NR 603 WEEK 3 CASE DISCUSSION
CARDIOVASCULAR EXAM SCRIPT 2026
FULL SOLUTIONS AND CORRECT ANSWERS
GRADED A+
⩥ Ophthalmic examination of a patient with a 10-year history of poorly
controlled hypertension, despite three-drug-therapy, would most likely
reveal: Answer: Arteriolar narrowing
⩥ Effective long-term treatment of systolic heart failure with reduced
ejection fraction should include which of the following? Answer:
Prescribing valsartan/sacubitril (Entresto) unless contraindicated on
discharge
Rationale: Angiotensin Receptor and Neprilysin Inhibition is considered
goal-directed therapy for patients with reduced systolic heart function as
evidence by the PARAGON-HF Trial. Auscultation is an assessment
item, not a treatment. Midazolam does not have any long term benefit
for heart failure. Fluid bolus in a patient with likely fluid overload from
systolic heart failure only worsen their presenting symptoms.
⩥ Although men less than 55 have an increased risk of cardiac events
compared to women, both men and women start to have equivalent
cardiac risks by age 60. This is primarily due to which following
, mechanism? Answer: Loss of cardioprotective estrogen levels in women
after menopause
Rationale: The loss of cardioprotective estrogen levels at menopause (or
prematurely with Lupron) put the female patient at increased risk for
cardiac events equivalent to that of men. Atherosclerosis does not slow
down in men, it accelerates in women. Medication compliance is
statistically better with women than men, and women statistically eat
less red meat and healthier diets than men.
⩥ Which of the following medications does not cause beta 1
stimulation? Answer: Phenylephrine
Rationale: Phenylephrine only stimulates alpha 1 receptors. The
remaining three all have beta receptor activity (dopamine, dobutamine,
epinepherine).
⩥ Recommendation for lipid check in adolescent with type 1 DM?
Answer: 1 year
⩥ Which of the following do not represent possible causes of a
prothrombotic state? Answer: Inhibition of factor Xa
Rationale: Protein C and S are the body's natural anticoagulants and a
deficit of these would make the patient more prone to clot. Factor V
CARDIOVASCULAR EXAM SCRIPT 2026
FULL SOLUTIONS AND CORRECT ANSWERS
GRADED A+
⩥ Ophthalmic examination of a patient with a 10-year history of poorly
controlled hypertension, despite three-drug-therapy, would most likely
reveal: Answer: Arteriolar narrowing
⩥ Effective long-term treatment of systolic heart failure with reduced
ejection fraction should include which of the following? Answer:
Prescribing valsartan/sacubitril (Entresto) unless contraindicated on
discharge
Rationale: Angiotensin Receptor and Neprilysin Inhibition is considered
goal-directed therapy for patients with reduced systolic heart function as
evidence by the PARAGON-HF Trial. Auscultation is an assessment
item, not a treatment. Midazolam does not have any long term benefit
for heart failure. Fluid bolus in a patient with likely fluid overload from
systolic heart failure only worsen their presenting symptoms.
⩥ Although men less than 55 have an increased risk of cardiac events
compared to women, both men and women start to have equivalent
cardiac risks by age 60. This is primarily due to which following
, mechanism? Answer: Loss of cardioprotective estrogen levels in women
after menopause
Rationale: The loss of cardioprotective estrogen levels at menopause (or
prematurely with Lupron) put the female patient at increased risk for
cardiac events equivalent to that of men. Atherosclerosis does not slow
down in men, it accelerates in women. Medication compliance is
statistically better with women than men, and women statistically eat
less red meat and healthier diets than men.
⩥ Which of the following medications does not cause beta 1
stimulation? Answer: Phenylephrine
Rationale: Phenylephrine only stimulates alpha 1 receptors. The
remaining three all have beta receptor activity (dopamine, dobutamine,
epinepherine).
⩥ Recommendation for lipid check in adolescent with type 1 DM?
Answer: 1 year
⩥ Which of the following do not represent possible causes of a
prothrombotic state? Answer: Inhibition of factor Xa
Rationale: Protein C and S are the body's natural anticoagulants and a
deficit of these would make the patient more prone to clot. Factor V
