NR 508: WEEK 4 TEST STUDY GUIDE WITH
ANS
I. A patient who has been taking digoxin 0.25 mg daily for 6
months reports that it is not working as well as it did initially. The
primary care NP should:
recommend a reduced potassium intake.
increase the dose of digoxin to
0.5 mg daily.
, hold the next dose of digoxin and obtain a serum digoxin level.
contact the patient’s pharmacy to ask if generic digoxin
was dispensed.
II. A patient is taking spironolactone and comes to the clinic
complaining of weakness and tingling of the hands and feet. The
primary care NP notes a heart rate of 62 beats per minute and a
blood pressure of 100/58 mm Hg. The NP should:
obtain a serum drug level.
order an electrocardiogram (ECG)
and serum electrolytes.
change the medication to a
thiazide diuretic.
question the patient about potassium intake.
III. 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:
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.
IV. 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).
add ezetimibe (Zetia) and lower the atorvastatin to
10 mg daily. recommend supplements of omega3
, along with the
atorvastatin.
V. The primary care NP is seeing a patient for a hospital follow-up
after the patient has had a first myocardial infarction. The
patient has a list of the prescribed medications and tells the NP
that “no one explained anything about them.” The NP’s initial
response should be to:
ask the patient to describe the medication regimen.
ask the patient to make a list of questions
about the medications.
determine what the patient understands about coronary
artery disease. give the patient information about drug
effects and any adverse
reactions.
VI. Osteopenia is diagnosed in a 55-year-old woman who has not
had a period in 15 months. She has a positive family history of
breast cancer. The primary care NP should recommend:
testosterone therapy.
estrogenonly therapy.
ANS
I. A patient who has been taking digoxin 0.25 mg daily for 6
months reports that it is not working as well as it did initially. The
primary care NP should:
recommend a reduced potassium intake.
increase the dose of digoxin to
0.5 mg daily.
, hold the next dose of digoxin and obtain a serum digoxin level.
contact the patient’s pharmacy to ask if generic digoxin
was dispensed.
II. A patient is taking spironolactone and comes to the clinic
complaining of weakness and tingling of the hands and feet. The
primary care NP notes a heart rate of 62 beats per minute and a
blood pressure of 100/58 mm Hg. The NP should:
obtain a serum drug level.
order an electrocardiogram (ECG)
and serum electrolytes.
change the medication to a
thiazide diuretic.
question the patient about potassium intake.
III. 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:
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.
IV. 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).
add ezetimibe (Zetia) and lower the atorvastatin to
10 mg daily. recommend supplements of omega3
, along with the
atorvastatin.
V. The primary care NP is seeing a patient for a hospital follow-up
after the patient has had a first myocardial infarction. The
patient has a list of the prescribed medications and tells the NP
that “no one explained anything about them.” The NP’s initial
response should be to:
ask the patient to describe the medication regimen.
ask the patient to make a list of questions
about the medications.
determine what the patient understands about coronary
artery disease. give the patient information about drug
effects and any adverse
reactions.
VI. Osteopenia is diagnosed in a 55-year-old woman who has not
had a period in 15 months. She has a positive family history of
breast cancer. The primary care NP should recommend:
testosterone therapy.
estrogenonly therapy.
