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MN 553 Final Exam Review
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Purdue Global University MN 553 Final Exam Review
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MN 553-Final reviewAcute Pain
6. Which of the following statements is true about acute pain?
1. Somatic pain comes from body surfaces and is only sharp and well-localized.
2. Visceral pain comes from the internal organs and is most responsive to acetaminophen and opiates.
3. Referred pain is present in a distant site for the pain source and is based on activation of the same spinal segment
as the actual pain site.
4. Acute neuropathic pain is caused by lack of blood supply to the nerves in a given area.
7. One of the main drug classes used to treat acute pain is NSAIDs. They are used because:
1. They have less risk for liver damage than acetaminophen.
2. Inflammation is a common cause of acute pain.
3. They have minimal GI irritation.
4. Regulation of blood flow to the kidney is not affected by these drugs.
10. The goal of treatment of acute pain is:
1. Pain at a tolerable level where the patient may return to activities of daily living
2. Reduction of pain with a minimum of drug adverse effects
3. Reduction or elimination of pain with minimum adverse reactions
4. Adequate pain relief without constipation or nausea from the drugs
13. Pathological similarities and differences between acute pain and chronic pain include:
1. Both have decreased levels of endorphins.
2. Chronic pain has a predominance of C-neuron stimulation.
3. Acute pain is most commonly associated with irritation of peripheral nerves.
4. Acute pain is diffuse and hard to localize.
Allopurinol
17. Which antigout medication is used to treat chronic tophaceous gout?
a. Allopurinol (Zyloprim)
b. Colchicine
c. Probenecid (Benemid)
d. Sulfinpyrazone (Anturane)
18. The nurse is assessing a patient who has gout who will begin taking allopurinol (Zyloprim). The nurse reviews
the patient’s medical record and will be concerned about which laboratory result?
a. Elevated BUN and creatinine
b. Increased serum uric acid
c. Slight increase in the white blood count
d. Increased serum glucose
19. The nurse provides teaching for a patient who will begin taking allopurinol. Which statement by the patient
indicates understanding of the teaching?
a. I should increase my vitamin C intake.
b. I will get yearly eye exams.
c. I will increase my protein intake.
d. I will limit fluids to prevent edema.
3. Larry is taking allopurinol to prevent gout. Monitoring of a patient who is taking allopurinol includes:
,1. Complete blood count
2. Blood glucose
3. C-reactive protein
4. BUN, creatinine, and creatinine clearance
Angina
20. Isosorbide dinitrate is prescribed for a patient with chronic stable angina. This drug is administered
twice daily, but the schedule is 7 a.m. and 2 p.m. because:
1. It is a long-acting drug with potential for toxicity.
2. Nitrate tolerance can develop.
3. Orthostatic hypotension is a common adverse effect.
4. It must be taken with milk or food.
21. Art is a 55-year-old smoker who has been diagnosed with angina and placed on nitrates. He
complains of headaches after using his nitrate. An appropriate reply might be:
1. This is a parasympathetic response to the vasodilating effects of the drug.
2. Headaches are common side effects with these drugs. How severe are they?
3. This is associated with your smoking. Let’s work on having you stop smoking.
4. This is not related to your medication. Are you under a lot of stress?
20. Elderly patients who are started on levothyroxine for thyroid replacement should be monitored for:
1. Excessive sedation
2. Tachycardia and angina
3. Weight gain
4. Cold intolerance
1. Angina is produced by an imbalance between myocardial oxygen supply (MOS) and demand (MOD) in the
myocardium. Which of the following drugs help to correct this imbalance by increasing MOS?
1. Calcium channel blockers
2. Beta blockers
3. Angiotensin-converting-enzyme (ACE) inhibitors
4. Aspirin
3. The New York Heart Association and the Canadian Cardiovascular Society have described grading
criteria for levels of angina. Angina that occurs with unusually strenuous activity or on walking or
climbing stair after meals is class:
1. I
2. II
3. III
4. IV
4. Patients at high risk for developing significant coronary heart disease are those with:
1. LDL values between 100 and 130
2. Systolic blood pressure between 120 and 130
3. Class III angina
4. Obesity
5. To reduce mortality, all patients with angina, regardless of class, should be on:
1. Aspirin 81 to 325 mg/d
2. Nitroglycerin sublingually for chest pain
3. ACE inhibitors or angiotensin receptor blockers
4. Digoxin
,6. Patients who have angina, regardless of class, who are also diabetic, should be on:
1. Nitrates
2. Beta blockers
3. ACE inhibitors
4. Calcium channel blockers
7. Management of all types and grades of angina includes the use of lifestyle modification to reduce risk factors.
Which of these modifications are appropriate for which reason? Both the modification and the reason for it must be
true for the answer to be correct.
