Cardiovascular Conditions and Medication Management in Older Adults, Exams of Nursing

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A pa%ent has had poorly controlled hypertension for more than 10 years. Indicate the most likely posi%on of his point of maximal impulse (PMI) a. 5th intercostal space (ICS) midclavicular line (MCL) b. 8th ICS MCL c. 5th ICS, leG of MCL d. 6th ICS, right of MCL c. 5th ICS, leG of MCL Valve most commonly involved in chronic rheuma%c heart disease is the: a. aor%c b. mitral c. pulmonic d. tricuspid b. mitral Previous Play Next Rewind 10 seconds Move forward 10 seconds

NR 661-CARDIOVASCULAR

EXAM QUESTIONS AND

VERIFIED ANSWERS

(2025/2025)RATED A+

Unmute 0: / 0: Full screen Brainpower Read More A 50 year old pa%ent with Hypertension has taken hydrochlorozide 25 mg daily for the past 4 weeks. How should the nurse prac%%oner proceed? BP-155/95; 145/ a. wait 4 weeks before making a dosage change b. increase the hydrochlorothiazide to 50mg daily c. add a drug from another class to the daily 25 mg hydrochlorothiazide d. stop the hydrochlorothiazide and start a drug from a different class c. add a drug from another class to the daily 25 mg hydrochlorothiazide Which choice below would be the best choice for an 80-year old pa%ent whose blood pressure is 172/ a. chlorthalidone b. amlodipine c. monopril d. acebutolol b. amlodipine The diagnosis of mitral valve prolapse can be confirmed by: a. physical examina%on

b. electrocardiography c. echocardiography d. chest xray c. echocardiography A pa%ent taking candesartan for treatment for hypertension should avoid a. strenuous exercise b. potassium supplements c. protein rich meals d. grapefruit juice b. potassium supplements According to the Na%onal Heart, Lung and Blood ins%tute, which characteris%c listed below is a coronary disease (CHD) risk equivelant; that is, which risk factor places the pa%ent at a CHD risk similar to a history of CHD a. Hypertension b. cigarece smoking c. male age >45 years d. Diabetes Mellitus d. Diabetes Mellitus Classic symptoms of deep vein thrombosis (DVT) include: a. swelling, pain, redness b. calf complaints, pain with walking, history of exercise c. swelling, pain, discolora%on in lower extremity d. warmth, edema and relief of pain with walking c. swelling, pain, discolora%on in lower extremity

Which mitral valve disorder results from redundancy of the mitral valve's leaflets?? a. acute mitral regurgita%on b. chronic mitral regurgita%on c. mitral valve prolapse d. mitral stenosis c. mitral valve prolapse Tables are used for determina%on of maximum blood pressure values for adolescents. How are blood pressure values established for adolescents? a. height percen%le, body mass index and gender b. gender and age c. height percen%le, gender and age d. body mass index and gender c. height percen%le, gender and age The correla%on between blood pressure and age greater than 60 years is that as age increases: a. diastolic blood pressure increases b. systolic blood pressure decreases c. blood pressure remains about the same d. diastolic blood pressure decreases d. diastolic blood pressure decreases An 80 year old female who is otherwise well has the following blood pressure readings. How should she be managed? 160/70; 175/68; 171/71; 163/

a. thiazide dirue%c b. ace inhibitor c. calcium channel blocker d. angiotensin receptor blocker c. calcium channel blocker Which choice below characterizes a pa%ent who has aor%c regurgita%on? a. long asymptoma%c period followed by exercise intolerance then dyspnea at rest b. an acute onset of shortness of breath in the fiGh or sixth decade c. dyspnea on exer%on for a long period of %me before sudden cardiac death d. a long asymptoma%c period with sudden death usually during exercise a. long asymptoma%c period followed by exercise intolerance then dyspnea at rest How oGen should lipids be screened in pa%ents who are 65 years and older if they have lipid disorders or cardiovascular risk factors a. annually b. every other year c. every 3 years d. every 5 years a. annually Risk assessment for dyslipidemia should begin at a. 2 years b. 6 years

c. 18 years d. 21 years a. 2 years In older adults, the three most common ailments are: a. hearing loss, vision loss, hypertension b. hearing loss, hypertension, arthri%s c. depression, vision loss, hypertension d. arthri%s, hearing loss, depression b. hearing loss, hypertension, arthri%s A 75 year old pa%ent with longstanding hypertension takes a combined ACE inhibitor/thiazide dirue%c and amlodipine daily. Today his diastolic blood pressure and heart rate is elevated. He has developed dyspnea on exer%on and peripheral edema over the past several days. These symptoms likely demonstrate: a. primary renal dysfunc%on b. development of heart failure c. renal insufficiency d. dietary indiscre%on b. development of heart failure Mr. Diagle is an 80 year old pa%ent who takes warfarin for chronic afib. The NP should: INR 6. a. stop the warfarin for the next two days and repeat the INR on day 3 b. admit to the hospital immediately

c. administer vitamin K and repeat INR tomorrow d. stop warfarin for one week and recheck INR a. stop the warfarin for the next two days and repeat the INR on day 3 A 42 year old hypertensive pa%ent was given a thiazide dirue%c 4 weeks ago for treatment of primary hypertension. On his return visit today, he reports feeling weak and %red. What should the NP consider to evaluate the weakness and fa%gue? a. glucose level b. potassium level c. cbc d. tsh b. potassium level The NP is caring for an independent 74 year old female who had acute coronary syndrome (ACS) about 6 weeks ago. what medica%ons should be part of her regimen unless there is a contraindica%on? a. ASA and beta blocker b. ACE and betablocker c. ACE, ASA and beta blocker d. ACE, ASA, beta blocker and sta%n d. ACE, ASA, beta blocker and sta%n Which hypertensive is most likely to have adverse blood pressure effects from excessive sodium consump%on? a. 21 year old Asian American Male b. 35 year old menstrua%ng female

c. 55 year old post menopausal female d. 70 year old african american male d. 70 year old african american male An 87 year old has a history of symptoma%c heart failure. He presents today with lower extremity edema and mild shortness of breath with exer%on. In addi%on to a dirue%c for volume overload, what other medica%on should he receive today? a. ACE inhibitor b. Beta Blocker c. Calcium Channel blocker d. oxygen a. ACE inhibitor A 76 year old pa%ent who is very ac%ve has elevated cholesterol and LDL's. He had been treated for hypertension for >10 years with near normal blood pressures. What is the current recommenda%on for managing his lipids? a. no treatment should take place since his age exceeds 75 years b. he should be treated with an aspirin only c. he should be treated with a sta%n d. the benefits of trea%ng this pa%ent do not exceed the risk of using a sta%n or aspirin c. he should be treated with a sta%n A pa%ent who has mitral valve prolapse (MVP) reports chest pain and frequent arrhythmias. In the absence of other underlying cardiac abnormalies, the drug of choice to treat her symptoms is:

a. lisinopril b. metoprolol c. Amlodipine d. Chlorthalidone b. metoprolol A pa%ent taking atorvasta%n for newly diagnosed dyslipidemia complains of fa%gue, weakness and muscle aches in his lower back, arms and legs for the past three days. It has not improved with rest. How should this be evaluated? a. stop the atorvasta%n immediately b. check liver enzymes first c. order a CPK level d. ask about nighlme muscle cramps a. stop the atorvasta%n immediately A 75 year old pa%ent who has aor%c stenosis wants to know what symptoms indicate worsening of his stenosis. The NP replies: a. palpita%ons and weakness b. ventricular arrythmias c. shortness of breath and syncope d. fa%gue and exercise intolerance c. shortness of breath and syncope The most common indicator of end-organ damage in adolescents with hypertension is: a. leG ventricular hypertrophy b. seizure

c. renal dysfunc%on d. renal artery damage a. leG ventricular hypertrophy A characteris%c of an ACE inhibitor-induced cough is that it: a. is mildly produc%ve b. is worse at nighlme c. usually begins within 2 weeks of star%ng therapy d. is more common in men c. usually begins within 2 weeks of star%ng therapy Which infant feeding behavior is least likely related to congenital heart disease (CHD)? a. limited intake of volume of milk b. feedings that take a long %me to complete c. feedings that are interrupted by sleeping d. infants that burp frequently when feeding d. infants that burp frequently when feeding Orthosta%c hypotension can be diagnosed in an older adult if the systolic blood pressure decreases: a. more than 20 points any%me aGer rising b. more than 20 points within 3 minutes aGer rising c. more than 20 points within 1 minute aGer rising d. any degree drop if the pa%ent becomes weak or dizzy b. more than 20 points within 3 minutes aGer rising

