Predictor Study Guide
A nurse practitioner places a 76-year-old patient on nifedipine (Procardia) 10 mg t.i.d. for angina. The
patient is unable to remember to take the medication at the scheduled times. The practitioner should:
*reinforce the importance of taking the medication.
*discuss the issue with the patient's daughter.
*increase the dosage to 20 mg b.i.d.
*change the dose to extended release 30 mg daily. - ANS: change the dose to extended release 30 mg
daily.
A patient is being followed for type 2 diabetes mellitus and hypertension. He also has a diagnosis of
polycythemia vera and has regular phlebotomies for management. Which of the following statements
about this patient is correct?
*The phlebotomies will increase his blood pressure
*The phlebotomies will improve his glycosylated hemoglobin levels
*He should increase dietary iron supplements
*He should avoid dietary iron supplements - ANS: He should avoid dietary iron supplements
A "code blue" is called on your patient in the waiting room of your urgent care. When you arrive, cardiac
monitoring is applied and their rhythm appears to be normal sinus rhythm with a rate of 80. On
palpation over the carotid artery, you do not feel a pulse. What is the name of this cardiac rhythm?
*Pulseless Electrical Activity (PEA)
*Idioventricular rhythm
*Wandering Atrial Pacemaker (WAP)
*Junctional Tachycardia - ANS: Pulseless Electrical Activity (PEA)
An older adult with diabetes mellitus presents with leg cramps. She states that the cramps were 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:
,*Benign nocturnal leg cramps
*Intermittent claudication
*Deep vein thrombosis
*Popliteal aneurism - ANS: Intermittent claudication
Your 53 year-old female patient is experiencing shortness of breath and has a diagnosis of pulmonary
arterial hypertension. Which ventricle is directly experiencing increased afterload from this disease
state?
*Both Right and Left Ventricles
*Left Ventricle
*Neither Left or Right Ventricles
*Right Ventricle - ANS: Right Ventricle
Which of the following medical exam requires the patient to be sedated?
*Transthoracic echocardiogram (TTE)
*Transesophageal echocardiogram (TEE)
*Nuclear stress test
*Tilt Table Test - ANS: Transesophageal echocardiogram (TEE)
Recommendation for lipid check in adolescent with type 1 DM?
* 1 year
*10 years
*5 years
*2 years - ANS: 1 year
A 45-year-old man presents with chest pain radiating to the left arm, diaphoresis, and shortness of
breath. His ECG shows ST-segment elevation. What is the initial management response?
,*Start intravenous heparin
*Administer aspirin and call for emergency medical services
*Administer nitroglycerin sublingually
*Perform immediate coronary angiography - ANS: Administer aspirin and call for emergency medical
services
The suggested International Normalized Ratio (INR) range in a patient being treated for atrial fibrillation
is:
*3.0-4.0
*1.0-2.0
*4.0-5.0
*2.0-3.0 - ANS: 2.0-3.0
Your patient presents with bradycardia, severe nausea, and substernal pain. STEMI was identified on the
EKG. Which region of the heart is most likely involved?
*Inferior Wall
*Anterior Wall
*Lateral Wall
*Septal Wall - ANS: Inferior Wall
Your patient has a diagnosis of Hashimoto's and is on Levothyroxine 75 mcg daily. Her recent TSH was
elevated at 15 uU/mL. Your next best action is to:
*Assess for symptoms and recheck TSH in 8 weeks
*Repeat anti-thyroperoxidase antibodies (anti-TPO)
*Increase Levothyroxine to 100 mcg daily
*Decrease Levothyroxine to 50 mcg daily - ANS: Increase Levothyroxine to 100 mcg daily
, A patient with diabetes mellitus who is taking insulin presents for a follow up. The patient's blood
glucose log reveals wide variations in readings, as well as numerous episodes of hyperglycemia and
hypoglycemia. Which is the nurse practitioner's best therapeutic intervention?
*Decrease the overall insulin dose
*Refer the patient for diet teaching
*Increase the overall insulin dose
*Instruct the patient to start daily exercise - ANS: Refer the patient for diet teaching
A patient presents for recheck of their thyroid-stimulating hormone (TSH). The patient was started on
levothyroxine (Synthroid) 50 mcg 8 weeks ago. Today the TSH is 10.5 μU/mL [normal = 0.4-2.5 μU/mL].
Based on this lab work, which is the most appropriate action?
*Decrease levothyroxine (Synthroid) to 25 mcg daily.
*Keep levothyroxine (Synthroid) at 50 mcg daily.
*Increase levothyroxine (Synthroid) to 75 mcg daily.
*Change to Armour Thyroid 50 mcg daily. - ANS: Increase levothyroxine (Synthroid) to 75 mcg daily.
A starting dose for a elderly adult patient with a BMI of 20 needing levothryoxine
*100 mcg
*25 mcg
*75 mcg
*125 mcg - ANS: 25 mcg
A patient has a 3 cm pituitary mass noted on CT. What is your next step in evaluating the patient?
