NR 603 - CEA Cardiac Exam Practice Questions and Answers 2026 Update

Cardiac 1. As the nurse practitioner on call on at a long term care facility, a nurse calls you to notify you that your patient who was in normal sinus rhythm has started to have extra premature beats noted on bedside telemetry. The nurse states these extra beats occur approximately every 6 normal beats and has an inverted p wave located after the narrow QRS complex which appears otherwise identical to the normal sinus rhythm QRS complex. What is this nurse likely describing? a. Sinus Exit Block b. Premature Junctional Contractions c. Premature Ventricular Contractions d. Premature Atrial Contractions i. Sinus exit block does have a pause, but no change in P wave morphology. PACs will maintain an early but otherwise normal P wave/QRS. PJCs will have absent, inverted or retrograde P waves(after the QRS) and be otherwise narrow complex QRS. PVCs will be absent of any P wave and have a wide complex QRS. 2. Your 53 year-old female patient is experiencing shortness of breath and has a diagnosis of pulmonary arterial hypertension. Which ventricle is directly experiencing increased afterload from this disease state? a. Right Ventricle b. Neither Left or Right Ventricles c. Both Right and Left Ventricles d. Left Ventricle i. Rationale: Understanding the flow of blood through the body is necessary to answer this question. The circuit of blood immediately prior to the pulmonary artery is the right ventricle. The left ventricle will not receive an increase in afterload from this, but may increase in preload. 3. Recommendation for lipid check in adolescent with type 1 DM? a. 5 years b. 1 year c. 2 years d. 10 years i. Remember than with pediatric patients with diabetes, the easiest way to remember the evaluation schedule is to perform lipid checks is with annual physicals. 4. An otherwise healthy African American adult male has been diagnosed with hypertension. He has been restricting his salt intake, eating a DASH (Dietary Approaches to Stop Hypertension) diet, and exercising more, but his blood pressure is still elevated. Which is the BEST medication to prescribe him? a. Beta blocker b. Angiotensin-converting-enzyme inhibitor c. Alpha blocker d. Calcium channel blocker 5. An adult patient must maintain an International Normalized Ratio (INR) between 2.0 and 3.0. The patient goes to a clinic for INR determination, and the result is 1.4. Which of the following would be likely to decrease the effects of warfarin (Coumadin)? a. Broccoli b. Red Wine c. Grapefruit d. Red meat i. It’s important to remember with warfarin (Coumadin) therapy that it is a vitamin K antagonist, and therefore it can be counteracted by a patient who is eating a dietary intake of vitamin K. Leafy green vegetables such as broccoli and spinach are notorious for increasing vitamin K levels, and therefore inhibiting the anticoagulation effect of warfarin. It’s also important to remember that with the direct oral anticoagulants category, vitamin K is not affected, and therefore no dietary restrictions are required for this class of medications such as apixaban, rivaroxaban, and edoxaban, which is a distinct benefit over warfarin as noted above. Also, with warfarin it is important to remember that the effects are based on the free drug, not the protein bound drug level, so patients who have considerable protein stores will require more warfarin than those who are emaciated or have low protein levels chronically. ii. With respect to this particular question, red wine and grapefruit do not have an effect of lowering the INR, in fact, they will raise it by their unique mechanisms. Grapefruit