Unit 7
Ray has been diagnosed with hypertension and an angiotensin-converting
enzyme inhibitoris determined to be needed. Prior to prescribing this drug, the
NP should assess for:
1.Hypokalemia
2.Impotence
3.Decreased renal function
4.Inability to concentrate
3
When comparing angiotensin-converting enzyme (ACE) and angiotensin II
receptor blocker (ARB) medications, which of the following holds true?
1. Both have major issues with a dry, irritating cough
2. Both contribute to some retention of potassium
3. ARBs have a stronger impact on hypertension control than ACE medications
4. ARBs have stronger diabetes mellitus renal protection properties than ACE
medications
2
Angiotensin-converting enzyme inhibitors are the drug of choice in treating
hypertension in diabeticpatients because they:
1.Improve insulin sensitivity
2.Improve renal hemodynamics
3.Reduce the production of angiotensin II
4.All of the above
4
A potentially life-threatening adverse response to angiotensin-converting enzyme
inhibitors is angioedema. Which of the following statements is true about this
adverse response?
1.Swelling of the tongue or hoarseness are the most common symptoms.
,2.It appears to be related to the decrease in aldosterone production.
3.Presence of a dry, hacky cough indicates a high risk for this adverse response.
4.Because it takes time to build up a blood level, it occurs after being on the drug
forabout 1 week.
1
Angiotensin-converting enzyme inhibitors are useful in a variety of disorders.
Which of the following statements are true about both its usefulness in the
disorder and the reason for its use?
1.Stable angina because it decreases the thickening of vascular walls due to
decreased modified release.
2.Heart failure because it reduces remodeling of injured myocardial tissues.
3.Both 1 and 2 are true and the reasons are correct.
4.Both 1 and 2 are true but the reasons are wrong.
5.Neither 1 nor 2 are true.
3
What does the provider understand about the issue of "Diabetic Renal
Protection" with
angiotensin-converting enzyme (ACE) medications? Diabetes mellitus patients:
1. Have a reduced rate of renal progression, but still need to be discontinued
when advanced renal issues present
2. Who start these medications never progress to renal nephropathy
3. With early renal dysfunction will see it reverse when on ACE medications
4. Without renal issues are the only ones who benefit from ACE protection
1
What dermatological issue is linked to Amiodarone use?
1. Increased risk of basal cell carcinoma
2. Flare up of any prior psoriasis problems
3. Development of plantar warts
4. Progressive change of skin tone toward a blue spectrum
4
,Commercials on TV for erectile dysfunction (ED) medications warn about mixing
them with nitrates. Why?
1. Increased risk of priapism
2. Profound hypotension
3. Development of blue discoloration to the visual field
4. Inactivation of the ED medication effect
2
Despite good blood pressure control, an NP might change a patient's drug from
an
angiotensin-converting enzyme (ACE) inhibitor to an angiotensin II receptor
blocker (ARB) becausethe ARB:
1.Is stronger than the ACE inhibitor
2.Does not produce a dry, hacky cough
3.Has no effect on the renal system
4.Reduces sodium and water retention
2
While taking an angiotensin II receptor blocker (ARB), patients need to avoid
certain over-the-counter drugs without first consulting the provider because:
1.Cimetidine is metabolized by the CYP 3A4 isoenzymes
2.Nonsteroidal anti-inflammatory drugs reduce prostaglandin levels
3.Both 1 and 2
4.Neither 1 nor 2
3
Laboratory monitoring for patients on angiotensin-converting enzyme inhibitors
or angiotensin II receptor blockers should include:
1. White blood cell counts with the drug dosage increased for elevations above
10,000 feet
2. Liver function tests with the drug dosage stopped for alanine aminotransferase
values twice that of normal
, 3. Serum creatinine levels with the drug dosage reduced for values greater than
2.5 mg/dL
4. Serum glucose levels with the drug dosage increased for levels greater than
120 mg/dL
3
Jacob has hypertension, for which a calcium channel blocker has been
prescribed. This drug helps control blood pressure because it:
1. Decreases the amount of calcium inside the cell
2. Reduces stroke volume
3. Increases the activity of the Na+/K+/ATPase pump indirectly
4. Decreases heart rate
1
Many patients with hyperlipidemia are treated with more than one drug.
Combining a fibric acid derivative such as gemfibrozil with which of the following
is not recommended? The drug and the reason must both be correct for the
answer to be correct.
1. Reductase inhibitors, due to an increased risk for rhabdomyolysis
2. Bile-acid sequestering resins, due to interference with folic acid absorption
3. Grapefruit juice, due to interference with metabolism
4. Niacin, due to decreased gemfibrozil activity
1
Felicity has been prescribed colestipol to treat her hyperlipidemia. Unlike other
anti-lipidemics, this drug:
1. Blocks synthesis of cholesterol in the liver
2. Exchanges chloride ions for negatively charged acids in the bowel
3. Increases HDL levels the most among the classes
4. Blocks the lipoprotein lipase pathway
2
Ray has been diagnosed with hypertension and an angiotensin-converting
enzyme inhibitoris determined to be needed. Prior to prescribing this drug, the
NP should assess for:
1.Hypokalemia
2.Impotence
3.Decreased renal function
4.Inability to concentrate
3
When comparing angiotensin-converting enzyme (ACE) and angiotensin II
receptor blocker (ARB) medications, which of the following holds true?
