NR508 Week 4 Midterm Exam Questions with Correct Answers and Rationales 2022
A 55-year-old patient with no prior history of hypertension has a blood
... [Show More] 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:
perform a careful cardiovascular physical assessment.
If the patient is younger than 20 or older than 50 years old at the onset of elevated blood pressure, the NP should look for causes of secondary hypertension. The physical examination should include a careful cardiovascular assessment. This patient will need pharmacologic treatment, but not until the underlying cause of hypertension is determined.
The primary care NP sees a patient who has a history of hypertension and alcoholism. The patient is not taking any medications. The NP auscultates crackles in both lungs and palpates the liver 2 cm below the costal margin. Laboratory tests show an elevated creatinine level. The NP will refer this patient to a cardiologist and should prescribe:
furosemide (Lasix).
In the treatment of heart failure, loop diuretics relieve the congestive symptoms of pulmonary and congestive edema. Loop diuretics are also useful to treat states of volume excess in cirrhosis and renal insufficiency. Because this patient has a history of alcoholism and has an enlarged liver on examination, furosemide is a good first choice to relieve this patient's congestive symptoms. Spironolactone and chlorthalidone are not loop diuretics. Albuterol might be used for symptomatic treatment only.
An 80-year-old patient has begun taking propranolol (Inderal) and reports feeling tired all of the time. The primary care NP should:
contact the patient's cardiologist to discuss decreasing the dose of propranolol.
Elderly patients have described sedation and sleep disturbances with β-blockers. Elderly patients often need lower doses of these drugs. Patients should not be advised to discontinue the medication abruptly.
A patient reports having occasional acute constipation with large, hard stools and pain and asks the primary care NP about medication to treat this condition. The NP learns that the patient drinks 1500 mL of water daily; eats fruits, vegetables, and bran; and exercises regularly. The NP should recommend:
a saline laxative as needed. [Show Less]