<\/p>\n
Question<\/span><\/p>\n Question 1<\/span>.<\/span><\/a>1<\/span>.<\/span><\/a>\u00a0A 72-year-old woman with a recent onset of syncopal episodes has been referred to a cardiology group by her family physician<\/span>.<\/span><\/a>\u00a0As part of the patient’s diagnostic workup, the nurse practitioner conducting the intake assessment has ordered a Holter monitor for 24 hours<\/span>.<\/span><\/a>\u00a0Which of the following statements best captures an aspect of Holter monitoring? (Points : 0<\/span>.<\/span><\/a>4)<\/span><\/p>\n A Holter monitor is preferable to standard ECG due to its increased sensitivity to cardiac electrical activity<\/span>.<\/span><\/a><\/p>\n The primary goal is to allow the cardiologist to accurately diagnose cardiomyopathies<\/span>.<\/span><\/a><\/p>\n Accurate interpretation of the results requires correlating the findings with the activity that the woman was doing at the time of recording<\/span>.<\/span><\/a><\/p>\n Holter monitors are normally set to record electrical activity of the heart at least once per hour<\/span>.<\/span><\/a><\/p>\n Question 2<\/span>.<\/span><\/a>2<\/span>.<\/span><\/a>\u00a0As part of the diagnostic workup for a male patient with a complex history of cardiovascular disease, the care team has identified the need for a record of the electrical activity of his heart, insight into the metabolism of his myocardium, and physical measurements, and imaging of his heart<\/span>.<\/span><\/a>\u00a0Which of the following series of tests is most likely to provide the needed data for his diagnosis and care? (Points : 0<\/span>.<\/span><\/a>4)<\/span><\/p>\n Echocardiogram, PET scan, ECG<\/span><\/p>\n Ambulatory ECG, cardiac MRI, echocardiogram<\/span><\/p>\n Serum creatinine levels, chest auscultation, myocardial perfusion scintigraphy<\/span><\/p>\n Cardiac catheterization, cardiac CT, exercise stress testing<\/span><\/p>\n Question 3<\/span>.<\/span><\/a>3<\/span>.<\/span><\/a>\u00a0An 81-year-old female patient of a long-term care facility has a history of congestive heart failure<\/span>.<\/span><\/a>\u00a0The nurse practitioner caring for the patient has positioned her sitting up at an angle in bed and is observing her jugular venous distention<\/span>.<\/span><\/a>\u00a0Why is jugular venous distention a useful indicator for the assessment of the patient’s condition? (Points : 0<\/span>.<\/span><\/a>4)<\/span><\/p>\n Increased cardiac demand causes engorgement of systemic blood vessels, of which the jugular vein is one of the largest<\/span>.<\/span><\/a><\/p>\n Blood backs up into the jugular vein because there are no valves at the point of entry into the heart<\/span>.<\/span><\/a><\/p>\n Peripheral dilation is associated with decreased stroke volume and ejection fraction<\/span>.<\/span><\/a><\/p>\n Heart valves are not capable of preventing backflow in cases of atrial congestion<\/span>.<\/span><\/a><\/p>\n Question 4<\/span>.<\/span><\/a>4<\/span>.<\/span><\/a>\u00a0A physical assessment of a 28-year-old female patient indicates that her blood pressure in her legs is lower than that in her arms and that her brachial pulse is weaker in her left arm than in her right<\/span>.<\/span><\/a>\u00a0In addition, her femoral pulses are weak bilaterally<\/span>.<\/span><\/a>\u00a0Which of the following possibilities would her care provider be most likely to suspect? (Points : 0<\/span>.<\/span><\/a>4)<\/span><\/p>\n Pheochromocytoma<\/span><\/p>\n Essential hypertension<\/span><\/p>\n Coarctation of the aorta<\/span><\/p>\n An adrenocortical disorder<\/span><\/p>\n Question 5<\/span>.<\/span><\/a>5<\/span>.