NU636 Quiz 2

Note- I got a 32/40 with the highlighted choices. I do not know which are wrong. 1. On your schedule for today is a 51-year-old African American male patient diagnosed three months ago with hypertension. The patient was started on chlorthalidone 25mg and educated on the DASH diet. At his one month follow up his chlorthalidone was increased to 50mg a day. He is I for his three month follow up. His BP today is 162/108. You review his home BP log and find todays reading aligns with most of the readings he documented from home monitoring. Witch the following is the most appropriate addition to his treatment plan? A .Add Ramipril 2.5 mg b .Change from Chlorthalidone to HCTZ c. Add Carvedilol 12.5 mg d. Add 5 mg of amlodipine 2. You have calculated the 10-Year risk of cardiac disease and stroke for your Type2 diabetic patient and find their values place in the pharmacologic treatment benefit range. The patient is averse to taking a statin but agrees to a trial of niacin. Patient education needs to include which of the following instructions? a .Avoid Prolonged Sun exposure. b. Decrease daily fluid intake c. Reduce frequency of blood glucose monitoring. d. Monitor for signs of orthostatic hypotension. 3. A 77-year-old patient with a history of hypertension comes in newly diagnosed with heart failure. Understanding the treatment guidelines for heart failure which of the following would you anticipate the patient to have been initially prescribed for NYHA class I/AHA stage A heart failure? A. Diurectic B. Calcium Channel Blocker C. ACE inhibitor D. Beta Blocker 4. You are seeing an 88 year old female patient in follow up for her long standing hypertension. Her hypertension. Her hypertension is well managed on 80 mg of Diovan (valsartan) for several years. Understanding the mechanism of action of the ARBs you know it works to lower blood pressure by which of the following? a. Facilitates the release of aldosterone b. Inhibits calcium influx into smooth muscle c. Enhances prostaglandin synthesis d. Blocks the action of angiotensin II 5. Ms. Y is a 74 year old African American female in for her annual health evaluation. She denies any health problems or concerns. She is not on any routine medications and reports to taking melatonin 5mg occasionally at night to sleep. Her BP on intake for the visit is 147/88. Based on the JNC 8 guidelines which of the following interventions should be included in the treatment plan for her? o Prescribe 12.5 mg chlorthalidone daily o Prescribe 5 mg amlodipine daily o Prescribe no medication o Prescribe 10mg lisinopril daily 6. One of your office colleagues patients is on your schedule today. When asking for a same day appointment reported to the front office staff they were feeling extremely fatigued and noted that there urine was "very dark". Upon interviewing the patient ,you learn that for the last 6 weeks the patient has been on lovastatin(Mevacor) 80 mg a day with dinner due to his last lipid panel with a total cholesterol level of 329.The patient denies any muscle pain or stiffness. You have the patient give you a urine specimen and inspection reveals it looks like "cola cola". The treatment plan for todays visit includes ordering labs and deciding on how to manage the Mevacor. Which of the following is most appropriate for todays treatment plan? a. Order a liver panel, a CK level, a lipid panel with no change in Mevacor. b. Order a liver panel, a CK level, a lipid panel and half the Mevacor dose c. Order a liver panel, a CK level, a lipid panel and dose of Mevacor every other day d. Order a liver panel, a CK level, a lipid panel and discontinue the Mevacor 7. You are evaluating lipid panel results of a 44-year old male. Results are as follow: total cholesterol of 256, HDL 32, LDL 159, and triglycerides 95. Based on these findings which of the following should you do? o Refer him to a cardiologist o Recommend regular aerobic activity o Calculate 10-year risk of heart disease/stroke o Prescribe a low dose statin 8. Two weeks ago, you diagnosed a 39 year old nonsmoking patient with hypertension. The patient returns to the office today with a complaint of a dry cough within a week of starting on the BP medication. With knowledge of the side effects of hypertensive medications the advanced practice nurse suspects the new onset cough is likely a side effect of which of the following? a. Thiazide Diuretic b .ACE inhibitor c. Beta Blocker d. Calcium channel blocker 9. You have a patient who is under the care of their cardiologist for atrial fibrillation. The patients current management regimen includes amiodarone. Which of the following is not an adverse event associated with the amiodarone?