NURS 5463 Test 4 practice questions with |\ |\ |\ |\ |\ |\ |\
answers
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? - CORRECT
|\ |\ |\ |\ |\ |\ |\ |\
ANSWERS ✔✔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? - CORRECT ANSWERS ✔✔A. Medical
|\ |\ |\ |\ |\ |\ |\ |\
management
Which of the following statements regarding carotid artery
|\ |\ |\ |\ |\ |\ |\ |\
stenting is most accurate? - CORRECT ANSWERS ✔✔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? - CORRECT ANSWERS
|\ |\ |\ |\ |\ |\ |\
✔✔A. Coumadin to target an INR of 2 to 3
|\ |\ |\ |\ |\ |\ |\ |\ |\
For which of the following patients is a left carotid
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
endarterectomy most indicated? - CORRECT ANSWERS ✔✔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 fol - CORRECT
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
ANSWERS ✔✔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? - CORRECT ANSWERS
|\ |\ |\ |\ |\ |\ |\ |\
✔✔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? - CORRECT ANSWERS ✔✔Aspirin to chew
|\ |\ |\ |\ |\ |\ |\ |\ |\
In the initial evaluation of a patient with chest pain, which is the
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
most important diagnostic test? - CORRECT ANSWERS ✔✔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? - CORRECT ANSWERS ✔✔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? - CORRECT |\ |\ |\ |\ |\ |\ |\ |\
ANSWERS ✔✔B Therapeutic hypothermia has a proven effect in |\ |\ |\ |\ |\ |\ |\ |\ |\
reducing the rate of recurrent ventricular fibrillation|\ |\ |\ |\ |\ |\
A 64-year-old man who was being treated in the hospital for
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
acute cholecystitis is found to be unresponsive. He was noted to
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
be in VF and underwent chest compressions for several minutes
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
in addition to cardioversion. The patient has return of
|\ |\ |\ |\ |\ |\ |\ |\ |\
spontaneous rhythm and vital signs. Which of the following is an |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
important treatment for this patient? - CORRECT ANSWERS ✔✔A |\ |\ |\ |\ |\ |\ |\ |\ |\
Percutaneous coronary angiography |\ |\
Which of the following statements regarding out-of-hospital
|\ |\ |\ |\ |\ |\ |\
sudden cardiac arrest (SCA) is true? - CORRECT ANSWERS ✔✔E
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
answers
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? - CORRECT
|\ |\ |\ |\ |\ |\ |\ |\
ANSWERS ✔✔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? - CORRECT ANSWERS ✔✔A. Medical
|\ |\ |\ |\ |\ |\ |\ |\
management
Which of the following statements regarding carotid artery
|\ |\ |\ |\ |\ |\ |\ |\
stenting is most accurate? - CORRECT ANSWERS ✔✔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? - CORRECT ANSWERS
|\ |\ |\ |\ |\ |\ |\
✔✔A. Coumadin to target an INR of 2 to 3
|\ |\ |\ |\ |\ |\ |\ |\ |\
For which of the following patients is a left carotid
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
endarterectomy most indicated? - CORRECT ANSWERS ✔✔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 fol - CORRECT
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
ANSWERS ✔✔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? - CORRECT ANSWERS
|\ |\ |\ |\ |\ |\ |\ |\
✔✔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? - CORRECT ANSWERS ✔✔Aspirin to chew
|\ |\ |\ |\ |\ |\ |\ |\ |\
In the initial evaluation of a patient with chest pain, which is the
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
most important diagnostic test? - CORRECT ANSWERS ✔✔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? - CORRECT ANSWERS ✔✔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? - CORRECT |\ |\ |\ |\ |\ |\ |\ |\
ANSWERS ✔✔B Therapeutic hypothermia has a proven effect in |\ |\ |\ |\ |\ |\ |\ |\ |\
reducing the rate of recurrent ventricular fibrillation|\ |\ |\ |\ |\ |\
A 64-year-old man who was being treated in the hospital for
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
acute cholecystitis is found to be unresponsive. He was noted to
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
be in VF and underwent chest compressions for several minutes
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
in addition to cardioversion. The patient has return of
|\ |\ |\ |\ |\ |\ |\ |\ |\
spontaneous rhythm and vital signs. Which of the following is an |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
important treatment for this patient? - CORRECT ANSWERS ✔✔A |\ |\ |\ |\ |\ |\ |\ |\ |\
Percutaneous coronary angiography |\ |\
Which of the following statements regarding out-of-hospital
|\ |\ |\ |\ |\ |\ |\
sudden cardiac arrest (SCA) is true? - CORRECT ANSWERS ✔✔E
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
