NR 667 Week 2 Exam with precise detailed ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
solutions
Your 50 year-old male African American (AA) patient was found to have a blood pressure
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
of 160/96 upon arrival to your clinic. He does not have any other medical conditions. For
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
the following 24 hours of self-reported vital signs, it remained between 160-170 systolic and
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
90-100 diastolic without treatment. After finding all basic metabolic panel (BMP) lab values
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
to be within normal limits, your first choice of antihypertensive is most likely which of the
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
following agents? ||//\\||
carvedilol
metoprolol
amlodipine
lisinopril - ✔✔amlodipine ||//\\|| ||//\\||
A patient is being followed for type 2 diabetes mellitus and hypertension. He also has a
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
diagnosis of polycythemia vera and has regular phlebotomies for management. Which of ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
the following statements about this patient is correct?
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
The phlebotomies will improve his glycosylated hemoglobin levels
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
The phlebotomies will increase his blood pressure
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
He should increase dietary iron supplements
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
He should avoid dietary iron supplements - ✔✔He should avoid dietary iron supplements
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
As the nurse practitioner working in a primary care clinic, you have been notified from a
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
hospitalist that your long-term patient with a history of HFrEF (heart failure with reduced ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
ejection fraction) with an ejection fraction of 40% two years ago who is also not on optimal
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
medical therapy has been diagnosed with a myocardial infarction this admission and
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
received emergent placement of a drug-eluting stent to the left anterior descending artery.
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
,As the patient's medical home who will manage this patient after discharge, which of the
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
following would you expect to be a priority in the patient's care for their heart failure after
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
an acute MI?||//\\|| ||//\\||
Ordering a Holter monitor for 7 days post-discharge ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Ordering a new transthoracic echocardiogram and Lifevest if EF is less than 35% ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Ordering aspirin and clopidogrel for 3 months at discharge ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Ordering a new transthoracic echocardiogram and order a Lifevest if EF is less than 45% -
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
✔✔Ordering a new transthoracic echocardiogram and Lifevest if EF is less than 35% ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
A 70-year-old man with a history of atrial fibrillation presents with sudden-onset left-sided
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
weakness and slurred speech. What is the most likely diagnosis? ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Stroke
Transient ischemic attack (TIA) ||//\\|| ||//\\|| ||//\\||
Myocardial infarction (MI) ||//\\|| ||//\\||
Seizure - ✔✔Stroke ||//\\|| ||//\\||
A 55 year-old female patient with no previous cardiac history and no family history of
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
hyperlipidemia with an acute myocardial infarction is treated successfully with a drug- ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
eluting stent during a recent hospitalization. As their long-term care provider, you
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
anticipate they were most likely to be also started on which of the following lipid-lowering ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
agents at discharge? ||//\\|| ||//\\||
Ezetimibe prior to initiating statin therapy ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
PCSK9 inhibitor therapy ||//\\|| ||//\\||
High intensity statin therapy ||//\\|| ||//\\|| ||//\\||
Moderate intensity statin therapy - ✔✔High intensity statin therapy ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
,Which of the following medications is not considered part of optimal medical therapy for a
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
54 year-old male patient with a diagnosis of heart failure with reduced ejection fraction
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
(HFrEF) with an EF of 30%, known coronary artery disease, and normal renal function? ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Aspirin
Carvedilol (Coreg) ||//\\||
Diltiazem (Cardizem) ||//\\||
Spironolactone (Aldactone) - ✔✔Diltiazem (Cardizem) ||//\\|| ||//\\|| ||//\\|| ||//\\||
An older adult with diabetes mellitus presents with leg cramps. She states that the cramps
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
were worst when walking to the supermarket. If she stops to rest, the pain subsides. The
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
nurse practitioner knows that this patient needs a workup for:
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Popliteal aneurism ||//\\||
Deep vein thrombosis ||//\\|| ||//\\||
Benign nocturnal leg cramps ||//\\|| ||//\\|| ||//\\||
Intermittent claudication - ✔✔Intermittent claudication ||//\\|| ||//\\|| ||//\\|| ||//\\||
What is the key long-term benefit of using carvedilol for patients with coronary artery
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
disease and heart failure with reduced ejection fraction (HFrEF)? ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Baseline reduction of blood pressure ||//\\|| ||//\\|| ||//\\|| ||//\\||
Increase in libido ||//\\|| ||//\\||
Potential increase in ejection fraction ||//\\|| ||//\\|| ||//\\|| ||//\\||
Reduce in cardiac output - ✔✔Potential increase in ejection fraction ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
An otherwise healthy patient reports episodes of palpitations lasting less than 5 minutes
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
and occurring 3-5 times daily. The patient describes a substernal flip-flop sensation with a
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
sudden rapid heart rate, ending with a forceful beat. Holter monitoring would most likely
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
document:
Premature ventricular contraction (extrasystole) ||//\\|| ||//\\|| ||//\\||
, Paroxysmal supraventricular tachycardia ||//\\|| ||//\\||
Sinus tachycardia ||//\\||
Atrial flutter - ✔✔Paroxysmal supraventricular tachycardia
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Which of the following people groups represent the least risk of cardiac disease?
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Native Hawaiians ||//\\||
American Indians ||//\\||
Caucasians
African Americans - ✔✔Caucasians ||//\\|| ||//\\|| ||//\\||
An adult female presents with a chief complaint of fatigue and weight gain. She states that
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
she doesn't feel like herself. A diagnosis of hypothyroidism is suspected. Which of the
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
following physical findings would support this diagnosis? ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Dry skin, bradycardia, and hypoactive deep tendon reflexes
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Tachycardia, exophthalmos, brittle hair ||//\\|| ||//\\|| ||//\\||
Diarrhea, tachycardia, and hypoactive deep tendon reflexes ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Palpitation, bradycardia, and constipation - ✔✔Dry skin, bradycardia, and hypoactive deep ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
tendon reflexes ||//\\||
An adult patient with type 2 diabetes mellitus returns at the nurse practitioner's request to
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
discuss medication management. Current medications include metformin (Glucophage),
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
1000 mg twice daily, sitagliptin (Januvia), 10 mg daily, and insulin detemir (Levemir), 60 U
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
daily. Lab values are: A1c = 10.4% [normal = less than 7.0%], fasting blood glucose = 180-
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
190 mg/dL range [normal = less than 99 mg/dL]. Which of the following regimens should
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
the nurse practitioner recommend?
||//\\|| ||//\\|| ||//\\||
Basal insulin only, continuing oral medications
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Switching to glargine (Lantus) ||//\\|| ||//\\|| ||//\\||
solutions
Your 50 year-old male African American (AA) patient was found to have a blood pressure
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
of 160/96 upon arrival to your clinic. He does not have any other medical conditions. For
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
the following 24 hours of self-reported vital signs, it remained between 160-170 systolic and
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
90-100 diastolic without treatment. After finding all basic metabolic panel (BMP) lab values
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
to be within normal limits, your first choice of antihypertensive is most likely which of the
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
following agents? ||//\\||
carvedilol
metoprolol
amlodipine
lisinopril - ✔✔amlodipine ||//\\|| ||//\\||
A patient is being followed for type 2 diabetes mellitus and hypertension. He also has a
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
diagnosis of polycythemia vera and has regular phlebotomies for management. Which of ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
the following statements about this patient is correct?
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
The phlebotomies will improve his glycosylated hemoglobin levels
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
The phlebotomies will increase his blood pressure
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
He should increase dietary iron supplements
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
He should avoid dietary iron supplements - ✔✔He should avoid dietary iron supplements
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
As the nurse practitioner working in a primary care clinic, you have been notified from a
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
hospitalist that your long-term patient with a history of HFrEF (heart failure with reduced ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
ejection fraction) with an ejection fraction of 40% two years ago who is also not on optimal
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
medical therapy has been diagnosed with a myocardial infarction this admission and
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
received emergent placement of a drug-eluting stent to the left anterior descending artery.
