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HTN,Lipid Meds

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Test Prep for Pharm
Maggie Throckmorton
Quiz by Maggie Throckmorton, updated more than 1 year ago
Maggie Throckmorton
Created by Maggie Throckmorton over 6 years ago
17
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Resource summary

Question 1

Question
T or F. African Americans respond better to a Thiazide diuretic.
Answer
  • True
  • False

Question 2

Question
T or F. Beta blockers are 1st line drugs for HTN.
Answer
  • True
  • False

Question 3

Question
Select all that apply. Which of the following are thiazide diuretics.
Answer
  • HCTZ
  • Indapamide
  • Lasix
  • Spironolactone
  • Metolazone

Question 4

Question
Which class of diuretics inhibits distal convoluted tubule sodium and chloride re-absorption?
Answer
  • Loop
  • Potassium Sparing
  • Potassium Wasting

Question 5

Question
Select all that apply. Which of the following electrolyte imbalances can occur with thiazide diuretics?
Answer
  • Hypokalemia
  • Hypehalemia
  • Hypercalcemia
  • Hypocalcemia
  • Hyponatremia
  • Hypernatremia
  • Hypomagnesemia
  • Hypermagnesemia

Question 6

Question
Chlorthalidone and indapamide, are longer acting thiazide diuretics, more potent than HCTZ and carry a higher risk for hypokalemia.
Answer
  • True
  • False

Question 7

Question
A dose of HCTZ greater than _____mg has an increased risk for hypokalemia.
Answer
  • 30mg
  • 70mg
  • 50mg
  • 60mg

Question 8

Question
What should the NP monitor when a patient is on thiazide diuretics? Select all that apply.
Answer
  • BUN
  • Serum Creatinine or CrCl
  • Heart rate
  • Blood pressure
  • Vision changes
  • Electrolytes

Question 9

Question
T or F. Thiazide diuretics are commonly combined with other anti-hypertensives.
Answer
  • True
  • False

Question 10

Question
T or F. Thiazide diuretics are contraindicated in persons with gout as they increase uric acid.
Answer
  • True
  • False

Question 11

Question
T or F. Loop diuretics are used more often for edema than HTN.
Answer
  • True
  • False

Question 12

Question
The following are exemplar Loop Diuretics:
Answer
  • Lasix
  • HCTZ
  • Lisinopril
  • Bumetanide
  • Indapamide
  • Metolazone
  • Toresemide

Question 13

Question
Identify the MOA for loop diuretics from the choices below:
Answer
  • Inhibits distal convoluted tubule Na+ and Cl reabsorption
  • Inhibits Loop of Henle and proximal/distal convoluted tubule Na+ and Cl reabsorption
  • Stops the conversion of Angiotensin I to Angiotensin II

Question 14

Question
Loop diuretics are contraindicated in patients with:
Answer
  • Shellfish allergies
  • Sulfa allergies
  • Diabetes
  • Edema

Question 15

Question
Loop diuretics:
Answer
  • Increase K+ and decrease Urea
  • Increase WBG
  • Decrease K+ and Increase Urea
  • Increase neutrophils

Question 16

Question
T or F. Potassium Sparing Diuretics have weak diuretic activity.
Answer
  • True
  • False

Question 17

Question
Exemplars of Potassium Sparing Diuretics Includes: (select all that apply)
Answer
  • Triameterene
  • Lasix
  • Bumentanide
  • Spironalactone
  • HCTZ
  • Eplerenone

Question 18

Question
Spironolactone:
Answer
  • Decreases K+ and Urea
  • Increases K+ and decreases Urea
  • Increases K+ and Urea
  • Increases Na+

Question 19

Question
Lisinopril should be d/c if serum K+ increases more than?
Answer
  • 40%
  • 15%
  • 20%
  • 30%

Question 20

Question
Which ACE is not used often for maintenance therapy d/t a short half-life and multiple dosing?
Answer
  • Benazepril
  • Catorpil
  • Lisinopril
  • Ramipril

Question 21

Question
If a patient is at high risk for renal artery stenosis, how soon after initiating ACEI should the patient's Cr be checked?
Answer
  • 1 week
  • 1 month
  • 48 hours
  • 3-5 days

Question 22

Question
Which patient populations have a greater risk of developing angioedema with the use of ACEI? Select all that apply.
Answer
  • Asian
  • Latino
  • Pacific Islander
  • Caucasian
  • African American

