,UTA CP2 NURS 5338
Question 1
A 72-year-old male with heart failure and reduced ejection fraction is
started on carvedilol. What is the most important adverse effect to monitor
during initiation?
A. Tachycardia
B. Hypotension and bradycardia
C. Hyperglycemia
D. Bronchospasm
Correct Answer: B. Hypotension and bradycardia
Rationale: Carvedilol is a non-selective beta-blocker with alpha-blocking
activity. Initiation can cause significant hypotension and bradycardia due to
decreased cardiac output and peripheral vasodilation. Doses must be titrated
slowly. Tachycardia is not expected; hyperglycemia is more associated with
thiazides; bronchospasm can occur but is less common with carvedilol than
with non-selective beta-blockers like propranolol.
Question 2
Which of the following medications is considered first-line therapy for
stable angina?
A. Amlodipine
B. Nitroglycerin sublingual
C. Metoprolol succinate
D. Ranolazine
Correct Answer: C. Metoprolol succinate
,Rationale: Beta-blockers like metoprolol are first-line for stable angina
because they reduce myocardial oxygen demand by decreasing heart rate
and contractility. Nitroglycerin is used for acute relief, not chronic
management. Amlodipine and ranolazine are second-line or adjunctive
agents.
Question 3
A patient with gout is started on allopurinol. What education should the
provider give regarding initial therapy?
A. Take with a full glass of water and expect flares to decrease immediately
B. Gout flares may increase initially; continue medication and use NSAIDs
for flare management
C. Avoid all dietary purines while taking this medication
D. This medication is safe in pregnancy without restrictions
Correct Answer: B. Gout flares may increase initially; continue
medication and use NSAIDs for flare management
Rationale: Allopurinol lowers uric acid, but rapid mobilization of urate can
precipitate acute flares. Prophylactic NSAIDs or colchicine are often
prescribed alongside allopurinol for the first few months. Patients must be
educated to continue allopurinol even during a flare.
Question 4
A 60-year-old female with osteoporosis is prescribed alendronate. Which
instruction is most important regarding administration?
A. Take with food to reduce gastric upset
B. Take on an empty stomach with a full glass of water and remain upright
for 30 minutes
, C. Take at bedtime with milk to enhance absorption
D. Take with calcium supplements to improve bone density
Correct Answer: B. Take on an empty stomach with a full glass of water
and remain upright for 30 minutes
Rationale: Alendronate must be taken on an empty stomach with plain water,
and the patient must remain upright for at least 30 minutes to prevent
esophageal ulceration. Food, calcium, and other beverages reduce absorption
significantly.
Question 5
A patient on hydrochlorothiazide for hypertension presents with new-onset
muscle cramps and fatigue. Which electrolyte abnormality is most likely?
A. Hyperkalemia
B. Hyponatremia
C. Hypokalemia
D. Hypercalcemia
Correct Answer: C. Hypokalemia
Rationale: Thiazide diuretics increase potassium excretion in the distal tubule,
leading to hypokalemia. This can present as muscle cramps, weakness, and
fatigue. Hyperkalemia is more common with potassium-sparing diuretics or
ACE inhibitors.
Question 6
Which statin has the highest potency for LDL reduction?
A. Simvastatin
B. Pravastatin
Question 1
A 72-year-old male with heart failure and reduced ejection fraction is
started on carvedilol. What is the most important adverse effect to monitor
during initiation?
A. Tachycardia
B. Hypotension and bradycardia
C. Hyperglycemia
D. Bronchospasm
Correct Answer: B. Hypotension and bradycardia
Rationale: Carvedilol is a non-selective beta-blocker with alpha-blocking
activity. Initiation can cause significant hypotension and bradycardia due to
decreased cardiac output and peripheral vasodilation. Doses must be titrated
slowly. Tachycardia is not expected; hyperglycemia is more associated with
thiazides; bronchospasm can occur but is less common with carvedilol than
with non-selective beta-blockers like propranolol.
Question 2
Which of the following medications is considered first-line therapy for
stable angina?
A. Amlodipine
B. Nitroglycerin sublingual
C. Metoprolol succinate
D. Ranolazine
Correct Answer: C. Metoprolol succinate
,Rationale: Beta-blockers like metoprolol are first-line for stable angina
because they reduce myocardial oxygen demand by decreasing heart rate
and contractility. Nitroglycerin is used for acute relief, not chronic
management. Amlodipine and ranolazine are second-line or adjunctive
agents.
Question 3
A patient with gout is started on allopurinol. What education should the
provider give regarding initial therapy?
A. Take with a full glass of water and expect flares to decrease immediately
B. Gout flares may increase initially; continue medication and use NSAIDs
for flare management
C. Avoid all dietary purines while taking this medication
D. This medication is safe in pregnancy without restrictions
Correct Answer: B. Gout flares may increase initially; continue
medication and use NSAIDs for flare management
Rationale: Allopurinol lowers uric acid, but rapid mobilization of urate can
precipitate acute flares. Prophylactic NSAIDs or colchicine are often
prescribed alongside allopurinol for the first few months. Patients must be
educated to continue allopurinol even during a flare.
Question 4
A 60-year-old female with osteoporosis is prescribed alendronate. Which
instruction is most important regarding administration?
A. Take with food to reduce gastric upset
B. Take on an empty stomach with a full glass of water and remain upright
for 30 minutes
, C. Take at bedtime with milk to enhance absorption
D. Take with calcium supplements to improve bone density
Correct Answer: B. Take on an empty stomach with a full glass of water
and remain upright for 30 minutes
Rationale: Alendronate must be taken on an empty stomach with plain water,
and the patient must remain upright for at least 30 minutes to prevent
esophageal ulceration. Food, calcium, and other beverages reduce absorption
significantly.
Question 5
A patient on hydrochlorothiazide for hypertension presents with new-onset
muscle cramps and fatigue. Which electrolyte abnormality is most likely?
A. Hyperkalemia
B. Hyponatremia
C. Hypokalemia
D. Hypercalcemia
Correct Answer: C. Hypokalemia
Rationale: Thiazide diuretics increase potassium excretion in the distal tubule,
leading to hypokalemia. This can present as muscle cramps, weakness, and
fatigue. Hyperkalemia is more common with potassium-sparing diuretics or
ACE inhibitors.
Question 6
Which statin has the highest potency for LDL reduction?
A. Simvastatin
B. Pravastatin