1. Lose at least 10 pounds of body weight. Excessive weight increases cardiac workload.
2. Reduce sodium intake to no more than 2,400 mg of sodium. Sodium increases blood volume and cardiac
workload.
3. Increase potassium intake to at least 100 mEq/d. The heart needs higher levels of potassium to improve
contractility and oxygen supply.
4. Intake a moderate amount of alcohol. Moderate intake has been shown by research to improve cardiac function.
8. Nitrates are especially helpful for patients with angina who also have:
1. Heart failure
2. Hypertension
3. Both 1 and 2
4. Neither 1 nor 2
9. Beta blockers are especially helpful for patients with exertional angina who also have:
1. Arrhythmias
2. Hypothyroidism
3. Hyperlipidemia
4. Atherosclerosis
10. Rapid-acting nitrates are important for all angina patients. Which of the following are true statements about their
use?
1. These drugs are useful for immediate symptom relief when the patient is certain it is angina.
2. The dose is one sublingual tablet or spray every 5 minutes until the chest pain goes away.
3. Take one nitroglycerine tablet or spray at the first sign of angina; repeat every 5minutes for no more than two
doses. If chest pain is still not relieved, call 911.
4. All of the above
12. Combinations of a long-acting nitrate and a beta blocker are especially effective in treating angina because:
1. Nitrates increase MOS and beta blockers increase MOD.
2. Their additive effects permit lower doses of both drugs and their adverse reactions cancel each other out.
3. They address the pathology of patients with exertional angina who have fixed atherosclerotic coronary heart
disease.
4. All of the above
13. Drug choices to treat angina in older adults differ from those of younger adults only in:
1. Consideration of risk factors for diseases associated with and increased in aging
2. The placement of drug therapy as a treatment choice before lifestyle changes are tried
3. The need for at least three drugs in the treatment regimen because of the complexity of angina in the older adult
4. Those with higher risk for silent myocardial infarction
15. Cost of antianginal drug therapy should be considered in drug selection because of all of the following EXCEPT:
1. Patients often require multiple drugs
2. A large number of angina patients are older adults on fixed incomes
3. Generic formulations may be cheaper but are rarely bioequivalent
, 4. Lack of drug selectivity may result in increased adverse reactions
16. Situations that suggest referral to a specialist is appropriate include:
1. When chronic stable angina becomes unpredictable in its characteristics and precipitating factors
2. When a post-myocardial infarction patient develops new-onset angina
3. When standard therapy is not successful in improving exercise tolerance or reducing the incidence of angina
4. All of the above
17. The rationale for prescribing calcium blockers for angina can be based on the need for:
1. Increased inotropic effect in the heart
2. Increasing peripheral perfusion
3. Keeping heart rates high enough to ensure perfusion of coronary arteries
4. Help with rate control
18. Medications are typically started for angina patients when:
1. The first permanent EKG changes occur
2. The start of class I or II symptoms
3. The events trigger a trip to the emergency department
4. When troponin levels become altered
19. The most common cause of angina is:
1. Vasospasm of the coronary arteries
2. Atherosclerosis
3. Platelet aggregation
4. Low systemic oxygen
20. Ranolazine is used in angina patients to:
1. Dilate plaque-filled arteries
2. Inhibit platelet aggregation
3. Restrict late sodium flow in the myocytes
4. Induce vasoconstriction in the periphery to open coronary vessels
21. When is aspirin (ASA) used in angina patients?
1. All angina patients should be taking ASA unless it is contraindicated for allergy or other medical reasons.
2. ASA should only be used in men.
3. ASA has no role in angina, but is useful in MI prevention.
4. The impact of ASA is best at the time of an angina attack.
6. Robert is a 72-year-old patient who has hypertension and angina. He is at risk for common
medication practices seen in the elderly including:
1. Use of another person’s medications
2. Hoarding medications
3. Changing his medication regimen without telling his provider
4. All of the above
Angioedema
3. A potentially life-threatening adverse response to angiotensin-converting enzyme inhibitors is angioedema. Which
of the following statements is true about this adverse response?
1. Swelling of the tongue or hoarseness are the most common symptoms.
2. It appears to be related to the decrease in aldosterone production.
3. Presence of a dry, hacky cough indicates a high risk for this adverse response.
4. Because it takes time to build up a blood level, it occurs after being on the drug for
about 1 week.
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