How should a sublingual nitroglycerin tablet be taken?

Placed under the tongue and allowed to dissolve

Which areas are appropriate for applying nitroglycerin ointment? SATA

Hairless area on the arm, Chest, Leg or back, Abdomen

What are common adverse effects of nitroglycerin? SATA

Tolerance, Headache, Reflex tachycardia, Orthostatic hypotension

Which statement best describes stable angina?

Pain is predictable and relieved by rest or nitroglycerin

What are effects of Digoxin? SATA

Positive inotrope (increased contractility), Decreases heart rate, Decreases AV node conduction

How does alirocumab lower LDL cholesterol levels?

By increasing clearance of LDL particles through more LDL receptors

Which patient is at increased risk for myopathy when taking Atorvastatin?

70-year-old female with hypothyroidism

How often should lipid levels be monitored while a patient is on alirocumab?

Baseline and every 3–12 months

What is an important instruction for nitroglycerin sustained-release tablets?

Swallow whole without chewing or crushing

If chest pain persists 5 minutes after the first nitroglycerin tablet, what should be done? SATA

Call 911, Administer a second tablet, Chew an aspirin if available

Which of the following are key clinical considerations when giving IV amiodarone? SATA

Must be diluted into a non-PVC bag, Use in-line filter if given peripherally, Give via central line when possible

Which effects do calcium channel blockers (CCBs) have in stable angina? SATA

Decrease oxygen demand, Decrease afterload by dilating arteries, Decrease heart rate (verapamil and diltiazem)

What is the purpose of aspirin in the treatment of atherosclerosis?

Prevent clot (thrombus) formation

Which substances or medications can interact with Atorvastatin? (SATA)

Other drugs that cause myopathy, Grapefruit juice, CYP3A4 inhibitors

Which routes are used for maintenance therapy with nitroglycerin? SATA

Topical ointment, Sustained-release (SR) tablets, Transdermal patch

What are the mechanisms of action of nitroglycerin? SATA

Dilates coronary arteries to improve oxygen delivery, Reduces the workload on the heart, Dilates veins to reduce preload

Before administering alirocumab, what temperature-related instruction should be followed?

Allow the pen to come to room temperature for 30–40 minutes

What are classic symptoms of right-sided heart failure (AW HEAD)? SATA

Hepatomegaly, Anorexia and nausea, Edema, Weight gain

What does “MONA + BS” stand for in initial ACS treatment? SATA

Nitrates, Oxygen, Antiplatelet + Beta blocker, Morphine, Statin

What are possible outcomes of myocardial ischemia? SATA

Decreased cardiac output, Angina due to lactic acid buildup, Reduced contractility

Which of the following can decrease oxygen supply to the heart? SATA

Decreased arterial oxygen content, Decreased perfusion pressure, Coronary plaque

Which statements about CK and CK-MB are true? SATA

CK-MB is specific to cardiac muscle, CK is found in all muscle tissue, CK-MB levels rise in myocardial infarction

Which of the following are adverse effects of Alirocumab? (SATA)

Urticaria, Relatively well tolerated, Rash, Injection site reactions, Vasculitis

What is the fundamental pathophysiology of coronary artery disease (CAD)?

Imbalance between cardiac oxygen supply and demand

When is an ARNI (e.g., sacubitril/valsartan) used in HFrEF?

When ACE inhibitor or ARB is ineffective

Which of the following make the vascular endothelium more vulnerable to injury? SATA

Hypertension, Hyperlipidemia, Hyperglycemia

Which of the following put a patient at increased risk for myopathy when taking Atorvastatin? (SATA)

Kidney impairment, Elderly, Hypothyroidism, Female gender

What type of tissue makes up the vascular endothelium involved in atherosclerosis?

Modified simple squamous epithelium

Amiodarone is used for rhythm control in AFib. What is its mechanism of action? SATA

Blocks potassium channels in myocardial tissue, Prolongs cardiac action potential

How do beta blockers help in HFrEF?

