NSG 6001 Midterm Exam 2 – Question with Answers and Explanations
N.B (Explanations are in brackets)
Question 1.
A 35 year old female arrives at your clinic. She has had diabetes and peripheral artery
disease for the past 5 years. You decide to obtain an ETT. The insurance company argues
that this is inappropriate. You justify the ETT because you are planning secondary
strategies to prevent future heart disease. Where could one find the supporting data for
these guidelines?
Medicare guidelines
Framingham risk score (These guidelines come from the Framingham risk score.)
Medicaid guidelines
Do not exist
Question 2.
You are counseling a patient diagnosed with stress-induced ischemia. You base your
discussion on your knowledge that stress-induced ischemia is thought to be caused by what
phenomena?
Diet and exercise
Heart muscle dysfunction
Too many carbonated drinks
Endothelial dysfunction of the microvascular (You base your discussion on your knowledge that
stress-induced ischemia is thought to be caused by endothelial dysfunction of the microvascular.)
Question 3.
What happens to coronary flow related to CAD?
Hyper profusion of the myocardium
Cerebral vascular infarction
Hypo profusion of the myocardium (Because of the restrictive flow of blook through the
coronary arteries, hypo profusion of the myocardium results from coronary flow related to CAD
which causes the presenting symptoms)
, Functional systolic pressures
Question 4:
A 47-year old female with general complaints of fatigue and shortness of breath shows up
in your clinic as a referral from another nurse practitioner. Several blood tests and chest x-
rays have been completed without any diagnosis or outstanding abnormalities. You decide
to order an ETT despite the fact that the recent ECG does not show any abnormalities.
From the answers below, which would be the best answer to support your decision?
You are out of other options
Women present with the same pattern of CAD as do males
CAD in women is under diagnosed (You make this choice because you are aware that CAD in
women is under diagnosed.)
To please the patient
Question 5:
You are in the clinic with your mentor observing the Echocardiogram exercise test of a 45-
year old male that has been experiencing slight chest pressure almost daily during exercise.
While observing your patient, your mentor points out that the left ventricle wall is thinning
and there is some hyperkinesias of the ventricular wall. From your time in the clinic, you
know that this test will be considered to be what type of result?
Impossible
Negative
Positive (From your time in the clinic, you know because of wall thinning and hyperkinesis that
this test will be considered to be positive.)
Non-readable
Question 6:
On the echocardiography during the ETT you notice the following change: abnormal left
ventricular ejection fraction. What do these changes suggest related to this patient?
Non-ischemic changes of the baseline ECG
Ischemia of the myocardium (Abnormal left ventricular ejection fraction suggests ischemia of
the myocardium.)
Rise in heart rate without evidence of ischemia
N.B (Explanations are in brackets)
Question 1.
A 35 year old female arrives at your clinic. She has had diabetes and peripheral artery
disease for the past 5 years. You decide to obtain an ETT. The insurance company argues
that this is inappropriate. You justify the ETT because you are planning secondary
strategies to prevent future heart disease. Where could one find the supporting data for
these guidelines?
Medicare guidelines
Framingham risk score (These guidelines come from the Framingham risk score.)
Medicaid guidelines
Do not exist
Question 2.
You are counseling a patient diagnosed with stress-induced ischemia. You base your
discussion on your knowledge that stress-induced ischemia is thought to be caused by what
phenomena?
Diet and exercise
Heart muscle dysfunction
Too many carbonated drinks
Endothelial dysfunction of the microvascular (You base your discussion on your knowledge that
stress-induced ischemia is thought to be caused by endothelial dysfunction of the microvascular.)
Question 3.
What happens to coronary flow related to CAD?
Hyper profusion of the myocardium
Cerebral vascular infarction
Hypo profusion of the myocardium (Because of the restrictive flow of blook through the
coronary arteries, hypo profusion of the myocardium results from coronary flow related to CAD
which causes the presenting symptoms)
, Functional systolic pressures
Question 4:
A 47-year old female with general complaints of fatigue and shortness of breath shows up
in your clinic as a referral from another nurse practitioner. Several blood tests and chest x-
rays have been completed without any diagnosis or outstanding abnormalities. You decide
to order an ETT despite the fact that the recent ECG does not show any abnormalities.
From the answers below, which would be the best answer to support your decision?
You are out of other options
Women present with the same pattern of CAD as do males
CAD in women is under diagnosed (You make this choice because you are aware that CAD in
women is under diagnosed.)
To please the patient
Question 5:
You are in the clinic with your mentor observing the Echocardiogram exercise test of a 45-
year old male that has been experiencing slight chest pressure almost daily during exercise.
While observing your patient, your mentor points out that the left ventricle wall is thinning
and there is some hyperkinesias of the ventricular wall. From your time in the clinic, you
know that this test will be considered to be what type of result?
Impossible
Negative
Positive (From your time in the clinic, you know because of wall thinning and hyperkinesis that
this test will be considered to be positive.)
Non-readable
Question 6:
On the echocardiography during the ETT you notice the following change: abnormal left
ventricular ejection fraction. What do these changes suggest related to this patient?
Non-ischemic changes of the baseline ECG
Ischemia of the myocardium (Abnormal left ventricular ejection fraction suggests ischemia of
the myocardium.)
Rise in heart rate without evidence of ischemia
