MSN 622 Week 2 – Cardiac Exam UPDATED
QUESTIONS AND CORRECT ANSWERS
A patient with congestive heart failure is started on furosemide. They should also be
prescribed which other medication? - CORRECT ANSWER Lisinopril
What is the recommended management for a patient with a 3.5 cm abdominal aortic
aneurysm? - CORRECT ANSWER Ultrasound every three years
A 78-year-old is found to have an asymptomatic pulsatile abdominal mass. The ultrasound
shows an abdominal aortic aneurysm measuring 5.5 cm. Which of the following statements
concerning this patient's condition is correct? - CORRECT ANSWER Surgery will
improve 5-year survival.
A 65-year-old male presents with severe substernal pain for 20 minutes, radiating to the upper
left limb and accompanied by dyspnea. He has a history of hypertension and smokes 30
cigarettes/day. His blood pressure is 145/90 mmHg and his pulse is 78/min. Physical
examination is unremarkable. The pain settled promptly following 300 mg aspirin orally and
800 mcg glyceryl trinitrate (GTN) spray sublingually. What is the most common underlying
pathological cause for this patient's symptoms? - CORRECT ANSWER Coronary
artery atherosclerosis
A 17-year-old male presents for a sports physical. He has been healthy up to this point. His
blood pressure is 145/95 mmHg bilaterally on three separate occasions. Lower extremity
blood pressure is also elevated. The patient's father, uncle, and grandfather all have
hypertension, and his father and grandfather have chronic kidney disease as well. Based on
this information, the clinician ordered an echocardiogram and abdominal ultrasound. The
echocardiogram was unremarkable. What is the most likely reason for ordering an abdominal
ultrasound? - CORRECT ANSWER Polycystic kidneys
A 65-year-old man presents with episodic substernal pain. Initially, he experienced chest pain
with physical activity, which remits with rest. But now it occurs at rest too. He has a history
of hypertension and smokes 30 cigarettes/day. In addition, he has aspirin hypersensitivity. His
blood pressure is 145/90 mmHg, pulse is 78/min, and oxygen saturation is 97%. Physical
examination is unremarkable. ECG reveals mild ST-segment depressions in V1-V2. Cardiac
, troponins are not elevated. Which of the following is the best option for the management in
this patient? - CORRECT ANSWER Clopidogrel
A 65-year-old female patient presents with worsening chest pain and blurring of vision. She
has a history of hypertension, diabetes mellitus, hyperlipidemia, renal insufficiency, and atrial
fibrillation. Vital signs show temperature 37.8°C (100 F), heart rate 98 bpm, blood pressure
190/110 mmHg, respiratory rate 20 breaths/min, and oxygen saturation 91%. Her complete
blood count shows a WBC of 12.0 and hematocrit 30%. Her eGFR is 39 ml/min/1.73 m2.
What is the contraindication for cardiac catheterization in this patient? - CORRECT
ANSWER Uncontrolled malignant hypertension
A 65-year-old male presents to the emergency department with chest pain for the past two
hours. The pain is located at the precordial region, described as sharp, 7/10 intensity, lasting
for 20 minutes, radiating to the upper left upper limb and accompanied by dyspnea. His past
medical history is significant for hypertension and diabetes mellitus type 2. His blood
pressure is 120/80 mmHg, the pulse rate 72/min; the temperature 98 F. EKG reveals ST-
segment depression. What is the best enzyme assay to diagnose this condition? - CORRECT
ANSWER Troponin
A 65-year-old male with a history of type 2 diabetes comes into the provider's office
complaining of blurry vision, nosebleeds, and exertional chest pain for the past six months.
The blood pressure is measured to be 160/94 mmHg. A CT angiogram is performed, which
reveals partially occlusive coronary artery plaques. Which of the following medication
regimens would be most appropriate for this patient? - CORRECT
ANSWER Losartan/hydrochlorothiazide and atorvastatin
A 75-year-old man presents to the emergency department with complaints of severe
abdominal pain and sweating. The pain started about an hour ago and is becoming worse with
time. He has been diagnosed with hypertension and diabetes and is on amlodipine and
metformin, respectively. On presentation, the vital signs show blood pressure 70/40 mmHg,
pulse 140/min, respiratory rate 32/min, temperature 38.5 C (101.3 F), and oxygen saturation
87% at room air. On physical examination of the abdomen, generalized tenderness and
guarding are seen. There is a midline pulsatile mass. What is the next best step in the
management of this patient? - CORRECT ANSWER Immediate surgery
A 67-year-old man with a history of hypertension and tobacco use presents with a two-day
history of hypogastric pain. An examination reveals a 5 cm, non-tender, pulsatile abdominal
mass above the umbilicus. Which of the following type of sounds might be heard upon
QUESTIONS AND CORRECT ANSWERS
A patient with congestive heart failure is started on furosemide. They should also be
prescribed which other medication? - CORRECT ANSWER Lisinopril
What is the recommended management for a patient with a 3.5 cm abdominal aortic
aneurysm? - CORRECT ANSWER Ultrasound every three years
A 78-year-old is found to have an asymptomatic pulsatile abdominal mass. The ultrasound
shows an abdominal aortic aneurysm measuring 5.5 cm. Which of the following statements
concerning this patient's condition is correct? - CORRECT ANSWER Surgery will
improve 5-year survival.
