Chapter 31. Contraception
1. Women who are taking an oral
contraceptive containing the progesterone drospirenone may require monitoring
of:
1. Hemoglobin
2. Serum
calcium
3. White
blood count
4. Serum
potassium
2. The mechanism of action of oral
combined contraceptives that prevents pregnancy is:
1. Estrogen
prevents the luteinizing hormone surge necessary for ovulation.
2. Progestins
thicken cervical mucus & slow tubal motility.
3. Estrogen
thins the endometrium making implantation difficult.
4. Progestin
suppresses follicle stimulating hormone release.
3. To improve actual effectiveness of
oral contraceptives women should be educated regarding:
1. Use of a
back-up method if they have vomiting or diarrhea during a pill packet
2. Doubling
pills if they have diarrhea during the middle of a pill pack
3. The fact
that they will have a normal menstrual cycle if they miss two pills
4. The fact
that mid-cycle spotting is not normal & the provider should be contacted immediately
4. A contraindication to the use of
combined contraceptives is:
1. Adolescence
(not approved for this age)
2. A history
of clotting disorder
3. Recent
pregnancy
4. Being
overweight
5. Obese women may have increased risk
of failure with which contraceptive method?
1. Combined
oral contraceptives
2. Progestin-only
oral contraceptive pill
3. Injectable
progestin
4. Combined
topical patch
6. Ashley comes to the clinic with a
request for oral contraceptives. She has successfully used oral contraceptives
before & has recently started dating a new boyfriend so would like to
restart contraception. She denies recent intercourse & has a negative urine
pregnancy test in the clinic. An appropriate plan of care would be:
1. Recommend
she return to the clinic at the start of her next menses to get a Depo Provera
shot.
2. Prescribe
oral combined contraceptives & recommend she start them at the beginning of
her next period & use a back-up method for the first 7 days.
3. Prescribe
oral contraceptives & have her start them the same day as the visit with a
back-up method used for the first 7 days.
4. Discuss
the advantages of using the topical birth control patch & recommend she
consider using the patch.
7. When discussing with a patient the
different start methods used for oral combined contraceptives, the advantage of
a Sunday start over the other start methods is:
1. Immediate
protection against pregnancy the first week of using the pill
2. No
back-up method is needed when starting
3. Menses
occur during the week
4. They can
start the pill on the Sunday after the office visit
8. The topical patch combined
contraceptive (Ortho Evra) is:
1. Started
on the first day of the menstrual cycle
2. Recommended
for women over 200 pounds
3. Not as
effective as oral combined contraceptives
4. Known to
have more adverse effects, such as nausea, than the oral combined
contraceptives
9. Progesterone-only pills are
recommended for women who:
1. Are
breastfeeding
2. Have a
history of migraine
3. Have a
medical history that contradicts the use of estrogen
4. All of
the above
10. Women who are prescribed
progestin-only contraception need education regarding which common adverse drug
effects?
1. Increased
migraine headaches
2. Increased
risk of developing blood clots
3. Irregular
vaginal bleeding for the first few months
4. Increased
risk for hypercalcemia
11. An advantage of using the NuvaRing
vaginal ring for contraception is:
1. It does
not require fitting & is easy to insert.
2. It is
inserted once a week, eliminating the need to remember to take a daily pill.
3. Patients
get a level of estrogen & progestin equal to combined oral contraceptives.
4. It also
provides protection against vaginal infections.
12. Oral emergency contraception (Plan B)
is contraindicated in women who:
1. Had
intercourse within the past 72 hours
2. May be
pregnant
3. Are
taking combined oral contraceptives
4. Are using
a diaphragm
Chapter 32. Dermatologic Conditions
1. When choosing a topical
corticosteroid cream to treat diaper dermatitis, the ideal medication would be:
1. Intermediate
potency corticosteroid ointment (Kenalog)
2. A
combination of a corticosteroid & an antifungal (Lotrisone)
3. A
low-potency corticosteroid cream applied sparingly (hydrocortisone 1%)
4. A
high-potency corticosteroid cream (Diprolene AF)
2. Topical immunomodulators such as
pimecrolimus (Elidel) or tacrolimus (Protopic) are used for:
1. Short-term
or intermittent treatment of atopic dermatitis
2. Topical
treatment of fungal infections (C&ida)
3. Chronic,
inflammatory seborrheic dermatitis
4. Recalcitrant
nodular acne
3. Long-term treatment of moderate
atopic dermatitis includes:
1. Topical
corticosteroids & emollients
2. Topical
corticosteroids alone
3. Topical
antipruritics
4. Oral
corticosteroids for exacerbations of atopic dermatitis
4. Severe contact dermatitis caused by
poison ivy or poison oak exposure often requires treatment with:
1. Topical
antipruritics
2. Oral
corticosteroids for 2 to 3 weeks
3. Thickly
applied topical intermediate-dose corticosteroids
4. Isolation
of the patient to prevent spread of the dermatitis
5. When a patient has contact
dermatitis, wet dressings with Domeboro solution are used for:
1. Cleaning
the weeping area of dermatitis
2. Bathing
the patient to prevent infection
3. Relief of
inflammation
4. Providing
a barrier layer to protect the surrounding skin
6. Appropriate initial treatment for
psoriasis would be:
1. An
immunomodulator (Protopic or Elidel)
2. Wet soaks
with Burrow’s or Domeboro solution
3. Intermittent
therapy with intermediate potency topical corticosteroids
4. Anthralin
(Drithocreme)
7. Patient education when prescribing
the vitamin D3 derivative calcipotriene for psoriasis includes:
1. Apply
thickly to affected psoriatic areas two to three times a day.
2. A maximum
of 100 grams per week may be applied.
3. Do not
use calcipotriene in combination with their topical corticosteroids.
4. Calcipotriene
may be augmented with the use of coal tar products.
8. Mild acne may be initially treated
with:
1. Topical
combined antibiotic
2. Minocycline
3. Topical
retinoid
4. OTC
benzoyl peroxide
9. Tobie presents to the clinic with
moderate acne. He has been using OTC benzoyl peroxide at home with minimal
improvement. A topical antibiotic (clindamycin) & a topical retinoid
adapalene (Differin) are prescribed. Education of Tobie would include:
1. He should
see an improvement in his acne within the first 2 weeks of treatment.
2. If there
is no response in a week, double the daily application of adapalene (Differin).
3. He may
see an initial worsening of his acne that will improve in 6 to 8 weeks.
4. Adapalene
may cause bleaching of clothing.
