NUR 6531 Combined midterm
and final review
A health care provider in a clinic finds a patient in a room, unresponsive and pale. Which sign should be used to
identify the need to initiate cardiopulmonary resuscitation (CPR)?
Evaluation of peripheral perfusion and level of consciousness
Obtaining a history of previous myocardial infarction
Determination of pulselessness or bradycardia
Assessment of gasping breaths or not breathing CORRECT ANSWER Assessment of gasping breaths or not breathing
An African-American patient who is being treated with a thiazide diuretic for chronic hypertension reports blurred
vision and shortness of breath. The provider notes a blood pressure of 185/115. What is the recommended action for
this patient?
Increase the dose of the thiazide medication
Add a beta blocker to the patient's regimen
Admit to the hospital for evaluation and treatment
Prescribe a calcium channel blocker CORRECT ANSWER Admit to the hospital for evaluation and treatment
A patient reports sustained, irregular heart palpitations. What is the most likely cause of these symptoms?
Atrial fibrillation
Anemia
Extrasystole
Paroxysmal attacks CORRECT ANSWER Atrial fibrillation
A patient has a cardiac murmur that peaks in midsystole and is best heard along the left sternal border. The provider
determines that the murmur decreases in intensity when the patient changes from standing to squatting and
increases in intensity with the Valsalva maneuver. Which cause will the provider suspect for this murmur?
Aortic stenosis
Tricuspid regurgitation
Hypertrophic cardiomyopathy
Mitral valve prolapse CORRECT ANSWER Hypertrophic cardiomyopathy
,A patient is brought to an emergency department with symptoms of acute ST-segment elevation MI (STEMI). The
nearest hospital that can perform percutaneous coronary intervention (PCI) is 3 hours away. What is the initial
treatment for this patient?
Give the patient an oral beta blocker
Transfer to the PCI-capable institution
Administer heparin
Initiate fibrinolytic treatment CORRECT ANSWER Initiate fibrinolytic treatment
Patients who meet the criteria for statin therapy to help prevent atherosclerotic cardiovascular disease are those
with a history of (Select all that apply.)
previous myocardial infarction.
a low-density lipoprotein (LDL) level >190 mg/dL.
diabetes and an LDL between 40 and 70 mg/dL.
a 10 year risk score of 8% with an LDL of 80 mg/dL.
a 10 year risk score of 5% and an LDL of 165 mg/dL. CORRECT ANSWER previous myocardial infarction.
a low-density lipoprotein (LDL) level >190 mg/dL.
a 10 year risk score of 8% with an LDL of 80 mg/dL.
A 75-year-old patient reports pain and a feeling of tiredness in both legs that only relieves after sitting for 30
minutes or more. What the does provider suspect as the cause for these symptoms?
Buerger's disease
Cauda equina syndrome
Diabetic neuropathy
Peripheral arterial disease CORRECT ANSWER Cauda equina syndrome
Which are causes of secondary hypertension? (Select all that apply.)
Oral contraceptives
Isometic excercises
NSAIDS
Sleep apnea
Increased salt intake CORRECT ANSWER Oral contraceptives
NSAIDS
Sleep apnea
A young female patient has known mitral valve prolapse. During a routine health maintenance exam, the provider
notes an apical systolic murmur and a midsystolic click on auscultation. The patient denies chest pain, syncope, or
palpitations. What will the provider do?
Reassure the patient that these findings are expected
Continue to monitor the patient every 3 years
Admit the patient to the hospital for evaluation and treatment
Consult with cardiology to determine appropriate diagnostic tests CORRECT ANSWER Consult with cardiology to
determine appropriate diagnostic tests
,A patient reports abdominal and back pain with anorexia and nausea. During an exam, the provider notes a pulsatile
abdominal mass. What is the initial action?
Scheduling an MRI to evaluate for aortic disease
Immediate referral to a thoracic surgeon
US of the mass to determine size
Ordering CT angiography CORRECT ANSWER US of the mass to determine size
A patient is brought to an emergency department with symptoms of acute ST-segment elevations MI (STEMI). The
nearest hospital that can perform percutaneous coronary intervention (PCI) is 3 hours away. What is the initial
treatment for this patient?
