NURS 615
Exam 3 Review Questions
1. Beta blockers (BBs) are generally contraindicated in which patient?
1 ] The patient who has unstable asthma
2 ] The patient who has had a myocardial infarction (MI)
3 ] The patient who has hypertension
4 ] The patient who has stable Type II diabetes
Rationale: gold standard to help reduce the second cardiac event post-MI and are not
contraindicated.
Do not abruptly w/drawal. They slow conduction. Lower heart rate would be a normal
finding. See what their baseline is.
2. Which drug inhibits the enzyme that converts T4 to T3, has iodine as a major
component, and has a risk for patients with underlying predisposition to thyroid disease
to develop thyrotoxicosis or hypothyroidism?
1 ] Enalapril
2 ] Amiodarone
3 ] Digoxin
4 ] Hydralazine
Recommended for patients to have a baseline CXR prior to starting to ensure they don’t
have any underlying interstitial lung disease. Recent PFT test in patients with a
diagnosis of COPD – there is an increased risk of pulmonary toxicity.
Visual changes may also be reported – deposits over the cornea
3. A frail, 78-year-old female patient with a history of type 2 diabetes mellitus (DM),
obesity, chronic obstructive pulmonary disease, and coronary artery disease is returning
for a followup evaluation. She has a previous history of hypoglycemia. Her current
medication regimen includes maximum dose of a biguanide and a dipeptidyl
peptidase-4 (DPP-4) inhibitor. Her HbA1c is 7.8%. Which action is most appropriate for
the APN to take?
1 ] Prescribe no additional medication.
2 ] Prescribe rapid-acting insulin (RAI) before meals.
3 ] Prescribe nasally inhaled human insulin.
4 ] Prescribe a sulfonylurea.
Rationale: American Diabetes Association (ADA) guidelines state that a less stringent
A1c goal of less than 8% may be appropriate for a patient with extensive comorbid
conditions.
4. A 32-year-old patient with ulcerative colitis and type 2 diabetes mellitus (DM) should
avoid which medication?
, 1 ] Biguanide
2 ] Meglitinide
3 ] Sulfonylurea
4 ] Alpha-glucosidase inhibitor
5. Alpha-glucosidase inhibitors function by which primary mechanism of action?
1 ] Increasing endogenous insulin secretion
2 ] Suppressing glucogenesis
3 ] Delaying the absorption of complex carbohydrates (CHO)
4 ] Inhibiting the reabsorption of glucose in the kidney
6. A 48-year-old patient with a history of type 2 diabetes mellitus (DM) has questions
about the initiation of insulin. The patient is told that exogenous insulin lowers blood
glucose by which mechanism?
1 ] Inhibiting the storage of glucose as glycogen
2 ] Stimulating glucose production in the liver
3 ] Decreasing fat storage
4 ] Stimulating glucose entry into the cell
7. Calcium channel blockers (CCBs) are indicated to treat which condition?
1 ] Migraine headache prophylaxis
2 ] Raynaud’s syndrome
3 ] Esophageal spasm
4 ] Chronic angina
8. A patient presents to the clinic today for follow-up on hypertension. He states that he
has noticed a dry “hacking” cough since he started lisinopril 4 weeks ago. He denies
other respiratory or cardiovascular symptoms. Which action taken by the APN is most
appropriate?
1 ] Increase the dose of lisinopril and evaluate the patient in 2 weeks.
2 ] Treat the patient with an antibiotic and prednisone.
3 ] Stop the lisinopril and start losartan.
4 ] Add aliskiren to the current medication regime.
9. Which adverse effect of metformin is most common?
1 ] Weight loss
2 ] Lactic acidosis
3 ] Flatulence
4 ] Reduction of low-density lipoprotein (LDL) levels
Exam 3 Review Questions
1. Beta blockers (BBs) are generally contraindicated in which patient?
1 ] The patient who has unstable asthma
2 ] The patient who has had a myocardial infarction (MI)
3 ] The patient who has hypertension
4 ] The patient who has stable Type II diabetes
Rationale: gold standard to help reduce the second cardiac event post-MI and are not
contraindicated.
Do not abruptly w/drawal. They slow conduction. Lower heart rate would be a normal
finding. See what their baseline is.
2. Which drug inhibits the enzyme that converts T4 to T3, has iodine as a major
component, and has a risk for patients with underlying predisposition to thyroid disease
to develop thyrotoxicosis or hypothyroidism?
1 ] Enalapril
2 ] Amiodarone
3 ] Digoxin
4 ] Hydralazine
Recommended for patients to have a baseline CXR prior to starting to ensure they don’t
have any underlying interstitial lung disease. Recent PFT test in patients with a
diagnosis of COPD – there is an increased risk of pulmonary toxicity.
Visual changes may also be reported – deposits over the cornea
3. A frail, 78-year-old female patient with a history of type 2 diabetes mellitus (DM),
obesity, chronic obstructive pulmonary disease, and coronary artery disease is returning
for a followup evaluation. She has a previous history of hypoglycemia. Her current
medication regimen includes maximum dose of a biguanide and a dipeptidyl
peptidase-4 (DPP-4) inhibitor. Her HbA1c is 7.8%. Which action is most appropriate for
the APN to take?
1 ] Prescribe no additional medication.
2 ] Prescribe rapid-acting insulin (RAI) before meals.
3 ] Prescribe nasally inhaled human insulin.
4 ] Prescribe a sulfonylurea.
Rationale: American Diabetes Association (ADA) guidelines state that a less stringent
A1c goal of less than 8% may be appropriate for a patient with extensive comorbid
conditions.
4. A 32-year-old patient with ulcerative colitis and type 2 diabetes mellitus (DM) should
avoid which medication?
, 1 ] Biguanide
2 ] Meglitinide
3 ] Sulfonylurea
4 ] Alpha-glucosidase inhibitor
5. Alpha-glucosidase inhibitors function by which primary mechanism of action?
1 ] Increasing endogenous insulin secretion
2 ] Suppressing glucogenesis
3 ] Delaying the absorption of complex carbohydrates (CHO)
4 ] Inhibiting the reabsorption of glucose in the kidney
6. A 48-year-old patient with a history of type 2 diabetes mellitus (DM) has questions
about the initiation of insulin. The patient is told that exogenous insulin lowers blood
glucose by which mechanism?
1 ] Inhibiting the storage of glucose as glycogen
2 ] Stimulating glucose production in the liver
3 ] Decreasing fat storage
4 ] Stimulating glucose entry into the cell
7. Calcium channel blockers (CCBs) are indicated to treat which condition?
1 ] Migraine headache prophylaxis
2 ] Raynaud’s syndrome
3 ] Esophageal spasm
4 ] Chronic angina
8. A patient presents to the clinic today for follow-up on hypertension. He states that he
has noticed a dry “hacking” cough since he started lisinopril 4 weeks ago. He denies
other respiratory or cardiovascular symptoms. Which action taken by the APN is most
appropriate?
1 ] Increase the dose of lisinopril and evaluate the patient in 2 weeks.
2 ] Treat the patient with an antibiotic and prednisone.
3 ] Stop the lisinopril and start losartan.
4 ] Add aliskiren to the current medication regime.
9. Which adverse effect of metformin is most common?
1 ] Weight loss
2 ] Lactic acidosis
3 ] Flatulence
4 ] Reduction of low-density lipoprotein (LDL) levels
