NR 508 EXAM QUESTIONS AND
ANSWERS
Preferred oral agent for DM type 2 - ANSWER>>metformin
Vitamin deficiency associated with metformin - ANSWER>>B12
Adverse effect of oral diabetes meds - ANSWER>>n/v/d, flatulence, myalgia, HA. Some cause
weight gain. Lactic acidosis (metformin)
Risk with SGLT2 inhibitors - ANSWER>>amputations, acidosis, yeast/mycotic infections, renal
injury, hyperkalemia
Preferred antihypertensive for African American - ANSWER>>CCB and ARB
Preferred antihypertensive with chronic kidney disease - ANSWER>>ACE/ARB
Use and side effect of acetazolamide - ANSWER>>Treatment of open angle glaucoma and acute
mountain sickness. Side effect - can cause metabolic acidosis.
use and side effect of eplerenone - ANSWER>>Aldosterone agonist. For treatment of moderate
to severe HF with reduced EF. Can cause hyperkalemia. Monitor renal function.
use and side effect of spironolactone - ANSWER>>Add to ACE and loop in treatment of severe
CHF. Side effect - hypokalemia (dose dependent)
use and side effect of triamterene - ANSWER>>Weak diuretic. Also interferes with bicarbonate
reabsorption and causes bicarb loss in urine. Used in treatment of severe metabolic alkalosis.
Excessive loss can cause metabolic acidosis.
Therapeutic use of mannitol - ANSWER>>Osmotic diuretic. Reduce intracranial pressure or
intraocular pressure in glaucoma
therapeutic use of acetazolamide - ANSWER>>treatment of open angle glaucoma and acute
mountain sickness
,MOA of eplerenone - ANSWER>>Competitively inhibit aldosterone receptor. Useful in tx of
cirrhosis, ascites and advance HF
Diuretic to use in chronic calcium stones - ANSWER>>Thiazide
Most effective diuretic for HTN, CHF and renal failure - ANSWER>>loop diuretics
Which diuretic is a mineralcorticoid agonist - ANSWER>>spironolactone
Carbonic anhydrase inhibitor used to treat altitude sickness - ANSWER>>acetazolamide
Fendoldopam MOA and use - ANSWER>>Rapid acting arteriolar vasodilator. Dopamine 1
receptor agonist. Used for treatment of malignant hypertension.
Adverse effect of hydralazine - ANSWER>>lupus like syndrome. Palps, n/v/d, HA, constipation
(common). Tachy, paresthesias, paralytic ileus, blood dyscrasia, abn LFT, myalgia (serious).
BB with alpha blocking an non-selective BB action - ANSWER>>labetolol and carvedilol
MOA of alpha methyldopa - ANSWER>>stimulate central inhibitory alpha adrenergic receptors.
Inhibit sympathetic cardioaccelerator and vasoconstrictor centers. Results in reduced
sympathetic outflow from CNS causing decreased peripheral resistance, renal vascular
resistance HR and BP.
Vasodilating antihypertensive that promotes hair growth - ANSWER>>monoxidil
Prazosin MOA, contraindications and adverse effect - ANSWER>>1st dose syncope and
hyoptension
MOA of esmolol (brevibloc) - ANSWER>>Beta blocker. Indication: intraoperative hypertension
and arrhythmia.
Alternate med for ACEI cough - ANSWER>>ARB
which CCB slows heart conduction - ANSWER>>diltiazem and verapamil
MOA and indication for nifedipine - ANSWER>>CCB. Block inward flow of calcium. Decreased
force of contraction (negative inotrope), decreased CO. Effect on vascular smooth muscle >
, efect on cardiac conduction. Indication: HTN, angina, raynauds. DO NOT use immediately after
MI or in acute coronary syndrome.
How to avoid nitrate tolerance if using NTG patch - ANSWER>>remove patch in PM. Scheduled
off time
MOA of NTG - ANSWER>>Relax smooth muscle by stimulation of intracellular cyclic guanosine
monophosphate production. Reduce myocardial O2 demand, decrease preload, small decrease
in afterload.
MOA of ezetimibe - ANSWER>>Selective cholesterol absorption inhibitor. Act on brush border
of intestinal epithelial cells where it selectively inhibits absorption of cholesterol from dietary
and biliary sources. Does not affect absorption of fat soluble vitamins.
MOA of fenofibrate - ANSWER>>Prodrug that is converted to fenofibric acid which inhibits
triglyceride synthesis and accelerates removal of lipoproteins.
Side effect of niacin - ANSWER>>Flushing
Both men and women experience bone loss with aging. The bones most likely to demonstrate
significant loss are:
1. Cortical bones
2. Femoral neck bones
3. Cervical vertebrae
4. Pelvic bones - ANSWER>>2. Femoral neck bones
Bisphosphonates treat or prevent osteoporosis by:
1. Inhibiting osteoclastic activity
2. Fostering bone resorption
3. Enhancing calcium uptake in the bone
4. Strengthening the osteoclastic proton pump - ANSWER>>1. Inhibiting osteoclastic activity
Prophylactic use of bisphosphonates is recommended for patients with early osteopenia
related to long-term use of which of the following drugs?
