Case Discussion: Heart Failure

Case Discussion: Heart Failure

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Question 332 pts A primary care NP sees a patient who is being treated for heart failure with digoxin, a loop diuretic, and an ACE inhibitor. The patient reports having nausea. The NP notes a heart rate of 60 beats per minute and a blood pressure of 100/60 mm Hg. The NP should: decrease the dose of the diuretic to prevent further dehydration. obtain a serum potassium level to assess for hyperkalemia. hold the ACE inhibitor until the patient’s blood pressure stabilizes. obtain a digoxin level before the patient takes the next dose of digoxin. Question 342 pts A patient who is taking an oral anticoagulant is in the clinic in the late afternoon and reports having missed the morning dose of the medication because the prescription was not refilled. The primary care NP should counsel this patient to: avoid foods that are high in vitamin K for several days. take a double dose of the medication the next morning. refill the prescription and take today’s dose immediately. skip today’s dose and resume a regular dosing schedule in the morning. Question 352 pts A primary care NP has prescribed phentermine for a patient who is obese. The patient loses 10 lb in the first month but reports that the drug does not seem to be suppressing appetite as much as before. The NP should: discontinue the phentermine. increase the dose of phentermine. continue the phentermine at the same dose. change to a combination of phentermine and topiramate. Question 362 pts A 45-year-old patient who has a positive family history but no personal history of coronary artery disease is seen by the primary care NP for a physical examination. The patient has a body mass index of 27 and a blood pressure of 130/78 mm Hg. Laboratory tests reveal low-density lipoprotein, 110 mg/dL; high-density lipoprotein, 70 mg/dL; and triglycerides, 120 mg/dL. The patient does not smoke but has a sedentary lifestyle. The NP should recommend: 30 minutes of aerobic exercise daily. taking 81 to 325 mg of aspirin daily. beginning therapy with a statin medication. starting a thiazide diuretic to treat hypertension.