Study with our free AANP Practice Questions, Qbank Test 5. The questions include answers and detailed rationales. Nursing topics focus on diagnosis, diagnostic tests, critical thinking, priorities of care, safe and effective care, treatments, and AANP clinical management. Achieve your highest score on the AANP Exam! Review antihypertensives, guidelines for treatment of aneurysms, diagnostic testing, and clinical management of critical illness and cardiac disease.
A 70-year-old patient with CHF presents with worsening symptoms despite being on optimal medical therapy. The patient has preserved ejection fraction. Which of the following medications should be considered to improve symptoms and quality of life in this patient?
A) Furosemide
B) Digoxin
C) Lisinopril
D) Sacubitril/valsartan
E) Ivabradine
Rationale: Ivabradine, a heart rate-reducing agent, can be considered in patients with CHF and preserved ejection fraction who have symptoms despite optimal therapy to improve quality of life.
A 68-year-old patient with CHF presents with worsening edema and fluid retention. The patient is already on diuretics and ACE inhibitors. Which of the following medications should be added to the treatment regimen to further reduce fluid overload and edema?
A) Furosemide
B) Digoxin
C) Lisinopril
D) Spironolactone
E) Sacubitril/valsartan
Rationale: Spironolactone, a potassium-sparing diuretic, is often added to the treatment regimen in patients with CHF to further reduce fluid overload and edema.
A 72-year-old patient with CHF and a history of severe chronic kidney disease presents with worsening symptoms. The patient is already on multiple medications for CHF. Which of the following medications should be used with caution or avoided in this patient due to the risk of worsening renal function?
A) Furosemide
B) Digoxin
C) Lisinopril
D) Sacubitril/valsartan
E) Metoprolol succinate
Rationale: Lisinopril, an ACE inhibitor, can worsen renal function in patients with severe chronic kidney disease and should be used with caution or avoided in such cases.
A 66-year-old patient with CHF and a history of chronic obstructive pulmonary disease (COPD) presents with worsening shortness of breath. The patient is already on multiple CHF medications. Which of the following medications should be used with caution in this patient due to the risk of exacerbating respiratory symptoms?
A) Furosemide
B) Digoxin
C) Lisinopril
D) Sacubitril/valsartan
E) Metoprolol succinate
Rationale: Metoprolol succinate, a beta-blocker, should be used with caution in patients with CHF and COPD due to the potential risk of exacerbating respiratory symptoms.
A 45-year-old patient presents with a history of rheumatic heart disease and aortic stenosis. The patient reports increasing fatigue, chest pain on exertion, and episodes of dizziness. On examination, you note a harsh systolic ejection murmur in the right upper sternal border and a delayed carotid upstroke. Which of the following medications is indicated for the management of symptomatic aortic stenosis?
A) Aspirin
B) Furosemide
C) Digoxin
D) Lisinopril
E) Amlodipine
Rationale: Amlodipine, a calcium channel blocker, is indicated for the management of symptomatic aortic stenosis. It helps reduce afterload and improve symptoms.
A 60-year-old patient with a history of mitral valve prolapse presents with palpitations and intermittent chest discomfort. On examination, you note a mid-systolic click and a late systolic murmur at the apex. An echocardiogram confirms the diagnosis of mitral valve prolapse. Which of the following medications is indicated for the management of mitral valve prolapse with significant symptoms?
A) Aspirin
B) Furosemide
C) Digoxin
D) Propranolol
E) Enalapril
Rationale: Propranolol, a beta-blocker, is indicated for the management of mitral valve prolapse with significant symptoms, such as palpitations and chest discomfort.
A 55-year-old patient with a history of rheumatic heart disease presents with fatigue, dyspnea, and orthopnea. On examination, you note a diastolic rumbling murmur at the apex, an irregularly irregular pulse, and elevated jugular venous pressure. Which of the following medications is indicated for the management of symptomatic mitral stenosis?
