NR 603 CEA practice Questions with Detailed
Verified Answers
Your patient has been diagnosed with a 4.5cm ascending aortic aneurysm. Which
medical imaging is considered standard of care for serial surveillance?
CT PE rule-out protocol
Transesophageal Echocardiogram
Plain film chest X-ray (CXR)
CT angiography of the chest Ans: CT angiography of the chest
Rationale: CT angiography is considered the standard of care for measuring vascular
luminal dimensions with contrast. CT PE protocol is not timed properly for the aorta
(it's timed for the pulmonary artery). Although a plain film is able to catch large
aneurysms at times, they are not able to provide multi-axis reconstruction needed to
accurately measure the size. Transesophageal echo is not needed to accurately
measure the aorta and requires the patient to undergo sedation which is unnecessary.
Which of the following end-organ sequelae is not directly caused by uncontrolled
hypertension?
Hemorrhagic stroke
Proteinuria
Peripheral neuropathy
AV nicking Ans: Peripheral neuropathy
,Rationale: Although patients with hypertension frequently have peripheral neuropathy,
it is only directly attributed to patients who are also diabetic and is commonly found in
non-hypertensive diabetic patients. Proteinuria, AV nicking, and hemorrhagic stroke
are all caused by uncontrolled hypertension.
Which of the following medical exam requires the patient to be sedated?
Tilt table test
Transesophageal echocardiogram (TEE)
Nuclear stress test
Transthoracic echocardiogram (TTE) Ans: TEE
Rationale: Due to the invasive nature of the TEE, patients will require procedural
sedation. The patient undergoing a transthoracic echo, tilt table, and nuclear stress test
are all fully alert during these procedures.
A nurse practitioner places a 76-year-old patient on nifedipine (Procardia) 10 mg t.i.d.
for angina. The patient is unable to remember to take the medication at the scheduled
times. The practitioner should:
increase the dosage to 20 mg b.i.d.
discontinue the issue with the patient's daughter.
change the dose to extended release 30 mg daily.
reinforce the importance of taking the medication. Ans: change the dose to extended
release 30 mg daily
An 80-year-old man with a history of atrial fibrillation presents with sudden-onset
unilateral leg pain and pallor. What is the most likely diagnosis?
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,Acute arterial occlusion
Deep vein thrombosis
Peripheral artery disease
Cellulitis Ans: Acute arterial occlusion
The most important diagnostic factor in evaluating angina pectoris is the patient's:
Physical examination
Echocardiogram
Cardiac MRI
History Ans: History
Rationale: When it comes to cardiac patients, it's important to remember that history
is the most important diagnostic factor in evaluating angina pectoris. A patient's history
can easily make the diagnosis by simply providing a history of their precipitating factors
and symptoms, such as exertional dyspnea, Reproducible, cardiac stressors such as
exercise, strenuous activity, and the associated symptoms. Cardiac MRI may evaluate
the patient's heart with find detail, but it does not show active ischemia well, rather
evidence of old MI and ventricular wall thinning. Physical examination likewise is not
very particular to cardiac patients and their cardiac disease state, and although there
may be some associated signs, they are not specific. Echocardiogram is also useful tool
to evaluate ejection fraction and valve/wall function, but this is not showcase ischemia
well.
Your patient is complaining of paroxysmal atrial fibrillation. Which medical procedure
is commonly used to treat this condition?
Cryoablation of the transition zone of the left pulmonary vein inflow to the left atrium
© Get it right 2025 Getaway - Stuvia US All rights reserved
, Placement of biventricular pacing
Radio frequency ablation of the left ventricular apex
Overdrive pacing via an epicardial lead Ans: Cryoablation of the transition zone of the
left pulmonary vein inflow to the left atrium
Rationale: The transition zone of pulmonary vein to left atrium represents the most
common source of atrial fibrillation and is commonly treated with scarification, radio
frequency ablation, or cryotherapy to impede the electrical stimulation of a-fib to the
rest of the atrium.
Wrong answerQuestion pts
Your patient with a history of two coronary stents and a LDL of 190 has been started
on lipid-lowering statin therapy on three separate attempts with considerable side
effects such as leg pain and in one event, hospitalization for rhabdomyolysis. Which is
the best option moving forward to manage their lipids?
Initiate PCSK9 Inhibitor therapy
Use ezetimibe as monotherapy
Reattempt statin therapy
Aspiring 81mg daily Ans: Initiate PCSK9 Inhibitor therapy
Rationale: Aspirin is not considered a lipid lowering agent. History of statin-induced
rhabdomyolysis is a contraindication for further statin attempts. Ezetimibe as
monotherapy does not provide any appreciable decrease in LDL to goal of <100 for
proven CAD (patient has stents in place). PCSK9 Inhibitors are the best available drug
class for this patient.
