NSG 554 Primary Care
NSG 554 Primary Care Newest
2025/2026 With Complete Questions
And Correct Answers |Already Graded
A+||Brand New Version!||Wilkes
2. A 70-year-old male patient has an aortic aneurysm measuring 5.0 cm. The patient has poorly-
controlled hypertension, and decompensated heart failure. What is the recommendation for
treatment for this patient?
a. Endovascular stent grafting of the aneurysm
b. Immediate open surgical repair of the aneurysm
c. No intervention is necessary for this patient
d. Serial ultrasonographic surveillance of the aneurysm –
Correct Answer :ANS: D
This patient's aneurysm is less than 5.5 cm and repair is not necessary at this time. Serial US
surveillance is necessary to continue to evaluate size. Repair is risky in patients with
hypertension and heart failure, so avoiding procedures if possible is recommended.
1. A patient reports sustained, irregular heart palpitations. What is the most likely cause of these
symptoms?
a. Anemia
b. Atrial fibrillation
c. Extrasystole
d. Paroxysmal attacks
- Correct Answer :ANS: B
Atrial fibrillation causes palpitations that are irregular and tend to be sustained. Anemia will
cause rapid palpitations that are regular. Extrasystole causes palpitations or an awareness of
isolated extra beats with a pause. Paroxysmal attacks start and terminate abruptly and are
usually rapid and regular.
3. A child with a history of asthma is brought to the clinic with a rapid heart rate. A cardiac
monitor shows a heart rate of 225 beats per minute. The provider notifies transport to take the
child to the emergency department. What initial intervention may be attempted in the clinic?
A+ TEST BANK 1
, NSG 554 Primary Care
a. Administration of intravenous adenosine
b. Giving a beta blocker
c. Providing a loading dose of digoxin
d. Using a vagal maneuver or carotid massage
- Correct Answer :ANS: D
This child has paroxysmal supraventricular tachycardi
a. Vagal maneuvers or carotid massage may be attempted to slow the ventricular rate.
Adenosine is contraindicated in patients with asthm
a. Medications such as beta blockers and digoxin are not used in emergency treatment of PSVT.
1. According to current research, which are associated with a decreased incidence of stroke?
a. ≧7 servings of fruits and vegetables per day
b. B-complex vitamin supplements
c. Intensive insulin therapy in type 1 diabetes
d. Low-sugar soda
e. Mediterranean diet
- Correct Answer :ANS: A, C, E
Individuals without hypertension in Sweden who consumed ≧7 servings of fruits and vegetables
per day had a 19% lower risk of stroke than those consuming only one serving per day. Intensive
insulin therapy in patients with type 1 diabetes was shown to lower the risk of stroke. Consuming
a Mediterranean diet is associated with a reduced stroke risk. B-complex vitamins and low-sugar
soda have not shown a
decreased risk.
2. During a routine health maintenance examination, the provider auscultates a cervical bruit.
The patient denies syncope, weakness, or headache. What will the provider do, based on this
finding?
a. Order a carotid duplex ultrasound
b. Order catheter-based angiography
c. Refer the patient to a neurosurgeon
d. Schedule a computed tomography angiography
- Correct Answer :ANS: A
Carotid duplex ultrasound is the primary diagnostic tool for carotid stenosis. A cervical bruit in an
asymptomatic patient is an indication for this test. Catheter-based angiography is the criterion-
based standard, but has inherent costs and risks. A neurosurgery referral is not indicated without
further testing. CTA is used instead of duplex US if the test is not available, if US results are
inconclusive, or further evaluation is needed based on US results.
A+ TEST BANK 2
, NSG 554 Primary Care
1. A patient reports recurrent chest pain that occurs regardless of activity and is not relieved by
rest. The provider administers a nitroglycerin tablet which does not relieve the discomfort. What
is the next action?
a. Administer a second nitroglycerin tablet
b. Give the patient a beta blocker medication
c. Prescribe a calcium channel blocker mediation
d. Start aspirin therapy and refer the patient to a cardiologist
- Correct Answer :ANS: B
Patient with these symptoms who do not respond to nitroglycerin is likely to have microvascular
angin
a. Treatment is effective with beta blockers. These symptoms are not characteristic of acute MI,
so aspirin is not given. A second nitroglycerin tablet is used for classic angin
a. Calcium channel blockers are not indicated.
2. A patient is brought to an emergency department with symptoms of acute ST-segment
elevation MI (STEMI). The nearest hospital that can perform percutaneous coronary intervention
(PCI) is 3 hours away. What is the initial treatment for this patient?
a. Administer heparin
b. Give the patient an oral beta blocker
c. Initiate fibrinolytic treatment
d. Transfer to the PCI-capable institution
- Correct Answer :ANS: C
Fibrinolytic therapy should be administered to any patient with evolving STEMI within 30
minutes of the time of first medical contact. Patients more than 120 minutes away from a PCI-
capable hospital should be given fibrinolytic therapy since PCI should be performed within 90
minutes if possible. Giving heparin or beta blockers is not helpful.
