PNN PRACTICE QUESTIONS WITH 100%
CORRECT ANSWERS
When reading a TB skin test, how many mm of induration is considered a positive reading for a pt w/
HIV?
A. >/= 3 mm
B. >/= 5 mm
C. >/= 10 mm
D. >/= 15 mm - correct answer -B. >/= 5 mm
Induration >/= 5 mm is considered positive in pts w/ low immunity (HIV, on steroid tx) or at high risk for
TB infection (close contact w/ someone w/ active TB).
Induration >/= 10 mm is considered positive in healthcare workers, pts w/ DM, and CKD.
Induration >/= 15 mm is considered positive for anyone.
Which BP meds should be used in the general population?
A. ACE-I/ARB
B. BB
C. CCB
D. Thiazides - correct answer -A. ACE-I/ARB
C. CCB
D. Thiazides
Which BP meds should be used in DM w/ signs of renal damage?
A. ACE-I/ARB
B. BB
C. CCB
D. Thiazides - correct answer -A. ACE-I/ARB
Which BP meds should be used for MI or CAD?
A. ACE-I/ARB
B. BB
C. CCB
D. Thiazides - correct answer -A. ACE-I/ARB
B. BB
Which BP meds should be used for CHF?
,A. ACE-I/ARB
B. BB
C. CCB
D. Thiazides
E. Entresto - correct answer -Low dose BB (carvedilol, metoprolol, bisoprolol) plus ACE-I/ARB or
Entresto.
Which BP meds are safe to use in pregnancy? - correct answer -1. Labetalol PO or IV (first line).
2. Other BBs (second line).
3. Nifedipine ER (Procardia XL) or nicardipine
4. Methyldopa
5. Hydralazine
Other CCBs and HCTZ are safe to use as well.
Which BP meds are used to treat Raynaud's? - correct answer -DHP-CCBs (-pines)
Which BP meds should be used in CKD?
A. ACE-I/ARB
B. BBs
C. CCBs
D. Thiazides
E. Loops - correct answer -A. ACE-I/ARB to preserve kidney function
Which BP med is best for pts with ESRD?
A. ACE-I/ARB
B. BBs
C. CCBs
D. Thiazides
E. Loops - correct answer -E. Loops
Others can be used as well though.
Caution with ACE-I/ARBs due to hyperkalemia.
Which BP med should be avoided in asthma/COPD?
A. ACE-I/ARB
B. BB
C. CCB
D. Thiazides - correct answer -B. BB
If a BB must be used, use one that is Beta-1 selective. AMEBBBA: Atenolol (Tenormin), metoprolol
(Lopressor, Toprol XL), esmolol (Brevibloc), bisoprolol (Zebeta), betaxolol (Kerlone, Betoptic-S), Bystolic
(nebivolol), acebutolol (Sectral).
Which BP med should be avoided/used with caution in patients with DM?
,A. ACE-I/ARB
B. BBs
C. CCBs
D. Thiazides - correct answer -B. BBs because they may mask symptoms of hypoglycemia
Which BP meds should be avoided if the patient has a sulfa allergy?
A. ACE-I/ARB
B. BBs
C. CCBs
D. Thiazides
E. Loops - correct answer -Thiazides and loops (except ethacrynic acid)
Which BP med should be avoided in patients with increased sun exposure?
A. ACE-I/ARB
B. BB
C. CCB
D. Thiazides
E. Loops - correct answer -D. Thiazides
Which BP med should be avoided in patients with Raynaud's?
A. ACE-I/ARB
B. BB
C. CCB
D. Thiazides
E. Loops - correct answer -B. BBs should be avoided.
Also avoid -ergots and -triptans.
DOC for tx of Raynaud's: DHP CCBs (nifedipine, amlodipine, isradipine, or felodipine)
DOC for tx of Prinzmetal's Angina: Nifedipine, nicardipine, diltiazem, or verapamil.
Which BP meds should be avoided in patients with gout or kidney stones?
A. ACE-I/ARB
B. BB
C. CCB
D. Thiazides
E. Loops - correct answer -Thiazides and loops should be avoided due to increasing uric acid.
Which meds are used to treat pheochromocytoma hypertensive crisis? - correct answer -IV sodium
nitroprusside, phentolamine, or nicardipine.
Which BP med should be avoided in pheochromocytoma hypertensive crisis?
A. ACE-I/ARB
, B. BB
C. CCB
D. Thiazides
E. Loops - correct answer -B. BBs should be avoided
How do thiazide diuretics affect:
1. Na+
2. Cl-
3. K+
4. Mg2+
5. Ca2+
6. Glucose
7. Cholesterol/Lipids
8. Uric Acid - correct answer -1. Dec Na+ (Inc lithium)
2. Dec Cl-
3. Dec K+ (inc digoxin toxicity)
4. Dec Mg2+
5. Inc Ca2+
6. Inc Glucose
7. Inc Cholesterol/Lipids
8. Inc Uric Acid
How do loop diuretics affect:
1. Na+
2. Cl-
3. K+
4. Mg2+
5. Ca2+
6. Glucose
7. Cholesterol/Lipids
8. Uric Acid - correct answer -1. Dec Na+ (Inc lithium)
2. Dec Cl-
3. Dec K+ (inc digoxin toxicity)
4. Dec Mg2+
5. Dec Ca2+
6. Inc Glucose
7. Inc Cholesterol/Lipids
8. Inc Uric Acid
What should be avoided with K+ sparing diuretics? - correct answer -ACE-Is, ARBs, salt substitutes,
patients with ESRD.
All increase risk of hyperkalemia.
What are the CIs and cautions of BBs? - correct answer -CIs: Heart block, bradycardia, asthma/COPD,
Raynaud's, cocaine overdose (treat with alpha blockers).
Caution: DM (masks hypoglycemia sx), CHF (use low dose only).
CORRECT ANSWERS
When reading a TB skin test, how many mm of induration is considered a positive reading for a pt w/
HIV?
A. >/= 3 mm
B. >/= 5 mm
C. >/= 10 mm
D. >/= 15 mm - correct answer -B. >/= 5 mm
Induration >/= 5 mm is considered positive in pts w/ low immunity (HIV, on steroid tx) or at high risk for
TB infection (close contact w/ someone w/ active TB).
Induration >/= 10 mm is considered positive in healthcare workers, pts w/ DM, and CKD.
Induration >/= 15 mm is considered positive for anyone.
Which BP meds should be used in the general population?
A. ACE-I/ARB
B. BB
C. CCB
D. Thiazides - correct answer -A. ACE-I/ARB
C. CCB
D. Thiazides
Which BP meds should be used in DM w/ signs of renal damage?
A. ACE-I/ARB
B. BB
C. CCB
D. Thiazides - correct answer -A. ACE-I/ARB
Which BP meds should be used for MI or CAD?
A. ACE-I/ARB
B. BB
C. CCB
D. Thiazides - correct answer -A. ACE-I/ARB
B. BB
Which BP meds should be used for CHF?
,A. ACE-I/ARB
B. BB
C. CCB
D. Thiazides
E. Entresto - correct answer -Low dose BB (carvedilol, metoprolol, bisoprolol) plus ACE-I/ARB or
Entresto.
Which BP meds are safe to use in pregnancy? - correct answer -1. Labetalol PO or IV (first line).
2. Other BBs (second line).
3. Nifedipine ER (Procardia XL) or nicardipine
4. Methyldopa
5. Hydralazine
Other CCBs and HCTZ are safe to use as well.
Which BP meds are used to treat Raynaud's? - correct answer -DHP-CCBs (-pines)
Which BP meds should be used in CKD?
A. ACE-I/ARB
B. BBs
C. CCBs
D. Thiazides
E. Loops - correct answer -A. ACE-I/ARB to preserve kidney function
Which BP med is best for pts with ESRD?
A. ACE-I/ARB
B. BBs
C. CCBs
D. Thiazides
E. Loops - correct answer -E. Loops
Others can be used as well though.
Caution with ACE-I/ARBs due to hyperkalemia.
Which BP med should be avoided in asthma/COPD?
A. ACE-I/ARB
B. BB
C. CCB
D. Thiazides - correct answer -B. BB
If a BB must be used, use one that is Beta-1 selective. AMEBBBA: Atenolol (Tenormin), metoprolol
(Lopressor, Toprol XL), esmolol (Brevibloc), bisoprolol (Zebeta), betaxolol (Kerlone, Betoptic-S), Bystolic
(nebivolol), acebutolol (Sectral).
Which BP med should be avoided/used with caution in patients with DM?
,A. ACE-I/ARB
B. BBs
C. CCBs
D. Thiazides - correct answer -B. BBs because they may mask symptoms of hypoglycemia
Which BP meds should be avoided if the patient has a sulfa allergy?
A. ACE-I/ARB
B. BBs
C. CCBs
D. Thiazides
E. Loops - correct answer -Thiazides and loops (except ethacrynic acid)
Which BP med should be avoided in patients with increased sun exposure?
A. ACE-I/ARB
B. BB
C. CCB
D. Thiazides
E. Loops - correct answer -D. Thiazides
Which BP med should be avoided in patients with Raynaud's?
A. ACE-I/ARB
B. BB
C. CCB
D. Thiazides
E. Loops - correct answer -B. BBs should be avoided.
Also avoid -ergots and -triptans.
DOC for tx of Raynaud's: DHP CCBs (nifedipine, amlodipine, isradipine, or felodipine)
DOC for tx of Prinzmetal's Angina: Nifedipine, nicardipine, diltiazem, or verapamil.
Which BP meds should be avoided in patients with gout or kidney stones?
A. ACE-I/ARB
B. BB
C. CCB
D. Thiazides
E. Loops - correct answer -Thiazides and loops should be avoided due to increasing uric acid.
Which meds are used to treat pheochromocytoma hypertensive crisis? - correct answer -IV sodium
nitroprusside, phentolamine, or nicardipine.
Which BP med should be avoided in pheochromocytoma hypertensive crisis?
A. ACE-I/ARB
, B. BB
C. CCB
D. Thiazides
E. Loops - correct answer -B. BBs should be avoided
How do thiazide diuretics affect:
1. Na+
2. Cl-
3. K+
4. Mg2+
5. Ca2+
6. Glucose
7. Cholesterol/Lipids
8. Uric Acid - correct answer -1. Dec Na+ (Inc lithium)
2. Dec Cl-
3. Dec K+ (inc digoxin toxicity)
4. Dec Mg2+
5. Inc Ca2+
6. Inc Glucose
7. Inc Cholesterol/Lipids
8. Inc Uric Acid
How do loop diuretics affect:
1. Na+
2. Cl-
3. K+
4. Mg2+
5. Ca2+
6. Glucose
7. Cholesterol/Lipids
8. Uric Acid - correct answer -1. Dec Na+ (Inc lithium)
2. Dec Cl-
3. Dec K+ (inc digoxin toxicity)
4. Dec Mg2+
5. Dec Ca2+
6. Inc Glucose
7. Inc Cholesterol/Lipids
8. Inc Uric Acid
What should be avoided with K+ sparing diuretics? - correct answer -ACE-Is, ARBs, salt substitutes,
patients with ESRD.
All increase risk of hyperkalemia.
What are the CIs and cautions of BBs? - correct answer -CIs: Heart block, bradycardia, asthma/COPD,
Raynaud's, cocaine overdose (treat with alpha blockers).
Caution: DM (masks hypoglycemia sx), CHF (use low dose only).
