FNP Leik 2024/2025 Actual final Pretest and
Post test Exam Questions and Best Graded
Guaranteed success
When does AFIB require anticoagulation? - correct answer
CHADS2 score > 2 requires anticoagulation.
What does CHADS2 stand for? - correct answer C=CHF,
H=HTN, A=age>75yo, D=diabetes, S2 (stroke or TIA)
INR range for afib - correct answer INR 2.0- 3.0
Afib diagnostic test - correct answer EKG
Afib tx - correct answer Correct baseline irritants
(electrolytes, thyroid, caffeine or drugs). Warfarin or others for
anticoagulation, CCB, B blockers, or digoxin for rate control.
Amiodarone as antiarrhythmic. Consistent one serving/day of
high vitamin K foods.
Paroxysmal atrial tachycardia(PAT or PVST) - correct answer
Usually has underlying cause like digoxin toxicity, ETOH,
increased TSH, caffeine or illicit drugs. 150-250 bpm. P wave
with peaked QRS. Tx= Valsalva (hold breath, ice water, carotid
massage), then rate control (amio or BB) and then cardioversion
Pulsus Paradoxus - correct answer Apical pulse can be
heard but radial pulse can not be felt. Pulmonary or cardiac
,condition compress the chambers of the heart (creates impaired
diastolic filling). Decreased systolic pressures of >10mmHg
during inspiration.
How to diagnose pulsus paradoxus - correct answer Listen
for S1 Korotkoff sound and note when it disappears only during
inspiration but is present during expiration. Then listen for S1
korotkoff sound is present in both inspiration and expiration. If
the difference is >10mmHg then suspect cardiac tamponade,
severe COPD, or constrictive pericarditis.
HTN labs - correct answer Kidney= Cr, BUN, UA.
Endocrine= Thyroid, glucose. Lytes=CMP. Lipid panel. CBC.
EKG (r/o cardiomegaly).
HTN target organ damage eye - correct answer AV nicking,
papilledema, flame shaped hemorrhages, silver/copper arterioles
HTN target organ damage kidney - correct answer
Microalbuminuria, proteinuria, increased Cr and decreased GFR
HTN target organ damage heart - correct answer S3, S4,
carotid bruits, decreased peripheral pulses (PAD/PVD).
HTN target organ damage TIA and CVA - correct answer
Secondary HTN kidney - correct answer Renal artery
stenosis, polyscystic kidney and CKD
,Secondary HTN endocrine - correct answer
Hyperthyroidism, hyperaldosteronism, phoechromocytoma
Secondary HTN other causes - correct answer Obstructive
sleep apneas and coarction of the aorta.
MVP sound and diagnosis - correct answer Classic finding is
S2 click or a midsystolic click (sound like a type writer).
Diagnosis with echocardiogram, Doppler flow studies and holter
monitor.
S/s of MVP - correct answer Fatigue, palpitations,
lightheadness that is aggravated by heavy exertion. May be
asymptomatic. Common in Marfan's syndrome and thin tall white
females.
MVO tx - correct answer Symptomatic pts need BB avoid
caffeine and ETOH and cigarettes.
What cuases MVP sound - correct answer Click from
billowing valve and pan murmur form back flow slipping from
around the bulges. S1, nothing until middle of systole, click the
than a pan murmur, S2
Obesity (waist circumference and waist to hip ratio - correct
answer Waist circumference males > 40in/102cm; Females
>35 in/88cam. Waist to hip ratio in males> 1.0 females >0.8
BMI - correct answer Wg (Kg)/Ht2 (meters)
, Metabolic syndrome - correct answer WEIGHT WE = waist
expansion, (>40in for males; >35in for females IG = Impaired
glucose (>110mg/dl) H= HTN ( >130/85) and low HDL
(<50mg /dl for females; <40mg/dg for males) T= triglycerides
(>150 mg.dl). Cause by hyperinsulinemia and peripheral insulin
resistance.
Fatty liver steatosis ( NAFLD Non alcoholic fatty liver disease) -
correct answer Caused by triglyceride fat deposits in
hepatocytes of the liver. Asymptomatic and sometimes reversible
condition. Liver biopsy is gold standard and other lab are
basically to r/o hepatitis and other liver disease.
Statins labs - correct answer Monitor LFTs and kidney fx.
Statin s/e - correct answer Rhadomylosis and liver failure
Statin interactions - correct answer Increased risk of
rhabdomylosis with fibrates, antifungals, macrolides and
amiodarone and grapefruit. Combinations of meds also increases
risk.
Nicotinic acid - correct answer Decrease triglycerides and
increase HDL. S/e flushing, itching, hepatotoxicity, and GI upset.
Fibrates - correct answer Desired effect same as Niaspan.
Do not use in renal disease. S/e include dyspepsia, gallstones and
myopathy.
