1. A medication that may produce exercise intolerance in a patient who has hypertension is:
metoprolol
2. According to the National Heart, Lung and
... [Show More] Blood Institute, which characteristic listed below is a coronary heart disease (CHD) risk equivalent; that is, which risk factor places the patient at a CHD risk similar to a history of CHD?
Diabetes mellitus
3. An 80-year-old female who is otherwise well has the following blood pressure readings. How should she be managed pharmacologically?
Calcium channel blocker
4. 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.
stop the warfarin today and repeat the INR tomorrow
5. Most hypertension in preadolescents and children is:
secondary hypertension.
6. A patient taking an angiotensin receptor blocker (ARB) should avoid:
potassium supplements.
7. 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
8. Older adults have a unique blood pressure pattern. Which blood pressure reading below reflects this pattern?
160/60 mmHg
9. Pharmacologic treatment for children who have hypertension should be initiated for:
diabetics with hypertension.
10. The usual clinical course of mitral valve prolapse:
is benign.
11. The correlation between blood pressure and age greater than 60 years is that as age increases:
diastolic blood pressure decreases.
12. Classic symptoms of deep vein thrombosis (DVT) include:
swelling, pain, and discoloration in lower extremity.
13. 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 Potassium level
14. 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
15. Which class of medication is frequently used to improve long-term outcomes in patients with systolic dysfunction?
ACE inhibitors
16. In older adults, the three most common ailments are:
hearing loss, hypertension, arthritis.
17. Pharmacologic treatment for older adults with hypertension should be initiated: for any type of hypertension.
for any type of hypertension.
18. A patient with hypertension describes a previous allergic reaction to a sulfa antibiotic as "sloughing of skin" and hospitalization. Which medication is contraindicated in this patient?
Hydrochlorothiazide
19. 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.
20. How often should blood pressure be measured in a child who is 3 years old? It should be measured annually.
It should be measured annually.
21. 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.
22. Which item below represents the best choice of antihypertensive agents for the indicated patient?
Beta blocker for a 38-year-old diabetic patient
23. 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 INR
24. Which group of medications would be detrimental if used to treat a patient who has heart failure (HF)?
Ramipril, aspirin, metoprolol
25. A 75-year-old patient who has aortic stenosis wants to know what symptoms indicate worsening of his stenosis. The nurse practitioner replies: shortness of breath and syncope.
shortness of breath and syncope.
26. Which choice below characterizes a patient who has aortic regurgitation?
Long asymptomatic period followed by exercise intolerance, then dyspnea at rest
27. Besides hypertension, which risk factor most contributes to development of an abdominal aortic aneurysm?
Cigarette smoking Cigarette smoking Correct
28. A 28-year-old has a Grade 3 murmur. Which characteristic indicates a need for referral?
A fixed split A fixed split Correct
29. A 91-year-old female with longstanding history of chronic heart failure has renal and liver studies that have slowly worsened over the past year. This probably indicates: target organ damage secondary to heart failure.
target organ damage secondary to heart failure. Correct
30. Which laboratory abnormality may be observed in a patient who takes lisinopril?
Increased potassium level
31. 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 Treatment is age dependent; he should receive a statin today Incorrect
32. A patient with newly diagnosed heart failure has started fosinopril in the last few days. She has developed a cough. What clinical finding can help distinguish the etiology of the cough as heart failure and not related to fosinopril? It is wet and worse with recumbence. It is wet and worse with recumbence. Correct
33. Which patient could be expected to have the highest systolic blood pressure? A 75-year-old male A 75-year-old male Correct
34. A decrease in blood pressure can occur in men who take sildenafil (Viagra) and: any antihypertensive medication. any antihypertensive medication. Correct
35. A patient who takes HCTZ 25 mg daily has complaints of muscle cramps. He probably has: hypokalemia. hypomagnesemia. Incorrect
36. Drugs that target the renin-angiotensin-aldosterone system are particularly beneficial in patients who have: diabetic nephropathy. diabetic nephropathy. Correct
37. A 25-year-old patient has aortic stenosis (AS). The etiology of his AS is probably: congenital. congenital. Correct
38. An 80-year-old patient with longstanding hypertension takes Monopril and HCTZ for hypertension. His most recent blood pressures are listed. What should be done about his blood pressure? Add a calcium channel blocker Add a calcium channel blocker Correct
39. Which hypertensive patient is most likely to have adverse blood pressure effects from excessive sodium consumption? 70-year-old African American male 70-year-old African American male Correct
40. The most common indicator of end-organ damage in adolescents with hypertension is: left ventricular hypertrophy. left ventricular hypertrophy. Correct
41. How often should lipids be screened in patients who are 65 years and older if they have lipid disorders or cardiovascular risk factors? Annually Annually
Which medication listed below could potentially exacerbate heart failure in a susceptible patient? Metoprolol Metoprolol
42. 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. refer to cardiology. Correct
43. 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 on day 3. stop warfarin for the next two days and repeat the INR on day 3. Correct
44. A patient will be screened for hyperlipidemia via a serum specimen. He should be told: to fast for 12-14 hours. to fast for 12-14 hours. Correct
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. acute mitral regurgitation. Incorrect
Which of the following medications may have an unfavorable effect on a hypertensive patient's blood pressure? Naproxen Naproxen Correct
A patient taking candesartan for treatment of hypertension should avoid: potassium supplements. potassium supplements. Correct
A 74-year-old patient has peripheral artery disease (PAD). Which item listed below is an important nonmodifiable risk factor for PAD? Diabetes Cigarette smoking Incorrect
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. anticoagulation. Correct
The most common arrhythmia resulting from valvular heart disease is: atrial fibrillation. atrial fibrillation. Correct [Show Less]