A) Aspirin
B) Furosemide
C) Digoxin
D) Lisinopril
E) Warfarin
Rationale: Warfarin, an anticoagulant, is indicated for the management of symptomatic mitral stenosis due to the risk of atrial fibrillation and thromboembolic events in these patients.
A 68-year-old patient presents with a history of infective endocarditis and a prosthetic aortic valve. The patient is scheduled for a dental procedure. Which of the following medications should be prescribed as antibiotic prophylaxis before the dental procedure to prevent infective endocarditis?
A) Aspirin
B) Furosemide
C) Amoxicillin
D) Lisinopril
E) Amlodipine
Rationale: Amoxicillin is the recommended antibiotic prophylaxis before dental procedures for patients with prosthetic heart valves to prevent infective endocarditis.
A 50-year-old patient with a history of aortic regurgitation presents with worsening shortness of breath and exercise intolerance. On examination, you note a diastolic blowing murmur at the right upper sternal border and a bounding pulse. Which of the following medications is indicated for the management of chronic aortic regurgitation with symptoms?
A) Aspirin
B) Furosemide
C) Digoxin
D) Lisinopril
E) Nifedipine
Rationale: Lisinopril, an ACE inhibitor, is indicated for the management of chronic aortic regurgitation with symptoms to reduce afterload and improve symptoms.
A 62-year-old patient with a history of aortic stenosis presents with syncope and exertional chest pain. On examination, you note a harsh systolic ejection murmur in the right upper sternal border and delayed carotid upstroke. An echocardiogram shows severe aortic stenosis. Which of the following medications is indicated as a bridge therapy while the patient awaits surgical aortic valve replacement?
A) Aspirin
B) Furosemide
C) Digoxin
D) Lisinopril
E) Nifedipine
Rationale: Nifedipine, a calcium channel blocker, can be used as bridge therapy to manage symptoms in patients with severe aortic stenosis while awaiting surgical valve replacement.
A 70-year-old patient with a history of mitral valve regurgitation presents with fatigue and exertional dyspnea. On examination, you note a holosystolic murmur at the apex radiating to the axilla. An echocardiogram shows moderate mitral regurgitation. Which of the following medications is indicated for the management of symptomatic mitral regurgitation?
A) Aspirin
B) Furosemide
C) Digoxin
D) Lisinopril
E) Sildenafil
Rationale: Sildenafil, a phosphodiesterase-5 inhibitor, can be considered in patients with symptomatic mitral regurgitation to reduce pulmonary vascular resistance and improve exercise tolerance.
A 58-year-old patient with a history of tricuspid valve regurgitation presents with lower extremity edema and abdominal distension. On examination, you note a holosystolic murmur at the lower left sternal border and elevated jugular venous pressure. Which of the following medications is indicated for the management of symptomatic tricuspid valve regurgitation?
A) Aspirin
B) Furosemide
C) Digoxin
D) Lisinopril
E) Spironolactone
Rationale: Spironolactone, a potassium-sparing diuretic, can be used to manage symptoms and fluid retention in patients with symptomatic tricuspid valve regurgitation.
A 65-year-old patient with a history of aortic regurgitation presents with worsening symptoms of heart failure. The patient is already on medications for aortic regurgitation. Which of the following medications should be used with caution in this patient due to the risk of worsening aortic regurgitation?
A) Aspirin
B) Furosemide
C) Digoxin
D) Lisinopril
E) Verapamil
Rationale: Verapamil, a calcium channel blocker, should be used with caution in patients with aortic regurgitation as it can worsen the regurgitation by decreasing afterload.
A 65-year-old patient with a history of hypertension presents with a pulsatile abdominal mass and abdominal pain. Imaging confirms the diagnosis of an abdominal aortic aneurysm (AAA) measuring 5.5 cm in diameter. The patient is asymptomatic. Which of the following medications is indicated for the medical management of this AAA?
A) Aspirin
B) Furosemide
C) Propranolol
D) Lisinopril
E) Clopidogrel
Rationale: Propranolol, a beta-blocker, is indicated for the medical management of small asymptomatic AAAs (4.0 to 5.4 cm) to reduce the risk of rupture.
