NR667 Practice Quiz - Cardiac, Endocrine, and Dermatology Assessments 100% Solved
1. Your patient presents with a blowing systolic murmur rated 3/6 that is heard best over
the left chest at the 5th intercostal space, left midclavicular space, radiating to the left
axilla. This likely represents which cardiac finding?
• Mitral Regurgitation
2. While working in a fast-track clinic as a NP in an emergency department, your patient
complains of shortness of breath with activity and near syncope with changing
position from seated to standing on multiple recent episodes. You examine them and
notice a harsh systolic murmur heard best at the right sternal border at the 2nd
intercostal space rated 3/6, which has a bruit radiating to the right carotid artery. Of the
following examinations, which is most appropriate or you to order next to evaluate this
murmur?
• Transthoracic echocardiogram
3. The most important diagnostic factor in evaluating angina pectoris is the patient’s:
• History
4. A 65-year-old woman presents for a follow-up examination. She is a smoker, and her
hypertension is now adequately controlled with medication. Her mother died at age 40
from a heart attack. The fasting lipid profile shows cholesterol = 240 mg/dL, HDL = 30,
and LDL = 200. In addition to starting therapeutic lifestyle changes, the nurse
practitioner should start the patient on:
• a statin drug.
5. As a f/u from a hospitalization an adult patent presents with ankle edema. Which of
the following medications is the most likely cause of the edema?
• Norvasc: The most common side effects of calcium channel blockers
include constipation and lower extremity edema.
6. An older adult with diabetes mellitus presents with leg cramps. She states that the
cramps as worst when walking to the supermarket. If she stops to rest, the pain subsides.
The nurse practitioner knows that this patient needs a workup for:
• Intermittent claudication
7. An otherwise healthy patient reports episodes of palpitations lasting less than 5 minutes
and occurring 3-5 times daily. The patient describes a substernal flip-flop sensation with
a sudden rapid heart rate, ending with a forceful beat. Holter monitoring would most
likely document:
• Paroxysmal supraventricular tachycardia
8. A patient presenting with symptoms of hypotension, narrowed pulse pressures,
muffled heart tones, and jugular venous distention is most likely experiencing which
of the following life-threatening conditions?
• Pericardial tamponade
9. An adult patient must maintain an International Normalized Ratio (INR) between 2.0 and
3.0. The patient goes to a clinic for INR determination, and the result is 1.4. Which of the
following would be likely to decrease the effects of warfarin (Coumadin)?
• Broccoli
10. An example of secondary prevention for a diagnosis of coronary artery disease
includes which of the following?
• Coronary artery bypass grafting
NR667 Practice Quiz - Cardiac, Endocrine, and Dermatology Assessments 100% Solved
, NR667 Practice Quiz - Cardiac, Endocrine, and Dermatology Assessments 100% Solved
11. A 50-year-old man presents with fatigue, muscle weakness, and hyperpigmentation of
the skin. Laboratory tests show low sodium, high potassium, and low cortisol levels.
What is the most likely diagnosis?
• Addison's disease
12. Patients on levothyroxine should be monitored for signs of which one of the following:
• Angina pectoris and dysrhythmias
13. A patient has a 2 cm pituitary adenoma on MRI. Deficiency of one of the pituitary
hormones can cause immediate hemodynamic instability and has a risk of death. Which
is the most critical hormone deficiency to rule out?
• ACTH
14. After confirming your patient is hypercortisolemic, a critical part of the diagnostic
work up is to do which next?
• Order ACTH level
15. A 33-year-old woman presents with irregular menstrual cycles, hirsutism, and obesity.
Laboratory tests reveal elevated serum testosterone and LH ratio > 2:1. What is the
most appropriate initial treatment?
• Oral contraceptives
16. A 40-year-old female presents with abnormal thyroid labs. Her labs show: TSH 0.25
(0.4- 5.69), Free T4 1.5 (0.5-1.1), TSI antibody positive. You counsel her that:
• She likely has autoimmune hyperthyroidism, and a thyroid uptake scan and
US may be helpful
17. A 27-year-old woman presents with frequent headaches, galactorrhea, and
amenorrhea. MRI of the brain reveals a pituitary adenoma. What is the most
appropriate initial treatment?
• Dopamine agonists
18. An adult patient presents with tachycardia and nervousness. The patient is currently
taking levothyroxine (Synthroid), 75 mcg daily. The nurse practitioner orders a
thyroid- stimulating hormone (TSH) and anticipates having to:
• lower the dose to 50 mcg daily.
19. An adult female recently returned for a recheck appointment. The only remarkable
laboratory result is for thyroid-stimulating hormone (TSH), at 0.3 microunits/mL
(normal
= 0.4–6 microunits/mL). The patient reports that her neck hurts; examination reveals
thyroid tenderness. Which of the following laboratory tests should the nurse practitioner
order now?
• Triiodothyronine (T3) and free thyroxine (FT4)
20. All the following are factors associated with the development of type II
diabetes EXCEPT:
• peripheral vascular disease
21. A 90-year-old female is brought to the clinic by her neighbor. She states that everything
is fine, but the nurse practitioner notes that she has poor hygiene and bruises on her trunk.
The neighbor is concerned that the patient often has no money to buy food, despite
income from social security and a coal miner’s pension. The nurse practitioner suspects
abuse. Which of the following is the nurse practitioner obligated to do next?
• Report the case to the proper authorities.
22. A frail elderly patient presents with constipation. Which of the following
normal physiologic changes seen with aging is the most likely cause?
