NR 565 MIDTERM QUESTIONS WITH ACCURATE
ANSWERS
12 Essential Considerations for Safe Pain Management correct answer 1. Opioids
are not first-line therapy
2. Establish goals for pain and function
3. Discuss risks and benefits
4. Use IR opioids when starting
5. Use the lowest effective dose
6. Prescribe short durations for acute pain
7. Evaluate benefits and harms frequently
8. Use strategies to mitigate risk
9. Review PDMP data
10. Use urine drug testing
11. Avoid concurrent opioid and benzo prescribing
12. Offer treatment of opioid use disorder
ACEI and ARB BBW correct answer Category C during 1st trimester, D during 2nd
and 3rd
Cause fetal kidney malformation and fetal hypotension
ACEI and ARB Contraindications correct answer Mod to severe kidney disease-
monitor GFR
Renal artery stenosis
ARF
,ACEI and ARB Side Effects correct answer Dry cough-up tp 10% with ACEI
Hyperkalemia
Angioedema-rare but life threatening
ACEI and ARBs MoA correct answer Inhibition of angiotensin-converting enzyme
decreases formation of angiotensin II resulting in prevention of vasoconstriction
and aldosterone-mediated volume expansion
Drug of choice in DM and CKD d/t renal protection
Aldosterone Receptor Antagonists/Mineralcorticoid Receptor Antagonists (MRAs)
Contraindications correct answer Anuria, ARF, renal impairment, hyperkalemia,
Addison's disease, concurrent use with eplerenone
Aldosterone Receptor Antagonists/Mineralcorticoid Receptor Antagonists (MRAs)
correct answer Spironolactone (Aldactone), eplerenone (Inspra)
Block effects of aldosterone , enhance action of thiazides and loops, counterract
K+ loss
Aldosterone Receptor Antagonists/Mineralcorticoid Receptor Antagonists (MRAs)
Side Effects correct answer Hyperkalemia, arrhythmias, amennorrhea,
gynecomastia, deepening voice, increased hair, muscle cramps, agranulocytosis
Aldosterone Receptor Antagonists/Mineralcorticoid Receptor Antagonists (MRAs)
Special Considerations correct answer Hepatic dysfunction
DM d/t increase risk of hyperkalemia
, Alendronate correct answer Biphosphonate, used as first-line treatment for
osteoporosis
Inhibits osteoclasts, reducing bone resorption and turnover
Amiodarone Contraindications correct answer Cardiogenic shock, severe sick
sinus syndrome, bradycardia, 2nd/3rd degree heart block, hypersensitivity to
iodine
Amiodarone MoA correct answer Decreases SA node impulse firing
Blocks sodium, potassium, and calcium channels
Has BB-like properties leading to vasodilation
Treats many tachyarrhythmias like aflutter, afib, vtach, vfib, svt
Amiodarone Side Effects correct answer Dizziness, fatigue, corneal microdeposits,
bradycardia, hypotension, anorexia, constipation, N/V, tremor
Amiodarone Special Considerations correct answer Heart failure, thyroid d/o,
corneal regractive laser surgery, advanced age
Angiotensin Receptor Neprilysin Inhibitors (ARNIs) correct answer Play critical role
in reducing risk of CV deaths and hospitalizations-increased diruesis, vasodilation
Sacubitril/valsartan (Entresto)
Often given in place of an ACEI or ARB-NOT together
Antiplatelet Med Contraindications correct answer Patients with active bleeding
Use lowest effective dose and notify providers before starting PPI
ANSWERS
12 Essential Considerations for Safe Pain Management correct answer 1. Opioids
are not first-line therapy
2. Establish goals for pain and function
3. Discuss risks and benefits
4. Use IR opioids when starting
5. Use the lowest effective dose
6. Prescribe short durations for acute pain
7. Evaluate benefits and harms frequently
8. Use strategies to mitigate risk
9. Review PDMP data
10. Use urine drug testing
11. Avoid concurrent opioid and benzo prescribing
12. Offer treatment of opioid use disorder
ACEI and ARB BBW correct answer Category C during 1st trimester, D during 2nd
and 3rd
Cause fetal kidney malformation and fetal hypotension
ACEI and ARB Contraindications correct answer Mod to severe kidney disease-
monitor GFR
Renal artery stenosis
ARF
,ACEI and ARB Side Effects correct answer Dry cough-up tp 10% with ACEI
Hyperkalemia
Angioedema-rare but life threatening
ACEI and ARBs MoA correct answer Inhibition of angiotensin-converting enzyme
decreases formation of angiotensin II resulting in prevention of vasoconstriction
and aldosterone-mediated volume expansion
Drug of choice in DM and CKD d/t renal protection
Aldosterone Receptor Antagonists/Mineralcorticoid Receptor Antagonists (MRAs)
Contraindications correct answer Anuria, ARF, renal impairment, hyperkalemia,
Addison's disease, concurrent use with eplerenone
Aldosterone Receptor Antagonists/Mineralcorticoid Receptor Antagonists (MRAs)
correct answer Spironolactone (Aldactone), eplerenone (Inspra)
Block effects of aldosterone , enhance action of thiazides and loops, counterract
K+ loss
Aldosterone Receptor Antagonists/Mineralcorticoid Receptor Antagonists (MRAs)
Side Effects correct answer Hyperkalemia, arrhythmias, amennorrhea,
gynecomastia, deepening voice, increased hair, muscle cramps, agranulocytosis
Aldosterone Receptor Antagonists/Mineralcorticoid Receptor Antagonists (MRAs)
Special Considerations correct answer Hepatic dysfunction
DM d/t increase risk of hyperkalemia
, Alendronate correct answer Biphosphonate, used as first-line treatment for
osteoporosis
Inhibits osteoclasts, reducing bone resorption and turnover
Amiodarone Contraindications correct answer Cardiogenic shock, severe sick
sinus syndrome, bradycardia, 2nd/3rd degree heart block, hypersensitivity to
iodine
Amiodarone MoA correct answer Decreases SA node impulse firing
Blocks sodium, potassium, and calcium channels
Has BB-like properties leading to vasodilation
Treats many tachyarrhythmias like aflutter, afib, vtach, vfib, svt
Amiodarone Side Effects correct answer Dizziness, fatigue, corneal microdeposits,
bradycardia, hypotension, anorexia, constipation, N/V, tremor
Amiodarone Special Considerations correct answer Heart failure, thyroid d/o,
corneal regractive laser surgery, advanced age
Angiotensin Receptor Neprilysin Inhibitors (ARNIs) correct answer Play critical role
in reducing risk of CV deaths and hospitalizations-increased diruesis, vasodilation
Sacubitril/valsartan (Entresto)
Often given in place of an ACEI or ARB-NOT together
Antiplatelet Med Contraindications correct answer Patients with active bleeding
Use lowest effective dose and notify providers before starting PPI
