NR 508 Week 2 Quiz, Chamberlain College of
Nursing
Question 1.1. 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: (Points
: 2)
amlodipine (Norvasc).
isradipine (DynaCirc).
verapamil HCl (Calan).
short-acting nifedipine (Procardia).
verapamil HCl (Calan).
Verapamil and diltiazem are less likely to cause hypotension than
nifedipine and related drugs, such as isradipine and amlodipine.
Question 2.2. 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: (Points : 2)
dissolve atheromatous lesions.
relax vascular smooth muscle.
prevent catecholamine release.
reduce C-reactive protein levels.
relax vascular smooth muscle.
,Nitrates relax vascular smooth muscle via stimulation of intracellular
cyclic guanosine monophosphate production with the major effect being
to reduce myocardial oxygen demand. Nitrates do not dissolve
atheromatous lesions, prevent catecholamine release, or reduce C-
reactive protein levels.
Question 3.3. A patient with Graves’ disease is taking methimazole.
After 6 months of therapy, the primary care NP notes normal T3 and
T4 and elevated TSH. The NP should: (Points : 2)
order a complete blood count (CBC) with differential.
order aspartate aminotransferase, AGT, and LDH tests.
decrease the dose of the medication.
add levothyroxine to the patient’s regimen.
c. decrease the dose of methimazole
Question 4.4. The primary care nurse practitioner (NP) sees a patient in
the clinic who has a blood pressure of 130/85 mm Hg. The patient’s
laboratory tests reveal high-density lipoprotein, 35 mg/dL; triglycerides,
120 mg/dL; and fasting plasma glucose, 100 mg/dL. The NP calculates
a body mass index of 29. The patient has a positive family history for
cardiovascular disease. The NP should: (Points : 2)
prescribe a thiazide diuretic.
consider treatment with an angiotensin-converting enzyme
inhibitor.
reassure the patient that these findings are normal.
counsel the patient about dietary and lifestyle changes.
,d. counsel the patient about dietary and lifestyle changes.
The patient's blood pressure indicates prehypertension, but the patient
does not have cardiovascular risk factors such as hyperlipidemia or
hyperinsulinemia. The body mass index indicates that the patient is
overweight but not obese. Pharmacologic treatment is not recommended
for prehypertension unless compelling reasons are present. The findings
are not normal, so it is appropriate to counsel the patient about diet and
exercise.
Question 5.5. A 45-year-old patient who has a positive family history
but no personal history of coronary artery disease is seen by the primary
care NP for a physical examination. The patient has a body mass index
of 27 and a blood pressure of 130/78 mm Hg. Laboratory tests reveal
low-density lipoprotein, 110 mg/dL; high-density lipoprotein, 70
mg/dL; and triglycerides, 120 mg/dL. The patient does not smoke but
has a sedentary lifestyle. The NP should recommend: (Points : 2)
30 minutes of aerobic exercise daily.
taking 81 to 325 mg of aspirin daily.
beginning therapy with a statin medication.
starting a thiazide diuretic to treat hypertension.
30 minutes of aerobic exercise daily.
This patient is overweight but not obese, and blood lipids are within
normal limits. Blood pressure is not elevated. Exercise is recommended
as an initial risk reduction strategy because of its positive effects on
blood pressure and blood lipids. Aspirin is generally given to patients
older than 55 to 65 who are at risk. Statin medications and thiazide
diuretics are not indicated.
Question 6.6. 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: (Points : 2)
a -blocker.
an angiotensin-converting enzyme inhibitor.
a thiazide diuretic.
dietary and lifestyle changes.
C. a thiazide diuretic.
The patient has stage I hypertension. Because there are no compelling
indications for other treatment, a thiazide diuretic should be used
initially to treat the hypertension. Dietary and lifestyle changes should
also be recommended but are not sufficient for patients with stage I
hypertension. Other drugs may be added later if thiazide diuretic therapy
fails
Question 7.7. An 80-year-old male patient will begin taking an -
antiadrenergic medication. The primary care NP should teach this
patient to: (Points : 2)
ask for assistance while bathing.
restrict fluids to aid with diuresis.
take the medication in the morning with food.
be aware that priapism is a common side effect.
a. ask for assistance while bathing.
