NURS 620 Maryville Exam 2 Test Questions with 100% Verified
Answers Graded A+
Risk factors for hypertension - ANSWER - -black: (without CKD)
1. age & sex- women older than 55 & men older CCB or thiazide
than 45
2.Obesity -DM:
3.Excessive dietary intake of salt thiazide
4.cigarette smoking CCB
5.chronic alcohol consumption ACEI
6.Family history of high blood pressure and/or ARB
cardiovascular disease
7.African American race -CKD:
8.Stress ACE
9.Sedentary lifestyle ARB
Blood pressure goals for JNC8 - Which medications for HTN should not be used
ANSWER -Healthy patients over 60 years together - ANSWER -ACE and ARBS
of age is okay if it is below 150/90
Healthy patients less than 60 years of age the
blood pressure is okay if less than 140/90 HTN therapy for patients over 75years old with
impaired kidney function - ANSWER -CCB
Patients with dx of DM or CKD regardless of age, Thiazides
goal BP is less than 140/90
Classification of HTN per AHA - ANSWER -
lifestyle modifications for - ANSWER - Normal BP: less than 120 Systolic, diastolic less
Weight reduction (BMI 18.5-24.9) than 80
DASH diet Elevated: 120-129 systolic, less than 80 diastolic
less than 2.4g a day of sodium Stage 1 HTN: 130-139/80-89
Increase Pysical activity to 30min most days of Stage 2 HTN: 140+/90+
the week Hypertensive crisis: 180+/120+
Stop smoking
Alcohol less than 2 drinks a day
If goal not met for HTN in a month of treatment
then what? - ANSWER -Increase the intital
JNC8 preferred agents: - ANSWER -- dose of drug or add a second agent, if goal not
general population: achieved with 2 agents consider a 3rd agent.
thiazide
CCB
ACEI
ARB When HTN treatment is initiated or dose changed
,NURS 620 Maryville Exam 2 Test Questions with 100% Verified
Answers Graded A+
when should patient follow up - ANSWER - actions and interactions (e.g. NSAIDs, illicit
2-4 weeks, then once goal has achieved every 3- drugs, sympathomimetics, OCPs), or OTC drugs
6 months. and herbals
5) Excess EtOH intake
6) Underlying ID causes of HTN (2ndary)
7) White coat hypertension
Diagnostic workup for HTN - ANSWER -
History- any symptoms?
Physical examination
What are their risk factors? - family history, Complications of HTN - ANSWER -Left
smoking, drinking, sedentary lifestyle. ventricular hypertrophy
Heart failure
Labs: BMP, CBC, UA, CMP, TSH, Lipid profile, Ischemic Stroke
ECG Intracerebral hemmorage
Ischemic heart disease
need to know kidney function, electrolytes, are CKD, ESRD
they spilling protein in their urine.
Signs of target organ damage in Hypertension -
Work up for secondary causes of HTN - ANSWER -Headaches
ANSWER -Cushings- need a 24 hour urine vision changes
Coarctation of the aorta- CXR papillary edema
Pheochromocytoma- 24 hour urine change in mental status
Primary hyperaldosteronism s/s heart failure
Renovascular hypertension- Renal arterogram, hematuria, proteinuria, elevated creatinine
ultrasound of kidneys
Dyslipidemia-->
Resistant Hypertension - ANSWER -failure Desirable/optimal serum lipid levels ****** -
to reach goal BP in patients who are taking full ANSWER -Total cholesterol: less than
doses of an appropriate three-drug therapy 200mg/dl
regimen that includes a diuretic Triglycerides: less than 150mg/dl
HDL: women greater than 45, men greater than
needs referral to cardiologist 40, cardio protective is greater than 60
LDL: less than 100, DM 50-70
Causes of resistant HTN - ANSWER -1)
Improper BP measurement Screening for hyperlipidemia - ANSWER -
2) Excess Na+ intake High Risk-
3) Inadequate diuretic Tx • More than 1 risk factor
4) Med issues such as inadequate doses, drug - HTN, Smoking, Family hx
• Single risk factor that is severe
, NURS 620 Maryville Exam 2 Test Questions with 100% Verified
Answers Graded A+
- i.e. siblings w/ CAD at a young age
- Very heavy smoking history Drug therapy for hyperlipidemia -
• Start screening at age 25 for men, age 35 for ANSWER -• HMG-CoA reductase inhibitors
women - STATINS
• Repeat screening every 3 years • Non-statin therapy - no longer recommended
- Bile acid sequestrates
Low Risk- - Niacin
• In the general population, guidelines indicate - Gemfibrozil - trigs
screening based on sex and age - Fenofibrate - trigs
• Males - age 35 - Fish oils - trigs
• Females - age 45 - Ezetimibe (Zetia)
• Rescreening recommended every 5 years
Statins-
• Rovastatin - Crestor
• Atorvastatin - Lipitor
symptoms of hyperlipidemia - ANSWER -A • Simvastatin - Zocor
person with hyperlipidemia usually has no signs • Pravastatin - Pravachol
or symptoms. In familial, or inherited, • Lovastatin
hyperlipidemia, there may be yellowish fatty • Fluvastatin
growths around the eyes or the joints.