Give the patient an oral beta blocker
Initiate fibrinolytic treatment
Administer heparin
Transfer to the PCI-capable institution CORRECT ANSWER Initiate fibrinolytic treatment
A 55-year-old patient has a blood pressure of 138/85 on three occasions. The patient denies headaches, palpitations,
snoring, muscle weakness, and nocturia and does not take any medications. What will the provider do next to
evaluate this patient?
Continue to monitor blood pressure at each health maintenance visit
Assess serum cortisol levels
Order urinalysis, CBC, BUN and creatinine
Refer to specialist for sleep study CORRECT ANSWER Order urinalysis, CBC, BUN and creatinine
A patient is diagnosed with PAD and elects to not have angioplasty after an angiogram reveals partial obstruction in
lower extremity arteries. What will the provider recommend to help with relief of symptoms in this patient?
Statin therapy with clopidogrel
Walking to the point of pain each day
Daily aspirin therapy to prevent clotting
Walking slowly for 15 to 20 minutes twice daily CORRECT ANSWER Walking to the point of pain each day
An adult patient reports frequent episodes of syncope and lightheadedness. The provider notes a heart rate of 70
beats per minute. What will the provider do next?
Order an electrocardiogram and exercise stress test
Monitor the patient's heart rate while the patient is bearing down
Evaluate the patient's orthostatic vital signs
Reassure the patient that the symptoms are non-cardiac in origin CORRECT ANSWER Evaluate the patient's
orthostatic vital signs
The AHA recommends early CPR and AED use for adult victims of cardiac arrest outside of a hospital setting because
most victims have which arrhythmia?
Atrial flutter
Ventricular fibrillation
Atrial fibrillation
Ventricular tachycardia CORRECT ANSWER Ventricular fibrillation
, A child with a history of asthma is brought to the clinic with a rapid heart rate. A cardiac monitor shows a heart rate
of 225 beats per minute. The provider notifies transport to take the child to the child emergency department. What
initial intervention may be attempted in the clinic?
Administration of intravenous adenosine
Using a vagal maneuver or carotid massage
Providing a loading dose of digoxin
Giving a beta blocker CORRECT ANSWER Using a vagal maneuver or carotid massage
Current American Heart Association (AHA) recommendations include: (Select all that apply.)
Using a ratio of 2 rescue breaths to 30 compressions
A compression depth of 1.5 inches or more on an adult
A rate of 100 compressions per minute at a minimum
Untrained rescuers giving compressions without breaths
Rescue breaths given during 2 seconds to allow full chest rise CORRECT ANSWER Using a ratio of 2 rescue breaths to
30 compressions
A rate of 100 compressions per minute at a minimum
Untrained rescuers giving compressions without breaths
A patient reports recurrent chest pain that occurs regardless of activity and is not relieved by rest. The provider
administers a nitroglycerin tablet which does not relieve the discomfort. What is the next action?
Prescribe a calcium channel blocker medication
Start aspirin therapy and refer the patient to a cardiologist
Give the patient a beta blocker medication
Administer a second nitroglycerin tablet CORRECT ANSWER Give the patient a beta blocker medication
A 70-year-old male patient has an aortic aneurysm measuring 5.0 cm. The patient has poorly-controlled
hypertension, and decompensated heart failure. What is the recommendation for treatment for this patient?
No intervention is necessary for this patient
Immediate open surgical repair of the aneurysm
Endovascular stent grafting of the aneurysm
Serial ultrasonographic surveillance of the aneurysm CORRECT ANSWER Serial ultrasonographic surveillance of the
aneurysm
Which laboratory values representing parathyroid hormone (PTH) and serum calcium are consistent with a diagnosis
of primary hyperparathyroidism?
Appropriately increased PTH and low or normal serum calcium
Inappropriate secretion of PTH along with hypercalcemia
Appropriately high PTH along with hypocalcemia
Prolonged inappropriate secretion of PTH with subsequent hypercalcemia CORRECT ANSWER Inappropriate secretion
of PTH along with hypercalcemia
A patient who is obese has recurrent urinary tract infections and reports feeling tired most of the time. What initial
diagnostic test will the provider order in the clinic at this visit?
and final review
A health care provider in a clinic finds a patient in a room, unresponsive and pale. Which sign should be used to
identify the need to initiate cardiopulmonary resuscitation (CPR)?
