NSG 5002 Week 2 Quiz / NSG5002 Week 2 Quiz / NSG 5002 Quiz 2 (2019): South University (Already graded A)

NSG 5002 Week 2 Quiz / NSG5002 Week 2 Quiz / NSG 5002 Quiz 2: South University Question 1 What three conditions definitely alter the results of echocardiography in determining CAD? Question 1 options: a) Diabetes, kidney disease and tooth decay b) Obesity, rapid heart rate and lung disease c) Obesity, slow heart rates and hypertension d) Previous MI, hypotension and diabetes Question 2 Your patient has a maximum age-predicted heart rate of 180. During the exercise he reaches a heart rate of 140 and then states he can no longer exercise. You see evidence of ischemic changes on the ECG. This would be predictive of what condition? Question 2 options: a) Significant CAD b) Low risk of CAD c) Impending death d) Stroke Question 3 What purpose does the principle of fidelity serve in the provider/patient relationship? Question 3 options: a) Ensures that patients receive whatever they want b) Maintains costs in the healthcare arena c) Obligates the provider to a one-on-one relationship with the individual d) Ensures that providers honor their commitments to the patient Question 4 A 55-year old man is referred to your clinic. He has been sedentary all of his life, is gaining weight and wishes to get into better physical shape. He has never had any chest pain or shortness of breath when walking or climbing a flight of stairs. Before recommending a vigorous exercise routine for this patient, you order what test? Question 4 options: a) CBC b) Thyroid levels c) Stool samples d) ETT Question 5 Medicare hospital insurance (Part A) is funded through what system? Question 5 options: a) State income taxes b) Federal payroll taxes c) Federal income taxes d) Interest from investments Question 6 Your patient is morbidly obese and cannot sit on a bicycle or walk a treadmill. She also has marked and severe emphysema. You need to make an assessment of the risk of significant CAD and your patient’s family says that their relative had their diagnosis based on an ultrasound echocardiography. What facts would influence your decision regarding the family request for echo assessment? Question 6 options: a) Sensitivity would be increased because of lung disease b) Specificity would be increased because of obesity c) Sensitivity would be reduced because of obesity and lung disease d) Specificity would be reduced because of obesity and lung disease Question 7 We all know that collaboration is integral to becoming a successful nurse practitioner. Among collaborations, however, only one can be considered as the most important. While each example below is important, which is the most important collaboration? The one that occurs: Question 7 options: a) Between the patient and the nurse practitioner b) Between the patient and their family c) Between two healthcare providers about a single patient d) Between the nurse practitioner and their physician mentor Question 8 Changes in Medicare are a method the government uses to make changes to reimbursement schedules for healthcare. Currently, Medicare reimburses nurse practitioners for all services, even those deemed to be exclusive to nursing? Question 8 options: a) True b) False Question 9 Narrowed coronary arteries or plague rupture within the arteries of the coronary system may directly cause which condition? Question 9 options: a) Diabetes b) Coronary artery disease c) Venous Statis d) Hypertension Question 10 Chronic, non-communicable diseases account for disproportionate costs to the healthcare system. According to the World Health Organization, what percent of preventable deaths and disabilities occur in the Americas related to chronic non-communicable diseases? Question 10 options: a) 80%-90% b) 10%-15% c) 35%-45% d) 60%-70% Question 11 Of the answers below, which would be included in defining a positive Exercise Echocardiogram? Question 11 options: a) Induced decrease in regional wall motion b) Increase in wall thickening c) Regional hypokensis of ventricular muscles walls d) Death two days after test Question 12 As patients that entrust our care to another individual, we always expect honesty to avoid leading us down a deceptive pathway in our healthcare decisions. Adherence to which principle compels providers to be truthful? Question 12 options: a) Fidelity b) Veracity c) Self-reflection d) Finance Question 13 By standard criteria, how is a positive stress test defined? Question 13 options: a) Development of a horizontal or down sloping ST-segment depression of 1mm b) Development of a horizontal or down sloping ST-segment depression of 10mm c) Upward sloping ST-segment measured at the J point of the QRS d) Down sloping of the ST-segment at the J point of the QRS Question 14 What are two of the most common forms of Exercise Stress Tests used today? Question 14 options: a) Unicycle