NR601 Week 4 Midterm Exam

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NR601 Week 4 Midterm Exam

A 68-year-old woman with a history of hypertension and diabetes presents with fatigue, mild ankle swelling, and exertional dyspnea. Echocardiography shows a preserved ejection fraction. What is the MOST LIKELY underlying pathophysiology of her symptoms?

1. Aortic stenosis with increased afterload
2. Acute mitral regurgitation with volume overload
3.  Abnormal ventricular relaxation and increased stiffness
4. Reduced preload and impaired systolic contraction

A NP is developing a preventive counseling program based on the U.S. Preventive Services Task Force (USPSTF) recommendations. Which combination of interventions would BEST address the prevention of cardiovascular disease in adults at increased risk?

1. Genetic counseling for BRCA-related cancer and screening for osteoporosis
2. Screening and counseling for anxiety disorders and prescribing low-dose aspirin
3.  Behavioral counseling for a healthy diet and physical activity, and screening for hypertension
4. Screening for asymptomatic bacteriuria and prescribing risk-reducing medications for breast cancer

The NP is evaluating a patient with mitral regurgitation (MR). Which findings are MOST indicative of chronic severe MR?

1.  Presence of dyspnea, fatigue, orthopnea, and palpitations
2. Mild left atrial enlargement with no symptoms
3. Normal left ventricular (LV) size and function
4. Occasional irregular heartbeat without significant symptoms

The NP is assessing an older adult for symptoms of aortic stenosis (AS). Which of the following symptoms is MOST likely to be precipitated by sudden changes in heart rate, volume status, or cardiac output (CO)?

1. Syncope
2. Palpitations
3. Cough
4. Peripheral edema

The NP is counseling an older adult patient on nutrition to reduce chronic disease risk. Which dietary pattern is MOST aligned with current evidence-based health promotion strategies?

1. Ketogenic diet with intermittent fasting and protein supplementation
2. Emphasis on nutrient-dense whole foods with minimal added sugars and sodium
3. Elimination of dairy, gluten, and legumes to reduce inflammation
4. Reliance on fortified snack products to boost calorie intake

A 58-year-old man with exertional chest discomfort undergoes evaluation in your primary care office. His physical exam is normal. Which of the following laboratory findings would provide the most useful information for cardiovascular risk stratification and potentially influence decisions about lipid-lowering therapy?

1. Normal hematocrit of 44%
2. Elevated hemoglobin A1C of 6.2%
3. High-sensitivity C-reactive protein (CRP) level of 2.5 mg/L
4. Mildly decreased thyroid-stimulating hormone (TSH)

The NP is counseling a patient with persistent asthma. Which of the following factors is MOST associated with airway hyperresponsiveness in asthma?

1. Surfactant deficiency in alveoli which results in elevated white blood cells
2.  Subepithelial collagen deposition and airway wall thickening
3. Pulmonary capillary wedge pressure elevation
4. Isolated airway infection with Mycoplasma pneumoniae