NR667 VISE Assignment | Family Nurse Practitioner Exam Prep Questions & Answers
Assessment: Hypertension -Most are asymptomatic; occipital headache,
headache upon waking, blurry vision, fundoscopic
exam (AV nicking, exudates, papilledema), left vent.
hypertrophy, pregnancy w/HTN and proteinuria,
edema, and excessive weight gain
Differential Diagnosis: Hypertension -Secondary HTN, white coat HTN (artificial elevation
d/t medical environment anxiety)
Final Diagnosis: Hypertension -Urinalysis = proteinuria
-Electrolytes, creatinine, calcium
-Fasting lipid profile and BS
-ECG
-Measure BP twice, 5 mins apart
-Patient should be seated; use proper cuff size and
application
Prevention: Hypertension -Maintaining healthy weight and BMI
-Smoking cessation
-Regular aerobic exercise
-Alcohol in moderation (< 1 oz/day)
-Stress management
-Medication compliance
-Assess for and treat OSA
,NR667 VISE Assignment | Family Nurse Practitioner Exam Prep Questions & Answers
Non-pharm management: -Stage 1: Risk score < 10% =lifestyle modification
Hypertension -Stage 2: lifestyle + medication
-DASH eating plan: high fruit, veggies, grains; low
fat dairy, fish, poultry, beans, nuts
-Reduce dietary sodium to 2,300mg/day, increase K+
-Reduce sat. fat intake
-Body weight reduction; 1kg of weight reduction = 1
mm/hg bp reduction
-150 mins of aerobic exercise and/or 3 sessions of
isometric resistance per week
-Treat other underlying diseases
-Check bp 2x/week during pregnancy
Pharmacological management: -Start medication for primary prevention of CVD if
Hypertension pt. has ASCVD risk ≥ 10% and stage 1 HTN or if
ASCVD is < 10% with bp >140/90
-Stage 2: start 2 bp-lowering medications
-African Americans: 2+ medications recommended;
thiazide and CCBs are the most effective
*DO NOT use ACE and ARB concurrently
-Beta blockers are NOT first line
-Thiazides, CCBs, ACEIs, and ARBs can be used
alone or in combo
Pregnancy considerations: -Can use beta blockers (labetalol), methyldopa,
Hypertension CCBs (nifedipine)
-AVOID ARBs and ACEIs
Follow-up: Hypertension -Inquire about adherence and any side effects
-Reassess monthly until patient reaches goal, then
every 3-6 months as needed
Expected course: Hypertension -Only 54% of treated patients are at goal treatment;
expect complications if under treated
-Most patients require more than one medication to
reach goal bp
,NR667 VISE Assignment | Family Nurse Practitioner Exam Prep Questions & Answers
Possible Complications: Hypertension -Stroke, CAD, MI, renal failure, heart failure,
eclampsia (seizures), pulmonary edema,
hypertensive crisis, hypertensive retinopathy, ED
Etiology: Hyperlipidemia -Inherited disorder, high dietary intake, obesity,
sedentary lifestyle, DM, hypothyroidism, anabolic
steroid use, hepatitis, cirrhosis, uremia, nephrotic
syndrome, stress, drug-induced (thiazide diuretics,
beta blockers, cyclosporine), alcohol, caffeine,
metabolic syndrome
Risk factors: Hyperlipidemia -Family history, physical inactivity, smoking, age
(men > 45, women > 55 or premature menopause
without estrogen replacement), obesity, diet high in
sat. fat, DM
Assessment findings: Hyperlipidemia -Few physical findings; xanthomata (fat deposits in
the skin), xanthelasma (yellow plaques on the
eyelid), corneal arcus prior to age 50 (arc of
cholesterol around the iris), bruits, angina pectoris,
MI, stroke
Differential diagnosis: Hyperlipidemia -Secondary causes: hypothyroidism, pregnancy,
DM, non-fasting state
, NR667 VISE Assignment | Family Nurse Practitioner Exam Prep Questions & Answers
Final diagnosis: Hyperlipidemia -Fasting lipid profile: 9-12 hours
-Glucose level
-Urinalysis, creatinine (for detection of nephrotic
syndrome which can induce dyslipidemia)
-Baseline transaminases
-TSH for detection of hypothyroidism (which can
cause secondary dyslipidemia)
-Calculate ASCVD 10-year risk
Prevention: Hyperlipidemia -Healthy lifestyle reduces ASCVD in all age groups
-Dietary interventions: encourage mediterranean
and DASH diet; limit saturated and trans fats; limit
sodium intake; increase fiber, vegetables, fruits, and
other whole grains; eat lean meats (poultry, fish);
eggs, beans, nuts, low-fat dairy, avoid red meat, limit
sugary drinks and sweets
-Mod to vigorous exercise of at least 40 mins 3-
4x/week (sustained aerobic activity increases HDL,
decreases total cholesterol)
-Avoid tobacco
-Appropriately manage systemic diseases (DM,
hypothyroidism, HTN)
Non-pharm management: -Nutrition, weight reduction, increased physical
Hyperlipidemia activity, patient education about risk factors
Pharmacological management: -Assign to a statin treatment group using ASCVD 10-
Hyperlipidemia year risk calculator
-Primary lipid target it LDL
-Statins are 1st-line therapy
-Combo of statin and non-statin in some patients
-Consider adding non-statin if unable to achieve
LDL < 70mg/dl, but VERIFY adherence to statins and
lifestyle changes
-Non-statins: ezetimibe (1st), bile acid sequestrant,
vibrate, PCSK9 inhibitor
Assessment: Hypertension -Most are asymptomatic; occipital headache,
headache upon waking, blurry vision, fundoscopic
exam (AV nicking, exudates, papilledema), left vent.
