Question

Question 1 2 / 2 points

When blood glucose levels are difficult to control in type 2 diabetes some form of insulin may be added to the treatment regimen to control blood glucose and limit complication risks. Which of the following statements is accurate based on research?

Question options:

Premixed insulin analogues are better at lowering HbA1C and have less risk for hypoglycemia.

Premixed insulin analogues and the newer premixed insulins are associated with more weight gain than the oral antidiabetic agents.

Newer premixed insulins are better at lowering HbA1C and postprandial glucose levels than long-acting insulins.

Patients who are not controlled on oral agents and have postprandial hyperglycemia can have neutral protamine Hagedorn insulin added at bedtime.

Question 2 2 / 2 points

Prior to prescribing metformin, the provider should:

Question options:

Draw a serum creatinine to assess renal function

Try the patient on insulin

Tell the patient to increase iodine intake

Have the patient stop taking any sulfonylurea to avoid dangerous drug interactions

Question 3 2 / 2 points

Insulin preparations are divided into categories based on onset, duration, and intensity of action following subcutaneous injection. Which of the following insulin preparations has the shortest onset and duration of action?

Question options:

Lispro

Glulisine

Glargine

Detemir

Question 4 2 / 2 points

The drugs recommended for older adults with type 2 diabetes include:

Question options:

Second-generation sulfonylureas

Metformin

Pioglitazone

Third-generation sulfonylureas

Question 5 2 / 2 points

Women with an intact uterus should be treated with both estrogen and progestin due to:

Question options:

Increased risk for endometrial cancer if estrogen alone is used

Combination therapy provides the best relief of menopausal vasomotor symptoms

Reduced risk for colon cancer with combined therapy

Lower risk of developing blood clots with combined therapy

Question 6 2 / 2 points

Bisphosphonate administration education includes:

Question options:

Taking it on a full stomach

Requiring sitting erect for at least 30 minutes afterward

Drinking it with orange juice

Taking it with H2 blockers or proton pump inhibitors (PPI) to protect the stomach

Question 7 2 / 2 points

Long-term use of androgens requires specific laboratory monitoring of:

Question options:

Glucose, calcium, testosterone, and thyroid function

Calcium, testosterone, PSA, and liver function

Calcium, testosterone, PSA, liver function, glucose, and lipids

CBC, testosterone, PSA, and thyroid level

Question 8 2 / 2 points

Patients taking hormonal contraceptives and hormone replacement therapy need to take the drug daily at the same time to prevent:

Question options:

Nausea

Breakthrough bleeding

Breast tenderness

Pregnancy

Question 9 2 / 2 points

The mechanism of action of oral combined contraceptives that prevents pregnancy is:

Question options:

Estrogen prevents the luteinizing hormone surge necessary for ovulation.

Progestins thicken cervical mucus and slow tubal motility.

Estrogen thins the endometrium making implantation difficult.

Progestin suppresses follicle stimulating hormone release.

Question 10 2 / 2 points

When starting a patient with hypothyroidism on thyroid replacement hormones patient education would include:

Question options:

They should feel symptomatic improvement in 1 to 2 weeks.

Drug adverse effects such as lethargy and dry skin may occur.

It may take 4 to 8 weeks to get to euthyroid symptomatically and by laboratory testing.

Because of its short half-life, levothyroxine doses should not be missed.

 

 

Question

Question 1 1 / 1 point

Ray has been diagnosed with hypertension and an angiotensin-converting enzyme inhibitor is determined to be needed. Prior to prescribing this drug, the NP should assess for:

Question options:

Hypokalemia

Impotence

Decreased renal function

Inability to concentrate

Question 2 1 / 1 point

Which of the following create a higher risk for digoxin toxicity? Both the cause and the reason for it must be correct.

Question options:

Older adults because of reduced renal function

Administration of aldosterone antagonist diuretics because of decreased potassium levels

Taking an antacid for gastroesophageal reflux disease because it increases the absorption of digoxin

Doses between 0.25 and 0.5 mg/day

Question 3 1 / 1 point

Juanita had a deep vein thrombosis (DVT) and was on heparin in the hospital and was discharged on warfarin. She asks her primary care provider NP why she was getting both medications while in the hospital. The best response is to:

Question options:

Contact the hospitalist as this is not the normal guideline for prescribing these two medications and she may have had a more complicated case.

Explain that warfarin is often started while a patient is still on heparin because warfarin takes a few days to reach effectiveness.

Encourage the patient to contact the Customer Service department at the hospital as this was most likely a medication error during her admission.

Draw anticoagulation studies to make sure she does not have dangerously high bleeding times.

Question 4 1 / 1 point

Robert, age 51 years, has been told by his primary care provider (PCP) to take an aspirin a day. Why would this be recommended?

Question options:

He has arthritis and this will help with the inflammation and pain.

Aspirin has anti-platelet activity and prevents clots that cause heart attacks.

Aspirin acidifies the urine and he needs this for prostrate health.

He has a history of GI bleed, and one aspirin a day is a safe dosage.

