2I/I2Ipts
AIpatientIhasIthreeIconsecutiveIbloodIpressureIreadingsIofI140/95ImmIHg.ITheIpatient’sIbodyImass
IindexIisI24.IAIfastingIplasmaIglucoseIisI10
... [Show More]0Img/dL.ICreatinineIclearanceIandIcholesterol ItestsIareInormal.
ITheIprimaryIcareINPIshouldIorder:
aIβ-blocker.
anIangiotensin-convertingIenzymeIinhibitor.
Correct!
aIthiazideIdiuretic.
dietaryIandIlifestyleIchanges.
TheIpatientIhasIstageIIIhypertension.IBecauseIthereIareInoIcompellingIindicationsIforIotherItreatment, Ia
IthiazideIdiureticIshouldIbeIusedIinitiallyItoItreatItheIhypertension.IDietaryIandIlifestyleIchangesIshould
IalsoIbeIrecommendedIbutIareInotIsufficientIforIpatientsIwithIstageIIIhypertension.IOtherIdrugsImayIbe
IaddedIlaterIifIthiazideIdiureticItherapyIfails.
QuestionI2
2I/I2Ipts
AnIAfrican-AmericanIpatientIisItakingIcaptopril I(Capoten)I25ImgItwiceIdaily.IWhenIperformingIaIphysical
Iexamination, ItheIprimaryIcareInurseIpractitionerI(NP)IlearnsIthatItheIpatientIcontinuesItoIhaveIblood
IpressureIreadingsIofI135/90ImmIHg.ITheINPIshould:
increaseItheIcaptopril IdoseItoI50ImgItwiceIdaily.
Correct!
addIaIthiazideIdiureticItoIthisIpatient’sIregimen.
changeItheIdrugItoIlosartanI(Cozaar)I50ImgIonceIdaily.
recommendIaIlow-sodiumIdietIinIadditionItoItheImedication.
SomeIAfrican-AmericanIpatientsIdoInotIappearItoIrespondIasIwell IasIwhitesIinItermsIofIbloodIpressure
Ireduction.ITheIadditionIofIaIlow-doseIthiazideIdiuretic IoftenIallowsIforIefficacyIinIbloodIpressure
IloweringIthatIisIcomparableIwithIthatIseenIinIwhiteIpatients.IIncreasingItheIcaptopril IdoseIisInot
Iindicated.ILosartanIisIanIangiotensinIreceptorIblockerI(ARB)IandIisInotIindicatedIinIthisIcase.
QuestionI3
2I/I2Ipts
AI50-year-oldIwomanIreportsIsevere, IfrequentIhotIflashesIandIvaginal Idryness.ISheIisIhavingIirregular
Iperiods.ISheIhasInoIfamilyIhistoryIofICHDIorIbreastIcancerIandIhasInoIpersonal IriskIfactors.ITheIprimary
IcareINPIshouldIrecommend:
estrogen-onlyIHT.
Correct!
low-doseIoralIcontraceptiveItherapy.
selectiveIserotoninIreuptakeIinhibitorItherapyIuntilImenopauseIbegins.
estrogen-progesteroneIHT.
Oral IcontraceptiveIpillsIareInotIapprovedIbyItheIU.S.IFoodIandIDrugIAdministrationIforImanagementIof
Iperimenopausal IsymptomsIexceptItoItreatIirregularImenstrual Ibleeding.IThisIpatientIhasIaIlowIriskIfor
ICHDIandIbreastIcancer, IsoIoral IcontraceptiveIpillsIareIrelativelyIsafe.ISheIisIalsoIatIriskIforIpregnancy,IsoIoral
IcontraceptiveIpillsIcanIhelpItoIpreventIthat.
QuestionI4
2I/I2Ipts
TheIprimaryIcareINPIisIprescribingIaImedicationIforIanIoff-label Iuse.IToIhelpIpreventIaImedicationIerror,Ithe
INPIshould:
Correct!
writeI“off-label Iuse”IonItheIprescriptionIandIprovideIaIrationale.
call ItheIpharmacistItoIexplainIwhyItheIinstructionsIdeviateIfromIcommonIuse.
writeItheIalternativeIdrugIregimenIonItheIprescriptionIandIsendIitItoItheIpharmacy.
tell ItheIpatientItoIignoreItheIlabel IdirectionsIandIfollowItheIverbal IinstructionsIgivenIinItheIclinic.
WhenIprescribingIaIdrugIforIanIoff-label Iuse, ItheIproviderIshouldIspecifyIthisIonItheIwrittenIprescription
IandIshouldIprovideIaIrationaleIsoIthatItheIpharmacistIunderstandsIwhyItheIprescriptionIisIdifferentIfrom
ItheInormal Iuse.ICallingItheIpharmacistIwouldInotIprovideIwrittenIdocumentation.IMerelyIwritingIthe
IdifferentIinstructionsIcanIleadItoIerrorsIifItheIpharmacistIchangesItheIlabel ItoIconformItoIusual
Istandards.ITheIpatientImayIforgetIverbal IinstructionsIandIfollowItheIusual IregimenIinstead.
QuestionI5
2I/I2Ipts
TheIprimaryIcareInurseIpractitionerI(NP)IseesIaIpatientIinItheIclinicIwhoIhasIaIbloodIpressureIofI130/85
ImmIHg.ITheIpatient’sIlaboratoryItestsIreveal Ihigh-densityIlipoprotein, I35Img/dL;Itriglycerides, I120
Img/dL;IandIfastingIplasmaIglucose, I100Img/dL.ITheINPIcalculatesIaIbodyImassIindexIofI29.ITheIpatient
IhasIaIpositiveIfamilyIhistory IforIcardiovascularIdisease.ITheINPIshould:
prescribeIaIthiazideIdiuretic.
considerItreatmentIwithIanIangiotensin-convertingIenzymeIinhibitor.
reassureItheIpatientIthatItheseIfindingsIareInormal.
Correct!
counsel ItheIpatientIaboutIdietaryIandIlifestyleIchanges.
TheIpatient’sIbloodIpressureIindicatesIprehypertension, IbutItheIpatientIdoesInotIhaveIcardiovascularIrisk
IfactorsIsuchIasIhyperlipidemiaIorIhyperinsulinemia.ITheIbodyImassIindexIindicatesIthatItheIpatientIis
IoverweightIbutInotIobese.IPharmacologicItreatmentIisInotIrecommendedIforIprehypertensionIunless
IcompellingIreasonsIareIpresent.ITheIfindingsIareInotInormal, IsoIitIisIappropriateItoIcounsel ItheIpatient
IaboutIdietIandIexercise.
QuestionI6
2I/I2Ipts
AIpatientIwhoIhasIhadIaInewIonsetIofIAFItheIdayIpriorIwill IundergoIcardioversionIthatIday.ITheIprimary
IcareINPIwill IexpectItheIcardiologistIto:
giveIclopidogrelIafterIadministeringIcardioversion.
Correct!
administerIcardioversionIwithoutIusingIanticoagulants.
giveIwarfarinIandIaspirinIbeforeIattemptingIcardioversion.
giveIlow-doseIaspirinIbeforeIadministeringIcardioversion. [Show Less]