NURS 508 WEEK 3 EXAM QUESTIONS WITH CORRECT
ANSWERS GRADED A+ SUCCESS ASSUARED
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, 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:
NURS 508 WEEK 3 EXAM QUESTIONS WITH CORRECT
ANSWERS GRADED A+ SUCCESS ASSUARED
,NURS 508 WEEK 3 EXAM QUESTIONS WITH CORRECT
ANSWERS GRADED A+ SUCCESS ASSUARED
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.
discuss quality-of-life issues as part of the decision to begin medication.
NURS 508 WEEK 3 EXAM QUESTIONS WITH CORRECT
ANSWERS GRADED A+ SUCCESS ASSUARED
, NURS 508 WEEK 3 EXAM QUESTIONS WITH CORRECT
ANSWERS GRADED A+ SUCCESS ASSUARED
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).
Testing for type 2 diabetes should be considered in all adults with a BMI greater than 25 who
have risk factors such as HDL less than 35 mg/dL or triglycerides greater than 250 mg/dL. A
fasting plasma glucose level greater than 126 mg/dL indicates diabetes. Metformin is not
indicated unless testing is positive. Lifestyle changes may be part of the treatment plan. Serum
insulin level is not indicated.
Question 5
pts
A child who has congenital hypothyroidism takes levothyroxine 75 mcg/day. The child weighs
15 kg. The primary care NP sees the child for a 3-year-old check-up. The NP should consult
NURS 508 WEEK 3 EXAM QUESTIONS WITH CORRECT
ANSWERS GRADED A+ SUCCESS ASSUARED
ANSWERS GRADED A+ SUCCESS ASSUARED
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, 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:
NURS 508 WEEK 3 EXAM QUESTIONS WITH CORRECT
ANSWERS GRADED A+ SUCCESS ASSUARED
,NURS 508 WEEK 3 EXAM QUESTIONS WITH CORRECT
ANSWERS GRADED A+ SUCCESS ASSUARED
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.
discuss quality-of-life issues as part of the decision to begin medication.
NURS 508 WEEK 3 EXAM QUESTIONS WITH CORRECT
ANSWERS GRADED A+ SUCCESS ASSUARED
, NURS 508 WEEK 3 EXAM QUESTIONS WITH CORRECT
ANSWERS GRADED A+ SUCCESS ASSUARED
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).
Testing for type 2 diabetes should be considered in all adults with a BMI greater than 25 who
have risk factors such as HDL less than 35 mg/dL or triglycerides greater than 250 mg/dL. A
fasting plasma glucose level greater than 126 mg/dL indicates diabetes. Metformin is not
indicated unless testing is positive. Lifestyle changes may be part of the treatment plan. Serum
insulin level is not indicated.
Question 5
pts
A child who has congenital hypothyroidism takes levothyroxine 75 mcg/day. The child weighs
15 kg. The primary care NP sees the child for a 3-year-old check-up. The NP should consult
NURS 508 WEEK 3 EXAM QUESTIONS WITH CORRECT
ANSWERS GRADED A+ SUCCESS ASSUARED
