Question 1.            Question :           Your patient is morb

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 and 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?

 

Specificity would be increased because of obesity

 

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?

 

False

True

 

 

 

3.            Question :           By standard criteria, how is a positive stress test defined?

 

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

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:

 

Low prevalence specific diseases

 

High prevalence 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?

 

Bicycle and treadmill

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?

 

Too many carbonated drinks

 

Diet and exercise

 

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?

 

Venous Statis

 

Diabetes

 

Hypertension

 

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?

 

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?

 

Stool samples

 

CBC

 

ETT

Thyroid levels

 

 

 

10.          Question :           What ECG changes can reduce the specificity of the ETT?

 

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.

 

Breasts and fat deposits in abdomen

 

Smoking rates and lack of uptake of photons

 

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?

 

Monetary savings and limited disruption in healthcare delivery

 

Population management and healthcare practice

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?

 

Decrease in coronary blood flow

 

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?

 

220+age

 

120-age

 

220-age

65+age

 

 

 

15.          Question :           Medicare hospital insurance (Part A) is funded through what system?

 

Interest from investments

 

State income taxes

 

Federal income taxes

 

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:

 

Between the patient and their family

 

Between the patient and the nurse practitioner

Between the nurse practitioner and their physician mentor

 

Between two healthcare providers about a single patient

 

 

 

17.          Question :           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?

 

False

 

True

 

 

18.          Question :           Ischemic changes on ECG during ETT is highly predictive of CAD. What is another important strong predictor of CAD that you might see during an ETT?

 

Slow heart rate

 

Exercise-induced hypotension

Exercise-induced hypertension

 

Rapid heart rate

 

 

 

19.          Question :           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?

 

False

 

True

 

 

20.          Question :           Chronic, non-communicable diseases account for disproportionate costs to the healthcare system.According to the World Health Organization, what percent of preventable deaths and disabilities occur in the Americas related to chronic non-communicable diseases?

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