1
NR 603 WEEK 3 QUIZ -ALL POSSIBLE
QUESTION
Per 2013 ACC/AHA guidelines, which patient below would NOT benefit from statin therapy?
- 42 yo male, LDL 162 mg/dL, 10 yr risk 4.9%
Which of the following patients should be on high-intensity statin therapy, if tolerated?
58 yo male w/ NSTEMI
- 71 yo female w/ DM, HTN, 10 yr risk 11.5%
- 41 yo male w/ baseline LDL 206 mg/dL
- 64 yo female w/ history of CVA
- All of the above
For someone who is intolerant to higher doses of statins, has tried 2-3 statins...what do we recommend?
There's no true guidelines on how many different statins to try before moving on to non-statin therapies, but
generally should try 3-4 different statins that differ in metabolism, hydro/lipophilic...and consider alternate day
dosing or twice a week dosing.
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?
It is appropriate to consider non-statin therapy for this pt. b/c they have ASCVD.
Since their LDL has gone down <50% (or if their LDL >70/non-HDL >100), they should be given ezetimibe 1st
line. PCSK9 would be second line.
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?
Alirocumab
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.
ezetimibe 10 mg once daily
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
Increase atorvastatin to 40 mg/day
Start niacin ER 500 mg/day and titrate by 500 mg every month to target 2000 mg/day
Which of the following drugs inhibits factor IIa (thrombin) and factor Xa by activating antithrombin?
Heparin
Which of the following drugs have pharmacogenomic information in the FDA label? Select all correct answers
(there may be more than one).
A. Clopidogrel B. Atorvastatin C. Metoprolol D. Warfarin. (they all do)
Variants in which of the following genes have the most compelling evidence for association with clopidogrel
response?
CYP2C19
Brown a 45-year-old African American male has elevated lipids. What should the nurse practitioner do next?
*A thyroid stimulating hormone (TSH) level
Which of the following medications may have an unfavorable effect on a hypertensive patient's blood pressure?
Naproxen
Which group of medications would be detrimental if used to treat a patient who has heart failure
Verapamil
NR 603 WEEK 3 QUIZ -ALL POSSIBLE
QUESTION
Per 2013 ACC/AHA guidelines, which patient below would NOT benefit from statin therapy?
- 42 yo male, LDL 162 mg/dL, 10 yr risk 4.9%
Which of the following patients should be on high-intensity statin therapy, if tolerated?
58 yo male w/ NSTEMI
- 71 yo female w/ DM, HTN, 10 yr risk 11.5%
- 41 yo male w/ baseline LDL 206 mg/dL
- 64 yo female w/ history of CVA
- All of the above
For someone who is intolerant to higher doses of statins, has tried 2-3 statins...what do we recommend?
There's no true guidelines on how many different statins to try before moving on to non-statin therapies, but
generally should try 3-4 different statins that differ in metabolism, hydro/lipophilic...and consider alternate day
dosing or twice a week dosing.
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?
It is appropriate to consider non-statin therapy for this pt. b/c they have ASCVD.
Since their LDL has gone down <50% (or if their LDL >70/non-HDL >100), they should be given ezetimibe 1st
line. PCSK9 would be second line.
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?
Alirocumab
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.
ezetimibe 10 mg once daily
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
Increase atorvastatin to 40 mg/day
Start niacin ER 500 mg/day and titrate by 500 mg every month to target 2000 mg/day
Which of the following drugs inhibits factor IIa (thrombin) and factor Xa by activating antithrombin?
Heparin
Which of the following drugs have pharmacogenomic information in the FDA label? Select all correct answers
(there may be more than one).
A. Clopidogrel B. Atorvastatin C. Metoprolol D. Warfarin. (they all do)
Variants in which of the following genes have the most compelling evidence for association with clopidogrel
response?
CYP2C19
Brown a 45-year-old African American male has elevated lipids. What should the nurse practitioner do next?
*A thyroid stimulating hormone (TSH) level
Which of the following medications may have an unfavorable effect on a hypertensive patient's blood pressure?
Naproxen
Which group of medications would be detrimental if used to treat a patient who has heart failure
Verapamil
