533 Final Exam 1 Questions And All
Correct Answers.
Benazepril should be discontinued immediately if:
1. dry cough
2. pregnancy occurs
3. potassium levels decrease
4. gout develops - Answer 2. pregnancy occurs
Benzapril is an ACEI and this class of drugs is contraindicated during pregnancy because of teratogenic
effects on the renal system of the developing fetus. Dry cough is an aggravating side effect that occurs in
some patients who take ACEI, but discontinuation is elective. ACEI use is associated with increased
potassium levels, not decreased levels. Gout is not exacerbated by ACEI use.
A characteristic of an ACEI iduced cough is that it:
1. is mildly productive
2. is worse at nightime
3. usually begins within 2 weeks of starting therapy
4. is more common in men - Answer 3. usually begins within 2 weeks of starting therapy
A patient taking atorvastatin for newly diagnosed dyslipidemia complains of fatigue, weakness, and
muscle aches in his lower back, arms, and legs for the past three days. It has not improved with rest.
How should this be evaluated?
1. stop the atorvastatin immediately
2. check liver enzymes first
3. order a CPK level
4. ask about nighttime muscle cramps - Answer 1. stop the atorvastatin immediately
,This patient has complaints highly suggestive of rhabdomyolysis. The atorvastatin should be stopped
immediately and a CPK should be ordered. Liver enzymes would not assess for the etiology of myalgias.
They assess tolernce of statins in the liver. Nighttime muscle cramps are not usually associated with
statin use. Myalgias are common but are not ypically associated with an elevated CPK. Rhabdomyolysis is
a rare side effect of the statins.
Which patient could be expected to have the highest systolic BP?
1. a 21 year old male
2. a 50 year old perimenopausal female
3. a 35 year old with T2DM
4. a 75 year old male - Answer 4. a 75 year old male
Nearly 25% of the US population has HTN. The greatest incidence is in older adults because of changes in
the intima of vessels as aging and calcium deposition occur. Males of any age are more likely than
females, with AA adults having the highest incidence.
A 50 year old patient with HTN has taken hydrochlorthiazide 25mg daily for the past 4 weeks. Her BP has
decreased from 155/95 to 145/90. How should the NP proceed?
1. Wait another 4 weeks before making a dosage change
2. Increase the HCTZ to 50mg daily
3. Add a drug from another class to the daily 25mg HCTZ
4. Stop the HCTZ and start a drug from a different class - Answer 3. Add a drug from another class to
the daily 25mg HCTZ
The recommended target BP is <140/90. The current plan has not allowed this patient to meet this goal,
so it is not acceptable to continue this current dose. Increasing the HCTZ to 50mg/daily will not result in
a decrease in BP, only and increase in potassium loss. Adding a drug from a different med class is a good
choice because the combined effects of antihypertensive medication is a good choice because the
combined effects of antihypertensive medication nearly always produce a decrease in BP and both drugs
can be maintained in low doses.
,Which of the following HTN meds should not be used in pregnant women?
a. CCBs
b. TZDs
c. ARBs and ACEIs
d. BBs - Answer c. ARBs and ACEIs
A 52 year old man presents to your office for a health maintenance exam, and initial vital signs show a BP
of 154/94. Previous BP measurements were normal. What is the next step in management?
a. start an anti-HTN med
b. repeat the BP measurement
c. Look for causes of secondary HTN
d. Perform a urine drug screen - Answer b. repeat the BP measurement
Which of the following states is correct regarding BP evaluation?
a. the patient should be lying quietly on the exam table for 5 mins prior to obtaining a BP
b. arm should be below heart level during BP
c. the bladder of the BP cuff should encircle 80% of the forearm
d. HTN can be dx by the average of 2 elevated BP readings on a single occasion - Answer c. the bladder
of the BP cuff should encircle 80% of the forearm
Which of the following anti-HTN medications should be avoided in patients with gout?
a. losartan
b. HCTZ
c. nifedipine
, d. atenolol - Answer b. HCTZ
Which of the following antihypertensive meds should be avoided in patients with poorly controlled
asthma?
a. losartan
b. HCTZ
c. nifedipine
d. atenolol - Answer d. atenolol
Which of the following antihypertensive meds should not be used as a first-line treatment for a person
with essential HTN and no other other medical conditions?
a. ACEI
b. BB
c. CCB
d. diuretic - Answer b. BB
Which of the following medications should be d/c in a woman with essential HTN who is trying to get
pregnant?
a. methyldopa
b. labetalol
c. nifedipine
d. losartan - Answer d. losartan
Which of the following lab values are the most likely to be affected by eating within an hour of lab draw?
a. LDL
b. total LDL
Correct Answers.