<\/span><\/a>\u00a0A 6-year-old boy has been brought to the emergency department by ambulance after his mother discovered that his heart rate was \u201cso fast I couldn’t even count it<\/span>.<\/span><\/a>\u201d The child was determined to be in atrial flutter and his mother is seeking an explanation from the health care team<\/span>.<\/span><\/a>\u00a0Which of the following points should underlie an explanation to the mother? (Points : 0<\/span>.<\/span><\/a>4)<\/span><\/p>\n The child is experiencing a reentry rhythm in his right atrium<\/span>.<\/span><\/a><\/p>\n The resolution of the problem is dependent on spontaneous recovery and is resistant to pacing interventions<\/span>.<\/span><\/a><\/p>\n The child is likely to have a normal ECG apart from the rapid heart rate<\/span>.<\/span><\/a><\/p>\n The boy’s atria are experiencing abnormal sympathetic stimulation<\/span>.<\/span><\/a><\/p>\n Question 6<\/span>.<\/span><\/a>6<\/span>.<\/span><\/a>\u00a0A 66-year-old patient’s echocardiogram reveals a hypertrophied left ventricle, normal chamber volume, and a normal ejection fraction from the heart<\/span>.<\/span><\/a>\u00a0What is this patient’s most likely diagnosis? (Points : 0<\/span>.<\/span><\/a>4)<\/span><\/p>\n Mitral valve regurgitation<\/span><\/p>\n Aortic valve stenosis<\/span><\/p>\n Mitral valve stenosis<\/span><\/p>\n Aortic valve regurgitation<\/span><\/p>\n Question 7<\/span>.<\/span><\/a>7<\/span>.<\/span><\/a>\u00a0A 70-year-old male patient presents to the emergency department complaining of pain in his calf that is exacerbated when he walks<\/span>.<\/span><\/a>\u00a0His pedal and popliteal pulses are faintly palpable and his leg distal to the pain is noticeably reddened<\/span>.<\/span><\/a>\u00a0What would his care provider’s preliminary diagnosis and anticipated treatment most likely be?(Points : 0<\/span>.<\/span><\/a>4)<\/span><\/p>\n Acute arterial occlusion that will be treated with angioplasty<\/span><\/p>\n Raynaud disease that will require antiplatelet medications<\/span><\/p>\n Atherosclerotic occlusive disease necessitating thrombolytic therapy<\/span><\/p>\n Giant cell temporal arteritis that will be treated with corticosteroids<\/span><\/p>\n Question 8<\/span>.<\/span><\/a>8<\/span>.<\/span><\/a>\u00a0A patient in the intensive care unit has a blood pressure of 87\/39 and has warm, flushed skin accompanying his sudden decline in level of consciousness<\/span>.<\/span><\/a>\u00a0The patient also has arterial and venous dilation and a decrease in systemic vascular resistance<\/span>.<\/span><\/a>\u00a0What is this patient’s most likely diagnosis? (Points : 0<\/span>.<\/span><\/a>4)<\/span><\/p>\n Hypovolemic shock<\/span><\/p>\n Septic shock<\/span><\/p>\n Neurogenic shock<\/span><\/p>\n Obstructive shock<\/span><\/p>\n Question 9<\/span>.<\/span><\/a>9<\/span>.<\/span><\/a>\u00a0A 31-year-old woman with a congenital heart defect reports episodes of lightheadedness and syncope, with occasional palpitations<\/span>.<\/span><\/a>A resting electrocardiogram reveals sinus bradycardia and she is\u00a0 suspected of having sick sinus syndrome<\/span>.<\/span><\/a>\u00a0Which of the following diagnostic methods is the best choice to investigate the suspicion? (Points : 0<\/span>.<\/span><\/a>4)<\/span><\/p>\n Signal-averaged ECG<\/span><\/p>\n Exercise stress testing<\/span><\/p>\n Electrophysiologic study<\/span><\/p>\n Holter monitoring<\/span><\/p>\n Question 10<\/span>.<\/span><\/a>10<\/span>.<\/span><\/a>\u00a0A nurse practitioner is providing care for several patients on a medical unit of a hospital<\/span>