CEA Prep: Full Practice Exam | questions and
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Terms in this set (324)
The patient is exhibiting a productive Left upper lobe lingula
cough and a low-grade fever. Chest Ratonale: Lingular consolidation is described in this
X-ray on PA view shows a left lower question precisely. If the cardiac margin/silhouette
chest area of consolidation adjacent is obliterated by the mass, the lesion is either right
to the left border of the heart middle lobe or left upper lobe lingula.
approximately 2 rib spaces above
the costophrenic angle. The lateral x-
ray view shows this lesion absent of
the window posterior to the cardiac
silhouette. Which is the most likely
location of this area of focal
consolidation?
*Left upper lobe apex
*Right middle lobe
*Left upper lobe lingula
*Left lower lobe
The inability to fully relax the Diastolic dysfunction
myocardium during relaxation is a Rationale: The inability for the heart to relax is a
trademark of which of the following trademark of the diagnosis of diastolic dysfunction
diagnoses? and is common in patients with thickened
hypertrophic myocardium.
,An otherwise healthy African Calcium channel blocker
American adult male has been Rationale: African American patients per JNC8
diagnosed with hypertension. He has Hypertension Guidelines should be managed with a
been restricting his salt intake, eating dihydropyridine calcium channel blocker such as
a DASH (Dietary Approaches to Stop amlodipine (Norvasc) as first line management
Hypertension) diet, and exercising therapy for hypertension not at goal with DASH
more, but his blood pressure is still and lifestyle modifications.
elevated. Which is the BEST
medication to prescribe him?
Your patient has been diagnosed CT angiography of the chest
with a 4.5cm ascending aortic Rationale: CT angiography is considered the
aneurysm. Which medical imaging is standard of care for measuring vascular luminal
considered standard of care for serial dimensions with contrast. CT PE protocol is not
surveillance? timed properly for the aorta (it's timed for the
pulmonary artery). Although a plain film is able to
catch large aneurysms at times, they are not able to
provide multi-axis reconstruction needed to
accurately measure the size. Transesophageal echo
is not needed to accurately measure the aorta and
requires the patient to undergo sedation which is
unnecessary.
Which of the following medications phenylephrine
does not cause beta 1 stimulation? Rationale: Phenylephrine only stimulates alpha 1
receptors. The remaining three all have beta
receptor activity.
,A 50-year-old woman with a history Congestive heart failure
of hypertension presents with Rationale: Of the available options, the most
dyspnea on exertion and orthopnea. accurate response is congestive heart failure as it is
On examination, she has jugular signifying both a right ventricular back up with
venous distention and bilateral jugular venous extension and crackles on lung
crackles on lung auscultation. What assault, which are suggestive of left ventricular
is the most likely diagnosis? back up. it is possible the patient may have an
acute myocardial infarction that precipitated this,
however, a patient has not described that, rather is
only describing dyspnea on exertion and
orthopnea, which both speak to a state of fluid
overload. The only appropriate response of these
available is congestive heart failure.
Your patient with a history of HFrEF Ordering a transthoracic echocardiogram and
(heart failure with reduced ejection order a Lifevest if EF is less than 35%
fraction) with an ejection fraction of Rationale: The patient should have a protective
40% who is also not on optimal mechanism such as an implantable automated
medical therapy has been diagnosed cardioverter defibrillator (AICD) or a Lifevest if the
with a myocardial infarction this EF is less than 35% due to the increased risk of
admission and received emergent sudden cardiac death with low EF states. Since
placement of a drug-eluting stent to most patients are not eligible for 90 days for an
the left anterior descending artery. AICD in this state, optimizing their medication
As the medical home who will regimen and repeating an echo in 2-3 months to re-
manage this patient after discharge, evaluate for improvement in their EF is required by
which medication strategy would you most insurance companies. A baseline echo is
expect to be a priority in the patient's needed at discharge to provide a baseline for
care? improvement vs their repeat echo in 2-3 months.
Dual anti-platelet therapy is required for 12 months
minimum post-MI.
A Holter monitor does not provide any conceivable
benefit for this patient as presented.
, Which of the following people Caucasians
groups represent the least risk of Rationale: Statistically African Americans, Native
cardiac disease? Hawaiians, and American Indians are at at
increased risk of cardiac disease due to higher rates
of hypertension, diabetes, and obesity than
Caucasians.
A 65-year-old woman presents for a a statin drug.
follow-up examination. She is a Rationale: Bile acid sequestrants and cholesterol
smoker, and her hypertension is now absorption inhibitors may be useful in reducing
adequately controlled with ASVD risk, but for a patient who is an active smoker
medication. Her mother died at age with premature coronary disease history (less than
40 from a heart attack. The fasting age 65 for women), has hypertension and is far from
lipid profile shows cholesterol = 240 an LDL goal, this patient is most certainly a
mg/dL, HDL = 30, and LDL = 200. In candidate for statin therapy, which represents the
addition to starting therapeutic most aggressive therapy option of these four listed.
lifestyle changes, the nurse
practitioner should start the patient
on:
Which of the following end-organ Peripheral neuropathy
sequelae is not directly caused by Ratioanle: Although patients with hypertension
uncontrolled hypertension? frequently have peripheral neuropathy, it is only
directly attributed to patients who are also diabetic
and is commonly found in non-hypertensive
diabetic patients. Proteinuria, AV nicking, and
hemorrhagic stroke are all caused by uncontrolled
hypertension.
answers | latest update
Save
Terms in this set (324)
The patient is exhibiting a productive Left upper lobe lingula
cough and a low-grade fever. Chest Ratonale: Lingular consolidation is described in this
X-ray on PA view shows a left lower question precisely. If the cardiac margin/silhouette
chest area of consolidation adjacent is obliterated by the mass, the lesion is either right
to the left border of the heart middle lobe or left upper lobe lingula.
approximately 2 rib spaces above
the costophrenic angle. The lateral x-
ray view shows this lesion absent of
the window posterior to the cardiac
silhouette. Which is the most likely
location of this area of focal
consolidation?