Evaluation of peripheral perfusion and level of consciousness
Obtaining a history of previous myocardial infarction
Determination of pulselessness or bradycardia
Assessment of gasping breaths or not breathing CORRECT ANSWER Assessment of gasping breaths or not breathing
An African-American patient who is being treated with a thiazide diuretic for chronic hypertension reports blurred
vision and shortness of breath. The provider notes a blood pressure of 185/115. What is the recommended action for
this patient?
Increase the dose of the thiazide medication
Add a beta blocker to the patient's regimen
Admit to the hospital for evaluation and treatment
Prescribe a calcium channel blocker CORRECT ANSWER Admit to the hospital for evaluation and treatment
A patient reports sustained, irregular heart palpitations. What is the most likely cause of these symptoms?
Atrial fibrillation
Anemia
Extrasystole
Paroxysmal attacks CORRECT ANSWER Atrial fibrillation
A patient has a cardiac murmur that peaks in midsystole and is best heard along the left sternal border. The provider
determines that the murmur decreases in intensity when the patient changes from standing to squatting and
increases in intensity with the Valsalva maneuver. Which cause will the provider suspect for this murmur?
Aortic stenosis
Tricuspid regurgitation
Hypertrophic cardiomyopathy
Mitral valve prolapse CORRECT ANSWER Hypertrophic cardiomyopathy
,A patient is brought to an emergency department with symptoms of acute ST-segment elevation MI (STEMI). The
nearest hospital that can perform percutaneous coronary intervention (PCI) is 3 hours away. What is the initial
treatment for this patient?
Give the patient an oral beta blocker
Transfer to the PCI-capable institution
Administer heparin
Initiate fibrinolytic treatment CORRECT ANSWER Initiate fibrinolytic treatment
Patients who meet the criteria for statin therapy to help prevent atherosclerotic cardiovascular disease are those
with a history of (Select all that apply.)
previous myocardial infarction.
a low-density lipoprotein (LDL) level >190 mg/dL.
diabetes and an LDL between 40 and 70 mg/dL.
a 10 year risk score of 8% with an LDL of 80 mg/dL.
a 10 year risk score of 5% and an LDL of 165 mg/dL. CORRECT ANSWER previous myocardial infarction.
a low-density lipoprotein (LDL) level >190 mg/dL.
a 10 year risk score of 8% with an LDL of 80 mg/dL.
A 75-year-old patient reports pain and a feeling of tiredness in both legs that only relieves after sitting for 30
minutes or more. What the does provider suspect as the cause for these symptoms?
Buerger's disease
Cauda equina syndrome
Diabetic neuropathy
Peripheral arterial disease CORRECT ANSWER Cauda equina syndrome
Which are causes of secondary hypertension? (Select all that apply.)
Oral contraceptives
Isometic excercises
NSAIDS
Sleep apnea
Increased salt intake CORRECT ANSWER Oral contraceptives
NSAIDS
Sleep apnea
A young female patient has known mitral valve prolapse. During a routine health maintenance exam, the provider
notes an apical systolic murmur and a midsystolic click on auscultation. The patient denies chest pain, syncope, or
palpitations. What will the provider do?
Reassure the patient that these findings are expected
Continue to monitor the patient every 3 years
Admit the patient to the hospital for evaluation and treatment
Consult with cardiology to determine appropriate diagnostic tests CORRECT ANSWER Consult with cardiology to
determine appropriate diagnostic tests
,A patient reports abdominal and back pain with anorexia and nausea. During an exam, the provider notes a pulsatile
abdominal mass. What is the initial action?
Scheduling an MRI to evaluate for aortic disease
Immediate referral to a thoracic surgeon
US of the mass to determine size
Ordering CT angiography CORRECT ANSWER US of the mass to determine size
A patient is brought to an emergency department with symptoms of acute ST-segment elevations MI (STEMI). The
nearest hospital that can perform percutaneous coronary intervention (PCI) is 3 hours away. What is the initial
treatment for this patient?
