CEA Prep: Full Practice Exam
Save
Terms in this set (324)
The patient is exhibiting a Left upper lobe lingula
productive cough and a low-grade Ratonale: Lingular consolidation is described in
fever. Chest X-ray on PA view shows this question precisely. If the cardiac
a left lower chest area of margin/silhouette is obliterated by the mass, the
consolidation adjacent to the left lesion is either right middle lobe or left upper
border of the heart approximately 2 lobe lingula.
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
diagnoses? dysfunction 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 Hypertension Guidelines should be managed
has been restricting his salt intake, with a dihydropyridine calcium channel blocker
eating a DASH (Dietary Approaches such as amlodipine (Norvasc) as first line
to Stop Hypertension) diet, and management therapy for hypertension not at
exercising more, but his blood goal with DASH and lifestyle modifications.
pressure is still 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 dimensions with contrast. CT PE protocol is not
serial 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 accurate response is congestive heart failure as it
orthopnea. On examination, she has is signifying both a right ventricular back up with
jugular venous distention and jugular venous extension and crackles on lung
bilateral crackles on lung assault, which are suggestive of left ventricular
auscultation. What is the most likely back up. it is possible the patient may have an
diagnosis? 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 cardioverter defibrillator (AICD) or a Lifevest if
diagnosed with a myocardial the EF is less than 35% due to the increased risk
infarction this admission and of sudden cardiac death with low EF states. Since
received emergent placement of a most patients are not eligible for 90 days for an
drug-eluting stent to the left AICD in this state, optimizing their medication
anterior descending artery. As the regimen and repeating an echo in 2-3 months to
medical home who will manage this re-evaluate for improvement in their EF is
patient after discharge, which required by most insurance companies. A
medication strategy would you baseline echo is needed at discharge to provide
expect to be a priority in the a baseline for improvement vs their repeat echo
patient's care? 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 statin drug.
a follow-up examination. She is a Rationale: Bile acid sequestrants and cholesterol
smoker, and her hypertension is absorption inhibitors may be useful in reducing
now adequately controlled with ASVD risk, but for a patient who is an active
medication. Her mother died at age smoker with premature coronary disease history
40 from a heart attack. The fasting (less than age 65 for women), has hypertension
lipid profile shows cholesterol = 240 and is far from an LDL goal, this patient is most
mg/dL, HDL = 30, and LDL = 200. In certainly a candidate for statin therapy, which
addition to starting therapeutic represents the most aggressive therapy option of
lifestyle changes, the nurse these four listed.
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.
Preventive cardiac care should Genetic predisposition
focus primarily on addressing all Rationale: Smoking cessation, exercise, and
the following except? medication compliance all represent modifiable
risk factors and should be the focus of preventive
care. Non-modifiable risk factors such as age,
gender, genetic/family history should not be the
primary focus of prevention.
Save
Terms in this set (324)
The patient is exhibiting a Left upper lobe lingula
productive cough and a low-grade Ratonale: Lingular consolidation is described in
fever. Chest X-ray on PA view shows this question precisely. If the cardiac
a left lower chest area of margin/silhouette is obliterated by the mass, the
consolidation adjacent to the left lesion is either right middle lobe or left upper
border of the heart approximately 2 lobe lingula.
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
diagnoses? dysfunction 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 Hypertension Guidelines should be managed
has been restricting his salt intake, with a dihydropyridine calcium channel blocker
eating a DASH (Dietary Approaches such as amlodipine (Norvasc) as first line
to Stop Hypertension) diet, and management therapy for hypertension not at
exercising more, but his blood goal with DASH and lifestyle modifications.
pressure is still 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 dimensions with contrast. CT PE protocol is not
serial 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 accurate response is congestive heart failure as it
orthopnea. On examination, she has is signifying both a right ventricular back up with
jugular venous distention and jugular venous extension and crackles on lung
bilateral crackles on lung assault, which are suggestive of left ventricular
auscultation. What is the most likely back up. it is possible the patient may have an
diagnosis? 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 cardioverter defibrillator (AICD) or a Lifevest if
diagnosed with a myocardial the EF is less than 35% due to the increased risk
infarction this admission and of sudden cardiac death with low EF states. Since
received emergent placement of a most patients are not eligible for 90 days for an
drug-eluting stent to the left AICD in this state, optimizing their medication
anterior descending artery. As the regimen and repeating an echo in 2-3 months to
medical home who will manage this re-evaluate for improvement in their EF is
patient after discharge, which required by most insurance companies. A
medication strategy would you baseline echo is needed at discharge to provide
expect to be a priority in the a baseline for improvement vs their repeat echo
patient's care? 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 statin drug.
a follow-up examination. She is a Rationale: Bile acid sequestrants and cholesterol
smoker, and her hypertension is absorption inhibitors may be useful in reducing
now adequately controlled with ASVD risk, but for a patient who is an active
medication. Her mother died at age smoker with premature coronary disease history
40 from a heart attack. The fasting (less than age 65 for women), has hypertension
lipid profile shows cholesterol = 240 and is far from an LDL goal, this patient is most
mg/dL, HDL = 30, and LDL = 200. In certainly a candidate for statin therapy, which
addition to starting therapeutic represents the most aggressive therapy option of
lifestyle changes, the nurse these four listed.
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.
Preventive cardiac care should Genetic predisposition
focus primarily on addressing all Rationale: Smoking cessation, exercise, and
the following except? medication compliance all represent modifiable
risk factors and should be the focus of preventive
care. Non-modifiable risk factors such as age,
gender, genetic/family history should not be the
primary focus of prevention.
