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NUR 111 APEA_Questions__1_HELPFUL
Cardiovascular Disorders Benazepril should be discontinued immediately if: pregnancy occurs. A patient is diagnosed with mild heart failure (HF). What drug listed below would be a good choice for reducing morbidity and mortality long term? Metoprolol A patient taking an ACE inhibitor should avoid: potassium supplements. An 87-year-old has history of symptomatic heart failure. He presents today with lower extremity edema and mild shortness of breath with exertion. In addition to a diuretic for volume overload, what other medication should he receive today? ACE inhibitor A 42 - year-old hypertensive patient was given a thiazide diuretic 4 weeks ago for treatment of primary hypertension. On his return visit today, he reports feeling weak and tired. What should the NP consider to evaluate the weakness and fatigue? Potassium level Which class of medication is frequently used to improve long- term outcomes in patients with systolic dysfunction? ACE inhibitors Orthostatic hypotension can be diagnosed in an older adult if the systolic blood pressure decreases: more than 20 points within 3 minutes after rising. A 74 - year-old patient has peripheral artery disease (PAD). Which item listed below is an important nonmodifiable risk factor for Diabetes
PAD?
The lipid particle with the greatest atherogenic effect is: LDL. Which medication could potentially exacerbate heart failure (HF)? Naproxen Where would the murmur associated with mitral regurgitation best be auscultated? Mitral listening point A 43-year-old Hispanic male has an audible diastolic murmur best heard in the mitral listening point. There is no audible click. His status has been monitored for the past 2 years. This murmur is probably: mitral stenosis. An independent 82-year-old male patient is very active but retired last year. His total cholesterol and LDLs are moderately elevated. How should the NP approach his lipid elevation? Treatment is based on expected length of life A patient who has diabetes presents with pain in his lower legs when he walks and pain resolution with rest. When specifically asked about the pain in his lower leg, he likely will report pain: in the calf muscle. A 75-year-old patient with longstanding hypertension takes an ACE inhibitor and a thiazide diuretic daily. He has developed dyspnea on exertion and peripheral edema over the past several days. This probably indicates: development of heart failure (HF).
A patient with aortic stenosis has been asymptomatic for decades. On routine exam, he states that he has had some dizziness associated with activity but no chest pain or shortness of breath. The best course of action for the nurse practitioner is to: refer to cardiology. The nurse practitioner is caring for an independent 74 - year-old female who had acute coronary syndrome (ACS) about 6 weeks ago. What medications should be part of her regimen unless there is a contraindication? ACE, ASA, beta blocker, and statin Which hypertensive patient is most likely to have adverse blood pressure effects from excessive sodium consumption? 70 - year-old African American male A common side effect of thiazide diuretics is: erectile dysfunction. The carotid arteries are auscultated for bruits because: this is indicative of generalized atherosclerosis. Which choice below would be the best choice for an 80 - year-old patient whose blood pressure is 172/72 mm Hg? Amlodipine Which item below represents the best choice of antihypertensive agents for the indicated patient? Lisinopril in a 35 - year-old Caucasian male A patient with hypertension has been diagnosed with gout. Which home medication may have contributed to this episode of gout? Furosemide
You are managing the warfarin dose for an older adult with a prosthetic heart valve. Which situation listed requires that warfarin be discontinued now? INR of 8, no significant bleeding Which of the following medications may have an unfavorable effect on a hypertensive patient's blood pressure? Naproxen Which study would be most helpful in evaluating the degree of hypertrophy of the atrium or ventricle? Echocardiography A patient has had poorly controlled hypertension for more than 10 years. Indicate the most likely position of his point of maximal impulse (PMI): 5th ICS, left of MCL. Drugs that target the renin-angiotensin-aldosterone system are particularly beneficial in patients who have: diabetic nephropathy. 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? Stop the atorvastatin immediately. How often should lipids be screened in patients who are 65 years and older if they have lipid disorders or cardiovascular risk factors? Annually A patient who takes HCTZ 25 mg daily has complaints of muscle cramps. He probably has: hypokalemia.
The major difference between varicose veins and arteriosclerosis is the: vessels affected. A patient with mitral regurgitation (MR) has developed the most common arrhythmia associated with MR. The intervention most likely to prevent complications from this arrhythmia is: anticoagulation. A patient taking an angiotensin receptor blocker (ARB) should avoid: potassium supplements. Mr. Brown a 45-year-old African American male has the following lab values. What should the nurse practitioner do next? A thyroid stimulating hormone (TSH) level Which choice below characterizes a patient who has aortic regurgitation? Long asymptomatic period followed by exercise intolerance, then dyspnea at rest Pharmacologic treatment for older adults with hypertension should be initiated: for any type of hypertension. The most common indicator of end-organ damage in adolescents with hypertension is: left ventricular hypertrophy. A decrease in blood pressure can occur in men who take sildenafil (Viagra) and: any antihypertensive medication.
