FINAL NUR 508 Questions with Detailed Verified Answers

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FINAL NUR 508 Questions with
Detailed Verified Answers

Question: A pt comes into the clinic with the request for oral contraceptives.
She has successfully used oral contraceptives before and has recently started
dating a new boyfriend so would like to start contraception. She denies recent
intercourse and has a negative urine pregnancy test in the clinic, An
appropriate plan would be
Answer: prescribe oral contraception and have her start them the same day as
the visit with the backup method used for the first 7 days


Question:First line treatment for Heart Failure
Answer: Ace inhibitors: captopril (capoten, enalpril (vasotec), lisinopril
(Prinivil or Zestril, ramipril (altace), trandolapril (mavik),
*should be prescribed to all patients with HF unless contrindicated


Question:Treatment of HF ARB's
Answer: candesartan (atacand), valsartan (diovan),
*should be used if ACE inhibitors are intolerant to patient


Question:Treatment of HF Beta blockers
Answer: bisoprolol (zebeta), carvediol (coreg), metroprolol (Lopressor),
*are the recommended agents for all patients with stable mild severe HF


Question:treatment of HF Lasix (furosemide)

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Answer: fluid overload


Question:Treatment of HF and pulmonary edema
Answer: L-LOOP: cause venodilation and diuresis-reduce pre-load
M-morphine:reduce anxiety, vasodilates, reducing preload, reduces
sympathetic drive, not routinely offered
N-nitrates: reduce preload and afterload, vasodilates
O- oxygen: maintains O2 sats
P-positioning: cardiogenic, decrease preload, decrease afterload, inc O2,
CPAP, BiPAP


nitrates, diuretics, morphine
Nitroprusside-vasodilator
Nesiritride- atrial peptide, vasodilator and diuretic


Question:ACE inhibitors SE
Answer: SE: cough (change to ARB) Angioedema, rash, diapphoresis, abd
pain, leukopenis, myalgia, HA, renal insuffiency, Increase creatinine,
hyperklemia, hypotension. Tetrogen (fetal renal abnormalities)


Question:ACE inhibitors MOA
Answer: Method of action; inhibits angiotension converting enzyme,
interfering with conversion or angiotension I to angiotension II. ACE inhibitors
inhibit the breakdown of bradykinin a potent and naturally occuring
vasodilator by blocking enzyne kininase II. This is thought to be the cause of
the cough common SE of this med

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Question:Antihypertensive med class contraindicated in pt with Asthma
Answer: Beta blockers- metoprolol


Question:Digoxin MOA
Answer: *Increases intracellular concentration of calcium which increases
force of myocardial contraction
*decreases activation of sympathetic nervous system
*improved quality of life but no decrease in mortality
*directly inhibits the Na+/K+ ATPase location in plasma membrane, which
leads to indirect inhibition of Na+Ca2+, increase in cardiac contractility.


Question:Penicillin use
Answer: uses
*inhibits bacterial cell wall synthesis
-Penicillins are bactericidal against susceptible organisms, disrupt synthesis of
the bacterial cell wall and compete for and bind to specific enyzme proteins
that catalyze transpeptidation and cross-linking. The enzyme to which they
bind are called penicillin-binding proteins (PBP's) They consist of
transpeptidases, tranglycosylases, and D-alanine carboxykinase and are
implicated in the final phase of building and reshaping of the bacterial cell wall
while it is growing and dividing


Question:Penicillin MOA
Answer: This action interferes with the biosynthesis of mucopeptides and
prevents linkage of structural components of the cell wall. After the penicillin
molecules bind and inhibit the transpeptidase enyzmes, susceptible bacteria
are no longer able to lay protein cross-links across the peptidoglycan