10. Josie has severe cystic acne & is
requesting treatment with Accutane. The appropriate treatment for her would be:
1. Order a
pregnancy test & if it is negative prescribe the isotretinoin (Accutane).
2. Order
Accutane after educating her on the adverse effects.
3. Recommend
she try oral antibiotics (minocycline).
4. Refer her
to a dermatologist for treatment.
11. The most cost-effective treatment for
two or three impetigo lesions on the face is:
1. Mupirocin
ointment
2. Retapamulin
(Altabax) ointment
3. Topical
clindamycin solution
4. Oral
amoxicillin/clavulanate (Augmentin)
12. Dwayne has classic tinea capitis.
Treatment for tinea on the scalp is:
1. Miconazole
cream rubbed in well for 4 weeks
2. Oral
griseofulvin for 6 to 8 weeks
3. Ketoconazole
shampoo daily for 6 weeks
4. Ciclopirox
cream daily for 4 weeks
13. Nicolas is a football player who
presents to the clinic with athlete’s foot. Patients with tinea pedis may be
treated with:
1. OTC
miconazole cream for 4 weeks
2. Oral
ketoconazole for 6 weeks
3. Mupirocin
ointment for 2 weeks
4. Nystatin
cream for 2 weeks
14. Jim presents with fungal infection of
two of his toenails (onychomycosis). Treatment for fungal infections of the
nail includes:
1. Miconazole
cream
2. Ketoconazole
cream
3. Oral
griseofulvin
4. Mupirocin
cream
15. Scabies treatment for a 4-year-old
child includes a prescription for:
1. Permethrin
5% cream applied from the neck down
2. Pyrethrin
lotion
3. Lindane
1% shampoo
4. All of
the above
16. Vanessa has been diagnosed with
scabies. Her education would include:
1. She
should apply the scabies treatment cream for an hour & wash it off.
2. Scabies
may need to be retreated in a week after initial treatment.
3. All
members of the household & close personal contacts should be treated.
4. Malathion
is flammable & she should take care until the solution dries.
17. Catherine has head lice & her
mother is asking about what products are available that are not neurotoxic. The
only non-neurotoxin head lice treatment is:
1. Permethrin
1% (Nix)
2. Lindane
shampoo
3. Malathion
(Ovide)
4. Benzoyl
alcohol (Ulesfia)
18. Rick has male pattern baldness on the
vertex of his head & has been using Rogaine for 2 months. He asks how
effective minoxidil (Rogaine) is. Minoxidil:
1. Provides
a permanent solution to male pattern baldness if used for at least 4 months
2. Will show
results after 4 months of twice-a-day use
3. May not
work for Rick’s type of baldness
4. Works
better if he also uses hydrocortisone cream daily on his scalp
Chapter 33. Diabetes Mellitus
1. Type 1 diabetes results from
autoimmune destruction of the beta cells. Eighty-five to 90% of type 1
diabetics have:
1. Autoantibodies
to two tyrosine phosphatases
2. Mutation
of the hepatic transcription factor on chromosome 12
3. A
defective glucokinase molecule due to a defective gene on chromosome 7p
4. Mutation
of the insulin promoter factor
2. Type 2 diabetes is a complex
disorder involving:
1. Absence
of insulin production by the beta cells
2. A
suboptimal response of insulin-sensitive tissues in the liver
3. Increased
levels of glucagon-like peptide in the postpr&ial period
4. Too much
fat uptake in the intestine
3. Diagnostic criteria for diabetes
include:
1. Fasting
blood glucose greater than 140 mg/dl on two occasions
2. Postpr&ial
blood glucose greater than 140 mg/dl
3. Fasting
blood glucose 100 to 125 mg/dl on two occasions
4. Symptoms
of diabetes plus a casual blood glucose greater than 200 mg/dl
4. Routine screening of asymptomatic
adults for diabetes is appropriate for:
1. Individuals
who are older than 45 & have a BMI of less than 25 kg/m2
2. Native
Americans, African Americans, & Hispanics
3. Persons
with HDL cholesterol greater than 100 mg/dl
4. Persons
with prediabetes confirmed on at least two occasions
5. Screening for children who meet the
following criteria should begin at age 10 & occur every 3 years thereafter:
1. BMI above
the 85th percentile for age & sex
2. Family
history of diabetes in first- or second-degree relative
3. Hypertension
based on criteria for children
4. Any of
the above
6. Insulin is used to treat both types
of diabetes. It acts by:
1. Increasing
beta cell response to low blood-glucose levels
2. Stimulating
hepatic glucose production
3. Increasing
peripheral glucose uptake by skeletal muscle & fat
4. Improving
the circulation of free fatty acids
7. Adam has type 1 diabetes & plays
tennis for his university. He exhibits a knowledge deficit about his insulin
& his diagnosis. He should be taught that:
1. He should
increase his carbohydrate intake during times of exercise.
2. Each
brand of insulin is equal in bioavailability, so buy the least expensive.
3. Alcohol
produces hypoglycemia & can help control his diabetes when taken in small
amounts.
4. If he
does not want to learn to give himself injections, he may substitute an oral
hypoglycemic to control his diabetes.
8. Insulin preparations are divided
into categories based on onset, duration, & intensity of action following
subcutaneous injection. Which of the following insulin preparations has the
shortest onset & duration of action?
1. Lispro
2. Glulisine
3. Glargine
4. Detemir
9. The drug of choice for type 2
diabetics is metformin. Metformin:
1. Decreases
glycogenolysis by the liver
2. Increases
the release of insulin from beta cells
3. Increases
intestinal uptake of glucose
4. Prevents
weight gain associated with hyperglycemia
10. Before prescribing metformin, the
provider should:
1. Draw a
serum creatinine level to assess renal function.
2. Try the
patient on insulin.
3. Prescribe
a thyroid preparation if the patient needs to lose weight.
4. All of
the above
11. Sulfonylureas may be added to a
treatment regimen for type 2 diabetics when lifestyle modifications &
metformin are insufficient to achieve target glucose levels. Sulfonylureas have
been moved to Step 2 therapy because they:
1. Increase
endogenous insulin secretion
2. Have a
significant risk for hypoglycemia
3. Address
the insulin resistance found in type 2 diabetics
4. Improve
insulin binding to receptors
12. Dipeptidyl peptidase-4 inhibitors
(gliptins) act on the incretin system to improve glycemic control. Advantages
of these drugs include:
1. Better
reduction in glucose levels than other classes
2. Less
weight gain than sulfonylureas
3. Low risk
for hypoglycemia
4. Can be
given twice daily
13. Control targets for patients with
diabetes include:
1. HbA1C
between 7 & 8
2. Fasting
blood glucose levels between 100 & 120 mg/dl
3. Blood
pressure less than 130/80 mm Hg
4. LDL
lipids less than 130 mg/dl
14. Establishing glycemic targets is the
first step in treatment of both types of diabetes. For type 1 diabetes:
1. Tight
control/intensive therapy can be given to adults who are willing to test their
blood glucose at least twice daily.
