NR 508 Week 4 Midterm Exam
NR 508: ADVANCED PHARMACOLOGY
,NR 508 Week 4 Midterm Exam
NR 508-Pharmacology Mid-term
Question 1
pts
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:
a β-blocker.
an angiotensin-converting enzyme inhibitor.
Correct!
a thiazide diuretic.
dietary and lifestyle changes.
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 2
pts
,An African-American patient is taking captopril (Capoten) 25 mg twice daily. When performing a physical
examination, the primary care nurse practitioner (NP) learns that the patient continues to have blood
pressure readings of 135/90 mm Hg. The NP should:
increase the captopril dose to 50 mg twice daily.
Correct!
add a thiazide diuretic to this patient’s regimen.
change the drug to losartan (Cozaar) 50 mg once daily.
recommend a low-sodium diet in addition to the medication.
Some African-American patients do not appear to respond as well as whites in terms of blood pressure
reduction. The addition of a low-dose thiazide diuretic often allows for efficacy in blood pressure
lowering that is comparable with that seen in white patients. Increasing the captopril dose is not
indicated. Losartan is an angiotensin receptor blocker (ARB) and is not indicated in this case.
Question 3
pts
A 50-year-old woman reports severe, frequent hot flashes and vaginal dryness. She is having irregular
periods. She has no family history of CHD or breast cancer and has no personal risk factors. The primary
care NP should recommend:
estrogen-only HT.
Correct!
, low-dose oral contraceptive therapy.
selective serotonin reuptake inhibitor therapy until menopause begins.
estrogen-progesterone HT.
Oral contraceptive pills are not approved by the U.S. Food and Drug Administration for management of
perimenopausal symptoms except to treat irregular menstrual bleeding. This patient has a low risk for
CHD and breast cancer, so oral contraceptive pills are relatively safe. She is also at risk for pregnancy, so
oral contraceptive pills can help to prevent that.
Question 4
pts
The primary care NP is prescribing a medication for an off-label use. To help prevent a medication error,
the NP should:
Correct!
write “off-label use” on the prescription and provide a rationale.
call the pharmacist to explain why the instructions deviate from common use.
write the alternative drug regimen on the prescription and send it to the pharmacy.
tell the patient to ignore the label directions and follow the verbal instructions given in the clinic.
NR 508: ADVANCED PHARMACOLOGY
,NR 508 Week 4 Midterm Exam
NR 508-Pharmacology Mid-term
Question 1
pts
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:
a β-blocker.
an angiotensin-converting enzyme inhibitor.
Correct!
a thiazide diuretic.
dietary and lifestyle changes.
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 2
pts
,An African-American patient is taking captopril (Capoten) 25 mg twice daily. When performing a physical
examination, the primary care nurse practitioner (NP) learns that the patient continues to have blood
pressure readings of 135/90 mm Hg. The NP should:
increase the captopril dose to 50 mg twice daily.
Correct!
add a thiazide diuretic to this patient’s regimen.
change the drug to losartan (Cozaar) 50 mg once daily.
recommend a low-sodium diet in addition to the medication.
Some African-American patients do not appear to respond as well as whites in terms of blood pressure
reduction. The addition of a low-dose thiazide diuretic often allows for efficacy in blood pressure
lowering that is comparable with that seen in white patients. Increasing the captopril dose is not
indicated. Losartan is an angiotensin receptor blocker (ARB) and is not indicated in this case.
Question 3
pts
A 50-year-old woman reports severe, frequent hot flashes and vaginal dryness. She is having irregular
periods. She has no family history of CHD or breast cancer and has no personal risk factors. The primary
care NP should recommend:
estrogen-only HT.
Correct!
, low-dose oral contraceptive therapy.
selective serotonin reuptake inhibitor therapy until menopause begins.
estrogen-progesterone HT.
Oral contraceptive pills are not approved by the U.S. Food and Drug Administration for management of
perimenopausal symptoms except to treat irregular menstrual bleeding. This patient has a low risk for
CHD and breast cancer, so oral contraceptive pills are relatively safe. She is also at risk for pregnancy, so
oral contraceptive pills can help to prevent that.
Question 4
pts
The primary care NP is prescribing a medication for an off-label use. To help prevent a medication error,
the NP should:
Correct!
write “off-label use” on the prescription and provide a rationale.
call the pharmacist to explain why the instructions deviate from common use.
write the alternative drug regimen on the prescription and send it to the pharmacy.
tell the patient to ignore the label directions and follow the verbal instructions given in the clinic.