Decrease sympathetic stimulation

Which of the following conditions is a contraindication for Ezetimibe use? (SATA)

Pregnancy, Active hepatic disease, Breastfeeding

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PHR 3101 Final Exam

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Questions 194

Answers

1
If amiodarone is added to a patient on warfarin, the warfarin dose should be:
Increased by 50%
Reduced by 25–50%
Switched to aspirin
Discontinued immediately
2
How should a sublingual nitroglycerin tablet be taken?
Chewed and swallowed
Placed between cheek and gum
Placed under the tongue and allowed to dissolve
Swallowed with water
3
Which areas are appropriate for applying nitroglycerin ointment? SATA
Feet
Scalp
Hairless area on the arm
Chest
Leg or back
Abdomen
4
What are common adverse effects of nitroglycerin? SATA
Hypertension
Tolerance
Headache
Reflex tachycardia
Dry mouth
Orthostatic hypotension
5
What diagnostic test determines ejection fraction and evaluates heart failure severity?
Chest X-ray
CT scan
Electrocardiogram
Echocardiogram
6
Which statement best describes stable angina?
Caused by sudden arterial rupture
Pain always occurs during sleep
Pain is unpredictable and unrelated to exertion
Pain is predictable and relieved by rest or nitroglycerin
7
What is the therapeutic range for serum Digoxin?
2.0–4.0 ng/ml
1.5–2.5 ng/ml
0.1–0.3 ng/ml
0.5–0.9 ng/ml
8
What are effects of Digoxin? SATA
Positive inotrope (increased contractility)
Decreases heart rate
Increases AV node conduction
Decreases AV node conduction
9
Which medication is emphasized for rhythm control in AFib?
Furosemide
Warfarin
Verapamil
Amiodarone
10
How does alirocumab lower LDL cholesterol levels?
By increasing clearance of LDL particles through more LDL receptors
By decreasing hepatic cholesterol synthesis
By breaking down LDL cholesterol in the bloodstream
By preventing cholesterol reabsorption in the kidneys
11
Are beta blockers (e.g., metoprolol, carvedilol) recommended for variant angina?
Only used with nitrates
Yes, they increase oxygen supply
No, they are not used
Yes, they prevent vasospasm
12
Which patients are more sensitive to Digoxin?
Diabetics
Liver failure patients
Those with hypothyroidism
Elderly
13
Which patient is at increased risk for myopathy when taking Atorvastatin?
35-year-old female with mild anemia
70-year-old female with hypothyroidism
25-year-old male with no medical history
40-year-old male with asthma
14
How often should lipid levels be monitored while a patient is on alirocumab?
Every 6–8 weeks only
Annually
Baseline and every 3–12 months
Only when symptoms appear
15
What is an important instruction for nitroglycerin sustained-release tablets?
Dissolve under the tongue
Chew for faster onset
Swallow whole without chewing or crushing
Crush and mix with food
16
If chest pain persists 5 minutes after the first nitroglycerin tablet, what should be done? SATA
Wait 10 more minutes without action
Call 911
Administer a second tablet
Chew an aspirin if available
17
Which of the following are key clinical considerations when giving IV amiodarone? SATA
Must be diluted into a non-PVC bag
Use in-line filter if given peripherally
Give via central line when possible
Must be given as an IM injection
18
Which effects do calcium channel blockers (CCBs) have in stable angina? SATA
Decrease oxygen demand
Increase contractility
Decrease afterload by dilating arteries
Decrease heart rate (verapamil and diltiazem)
19
What is the purpose of aspirin in the treatment of atherosclerosis?
Improve blood sugar control
Prevent clot (thrombus) formation
Reduce blood pressure
Lower cholesterol
20
What is the typical triglyceride-lowering effect of Gemfibrozil and Fenofibrate?
15–25%
70–90%
5–10%
30–60%
21
Which substances or medications can interact with Atorvastatin? (SATA)
Other drugs that cause myopathy
Grapefruit juice
Acetaminophen
CYP3A4 inhibitors
22
Which routes are used for maintenance therapy with nitroglycerin? SATA
Topical ointment
Sustained-release (SR) tablets
Sublingual
Transdermal patch
23
Which medications are commonly used for rate control in AFib?