2. Tight
control is acceptable for older adults if they are without complications.
3. Plasma
glucose levels are the same for children as adults.
4. Conventional
therapy has a fasting plasma glucose target between 120 & 150 mg/dl.
15. Treatment with insulin for type 1
diabetics:
1. Starts
with a total daily dose of 0.2 to 0.4 units per kg of body weight
2. Divides
the total doses into three injections based on meal size
3. Uses a
total daily dose of insulin glargine given once daily with no other insulin
required
4. Is based
on the level of blood glucose
16. When the total daily insulin dose is
split & given twice daily, which of the following rules may be followed?
1. Give
two-thirds of the total dose in the morning & one-third in the evening.
2. Give 0.3
units per kg of premixed 70/30 insulin with one-third in the morning &
two-thirds in the evening.
3. Give 50%
of an insulin glargine dose in the morning & 50% in the evening.
4. Give
long-acting insulin in the morning & short-acting insulin at bedtime.
17. Studies have shown that control
targets that reduce the HbA1C to less than 7% are associated with fewer
long-term complications of diabetes. Patients who should have such a target
include:
1. Those
with long-st&ing diabetes
2. Older
adults
3. Those
with no significant cardiovascular disease
4. Young
children who are early in their disease
18. Prevention of conversion from
prediabetes to diabetes in young children must take highest priority &
should focus on:
1. Aggressive
dietary manipulation to prevent obesity
2. Fostering
LDL levels less than 100 mg/dl & total cholesterol less than 170 mg/dl to
prevent cardiovascular disease
3. Maintaining
a blood pressure that is less than 80% based on weight & height to prevent
hypertension
4. All of
the above
19. The drugs recommended by the American
Academy of Pediatrics for use in children with diabetes (depending upon type of
diabetes) are:
1. Metformin
& insulin
2. Sulfonylureas
& insulin glargine
3. Split-mixed
dose insulin & GPL-1 agonists
4. Biguanides
& insulin lispro
20. Unlike most type 2 diabetics where
obesity is a major issue, older adults with low body weight have higher risks
for morbidity & mortality. The most reliable indicator of poor nutritional
status in older adults is:
1. Weight
loss in previously overweight persons
2. Involuntary
loss of 10% of body weight in less than 6 months
3. Decline
in lean body mass over a 12-month period
4. Increase
in central versus peripheral body adiposity
21. The drugs recommended for older adults
with type 2 diabetes include:
1. Second-generation
sulfonylureas
2. Metformin
3. Pioglitazone
4. Third-generation
sulfonylureas
22. Ethnic groups differ in their risk for
& presentation of diabetes. Hispanics:
1. Have a
high incidence of obesity, elevated triglycerides, & hypertension
2. Do best
with drugs that foster weight loss, such as metformin
3. Both 1
& 2
4. Neither 1
nor 2
23. The American Heart Association states
that people with diabetes have a 2- to 4-fold increase in the risk of dying
from cardiovascular disease. Treatments & targets that do not appear to
decrease risk for micro- & macro-vascular complications include:
1. Glycemic
targets between 7% & 7.5%
2. Use of
insulin in type 2 diabetics
3. Control
of hypertension & hyperlipidemia
4. Stopping
smoking
24. All diabetic patients with known
cardiovascular disease should be treated with:
1. Beta
blockers to prevent MIs
2. Angiotensin-converting
enzymeinhibitors & aspirin to reduce risk of cardiovascular events
3. Sulfonylureas
to decrease cardiovascular mortality
4. Pioglitazone
to decrease atherosclerotic plaque buildup
25. All diabetic patients with
hyperlipidemia should be treated with:
1. HMG-CoA
reductase inhibitors
2. Fibric
acid derivatives
3. Nicotinic
acid
4. Colestipol
26. Both angiotensin converting
enzymeinhibitors & some angiotensin II receptor blockers have been approved
in treating:
1. Hypertension
in diabetic patients
2. Diabetic
nephropathy
3. Both 1
& 2
4. Neither 1
nor 2
27. Protein restriction helps slow the
progression of albuminuria, glomerular filtration rate, decline, & end
stage renal disease in some patients with diabetes. It is useful for patients
who:
1. Cannot
tolerate angiotensin converting enzymeinhibitors or angiotensin
receptorblockers
2. Have
uncontrolled hypertension
3. Have
HbA1C levels above 7%
4. Show
progression of diabetic nephropathy despite optimal glucose & blood
pressure control
28. Diabetic autonomic neuropathy (DAN) is
the earliest & most common complication of diabetes. Symptoms associated
with DAN include:
1. Resting
tachycardia, exercise intolerance, & orthostatic hypotension
2. Gastroparesis,
cold intolerance, & moist skin
3. Hyperglycemia,
erectile dysfunction, & deficiency of free fatty acids
4. Pain,
loss of sensation, & muscle weakness
29. Drugs used to treat diabetic
peripheral neuropathy include:
1. Metoclopramide
2. Cholinergic
agonists
3. Cardioselective
beta blockers
4. Gabapentin
30. The American Diabetic Association has
recommended which of the following tests for ongoing management of diabetes?
1. Fasting
blood glucose
2. HbA1C
3. Thyroid
function tests
4. Electrocardiograms
31. Allison is an 18-year-old college
student with type 1 diabetes. She is on NPH twice daily & Novolog before
meals. She usually walks for 40 minutes each evening as part of her exercise
regimen. She is beginning a 30-minute swimming class three times a week at 1
p.m. What is important for her to do with this change in routine?
1. Delay
eating the midday meal until after the swimming class.
2. Increase
the morning dose of NPH insulin on days of the swimming class.
3. Adjust
the morning insulin injection so that the peak occurs while swimming.
4. Check
glucose level before, during, & after swimming.
32. Allison is an 18-year-old college
student with type 1 diabetes. Allison’s pre-meal BG at 11:30 a.m. is 130. She
eats an apple & has a sugar-free soft drink. At 1 p.m. before swimming her
BG is 80. What should she do?
1. Proceed
with the swimming class.
2. Recheck
her BG immediately.
