CARDIOVASCULAR

Question 1

Your patient has a history of coagulopathy and is about to go to surgery. Which order is appropriate for DVT/Bleeding prophylaxis?

Answer 1

Pneumatic stockings

Question 2

Which of the following is least likely to experience a DVT?

Answer 2

58 Y M liver patient

Question 3

The nurse calls you to report low BP in a CHF patient on the unit. You have IVF ordered, and the cardiologist has ordered Lasix.

Answer 3

D/C the Lasix

Question 4

You are assessing heart sounds pre-operatively and hear a classic “aortic stenosis” type murmur, as well as a carotid bruit. There are no neurological symptoms. What should you order first?

Answer 4

Echocardiogram

Question 5

Which of the following is contraindicated for a patient receiving a renal angiogram?

Answer 5

Ace Inhibitor

Question 6

Your 45M patient has new onset Atrial Fibrillation, but no other past medical history. What should you prescribe?

Answer 6

ASA (young with no risk factors/history)

Question 7

Which is best used to diagnose pulmonary HTN?

Answer 7

2D ECHO (confirmed by cardiac cath)

Question 8

Your patient has overdosed on Lopressor. It has been 5-6 hours. What do you order?

Answer 8

Glucagon and Atropine

Question 9

Your pt is pre-operative for an elective surgery. You notice a pulsating mass in the mid abdomen (AAA). What is next action?

Answer 9

Order abdominal U/S

Question 10

Your patient is post-op after an aneurysm clipping. Which intervention is used?

Answer 10

Place pt in a quiet room

Question 11

Your 67 yr old pt has a BP of 168/92. On her second visit her BP is 158/88. What is your initial Tx plan?

Answer 11

Teach lifestyle changes

Question 12

Normal HDL

Answer 12

40-60

Question 13

Normal LDL

Answer 13

100 mg/dL or less

Question 14

Normal Triglycerides

Answer 14

150 md/dL or less

Question 15

Normal total cholesterol

Answer 15

180 to 200

Question 16

Your patient is an obese 38 F with the following fasting lipid panel: TC 270, LDL 168, HDL 28. What is your action?

Answer 16

Start a statin (key word is obese)

Question 17

Which med must be on the d/c list of a patient admitted for CHF?

Answer 17

Lisinopril-ACE

Question 18

31 yo M with a blowing murmur occurring during S1 and galloping addition heart sound. Murmur is heard best at the base of the heart. What is the murmur?

Answer 18

Mitral Regurgitation

Question 19

When d/c an 85F pt w/stasis dermatitis, the NP includes instructions to:

Answer 19

keep legs elevated while seated.

Question 20

A 70-year-old patient with acute systolic HF denies any functional limitations, is able to walk five blocks before tiring, and is euvolemic. Which medication is the first-line therapy for this patient?

Answer 20

Lisinopril (Zestril).

Question 21

A patient with HF has DOE and sleeps all night while using 3 pillows. What is her NYHA HF stage?

Answer 21

Stage III

Question 22

Treatment 2nd type 2 or Complete/3rd degree block

Answer 22

Tx transcutaneous pacing, venous if can’t capture, atropine if very symptomatic, plan for pacemaker. d/c AV-nodal blocking drugs

Question 23

Pt had an EF of 20 and bronchospasm-what med caused it?

Answer 23

Beta Blocker

Question 24

Hypertensive Emergency

Answer 24

220/120 (Urgency is 180/110)

Question 25

Treat Afib

Answer 25

check TSH (for hyperthyroid), Tx with beta blocker

Question 26

What grade murmur do /you first hear a thrill

Answer 26

4 (listed on test as IV)

Question 27

On physical exam, you note a mod. Loud MM with no thrill. What grade?

Answer 27

3

Question 28

Pt has low diastolic rumble murmur in the left lateral position with no radiation

Answer 28

Mitral stenosis

Question 29

Pt presents with suspected mitral regurg. What physical findings would confirm?

Answer 29

S3 systolic murmur

Question 30

Heart problems with RA

Answer 30

tricuspid regurgitation

Question 31

Pt w/Hx of HF or PRBCs, wet LS, LE edema, dyspnea- cause of edema:

Answer 31

increased hydrostatic capillary pressure.

Question 32

What is the purpose of cardiac stress testing?

Answer 32

Differentiate ischemia vs infarction

Question 33

STEMI guidelines

Answer 33

“door to needle” 30 minutes “door to balloon” 90 minutes

Question 34

Pt is post-MI, on a beta blocker and statin. What do they need?

Answer 34

ACE-I

Question 35

HTN + DM

Answer 35

ACEi

Question 36

Which drug prevents cardiac remodeling

Answer 36

ACEi (double checked this. Beta blockers also possibly prevent remodeling)

Question 37

Pt w/ 14 hrs of CP presents to the ED. next step of action?

Answer 37

Take to cath lab (fibrinolytic therapy 6° window is closed)

Question 38

Pericarditis

Answer 38

pt with normal CXR, low grade temp, elevation in all leads- best diagnostic test- echo, send home on NSAIDS, -risk for what: tamponade

Question 39

A pt post CABG with abd distention, labs provided, diagnosis?

Answer 39

Dx = mesenteric infarct (one RF is cardiac surgery)

Question 40

Gerontology and cardiac problems

Answer 40

Cardiomegaly

Question 41

Treatment for CVI: Venous status ulcer

Answer 41

use compression stocking

Question 42

How pt w/ DM and ♥dz decrease LDL non-pharm?

Answer 42

Diet and exercise, lifestyle changes

Question 43

Temporal arteritis requires immediate Tx in order to prevent what

Answer 43

blindness in the affected eye.

Question 44

Pt in the ER with sudden LOC and motor function. The ER dx TIA. The pt has right-handed weakness and numbness. Carotid studies are completed and revel 92-95% occlusion bilaterally. What is next step?

Answer 44

Patient to have left carotid explored first followed by the right one at a later date

Question 45

62 yo M presents with angina after his daily walk. Lipid panel reveals LDL 250, HDL 25, chol 350 and triglycerides 250. You prescribe niacin. How would you explain the mechanism of action to the pt?

Answer 45

Niacin lowers LDL and increases HDL