NSG 6005 WEEK 3 KNOWLEDGE CHECK QUIZ 1 ANSWERS (Graded A+)

NSG 6005 WEEK 3 KNOWLEDGE CHECK QUIZ 1 ANSWERS Question : Disease states in addition to hypertension in which beta blockade is a compelling indication for the use of beta blockers include: Student Answer: Heart failure Angina MI Dyslipidemia Points Received: 2.5 of 2.5 Comments: Question 2. Question : Patients who are being treated for folate deficiency require monitoring of: Student Answer: Complete blood count every four weeks Hematocrit and hemoglobin at one week and then at eight weeks Reticulocyte count at one week Folate levels every four weeks until the hemoglobin stabilizes Points Received: 2.5 of 2.5 Comments: Question 3. Question : A potentially life-threatening adverse response to ACE inhibitors is angioedema. Which of the following statements is true about this adverse response? Student Answer: Swelling of the tongue and hoarseness are the most common symptoms. It appears to be related to a decrease in aldosterone production. The presence of a dry, hacky cough indicates a high risk for this adverse response. Because it takes time to build up a blood level, it occurs after being on the drug for about one week. Points Received: 2.5 of 2.5 Comments: Question 4. Question : The treatment for vitamin B12 deficiency is: Student Answer: 1,000 mcg daily of oral cobalamin 2 gm/day of oral cobalamin 100 mcg/day vitamin B12 IM 500 mcg/dose nasal cyanocobalamin two sprays once a week Points Received: 2.5 of 2.5 Comments: Question 5. Question : Scott is presenting for follow-up on his lipid panel. He had elevated total cholesterol, elevated triglycerides, and an LDL of 122 mg/dL. He has already implemented diet changes and increased physical activity. He has mildly elevated liver studies. An appropriate next step for therapy would be: Student Answer: Atorvastatin (Lipitor) Niacin (Niaspan) Simvastatin and ezetimibe (Vytorin) Gemfibrozil (Lopid) Points Received: 2.5 of 2.5 Comments: Question 6. Question : The American Heart Association and the American College of Cardiology have devised a classification system for heart failure that can be used to direct treatment. Patients with symptoms and underlying disease are classified as: Student Answer: Stage A Stage B Stage C Stage D Points Received: 2.5 of 2.5 Comments: Question 7. Question : ACE inhibitors are the drug of choice in treating hypertension in diabetic patients because they: Student Answer: Improve insulin sensitivity Improve renal hemodynamics Reduce the production of angiotensin II All of the above Points Received: 2.5 of 2.5 Comments: Question 8. Question : Beta blockers treat hypertension because they: Student Answer: Reduce peripheral resistance. Vasoconstrict coronary arteries. Reduce norepinephrine. Reduce angiotensin II production. Points Received: 2.5 of 2.5 Comments: Question 9. Question : At which stage/classification of hypertension should drug therapy be instituted according to the JNC-7 Report? Student Answer: Prehypertension Stage 1 Stage 2 Any stage where the blood pressure is greater than 120/80 mm Hg Points Received: 2.5 of 2.5 Comments: Question 10. Question : Despite good blood pressure control, a nurse practitioner might change a patient’s drug from an ACEI to an ARB because the ARB: Student Answer: Is stronger than the ACEI Does not produce a dry, hacky cough Has no effect on the renal system Reduces sodium and water retention Points Received: 2.5 of 2.5 Comments: Question 11. Question : Furosemide is added to a treatment regimen for heart failure, which includes digoxin. Monitoring for this combination includes: Student Answer: Hemoglobin Serum potassium Blood urea nitrogen Serum glucose Points Received: 2.5 of 2.5 Comments: Question 12. Question : Kyle has Crohn’s disease and has a documented folate deficiency. Drug therapy for folate deficiency anemia is: Student Answer: Oral folic acid 1 to 2 mg/day Oral folic acid 1 gm/day IM folate weekly for at least six months Oral folic acid 400 mcg daily Points Received: 2.5 of 2.5 Comments: Question 13. Question : Heart failure is a chronic condition that can be adequately managed in primary care. However, consultation with or referral to a cardiologist is appropriate when: Student Answer: Symptoms markedly worsen or the patient becomes hypotensive and has syncope. There is evidence of progressive renal insufficiency or failure. The patient remains symptomatic on optimal doses of an ACE inhibitor, a beta blocker, and a diuretic. All the above options are correct. Points Received: 2.5 of 2.5 Comments: Question 14. Question : Dulcea has type II diabetes and a high triglyceride level. She has gemfibrozil prescribed to treat her hypertriglyceridemia. A history of which of the following might contraindicate the use of this drug? Student Answer: Reactive airway disease/asthma Inflammatory bowel disease Allergy to aspirin Gallbladder disease Points Received: 2.5 of 2.5 Comments: Question 15. Question : An ACE inhibitor and what other class of drug may reduce proteinuria in patients with diabetes better than either drug alone? Student Answer: Beta blockers Diuretics Nondihydropyridine calcium channel blockers Angiotensin II receptor blockers Points Received: 2.5 of 2.5 Comments: Question 16. Question : Art is a fifty-five-year-old smoker who has been diagnosed with angina and placed on nitrates. He complains of headaches after using his nitrate. An appropriate reply might be: Student Answer: “This is a parasympathetic response to the vasodilating effects of the drug.” “Headaches are common side effects with these drugs. How severe are they?” “This is associated with your smoking. Let’s work on having you stop smoking.” “This is not related to your medication. Are you under a lot of stress?” Points Received: 2.5 of 2.5 Comments: Question 17. Question : Digoxin has a very limited role in the treatment of heart failure. It is used mainly for patients with: Student Answer: Ejection fractions above 40% An audible S3 Mitral stenosis as a primary cause for heart failure Renal insufficiency Points Received: 2.5 of 2.5 Comments: Question 18. Question : Jose is a twelve-year-old overweight child with a total cholesterol level of 180 mg/dL and LDL of 125 mg/dL. Along with diet education and recommending increased physical activity, a treatment plan for Jose would include ____ with a reevaluation in six months. Student Answer: statins niacin sterols bile acid-binding resins Points Received: 2.5 of 2.5 Comments: Question 19. Question : In teaching about the use of sublingual nitroglycerine, the patient should be instructed: Student Answer: To swallow the tablet with a full glass of water To place one tablet under the tongue if chest pain occurs and allow it to dissolve To take one tablet every five minutes until the chest pain goes away That it should “burn” when placed under the tongue or it is no longer effective Points Received: 2.5 of 2.5 Comments: Question 20. Question : Which of the following classes of drugs is contraindicated in heart failure? Student Answer: Nitrates Long-acting dihydropyridines Calcium channel blockers Alpha-beta blockers Points Received: 2.5 of 2.5 Comments: