Docsity
Docsity

Prepare for your exams
Prepare for your exams

Study with the several resources on Docsity


Earn points to download
Earn points to download

Earn points by helping other students or get them with a premium plan


Guidelines and tips
Guidelines and tips

NSG 6001 Midterm Exam - Question and Answers, Exams of Nursing

A list of questions and answers related to various topics in healthcare, including Medicaid, stress tests, and ischemia. The questions cover topics such as eligibility for Medicaid, the definition of a positive stress test, and the leading cause of death for women in the United States. The answers provide detailed explanations and definitions for each question.

Typology: Exams

2022/2023

Available from 05/28/2023

Doctormitch
Doctormitch 🇺🇸

3.6

(5)

93 documents

1 / 12

Toggle sidebar

This page cannot be seen from the preview

Don't miss anything!

bg1
NSG 6001 MIDTERM EXAM QUESTION AND
ANSWERS (100% CORRECT)
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 b ased on an
ultrasound echocardiography. What facts would influence your decision regarding the
family request for echo assessment?
Student Answer: Specificity would be increased because of obesity
Sensitivity would be reduced because of obesity and lung disease (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?
Student Answer:
False (Medicaid is mandated to be provided by each state, however, Mediciad
is not required to be delivered by any certain formula. Each state has autonomy to deliver
Mediciad services under its own guidelines, provided that each state meets the federal
guidelines for Medicaid coverage. )
True
3.
Question :
By standard criteria, how is a positive stress test defined?
Student Answer:
Development of a horizontal or down sloping ST-segment depression of
10mm
Development of a horizontal or down sloping ST-segment depression of
1mm (A positive stress test is defined as the development of a horizontal or down sloping
ST-segment depression of 1mm. )
Upward sloping ST-segment measured at the J point of the QRS
pf3
pf4
pf5
pf8
pf9
pfa

Partial preview of the text

Download NSG 6001 Midterm Exam - Question and Answers and more Exams Nursing in PDF only on Docsity!

ANSWERS (100% CORRECT)

  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? Student Answer: Specificity would be increased because of obesity Sensitivity would be reduced because of obesity and lung disease (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? Student Answer: False (Medicaid is mandated to be provided by each state, however, Mediciad is not required to be delivered by any certain formula. Each state has autonomy to deliver Mediciad services under its own guidelines, provided that each state meets the federal guidelines for Medicaid coverage. ) True
  3. Question : By standard criteria, how is a positive stress test defined? Student Answer: Development of a horizontal or down sloping ST-segment depression of 10mm Development of a horizontal or down sloping ST-segment depression of 1mm (A positive stress test is defined as the development of a horizontal or down sloping ST-segment depression of 1mm. ) Upward sloping ST-segment measured at the J point of the QRS

ANSWERS (100% CORRECT)

Down sloping of the ST-segment at the J point of the QRS

  1. Question : Population disease management is a term used to describe: Student Answer: Low prevalence specific diseases High prevalence specific diseases (Population disease management is a term used to describe the high prevalence of specific diseases. ) Low specificity diseases states High specificity disease states
  2. Question : What are two of the most common forms of Exercise Stress Tests used today? Student Answer: Bicycle and treadmill (Bicycle and treadmill are the two most common forms of exercise stress tests used today. ) Unicycle and Running in pace Thallium and Dobutamine Bicycle and rowing machine
  3. 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? Student Answer: Too many carbonated drinks Diet and exercise

ANSWERS (100% CORRECT)

Student Answer: Stool samples CBC ETT (Many patients have underlying CAD but remain asymptomatic. Before beginning any new vigorous activities after years of sedentary lifestyle, it is recommended that the patient obtains an ETT to rule out underlying CAD.) Thyroid levels

  1. Question : What ECG changes can reduce the specificity of the ETT? Student Answer: Paced rhythm and resting bundle branch block (The ECG changes that can reduce the specificity of the ETT are 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
  2. 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. Student Answer: Breasts and fat deposits in abdomen Smoking rates and lack of uptake of photons Breasts and smaller coronary arteries (Single-photon emissions CT imaging is technically limited in women due to breasts and smaller coronary arteries.) Multiple vessel disease and fat deposits