A 65-year-old male presents with severe substernal pain for 20 minutes, radiating to the upper
left limb and accompanied by dyspnea. He has a history of hypertension and smokes 30
cigarettes/day. His blood pressure is 145/90 mmHg and his pulse is 78/min. Physical
examination is unremarkable. The pain settled promptly following 300 mg aspirin orally and
800 mcg glyceryl trinitrate (GTN) spray sublingually. What is the most common underlying
pathological cause for this patient's symptoms? - CORRECT ANSWER Coronary
artery atherosclerosis
A 17-year-old male presents for a sports physical. He has been healthy up to this point. His
blood pressure is 145/95 mmHg bilaterally on three separate occasions. Lower extremity
blood pressure is also elevated. The patient's father, uncle, and grandfather all have
hypertension, and his father and grandfather have chronic kidney disease as well. Based on
this information, the clinician ordered an echocardiogram and abdominal ultrasound. The
echocardiogram was unremarkable. What is the most likely reason for ordering an abdominal
ultrasound? - CORRECT ANSWER Polycystic kidneys
A 65-year-old man presents with episodic substernal pain. Initially, he experienced chest pain
with physical activity, which remits with rest. But now it occurs at rest too. He has a history
of hypertension and smokes 30 cigarettes/day. In addition, he has aspirin hypersensitivity. His
blood pressure is 145/90 mmHg, pulse is 78/min, and oxygen saturation is 97%. Physical
examination is unremarkable. ECG reveals mild ST-segment depressions in V1-V2. Cardiac
, troponins are not elevated. Which of the following is the best option for the management in
this patient? - CORRECT ANSWER Clopidogrel
A 65-year-old female patient presents with worsening chest pain and blurring of vision. She
has a history of hypertension, diabetes mellitus, hyperlipidemia, renal insufficiency, and atrial
fibrillation. Vital signs show temperature 37.8°C (100 F), heart rate 98 bpm, blood pressure
190/110 mmHg, respiratory rate 20 breaths/min, and oxygen saturation 91%. Her complete
blood count shows a WBC of 12.0 and hematocrit 30%. Her eGFR is 39 ml/min/1.73 m2.
What is the contraindication for cardiac catheterization in this patient? - CORRECT
ANSWER Uncontrolled malignant hypertension
A 65-year-old male presents to the emergency department with chest pain for the past two
hours. The pain is located at the precordial region, described as sharp, 7/10 intensity, lasting
for 20 minutes, radiating to the upper left upper limb and accompanied by dyspnea. His past
medical history is significant for hypertension and diabetes mellitus type 2. His blood
pressure is 120/80 mmHg, the pulse rate 72/min; the temperature 98 F. EKG reveals ST-
segment depression. What is the best enzyme assay to diagnose this condition? - CORRECT
ANSWER Troponin
A 65-year-old male with a history of type 2 diabetes comes into the provider's office
complaining of blurry vision, nosebleeds, and exertional chest pain for the past six months.
The blood pressure is measured to be 160/94 mmHg. A CT angiogram is performed, which
reveals partially occlusive coronary artery plaques. Which of the following medication
regimens would be most appropriate for this patient? - CORRECT
ANSWER Losartan/hydrochlorothiazide and atorvastatin
A 75-year-old man presents to the emergency department with complaints of severe
abdominal pain and sweating. The pain started about an hour ago and is becoming worse with
time. He has been diagnosed with hypertension and diabetes and is on amlodipine and
metformin, respectively. On presentation, the vital signs show blood pressure 70/40 mmHg,
pulse 140/min, respiratory rate 32/min, temperature 38.5 C (101.3 F), and oxygen saturation
87% at room air. On physical examination of the abdomen, generalized tenderness and
guarding are seen. There is a midline pulsatile mass. What is the next best step in the
management of this patient? - CORRECT ANSWER Immediate surgery
A 67-year-old man with a history of hypertension and tobacco use presents with a two-day
history of hypogastric pain. An examination reveals a 5 cm, non-tender, pulsatile abdominal
mass above the umbilicus. Which of the following type of sounds might be heard upon
