NR 603 WEEK 3 QUIZ -ALL POSSIBLE QUESTION

NR 603 WEEK 3 QUIZ -ALL POSSIBLE QUESTION Per 2013 ACC/AHA guidelines, which patient below would NOT benefit from statin therapy? • - 42 yo male, LDL 162 mg/dL, 10 yr risk 4.9% Which of the following patients should be on high-intensity statin therapy, if tolerated? • 58 yo male w/ NSTEMI - 71 yo female w/ DM, HTN, 10 yr risk 11.5% - 41 yo male w/ baseline LDL 206 mg/dL - 64 yo female w/ history of CVA - All of the above For someone who is intolerant to higher doses of statins, has tried 2-3 statins...what do we recommend? • There's no true guidelines on how many different statins to try before moving on to non-statin therapies, but generally should try 3-4 different statins that differ in metabolism, hydro/lipophilic...and consider alternate day dosing or twice a week dosing. You have a patient with ASCVD but no comorbidities. Their LDL has gone down 30% from baseline and they are on maximally tolerated statin therapy. Is this patient appropriate for non-statin therapy and if so, what do you recommend? • It is appropriate to consider non-statin therapy for this pt. b/c they have ASCVD. Since their LDL has gone down 50% (or if their LDL 70/non-HDL 100), they should be given ezetimibe 1st line. PCSK9 would be second line. IG is a 47 yo male with CAD s/p MI 2015. He is currently prescribed atorvastatin 20 mg/day. Pt states he is unable to tolerate higher doses and refuses to try another statin. LDL 114 mg/dL. What is the next best step? • Alirocumab YZ is a 67 yo female with DM and 10 year risk score 11.1%. She is currently prescribed atorvastatin 80 mg once daily with reported adherence. Current LDL-C 141 mg/dL. What is the next best step for cardiovascular risk reduction. • ezetimibe 10 mg once daily TL is a 52 yo black male overbooked in your clinic today for evaluation of fasting labs per primary provider request. He is without complaints. Pertinent medications include amlodipine 10 mg/day and atorvastatin 20 mg/day + tobacco use, 3-4 beer/night Labs: TC 302, HDL 21, TG 1167, direct LDL 152, SCr 1.1 BP 145/78, height 74 inches, weight 113.4 kg • Increase atorvastatin to 40 mg/day Start niacin ER 500 mg/day and titrate by 500 mg every month to target 2000 mg/day Which of the following drugs inhibits factor IIa (thrombin) and factor Xa by activating antithrombin? • Heparin Which of the following drugs have pharmacogenomic information in the FDA label? Select all correct answers (there may be more than one). A. Clopidogrel B. Atorvastatin C. Metoprolol D. Warfarin. (they all do) Variants in which of the following genes have the most compelling evidence for association with clopidogrel response? • CYP2C19 Brown a 45-year-old African American male has elevated lipids. What should the nurse practitioner do next? *A thyroid stimulating hormone (TSH) level Which of the following medications may have an unfavorable effect on a hypertensive patient's blood pressure? • Naproxen