and Running in pace b) Bicycle and treadmill c) Bicycle and rowing machine d) Thallium and Dobutamine Question 15 Your patient cannot sit on a bicycle and has difficulties walking a treadmill with limited capacity for exercising. Still, you know that the ETT is the preferred test for CAD. You consider adding a pharmacological agent to get to maximum heart rate. What agent would be the most commonly used agent to assist in an ETT? Question 15 options: a) Aspirin b) Epinephrine c) Dobutamine d) Dopamine Question 16 Population disease management is a term used to describe: Question 16 options: a) Low prevalence specific diseases b) High prevalence specific diseases c) High specificity disease states d) Low specificity diseases states Question 17 What ECG changes can reduce the specificity of the ETT? Question 17 options: a) Paced rhythm and resting bundle branch block b) Exercise induced bundle branch blocks c) Paced rhythm and exercise induced bundle branch blocks d) Low voltage up sloping of the ST-segment Question 18 Your patient has a maximum age-predicted heart rate of 180. During the exercise, he reaches a heart rate of 140 and then states he can no longer exercise. You see no evidence of ischemia on the ECG. This would be diagnostic for what condition? Question 18 options: a) Diagnostic for impending Myocardial Infarction b) Predictive of no CAD c) Diagnostic of laziness d) Has no diagnostic value to rule out CAD Question 19 Of the following, which is the best answer when asked for an advantage of echocardiogram exercise testing over thallium stress testing? Question 19 options: a) Results are available more quickly b) Does not depend on operator experience c) Costs are the same d) Doesn’t matter because there are no advantages Question 20 On the echocardiography during the ETT you notice the following change: abnormal left ventricular ejection fraction. What do these changes suggest related to this patient? Question 20 options: a) Non-ischemic changes of the baseline ECG b) Ischemia of the myocardium c) Weak ventricular muscles d) Rise in heart rate without evidence of ischemia Question 21 Specifically, when is an ETT considered to be negative? Question 21 options: a) Patient exercises to 85% of age predicted maximum heart rate without evidence of induced ischemia b) Patient exercises until tired without evidence of induced ischemia c) Patient has ST-segmental changes with down sloping of greater than 1 mm at 50% of age-predicted maximum heart rate d) Patient exercises to 20% maximum age-predicted heart rate without induced ischemia Question 22 Medicaid is mandated to be provided by each state through federal codes. Each state must offer Medicaid exactly as the federal government prescribes. Question 22 options: a) True b) False Question 23 The leads on the ECG showing ischemic changes during or immediately after an ETT can correlate roughly to the culprit artery or arteries with significant CAD. Is this true or false? Question 23 options: a) True b) False Question 24 What happens to coronary flow related to CAD? Question 24 options: a) Hyper profusion of the myocardium b) Hypo profusion of the myocardium c) Functional systolic pressures d) Cerebral vascular infarction Question 25 What do you know regarding ischemia that is confined to only the posterior and or lateral segments of the left ventricle? Question 25 options: a) Easier to detect by ETT b) Difficult to detect by ETT c) Requires both for detection of changes by ETT d) ETT cannot be used for detection Question 26 Encouragement of patients to take effective actions in their own healthcare refers to the concept of: Question 26 options: a) Physician or provider-driven care b) Family care givers c) Self-management support d) Interprofessional support Question 27 Your practice partner just ordered an exercise echocardiography 2DE for a patient with suspected cardiovascular risk. This patient has known resting wall motion abnormalities. Why would this not be the best test to assess this patient’s cardiac risk? Question 27 options: a) Sensitivity is increased b) Sensitivity is decreased c) Specificity is increased d) Specificity is decreased Question 28 All patients, even if asymptomatic, require risk stratification according to the Farmingham risk score. At present, ACC/AHA guidelines, however, do not normally support stress tests for asymptomatic patients without addiitonal justification. From the list below, what could be used to justify a ETT in an asymptomatic patient? Question 28 options: a) Sedentary and wishes to begin aggressive exercise b) A member of congress c) Developmentally challenged d) A smoker of 3 weeks Question 29 A 35 year old female arrives at your clinic. She has had diabetes and peripheral artery disease for the past 5 years. You decide to obtain an ETT. The insurance company argues that this is inappropriate. You