3. Eat a
granola bar or other snack with CHO.
4. Take an
additional dose of insulin.
33. Bart is a patient is a 67-year-old
male with T2 DM. He is on glipizide & metformin. He presents to the clinic
with confusion, sluggishness, & extreme thirst. His wife tells you Bart
does not follow his meal plan or exercise regularly, & hasn’t checked his
BG for 1 week. A r&om glucose is drawn & it is 500. What is a likely
diagnosis based on preliminary assessment?
1. Diabetic
keto acidosis (DKA)
2. Hyperglycemic
hyperosmolar syndrome (HHS)
3. Infection
4. Hypoglycemia
34. What would one expected assessment
finding be for hyperglycemic hyperosmolar syndrome?
1. Low
hemoglobin
2. Ketones
in the urine
3. Deep,
labored breathing
4. pH of
7.35
35. A patient on metformin & glipizide
arrives at her 11:30 a.m. clinic appointment diaphoretic & dizzy. She
reports taking her medication this morning & ate a bagel & coffee for
breakfast. BP is 110/70 & r&om finger-stick glucose is 64. How should
this patient be treated?
1. 12 oz
apple juice with 1 tsp sugar
2. 10 oz
diet soda
3. 8 oz milk
or 4 oz orange juice
4. 4 cookies
& 8 oz chocolate milk
Chapter 34. Gastroesophageal Reflux & Peptic Ulcer
Disease
1. Gastroesophageal reflux disease may
be aggravated by the following medication that affects lower esophageal
sphincter (LES) tone:
1. Calcium
carbonate
2. Estrogen
3. Furosemide
4. Metoclopramide
2. Lifestyle changes are the first step
in treatment of gastroesophageal reflux disease (GERD). Food or drink that may
aggravate GERD include:
1. Eggs
2. Caffeine
3. Chocolate
4. Soda pop
3. Metoclopramide improves
gastroesophageal reflux disease symptoms by:
1. Reducing
acid secretion
2. Increasing
gastric pH
3. Increasing
lower esophageal tone
4. Decreasing
lower esophageal tone
4. Antacids treat gastroesophageal
reflux disease by:
1. Increasing
lower esophageal tone
2. Increasing
gastric pH
3. Inhibiting
gastric acid secretion
4. Increasing
serum calcium level
5. When treating patients using the
“Step-Down” approach the patient with gastroesophageal reflux disease is
started on ___ first.
1. Antacids
2. Histamine2
receptor antagonists
3. Prokinetics
4. Proton
pump inhibitors
6. If a patient with symptoms of
gastroesophageal reflux disease states that he has been self-treating at home
with OTC ranitidine daily, the appropriate treatment would be:
1. Prokinetic
(metoclopramide) for 4 to 8 weeks
2. Proton
pump inhibitor (omeprazole) for 12 weeks
3. Histamine2
receptor antagonist (ranitidine) for 4 to 8 weeks
4. Cytoprotective
drug (misoprostol) for 2 weeks
7. If a patient with gastroesophageal
reflux disease who is taking a proton pump inhibitor daily is not improving,
the plan of care would be:
1. Prokinetic
(metoclopramide) for 8 to 12 weeks
2. Proton
pump inhibitor (omeprazole) twice a day for 4 to 8 weeks
3. Histamine2
receptor antagonist (ranitidine) for 4 to 8 weeks
4. Cytoprotective
drug (misoprostol) for 4 to 8 weeks
8. The next step in treatment when a
patient has been on proton pump inhibitors twice daily for 12 weeks & not
improving is:
1. Add a
prokinetic (metoclopramide)
2. Referral
for endoscopy
3. Switch to
another proton pump inhibitor
4. Add a
cytoprotective drug
9. Infants with reflux are initially
treated with:
1. Histamine2
receptor antagonist (ranitidine)
2. Proton
pump inhibitor (omeprazole)
3. Anti-reflux
maneuvers (elevate head of bed)
4. Prokinetic
(metoclopramide)
10. Long-term use of proton pump
inhibitors may lead to:
1. Hip
fractures in at-risk persons
2. Vitamin
B6 deficiency
3. Liver
cancer
4. All of
the above
11. An acceptable first-line treatment for
peptic ulcer disease with positive H. pylori test is:
1. Histamine2
receptor antagonists for 4 to 8 weeks
2. Proton
pump inhibitor bid for 12 weeks until healing is complete
3. Proton
pump inhibitor bid plus clarithromycin plus amoxicillin for 14 days
4. Proton
pump inhibitor bid & levofloxacin for 14 days
12. Treatment failure in patients with
peptic ulcer disease associated with H. pylori may be because of:
1. Antimicrobial
resistance
2. An
ineffective antacid
3. Overuse
of proton pump inhibitors
4. All of
the above
13. If a patient with H. pylori-positive
peptic ulcer disease fails first-line therapy, the second-line treatment is:
1. Proton
pump inhibitor bid plus metronidazole plus tetracycline plus bismuth
subsalicylate for 14 days
2. Test H.
pylori for resistance to common treatment regimens
3. Proton
pump inhibitor plus clarithromycin plus amoxicillin for 14 days
4. Proton
pump inhibitor & levofloxacin for 14 days
14. After H. pylori treatment is
completed, the next step in peptic ulcer disease therapy is:
1. Testing
for H. pylori eradication with a serum ELISA test
2. Endoscopy
by a specialist
3. A proton
pump inhibitor for 8 to 12 weeks until healing is complete
4. All of
the above
Chapter 35. Headaches
1. Paige has a history of chronic
migraines & would benefit from preventative medication. Education regarding
migraine preventive medication includes:
1. Medication
is taken at the beginning of the headache to prevent it from getting worse.
2. Medication
alone is the best preventative against migraines occurring.
3. Medication
should not be used more than four times a month.
4. The goal
of treatment is to reduce migraine occurrence by 50%.
2. A first-line drug for abortive
therapy in simple migraine is:
1. Sumatriptan
(Imitrex)
2. Naproxen
(Aleve)
3. Butorphanol
nasal spray (Stadol NS)
4. Butalbital
& acetaminophen (Fioricet)
3. Vicky, age 56 years, comes to the
clinic requesting a refill of her Fiorinal (aspirin & butalbital) that she
takes for migraines. She has been taking this medication for over 2 years for
migraines & states one dose usually works to abort her migraine. What is
the best care for her?
1. Switch
her to sumatriptan (Imitrex) to treat her migraines.
2. Assess
how often she is using Fiorinal & refill her medication.