3. Patients who meet the criteria for statin therapy to help prevent atherosclerotic
cardiovascular disease are those with a history of
a. a 10-year risk score of 5% and an LDL of 165 mg/dL.
b. a 10-year risk score of 8% with an LDL of 80 mg/dL.
c. a low-density lipoprotein (LDL) level >190 mg/dL.
d. diabetes and an LDL between 40 and 70 mg/dL.
e. previous myocardial infarction.
- Correct Answer :ANS: B, C, E
A+ TEST BANK 3
, NSG 554 Primary Care
Patients with previous MI, those with risk scores >8% and an LDL >70 mg/dL, and those with LDL
levels >190 mg/dL are candidates for statin therapy. Patients with a risk score <7.5% with LDL
levels between 75 and 190 mg/dL are not candidates and patients who have diabetes with LDL
levels <75 mg/dL are not candidates.
1. A patient who has heart failure with reduced ejection fraction will have which symptoms?
a. Dyspnea and fatigue without volume overload
b. Impairment of ventricular filling and relaxation
c. Mild, exertionally related dyspnea
d. Pump failure from left ventricular systolic dysfunction
- Correct Answer :ANS: D
Heart failure with reduced ejection fraction results in pump failure from ventricular systolic
dysfunction. Heart failure with preserved ejection fraction may have milder symptoms and is
associated with impairment of ventricular filling and relaxation.
2. A patient who has been diagnosed with heart failure for over a year reports being comfortable
while at rest and experiences palpitations and dyspnea when walking to the bathroom. Which
classification of heart failure is appropriate based on these symptoms?
a. Class I
b. Class II
c. Class III
d. Class IV
- Correct Answer :ANS: B
Patients with Class II heart failure (HF) will have slight limitation of activity and will be
comfortable at rest with symptoms occurring with ordinary physical activity. Patients with Class I
HF do not have limitations and ordinary physical activity does not produce symptoms. With Class
III HF, less than usual activity will produce symptoms. With Class IV HF, symptoms are present
even at rest and all physical activity worsens symptoms.
3. A patient who has Class II heart failure is taking an ACE inhibitor and reports a recurrent cough
that does not interfere with sleep or activity. What will the provider do initially to manage this
patient?
a. Assess serum potassium and sodium immediately
b. Discontinue the ACE inhibitor and prescribe an ARB
c. Provide reassurance that this is a benign side effect
d. Withhold the drug and evaluate renal and pulmonary function
A+ TEST BANK 4
NSG 554 Primary Care Newest
2025/2026 With Complete Questions
And Correct Answers |Already Graded
A+||Brand New Version!||Wilkes
2. A 70-year-old male patient has an aortic aneurysm measuring 5.0 cm. The patient has poorly-
controlled hypertension, and decompensated heart failure. What is the recommendation for
treatment for this patient?
a. Endovascular stent grafting of the aneurysm
b. Immediate open surgical repair of the aneurysm
c. No intervention is necessary for this patient
d. Serial ultrasonographic surveillance of the aneurysm –
Correct Answer :ANS: D
This patient's aneurysm is less than 5.5 cm and repair is not necessary at this time. Serial US
surveillance is necessary to continue to evaluate size. Repair is risky in patients with
hypertension and heart failure, so avoiding procedures if possible is recommended.
1. A patient reports sustained, irregular heart palpitations. What is the most likely cause of these
symptoms?
a. Anemia
b. Atrial fibrillation
c. Extrasystole
d. Paroxysmal attacks
- Correct Answer :ANS: B
Atrial fibrillation causes palpitations that are irregular and tend to be sustained. Anemia will
cause rapid palpitations that are regular. Extrasystole causes palpitations or an awareness of
isolated extra beats with a pause. Paroxysmal attacks start and terminate abruptly and are
usually rapid and regular.
3. A child with a history of asthma is brought to the clinic with a rapid heart rate. A cardiac
monitor shows a heart rate of 225 beats per minute. The provider notifies transport to take the
child to the emergency department. What initial intervention may be attempted in the clinic?
A+ TEST BANK 1
, NSG 554 Primary Care
a. Administration of intravenous adenosine
b. Giving a beta blocker
c. Providing a loading dose of digoxin
d. Using a vagal maneuver or carotid massage
- Correct Answer :ANS: D
This child has paroxysmal supraventricular tachycardi
a. Vagal maneuvers or carotid massage may be attempted to slow the ventricular rate.
Adenosine is contraindicated in patients with asthm
a. Medications such as beta blockers and digoxin are not used in emergency treatment of PSVT.
1. According to current research, which are associated with a decreased incidence of stroke?
a. ≧7 servings of fruits and vegetables per day
b. B-complex vitamin supplements
c. Intensive insulin therapy in type 1 diabetes
d. Low-sugar soda
e. Mediterranean diet
- Correct Answer :ANS: A, C, E
Individuals without hypertension in Sweden who consumed ≧7 servings of fruits and vegetables
per day had a 19% lower risk of stroke than those consuming only one serving per day. Intensive
insulin therapy in patients with type 1 diabetes was shown to lower the risk of stroke. Consuming
a Mediterranean diet is associated with a reduced stroke risk. B-complex vitamins and low-sugar
soda have not shown a
decreased risk.
