2021-Midterm Exam Questions. |Elaborated| NSG 6001 – Advanced Practice Nursing

Guide for Week 4 Quiz – Study the following: 1) Women and assessing by procedures for CAD - ACC guidelines do not recommend stress tests for asymptomatic patients unless women are 55 years> , is sedentary & wishes to begin exercising aggressively; For women who are symptomatic but who have a normal resting ECG recording, good exercise tolerance, and no coronary risk factors, an exercise stress test is appropriate; diagnostic imaging is not recommended for low-risk women who are asymptomatic; For women who are symptomatic and have known CAD, an abnormal resting ECG recording, questionable exercise tolerance, or coronary risk factors such as diabetes or peripheral arterial disease, stress test imaging is recommended. The burden of coronary artery disease (CAD) in women is significant. In spite of increasing uses of noninvasive testing, coronary angiography remains the gold standard in the diagnosis and assessment of CAD. Since gender differences exist in the clinical presentation of CAD and in the sensitivity and specificity of noninvasive testing, coronary angiography remains an invaluable tool in providing diagnostic and prognostic information in women. 2) Changes that occur in an ECG that demonstrate ischemia late in the ischemic cascade - Typical ECG changes of ischemia result, although the ST-segment and T-wave changes that are central to demonstration of ischemia occur relatively late in the ischemic cascade; The hypoperfusion produces first diastolic, and then systolic dysfunction, with characteristic signs and symptoms of chest pain; Various imaging modalities that can be used as adjuncts to the graded exercise test can be viewed in the context of the ischemic cascade. 3) Understand the terms: Specificity and Sensitivity and an exercise echocardiography 2DE - Current data suggest that adjunctive echocardiographic imaging enhances the sensitivity and specificity of CAD detection to an extent comparable to that provided by nuclear techniques. Another study found the sensitivity of dobutamine stress 2DE to be comparable to that of dobutamine single-photon emission CT (85% versus 80%, respectively). The specificity of the two techniques was also comparable (82% versus 74%, respectively), as were the predictive values. Sensitivity – percentage of people with disease who test positive Spcificity – percentage of people without disease who test negative 4) What part of Medicare covers inpatient hospital services - Part A – paid through federal payroll taxes – Covers inpatient hospital services as well as some post-hospital nursing care & home health care