A patient has poorly controlled hypertension for more than 10 years. Indicate the most likely position of
his point of maximal impulse (PMI) - -----ANSWER---->5th ICS, left of MCL
A 43 year old Hispanic male has an audible diastolic murmur best heard in the mitral listening point.
There is no audible click. His status has been monitored for the past two years. This murmur is probably -
-----ANSWER---->mitral stenosis
A patient who has diabetes presents with pain in his lower legs when he walks and pain resolution with
rest. When specifically asked about his pain in his lower leg, he likely will report pain - -----ANSWER---->in
the calf muscle
A patient with hypertension describes a previous allergic reaction to a sulfa antibiotic as "sloughing of
skin" and hospitalization. Which medication is contraindicated in this patient? - -----ANSWER----
>hydrochlorothiazide
A 75 year old patient who has aortic stenosis wants to know what symptoms indicate worsening of his
stenosis. the NP replies: - -----ANSWER---->shortness of breath and syncope
,A 74 year old patient has PAD. Which item listed below is an important nonmodifiable risk factor for
PAD? - -----ANSWER---->diabetes
Benazepril should be d/c immediately if - -----ANSWER---->pregnancy occurs
aortic regurgitation characteristics - -----ANSWER---->long asymptomatic period follow by exercise
intolerance, then dyspnea at rest
DVT classic symptoms - -----ANSWER---->swelling, pain, and discoloration of lower extremity
Characteristic of ACE-induced cough is that? - -----ANSWER---->usually begins two weeks of starting
therapy
Valve most commonly involved in chronic rheumatic heart disease - -----ANSWER---->mitral
Medication that can exacerbate HF - -----ANSWER---->naproxen
Patient taking ACE inhibitors should avoid? - -----ANSWER---->potassium supplements
Grade 3 murmur indication for a referral - -----ANSWER---->a fixed split
Group of meds used to treat HF - -----ANSWER---->fosinopril, HCTZ, verapamil
Mr. Smith is a 72-year-old patient who takes warfarin for chronic A-fib. INR today is 4.0. the NP should: - -
----ANSWER---->stop the warfarin today and repeat INR tomorrow
According to the NHLBI, which characteristic is a coronary heart disease risk equivalent, that is, which
risk factor places the pt. as a CHD risk similar to a hx of CHD - -----ANSWER---->diabetes mellitus
good drug to reduce morbidity and mortality in mild HF - -----ANSWER---->metoprolol
,A pt. taking atorvastatin newly diagnosed with dyslipidemia complaints of fatigue, weakness, and muscle
aches in his lower back, arms, legs for the past 3 days. it is not improved with rest How should this be
evaluated? - -----ANSWER---->Stop the atorvastatin immediately
symptom not indicative of HF - -----ANSWER---->headache
What class of meds is preferred to normalized lipid levels and reduce risk of cardiac events - -----
ANSWER---->HMG CoA reductase inhibitors
Highest sensitivity in diagnosing HF - -----ANSWER---->BNP
The NP is caring for a 74-year-old who had an acute coronary syndrome 6 weeks ago. What medications
should be part of his regimen unless contraindicated - -----ANSWER---->ACE, ASA, beta blockers, and
statin
patient with the highest systolic B/P - -----ANSWER---->75-year-old male
test that is most cost effective to screen for abdominal aortic aneurysm - -----ANSWER---->abdominal
ultrasound
a 74-year-old patient has had an increase in b/p since the last exam. his b/p has increased from 144/90
to reading in the upper 160's/upper 80's. If medication is to be started on this patient, what would be a
good first choice? - -----ANSWER---->Calcium channel blocker
Factor contributing to the development of AAA - -----ANSWER---->cigarette smoking
A 40-year-old African-American pt. has a b/p of 175/100 and 170/102. What is a reasonable plan of care
for this pt today? - -----ANSWER---->initiate amlodipine 5mg daily
Usual course of treatment for mitral valve prolapse - -----ANSWER---->is benign
, A 50-year-old patient with hypertension has taken HCTZ 25mg daily for the past 4 weeks. Her b/p has
decreased from 155/95 to 145/90. How should the NP proceed? - -----ANSWER---->add another drug
from another class to the daily 25mg HCTZ
A patient with mitral valve prolapse reports chest pain and frequent arrhythmias. In the absence of other
cardiac anomalies, the drug of choice to treat her symptoms is: - -----ANSWER---->metoprolol
which hypertensive pt. is most likely to have adverse b/p effects from excessive sodium consumption? - -
----ANSWER---->a 70-year-old African American
where would the murmur associated w/mitral regurgitation best be auscultated? - -----ANSWER----
>mitral listening point
A pt. with a positive hx of a tick bite 2 weeks ago and erythema migrans has a positive ELISA for borrelia
burgdorferi. The Western blot is positive. How should he be managed? - -----ANSWER---->he should
receive Doxycycline for Lyme disease
a pt. has/seborrheic dermatitis. Which vehicle would be most appropriate to use in the hairline area to
treat this? - -----ANSWER---->foam
A microscopic exam of the sample taken from a skin lesion indicates hyphae. What type of infection
might this indicate? - -----ANSWER---->fungal
A pt. has been dx w/MRSA. she is allergic to sulfa. Which medication could be used to treat her? - -----
ANSWER---->doxycycline
A 15-year-old male has worked this summer as a lifeguard at a local swimming pool. He complains of
itching in the groin area. He is dx with tinea cruris. The NP is likely to identify - -----ANSWER---->well
marginated half moon shape macules on the inner thigh
A pt. exhibits petechiae on both lower legs w/o other complaints. How should the NP proceed? - -----
ANSWER---->order a CBC
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