NR 508-Pharmacology Midterm Exam (Questions and Answers)
Question 1
2 / 2 pts
A patient has three consecutive blood pressure readings of 140/95 mm Hg.
... [Show More] The patient’s body mass
index is 24. A fasting plasma glucose is 100 mg/dL. Creatinine clearance and cholesterol tests are normal.
The primary care NP should order:
a β-blocker.
an angiotensin-converting enzyme inhibitor.
Correct!
a thiazide diuretic.
dietary and lifestyle changes.
The patient has stage I hypertension. Because there are no compelling indications for other treatment, a
thiazide diuretic should be used initially to treat the hypertension. Dietary and lifestyle changes should
also be recommended but are not sufficient for patients with stage I hypertension. Other drugs may be
added later if thiazide diuretic therapy fails.
Question 2
2 / 2 pts
An African-American patient is taking captopril (Capoten) 25 mg twice daily. When performing a physical
examination, the primary care nurse practitioner (NP) learns that the patient continues to have blood
pressure readings of 135/90 mm Hg. The NP should:
increase the captopril dose to 50 mg twice daily.
Correct!
add a thiazide diuretic to this patient’s regimen.
change the drug to losartan (Cozaar) 50 mg once daily.
recommend a low-sodium diet in addition to the medication.
Some African-American patients do not appear to respond as well as whites in terms of blood pressure
reduction. The addition of a low-dose thiazide diuretic often allows for efficacy in blood pressure
lowering that is comparable with that seen in white patients. Increasing the captopril dose is not
indicated. Losartan is an angiotensin receptor blocker (ARB) and is not indicated in this case.
Question 3
2 / 2 pts
A 50-year-old woman reports severe, frequent hot flashes and vaginal dryness. She is having irregular
periods. She has no family history of CHD or breast cancer and has no personal risk factors. The primary
care NP should recommend:
estrogen-only HT.
Correct!
low-dose oral contraceptive therapy.
selective serotonin reuptake inhibitor therapy until menopause begins.
estrogen-progesterone HT.
Oral contraceptive pills are not approved by the U.S. Food and Drug Administration for management of
perimenopausal symptoms except to treat irregular menstrual bleeding. This patient has a low risk for
CHD and breast cancer, so oral contraceptive pills are relatively safe. She is also at risk for pregnancy, so
oral contraceptive pills can help to prevent that. [Show Less]