NR566 MIDTERM ADVANCED PHARMACOLOGY FOR CARE OF THE
FAMILY MIDTERM EXAM NEWEST 2025 ACTUAL EXAM COMPLETE
QUESTIONS AND CORRECT DETAILED ANSWERS (VERIFIED ANSWERS)
|ALREADY GRADED A+
Myocardial oxygen supply - CORRECT ANSWERS-Supply is reduced by the following:
• Hemodynamic factors such as increased resistance in coronary vessels, hypotension, and decreased
blood volume. ACE inhibitors, beta blockers, direct renin inhibitors, and the dihydropyridine CCBs
decrease peripheral resistance through their vasodilatory actions.
• Cardiac factors such as decreases in diastolic filling time, increases in heart rate, and valvular
incompetence. Beta blockers and non-dihydropyridine CCBs decrease heart rate. The beta blockers have
the further advantage of preventing the recurrence of MIs.
• Hematological factors such as the oxygen content of the blood, the acid-base status of the blood, and
anemia.
• Systemic disorders, such as shock, which reduce blood flow or the availability of oxygen.
Myocardial oxygen demand - CORRECT ANSWERS-High systolic blood pressure, which
increases the work the heart has to do to move blood from the left ventricle to the systemic circulation.
One focus of anginal management is control of blood pressure. ACE inhibitors, beta blockers, direct renin
inhibitors, and both types of CCBs decrease blood pressure.
• Increased ventricular volume, which increases the work the heart has to do because the left ventricle
must move more blood. ACE inhibitors reduce sodium and water retention.
• Increased thickness of the myocardium (ventricular hypertrophy). The same mechanism that facilitated
growth of the vessel walls in atherosclerosis also increases the thickness of the myocardium. ACE
inhibitors play a major role here to decrease the remodeling. Beta blockers can assist in prevention of
ventricular hypertrophy but play a smaller role.
• Increased heart rate resulting from exercise, stress, hyperthyroidism, fever, anemia, hyperviscosity of
the blood, or negative feedback systems' response to decreased cardiac output. Beta blockers can assist
in decreasing heart rate resulting from conditions such as hyperthyroidism and from negative feedback
patterns secondary to decreased cardiac output.
• Conditions that heighten the myocardium's contractile response. Beta blockers and CCBs both have
negative inotropic effects.
,Angina - CORRECT ANSWERS-Pain in the heart region caused by lack of oxygen. Ischemia
caused by the imbalance between myocardial oxygen supply (MOS) and myocardial oxygen demand
(MOD) produces pain referred to as _____.
Angina risk factors - CORRECT ANSWERS-smoking, hypertension, hypercholesterolemia, low
high-density lipoprotein (HDL) cholesterol, diabetes mellitus.
Class I Angina - CORRECT ANSWERS-Proven coronary artery disease without symptoms
Ordinary physical activity, such as walking or climbing stairs, does not cause angina. Angina occurs with
strenuous, rapid, or prolonged exertion at work or recreation.
Class II Angina - CORRECT ANSWERS-Angina only with unusually strenuous physical exertion
Slight limitation of ordinary activity. Angina occurs on walking or climbing stairs rapidly; walking uphill;
walking or stair climbing after meals; in cold wind; under emotional stress; or only during the few hours
after awakening.
Walking more than two blocks on the level and climbing more than one flight of ordinary stairs at a
normal pace and in normal conditions does not cause angina.
Class III Angina - CORRECT ANSWERS-Angina during routine physical activity
Marked limitations of ordinary activity. Angina occurs on walking one to two blocks on the level and
climbing one flight of stairs in normal conditions and at a normal pace.
Class IV Angina - CORRECT ANSWERS-Angina during minimal activity or rest
Inability to carry on any physical activity without discomfort.
Angina may occur at rest.
