BIOS MISC NURSING EXAM WITH BEST QUESTIONS AND ANSWERS 100% VERIFIED, Exams of Nursing

Download BIOS MISC NURSING EXAM WITH BEST QUESTIONS AND ANSWERS 100% VERIFIED and more Exams Nursing in PDF only on Docsity! Question 2 2 / 2 pts BIOS MISC NURSING EXAM WITH BEST QUESTIONS AND ANSWERS 100% VERIFIED Question 1 0 / 0 pts I understand the value of doing my own work and learning this skill to support my future independent practice as a nurse practitioner. I understand that while there may be opportunities beyond my faculty’s control to collaborate or share answers with peers, that it would not benefit my own personal and professional growth to do so. I agree to do my own work and take personal responsibility for my learning. I do not. I do Use the Mark Jones case study to answer the following question. How do thiazide diuretics differ from loop diuretics? Thiazide diuretics act on the early distal convoluted tubules while loop diuretics act on the ascending loop of Henle Thiazide diuretics act on the proximal convoluted tubule while loop diuretics act on the ascending loop of Henle Loop diuretics act on the proximal convoluted tubule while thiazide diuretics act on the late distal convoluted tubule Loop diuretics act on the early distal convoluted tubules while thiazide diuretics act on the ascending loop of Henle BIOS MISC NURSING EXAM WITH BEST QUESTIONS AND ANSWERS 100% VERIFIED Loop diuretics act on the thick segment of the ascending limb of the loop of Henle to block reabsorption of sodium and chloride while thiazide diuretics promote urine IncorrectQuestion 7 0 / 2 pts Question 6 2 / 2 pts Use the Mark Jones case study to answer the following question. What is your recommendation to Mark on the use of NSAIDs considering his new diagnosis of hypertension? Mark should switch his NSAID to ketorolacMark should switch his NSAID to ketorolac Mark can continue NSAID use liberally Mark should add on a topical NSAIDs Mark should stop taking NSAIDS Mark should stop taking NSAIDS as they cause fluid retention. NSAIDs promote sodium and water retention, by inhibiting renal prostaglandin synthesis. This inhibition also leads to increased plasma volume and may lead to an increase in peripheral resistance. Use the Mark Jones case study to answer the following question. The NP decided to write Mark a prescription for 1 year of hydrochlorothiazide. What errors are contained in this prescription? Select all that apply. Refills DISP Medicatio n Question 8 2 / 2 pts IncorrectQuestion 9 0 / 2 pts Sig For 1 year the refills should be #11 if filling for a 30-day supply. The sig is missing the route and should not use “qd” abbreviation per ISMP guidelines. Use the Mark Jones case study to answer the following question. What lifestyle modifications would you counsel Mark on? Select all that apply. Moderate alcohol consumption Eat healthy Reduce sodium intake to less than 3,400mg/day Moderate to vigorous physical activity Per JNC 8 the follow is recommended: • Smoking Cessation • Control blood glucose and lipids • Diet: Eat healthy (i.e., DASH diet), Moderate alcohol consumption, Reduce sodium intake to no more than 2,400 mg/day • Physical activity: Moderate-to-vigorous activity 3-4 days a week averaging 40 min per session. Use the Mark Jones case study to answer the following question. If a beta-blocker was indicated for Mark and he had a past medication history that Question 10 2 / 2 pts consisted of asthma, which beta-blocker would be best to prescribe? Carvedilol Labetalol Sotalol Bisoprolol Beta-1 selective beta blockers are likely the safest to use in COPD/asthma patients due to their selectivity for cardiac beta 1 receptors. Use the Mark Jones case study to answer the following question. Regarding Mark’s prescription. What education would you provide him on checking his blood pressure, taking his medication, side effects, next follow up appointment, and labs that need to be monitored. Select all that apply. The initial HCTZ dose is generally 50-100mg per day Labs to monitor include renal status, electrolytes, and liver function. Side effects include hypokalemia, and muscle aches. Recheck lipid panel in 6-8 weeks. Question 15 2 / 2 pts Question 14 2 / 2 pts Use the Mark Jones case study to answer the following question. According to the JNC 8 guidelines, what class of medication can be prescribed for treating Mark’s hypertension. Select all that apply. Spironolactone Calcium channel blocker Beta blocker Thiazide diuretics JNC8 recommends initiating a thiazide-type diuretic, or CCB alone or in combination for the following reasons: 1. Thiazides produce better CV outcomes (including reduced stroke risk) than ACEIs in African Americans. 