© Get it right 2025 Getaway - Stuvia US All rights reserved
Verified Answers
Your patient has been diagnosed with a 4.5cm ascending aortic aneurysm. Which
medical imaging is considered standard of care for serial surveillance?
CT PE rule-out protocol
Transesophageal Echocardiogram
Plain film chest X-ray (CXR)
CT angiography of the chest Ans: CT angiography of the chest
Rationale: CT angiography is considered the standard of care for measuring vascular
luminal dimensions with contrast. CT PE protocol is not timed properly for the aorta
(it's timed for the pulmonary artery). Although a plain film is able to catch large
aneurysms at times, they are not able to provide multi-axis reconstruction needed to
accurately measure the size. Transesophageal echo is not needed to accurately
measure the aorta and requires the patient to undergo sedation which is unnecessary.
Which of the following end-organ sequelae is not directly caused by uncontrolled
hypertension?
Hemorrhagic stroke
Proteinuria
Peripheral neuropathy
AV nicking Ans: Peripheral neuropathy
,Rationale: Although patients with hypertension frequently have peripheral neuropathy,
it is only directly attributed to patients who are also diabetic and is commonly found in
non-hypertensive diabetic patients. Proteinuria, AV nicking, and hemorrhagic stroke
are all caused by uncontrolled hypertension.
Which of the following medical exam requires the patient to be sedated?
Tilt table test
Transesophageal echocardiogram (TEE)
Nuclear stress test
Transthoracic echocardiogram (TTE) Ans: TEE
Rationale: Due to the invasive nature of the TEE, patients will require procedural
sedation. The patient undergoing a transthoracic echo, tilt table, and nuclear stress test
are all fully alert during these procedures.
A nurse practitioner places a 76-year-old patient on nifedipine (Procardia) 10 mg t.i.d.
for angina. The patient is unable to remember to take the medication at the scheduled
times. The practitioner should:
increase the dosage to 20 mg b.i.d.
discontinue the issue with the patient's daughter.
change the dose to extended release 30 mg daily.
reinforce the importance of taking the medication. Ans: change the dose to extended
release 30 mg daily
An 80-year-old man with a history of atrial fibrillation presents with sudden-onset
unilateral leg pain and pallor. What is the most likely diagnosis?
© Get it right 2025 Getaway - Stuvia US All rights reserved
,Acute arterial occlusion
Deep vein thrombosis
Peripheral artery disease
Cellulitis Ans: Acute arterial occlusion
The most important diagnostic factor in evaluating angina pectoris is the patient's:
Physical examination
Echocardiogram
Cardiac MRI
History Ans: History
Rationale: When it comes to cardiac patients, it's important to remember that history
is the most important diagnostic factor in evaluating angina pectoris. A patient's history
can easily make the diagnosis by simply providing a history of their precipitating factors
and symptoms, such as exertional dyspnea, Reproducible, cardiac stressors such as
exercise, strenuous activity, and the associated symptoms. Cardiac MRI may evaluate
the patient's heart with find detail, but it does not show active ischemia well, rather
evidence of old MI and ventricular wall thinning. Physical examination likewise is not
very particular to cardiac patients and their cardiac disease state, and although there
may be some associated signs, they are not specific. Echocardiogram is also useful tool
to evaluate ejection fraction and valve/wall function, but this is not showcase ischemia
well.
Your patient is complaining of paroxysmal atrial fibrillation. Which medical procedure
is commonly used to treat this condition?
Cryoablation of the transition zone of the left pulmonary vein inflow to the left atrium
© Get it right 2025 Getaway - Stuvia US All rights reserved
, Placement of biventricular pacing
Radio frequency ablation of the left ventricular apex
Overdrive pacing via an epicardial lead Ans: Cryoablation of the transition zone of the
left pulmonary vein inflow to the left atrium
Rationale: The transition zone of pulmonary vein to left atrium represents the most
common source of atrial fibrillation and is commonly treated with scarification, radio
frequency ablation, or cryotherapy to impede the electrical stimulation of a-fib to the
rest of the atrium.
Wrong answerQuestion pts
Your patient with a history of two coronary stents and a LDL of 190 has been started
on lipid-lowering statin therapy on three separate attempts with considerable side
effects such as leg pain and in one event, hospitalization for rhabdomyolysis. Which is
the best option moving forward to manage their lipids?
Initiate PCSK9 Inhibitor therapy
Use ezetimibe as monotherapy
Reattempt statin therapy
Aspiring 81mg daily Ans: Initiate PCSK9 Inhibitor therapy
Rationale: Aspirin is not considered a lipid lowering agent. History of statin-induced
rhabdomyolysis is a contraindication for further statin attempts. Ezetimibe as
monotherapy does not provide any appreciable decrease in LDL to goal of <100 for
proven CAD (patient has stents in place). PCSK9 Inhibitors are the best available drug
class for this patient.
© Get it right 2025 Getaway - Stuvia US All rights reserved