Clinical signs and symptoms DM - CORRECT ANSWERS-Increased thirst
Frequent urination
Extreme hunger
Unexplained weight loss
Presence of ketones in the urine (ketones are a byproduct of the breakdown of muscle and fat that
happens when there's not enough available insulin)
, Fatigue
Irritability
Blurred vision
Slow-healing sores
Frequent infections, such as gums or skin infections and vaginal infections
Risk factors & associated complications of DM - CORRECT ANSWERS-Complications: stroke,
heart attack, peripheral artery disease, diabetic retinopathy, cataracts, glaucoma, diabetic nephropathy,
peripheral neuropathy, diabetic foot.
Risk factors: >45 years old, physical inactivity, 1st degree relative relative with DM, high risk ethic group
(african american, hispanic, native american, asian american, and pacific islander), hx of gest DM, htn,
HDL < 35, triglycerides >250, polycystic ovarian syndrome, acanthosis nigricans, hx of cardiovascular
disease.
Diagnostic criteria of DM - CORRECT ANSWERS-Acute symptoms of diabetes plus casual
plasma glucose concentration ≥200 mg/dL.
*Casual is defined as any time of day without regard to time since last meal. The classic symptoms of
diabetes are polyuria, polydipsia, and unexplained weight loss.
Fasting plasma glucose ≥126 mg/dL. * Fasting is defined as no caloric intake for at least 8 h.
2-h postload plasma glucose in an oral glucose tolerance test ≥200 mg/dL. The test uses a glucose load
containing the equivalent of 75 g anhydrous glucose dissolved in water.
Hb A1c ≥6.5%.
PRE-DIABETES:
Fasting plasma glucose 100-125 mg/dL (IFG) or
plasma glucose 140-199 mg/dL (IGT) 2 hr post-ingestion of standard glucose load (75 g) or
Hb A1c 5.7%-6.4%
Criteria for screening asymptomatic adults - CORRECT ANSWERS-Individuals ≥45 yr and who
have a BMI ≥25 kg/m2 should be tested. If normal, the test should be repeated at 3 yr intervals.
Individuals <45 yr and who have a BMI ≥25 kg/m2 and have additional risk factors should have more
frequent testing.
Additional risk factors are the following:
FAMILY MIDTERM EXAM NEWEST 2025 ACTUAL EXAM COMPLETE
QUESTIONS AND CORRECT DETAILED ANSWERS (VERIFIED ANSWERS)
|ALREADY GRADED A+
Myocardial oxygen supply - CORRECT ANSWERS-Supply is reduced by the following:
• Hemodynamic factors such as increased resistance in coronary vessels, hypotension, and decreased
blood volume. ACE inhibitors, beta blockers, direct renin inhibitors, and the dihydropyridine CCBs
decrease peripheral resistance through their vasodilatory actions.
• Cardiac factors such as decreases in diastolic filling time, increases in heart rate, and valvular
incompetence. Beta blockers and non-dihydropyridine CCBs decrease heart rate. The beta blockers have
the further advantage of preventing the recurrence of MIs.
• Hematological factors such as the oxygen content of the blood, the acid-base status of the blood, and
anemia.
• Systemic disorders, such as shock, which reduce blood flow or the availability of oxygen.
Myocardial oxygen demand - CORRECT ANSWERS-High systolic blood pressure, which
increases the work the heart has to do to move blood from the left ventricle to the systemic circulation.
One focus of anginal management is control of blood pressure. ACE inhibitors, beta blockers, direct renin
inhibitors, and both types of CCBs decrease blood pressure.
• Increased ventricular volume, which increases the work the heart has to do because the left ventricle
must move more blood. ACE inhibitors reduce sodium and water retention.
• Increased thickness of the myocardium (ventricular hypertrophy). The same mechanism that facilitated
growth of the vessel walls in atherosclerosis also increases the thickness of the myocardium. ACE
inhibitors play a major role here to decrease the remodeling. Beta blockers can assist in prevention of
ventricular hypertrophy but play a smaller role.
