NR-603 Week 3 Quiz Essay Assignment

NR-603 Week 3 Quiz: Solutions, Possible Q & A, Topics

NR-603 Week 3 Quiz: Solutions, Possible Q & A, Topics

NR 603 Week 3 Quiz (Possible Q & A)
  1. Question: Per 2013 ACC/AHA guidelines, which patient below would NOT benefit from statin therapy?
  2. Question: Which of the following patients should be on high-intensity statin therapy, if tolerated?
  3. Question: For someone who is intolerant to higher doses of statins, has tried 2-3 statins…what do we recommend?
  4. Question: You have a patient with ASCVD but no comorbidities. Their LDL has gone down 30% from baseline and they are on maximally tolerated statin therapy.  Is this patient appropriate for non-statin therapy and if so, what do you recommend?
  5. Question: IG is a 47 yo male with CAD s/p MI 2015. He is currently prescribed atorvastatin 20 mg/day. Pt states he is unable to tolerate higher doses and refuses to try another statin. LDL 114 mg/dL. What is the next best step?
  6. Question: YZ is a 67 yo female with DM and 10 year risk score 11.1%. She is currently prescribed atorvastatin 80 mg once daily with reported adherence. Current LDL-C 141 mg/dL. What is the next best step for cardiovascular risk reduction.
  7. Question: TL is a 52 yo black male overbooked in your clinic today for evaluation of fasting labs per primary provider request. He is without complaints.
    Pertinent medications include amlodipine 10 mg/day and atorvastatin 20 mg/day
    + tobacco use, 3-4 beer/night Labs: TC 302, HDL 21, TG 1167, direct LDL 152, SCr 1.1
    BP 145/78, height 74 inches, weight 113.4 kg
  8. Question: Which of the following drugs inhibits factor IIa (thrombin) and factor Xa by activating antithrombin?
  9. Question: Which of the following drugs have pharmacogenomic information in the FDA label? Select all correct answers (there may be more than one).
    Clopidogrel   B. Atorvastatin   C. Metoprolol    D. Warfarin.   (they all do)
  10. Question: Variants in which of the following genes have the most compelling evidence for association with clopidogrel response?
  11. Question: Brown a 45-year-old African American male has elevated lipids. What should the nurse practitioner do next?
    *A thyroid stimulating hormone (TSH) level
  12. Question: Which of the following medications may have an unfavorable effect on a hypertensive patient’s blood pressure?
  13. Question: Which group of medications would … detrimental if used to treat a patient who has heart failure
  14. Question: A patient with hypertension has been … with gout. Which home medication may have contributed to this episode of gout?
  15. Question: Which of the … class of drugs is preferred treatment for a diabetic with stage II hypertension?
  16. Question: 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?
  17. Question: You are treating a young adult female with HTN and migraine headaches. Which class of medications could you choose to treat both?
  18. Question: A 42-year-old male presents with the following lipid profile. He is not on any medications for cholesterol or herbal supplements…….What medication would you recommend?
  19. Question: 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?
  20. Question: What would you advise this patient regarding taking his atrovastatin (Lipitor)?
  21. Question: 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 … with rest. Which of the following does this best describe?
  22. Question: Which of the following antihypertensive medications would you avoid prescribing for an elderly white female with the comorbid diagnosis of osteoporosis?
  23. Question: What is the most common cause of left ventricular hypertrophy in the United States
  24. Question: Which of the following heart sounds is …. with heart failure?
  25. Question: 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
  26. Question: 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?
  27. Question: What is your treatment plan for this patient with difficulty breathing, cough, weight gain, edema, and S3 heart sounds?
  28. Question: 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?
  29. Question: Upon examination of a 17-year-old during a sports physical, you hear a split S2 during inspiration that disappears during expiration. The patient denies chest pain and dyspnea. What will you tell the mother and patient regarding your findings?
  30. Question: Which of the following findings are suggestive of renovascular hypertension?
  31. Question: Selma has acute peripheral arterial occlusion of a lower extremity. Before you begin your examination, you know that it:
  32. Question: Marvin, age 56, is a smoker with diabetes mellitus. He has just been … as hypertensive. Which of the following drugs has the potential to cause the development of bronchial asthma and inhibit gluconeogenesis?
  33. Question: Nathan, age 63, comes for his annual physical. He has a history of mild hypertension and hyperlipidemia that he has not been successful in treating by diet and weight loss. His only complaint is a problem with impotence. On physical examination, you note a palpable, pulsatile abdominal mass in the umbilical region; a bruit above the umbilical region; and diminished femoral pulses. You suspect:
  34. Question: Which of the following usually indicates hyperlipidemia?
  35. Question: Ted, age 18, is to have a cardiac screening examination to determine if he can play college basketball. The … test of choice for detecting hypertrophic cardiomyopathy or idiopathic left ventricular hypertrophy is a(n):
  36. Question: Which of the following conditions or medications can increase triglycerides?
  37. Question: What is the most important question to ask when a client presents with chest pain?
  38. Question: Pathological U waves on the electrocardiogram are most commonly … with which disorder?
  39. Question: Cough, loss of taste, and rash are adverse effects … with which class of antihypertensive agents?
  40. Question: According to the Eighth Joint National Committee JNC 8 guidelines, what is the goal BP level in healthy patients age 60 and older?
  41. Question: Signs of right-sided heart failure include:
  42. Question: Rick is modifying his diet to try to lose weight, but after 3 months, he has not lost any weight, even though he has complied with his diet plan. A follow-up lipid profile reveals the following: total cholesterol, 238 mg/dL; triglycerides, 100 mg/dL; high-density lipoprotein cholesterol, 28 mg/dL; and low-density lipoprotein cholesterol, 190 mg/dL. What would you recommend?
  43. Question: Jeremiah has been on lipid-lowering therapy (statins) for 2 years. He is new to your practice. He says, “I haven’t had my liver function tests (LFTs) in a while to check if my cholesterol medication is causing a problem.” What do you tell him?
  44. Question: Which of the following statements is true about hypertension (HTN) during pregnancy?
  45. Question: Michaels has a long-standing cardiac problem. His electrocardiogram rhythm strip is shown below. Which medication should he be taking to prevent a pulmonary or cerebral problem?
    Afib rhythm
  46. Question: While much teaching is … for your client with congestive heart failure, the most beneficial thing you can tell him that might prevent rehospitalization may … :
  47. Question: A patient with a shallow ulcer on foot with edema to that leg presents. The patient the effected leg has had a chronic dull pain for the last year. Based on these findings the nurse practitioner suspects what diagnosis?

