6531 Combined midterm and final review Questions and correct Answers 2022 A health care provider in a clinic finds a patient in a room, unresponsive and pale. Which sign should be used to identify the need to initiate cardiopulmonary resuscitation (CPR)?Evaluation of peripheral perfusion and level of consciousness Obtaining a history of previous myocardial infarction Determination of pulselessness or bradycardia Assessment of gasping breaths or not breathing - correct answer Assessment of gasping breaths or not breathing An African-American patient who is being treated with a thiazide diuretic for chronic hypertension reports blurred vision and shortness of breath. The provider notes a blood pressure of 185/115. What is the recommended action for this patient?Increase the dose of the thiazide medication Add a beta blocker to the patient's regimen Admit to the hospital for evaluation and treatment Prescribe a calcium channel blocker - correct answer Admit to the hospital for evaluation and treatment A patient reports sustained, irregular heart palpitations. What is the most likely cause of these symptoms?Atrial fibrillation Anemia Extrasystole Paroxysmal attacks - correct answer Atrial fibrillation A patient has a cardiac murmur that peaks in midsystole and is best heard along the left sternal border.The provider determines that the murmur decreases in intensity when the patient changes from standing to squatting and increases in intensity with the Valsalva maneuver. Which cause will the provider suspect for this murmur? 1 / 4
Aortic stenosis Tricuspid regurgitation Hypertrophic cardiomyopathy Mitral valve prolapse - correct answer Hypertrophic cardiomyopathy A patient is brought to an emergency department with symptoms of acute ST-segment elevation MI (STEMI). The nearest hospital that can perform percutaneous coronary intervention (PCI) is 3 hours away. What is the initial treatment for this patient?Give the patient an oral beta blocker Transfer to the PCI-capable institution Administer heparin Initiate fibrinolytic treatment - correct answer Initiate fibrinolytic treatment Patients who meet the criteria for statin therapy to help prevent atherosclerotic cardiovascular disease are those with a history of (Select all that apply.) previous myocardial infarction.a low-density lipoprotein (LDL) level >190 mg/dL.diabetes and an LDL between 40 and 70 mg/dL.a 10 year risk score of 8% with an LDL of 80 mg/dL.a 10 year risk score of 5% and an LDL of 165 mg/dL. - correct answer previous myocardial infarction.a low-density lipoprotein (LDL) level >190 mg/dL.a 10 year risk score of 8% with an LDL of 80 mg/dL.A 75-year-old patient reports pain and a feeling of tiredness in both legs that only relieves after sitting for 30 minutes or more. What the does provider suspect as the cause for these symptoms?Buerger's disease Cauda equina syndrome Diabetic neuropathy Peripheral arterial disease - correct answer Cauda equina syndrome 2 / 4
Which are causes of secondary hypertension? (Select all that apply.) Oral contraceptives Isometic excercises
NSAIDS
Sleep apnea Increased salt intake - correct answer Oral contraceptives
NSAIDS
Sleep apnea A young female patient has known mitral valve prolapse. During a routine health maintenance exam, the provider notes an apical systolic murmur and a midsystolic click on auscultation. The patient denies chest pain, syncope, or palpitations. What will the provider do?Reassure the patient that these findings are expected Continue to monitor the patient every 3 years Admit the patient to the hospital for evaluation and treatment Consult with cardiology to determine appropriate diagnostic tests - correct answer Consult with cardiology to determine appropriate diagnostic tests A patient reports abdominal and back pain with anorexia and nausea. During an exam, the provider notes a pulsatile abdominal mass. What is the initial action?Scheduling an MRI to evaluate for aortic disease Immediate referral to a thoracic surgeon US of the mass to determine size Ordering CT angiography - correct answer US of the mass to determine size A patient is brought to an emergency department with symptoms of acute ST-segment elevations MI (STEMI). The nearest hospital that can perform percutaneous coronary intervention (PCI) is 3 hours away. What is the initial treatment for this patient?Give the patient an oral beta blocker Initiate fibrinolytic treatment Administer heparin 3 / 4
Transfer to the PCI-capable institution - correct answer Initiate fibrinolytic treatment A 55-year-old patient has a blood pressure of 138/85 on three occasions. The patient denies headaches, palpitations, snoring, muscle weakness, and nocturia and does not take any medications. What will the provider do next to evaluate this patient?Continue to monitor blood pressure at each health maintenance visit Assess serum cortisol levels Order urinalysis, CBC, BUN and creatinine Refer to specialist for sleep study - correct answer Order urinalysis, CBC, BUN and creatinine A patient is diagnosed with PAD and elects to not have angioplasty after an angiogram reveals partial obstruction in lower extremity arteries. What will the provider recommend to help with relief of symptoms in this patient?Statin therapy with clopidogrel Walking to the point of pain each day Daily aspirin therapy to prevent clotting Walking slowly for 15 to 20 minutes twice daily - correct answer Walking to the point of pain each day An adult patient reports frequent episodes of syncope and lightheadedness. The provider notes a heart rate of 70 beats per minute. What will the provider do next?Order an electrocardiogram and exercise stress test Monitor the patient's heart rate while the patient is bearing down Evaluate the patient's orthostatic vital signs Reassure the patient that the symptoms are non-cardiac in origin - correct answer Evaluate the patient's orthostatic vital signs The AHA recommends early CPR and AED use for adult victims of cardiac arrest outside of a hospital setting because most victims have which arrhythmia?Atrial flutter Ventricular fibrillation Atrial fibrillation
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