NURS 5463 Test 4 Practice Questions And
100% Correct Answers (A+)
A 73-year-old female seen in ED and admitted to ICU due to chest pain of 4 hours
duration. She has a history of hypertension for 20 years and Type II diabetes mellitus.
Her current medications include metformin, atenolol, and ASA. On physical exam, 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 pain free on IV nitroglycerin and is hemodynamically stable. Which
of the fol - Answer A. Left bundle branch block with normal sinus rhythm
A 55-year-old male patient is admitted to the ICU with ACS, ST elevation 2 mm on the
leads II, III, and aVF. The troponins are positive. The blood pressure is 130/70 mm Hg
while on
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? Answer 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? - Answer Aspirin to chew
In the initial evaluation of a patient with chest pain, which is the most important
diagnostic test? - Answer ECG
A 54-year-old male presents to a rural ED with 1 hour of nausea and substernal chest
pain radiating to his jaw. The ECG demonstrates 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 statements regarding hypothermia treatment for post-cardiac
arrest patients is NOT correct? - Answer B There is evidence for a beneficial effect of
therapeutic hypothermia with regard to the rate of recurrent ventricular fibrillation.
A 63-year-old male 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. Aside from best medical management, the most appropriate
treatment would be which of the following? A. Left CEA
An 84-year-old woman with diabetes and congestive heart failure that is refractory to
medical treatment. Physical examination reveals the presence of a right carotid bruit. A
duplex study suggests a 50% to 75% right carotid stenosis. Which of the following is the
most appropriate treatment? Answer A - Medical management
Which of the following statements regarding carotid artery stenting is most accurate? -
Answer 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? - Answer A. Coumadin to target an INR of 2 to 3
For which of the following patients is left carotid endarterectomy most indicated?
-Answer A. A 70-year-old male with transient loss of vision in the left eye recovered in 20
minutes and who has 75% left carotid stenosis
A 64-year-old male is in the hospital being treated for acute cholecystitis. He is found
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? Answer A:
Percutaneous coronary angiography
Which of the following statements regarding out-of-hospital sudden cardiac arrest
100% Correct Answers (A+)
A 73-year-old female seen in ED and admitted to ICU due to chest pain of 4 hours
duration. She has a history of hypertension for 20 years and Type II diabetes mellitus.
Her current medications include metformin, atenolol, and ASA. On physical exam, 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 pain free on IV nitroglycerin and is hemodynamically stable. Which
of the fol - Answer A. Left bundle branch block with normal sinus rhythm
A 55-year-old male patient is admitted to the ICU with ACS, ST elevation 2 mm on the
leads II, III, and aVF. The troponins are positive. The blood pressure is 130/70 mm Hg
while on
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? Answer 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? - Answer Aspirin to chew
In the initial evaluation of a patient with chest pain, which is the most important
diagnostic test? - Answer ECG
A 54-year-old male presents to a rural ED with 1 hour of nausea and substernal chest
pain radiating to his jaw. The ECG demonstrates 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 statements regarding hypothermia treatment for post-cardiac
arrest patients is NOT correct? - Answer B There is evidence for a beneficial effect of
therapeutic hypothermia with regard to the rate of recurrent ventricular fibrillation.
A 63-year-old male 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. Aside from best medical management, the most appropriate
treatment would be which of the following? A. Left CEA
An 84-year-old woman with diabetes and congestive heart failure that is refractory to
medical treatment. Physical examination reveals the presence of a right carotid bruit. A
duplex study suggests a 50% to 75% right carotid stenosis. Which of the following is the
most appropriate treatment? Answer A - Medical management
Which of the following statements regarding carotid artery stenting is most accurate? -
Answer 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? - Answer A. Coumadin to target an INR of 2 to 3
For which of the following patients is left carotid endarterectomy most indicated?
-Answer A. A 70-year-old male with transient loss of vision in the left eye recovered in 20
minutes and who has 75% left carotid stenosis
A 64-year-old male is in the hospital being treated for acute cholecystitis. He is found
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? Answer A:
Percutaneous coronary angiography
Which of the following statements regarding out-of-hospital sudden cardiac arrest
