1
NURS 6531 Combined Midterm and Final
Review Walden University Comprehensive
Study Guide
A health care provider in a clinic finds a patient in a room,
unresponsive and pale. Which sign should be used to identify the
need to initiate cardiopulmonary resuscitation (CPR)?
Evaluation of peripheral perfusion and level of consciousness
Obtaining a history of previous myocardial infarction
Determination of pulselessness or bradycardia
Assessment of gasping breaths or not breathing
- correct answer-Assessment of gasping breaths or not breathing
An African-American patient who is being treated with a thiazide
diuretic for chronic hypertension reports blurred vision and shortness
of breath. The provider notes a blood pressure of 185/115. What is
the recommended action for this patient?
Increase the dose of the thiazide medication
Add a beta blocker to the patient's regimen
Admit to the hospital for evaluation and treatment
Prescribe a calcium channel blocker
- correct answer-Admit to the hospital for evaluation and treatment
A patient reports sustained, irregular heart palpitations. What is the
most likely cause of these symptoms?
Atrial fibrillation
Anemia
Extrasystole
Paroxysmal attacks
- correct answer-Atrial fibrillation
1
, 2
A patient has a cardiac murmur that peaks in midsystole and is best
heard along the left sternal border. The provider determines that the
murmur decreases in intensity when the patient changes from
standing to squatting and increases in intensity with the Valsalva
maneuver. Which cause will the provider suspect for this murmur?
Aortic stenosis
Tricuspid regurgitation
Hypertrophic cardiomyopathy
Mitral valve prolapse
- correct answer-Hypertrophic cardiomyopathy
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?
Give the patient an oral beta blocker
Transfer to the PCI-capable institution
Administer heparin
Initiate fibrinolytic treatment - correct answer-Initiate fibrinolytic
treatment
Patients who meet the criteria for statin therapy to help prevent
atherosclerotic cardiovascular disease are those with a history of
(Select all that apply.)
previous myocardial infarction.
a low-density lipoprotein (LDL) level >190 mg/dL.
diabetes and an LDL between 40 and 70 mg/dL.
a 10 year risk score of 8% with an LDL of 80 mg/dL.
a 10 year risk score of 5% and an LDL of 165 mg/dL. - correct answer-
previous myocardial infarction.
a low-density lipoprotein (LDL) level >190 mg/dL.
a 10 year risk score of 8% with an LDL of 80 mg/dL.
2
, 3
A 75-year-old patient reports pain and a feeling of tiredness in both
legs that only relieves after sitting for 30 minutes or more. What the
does provider suspect as the cause for these symptoms?
Buerger's disease
Cauda equina syndrome
Diabetic neuropathy
Peripheral arterial disease - correct answer-Cauda equina syndrome
Which are causes of secondary hypertension? (Select all that apply.)
Oral contraceptives
Isometic excercises
NSAIDS
Sleep apnea
Increased salt intake - correct answer-Oral contraceptives
NSAIDS
Sleep apnea
A young female patient has known mitral valve prolapse. During a
routine health maintenance exam, the provider notes an apical
systolic murmur and a midsystolic click on auscultation. The patient
denies chest pain, syncope, or palpitations. What will the provider
do?
Reassure the patient that these findings are expected
Continue to monitor the patient every 3 years
Admit the patient to the hospital for evaluation and treatment
Consult with cardiology to determine appropriate diagnostic tests -
correct answer-Consult with cardiology to determine appropriate
diagnostic tests
A patient reports abdominal and back pain with anorexia and nausea.
During an exam, the provider notes a pulsatile abdominal mass. What
is the initial action?
Scheduling an MRI to evaluate for aortic disease
Immediate referral to a thoracic surgeon
US of the mass to determine size
3
, 4
Ordering CT angiography - correct answer-US of the mass to
determine size
A patient is brought to an emergency department with symptoms of
acute ST-segment elevations MI (STEMI). The nearest hospital that
can perform percutaneous coronary intervention (PCI) is 3 hours
away. What is the initial treatment for this patient?
Give the patient an oral beta blocker
Initiate fibrinolytic treatment
Administer heparin
Transfer to the PCI-capable institution - correct answer-Initiate
fibrinolytic treatment
A 55-year-old patient has a blood pressure of 138/85 on three
occasions. The patient denies headaches, palpitations, snoring,
muscle weakness, and nocturia and does not take any medications.
What will the provider do next to evaluate this patient?
Continue to monitor blood pressure at each health maintenance visit
Assess serum cortisol levels
Order urinalysis, CBC, BUN and creatinine
Refer to specialist for sleep study - correct answer-Order urinalysis,
CBC, BUN and creatinine
A patient is diagnosed with PAD and elects to not have angioplasty
after an angiogram reveals partial obstruction in lower extremity
arteries. What will the provider recommend to help with relief of
symptoms in this patient?
