FINAL NUR 508 Exam Questions and Correct Answers Latest Update 2024 (Already Passed)
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 - Answers prescribe oral contraception and have her start them the same day
as the visit with the backup method used for the first 7 days
First line treatment for Heart Failure - Answers Ace inhibitors: captopril (capoten, enalpril (vasotec),
lisinopril (Prinivil or Zestril, ramipril (altace), trandolapril (mavik),
*should be prescribed to all patients with HF unless contrindicated
Treatment of HF ARB's - Answers candesartan (atacand), valsartan (diovan),
*should be used if ACE inhibitors are intolerant to patient
Treatment of HF Beta blockers - Answers bisoprolol (zebeta), carvediol (coreg), metroprolol (Lopressor),
*are the recommended agents for all patients with stable mild severe HF
treatment of HF Lasix (furosemide) - Answers fluid overload
Treatment of HF and pulmonary edema - Answers 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
ACE inhibitors SE - Answers SE: cough (change to ARB) Angioedema, rash, diapphoresis, abd pain,
leukopenis, myalgia, HA, renal insuffiency, Increase creatinine, hyperklemia, hypotension. Tetrogen
(fetal renal abnormalities)
, ACE inhibitors MOA - Answers 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
Antihypertensive med class contraindicated in pt with Asthma - Answers Beta blockers- metoprolol
Digoxin MOA - Answers *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.
Penicillin use - Answers 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
Penicillin MOA - Answers 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 backbone of the cell wall. In addition to being structurally weak, this formation is thought
to catalyze the activation of autolytic enzymes in the cell wall that cause progressive bacterial lysis.
Beta Blockers use - Answers *HTN, Angina, secondary prevention post MI, Chronic HF, Arrhythmias
*uses for nonselective BB include prophylactic treatment or migraines, graves' disease, glucoma,
hypertrophicnsubaortic stenosis, and essential tremors.
Beta Blocker MOA - Answers Beta receptors are found mainly in the heart and stimulation from
catecholamines causes an increase in heart rate blood pressure, myocardial contractility, and av
conduction and a decrease in av node refractoriness. All BB have similar MOA. Competitive blockade of
the beta adrenergic receptor. This results in the decreased heart rate, myocardial contractility, blood
pressure and myocardial oxygen demand. BB also reduce the metabolic (glycogenolytic, lipolytic)
myocardial stimulant, vasodilator, and bronchodilation actions of the catecholamines, and they
supressrenin release. As a result of the beta blockade, cardiac output and heart rate are decreased.
Slowing of the AV conduction system prevents an increase in cardiac automaticity and prolongs the
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 - Answers prescribe oral contraception and have her start them the same day
as the visit with the backup method used for the first 7 days
First line treatment for Heart Failure - Answers Ace inhibitors: captopril (capoten, enalpril (vasotec),
lisinopril (Prinivil or Zestril, ramipril (altace), trandolapril (mavik),
*should be prescribed to all patients with HF unless contrindicated
Treatment of HF ARB's - Answers candesartan (atacand), valsartan (diovan),
*should be used if ACE inhibitors are intolerant to patient
Treatment of HF Beta blockers - Answers bisoprolol (zebeta), carvediol (coreg), metroprolol (Lopressor),
*are the recommended agents for all patients with stable mild severe HF
treatment of HF Lasix (furosemide) - Answers fluid overload
Treatment of HF and pulmonary edema - Answers 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
ACE inhibitors SE - Answers SE: cough (change to ARB) Angioedema, rash, diapphoresis, abd pain,
leukopenis, myalgia, HA, renal insuffiency, Increase creatinine, hyperklemia, hypotension. Tetrogen
(fetal renal abnormalities)
, ACE inhibitors MOA - Answers 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
Antihypertensive med class contraindicated in pt with Asthma - Answers Beta blockers- metoprolol
Digoxin MOA - Answers *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.
Penicillin use - Answers 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
Penicillin MOA - Answers 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 backbone of the cell wall. In addition to being structurally weak, this formation is thought
to catalyze the activation of autolytic enzymes in the cell wall that cause progressive bacterial lysis.
Beta Blockers use - Answers *HTN, Angina, secondary prevention post MI, Chronic HF, Arrhythmias
*uses for nonselective BB include prophylactic treatment or migraines, graves' disease, glucoma,
hypertrophicnsubaortic stenosis, and essential tremors.
Beta Blocker MOA - Answers Beta receptors are found mainly in the heart and stimulation from
catecholamines causes an increase in heart rate blood pressure, myocardial contractility, and av
conduction and a decrease in av node refractoriness. All BB have similar MOA. Competitive blockade of
the beta adrenergic receptor. This results in the decreased heart rate, myocardial contractility, blood
pressure and myocardial oxygen demand. BB also reduce the metabolic (glycogenolytic, lipolytic)
myocardial stimulant, vasodilator, and bronchodilation actions of the catecholamines, and they
supressrenin release. As a result of the beta blockade, cardiac output and heart rate are decreased.
Slowing of the AV conduction system prevents an increase in cardiac automaticity and prolongs the