Benazepril should be discontinued immediately if:
1. dry cough
2. pregnancy occurs
3. potassium levels decrease
4. gout develops - Answer 2. pregnancy occurs
Benzapril is an ACEI and this class of drugs is contraindicated during pregnancy because of teratogenic
effects on the renal system of the developing fetus. Dry cough is an aggravating side effect that occurs in
some patients who take ACEI, but discontinuation is elective. ACEI use is associated with increased
potassium levels, not decreased levels. Gout is not exacerbated by ACEI use.
A characteristic of an ACEI iduced cough is that it:
1. is mildly productive
2. is worse at nightime
3. usually begins within 2 weeks of starting therapy
4. is more common in men - Answer 3. usually begins within 2 weeks of starting therapy
A patient taking atorvastatin for newly diagnosed dyslipidemia complains of fatigue, weakness, and
muscle aches in his lower back, arms, and legs for the past three days. It has not improved with rest.
How should this be evaluated?
1. stop the atorvastatin immediately
2. check liver enzymes first
3. order a CPK level
4. ask about nighttime muscle cramps - Answer 1. stop the atorvastatin immediately
,This patient has complaints highly suggestive of rhabdomyolysis. The atorvastatin should be stopped
immediately and a CPK should be ordered. Liver enzymes would not assess for the etiology of myalgias.
They assess tolernce of statins in the liver. Nighttime muscle cramps are not usually associated with
statin use. Myalgias are common but are not ypically associated with an elevated CPK. Rhabdomyolysis is
a rare side effect of the statins.
Which patient could be expected to have the highest systolic BP?
1. a 21 year old male
2. a 50 year old perimenopausal female
3. a 35 year old with T2DM
4. a 75 year old male - Answer 4. a 75 year old male
Nearly 25% of the US population has HTN. The greatest incidence is in older adults because of changes in
the intima of vessels as aging and calcium deposition occur. Males of any age are more likely than
females, with AA adults having the highest incidence.
A 50 year old patient with HTN has taken hydrochlorthiazide 25mg daily for the past 4 weeks. Her BP has
decreased from 155/95 to 145/90. How should the NP proceed?
1. Wait another 4 weeks before making a dosage change
2. Increase the HCTZ to 50mg daily
3. Add a drug from another class to the daily 25mg HCTZ
4. Stop the HCTZ and start a drug from a different class - Answer 3. Add a drug from another class to
the daily 25mg HCTZ
The recommended target BP is <140/90. The current plan has not allowed this patient to meet this goal,
so it is not acceptable to continue this current dose. Increasing the HCTZ to 50mg/daily will not result in
a decrease in BP, only and increase in potassium loss. Adding a drug from a different med class is a good
choice because the combined effects of antihypertensive medication is a good choice because the
combined effects of antihypertensive medication nearly always produce a decrease in BP and both drugs
can be maintained in low doses.
,Which of the following HTN meds should not be used in pregnant women?
a. CCBs
b. TZDs
c. ARBs and ACEIs
d. BBs - Answer c. ARBs and ACEIs
A 52 year old man presents to your office for a health maintenance exam, and initial vital signs show a BP
of 154/94. Previous BP measurements were normal. What is the next step in management?
a. start an anti-HTN med
b. repeat the BP measurement
c. Look for causes of secondary HTN
d. Perform a urine drug screen - Answer b. repeat the BP measurement
Which of the following states is correct regarding BP evaluation?
a. the patient should be lying quietly on the exam table for 5 mins prior to obtaining a BP
b. arm should be below heart level during BP
c. the bladder of the BP cuff should encircle 80% of the forearm
d. HTN can be dx by the average of 2 elevated BP readings on a single occasion - Answer c. the bladder
of the BP cuff should encircle 80% of the forearm
Which of the following anti-HTN medications should be avoided in patients with gout?
a. losartan
b. HCTZ
c. nifedipine
, d. atenolol - Answer b. HCTZ
Which of the following antihypertensive meds should be avoided in patients with poorly controlled
asthma?
a. losartan
b. HCTZ
c. nifedipine
d. atenolol - Answer d. atenolol
Which of the following antihypertensive meds should not be used as a first-line treatment for a person
with essential HTN and no other other medical conditions?
a. ACEI
b. BB
c. CCB
d. diuretic - Answer b. BB
Which of the following medications should be d/c in a woman with essential HTN who is trying to get
pregnant?
a. methyldopa
b. labetalol
c. nifedipine
d. losartan - Answer d. losartan
Which of the following lab values are the most likely to be affected by eating within an hour of lab draw?
a. LDL
b. total LDL