*Repeat MRI in 3 months
*Refer to surgery
*Screen for hormone deficiencies
*Start Cabergoline - ANS: Screen for hormone deficiencies
A nurse practitioner places a 76-year-old patient on nifedipine (Procardia) 10 mg t.i.d. for angina. The
patient is unable to remember to take the medication at the scheduled times. The practitioner should:
*reinforce the importance of taking the medication.
*discuss the issue with the patient's daughter.
*increase the dosage to 20 mg b.i.d.
*change the dose to extended release 30 mg daily. - ANS: change the dose to extended release 30 mg
daily.
A patient is being followed for type 2 diabetes mellitus and hypertension. He also has a diagnosis of
polycythemia vera and has regular phlebotomies for management. Which of the following statements
about this patient is correct?
*The phlebotomies will increase his blood pressure
*The phlebotomies will improve his glycosylated hemoglobin levels
*He should increase dietary iron supplements
*He should avoid dietary iron supplements - ANS: He should avoid dietary iron supplements
A "code blue" is called on your patient in the waiting room of your urgent care. When you arrive, cardiac
monitoring is applied and their rhythm appears to be normal sinus rhythm with a rate of 80. On
palpation over the carotid artery, you do not feel a pulse. What is the name of this cardiac rhythm?
*Pulseless Electrical Activity (PEA)
*Idioventricular rhythm
*Wandering Atrial Pacemaker (WAP)
*Junctional Tachycardia - ANS: Pulseless Electrical Activity (PEA)
An older adult with diabetes mellitus presents with leg cramps. She states that the cramps were 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:
,*Benign nocturnal leg cramps
*Intermittent claudication
*Deep vein thrombosis
*Popliteal aneurism - ANS: Intermittent claudication
Your 53 year-old female patient is experiencing shortness of breath and has a diagnosis of pulmonary
arterial hypertension. Which ventricle is directly experiencing increased afterload from this disease
state?
*Both Right and Left Ventricles
*Left Ventricle
*Neither Left or Right Ventricles
*Right Ventricle - ANS: Right Ventricle
Which of the following medical exam requires the patient to be sedated?
*Transthoracic echocardiogram (TTE)
*Transesophageal echocardiogram (TEE)
*Nuclear stress test
*Tilt Table Test - ANS: Transesophageal echocardiogram (TEE)
Recommendation for lipid check in adolescent with type 1 DM?
* 1 year
*10 years
*5 years
*2 years - ANS: 1 year
A 45-year-old man presents with chest pain radiating to the left arm, diaphoresis, and shortness of
breath. His ECG shows ST-segment elevation. What is the initial management response?
,*Start intravenous heparin
*Administer aspirin and call for emergency medical services
*Administer nitroglycerin sublingually
*Perform immediate coronary angiography - ANS: Administer aspirin and call for emergency medical
services
The suggested International Normalized Ratio (INR) range in a patient being treated for atrial fibrillation
is:
*3.0-4.0
*1.0-2.0
*4.0-5.0
*2.0-3.0 - ANS: 2.0-3.0
Your patient presents with bradycardia, severe nausea, and substernal pain. STEMI was identified on the
EKG. Which region of the heart is most likely involved?
*Inferior Wall
*Anterior Wall
*Lateral Wall
*Septal Wall - ANS: Inferior Wall
Your patient has a diagnosis of Hashimoto's and is on Levothyroxine 75 mcg daily. Her recent TSH was
elevated at 15 uU/mL. Your next best action is to:
*Assess for symptoms and recheck TSH in 8 weeks
*Repeat anti-thyroperoxidase antibodies (anti-TPO)
*Increase Levothyroxine to 100 mcg daily
*Decrease Levothyroxine to 50 mcg daily - ANS: Increase Levothyroxine to 100 mcg daily
, A patient with diabetes mellitus who is taking insulin presents for a follow up. The patient's blood
glucose log reveals wide variations in readings, as well as numerous episodes of hyperglycemia and
hypoglycemia. Which is the nurse practitioner's best therapeutic intervention?
*Decrease the overall insulin dose
*Refer the patient for diet teaching
*Increase the overall insulin dose
*Instruct the patient to start daily exercise - ANS: Refer the patient for diet teaching
A patient presents for recheck of their thyroid-stimulating hormone (TSH). The patient was started on
levothyroxine (Synthroid) 50 mcg 8 weeks ago. Today the TSH is 10.5 μU/mL [normal = 0.4-2.5 μU/mL].
Based on this lab work, which is the most appropriate action?
*Decrease levothyroxine (Synthroid) to 25 mcg daily.
*Keep levothyroxine (Synthroid) at 50 mcg daily.
*Increase levothyroxine (Synthroid) to 75 mcg daily.
*Change to Armour Thyroid 50 mcg daily. - ANS: Increase levothyroxine (Synthroid) to 75 mcg daily.
A starting dose for a elderly adult patient with a BMI of 20 needing levothryoxine
*100 mcg
*25 mcg
*75 mcg
*125 mcg - ANS: 25 mcg
A patient has a 3 cm pituitary mass noted on CT. What is your next step in evaluating the patient?
*Repeat MRI in 3 months
*Refer to surgery
*Screen for hormone deficiencies
*Start Cabergoline - ANS: Screen for hormone deficiencies