2. African Americans have high stroke risk and CCBs provide better stroke prevention and blood pressure reduction in African Americans vs ACEIs. Based on the recommendations, I would start HCTZ 12.5mg po qd, monitor BPs, max the dose out if no improvement in BP and then add a CCB if needed. MOA for thiazide diuretics: Act on the early potion of the distal tubule to inhibit the NACl reabsorption. By decreasing sodium reabsorption, thiazide use acutely results in an increase in fluid loss to urine, which leads to decreased extracellular fluid (ECF) and plasma volume. This volume loss results in diminished venous return, increased renin release, reduced cardiac output and decreased blood pressure. Use the Mark Jones case study to answer the following question. Diuretics are an important part of caring for patients with various cardiac diseases. Which diuretic(s) can adversely cause an increase in potassium levels? Select all that apply. triamterene (Dyrenium) Question 16 2 / 2 pts furosemide (Lasix) spironolactone (Aldactone) hydrochlorothiazide (Microzide) Spironolactone is a renal competitive aldosterone antagonist. It inhibits the effect of aldosterone by competing for the aldosterone-dependent sodium- potassium exchange site in the distal tubule cells. This increases the secretion of water and sodium, while decreasing the excretion of potassium (Micromedex) Triamterene, a potassium-sparing diuretic, inhibits the reabsorption of sodium in exchange for potassium and hydrogen ions by exerting a direct effect on the distal renal tubule (Micromedex) Use the Mark Jones case study to answer the following question. Which antihypertensive medication is available in a patch formulation? Select all that apply. Clonidine Minoxidil Furosemide Methyldopa Clonidine is available in a weekly patch formulation for drug resistant hypertension Question 18 2 / 2 pts Question 17 2 / 2 pts Use the Charlie George case study to answer the following question. What is Charlie's CHA2DS2-VASc score? 3 2 1 4 1 for hypertension 2 for age 1 for diabetes Use the Charlie George case study to answer the following question. Which of the following are categories of anti-dysrhythmic drugs that can be considered for Charlie to help control is atrial fibrillation? Select all that apply. Sodium channel blockers Potassium channel blockers Beta blockers In the atria and ventricles, they reduce contractility Question 23 2 / 2 pts On the alpha receptors, they induce vasoconstriction In the SA node, they reduce automaticity In the AV node, they slow conduction velocity Beta blockers slow action potential and reduce automaticity, slow conduction velocity, and reduce contractility through their interaction with beta receptors. Use the Charlie George case study to answer the following question. If the NP decided to write a prescription for warfarin for Charlie, which choice is the best to write on the prescription? Take 2.5mg by mouth every for atrial fibrillation with an INR goal of 2.5-3.5 Take 2.5mg by mouth every day Take 2.5mg by mouth every for atrial fibrillation with an INR goal of 2-3 Take 2.5mg every day for atrial fibrillation with an INR goal of 2-3 It is best practice to include dose, route, frequency, and indication. In this case, it is also crucial to define Charlies INR goal for follow-up purposes. Since he has non-valvular atrial fibrillation his INR goal would be 2-3. Question 25 2 / 2 pts Question 24 2 / 2 pts Use the Charlie George case study to answer the following question. Charlie has multiple follow-up visits, and it is decided that he will require treatment with ezetimibe. The NP decides to write for a 12-month total supply, providing 3 months at a time. Which of the following is the correct dispensing quantity and refill numbers? DISP 30 Refills 4 DISP 30 Refills 3 DISP 90 Refills 3 DISP 90 Refills 4 A 3-month supply will equal 90 tablets and will require 3 refills (9-months coverage) with the initial prescription for 3-months providing the patients with a 12-month total supply. Use the Charlie George case study to answer the following question. Which of the following medications is considered a direct thrombin inhibitor anticoagulant? Warfarin Apixaban Dabigatran IncorrectQuestion 26 0 / 2 pts Question 27 2 / 2 pts Rivaroxaban Rivaroxaban and apixaban are factor Xa inhibitors. Warfarin is a vitamin k antagonist. Dabigatran is a direct thrombin inhibitor. Use the Charlie George case study to answer the following question. If Charlie was already on a maximal dose of a high intensity statin and his LDL remained elevated, which agent would be recommended to initiate? Nicotinic Acid PCSK9-I Ezetimibe Bile acid sequestrant Per the guidelines: If on a maximal statin and LDL-C is above 70mg/dL, adding ezetimibe is reasonable. If PCSK9-I is considered, add ezetimibe to maximal statin before initiating. Use the Charlie George case study to answer the following question. Which of the following are HMG-CoA reductase inhibitors that could be used for Charlies hyperlipidemia? Colesevelam Gemfibrozil Question 32 2 / 2 pts What are important side effects to monitor for in Charlie if statin therapy is initiated? Select all that apply. Hepatotoxicity Renal toxicity Myopathy Rhabdomyolysis Myopathy, rhabdomyolysis, and hepatoxicity are important side effects to monitor for in patients who are taking statins. Use the Charlie George case study to answer the following question. If long-term amiodarone therapy was indicated for Charlie, which toxicities would need to be monitored for? Select all that apply. Select all that apply. Thyrotoxicity Skeletal toxicity Renal toxicity Pulmonary toxicity Amiodarone can have many toxicities, notable ones include thyroid toxicity, dermatologic toxicity, and pulmonary toxicity. Question 34 2 / 2 pts Question 33 2 / 2 pts Use the Charlie George case study