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NR 508 Week-3 Quiz (Version 1), NR 508: ADVANCED PHARMACOLOGY, Chamberlain College of Nursing
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NR 508 Week-3 Quiz (Version 1), NR 508: ADVANCED PHARMACOLOGY, Chamberlain College of Nursing
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NR 508 Week 3 QuizNR 508: ADVANCED PHARMACOLOGY
,Question 1
pts
A patient who has angina uses 0.4 mg of sublingual nitroglycerin for angina episodes. The
patient brings a log of angina episodes to an annual physical examination. The primary care NP
notes that the patient has experienced an increase in frequency of episodes in the past month but
no increase in duration or severity of pain. The NP should:
increase the nitroglycerin dose to 0.6 mg per dose.
Correct Answer
contact the patient’s cardiologist to discuss admission to the hospital.
discontinue the nitroglycerin and order ranolazine (Ranexa ER).
You Answered
change from a sublingual to a transdermal patch nitroglycerin.
Unstable angina is a change in pattern or pain, such as an increase in frequency, severity, or
duration of pain and fewer precipitating factors. Patients with unstable angina should be admitted
to a coronary care unit. The primary care NP should not change any medications without
consultation with the patient’s cardiologist.
Question 2
pts
A patient who has hyperlipidemia has been taking atorvastatin (Lipitor) 60 mg daily for 6
months. The patient’s initial lipid profile showed LDL of 180 mg/dL, HDL of 45 mg/dL, and
triglycerides of 160 mg/dL. The primary care NP orders a lipid profile today that shows LDL of
105 mg/dL, HDL of 50 mg/dL, and triglycerides of 120 mg/dL. The patient reports muscle pain
and weakness. The NP should:
You Answered
, order liver function tests (LFTs).
add gemfibrozil (Lopid) to the patient’s medication regimen.
Correct Answer
order a creatine kinase-MM (CK-MM) level.
change atorvastatin to twice-daily dosing.
Hepatotoxicity and muscle toxicity are the two primary adverse effects of greatest concern with
statin use. Patients who report muscle discomfort or weakness should have a CK-MM level
drawn. LFTs are indicated with signs of hepatotoxicity. It is not correct to change the dosing
schedule. Gemfibrozil is not indicated.
Question 3
pts
A 55-year-old woman has a history of myocardial infarction (MI). A lipid profile reveals LDL of
130 mg/dL, HDL of 35 mg/dL, and triglycerides 150 mg/dL. The woman is sedentary with a
body mass index of 26. The woman asks the primary care NP about using a statin medication.
The NP should:
tell her there is no clinical evidence of efficacy of statin medication in her case.
Correct Answer
begin therapy with atorvastatin 10 mg per day.
discuss quality-of-life issues as part of the decision to begin medication.
You Answered
recommend dietary and lifestyle changes first.
This woman would be using a statin medication for secondary prevention because she already
has a history of MI, so a statin should be prescribed. Dietary and lifestyle changes should be a
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