1. Both have major issues with a dry, irritating cough
2. Both contribute to some retention of potassium
3. ARBs have a stronger impact on hypertension control than ACE medications
4. ARBs have stronger diabetes mellitus renal protection properties than ACE
medications
2
Angiotensin-converting enzyme inhibitors are the drug of choice in treating
hypertension in diabeticpatients because they:
1.Improve insulin sensitivity
2.Improve renal hemodynamics
3.Reduce the production of angiotensin II
4.All of the above
4
A potentially life-threatening adverse response to angiotensin-converting enzyme
inhibitors is angioedema. Which of the following statements is true about this
adverse response?
1.Swelling of the tongue or hoarseness are the most common symptoms.
,2.It appears to be related to the decrease in aldosterone production.
3.Presence of a dry, hacky cough indicates a high risk for this adverse response.
4.Because it takes time to build up a blood level, it occurs after being on the drug
forabout 1 week.
1
Angiotensin-converting enzyme inhibitors are useful in a variety of disorders.
Which of the following statements are true about both its usefulness in the
disorder and the reason for its use?
1.Stable angina because it decreases the thickening of vascular walls due to
decreased modified release.
2.Heart failure because it reduces remodeling of injured myocardial tissues.
3.Both 1 and 2 are true and the reasons are correct.
4.Both 1 and 2 are true but the reasons are wrong.
5.Neither 1 nor 2 are true.
3
What does the provider understand about the issue of "Diabetic Renal
Protection" with
angiotensin-converting enzyme (ACE) medications? Diabetes mellitus patients:
1. Have a reduced rate of renal progression, but still need to be discontinued
when advanced renal issues present
2. Who start these medications never progress to renal nephropathy
3. With early renal dysfunction will see it reverse when on ACE medications
4. Without renal issues are the only ones who benefit from ACE protection
1
What dermatological issue is linked to Amiodarone use?
1. Increased risk of basal cell carcinoma
2. Flare up of any prior psoriasis problems
3. Development of plantar warts
4. Progressive change of skin tone toward a blue spectrum
4
,Commercials on TV for erectile dysfunction (ED) medications warn about mixing
them with nitrates. Why?
1. Increased risk of priapism
2. Profound hypotension
3. Development of blue discoloration to the visual field
4. Inactivation of the ED medication effect
2
Despite good blood pressure control, an NP might change a patient's drug from
an
angiotensin-converting enzyme (ACE) inhibitor to an angiotensin II receptor
blocker (ARB) becausethe ARB:
1.Is stronger than the ACE inhibitor
2.Does not produce a dry, hacky cough
3.Has no effect on the renal system
4.Reduces sodium and water retention
2
While taking an angiotensin II receptor blocker (ARB), patients need to avoid
certain over-the-counter drugs without first consulting the provider because:
1.Cimetidine is metabolized by the CYP 3A4 isoenzymes
2.Nonsteroidal anti-inflammatory drugs reduce prostaglandin levels
3.Both 1 and 2
4.Neither 1 nor 2
3
Laboratory monitoring for patients on angiotensin-converting enzyme inhibitors
or angiotensin II receptor blockers should include:
1. White blood cell counts with the drug dosage increased for elevations above
10,000 feet
2. Liver function tests with the drug dosage stopped for alanine aminotransferase
values twice that of normal
, 3. Serum creatinine levels with the drug dosage reduced for values greater than
2.5 mg/dL
4. Serum glucose levels with the drug dosage increased for levels greater than
120 mg/dL
3
Jacob has hypertension, for which a calcium channel blocker has been
prescribed. This drug helps control blood pressure because it:
1. Decreases the amount of calcium inside the cell
2. Reduces stroke volume
3. Increases the activity of the Na+/K+/ATPase pump indirectly
4. Decreases heart rate
1
Many patients with hyperlipidemia are treated with more than one drug.
Combining a fibric acid derivative such as gemfibrozil with which of the following
is not recommended? The drug and the reason must both be correct for the
answer to be correct.
1. Reductase inhibitors, due to an increased risk for rhabdomyolysis
2. Bile-acid sequestering resins, due to interference with folic acid absorption
3. Grapefruit juice, due to interference with metabolism
4. Niacin, due to decreased gemfibrozil activity
1
Felicity has been prescribed colestipol to treat her hyperlipidemia. Unlike other
anti-lipidemics, this drug:
1. Blocks synthesis of cholesterol in the liver
2. Exchanges chloride ions for negatively charged acids in the bowel
3. Increases HDL levels the most among the classes
4. Blocks the lipoprotein lipase pathway
2