Amiodarone
Metoprolol
Diltiazem
Digoxin
24
What are the mechanisms of action of nitroglycerin? SATA
Constricts coronary arteries to improve perfusion
Dilates coronary arteries to improve oxygen delivery
Reduces the workload on the heart
Dilates veins to reduce preload
25
Before administering alirocumab, what temperature-related instruction should be followed?
Shake the pen vigorously for 1 minute
Allow the pen to come to room temperature for 30–40 minutes
Freeze the pen for 30 minutes to activate it
Warm the pen in hot water before use
26
What must be done before using translingual spray for the first time?
Prime it
Refrigerate it
Dilute with water
Shake vigorously
27
Patients with AFib have a ___-fold increased risk of ischemic stroke.
5
3
2
10
28
What is the function of digoxin in heart failure?
Vasodilator
Positive inotrope
Diuretic
Beta blocker
29
What are classic symptoms of right-sided heart failure (AW HEAD)? SATA
Pulmonary congestion
Hepatomegaly
Anorexia and nausea
Dyspnea
Edema
Weight gain
30
What should be done if a patient develops a hypersensitivity reaction while using alirocumab?
Discontinue the medication
Continue therapy with antihistamines
Switch to oral form
Lower the dose
31
How is Atorvastatin typically administered?
Oral
Intravenous
Subcutaneous injection
Transdermal patch
32
What does “MONA + BS” stand for in initial ACS treatment? SATA
Nitrates
Oxygen
Steroid
Antiplatelet + Beta blocker
Morphine
Statin
33
What are possible outcomes of myocardial ischemia? SATA
Decreased cardiac output
Increased cardiac output
Angina due to lactic acid buildup
Reduced contractility
34
Which of the following can decrease oxygen supply to the heart? SATA
Decreased arterial oxygen content
Decreased perfusion pressure
Increased preload
Coronary plaque
35
Which diagnostic tool can reveal ischemia, tachycardia, or extrasystole?
Cardiac MRI
Echocardiogram
Electrocardiogram (ECG)
Chest X-ray
36
Which statements about CK and CK-MB are true? SATA
CK-MB is specific to cardiac muscle
CK-MB is specific to skeletal muscle
CK is found in all muscle tissue
CK-MB levels rise in myocardial infarction
37
Which LVEF range is classified as HF with mid-range ejection fraction (HFmrEF)?
>50%
<30%
41–49%
60–75%
38
Which of the following are adverse effects of Alirocumab? (SATA)
Urticaria
Relatively well tolerated
Rash
Injection site reactions
Brittle nails
Vasculitis
39
What is the fundamental pathophysiology of coronary artery disease (CAD)?
Valve narrowing due to infection
Overproduction of red blood cells
Increase in pulmonary pressure
Imbalance between cardiac oxygen supply and demand
40
Which fibrate should not be given with statins due to high risk of myopathy?
Fenofibrate
Niacin
Both can be used safely
Gemfibrozil
41
What is the prototype anti-anginal drug?
Amlodipine
Nitroglycerin
Metoprolol
Atorvastatin
42
How long should patients wait after taking nitroglycerin before taking sildenafil?
2 hours
12 hours
At least 24 hours
6 hours
43
When is an ARNI (e.g., sacubitril/valsartan) used in HFrEF?
To replace beta blockers
When ACE inhibitor or ARB is ineffective
In addition to ACE inhibitors
For pulmonary edema only
44
Which of the following make the vascular endothelium more vulnerable to injury? SATA
Hypertension
Hyperlipidemia
Hyperglycemia
Hypotension
45
Which of the following put a patient at increased risk for myopathy when taking Atorvastatin? (SATA)
Kidney impairment
Hyperthyroidism
Elderly
Male gender
Hypothyroidism
Female gender
46
What type of tissue makes up the vascular endothelium involved in atherosclerosis?
Stratified squamous epithelium
Connective tissue
Modified simple squamous epithelium
Smooth muscle tissue
47
Amiodarone is used for rhythm control in AFib. What is its mechanism of action? SATA
Blocks potassium channels in myocardial tissue
Prolongs cardiac action potential
Stimulates SA node to increase rate
Blocks calcium channels
48
Which of the following is a contraindication for amiodarone?
Hypersensitivity to iodine
Diabetes mellitus
Hypertension
Atrial flutter
49
How do beta blockers help in HFrEF?
