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NR 667 VISE STUDY GUIDE NEWEST UPGRADES 2024| JUST RELEASED

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NR 667 VISE STUDY GUIDE NEWEST UPGRADES 2024| JUST RELEASED

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NR 667
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September 24, 2024
Number of pages
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2024/2025
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Page 1 of 128



NR 667 VISE STUDY GUIDE
NEWEST UPGRADES 2024| JUST
RELEASED
Hyperlipidemia Diagnosis✔✔✔✔ANSWER➖Diagnosis is confirmed
when the optimal goal of LDL is <100 mg/dL, and patients with LDL >=
190mg/dL are candidates for high-intensity statin therapy.

Etiology: Hypertension ✔✔✔✔✔✔ANSWER➖-No known cause in
90% of cases of primary HTN

-Secondary causes: renal failure, kidney disease, renal artery stenosis,
Cushing syndrome, hyper/hypo thyroidism, increased ICP, sleep apnea,
oral contraceptives, steroids, cocaine, NSAIDs, decongestants,
sympathomimetics, alcohol, antidepressants, caffeine



Risk Factors: Hypertension ✔✔✔✔✔✔ANSWER➖-Modifiable:
smoking, DM, high cholesterol, obesity (single most important factor in
children), physical inactivity, poor diet, excessive sodium intake,
excessive alcohol consumption

-Non-modifiable: CKD, family hx, increased age (>55 men, > 65
women), low socioeconomic status, low educational status, male sex,
OSA, stress, pregnancy

, Page 2 of 128




Hypertension✔✔✔✔ANSWER➖Elevated blood pressure (>140/90
mm Hg) leading to asymptomatic or symptomatic presentation including
occipital headaches, blurry vision, and microvascular or macrovascular
clinical findings.



Microvascular✔✔✔✔ANSWER➖Clinical findings related to
hypertension retinopathy and kidney damage including AV nicking,
papilledema, microalbuminuria, proteinuria, elevated serum creatinine,
abnormal eGFR, and peripheral or generalized edema.




Hypertension Diagnosis✔✔✔✔ANSWER➖Diagnosis of hypertension
is made when blood pressure is consistently >140/90 mm Hg, leading to
the initiation of blood pressure medication.



Hypertension Pharmacologic
Management✔✔✔✔ANSWER➖Pharmacologic management includes
first-line diuretic (Hydrochlorothiazide), alternative CCB (Amlodipine

, Page 3 of 128


besylate), ACE inhibitors (lisinopril), and consideration of ACE/ARB in
specific patient populations.



Hypertension Follow-up✔✔✔✔ANSWER➖Patients should be
followed up every 2-4 weeks, and referrals should be made to cardiology
if EKG is abnormal.



Hyperlipidemia✔✔✔✔ANSWER➖Elevated levels of lipids in the
blood leading to asymptomatic presentation until the development of
ASCVD, with symptoms including xanthomata, corneal arcus, angina,
bruits, MI, and stroke.




Assessment: Hypertension ✔✔✔✔✔✔ANSWER➖-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

, Page 4 of 128


Differential Diagnosis: Hypertension ✔✔✔✔✔✔ANSWER➖-
Secondary HTN, white coat HTN (artificial elevation d/t medical
environment anxiety)



Final Diagnosis: Hypertension ✔✔✔✔✔✔ANSWER➖-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 ✔✔✔✔✔✔ANSWER➖-Maintaining
healthy weight and BMI

-Smoking cessation

-Regular aerobic exercise

-Alcohol in moderation (< 1 oz/day)

-Stress management

-Medication compliance

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