1. A patient who has been taking digoxin 0.25 mg daily for 6 months reports that it is not
, working as well as it did initially. The primary care NP should: (Points : 2)
recommend a reduced potassium intake.
increase the dose of digoxin to 0.5 mg daily.
hold the next dose of digoxin and obtain a serum digoxin level.
contact the patient’s pharmacy to ask if generic digoxin was dispensed.
Question 2.2. A patient with a history of coronary heart disease develops atrial fibrillation. The
primary care NP refers the patient to a cardiologist who performs direct current cardioversion.
The NP should expect the patient to begin taking which -blocker medication? (Points : 2)
Nadolol (Corgard)
Sotalol (Betapace)
Timolol (Blocadren)
Propranolol (Inderal)
Question 3.3. A patient comes to the clinic with a complaint of gradual onset of left-sided
weakness. The primary care NP notes slurring of the patient’s speech. A family member
accompanying the patient tells the NP that these symptoms began 4 or 5 hours ago. The NP
will activate the emergency medical system and expect to administer: (Points : 2)
325 mg of chewable aspirin.
LMWH.
intravenous alteplase and aspirin.
warfarin (Coumadin) and aspirin.
Question 4.4. The primary care NP sees a new patient for a routine physical examination.
When auscultating the heart, the NP notes a heart rate of 78 beats per minute with occasional
extra beats followed by a pause. History reveals no past cardiovascular disease, but the
patient reports occasional syncope and shortness of breath. The NP should: (Points : 2)
order an ECG and refer to a cardiologist.
schedule a cardiac stress test and a graded exercise test.
order a complete blood count (CBC) and electrolytes and consider a trial of
procainamide.
prescribe a -blocker and anticoagulant and order 24-hour Holter monitoring.
Question 5.5. The primary care NP refers a patient to a cardiologist who diagnoses long QT
syndrome. The cardiologist has prescribed propranolol (Inderal). The patient exercises
regularly and is not obese. The patient asks the NP what else can be done to minimize risk of
sudden cardiac arrest. The NP should counsel the patient to: (Points : 2)
drink extra fluids when exercising.
reduce stress with yoga and hot baths.
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