Question 23

Question
ACEI therapy is preferred for the following populations (select all that apply):
Answer
  • Patient's with Diabetic Kidney Disease
  • Pregnant Women
  • Patients with DM
  • Young patients
  • Patients who are Post MI
  • Patients with Heart Failure
  • Patients with Angina

Question 24

Question
ACEI and ARBS can have the following additional positive effects (select all that apply):
Answer
  • Improve oxygenation to the heart
  • Decrease inappropriate remodeling of heart muscle after MI
  • Reduce effects of diabetes on the kidneys
  • Improve insulin sensitivity
  • All of the Above

Question 25

Question
What is a possible inconvenient but not life threatening adverse reaction from ACEI therapy?
Answer
  • Itching
  • Bradykinin mediated cough
  • Edema
  • Tachycardia

Question 26

Question
ACEI can increase K+
Answer
  • True
  • False

Question 27

Question
An increase in Cr with ACEI therapy is often transient.
Answer
  • True
  • False

Question 28

Question
What is the most common adverse reaction to ACEI therapy?
Answer
  • SOB
  • Hypotension
  • Bradycardia
  • Fever

Question 29

Question
The following are exemplars for ARBS (select all that apply)
Answer
  • Lisinopril
  • Losartan
  • Amlodipine
  • Valsartan
  • Verapamil
  • Olmesartan

Question 30

Question
ARBS prevent the binding of Angiotensin II to receptors in the kidneys, brain, heart and arterial walls-inhibit RAAS and cause fall in peripheral resistance.
Answer
  • True
  • False

Question 31

Question
ARBS may never be combined with which class of drug?
Answer
  • Thiazide diuretics
  • ACEI
  • CC Blockers
  • Direct Renin Inhibitors

Question 32

Question
ACEI and ARBS should be avoided in:
Answer
  • Women who are pregnant or may become pregnant
  • Menopausal women
  • Patients with DM
  • The elderly

Question 33

Question
ARBS can be a good choice for patients with Gout because:
Answer
  • There is decreased uric acid secretion
  • Increased uric acid secretion

Question 34

Question
T or F. ARBS can raise serum K+.
Answer
  • True
  • False

Question 35

Question
The Direct Renin Inhibitor Tekturna shares this possible side effect with ACEI.
Answer
  • Increased WBG
  • Angioedema
  • Cough
  • Decreased K+

Question 36

Question
T or F. Tekturna can increase serum K+.
Answer
  • True
  • False

Question 37

Question
T or F. ARBS are contraindicated in patients with Renal Artery Stenosis.
Answer
  • True
  • False

Question 38

Question
T or F. You can combine ACEI, ARBS and DRI.
Answer
  • True
  • False

Question 39

Question
The following is true of dihydropyridine CCB (select all that apply):
Answer
  • Are potent vasodilators that lower calcium influx into the smooth muscle.
  • Have little or no negative effect on cardiac contractility and conduction.
  • Can treat chronic stable angina
  • Can be used in patients with CHF

Question 40

Question
Dihyropyridine CCB include (select all that apply)
Answer
  • Norvasc
  • Losartan
  • Nifedipine
  • Benazepril
  • Felodipine

Question 41

Question
T or F. Peripheral edema can be caused by amlodipine.
Answer
  • True
  • False

Question 42

Question
Which class of drugs can be combined with Amlodipine to reduce peripheral edema?
Answer
  • ARBS
  • DRI
  • ACES
  • Thiazide Diuretics

Question 43

Question
Dihyrdopyridine CCB have greater efficacy in African Americans.
Answer
  • True
  • False

Question 44

Question
T or F. ACEI can never be prescribed to African Americans.
Answer
  • True
  • False

Question 45

Question
The following is true of non-dihyrdopyridine CCB (select all that apply):
Answer
  • Can treat A-fib
  • Can be effective in proteinuria reduction.
  • Have a depressive effect on cardiac contractility and conduction
  • Should be avoided in patients who are taking beta blockers

Question 46

Question
T or F. Verapamil has the strongest inotropic effect of the non-dihyrdopyridine CCB and should be avoided in patients with Heart Failure.
Answer
  • True
  • False

Question 47

Question
Verapamil can interact with the following (select all that apply):
Answer
  • Simvastatin
  • Lithium
  • Amiodarone
  • Codeine
  • Spironalactone

