1
,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
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
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.
When signs of thyrotoxicosis occur, the drug should be decreased or temporarily
discontinued for 5 to 7 days. Liothyronine is not indicated. Propylthiouracil is not
indicated.
Question 5
An African-American patient who is obese has persistent blood pressure readings
greater than 150/95 mm Hg despite treatment with a thiazide diuretic. The primary care
NP should consider prescribing a(n):
ACE inhibitor.
angiotensin receptor blocker.
β-blocker.
Correct!
calcium channel blocker.
African-American patients are considered good candidates for calcium channel blockers
to treat hypertension. Treatment with calcium channel blockers as monotherapy in
African-American patients has proved to be more effective than some other classes of
antihypertensive agents.
Question 6
A patient who has stable angina is taking nitroglycerin and a β-blocker. The patient tells
the primary care NP that the cardiologist is considering adding a calcium channel
blocker. The NP should anticipate that the cardiologist will prescribe:
Correct!
verapamil HCl (Calan).
nifedipine (Procardia XL).
,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
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
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.
When signs of thyrotoxicosis occur, the drug should be decreased or temporarily
discontinued for 5 to 7 days. Liothyronine is not indicated. Propylthiouracil is not
indicated.
Question 5
An African-American patient who is obese has persistent blood pressure readings
greater than 150/95 mm Hg despite treatment with a thiazide diuretic. The primary care
NP should consider prescribing a(n):
ACE inhibitor.
angiotensin receptor blocker.
β-blocker.
Correct!
calcium channel blocker.
African-American patients are considered good candidates for calcium channel blockers
to treat hypertension. Treatment with calcium channel blockers as monotherapy in
African-American patients has proved to be more effective than some other classes of
antihypertensive agents.
Question 6
A patient who has stable angina is taking nitroglycerin and a β-blocker. The patient tells
the primary care NP that the cardiologist is considering adding a calcium channel
blocker. The NP should anticipate that the cardiologist will prescribe:
Correct!
verapamil HCl (Calan).
nifedipine (Procardia XL).
