NR565: WEEK 3: TEST QUESTIONS WITH COMPLETE
SOLUTIONS
1) Heart failure tx plan -- Answer ✔✔ -ACEI or ARB as first line
• plus beta blockers, diuretics, & others as needed
2) diabetes tx plan -- Answer ✔✔ -ACEI or ARB as first line
- if African American, start with CCB or thiazide diuretic
3) CKD tx plan -- Answer ✔✔ -ACEI or ARB as first line
• can add CCB or thiazide diuretic
4) pregnancy tx plan -- Answer ✔✔ labetalol
5) LaMar reports a family history of hypertension & cardiovascular disease but has
no other risk factors. Current BP is 126/82 mm Hg; normal weight & BMI for
height & age are noted. Which of the following tx plans is the primary focus for
educating LaMar about his cardiovascular health?
, A) increased calcium and potassium supplements
B) angiotensin-converting enzyme (ace) inhibitors and calcium channel
blocker medications
C) the DASH diet, sodium restriction, and exercise
D) thiazide diuretics and lifestyle changes -- Answer ✔✔ the DASH diet,
sodium restriction, and exercise
Rationale: LaMar patient has elevated hypertension without other risk factors;
therefore, lifestyle changes are indicated rather than pharmaceutical agents. If
blood pressure rises to hypertensive levels, other measures, including drug
therapy, may be initiated. Calcium and potassium supplements are not indicated
at this time for LaMar.
6) Anda presents to the clinic for monitoring. She has been diagnosed with heart
failure & has been taking an angiotensin-converting enzyme inhibitor (ACEI),
thiazide diuretic, & beta blocker for several months. Which of the following
diagnostic tests are required to ensure Anda is not developing any adverse effects
from her medication regimen?
A) maximal exercise capacity
B) complete blood count
C) serum electrolyte levels
D) ejection fraction -- Answer ✔✔ serum electrolyte levels
Rationale: Anda is taking a thiazide diuretic and may develop hypokalemia, which
increases the risk for dysrhythmias. Therefore, serum electrolyte levels are
required to ensure she is not developing any adverse effects from her medication
regimen. At this time, a CBC is not recommended. Anda is taking the medications
recommended for patients with Stage C heart failure. Although her quality of life
and ability to participate in activities should be monitored, routine measurement
of the ejection fraction and maximal exercise capacity is not warranted at this
time.
7) Dyslipidemia -- Answer ✔✔ -elevation of one or more lipids or lipoproteins
- Cholesterol & triglycerides are essential lipids that are insoluble in water
, • must be transported within proteins in the circulation
- Cholesterol carried in low-density lipoprotein (LDL) & high-density
lipoprotein (HDL) particles
- AKA hypercholesterolemia or hypertriglyceridemia
- cause
• genetic
• secondary factors: poor diet, obesity, hypothyroidism, kidney or liver
disease, and some meds
- significant role in atherosclerosis leading to coronary heart disease (CHD) &
atherosclerotic cardiovascular disease (ASCVD)
8) Dyslipidemia tx -- Answer ✔✔ -diet
- lifestyle modifications
- control of secondary factors
- pharmacological agents
• statins & non-statins
9) Hypertriglyceridemia -- Answer ✔✔ -often is associated with secondary factors,
including poor diet, alcohol use, obesity, metabolic syndrome, diabetes, and
certain medications
- Extremely high triglyceride levels increase the risk of acute pancreatitis,
xanthomas, and corneal arcus
- Treatment:
• diet and lifestyle modifications
• control of secondary factors
• pharmacological agents
➣ moderately high - statins
➣ extremely high - fibrates
10) DASH Diet -- Answer ✔✔ -low sodium
- low saturated fat
11) Clinical practice guidelines (CPGs) for the management of blood cholesterol --
Answer ✔✔ -lifestyle changes
• weight loss
SOLUTIONS
1) Heart failure tx plan -- Answer ✔✔ -ACEI or ARB as first line
• plus beta blockers, diuretics, & others as needed
2) diabetes tx plan -- Answer ✔✔ -ACEI or ARB as first line
- if African American, start with CCB or thiazide diuretic
3) CKD tx plan -- Answer ✔✔ -ACEI or ARB as first line
• can add CCB or thiazide diuretic
4) pregnancy tx plan -- Answer ✔✔ labetalol
5) LaMar reports a family history of hypertension & cardiovascular disease but has
no other risk factors. Current BP is 126/82 mm Hg; normal weight & BMI for
height & age are noted. Which of the following tx plans is the primary focus for
educating LaMar about his cardiovascular health?
, A) increased calcium and potassium supplements
B) angiotensin-converting enzyme (ace) inhibitors and calcium channel
blocker medications
C) the DASH diet, sodium restriction, and exercise
D) thiazide diuretics and lifestyle changes -- Answer ✔✔ the DASH diet,
sodium restriction, and exercise
Rationale: LaMar patient has elevated hypertension without other risk factors;
therefore, lifestyle changes are indicated rather than pharmaceutical agents. If
blood pressure rises to hypertensive levels, other measures, including drug
therapy, may be initiated. Calcium and potassium supplements are not indicated
at this time for LaMar.
6) Anda presents to the clinic for monitoring. She has been diagnosed with heart
failure & has been taking an angiotensin-converting enzyme inhibitor (ACEI),
thiazide diuretic, & beta blocker for several months. Which of the following
diagnostic tests are required to ensure Anda is not developing any adverse effects
from her medication regimen?
A) maximal exercise capacity
B) complete blood count
C) serum electrolyte levels
D) ejection fraction -- Answer ✔✔ serum electrolyte levels
Rationale: Anda is taking a thiazide diuretic and may develop hypokalemia, which
increases the risk for dysrhythmias. Therefore, serum electrolyte levels are
required to ensure she is not developing any adverse effects from her medication
regimen. At this time, a CBC is not recommended. Anda is taking the medications
recommended for patients with Stage C heart failure. Although her quality of life
and ability to participate in activities should be monitored, routine measurement
of the ejection fraction and maximal exercise capacity is not warranted at this
time.
7) Dyslipidemia -- Answer ✔✔ -elevation of one or more lipids or lipoproteins
- Cholesterol & triglycerides are essential lipids that are insoluble in water
, • must be transported within proteins in the circulation
- Cholesterol carried in low-density lipoprotein (LDL) & high-density
lipoprotein (HDL) particles
- AKA hypercholesterolemia or hypertriglyceridemia
- cause
• genetic
• secondary factors: poor diet, obesity, hypothyroidism, kidney or liver
disease, and some meds
- significant role in atherosclerosis leading to coronary heart disease (CHD) &
atherosclerotic cardiovascular disease (ASCVD)
8) Dyslipidemia tx -- Answer ✔✔ -diet
- lifestyle modifications
- control of secondary factors
- pharmacological agents
• statins & non-statins
9) Hypertriglyceridemia -- Answer ✔✔ -often is associated with secondary factors,
including poor diet, alcohol use, obesity, metabolic syndrome, diabetes, and
certain medications
- Extremely high triglyceride levels increase the risk of acute pancreatitis,
xanthomas, and corneal arcus
- Treatment:
• diet and lifestyle modifications
• control of secondary factors
• pharmacological agents
➣ moderately high - statins
➣ extremely high - fibrates
10) DASH Diet -- Answer ✔✔ -low sodium
- low saturated fat
11) Clinical practice guidelines (CPGs) for the management of blood cholesterol --
Answer ✔✔ -lifestyle changes
• weight loss