3. Switch
her to a beta blocker such as propranolol to prevent her migraine.
4. Request
she return to the original prescriber of Fiorinal as you do not prescribe
butalbital for migraines.
4. When prescribing ergotamine
suppositories (Wigraine) to treat acute migraine, patient education would
include:
1. Ergotamine
will briefly make the migraine worse before the migraine resolves.
2. The
patient may experience bradycardia & dizziness.
3. They may
need premedication with an antinausea medication.
4. Ergotamine
works best if the patient starts off with a full suppository to get the full
effect.
5. Migraines in pregnancy may be safely
treated with:
1. Acetaminophen
with codeine (Tylenol #3)
2. Sumatriptan
(Imitrex)
3. Ergotamine
tablets (Ergostat)
4. Dihydroergotamine
(DHE)
6. Xi, a 54-year-old female, has a
history of migraines that do not respond well to OTC migraine medication. She
is asking to try Maxalt (rizatriptan) because it works well for her friend.
Appropriate decision making would be:
1. Prescribe
the Maxalt, but only give her four tablets with no refills to monitor the use.
2. Prescribe
Maxalt & arrange to have her observed in the clinic or urgent care with the
first dose.
3. Explain
that rizatriptan is not used for postmenopausal migraines & recommend
Fiorinal (aspirin & butalbital).
4. Prescribe
sumatriptan (Imitrex) with the explanation that it is the most effective
triptan.
7. Kelly is a 14-year-old patient who
presents to the clinic with a classic migraine. She says she is having a
headache two to three times a month. The initial plan would be:
1. Prescribe
NSAIDs as abortive therapy & have her keep a headache diary to identify her
triggers.
2. Prescribe
zolmitriptan (Zomig) as abortive therapy & recommend relaxation therapy to
reduce her stress.
3. Prescribe
acetaminophen with codeine (Tylenol #3) for her to take at the first onset of
her migraine.
4. Prescribe
sumatriptan (Imitrex) nasal spray & arrange for her to receive the first
dose in the clinic.
8. Jayla is a 9-year-old patient who
has been diagnosed with migraines for almost 2 years. She is missing up to a
week of school each month. Her headache diary confirms she averages four or
five migraines per month. Which of the following would be appropriate?
1. Prescribe
amitriptyline (Elavil) daily, start at a low dose & increase dosage slowly
every 2 weeks until it’s effective in eliminating migraines.
2. Encourage
her mother to give her Excedrin Migraine (aspirin, acetaminophen, &
caffeine) at the first sign of a headache to abort the headache.
3. Prescribe
propranolol (Inderal) to be taken daily for at least 3 months.
4. Explain
that it is rare for a 9-year-old child to get migraines & she needs an MRI
to rule out a brain tumor.
9. Amber is a 24-year-old patient who
has had migraines for 10 years. She reports a migraine on average of once a
month. The migraines are effectively aborted with naratriptan (Amerge). When
refilling Amber’s naratriptan, education would include:
1. Naratriptan
will interact with antidepressants, including selective serotonin reuptake
inhibitors (SSRIs) & St John’s wort, & she should inform any providers
she sees that she has migraines.
2. Continue
to monitor her headaches, if the migraine is consistently happening around her
menses there is preventive therapy available.
3. Pregnancy
is contraindicated when taking a triptan.
4. All of
the above
10. When prescribing for migraines,
patient education includes:
1. Triptans
are safe to be used as often as needed as long as the patient is healthy.
2. Use
triptan before trying OTC meds such as acetaminophen or naproxen.
3. Stress
reduction & regular sleep are integral to migraine treatment.
4. If
migraines worsen they are to increase their medication.
11. Juanita presents to the clinic with a
complaint of headaches off & on for months. She reports they feel like
someone is “squeezing” her head. She occasionally takes Tylenol for the pain, but
usually just “toughs it out.” Initial treatment for tension headache includes
asking her to keep a headache diary & a prescription for:
1. Sumatriptan
(Imitrex)
2. Naproxen
(Aleve)
3. Ergotamine
(Ergostat)
4. Tylenol
with codeine (Tylenol #3)
12. Nonpharmacologic therapy for tension
headaches includes:
1. Biofeedback
2. Stress
management
3. Massage
therapy
4. All of
the above
13. James has been diagnosed with cluster
headaches. Appropriate acute therapy would be:
1. Butalbital
& aspirin (Fiorinal)
2. Meperidine
IM (Demerol)
3. Oxygen
100% for 15 to 30 minutes
4. Indomethacin
(Indocin)
14. Preventative therapy for cluster
headaches includes:
1. Massage
or relaxation therapy
2. Ergotamine
nightly before bed
3. Intranasal
lidocaine four times a day during “clusters” of headaches
4. Propranolol
(Inderal) daily
15. When prescribing any headache therapy,
appropriate use of medications needs to be discussed to prevent
medication-overuse headaches. A clinical characteristic of medication-overuse
headaches is that they:
1. Are
increasing in frequency
2. Are
increasing in intensity
3. Recur
when medication wears off
4. Begin to
“cluster” into a pattern
Chapter 36. Heart Failure
1. Angiotensin-converting-enzyme(ACE)
inhibitors are a central part of the treatment of heart failure because they
have more than one action to address the pathological changes in this disorder.
Which of the following pathological changes in heart failure is NOT addressed
by ACE inhibitors?
1. Changes
in the structure of the left ventricle so that it dilates, hypertrophies, &
uses energy less efficiently.
2. Reduced
formation of cross-bridges so that contractile force decreases.
3. Activation
of the sympathetic nervous system that increases heart rate & preload.
4. Decreased
renal blood flow that decreases oxygen supply to the kidneys.
