Cardiac Arrhythmias

Question

Question 1

More than half of all cardiac arrhythmias involve the atria.

True

False

Question 2.

What are the most common symptoms caused by tachyarrhythmias?

Sweating

Thirst

Palpitations

Headaches

Question 3.

For women with known CAD and diabetes, which is most appropriate to assess CAD risk?

ETT

Coronary bypass surgery

Coronary catheterization

ETT with imaging

Question 4.

Of the following, which is the best answer when asked for an advantage of echocardiogram exercise testing over thallium stress testing?

Does not depend on operator experience

Costs are the same

Results are available more quickly

Doesn’t matter because there are no advantages

Question 5.

Your patient has uncomplicated pyelonephritis. In deciding your recommended treatment, you consider the most common pathogenic reason for this diagnosis. What pathogen accounts for the majority of pyelonephritis?

E. Coli

Gardnerella Vaginalis

Mycoplasma Hominis

Chlamydia

Question 6.

What purpose does the principle of fidelity serve in the provider/patient relationship?

Ensures that providers honor their commitments to the patient

Obligates the provider to a one-on-one relationship with the individual

Ensures that patients receive whatever they want

Maintains costs in the healthcare arena

Question 7.

In CAD, after both systolic and diastolic dysfunction have occurred, the typical pattern of chest pain and related EKG changes occur. During an EKG, you should expect to see ST-segment and T-wave changes that are central to demonstration of ischemia occurring relatively late in the ischemic cascade. Is this true or false?

True

False

Question 8.

The leads on the ECG showing ischemic changes during or immediately after an ETT can correlate roughly to the culprit artery or arteries with significant CAD. Is this true or false?

True

False

Question 9.

Skin cancer is the most common malignant neoplasm in males in the US. What is the second leading cause of cancer deaths in men greater than 50 years of age?

Prostate cancer

Lung cancer

Lymphoma

Lupus

Question 10.

What ECG changes can reduce the specificity of the ETT?

Exercise induced bundle branch blocks

Paced rhythm and resting bundle branch block

Paced rhythm and exercise induced bundle branch blocks

Low voltage up sloping of the ST-segment

Question 11.

You have confirmed that your patient does indeed have an abdominal aortic aneurysm. In teaching your patient about symptoms to report immediately to the vascular surgeon, you instruct the patient to report which of the following?

Newly diagnosed diabetes

Back pain or flank pain

Visual disturbances

Headaches

Question 12.

What is one of the common causes of a Saccular Abdominal Aneurysm?

Poor kidney functioning

Age

Drugs: illicit and prescribed

Trauma

Question 13.

The diagnostic accuracy of stress testing is decreased among women compared to men for what reasons?

Women having thinner ventricular and septal muscles

Women usually have single vessel or non-obstructive disease

Women cannot exercise as vigorously as men

Women typically have multiple vessel disease

Question 14.

Population disease management is a term used to describe:

High specificity disease states

Low specificity diseases states

Low prevalence specific diseases

High prevalence specific diseases

Question 15.

You receive a report back on the suspected abdominal aortic aneurysm for your patient. It confirms your suspicion of AAA. The report describes the aneurysm as a symmetric weakness of the entire circumference of the aorta. You know that this form of aneurysm is referred to as what kind of aneurysm?

Thoracic aneurysm

Budging sac aneurysm

Saccular aneurysm

Fusiform aneurysm

Question 16.

Your practice partner just ordered an exercise echocardiography 2DE for a patient with suspected cardiovascular risk. This patient has known resting wall motion abnormalities.Why would this not be the best test to assess this patient’s cardiac risk?

Sensitivity is increased

Sensitivity is decreased

Specificity is increased

Specificity is decreased

Question 17.

Your 60-year old male patient arrives for his appointment. He complains of general malaise and fever over the past several days with low back pain. He also states that he is getting up at night more often to urinate and never feels his bladder is completely empty.What differential diagnosis should you consider in this patient?

Acute viral prostatitis

Stomach virus

Acute bacterial prostatitis

BPH only

Question 18.

