FNP 2 Exam 2 Practice Questions Complete Solution 2023

72 y.o woman has been on hydrochlorothiazide 12.5 mg for many years to control her stage 2 hypertension. Her BP at this visit is 168/ 96. She has pain to her right hip/ knees and takes 400mg Ibuprofen 3X daily. Which of the following is the appropriate education to give her about Ibuprofen on her disease? A. Increases the chances of adverse effects on her health. B. Inhibits the effect of renal prostaglandins and blunts the effectiveness of the diuretic. C. Prolongs the therapeutic effects of hydrochlorothiazide and other diuretics D. None of the above are true - B. It inhibits the effect of renal prostaglandins and blunts the effectiveness of the diuretic: NSAIDS and ASA inhibit vasodilatory effects of prostaglandins which predisposes the kidney to ischemia. NSAIDS and diuretics can cause acute pre-renal failure by decreasing renal blood flow Which of the following anti-hypertensive medications has beneficial effects for an elderly female with osteoporosis? A. Calcium Channel Blocker B. Angiotensin-converting enzyme (ACE) inhibitor C. Beta-Blocker D. Diuretic - A. Calcium Channel blocker: these work by blocking the calcium channels in the heart muscle and blood vessels, thereby keeping more calcium in the bones. Which of the following lab tests is used in primary care to evaluate renal function? A. Electrolyte panel B. Creatinine C. Alkaline Phosphatase D. Blood Urea Nitrogen (BUN) - B. Creatinine A 63 y.o. patient presents with a 10 year history of poorly controlled hypertension presents with a cluster of physical exam findings. Which of the following indicates target organ damage commonly seen in hypertensive patients? A. Pedal Edema, hepatomegaly and enlarged kidneys B. Hepatomegaly, AV nicking, bibasilar crackles C. Renal infection, S3, neuromuscular abnormalities D. Glaucoma, jugular vein atrophy and heart failure - B: hepatomegaly Av nicking and bibasilar crackles: with long-term HTN, organ damage can occur. Organs commonly affected include brain (stroke), eyes (retinopathy, AV nicking, bleeding, blindness) and heart ( left ventricle hypertrophy, MI, and/or CHF), and kidneys (renal failure, proteinuria). Jason, an 8 y.o. boy with Type 1 diabetes is being seen for a 3 day history of nocturia and frequency. Denies flank pain, and is afebrile. The UA result is negative for blood and nitrites but is positive for a large amount of leukocytes and ketones. He has a trace amount of proteins. Which of the following is the best test to order inititally? A. Urine culture/ Sensitivity B. 24 hour urine for protein and creatinine clearance C. 24 hour urine for microalbumin D. An IV pyelogram - A. Urine culture and sensitivity: an 8 y.o. boy with Type 1 diabetes is at high risk for UTI. Large amount of leukocytes is abnormal, and he has symptoms of frequency and nocturia for the last 3 days. The Urine culture and sensitivity would be best to diagnose and treat UTI.