NURS 508 WEEK 2 EXAM TEST QUESTIONS WITH CORRECT ANSWERS GRADED A+

NURS 508 WEEK 2 EXAM TEST QUESTIONS WITH CORRECT
ANSWERS GRADED A+

Question 1
pts
A patient who has angina uses 0.4 mg of sublingual nitroglycerin for
angina episodes. The patient brings a log of angina episodes to an annual
physical examination. The primary care NP notes that the patient has
experienced an increase in frequency of episodes in the past month but no
increase in duration or severity of pain. The NP should:


increase the nitroglycerin dose to 0.6 mg per dose.

Correct Answer


contact the patient’s cardiologist to discuss admission to the hospital.




discontinue the nitroglycerin and order ranolazine (Ranexa ER).




change from a sublingual to a transdermal patch nitroglycerin.

Unstable angina is a change in pattern or pain, such as an increase in
frequency, severity, or duration of pain and fewer precipitating factors.
Patients with unstable angina should be admitted to a coronary care
unit. The primary care NP should not change any medications without
consultation with the patient’s cardiologist.


Question 2
pts
A patient who has hyperlipidemia has been taking atorvastatin (Lipitor) 60
mg daily for 6 months. The patient’s initial lipid profile showed LDL of 180
mg/dL, HDL of 45 mg/dL,




NURS 508 WEEK 2 EXAM TEST QUESTIONS WITH CORRECT
ANSWERS GRADED A+

,NURS 508 WEEK 2 EXAM TEST QUESTIONS WITH CORRECT
ANSWERS GRADED A+
and triglycerides of 160 mg/dL. The primary care NP orders a lipid profile
today that shows LDL of 105 mg/dL, HDL of 50 mg/dL, and triglycerides of
120 mg/dL. The patient reports muscle pain and weakness. The NP should:




order liver function tests (LFTs).




add gemfibrozil (Lopid) to the patient’s medication regimen.

Correct Answer


order a creatine kinase-MM (CK-MM) level.




change atorvastatin to twice-daily dosing.

Hepatotoxicity and muscle toxicity are the two primary adverse effects
of greatest concern with statin use. Patients who report muscle
discomfort or weakness should have a CK-MM level drawn. LFTs are
indicated with signs of hepatotoxicity. It is not correct to change the
dosing schedule. Gemfibrozil is not indicated.


Question 3
pts
A 55-year-old woman has a history of myocardial infarction (MI). A lipid
profile reveals LDL of 130 mg/dL, HDL of 35 mg/dL, and triglycerides 150
mg/dL. The woman is sedentary with a body mass index of 26. The woman
asks the primary care NP about using a statin medication. The NP should:


tell her there is no clinical evidence of efficacy of statin medication in her case.
Correct Answer


begin therapy with atorvastatin 10 mg per day.
NURS 508 WEEK 2 EXAM TEST QUESTIONS WITH CORRECT
ANSWERS GRADED A+

, NURS 508 WEEK 2 EXAM TEST QUESTIONS WITH CORRECT
ANSWERS GRADED A+



discuss quality-of-life issues as part of the decision to begin medication.




recommend dietary and lifestyle changes first.

This woman would be using a statin medication for secondary prevention
because she already has a history of MI, so a statin should be prescribed.
Dietary and lifestyle changes should be a part of therapy, but not the only
therapy. She is relatively young, and quality-of-life issues are not a concern.
There is no clinical evidence to support use of statins as primary prevention
in women.


Question 4
pts
A 40-year-old patient is in the clinic for a routine physical examination. The
patient has a body mass index (BMI) of 26. The patient is active and walks a
dog daily. A lipid profile reveals low-density lipoprotein (LDL) of 100 mg/dL,
high-density lipoprotein (HDL) of 30 mg/dL, and triglycerides of 250 mg/dL.
The primary care nurse practitioner (NP) should:
Correct Answer


order a fasting plasma glucose level.




obtain serum insulin and hemoglobin A levels.
1c




suggest dietary changes and increased exercise.




consider prescribing metformin (Glucophage).
NURS 508 WEEK 2 EXAM TEST QUESTIONS WITH CORRECT
ANSWERS GRADED A+