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MN 553 Final Review (1).pdf
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MN h553-Final hreviewAcute hPain
6. hWhich hof hthe hfollowing hstatements his htrue habout hacute hpain?
1. Somatic hpain hcomes hfrom hbody hsurfaces hand his honly hsharp hand hwell-localized.
2. Visceral hpain hcomes hfrom hthe hinternal horgans hand his hmost hresponsive hto hacetaminophen hand hopiates.
3. Referred hpain his hpresent hin ha hdistant hsite hfor hthe hpain hsource hand his hbased hon hactivation hof hthe hsame
hspinal hsegmenthas hthe hactual hpain hsite.
4. Acute hneuropathic hpain his hcaused hby hlack hof hblood hsupply hto hthe hnerves hin ha hgiven harea.
7. hOne hof hthe hmain hdrug hclasses hused hto htreat hacute hpain his hNSAIDs. hThey hare hused hbecause:
1. They hhave hless hrisk hfor hliver hdamage hthan hacetaminophen.
2. Inflammation his ha hcommon hcause hof hacute hpain.
3. They hhave hminimal hGI hirritation.
4. Regulation hof hblood hflow hto hthe hkidney his hnot haffected hby hthese hdrugs.
10. hThe hgoal hof htreatment hof hacute hpain his:
1. Pain hat ha htolerable hlevel hwhere hthe hpatient hmay hreturn hto hactivities hof hdaily hliving
2. Reduction hof hpain hwith ha hminimum hof hdrug hadverse heffects
3. Reduction hor helimination hof hpain hwith hminimum hadverse hreactions
4. Adequate hpain hrelief hwithout hconstipation hor hnausea hfrom hthe hdrugs
13. hPathological hsimilarities hand hdifferences hbetween hacute hpain hand hchronic hpain hinclude:
1. Both hhave hdecreased hlevels hof hendorphins.
2. Chronic hpain hhas ha hpredominance hof hC-neuron hstimulation.
3. Acute hpain his hmost hcommonly hassociated hwith hirritation hof hperipheral hnerves.
4. Acute hpain his hdiffuse hand hhard hto hlocalize.
Allopurinol
17. Which hantigout hmedication his hused hto htreat hchronic htophaceous hgout?
a. Allopurinol h(Zyloprim)
b. Colchicine
c. Probenecid h(Benemid)
d. Sulfinpyrazone h(Anturane)
18. The h nurse h is h assessing h a h patient h who h has h gout h who h will h begin h taking h allopurinol h (Zyloprim). h The
h nurse h reviewshthe hpatient’s hmedical hrecord hand h will hbe hconcerned habout hwhich hlaboratory hresult?
a. Elevated hBUN hand hcreatinine
b. Increased hserum huric hacid
c. Slight hincrease hin hthe hwhite hblood hcount
d. Increased hserum hglucose
19. The h nurse h provides h teaching h for h a h patient h who h will h begin h taking h allopurinol. h Which h statement h by
h the h patienthindicates hunderstanding hof hthe hteaching?
a. I hshould hincrease hmy hvitamin hC hintake.
b. I hwill hget hyearly heye hexams.
c. I hwill hincrease hmy hprotein hintake.
d. I hwill hlimit hfluids hto hprevent hedema.
3. hLarry his htaking hallopurinol hto hprevent hgout. hMonitoring hof ha hpatient hwho his htaking hallopurinol hincludes:
,1. Complete hblood hcount
2. Blood hglucose
3. C-reactive hprotein
4. BUN, hcreatinine, hand hcreatinine hclearance
Angina
20. hIsosorbide hdinitrate his hprescribed hfor ha hpatient hwith hchronic hstable hangina. hThis hdrug his
hadministeredhtwice hdaily, hbut hthe hschedule his h7 ha.m. hand h2 hp.m. hbecause:
1. It his ha hlong-acting hdrug hwith hpotential hfor htoxicity.
2. Nitrate htolerance hcan hdevelop.
3. Orthostatic hhypotension his ha hcommon hadverse heffect.
4. It hmust hbe htaken hwith hmilk hor hfood.
21. hArt h is h a h 55-year-old h smoker h who h has h been h diagnosed h with h angina h and h placed h on
h nitrates. h Hehcomplains h of h headaches h after h using h his h nitrate. hAn h appropriate h reply h might
h be:
1. This his ha hparasympathetic hresponse hto hthe hvasodilating heffects hof hthe hdrug.
2. Headaches hare hcommon hside heffects hwith hthese hdrugs. hHow hsevere hare hthey?
3. This his hassociated hwith hyour hsmoking. hLet’s hwork hon hhaving hyou hstop hsmoking.
4. This h is h not h related h to h your h medication. hAre h you h under h a h lot h of h stress?
20. hElderly hpatients hwho hare hstarted hon hlevothyroxine hfor hthyroid hreplacement hshould hbe hmonitored hfor:
1. Excessive hsedation
2. Tachycardia hand hangina
3. Weight hgain
4. Cold hintolerance
1. h Angina h is h produced h by h an h imbalance h between h myocardial h oxygen h supply h (MOS) h and h demand
h (MOD) h in h thehmyocardium. hWhich hof hthe hfollowing hdrugs hhelp hto hcorrect hthis himbalance hby
hincreasing hMOS?
1. Calcium hchannel hblockers
2. Beta hblockers
3. Angiotensin-converting-enzyme h (ACE) h inhibitors
4. Aspirin
3. h The h New h York h Heart hAssociation h and h the h Canadian h Cardiovascular h Society h have
h described h gradinghcriteria h for h levels h of h angina. h Angina h that h occurs h with h unusually h strenuous
h activity h or h on h walking h or hclimbing hstair hafter hmeals his hclass:
1. I
2. II
3. III
4. IV
4. hPatients hat hhigh hrisk hfor hdeveloping hsignificant hcoronary hheart hdisease hare hthose hwith:
1. LDL hvalues h between h 100 h and h 130
2. Systolic hblood hpressure hbetween h120 hand h130
3. Class hIII hangina
4. Obesity
5. To h reduce h mortality, h all h patients h with h angina, h regardless h of h class, h should h be h on:
1. Aspirin h81 hto h325 hmg/d
2. Nitroglycerin hsublingually hfor hchest hpain
3. ACE hinhibitors hor hangiotensin hreceptor hblockers
4. Digoxin
,6. hPatients hwho hhave hangina, hregardless hof hclass, hwho hare halso hdiabetic, hshould hbe hon:
1. Nitrates
2. Beta hblockers
3. ACE hinhibitors
4. Calcium hchannel hblockers
7. hManagement hof hall htypes hand hgrades hof hangina hincludes hthe huse hof hlifestyle hmodification hto hreduce
hrisk hfactors. hWhich hof hthese hmodifications hare happropriate hfor hwhich hreason? hBoth hthe hmodification hand
hthe hreason hfor hit hmust hbehtrue hfor hthe hanswer hto hbe hcorrect.
1. Lose hat hleast h10 hpounds hof hbody hweight. hExcessive hweight hincreases hcardiac hworkload.
2. Reduce hsodium hintake hto hno hmore hthan h2,400 hmg hof hsodium. hSodium hincreases hblood hvolume hand
hcardiachworkload.
3. Increase hpotassium hintake hto hat hleast h100 hmEq/d. hThe hheart hneeds hhigher hlevels hof hpotassium hto himprove
contractility hand hoxygen hsupply.
4. Intake ha hmoderate hamount hof halcohol. hModerate hintake hhas hbeen hshown hby hresearch hto himprove hcardiac
hfunction.
8. hNitrates hare hespecially hhelpful hfor hpatients hwith hangina hwho halso hhave:
1. Heart h failure
2. Hypertension
3. Both h1 hand h2
4. Neither h1 hnor h2
9. hBeta hblockers hare hespecially hhelpful hfor hpatients hwith hexertional hangina hwho halso hhave:
1. Arrhythmias
2. Hypothyroidism
3. Hyperlipidemia
4. Atherosclerosis
10. hRapid-acting hnitrates hare himportant hfor hall hangina hpatients. hWhich hof hthe hfollowing hare htrue hstatements
habout htheirhuse?
1. These hdrugs hare huseful hfor himmediate hsymptom hrelief hwhen hthe hpatient his hcertain hit his hangina.
2. The hdose his hone hsublingual htablet hor hspray hevery h5 hminutes huntil hthe hchest hpain hgoes haway.
3. Take hone hnitroglycerine htablet hor hspray hat hthe hfirst hsign hof hangina; hrepeat hevery h5minutes hfor hno hmore
hthan htwohdoses. hIf hchest hpain his hstill hnot hrelieved, hcall h911.
4. All hof hthe habove
12. hCombinations hof ha hlong-acting hnitrate hand ha hbeta hblocker hare hespecially heffective hin htreating hangina hbecause:
1. Nitrates hincrease hMOS hand hbeta hblockers hincrease hMOD.
2. Their hadditive heffects hpermit hlower hdoses hof hboth hdrugs hand htheir hadverse hreactions hcancel heach hother hout.
