NR 603 CEA EXAM TEST BANK| COMPLETE 350
REAL EXAM QUESTIONS AND CORRECT
DETAILED ANSWERS (VERIFIED ANSWERS)
GRADED A+|
Q1. A patient has been diagnosed with a 4.5 cm ascending aortic aneurysm. Which
medical imaging is considered standard of care for serial surveillance?
A) CT PE rule-out protocol
B) Transesophageal echocardiogram
C) Plain film chest X-ray (CXR)
D) CT angiography of the chest
Correct Answer: D
Explanation: CT angiography of the chest is the standard of care for precise measurement
of vascular luminal dimensions in aortic aneurysm surveillance.
Q2. A patient with paroxysmal atrial fibrillation asks about procedural treatment options.
Which procedure is commonly used?
A) Coronary artery bypass grafting
B) Cryoablation of the transition zone of the left pulmonary vein inflow to the left atrium
C) Left atrial appendage closure
D) Maze procedure
Correct Answer: B
Explanation: Cryoablation of the pulmonary vein transition zone is a standard catheter-
based treatment for paroxysmal atrial fibrillation.
Q3. Effective long-term treatment of systolic heart failure with reduced ejection fraction
(HFrEF) should include which of the following?
A) Digoxin monotherapy
B) Prescribing valsartan/sacubitril (Entresto)
C) High-dose loop diuretics only
D) Beta-blocker monotherapy
Correct Answer: B
Explanation: Valsartan/sacubitril is first-line therapy for HFrEF that reduces morbidity and
mortality.
,Q4. A patient admitted with crushing chest pain just converted from normal sinus
rhythm to bradycardia with elevated ST segments. What is the priority?
A) Administer atropine
B) Cath lab activation
C) Obtain serial troponins
D) Start a beta-blocker
Correct Answer: B
Explanation: The patient is experiencing an acute STEMI with bradycardia. Emergent
cardiac catheterization is the priority.
Q5. An older adult presents with bilateral pitting edema. History of diabetes and
hypertension. Which medication is the MOST likely cause?
A) Lisinopril
B) Metformin
C) Amlodipine (Norvasc)
D) Hydrochlorothiazide
Correct Answer: C
Explanation: Amlodipine commonly causes bilateral pitting edema due to peripheral
vasodilation.
Q6. Where is the point of maximum impulse (PMI) most commonly located in a healthy
adult?
A) Left 2nd intercostal space, midaxillary line
B) Left 5th intercostal space, midclavicular line
C) Right 4th intercostal space, midaxillary line
D) Right 2nd intercostal space, midclavicular line
Correct Answer: B
Explanation: The left 5th intercostal space, midclavicular line is the standard anatomical
location for the PMI in a healthy adult.
Q7. A patient with hypertension is started on lisinopril. Which lab value requires
monitoring?
A) Serum potassium and creatinine
B) Hemoglobin and hematocrit
C) Liver function tests
D) Thyroid stimulating hormone
Correct Answer: A
Explanation: ACE inhibitors can cause hyperkalemia and acute kidney injury, especially in
patients with renal impairment.
,Q8. Which ECG finding is most concerning for acute pericarditis?
A) ST depressions in precordial leads
B) Pathologic Q waves
C) Diffuse ST elevations with PR depression
D) Prolonged QT interval
Correct Answer: C
Explanation: Diffuse ST elevations and PR depression are classic for acute pericarditis.
Q9. A patient presents with sudden-onset tearing chest pain radiating to the back,
unequal blood pressures in arms. Most likely diagnosis?
A) Acute coronary syndrome
B) Aortic dissection
C) Pulmonary embolism
D) Pericarditis
Correct Answer: B
Explanation: Tearing chest pain radiating to the back with pulse deficits is classic for aortic
dissection.
Q10. A patient with chronic heart failure develops worsening dyspnea, jugular venous
distension, and peripheral edema. What medication is first-line for acute symptom
management?
A) Metoprolol
B) Digoxin
C) Spironolactone
D) Furosemide IV
Correct Answer: D
Explanation: Loop diuretics are first-line for acute decompensated heart failure to reduce
fluid overload.