Hyperlipidemia is usually detected during a
routine blood test, or following a cardiovascular
event, such as a heart attack or stroke. Rechecking labs for hyperlipidemia -
ANSWER -• LDL-C response at 6 weeks
after initiating therapy
• Every 6 to 12 months thereafter may be helpful
How to manage hyperlipidemia - in assessing medication adherence.
ANSWER -• Therapy should be initiated • No need to monitor the LDL-C response to
when a patient's 10-year risk for a first therapy other than to assess adherence, since
atherosclerotic cardiovascular disease (ASCVD) we do not suggest intensifying the regimen for
event is 7.5% any particular level of LDL-C response
• This calculator can be found at
- http://tools.cardiosource.org/ASCVD-Risk-
Estimator/
Coranary Artery Disease (CAD) -
ANSWER -caused by plaque formation of
cornary arteries, leads to restricted blood flow to
When would you initiate drug therapy for high the heart tissue.
cholesterol according to lab results? -
ANSWER -• Therapy should be initiated
when a patient's 10-year risk for a first
atherosclerotic cardiovascular disease (ASCVD) Angina vs MI - ANSWER -Restricted blood
event is 7.5% flow to the heart that causes chest pain
MI- obstruction within a coronary artery or
Answers Graded A+
Risk factors for hypertension - ANSWER - -black: (without CKD)
1. age & sex- women older than 55 & men older CCB or thiazide
than 45
2.Obesity -DM:
3.Excessive dietary intake of salt thiazide
4.cigarette smoking CCB
5.chronic alcohol consumption ACEI
6.Family history of high blood pressure and/or ARB
cardiovascular disease
7.African American race -CKD:
8.Stress ACE
9.Sedentary lifestyle ARB
Blood pressure goals for JNC8 - Which medications for HTN should not be used
ANSWER -Healthy patients over 60 years together - ANSWER -ACE and ARBS
of age is okay if it is below 150/90
Healthy patients less than 60 years of age the
blood pressure is okay if less than 140/90 HTN therapy for patients over 75years old with
impaired kidney function - ANSWER -CCB
Patients with dx of DM or CKD regardless of age, Thiazides
goal BP is less than 140/90
Classification of HTN per AHA - ANSWER -
lifestyle modifications for - ANSWER - Normal BP: less than 120 Systolic, diastolic less
Weight reduction (BMI 18.5-24.9) than 80
DASH diet Elevated: 120-129 systolic, less than 80 diastolic
less than 2.4g a day of sodium Stage 1 HTN: 130-139/80-89
Increase Pysical activity to 30min most days of Stage 2 HTN: 140+/90+
the week Hypertensive crisis: 180+/120+
Stop smoking
Alcohol less than 2 drinks a day
If goal not met for HTN in a month of treatment
then what? - ANSWER -Increase the intital
JNC8 preferred agents: - ANSWER -- dose of drug or add a second agent, if goal not
general population: achieved with 2 agents consider a 3rd agent.
thiazide
CCB
ACEI
ARB When HTN treatment is initiated or dose changed
,NURS 620 Maryville Exam 2 Test Questions with 100% Verified
Answers Graded A+
when should patient follow up - ANSWER - actions and interactions (e.g. NSAIDs, illicit
2-4 weeks, then once goal has achieved every 3- drugs, sympathomimetics, OCPs), or OTC drugs
6 months. and herbals
5) Excess EtOH intake
6) Underlying ID causes of HTN (2ndary)
7) White coat hypertension
Diagnostic workup for HTN - ANSWER -
History- any symptoms?