3. They haddress hthe hpathology hof hpatients hwith hexertional hangina hwho hhave hfixed hatherosclerotic
hcoronary hhearthdisease.
4. All hof hthe habove
13. hDrug hchoices hto htreat hangina hin holder hadults hdiffer hfrom hthose hof hyounger hadults honly hin:
1. Consideration hof hrisk hfactors hfor hdiseases hassociated hwith hand hincreased hin haging
2. The hplacement hof hdrug htherapy has ha htreatment hchoice hbefore hlifestyle hchanges hare htried
3. The hneed hfor hat hleast hthree hdrugs hin hthe htreatment hregimen hbecause hof hthe hcomplexity hof hangina hin hthe holder
hadult
4. Those hwith hhigher hrisk hfor hsilent hmyocardial hinfarction
15. hCost hof hantianginal hdrug htherapy hshould hbe hconsidered hin hdrug hselection hbecause hof hall hof hthe hfollowing
hEXCEPT:
1. Patients hoften hrequire hmultiple hdrugs
2. A hlarge h number h of h angina h patients h are h older h adults h on h fixed h incomes
3. Generic hformulations hmay hbe hcheaper hbut hare hrarely hbioequivalent
, 4. Lack hof hdrug hselectivity hmay hresult hin hincreased hadverse hreactions
16. hSituations hthat hsuggest hreferral hto ha hspecialist his happropriate hinclude:
1. When hchronic hstable hangina hbecomes hunpredictable hin hits hcharacteristics hand hprecipitating hfactors
2. When ha hpost-myocardial hinfarction hpatient hdevelops hnew-onset hangina
3. When hstandard htherapy his hnot hsuccessful hin himproving hexercise htolerance hor hreducing hthe hincidence hof hangina
4. All hof hthe habove
17. hThe hrationale hfor hprescribing hcalcium hblockers hfor hangina hcan hbe hbased hon hthe hneed hfor:
1. Increased hinotropic heffect hin hthe hheart
2. Increasing hperipheral hperfusion
3. Keeping hheart hrates hhigh henough hto hensure hperfusion hof hcoronary harteries
4. Help hwith hrate hcontrol
18. hMedications hare htypically hstarted hfor hangina hpatients hwhen:
1. The hfirst hpermanent hEKG hchanges hoccur
2. The hstart hof hclass hI hor hII hsymptoms
3. The hevents htrigger ha htrip hto hthe hemergency hdepartment
4. When htroponin hlevels hbecome haltered
19. hThe hmost hcommon hcause hof hangina his:
1. Vasospasm hof hthe hcoronary harteries
2. Atherosclerosis
3. Platelet haggregation
4. Low hsystemic hoxygen
20. hRanolazine his hused hin hangina hpatients hto:
1. Dilate h plaque-filled h arteries
2. Inhibit h platelet h aggregation
3. Restrict hlate hsodium hflow hin hthe hmyocytes
4. Induce hvasoconstriction hin hthe hperiphery hto hopen hcoronary hvessels
21. hWhen his haspirin h(ASA) hused hin hangina hpatients?
1. All h angina h patients h should h be h taking h ASA hunless h it h is h contraindicated h for h allergy h or h other h medical h reasons.
2. ASA hshould h only h be h used h in h men.
3. ASA hhas h no h role h in h angina, h but h is h useful h in h MI h prevention.
4. The h impact h of hASA his h best h at h the h time h of h an h angina h attack.
6. hRobert his ha h72-year-old hpatient hwho hhas hhypertension hand hangina. hHe his hat hrisk hfor
hcommonhmedication hpractices hseen hin hthe helderly hincluding:
1. Use hof hanother hperson’s hmedications
2. Hoarding hmedications
3. Changing hhis hmedication hregimen hwithout htelling hhis hprovider
4. All hof hthe habove
Angioedema
3. h A h potentially h life-threatening h adverse h response h to h angiotensin-converting h enzyme h inhibitors h is
h angioedema. h Whichhof hthe hfollowing hstatements his htrue habout hthis hadverse hresponse?
1. Swelling hof hthe htongue hor hhoarseness hare hthe hmost hcommon hsymptoms.
2. It happears hto hbe hrelated hto hthe hdecrease hin haldosterone hproduction.
3. Presence hof ha hdry, hhacky hcough hindicates ha hhigh hrisk hfor hthis hadverse hresponse.
4. Because hit htakes htime hto hbuild hup ha hblood hlevel, hit hoccurs hafter hbeing hon hthe
hdrug hforhabout h1 hweek.
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