The caro%d arteries are auscultated for bruits because: a. a bruit is indica%ve of an impending state b. a bruit is indica%ve of caro%d stenosis c. this is indica%ve of generalized artherosclerosis d. this is reflec%ve of stroke risk c. this is indica%ve of generalized artherosclerosis A common early finding in pa%ents with chronic aor%c regurgita%on (AR) is... a. an hypertrophied leG ventricle b. atrial fibrilla%on c. pulmonary conges%on d. low systolic blood pressure a. an hypertrophied leG ventricle Mr. Holbrook, a 75 year-old male, is a former smoker. He has come in today for an annual exam. He walks daily for 25 minutes, has had inten%onal weight loss, and has a near normal BMI. On examina%on, the pa%ent is noted to have an absence of hair growth on his lower legs. Which statement is true regarding this pa%ent? a. this is a normal concequence of aging b. this might indicate disease in the lower extremi%es c. it might be from exercise ini%a%on d. this is secondary to long term smoking b. this might indicate disease in the lower extremi%es A 75 year old has isolated systolic hypertension. She started on amlodipine 4 weeks ago. She states that since then, she has developed urinary incon%nence.

What is the NP's assessment? a. this is unrelated to her new medica%on b. this is coincidental c. she may have underlying urinary tract pathology d. it is probably related to amlodipine d. it is probably related to amlodipine Pharmacologic treatment for older adults with hypertension should be ini%ated: a. only if there is a life expectancy of 10 years or more b. for any type of hypertension c. without regard to lifestyle modifica%on d. only for those who are symptoma%c b. for any type of hypertension Which test below is most cost-effec%ve to screen for abdominal aor%c aneurysm? a. CT of abdomen b. MRI of the abdomen c. abdominal ultrasound d. two handed palpa%on test c. abdominal ultrasound A pa%ent who has mitral valve prolapse (MVP) reports chest pain and frequent arrhythmia's. In the absence of other underlying cardiac anomalies, the drug of choice to treat her symptoms is:

a. lisinopril b. metoprolol c. amlodipine d. chlorthalidone b. metoprolol Mr. Smith is a 72 year-old pa%ent who takes warfarin for chronic atrial fibrilla%on. Today his INR is 4.0. His CBC is normal : a. stop the warfarin for the next 4 days and repeat the iNR on day 5 b. admit to the hospital immediately c. administer vitamin K and repeat INR in 2 hours d. stop the warfarin today and repeat the INR tomorrow d. stop the warfarin today and repeat the INR tomorrow An ACE inhibitor is specifically indicated in pa%ents who have: a. hypertension, diabetes with proteinuria, heart failure. b. diabetes, hypertension, hyperlipidemia. c. asthma, hypertension, diabetes d. renal nephropathy, heart failure, hyperlipidemia. a. hypertension, diabetes with proteinuria, heart failure. The major difference between varicose veins and arteriosclerosis is the: a. limbs affected b. gender affected c. vessels affected d. degree of pain

c. vessels affected The most common arrhythmia resul%ng from valvular heart disease is: a. atrial fibrilla%on b. paroxysmal supra-ventricular tachycardia c. ventricular fibrilla%on d. heart block a. atrial fibrilla%on Older adults have a unique blood pressure pacern. Which blood pressure reading below reflects this pacern? a. 100/ b. 140/ c. 160/ d. 160/ c. 160/ The usual clinical course of mitral valve prolapse: a. is benign b. results in sudden cardiac death c. results in chronic heart failure d. is associated with mul%ple episodes of emboli a. is benign A 74 year old pa%ent has peripheral artery disease (PAD). Which item listed below is an important nonmodifiable risk factor for PAD? a. cigarece smoking

b. hyperlipidemia c. diabetes d. alcohol consump%on c. diabetes Many factors can contribute to the risk of congenital heart disease. Which maternal disease carries a higher risk of transposi%on of the great vessels (TGA), ventricular septal defect (VSD), and hypertrophic cardiomyopathy? a. hypothyroidism b. diabetes c. lupus d. hypertension b. diabetes We have an expert-wri4en solu9on to this problem! Which item below represents the best choice of an%hypertensive agents for the indicated pa%ent? a. beta blocker for a 38 year old diabe%c pa%ent b. ACE inhibitor for a pa%ent on a K sparing diure%c c. lisinopril in a 35 year old caucasian male d. diure%c in a pa%ent with history of gout c. lisinopril in a 35 year old caucasian male A pa%ent has shortness of breath. If heart failure is the e%ology, which test demonstrates the highest sensi%vity in diagnosing this?

