MSN 611 Quiz 2 Questions and answers latest
update
The primary care NP sees a 68 yer old male having difficulty initiating urine stream and urine
frequency. Pt has no significant past medical history and vitals at visit are as follows: BP 112/72, HR
70, Temp 98.7 F. Which of the following is most appropriate to treat the pts' current symptoms?
Tamsulosin
A patient who has been taking propranolol for 6 months reporting having nocturnal cough and SOB.
The primary care NP should:
tell the patient to stop taking the medication.
JW is a patient at your clinic started on several new medications during first clinic visit two months
ago. Pt reports feeling up and down emotionally for the past month with little interest in socializing.
Medical hx: xxxxxxx
Vitals today: xxxxxxxxx
Current medication list: simvastatin, clonidine 0.1 every 8 hours, hydrochlorothiazide, etc
pt has another appt in a month but is inquiring abot a med to help with mood at his visit. Which of the
following is the best intervention at this time?
decrease clonidine to 0.1 mg every 12 hours for 4 days then discontinue
A pt who will begin using nitroglycerin for angina asks the primary care NP how the medication works
to relieve the pain. The NP should tell the pt that nitroglycerin acts to:
relax vascular smooth muscle
A primary care NP prescribes nitroglycerin transdermal patch 0.4 mg/hour release, for a pt with
chronic stable angina describing sxs occurring mostly in the evening. The NP should teach the pt to:
apply patch at 8 pm and remove at 6 am daily
A pt who has heart failure has been treated with furosemide and an ACE inhibitor. The pts'
cardiologist has added digoxin to the pts' med regimen. The primary care NP who cares for this pt
should expect to monitor:
serum electrolytes
A pt is seen in a clinic and you question choice of beta blocker pt is receiving post MI. Pt is receiving
atenolol. Which of the following would support use of this beta blocker?
atenolol may prevent post MI arrhythmia
Which of the following would be recommended to lower a triglyceride value of 220mg/dL, assuming
all other lipid values are WNL?
gemfibrozil
A pt who is taking an ACE inhibitor sees the primary care NP for a follow-up visit. The pt reports
having a persistent cough. The NP should:
consider changing the med to an ARB
Which of the following meds is contraindicated n a pt with bilateral renal artery stenosis?
, ramipril
When attempting to slow the progression of nephropathy with proteinuria, which of the following
would the NP order?
Losartan
The NP is preparing to prescribe isosorbide dinitrate SR (Dilatrate SR) for a pt who has chronic, stable
angina. The NP should recommend initial dosing of"
40 mg twice daily at 8 am and 4 pm
If a pt develops angioedema with lisinopril, which of the following is an alternative for blood pressure
lowering?
metoprolol
A pt receiving warfarin has an INR today of 10.3. Pt denies unusual bleeding and physical exam reveals
no bruising or signs of bleeding. Which of the following should the NP order?
Vitamin K 5 mg orally x 1
A pt who has a hx of angina has sublingual nitroglycerin tablets to use as needed. The NP reviews this
med w the pt at the pts' annual physical exam. Which statement by the pt indicates understanding of
the med?
"I should call 911 if chest pain persists 5 min after the first dose."
Which of the following should be avoided in a patient post MI with EF=35%?
dilitiazem IR
Which of the following would indicate potential need for therapy adjustment in a pt with heart
failure?
weight gain of 5 lbs in 1 week
Which of the following serum levels should be targeted for a pt receiving digoxin for sxs associated
with heart failure?
0.8-1.2 ng/mL
A pt with heart failure managed at the family medicine clinic remains symptomatic with SOB, edema,
and lethargy despite appropriately dosed ACE inhibitor, beta blocker, diuretic, and digoxin therapy.
The NP should:
refer to cardiologist
A pt seen in clinic today has a hx of CAD and glaucoma. Lab results: LDL= 188 mg/dl, triglycerides= 175
mg/dl, and HDL= 38 mg/dl. All other lab results WNL. Next tx step is:
lifestyle change and atorvastatin 80 mg daily
The NP diagnoses hypothyroidism in a pt based on annual labwork. Pt has a hx of depression and
osteoarthritis. Other labs include: LDL=168 mg/dl, triglycerides= 132 and blood glucose=98. The NP
should:
update
The primary care NP sees a 68 yer old male having difficulty initiating urine stream and urine
frequency. Pt has no significant past medical history and vitals at visit are as follows: BP 112/72, HR
70, Temp 98.7 F. Which of the following is most appropriate to treat the pts' current symptoms?