hypertrophy, pregnancy w/HTN and proteinuria,
edema, and excessive weight gain
Differential Diagnosis: Hypertension -Secondary HTN, white coat HTN (artificial elevation
d/t medical environment anxiety)
Final Diagnosis: Hypertension -Urinalysis = proteinuria
-Electrolytes, creatinine, calcium
-Fasting lipid profile and BS
-ECG
-Measure BP twice, 5 mins apart
-Patient should be seated; use proper cuff size and
application
Prevention: Hypertension -Maintaining healthy weight and BMI
-Smoking cessation
-Regular aerobic exercise
-Alcohol in moderation (< 1 oz/day)
-Stress management
-Medication compliance
-Assess for and treat OSA
,NR667 VISE Assignment | Family Nurse Practitioner Exam Prep Questions & Answers
Non-pharm management: -Stage 1: Risk score < 10% =lifestyle modification
Hypertension -Stage 2: lifestyle + medication
-DASH eating plan: high fruit, veggies, grains; low
fat dairy, fish, poultry, beans, nuts
-Reduce dietary sodium to 2,300mg/day, increase K+
-Reduce sat. fat intake
-Body weight reduction; 1kg of weight reduction = 1
mm/hg bp reduction
-150 mins of aerobic exercise and/or 3 sessions of
isometric resistance per week
-Treat other underlying diseases
-Check bp 2x/week during pregnancy
Pharmacological management: -Start medication for primary prevention of CVD if
Hypertension pt. has ASCVD risk ≥ 10% and stage 1 HTN or if
ASCVD is < 10% with bp >140/90
-Stage 2: start 2 bp-lowering medications
-African Americans: 2+ medications recommended;
thiazide and CCBs are the most effective
*DO NOT use ACE and ARB concurrently
-Beta blockers are NOT first line
-Thiazides, CCBs, ACEIs, and ARBs can be used
alone or in combo
Pregnancy considerations: -Can use beta blockers (labetalol), methyldopa,
Hypertension CCBs (nifedipine)
-AVOID ARBs and ACEIs
Follow-up: Hypertension -Inquire about adherence and any side effects
-Reassess monthly until patient reaches goal, then
every 3-6 months as needed
Expected course: Hypertension -Only 54% of treated patients are at goal treatment;
expect complications if under treated
-Most patients require more than one medication to
reach goal bp
,NR667 VISE Assignment | Family Nurse Practitioner Exam Prep Questions & Answers
Possible Complications: Hypertension -Stroke, CAD, MI, renal failure, heart failure,
eclampsia (seizures), pulmonary edema,
hypertensive crisis, hypertensive retinopathy, ED
Etiology: Hyperlipidemia -Inherited disorder, high dietary intake, obesity,
sedentary lifestyle, DM, hypothyroidism, anabolic
steroid use, hepatitis, cirrhosis, uremia, nephrotic
syndrome, stress, drug-induced (thiazide diuretics,
beta blockers, cyclosporine), alcohol, caffeine,
metabolic syndrome
Risk factors: Hyperlipidemia -Family history, physical inactivity, smoking, age
(men > 45, women > 55 or premature menopause
without estrogen replacement), obesity, diet high in
sat. fat, DM
Assessment findings: Hyperlipidemia -Few physical findings; xanthomata (fat deposits in
the skin), xanthelasma (yellow plaques on the
eyelid), corneal arcus prior to age 50 (arc of
cholesterol around the iris), bruits, angina pectoris,
MI, stroke
Differential diagnosis: Hyperlipidemia -Secondary causes: hypothyroidism, pregnancy,
DM, non-fasting state
, NR667 VISE Assignment | Family Nurse Practitioner Exam Prep Questions & Answers
Final diagnosis: Hyperlipidemia -Fasting lipid profile: 9-12 hours
-Glucose level
-Urinalysis, creatinine (for detection of nephrotic
syndrome which can induce dyslipidemia)
-Baseline transaminases
-TSH for detection of hypothyroidism (which can
cause secondary dyslipidemia)
-Calculate ASCVD 10-year risk
Prevention: Hyperlipidemia -Healthy lifestyle reduces ASCVD in all age groups
-Dietary interventions: encourage mediterranean
and DASH diet; limit saturated and trans fats; limit
sodium intake; increase fiber, vegetables, fruits, and
other whole grains; eat lean meats (poultry, fish);
eggs, beans, nuts, low-fat dairy, avoid red meat, limit
sugary drinks and sweets
-Mod to vigorous exercise of at least 40 mins 3-
4x/week (sustained aerobic activity increases HDL,
decreases total cholesterol)
-Avoid tobacco
-Appropriately manage systemic diseases (DM,
hypothyroidism, HTN)
Non-pharm management: -Nutrition, weight reduction, increased physical
Hyperlipidemia activity, patient education about risk factors
Pharmacological management: -Assign to a statin treatment group using ASCVD 10-
Hyperlipidemia year risk calculator
-Primary lipid target it LDL
-Statins are 1st-line therapy
-Combo of statin and non-statin in some patients
-Consider adding non-statin if unable to achieve
LDL < 70mg/dl, but VERIFY adherence to statins and
lifestyle changes
-Non-statins: ezetimibe (1st), bile acid sequestrant,
vibrate, PCSK9 inhibitor