justify the ETT because you are planning secondary strategies to prevent future heart disease. Where could one find the supporting data for these guidelines? Question 29 options: a) Framingham risk score b) Medicare guidelines c) Medicaid guidelines d) Do not exist Question 30 In CAD, after both systolic and diastolic dysfunction have occurred, the typical pattern of chest pain and related EKG changes occur. During an EKG, you should expect to see ST-segment and T-wave changes that are central to demonstration of ischemia occurring relatively late in the ischemic cascade. Question 30 options: a) True b) False Question 31 For women with known CAD and diabetes, which is most appropriate to assess CAD risk? Question 31 options: a) ETT b) Coronary catheterization c) ETT with imaging d) Coronary bypass surgery Question 32 You are counseling a patient diagnosed with stress-induced ischemia. You base your discussion on your knowledge that stress-induced ischemia is thought to be caused by what phenomena? Question 32 options: a) Heart muscle dysfunction b) Diet and exercise c) Endothelial dysfunction of the microvascular d) Too many carbonated drinks Question 33 Eligibility for Medicaid includes the following: Question 33 options: a) Very young and elderly only b) Children and women regardless of income c) Elderly, children and women living in poverty d) Everyone unemployed Question 34 You are in the clinic with your mentor observing the Echocardiogram exercise test of a 45-year old male that has been experiencing slight chest pressure almost daily during exercise. While observing your patient, your mentor points out that the left ventricle wall is thinning and there is some hyperkinesias of the ventricular wall. From your time in the clinic, you know that this test will be considered to be what type of result? Question 34 options: a) Positive b) Negative c) Non-readable d) Impossible Question 35 In women, you need to know the limitations of certain tests for CAD. For example, single-photon emissions CT imaging, while an acceptable test for most men and some women, is technically limited in women for two reasons. From the following, choose the best possible answer. Question 35 options: a) Multiple vessel disease and fat deposits b) Smoking rates and lack of uptake of photons c) Breasts and smaller coronary arteries d) Breasts and fat deposits in abdomen Question 36 Your patient underwent an exercise stress test for CAD. There is significant elevation of the ST-segment. What do you need to know about these changes to manage your patient’s care? Question 36 options: a) These changes are predictive of myocardial infarction b) This patient needs to see someone more experienced in treatment of CAD c) These changes predict dire outcomes d) These changes have minimal predictive value for CAD Question 37 Your preceptor decides to add Doppler Flow studies to the echocardiogram exercise test for a patient with a recent history of a holistic murmur best auscultated at the left steral boarder. The patient has no history of cardiac surgeries. He asks you what might be the main advantages of adding Doppler Flow for this particular patient. You know from your readings that there are several reasons to add Doppler Flow and below are listed more than one correct reason. Your best response for this specific case, however, would be that Doppler Flow studies would be of what additive value during the echocardiogram study? Question 37 options: a) Gives better screen shots of wall b) Provides assessment of prosthetic valve function c) Detect and evaluate blood shunting from a septal defect d) No advantage is seen for this patient Question 38 The sensitivity of a routine ETT is effort dependent. What physiological changes occur during effort in the routine ETT? Question 38 options: a) Decrease in coronary blood flow b) Decreased heart rate and increased systolic blood pressure c) Rapid heart rates and coronary artery narrowing d) Increased coronary flow and increased systolic blood pressure Question 39 Medicare covers inpatient hospital services under which part of the Medicare insurance? Question 39 options: a) Part B b) Part D c) Part C d) Part A Question 40 Maintenance of an Isoelectric ST-segment during exercise is the response of? Question 40 options: a) A normal heart b) An abnormal heart c) CAD d) Hypo profusion Question 41 The diagnostic accuracy of stress testing is decreased among women compared to men for what reasons? Question 41 options: a) Women usually have single vessel or non-obstructive disease b) Women typically have multiple vessel disease c) Women having thinner ventricular and septal muscles d) Women cannot exercise as vigorously as men Question 42 What is the leading cause of death for women in the United States? Question 42 options: a) Breast cancer b) Lung cancer c) Heart disease d) Complications of childbirth