UPDATED APEA FNP CARDIO ADULT HEALTH EXAM 1 | REAL EXAMS FOR 2023/2024

UPDATED APNEA FNP CARDIO ADULT HEALTH EXAM 1 | REAL EXAMS FOR 2023/2024 A common lab findings with ACE Inhibitors -------- Correct Answer Increase K+ --------ACE inhibitor = retention of potassium. Measure potassium one month after starting and one month after changing a dose What should you do? Pt on Monopril and HCTZ for hypertension. His blood pressure is 160-170/92-98 on several blood pressure checks ? Would you add an ARB? -------- Correct Answer If these are at maximum doses, ---------consideration should be given to adding a medication from a different class. CALCIUM CHANNEL BLOCKER NOT ARB - Adding an ARB may result in a precipitous decrease in his blood pressure because he takes an ACE inhibitor and both of these medications work in the renin- angiotensin-aldosterone system. Significance of sildenafil and any blood pressure meds -------- Correct Answer Any --------antihypertensive medication could have an additive effect with sildenafil (or another .... medication in this A specific drug-drug interaction to be aware of is the one that can occur with sildenafil and alpha blockers like tamsulosin, alfuzosin, prazosin, doxazosin, or terazosin. This combination of medications may increase the risk of symptomatic hypotension because the effect of these two drugs is additive -------- Correct Answer Consider two meds --------low dose HCTZ and ARB or ace This patient's blood pressure goal is < 140/90 according to JNC VIII. Since he is more than 20 points above systolic goal (or greater than 10 points above diastolic goal) it is reasonable to consider two medications Risk assessment for dyslipidemia- what age to start assessment Correct Answer ------------------ Start at age 2 Dyslipidemia assessment does not necessarily mean a Dyslipidemia assessment refers to assessing family history of dyslipidemia, premature cardiovascular disease, or diabetes, body mass index > 85% for age and sex, or history of other systemic diseases like Kawasaki Disease or treatment, or renal disease. When to start lipid profiles -------- Correct Answer recommended between 18 and --------21 years of age. A patient taking an ACE inhibitor should avoid: -------- Correct Answer No K ------- ACE inhibitor potentially can produce hyperkalemia because its mechanism of action is in the renin-angiotensin-aldosterone system where potassium is spared. If potassium is taken in the form of potassium supplements, the effect will be additive and the risk of hyperkalemia can be great. An 80 year-old female who is otherwise well, has a blood pressure of 176/80. How should she be managed pharmacologically? -------- Correct Answer CCB --This patient has isolated systolic hypertension (ISH). This is common in older adults and is associated with tragic cardiac and cerebrovascular events. The drug class of choice to treat these patients is a long-acting calcium channel blocker. The class of calcium channel blockers recommended for ISH has the suffix "pine" (amlodipine, felodipine, etc). supplements Remember ISH = PINE ACE inhibitor is specifically indicated in patients who have .. Correct Answer ---------------- hypertension, diabetes with proteinuria, heart failure. 77 year-old patient has had an increase in blood pressure since the last exam. The blood pressure has risen to 168/88 with 2 readings. The last exam's reading was 144/90. If medication is to be started on this patient, what would be a good first choice? -------- Correct Answer CCB --------This patient is 77 years old and should have a goal blood pressure of < 150/90. A thiazide diuretic is not a good first choice in this patient because it will not be potent enough to decrease blood pressure by 25 points to get him to goal. A long acting calcium channel blocker is appropriate for patients with isolated systolic hypertension and will be more likely to get this patient to goal pressure than HCTZ. Beta-blockers are no longer recommended first line for uncomplicated hypertension. ACE inhibitors are very effective in patients who are high renin producers. Elderly patients tend to produce lower amounts of renin. A 63 year-old male has been your patient for several years. He is a former smoker who