1. Selective estrogen receptor modulators
2. Aspirin
3. Glucocorticoids
4. Calcium supplements - ANSWER>>3. Glucocorticoids
ANSWERS
Preferred oral agent for DM type 2 - ANSWER>>metformin
Vitamin deficiency associated with metformin - ANSWER>>B12
Adverse effect of oral diabetes meds - ANSWER>>n/v/d, flatulence, myalgia, HA. Some cause
weight gain. Lactic acidosis (metformin)
Risk with SGLT2 inhibitors - ANSWER>>amputations, acidosis, yeast/mycotic infections, renal
injury, hyperkalemia
Preferred antihypertensive for African American - ANSWER>>CCB and ARB
Preferred antihypertensive with chronic kidney disease - ANSWER>>ACE/ARB
Use and side effect of acetazolamide - ANSWER>>Treatment of open angle glaucoma and acute
mountain sickness. Side effect - can cause metabolic acidosis.
use and side effect of eplerenone - ANSWER>>Aldosterone agonist. For treatment of moderate
to severe HF with reduced EF. Can cause hyperkalemia. Monitor renal function.
use and side effect of spironolactone - ANSWER>>Add to ACE and loop in treatment of severe
CHF. Side effect - hypokalemia (dose dependent)
use and side effect of triamterene - ANSWER>>Weak diuretic. Also interferes with bicarbonate
reabsorption and causes bicarb loss in urine. Used in treatment of severe metabolic alkalosis.
Excessive loss can cause metabolic acidosis.
Therapeutic use of mannitol - ANSWER>>Osmotic diuretic. Reduce intracranial pressure or
intraocular pressure in glaucoma
therapeutic use of acetazolamide - ANSWER>>treatment of open angle glaucoma and acute
mountain sickness
,MOA of eplerenone - ANSWER>>Competitively inhibit aldosterone receptor. Useful in tx of
cirrhosis, ascites and advance HF
Diuretic to use in chronic calcium stones - ANSWER>>Thiazide
Most effective diuretic for HTN, CHF and renal failure - ANSWER>>loop diuretics
Which diuretic is a mineralcorticoid agonist - ANSWER>>spironolactone
Carbonic anhydrase inhibitor used to treat altitude sickness - ANSWER>>acetazolamide
Fendoldopam MOA and use - ANSWER>>Rapid acting arteriolar vasodilator. Dopamine 1
receptor agonist. Used for treatment of malignant hypertension.
Adverse effect of hydralazine - ANSWER>>lupus like syndrome. Palps, n/v/d, HA, constipation
(common). Tachy, paresthesias, paralytic ileus, blood dyscrasia, abn LFT, myalgia (serious).
BB with alpha blocking an non-selective BB action - ANSWER>>labetolol and carvedilol
MOA of alpha methyldopa - ANSWER>>stimulate central inhibitory alpha adrenergic receptors.
Inhibit sympathetic cardioaccelerator and vasoconstrictor centers. Results in reduced
sympathetic outflow from CNS causing decreased peripheral resistance, renal vascular
resistance HR and BP.
Vasodilating antihypertensive that promotes hair growth - ANSWER>>monoxidil
Prazosin MOA, contraindications and adverse effect - ANSWER>>1st dose syncope and
hyoptension
MOA of esmolol (brevibloc) - ANSWER>>Beta blocker. Indication: intraoperative hypertension
and arrhythmia.
Alternate med for ACEI cough - ANSWER>>ARB
which CCB slows heart conduction - ANSWER>>diltiazem and verapamil
MOA and indication for nifedipine - ANSWER>>CCB. Block inward flow of calcium. Decreased
force of contraction (negative inotrope), decreased CO. Effect on vascular smooth muscle >
, efect on cardiac conduction. Indication: HTN, angina, raynauds. DO NOT use immediately after
MI or in acute coronary syndrome.
How to avoid nitrate tolerance if using NTG patch - ANSWER>>remove patch in PM. Scheduled
off time
MOA of NTG - ANSWER>>Relax smooth muscle by stimulation of intracellular cyclic guanosine
monophosphate production. Reduce myocardial O2 demand, decrease preload, small decrease
in afterload.
MOA of ezetimibe - ANSWER>>Selective cholesterol absorption inhibitor. Act on brush border
of intestinal epithelial cells where it selectively inhibits absorption of cholesterol from dietary
and biliary sources. Does not affect absorption of fat soluble vitamins.
MOA of fenofibrate - ANSWER>>Prodrug that is converted to fenofibric acid which inhibits
triglyceride synthesis and accelerates removal of lipoproteins.
Side effect of niacin - ANSWER>>Flushing
Both men and women experience bone loss with aging. The bones most likely to demonstrate
significant loss are:
1. Cortical bones
2. Femoral neck bones
3. Cervical vertebrae
4. Pelvic bones - ANSWER>>2. Femoral neck bones
Bisphosphonates treat or prevent osteoporosis by:
1. Inhibiting osteoclastic activity
2. Fostering bone resorption
3. Enhancing calcium uptake in the bone
4. Strengthening the osteoclastic proton pump - ANSWER>>1. Inhibiting osteoclastic activity
Prophylactic use of bisphosphonates is recommended for patients with early osteopenia
related to long-term use of which of the following drugs?
1. Selective estrogen receptor modulators
2. Aspirin
3. Glucocorticoids
4. Calcium supplements - ANSWER>>3. Glucocorticoids