Physical examination
What are their risk factors? - family history, Complications of HTN - ANSWER -Left
smoking, drinking, sedentary lifestyle. ventricular hypertrophy
Heart failure
Labs: BMP, CBC, UA, CMP, TSH, Lipid profile, Ischemic Stroke
ECG Intracerebral hemmorage
Ischemic heart disease
need to know kidney function, electrolytes, are CKD, ESRD
they spilling protein in their urine.
Signs of target organ damage in Hypertension -
Work up for secondary causes of HTN - ANSWER -Headaches
ANSWER -Cushings- need a 24 hour urine vision changes
Coarctation of the aorta- CXR papillary edema
Pheochromocytoma- 24 hour urine change in mental status
Primary hyperaldosteronism s/s heart failure
Renovascular hypertension- Renal arterogram, hematuria, proteinuria, elevated creatinine
ultrasound of kidneys
Dyslipidemia-->
Resistant Hypertension - ANSWER -failure Desirable/optimal serum lipid levels ****** -
to reach goal BP in patients who are taking full ANSWER -Total cholesterol: less than
doses of an appropriate three-drug therapy 200mg/dl
regimen that includes a diuretic Triglycerides: less than 150mg/dl
HDL: women greater than 45, men greater than
needs referral to cardiologist 40, cardio protective is greater than 60
LDL: less than 100, DM 50-70
Causes of resistant HTN - ANSWER -1)
Improper BP measurement Screening for hyperlipidemia - ANSWER -
2) Excess Na+ intake High Risk-
3) Inadequate diuretic Tx • More than 1 risk factor
4) Med issues such as inadequate doses, drug - HTN, Smoking, Family hx
• Single risk factor that is severe
, NURS 620 Maryville Exam 2 Test Questions with 100% Verified
Answers Graded A+
- i.e. siblings w/ CAD at a young age
- Very heavy smoking history Drug therapy for hyperlipidemia -
• Start screening at age 25 for men, age 35 for ANSWER -• HMG-CoA reductase inhibitors
women - STATINS
• Repeat screening every 3 years • Non-statin therapy - no longer recommended
- Bile acid sequestrates
Low Risk- - Niacin
• In the general population, guidelines indicate - Gemfibrozil - trigs
screening based on sex and age - Fenofibrate - trigs
• Males - age 35 - Fish oils - trigs
• Females - age 45 - Ezetimibe (Zetia)
• Rescreening recommended every 5 years
Statins-
• Rovastatin - Crestor
• Atorvastatin - Lipitor
symptoms of hyperlipidemia - ANSWER -A • Simvastatin - Zocor
person with hyperlipidemia usually has no signs • Pravastatin - Pravachol
or symptoms. In familial, or inherited, • Lovastatin
hyperlipidemia, there may be yellowish fatty • Fluvastatin
growths around the eyes or the joints.
Hyperlipidemia is usually detected during a
routine blood test, or following a cardiovascular
event, such as a heart attack or stroke. Rechecking labs for hyperlipidemia -
ANSWER -• LDL-C response at 6 weeks
after initiating therapy
• Every 6 to 12 months thereafter may be helpful
How to manage hyperlipidemia - in assessing medication adherence.
ANSWER -• Therapy should be initiated • No need to monitor the LDL-C response to
when a patient's 10-year risk for a first therapy other than to assess adherence, since
atherosclerotic cardiovascular disease (ASCVD) we do not suggest intensifying the regimen for
event is 7.5% any particular level of LDL-C response
• This calculator can be found at
- http://tools.cardiosource.org/ASCVD-Risk-
Estimator/
Coranary Artery Disease (CAD) -
ANSWER -caused by plaque formation of
cornary arteries, leads to restricted blood flow to
When would you initiate drug therapy for high the heart tissue.
cholesterol according to lab results? -
ANSWER -• Therapy should be initiated
when a patient's 10-year risk for a first
atherosclerotic cardiovascular disease (ASCVD) Angina vs MI - ANSWER -Restricted blood
event is 7.5% flow to the heart that causes chest pain
MI- obstruction within a coronary artery or