Give the patient an oral beta blocker
Initiate fibrinolytic treatment
Administer heparin
Transfer to the PCI-capable institution CORRECT ANSWER Initiate fibrinolytic treatment
A 55-year-old patient has a blood pressure of 138/85 on three occasions. The patient denies headaches, palpitations,
snoring, muscle weakness, and nocturia and does not take any medications. What will the provider do next to
evaluate this patient?
Continue to monitor blood pressure at each health maintenance visit
Assess serum cortisol levels
Order urinalysis, CBC, BUN and creatinine
Refer to specialist for sleep study CORRECT ANSWER Order urinalysis, CBC, BUN and creatinine
A patient is diagnosed with PAD and elects to not have angioplasty after an angiogram reveals partial obstruction in
lower extremity arteries. What will the provider recommend to help with relief of symptoms in this patient?
Statin therapy with clopidogrel
Walking to the point of pain each day
Daily aspirin therapy to prevent clotting
Walking slowly for 15 to 20 minutes twice daily CORRECT ANSWER Walking to the point of pain each day
An adult patient reports frequent episodes of syncope and lightheadedness. The provider notes a heart rate of 70
beats per minute. What will the provider do next?
Order an electrocardiogram and exercise stress test
Monitor the patient's heart rate while the patient is bearing down
Evaluate the patient's orthostatic vital signs
Reassure the patient that the symptoms are non-cardiac in origin CORRECT ANSWER Evaluate the patient's
orthostatic vital signs
The AHA recommends early CPR and AED use for adult victims of cardiac arrest outside of a hospital setting because
most victims have which arrhythmia?
Atrial flutter
Ventricular fibrillation
Atrial fibrillation
Ventricular tachycardia CORRECT ANSWER Ventricular fibrillation
, A child with a history of asthma is brought to the clinic with a rapid heart rate. A cardiac monitor shows a heart rate
of 225 beats per minute. The provider notifies transport to take the child to the child emergency department. What
initial intervention may be attempted in the clinic?
Administration of intravenous adenosine
Using a vagal maneuver or carotid massage
Providing a loading dose of digoxin
Giving a beta blocker CORRECT ANSWER Using a vagal maneuver or carotid massage
Current American Heart Association (AHA) recommendations include: (Select all that apply.)
Using a ratio of 2 rescue breaths to 30 compressions
A compression depth of 1.5 inches or more on an adult
A rate of 100 compressions per minute at a minimum
Untrained rescuers giving compressions without breaths
Rescue breaths given during 2 seconds to allow full chest rise CORRECT ANSWER Using a ratio of 2 rescue breaths to
30 compressions
A rate of 100 compressions per minute at a minimum
Untrained rescuers giving compressions without breaths
A patient reports recurrent chest pain that occurs regardless of activity and is not relieved by rest. The provider
administers a nitroglycerin tablet which does not relieve the discomfort. What is the next action?
Prescribe a calcium channel blocker medication
Start aspirin therapy and refer the patient to a cardiologist
Give the patient a beta blocker medication
Administer a second nitroglycerin tablet CORRECT ANSWER Give the patient a beta blocker medication
A 70-year-old male patient has an aortic aneurysm measuring 5.0 cm. The patient has poorly-controlled
hypertension, and decompensated heart failure. What is the recommendation for treatment for this patient?
No intervention is necessary for this patient
Immediate open surgical repair of the aneurysm
Endovascular stent grafting of the aneurysm
Serial ultrasonographic surveillance of the aneurysm CORRECT ANSWER Serial ultrasonographic surveillance of the
aneurysm
Which laboratory values representing parathyroid hormone (PTH) and serum calcium are consistent with a diagnosis
of primary hyperparathyroidism?
Appropriately increased PTH and low or normal serum calcium
Inappropriate secretion of PTH along with hypercalcemia
Appropriately high PTH along with hypocalcemia
Prolonged inappropriate secretion of PTH with subsequent hypercalcemia CORRECT ANSWER Inappropriate secretion
of PTH along with hypercalcemia
A patient who is obese has recurrent urinary tract infections and reports feeling tired most of the time. What initial
diagnostic test will the provider order in the clinic at this visit?
