Which of the following microorganisms are most frequently associated
with acute bacterial rhino-sinusitis? Correct Answer.-Streptococcus
pneumoniae and Haemophilus influenzae
A 38-year-old patient who is Vietnamese tells the family nurse
practitioner that their parent died in their 40s from liver cancer. The
nurse practitioner assesses that the patient is at risk for: Correct Answer.-
hepatitis B.
Effective long-term treatment of systolic heart failure with reduced
ejection fraction should include which of the following? Correct Answer.-
Prescribing valsartan/sacubitril (Entresto) unless contraindicated on
discharge
*Angiotensin Receptor and Neprilysin Inhibition is considered goal-
directed therapy for patients with reduced systolic heart function
Which of the following medications is not considered part of optimal
medical therapy for a 54 year-old male patient with a diagnosis of heart
failure with reduced ejection fraction (HFrEF) with an EF of 30%,
known coronary artery disease, and normal renal function? Correct
Answer.-Diltiazem (cardizem)
*Cardizem is not indicated for patients with heart failure it decreases
myocardial contractility, fluid retention, and lower cardiac output.
,Appropriate for patient with HFrEF, CAD, and normal renal function are
spironolactone (aldactone), Carvedilol (Coreg). and Aspirin
A 55 year-old female patient with no previous cardiac history and no
family history of hyperlipidemia with an acute myocardial infarction is
treated successfully with a drug-eluting stent during a recent
hospitalization. As their long-term care provider, you anticipate they
were most likely to be also started on which of the following lipid-
lowering agents at discharge? Correct Answer.-Patients with drug-eluting
stents should take a lipid-lowering agent at discharge.
**The high intensity statin therapy is first line.
PCSK9 therapy is indicated if familial history of HLD or cardiac disease
with failed statin therapy
Your patient with a diagnosis of peripheral arterial disease asks you
what is considered a non-modifiable risk factor. Which of the following
represent the best answer for his question? Correct Answer.-A non
modifiable risk factor of peripheral artery disease is family history of
peripheral artery disease
Modifiable risk factors of peripheral artery disease are smoking, DM
control, and medication compliance
, What is the chamber which directly pumps blood into the ascending
aorta? Correct Answer.-The left ventricle pumps directly into the
ascending aorta
A patient has been complaining of palpitations for the past week and
presents to you at an urgent care clinic for evaluation. You perform a 12
lead EKG and identify atrial fibrillation with a heart rate of 122 beats per
minute. What is your next order? Correct Answer.-Order a stat
echocardiogram (identify a clot burden) and prepare for patient to be
transported to nearest hospital
Your patient with a history of two coronary stents and a LDL of 190 has
been started on lipid-lowering statin therapy on three separate attempts
with considerable side effects such as leg pain and in one event,
hospitalization for rhabdomyolysis. Which is the best option moving
forward to manage their lipids? Correct Answer.-PCSK9 Inhibitors.
*History of statin-induced rhabdomyolosis is a contraindication to
reattempt statin therapy.
An older adult with diabetes mellitus presents with leg cramps. She
states that the cramps as worst when walking to the supermarket. If she
stops to rest, the pain subsides. The nurse practitioner knows that this
patient needs a workup for: Correct Answer.-intermittent claudication
Preventive cardiac care should focus primarily on addressing all the
following except? Correct Answer.-Smoking cessation, exercise, and