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
,As the patient's medical home who will manage this patient after discharge, which of the
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
following would you expect to be a priority in the patient's care for their heart failure after
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
an acute MI?||//\\|| ||//\\||
Ordering a Holter monitor for 7 days post-discharge ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Ordering a new transthoracic echocardiogram and Lifevest if EF is less than 35% ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Ordering aspirin and clopidogrel for 3 months at discharge ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Ordering a new transthoracic echocardiogram and order a Lifevest if EF is less than 45% -
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
✔✔Ordering a new transthoracic echocardiogram and Lifevest if EF is less than 35% ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
A 70-year-old man with a history of atrial fibrillation presents with sudden-onset left-sided
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
weakness and slurred speech. What is the most likely diagnosis? ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Stroke
Transient ischemic attack (TIA) ||//\\|| ||//\\|| ||//\\||
Myocardial infarction (MI) ||//\\|| ||//\\||
Seizure - ✔✔Stroke ||//\\|| ||//\\||
A 55 year-old female patient with no previous cardiac history and no family history of
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
hyperlipidemia with an acute myocardial infarction is treated successfully with a drug- ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
eluting stent during a recent hospitalization. As their long-term care provider, you
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
anticipate they were most likely to be also started on which of the following lipid-lowering ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
agents at discharge? ||//\\|| ||//\\||
Ezetimibe prior to initiating statin therapy ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
PCSK9 inhibitor therapy ||//\\|| ||//\\||
High intensity statin therapy ||//\\|| ||//\\|| ||//\\||
Moderate intensity statin therapy - ✔✔High intensity statin therapy ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
,Which of the following medications is not considered part of optimal medical therapy for a
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
54 year-old male patient with a diagnosis of heart failure with reduced ejection fraction
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
(HFrEF) with an EF of 30%, known coronary artery disease, and normal renal function? ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Aspirin
Carvedilol (Coreg) ||//\\||
Diltiazem (Cardizem) ||//\\||
Spironolactone (Aldactone) - ✔✔Diltiazem (Cardizem) ||//\\|| ||//\\|| ||//\\|| ||//\\||
An older adult with diabetes mellitus presents with leg cramps. She states that the cramps
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
were worst when walking to the supermarket. If she stops to rest, the pain subsides. The
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
nurse practitioner knows that this patient needs a workup for:
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Popliteal aneurism ||//\\||
Deep vein thrombosis ||//\\|| ||//\\||
Benign nocturnal leg cramps ||//\\|| ||//\\|| ||//\\||
Intermittent claudication - ✔✔Intermittent claudication ||//\\|| ||//\\|| ||//\\|| ||//\\||
What is the key long-term benefit of using carvedilol for patients with coronary artery
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
disease and heart failure with reduced ejection fraction (HFrEF)? ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Baseline reduction of blood pressure ||//\\|| ||//\\|| ||//\\|| ||//\\||
Increase in libido ||//\\|| ||//\\||
Potential increase in ejection fraction ||//\\|| ||//\\|| ||//\\|| ||//\\||
Reduce in cardiac output - ✔✔Potential increase in ejection fraction ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
An otherwise healthy patient reports episodes of palpitations lasting less than 5 minutes
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
and occurring 3-5 times daily. The patient describes a substernal flip-flop sensation with a
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
sudden rapid heart rate, ending with a forceful beat. Holter monitoring would most likely
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
document:
Premature ventricular contraction (extrasystole) ||//\\|| ||//\\|| ||//\\||
, Paroxysmal supraventricular tachycardia ||//\\|| ||//\\||
Sinus tachycardia ||//\\||
Atrial flutter - ✔✔Paroxysmal supraventricular tachycardia
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Which of the following people groups represent the least risk of cardiac disease?
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Native Hawaiians ||//\\||
American Indians ||//\\||
Caucasians
African Americans - ✔✔Caucasians ||//\\|| ||//\\|| ||//\\||
An adult female presents with a chief complaint of fatigue and weight gain. She states that
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she doesn't feel like herself. A diagnosis of hypothyroidism is suspected. Which of the
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following physical findings would support this diagnosis? ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Dry skin, bradycardia, and hypoactive deep tendon reflexes
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Tachycardia, exophthalmos, brittle hair ||//\\|| ||//\\|| ||//\\||
Diarrhea, tachycardia, and hypoactive deep tendon reflexes ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Palpitation, bradycardia, and constipation - ✔✔Dry skin, bradycardia, and hypoactive deep ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
tendon reflexes ||//\\||
An adult patient with type 2 diabetes mellitus returns at the nurse practitioner's request to
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discuss medication management. Current medications include metformin (Glucophage),
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1000 mg twice daily, sitagliptin (Januvia), 10 mg daily, and insulin detemir (Levemir), 60 U
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daily. Lab values are: A1c = 10.4% [normal = less than 7.0%], fasting blood glucose = 180-
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190 mg/dL range [normal = less than 99 mg/dL]. Which of the following regimens should
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the nurse practitioner recommend?
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Basal insulin only, continuing oral medications
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Switching to glargine (Lantus) ||//\\|| ||//\\|| ||//\\||