a. echcardiogram b. B type natriure%c pep%de (BNP) c EKG d. chest xray b. B type natriure%c pep%de (BNP) Which group of medica%ons would be detrimental if used to treat a pa%ent who has heart failure? a. Ramipril, aspirin, metoprolol b. digoxin, furosemide, aspirin c. fosinopril, HCTZ, verapamil d. Furosemide, enalapril, aspirin c. fosinopril, HCTZ, verapamil Which finding below is considered "within normal limits"? a. a diastolic murmur in an 18 year old b. an INR of 2.0 in a pa%ent taking Coumadin c. cholesterol level of 205 in a 15 year old d. blood pressure of 160/70 in a 75 year old b. an INR of 2.0 in a pa%ent taking Coumadin A 40 year old african american pa%ent has blood pressure readings of 175/ and 170/102. What is a reasonable plan of care for this pa%ent today? a. start 12.5mg Hydrochlorothiazide daily (usual dose 12.5-50mg daily) b. start 10 mg Lisinopril daily (usual dose 10-40 mg daily) c. ini%ate 5 mg amlodipine daily (usual dose 5-10mg daily) d. ini%ate 5 mg amlodipine and 10 mg lisinopril daily

c. ini%ate 5 mg amlodipine daily (usual dose 5-10mg daily) Which medica%on listed below could poten%al exacerbate heart failure in a suscep%ble pa%ent? a. Metoprolol b. Furosemide c. Insulin d. Acetaminophen a. Metoprolol The lipid par%cle with the greatest atherogenic effect is: a. cholesterol b. HDL c. LDL d. triglycerides c. LDL Benzapril should be discon%nued immediately if : a. dry cough develops b. pregnancy occurs c. potassium levels decrease d. gout develops b. pregnancy occurs A pa%ent is diagnosed with mild heart failure (HF). What drug listed below would be a good choice for reducing morbidity and mortality long term? a. verapamil

b. digoxin c. furosemide d. metoprolol d. metoprolol A NP has not increased the dosage of an an%hypertensive medica%on even though the pa%ent's blood pressure has remained >140/90. This might be described as a. clinical iner%a b. malprac%ce c. resistant hypertension d. lackadasical altude a. clinical iner%a You are managing the warfarin dose for an older adult with a prosthe%c heart valve. Which situa%on listed requires that warfarin be discon%nued now? a. INR of 3 some bleeding b. INR of 8, no significant bleeding c. INR of 6, no significant bleeding d. INR of 2, with minimal bleeding b. INR of 8, no significant bleeding A pa%ent with poorly controlled hypertension and history of myocardial infarc%on 6 years ago presents today with mild shortness of breath. He takes quinapril, ASA, metoprolol and a sta%n daily. What symptom is NOT indica%ve of heart failure? a. fa%gue

b. headache c. orthopnea d. cough b. headache Mrs. Jones is an 85 year old who has average blood pressures of 170/70. What agent would be a good star%ng medica%on to normalize her blood pressure? a. Fosinopril b. Losartan c. Amlodipine d. Hydrochlorothiazide c. Amlodipine A 64 year old male has been your pa%ent for several years. He is a former smoker. He presents to your clinic with complaints of fa%gue and "just not feeling well" for the last few days. His exam is normal. His blood pressure is well controlled. His medica%ons include: Ramipril 5mg po daily, Simvista%n 20mg daily, ASA 81mg po daily. Total cholesterol=158, LDL=76, HDL=55 and Triglycerides=114. BP= 130/72 HR 65, RR=18, Temp= 98.1. What should be done next? a. order a CBC and consider wai%ng a few days if normal b. inquire about feelings of depression and hopelessness c. order a CBC, metabolic panel, TSH and urinalysis d. Order B12 level, TSH, CBC and chest xray c. order a CBC, metabolic panel, TSH and urinalysis A congenital heart abnormality oGen discovered during the newborn period is coarcta%on of the aorta. How is this assessed?

