NURSE PRACTITIONER CERTIFICATION EXAM AND PRACTICE PREP CARDIOVASCULAR REVIEW TEST.

NURSE PRACTITIONER CERTIFICATION EXAM AND PRACTICE PREP CARDIOVASCULAR REVIEW TEST. You examine a 38 year old woman who has presented for an initial examination and Papanicolaou test. She has no complaint. Her BP is 154/98 mm Hg bilaterally and her BMI is 31 kg/m2. The rest of her physical exam is unremarkable. Your next best action is to: A. initiate antihypertensive therapy B. arrange for at least two additional BP measurements during the next 2 weeks. C. order BUN, creatinine, and potassium ion measurements and UA D. advise her to reduce her sodium intake - CORRECT ANSWER B. arrange for at least two additional BP measurements during the next 2 weeks You see a 68 year old woman as a pt who is transferring care into your practice. She has a 10y history of HTN, diabetes mellitus, and hyperlipidemia. Current medications include HCTZ, glipizide, metformin, simvastatin, and daily low-dose aspirin. Today's BP reading is 158/92mm Hg and the rest of her history and exam are unremarkable. Documentation from her former healthcare provider indicates that her BP has been in the range for the past 12 months. Your next best action is to: A. prescribe an ACEI B. have her return for a BP check in 1 week C. advise that her current therapy is adequate D. add therapy with an aldosterone antagonist - CORRECT ANSWER A. prescribe an ACEI You examine a 78 y/o woman with long-standing poorly controlled hHTN. When evaluating her for HTN target organ damage, you look for evidence of: A. lipid abnormalities B. insulin resistance C. left ventricular hypertrophy D. clotting disorders - CORRECT ANSWER C. left ventricular hypertrophy Diagnostic testing for a pt with newly diagnosed primary hHTN should include all of the following except: A. hematocrit B. uric acid C. creatinine D. potassium - CORRECT ANSWER B. uric acid In the person w/HTN, the nurse practitioner recommends all of the following to potentially reduce BP in a patient with a BMI of 30 kg/m2 except: A. 10kg weight loss B. dietary sodium restriction to 2.4g per day C. regular aerobic physical activity, such as 30-40 minutes of brisk walking most days of the week D. consuming at least 1-2 servings of alcohol - CORRECT ANSWER D. consuming at least 1-2 servings of alcohol what class of antihypertension medication is amlodipine? - CORRECT ANSWER dihydropyridine calcium channel blocker what class of antihypertension medication is diltiazem? - CORRECT ANSWER nondihydropyridine calcium channel blocker what class of antihypertension medication is trandolapril? - CORRECT ANSWER ACEI what class of antihypertension medication is telmisartan? - CORRECT ANSWER angiotensin receptor antagonist what class of antihypertension medication is pindolol? - CORRECT ANSWER beta-adrenergic receptor antagonist You see a 38-year old African American male with HTN who is currently being treated with thiazide-type diuretic. His current BP reading is 156/94mm HG and he has no history of DM or CKD. Following current best evidence, you consider adding which of the following medications? A. ACEI B. ARBs C. beta-adrenergic receptor antagonist D. calcium channel blocker - CORRECT ANSWER D. calcium channel blocker nondihydropyridine calcium channel blockers are contraindicated in pts with: A. type 1 DM B. a history of venous thromboembolism C. severe left ventricular dysfunction D. concomitant treatment with an ACEI - CORRECT ANSWER C. severe left ventricular dysfunction In obtaining an office BP measurement, which of the following is most reflective of the best practice? A. the patient should sit in a chair with feet flat on the floor for at least 5 minutes before obtaining the reading B. the BP cuff should not cover more than 50% of the upper arm C. the pt should sit on the edge of the exam table w/o arm support to enhance reading accuracy D. obtaining the BP reading immediately after the pt walks into the exam room is recommended - CORRECT ANSWER A. the patient should sit in a chair with feet flat on the floor for at least 5 minutes before obtaining the reading A BP elevation noted only at an office visit is commonly known as ____________ hypertension A. provider-induced B. clinical C. white coat D. pseudo - CORRECT ANSWER C. white coat The most important long-term goal of treating HTN is to: A. strive to reach recommended numeric BP measurement B. avoid disease-related target organ damage C. develop a plan of care with minimal adverse effects D. treat concomitant health problems often noted in the person with this condition - CORRECT ANSWER B. avoid disease-related target organ damage You start a pt with HTN who is already receiving an ACEI on spironolactone. You advise pt to return in 4 weeks to check which of the following lab parameters? A. sodium B. calcium C. potassium D. chloride - CORRECT ANSWER C. potassium