Chapter 8: Chest Disorders Flashcards
In mitral stenosis, p waves may suggest:
Left atrial enlargement
Aortic regurgitation requires medical treatment for early signs of CHF with:
ACE inhibitors
A key symptom of ischemic heart disease is chest pain. However, angina equivalents may include exertional dyspnea. Angina equivalents are important because:
A & B only
The best evidence rating drugs to consider in a post myocardial infarction patient include:
ASA, ACE/ARB, beta-blocker, aldosterone blockade
A 55-year-old post-menopausal woman with a history of hypertension complains of jaw pain on heavy exertion. There were no complaints of chest pain. Her ECG indicates normal sinus rhythm without ST segment abnormalities. Your plan may include:
Exercise stress test
Preceding a stress test, the following lab work might include:
A & C only
Which test is the clinical standard for the assessment of aortic stenosis?
Echocardiography
What is the most common valvular heart disease in the older adult?
Aortic stenosis
Ischemic heart disease is:
All of the above.
On examination, what type of murmur can be auscultated with aortic regurgitation?
Austin flint
Which test is the clinical standard for the assessment of aortic stenosis?
Echocardiography
The aging process causes what normal physiological changes in the heart?
The heart valve thickens and becomes rigid, secondary to fibrosis and sclerosis
An older adult may present with atypical clinical signs of pneumonia. The nurse practitioner needs to be aware that the clustering of all of the following signs and symptoms may be indicative of pneumonia in an older person except:
Bradycardia
Which of the following statements is true concerning anti-arrhythmic drugs?
Most anti-arrhythmics have a low toxic/therapeutic ratio and some are exceedingly toxic.
Dan G., a 65-year-old man, presents to your primary care office for the evaluation of chest pain and left-sided shoulder pain. Pain begins after strenuous activity, including walking. Pain is characterized as dull, aching; 8/10 during activity, otherwise 0/10. Began a few months ago, intermittent, aggravated by exercise, and relieved by rest. Has occasional nausea. Pain is retrosternal, radiating to left shoulder, definitely affects quality of life by limiting activity. Pain is worse today; did not go away after he stopped walking. BP 120/80. Pulse 72 and regular. Normal heart sounds, S1 and S2, no murmurs. Which of the following differential diagnoses would be most likely?
Coronary artery disease with angina pectoris
ose M. is a 68-year-old man who presents to your primary care practice for a physical. Jose has had type 2 diabetes mellitus for 5 years, diet controlled. His BMI is 32. Smoker, pack per day for 25 years. He denies other medical problems. Family history includes CAD, CABG x4 for father, now deceased; CHF, type 2 diabetes mellitus, HT for mother. According to the AHA/ACC guidelines, what stage is Jose?
Stage A
Susan P., a 60-year-old woman with a 30 pack year history, presents to your primary care practice for evaluation of a persistent, daily cough with increased sputum production, worse in the morning, occurring over the past three months. She tells you, “I have the same thing, year after year.” Which of the following choices would you consider strongly in your critical thinking process?
Chronic bronchitis
The best way to diagnose structural heart disease/dysfunction non-invasively is:
Echocardiogram
A common auscultatory finding in advanced CHF is:
S3 gallop rhythm
The organism most commonly responsible for community-acquired pneumonia in older adults is:
Streptococcus pneumonia
A 72-year-old woman and her husband are on a cross-country driving vacation. After a long day of driving, they stop for dinner. Midway through the meal, the woman becomes very short of breath, with chest pain and a feeling of panic. Which of the following problems is most likely?
Pulmonary embolism
