Which test listed below may be used to exclude a secondary cause of hyperlipidemia in a
patient with elevated lipids?
a. CBC
b. TSH
c. Urine culture and sensitivity
d. Sedimentation rate CORRECT ANS-b. TSH
Rationale:
Patients who have dyslipidemia should be screened for diabetes, renal disease, and
hypothyroidism. Nephrotic syndrome can produce remarkably elevated cholesterol levels.
Therefore, measurements of glucose, creatinine, and thyroid stimulating hormone should be
performed when elevating dyslipidemia. Sedimentation rate is a measurement of non-specific
inflammation and so it is not helpful in this situation. Specifically, hypothyroidism can
produce marked lipid abnormalities.
In order to reduce lipid levels, statins are most beneficial when taken:
a. once daily in the AM
b. always with food
c. with an aspirin in the evening
d. in conjunction with diet and exercise CORRECT ANS-d. in conjunction with diet and
exercise
, FNP Review questions and Answers 100% Solved
Rationale:
Statins are used to reduce elevated level of lipids in conjunction with modifications in diet and
exercise. The timing of statin dosing and and indication with food (or not) is different for each
statin. Most patients who take statins are also candidates for aspirin therapy as primary or
secondary prevention, but aspirin does not improve statin tolerance. Statins are correctly
taken once daily.
A patient is taking atorvastatin for newly diagnosed dyslipidemia complains of muscle aches
in his upper and lower legs for the past 3-weeks. It has not improved with rest. How should
this be evaluated?
a. Stop the atorvastatin immediately.
b. Check liver enzymes first.
c. Order a CPK level
d. Ask about nighttime muscle cramps. CORRECT ANS-c. Order a CPK level
Rationale:
This patient has a complaint of myalgias that could be associated with statin use. This patient
should be assessed for rhabdomyolysis. This is done by measuring a CPK level. If this level is
elevated, atorvastatin should be stopped immediately. Liver enzymes would not assess for the
etiology of myalgias. They assess tolerance of statins in the liver. Nighttime muscle cramps are
not associated with statin use.
Which hypertensive patient is most likely to have adverse blood pressure effects from
excessive sodium consumption?
, FNP Review questions and Answers 100% Solved
a. 21-year-old Asian American male
b. 35-year-old menstruating female
c. 55-year-old post menopausal female
d. 70-year-old African American male CORRECT ANS-d. 70-year-old African American male
Rationale:
Two groups of patients typically experience adverse blood pressure effects from consumption
of sodium greater than 2,000 mg daily. Those patients considered to be most sodium sensitive
are elderly patients and African American patients.
A patient with poorly controlled hypertension and history of myocardial infarction 6-years-
ago presents today with mild shortness of breath. He takes quinapril, ASA, metoprolol, and a
statin daily. What symptom in NOT indicative of a heart failure exacerbation?
a. fatigue
b. headache
c. orthopnea
d. cough CORRECT ANS-b. headache
Rationale:
Fatigue is a common symptom in cardiac patients that can represent a worsening of many
cardiac diseases such as coronary artery disease, heart failure, and valvular dysfunction.
Orthopnea and cough, especially nocturnal, are classic symptoms of heart failure.
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