NR 508 Week 2 Quiz, Chamberlain College of
Nursing
Question 1
pts
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).
recommend supplements of omega-3 along with the atorvastatin.
Correct!
add ezetimibe (Zetia) and lower the atorvastatin to 10 mg daily.
When used in combination with a low-dose statin, ezetimibe has been
noted to produce an additional 18% reduction in LDL. Because this
patient continues to have elevated LDL along with side effects of the
statin, the NP should resume the lower dose of the statin and add
ezetimibe. Atorvastatin is given once daily. Cholestyramine and omega-
3 supplements are not indicated.
Question 2
pts
,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:
lifestyle modifications.
a calcium-channel blocker.
a thiazide diuretic.
Correct!
an angiotensin-converting enzyme inhibitor.
This patient has prehypertension but has a compelling reason for
treatment. Patients who have had a myocardial infarction should be
treated with a β-blocker and angiotensin-converting enzyme inhibitor or
angiotensin II receptor blocker (ARB).
Question 3
pts
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 a lipid profile, complete blood count, and liver function tests
(LFTs).
, order an oral glucose tolerance test.
order metformin (Glucophage).
Correct!
set a weight loss goal of 10 to 15 lb.
To prevent or delay onset of diabetes, patients with impaired glucose
should be advised to lose 5% to 10% of body weight. Metformin should
be considered in patients with high risk of developing diabetes. This
woman does not have risk factors. Other tests are not indicated.
Question 4
pts
A patient has been taking levothyroxine 100 mcg daily for several
months. The patient comes to the clinic with complaints of insomnia and
irritability. The primary care NP notes a heart rate of 92 beats per
minute. The NP should:
Correct!
order TSH and T4 levels and decrease the dose to 75 mcg/day.
discontinue levothyroxine indefinitely.
change to liothyronine 75 mcg/day.
order propylthiouracil to counter the increased thyroid levels.
Nursing
Question 1
pts
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).
recommend supplements of omega-3 along with the atorvastatin.
Correct!
add ezetimibe (Zetia) and lower the atorvastatin to 10 mg daily.
When used in combination with a low-dose statin, ezetimibe has been
noted to produce an additional 18% reduction in LDL. Because this
patient continues to have elevated LDL along with side effects of the
statin, the NP should resume the lower dose of the statin and add
ezetimibe. Atorvastatin is given once daily. Cholestyramine and omega-
3 supplements are not indicated.
Question 2
pts
,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:
lifestyle modifications.
a calcium-channel blocker.
a thiazide diuretic.
Correct!
an angiotensin-converting enzyme inhibitor.
This patient has prehypertension but has a compelling reason for
treatment. Patients who have had a myocardial infarction should be
treated with a β-blocker and angiotensin-converting enzyme inhibitor or
angiotensin II receptor blocker (ARB).
Question 3
pts
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 a lipid profile, complete blood count, and liver function tests
(LFTs).
, order an oral glucose tolerance test.
order metformin (Glucophage).
Correct!
set a weight loss goal of 10 to 15 lb.
To prevent or delay onset of diabetes, patients with impaired glucose
should be advised to lose 5% to 10% of body weight. Metformin should
be considered in patients with high risk of developing diabetes. This
woman does not have risk factors. Other tests are not indicated.
Question 4
pts
A patient has been taking levothyroxine 100 mcg daily for several
months. The patient comes to the clinic with complaints of insomnia and
irritability. The primary care NP notes a heart rate of 92 beats per
minute. The NP should:
Correct!
order TSH and T4 levels and decrease the dose to 75 mcg/day.
discontinue levothyroxine indefinitely.
change to liothyronine 75 mcg/day.
order propylthiouracil to counter the increased thyroid levels.
