NR 508 WEEK 2 QUIZ / NR508 WEEK 2 QUIZ: LATEST,CHAMBERLAIN COLLEGE OF NURSING: LATEST,CHAMBERLAIN COLLEGE OF NURSING

NR 508 WEEK 2 QUIZ / NR508 WEEK 2 QUIZ: LATEST,CHAMBERLAIN COLLEGE OF NURSING: LATEST,CHAMBERLAIN COLLEGE OF NURSINGQuestion 1. Question : A 55-year-old patient with no prior history of hypertension has a blood pressure greater than 140/90 on three separate occasions. The patient does not smoke, has a body mass index of 24, and exercises regularly. The patient has no known risk factors for cardiovascular disease. The primary care NP should: prescribe a thiazide diuretic and an angiotensin-converting enzyme inhibitor. perform a careful cardiovascular physical assessment. counsel the patient about dietary and lifestyle changes. order a urinalysis and creatinine clearance and begin therapy with a ?-blocker. Question 2. Question : A patient who takes nitroglycerin for stable angina pectoris develops hypertension. The primary care NP should contact the patient’s cardiologist to discuss adding: amlodipine (Norvasc). diltiazem (Cardizem). verapamil HCl (Calan). nifedipine (Procardia XL). Question 3. Question : A patient who has insulin-dependent type 2 diabetes reports having difficulty keeping blood glucose within normal limits and has had multiple episodes of both hypoglycemia and hyperglycemia. As adjunct therapy to manage this problem, the primary care NP should prescribe: pramlintide (Symlin). repaglinide (Prandin). glyburide (Micronase). metformin (Glucophage). Question 4. Question : A 40-year-old patient is in the clinic for a routine physical examination. The patient has a body mass index (BMI) of 26. The patient is active and walks a dog daily. A lipid profile reveals low-density lipoprotein (LDL) of 100 mg/dL, high-density lipoprotein (HDL) of 30 mg/dL, and triglycerides of 250 mg/dL. The primary care nurse practitioner (NP) should: order a fasting plasma glucose level. consider prescribing metformin (Glucophage). suggest dietary changes and increased exercise. obtain serum insulin and hemoglobin A1c levels. Question 5. Question : An 80-year-old female patient with a history of angina has increased TSH and decreased T4. The primary care NP should prescribe _____ mcg of _____. 25; liothyronine 75; liothyronine 25; levothyroxine 75; levothyroxine Question 6. Question : A 12-year-old patient who is obese develops type 2 diabetes mellitus. The primary care NP should order: nateglinide (Starlix). glyburide (Micronase). colesevelam (Welchol). metformin (Glucophage). Question 7. Question : The primary care NP sees a new patient who has diabetes and hypertension and has been taking a thiazide diuretic for 6 months. The patient’s blood pressure at the beginning of treatment was 150/95 mm Hg. The blood pressure today is 138/85 mm Hg. The NP should: order a ?-blocker. add an angiotensin-converting enzyme inhibitor. continue the current drug regimen. change to an aldosterone antagonist medication. Question 8. Question : A primary care NP orders thyroid function tests. The patient’s TSH is 1.2 microunits/mL, and T4 is 1.7 ng/mL. The NP should: assess the patient for symptoms of hyperthyroidism. ask the patient about the use of medications such as lithium. tell the patient that the results most likely indicate hypothyroidism. ask an endocrinologist to evaluate for possible Hashimoto’s thyroiditis. Question 9. Question : A patient who will begin using nitroglycerin for angina asks the primary care NP how the medication works to relieve pain. The NP should tell the patient that nitroglycerin acts to: dissolve atheromatous lesions. relax vascular smooth muscle. prevent catecholamine release. reduce C-reactive protein levels. Question 10. Question : A child who has congenital hypothyroidism takes levothyroxine 75 mcg/day. The child weighs 15 kg. The primary care NP sees the child for a 3-year-old check-up. The NP should consult with a pediatric endocrinologist to discuss: increasing the dose to 90 mcg/day. decreasing the dose to 30 mcg/day. stopping the medication and checking TSH and T4 in 4 weeks. discussing the need for lifetime replacement therapy with the child’s parents. Question 11. Question : A patient who has had a previous myocardial infarction has a blood pressure of 135/82 mm Hg. The patient’s body mass index is 28, and the patient has a fasting plasma glucose of 105 mg/dL. The primary care NP should prescribe: an angiotensin-converting enzyme inhibitor. a thiazide diuretic. lifestyle modifications. a calcium-channel blocker. Question 12. Question : A patient who has hypothyroidism has been taking levothyroxine 50 mcg daily for 2 weeks. The patient reports continued fatigue. The primary care NP should: order a T4 level today. increase the dose to 100 mcg. check the TSH level in 1 week. reassure the patient that this will improve in several weeks. Question 13. Question : A patient who takes a calcium channel blocker is in the clinic for an annual physical examination. The cardiovascular examination is normal. As part of routine monitoring for this patient, the primary care NP should evaluate: serum