Test #2

Question 1

How do you determine if someone may have had too many anticholinergic drugs or have an anticholinergic toxidrome?

Answer 1

• flushed skin
• dilated pupils
• difficulty seeing (visual disturbances)
• urinary retention
• dry mouth
• confusion
• hyperthermia
• tachycardia
• tremors
• absent bowel sounds

Question 2

what indicates poor control of asthma

Answer 2

Increased wheezing, SOB
Daytime symptoms > 4 days/week
Nighttime symptoms >1 time/week
>4 doses/week of a SABA (may use 1 dose/ day to prevent exercise induced symptoms)
Poor spirometry results

Question 3

heart failure: class 1

Answer 3

a patient who is not limited in normal physical activity by symptoms

Question 4

heart failure: class 2

Answer 4

ordinary physical activity results in fatigue, dyspnea, or other symptoms

Question 5

heart failure: class 3

Answer 5

marked limitation in normal physical activity

Question 6

heart failure: class 4

Answer 6

symptoms at rest or with any physical activity at all

Question 7

medications for heart failure with preserved EF

Answer 7

ACE inhibitors or ARBs
Aldosterone Antagonists (MRAs)
Beta blockers
nitrates

Question 8

medications for heart failure with reduced EF

Answer 8

ARNI (or ACEI/ARB)
Beta blocker
Aldosterone Antagonists (MRAs)
SGLT2 inhibitor

Question 9

main drugs to treat angina

Answer 9

Nitrates
Beta blockers
Calcium channel blockers

Question 10

drugs for heart failure

Answer 10

ACE inhibitors
Angiotensin II Receptor Blockers (ARBs)
Beta blockers
Aldosterone antagonists (spironolactone)

Question 11

INR (aka prothrombin time (PT))

Answer 11

Indications for an INR would be:
- monitoring those with a coagulation factor deficiency
disseminated intravascular coagulation (a condition that causes abnormal clotting)
- baseline sample before starting anticoagulation therapy
- monitoring while on anticoagulation therapy
- and liver function assessment
- associated with WARFARIN

if not on anticoagulation a normal value is usually around 1.0
those on anticoagulation therapy, the therapeutic INR is usually between 2.0-3.0

Question 12

partial thromboplastin time (PTT)

Answer 12

normal PTT for someone not on heparin is between 25 to 35

for someone on heparin therapeutic range for PTT is 45-70 (or 1.5-2.5 x the baseline value)

Common reasons to order a PTT include:
- Assessment of blood disorders
- During heparin therapy
- Preoperatively
- associated with HEPARIN

Question 13

Protein-calorie malnutrition (or starvation-related malnutrition)

Answer 13

anorexia nervosa

Question 14

chronic disease related malnutrition

Answer 14

Dietary intake does not meet the tissues needs due to the disease (but it would under normal conditions)
ie. inflammatory conditions, Cancer, rheumatoid arthritis, organ failure, etc.

Question 15

acute disease or injury related malnutrition

Answer 15

Examples: major infections, burns, trauma, etc

Question 16

how to maintain NG tube patency

Answer 16

• Requires routine flushing
• Flushed with 30mL of warm tap water every 4 hours during continuous feedings or before and after each intermittent feeding
• Sterile water used in immunocompromised patients
• Tubes must be flushed between each medication and after all meds are given
• Try to use only liquid meds

Question 17

metabolic syndrome

Answer 17

At least 3/5 must exceed the cutoff levels for diagnosis
- Elevated waist circumference
- Elevated triglycerides
- Low HDL (good cholesterol)
- Elevated blood pressure
- Elevated fasting glucose levels

Question 18

5 A’s of Obesity Management

Answer 18

Ask, Assess, Advise, Agree, and Assist
- Ask for permission to discuss weight
- Assess risk & potential causes of weight gain
- Advise on risks, benefits, and options
- Agree on weight loss goals and plans
- Assist with education, resources & follow up care