NSG 554 Primary Care
NSG 554 Primary Care Newest 2025/2026
With Complete Questions And Correct
Answers |Already Graded A+||Brand New
Version!||Wilkes
A 59-year-old diabetic woman had suffered an acute AWMI. Five days later she gets into an
argument with her husband and complains of chest pain. Her initial EKG shows no ischemic
changes, but serum cardiac troponin levels are drawn and return mildly elevated at this time.
Which of the following is the best next therapy?
A. Use thrombolytic therapy
B. Treat with PTCA
C. Perform CABG surgery
D. Perform serial ECGS and obtain CK-MB
- Correct Answer :Answer D
Perform serial ECGs and obtain CK-MB
In which of the following patients would PTCA most likely be used?
A. A patient with left main stem disease
B. A patient with triple-vessel disease
C. A patient with a ventricular aneurysm
D. A patient with one vessel disease
E. Any of the above are good indications for PCTA
- Correct Answer :Answer D
A patient with one vessel disease
Which of the following is an absolute contraindication to thrombolytic therapy in a patient with
an acute STEMI?
A. history of severe HTN presently controlled
B. current use of anticoagulation therapy
C. previous hemorrhagic stroke
D. active PUD - Correct
A+ TEST BANK 1
, NSG 554 Primary Care
Answer :Answer C
previous hemorrhagic stroke
A 72-year-old man collapses while playing golf. He has a 5-year history of angina and type 2 DM .
Paramedics arrive in 10 minutes. Examination shows no respirations or BP . CPR is attempted for
10 minutes without success. Which of the following is the most likely cause of death in this
patient?
A. Ventricular fibrillation
B. Rupture of the papillary muscle
C. Necrosis of the myocardium
D. Embolus to the right middle cerebral artery
E. Cardiac tamponade
- Correct Answer :Answer A
V-fib
Four days after an anterior MI, a patient abruptly develops severe hypotension. A pansystolic
murmur is heard at the LSB. Most likely diagnosis is:
A. Pericardial tamponade
B. Acute mitral regurgitation
C. Right ventricular infarction
D. Ventricular septal rupture
- Correct Answer :Answer D
Ventricular septal rupture
Which of the following situations in the periinfarction period would suggest the presence of
ventricular septal perforation?
A. Systolic murmur, large v waves in pulmonary capillary wedge tracing; Po2 in right atrium
equals that in right ventricle
B. Systolic murmur, large v waves in pulmonary capillary wedge tracing; Po2 in right atrium is
greater than that in right ventricle
C. Systolic murmur, large v waves in pulmonary capillary wedge tracing; Po2 in right atrium is less
than that in right ventricle
A+ TEST BANK 2
, NSG 554 Primary Care
D. Diastolic murmur, large v waves in pulmonary capillary wedge tracing; Po2 in right atrium is
less than that in right ventricle
E. Diastolic murmur, large v waves in pulmonary capillary wedge tracing; Po2 in right atrium is
greater than that in right ventricle
- Correct Answer :Answer C
Systolic murmur, large v waves in pulmonary capillary wedge tracing; Po2 in right atrium is less
than that in right ventricle
A 65 year-old female who recently had an anterior MI returns to clinic for follow-up six weeks
after. She has no CP , but reports decreased exercise tolerance EKG shows persistent ST
elevation in leads V2- V4. Which of the following is the most likely diagnosis?
A RV infarction
B. Pericarditis
C. Re-occlusion of the RCA
D. Ventricular aneurysm
- Correct Answer :Answer D
Ventricular aneurysm
Coronary artery bypass graft (CABG) surgery may be indicated as the treatment of choice for
angina pectoris with which of the following angina patients?
A. A patient with triple-vessel disease
B. A patient with one-vessel disease
C. A patient with two-vessel disease
D. CABG may be first-line therapy in any of the above
- Correct Answer :Answer D
CABG may be first-line therapy in any of the above
A 61-year-old man with coronary artery disease complains of progressive orthopnea and pedal
edema. He is hospitalized with a blood pressure of 190/105mm Hg.
