3/23/25, 7:43 FNP CARDIO Flashcards |
AM
FNP CARDIO EXAM QUESTIONS AND ANSWERS WITH COMPLETE
SOLUTIONS VERIFIED
Terms in this set (83)
Increase K+
ACE inhibitor
A common lab findings with ACE Inhibitors =
retention of potassium.
Measure potassium one month after starting and one month after changing a dose
If these are at maximum doses, consideration should be given to adding a
medication from a different class.
What should you do?
Pt on Monopril and HCTZ for hypertension.
CALCIUM CHANNEL BLOCKER
His blood pressure is 160-170/92-98 on
several blood pressure checks
NOT ARB - Adding an ARB may result in a precipitous decrease in his blood pressure
? Would you add an ARB?
because he takes an ACE inhibitor and both of these medications work in the renin-
angiotensin-aldosterone system.
Any antihypertensive medication ... could have an additive effect with sildenafil (or
another medication in this
Significance of sildenafil and any blood A specific drug-drug interaction to be aware of is the one that can occur with
pressure meds sildenafil and alpha blockers like tamsulosin, alfuzosin, prazosin, doxazosin, or
terazosin. This combination of medications may increase the risk of symptomatic
hypotension because the effect of these two drugs is additive
Consider two meds
low dose HCTZ and ARB or ace
This patient's blood pressure goal is < 140/90 according to JNC VIII. Since he is more
than 20 points above systolic goal (or greater than 10 points above diastolic goal) it
is reasonable to consider two medications
Start at age 2
Risk assessment for dyslipidemia- what age Dyslipidemia assessment does not necessarily mean a Dyslipidemia assessment
to start assessment refers to assessing family history of dyslipidemia, premature cardiovascular disease,
or diabetes, body mass index > 85% for age and sex, or history of other systemic
diseases like Kawasaki Disease or treatment, or renal disease.
When to start lipid profiles recommended between 18 and 21 years of age.
No K supplements
ACE inhibitor potentially can produce hyperkalemia because its mechanism of action
A patient taking an ACE inhibitor should
is in the renin-angiotensin-aldosterone system where potassium is spared. If
avoid:
potassium is taken in the form of potassium supplements, the effect will be additive
and the risk of hyperkalemia can be great.
1/17
,3/23/25, 7:43 FNP CARDIO Flashcards |
AM
CCB
This patient has isolated systolic hypertension (ISH). This is common in older adults
An 80 year-old female who is otherwise
and is associated with tragic cardiac and cerebrovascular events. The drug class of
well, has a blood pressure of 176/80. How
choice to treat these patients is a long-acting calcium channel blocker. The class of
should she be managed
calcium channel blockers recommended for ISH has the suffix "pine" (amlodipine,
pharmacologically?
felodipine, etc).
Remember
ISH = PINE
ACE inhibitor is specifically indicated in hypertension, diabetes with proteinuria, heart failure.
patients who have ...
CCB
77 year-old patient has had an increase in
This patient is 77 years old and should have a goal blood pressure of < 150/90. A
blood pressure since the last exam. The
thiazide diuretic is not a good first choice in this patient because it will not be
blood pressure has risen to 168/88 with 2
potent enough to decrease blood pressure by 25 points to get him to goal. A
readings. The last exam's reading was
long acting calcium channel blocker is appropriate for patients with isolated
144/90. If medication is to be started on
systolic hypertension and will be more likely to get this patient to goal pressure
this patient, what would be a good first
than HCTZ. Beta-blockers are no longer recommended first line for
choice?
uncomplicated hypertension. ACE inhibitors are very effective in patients who are
high renin producers. Elderly patients tend to produce lower amounts of renin.
2/17
, 3/23/25, 7:43 FNP CARDIO Flashcards |
AM
A 63 year-old male has been your patient Order CBC, BMP, TSH, u/a
for several years. He is a former
smoker who takes simvastatin, ramipril, Fatigue is a difficult complaint to assess and diagnose. This patient's exam and vital
and an aspirin daily. His blood pressure signs are normal. There is no reason to think that he is infected or is bleeding, so a
and lipids are well controlled. He lone CBC, offers little diagnostic help. However, in addition to a CBC, adding a
presents to your clinic with complaints metabolic panel, TSH, and urine (to screen for blood in this former smoker) is a
of fatigue and "just not feeling well" for more thorough laboratory assessment of his fatigue.
the last few days. His vital signs and
exam are normal. What should be
done next?
