Nurse Practitioner Certification Exam and Practice Prep Cardiovascular Questions and Answers, Exams of Nursing

Download Nurse Practitioner Certification Exam and Practice Prep Cardiovascular Questions and Answers and more Exams Nursing in PDF only on Docsity! NURSE PRACTITIONER CERTIFICATION EXAM AND PRACTICE PREP CARDIOVASCULAR questions and answers You examine a 38 year old woman who has presented for an initial examination and Papanicolaou test. She has no complaint. Her BP is 154/98 mm Hg bilaterally and her BMI is 31 kg/m2. The rest of her physical exam is unremarkable. Your next best action is to: A. initiate antihypertensive therapy B. arrange for at least two additional BP measurements during the next 2 weeks. C. order BUN, creatinine, and potassium ion measurements and UA D. advise her to reduce her sodium intake - correct answer ✅B. arrange for at least two additional BP measurements during the next 2 weeks You see a 68 year old woman as a pt who is transferring care into your practice. She has a 10y history of HTN, diabetes mellitus, and hyperlipidemia. Current medications include HCTZ, glipizide, metformin, simvastatin, and daily low-dose aspirin. Today's BP reading is 158/92mm Hg and the rest of her history and exam are unremarkable. Documentation from her former healthcare provider indicates that her BP has been in the range for the past 12 months. Your next best action is to: A. prescribe an - correct answer ✅A. prescribe an ACEI NURSE PRACTITIONER CERTIFICATION EXAM AND PRACTICE PREP CARDIOVASCULAR questions and answers You examine a 78 y/o woman with long-standing poorly controlled hHTN. When evaluating her for HTN target organ damage, you look for evidence of: A. lipid abnormalities B. insulin resistance C. left ventricular hypertrophy D. clotting disorders - correct answer ✅C. left ventricular hypertrophy Diagnostic testing for a pt with newly diagnosed primary hHTN should include all of the following except: A. hematocrit B. uric acid C. creatinine D. potassium - correct answer ✅B. uric acid In the person w/HTN, the nurse practitioner recommends all of the following to potentially reduce BP in a patient with a BMI of 30 kg/m2 except: A. 10kg weight loss B. dietary sodium restriction to 2.4g per day NURSE PRACTITIONER CERTIFICATION EXAM AND PRACTICE PREP CARDIOVASCULAR questions and answers A. the patient should sit in a chair with feet flat on the floor for at least 5 minutes before obtaining the reading B. the BP cuff should not cover more than 50% of the upper arm C. the pt should sit on the edge of the exam table w/o arm support to enhance reading accuracy D. obtaining the BP reading immediately after the pt walks into the exam room is recommended - correct answer ✅A. the patient should sit in a chair with feet flat on the floor for at least 5 minutes before obtaining the reading A BP elevation noted only at an office visit is commonly known as ____________ hypertension A. provider-induced B. clinical C. white coat D. pseudo - correct answer ✅C. white coat The most important long-term goal of treating HTN is to: A. strive to reach recommended numeric BP measurement B. avoid disease-related target organ damage NURSE PRACTITIONER CERTIFICATION EXAM AND PRACTICE PREP CARDIOVASCULAR questions and answers C. develop a plan of care with minimal adverse effects D. treat concomitant health problems often noted in the person with this condition - correct answer ✅B. avoid disease-related target organ damage You start a pt with HTN who is already receiving an ACEI on spironolactone. You advise pt to return in 4 weeks to check which of the following lab parameters? A. sodium B. calcium C. potassium D. chloride - correct answer ✅C. potassium A 68yo woman presents with HTN and BP of 152-158/92-96mmHg documented over 2 months on three different occasions. ECG and creatinine are normal, and she has no proteinuria. Clinical findings include the following: BMI 26.4, no 23 24 or murmur, and point of maximal impulse at 5th intercostal space, mid-clavicular line. Which of the following represents the best intervention? A. initiate therapy with metoprolol B. initiate therapy w/hydrochlorothiazide C. Initiate therapy with methyldopa NURSE PRACTITIONER CERTIFICATION EXAM AND PRACTICE PREP CARDIOVASCULAR questions and answers D. Contin - correct answer ✅B. initiate therapy w/hydrochlorothiazide Which of the following can have a favorable effect on a comorbid condition in a person with HTN? A. chlorthalidone in gout B. propranolol with airway disease C. aldosterone antagonist in heart failure D. methyldopa in an older adult - correct answer ✅C. aldosterone antagonist in heart failure *According to JNC-8 guidelines, all of the following medications are