A 75-year-old patient with longstanding hypertension takes a combination ACE inhibitor/thiazide diuretic and amlodipine daily. Today his diastolic blood pressure and heart rate are elevated. He has developed dyspnea on exertion and peripheral edema over the past several days. These symptoms likely demonstrate: development of heart failure. Tables are used for determination of maximum blood pressure values for adolescents. How are these blood pressure values established for adolescents? Height percentile, gender, and age Which group of medications would be detrimental if used to treat a patient who has heart failure (HF)? Fosinopril, HCTZ, verapamil Mr. Holbrook, a 75 - year-old male, is a former smoker with a 30 pack-year history. He has come in today for an annual exam. He walks daily for 25 minutes, has had intentional weight loss, and has a near normal BMI. On examination, the patient is noted to have an absence of hair growth on his lower legs. Which statement is true regarding this patient? This might indicate disease in the lower extremities. Which test listed below may be used to exclude a secondary cause of hyperlipidemia in a patient who has elevated lipids?
TSH
An overweight 76-year-old female with a recent onset of diabetes has longstanding hypertension and hyperlipidemia. She has developed atrial fibrillation. The nurse practitioner knows that this patient is at risk for: heart failure (HF).
reasonable plan of care for this patient today? daily). Besides hypertension, which risk factor most contributes to development of an abdominal aortic aneurysm? Cigarette smoking A 50-year-old patient with hypertension has taken hydrochlorothiazide 25 mg daily for the past 4 weeks. How should the nurse practitioner proceed? Add a drug from another class to the daily 25 mg hydrochlorothiazide. Three of the following medications warrant monitoring of potassium levels. Which one does NOT? Amlodipine The most common arrhythmia resulting from valvular heart disease is: atrial fibrillation. Classic symptoms of deep vein thrombosis (DVT) include: swelling, pain, and discoloration in lower extremity. A 65-year-old male patient has the following lipid levels. What class of medications is preferred to normalize his lipid levels and reduce his risk of a cardiac event? HMG CoA reductase inhibitors A 28 - year-old has a Grade 3 murmur. Which characteristic indicates a need for referral? A fixed split
Which mitral disorder results from redundancy of the mitral valve's leaflets? Mitral valve prolapse Mr. Smith is a 72 - year-old patient who takes warfarin for chronic atrial fibrillation. His INR and CBC results are provided. The nurse practitioner should: stop the warfarin today and repeat the INR tomorrow. In order to reduce lipid levels, statins are most beneficial when taken: in conjunction with diet and exercise. A child's resting heart rate is expected to be between 60 and 100 beats per minute once he reaches: 10 years of age. An older adult who has hypertension and angina takes multiple medications. Which one of the following decreases the likelihood of his having angina? Beta blocker At what age should initial blood pressure screening take place? 3 years Which patient could be expected to have the highest systolic blood pressure? A 75 - year-old male An older adult who has hypertension also has osteoporosis. Which antihypertensive agent would have the secondary effect of improving her osteoporosis? A thiazide diuretic Mr. Daigle is an 80 - year-old patient who takes warfarin for chronic atrial fibrillation. The nurse practitioner should: stop warfarin for the next two days and repeat the INR
Pharmacologic treatment for children who have hypertension should be initiated for: diabetics with hypertension. Many factors can contribute to the risk of congenital heart disease. Which maternal disease carries a higher risk of transposition of the great vessels (TGA), ventricular septal defect (VSD), and hypertrophic cardiomyopathy? Diabetes Which test below is most cost-effective to screen for abdominal aortic aneurysm? Abdominal ultrasound A patient with poorly controlled hypertension and history of myocardial infarction 6 years ago presents today with mild shortness of breath. He takes quinapril, ASA, metoprolol, and a statin daily. What symptom is NOT indicative of heart failure? Headache A patient who has mitral valve prolapse (MVP) reports chest pain and frequent arrhythmias. In the absence of other underlying cardiac anomalies, the drug of choice to treat her symptoms is: metoprolol. A 25 - year-old patient has aortic stenosis (AS). The etiology of his AS is probably: congenital. A young child has an audible murmur. The nurse practitioner describes it as a grade 4 murmur. How should this be managed? The child should be referred to cardiology. A characteristic of an ACE inhibitor-induced cough is that it: usually begins within 2