A 55-year-old patient with a history of tobacco use presents with a pulsatile headache and visual disturbances. On examination, you note a widened mediastinum on chest X-ray. Imaging confirms the diagnosis of a thoracic aortic aneurysm (TAA) involving the aortic arch. The patient is asymptomatic. Which of the following medications is indicated for the medical management of this TAA?
A) Aspirin
B) Furosemide
C) Propranolol
D) Losartan
E) Dipyridamole
Rationale: Losartan, an angiotensin II receptor blocker (ARB), is indicated for the medical management of TAAs to reduce the rate of growth and the risk of complications.
A 70-year-old patient with a history of smoking and hypertension presents with sudden-onset severe chest pain radiating to the back. On examination, you note decreased femoral pulses and a diastolic murmur. Imaging confirms the diagnosis of a descending thoracic aortic aneurysm (TAA) with dissection. Which of the following medications is indicated as the initial therapy for this acute aortic dissection?
A) Aspirin
B) Furosemide
C) Propranolol
D) Nicardipine
E) Heparin
Rationale: Nicardipine, a calcium channel blocker, is indicated as initial therapy for acute aortic dissection to reduce blood pressure and shear stress on the aortic wall.
A 62-year-old patient with a history of Marfan syndrome presents with an asymptomatic ascending thoracic aortic aneurysm (TAA) measuring 4.8 cm in diameter. Which of the following medications is indicated for the medical management of TAAs in patients with connective tissue disorders like Marfan syndrome?
A) Aspirin
B) Furosemide
C) Propranolol
D) Losartan
E) Clopidogrel
Rationale: Losartan, an angiotensin II receptor blocker (ARB), is indicated for the medical management of TAAs in patients with connective tissue disorders like Marfan syndrome to reduce the rate of growth and the risk of complications.
A 55-year-old patient with a history of hypertension presents with an asymptomatic thoracoabdominal aortic aneurysm (TAAA) measuring 6.0 cm in diameter. Which of the following medications is indicated for the medical management of this TAAA?
A) Aspirin
B) Furosemide
C) Propranolol
D) Losartan
E) Clopidogrel
Rationale: Losartan, an angiotensin II receptor blocker (ARB), is indicated for the medical management of TAAs to reduce the rate of growth and the risk of complications.
A 65-year-old patient with a history of hypertension presents with a pulsatile abdominal mass and abdominal pain. Imaging confirms the diagnosis of an abdominal aortic aneurysm (AAA) measuring 6.5 cm in diameter. The patient is considered a high surgical risk. Which of the following medications is indicated for the medical management of this AAA?
A) Aspirin
B) Furosemide
C) Propranolol
D) Atenolol
E) Edoxaban
Correct Answer: C
Rationale: Propranolol, a beta-blocker, is indicated for the medical management of large AAAs (>5.5 cm) in patients who are not surgical candidates to reduce the risk of rupture.
A 58-year-old patient with a history of hypertension presents with sudden-onset severe abdominal pain radiating to the back. On examination, you note a pulsatile abdominal mass and decreased femoral pulses. Imaging confirms the diagnosis of an infrarenal AAA with rupture. Which of the following medications is indicated as an adjunct to surgical repair in this patient?
A) Aspirin
B) Furosemide
C) Propranolol
D) Vasopressin
E) Heparin
Rationale: Vasopressin can be used as an adjunct to surgical repair in patients with a ruptured AAA to help control bleeding and maintain blood pressure.
A 70-year-old patient with a history of hypertension presents with a pulsatile mass in the right groin. Imaging confirms the diagnosis of a femoral artery aneurysm. Which of the following medications is indicated for the medical management of femoral artery aneurysms?
A) Aspirin
B) Furosemide
C) Propranolol
D) Warfarin
E) Clopidogrel
Rationale: Aspirin is indicated for the medical management of femoral artery aneurysms to reduce the risk of thromboembolic complications.
A 62-year-old patient with a history of hypertension presents with a pulsatile mass in the left popliteal fossa. Imaging confirms the diagnosis of a popliteal artery aneurysm. Which of the following medications is indicated for the medical management of popliteal artery aneurysms?
