NR 603 CHAMBERLAIN COLLEGE OF
NURSING NR603 CEA EXAM
COMPLETE QUESTIONS AND
ANSWERS
\.Your patient has been diagnosed with a 4.5cm ascending aortic aneurysm. Which medical
imaging is considered standard of care for serial surveillance?
CT PE rule-out protocol
Transesophageal Echocardiogram
Plain film chest X-ray (CXR)
CT angiography of the chest - Answer- CT angiography of the chest
Rationale: CT angiography is considered the standard of care for measuring vascular luminal
dimensions with contrast. CT PE protocol is not 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 end-organ sequelae is not directly caused by uncontrolled
hypertension?
Hemorrhagic stroke
Proteinuria
Peripheral neuropathy
,AV nicking - Answer- Peripheral neuropathy
Rationale: Although patients with 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.
\.Which of the following medical exam requires the patient to be sedated?
Tilt table test
Transesophageal echocardiogram (TEE)
Nuclear stress test
Transthoracic echocardiogram (TTE) - Answer- TEE
Rationale: Due to the invasive nature of the TEE, patients will require procedural sedation. The
patient undergoing a transthoracic echo, tilt table, and nuclear stress test are all fully alert
during these procedures.
\.A nurse practitioner places a 76-year-old patient on nifedipine (Procardia) 10 mg t.i.d. for
angina. The patient is unable to remember to take the medication at the scheduled times. The
practitioner should:
increase the dosage to 20 mg b.i.d.
discontinue the issue with the patient's daughter.
change the dose to extended release 30 mg daily.
reinforce the importance of taking the medication. - Answer- change the dose to extended
release 30 mg daily
\.An 80-year-old man with a history of atrial fibrillation presents with sudden-onset unilateral
leg pain and pallor. What is the most likely diagnosis?
Acute arterial occlusion
,Deep vein thrombosis
Peripheral artery disease
Cellulitis - Answer- Acute arterial occlusion
\.The most important diagnostic factor in evaluating angina pectoris is the patient's:
Physical examination
Echocardiogram
Cardiac MRI
History - Answer- History
Rationale: When it comes to cardiac patients, it's important to remember that history is the
most important diagnostic factor in evaluating angina pectoris. A patient's history can easily
make the diagnosis by simply providing a history of their precipitating factors and symptoms,
such as exertional dyspnea, Reproducible, cardiac stressors such as exercise, strenuous activity,
and the associated symptoms. Cardiac MRI may evaluate the patient's heart with find detail, but
it does not show active ischemia well, rather evidence of old MI and ventricular wall thinning.
Physical examination likewise is not very particular to cardiac patients and their cardiac disease
state, and although there may be some associated signs, they are not specific. Echocardiogram
is also useful tool to evaluate ejection fraction and valve/wall function, but this is not showcase
ischemia well.
\.Your patient is complaining of paroxysmal atrial fibrillation. Which medical procedure is
commonly used to treat this condition?
Cryoablation of the transition zone of the left pulmonary vein inflow to the left atrium
Placement of biventricular pacing
Radio frequency ablation of the left ventricular apex
Overdrive pacing via an epicardial lead - Answer- Cryoablation of the transition zone of the
left pulmonary vein inflow to the left atrium
, Rationale: The transition zone of pulmonary vein to left atrium represents the most common
source of atrial fibrillation and is commonly treated with scarification, radio frequency ablation,
or cryotherapy to impede the electrical stimulation of a-fib to the rest of the atrium.
\.Wrong answerQuestion pts
Your patient with a history of two coronary stents and a LDL of 190 has been started on lipid-
lowering statin therapy on three separate attempts with considerable side effects such as leg
pain and in one event, hospitalization for rhabdomyolysis. Which is the best option moving
forward to manage their lipids?
Initiate PCSK9 Inhibitor therapy
Use ezetimibe as monotherapy
Reattempt statin therapy
Aspiring 81mg daily - Answer- Initiate PCSK9 Inhibitor therapy
Rationale: Aspirin is not considered a lipid lowering agent. History of statin-induced
rhabdomyolysis is a contraindication for further statin attempts. Ezetimibe as monotherapy
does not provide any appreciable decrease in LDL to goal of <100 for proven CAD (patient has
stents in place). PCSK9 Inhibitors are the best available drug class for this patient.
\.Wrong answerQuestion pts
Which of the following medications does not cause beta 1 stimulation?
dobutamine
phenylephrine
epinephrine
dopamine - Answer- Phenylepherine
Rationale: Phenylephrine only stimulates alpha 1 receptors. The remaining three all have beta
receptor activity.