ANSWERS (100% CORRECT)

  1. 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? Student Answer: Monetary savings and limited disruption in healthcare delivery Population management and healthcare practice (Population management and healthcare practice are strategic in the movement to improve the nation’s healthcare system. ) Socialized medicine and governmental controls President and Congress
  2. Question : The sensitivity of a routine ETT is effort dependent. What physiological changes occur during effort in the routine ETT? Student Answer: Decrease in coronary blood flow Increased coronary flow and increased systolic blood pressure (The physiological changes that occur during effort in the routine ETT are increased coronary flow and increased systolic blood pressure.) Rapid heart rates and coronary artery narrowing Decreased heart rate and increased systolic blood pressure
  3. 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? Student Answer: 220+age 120 - age

ANSWERS (100% CORRECT)

  1. 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? Student Answer: False True (This statement is true: 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. )
  2. 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? Student Answer: Slow heart rate Exercise-induced hypotension (Another important strong predictor of CAD that you might see during an ETT is exercise-induced hypotension. ) Exercise-induced hypertension Rapid heart rate
  3. 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? Student Answer: False True (This is a true statement. 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. )
  4. Question :

ANSWERS (100% CORRECT)

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 noncommunicable diseases? Student Answer: 10%-15% 80%-90% 35%-45% 60%-70% (According to the World Health Organization, 60%--7 0% of preventable deaths and disabilities occur in the Americas related to chronic noncommunicable diseases. )

  1. Question : Your patient has a maximum age-predicted heart rate of 180. During the exercise, he reaches a heart rate of 140 and then states he can no longer exercise. You see no evidence of ischemia on the ECG. This would be diagnostic for what condition? Student Answer: Has no diagnostic value to rule out CAD (This scenario has no diagnostic value to rule out CAD.) Predictive of no CAD Diagnostic of laziness Diagnostic for impending Myocardial Infarction
  2. Question : What happens to coronary flow related to CAD? Student Answer: Functional systolic pressures Hyper profusion of the myocardium

ANSWERS (100% CORRECT)

  1. Question : Why would inability to exercise reduce the specificity of the routine ETT? Student Answer: Produces persistent ST-segmental changes and T-wave abnormalities (The inability to exercise reduces the specificity of the routine ETT because it produces persistent ST-segmental changes and T-wave abnormalities. ) Will not produce any changes in ECG Produces QRS changes that cannot be interpreted Causes ST-segment changes and P-wave abnormalities
  2. Question : On the echocardiography during the ETT you notice the following change: Student Answer: Ischemia of the myocardium (Abnormal left ventricular ejection fraction suggests ischemia of the myocardium.) Weak ventricular muscles Rise in heart rate without evidence of ischemia Non-ischemic changes of the baseline ECG
  3. Question : Specifically, when is an ETT considered to be negative? Student Answer: Patient exercises to 20% maximum age-predicted heart rate without induced ischemia Patient exercises to 85% of age predicted maximum heart rate without evidence of induced ischemia (An ETT is considered to be negative when the patient exercises to 85% of age predicted maximum heart rate without evidence of induced ischemia. ) Patient exercises until tired without evidence of induced ischemia

ANSWERS (100% CORRECT)

Patient has ST-segmental changes with down sloping of greater than 1 mm at 50% of age-predicted maximum heart rate

  1. Question : Eligibility for Medicaid includes the following: Student Answer: Elderly, children and women living in poverty (Eligibility for Medicaid includes the elderly as well as children and women living in poverty. ) Very young and elderly only Everyone unemployed Children and women regardless of income
  2. Question : What is the leading cause of death for women in the United States? Student Answer: Complications of childbirth Lung cancer Breast cancer Heart disease (Heart disease is the leading cause of death for women in the United States.)
  3. Question : What do you know regarding ischemia that is confined to only the posterior and or lateral segments of the left ventricle? Student Answer: Requires both for detection of changes by ETT Easier to detect by ETT Difficult to detect by ETT (Ischemia that is confined to only the posterior and