Q11. A patient with known CAD presents with new-onset dyspnea on exertion and
orthopnea. Which physical exam finding is most specific for heart failure?
A) S3 gallop
B) S4 gallop
C) Split S2
D) Ejection click
Correct Answer: A
Explanation: An S3 gallop is highly specific for elevated filling pressures in heart failure.
Q12. Which medication class is contraindicated in patients with severe aortic stenosis?
A) Beta-blockers
B) Vasodilators (e.g., nitrates)
, C) Calcium channel blockers
D) Diuretics
Correct Answer: B
Explanation: Vasodilators can cause profound hypotension in severe aortic stenosis due to
fixed outflow obstruction.
Q13. A patient presents with palpitations, lightheadedness, and irregularly irregular
pulse. Most likely rhythm?
A) Atrial flutter
B) Sinus arrhythmia
C) Atrial fibrillation
D) Multifocal atrial tachycardia
Correct Answer: C
Explanation: Irregularly irregular pulse is the hallmark of atrial fibrillation.
Q14. What is the target LDL cholesterol level for a patient with established
atherosclerotic cardiovascular disease (ASCVD)?
A) <100 mg/dL
B) <70 mg/dL
C) <130 mg/dL
D) <190 mg/dL
Correct Answer: B
*Explanation: Guideline-directed therapy recommends LDL <70 mg/dL for secondary
prevention in ASCVD.*
Q15. A patient with hypertension has a blood pressure of 150/95 mmHg despite being
on lisinopril and HCTZ. Next best step?
A) Increase lisinopril
B) Increase HCTZ
C) Add spironolactone
D) Add amlodipine
Correct Answer: D
Explanation: A third agent (calcium channel blocker) is indicated for resistant
hypertension.
Q16. Which finding on cardiac auscultation is most consistent with mitral regurgitation?
A) Holosystolic murmur at apex radiating to axilla
B) Diastolic murmur at left sternal border
C) Systolic ejection murmur at right upper sternal border
D) Continuous murmur at left infraclavicular area
Correct Answer: A
REAL EXAM QUESTIONS AND CORRECT
DETAILED ANSWERS (VERIFIED ANSWERS)
GRADED A+|
Q1. A patient has been diagnosed with a 4.5 cm ascending aortic aneurysm. Which
medical imaging is considered standard of care for serial surveillance?
A) CT PE rule-out protocol
B) Transesophageal echocardiogram
C) Plain film chest X-ray (CXR)
D) CT angiography of the chest
Correct Answer: D
Explanation: CT angiography of the chest is the standard of care for precise measurement
of vascular luminal dimensions in aortic aneurysm surveillance.
Q2. A patient with paroxysmal atrial fibrillation asks about procedural treatment options.
Which procedure is commonly used?
A) Coronary artery bypass grafting
B) Cryoablation of the transition zone of the left pulmonary vein inflow to the left atrium
C) Left atrial appendage closure
D) Maze procedure
Correct Answer: B
Explanation: Cryoablation of the pulmonary vein transition zone is a standard catheter-
based treatment for paroxysmal atrial fibrillation.
Q3. Effective long-term treatment of systolic heart failure with reduced ejection fraction
(HFrEF) should include which of the following?
A) Digoxin monotherapy
B) Prescribing valsartan/sacubitril (Entresto)
C) High-dose loop diuretics only
D) Beta-blocker monotherapy
Correct Answer: B
Explanation: Valsartan/sacubitril is first-line therapy for HFrEF that reduces morbidity and
mortality.
,Q4. A patient admitted with crushing chest pain just converted from normal sinus
rhythm to bradycardia with elevated ST segments. What is the priority?
A) Administer atropine
B) Cath lab activation
C) Obtain serial troponins
D) Start a beta-blocker
Correct Answer: B
Explanation: The patient is experiencing an acute STEMI with bradycardia. Emergent
cardiac catheterization is the priority.
Q5. An older adult presents with bilateral pitting edema. History of diabetes and
hypertension. Which medication is the MOST likely cause?