The cardiac enzymes and EKG are normal. IV furosemide has been administered. What is the
best next step?
A. Prescribe a beta-blocker to decrease myocardial oxygen demands
B. Start intravenous dopamine
A+ TEST BANK 3
, NSG 554 Primary Care
C. Observe
D. Start an ACE inhibitor
- Correct Answer :Answer D
Start an ACE-I
Which of the following treatment modalities has been proven to lower mortality and should be
instituted for all patients having a MI (unless contraindications exist)?
A. Lidocaine
B. Digoxin
C. Beta blockers
D. Alpha blockers
- Correct Answer :Answer C
Beta blockers
A 76 y/o female with known chronic AR has a 3-week history of arthralgia, weakness, and low-
grade fever. BP is 135/65, pulse is 90, and resp. is 22. Axillary temp is 100.2 degrees. Exam
showed an alert, oriented patient with conjunctival petechiae and a 2/6 LSB diastolic murmur.
Hgb is low at 9.4 g/dL and WBC count is high at 18.2 K/UL. Which of the following is the most
likely diagnosis?
A. Endocarditis
B. Multiple myeloma
C. Ankylosing spondylitis
D. Waldenstrom's macroglobulinemia
E. Idiopathic thrombocytic purpura –
Correct Answer :Answer A
Endocarditis
A 37 year-old female with history of Turner's syndrome and coarctation of the aorta repaired at
the age of 3 presents for routine examination. The patient is without complaints of chest pain,
dyspnea, palpitations, or syncope. On PE, VS reveal a BP of 130/76, HR 70, regular, RR 16. On
cardiac examination you note a grade II/VI SEM at the LSB and a grade III/VI blowing diastolic
murmur. Which of the following does this patient require?
A. antibiotic prophylaxis
A+ TEST BANK 4
NSG 554 Primary Care Newest 2025/2026
With Complete Questions And Correct
Answers |Already Graded A+||Brand New
Version!||Wilkes
A 59-year-old diabetic woman had suffered an acute AWMI. Five days later she gets into an
argument with her husband and complains of chest pain. Her initial EKG shows no ischemic
changes, but serum cardiac troponin levels are drawn and return mildly elevated at this time.
Which of the following is the best next therapy?
A. Use thrombolytic therapy
B. Treat with PTCA
C. Perform CABG surgery
D. Perform serial ECGS and obtain CK-MB
- Correct Answer :Answer D
Perform serial ECGs and obtain CK-MB
In which of the following patients would PTCA most likely be used?
A. A patient with left main stem disease
B. A patient with triple-vessel disease
C. A patient with a ventricular aneurysm
D. A patient with one vessel disease
E. Any of the above are good indications for PCTA
- Correct Answer :Answer D
A patient with one vessel disease
Which of the following is an absolute contraindication to thrombolytic therapy in a patient with
an acute STEMI?
A. history of severe HTN presently controlled
B. current use of anticoagulation therapy
C. previous hemorrhagic stroke
D. active PUD - Correct
A+ TEST BANK 1
, NSG 554 Primary Care
Answer :Answer C
previous hemorrhagic stroke
A 72-year-old man collapses while playing golf. He has a 5-year history of angina and type 2 DM .
Paramedics arrive in 10 minutes. Examination shows no respirations or BP . CPR is attempted for
10 minutes without success. Which of the following is the most likely cause of death in this
patient?
A. Ventricular fibrillation
B. Rupture of the papillary muscle
C. Necrosis of the myocardium
D. Embolus to the right middle cerebral artery
E. Cardiac tamponade
- Correct Answer :Answer A
V-fib
Four days after an anterior MI, a patient abruptly develops severe hypotension. A pansystolic
murmur is heard at the LSB. Most likely diagnosis is:
A. Pericardial tamponade
B. Acute mitral regurgitation
C. Right ventricular infarction
D. Ventricular septal rupture
- Correct Answer :Answer D
Ventricular septal rupture
Which of the following situations in the periinfarction period would suggest the presence of
ventricular septal perforation?