to answer the following question. What is the role of gemfibrozil in therapy? Primarily used to increase HDL Primarily used to decrease triglycerides Primarily used to decrease LDL Primarily used to decrease cholesterol Gemfibrozil is generally used to decrease triglyceride levels. Use the Charlie George case study to answer the following question. Per the American College of Cardiology, what is Charlies 10-year ASCVD risk? 34.8% 56.3% 50.6% 43.7% IncorrectQuestion 35 0 / 2 pts PartialQuestion 36 1.33 / 2 pts Per the ACC calculator Charlies 1-0year ASCVD risk is 56.3%, he is considered high risk. Use the Charlie George case study to answer the following question. Which statin(s) would be most appropriate to initiate for Charlie? Select all that apply. Pravastatin 80mg Atorvastatin 10mg Atorvastatin 40mg Rosuvastatin 20mg Charlie requires a high intensity statin, only atorvastatin at doses of 40mg or higher and rosuvastatin at doses 20mg or higher are considered high intensity statins. Use the Charlie George case study to answer the following question. Which of the following are considered high-risk conditions for future ASCVD events? Select all that apply. Diabetes mellitus History of congestive heart failure Hypertension Question 40 2 / 2 pts IncorrectQuestion 41 0 / 2 pts Included on an RX for best practice: medication, dose, route, frequency, indication. The initial starting dose of spironolactone is 12.5-25mg once daily. Use the Janie Smith case study to answer the following question. If Janie required digoxin therapy, what hemodynamic benefit(s) would this provide? Select all that apply. Increased sympathetic tone Decrease urine output Increased cardiac output Decreased renin release Digoxin has several hemodynamic benefits in heart failure, they include increased cardiac output, decreased sympathetic tone, increased urine production, and decreased renin release. Use the Janie Smith case study to answer the following question. Which beta blockers are approved for use in heart failure patients? Select all that apply. Bisoprolol Metoprolol tartrate Carvedilol Question 42 2 / 2 pts Question 43 2 / 2 pts Metoprolol succinate Controlled trials have shown that three beta blockers can improve LV ejection fraction, increase exercise tolerance, slow progression of HF, reduce the need for hospitalization, and prolong survival. These three are: carvedilol, bisoprolol, and metoprolol succinate Use the Janie Smith case study to answer the following question. What is considered the most serious adverse effect of digoxin? Dizziness Dysrhythmias Pulmonary toxicity Hepatic toxicity Dysrhythmias are considered the most serious adverse effect of digoxin as they can be life threatening. Therefore, drug levels are closely monitored. Use the Janie Smith case study to answer the following question. Which medication would promote the most profound diuresis for Janie? Spironolactone iw Furosemide Eplerenone is an aldosterone antagonist. Question 48 2 / 2 pts Question 47 2 / 2 pts Use the Janie Smith case study to answer the following question. What is the best plan to treat Janie’s lipid panel? Initiate a statin with a goal LDL-C reduction of 10-20% Moderate intensity statin with a goal LDL-C reduction of 30-49% Initiate a statin with a goal LDL-C reduction of greater than or equal to 50% Low intensity statin with a goal LDL-C reduction of 20-30% Per the guidelines given her age 0f 60 years old and high risk (ASCVD >20%) she would qualify for maximal LDL-C reduction of greater than 50%. Use the Janie Smith case study to answer the following question. When initiating furosemide for Janie, which electrolyte is crucial to monitor? Potassium Calcium Phosphorous Chlorid e Question 49 2 / 2 pts Question 50 2 / 2 pts Furosemide can frequently cause hypokalemia which can lead to serious EKG changes and needs to be closely monitored. Use the Janie Smith case study to answer the following question. When writing Janie a prescription for her lisinopril, which components are essential for completeness? Select all that apply. DEA number Patient allergies Name of medication Patient date of birth Essential components to a prescription: • Prescriber name, license number, and contact information • Prescriber U.S. Drug Enforcement Administration (DEA) number, if applicable (lisinopril is not a controlled substance and does not require a DEA number) • Patient name and date of birth • Patient allergies • Name of medication • Indication of medication (e.g., atenolol) • Medication strength (e.g., 25 mg, 500 mg/mL) • Dose of medication and frequency (e.g., 12.5 mg once daily) • Number of tablets or capsules to dispense • Number of refills Use the Janie Smith case study to answer the following question. Question 51 2 / 2 pts If Janie required a vasodilator as part of her heart failure treatment plan, which medications could be considered? Select all that apply. Isosorbide dinitrate Sacubitril Hydralazine Bisoprolol Isosorbide dinitrate and hydralazine in a fixed dose combination or as individual agents can be used as vasodilators in heart failure patients. Use the Janie Smith case study to answer the following question. What is Janie’s current 10-year ASCVD risk? 25.6% 48.2% 19.4% 14.2% Per ACC, her 10-year ASCVD risk is 25.6%.