All antihypertensives can cause orthostatic hypotension, so patients
should be cautioned to avoid sudden changes in position and to use
caution when bathing because a hot bath or shower may aggravate
dizziness. Older patients are at increased risk for falls and should be
cautioned to ask for assistance. Patients taking a-antiadrenergics
Nursing
Question 1.1. 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: (Points
: 2)
amlodipine (Norvasc).
isradipine (DynaCirc).
verapamil HCl (Calan).
short-acting nifedipine (Procardia).
verapamil HCl (Calan).
Verapamil and diltiazem are less likely to cause hypotension than
nifedipine and related drugs, such as isradipine and amlodipine.
Question 2.2. 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: (Points : 2)
dissolve atheromatous lesions.
relax vascular smooth muscle.
prevent catecholamine release.
reduce C-reactive protein levels.
relax vascular smooth muscle.
,Nitrates relax vascular smooth muscle via stimulation of intracellular
cyclic guanosine monophosphate production with the major effect being
to reduce myocardial oxygen demand. Nitrates do not dissolve
atheromatous lesions, prevent catecholamine release, or reduce C-
reactive protein levels.
Question 3.3. A patient with Graves’ disease is taking methimazole.
After 6 months of therapy, the primary care NP notes normal T3 and
T4 and elevated TSH. The NP should: (Points : 2)
order a complete blood count (CBC) with differential.
order aspartate aminotransferase, AGT, and LDH tests.
decrease the dose of the medication.
add levothyroxine to the patient’s regimen.
c. decrease the dose of methimazole
Question 4.4. The primary care nurse practitioner (NP) sees a patient in
the clinic who has a blood pressure of 130/85 mm Hg. The patient’s
laboratory tests reveal high-density lipoprotein, 35 mg/dL; triglycerides,
120 mg/dL; and fasting plasma glucose, 100 mg/dL. The NP calculates
a body mass index of 29. The patient has a positive family history for
cardiovascular disease. The NP should: (Points : 2)
prescribe a thiazide diuretic.
consider treatment with an angiotensin-converting enzyme
inhibitor.
reassure the patient that these findings are normal.
counsel the patient about dietary and lifestyle changes.
,d. counsel the patient about dietary and lifestyle changes.
The patient's blood pressure indicates prehypertension, but the patient
does not have cardiovascular risk factors such as hyperlipidemia or
hyperinsulinemia. The body mass index indicates that the patient is
overweight but not obese. Pharmacologic treatment is not recommended
for prehypertension unless compelling reasons are present. The findings
are not normal, so it is appropriate to counsel the patient about diet and
exercise.
Question 5.5. A 45-year-old patient who has a positive family history
but no personal history of coronary artery disease is seen by the primary
care NP for a physical examination. The patient has a body mass index
of 27 and a blood pressure of 130/78 mm Hg. Laboratory tests reveal
low-density lipoprotein, 110 mg/dL; high-density lipoprotein, 70
mg/dL; and triglycerides, 120 mg/dL. The patient does not smoke but
has a sedentary lifestyle. The NP should recommend: (Points : 2)
30 minutes of aerobic exercise daily.
taking 81 to 325 mg of aspirin daily.
beginning therapy with a statin medication.
starting a thiazide diuretic to treat hypertension.
30 minutes of aerobic exercise daily.
This patient is overweight but not obese, and blood lipids are within
normal limits. Blood pressure is not elevated. Exercise is recommended
as an initial risk reduction strategy because of its positive effects on
blood pressure and blood lipids. Aspirin is generally given to patients
older than 55 to 65 who are at risk. Statin medications and thiazide
diuretics are not indicated.
Question 6.6. 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: (Points : 2)
a -blocker.
an angiotensin-converting enzyme inhibitor.
a thiazide diuretic.
dietary and lifestyle changes.
C. a thiazide diuretic.
The patient has stage I hypertension. Because there are no compelling
indications for other treatment, a thiazide diuretic should be used
initially to treat the hypertension. Dietary and lifestyle changes should
also be recommended but are not sufficient for patients with stage I
hypertension. Other drugs may be added later if thiazide diuretic therapy
fails
Question 7.7. An 80-year-old male patient will begin taking an -
antiadrenergic medication. The primary care NP should teach this
patient to: (Points : 2)
ask for assistance while bathing.
restrict fluids to aid with diuresis.
take the medication in the morning with food.
be aware that priapism is a common side effect.
a. ask for assistance while bathing.
All antihypertensives can cause orthostatic hypotension, so patients
should be cautioned to avoid sudden changes in position and to use
caution when bathing because a hot bath or shower may aggravate
dizziness. Older patients are at increased risk for falls and should be
cautioned to ask for assistance. Patients taking a-antiadrenergics