2. During a routine health maintenance examination, the provider auscultates a cervical bruit.
The patient denies syncope, weakness, or headache. What will the provider do, based on this
finding?
a. Order a carotid duplex ultrasound
b. Order catheter-based angiography
c. Refer the patient to a neurosurgeon
d. Schedule a computed tomography angiography
- Correct Answer :ANS: A
Carotid duplex ultrasound is the primary diagnostic tool for carotid stenosis. A cervical bruit in an
asymptomatic patient is an indication for this test. Catheter-based angiography is the criterion-
based standard, but has inherent costs and risks. A neurosurgery referral is not indicated without
further testing. CTA is used instead of duplex US if the test is not available, if US results are
inconclusive, or further evaluation is needed based on US results.
A+ TEST BANK 2
, NSG 554 Primary Care
1. A patient reports recurrent chest pain that occurs regardless of activity and is not relieved by
rest. The provider administers a nitroglycerin tablet which does not relieve the discomfort. What
is the next action?
a. Administer a second nitroglycerin tablet
b. Give the patient a beta blocker medication
c. Prescribe a calcium channel blocker mediation
d. Start aspirin therapy and refer the patient to a cardiologist
- Correct Answer :ANS: B
Patient with these symptoms who do not respond to nitroglycerin is likely to have microvascular
angin
a. Treatment is effective with beta blockers. These symptoms are not characteristic of acute MI,
so aspirin is not given. A second nitroglycerin tablet is used for classic angin
a. Calcium channel blockers are not indicated.
2. A patient is brought to an emergency department with symptoms of acute ST-segment
elevation MI (STEMI). The nearest hospital that can perform percutaneous coronary intervention
(PCI) is 3 hours away. What is the initial treatment for this patient?
a. Administer heparin
b. Give the patient an oral beta blocker
c. Initiate fibrinolytic treatment
d. Transfer to the PCI-capable institution
- Correct Answer :ANS: C
Fibrinolytic therapy should be administered to any patient with evolving STEMI within 30
minutes of the time of first medical contact. Patients more than 120 minutes away from a PCI-
capable hospital should be given fibrinolytic therapy since PCI should be performed within 90
minutes if possible. Giving heparin or beta blockers is not helpful.
3. Patients who meet the criteria for statin therapy to help prevent atherosclerotic
cardiovascular disease are those with a history of
a. a 10-year risk score of 5% and an LDL of 165 mg/dL.
b. a 10-year risk score of 8% with an LDL of 80 mg/dL.
c. a low-density lipoprotein (LDL) level >190 mg/dL.
d. diabetes and an LDL between 40 and 70 mg/dL.
e. previous myocardial infarction.
- Correct Answer :ANS: B, C, E
A+ TEST BANK 3
, NSG 554 Primary Care
Patients with previous MI, those with risk scores >8% and an LDL >70 mg/dL, and those with LDL
levels >190 mg/dL are candidates for statin therapy. Patients with a risk score <7.5% with LDL
levels between 75 and 190 mg/dL are not candidates and patients who have diabetes with LDL
levels <75 mg/dL are not candidates.
1. A patient who has heart failure with reduced ejection fraction will have which symptoms?
a. Dyspnea and fatigue without volume overload
b. Impairment of ventricular filling and relaxation
c. Mild, exertionally related dyspnea
d. Pump failure from left ventricular systolic dysfunction
- Correct Answer :ANS: D
Heart failure with reduced ejection fraction results in pump failure from ventricular systolic
dysfunction. Heart failure with preserved ejection fraction may have milder symptoms and is
associated with impairment of ventricular filling and relaxation.
2. A patient who has been diagnosed with heart failure for over a year reports being comfortable
while at rest and experiences palpitations and dyspnea when walking to the bathroom. Which
classification of heart failure is appropriate based on these symptoms?
a. Class I
b. Class II
c. Class III
d. Class IV
- Correct Answer :ANS: B
Patients with Class II heart failure (HF) will have slight limitation of activity and will be
comfortable at rest with symptoms occurring with ordinary physical activity. Patients with Class I
HF do not have limitations and ordinary physical activity does not produce symptoms. With Class
III HF, less than usual activity will produce symptoms. With Class IV HF, symptoms are present
even at rest and all physical activity worsens symptoms.
3. A patient who has Class II heart failure is taking an ACE inhibitor and reports a recurrent cough
that does not interfere with sleep or activity. What will the provider do initially to manage this
patient?
a. Assess serum potassium and sodium immediately
b. Discontinue the ACE inhibitor and prescribe an ARB
c. Provide reassurance that this is a benign side effect
d. Withhold the drug and evaluate renal and pulmonary function
A+ TEST BANK 4
