NR 439 WEEK 2 GRADED DISCUSSION TOPIC
RESEARCH COMPREHENSIVE EXAMINATION
TEST
◉ A patient is being followed for type 2 diabetes mellitus and
hypertension. He also has a diagnosis of polycythemia vera and has
regular phlebotomies for management. Which of the following
statements about this patient is correct?
The phlebotomies will improve his glycosylated hemoglobin levels
The phlebotomies will increase his blood pressure
He should increase dietary iron supplements
He should avoid dietary iron supplements. Answer: He should avoid
dietary iron supplements
◉ As the nurse practitioner working in a primary care clinic, you
have been notified from a hospitalist that your long-term patient
with a history of HFrEF (heart failure with reduced ejection fraction)
with an ejection fraction of 40% two years ago who is also not on
optimal medical therapy has been diagnosed with a myocardial
infarction this admission and received emergent placement of a
drug-eluting stent to the left anterior descending artery. As the
patient's medical home who will manage this patient after discharge,
which of the following would you expect to be a priority in the
patient's care for their heart failure after an acute MI?
Ordering a Holter monitor for 7 days post-discharge
,Ordering a new transthoracic echocardiogram and Lifevest if EF is
less than 35%
Ordering aspirin and clopidogrel for 3 months at discharge
Ordering a new transthoracic echocardiogram and order a Lifevest if
EF is less than 45%. Answer: Ordering a new transthoracic
echocardiogram and Lifevest if EF is less than 35%
◉ A 70-year-old man with a history of atrial fibrillation presents
with sudden-onset left-sided weakness and slurred speech. What is
the most likely diagnosis?
Stroke
Transient ischemic attack (TIA)
Myocardial infarction (MI)
Seizure. Answer: Stroke
◉ A 55 year-old female patient with no previous cardiac history and
no family history of hyperlipidemia with an acute myocardial
infarction is treated successfully with a drug-eluting stent during a
recent hospitalization. As their long-term care provider, you
anticipate they were most likely to be also started on which of the
following lipid-lowering agents at discharge?
Ezetimibe prior to initiating statin therapy
PCSK9 inhibitor therapy
,High intensity statin therapy
Moderate intensity statin therapy. Answer: High intensity statin
therapy
◉ Which of the following medications is not considered part of
optimal medical therapy for a 54 year-old male patient with a
diagnosis of heart failure with reduced ejection fraction (HFrEF)
with an EF of 30%, known coronary artery disease, and normal
renal function?
Aspirin
Carvedilol (Coreg)
Diltiazem (Cardizem)
Spironolactone (Aldactone). Answer: Diltiazem (Cardizem)
◉ An older adult with diabetes mellitus presents with leg cramps.
She states that the cramps were worst when walking to the
supermarket. If she stops to rest, the pain subsides. The nurse
practitioner knows that this patient needs a workup for:
Popliteal aneurism
Deep vein thrombosis
Benign nocturnal leg cramps
Intermittent claudication. Answer: Intermittent claudication
, ◉ What is the key long-term benefit of using carvedilol for patients
with coronary artery disease and heart failure with reduced ejection
fraction (HFrEF)?
Baseline reduction of blood pressure
Increase in libido
Potential increase in ejection fraction
Reduce in cardiac output. Answer: Potential increase in ejection
fraction
◉ An otherwise healthy patient reports episodes of palpitations
lasting less than 5 minutes and occurring 3-5 times daily. The
patient describes a substernal flip-flop sensation with a sudden
rapid heart rate, ending with a forceful beat. Holter monitoring
would most likely document:
Premature ventricular contraction (extrasystole)
Paroxysmal supraventricular tachycardia
Sinus tachycardia
Atrial flutter. Answer: Paroxysmal supraventricular tachycardia
◉ Which of the following people groups represent the least risk of
cardiac disease?
Native Hawaiians
American Indians
Caucasians
RESEARCH COMPREHENSIVE EXAMINATION
TEST
◉ A patient is being followed for type 2 diabetes mellitus and
hypertension. He also has a diagnosis of polycythemia vera and has
regular phlebotomies for management. Which of the following
statements about this patient is correct?
The phlebotomies will improve his glycosylated hemoglobin levels
The phlebotomies will increase his blood pressure
He should increase dietary iron supplements
He should avoid dietary iron supplements. Answer: He should avoid
dietary iron supplements
◉ As the nurse practitioner working in a primary care clinic, you
have been notified from a hospitalist that your long-term patient
with a history of HFrEF (heart failure with reduced ejection fraction)
with an ejection fraction of 40% two years ago who is also not on
optimal medical therapy has been diagnosed with a myocardial
infarction this admission and received emergent placement of a
drug-eluting stent to the left anterior descending artery. As the
patient's medical home who will manage this patient after discharge,
which of the following would you expect to be a priority in the
patient's care for their heart failure after an acute MI?
Ordering a Holter monitor for 7 days post-discharge
,Ordering a new transthoracic echocardiogram and Lifevest if EF is
less than 35%
Ordering aspirin and clopidogrel for 3 months at discharge
Ordering a new transthoracic echocardiogram and order a Lifevest if
EF is less than 45%. Answer: Ordering a new transthoracic
echocardiogram and Lifevest if EF is less than 35%
◉ A 70-year-old man with a history of atrial fibrillation presents
with sudden-onset left-sided weakness and slurred speech. What is
the most likely diagnosis?
Stroke
Transient ischemic attack (TIA)
Myocardial infarction (MI)
Seizure. Answer: Stroke
◉ A 55 year-old female patient with no previous cardiac history and
no family history of hyperlipidemia with an acute myocardial
infarction is treated successfully with a drug-eluting stent during a
recent hospitalization. As their long-term care provider, you
anticipate they were most likely to be also started on which of the
following lipid-lowering agents at discharge?
Ezetimibe prior to initiating statin therapy
PCSK9 inhibitor therapy
,High intensity statin therapy
Moderate intensity statin therapy. Answer: High intensity statin
therapy
◉ Which of the following medications is not considered part of
optimal medical therapy for a 54 year-old male patient with a
diagnosis of heart failure with reduced ejection fraction (HFrEF)
with an EF of 30%, known coronary artery disease, and normal
renal function?
Aspirin
Carvedilol (Coreg)
Diltiazem (Cardizem)
Spironolactone (Aldactone). Answer: Diltiazem (Cardizem)
◉ An older adult with diabetes mellitus presents with leg cramps.
She states that the cramps were worst when walking to the
supermarket. If she stops to rest, the pain subsides. The nurse
practitioner knows that this patient needs a workup for:
Popliteal aneurism
Deep vein thrombosis
Benign nocturnal leg cramps
Intermittent claudication. Answer: Intermittent claudication
, ◉ What is the key long-term benefit of using carvedilol for patients
with coronary artery disease and heart failure with reduced ejection
fraction (HFrEF)?
Baseline reduction of blood pressure
Increase in libido
Potential increase in ejection fraction
Reduce in cardiac output. Answer: Potential increase in ejection
fraction
◉ An otherwise healthy patient reports episodes of palpitations
lasting less than 5 minutes and occurring 3-5 times daily. The
patient describes a substernal flip-flop sensation with a sudden
rapid heart rate, ending with a forceful beat. Holter monitoring
would most likely document:
Premature ventricular contraction (extrasystole)
Paroxysmal supraventricular tachycardia
Sinus tachycardia
Atrial flutter. Answer: Paroxysmal supraventricular tachycardia
◉ Which of the following people groups represent the least risk of
cardiac disease?
Native Hawaiians
American Indians
Caucasians
