MN 553 FINAL EXAM ACTUAL EXAM WITH

MN 553 FINAL EXAM | ACTUAL EXAM WITH

100% CORRECT ANSWERS| BRAND NEW/A+ GRADE

MN 553 FINAL EXAM VERSION A

• Which of the following statements is true about acute pain?
• Somatic pain comes from body surfaces and is only sharp and well-localized.
• Visceral pain comes from the internal organs and is most responsive to acetaminophen and

opiates.

• 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.

• Acute neuropathic pain is caused by lack of blood supply to the nerves in a given area.

• One of the main drug classes used to treat acute pain is NSAIDs. They are used because:
• They have less risk for liver damage than

acetaminophen.

• Inflammation is a common cause of acute pain.
• They have minimal GI irritation.
• Regulation of blood flow to the kidney is not affected by these drugs.

3. The goal of treatment of acute pain is:

• Pain at a tolerable level where the patient may return to activities of daily living
• Reduction of pain with a minimum of drug adverse effects
• Reduction or elimination of pain with minimum adverse reactions
• Adequate pain relief without constipation or nausea from the drugs

• Pathological similarities and differences between acute pain and chronic pain include:
• Both have decreased levels of endorphins.
• Chronic pain has a predominance of C-neuron stimulation.
• Acute pain is most commonly associated with irritation of peripheral nerves.
• Acute pain is diffuse and hard to localize.
• Which antigout medication is used to treat chronic

tophaceous gout?

• Allopurinol (Zyloprim)
• Colchicine
• Probenecid (Benemid)
• Sulfinpyrazone (Anturane)

• 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?

• Elevated BUN and creatinine
• Increased serum uric acid
• Slight increase in the white blood count
• Increased serum glucose

• The nurse provides teaching for a patient who will begin taking allopurinol. Which

statement by the patient indicates understanding of the teaching?

• I should increase my vitamin C

intake. 1 / 4

• I will get yearly eye exams.
• I will increase my protein intake.
• I will limit fluids to prevent edema.

• Larry is taking allopurinol to prevent gout. Monitoring of a patient who is taking allopurinol

includes:

• Complete blood count
• Blood glucose
• C-reactive protein
• BUN, creatinine, and creatinine clearance

• 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:

• It is a long-acting drug with potential for

toxicity.

• Nitrate tolerance can develop.
• Orthostatic hypotension is a common adverse effect.
• It must be taken with milk or food.

• 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:

• This is a parasympathetic response to the vasodilating effects

of the drug.

• Headaches are common side effects with these drugs. How

severe are they?

• This is associated with your smoking. Let’s work on having you stop smoking.
• This is not related to your medication. Are you under a lot of stress?

• Elderly patients who are started on levothyroxine for thyroid replacement should be monitored

for:

• Excessive sedation
• Tachycardia and angina
• Weight gain
• Cold intolerance

• 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?

• Calcium channel blockers
• Beta blockers
• Angiotensin-converting-enzyme (ACE) inhibitors
• Aspirin

• 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:

• I

2. II

3. II

I 4. 2 / 4

IV

• Patients at high risk for developing significant coronary heart disease are those with:
• LDL values between 100 and 130
• Systolic blood pressure between 120

and 130

• Class III angina
• Obesity

• To reduce mortality, all patients with angina, regardless of class,

should be on:

• Aspirin 81 to 325 mg/d
• Nitroglycerin sublingually for chest pain
• ACE inhibitors or angiotensin receptor blockers
• Digoxin

• Patients who have angina, regardless of class, who are also diabetic, should be on:
• Nitrates
• Beta

blockers

3. ACE

inhibitors

• Calcium channel blockers

• 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.

• Lose at least 10 pounds of body weight. Excessive weight increases cardiac workload.
• Reduce sodium intake to no more than 2,400 mg of sodium. Sodium increases blood

volume and cardiac workload.

• Increase potassium intake to at least 100 mEq/d. The heart needs higher levels of

potassium to improve contractility and oxygen supply.

• Intake a moderate amount of alcohol. Moderate intake has been shown by research to improve

cardiac function.

8. Nitrates are especially helpful for patients with angina who also have:

• Heart failure
• Hypertensi

on

• Both 1

and 2

• Neither 1 nor 2

• Beta blockers are especially helpful for patients with exertional angina

who also have

• Arrhythmias
• Hypothyroidism
• Hyperlipidemia
• Atherosclerosis

• Rapid-acting nitrates are important for all angina patients. Which of the following are true

statements about their use?

• These drugs are useful for immediate symptom relief when the patient is certain it is angina. 3 / 4

• The dose is one sublingual tablet or spray every 5 minutes until the chest pain goes away.
• 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.

• All of the above

• Combinations of a long-acting nitrate and a beta blocker are especially effective in treating

angina because:

• Nitrates increase MOS and beta blockers increase MOD.
• Their additive effects permit lower doses of both drugs and their adverse reactions cancel each

other out.

• They address the pathology of patients with exertional angina who have fixed

atherosclerotic coronary heart disease.

• All of the above

• Drug choices to treat angina in older adults differ from those of

younger adults only in:

• Consideration of risk factors for diseases associated with and increased

in aging

• The placement of drug therapy as a treatment choice before lifestyle changes are tried
• The need for at least three drugs in the treatment regimen because of the complexity of angina

in the older adult

• Those with higher risk for silent myocardial infarction

• Cost of antianginal drug therapy should be considered in drug selection because of all of the

following EXCEPT:

• Patients often require multiple drugs
• A large number of angina patients are older adults on

fixed incomes

• Generic formulations may be cheaper but are rarely

bioequivalent

• Lack of drug selectivity may result in increased adverse reactions

16. Situations that suggest referral to a specialist is appropriate include:

• When chronic stable angina becomes unpredictable in its characteristics and precipitating

factors

• When a post-myocardial infarction patient develops new-onset angina
• When standard therapy is not successful in improving exercise tolerance or reducing the

incidence of angina

• All of the above

• The rationale for prescribing calcium blockers for angina can be based on the need for:
• Increased inotropic effect in the heart
• Increasing peripheral perfusion
• Keeping heart rates high enough to ensure perfusion of

coronary arteries

• Help with rate control

18. Medications are typically started for angina patients when:

• The first permanent EKG

changes occur

• The start of class I or II symptoms
• The events trigger a trip to the emergency department
• When troponin levels become altered
• / 4