Question | Answer |
What is the gold standard for the diagnosis of diabetes? | fasting glucose |
You, the APN, have prescribed a beta blocker to your diabetic patient. You know that your patient understands potential side effects when she says: | "If I begin sweating, I should check my blood sugar" |
Which of the following medications is NOT considered first-line treatment for hypertension? | Beta Blockers |
A diabetic patient comes into your clinic, saying that they are no longer able to determine when they are having a low blood sugar. After reviewing their medications you determine which class of meds might be to blame | Beta blockers |
The nurse practitioner is considering prescribing metformin (Glucophage) to a patient with type II diabetes. She informs the patient of what possible common side effects: | GI problems |
Your patient is a newly diagnosed type 2 diabetic. When selecting appropriate therapy to start him on, you consider the following: | Metformin is a reasonable choice, starting with 500mg daily or BID and titrating up for maximum effect |
You are a NP working in a family practice clinic. You have just finished educating a patient about the use of sublingual nitroglycerin tablets. You realize the patient needs additional teaching when the patient states: | I should take one tablet every 5 minutes x 3 doses if chest pain continues I should call 911 |
Beta Blockers are the drug of choice for angina except in patients with which disease process? | Asthma |
As an APN caring for Mrs. G. who has a 2 year history of diet controlled Type 2 diabetes but now requires medication, you consider all of the following when selecting her treatment: | The American Diabetes Association,(ADA), considers Metformin (Glucophage) the gold standard treatment for type 2 diabetes. AND Metformin offers additional benefits of improved lipid profile, weight loss, and reduction in macrovascular events |
Which of the following is NOT a true statement regarding cholesterol? | Increased cholesterol will increase the risk of pancreatitis |
A TSH level is 12.5 and you diagnose your pt with Hypothyroidism. You decide to start him on Levothyroxine. Which of the following statements by the pt indicates he understands the medication, adverse side effects, and how it should be taken? | Levothyroxine has a long half life which can take 4-7 weeks to reach a steady state, but symptom relief can start 2-4 weeks after starting the medication. Levothyroxine has many interactions so it is recommended that it is taken on an empty stomach. |
In the absence of liver disease, kidney disease, gout and diabetes, which treatment would be the most appropriate for a patient with the following lipid panel?
Total Cholesterol: 201
LDL: 101
HDL: 65
Trigylcerides: 144 | Diet and exercise |
In what patient would thiazide diuretics be a good first line treatment choice for hypertension? | A 50 year old white male with a creatinine clearance above 30. |
In chronological order, which are the first and second line drugs in angina therapy? | Beta-adrenergic blockers and Calcium channel blockers |
Which drug is used for rate control in in a patient with an arrhythmia but also impaired cardiac contractility? | Digoxin |
According to the American Association of Clinical Endocrinologists a DEXA scan should be used for all the following examples EXCEPT: | All women over the age of 20 that have sustained a fracture. |
High doses of hydralazine in the treatment of hypertension may increase antinuclear antibodies (ANA). An increase in ANA may indicate the following condition: | Systemic Lupus Erythematosus |
Which is the treatment of choice for hypothyroidism? | Levothyroxine (T4) |
When considering to administer a loop diuretic, it is important to keep in mind that loops: | Have some active secretion and are very potent |
Which medication would cause concern for lactic acidosis? | Metformin |
Which of the following diuretics has a site of action outside the kidney and thus need not pass through the kidney to have an effect? | Spironolactone |
Which of the following classes of oral anti-hyperglycemic agents is associated with weight loss, inhibited platelet aggregation, and reduced blood viscosity and is considered tier 1 therapy in type 2 diabetic persons older than 10 years of age? | Biguanides |
You are prescribing Levothyroxine for a 45year old female that you just diagnosed with hypothyroidism. You know all of the following are true with Levothyroxine except: | Do not use in pregnancy |
When starting a patient on nitrate therapy you would include all of the following in your teaching except: | The patch may be left on at night if you find you are having nocturnal angina as well. |
This injectible used to treat Type 2 Diabetes is associated with weight loss and is an Incretin mimetic. | Exenatide (Byetta) |
Diabetic medication, Pramlintide is a/an | Amylin agonist and is weight neutral |
Diabetic medication, Sitagliptin is a/an | Dipeptidyl Peptidase (DDP-IV) Inhibitor and is weight neutral |
For patients using nitrates; which of the following statements is not true regarding use of PDE5 Inhibitors: | Nitroglycerin can be taken, even if Viagra is still in the system |
Which medication has the side effect of a cough and happens to be the drug of choice for heart failure? | ACE inhibitors |
Due to the side effects this type of drug is contraindicated in Type 2 diabetic patients with a history of CHF | Thiazolidinediones (TZDS) |
Among the potential agents below, which one is the least likely to be pro-arrhythmic? | Amiodarone |
When monitoring a patient on HMG CoA Reductase Inhibitor therapy, patient monitoring would include | Baseline LFTs, Screening for diabetes, and fasting lipid panel on therapy initiation |
Gynecomastia and impotence are adverse drug reactions of what antihypertensive medication? | Spironolactone |
Mr. Smith is a black male age 62 presents with a blood pressure of 160/100 which medications should he be prescribed: | Calcium channel blockers and thiazide diuretics |
The treatment of CAD is with high intensity statins (goal of 50% LDL reduction) or moderate intensity statins (goal of 30-50% LDL reduction). What two drugs are specifically high intensity statins? | Rosuvastatin (Crestor) 20-40 mg and Atorvastatin (Lipitor) 40-80mg |
When taken with warfarin, which of the following causes a possibly increased anticoagulant effect? | Metronidazole and Bactrim |
In a patient with a mitral mechanical valve, what is the appropriate therapeutic INR level for stroke prophylaxis: | 2.5-3.5 |
Of the adverse drug reactions involved with direct vasodilators, which is specifically associated with hydralazine. | Lupus-type symptoms |
When prescribing nitrates for the management of angina, you want to use cautiously with patients who have | Hyperthyroidism, glaucoma, and severe anemia |
What daily dose is most often used to initiate Warfarin therapy? | 5mg |
Mr. D is experiencing chest pain at home. He has a a prescription for Nitroglycerin (SL). He takes one dose and is still experiencing chest pain after 5 minutes. What should he do? | Take a second dose of SL nitro |
When a patient is taking Digoxin what lab value should an ANP monitor? | Potassium |
You send a CHF pt home on furosemide 40mg BID and she is also taking digoxin. The next day you call to follow up, and she complains of nausea, vomitting, weakness, and sounds confused. This warrants your immediate attention because: | Digoxin toxicity related to hypokalemia |
Which of the following are true regarding Amiodarone? | It has an extremely long half-life (7 weeks), it is the drug of choice for severe, symptomatic arrhythmias, and it can cause pulmonary toxicity, hepatoxicity, and optic neuropathy that can be irreversible. |