N5334 c Advanced c Pharmacology c Test c 2 c exam c questions c and c answers c graded c A+(fall c 2024

N5334 c Advanced c Pharmacology c Test c 2 c exam c questions c and c answers c graded c A+(fall c 2024) You c examine c a c 38-year-old c woman c who c has c presented for c an c initial c examination c and c Papanicolaou c test. c She c has no c complaint. c Her c blood c pressure c (BP) c is c 154/98 c mm c Hg bilaterally c and c her c body c mass c index c (BMI) c is c 31 c kg/m2. The c rest c of c her c physical c examination c is c unremarkable. Your c next c best c action c is c to: A. c initiate c antihypertensive c therapy. B. c arrange c for c at c least c two c additional c BP c measurements during c the c next c 2 c weeks. C. c order c blood c urea c nitrogen, c creatinine, c and c potassium ion c measurements c and c urinalysis. D. c advise c her c to c reduce c her c sodium c intake. c - c correct c answers-B You c see c a c 68-year-old c woman c as c a c patient c who c is c transferring care c into c your c practice. c She c has c a c 10-year c history of c hypertension, c diabetes c mellitus, c and c hyperlipidemia. Current c medications c include c hydrochlorothiazide (HCTZ), c glipizide, c metformin, c simvastatin, c and c daily low-dose c aspirin. c Today's c BP c reading c is c 158/92 c mm c Hg, and c the c rest c of c her c history c and c examination c are c unremarkable. Documentation c from c her c former c healthcare provider c indicates c that c her c BP c has c been c in c the c range c for the c past c 12 c months. c Your c next c best c action c is c to: A. c prescribe c an c angiotensin-converting c enzyme c inhibitor (ACEI). B. c have c her c return c for c a c BP c check c in c 1 c week. C. c advise c that c her c current c therapy c is c adequate. D. c add c therapy c with c an c aldosterone c antagonist. c - c correct c answers-A You c examine c a c 78-year-old c woman c with c long-standing, poorly c controlled c hypertension. c When c evaluating c her for c hypertensive c target c organ c damage, c you c look c for evidence c of: A. c lipid c abnormalities. B. c insulin c resistance. C. c left c ventricular c hypertrophy. D. c clotting c disorders. c - c correct c answers-C Diagnostic c testing c for c a c patient c with c newly c diagnosed primary c hypertension c should c include c all c of c the c following except: A. c hematocrit. B. c uric c acid. C. c creatinine. D. c potassium. c - c correct c answers-B In c the c person c with c hypertension, c the c nurse c practitioner (NP) c recommends c all c of c the c following c to c potentially reduce c BP c in c a c patient c with c a c BMI c of c 30 c kg/m2 c except: A. c 10-kg c (22-lb) c weight c loss. B. c dietary c sodium c restriction c to c 2.4 c g c (6 c g c NaCl) c per c day. C. c regular c aerobic c physical c activity, c such c as c 30-40 c minutes of c brisk c walking c most c days c of c the c week. D. c consuming c at c least c 1-2 c servings c of c alcohol. c - c correct c answers-D Match c the c antihypertension c medication c with c its appropriate c class. _______6. c amlodipine _______7. c diltiazem _______8. c trandolapril _______9. c telmisartan _______10. c pindolol A. c beta-adrenergic c receptor antagonist B. c nondihydropyridine calcium c channel c blocker C. c dihydropyridine c calcium channel c blocker D. c angiotensin c receptor antagonist E. c ACEI c - c correct c answers-6. c C. 7. c B. 8. c E. 9. c D. 10. c A. You c see c a c 38-year-old c African c American c male c with hypertension c who c is c currently c being c treated c with thiazide-type c diuretic. c His c current c blood c pressure reading c is c 156/94 c mm c Hg c and c he c has c no c history c of diabetes c mellitus c or c chronic c kidney c disease. c Following current c best c evidence, c you c consider c adding c which c of the c following c medications? A. c ACEI B. c angiotensin c receptor c blocker c (ARBs) C. c beta-adrenergic c receptor c antagonist D. c calcium c channel c blocker c - c correct c answers-D Nondihydropyridine c calcium c channel c blockers c are c contraindicated in c patients c with: A. c type c 1 c diabetes c mellitus. B. c a c history c of c venous c thromboembolism. C. c severe c left c ventricular c dysfunction. D. c concomitant c treatment c with c an c ACEI. c - c correct c answers-C In c obtaining c an c office c BP c measurement, c which c of c the following c is c most c reflective c of c the c best c practice? A. c The c patient c should c sit c in c a c chair c with c feet c flat c on c the floor c for c at c least c 5 c minutes c before c obtaining c the reading. B. c The c BP c cuff c should c not c cover c more c than c 50% c of c the upper c arm. C. c The c patient c should c sit c on c the c edge c of c the c examination table c without c arm c support c to c enhance c reading accuracy. D. c Obtaining c the c BP c reading c immediately c after c the patient c walks c into c the c examination c room c is recommended. c - c correct c answers-A A c BP c elevation c noted c only c at c an c office c visit c is c commonly known c as