NSG 6001Study Guide for Final Exam for Advanced Nursing Practice II
Study Guide for Final Exam
1. Know the causes of an abdominal aortic aneurysm.
The proposed causes of AAA include atherosclerosis, inflammation, mycotic
infection, inheritable connective tissue disorders (Marfan syndrome, type IV
Ehlers-Danlos syndrome), and trauma. Traditionally, atherosclerosis has
been considered the most common cause of AAA. However, aneurysm
formation is associated with atherosclerosis in only 25% of cases.
2. Why is CT imaging limited in women?
Single-photon emission CT imaging is technically limited in women because
breast tissue and smaller coronary artery size.
3. What is self-management support?
Self-management support is a crucial component of the CCM and effectively
implemented by use of a population approach. The goal of self-management
support is to engage patients in their own care and to empower them to
reach their full potential as self-advocates and partners in care. Before
patients can begin self-management, they must have access to information
that is appropriate for how they learn and who they are—educationally,
cognitively, emotionally, culturally, and experientially.
4. Which Medicare part covers inpatient hospital services?
Part A – paid through federal payroll taxes – Covers inpatient hospital services as well as some
post-hospital nursing care & home health care
5. Understand risk factors for abdominal aortic aneurysm.
Risk factors for AAA include atherosclerotic vascular disease, white race,
male gender, advanced age, hypertension, smoking, chronic obstructive
pulmonary disease (COPD), history of hernias, family history of AAA, and
presence of other aneurysms.4,5 Despite extensive investigation, the link
between COPD and AAA remains elusive. Evidence suggests that the high
prevalence of AAA in patients with COPD may be related to medications
(oral steroids) and coexisting diseases rather than to a common pathway of
pathogenesis involving plasma elastase or α1-antitrypsin
6. Study atrial fibrillation and at what age is it more common.
Atrial fibrillation is the most common sustained cardiac rhythm
disturbance, more common in men and increasing in prevalence with age. It
is estimated
,NSG 6001Study Guide for Final Exam for Advanced Nursing Practice II
that 2.3 million Americans have atrial fibrillation, which more commonly
occurs after the age of 60years.
7. Where could you find supporting data for guidelines for prevention of future heart disease?
The recommendation for asymptomatic women with diabetes, peripheral
vascular disease, and possible kidney disease is for secondary prevention
strategies to prevent future cardiac events.
8. Can ischemic changes on an ECG during or after an ETT correlate to the effected artery or
arteries?
It is helpful to correlate the ischemic leads on exercise electrocardiography
to the underlying coronary anatomy to roughly identify the culprit artery or
arteries.
9. What is the goal of self-management?
Self-management support is a crucial component of the CCM and effectively
implemented by use of a population approach. The goal of self-management
support is to engage patients in their own care and to empower them to
reach their full potential as self-advocates and partners in care. For many
patients and providers alike, this patient-centered practice is a new method.
In the acute care model, clinicians prescribe and patients comply. Self-
management support in the CCM requires different assumptions, processes,
and skills.
10. Know the symptoms of an abdominal aortic aneurysm.
Thromboembolic phenomena may herald the presence of an AAA.
Microembolic infarcts in the lower extremity of a patient with easily
palpable pedal pulses may suggest either abdominal or popliteal aneurysm.
Embolization of mural thrombus from an abdominal aneurysm may be seen
with acute limb ischemia caused by femoral or popliteal occlusion. The
classic diagnostic triad of ruptured AAA is hypotension (42%), pulsatile
abdominal mass (91%), and abdominal pain (58%) or back pain (70%). The
triad is encountered in only 50% of patients with a ruptured AAA. Ruptured
AAAs should be suspected in any patient who comes in with complaints of
hypotension and atypical abdominal or back pain symptoms. In a patient
with a history of aneurysm or pulsatile mass, abdominal pain must be
, NSG 6001Study Guide for Final Exam for Advanced Nursing Practice II
considered to represent a rapidly expanding or ruptured aneurysm and
must be treated accordingly. In the community setting, the death rate from
ruptured AAAs is almost 80%.
11. Know the difference between the principles of fidelity, veracity, self-reflection, and finance.
Justice, fidelity, and veracity are ethical principles that health care
providers use to guide their professional interactions. When health care
providers treat all with respect and address their patient's health care
needs, they are following the principle of justice. Adherence to the principle
offidelity mandates that health care providers honor their commitments;
adherence to veracity compels health care providers to tell the truth and
not to be deceptive.
When health care providers treat all with respect and address their
patient's health care needs, they are following the principle of justice.
Whereas we bring considerable thought and reflection to the dilemmas we
encounter, the initial reaction of outrage or distress can be quite protective
for patients. These emotions highlight the urgency and significance of
issues identified in clinical practice and frame approaches to bring best
thinking to these dilemmas.
Reflective practice is considered to be a means to enhance the identification
of clinical concerns and to initiate strategies for assessing and planning
care when ethical issues and dilemmas present themselves.8 Reflective
opportunities in daily practice allow the practitioner to consider thoughts,
feelings, and actions in compelling or difficult cases and then to use team
meetings or practice rounds to identify best practice in these cases.
12. Understand the coronary flow related to CAD.
CAD exists when coronary arteries are narrowed by atherosclerotic plaque
formation, plaque rupture, or spasm. This narrowing impedes coronary
blood flow, resulting in hypoperfusion of the myocardium. The
hypoperfusion produces first diastolic, and then systolic dysfunction, with
characteristic signs and symptoms, including chest pain. Typical ECG
changes of ischemia result, although the ST-segment and T-wave changes
that are central to demonstration of ischemia occur relatively late in the
ischemic cascade.
