NR 508 Advanced Pharmacology Week 2 Quiz_Fall 2020
1. A patient who has stable angina and uses sublingual nitroglycerin tablets is in the clinic and
... [Show More] begins having chest pain. The primary care NP administers a nitroglycerin tablet and instructs the patient to lie down. The NP’s next action should be to: (Points : 2)
obtain an electrocardiogram.
administer oxygen at 2 L/minute. give 325 mg of chewable aspirin. call EMS.
Question 2.2. A patient has been taking levothyroxine 100 mcg daily for several months. The patient comes to the clinic with complaints of insomnia and irritability. The primary care NP notes a heart rate of 92 beats per minute. The NP should: (Points : 2)
change to liothyronine 75 mcg/day. discontinue levothyroxine indefinitely.
order propylthiouracil to counter the increased thyroid levels.
order TSH and T4 levels and decrease the dose to 75 mcg/day.
Question 3.3. A 55-year-old patient with no prior history of hypertension has a blood pressure greater than 140/90 on three separate occasions. The patient does not smoke, has a body mass index of 24, and exercises regularly. The patient has no known risk factors for cardiovascular disease. The primary care NP should: (Points : 2)
prescribe a thiazide diuretic and an angiotensin-converting enzyme
inhibitor.
perform a careful cardiovascular physical assessment. counsel the patient about dietary and lifestyle changes.
order a urinalysis and creatinine clearance and begin therapy with a □- blocker.
Question 4.4. A 75-year-old patient who has cardiovascular disease reports insomnia and vomiting for several weeks. The primary care NP orders thyroid function tests. The tests show TSH is decreased and T4 is increased. The NP should consult with an endocrinologist and order: (Points : 2)
thyrotropin. methimazole. levothyroxine.
propylthiouracil.
Question 5.5. A patient with primary hypercholesterolemia is taking an HMG- CoA reductase inhibitor. All of the patient’s baseline LFTs were normal. At a 6- month follow-up visit, the patient reports occasional headache. A lipid profile reveals a decrease of 20% in the patient’s LDL cholesterol. The NP should: (Points : 2)
order LFTs.
order CK-MM tests.
consider decreasing the dose of the medication.
reassure the patient that this side effect is common.
Question 6.6. A patient who has type 2 diabetes mellitus will begin taking a bile acid sequestrant. Which bile acid sequestrant should the primary care NP order?
(Points : 2)
Colesevelam (Welchol) Colestipol (Colestid)
Cholestyramine (Questran)
Cholestyramine (Questran Light)
Question 7.7. A patient with Graves’ disease is taking methimazole. After 6 months of therapy, the primary care NP notes normal T3 and T4 and elevated TSH. The NP should: (Points : 2)
order a complete blood count (CBC) with differential. order aspartate aminotransferase, AGT, and LDH tests. decrease the dose of the medication.
add levothyroxine to the patient’s regimen.
Question 8.8. A patient who has type 2 diabetes mellitus takes metformin (Glucophage). The patient tells the primary care NP that he will have surgery in a few weeks. The NP should recommend: (Points : 2)
taking the metformin dose as usual the morning of surgery.
using insulin during the perioperative and postoperative periods. that the patient stop taking metformin several days before surgery.
adding a sulfonylurea medication until recovery from surgery is complete.
Question 9.9. A child who has congenital hypothyroidism takes levothyroxine 75 mcg/day. The child weighs 15 kg. The primary care NP sees the child for a 3- year-old check-up. The NP should consult with a pediatric endocrinologist to discuss: (Points : 2)
increasing the dose to 90 mcg/day. decreasing the dose to 30 mcg/day.
stopping the medication and checking TSH and T4 in 4 weeks.
discussing the need for lifetime replacement therapy with the child’s parents.
Question 10.10. A patient who is newly diagnosed with type 2 diabetes mellitus has not responded to changes in diet or exercise. The patient is mildly obese and has a fasting blood glucose of 130 mg/dL. The patient has normal renal function tests. The primary care NP plans to prescribe a combination product. Which of the following is indicated for this patient? (Points : 2)
Metformin/glyburide (Glucovance) Insulin and metformin (Glucophage) Saxagliptin/metformin (Kombiglyze)
Metformin/pioglitazone (ACTOplus met)
Question 11.11. An 80-year-old male patient will begin taking an □- antiadrenergic medication. The primary care NP should teach this patient to: (Points : 2)
ask for assistance while bathing. restrict fluids to aid with diuresis.
take the medication in the morning with food. be aware that priapism is a common side effect. [Show Less]