Tamsulosin
A patient who has been taking propranolol for 6 months reporting having nocturnal cough and SOB.
The primary care NP should:
tell the patient to stop taking the medication.
JW is a patient at your clinic started on several new medications during first clinic visit two months
ago. Pt reports feeling up and down emotionally for the past month with little interest in socializing.
Medical hx: xxxxxxx
Vitals today: xxxxxxxxx
Current medication list: simvastatin, clonidine 0.1 every 8 hours, hydrochlorothiazide, etc
pt has another appt in a month but is inquiring abot a med to help with mood at his visit. Which of the
following is the best intervention at this time?
decrease clonidine to 0.1 mg every 12 hours for 4 days then discontinue
A pt who will begin using nitroglycerin for angina asks the primary care NP how the medication works
to relieve the pain. The NP should tell the pt that nitroglycerin acts to:
relax vascular smooth muscle
A primary care NP prescribes nitroglycerin transdermal patch 0.4 mg/hour release, for a pt with
chronic stable angina describing sxs occurring mostly in the evening. The NP should teach the pt to:
apply patch at 8 pm and remove at 6 am daily
A pt who has heart failure has been treated with furosemide and an ACE inhibitor. The pts'
cardiologist has added digoxin to the pts' med regimen. The primary care NP who cares for this pt
should expect to monitor:
serum electrolytes
A pt is seen in a clinic and you question choice of beta blocker pt is receiving post MI. Pt is receiving
atenolol. Which of the following would support use of this beta blocker?
atenolol may prevent post MI arrhythmia
Which of the following would be recommended to lower a triglyceride value of 220mg/dL, assuming
all other lipid values are WNL?
gemfibrozil
A pt who is taking an ACE inhibitor sees the primary care NP for a follow-up visit. The pt reports
having a persistent cough. The NP should:
consider changing the med to an ARB
Which of the following meds is contraindicated n a pt with bilateral renal artery stenosis?
, ramipril
When attempting to slow the progression of nephropathy with proteinuria, which of the following
would the NP order?
Losartan
The NP is preparing to prescribe isosorbide dinitrate SR (Dilatrate SR) for a pt who has chronic, stable
angina. The NP should recommend initial dosing of"
40 mg twice daily at 8 am and 4 pm
If a pt develops angioedema with lisinopril, which of the following is an alternative for blood pressure
lowering?
metoprolol
A pt receiving warfarin has an INR today of 10.3. Pt denies unusual bleeding and physical exam reveals
no bruising or signs of bleeding. Which of the following should the NP order?
Vitamin K 5 mg orally x 1
A pt who has a hx of angina has sublingual nitroglycerin tablets to use as needed. The NP reviews this
med w the pt at the pts' annual physical exam. Which statement by the pt indicates understanding of
the med?
"I should call 911 if chest pain persists 5 min after the first dose."
Which of the following should be avoided in a patient post MI with EF=35%?
dilitiazem IR
Which of the following would indicate potential need for therapy adjustment in a pt with heart
failure?
weight gain of 5 lbs in 1 week
Which of the following serum levels should be targeted for a pt receiving digoxin for sxs associated
with heart failure?
0.8-1.2 ng/mL
A pt with heart failure managed at the family medicine clinic remains symptomatic with SOB, edema,
and lethargy despite appropriately dosed ACE inhibitor, beta blocker, diuretic, and digoxin therapy.
The NP should:
refer to cardiologist
A pt seen in clinic today has a hx of CAD and glaucoma. Lab results: LDL= 188 mg/dl, triglycerides= 175
mg/dl, and HDL= 38 mg/dl. All other lab results WNL. Next tx step is:
lifestyle change and atorvastatin 80 mg daily
The NP diagnoses hypothyroidism in a pt based on annual labwork. Pt has a hx of depression and
osteoarthritis. Other labs include: LDL=168 mg/dl, triglycerides= 132 and blood glucose=98. The NP
should:
