NSG 533 ADVANCED PHARMACOLOGY TEST 1 LATEST ACTUAL EXAM 100 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES| Latest Update
4 views 0 purchase
Course
NSG
Institution
NSG
EP is a 38-year-old female patient that comes in for diabetes education and management.
She was diagnosed 12 years ago and states lately she is not able to control her diet although
she continues a 1600 calorie diet with appropriate daily carbohydrate intake (per dietitian
prescription) and w...
TestTrackers: Unlock Your Exam Potential! | Quality Practice Materials | Boost Your Confidence Today!
NSG 533 ADVANCED PHARMACOLOGY
TEST 1 LATEST 2024-2025 ACTUAL EXAM
100 QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES| Latest
Update
EP is a 38-year-old female patient that comes in for diabetes education and management.
She was diagnosed 12 years ago and states lately she is not able to control her diet although
she continues a 1600 calorie diet with appropriate daily carbohydrate intake (per dietitian
prescription) and walks 40 minutes every day of the week. She states compliance with all
medications. She denies any history of hypoglycemia despite being able to identify signs and
symptoms and describe appropriate treatment strategies.
PMH: T2DM, HTN, obesity, depression, s/p thyroidectomy due to thyroid cancer
FmHx: Noncontributory
SHx: (−) Smoking, alcohol use, past marijuana use while in high school
, TestTrackers: Unlock Your Exam Potential! | Quality Practice Materials | Boost Your Confidence Today!
✓ Exenatide - Exenatide (Bydureon) once weekly has been able to demonstrate weight loss
and decrease A1C% by 0.7% to 1.2% in clinical trials; however it is contraindicated for
EP due to the self-reported history of thyroid cancer.
✓ Dapagliflozin - Dapagliflozin (Farxiga) is contraindicated in this patient due to
hyperkalemia which could be made worse by this drug. The package insert does not
indicate a specific potassium concentration cut off to no longer use this medication;
however, there are better choices in this patient.
✓ Sitagliptin - Sitagliptin (Januvia) is able to obtain an A1C goal of less than 7% based on
clinical trials and currently the patient does not have any cautionary objective measures to
not use this medication. DPP-IV inhibitors are weight neutral. DPP-IV inhibitors can be
used in patients taking sulfonylureas; however, it may be recommended to reduce or stop
the sulfonylurea dose.
✓ Acarbose - Acarbose (Precose) is not recommended for initial management and is
associated with significant GI side effects. More information would be needed regarding
fasting and post-prandial numbers. In addition, adding acarbose would only lower A1c
by 0.8% at best and therefore would not achieve the desired A1C goal of <7%
JR is a 68-year-old African American man with a new diagnosis of T2DM. He was classified as
having prediabetes (at risk for developing diabetes) 5 years before the diagnosis and has a
strong family history of type 2 diabetes. JR's blood pressure was 150/92 mm Hg. His
laboratory results revealed an A1C of 8.1%, normal cholesterol panel, and normal
renal/hepatic function were noted with today's laboratory test results.
Past medical history: Hypertension (diagnosed 4 y ago) Hyperlipidemia (diagnosed 2 y ago)
Pancreatitis (idiopathic) (acute hospitalization 3 y ago)
, TestTrackers: Unlock Your Exam Potential! | Quality Practice Materials | Boost Your Confidence Today!
✓ Metformin is the drug of choice recommended for most patients with diabetes in addition
to lifestyle modifications assuming no contraindications or intolerabilities are present upon
evaluation. Metformin has also shown to provide positive weight neutral/loss effects in
obese patients. It is crucial to know the renal status of patients commencing metformin
therapy to limit the risk of lactic acidosis (JR is without contraindication).
✓ Since his entry A1C is >7.5%, dual therapy is indicated. There are several potential
choices. The second step can be a dipeptidyl peptidase-4 inhibitor, it can be a glucagon-
like peptide-1 (GLP-1) receptor agonist, it can be a TZD, it can be a sulfonylurea agent,
it can be a SGLT2 inhibitor, or it could be basal insulin. Anything next can be tried
depending on what suits the circumstance
✓ DPP4 inhibitors are weight neutral bet relatively benign side effect profile. Sitagliptin has
been associated with case reports of pancreatitis, so this specific agent should be avoided.
$$$
✓ GLP-1 analog and has data to support an A1C reduction necessary to gain glycemic
control and may assist with weight loss goals for this patient. New information suggests
these agents may provide benefits in those with ASCVD. JR has a past history of
pancreatitis and GLP-1 analogs are not recommended due to this contraindication
✓ TZDs have data to support an A1C reduction necessary to gain glycemic control, but are
associated with weight gain, negative effects on lipids and increased risk of fracture. Until
recently, TZDs have also been linked to increased CV events and use has fallen out of
favor
✓ Sulfonylureas provide excellent A1C lowering, but are also associated with weight gain.
They also have the potential to cause hypoglycemia, so patient education is crucial.
Because of his allergies to "sulfa", use would be contr
A patient with type 1 diabetes reports taking propranolol for hypertension. What concern
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 TestTrackers. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $14.49. You're not tied to anything after your purchase.