Order a CBC and consider waiting a
few days if normal.
Inquire about feelings of depression and
hopelessness.
Order a CBC, metabolic panel, TSH, and
urine analysis.
Order a B12 level, TSH, CBC, and chest x-
ray
BNP CHEAPER
BNP is a hormone involved in regulation of blood pressure and fluid volume.
A patient with shortness of breath has
When the BNP level is 80 pg/mL or greater, the sensitivity and specificity is 98% and
suspected heart failure. What diagnostic
92%, favoring a diagnosis of heart failure. Alternatively, BNP levels less than 80
test would best help determine this?
pg/mL strongly suggest that heart failure is not present (Some US institutions use
100 pg/mL). Other conditions may cause elevated BNP levels: thoracic and
abdominal surgery, renal failure, and subarachnoid hemorrhage. Consequently,
Echocardiogram
careful assessment of the patient is prudent. Echocardiograms mechanically
B type natriuretic peptide (BNP)
evaluate the heart and establish an ejection fraction. If <35-40%, then HF can
EKG
usually be diagnosed. Ejection fractions do not always correlate with patient
Chest x-ray
symptoms. EKG evaluates the electrical activity of the heart. Chest x-ray can
indicate heart failure but a BNP is a more sensitive measure.
An 80 year-old patient with long add CCB
standing hypertension takes Monopril and
HCTZ for hypertension. His blood This patient takes medications from 2 different classes of antihypertensives. If
pressure is 160- 170/92-98 on several these are at maximum doses, consideration should be given to adding a medication
blood pressure checks. What should be from a different class. Adding an ARB may result in a precipitous decrease in his
done about his blood pressure? blood pressure because he takes an ACE inhibitor and both of these
medications work in the renin-angiotensin-aldosterone system. Adding another
diuretic will likely produce hypokalemia with a small decrease in blood pressure.
Add an angiotensin receptor blocker (ARB) The calcium channel blocker is a good choice because it will have an additive
Add another diuretic effect with the other medications he is taking. A beta blocker will slow the
Add a calcium channel blocker heart rate, not a preferred outcome in an elderly patient unless he has
Stop the HCTZ and add a beta blocker underlying angina or a heart rate problem.
3/17
AM
FNP CARDIO EXAM QUESTIONS AND ANSWERS WITH COMPLETE
SOLUTIONS VERIFIED
Terms in this set (83)
Increase K+
ACE inhibitor
A common lab findings with ACE Inhibitors =
retention of potassium.
Measure potassium one month after starting and one month after changing a dose
If these are at maximum doses, consideration should be given to adding a
medication from a different class.
What should you do?
Pt on Monopril and HCTZ for hypertension.
CALCIUM CHANNEL BLOCKER
His blood pressure is 160-170/92-98 on
several blood pressure checks
NOT ARB - Adding an ARB may result in a precipitous decrease in his blood pressure
? Would you add an ARB?
because he takes an ACE inhibitor and both of these medications work in the renin-
angiotensin-aldosterone system.
Any antihypertensive medication ... could have an additive effect with sildenafil (or
another medication in this
Significance of sildenafil and any blood A specific drug-drug interaction to be aware of is the one that can occur with
pressure meds sildenafil and alpha blockers like tamsulosin, alfuzosin, prazosin, doxazosin, or
terazosin. This combination of medications may increase the risk of symptomatic
hypotension because the effect of these two drugs is additive
Consider two meds
low dose HCTZ and ARB or ace
This patient's blood pressure goal is < 140/90 according to JNC VIII. Since he is more
than 20 points above systolic goal (or greater than 10 points above diastolic goal) it
is reasonable to consider two medications
Start at age 2
Risk assessment for dyslipidemia- what age Dyslipidemia assessment does not necessarily mean a Dyslipidemia assessment
to start assessment refers to assessing family history of dyslipidemia, premature cardiovascular disease,
or diabetes, body mass index > 85% for age and sex, or history of other systemic
diseases like Kawasaki Disease or treatment, or renal disease.
When to start lipid profiles recommended between 18 and 21 years of age.
No K supplements
ACE inhibitor potentially can produce hyperkalemia because its mechanism of action
A patient taking an ACE inhibitor should
is in the renin-angiotensin-aldosterone system where potassium is spared. If
avoid:
potassium is taken in the form of potassium supplements, the effect will be additive
and the risk of hyperkalemia can be great.
1/17
,3/23/25, 7:43 FNP CARDIO Flashcards |
AM
CCB
This patient has isolated systolic hypertension (ISH). This is common in older adults
An 80 year-old female who is otherwise
and is associated with tragic cardiac and cerebrovascular events. The drug class of
well, has a blood pressure of 176/80. How
choice to treat these patients is a long-acting calcium channel blocker. The class of
should she be managed
calcium channel blockers recommended for ISH has the suffix "pine" (amlodipine,
pharmacologically?
felodipine, etc).
Remember
ISH = PINE
ACE inhibitor is specifically indicated in hypertension, diabetes with proteinuria, heart failure.
patients who have ...
CCB
77 year-old patient has had an increase in
This patient is 77 years old and should have a goal blood pressure of < 150/90. A
blood pressure since the last exam. The
thiazide diuretic is not a good first choice in this patient because it will not be
blood pressure has risen to 168/88 with 2
potent enough to decrease blood pressure by 25 points to get him to goal. A
readings. The last exam's reading was
long acting calcium channel blocker is appropriate for patients with isolated
144/90. If medication is to be started on
systolic hypertension and will be more likely to get this patient to goal pressure
this patient, what would be a good first
than HCTZ. Beta-blockers are no longer recommended first line for
choice?
uncomplicated hypertension. ACE inhibitors are very effective in patients who are
high renin producers. Elderly patients tend to produce lower amounts of renin.
2/17
, 3/23/25, 7:43 FNP CARDIO Flashcards |
AM
A 63 year-old male has been your patient Order CBC, BMP, TSH, u/a
for several years. He is a former
smoker who takes simvastatin, ramipril, Fatigue is a difficult complaint to assess and diagnose. This patient's exam and vital
and an aspirin daily. His blood pressure signs are normal. There is no reason to think that he is infected or is bleeding, so a
and lipids are well controlled. He lone CBC, offers little diagnostic help. However, in addition to a CBC, adding a
presents to your clinic with complaints metabolic panel, TSH, and urine (to screen for blood in this former smoker) is a
of fatigue and "just not feeling well" for more thorough laboratory assessment of his fatigue.
the last few days. His vital signs and
exam are normal. What should be
done next?
Order a CBC and consider waiting a
few days if normal.
Inquire about feelings of depression and
hopelessness.
Order a CBC, metabolic panel, TSH, and
urine analysis.
Order a B12 level, TSH, CBC, and chest x-
ray
BNP CHEAPER
BNP is a hormone involved in regulation of blood pressure and fluid volume.
A patient with shortness of breath has
When the BNP level is 80 pg/mL or greater, the sensitivity and specificity is 98% and
suspected heart failure. What diagnostic
92%, favoring a diagnosis of heart failure. Alternatively, BNP levels less than 80
test would best help determine this?
pg/mL strongly suggest that heart failure is not present (Some US institutions use
100 pg/mL). Other conditions may cause elevated BNP levels: thoracic and
abdominal surgery, renal failure, and subarachnoid hemorrhage. Consequently,
Echocardiogram
careful assessment of the patient is prudent. Echocardiograms mechanically
B type natriuretic peptide (BNP)
evaluate the heart and establish an ejection fraction. If <35-40%, then HF can
EKG
usually be diagnosed. Ejection fractions do not always correlate with patient
Chest x-ray
symptoms. EKG evaluates the electrical activity of the heart. Chest x-ray can
indicate heart failure but a BNP is a more sensitive measure.
An 80 year-old patient with long add CCB
standing hypertension takes Monopril and
HCTZ for hypertension. His blood This patient takes medications from 2 different classes of antihypertensives. If
pressure is 160- 170/92-98 on several these are at maximum doses, consideration should be given to adding a medication
blood pressure checks. What should be from a different class. Adding an ARB may result in a precipitous decrease in his
done about his blood pressure? blood pressure because he takes an ACE inhibitor and both of these
medications work in the renin-angiotensin-aldosterone system. Adding another
diuretic will likely produce hypokalemia with a small decrease in blood pressure.
Add an angiotensin receptor blocker (ARB) The calcium channel blocker is a good choice because it will have an additive
Add another diuretic effect with the other medications he is taking. A beta blocker will slow the
Add a calcium channel blocker heart rate, not a preferred outcome in an elderly patient unless he has
Stop the HCTZ and add a beta blocker underlying angina or a heart rate problem.
3/17