*Left upper lobe apex
*Right middle lobe
*Left upper lobe lingula
*Left lower lobe
The inability to fully relax the Diastolic dysfunction
myocardium during relaxation is a Rationale: The inability for the heart to relax is a
trademark of which of the following trademark of the diagnosis of diastolic dysfunction
diagnoses? and is common in patients with thickened
hypertrophic myocardium.
,An otherwise healthy African Calcium channel blocker
American adult male has been Rationale: African American patients per JNC8
diagnosed with hypertension. He has Hypertension Guidelines should be managed with a
been restricting his salt intake, eating dihydropyridine calcium channel blocker such as
a DASH (Dietary Approaches to Stop amlodipine (Norvasc) as first line management
Hypertension) diet, and exercising therapy for hypertension not at goal with DASH
more, but his blood pressure is still and lifestyle modifications.
elevated. Which is the BEST
medication to prescribe him?
Your patient has been diagnosed CT angiography of the chest
with a 4.5cm ascending aortic Rationale: CT angiography is considered the
aneurysm. Which medical imaging is standard of care for measuring vascular luminal
considered standard of care for serial dimensions with contrast. CT PE protocol is not
surveillance? timed properly for the aorta (it's timed for the
pulmonary artery). Although a plain film is able to
catch large aneurysms at times, they are not able to
provide multi-axis reconstruction needed to
accurately measure the size. Transesophageal echo
is not needed to accurately measure the aorta and
requires the patient to undergo sedation which is
unnecessary.
Which of the following medications phenylephrine
does not cause beta 1 stimulation? Rationale: Phenylephrine only stimulates alpha 1
receptors. The remaining three all have beta
receptor activity.
,A 50-year-old woman with a history Congestive heart failure
of hypertension presents with Rationale: Of the available options, the most
dyspnea on exertion and orthopnea. accurate response is congestive heart failure as it is
On examination, she has jugular signifying both a right ventricular back up with
venous distention and bilateral jugular venous extension and crackles on lung
crackles on lung auscultation. What assault, which are suggestive of left ventricular
is the most likely diagnosis? back up. it is possible the patient may have an
acute myocardial infarction that precipitated this,
however, a patient has not described that, rather is
only describing dyspnea on exertion and
orthopnea, which both speak to a state of fluid
overload. The only appropriate response of these
available is congestive heart failure.
Your patient with a history of HFrEF Ordering a transthoracic echocardiogram and
(heart failure with reduced ejection order a Lifevest if EF is less than 35%
fraction) with an ejection fraction of Rationale: The patient should have a protective
40% who is also not on optimal mechanism such as an implantable automated
medical therapy has been diagnosed cardioverter defibrillator (AICD) or a Lifevest if the
with a myocardial infarction this EF is less than 35% due to the increased risk of
admission and received emergent sudden cardiac death with low EF states. Since
placement of a drug-eluting stent to most patients are not eligible for 90 days for an
the left anterior descending artery. AICD in this state, optimizing their medication
As the medical home who will regimen and repeating an echo in 2-3 months to re-
manage this patient after discharge, evaluate for improvement in their EF is required by
which medication strategy would you most insurance companies. A baseline echo is
expect to be a priority in the patient's needed at discharge to provide a baseline for
care? improvement vs their repeat echo in 2-3 months.
Dual anti-platelet therapy is required for 12 months
minimum post-MI.
A Holter monitor does not provide any conceivable
benefit for this patient as presented.
, Which of the following people Caucasians
groups represent the least risk of Rationale: Statistically African Americans, Native
cardiac disease? Hawaiians, and American Indians are at at
increased risk of cardiac disease due to higher rates
of hypertension, diabetes, and obesity than
Caucasians.
A 65-year-old woman presents for a a statin drug.
follow-up examination. She is a Rationale: Bile acid sequestrants and cholesterol
smoker, and her hypertension is now absorption inhibitors may be useful in reducing
adequately controlled with ASVD risk, but for a patient who is an active smoker
medication. Her mother died at age with premature coronary disease history (less than
40 from a heart attack. The fasting age 65 for women), has hypertension and is far from
lipid profile shows cholesterol = 240 an LDL goal, this patient is most certainly a
mg/dL, HDL = 30, and LDL = 200. In candidate for statin therapy, which represents the
addition to starting therapeutic most aggressive therapy option of these four listed.
lifestyle changes, the nurse
practitioner should start the patient
on:
Which of the following end-organ Peripheral neuropathy
sequelae is not directly caused by Ratioanle: Although patients with hypertension
uncontrolled hypertension? frequently have peripheral neuropathy, it is only
directly attributed to patients who are also diabetic
and is commonly found in non-hypertensive
diabetic patients. Proteinuria, AV nicking, and
hemorrhagic stroke are all caused by uncontrolled
hypertension.
