MN 553 FINAL EXAM 2023-2024 ACTUAL EXAM 2 LATEST VERSIONS A & B EACH VERSION CONTAINS 100 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (100% VERIFIED ANSWERS) |ALREADY GRADED A+||BRAND NEW!!

MN 553 FINAL EXAM 2023-2024 ACTUAL EXAM 2 LATEST VERSIONS& B EACH VERSION CONTAINS 100 QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES (100% VERIFIED
ANSWERS) |ALREADY GRADED A+||BRAND NEW!!
VERSION A

1. Which of the following statements is true about acute pain?
2. Somatic pain comes from body surfaces and is only sharp and well-localized.
3. Visceral pain comes from the internal organs and is most responsive to acetaminophen and opiates.
4. Referred pain is present in a distant site for the pain source and is based on activation of the same spinal segment
   as the actual pain site.
5. Acute neuropathic pain is caused by lack of blood supply to the nerves in a given area.
6. One of the main drug classes used to treat acute pain is NSAIDs. They are used because:
7. They have less risk for liver damage than acetaminophen.
8. Inflammation is a common cause of acute pain.
9. They have minimal GI irritation.
10. Regulation of blood flow to the kidney is not affected by these drugs.
11. The goal of treatment of acute pain is:
12. Pain at a tolerable level where the patient may return to activities of daily living
13. Reduction of pain with a minimum of drug adverse effects
14. Reduction or elimination of pain with minimum adverse reactions
15. Adequate pain relief without constipation or nausea from the drugs
16. Pathological similarities and differences between acute pain and chronic pain include:
17. Both have decreased levels of endorphins.
18. Chronic pain has a predominance of C-neuron stimulation.
19. Acute pain is most commonly associated with irritation of peripheral nerves.
20. Acute pain is diffuse and hard to localize.
    Allopurinol
21. Which antigout medication is used to treat chronic tophaceous gout?
    a. Allopurinol (Zyloprim)
    b. Colchicine
    c. Probenecid (Benemid)
    d. Sulfinpyrazone (Anturane)
22. The nurse is assessing a patient who has gout who will begin taking allopurinol (Zyloprim). The nurse reviews
    the patient’s medical record and will be concerned about which laboratory result?
    a. Elevated BUN and creatinine
    b. Increased serum uric acid
    c. Slight increase in the white blood count
    d. Increased serum glucose
23. The nurse provides teaching for a patient who will begin taking allopurinol. Which statement by the patient
    indicates understanding of the teaching?
    a. I should increase my vitamin C intake.
    b. I will get yearly eye exams.
    c. I will increase my protein intake.
    d. I will limit fluids to prevent edema.
24. Larry is taking allopurinol to prevent gout. Monitoring of a patient who is taking allopurinol includes:
25. Complete blood count
26. Blood glucose
27. C-reactive protein
28. BUN, creatinine, and creatinine clearance
    Angina
29. Isosorbide dinitrate is prescribed for a patient with chronic stable angina. This drug is administered
    twice daily, but the schedule is 7 a.m. and 2 p.m. because:
30. It is a long-acting drug with potential for toxicity.
31. Nitrate tolerance can develop.
32. Orthostatic hypotension is a common adverse effect.
33. It must be taken with milk or food.
34. Art is a 55-year-old smoker who has been diagnosed with angina and placed on nitrates. He
    complains of headaches after using his nitrate. An appropriate reply might be:
35. This is a parasympathetic response to the vasodilating effects of the drug.
36. Headaches are common side effects with these drugs. How severe are they?
37. This is associated with your smoking. Let’s work on having you stop smoking.
38. This is not related to your medication. Are you under a lot of stress?
39. Elderly patients who are started on levothyroxine for thyroid replacement should be monitored for:
40. Excessive sedation
41. Tachycardia and angina
42. Weight gain
43. Cold intolerance
44. 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?
45. Calcium channel blockers
46. Beta blockers
47. Angiotensin-converting-enzyme (ACE) inhibitors
48. Aspirin
49. The New York Heart Association and the Canadian Cardiovascular Society have described grading
    criteria for levels of angina. Angina that occurs with unusually strenuous activity or on walking or
    climbing stair after meals is class:
50. I
51. II
52. III
53. IV
54. Patients at high risk for developing significant coronary heart disease are those with:
55. LDL values between 100 and 130
56. Systolic blood pressure between 120 and 130
57. Class III angina
58. Obesity
59. To reduce mortality, all patients with angina, regardless of class, should be on:
60. Aspirin 81 to 325 mg/d
61. Nitroglycerin sublingually for chest pain
62. ACE inhibitors or angiotensin receptor blockers
63. Digoxin
64. Patients who have angina, regardless of class, who are also diabetic, should be on:
65. Nitrates
66. Beta blockers
67. ACE inhibitors
68. Calcium channel blockers
69. Management of all types and grades of angina includes the use of lifestyle modification to reduce risk factors.
    Which of these modifications are appropriate for which reason? Both the modification and the reason for it must be
    true for the answer to be correct.