2. One of the three types of heart
failure involves systolic dysfunction. Potential causes of this most common
form of heart failure include:
1. Myocardial
ischemia & injury secondary to myocardial infarction
2. Inadequate
relaxation & loss of muscle fiber secondary to valvular dysfunction
3. Increased
dem&s of the heart beyond its ability to adapt secondary to anemia
4. Slower
filling rate & elevated systolic pressures secondary to uncontrolled
hypertension
3. The American Heart Association &
the American College of Cardiology have devised a classification system for
heart failure that can be used to direct treatment. Patients with symptoms
& underlying disease are classified as stage:
1. A
2. B
3. C
4. D
4. Diagnosis of heart failure cannot be
made by symptoms alone because many disorders share the same symptoms. The most
specific & sensitive diagnostic test for heart failure is:
1. Chest
x-rays that show cephalization & measure heart size
2. Two-dimensional
echocardiograms that identify structural anomalies & cardiac dysfunction
3. Complete
blood count, blood urea nitrogen, & serum electrolytes that facilitate
staging for end-organ damage
4. Measurement
of brain natriuretic peptide to distinguish between systolic & diastolic
dysfunction
5. Treatments for heart failure,
including drug therapy, are based on the stages developed by the ACC/AHA. Stage
A patients are treated with:
1. Drugs for
hypertension & hyperlipidemia, if they exist
2. Lifestyle
management including diet, exercise, & smoking cessation only
3. Angiotensin-converting
enzyme(ACE) inhibitors to directly affect the heart failure only
4. No drugs
are used in this early stage
6. Class I recommendations for stage A
heart failure include:
1. Aerobic
exercise within tolerance levels to prevent the development of heart failure
2. Reduction
of sodium intake to less than 2,000 mg/day to prevent fluid retention
3. Beta
blockers for all patients regardless of cardiac history
4. Treatment
of thyroid disorders, especially if they are associated with tachyarrhythmias
7. Stage B patients should have beta
blockers added to their heart failure treatment regimen when:
1. They have
an ejection fraction less than 40%
2. They have
had a recent MI
3. Both 1
& 2
4. Neither 1
nor 2
8. Increased life expectancy for
patients with heart failure has been associated with the use of:
1. ACE
inhibitors, especially when started early in the disease process
2. All beta
blockers regardless of selectivity
3. Thiazide
& loop diuretics
4. Cardiac
glycosides
9. Stage C patients usually require a
combination of three to four drugs to manage their heart failure. In addition
to ACE inhibitors & beta blockers, diuretics may be added. Which of the
following statements about diuretics is NOT true?
1. Diuretics
reduce preload associated with fluid retention.
2. Diuretics
can be used earlier than stage C when the goal is control of hypertension.
3. Diuretics
may produce problems with electrolyte imbalances & abnormal glucose &
lipid metabolism.
4. Diuretics
from the potassium-sparing class should be used when using an angiotensin
receptor blocker(ARB).
10. Digoxin has a very limited role in
treatment of heart failure. It is used mainly for patients with:
1. Ejection fractions
above 40%
2. An
audible S3
3. Mitral
stenosis as a primary cause for heart failure
4. Renal
insufficiency
11. Which of the following classes of
drugs is contraindicated in heart failure?
1. Nitrates
2. Long-acting
dihydropyridines
3. Calcium
channel blockers
4. Alpha-beta
blockers
12. Heart failure is a leading cause of
death & hospitalization in older adults (greater than 65 years old). The
drug of choice for this population is:
1. Aldosterone
antagonists
2. Eplerenone
3. ACE inhibitors
4. ARBs
13. ACE inhibitors are contraindicated in
pregnancy. While treatment of heart failure during pregnancy is best done by a
specialist, which of the following drug classes
is considered to be safe, at least in the later parts of pregnancy?
1. Diuretics
2. ARBs
3. Beta
blockers
4. Nitrates
14. Heart failure is a chronic condition
that can be adequately managed in primary care. However, consultation with or
referral to a cardiologist is appropriate when:
1. Symptoms
markedly worsen or the patient becomes hypotensive & has syncope
2. There is
evidence of progressive renal insufficiency or failure
3. The
patient remains symptomatic on optimal doses of an ACE inhibitor, a beta
blocker, & a diuretic
4. Any of
the above
15. ACE inhibitors are a foundational
medication in HF. Which group of patients cannot take them safely?
1. Elderly
patients with reduced renal clearance
2. Pregnant
women
3. Women
under age 30
4. 1 & 2
16. What assessment that can be done at
home is the most reliable for making decisions to change HF medications?
1. Weight
2. BP
3. Heart
rate
4. Serum
Glucose
17. Evidence is strong that the timing of
HF interventions are best initiated when:
1. The person
enters stage C
2. The
person has functional disabilities
3. At the
earliest indication
4. When
stage IV is determined
18. HF patients frequently take more than
one drug. When are anticoagulants typically used?
1. When the
patient enters stage III
2. Only in
cases of diastolic failure
3. When
there is concurrent A Fib
4. In all
cases
19. What can chest x-rays contribute to
the diagnosis & management of HF?
1. They have
no role.
2. They can
give very precise pictures of pulmonary fluid status.
3. They
provide an idea of general cardiac size & pulmonary great vessel
distribution.
4. They can
confirm the diagnosis.
Chapter 38. Hormone Replacement Therapy & Osteoporosis
1. The goals of therapy when
prescribing hormone replacement therapy (HRT) include reducing:
1. Cardiovascular
risk
2. Risk of
stroke or other thromboembolic event
3. Breast
cancer
4. Vasomotor
symptoms
2. The optimal maximum time frame for
HRT or estrogen replacement therapy (ERT) is:
1. 2 years
2. 5 years
3. 10 years
4. 15 years
3. Dosage changes of conjugated equine
estrogen (Premarin) are made at _ intervals.
1. 1 to 2
week
2. 2 to 4
week
3. 6 to 8
week
4. 12 week
4. The advantage of vaginal estrogen
preparations in the treatment of vulvovaginal atrophy & dryness is:
1. Ability
to deliver higher doses of estrogen in a non-oral form
2. The
vaginal cream formula provides moisture to the vaginal area
3. Relief of
symptoms without increasing cardiovascular risk
4. All of
the above
5. Women with an intact uterus should
be treated with both estrogen & progestin due to:
1. Increased
risk for endometrial cancer if estrogen alone is used
2. Combination
therapy provides the best relief of menopausal vasomotor symptoms
3. Reduced
risk for colon cancer with combined therapy
4. Lower
risk of developing blood clots with combined therapy
6. Ongoing monitoring for women on ERT
includes:
1. Lipid
levels, repeated annually if abnormal
2. Annual
health history & review of risk profile
3. Annual
mammogram
4. All of
the above
7. Kristine would like to start HRT to
treat the significant vasomotor symptoms she is experiencing during menopause.
Education for a woman considering hormone replacement would include:
1. Explaining
that HRT is totally safe if used short term
2. Telling
her to ignore media hype regarding HRT
3. Discussing
the advantages & risks of HRT
4. Encouraging
the patient to use phytoestrogens with the HRT
8. Angela is a black woman who has
heard that women of African descent do not need to worry about osteoporosis.
What education would you provide Angela about her risk?
1. She is
correct, black women do not have much risk of developing osteoporosis due to
their dark skin.