Question 5 1 / 1 point

Education of patients who are taking warfarin includes discussing their diet. Instructions include:

Question options:

Avoiding all vitamin K-containing foods

Avoiding high-vitamin K-containing foods

Increasing intake of iron-containing foods

Making sure they eat 35 grams of fiber daily

Question 6 0 / 1 point

Pernicious anemia is treated with:

Question options:

Folic acid supplements

Thiamine supplements

Vitamin B12

Iron

Question 7 1 / 1 point

Valerie presents to the clinic with menorrhagia. Her hemoglobin is 10.2 and her ferritin is 15 ng/mL. Initial treatment for her anemia would be:

Question options:

18 mg/day of iron supplementation

6 mg/kg per day of iron supplementation

325 mg ferrous sulfate per day

325 mg ferrous sulfate tid

Question 8 1 / 1 point

Kyle has Crohn’s disease and has a documented folate deficiency. Drug therapy for folate deficiency anemia is:

Question options:

Oral folic acid 1 to 2 mg per day

Oral folic acid 1 gram per day

IM folate weekly for at least 6 months

Oral folic acid 400 mcg daily

Question 9 1 / 1 point

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?

Question options:

Calcium channel blockers

Beta blockers

Angiotensin-converting-enzyme (ACE) inhibitors

Aspirin

Question 10 1 / 1 point

The rationale for prescribing calcium blockers for angina can be based on the need for:

Question options:

Increased inotropic effect in the heart

Increasing peripheral perfusion

Keeping heart rates high enough to ensure perfusion of coronary arteries

Help with rate control

Question 11 1 / 1 point

Which of the following drugs has been associated with increased risk for myocardial infarction in women?

Question options:

Aspirin

Beta blockers

Estrogen replacement

Lipid-lowering agents

Question 12 1 / 1 point

Increased life expectancy for patients with heart failure has been associated with the use of:

Question options:

ACE inhibitors, especially when started early in the disease process

All beta blockers regardless of selectivity

Thiazide and loop diuretics

Cardiac glycosides

Question 13 1 / 1 point

Digoxin has a very limited role in treatment of heart failure. It is used mainly for patients with:

Question options:

Ejection fractions above 40%

An audible S3

Mitral stenosis as a primary cause for heart failure

Renal insufficiency

Question 14 1 / 1 point

Which of the following classes of drugs is contraindicated in heart failure?

Question options:

Nitrates

Long-acting dihydropyridines

Calcium channel blockers

Alpha-beta blockers

Question 15 1 / 1 point

What is considered the order of statin strength from lowest effect to highest?

Question options:

Lovastatin, Simvastatin, Rosuvastatin

Rosuvastatin, Lovastatin, Atorvastatin

Atorvastatin, Rosuvastatin, Simvastatin

Simvastatin, Atorvastatin, Lovastatin

Question 16 1 / 1 point

First-line therapy for hyperlipidemia is:

Question options:

Statins

Niacin

Lifestyle changes

Bile acid-binding resins

Question 17 1 / 1 point

Han is a 48-year-old diabetic with hyperlipidemia and high triglycerides. His LDL is 112 mg/dL and he has not tolerated statins. He warrants a trial of a:

Question options:

Sterol

Niacin

Fibric acid derivative

Bile acid-binding resin

Question 18 1 / 1 point

Hypertensive African Americans are typically listed as not being as responsive to which drug groups?

Question options:

ACE inhibitors

Calcium channel blockers

Diuretics

Bidil (hydralazine family of medications)

Question 19 0 / 1 point

Because of its action on various body systems, the patient taking a thiazide or loop diuretic may also need to receive the following supplement:

Question options:

Potassium

Calcium

Magnesium

Phosphates

Question 20 1 / 1 point

An ACE inhibitor and what other class of drug may reduce proteinuria in patients with diabetes better than either drug alone?

Question options:

Beta blockers

Diuretics

Nondihydropyridine calcium channel blockers

Angiotensin II receptor blockers

 

Health Assessments

Most community health assessments involve the analysis of some type of population-based data. However, there are many different data sources and statistical techniques that can be used. The question then becomes, which statistical sources are most appropriate for describing health problems? In short, it is essential for you to review some of the basic statistical techniques used in these analyses.

Utilizing resources such as interviews of key staff, documents at your local government health offices, and the Internet, compile your observations about the types of statistics used in describing health problems within your community. Based on your observations and understanding, respond to the following:

 

• Examine and explain the types of statistics used in describing health problems.
• Describe an odds ratio.
• Describe relative risk.
• Describe a confidence interval (CI).

Identify three specific impacts of social factors on the healthcare system, and write a three-page essay detailing how healthcare providers and/or members of a healthcare ethics committee can impact change in these areas for a more equitable healthcare system. Your essay should be a minimum of three pages in length. Use a minimum of three sources, including your textbook. All sources used must be referenced; paraphrased and quoted material must have accompanying citations. The essay and all references and citations used must be formatted using APA style.