a. by comparing right and leG femoral pulses b. by comparing right and leG pedal pulses c. by comparing upper and lower extremity blood pressures d. by ausculta%ng an audible bruit in the caro%d arteries c. by comparing upper and lower extremity blood pressures Which pa%ent could be expected to have the highest systolic blood pressure a. a 21 year old male b. a 50 year old perimenopausal female c. a 35 year old with Type 2 diabetes d. a 75 year old male d. a 75 year old male Mrs. Brandy is having contrast dye next week for a heart catheteriza%on. What drug does NOT need to be stopped prior to her cath? a. naproxen b. Furosemide c. Mesormin d. Losartan d. Losartan Where would the murmur associated with mitral regurgita%on best be auscultated? a. aor%c listening point b. mitral listening point

c. pulmonic listening point d. tricuspid listening point b. mitral listening point A decrease in blood pressure can occur in men who take sildenafil (Viagra) and : a. ibuprofen b. trimethoprim-sulfamethoxazole c. levothyroxine d. any an%-hypertensive medica%on d. any an%-hypertensive medica%on What choice below would be beneficial to a 76 year old who takes daily oral steroids for COPD and now takes a daily aspirin for primary preven%on of myocardial infarc%on? a. screen for infec%on with H pylori b. daily proton pump inhibitor c. antacids PRN heartburn d. daily use of low dose famatodine b. daily proton pump inhibitor A 91 year old female with longstanding history of chronic heart failure has renal and liver studies that have slowly worsened over the past year. This probably indicates a. final stage of heart failure b. target organ damage secondary to heart failure

c. poor nutri%on intake and need for nutri%on assessment d. new disease processes involving the liver and kidneys b. target organ damage secondary to heart failure An independent 82 year old male is very ac%ve but re%red last year. His total cholesterol and LDL are moderately elevated. How should the NP approach his lipid eleva%on? a. he has reached an age where treatment holds licle benefit b. treatment is age dependent; he should receive a sta%n today c. treatment is based on expected length of life d. he should receive a sta%n today un%l he is 85 years ago c. treatment is based on expected length of life A pa%ent with newly diagnosed heart failure has started fosinopril in the last few days. She has developed a cough. What clinical finding can help dis%nguish the e%ology of the cough as heart failure and not related to the fosinopril a. it is a dry and nonproduc%ve cough b. it is wet and worse with recumbence c. it is purulent and tachycardia d. shortness of breath and always results aGer coughing b. it is wet and worse with recumbence A common side effect of thiazide diure%cs is: a. prosta%%s b. erec%le dysfunc%on c. fa%gue d. hyperkalemia

b. erec%le dysfunc%on How oGen should a blood pressure be measured in a child who is 3 years old? a. blood pressure measurement should begin at age 6 then every other year b. it should be measured every other year c. it should be measured annually d. it should be measured only at well child visits c. it should be measured annually The most common arrhythmia resul%ng from valvular heart disease is: a. atrial fibrilla%on b. paroxysmal supraventricular tachycardia c. ventricular fibrilla%on d. heart block a. atrial fibrilla%on Which laboratory abnormality may be observed in a pa%ent who takes lisinopril? a. decreased INR b. decreased calcium level c. increased potassium level d.. increased AST/ALT c. increased potassium level Which study would be most helpful in evalua%ng the degree of hypertrophy of the atrium or ventricle? a. Chest x-ray

b. electrocardiography c. echocardiography d. doppler ultrasound c. echocardiography An 80 year old pa%ent with longstanding hypertension takes monopril and HCTZ for hypertension. His most recent blood pressures are 166/82; 169/86; 170/88; 167/85. What should be done about his blood pressure a. add an angiotensin receptor blocker b. add another dirue%c c. add a calcium channel blocker d. stop the HCTZ and add a beta blocker c. add a calcium channel blocker A pa%ent with hypertension has been diagnosed with gout, which home medica%on may have contributed to this episode of gout? a. lisinopril b. amlodipine c. furosemide d. allopurinol c. furosemide A 25 year old pa%ent has aor%c stenosis (AS). The e%ology of his AS is probably: a. congenital b. rheuma%c c. acquired clacific d. unknown

a. congenital An older adult who has hypertension also has osteoporosis. Which an%hypertensive agent would have the secondary effect of improving her osteoporosis? a. a thiazide dirue%c b. a calcium channel blocker c. an ACE inhibitor d. a beta blocker a. a thiazide dirue%c Ramipril has been ini%ated at a low dose in a pa%ent with heart failure. What is most important to monitor in about one week? a. heart rate b. blood pressure c. ekg d. potassium level d. potassium level Most hypertension in pre-adolescents and children is: a. obesity related. b. primary hypertension. c. secondary hypertension. d. endocrine related c. secondary hypertension.