2. Black
women are at risk of developing osteoporosis due to their lower calcium intake
as a group.
3. If she
doesn’t drink alcohol, her risk of developing osteoporosis is low.
4. If she
has not lost more than 10% of her weight lately, her risk is low.
9. Drugs that increase the risk of
osteoporosis developing include:
1. Oral
combined contraceptives
2. Carbamazepine
3. Calcium
channel blockers
4. High
doses of vitamin D
10. Selective estrogen receptor modifiers
(SERMs) treat osteoporosis by selectively:
1. Inhibiting
magnesium resorption in the kidneys
2. Increasing
calcium absorption from the GI tract
3. Acting on
the bone to inhibit osteoblast activity
4. Selectively
acting on the estrogen receptors in the bone
11. Sallie has been diagnosed with
osteoporosis & is asking about the “once a month” pill to treat her
condition. How do bisphosphonates treat osteoporosis?
1. By
selectively activating estrogen pathways in the bone
2. By
reducing bone resorption by inhibiting parathyroid hormone (PTH)
3. By
reducing bone resorption & inhibiting osteoclastic activity
4. By
increasing PTH production
12. Inadequate vitamin D intake can
contribute to the development of osteoporosis by:
1. Increasing
calcitonin production
2. Increasing
calcium absorption from the intestine
3. Altering
calcium metabolism
4. Stimulating
bone formation
13. The drug recommended as primary
prevention of osteoporosis in women over age 70 years is:
1. Alendronate
(Fosamax)
2. Ib&ronate
(Boniva)
3. Calcium
carbonate
4. Raloxifene
(Evista)
14. The drug recommended as primary
prevention of osteoporosis in men over age 70 years is:
1. Alendronate
(Fosamax)
2. Ib&ronate
(Boniva)
3. Calcium
carbonate
4. Raloxifene
(Evista)
15. The ongoing monitoring for patients
over age 65 years taking alendronate (Fosamax) or any other bisphosphonate is:
1. Annual
dual-energy x-ray absorptiometry (DEXA) scans
2. Annual
vitamin D level
3. Annual
renal function evaluation
4. Electrolytes
every 3 months
16. Bisphosphonate administration
education includes:
1. Taking it
on a full stomach
2. Requiring
sitting erect for at least 30 minutes afterward
3. Drinking
it with orange juice
4. Taking it
with H2 blockers or proton pump inhibitors (PPI) to protect the stomach
17. IV forms of bisphosphonates are used
for all the following except:
1. Severe
gastric irritation with oral forms
2. Known
cancer mets into the bone
3. Persons
with advancing renal dysfunction
4. Progression
of bone loss on oral formulations
18. What is the established frequency of
repeating DEXA imaging after stating bisphosphonates?
1. Every 2
years
2. Every 5
years
3. There is
no evidence-based time line for monitoring after the first 2 years
4. There
need to be annual exams
19. What is the duration of SERM use for
menopausal issues?
1. It
matches the 5 years for estrogen products
2. The bone
health impact allows long-term use
3. The
increased risk of breast cancer encourages tapering as soon as possible
4. The
abnormal lipid profile contributes to an early termination as soon as hot
flashes no longer occur
20. Why are SERMS generally not ordered
for women early into menopause?
1. The rapid
onset of severe hot flashes can be unbearable.
2. The bone
remodeling effect results in osteoporosis.
3. They tend
to induce intermittent spotting.
4. They
create more risk with breast cancer than they are worth.
Chapter 39. Hyperlipidemia
1. The overall goal of treating
hyperlipidemia is:
1. Maintain
an LDL level of less than 160 mg/dL
2. To reduce
atherogenesis
3. Lowering
apo B, one of the apoliproteins
4. All of
the above
2. When considering which
cholesterol-lowering drug to prescribe, which factor determines the type &
intensity of treatment?
1. Total LDL
2. Fasting
HDL
3. Coronary
artery disease risk level
4. Fasting
total cholesterol
3. First-line therapy for
hyperlipidemia is:
1. Statins
2. Niacin
3. Lifestyle
changes
4. Bile
acid-binding resins
4. James is a 45-year-old patient with
an LDL level of 120 & normal triglycerides. Appropriate first-line therapy
for James may include diet counseling, increased physical activity, &:
1. A statin
2. Niacin
3. Sterols
4. A fibric
acid derivative
5. Joanne is a 60-year-old patient with
an LDL of 132 & a family history of coronary artery disease. She has
already tried diet changes (increased fiber & plant sterols) to lower her
LDL & after 6 months her LDL is slightly higher. The next step in her treatment
would be:
1. A statin
2. Niacin
3. Sterols
4. A fibric
acid derivative
6. Sharlene is a 65-year-old patient
who has been on a lipid-lowering diet & using plant sterol margarine daily
for the past 3 months. Her LDL is 135 mg/dL. An appropriate treatment for her
would be:
1. A statin
2. Niacin
3. A fibric
acid derivative
4. Determined
by her risk factors
7. Phil is a 54-year-old male with
multiple risk factors who has been on a high-dose statin for 3 months to treat
his high LDL level. His LDL is 135 mg/dL & his triglycerides are elevated.
A reasonable change in therapy would be to:
1. Discontinue
the statin & change to a fibric acid derivative.
2. Discontinue
the statin & change to ezetimibe.
3. Continue
the statin & add in ezetimibe.
4. Refer him
to a specialist in managing patients with recalcitrant hyperlipidemia.
8. Jamie is a 34-year-old pregnant
woman with familial hyperlipidemia & elevated LDL levels. What is the
appropriate treatment for a pregnant woman?
1. A statin
2. Niacin
3. Fibric
acid derivative
4. Bile
acid-binding resins
9. Han is a 48-year-old diabetic with
hyperlipidemia & high triglycerides. His LDL is 112 mg/dL & he has not
tolerated statins. He warrants a trial of a:
1. Sterol
2. Niacin
3. Fibric
acid derivative
4. Bile
acid-binding resin
10. Jose is a 12-year-old overweight child
with a total cholesterol of 180 mg/dL & LDL of 125 mg/dL. Along with diet
education & recommending increased physical activity, a treatment plan for
Jose would include with a reevaluation
in 6 months.