weeks of starting therapy. The valve most commonly involved in chronic rheumatic heart disease is the: mitral. A 75 - year-old has isolated systolic hypertension. She started on amlodipine 4 weeks ago. She states that since then, she has developed urinary incontinence. What is the nurse practitioner's assessment? It is probably related to amlodipine. It is probably related to amlodipine. Most hypertension in preadolescents and children is: secondary hypertension. The diagnosis of mitral valve prolapse can be confirmed by: echocardiography. Mrs. Jones is an 85-year-old who has average blood pressures of 170/70 mmHg. Which agent would be a good starting medication to normalize her blood pressure? Amlodipine Which laboratory abnormality may be observed in a patient who takes lisinopril? Increased potassium level
A 70 - year-old is diagnosed with multiple cherry angiomas. The nurse practitioner knows that: these may bleed profusely if ruptured. A patient is found to have koilonychia. What laboratory test would be prudent to perform? Complete blood count Most cases of atopic dermatitis exacerbation are treated with: topical steroids. Which vehicle is least appropriate in a patient who has atopic dermatitis? Lotions A 23-year-old male appears in clinic with the following lesion on his trunk. This lesion is usually associated with: pityriasis rosea. The nurse practitioner examines a patient who has had poison ivy for 3 days. She asks if she can spread it to her family members. The nurse practitioner replies: “No, transmission does not occur from the blister’s contents.” A patient will be taking oral terbinafine for fingernail fungus. The NP knows that: terbinafine is an inhibitor of the CYP 2D6 enzymes. Mr. Johnson is a 74-year-old who presents with a pearly-domed, nodular-looking lesion on the back of the neck. It does not hurt or itch. What is a likely etiology? Basal cell carcinoma
A patient reports that he found a tick on himself about 2 weeks ago. He presents today with a red circle and a white center near where he remembers the tick bite. He did not seek treatment at that time. Today he complains of myalgias and arthralgias. Which laboratory test can be used to help diagnose Lyme disease?
ELISA
A patient with a positive history of a tick bite about 2 weeks ago and erythema migrans has a positive ELISA for Borrelia burgdorferi. The Western blot is positive. How should he be managed? He should receive doxycycline for Lyme disease. A 74-year-old male patient has sustained a laceration to his foot. His last tetanus shot was more than 10 years ago. He has completed the primary series. What should be recommended? Tetanus, diphtheria, and acellular pertussis (Tdap) A 71-year-old female presents with a vesicular rash that burns and itches. Shingles is diagnosed. An oral antiviral: should be started within 72 hours of the onset of symptoms. A microscopic examination of the sample taken from a skin lesion indicates hyphae. What type of infection might this indicate? Fungal Topical 5 - fluorouracil (5-FU) is used to treat: basal cell carcinoma.
anterior surface of both legs. She is concerned. These are probably associated with her history of: A patient presents with plaques on the extensor surface of the elbows, knees, and back. The plaques are erythematous and thick, silvery scales are present. This is likely: plaque psoriasis. Which of the following skin lesions in an older adult is a premalignant condition? Actinic keratosis A patient has seborrheic dermatitis. Which vehicle would be most appropriate to use in the hairline area to treat this? Foam A 16-year-old has been diagnosed with Lyme disease. Which drug should be used to treat him? Doxycycline A patient exhibits petechiae on both lower legs but has no other complaints. How should the NP proceed? Order a CBC Which chronic skin disorder primarily affects hairy areas of the body? Seborrheic dermatitis A skin lesion that is a solid mass is described as a: papule.
An older adult patient has been diagnosed with shingles on the right lateral aspect of her trunk. It initially appeared yesterday. It is very painful. How should she be managed? An oral antiviral agent and pain medication A patient has been diagnosed with scabies. What is the medication of choice to treat this? Permethrin Patients with atopic dermatitis are likely to exhibit: itching. The primary therapeutic intervention for patients who present with hives is: antihistamines. Which of the following lesions never blanches when pressure is applied? Purpura or petechiae The most common form of skin cancer is: basal cell carcinoma. Which of the following areas of the body has the greatest percutaneous absorption? Genitalia A patient presents to the minor care area of the emergency department after being bitten by a dog. The patient states that the dog had a tag around his neck and had been seen roaming around the neighborhood for days before the patient was bitten. The dog did not exhibit any odd behavior. How should this be managed? Report the bite to animal control and administer appropriate medical care.