A. Systolic murmur, large v waves in pulmonary capillary wedge tracing; Po2 in right atrium
equals that in right ventricle
B. Systolic murmur, large v waves in pulmonary capillary wedge tracing; Po2 in right atrium is
greater than that in right ventricle
C. Systolic murmur, large v waves in pulmonary capillary wedge tracing; Po2 in right atrium is less
than that in right ventricle
A+ TEST BANK 2
, NSG 554 Primary Care
D. Diastolic murmur, large v waves in pulmonary capillary wedge tracing; Po2 in right atrium is
less than that in right ventricle
E. Diastolic murmur, large v waves in pulmonary capillary wedge tracing; Po2 in right atrium is
greater than that in right ventricle
- Correct Answer :Answer C
Systolic murmur, large v waves in pulmonary capillary wedge tracing; Po2 in right atrium is less
than that in right ventricle
A 65 year-old female who recently had an anterior MI returns to clinic for follow-up six weeks
after. She has no CP , but reports decreased exercise tolerance EKG shows persistent ST
elevation in leads V2- V4. Which of the following is the most likely diagnosis?
A RV infarction
B. Pericarditis
C. Re-occlusion of the RCA
D. Ventricular aneurysm
- Correct Answer :Answer D
Ventricular aneurysm
Coronary artery bypass graft (CABG) surgery may be indicated as the treatment of choice for
angina pectoris with which of the following angina patients?
A. A patient with triple-vessel disease
B. A patient with one-vessel disease
C. A patient with two-vessel disease
D. CABG may be first-line therapy in any of the above
- Correct Answer :Answer D
CABG may be first-line therapy in any of the above
A 61-year-old man with coronary artery disease complains of progressive orthopnea and pedal
edema. He is hospitalized with a blood pressure of 190/105mm Hg.
The cardiac enzymes and EKG are normal. IV furosemide has been administered. What is the
best next step?
A. Prescribe a beta-blocker to decrease myocardial oxygen demands
B. Start intravenous dopamine
A+ TEST BANK 3
, NSG 554 Primary Care
C. Observe
D. Start an ACE inhibitor
- Correct Answer :Answer D
Start an ACE-I
Which of the following treatment modalities has been proven to lower mortality and should be
instituted for all patients having a MI (unless contraindications exist)?
A. Lidocaine
B. Digoxin
C. Beta blockers
D. Alpha blockers
- Correct Answer :Answer C
Beta blockers
A 76 y/o female with known chronic AR has a 3-week history of arthralgia, weakness, and low-
grade fever. BP is 135/65, pulse is 90, and resp. is 22. Axillary temp is 100.2 degrees. Exam
showed an alert, oriented patient with conjunctival petechiae and a 2/6 LSB diastolic murmur.
Hgb is low at 9.4 g/dL and WBC count is high at 18.2 K/UL. Which of the following is the most
likely diagnosis?
A. Endocarditis
B. Multiple myeloma
C. Ankylosing spondylitis
D. Waldenstrom's macroglobulinemia
E. Idiopathic thrombocytic purpura –
Correct Answer :Answer A
Endocarditis
A 37 year-old female with history of Turner's syndrome and coarctation of the aorta repaired at
the age of 3 presents for routine examination. The patient is without complaints of chest pain,
dyspnea, palpitations, or syncope. On PE, VS reveal a BP of 130/76, HR 70, regular, RR 16. On
cardiac examination you note a grade II/VI SEM at the LSB and a grade III/VI blowing diastolic
murmur. Which of the following does this patient require?
A. antibiotic prophylaxis
A+ TEST BANK 4