1. Statins
2. Niacin
3. Sterols
4. Bile
acid-binding resins
11. Monitoring of a patient who is on a
lipid-lowering drug includes:
1. Fasting
total cholesterol every 6 months
2. Lipid
profile with attention to serum LDL 6 to 8 weeks after starting therapy, then
again in 6 weeks
3. Complete
blood count, C-reactive protein, & erythrocyte sedimentation rate after 6
weeks of therapy
4. All of
the above
12. Before starting therapy with a statin,
the following baseline laboratory values should be evaluated:
1. Complete
blood count
2. Liver
function (ALT/AST) & creatine kinase
3. C-reactive
protein
4. All of
the above
13. When starting a patient on a statin,
education would include:
1. If they
stop the medication their lipid levels will return to pretreatment levels.
2. Medication
is a supplement to diet therapy & exercise.
3. If they
have any muscle aches or pain, they should contact their provider.
4. All of
the above
14. Omega 3 fatty acids are best used to
help treat:
1. High HDL
2. Low LDL
3. High
triglycerides
4. Any high
lipid value
15. When are statins traditionally ordered
to be taken?
1. At
bedtime
2. At noon
3. At
breakfast
4. With the
evening meal
16. Which the following persons should not
have a statin medication ordered?
1. Someone
with 3 first- or second-degree family members with history of muscle issues
when started on statins
2. Someone
with high lipids, but low BMI
3. Premenopausal
woman with recent history of hysterectomy
4. Prediabetic
male with known metabolic syndrome
17. Fiber supplements are great options
for elderly patients who have the concurrent problem of:
1. End-stage
renal failure on fluid restriction
2. Recurrent
episodes of diarrhea several times a day
3. Long-term
issues of constipation
4. Needing
to take multiple medications around the clock every 2 hours
18. What is considered the order of statin
strength from lowest effect to highest?
1. Lovastatin,
Simvastatin, Rosuvastatin
2. Rosuvastatin,
Lovastatin, Atorvastatin
3. Atorvastatin,
Rosuvastatin, Simvastatin
4. Simvastatin,
Atorvastatin, Lovastatin
Chapter 40. Hypertension
1. Because primary hypertension has no
identifiable cause, treatment is based on interfering with the physiological
mechanisms that regulate blood pressure. Thiazide diuretics treat hypertension
because they:
1. Increase
renin secretion
2. Decrease
the production of aldosterone
3. Deplete
body sodium & reduce fluid volume
4. Decrease
blood viscosity
2. Because of its action on various
body systems, the patient taking a thiazide or loop diuretic may also need to
receive the following supplement:
1. Potassium
2. Calcium
3. Magnesium
4. Phosphates
3. All patients with hypertension
benefit from diuretic therapy, but those who benefit the most are:
1. Those
with orthostatic hypertension
2. African
Americans
3. Those
with stable angina
4. Diabetics
4. Beta blockers treat hypertension
because they:
1. Reduce
peripheral resistance
2. Vasoconstrict
coronary arteries
3. Reduce
norepinephrine
4. Reduce
angiotensin II production
5. Which of the following disease
processes could be made worse by taking a nonselective beta blocker?
1. Asthma
2. Diabetes
3. Both
might worsen
4. Beta
blockade does not affect these disorders
6. Disease states in addition to
hypertension in which beta blockade is a compelling indication for the use of
beta blockers include:
1. Heart
failure
2. Angina
3. Myocardial
infarction
4. Dyslipidemia
7. Angiotensin-converting enzyme(ACE)
inhibitors treat hypertension because they:
1. Reduce
sodium & water retention
2. Decrease
vasoconstriction
3. Increase
vasodilation
4. All of
the above
8. Compelling indications for an ACE
inhibitor as treatment for hypertension based on clinical trials includes:
1. Pregnancy
2. Renal
parenchymal disease
3. Stable
angina
4. Dyslipidemia
9. An ACE inhibitor & what other
class of drug may reduce proteinuria in patients with diabetes better than
either drug alone?
1. Beta
blockers
2. Diuretics
3. Nondihydropyridine
calcium channel blockers
4. Angiotensin
II receptor blockers
10. If not chosen as the first drug in
hypertension treatment, which drug class should be added as a second step
because it will enhance the effects of most other agents?
1. ACE
inhibitors
2. Beta
blockers
3. Calcium
channel blockers
4. Diuretics
11. Treatment costs are important for
patients with hypertension. Which of the following statements about cost is NOT
true?
1. Hypertension
is a chronic disease where patients may be taking drugs for a long time.
2. Most
patients will require more than one drug to treat the hypertension.
3. The cost
includes the price of any routine or special laboratory tests that a specific
drug may require.
4. Few
antihypertensive drugs come in generic formulations.
12. Caffeine, exercise, & smoking
should be avoided for at least how many minutes before blood pressure
measurement?
1. 15
2. 30
3. 60
4. 90
13. Blood pressure checks in children:
1. Should
occur with their annual physical examinations after 6 years of age
2. Require a
blood pressure cuff that is one-third the diameter of the child’s arm
3. Should be
done during every health-care visit after 3 years of age
4. Require
additional laboratory tests such as serum creatinine
14. Lack of adherence to blood pressure
management is very common. Reasons for this lack of adherence include:
1. Lifestyle
changes are difficult to achieve & maintain.
2. Adverse
drug reactions are common & often fall into the categories more associated
with nonadherence.
3. Costs of
drugs & monitoring with laboratory tests can be expensive.
4. All of
the above
15. Lifestyle modifications for patients
with prehypertension or hypertension include:
1. Diet
& increase exercise to achieve a BMI greater than 25.
2. Drink 4
ounces of red wine at least once per week.
3. Adopt the
dietary approaches to stop hypertension (DASH) diet.
4. Increase
potassium intake.
16. Which diuretic agents typically do not
need potassium supplementation?
1. The loop
diuretics
2. The
thiazide diuretics
3. The
aldosterone inhibitors
4. They all
need supplementation
17. Aldactone family medications are
frequently used when the hypertensive patient also has:
1. Hyperkalemia
2. Advancing
liver dysfunction
3. The need
for birth control
4. Rheumatoid
arthritis
18. Hypertensive African Americans are
typically listed as not being as responsive to which drug groups?
1. ACE
inhibitors
2. Calcium
channel blockers
3. Diuretics
4. Bidil
(hydralazine family of medications)
19. What educational points concerning
fluid intake must be covered with diuretic prescriptions?
1. Fluid
should be restricted when on them.
2. Fluids
should contain at least one salty item daily.
3. Fluid
intake should remain near normal for optimal performance.
4. Avoidance
of potassium-rich fluids is encouraged.
20. What is a common side effect concern
with hypertensive medications & all individuals, but especially the
elderly?
1. Risk of
falls
2. Triggering
of a hypertensive crisis
3. Erectile
priapism
4. Risk for
bladder cancer development