c hypertension. A. c provider-induced B. c clinical C. c white c coat D. c pseudo c - c correct c answers-C The c most c important c long-term c goal c of c treating hypertension c is c to: A. c strive c to c reach c recommended c numeric BP c measurement. B. c avoid c disease-related c target c organ c damage. C. c develop c a c plan c of c care c with c minimal c adverse c effects. D. c treat c concomitant c health c problems c often c noted c in the c person c with c this c condition. c - c correct c answers-B You c start c a c patient c with c hypertension c who c is c already receiving c an c ACEI c on c spironolactone. c You c advise c the patient c to c return c in c 4 c weeks c to c check c which c of c the following c laboratory c parameters? A. c sodium B. c calcium C. c potassium D. c chloride c - c correct c answers-C A c 68-year-old c woman c presents c with c hypertension c and c BP of c 152-158/92-96 c mm c Hg c documented c over c 2 c months c on three c different c occasions. c Electrocardiogram c (ECG) c and creatinine c are c normal, c and c she c has c no c proteinuria. c Clinical findings c include c the c following: c BMI c 26.4 c kg/m2; c no c S3, S4, c or c murmur; c and c point c of c maximal c impulse c at c fifth intercostal c space, c mid-clavicular c line. c Which c of c the following c represents c the c best c intervention? A. c Initiate c therapy c with c metoprolol. B. c Initiate c therapy c with c hydrochlorothiazide. C. c Initiate c therapy c with c methyldopa. D. c Continue c to c monitor c BP, c and c start c drug c therapy c if evidence c of c target c organ c damage. c - c correct c answers-B Which c of c the c following c can c have c a c favorable c effect on c a c comorbid c condition c in c a c person c with hypertension? A. c chlorthalidone c in c gout B. c propranolol c with c airway c disease C. c aldosterone c antagonist c in c heart c failure D. c methyldopa c in c an c older c adult c - c correct c answers-C According c to c JNC-8 c guidelines, c all c of c the c following medications c are c first-line c agents c for c use c in c a middle-aged c white c man c without c diabetes mellitus c except: A. c lisinopril. B. c hydrochlorothiazide. C. c metoprolol. D. c amlodipine. c - c correct c answers-C You c see c a c 59-year-old c man c with c poorly c controlled hypertension. c On c physical c examination, c you c note grade c 1 c hypertensive c retinopathy. c You c anticipate c all of c the c following c will c be c present c except: A. c patient c report c of c acute c visual c change. B. c narrowing c of c the c terminal c arterioles. C. c sharp c optic c disc c borders. D. c absence c of c retinal c hemorrhage. c - c correct c answers-A According c to c JNC-8, c a c 52-year-old c well c woman with c a c healthy c BMI c whose c blood c pressure c is consistently c 130-135/82-86 c mm c Hg c is c considered to c have: A. c normal c blood c pressure. B. c hypertension c requiring c therapy c with c a c calcium channel c blocker c (CCB). C. c hypertension c requiring c therapy c with c an c alpha blocker. D. c hypertension c requiring c therapy c with c a c thiazide-type diuretic. c - c correct c answers-A Which c of c the c following c is c associated c with c the c highest risk c of c ischemic c heart c disease? A. c presence c of c microalbuminuria c plus c heavy c alcohol intake B. c absence c of c microalbuminuria c plus c use c of c a thiazolidinedione C. c absence c of c microalbuminuria c plus c chronic c physical inactivity D. c presence c of c microalbuminuria c plus c cigarette smoking c - c correct c answers-D When c compared c with c Caucasians, c African c Americans tend c to c have c a c reduced c effect c with c monotherapy with c all c of c the c following c blood c pressure c medications except: A. c ACEIs. B. c ARBs. C. c CCB. D. c beta c blockers. c - c correct c answers-C Match c the c recommended c blood c pressure c goal c for each c patient c according c to c JNC-8 c guidelines. c (An answer c can c be c used c more c than c once.) A. c <130/80 c mm c Hg B. c <140/80 c mm c Hg C. c <140/90 c mm c Hg D. c <150/90 c mm _______24. c a c 57-year-old c white male c with c no c history of c diabetes c mellitus (DM) c or c chronic kidney c disease c (CKD) _______25. c a c 62-year-old c African American c male c with diabetes c mellitus _______26. c a c 67-year-old c female with c CKD _______27. c a c 62-year-old c female with c no c history of c DM c or c CKD _______28. c an c 82-year-old c male with c no c history of c DM c or c CKD _______29. c a c 72-year-old c female with c DM c and c CKD c - c correct c answers-24. c C. 25. c C. 26. c C. 27. c D. 28. c D. 29. c C. You c see c a c 62-year-old c man c without c chronic c kidney disease c or c diabetes c mellitus c who c is c currently c being treated c with c low-dose c HCTZ c and c losartan. c His c blood pressure c is c currently c 162/88 c mm c Hg. c All c of c the c following are c appropriate c next c courses c of c action c except: A. c increasing c the c dose c of c losartan. B. c adding c a c beta-adrenergic c receptor c antagonis