Statin therapy with clopidogrel
Walking to the point of pain each day
Daily aspirin therapy to prevent clotting
Walking slowly for 15 to 20 minutes twice daily - correct answer-
Walking to the point of pain each day
4
NURS 6531 Combined Midterm and Final
Review Walden University Comprehensive
Study Guide
A health care provider in a clinic finds a patient in a room,
unresponsive and pale. Which sign should be used to identify the
need to initiate cardiopulmonary resuscitation (CPR)?
Evaluation of peripheral perfusion and level of consciousness
Obtaining a history of previous myocardial infarction
Determination of pulselessness or bradycardia
Assessment of gasping breaths or not breathing
- correct answer-Assessment of gasping breaths or not breathing
An African-American patient who is being treated with a thiazide
diuretic for chronic hypertension reports blurred vision and shortness
of breath. The provider notes a blood pressure of 185/115. What is
the recommended action for this patient?
Increase the dose of the thiazide medication
Add a beta blocker to the patient's regimen
Admit to the hospital for evaluation and treatment
Prescribe a calcium channel blocker
- correct answer-Admit to the hospital for evaluation and treatment
A patient reports sustained, irregular heart palpitations. What is the
most likely cause of these symptoms?
Atrial fibrillation
Anemia
Extrasystole
Paroxysmal attacks
- correct answer-Atrial fibrillation
1
, 2
A patient has a cardiac murmur that peaks in midsystole and is best
heard along the left sternal border. The provider determines that the
murmur decreases in intensity when the patient changes from
standing to squatting and increases in intensity with the Valsalva
maneuver. Which cause will the provider suspect for this murmur?
Aortic stenosis
Tricuspid regurgitation
Hypertrophic cardiomyopathy
Mitral valve prolapse
- correct answer-Hypertrophic cardiomyopathy
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?
Give the patient an oral beta blocker
Transfer to the PCI-capable institution
Administer heparin
Initiate fibrinolytic treatment - correct answer-Initiate fibrinolytic
treatment
Patients who meet the criteria for statin therapy to help prevent
atherosclerotic cardiovascular disease are those with a history of
(Select all that apply.)
previous myocardial infarction.
a low-density lipoprotein (LDL) level >190 mg/dL.
diabetes and an LDL between 40 and 70 mg/dL.
a 10 year risk score of 8% with an LDL of 80 mg/dL.
a 10 year risk score of 5% and an LDL of 165 mg/dL. - correct answer-
previous myocardial infarction.
a low-density lipoprotein (LDL) level >190 mg/dL.
a 10 year risk score of 8% with an LDL of 80 mg/dL.
2
, 3
A 75-year-old patient reports pain and a feeling of tiredness in both
legs that only relieves after sitting for 30 minutes or more. What the
does provider suspect as the cause for these symptoms?
Buerger's disease
Cauda equina syndrome
Diabetic neuropathy
Peripheral arterial disease - correct answer-Cauda equina syndrome
Which are causes of secondary hypertension? (Select all that apply.)
Oral contraceptives
Isometic excercises
NSAIDS
Sleep apnea
Increased salt intake - correct answer-Oral contraceptives
NSAIDS
Sleep apnea
A young female patient has known mitral valve prolapse. During a
routine health maintenance exam, the provider notes an apical
systolic murmur and a midsystolic click on auscultation. The patient
denies chest pain, syncope, or palpitations. What will the provider
do?
Reassure the patient that these findings are expected
Continue to monitor the patient every 3 years
Admit the patient to the hospital for evaluation and treatment
Consult with cardiology to determine appropriate diagnostic tests -
correct answer-Consult with cardiology to determine appropriate
diagnostic tests
A patient reports abdominal and back pain with anorexia and nausea.
During an exam, the provider notes a pulsatile abdominal mass. What
is the initial action?
Scheduling an MRI to evaluate for aortic disease
Immediate referral to a thoracic surgeon
US of the mass to determine size
3
, 4
Ordering CT angiography - correct answer-US of the mass to
determine size
A patient is brought to an emergency department with symptoms of
acute ST-segment elevations MI (STEMI). The nearest hospital that
can perform percutaneous coronary intervention (PCI) is 3 hours
away. What is the initial treatment for this patient?
Give the patient an oral beta blocker
Initiate fibrinolytic treatment
Administer heparin
Transfer to the PCI-capable institution - correct answer-Initiate
fibrinolytic treatment
A 55-year-old patient has a blood pressure of 138/85 on three
occasions. The patient denies headaches, palpitations, snoring,
muscle weakness, and nocturia and does not take any medications.
What will the provider do next to evaluate this patient?
Continue to monitor blood pressure at each health maintenance visit
Assess serum cortisol levels
Order urinalysis, CBC, BUN and creatinine
Refer to specialist for sleep study - correct answer-Order urinalysis,
CBC, BUN and creatinine
A patient is diagnosed with PAD and elects to not have angioplasty
after an angiogram reveals partial obstruction in lower extremity
arteries. What will the provider recommend to help with relief of
symptoms in this patient?
Statin therapy with clopidogrel
Walking to the point of pain each day
Daily aspirin therapy to prevent clotting
Walking slowly for 15 to 20 minutes twice daily - correct answer-
Walking to the point of pain each day
4