Study Guide for Final Exam
1. Know the causes of an abdominal aortic aneurysm.
The proposed causes of AAA include atherosclerosis, inflammation, mycotic
infection, inheritable connective tissue disorders (Marfan syndrome, type IV
Ehlers-Danlos syndrome), and trauma. Traditionally, atherosclerosis has
been considered the most common cause of AAA. However, aneurysm
formation is associated with atherosclerosis in only 25% of cases.
2. Why is CT imaging limited in women?
Single-photon emission CT imaging is technically limited in women because
breast tissue and smaller coronary artery size.
3. What is self-management support?
Self-management support is a crucial component of the CCM and effectively
implemented by use of a population approach. The goal of self-management
support is to engage patients in their own care and to empower them to
reach their full potential as self-advocates and partners in care. Before
patients can begin self-management, they must have access to information
that is appropriate for how they learn and who they are—educationally,
cognitively, emotionally, culturally, and experientially.
4. Which Medicare part covers inpatient hospital services?
Part A – paid through federal payroll taxes – Covers inpatient hospital services as well as some
post-hospital nursing care & home health care
5. Understand risk factors for abdominal aortic aneurysm.
Risk factors for AAA include atherosclerotic vascular disease, white race,
male gender, advanced age, hypertension, smoking, chronic obstructive
pulmonary disease (COPD), history of hernias, family history of AAA, and
presence of other aneurysms.4,5 Despite extensive investigation, the link
between COPD and AAA remains elusive. Evidence suggests that the high
prevalence of AAA in patients with COPD may be related to medications
(oral steroids) and coexisting diseases rather than to a common pathway of
pathogenesis involving plasma elastase or α1-antitrypsin
6. Study atrial fibrillation and at what age is it more common.
Atrial fibrillation is the most common sustained cardiac rhythm
disturbance, more common in men and increasing in prevalence with age. It
is estimated
,NSG 6001Study Guide for Final Exam for Advanced Nursing Practice II
that 2.3 million Americans have atrial fibrillation, which more commonly
occurs after the age of 60years.
7. Where could you find supporting data for guidelines for prevention of future heart disease?
The recommendation for asymptomatic women with diabetes, peripheral
vascular disease, and possible kidney disease is for secondary prevention
strategies to prevent future cardiac events.
8. Can ischemic changes on an ECG during or after an ETT correlate to the effected artery or
arteries?
It is helpful to correlate the ischemic leads on exercise electrocardiography
to the underlying coronary anatomy to roughly identify the culprit artery or
arteries.
9. What is the goal of self-management?
Self-management support is a crucial component of the CCM and effectively
implemented by use of a population approach. The goal of self-management
support is to engage patients in their own care and to empower them to
reach their full potential as self-advocates and partners in care. For many
patients and providers alike, this patient-centered practice is a new method.
In the acute care model, clinicians prescribe and patients comply. Self-
management support in the CCM requires different assumptions, processes,
and skills.
10. Know the symptoms of an abdominal aortic aneurysm.
Thromboembolic phenomena may herald the presence of an AAA.
Microembolic infarcts in the lower extremity of a patient with easily
palpable pedal pulses may suggest either abdominal or popliteal aneurysm.
Embolization of mural thrombus from an abdominal aneurysm may be seen
with acute limb ischemia caused by femoral or popliteal occlusion. The
classic diagnostic triad of ruptured AAA is hypotension (42%), pulsatile
abdominal mass (91%), and abdominal pain (58%) or back pain (70%). The
triad is encountered in only 50% of patients with a ruptured AAA. Ruptured
AAAs should be suspected in any patient who comes in with complaints of
hypotension and atypical abdominal or back pain symptoms. In a patient
with a history of aneurysm or pulsatile mass, abdominal pain must be
, NSG 6001Study Guide for Final Exam for Advanced Nursing Practice II
considered to represent a rapidly expanding or ruptured aneurysm and
must be treated accordingly. In the community setting, the death rate from
ruptured AAAs is almost 80%.
11. Know the difference between the principles of fidelity, veracity, self-reflection, and finance.
Justice, fidelity, and veracity are ethical principles that health care
providers use to guide their professional interactions. When health care
providers treat all with respect and address their patient's health care
needs, they are following the principle of justice. Adherence to the principle
offidelity mandates that health care providers honor their commitments;
adherence to veracity compels health care providers to tell the truth and
not to be deceptive.
When health care providers treat all with respect and address their
patient's health care needs, they are following the principle of justice.
Whereas we bring considerable thought and reflection to the dilemmas we
encounter, the initial reaction of outrage or distress can be quite protective
for patients. These emotions highlight the urgency and significance of
issues identified in clinical practice and frame approaches to bring best
thinking to these dilemmas.
Reflective practice is considered to be a means to enhance the identification
of clinical concerns and to initiate strategies for assessing and planning
care when ethical issues and dilemmas present themselves.8 Reflective
opportunities in daily practice allow the practitioner to consider thoughts,
feelings, and actions in compelling or difficult cases and then to use team
meetings or practice rounds to identify best practice in these cases.
12. Understand the coronary flow related to CAD.
CAD exists when coronary arteries are narrowed by atherosclerotic plaque
formation, plaque rupture, or spasm. This narrowing impedes coronary
blood flow, resulting in hypoperfusion of the myocardium. The
hypoperfusion produces first diastolic, and then systolic dysfunction, with
characteristic signs and symptoms, including chest pain. Typical ECG
changes of ischemia result, although the ST-segment and T-wave changes
that are central to demonstration of ischemia occur relatively late in the
ischemic cascade.