We all know that collaboration is integral to becoming a successful nurse practitioner. Among collaborations, however, only one can be considered as the most important. While each example below is important, which is the most important collaboration? The one that occurs:

Between the nurse practitioner and their physician mentor

Between two healthcare providers about a single patient

Between the patient and their family

Between the patient and the nurse practitioner

Question 19.

The sensitivity of a routine ETT is effort dependent. What physiological changes occur during effort in the routine ETT?

Rapid heart rates and coronary artery narrowing

Decrease in coronary blood flow

Decreased heart rate and increased systolic blood pressure

Increased coronary flow and increased systolic blood pressure

Question 20.

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

CAD in women is under diagnosed

To please the patient

Women present with the same pattern of CAD as do males

Question 21.

Your patient underwent an exercise stress test for CAD. There is significant elevation of the ST-segment.What do you need to know about these changes to manage your patient’s care?

: This patient needs to see someone more experienced in treatment of CAD

These changes are predictive of myocardial infarction

These changes have minimal predictive value for CAD

These changes predict dire outcomes

Question 22.

When there is a consequential loss of structural integrity of the abdominal aorta, the resulting issue is what condition?

Bloated stomach

Kidney failure

Bleeding ulcers

Abdominal aortic aneurysm

Question 23.

You see a 60-year old African American male in your clinic with a recent diagnosis of hypertension. He asks you what he should restrict in his diet, and is particularly interested in limiting his sodium intake. What amount of sodium intake would you recommend on a daily basis for this patient?

1.5 g/day

No added table salt

3.0 g/day

2.3 g/day

Question 24.

Why would inability to exercise reduce the specificity of the routine ETT?

Produces QRS changes that cannot be interpreted

Produces persistent ST-segmental changes and T-wave abnormalities

Causes ST-segment changes and P-wave abnormalities

Will not produce any changes in ECG

Question 25.

By standard criteria, how is a positive stress test defined?

Development of a horizontal or down sloping ST-segment depression of 1mm

Down sloping of the ST-segment at the J point of the QRS

Development of a horizontal or down sloping ST-segment depression of 10mm

Upward sloping ST-segment measured at the J point of the QRS

Question 26.

What are the two types of bradycardia recognized by the American Heart Association?

Relative and absolute

Absolute and pending

Refractory and non-refractory

Relative and dynamic

Question 27.

You see a 75-year old female in your clinic today complaining of urinary incontinence. She is otherwise healthy based upon her last visit. She states that her mother told her this would happen someday because it happens to every woman at some age. What would you tell this patient?

This happens to all women as they age

No need to worry. This is normal. Your mother was correct.

This is not an expected condition related to aging.

This happens to men as well and most women before your age.

Question 28.

What do you know regarding ischemia that is confined to only the posterior and or lateral segments of the left ventricle?

ETT cannot be used for detection

Difficult to detect by ETT

Requires both for detection of changes by ETT

Easier to detect by ETT

Question 29.

What three conditions definitely alter the results of echocardiography in determining CAD?

Obesity, rapid heart rate and lung disease

Diabetes, kidney disease and tooth decay

Obesity, slow heart rates and hypertension

Previous MI, hypotension and diabetes

Question 30.

Specifically, when is an ETT considered to be negative?

Patient has ST-segmental changes with down sloping of greater than 1 mm at 50% of age-predicted maximum heart rate

Patient exercises to 85% of age predicted maximum heart rate without evidence of induced ischemia

Patient exercises to 20% maximum age-predicted heart rate without induced ischemia

Patient exercises until tired without evidence of induced ischemia

Question 31.

All patients, even is asymptomatic, require risk stratification according to the Farmingham risk score. At present, ACC/AHA guidelines, however, do not normally support stress tests for asymptomatic patients without addiitonal justification. From the list below, what could be used to justify a ETT in an asymptomatic patient?

A smoker of 3 weeks

A member of congress

Sedentary and wishes to begin aggressive exercise

Developmentally challenged

Question 32.

BPH is not a risk factor for Prostate cancer. Is this statement true or false?