Question 48

Question
T or F. Beta blockers are 1st line in the treatment of HTN.
Answer
  • True
  • False

Question 49

Question
Cardio-selective beta-blockers include (select all that apply):
Answer
  • Atenolol
  • Metropolol
  • Coreg
  • Propranolol
  • Bisoprolol
  • Esmolol
  • Acebutolol

Question 50

Question
Propranolol is a non-cardioselective beta-blocker that is used for symptom management with which endocrine issue:
Answer
  • Hypothyroidism
  • Hyperthyroidism

Question 51

Question
T or F. CCB and Beta-blockers can used for prophylactic treatment of migraines.
Answer
  • True
  • False

Question 52

Question
T or F. Beta-blockers are superior protection against stroke.
Answer
  • True
  • False

Question 53

Question
An example of mixed alpha and beta blocker is:
Answer
  • Carvedilol (coreg)
  • Nadolol
  • Atenolol
  • Propranolol

Question 54

Question
What is major consideration when prescribing a beta-blocker in a patient with DM?
Answer
  • It can mask hypogylcemia
  • It can cause tachycardia
  • Can improve blood glucose
  • Protects against strokes

Question 55

Question
In a patient with decompensated bronchospastic disease with stable angina, the NP should prescribe:
Answer
  • A beta-blocker
  • A cardio-selective dihydropyridine
  • ACEI
  • Aspirin

Question 56

Question
S/E of beta-blockers can include (select all that apply):
Answer
  • Hypotension
  • Bradycardia
  • Fatigue
  • Depression
  • 2nd and 3rd degree AV Block
  • Angioedema

Question 57

Question
T or F. Discontinuation of beta-blockers needs to occur over a few weeks.
Answer
  • True
  • False

Question 58

Question
Clonodine belongs to which class of anti-hypertensives?
Answer
  • ACEI
  • DRI
  • Beta-blockers
  • Centrally Acting Agents

Question 59

Question
Centrally acting agents can be used to treat which condition in pediatric patients.
Answer
  • Depression
  • Dry Mouth
  • ADHD
  • Dizziness

Question 60

Question
Possible Adverse Reactions to Centrally Acting Agents includes (select all that apply):
Answer
  • Fatigue
  • Dry mouth
  • Lightheadedness
  • Rash
  • Hypoglycemia
  • Bradycarida

Question 61

Question
T or F. Patients wanting to come off of clonidine need to be tapered due to risk for rebound HTN.
Answer
  • True
  • False

Question 62

Question
Methyldopa is indicated in which population?
Answer
  • Elderly
  • Pregnant women
  • Adolescents
  • African Amercians

Question 63

Question
A contraindication for Methyldopa is:
Answer
  • Kidney Disease
  • DM
  • CHF
  • Active Hepatic Disease

Question 64

Question
T or F. The MOA of methyldopa is it stimulates the Alpha 2 adrenergic receptors.
Answer
  • True
  • False

Question 65

Question
Prazosin a peripherally acting agent, while not a 1st line anti-hypertensive is effective in treating:
Answer
  • Anigna
  • HF
  • PTSD and associated night terrors
  • The elderly

Question 66

Question
T or F. Doxazosin should be taken at bedtime due to risk for postural lightheadedness.
Answer
  • True
  • False

Question 67

Question
The following should be avoided in pregnancy (select all that apply):
Answer
  • ACEI
  • ARBS
  • Direct Renin Inhibitors
  • Sprionolactone
  • Eplerenone
  • Methyldopa

Question 68

Question
In addition to methyldopa, which two other drugs are commonly used for HTN in pregnancy:
Answer
  • Lisinopril and Clonidine
  • Norvasc and Tekturna
  • Losartan and Spironalactone
  • Labetalol and Nifedipine

Question 69

Question
T or F. Betablockers are not recommended as initial therapy in children.
Answer
  • True
  • False

Question 70

Question
Which class of diuretics is used in fluid volume overload?
Answer
  • Thiazide
  • Potassium Sparing
  • Loop
  • HCTZ

Question 71

Question
When using Digoxin to treat Stage C Heart Failure, the NP knows which medicine can upset the narrow therapeutic index of the drug:
Answer
  • Diltiazem
  • Benazapril
  • Spironolactone
  • ASA

