msn 622 final newest actual exam complete 2024 que
msn 622 final newest actual exam
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MSN 622 FINAL NEWEST ACTUAL EXAM
COMPLETE 2024 QUESTIONS AND CORRECT
DETAILED ANSWERS (VERIFIED ANSWERS)
ALREADY GRADED A+
A 72-year-old man with a recent history of a large anterior wall
myocardial infarction complains of dyspnea on exertion,
orthopnea, and increasing pedal edema. There is concern about
congestive heart failure. Which of the following would support the
diagnosis? - ANSWER >>>>A S3 gallop
Which of the following may be the initial presentation of long-term
hypertension? - ANSWER >>>>Cerebrovascular accident
A patient presents with shortness of breath. Rales are heard in
the lower lung fields. There is an S4. Hepatojugular reflux is
present. The chest x-ray shows cardiomegaly and enlargement of
the mediastinal veins. Congestive heart failure is suspected.
Reduced bloodflow in the ascending aorta would not cause
decreased blood flow in which of the following arteries? -
ANSWER >>>>Pulmonary artery
A 65-year-old woman presents with intermittent, sudden-onset
chest pain and shortness of breath, which radiates to her left jaw
and arm. A history of present illness reveals that the pain initially
occurred with activity, but now it occurs throughout the day. A
review of systems is positive for tiring easily with mild physical
activity. Her medical history is significant for hypertension and
type 2 diabetes mellitus. An electrocardiogram (ECG) and cardiac
enzyme markers are ordered. Which of the following tests will be
most helpful in differentiating unstable angina from a non-ST
,segment elevation myocardial infarction (NSTEMI)? - ANSWER
>>>>Troponin I
A 65-year-old man presents with a 4-hour history of progressively
worsening left chest pain that radiates to his left neck. A history of
present illness reveals minor episodes of transient chest pain over
the last 6 months after climbing 2 flights of stairs or running. His
past medical history includes hypertension, type 2 diabetes
mellitus, and hyperlipidemia. His vital signs are oxygen saturation
98% on room air, respiratory rate 18 breaths/min, heart rate 91
bpm, blood pressure 131/91 mm Hg, and temperature 98.6 °F (37
°C). A 12-lead electrocardiogram (ECG) demonstrates ST
depressions in leads V5, V6, and aVL. The patient is administered
oxygen, morphine, nitroglycerin, and aspirin. What is the principle
behind giving this patient nitroglycerin? - ANSWER >>>>To dilate
the venous system and decrease cardiac preload.
A 70-year-old patient comes to the clinic with complaints of
increased blood pressure. He was diagnosed with hypertension
10 years ago. His other problems include osteoporosis and
hyperlipidemia. His readings range from systolic 160 mmHg to
170 mmHg while diastolic falling in between 70 mmHg to 90
mmHg. His current blood pressure is 160/80 mmHg. His
medications include lisinopril, amlodipine, atorvastatin, calcium
and vitamin D supplements, and bisphosphonates. He does not
exercise and smokes a pack of cigarettes daily. He drinks two
glasses of beer every day. Family history is significant for stroke
in father and MI in his sister. Which of the following is the most
likely effect of increased blood pressure on his heart? - ANSWER
>>>>Left ventricular (concentric) hypertrophy
A middle-aged patient with diabetes mellitus is referred to the
clinic by his primary care provider to diagnose heart failure. The
patient states that he does not have any documentation or labs
from his previous medical encounters. Which of the following is
,the most significant and earliest sign of heart failure? - ANSWER
>>>>An S3 gallop
A woman presents with chronic fatigue and trouble breathing.
Upon inspection, there is peripheral edema and significant jugular
venous pressure. She has had longstanding hypertension with
exertional fatigue, which has been worsening over the past
several years. She has not been adherent to medications. What is
the most common cause of her symptoms? - ANSWER >>>>Left-
sided heart failure
A 60-year-old woman with obesity and congestive heart failure
(CHF) presents with a complaint of increased abdominal girth.
She has noticed this occur over the last week, making her self-
conscious about her appearance. She reports shortness of
breath, constipation, and abdominal discomfort but denies nausea
and vomiting or any changes in appetite. She also reports a
history of cholecystectomy and frequently experiences
constipation. Physical examination reveals jugular venous
distension, pulmonary crackles, a non-tender distended abdomen,
and bulging flanks. The liver is non-palpable. Which of the
following is the best assessment of this patient? - ANSWER
>>>>There is a pathologic buildup of fluid in her peritoneum due
to abnormal changes in her hydrostatic pressure due to a CHF
exacerbation. Her serum albumin is 4 g/dL, and ascitic fluid
albumin is 2 g/dL.
A 65-year-old male patient with a medical history of hypertension,
diabetes mellitus, and coronary artery disease is being evaluated
for chronic stable anginal symptoms. He was prescribed
sublingual nitroglycerin as needed for chest pain. Which of the
following medications should be avoided in this patient due to this
drug? - ANSWER >>>>Sildenafil
, A 55-year-old asymptomatic, female smoker, with an extensive
family history of premature coronary artery disease, presents to
the office for further cardiovascular risk stratification. Her 10-year
ASCVD risk score by the pool cohort equation is 5.3%, and she is
concerned about testing for further risk stratification as she is
reluctant to take medications. Which of the following is most
appropriate to order to assist in treatment decision making? -
ANSWER >>>>Coronary artery calcium scoring
A 50-year-old man presents to the clinic for recurrent headaches.
His office blood pressure has been consistently found to be
elevated. He is not on any hypertensive agent. Home blood
pressure diary measurements reveal an average systolic blood
pressure (SBP) of 135 mm Hg and diastolic blood pressure (DBP)
of 85 mm Hg over 3 weeks. The chemistry panel and
electrocardiogram are normal. What is the best initial step in the
management of this patient? - ANSWER
>>>>Hydrochlorothiazide
A 44-year-old man comes to the clinic for a follow-up. The patient
was found to have elevated blood pressure on his annual physical
exam last week. He was thus asked to keep a blood pressure
diary for one week. Today, the diary reveals an average blood
pressure of between 125-135/80-85 mmHg over the past week.
Which of the following the best advice to this patient by the
nurse? - ANSWER >>>>Get about 150 minutes of moderate-
intensity exercise per week
A 42-year-man with a past medical history of mitral stenosis due
to rheumatic heart disease dies during open-heart surgery.
Autopsy findings were consistent with mitral valve stenosis.
Addtitionionally, it also revealed the presence of heart failure
cells. What is the most probable explanation for the presence of
these cells? - ANSWER >>>>Passive congestion of pulmonary
parenchyma
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