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NR-603 Week 3 Quiz (Study Topics)

Heart Failure (ch 121)

  • Congestive heart failure (CHF) risks
  • CHF typical presentation
  • NYHA Classification of CHF
  • AHA/ACC 2009 – staging system of heart
  • HFrEF stands for
  • HFpEF stands for
  • HFmrEF stands for
  • CHF Diagnosis orders
  • CHF treatment & management
  • CHF treatment & management : ACE targets
  • CHF treatment & management : Beta blocker targets
  • **CHF treatment & management : 2016 guidelines**
  • ARNI – ARB combined w neprilysin
  • Other management guidelines for CHF
  • Top 10 challenges of CHF management

High Cholesterol ( ch 211)

  • Hyperlipidemia LDL-C (mg/dL)
  • Triglycerides (mg/dL) HDL-C
  • 10-year ASCVD risk (IB) assessment
  • Lifetime ASCVD risk assessment
  • Other tests of value for ASCVD assessment
  • Lifestyle recommendations forASCVD prevention
  • TLC for hyperlipidemia ; Nutrition
  • Exercise recommendations for hyperlipidemia/BP
  • Primary prevention for ASCVD; Statin Medications
  • Secondary prevention for ASCVD; Statin Medications
  • What do you assess prior to starting Statin therapy
  • Common secondary causes of hyperlipidemia
  • Complimentary medicine for hypercholesterolemia
  • Co-enzyme Q 10 doses
  • interpret labs and ASCVD risk assessment:

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HTN- (ch 122)

  • Define hypertension, both systolic and diastolic
  • Differentiate between:
  • Discuss the prevalence of primary and secondary hypertension in this country
  • Discuss the procedure for obtaining an accurate blood pressure
  • Compare office blood pressure to ambulatory blood pressure monitoring and home monitoring in the diagnosis and treatment of hypertension
  • Outline and explain each portion of the work-up for the patient with primary and secondary hypertension. Include important aspects of:
  • Formulate treatment goals for hypertension
  • Manage the treatment of hypertension including lifestyle modification and pharmacologic therapy based on the JNC 7 algorithm
  • Describe the following for Thiazide-diuretics:
  • Describe the following for Beta-Blockers:
  • Describe the following for Ca Channel Blockers:
  • Describe the following for ACE-Inhibitors:
  • Describe the following for Aldosterone antagonists:
  • Discuss the use of Osteopathic Manipulation in the treatment of hypertension
  • Outline follow-up visits for the treatment of hypertension
  • What are causes of secondary hypertension? (hint ABCDE)
  • Define hypertension for children and adolescents
  • Discuss the relationship between BP & CVD
  • What specific questions should you ask during the history?
  • What specific questions should you ask during the review of systems?
  • What specifically should you look at when performing a physical exam on a pt whom you suspect has HTN
  • Describe what lab and diagnostic tests would be useful to determine cause of secondary hypertension?
  • Describe recommended lifestyle modifications
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  • Discuss the treatment of hypertension in special groups such as:
  • Describe the favorable outcomes for drug considerations in treatment of HTN
  • Describe the unfavorable outcomes for drug considerations in treatment of HTN
  • Define resistant hypertension
  • List possible reasons for resistant hypertension
  • Discuss patient compliance for treatment of HTN
  • Differentiate secondary causes of hypertension based of clinical presentation:
  • Discuss the treatment of hypertension in special groups such as:

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 MI- ( ch 120)

  • Types of MI
  • Anterior wall MI
  • Septal Wall MI
  • lateral wall MI
  • Inferior wall MI
  • RV infarction
  • Symptoms of MI
  • 5 components of Pain Assessment
  • Diagnositc Test for MI
  • Tx and *N intervention for MI
  • Drug therapy for MI
  • Additional *N care for MI
  • Discharge planning for MI

PE (pulmonary embolism)  

  • Define PE: Pulmonary Embolus.
  • What does it reduce?
  • What do the effects produce?
  • Blockage of pulmonary arteries by thrombus, fat or air embolus, or tumor tissue and Obstructs alveolar perfusion is what condition?
  • Pulmonary embolism most commonly affect what lobes?
  • What are risk factors for pulmonary embolism?
  • What is the most common symptom of pulmonary embolism(PE)?
  • S/S of PE are dependent on size and extent of?
  • Alveolar necrosis and hemorrhage, Abscess, and Pleural effusion are s/s is from what complication that can happen from PE?
  • What complication from PE Results from hypoxemia associated with massive or recurrent emboli and Right ventricular hypertrophy?
  • … for PE gets Elevated with any clot degradation and False negatives with small PE?
  • What diagnostic test is used most frequently for dx test and requires IV contrast media?
  • What diagnostic test is used if pt can’t have contrast?
  • … test is the most sensitive but invasive?
  • ______ is key for PE?
  • Collaborative care for PE:
  • Goals of treatment for PE:
  • Examples of supportive care for PE?
  • Examples of fibrinolytic agents used for PE?
  • What surgical therapy should be used for a massive PE?
  • What surgical therapy prevents migration of clots in pulmonary system?
  • Nursing management for PE:
  • What should a nurse teach to a pt with PE?
  • Evaluation:

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NR 603 Week 3 Quiz (Correct Solutions)
  1. Question: Which of the following drugs does the 8th Joint National Committee (JNC-8) 2014 Evidence Based Guidelines for the Management of High Blood Pressure in Adults recommend for the initial treatment for Caucasian males with microalbuminuria?
  2. Question: A 58 year old male presents to the clinic with a several year history of uncontrolled hypertension. You perform your physical assessment. Which group of physical findings is commonly seen in target organ change in uncontrolled hypertension?
  3. Question: A 44 year old male patient presents to the clinic for evaluation of an episode of chest tightness that radiated to his back that he had earlier in the day when he was out for a walk. He states that once he came home and sat down, the chest tightness resolved. What is the most likely cause of the chest tightness?
  4. Question: A 60 year old woman comes in to the clinic complaining of nausea, shortness of breath, and a dull pain in the middle of her back while playing tag in the yard with her grandchildren yesterday. Her past medical history includes CAD, Type 2 DM, and HTN. Lab work reveals negative Troponins….The most appropriate diagnostic testing includes:
  1. Question: Exercise tolerance Test (ETT) is the first line approach to detecting CAD in stable patients. However, ETT is contraindicated for some patients. Knowing when to consult with specialists is an important part of NP practice. Which patient should … referred to Cardiology to ordering and Exercise Tolerance Test?
  2. Question: A 60 year old male with a history of Type 2 Diabetes and HTN comes in for a follow-up Blood Pressure Check to evaluate the recent medication/diet/exercise plan you prescribed at his visit 3 months ago. Hi BMI is 20
  • His Blood Pressures sitting and standing are
  • 138/80 mm/Hg
  • 132/76 mm/Hg
  • What is the best analysis of the … treatment plan?
  1. Question: This hypertensive drug is the first choice for diabetic and renal failure pts per National Guidelines.
  2. Question: … cause of death for women in the United States is
  3. Question: You are reviewing the labs of a 50 year old patient who … to you for a physical examination. You note, upon review of her lab, that her triglycerides are 670. Triglyceride levels over 500 mg/dl raise an immediate concern for which of the following:
  4. Question: An 82 year old obese female patient presents to the clinic complaining of gradually increasing shortness of breath, weight gain of 4 pounds in the last week and atrial fibrillation on EKG. The most likely cause of her symptoms is:

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