A) Lisinopril
B) Metformin
C) Amlodipine (Norvasc)
D) Hydrochlorothiazide
Correct Answer: C
Explanation: Amlodipine commonly causes bilateral pitting edema due to peripheral
vasodilation.
Q6. Where is the point of maximum impulse (PMI) most commonly located in a healthy
adult?
A) Left 2nd intercostal space, midaxillary line
B) Left 5th intercostal space, midclavicular line
C) Right 4th intercostal space, midaxillary line
D) Right 2nd intercostal space, midclavicular line
Correct Answer: B
Explanation: The left 5th intercostal space, midclavicular line is the standard anatomical
location for the PMI in a healthy adult.
Q7. A patient with hypertension is started on lisinopril. Which lab value requires
monitoring?
A) Serum potassium and creatinine
B) Hemoglobin and hematocrit
C) Liver function tests
D) Thyroid stimulating hormone
Correct Answer: A
Explanation: ACE inhibitors can cause hyperkalemia and acute kidney injury, especially in
patients with renal impairment.
,Q8. Which ECG finding is most concerning for acute pericarditis?
A) ST depressions in precordial leads
B) Pathologic Q waves
C) Diffuse ST elevations with PR depression
D) Prolonged QT interval
Correct Answer: C
Explanation: Diffuse ST elevations and PR depression are classic for acute pericarditis.
Q9. A patient presents with sudden-onset tearing chest pain radiating to the back,
unequal blood pressures in arms. Most likely diagnosis?
A) Acute coronary syndrome
B) Aortic dissection
C) Pulmonary embolism
D) Pericarditis
Correct Answer: B
Explanation: Tearing chest pain radiating to the back with pulse deficits is classic for aortic
dissection.
Q10. A patient with chronic heart failure develops worsening dyspnea, jugular venous
distension, and peripheral edema. What medication is first-line for acute symptom
management?
A) Metoprolol
B) Digoxin
C) Spironolactone
D) Furosemide IV
Correct Answer: D
Explanation: Loop diuretics are first-line for acute decompensated heart failure to reduce
fluid overload.
Q11. A patient with known CAD presents with new-onset dyspnea on exertion and
orthopnea. Which physical exam finding is most specific for heart failure?
A) S3 gallop
B) S4 gallop
C) Split S2
D) Ejection click
Correct Answer: A
Explanation: An S3 gallop is highly specific for elevated filling pressures in heart failure.
Q12. Which medication class is contraindicated in patients with severe aortic stenosis?
A) Beta-blockers
B) Vasodilators (e.g., nitrates)
, C) Calcium channel blockers
D) Diuretics
Correct Answer: B
Explanation: Vasodilators can cause profound hypotension in severe aortic stenosis due to
fixed outflow obstruction.
Q13. A patient presents with palpitations, lightheadedness, and irregularly irregular
pulse. Most likely rhythm?
A) Atrial flutter
B) Sinus arrhythmia
C) Atrial fibrillation
D) Multifocal atrial tachycardia
Correct Answer: C
Explanation: Irregularly irregular pulse is the hallmark of atrial fibrillation.
Q14. What is the target LDL cholesterol level for a patient with established
atherosclerotic cardiovascular disease (ASCVD)?
A) <100 mg/dL
B) <70 mg/dL
C) <130 mg/dL
D) <190 mg/dL
Correct Answer: B
*Explanation: Guideline-directed therapy recommends LDL <70 mg/dL for secondary
prevention in ASCVD.*
Q15. A patient with hypertension has a blood pressure of 150/95 mmHg despite being
on lisinopril and HCTZ. Next best step?
A) Increase lisinopril
B) Increase HCTZ
C) Add spironolactone
D) Add amlodipine
Correct Answer: D
Explanation: A third agent (calcium channel blocker) is indicated for resistant
hypertension.
Q16. Which finding on cardiac auscultation is most consistent with mitral regurgitation?
A) Holosystolic murmur at apex radiating to axilla
B) Diastolic murmur at left sternal border
C) Systolic ejection murmur at right upper sternal border
D) Continuous murmur at left infraclavicular area
Correct Answer: A