calcium channel blocker level. complete blood count and electrolytes. liver function tests (LFTs) and renal function. thyroid and insulin levels. Question 14. Question : A patient who has type 2 diabetes mellitus will begin taking a bile acid sequestrant. Which bile acid sequestrant should the primary care NP order? Colesevelam (Welchol) Colestipol (Colestid) Cholestyramine (Questran) Cholestyramine (Questran Light) Question 15. Question : A patient who has primary hyperlipidemia and who takes atorvastatin (Lipitor) continues to have LDL cholesterol of 140 mg/dL after 3 months of therapy. The primary care NP increases the dose from 10 mg daily to 20 mg daily. The patient reports headache and dizziness a few weeks after the dose increase. The NP should: change the atorvastatin dose to 15 mg twice daily. change the patient’s medication to cholestyramine (Questran). add ezetimibe (Zetia) and lower the atorvastatin to 10 mg daily. recommend supplements of omega-3 along with the atorvastatin. Question 16. Question : A patient with type 2 diabetes mellitus takes metformin (Glucophage) 1000 mg twice daily and glyburide (Micronase) 12 mg daily. At an annual physical examination, the BMI is 29 and hemoglobin A1c is 7.3%. The NP should: begin insulin therapy. change to therapy with colesevelam (Welchol). add a third oral antidiabetic agent to this patient’s drug regimen. enroll the patient in a weight loss program to achieve better glycemic control. Question 17. Question : A patient has three consecutive blood pressure readings of 140/95 mm Hg. The patient’s body mass index is 24. A fasting plasma glucose is 100 mg/dL. Creatinine clearance and cholesterol tests are normal. The primary care NP should order: a ?-blocker. an angiotensin-converting enzyme inhibitor. a thiazide diuretic. dietary and lifestyle changes. Question 18. Question : A 30-year-old white woman has a BMI of 26 and weighs 150 lb. At an annual physical examination, the patient’s fasting plasma glucose is 130 mg/dL. The patient walks 1 mile three or four times weekly. She has had two children who weighed 7 lb and 8 lb at birth. Her personal and family histories are noncontributory. The primary care NP should: order metformin (Glucophage). order a lipid profile, complete blood count, and liver function tests (LFTs). order an oral glucose tolerance test. set a weight loss goal of 10 to 15 lb. Question 19. Question : A patient who has diabetes is taking metformin 1000 mg daily. At a clinic visit, the patient reports having abdominal pain and nausea. The primary care NP notes a heart rate of 92 beats per minute. The NP should: obtain LFTs. decrease the dose of metformin. change metformin to glyburide. order electrolytes, ketones, and serum glucose. Question 20. Question : A patient who has diabetes is taking simvastatin (Zocor) 80 mg daily to treat LDL cholesterol level of 170 mg/dL. The patient has a body mass index of 29. At a follow-up visit, the patient’s LDL level is 120 mg/dL. The primary care NP should consider: increasing the simvastatin to 80 mg twice daily. adding nicotinic acid to the patient’s drug regimen. changing the medication to ezetimibe/simvastatin (Vytorin). referring the patient to a dietitian for assistance with weight reduction. Question 21. Question : A patient who has angina is taking nitroglycerin and long-acting nifedipine. The primary care NP notes a persistent blood pressure of 90/60 mm Hg at several follow-up visits. The patient reports lightheadedness associated with standing up. The NP should consult with the patient’s cardiologist about changing the medication to: amlodipine (Norvasc). isradipine (DynaCirc). verapamil HCl (Calan). short-acting nifedipine (Procardia). Question 22. Question : A patient who is taking nifedipine develops mild edema of both feet. The primary care NP should contact the patient’s cardiologist to discuss: changing to amlodipine. ordering renal function tests. increasing the dose of nifedipine. evaluation of left ventricular function. Question 23. Question : A patient reports fatigue, weight loss, and dry skin. The primary care nurse practitioner (NP) orders thyroid function tests. The patient’s thyroid stimulating hormone (TSH) is 40 microunits/mL, and T4 is 0.1 ng/mL. The NP should refer the patient to an endocrinologist and prescribe: methimazole. liothyronine. levothyroxine. propylthiouracil. Question 24. Question : A primary care NP prescribes a nitroglycerin transdermal patch, 0.4 mg/hour release, for a patient with chronic stable angina. The NP should teach the patient to: change the patch four times daily. use the patch as needed for angina pain. use two patches daily and change them every 12 hours. apply one patch daily in the morning and remove in 12 hours. Question 25. Question : A patient is newly diagnosed with type 2 diabetes mellitus. The primary care NP reviews this patient’s laboratory tests and notes normal renal function, increased triglycerides, and deceased HDL levels. The NP should prescribe: nateglinide (Starlix). glyburide (Micronase). colesevelam (Welchol). metformin (Glucophage).