A) Aspirin
B) Furosemide
C) Propranolol
D) Cilostazol
E) Edoxaban
Rationale: Cilostazol, a phosphodiesterase inhibitor, can be used for the medical management of popliteal artery aneurysms to improve claudication symptoms.
A 68-year-old patient with a history of hypertension and smoking presents with recurrent episodes of transient monocular vision loss in the left eye. The symptoms last for a few minutes and resolve spontaneously. On examination, you note an auscultatory bruit over the left carotid artery. Imaging confirms the presence of significant left carotid artery stenosis. Which of the following medications is indicated for the medical management of carotid artery stenosis?
A) Aspirin
B) Furosemide
C) Clopidogrel
D) Atorvastatin
E) Lisinopril
Rationale: Atorvastatin, a statin medication, is indicated for the medical management of carotid artery stenosis to reduce the risk of stroke and cardiovascular events by lowering LDL cholesterol levels.
A 60-year-old patient with a history of diabetes and hyperlipidemia presents with recurrent episodes of weakness and clumsiness in the right hand and arm. These symptoms last for several minutes and are followed by complete resolution. On examination, you note an auscultatory bruit over the right carotid artery. Imaging confirms the presence of significant right carotid artery stenosis. Which of the following medications is indicated for the medical management of carotid artery stenosis in this patient?
A) Aspirin
B) Furosemide
C) Clopidogrel
D) Cilostazol
E) Warfarin
Rationale: Clopidogrel, an antiplatelet medication, is indicated for the medical management of carotid artery stenosis to reduce the risk of stroke and cardiovascular events by preventing platelet aggregation.
A 55-year-old patient with a history of hypertension and smoking presents with a sudden-onset severe headache and left-sided weakness. On examination, you note right-sided hemiparesis and aphasia. Imaging reveals an acute ischemic stroke in the left middle cerebral artery territory. Carotid artery imaging shows severe left carotid artery stenosis. Which of the following medications is indicated as a secondary prevention strategy for this patient with carotid artery stenosis?
A) Aspirin
B) Furosemide
C) Clopidogrel
D) Warfarin
E) Dipyridamole
Rationale: Aspirin, an antiplatelet medication, is indicated as a secondary prevention strategy for patients with carotid artery stenosis to reduce the risk of recurrent strokes.
A 65-year-old patient with a history of hypertension and coronary artery disease presents with recurrent episodes of dizziness and imbalance. On examination, you note an auscultatory bruit over the right carotid artery. Imaging confirms significant right carotid artery stenosis. Which of the following medications is indicated for the medical management of carotid artery stenosis in this patient?
A) Aspirin
B) Furosemide
C) Clopidogrel
D) Ramipril
E) Nicardipine
Rationale: Ramipril, an ACE inhibitor, may be indicated for the medical management of carotid artery stenosis to reduce blood pressure and improve outcomes.
A 58-year-old patient with a history of atrial fibrillation and recent transient ischemic attack presents with significant carotid artery stenosis. The patient is already on warfarin for stroke prevention. Which of the following medications can be added as adjunctive therapy for carotid artery stenosis in this patient?
A) Aspirin
B) Furosemide
C) Clopidogrel
D) Atorvastatin
E) Nicardipine
Rationale: Clopidogrel, an antiplatelet medication, can be added as adjunctive therapy for carotid artery stenosis in patients with atrial fibrillation who are already on warfarin for stroke prevention.
A 70-year-old patient with a history of smoking presents with recurrent episodes of syncope. On examination, you note an auscultatory bruit over the left carotid artery. Imaging confirms significant left carotid artery stenosis. Which of the following medications is indicated for the medical management of carotid artery stenosis in this patient?
A) AspirinB) Furosemide
C) Clopidogrel
D) Cilostazol
E) Lisinopril
Rationale: Cilostazol, a phosphodiesterase inhibitor, is indicated for the medical management of carotid artery stenosis to improve symptoms and reduce the risk of stroke.