NRNP6550 Week 4 Knowledge Check Latest 2021 July

NRNP6550 Advanced Care of Adults in Acute Settings II

Week 4 Knowledge Check

Question 1In Heart Failure (HF), lack of forward flow can cause decrease perfusion to the kidneys. This will lead to fluid retention and HF exacerbation based on the activation of the ________________.

Portal system

Systolic/Diastolic system

Reno angiotensin (RAS) system

Pituitary/Thyroid feedback system

Question 2A 40-year-old male with no significant past medical history presents with intermittent shortness of breath when walking more than 2 blocks. He denies chest pain, smoking, and drug/alcohol abuse. He is in no acute distress and has normal vital signs and his lungs are clear to auscultation. Of note, he has a systolic murmur that is heard best at the apex and left lower sternal border. The ECG shows left ventricular hypertrophy. Which of the following is the BEST statement to describe further clinical management?

Order an Echocardiogram

Start a loop diuretic

Start Aspirin and Plavix

No further work up is indicated

Question 3Which of the following pharmacologic therapies is indicated for Aortic Insufficiency due to Aortic Stenosis?

Beta blocker

Calcium channel blocker

Nitrate

ACE Inhibitor

Question 4Which of the following is unlikely to be noted in the person experiencing HF?

Elevated serum B-type natriuretic peptide (BNP)

Kerley B lines noted on CXR

Left ventricular hypertrophy on ECG

Evidence of hemoconcentration on hemogram

Question 5A 30-year-old patient is transferred to your facility from the Caribbean for further treatment. The patient is currently in Atrial Fibrillation (Afib) and has dyspnea, orthopnea, and paroxysmal nocturnal dyspnea. The patient has history of Rheumatic Fever and on auscultation has a low-pitched diastolic murmur best heard at the apex. What is the TOP differential diagnosis for this patient?

Mitral valve regurgitation

Mitral valve stenosis

Tricuspid valve regurgitation

Tricuspid valve stenosis

Question 6Which of the following best describes the patient presentation of NY Heart Association stage III heart disease?

Ordinary physical activity does not cause undue fatigue, dyspnea or palpitations

Ordinary physical activity results in fatigue, palpitations, dyspnea or angina

Less-than-ordinary activity leads to fatigue, dyspnea, palpitations or angina

Discomfort increases with any physical activity

Question 7Of the following people, who has no significant increased risk for developing bacterial endocarditis?

43-year-old woman with bicuspid aortic valve

55-year-old man who was diagnosed with a Still's murmur as a child

45-year-old woman with a history of endocarditis

75-year-old man with dilated cardiomyopathy

Question 8Almost all cases of Mitral Stenosis are related to ________________.

Rheumatic heart disease

Left ventricular hypertrophy

Kawasaki heart disease

Right ventricular hypertrophy

Question 9Heart Failure (HF) with an Ejection Fraction (EF) of 20% is most likely due to _____________.

Mitral valve dysfunction

Aortic valve dysfunction

Diastolic dysfunction

Systolic dysfunction

Question 10Which of the following initial diagnostic tests is the BEST for confirmation of the diagnosis of Aortic Stenosis?

Chest Xray

Arterial blood gas

Troponin levels

Echocardiogram (ECHO)