Exam 4: NURS 5463 / NURS5463
(Latest Update ) Adult
Gerontology Acute Care | Questions &
Answers | Grade A | 100% Correct -
UTA
A 63-year-old man has a 4-minute period of documented expressive aphasia that completely
resolved. A workup reveals 70% left internal carotid stenosis and a 50% right internal carotid
stenosis. In addition to best medical management, which of the following is the most appropriate
treatment?
A. Left CEA
An 84-year-old woman has diabetes and congestive heart failure that is refractory to medical
treatment. A right carotid bruit is detected on physical examination. A duplex study suggests a
50% to 75% right carotid stenosis. Which of the following is the most appropriate treatment?
A. Medical management
Which of the following statements regarding carotid artery stenting is most accurate?
A. CREST study suggests that older patients have increased combined stroke and death rates in
comparison to younger patients
Which of the following does NOT need to be instituted for a patient following carotid
endarterectomy?
A. Coumadin to target an INR of 2 to 3
, Exam 4: NURS 5463 / NURS5463
(Latest Update ) Adult
Gerontology Acute Care | Questions &
Answers | Grade A | 100% Correct -
UTA
For which of the following patients is a left carotid endarterectomy most indicated?
A. A 70-year-old man with transient loss of vision in the left eye that recovered after 20 minutes,
and he has 75% left carotid stenosis
A 73-year-old woman is evaluated in the ED and transferred to the ICU because of chest pain of
4 hours' duration. Her medical history includes a 20-year history of hypertension and Type II
diabetes mellitus. Her medications include metformin, atenolol, and ASA. On physical
examination, her blood pressure is 130/84 mm Hg, and her heart rate is 87 beats/min and regular.
Her jugular vein is distended to 5 cm while the patient is upright. She has a faint left carotid bruit
and bibasilar crackles to one quarter up from the lung bases. A normal S1 and S2 is heard, with a
grade II/VI holosystolic murmur heard best at the apex to the axilla. An electrocardiogram from
six months ago was normal. The ECG was seen during the chest pain. The initial serum troponin
measurement is elevated. She is now admitted to the ICU for an MI. She is free of chest pain
while on IV nitroglycerin, and her vital signs are stable. Which of the following is the most likely
ECG diagnosis?
A. Left bundle branch block with normal sinus rhythm
A 55-year-old man in the ICU has ACS, with 2 mm of ST elevation on the leads II, III, and aVF.
The troponins are positive. The blood pressure is 130/70 mm Hg on
a nitroglycerin drip at 5 μg/kg/min keeping the patient chest pain free, but ECG changes persist
and only 1 mm of ST elevation is seen. There is no lower extremity edema. The patient was
given ASA upon entry into the ED. What is/are the next best steps in the management of this
patient?
, Exam 4: NURS 5463 / NURS5463
(Latest Update ) Adult
Gerontology Acute Care | Questions &
Answers | Grade A | 100% Correct -
UTA
Anticoagulation, IV β-blocker, ACE inhibitor, nitroglycerin, and alert catheterization lab
A 65-year-old man with history of diabetes presents to the Emergency Department stating he has
had substernal chest pain and diaphoresis for 45 minutes. Which is the most important next step
in management?
Aspirin to chew
In the initial evaluation of a patient with chest pain, which is the most important diagnostic test?
ECG
A 54-year-old man is seen at a rural ED with 1 hour of nausea and substernal chest pain radiating
to his jaw. The ECG shows STEMI. PCI is not performed at this hospital and only performed at a
hospital 2 1/2 hours away. Which of the following statements is most accurate?
C Administer thrombolytics, then transfer to PCI center.
Which of the following is NOT an accurate description of hypothermia therapy for post-cardiac
arrest patients?
B Therapeutic hypothermia has a proven effect in reducing the rate of recurrent ventricular
fibrillation
(Latest Update ) Adult
Gerontology Acute Care | Questions &
Answers | Grade A | 100% Correct -
UTA
A 63-year-old man has a 4-minute period of documented expressive aphasia that completely
resolved. A workup reveals 70% left internal carotid stenosis and a 50% right internal carotid
stenosis. In addition to best medical management, which of the following is the most appropriate
treatment?
A. Left CEA
An 84-year-old woman has diabetes and congestive heart failure that is refractory to medical
treatment. A right carotid bruit is detected on physical examination. A duplex study suggests a
50% to 75% right carotid stenosis. Which of the following is the most appropriate treatment?
A. Medical management
Which of the following statements regarding carotid artery stenting is most accurate?
A. CREST study suggests that older patients have increased combined stroke and death rates in
comparison to younger patients
Which of the following does NOT need to be instituted for a patient following carotid
endarterectomy?
A. Coumadin to target an INR of 2 to 3
, Exam 4: NURS 5463 / NURS5463
(Latest Update ) Adult
Gerontology Acute Care | Questions &
Answers | Grade A | 100% Correct -
UTA
For which of the following patients is a left carotid endarterectomy most indicated?
A. A 70-year-old man with transient loss of vision in the left eye that recovered after 20 minutes,
and he has 75% left carotid stenosis
A 73-year-old woman is evaluated in the ED and transferred to the ICU because of chest pain of
4 hours' duration. Her medical history includes a 20-year history of hypertension and Type II
diabetes mellitus. Her medications include metformin, atenolol, and ASA. On physical
examination, her blood pressure is 130/84 mm Hg, and her heart rate is 87 beats/min and regular.
Her jugular vein is distended to 5 cm while the patient is upright. She has a faint left carotid bruit
and bibasilar crackles to one quarter up from the lung bases. A normal S1 and S2 is heard, with a
grade II/VI holosystolic murmur heard best at the apex to the axilla. An electrocardiogram from
six months ago was normal. The ECG was seen during the chest pain. The initial serum troponin
measurement is elevated. She is now admitted to the ICU for an MI. She is free of chest pain
while on IV nitroglycerin, and her vital signs are stable. Which of the following is the most likely
ECG diagnosis?
A. Left bundle branch block with normal sinus rhythm
A 55-year-old man in the ICU has ACS, with 2 mm of ST elevation on the leads II, III, and aVF.
The troponins are positive. The blood pressure is 130/70 mm Hg on
a nitroglycerin drip at 5 μg/kg/min keeping the patient chest pain free, but ECG changes persist
and only 1 mm of ST elevation is seen. There is no lower extremity edema. The patient was
given ASA upon entry into the ED. What is/are the next best steps in the management of this
patient?
, Exam 4: NURS 5463 / NURS5463
(Latest Update ) Adult
Gerontology Acute Care | Questions &
Answers | Grade A | 100% Correct -
UTA
Anticoagulation, IV β-blocker, ACE inhibitor, nitroglycerin, and alert catheterization lab
A 65-year-old man with history of diabetes presents to the Emergency Department stating he has
had substernal chest pain and diaphoresis for 45 minutes. Which is the most important next step
in management?
Aspirin to chew
In the initial evaluation of a patient with chest pain, which is the most important diagnostic test?
ECG
A 54-year-old man is seen at a rural ED with 1 hour of nausea and substernal chest pain radiating
to his jaw. The ECG shows STEMI. PCI is not performed at this hospital and only performed at a
hospital 2 1/2 hours away. Which of the following statements is most accurate?
C Administer thrombolytics, then transfer to PCI center.
Which of the following is NOT an accurate description of hypothermia therapy for post-cardiac
arrest patients?
B Therapeutic hypothermia has a proven effect in reducing the rate of recurrent ventricular
fibrillation
