NSG 6440 – Practice Test (Majority) – Advanced Primary Care and Clinical Management Review
Which of the following antihypertensive medications would you avoid prescribing for an elderly
white female with the comorbid diagnosis of osteoporosis?
a. Beta blockers
b. Calcium channel blockers
c. Ace inhibitors
d. Diuretics - correct answer Calcium channel blockers
Which of the following class of drugs is preferred treatment for a diabetic with stage II
hypertension?
a. Calcium channel blockers
b. Alpha blockers
c. Angiotensin converting enzyme inhibitor
d. Loop diuretics - correct answer Angiotensin converting enzyme inhibitor
You are caring for a 30-year-old white male in your office with a BP of 144/90. He has never had
a diagnosis of hypertension. He doesn't check his blood pressure at home. He has a family
history of hypertension. What are your recommendations?
a. Start HCTZ 12.5mg daily, purchase a blood pressure cuff, and return to your office in 1 mth
b. Instruct to purchase a BP cuff, record blood pressures, call if over 140's over 90's, low salt
diet, return in 2 weeks.
c. Order EKG, CMP, CBC, and lipid panel, and refer to cardiology.
d. Order a cardiac stress test and lipid panel. - correct answer Instruct to purchase a BP cuff,
record blood pressures, call if over 140's over 90's, low salt diet, return in 2 weeks
You are treating a young adult female with HTN and migraine headaches. Which class of
medications could you choose to treat both?
,NSG 6440 – Practice Test (Majority) – Advanced Primary Care and Clinical Management Review
Ace inhibitors
Calcium channel blockers
Beta blockers
Angiotensin receptor blockers - correct answer Beta blockers
A 42-year-old male presents with the following lipid profile. He is not on any medications for
cholesterol or herbal supplements.
Total: 210
LDL: 145
TG 162
HDL 52
What medication would you recommend?
a. Low dose statin
b. Low dose bile acid sequestrant
c. Low dose fibrate
d. Fish oil - correct answer Low dose statin
You are caring for a 68-year-old male who has been taking atorvastain (Lipitor) for 8 weeks. He
complains of fatigue, muscle aches, and dark-colored urine. Which of the following is the most
appropriate treatment plan?
a. Order a CBC and CMP.
b. Order lipid level and serum creatine phosphokinase
(CPK, creatine kinase)
c. Order a 24 hr urine
d. Recommend increasing his fluids and rest. - correct answer Order lipid level and serum
creatine phosphokinase (CPK, creatine kinase).
What would you advise this patient regarding taking his atrovastatin (Lipitor)?
,NSG 6440 – Practice Test (Majority) – Advanced Primary Care and Clinical Management Review
Continuing taking the medication until the labs are
available
Take atorvastatin every other day until labs are
available
Take half of the atorvastatin every other day until labs
are available
Stop taking the atorvastatin until the labs are
available - correct answer Stop taking atorvastatin until the labs are available.
A 58 year old male presents to your office with an episode of chest tightness in his substernal
area that radiated to his back while he was jogging. It was relieved with rest. Which of the
following does this best describe?
Acute myocardial infarction
Gastroesophageal reflux disease
Angina pectoris
Acute costochondritis - correct answer Angina pectoris
What is the most common cause of left ventricular hypertrophy in the United States?
Mitral valve prolapse
Chronic atrial fibrillation
Pulmonary hypertension
Chronic hypertension - correct answer Chronic hypertension
Which of the following heart sounds is associated with heart failure?
Still's murmer and S4
S3
S1, S2, and S4
, NSG 6440 – Practice Test (Majority) – Advanced Primary Care and Clinical Management Review
S1, S2, and S3 - correct answer S3
While performing a routine physical exam on a 60-year-old hypertensive male, you notice a
bruit over the carotid area on the left side of the neck. There is no induration of the skin. This
patient is at higher risk for:
Stroke and coronary heart disease
Temporal arteritis and brain aneurysms
Abdominal aneurysm and congestive heart gailure
Dizziness and headaches - correct answer Stroke and coronary heart disease
A 72-year-old female presents to your office with gradual difficulty breathing, non-productive
cough, bilateral swelling of her feet, and a 10 pound weight gain. Upon examination you hear
crackles and rhonchi with an S3 heart sound. What is the most likely diagnosis?
COPD
Renal hypertension
Congestive heart hailure
Asthma - correct answer Congestive heart failure
What is your treatment plan for this patient with difficulty breathing, cough, weight gain,
edema, and S3 heart sounds?
Rest and increase fluids
Diuretics, digoxin, and anti-hypertensive medications
Nebulized albuterol and prednisone
Anti-coagulation and cardiology evaluation - correct answer Diuretics, digoxin, and anti-
hypertensive medications
You are treating a 49-year-old female who presents with fatigue and palpitations. You check her
apical pulse and she is irregular and tachycardic. You obtain an EKG and it reveals afib with
rapid ventricular response. What is your treatment plan?