70. Lose at least 10 pounds of body weight. Excessive weight increases cardiac workload.
71. Reduce sodium intake to no more than 2,400 mg of sodium. Sodium increases blood volume and cardiac
    workload.
72. Increase potassium intake to at least 100 mEq/d. The heart needs higher levels of potassium to improve
    contractility and oxygen supply.
73. Intake a moderate amount of alcohol. Moderate intake has been shown by research to improve cardiac function.
74. Nitrates are especially helpful for patients with angina who also have:
75. Heart failure
76. Hypertension
77. Both 1 and 2
78. Neither 1 nor 2
79. Beta blockers are especially helpful for patients with exertional angina who also have:
80. Arrhythmias
81. Hypothyroidism
82. Hyperlipidemia
83. Atherosclerosis
84. Rapid-acting nitrates are important for all angina patients. Which of the following are true statements about their
    use?
85. These drugs are useful for immediate symptom relief when the patient is certain it is angina.
86. The dose is one sublingual tablet or spray every 5 minutes until the chest pain goes away.
87. Take one nitroglycerine tablet or spray at the first sign of angina; repeat every 5minutes for no more than two
    doses. If chest pain is still not relieved, call 911.
88. All of the above
89. Combinations of a long-acting nitrate and a beta blocker are especially effective in treating angina because:
90. Nitrates increase MOS and beta blockers increase MOD.
91. Their additive effects permit lower doses of both drugs and their adverse reactions cancel each other out.
92. They address the pathology of patients with exertional angina who have fixed atherosclerotic coronary heart
    disease.
93. All of the above
94. Drug choices to treat angina in older adults differ from those of younger adults only in:
95. Consideration of risk factors for diseases associated with and increased in aging
96. The placement of drug therapy as a treatment choice before lifestyle changes are tried
97. The need for at least three drugs in the treatment regimen because of the complexity of angina in the older adult
98. Those with higher risk for silent myocardial infarction
99. Cost of antianginal drug therapy should be considered in drug selection because of all of the following EXCEPT:
100. Patients often require multiple drugs
101. A large number of angina patients are older adults on fixed incomes
102. Generic formulations may be cheaper but are rarely bioequivalent
103. Lack of drug selectivity may result in increased adverse reactions
104. Situations that suggest referral to a specialist is appropriate include:
105. When chronic stable angina becomes unpredictable in its characteristics and precipitating factors
106. When a post-myocardial infarction patient develops new-onset angina
107. When standard therapy is not successful in improving exercise tolerance or reducing the incidence of angina
108. All of the above
109. The rationale for prescribing calcium blockers for angina can be based on the need for:
110. Increased inotropic effect in the heart
111. Increasing peripheral perfusion
112. Keeping heart rates high enough to ensure perfusion of coronary arteries
113. Help with rate control
114. Medications are typically started for angina patients when:
115. The first permanent EKG changes occur
116. The start of class I or II symptoms
117. The events trigger a trip to the emergency department
118. When troponin levels become altered
119. The most common cause of angina is:
120. Vasospasm of the coronary arteries
121. Atherosclerosis
122. Platelet aggregation
123. Low systemic oxygen
124. Ranolazine is used in angina patients to:
125. Dilate plaque-filled arteries
126. Inhibit platelet aggregation
127. Restrict late sodium flow in the myocytes
128. Induce vasoconstriction in the periphery to open coronary vessels
129. When is aspirin (ASA) used in angina patients?
130. All angina patients should be taking ASA unless it is contraindicated for allergy or other medical reasons.
131. ASA should only be used in men.
132. ASA has no role in angina, but is useful in MI prevention.
133. The impact of ASA is best at the time of an angina attack.
134. Robert is a 72-year-old patient who has hypertension and angina. He is at risk for common
     medication practices seen in the elderly including:
135. Use of another person’s medications
136. Hoarding medications
137. Changing his medication regimen without telling his provider
138. All of the above
     Angioedema
139. A potentially life-threatening adverse response to angiotensin-converting enzyme inhibitors is angioedema. Which
     of the following statements is true about this adverse response?
140. Swelling of the tongue or hoarseness are the most common symptoms.
141. It appears to be related to the decrease in aldosterone production.
142. Presence of a dry, hacky cough indicates a high risk for this adverse response.
143. Because it takes time to build up a blood level, it occurs after being on the drug for
     about 1 week.