NSG 6001 MIDTERM EXAM QUESTIONS AND ANSWERS( COMPLETE SOLUTION RATED A)100%

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1. Question : Your patient is morbidly obese and cannot sit on a bicycle or walk a treadmill. She also has marked and severe emphysema. You need to make an assessment of the risk of significant CAD an... d your patient’s family says that their relative had their diagnosis based on an ultrasound echocardiography. What facts would influence your decision regarding the family request for echo assessment? Student Answer: Specificity would be increased because of obesity Sensitivity would be reduced because of obesity and lung disease (Sensitivity would be reduced because of obesity and lung disease.) Sensitivity would be increased because of lung disease Specificity would be reduced because of obesity and lung disease 2. Question : Medicaid is mandated to be provided by each state through federal codes. Each state must offer Medicaid exactly as the federal government prescribes. True or false? Student Answer: False (Medicaid is mandated to be provided by each state, however, Mediciad is not required to be delivered by any certain formula. Each state has autonomy to deliver Mediciad services under its own guidelines, provided that each state meets the federal guidelines for Medicaid coverage. ) True 3. Question : By standard criteria, how is a positive stress test defined? Student Answer: Development of a horizontal or down sloping ST-segment depression of 10mm Development of a horizontal or down sloping ST-segment depression of 1mm (A positive stress test is defined as the development of a horizontal or down sloping ST-segment depression of 1mm. ) Upward sloping ST-segment measured at the J point of the QRS Down sloping of the ST-segment at the J point of the QRS 4. Question : Population disease management is a term used to describe: Student Answer: Low prevalence specific diseases High prevalence specific diseases (Population disease management is a term used to describe the high prevalence of specific diseases. ) Low specificity diseases states High specificity disease states 5. Question : What are two of the most common forms of Exercise Stress Tests used today? Student Answer: Bicycle and treadmill (Bicycle and treadmill are the two most common forms of exercise stress tests used today. ) Unicycle and Running in pace Thallium and Dobutamine Bicycle and rowing machine 6. Question : You are counseling a patient diagnosed with stress-induced ischemia. You base your discussion on your knowledge that stress-induced ischemia is thought to be caused by what phenomena? Student Answer: Too many carbonated drinks Diet and exercise Endothelial dysfunction of the microvascular (You base your discussion on your knowledge that stress-induced ischemia is thought to be caused by endothelial dysfunction of the microvascular.) Heart muscle dysfunction 7. Question : Narrowed coronary arteries or plague rupture within the arteries of the coronary system may directly cause which condition? Student Answer: Venous Statis Diabetes Hypertension Coronary artery disease (Narrowed coronary arteries, plague rupture, and sometimes even spasms of the coronary arteries are the three most common direct causes for the diagnosis of coronary artery disease. ) 8. Question : Of the following, which is the best answer when asked for an advantage of echocardiogram exercise testing over thallium stress testing? Student Answer: Results are available more quickly (Echocardiogram exercise test results are available more quickly.) Does not depend on operator experience Doesn’t matter because there are no advantages Costs are the same 9. Question : A 55-year old man is referred to your clinic. He has been sedentary all of his life, is gaining weight and wishes to get into better physical shape. He has never had any chest pain or shortness of breath when walking or climbing a flight of stairs. Before recommending a vigorous exercise routine for this patient, you order what test? Student Answer: Stool samples CBC ETT (Many patients have underlying CAD but remain asymptomatic. Before beginning any new vigorous activities after years of sedentary lifestyle, it is recommended that the patient obtains an ETT to rule out underlying CAD.) Thyroid levels 10. Question : What ECG changes can reduce the specificity of the ETT? Student Answer: Paced rhythm and resting bundle branch block (The ECG changes that can reduce the specificity of the ETT are paced rhythm and resting bundle branch block. ) Low voltage up sloping of the ST-segment Exercise induced bundle branch blocks Paced rhythm and exercise induced bundle branch blocks 11. Question : In women, you need to know the limitations of certain tests for CAD. For example, single-photon emissions CT imaging, while an acceptable test for most men and some women, is technically limited in women for two reasons. From the following, choose the best possible answer. Student Answer: Breasts and fat deposits in abdomen Smoking rates and lack of uptake of photons Breasts and smaller coronary arteries (Single-photon emissions CT imaging is technically limited in women due to breasts and smaller coronary arteries.) Multiple vessel disease and fat deposits 12. Question : Improvements in the delivery and management of healthcare are necessary if we are to improve the overall health of this nation’s population. Which of the following are identified in your readings as strategic in the movement to improve the healthcare system? Student Answer: Monetary savings and limited disruption in healthcare delivery Population management and healthcare practice (Population management and healthcare practice are strategic in the movement to improve the nation’s healthcare system. ) Socialized medicine and governmental controls President and Congress 13. Question : The sensitivity of a routine ETT is effort dependent. What physiological changes occur during effort in the routine ETT? Student Answer: Decrease in coronary blood flow Increased coronary flow and increased systolic blood pressure (The physiological changes that occur during effort in the routine ETT are increased coronary flow and increased systolic blood pressure.) Rapid heart rates and coronary artery narrowing Decreased heart rate and increased systolic blood pressure 14. Question : Your mentor says that you should be prepared to know how to determine the maximum heart rate for your patient during the ETT. How is the age-predicted maximum heart rate during an ETT determined? Student Answer: 220+age 120-age 220-age (The age-predicted maximum heart rate during an ETT determined by subtracting the patient’s age from 220 (220 – age). ) 65+age 15. Question : Medicare hospital insurance (Part A) is funded through what system? Student Answer: Interest from investments State income taxes Federal income taxes Federal payroll taxes (Medicare Part A is funded through federal payroll taxes. ) 16. Question : 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: Student Answer: Between the patient and their family Between the patient and the nurse practitioner (The collaboration that is most important is the one that occurs between the patient and the nurse practitioner. ) Between the nurse practitioner and their physician mentor Between two healthcare providers about a single patient 17. [Show More]

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