NR667 Practice Quiz - Cardiac, Endocrine, and Dermatology Assessments 100% Solved
1. Your patient presents with a blowing systolic murmur rated 3/6 that is heard best over
the left chest at the 5th intercostal space, left midclavicular space, radiating to the left
axilla. This likely represents which cardiac finding?
• Mitral Regurgitation
2. While working in a fast-track clinic as a NP in an emergency department, your patient
complains of shortness of breath with activity and near syncope with changing
position from seated to standing on multiple recent episodes. You examine them and
notice a harsh systolic murmur heard best at the right sternal border at the 2nd
intercostal space rated 3/6, which has a bruit radiating to the right carotid artery. Of the
following examinations, which is most appropriate or you to order next to evaluate this
murmur?
• Transthoracic echocardiogram
3. The most important diagnostic factor in evaluating angina pectoris is the patient’s:
• History
4. A 65-year-old woman presents for a follow-up examination. She is a smoker, and her
hypertension is now adequately controlled with medication. Her mother died at age 40
from a heart attack. The fasting lipid profile shows cholesterol = 240 mg/dL, HDL = 30,
and LDL = 200. In addition to starting therapeutic lifestyle changes, the nurse
practitioner should start the patient on:
• a statin drug.
5. As a f/u from a hospitalization an adult patent presents with ankle edema. Which of
the following medications is the most likely cause of the edema?
• Norvasc: The most common side effects of calcium channel blockers
include constipation and lower extremity edema.
6. An older adult with diabetes mellitus presents with leg cramps. She states that the
cramps as worst when walking to the supermarket. If she stops to rest, the pain subsides.
The nurse practitioner knows that this patient needs a workup for:
• Intermittent claudication
7. An otherwise healthy patient reports episodes of palpitations lasting less than 5 minutes
and occurring 3-5 times daily. The patient describes a substernal flip-flop sensation with
a sudden rapid heart rate, ending with a forceful beat. Holter monitoring would most
likely document:
• Paroxysmal supraventricular tachycardia
8. A patient presenting with symptoms of hypotension, narrowed pulse pressures,
muffled heart tones, and jugular venous distention is most likely experiencing which
of the following life-threatening conditions?
• Pericardial tamponade
9. An adult patient must maintain an International Normalized Ratio (INR) between 2.0 and
3.0. The patient goes to a clinic for INR determination, and the result is 1.4. Which of the
following would be likely to decrease the effects of warfarin (Coumadin)?
• Broccoli
10. An example of secondary prevention for a diagnosis of coronary artery disease
includes which of the following?
• Coronary artery bypass grafting
NR667 Practice Quiz - Cardiac, Endocrine, and Dermatology Assessments 100% Solved
, NR667 Practice Quiz - Cardiac, Endocrine, and Dermatology Assessments 100% Solved
11. A 50-year-old man presents with fatigue, muscle weakness, and hyperpigmentation of
the skin. Laboratory tests show low sodium, high potassium, and low cortisol levels.
What is the most likely diagnosis?
• Addison's disease
12. Patients on levothyroxine should be monitored for signs of which one of the following:
• Angina pectoris and dysrhythmias
13. A patient has a 2 cm pituitary adenoma on MRI. Deficiency of one of the pituitary
hormones can cause immediate hemodynamic instability and has a risk of death. Which
is the most critical hormone deficiency to rule out?
• ACTH
14. After confirming your patient is hypercortisolemic, a critical part of the diagnostic
work up is to do which next?
• Order ACTH level
15. A 33-year-old woman presents with irregular menstrual cycles, hirsutism, and obesity.
Laboratory tests reveal elevated serum testosterone and LH ratio > 2:1. What is the
most appropriate initial treatment?
• Oral contraceptives
16. A 40-year-old female presents with abnormal thyroid labs. Her labs show: TSH 0.25
(0.4- 5.69), Free T4 1.5 (0.5-1.1), TSI antibody positive. You counsel her that:
• She likely has autoimmune hyperthyroidism, and a thyroid uptake scan and
US may be helpful
17. A 27-year-old woman presents with frequent headaches, galactorrhea, and
amenorrhea. MRI of the brain reveals a pituitary adenoma. What is the most
appropriate initial treatment?
• Dopamine agonists
18. An adult patient presents with tachycardia and nervousness. The patient is currently
taking levothyroxine (Synthroid), 75 mcg daily. The nurse practitioner orders a
thyroid- stimulating hormone (TSH) and anticipates having to:
• lower the dose to 50 mcg daily.
19. An adult female recently returned for a recheck appointment. The only remarkable
laboratory result is for thyroid-stimulating hormone (TSH), at 0.3 microunits/mL
(normal
= 0.4–6 microunits/mL). The patient reports that her neck hurts; examination reveals
thyroid tenderness. Which of the following laboratory tests should the nurse practitioner
order now?
• Triiodothyronine (T3) and free thyroxine (FT4)
20. All the following are factors associated with the development of type II
diabetes EXCEPT:
• peripheral vascular disease
21. A 90-year-old female is brought to the clinic by her neighbor. She states that everything
is fine, but the nurse practitioner notes that she has poor hygiene and bruises on her trunk.
The neighbor is concerned that the patient often has no money to buy food, despite
income from social security and a coal miner’s pension. The nurse practitioner suspects
abuse. Which of the following is the nurse practitioner obligated to do next?
• Report the case to the proper authorities.
22. A frail elderly patient presents with constipation. Which of the following
normal physiologic changes seen with aging is the most likely cause?
NR667 Practice Quiz - Cardiac, Endocrine, and Dermatology Assessments 100% Solved
