NSG 6420 WEEK 4 quiz with correct solutions | Latest 2023/2024
A patient comes to a clinic for a annual visit. He has a history of Type 2 diabetes.
... [Show More] His lab work today indicates creatinine of 1.6 (0.6-1.5). Last year, his BP was 138/80 in both arms. Today, his BP is 150/80 in both arms. Which of the following is the most appropriate intervention?
Counseling him regarding lifestyle modifications and placing him on an ACE-I
A seventy-eight-year-old African American woman presents to our office as a new patient. She complains of headache and dizziness. Her PMH is significant for HTN. She states, "I have been taking HCTZ for a long time." Her temperature is normal. BP 190/100, HR 86, RR 16. Which of the following would be the most appropriate action to assist in determining how to treat her current symptoms?
Perform a fundoscopic exam of her eyes
A seventy-eight-year-old woman comes to see you for her annual visit. She has a history of osteoarthritis and GERD. She comes in today for her annual visit. Her BP is 14/88, Last year, her BP was 140/80 and you had advised a 2-gram sodium diet and exercise. She states that she has been faithfully following your instructions. Which of the following would be the most appropriate management strategy for this patient?
Advise her that she needs to follow a strict 1.5 gram sodium diet
A hypertensive middle-aged man has been recently diagnosed with mild renal insufficiency. He has been on lisinopril (Accupril) for many years. Which of the following laboratory values should be carefully monitored ?
Serum creatinine and potassium levels
Mr. Wilson is a seventy-three-year-old male who has been on rosuvastatin (Crestor) 20mg QD for the past three months. He complains of diffuse muscle aches and severe fatigue and weakness in spite of getting his usual eight hours of sleep every night. What is the most appropriate management for this patient?
Stop crestor
Your patients is a forty-five-year-old white male. You have been seeing him monthly for an elevated blood pressure. His reading three months ago was 160/100. He has been checking his blood pressure at home. The lowest reading he has recorded was 150/94. He tells you he has tried to change his diet and increase his exercise. You explain to him that you would like to start him on lisinopril 10mg po q hs today to try to decrease his blood pressures. As part of your teaching, you explain to him that he should notify you right away if after he starts the medication he notices
a dry cough and angioedema
Mrs. Murphy presents to you for follow-up for the treatment of dyslipidemia. She is a fifty-five-year-old obese female with a BMI of 34%. She has no other cardiovascular risk factors. You have been working with her for several months on therapeutic lifestyle changes (TLCs). She has done well by increasing her exercise and reducing her BMI from 37 to 34. She does not smoke or consume alcohol. Her fasting lipid results today are:
Start fibric acid (fenofibrate) and Omega 3 fatty acids and advise on restriction of simple carbohydrates
A sixty-year-old white male adult male client with essential hypertension diagnosed three months ago was initially treated by the nurse practitioner with sodium restriction, weight loss, and exercise. He presents with blood pressure of 160/100 on follow-up. He is asymptomatic and does not take any medication. EKG show evidence of left ventricular hypertrophy (LVH). According to JNC-8, what would be the best choice of initial therapy?
Evaluate for cardiac risk factors and start therapy with an ACEI or an ARB
Choose the most compelling class of medications for the associated disease state. ( Choose the best answer)
all of the above
Mr. Murphy is a forty-eight-year-old male who presents for evaluation of his elevated cholesterol. He is also treated for hypertension with chlorthalidone 25mg once daily. He smokes 1/2 ppd. He denies prior cardiovascular disease or diabetes. His TC is 260, Trig 283, HDL 38, and LDL value is 192mg/dL. His ten-year calculated ASCVD risk is 17.8%. According to the ACC/AHA guidelines, what is the most appropriate treatment at this stage?
Institute high-intensity statin treatment (i.e., Atrovastatin 40 mg or rosuvastatin 20 mg) plus TLCs [Show Less]