Increase contractility
Promote vasodilation
Decrease sympathetic stimulation
Block aldosterone
50
Which of the following conditions is a contraindication for Ezetimibe use? (SATA)
Renal failure
Pregnancy
Active hepatic disease
Breastfeeding
51
Which visual symptom may indicate Digoxin toxicity?
Yellow/green halos
Tunnel vision
Flashing red lights
Night blindness
52
What should be monitored when a patient is taking alirocumab?
Liver enzymes and hemoglobin A1c
Blood pressure and electrolyte levels
Lipid panel and signs of hypersensitivity
White blood cell count and INR
53
What can an echocardiogram determine in the evaluation of heart failure? SATA
Underlying cause
Left ventricular ejection fraction (LVEF)
Blood glucose levels
Severity of HF
54
Which drugs can interact with nitroglycerin and increase risk of hypotension? SATA
Warfarin
Other antihypertensives
Diuretics
Sildenafil
55
Ezetimibe is used as an adjunct to statin therapy.
True
False
56
Where should sublingual nitroglycerin be stored? SATA
Away from light and moisture
In a cool, dark place
In a bathroom medicine cabinet
In the original bottle
57
What is the primary mechanism of nitroglycerin in variant angina?
Increases preload
Prevents coronary vasospasm and increases oxygen supply
Reduces afterload
Decreases contractility
58
What NT-proBNP level is considered elevated and indicative of heart failure?
>100 pg/ml
>50 pg/ml
>300 pg/ml
>500 pg/ml
59
Which statement is true about amiodarone’s half-life?
3–5 hours
25–100 days
Less than 12 hours
It’s short, requiring frequent dosing
60
A patient on Atorvastatin reports muscle pain, tenderness, and weakness. What is the most likely concern?
Dehydration
Hepatitis
Myopathy
Allergy to statins
61
Which routes are used for rapid relief of angina symptoms? SATA
Topical ointment
Translingual spray
Sublingual
Transdermal patch
62
Before applying a new dose of nitroglycerin ointment, what should you do?
Rub it in thoroughly with bare hands
Wipe the old dose clean
Apply it over the last dose for better effect
Remove the previous dose completely
63
Which of the following can increase myocardial oxygen demand? SATA
Increased heart rate
Increased afterload
Increased contractility
Increased preload
64
Besides HFrEF, Digoxin can also be used to treat:
AV block
Sinus bradycardia
Ventricular fibrillation
Atrial fibrillation
65
Which systems drive the remodeling process in heart failure? SATA
Parasympathetic nervous system
RAAS
Sympathetic nervous system
Renal filtration system
66
Which fibrate may be used with statins if needed for high triglycerides?
Gemfibrozil
Fenofibrate
Ezetimibe
Lovastatin
67
Which of the following is not a common adverse effect of fibrates?
Myopathy
Gallstones
Hyperkalemia
GI issues like dyspepsia and nausea
68
Which of the following is true about the progression of heart failure?
Right-sided HF often leads to left-sided HF
Left-sided HF only affects the lungs
Right-sided HF rarely affects other organs
Left-sided HF can lead to right-sided HF
69
What is an important clinical consideration when discontinuing nitroglycerin maintenance therapy?
Increase dose slowly before stopping
Gradually taper to avoid rebound angina
Stop immediately if BP is normal
Switch to oral route permanently
70
What is atherosclerosis?
Hardening of veins due to calcium buildup
An infection of the arterial wall
A condition where arteries become narrowed by muscle overgrowth
A buildup of fat inside the arteries
71
Which of the following should a nurse advise a patient taking Atorvastatin to limit? (SATA)
Salt
Dairy products
Alcohol
Acetaminophen
72
Which statements are true regarding STEMI management? SATA
If PCI is unavailable, thrombolytics are used
PCI is the preferred treatment
Goal is door-to-balloon time of <90 minutes
Goal for thrombolytics is door-to-needle time <60 minutes
73
What route must Alirocumab be administered?
Oral
IV
Subcutaneous
IM
74
Which medications are included in the initial emergency treatment of ACS? SATA
Oxygen
Beta Blocker
Antiplatelet agent
Statin
Diuretic
Nitroglycerin
75
What route can Ezetimibe be administered?
Oral
IM
Subcutaneous