Question 72

Question
T or F. Digoxin increases myocardial contractility.
Answer
  • True
  • False

Question 73

Question
The therapeutic index for digoxin is:
Answer
  • 0.10-0.20
  • 0.1-0.3
  • 0.5-0.9
  • 0.3-0.8

Question 74

Question
T or F. Low K+ and Mg+ and high Ca+ increase the risk for digoxin toxicity.
Answer
  • True
  • False

Question 75

Question
Signs of toxicity to tell your patient who is taking digoxin are (select all that apply):
Answer
  • Seeing green and yellow halos
  • Delirium and confusion
  • Insomina
  • Weakness
  • Dry Mouth

Question 76

Question
HMG CoA reductase inhibitors are more commonly known as:
Answer
  • Statins
  • ARBS
  • Fibrates
  • Omega 3 Fatty Acids

Question 77

Question
The primary treatment goal of statins is to:
Answer
  • Increase LDL
  • Increase HDL
  • Decrease LDL
  • Increase Liver Function

Question 78

Question
T or F. It is fine for pregnant women or women planning to become pregnant to take simvastatin.
Answer
  • True
  • False

Question 79

Question
Which group of patients could benefit from statins:
Answer
  • Age 21 years> with an LDL>190
  • Patients with active liver disease
  • African American Females
  • Smokers

Question 80

Question
Statins should be discontinued if which lab value if it is >3x the normal value?
Answer
  • GGT
  • TSH
  • ALT
  • WBG

Question 81

Question
There is an increased risk of myopathy/rhabdomyolysis with which drug interactions:
Answer
  • gemfibrozil and statins
  • Statins and ACEI
  • Beta-blockers and Statins
  • Calcium channel blockers and statins

Question 82

Question
What lab level should be checked if a patient complains of muscle pain while taking a statin?
Answer
  • Vitamin D
  • B12
  • Platelets
  • Hgb

Question 83

Question
T or F. New onset DM is less common with pravastatin and pitavastatin.
Answer
  • True
  • False

Question 84

Question
Before changing a patient to new statin. the NP should ensure the patient has been adhering to their current statin medication by checking:
Answer
  • BP
  • CMP
  • Lipid panel
  • Fasting Blood Glucose

Question 85

Question
T or F. Short acting statins like Lovastatin should be taken at bedtime?
Answer
  • True
  • False

Question 86

Question
Lower doses of rosuvastatin is recommended in which population?
Answer
  • African Americans
  • Latinos
  • Canadians
  • Asians

Question 87

Question
One of the advantages of zetia over statins is:
Answer
  • You can give it to children younger than 10 y/o
  • It is indicated for use in pregnant women
  • It raises HDL
  • It raises LDL

Question 88

Question
T or F. The MOA of Zetia is the inhibition of cholesterol at the small intestine.
Answer
  • True
  • False

Question 89

Question
PCSK9 Inhibitors like Alirocumab and Evolocumab:
Answer
  • Are inexpensive
  • Are powerful at lowering LDL
  • Are less effective than statins
  • Can be taken orally

Question 90

Question
T or F. Alirocumab must be stored in the refrigerator.
Answer
  • True
  • False

Question 91

Question
T or F. PCSK9 inhibitors should be avoided in pregnancy.
Answer
  • True
  • False

Question 92

Question
What is one way to decrease the flushing side effect that can come with the use of Niacin?
Answer
  • Take it with milk
  • Take it at bedtime
  • Take 325mg ASA 30 minutes before
  • Take it on an empty stomach

Question 93

Question
T or F. Fibrates are only taken to reduce high triglycerides.
Answer
  • True
  • False

Question 94

Question
Gemfibrozil and Fenofibrate should not be taken with statins because:
Answer
  • Increased risk for heart palpitations
  • Increase risk for drug interactions
  • They potentiate each other
  • Causes flushing

Question 95

Question
Fibrates should be avoided in (Select all that apply)
Answer
  • Hepatic Impairment
  • Lactation
  • Pregnancy
  • In children over age 10 with Triglycerides >500

Question 96

Question
T or F. Statins can be used in children older than age ten with an elevated LDL.
Answer
  • True
  • False

Question 97

Question
Omega 3 Fatty Acids are helpful in reducing:
Answer
  • Trigylcerides
  • WBG
  • HDL
  • Muscle Pain
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