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2024 NRNP 6566 WK1-5 MIDTERM EXAM WITH CORRECT ANSWERS
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2024 NRNP 6566 WK1-5 MIDTERM EXAM WITH CORRECT ANSWERS
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2024 NRNP 6566 WK1-5 MIDTERMEXAM WITH CORRECT ANSWERS
Dihydropyridine Calcium Channel Blockers - CORRECT-ANSWERSnefedipine,
amlodipine
these primarily act on vascular smooth muscles
Use this for hypertension
Non-Dihydropyridine Calcium Channel blocker - CORRECT-
ANSWERSDiltiazem < verapamil
Primarily act on the heart
Use these for CP, SVT (verapamil), controlling irregular heart rate and
lowering blood pressure (Diltiazem)
CHADS 2 score - CORRECT-ANSWERSanything greater than 3 is high risk and
start anticoagulant
1 point for each with history of heart failure, hypertension, and diabetes
mellitus
Stroke is 2 points
and greater than 75 years old is one point
Hyperthyroidism - CORRECT-ANSWERSheat intolerance
fatigue
anxiety
nervousness
manic
confusion / restless
emotional liability
fine tremors
diaphoresis
hyperreflexia of deep tendon reflexes
resting tachycardia, palpitations, afib
exterional dyspnea
low-grade fever
increased appetite
weight loss
fine thin hair
exopthalamus
Graves
, Abnormal labs with hyperthyroidism - CORRECT-ANSWERSelevated T3, T4,
thyroid resin uptake, and free thyroxine index. Sometimes T4 is normal but
T3 is always high
Elevated sed rate
Elevated antinuclear antibody, without evidence of lupus or autoimmune
disorder
Hypercalcemia and low h/h
Treatment for hyperthyroidism - CORRECT-ANSWERSpropanolol (inderal)
10mg 4 times a day (up to 80 mg)
Metoprolol 25 mg by mouth (Up to 50 mg) every 6*8 hours
Antithyroid medications- methimazole (tapazole) initial dose is 30 to 60mg a
day in three doses, and then maintenance of 5 to 15 mg daily
If intolerant to tapazole, propylthiouracil initial dose is 300 to 600 mg a day
in 4 doses, maintenance dosage is 100 to 150 mg daily in three doses
Identify when cardioversion is indicated and relevant testing that should
occur prior to it - CORRECT-ANSWERSUnstable afib / flutter causing RVR, MI,
hypotension or heart failure; WPW syndrome in a fib
TEE should always proceed DCCV to rule out valve disease or thrombus
Hypertension definition - CORRECT-ANSWERSsustained BP of 140's over 90's
for a sustained period of time
Stage 1 is 140-159; and 90-99 diastolic
Stage 2 is equal or greater than 160 over greater or equal to 100 diastolic
Essential hypertension - CORRECT-ANSWERSunknown cause
95% cases; onset 25 years old - 55
Secondary hypertension- related to known cause or disease process. This
could be from estrogen uses, renal disease, pregnant, endocrine disorders
Isolated systolic blood pressure- hypertension and systolic blood pressure
greater than 140 over 90
Effectively treated with diuretics and long-acting calcium channel blockers
Signs and symptoms of hypertension: headache in the morning, epitaxis,
lightheadedness, visual disturbances, S4 present related to left ventricular
hypertrophy, retinal changes, hematuria (which is rare)
Hypertensive urgency - CORRECT-ANSWERSseverely elevated blood pressure
180 over 110 or higher without progressive target organ dysfunction
signs and symptoms: severe headache, shortness of breath, epistaxis,
severe anxiety
treatment includes Clonidine (alpha-adrenergic stimulant 0.2 mg initial dose,
then 0.1 mg every hour until controlled or total of 0.8 mg
May experience sedation, possible rebound hypertension once stopped
Captopril - ACE dose of 12.5 to 25mg
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