1. Which of the following is a high intensity statin therapy Rosuvastatin 20-40 2. Depression is more common if there is a family history True 3. Clinicians are greatly concerned with liver disease in patients taking statins Check ALT (alanine amin

NURS 5336 Family 3- Final Exam Questions and Answers1 1. Which of the following is a high intensity statin therapy Rosuvastatin 20-40 2. Depression is more common if there is a family history True 3. Clinicians are greatly concerned with liver disease in patients taking statins Check ALT (alanine aminotransferase) at baseline. Repeat only if symptoms of hepatotoxicity occur (from prescriber’s letter in module) With the use of a lipid-lowering resin, which of the following enzymes should be periodically monitored? A. ALP B. LDH C. AST D. No particular monitoring is recommended. 4. Drug category most likely to cause hypoglycemia Sulfonylureas 5. In 2016 caring for patients who are candidates for statin therapy our most important guideline. Decreasing global risk, not a specific LDL target (from prescriber’s letter in module) 6. Components of tobacco use cessation Ask, Advise, Assess, Assist, Arrange Model 7. USPT screen all the following sexually active women EXCEPT A woman in a mutually monogamous relationship 8. Metabolic syndrome significantly increased risk for: Cardiovascular disease 9. When prescribing a meal plan for a type II diabetic advise the patient that the macronutrient that provides post prandial hyperglycemia: Carbohydrates 10. In the person with hypertension, which of the following would likely yield the greatest potential reduction in BP in a patient with a BMI of 30 kg/m2? A. 10-kg (22-lb) weight loss B. dietary sodium restriction to 2.4 g (6 g NaCl) per day C. regular aerobic physical activity, such as 30 minutes of brisk walking most days of the week D. moderation of alcohol consumption 11. A middle-aged woman who has taken therapeutic dose of lorazepam for the past 6 years wishes to stop taking the medication. You advise her that: A. she can discontinue the drug immediately if she believes it no longer helps with her symptoms. B. rapid withdrawal in this situation can lead to tremors and hallucinations. C. she should taper down the dose of the medication over the next week. D. gastrointestinal upset is typically reported 12. Patient forgetful would benefit from a med that has a long half life Zoloft Celexa Fluoxetine (Prozac) has the longest half life 13. Add basal insulin to a patient already taking 3 oral meds. Reduce which med? Metformin Glipizide (sulfonylurea) TZD DPP 4 inhibitor According to slide 13 on PEARL 14. Lipid lowering moderate intensity statins Moderate dose statin (avg LDL reduction 30-50%)Mimi chose 20-30% 15. An example of an appropriate question to pose to a person with obesity who is in the precontemplation change stage is: A. “How do you feel about your weight?” B. “What are barriers you see to losing weight?” C. “What is your personal goal for weight loss?” D. “How do you envision my helping you meet your weight loss goal?” 16. Which disorder seen in uncontrolled DM with increased glucose? Pancreatitis Hypothyroidism ??? Gall stones High triglycerides 17. The USPSTF recommends screening for cervical cancer in women ages 21 to 65 years with cytology (Pap smear) every 3 years or, for women ages 30 to 65 years who want to lengthen the screening interval, screening with a combination of cytology and human papillomavirus (HPV) testing every 5 years. 32 Y.O FEMALE 18. Nicotine replacement can be used in combination, such as gum and a patch Never combine Always start with gum 19. Most important long term goal of hypertension tx Stop target organ damage 20. A patient calls office after being on SSRI, thoughts are racing. May have undiagnosed bipolar with mania set off by SSRI 21. To achieve successful weight loss must 3500 cal = 1 pound 22. An example of an appropriate question to pose to a person with obesity who is in the contemplation change stage is: A. “How do you feel about your weight?” B. “What are barriers you see to losing weight?” C. “What is your personal goal for weight loss?” D. “How do you envision my helping you meet your weight loss goal?” 23. Educate patient to inject insulin (Humalog) @ meal time During meal At least one hour before eating 15 min before 30 min before Relapse prevention is important: (kindling) 50% after 1 episode 70% after 2 episodes 90% after 3 episodes 24. Benzo with can enhance the effect Alcohol 25. When prescribing a fibrate, the NP expects to see which of the following changes in lipid profile? A. marked decrease in LDL level B. no effect on HDL level C. Decrease in triglyceride level D. increase in very low density lipoprotein (VLDL) level 26. According to DSM-5, a diagnosis of depression must include either depressed mood or which of the following? A. loss of interest or pleasure B. recurrent thoughts of death C. feelings of worthlessness D. weight change (either increase or decrease) 27. Research shows that patient outcomes for those diagnosed are improved when counseling is combined with using medications. True 28. Patient who is insulin resistant hyperinsulemia causes. Retinopathy Elevated BP 29. All of the following are risks for statin-induced myalgias except: A. advanced age. B. use of a low-intensity statin therapy with a resin. C. low body weight. D. high-intensity statin therapy. 30. Postprandial hyperglycemia is clinically important because Medications that target has been linked to Contributes to the h A1C All of the above 31. Which of the following women should have screening for Pap starts at 21 32. Which of the following indicates a patient managed successfully with multiple doses of insulin B & C 33. Stages of change. I’ll be ok in spite of risk Precontemplation 34. 42 y/o obese patient, Family history of DM, HTN, total chol is 255, triglycerides 150, HDL 45, LDL 180 Atorvastatin 40-80 Rosuvastatin 20-40 These are both listed in the prescriber’s letter in the module. There was a choice for lifestyle. I picked this b/c he doesn’t meet any criteria Start with statin: All DM should be on statin per ADA 35. Diagnose DM in the following patient Random glucose of 230 with fatigue and blurred vision Metabolic syndrome for 6 months A1C of 7.8 (I picked this b/c it’s the best predictor in 3 months) Fasting blood sugar of 127 Not sure what they’re looking for here? 36. Patient taking Chantix (varenicline) 4 weeks ago ask which of the following How many cigarettes are you currently smoking per day Any changes in mood 37. HPV vaccine Prevent HPV in large % of patientsDidn’t see this question 38. The use of which of the following drugs often mimics generalized anxiety disorder? A. sympathomimetics B. antipsychotics C. anticholinergics D. alpha-beta antagonists 39. Pedi HTN caused by Renal 40. It is not uncommon to use a sleep med short term when starting anti-depressant to restore normal sleep patterns True (from lecture, she said Benadryl) 41. Brief intervention that involves motivation should be Tobacco cessation every session (from lecture) 42. Difference between HTN urgency vs emergency Target organ damage 43. Most important risk factor when a patient is thinking about suicide Previous attempt 44. AAA screening maybe, there is no question? The USPSTF recommends against routine screening for AAA in women who have never smokedDidn’t see this question 45. Which patient presentation is most consistent with the diagnosis of depression? A. recurrent diarrhea and cramping B. difficulty initiating sleep C. diminished cognitive ability D. consistent early morning wakening