NURSING NR603 CEA EXAM
COMPLETE QUESTIONS AND
ANSWERS
\.Your patient has been diagnosed with a 4.5cm ascending aortic aneurysm. Which medical
imaging is considered standard of care for serial surveillance?
CT PE rule-out protocol
Transesophageal Echocardiogram
Plain film chest X-ray (CXR)
CT angiography of the chest - Answer- CT angiography of the chest
Rationale: CT angiography is considered the standard of care for measuring vascular luminal
dimensions with contrast. CT PE protocol is not 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 end-organ sequelae is not directly caused by uncontrolled
hypertension?
Hemorrhagic stroke
Proteinuria
Peripheral neuropathy
,AV nicking - Answer- Peripheral neuropathy
Rationale: Although patients with 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.
\.Which of the following medical exam requires the patient to be sedated?
Tilt table test
Transesophageal echocardiogram (TEE)
Nuclear stress test
Transthoracic echocardiogram (TTE) - Answer- TEE
Rationale: Due to the invasive nature of the TEE, patients will require procedural sedation. The
patient undergoing a transthoracic echo, tilt table, and nuclear stress test are all fully alert
during these procedures.
\.A nurse practitioner places a 76-year-old patient on nifedipine (Procardia) 10 mg t.i.d. for
angina. The patient is unable to remember to take the medication at the scheduled times. The
practitioner should:
increase the dosage to 20 mg b.i.d.
discontinue the issue with the patient's daughter.
change the dose to extended release 30 mg daily.
reinforce the importance of taking the medication. - Answer- change the dose to extended
release 30 mg daily
\.An 80-year-old man with a history of atrial fibrillation presents with sudden-onset unilateral
leg pain and pallor. What is the most likely diagnosis?
Acute arterial occlusion
,Deep vein thrombosis
Peripheral artery disease
Cellulitis - Answer- Acute arterial occlusion
\.The most important diagnostic factor in evaluating angina pectoris is the patient's:
Physical examination
Echocardiogram
Cardiac MRI
History - Answer- History
Rationale: When it comes to cardiac patients, it's important to remember that history is the
most important diagnostic factor in evaluating angina pectoris. A patient's history can easily
make the diagnosis by simply providing a history of their precipitating factors and symptoms,
such as exertional dyspnea, Reproducible, cardiac stressors such as exercise, strenuous activity,
and the associated symptoms. Cardiac MRI may evaluate the patient's heart with find detail, but
it does not show active ischemia well, rather evidence of old MI and ventricular wall thinning.
Physical examination likewise is not very particular to cardiac patients and their cardiac disease
state, and although there may be some associated signs, they are not specific. Echocardiogram
is also useful tool to evaluate ejection fraction and valve/wall function, but this is not showcase
ischemia well.
\.Your patient is complaining of paroxysmal atrial fibrillation. Which medical procedure is
commonly used to treat this condition?
Cryoablation of the transition zone of the left pulmonary vein inflow to the left atrium
Placement of biventricular pacing
Radio frequency ablation of the left ventricular apex
Overdrive pacing via an epicardial lead - Answer- Cryoablation of the transition zone of the
left pulmonary vein inflow to the left atrium
, Rationale: The transition zone of pulmonary vein to left atrium represents the most common
source of atrial fibrillation and is commonly treated with scarification, radio frequency ablation,
or cryotherapy to impede the electrical stimulation of a-fib to the rest of the atrium.
\.Wrong answerQuestion pts
Your patient with a history of two coronary stents and a LDL of 190 has been started on lipid-
lowering statin therapy on three separate attempts with considerable side effects such as leg
pain and in one event, hospitalization for rhabdomyolysis. Which is the best option moving
forward to manage their lipids?
Initiate PCSK9 Inhibitor therapy
Use ezetimibe as monotherapy
Reattempt statin therapy
Aspiring 81mg daily - Answer- Initiate PCSK9 Inhibitor therapy
Rationale: Aspirin is not considered a lipid lowering agent. History of statin-induced
rhabdomyolysis is a contraindication for further statin attempts. Ezetimibe as monotherapy
does not provide any appreciable decrease in LDL to goal of <100 for proven CAD (patient has
stents in place). PCSK9 Inhibitors are the best available drug class for this patient.
\.Wrong answerQuestion pts
Which of the following medications does not cause beta 1 stimulation?
dobutamine
phenylephrine
epinephrine
dopamine - Answer- Phenylepherine
Rationale: Phenylephrine only stimulates alpha 1 receptors. The remaining three all have beta
receptor activity.