• Increased heart rate resulting from exercise, stress, hyperthyroidism, fever, anemia, hyperviscosity of
the blood, or negative feedback systems' response to decreased cardiac output. Beta blockers can assist
in decreasing heart rate resulting from conditions such as hyperthyroidism and from negative feedback
patterns secondary to decreased cardiac output.
• Conditions that heighten the myocardium's contractile response. Beta blockers and CCBs both have
negative inotropic effects.
,Angina - CORRECT ANSWERS-Pain in the heart region caused by lack of oxygen. Ischemia
caused by the imbalance between myocardial oxygen supply (MOS) and myocardial oxygen demand
(MOD) produces pain referred to as _____.
Angina risk factors - CORRECT ANSWERS-smoking, hypertension, hypercholesterolemia, low
high-density lipoprotein (HDL) cholesterol, diabetes mellitus.
Class I Angina - CORRECT ANSWERS-Proven coronary artery disease without symptoms
Ordinary physical activity, such as walking or climbing stairs, does not cause angina. Angina occurs with
strenuous, rapid, or prolonged exertion at work or recreation.
Class II Angina - CORRECT ANSWERS-Angina only with unusually strenuous physical exertion
Slight limitation of ordinary activity. Angina occurs on walking or climbing stairs rapidly; walking uphill;
walking or stair climbing after meals; in cold wind; under emotional stress; or only during the few hours
after awakening.
Walking more than two blocks on the level and climbing more than one flight of ordinary stairs at a
normal pace and in normal conditions does not cause angina.
Class III Angina - CORRECT ANSWERS-Angina during routine physical activity
Marked limitations of ordinary activity. Angina occurs on walking one to two blocks on the level and
climbing one flight of stairs in normal conditions and at a normal pace.
Class IV Angina - CORRECT ANSWERS-Angina during minimal activity or rest
Inability to carry on any physical activity without discomfort.
Angina may occur at rest.
Clinical signs and symptoms DM - CORRECT ANSWERS-Increased thirst
Frequent urination
Extreme hunger
Unexplained weight loss
Presence of ketones in the urine (ketones are a byproduct of the breakdown of muscle and fat that
happens when there's not enough available insulin)
, Fatigue
Irritability
Blurred vision
Slow-healing sores
Frequent infections, such as gums or skin infections and vaginal infections
Risk factors & associated complications of DM - CORRECT ANSWERS-Complications: stroke,
heart attack, peripheral artery disease, diabetic retinopathy, cataracts, glaucoma, diabetic nephropathy,
peripheral neuropathy, diabetic foot.
Risk factors: >45 years old, physical inactivity, 1st degree relative relative with DM, high risk ethic group
(african american, hispanic, native american, asian american, and pacific islander), hx of gest DM, htn,
HDL < 35, triglycerides >250, polycystic ovarian syndrome, acanthosis nigricans, hx of cardiovascular
disease.
Diagnostic criteria of DM - CORRECT ANSWERS-Acute symptoms of diabetes plus casual
plasma glucose concentration ≥200 mg/dL.
*Casual is defined as any time of day without regard to time since last meal. The classic symptoms of
diabetes are polyuria, polydipsia, and unexplained weight loss.
Fasting plasma glucose ≥126 mg/dL. * Fasting is defined as no caloric intake for at least 8 h.
2-h postload plasma glucose in an oral glucose tolerance test ≥200 mg/dL. The test uses a glucose load
containing the equivalent of 75 g anhydrous glucose dissolved in water.
Hb A1c ≥6.5%.
PRE-DIABETES:
Fasting plasma glucose 100-125 mg/dL (IFG) or
plasma glucose 140-199 mg/dL (IGT) 2 hr post-ingestion of standard glucose load (75 g) or
Hb A1c 5.7%-6.4%
Criteria for screening asymptomatic adults - CORRECT ANSWERS-Individuals ≥45 yr and who
have a BMI ≥25 kg/m2 should be tested. If normal, the test should be repeated at 3 yr intervals.
Individuals <45 yr and who have a BMI ≥25 kg/m2 and have additional risk factors should have more
frequent testing.
Additional risk factors are the following:
