NSG 6420 Week 4 Quiz

NSG 6420 Week 4 Quiz Question 1 (2 points) A patient comes to a clinic for an annual visit. He has a history of Type 2 DM. His lab work today indicates creatinine of 1.6 (0.6–1.5). Last year, his BP was 138/80 in both arms. Today, his BP is 150/80 in both arms. Which of the following is the most appropriate intervention? Question 1 options: Placing him on an alpha blocker Counseling him to lower his BP with lifestyle modification Counseling him regarding lifestyle modifications and placing him on an ACE-I Counseling him regarding lifestyle modifications and placing him on a vasodilator Question 2 (2 points) A seventy-eight-year-old African American woman presents to your office as a new patient. She complains of headache and dizziness. Her PMH is significant for HTN. She states, "I have been taking HCTZ for a long time." Her temperature is normal. BP 190/100, HR 86, RR 16. Which of the following would be the most appropriate action to assist in determining how to treat her current symptoms? Question 2 options: Perform a fundoscopic exam of her eyes. Perform a monofilament test on her feet. Order an echocardiogram for the next week.Order a lipid profile and liver panel. Question 3 (2 points) A seventy-eight-year-old woman comes to see you for her annual visit. She has a history of osteoarthritis and GERD. She comes in today for her annual visit. Her BP is 148/88. Last year, her BP was 140/80 and you had advised a 2-gram sodium diet and exercise. She states that she has been faithfully following your instructions. Which of the following would be the most appropriate management strategy for this patient? Question 3 options: Praise her for her efforts and tell her to keep up the good work Start her on HCTZ 50 mg daily Start her on hydralazine 25 mg daily Advise her that she needs to follow a strict 1.5 gram sodium diet Question 4 (2 points) A hypertensive middle-aged man has been recently diagnosed with mild renal insufficiency. He has been on lisinopril (Accupril) for many years. Which of the following laboratory values should be carefully monitored? Question 4 options: Hemoglobin, hematocrit, and MCV Serum creatinine and potassium levels AST and ALTSerum sodium, phosphate, and magnesium Question 5 (2 points) Mr. Wilson is a seventy-three-year-old male who has been on rosuvastatin (Crestor) 20 mg QD for the past three months. He complains of diffuse muscle aches and severe fatigue and weakness in spite of getting his usual eight hours of sleep every night. What is the MOST appropriate management for this patient? Question 5 options: Stop Crestor. Half the dose of Crestor. Stop Crestor and send for liver panel. Switch to Lipitor 10 mg QD. Question 6 (2 points) Your patients is a forty-five-year-old white male. You have been seeing him monthly for an elevated blood pressure. His reading three months ago was 160/100. He has been checking his blood pressure at home. The lowest reading he has recorded was 150/94. He tells you he has tried to change his diet and increase his exercise. You explain to him that you would like to start him on Lisinopril 10 mg po q hs today to try to decrease his blood pressure. As part of your teaching, you explain to him that he should notify you right away if after he starts the medication he notices ________. Question 6 options: fatigue and depression swollen ankles and a headachea dry cough and angioedema thirst and dizziness Question 7 (2 points) Mrs. Murphy presents to you for follow-up for the treatment of dyslipidemia. She is a fifty-five-year-old obese female with a BMI of 34%. She has no other cardiovascular risk factors. You have been working with her for several months on therapeutic lifestyle changes (TLCs). She has done well by increasing her exercise and reducing her BMI from 37 to 34. She does not smoke or consume alcohol. Her fasting lipid results today are: Question 7 options: Total cholesterol 200, triglycerides 560, HDL 31, LDL 100 What would be the most appropriate treatment at this stage? Start cholesterol absorption inhibitor ezetamide (Zetia) and low-fat diet Start fibric acid (fenofibrate) and Omega 3 fatty acids and advise on restriction of simple carbohydrates Start moderate intensity HMG Co-A reductase inhibitor (lovastatin) and Aspirin Advise her to start bile acid sequestrate cholestyramine (Colestipol) and continue therapeutic lifestyle change Question 8 (2 points) A sixty-year-old white male adult male client with essential hypertension diagnosed three months ago was initially treated by the nurse practitioner with sodium restriction, weight loss, and exercise. He presents with blood pressure of 160/100 on follow-up. He is asymptomatic and does not take any medication. EKG shows evidence of left ventricular hypertrophy (LVH). According to JNC-8, what would be the best choice of initial therapy?Question 8 options: Consider “white coat” hypertension, continue lifestyle modification therapy, and reassess in three months. Start therapy with a beta blocker and refer for echocardiogram. Evaluate for cardiac risk factors and start therapy with an ACEI or an ARB. Measure 24-h free cortisol and refer for sleep study (polysomnography). Question 9 (2 points) Saved Choose the most compelling class of medications for the associated disease state. (Choose the best answer.) Question 9 options: ACE-inhibitor (ACEI) or angiotensin receptor blocker (ARB) for chronic kidney disease Calcium channel blocker and diuretic for African American individuals Labetolol or hydralazine for pregnancy-induced hypertension A & B All of the above (A.B.C.) Question 10 (2 points) Mr. Murphy is a forty-eight-year-old male who presents for evaluation of his elevated cholesterol. He is also treated for hypertension with chlorthalidone 25 mg once daily. He smokes ½ ppd. He denies prior cardiovascular disease or diabetes. His TC is 260, Trig 283, HDL 38, and LDL value is 192 mg/dL. His ten-year calculated ASCVD risk is 17.8%. According to the ACC/AHA guidelines, what is the most appropriate treatment at this stage? Question 10 options:Institute therapeutic lifestyle changes (TLCs) and recheck the lipid panel in four to six months. Institute moderate-intensity statin treatment (i.e., Atorvastatin 20 mg or pravastatin 40 mg) plus therapeutic lifestyle changes (TLCs). Institute high-intensity statin treatment (i.e., Atorvastatin 40 mg or rosuvastatin 20 mg) plus TLCs. Start nicotinic acid (Niacin 1000 mg) and Omega 3 fatty acid