Question 1
Ray has been diagnosed with hypertension and an angiotensin-converting enzyme inhibitor is determined to be needed. Prior to prescribing this drug, the NP should assess for:

Question options:
Hypokalemia
Impotence
Decreased renal function
Inability to concentrate

Question 2
Which of the following create a higher risk for digoxin toxicity? Both the cause and the reason for it must be correct.

Question options:
Older adults because of reduced renal function
Administration of aldosterone antagonist diuretics because of decreased potassium levels
Taking an antacid for gastroesophageal reflux disease because it increases the absorption of digoxin
Doses between 0.25 and 0.5 mg/day

Question 3
Juanita had a deep vein thrombosis (DVT) and was on heparin in the hospital and was discharged on warfarin. She asks her primary care provider NP why she was getting both medications while in the hospital. The best response is to:

Question options:
Contact the hospitalist as this is not the normal guideline for prescribing these two medications and she may have had a more complicated case.
Explain that warfarin is often started while a patient is still on heparin because warfarin takes a few days to reach effectiveness.
Encourage the patient to contact the Customer Service department at the hospital as this was most likely a medication error during her admission.
Draw anticoagulation studies to make sure she does not have dangerously high bleeding times.

Question 4
Robert, age 51 years, has been told by his primary care provider (PCP) to take an aspirin a day. Why would this be recommended?

Question options:
He has arthritis and this will help with the inflammation and pain.
Aspirin has anti-platelet activity and prevents clots that cause heart attacks.
Aspirin acidifies the urine and he needs this for prostrate health.
He has a history of GI bleed, and one aspirin a day is a safe dosage.

Question 5
Education of patients who are taking warfarin includes discussing their diet. Instructions include:

Question options:
Avoiding all vitamin K-containing foods
Avoiding high-vitamin K-containing foods
Increasing intake of iron-containing foods
Making sure they eat 35 grams of fiber daily

Question 6
Pernicious anemia is treated with:

Question options:
Folic acid supplements
Thiamine supplements
Vitamin B12
Iron

Question 7
Valerie presents to the clinic with menorrhagia. Her hemoglobin is 10.2 and her ferritin is 15 ng/mL. Initial treatment for her anemia would be:

Question options:
18 mg/day of iron supplementation
6 mg/kg per day of iron supplementation
325 mg ferrous sulfate per day
325 mg ferrous sulfate tid

Question 8
Kyle has Crohn's disease and has a documented folate deficiency. Drug therapy for folate deficiency anemia is:

Question options:
Oral folic acid 1 to 2 mg per day
Oral folic acid 1 gram per day
IM folate weekly for at least 6 months
Oral folic acid 400 mcg daily

Question 9
Angina is produced by an imbalance between myocardial oxygen supply (MOS) and demand (MOD) in the myocardium. Which of the following drugs help to correct this imbalance by increasing MOS?

Question options:
Calcium channel blockers
Beta blockers
Angiotensin-converting-enzyme (ACE) inhibitors
Aspirin

Question 10
The rationale for prescribing calcium blockers for angina can be based on the need for:

Question options:
Increased inotropic effect in the heart
Increasing peripheral perfusion
Keeping heart rates high enough to ensure perfusion of coronary arteries
Help with rate control

Question 11
Which of the following drugs has been associated with increased risk for myocardial infarction in women?

Question options:
Aspirin
Beta blockers
Estrogen replacement
Lipid-lowering agents

Question 12
Increased life expectancy for patients with heart failure has been associated with the use of:

Question options:
ACE inhibitors, especially when started early in the disease process
All beta blockers regardless of selectivity
Thiazide and loop diuretics
Cardiac glycosides

Question 13
Digoxin has a very limited role in treatment of heart failure. It is used mainly for patients with:

Question options:
Ejection fractions above 40%
An audible S3
Mitral stenosis as a primary cause for heart failure
Renal insufficiency

Question 14
Which of the following classes of drugs is contraindicated in heart failure?

Question options:
Nitrates
Long-acting dihydropyridines
Calcium channel blockers
Alpha-beta blockers

Question 15
What is considered the order of statin strength from lowest effect to highest?

Question options:
Lovastatin, Simvastatin, Rosuvastatin
Rosuvastatin, Lovastatin, Atorvastatin
Atorvastatin, Rosuvastatin, Simvastatin
Simvastatin, Atorvastatin, Lovastatin

Question 16
First-line therapy for hyperlipidemia is:

Question options:
Statins
Niacin
Lifestyle changes
Bile acid-binding resins

Question 17
Han is a 48-year-old diabetic with hyperlipidemia and high triglycerides. His LDL is 112 mg/dL and he has not tolerated statins. He warrants a trial of a:

Question options:
Sterol
Niacin
Fibric acid derivative
Bile acid-binding resin

Question 18
Hypertensive African Americans are typically listed as not being as responsive to which drug groups?

Question options:
ACE inhibitors
Calcium channel blockers
Diuretics
Bidil (hydralazine family of medications)

Question 19
Because of its action on various body systems, the patient taking a thiazide or loop diuretic may also need to receive the following supplement:

Question options:
Potassium
Calcium
Magnesium
Phosphates


Question 20
An ACE inhibitor and what other class of drug may reduce proteinuria in patients with diabetes better than either drug alone?

Question options:
Beta blockers
Diuretics
Nondihydropyridine calcium channel blockers
Angiotensin II receptor blockers