Exam (elaborations)
ACNP I Midterm Exam - Questions & Solutions (Pass!)
- Course
- Institution
ACNP I Midterm Exam - Questions & Solutions (Pass!)
[Show more]
Content preview
ACNP I Midterm Exam - Questions & Solutions (Pass!)Stage A: At-Risk for Heart Failure Right Ans - HF Stage _____
Pts. at risk w/o current or previous s/s of HF and w/o structural/functional
heart disease or abnormal biomarkers
Pts. with HTN, CVD, diabetes, obesity, exposure to cardiotoxic agents, genetic
variant/family history for cardiomyopathy
Stage B: Pre-Heart Failure Right Ans - HF Stage ______
Pts. w/o current or previous s/s of HF but evidence of 1 of the following:
-structural heart disease
-increased filling pressures
-risk factors and increased natriuretic peptide levels OR persistently elevated
cardiac troponin in the absence of competing diagnoses
Stage C: Symptomatic Heart Failure Right Ans - HF Stage ______
Pts. with current or previous s/s of HF
Stage D: Advanced Heart Failure Right Ans - HF Stage ______
Marked HF symptoms that interfere with daily life and with recurrent
hospitalizations despite attempts to optimize GDMT
NYHA Functional Classification: I Right Ans - NYHA Functional Class ______:
No limitation of physical activity. Ordinary physical activity does not cause
symptoms of HF
NYHA Functional Classification: II Right Ans - NYHA Functional Class ______:
Slight limitation of physical activity. Comfortable at rest, but ordinary physical
activity results in symptoms of HF
NYHA Functional Classification: III Right Ans - NYHA Functional Class
______:
,Marked limitation of physical activity. Comfortable at rest, but less than
ordinary activity causes symptoms of HF
NYHA Functional Classification: IV Right Ans - NYHA Functional Class
______:
Unable to carry on any physical activity without symptoms of HF, or
symptoms of HF at rest
SGLT2 Inhibitors Right Ans - Used for treatment of type 2 DM, found to
benefit those with HF (reduced hospitalizations and death)
SGLT2 inhibitors Right Ans - Dapaglifozin, Empaglifozin
SGLT2 inhibitors Right Ans - -Used with EF < 40%
-Appropriate for NYHA class II-IV
-Contraindicated in type 1 DM (increased risk ketoacidosis)
SGLT2 inhibitors Right Ans - -Blocks SGLT2 protein in the proximal tubule
of the nephron, reducing the amount of reabsorbed glucose and sodium into
the blood
-Results in glycosuria, resulting in natriuresis and diuresis
True Right Ans - T/F: ARNI is superior to ARB
ARNI Right Ans - Valsartan/sacubril (Entresto)
ARNI Right Ans - Recommended as first line therapy for chronic HF NYHA
class II-IV in patients who have access to this drug class
ARNI Right Ans - Do not administer with ACEI or within 36 hours of last
ACEI dose or to patients with history of angioedema
Valsartan component of Entresto Right Ans - Component of this drug has
black box warning for fetal toxicity
Isosorbide + hydralazine (Bidil) Right Ans - -Venodilator + arteriodilator
, Reduces morbidity and mortality in patients who identify as black with class
III-IV HFrEF who are on optimal doses of ACEI/ARB and BB, unless
contraindicated
Ivabradine (Corlanor) Right Ans - Selectively inhibits the current in the SA
node and reduces HR
· Does not affect myocardial contractility
· Inhibits If (HCN) channels (mixed sodium=potassium channels)
Ivabradine (Corlanor) Right Ans - Indicated for:
· Sinus rhythm with a HR > or = 70 BPM
· Patients on maximally tolerated doses of GMDT meds
· Adjunct therapy for chronic, stable HFrEF (EF < 35%)
Digoxin Right Ans - -Can be considered for all patients with HFrEF who
have not responded symptomatically to other GDMT
-Does not affect mortality
-Commonly initiated and maintained at a dose of 0.125 to 0.25 mg daily
Digoxin Right Ans - Caution if stopping - withdrawal can lead to worsening
HF symptoms
Aldosterone antagonists Right Ans - Spironolactone, Eplerenone
Aldosterone antagonists Right Ans - Do not use if GFR < 30 mL/min/1.73
m2 or if potassium > 5.0 mEq/dL
Vericiguat Right Ans - For high risk patients with HFrEF on optimal GDMT
to reduce hospitalizations and death
-Oral soluble guanylyl cyclase stimulator
-Increases cGMP production
Omega-3 polyunsaturated fatty acid (PUFA) supplementation Right Ans -
Reasonable to use as adjunctive therapy to reduce mortality and
hospitalizations in patients with HF class II-IV with symptoms
Potassium binders Right Ans - Sodium polystyrene sulfonate (Kayexalate)
Patiromer (Veltassa)
Sodium zirconium cyclosilicate (Lokelma)
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller LeCrae. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $14.99. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
67866 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now