You order a 2D echo.
Which of the following antihypertensive medications would you avoid prescribing for an elderly
white female with the comorbid diagnosis of osteoporosis?
a. Beta blockers
b. Calcium channel blockers
c. Ace inhibitors
d. Diuretics - correct answer Calcium channel blockers
Which of the following class of drugs is preferred treatment for a diabetic with stage II
hypertension?
a. Calcium channel blockers
b. Alpha blockers
c. Angiotensin converting enzyme inhibitor
d. Loop diuretics - correct answer Angiotensin converting enzyme inhibitor
You are caring for a 30-year-old white male in your office with a BP of 144/90. He has never had
a diagnosis of hypertension. He doesn't check his blood pressure at home. He has a family
history of hypertension. What are your recommendations?
a. Start HCTZ 12.5mg daily, purchase a blood pressure cuff, and return to your office in 1 mth
b. Instruct to purchase a BP cuff, record blood pressures, call if over 140's over 90's, low salt
diet, return in 2 weeks.
c. Order EKG, CMP, CBC, and lipid panel, and refer to cardiology.
d. Order a cardiac stress test and lipid panel. - correct answer Instruct to purchase a BP cuff,
record blood pressures, call if over 140's over 90's, low salt diet, return in 2 weeks
You are treating a young adult female with HTN and migraine headaches. Which class of
medications could you choose to treat both?
,NSG 6440 – Practice Test (Majority) – Advanced Primary Care and Clinical Management Review
Ace inhibitors
Calcium channel blockers
Beta blockers
Angiotensin receptor blockers - correct answer Beta blockers
A 42-year-old male presents with the following lipid profile. He is not on any medications for
cholesterol or herbal supplements.
Total: 210
LDL: 145
TG 162
HDL 52
What medication would you recommend?
a. Low dose statin
b. Low dose bile acid sequestrant
c. Low dose fibrate
d. Fish oil - correct answer Low dose statin
You are caring for a 68-year-old male who has been taking atorvastain (Lipitor) for 8 weeks. He
complains of fatigue, muscle aches, and dark-colored urine. Which of the following is the most
appropriate treatment plan?
a. Order a CBC and CMP.
b. Order lipid level and serum creatine phosphokinase
(CPK, creatine kinase)
c. Order a 24 hr urine
d. Recommend increasing his fluids and rest. - correct answer Order lipid level and serum
creatine phosphokinase (CPK, creatine kinase).
What would you advise this patient regarding taking his atrovastatin (Lipitor)?
,NSG 6440 – Practice Test (Majority) – Advanced Primary Care and Clinical Management Review
Continuing taking the medication until the labs are
available
Take atorvastatin every other day until labs are
available
Take half of the atorvastatin every other day until labs
are available
Stop taking the atorvastatin until the labs are
available - correct answer Stop taking atorvastatin until the labs are available.
A 58 year old male presents to your office with an episode of chest tightness in his substernal
area that radiated to his back while he was jogging. It was relieved with rest. Which of the
following does this best describe?
Acute myocardial infarction
Gastroesophageal reflux disease
Angina pectoris
Acute costochondritis - correct answer Angina pectoris
What is the most common cause of left ventricular hypertrophy in the United States?
Mitral valve prolapse
Chronic atrial fibrillation
Pulmonary hypertension
Chronic hypertension - correct answer Chronic hypertension
Which of the following heart sounds is associated with heart failure?
Still's murmer and S4
S3
S1, S2, and S4
, NSG 6440 – Practice Test (Majority) – Advanced Primary Care and Clinical Management Review
S1, S2, and S3 - correct answer S3
While performing a routine physical exam on a 60-year-old hypertensive male, you notice a
bruit over the carotid area on the left side of the neck. There is no induration of the skin. This
patient is at higher risk for:
Stroke and coronary heart disease
Temporal arteritis and brain aneurysms
Abdominal aneurysm and congestive heart gailure
Dizziness and headaches - correct answer Stroke and coronary heart disease
A 72-year-old female presents to your office with gradual difficulty breathing, non-productive
cough, bilateral swelling of her feet, and a 10 pound weight gain. Upon examination you hear
crackles and rhonchi with an S3 heart sound. What is the most likely diagnosis?
COPD
Renal hypertension
Congestive heart hailure
Asthma - correct answer Congestive heart failure
What is your treatment plan for this patient with difficulty breathing, cough, weight gain,
edema, and S3 heart sounds?
Rest and increase fluids
Diuretics, digoxin, and anti-hypertensive medications
Nebulized albuterol and prednisone
Anti-coagulation and cardiology evaluation - correct answer Diuretics, digoxin, and anti-
hypertensive medications
You are treating a 49-year-old female who presents with fatigue and palpitations. You check her
apical pulse and she is irregular and tachycardic. You obtain an EKG and it reveals afib with
rapid ventricular response. What is your treatment plan?
You order a 2D echo.