first-line agents for use in a middle-aged white man without diabetes mellitus except: a. Lisinopril b. hydrochlorothiazide c. metoprolol d. amlodipine - correct answer ✅C. metoprolol NURSE PRACTITIONER CERTIFICATION EXAM AND PRACTICE PREP CARDIOVASCULAR questions and answers Target BP for a 62yo female with no history of DM or CKD? - correct answer ✅<150/90 Target BP for an 82yo male with no history of DM or CKD? - correct answer ✅<150/90 Target BP for 74yo female with DM and CKD? - correct answer ✅<140/90 You see a 62 year old man without CKD or DM who is currently being TX with low dose HCT & Losartan. His BP is 162/88. All of the following are appropriate next courses of action EXCEPT: A. increasing the dose of losartan B. adding a Beta Blocker C. adding a CCB D. increasing the dose of HCTZ - correct answer ✅B. adding a Beta Blocker Which of the following statements concerning postural hypotension in the elderly is false? NURSE PRACTITIONER CERTIFICATION EXAM AND PRACTICE PREP CARDIOVASCULAR questions and answers A. It increases the risk of falls and syncope B. it is characterized by a drop in BP when going from a standing to a sitting position C. It increases the risk of cardiovascular events D. It is associated with the use of vasodilating medications - correct answer ✅B. it is characterized by a drop in BP when going from a standing to a sitting position You examine a 24-year-old woman with mitral valve prolapse (MVP). Her physical examination finding may include: a. pectus excavatum b. obesity c. petite stature d. hyperextensible joints - correct answer ✅A. pectus excavatum In performing a cardiac examination in a person with MVP, you expect to find: a. early to mid systolic, crescendo-decrescendo murmur b. a pansystolic murmur c. a low-pitched, diastolic rumble NURSE PRACTITIONER CERTIFICATION EXAM AND PRACTICE PREP CARDIOVASCULAR questions and answers d. a mid to late systolic murmur - correct answer ✅D. a mid to late systolic murmur A risk factor for MVP includes a history of: A. rheumatic fever B. rheumatoid arthritis C. kawasaki disease D. marfan syndrome - correct answer ✅D. marfan syndrome Additional findings in MVP include: a. an opening snap b. a mid-systolic click c. a paradoxical splitting of the second heart sound (S2) d. a fourth heart sound (S4). - correct answer ✅B. a mid-systolic click Interventions for patients with MVP often includes advice about which of the following? A. restricted activity because of low cardiac output NURSE PRACTITIONER CERTIFICATION EXAM AND PRACTICE PREP CARDIOVASCULAR questions and answers b. diastolic with little radiation c. diastolic with radiation to the axilla d. localized systolic - correct answer ✅A. systolic with radiation to the axilla In evaluating the person w/ aortic stenosis the NP anticipates finding 12 lead ecg changes consistent with: A. Right BBB B. extreme axis deviation C. right atrial enlargement D. LVH - correct answer ✅D. LVH Signs and symptoms consistent with endocarditis include all of the following except: A. bradycardia B. Osler's nodes C. hematuria D. petechiae - correct answer ✅A. bradycardia NURSE PRACTITIONER CERTIFICATION EXAM AND PRACTICE PREP CARDIOVASCULAR questions and answers From the following list, the most helpful test in suspected bacterial endocarditis includes: A. urine culture B. blood culture C. chest x-ray D. myocardial biopsy - correct answer ✅B. blood culture Of the following patients, who is in greatest need of endocarditis prophylaxis when planning dental work? A. a 22yo woman with MVP w/trace mitral regurgitation noted on EKG B. a 54yo woman with a prosthetic aortic valve C. a 66yo man with cardiomyopathy D. a 58yo woman who had a three-vessel coronary artery bypass graft with drug- eluting stents 1 year ago - correct answer ✅B. a 54yo woman with a prosthetic aortic valve Of the following people, who has no significant increased risk for developing bacterial endocarditis? A. a 43yo woman with a biscuspid aortic valve NURSE PRACTITIONER CERTIFICATION EXAM AND PRACTICE PREP CARDIOVASCULAR questions and answers B. a 55yo man who was diagnosed with a Still's murmur during childhood C. a 45yo woman with a history of endocarditis D. a 75yo man with dilated cardiomyopathy - correct answer ✅B. a 55yo man who was diagnosed with a Still's murmur during childhood You are examining an 85yo woman and find a grade 3/6 crescendo-decrescendo systolic murmur with radiation to the neck. This is most likely caused by: A. aortic stenosis B. aortic regurgitation C. anemia D. mitral stenosis - correct answer ✅A. aortic stenosis Aortic stenosis in a 15yo male is most likely: A. a sequela of rheumatic fever B. a result of a congenital defect C. calcific in nature D. found with ASD - correct answer ✅B. a result of a congenital defect NURSE PRACTITIONER CERTIFICATION EXAM AND PRACTICE PREP CARDIOVASCULAR questions and answers A. softer than the S2 heart sound B. about as loud as the S1 heart sound C. accompanied by a thrill D. heard across the precordium but without radiation - correct answer ✅B. about as loud as the S1 heart sound The S3 heart sound has all of the following characteristics except: A. it is heard in early diastole B. a presystolic sound C. it is noted in the presence of ventricular overload D. it is heard best with the bell of the stethoscope - correct answer ✅B. a presystolic sound The S4 heart sound has which of the following characteristics? A. after it is initially noted, it is a permanent finding B. it is noted in the presence of poorly controlled hypertension C. it is heard best in early diastole D. it is a high-pitched sound best heard with the diaphragm of the stethoscope - correct answer ✅B. it is noted in the presence of poorly controlled hypertension NURSE PRACTITIONER CERTIFICATION EXAM AND PRACTICE PREP CARDIOVASCULAR questions and answers Of the following individuals, who is most likely to have a physiological split S2 heart sound? A. a 19yo healthy athlete B. a 49yo with well-controlled HTN C. a 68yo with stable heart failure D. a 78yo with cardiomyopathy - correct answer ✅A. a 19yo healthy athlete Idiopathic hypertrophic subaortic stenosis is inherited in: A. a sex-linked recessive manner B. a sex-linked dominant manner C. an autosomal-recessive manner D. an autosomal-dominant manner - correct answer ✅D. an autosomal-dominant manner Heart failure pathophysiology is characterized by: A. impaired atrial filling and ejection of blood B. incomplete closure of tricuspid valve NURSE PRACTITIONER CERTIFICATION EXAM AND PRACTICE PREP CARDIOVASCULAR questions and answers C. near normal ventricular function D. inadequate cardiac output to meet oxygen and metabolic demands of the body - correct answer ✅D. inadequate cardiac output to meet oxygen and metabolic demands of the body A leading cause of heart failure is: A. hypertensive heart disease B. atrial fibrillation C. pulmonary embolism D. type 2 diabetes - correct answer ✅A. hypertensive heart disease The condition of a sudden shortness of breath that usually occurs after 2-3 of hours of sleep that leads to sudden awakening followed by a feeling of severe anxiety and breathlessness is known as: A. dyspnea. B. orthopnea. C. resting dyspnea. D. paroxysmal nocturnal dyspnea. - correct answer ✅D. paroxysmal nocturnal dyspnea. NURSE PRACTITIONER CERTIFICATION EXAM AND PRACTICE PREP CARDIOVASCULAR questions and answers A potential adverse effect of ACEI when used with spironolactone therapy is: A. hypertension B. hyperkalemia C. renal insufficiency D. proteinuria - correct answer ✅B. hyperkalemia *ECG findings in a patient with digoxin toxicity would most likely include: a. atrioventricular heart block b. T wave inversion c. sinus tachycardia d. pointed P waves - correct answer ✅A. atrioventricular heart block Patients reporting symptoms of digoxin toxicity are most likely to include: A. anorexia. B. disturbance in color perception. C. blurred vision. D. diarrhea. - correct answer ✅A. anorexia. NURSE PRACTITIONER CERTIFICATION EXAM AND PRACTICE PREP CARDIOVASCULAR questions and answers Which of the following is among the most common causes of HF? A. dietary indiscretion B. COPD C. hypertensive heart disease D. anemia - correct answer ✅C. hypertensive heart disease Which of the following medications is an aldosterone antagonist? A. clonidine B. spironolactone C. hydrochlorothiazide D. furosemide - correct answer ✅B. spironolactone Which of the following best describes orthopnea? A. shortness of breath with exercise B. dyspnea that develops when the individual is recumbent and is relieved with elevation of the head. NURSE PRACTITIONER CERTIFICATION EXAM AND PRACTICE PREP CARDIOVASCULAR questions and answers C. shortness of breath that occurs at night, characterized by a sudden awakening after a couple of hours of sleep, with a feeling of severe anxiety, breathlessness, and suffocation D. dyspnea at rest - correct answer ✅B. dyspnea that develops when the individual is recumbent and is relieved with elevation of the head. Which of the following is unlikely to be noted in the person experiencing HF? A. elevated serum BNP B. Kerley B lines noted on chest x-ray C. left ventricular hypertrophy on ECG D. evidence of hemoconcentration on hemogram - correct answer ✅D. evidence of hemoconcentration on hemogram Which of the following medications is an alpha/beta-adrenergic antagonist? A. atenolol B. metoprolol C. propranolol D. carvedilol - correct answer ✅D. carvedilol