FNP REVIEW QUESTIONS WITH COMPLETE SOLUTIONS AND
VERIFIED CORRECT ANSWERS ALREADY PASSED 100%
GUARANTEED GRADED A+
According to the National Heart, Lung and Blood Institute, which
characteristic listed below is a coronary heart disease (CHD) risk
equivalent; that is, which risk factor places the patient at similar
risk for CHD as a history of CHD?
a. Hypertension
b. Cigarette smoking
c. Male age > 45 years
d. Diabetes mellitus
d. Diabetes mellitus
Rationale:
In determining whether a patient should be treated for hyperlipidemia, a
patient's risk factors must be determined. After assessing fasting lipids,
specifically LDLs, CHD equivalents must be identified. These are diabetes,
symptomatic carotid artery disease, peripheral artery disease, abnormal
aortic aneurysm, and multiple risk factors that confer a 10 year risk of CHD >
20%. Major CHD risk factors are elevated LDL cholesterol, cigarette smoking,
hypertension, low HDL cholesterol, family history of premature CHD [in male
first degree relatives (FDR) < 55years; female FDR, 65 years] , and age (men
≥ 45 years, women ≥ 55 years). Patients with 2 or more risk factors should
have a 10 risk assessment performed and treated accordingly.
,A patient will be screened for hyperlipidemia via a serum specimen.
He should be told:
a. to fast for 12 to 14 hours
b. to fast for 6 to 8 hours
c. that black coffee is allowed
d. a non-fasting state will not affect the results
a. to fast for 12 to 14 hours
Rationale:
Serum total and HDL cholesterol can be measured in fasting or non-fasting
individuals. There are very small and clinically insignificant differences in
these values when fasting or not. The primary effect of eating on a patient's
lipid values is on the triglyceride levels. The maximum effect of eating on
triglyceride levels occurs at 3 to 4 hours after eating, but there may be
several peaks during a 12-hour period. Therefore, the most accurate
triglyceride levels will be obtained following a 12-hour fast.
A 65-year-old male patient has the following lipid levels:
Total cholesterol = 240 mg/dL
LDL = 140 mg/dL
HDL = 35 mg/dL
Triglycerides = 129 mg/dL
What class of medications is preferred to normalize his lipid levels
and reduce his risk of a cardiac event?
a. Niacin
b. Fibric acids
c. HMG Co-A reductase inhibitors
d. Bile acid sequestrants
c. HMG Co-A reductase inhibitors
, Rationale:
The only medication class that reduces elevated lipid levels and has proven
efficacy in reducing risk of cardiac events, even for primary prevention, is a
HMG Co-A reductase inhibitor, a statin. Statin therapy has been shown to
reduce overall mortality due to cardiovascular deaths. The statin should
significantly reduce his total cholesterol and LDL levels.
Which test listed below may be used to exclude a secondary cause
of hyperlipidemia in a patient with elevated lipids?
a. CBC
b. TSH
c. Urine culture and sensitivity
d. Sedimentation rate
b. TSH
Rationale:
Patients who have dyslipidemia should be screened for diabetes, renal
disease, and hypothyroidism. Nephrotic syndrome can produce remarkably
elevated cholesterol levels. Therefore, measurements of glucose, creatinine,
and thyroid stimulating hormone should be performed when elevating
dyslipidemia. Sedimentation rate is a measurement of non-specific
inflammation and so it is not helpful in this situation. Specifically,
hypothyroidism can produce marked lipid abnormalities.
In order to reduce lipid levels, statins are most beneficial when
taken:
a. once daily in the AM
b. always with food
c. with an aspirin in the evening
d. in conjunction with diet and exercise
d. in conjunction with diet and exercise
Rationale:
VERIFIED CORRECT ANSWERS ALREADY PASSED 100%
GUARANTEED GRADED A+
According to the National Heart, Lung and Blood Institute, which
characteristic listed below is a coronary heart disease (CHD) risk
equivalent; that is, which risk factor places the patient at similar
risk for CHD as a history of CHD?
a. Hypertension
b. Cigarette smoking
c. Male age > 45 years
d. Diabetes mellitus
d. Diabetes mellitus
Rationale:
In determining whether a patient should be treated for hyperlipidemia, a
patient's risk factors must be determined. After assessing fasting lipids,
specifically LDLs, CHD equivalents must be identified. These are diabetes,
symptomatic carotid artery disease, peripheral artery disease, abnormal
aortic aneurysm, and multiple risk factors that confer a 10 year risk of CHD >
20%. Major CHD risk factors are elevated LDL cholesterol, cigarette smoking,
hypertension, low HDL cholesterol, family history of premature CHD [in male
first degree relatives (FDR) < 55years; female FDR, 65 years] , and age (men
≥ 45 years, women ≥ 55 years). Patients with 2 or more risk factors should
have a 10 risk assessment performed and treated accordingly.
,A patient will be screened for hyperlipidemia via a serum specimen.
He should be told:
a. to fast for 12 to 14 hours
b. to fast for 6 to 8 hours
c. that black coffee is allowed
d. a non-fasting state will not affect the results
a. to fast for 12 to 14 hours
Rationale:
Serum total and HDL cholesterol can be measured in fasting or non-fasting
individuals. There are very small and clinically insignificant differences in
these values when fasting or not. The primary effect of eating on a patient's
lipid values is on the triglyceride levels. The maximum effect of eating on
triglyceride levels occurs at 3 to 4 hours after eating, but there may be
several peaks during a 12-hour period. Therefore, the most accurate
triglyceride levels will be obtained following a 12-hour fast.
A 65-year-old male patient has the following lipid levels:
Total cholesterol = 240 mg/dL
LDL = 140 mg/dL
HDL = 35 mg/dL
Triglycerides = 129 mg/dL
What class of medications is preferred to normalize his lipid levels
and reduce his risk of a cardiac event?
a. Niacin
b. Fibric acids
c. HMG Co-A reductase inhibitors
d. Bile acid sequestrants
c. HMG Co-A reductase inhibitors
, Rationale:
The only medication class that reduces elevated lipid levels and has proven
efficacy in reducing risk of cardiac events, even for primary prevention, is a
HMG Co-A reductase inhibitor, a statin. Statin therapy has been shown to
reduce overall mortality due to cardiovascular deaths. The statin should
significantly reduce his total cholesterol and LDL levels.
Which test listed below may be used to exclude a secondary cause
of hyperlipidemia in a patient with elevated lipids?
a. CBC
b. TSH
c. Urine culture and sensitivity
d. Sedimentation rate
b. TSH
Rationale:
Patients who have dyslipidemia should be screened for diabetes, renal
disease, and hypothyroidism. Nephrotic syndrome can produce remarkably
elevated cholesterol levels. Therefore, measurements of glucose, creatinine,
and thyroid stimulating hormone should be performed when elevating
dyslipidemia. Sedimentation rate is a measurement of non-specific
inflammation and so it is not helpful in this situation. Specifically,
hypothyroidism can produce marked lipid abnormalities.
In order to reduce lipid levels, statins are most beneficial when
taken:
a. once daily in the AM
b. always with food
c. with an aspirin in the evening
d. in conjunction with diet and exercise
d. in conjunction with diet and exercise
Rationale:
