnosis of heart failure cannot be made by symptoms alone because many disorders share the
same symptoms. The most specific and sensitive diagnostic test for heart failure is:
1. Chest x-rays that show cephalization and measure heart size
,2. Two-dimensional echocardiograms that identify structural anomalies and cardiac dysfunction
3. Complete blood count, blood urea nitrogen, and serum electrolytes that facilitate staging for
endorgan damage
4. Measurement of brain natriuretic peptide to distinguish between systolic and diastolic
dysfunction - correct answer-2. Two-dimensional echocardiograms that identify structural
anomalies and cardiac dysfunction
Treatments for heart failure, including drug therapy, are based on the stages developed by the
ACC/AHA. Stage A patients are treated with:
1. Drugs for hypertension and hyperlipidemia, if they exist
2. Lifestyle management including diet, exercise, and smoking cessation only
3. Angiotensin-converting enzyme (ACE) inhibitors to directly affect the heart failure only
4. No drugs are used in this early stage - correct answer-1. Drugs for hypertension and
hyperlipidemia, if they exist
Class I recommendations for stage A heart failure include:
1. Aerobic exercise within tolerance levels to prevent the development of heart failure
2. Reduction of sodium intake to less than 2,000 mg/day to prevent fluid retention
3. Beta blockers for all patients regardless of cardiac history
4. Treatment of thyroid disorders, especially if they are associated with tachyarrhythmias - correct
answer-4. Treatment of thyroid disorders, especially if they are associated with tachyarrhythmias
Stage B patients should have beta blockers added to their heart failure treatment regimen when:
1. They have an ejection fraction less than 40%
2. They have had a recent MI
3. Both 1 and 2
4. Neither 1 nor 2 - correct answer-3. Both 1 and 2
Increased life expectancy for patients with heart failure has been associated with the use of:
, 1. ACE inhibitors, especially when started early in the disease process
2. All beta blockers regardless of selectivity
3. Thiazide and loop diuretics
4. Cardiac glycosides - correct answer-1. ACE inhibitors, especially when started early in the disease
process
Stage C patients usually require a combination of three to four drugs to manage their heart failure. In
addition to ACE inhibitors and beta blockers, diuretics may be added. Which of the following
statements about diuretics is NOT true?
1. Diuretics reduce preload associated with fluid retention.
2. Diuretics can be used earlier than stage C when the goal is control of hypertension.
3. Diuretics may produce problems with electrolyte imbalances and abnormal glucose and lipid
metabolism.
4. Diuretics from the potassium-sparing class should be used when using an angiotensin receptor
blocker (ARB). - correct answer-4. Diuretics from the potassium-sparing class should be used when
using an angiotensin receptor blocker (ARB).
What assessment that can be done at home is the most reliable for making decisions to
change HF medications?
1. Weight
2. BP
3. Heart rate
4. Serum Glucose - correct answer-1. Weight
Evidence is strong that the timing of HF interventions are best initiated when:
1. The person enters stage C
2. The person has functional disabilities
3. At the earliest indication
4. When stage IV is determined - correct answer-3. At the earliest indication
YIELD QUESTIONS & VERIFIED ANSWERS |
LATEST TEST PREP | RECENT & MOST
TESTED TOPICS | A+ PREPARATION
An elderly person has been prescribed lactulose for treatment of chronic constipation.
Monitoring with long-term treatment would include:
1. Electrolytes, including potassium and chloride
2. Bone mineral density for osteoporosis
3. Magnesium level
4. Liver function - correct answer-1. Electrolytes, including potassium and chloride
Angina is produced by an imbalance between myocardial oxygen supply (MOS) and demand
(MOD) in the myocardium. Which of the following drugs help to correct this imbalance by
increasing MOS?
1. Calcium channel blockers
2. Beta blockers
3. Angiotensin-converting-enzyme (ACE) inhibitors
4. Aspirin - correct answer-3. Angiotensin-converting-enzyme (ACE) inhibitors
Not all chest pain is caused by myocardial ischemia. Noncardiac causes of chest pain include:
1. Pulmonary embolism
2. Pneumonia
3. Gastroesophageal reflux
4. All of the above - correct answer-4. All of the above
,Angiotensin-converting-enzyme (ACE) inhibitors are a central part of the treatment of heart failure
because they have more than one action to address the pathological changes in this disorder. Which
of the following pathological changes in heart failure is NOT addressed by ACE inhibitors?
1. Changes in the structure of the left ventricle so that it dilates, hypertrophies, and uses energy less
efficiently.
2. Reduced formation of cross-bridges so that contractile force decreases.
3. Activation of the sympathetic nervous system that increases heart rate and preload.
4. Decreased renal blood flow that decreases oxygen supply to the kidneys. - correct answer-3.
Activation of the sympathetic nervous system that increases heart rate and preload.
One of the three types of heart failure involves systolic dysfunction. Potential causes of this most
common form of heart failure include:
1. Myocardial ischemia and injury secondary to myocardial infarction
2. Inadequate relaxation and loss of muscle fiber secondary to valvular dysfunction
3. Increased demands of the heart beyond its ability to adapt secondary to anemia
4. Slower filling rate and elevated systolic pressures secondary to uncontrolled hypertension -
correct answer-1. Myocardial ischemia and injury secondary to myocardial infarction
The American Heart Association and the American College of Cardiology have devised a classification
system for heart failure that can be used to direct treatment. Patients with symptoms and
underlying disease are classified as stage:
1. A
2. B
3. C
4. D - correct answer-3. C
Diagnosis of heart failure cannot be made by symptoms alone because many disorders share the
same symptoms. The most specific and sensitive diagnostic test for heart failure is:
1. Chest x-rays that show cephalization and measure heart size
,2. Two-dimensional echocardiograms that identify structural anomalies and cardiac dysfunction
3. Complete blood count, blood urea nitrogen, and serum electrolytes that facilitate staging for
endorgan damage
4. Measurement of brain natriuretic peptide to distinguish between systolic and diastolic
dysfunction - correct answer-2. Two-dimensional echocardiograms that identify structural
anomalies and cardiac dysfunction
Treatments for heart failure, including drug therapy, are based on the stages developed by the
ACC/AHA. Stage A patients are treated with:
1. Drugs for hypertension and hyperlipidemia, if they exist
2. Lifestyle management including diet, exercise, and smoking cessation only
3. Angiotensin-converting enzyme (ACE) inhibitors to directly affect the heart failure only
4. No drugs are used in this early stage - correct answer-1. Drugs for hypertension and
hyperlipidemia, if they exist
Class I recommendations for stage A heart failure include:
1. Aerobic exercise within tolerance levels to prevent the development of heart failure
2. Reduction of sodium intake to less than 2,000 mg/day to prevent fluid retention
3. Beta blockers for all patients regardless of cardiac history
4. Treatment of thyroid disorders, especially if they are associated with tachyarrhythmias - correct
answer-4. Treatment of thyroid disorders, especially if they are associated with tachyarrhythmias
Stage B patients should have beta blockers added to their heart failure treatment regimen when:
1. They have an ejection fraction less than 40%
2. They have had a recent MI
3. Both 1 and 2
4. Neither 1 nor 2 - correct answer-3. Both 1 and 2
Increased life expectancy for patients with heart failure has been associated with the use of:
, 1. ACE inhibitors, especially when started early in the disease process
2. All beta blockers regardless of selectivity
3. Thiazide and loop diuretics
4. Cardiac glycosides - correct answer-1. ACE inhibitors, especially when started early in the disease
process
Stage C patients usually require a combination of three to four drugs to manage their heart failure. In
addition to ACE inhibitors and beta blockers, diuretics may be added. Which of the following
statements about diuretics is NOT true?
1. Diuretics reduce preload associated with fluid retention.
2. Diuretics can be used earlier than stage C when the goal is control of hypertension.
3. Diuretics may produce problems with electrolyte imbalances and abnormal glucose and lipid
metabolism.
4. Diuretics from the potassium-sparing class should be used when using an angiotensin receptor
blocker (ARB). - correct answer-4. Diuretics from the potassium-sparing class should be used when
using an angiotensin receptor blocker (ARB).
What assessment that can be done at home is the most reliable for making decisions to
change HF medications?
1. Weight
2. BP
3. Heart rate
4. Serum Glucose - correct answer-1. Weight
Evidence is strong that the timing of HF interventions are best initiated when:
1. The person enters stage C
2. The person has functional disabilities
3. At the earliest indication
4. When stage IV is determined - correct answer-3. At the earliest indication