IV
76
What is the correct patient position when taking sublingual nitroglycerin?
Standing
Sitting or lying down
Reclined only if symptoms are severe
Walking slowly
77
What defines Paroxysmal Atrial Fibrillation?
Lasts more than 7 days
Never terminates, even with cardioversion
Terminates spontaneously within 7 days
Lasts more than 12 months
78
True or False: Atorvastatin must be taken with the evening meal to be effective.
False
True
79
Which medication is commonly used to stabilize and prevent plaque formation in atherosclerosis?
Nitroglycerin
Statins
Metformin
ACE inhibitors
80
What is the half-life (T½) of nitroglycerin?
10–12 hours
5–7 minutes
1 hour
30 minutes
81
What heart rate should prompt the nurse to hold Digoxin and notify the provider?
< 50 bpm
< 70 bpm
< 90 bpm
< 60 bpm
82
What is the primary benefit of spironolactone in HFrEF?
Fluid retention
Increased blood pressure
Some diuresis and potassium-sparing effect
Vasoconstriction
83
Which mechanism leads to long-term reduction in morbidity and mortality in HFrEF?
Inhibition of RAAS and sympathetic system
Reducing heart rate
Using positive inotropes
Decreasing preload and afterload
84
What drug classes are used to prevent acute coronary syndromes?
Antiplatelet and cholesterol-lowering drugs
ACE inhibitors and vasodilators
Beta blockers and digoxin
Diuretics and nitrates
85
When can sublingual nitroglycerin be used prophylactically?
30 minutes before anticipated exertion
At bedtime every night
Before climbing stairs if angina is triggered by exertion
Right after exercise
86
What is the most common type of heart disease?
Coronary artery disease
Heart failure
Cardiomyopathy
Heart valve disease
87
Which of the following is true about variant angina?
It is caused by a fixed obstruction
It always occurs during exercise
It is predictable and occurs at regular intervals
It can occur at rest and is unpredictable
88
Atherosclerosis can become dangerous when: (SATA)
Part of the plaque breaks off and causes an embolism
The arteries grow larger to accommodate plaque
Plaque ruptures and causes clot formation
Plaque becomes large and reduces blood flow
89
Which serum protein marker is the most sensitive indicator of myocardial infarction?
CK
CK-MB
Myoglobin
Troponin
90
Which of the following conditions is a contraindication for Colesevelam use? (SATA)
High LDL cholesterol
Pancreatitis due to triglycerides
Complete biliary or bowel obstruction
Hypertension
91
What should be checked prior to administering Digoxin?
Capillary refill
Temperature
Blood pressure
Apical pulse for 60 seconds
92
Which BNP value supports the diagnosis of heart failure?
>100 pg/m
<100 pg/ml
>50 pg/ml
>300 pg/ml
93
What is cardioversion?
Removal of a pacemaker
Ablation of cardiac tissue
Procedure for implanting a defibrillator
Medical or electrical restoration of normal rhythm
94
What causes variant (Prinzmetal) angina?
Coronary artery spasm
Increased venous return
Sudden loss of blood pressure
Overuse of beta blockers
95
What is the role of the TIMI score in ACS management?
Determines PCI candidacy
Guides discharge meds
Evaluates risk in unstable angina/NSTEMI
Used to diagnose STEMI
96
What is the main mechanism of action of alirocumab?
Inhibits triglyceride synthesis in adipose tissue
Blocks cholesterol absorption in the intestine
Stimulates bile acid production to reduce cholesterol
Inhibits PCSK9 to increase LDL receptor availability on liver cells
97
Why should sublingual nitroglycerin tablets be kept in the original bottle?
To protect from light and moisture
To prevent them from drying out
Because it improves absorption
Due to legal labeling requirements
98
Which type of AFib does not terminate, even with cardioversion?
Persistent
Permanent
Paroxysmal
Long-standing persistent
99
What are signs and symptoms of left-sided heart failure (DO CHAP)? SATA
Orthopnea
Dyspnea
Pulmonary congestion
Distended jugular vein
Adventitious breath sounds
Edema
100
What should be monitored regularly in patients on amiodarone? SATA
Liver function
ECG
Thyroid function
Pulmonary function
101
