M2 Dunphy (Chapters 34-37) Questions with
Correct Answers
A 16-year-old with a history of anxiety presents with her mother to your primary care office
complaining of intermittent palpitations. They occur randomly every couple of days and are not
made worse with exercise. The patient is healthy and takes only Prozac for anxiety and an oral
contraceptive. On physical exam, a midsystolic click is heard. It is louder when lying in a supine
position and heard best at the apex of the heart. What condition does the patient have?
Mitral valve prolapse
Harry, age 54, comes to your office with waxing and waning ischemic symptoms over a period
of days and weeks, an increase in angina while at rest, and transient ST changes on his
electrocardiogram. This presentation leads you to believe that he is experiencing:
Unstable angina
Rona, age 69, has hypertension (HTN), drinks 1 glass of white wine per day, and is slightly
overweight. She asks you if making changes in her life at this age will make any difference. You
tell her that lifestyle modifications for the control of HTN: May lower elevated blood
pressure, and reduce the number and dosage of antihypertensive medications needed to manage
the condition
,Jamie, age 49, who has a history of hyperlipidemia, has symptoms that lead you to suspect
unstable angina. Her electrocardiogram (ECG) shows some changes. Your next action would be
to: Hospitalize the client in a monitored setting with pharmacological control of ischemia,
arrhythmias, and thrombosis as appropriate
Greg, age 68, has just been given a diagnosis of congestive heart failure (CHF). Which of his
medications should be discontinued? Nifedipine (Procardia XL) for long-term
management of his chronic stable angina
Sheila, age 78, presents with a chief complaint of waking up during the night coughing. You
examine her and find an S3 heart sound, pulmonary crackles (rales) that do not clear with
coughing, and peripheral edema. What do you suspect? Heart failure
Harry has been on antihypertensive therapy with a single agent for 1 month, but his readings are
still too high. What do you tell him? "We must increase the dosage of that drug now or
add a second drug."
Sarah, who is postmenopausal, has controlled asthma and hypertension that is effectively treated
with medication, and she smokes cigarettes. She has a low-density lipoprotein (LDL) cholesterol
level of 170 mg/dL and a high-density lipoprotein (HDL) cholesterol level of 40 mg/dL. To
, reduce Sarah's risk of a coronary event, the treatment plan would focus on: Lowering her
LDL cholesterol level
Sexual activity is a major concern for clients with chronic ischemic heart disease. Which
statement is true? The sexual partner should be included in the education process
Headache, flushing, tachycardia, and peripheral edema are adverse effects associated with which
class of antihypertensive agents? Calcium channel blockers
While much teaching is needed for your client with congestive heart failure (CHF), the most
beneficial thing you can tell him that might prevent rehospitalization is which of the following?
"Weigh yourself every day; if your weight increases by three pounds in twenty-four hours
or five pounds in one week, call me."
Clients with Prinzmetal angina frequently have a history of Raynaud disease and which other
disorder? Migraine headaches
Mort is hypertensive, and you need to add a second antihypertensive agent to his medication
regimen. Which of the following factors influences your choice of using an alpha blocker as the
second antihypertensive medication? Mort has BPH
Correct Answers
A 16-year-old with a history of anxiety presents with her mother to your primary care office
complaining of intermittent palpitations. They occur randomly every couple of days and are not
made worse with exercise. The patient is healthy and takes only Prozac for anxiety and an oral
contraceptive. On physical exam, a midsystolic click is heard. It is louder when lying in a supine
position and heard best at the apex of the heart. What condition does the patient have?
Mitral valve prolapse
Harry, age 54, comes to your office with waxing and waning ischemic symptoms over a period
of days and weeks, an increase in angina while at rest, and transient ST changes on his
electrocardiogram. This presentation leads you to believe that he is experiencing:
Unstable angina
Rona, age 69, has hypertension (HTN), drinks 1 glass of white wine per day, and is slightly
overweight. She asks you if making changes in her life at this age will make any difference. You
tell her that lifestyle modifications for the control of HTN: May lower elevated blood
pressure, and reduce the number and dosage of antihypertensive medications needed to manage
the condition
,Jamie, age 49, who has a history of hyperlipidemia, has symptoms that lead you to suspect
unstable angina. Her electrocardiogram (ECG) shows some changes. Your next action would be
to: Hospitalize the client in a monitored setting with pharmacological control of ischemia,
arrhythmias, and thrombosis as appropriate
Greg, age 68, has just been given a diagnosis of congestive heart failure (CHF). Which of his
medications should be discontinued? Nifedipine (Procardia XL) for long-term
management of his chronic stable angina
Sheila, age 78, presents with a chief complaint of waking up during the night coughing. You
examine her and find an S3 heart sound, pulmonary crackles (rales) that do not clear with
coughing, and peripheral edema. What do you suspect? Heart failure
Harry has been on antihypertensive therapy with a single agent for 1 month, but his readings are
still too high. What do you tell him? "We must increase the dosage of that drug now or
add a second drug."
Sarah, who is postmenopausal, has controlled asthma and hypertension that is effectively treated
with medication, and she smokes cigarettes. She has a low-density lipoprotein (LDL) cholesterol
level of 170 mg/dL and a high-density lipoprotein (HDL) cholesterol level of 40 mg/dL. To
, reduce Sarah's risk of a coronary event, the treatment plan would focus on: Lowering her
LDL cholesterol level
Sexual activity is a major concern for clients with chronic ischemic heart disease. Which
statement is true? The sexual partner should be included in the education process
Headache, flushing, tachycardia, and peripheral edema are adverse effects associated with which
class of antihypertensive agents? Calcium channel blockers
While much teaching is needed for your client with congestive heart failure (CHF), the most
beneficial thing you can tell him that might prevent rehospitalization is which of the following?
"Weigh yourself every day; if your weight increases by three pounds in twenty-four hours
or five pounds in one week, call me."
Clients with Prinzmetal angina frequently have a history of Raynaud disease and which other
disorder? Migraine headaches
Mort is hypertensive, and you need to add a second antihypertensive agent to his medication
regimen. Which of the following factors influences your choice of using an alpha blocker as the
second antihypertensive medication? Mort has BPH
