NSG 6020 / NSG6020 WEEK 4 QUIZ 3 CARDIAC STUDY GUIDE QUESTIONS AND ANSWERS

All of the following are possible causes for secondary hypertension? A. Acute pyelonephritis Which of the following antihypertensive medications has beneficial effects for an elderly White woman with osteoporosis? D. Thiazide diuretics A 75-year-old woman has been on nifedepine (Procardia XL) 10-mg capsule for many years to control her stage II hypertension. Her blood pressure at this visit is 165/80 mmHg. She is currently complaining of pain at her right hip and in both knees. She has increased her dose of ibuprofen (Motrin) from 400mg three times daily (TID) to 800mg TID. She is still in pain and would like something stronger. Which of the following statements is the best explanation of the effects of ibuprofen (Motrin) on her disease? B. It inhibits the effect of renal prostaglandins and blunts the effectiveness of the diuretic Which of the following antihypertensive medications should the NP avoid when treating patients with emphysema? C. Beta-blockers A 63-year-old patient with a 10-year history of poorly controlled hypertension presents with a cluster of physical exam findings. Which of the following clusters indicates the target organ damage commonly seen in hypertensive patients? B. Arteriovenous (AV) nicking, left ventricular hypertrophy Which of the following laboratory tests in a sensitive test for evaluating renal function? B. Estimated GFR All of the following are possible causes for secondary hypertension except: A. Acute pyelonephritis An 8-year-old boy with type I diabetes is being seen for a 3-day history of urinary frequency and nocturia. He denies flank pain and is afebrile. The urinalysis result is negative for blood and nitrites but is positive for a large amount of leukocytes and ketones. He has a trace amount of protein. Which of the following is the best test to order initially? A. urine for culture and sensitivity A 55-year-old woman who has had type 2 diabetes for 20 years is concerned about her kidneys. She has a history of three urinary tract infections (UTIs) within the past 8 months, but is currently asymptomatic. Which of the following is the best course to follow? A. Recheck urine during the visit, send a urine specimen for culture and sensitivity, and refer to a nephrologist When evaluating the blood pressure on both arms and legs of an infant who has a diagnosis of coarctation of the aorta, which of the following is the correct finding? A. The blood pressure is higher in the arms than in the legs. Your 35-year-old patient is being worked up for microscopic hematuria. All of the following are differential diagnoses of microscopic hematuria except: D. Renal artery stenosis A common side effect of metformin (Glucophage) therapy is: D. Diarrhea The nurse practitioner is evaluating patients who are at high risk for complications due to UTIs. Which of the following patients does not belong in this category? C. A 21-year-old woman who has a history of irritable bowel disease A 68-year-old woman with hypertension and diabetes is seen by the NP for a dry cough that worsens at night when she lies in bed. She has shortness of breath, which worsens when she exerts herself, and has gained 6 lbs during the past 2 months. Her pulse rate is 90 beats/min and regular. She is on a nitroglycerine patch and furosemide daily. The best explanation for her symptoms is: B. Congestive heart failure A 21-year-old woman complains to you of a 1-week episode of dysuria, frequency, and a strong odor to her urine. This is her second episode of the year. The previous urinary tract infection occurred 3 months ago. What is the most appropriate follow-up for this patient? A. order a urinalysis and urine for culture and sensitivity, and treat the patient with antibiotics A 30-year-old woman with type 2 diabetes uses regular and NPH insulin in the morning and in the evening. She denies changes in her diet of any illness, but recently started attending aerobic classes in the afternoon. Her fasting blood glucose level before breakfast is now elevated. Which of the following is best described? A. Somogyi phenomenon Which of the following would you recommend on an annual basis for an elderly patient with type 2 diabetes? A. Eye exam with an opthalmologist Which of the following drugs does the JNC 9 2014 recommend for the initial treatment for White adults with microalbuminuria? A. ACE inhibitors A male patient has type 2 diabetes mellitus and a "sensitive stomach." Which medication is least likely to cause him gastrointestinal distress? D. Sucralfate A lipid profile for newly diagnosed hypertensive patient with a BMI of 27 shows a triglyceride level of 950 mg/dL, total cholesterol of 240mg/dL, LDL of 145 mg/dL, and HDL of 45 mg/dL. What is the best intervention for this patient? D. Initiate a prescription of fenofibrate (Tricor) A hypertensive middle-aged man who is a Native American has recently been diagnosed with renal insufficiency. He has been on lisinopril for many years. Which of the following laboratory values should be carefully monitored? B. Serum creatinine and estimated GFR A 65-year-old Hispanic woman has a history of type 2 diabetes. A routine urinalysis reveals a few epithelial cells and is negative for leukocytes, nitrites, and protein. The serum creatinine is 1.5 mg/dL. Which of the following actions would you recommend next? B. Order a spot urine-albumin-to-creatinine ratio The most current JNC 8 recommendation for the blood pressure goal in diabetes is: A. 140/90 mmHg A 10-year-old boy has type 1 diabetes. His late afternoon sugars over the past 2 weeks have ranged between 210 mg/dL and 230 mg/dL. He currently injects 10 units of regular insulin and 25 units of NPH in the morning and 15 units of regular insulin and 10 units of NPH insulin in the evening. Which of the following is the best treatment plan for this patient? B. Increase only the NPH insulin in the morning