Which of the following are part of discharge and secondary prevention post-ACS? SATA
Diuretic
Nitroglycerin
ACE Inhibitor or ARB
Beta Blocker
Statin
Antiplatelet(s)
102
Risk of adverse effects increase when Ezetimibe is combined with statin or fibrate
False
True
103
Which of the following statements about rhabdomyolysis are true? (SATA)
It can lead to heart and kidney damage
It improves muscle strength
occurs when damaged muscle tissue release proteins/electrolytes in bloodstr
It is a minor side effect of statins
104
Symptoms of heart failure often reflect dysfunction in:
The kidneys
The right or left side of the heart
The liver
The nervous system
105
What route can Colsevalam be administered?
IM
IV ONLY
Sub Q
Oral tablets and suspension
106
A high TIMI score is most likely to result in which intervention?
Statin therapy only
Lifestyle counseling
Invasive strategy like PCI
Cardiac ablation
107
Which classifications of AFib last more than 7 days? SATA
Paroxysmal
Long-standing persistent
Permanent
Persistent
108
What are the approved routes of administration for Amiodarone?(Select all that apply)
Intramuscular injection
Oral
Intravenous (IV) infusion
Subcutaneous injection
109
What should patients be taught when taking Digoxin?
Check their pulse daily
Take at the same time each day
Recognize signs of hypokalemia
Take with antacids for absorption
110
In a coronary artery bypass graft (CABG), which vessels are typically used for grafting? SATA
Pulmonary artery
Carotid artery
Vein from the leg
Artery from the chest
111
How should other medications be scheduled when taking a bile acid sequestrant?
Only before bed
1 hour before or 4 hours after taking the sequestrant
At the same time with food
Only in the morning
112
Why are most statins taken with an evening meal?
They have sedative effects
Patients are more compliant at night
Cholesterol biosynthesis peaks at night
They interact with daytime meals
113
What is the therapeutic role of alirocumab?
Add-on to statins when more LDL lowering is needed
Used only in patients with triglyceride levels >500 mg/dL
First-line monotherapy for all patients with high cholesterol
Alternative to statins in patients with diabetes
114
Which are correct instructions for applying nitroglycerin topical ointment? SATA
Apply over previous dose for consistent absorption
Measure dose using applicator paper
Apply to a hairless area of the body
Wear gloves during application
115
Why do thiazide and loop diuretics increase Digoxin toxicity risk?
They raise potassium levels
They cause hypokalemia
They increase digoxin absorption
They increase digoxin metabolism
116
What are early symptoms of Digoxin toxicity (BANDAV)? SATA
Diarrhea
Abdominal pain
Increased appetite
Bradycardia
Visual disturbances
Anorexia
117
Which lifestyle and medical strategies help reduce cardiovascular risk in patients with atherosclerosis? SATA
Blood glucose control
High-fat diet
Fish oil
Exercise
Rest
Blood pressure control
118
Which of the following does not reverse the progression of HFrEF but offers symptomatic relief?
Reducing sympathetic stimulation
Reducing preload
Inhibition of RAAS
Reducing afterload
119
Colsevalam increase excretion of bile acids which results in cholesterol being used from blood to make more to lower LDL
True
False
120
What are hallmark signs and symptoms of heart failure? SATA
Fatigue
Intolerance to daily-life activities
SOB
Dyspnea
Edema (fluid retention)
Hypertension
121
Which condition describes left-sided heart failure?
Leads to systemic edema
Blood backs up into the lungs
Blood backs up into the body’s veins
Right ventricle cannot pump effectively
122
What are the effects of RAAS and SNS activation in heart failure? SATA
Promote cardiac fibrosis
Improve myocardial relaxation
Induce myocyte death
Lower blood volume
123
What causes angina during ischemia?
Lactic acid buildup from anaerobic metabolism
Overstretching of the heart muscle
High blood pressure
Inflammation of the myocardium
124
Which lifestyle components are part of post-ACS rehabilitation? SATA
Smoking cessation
Diet and exercise
Increased salt intake
Cardiac rehabilitation programs
125
How often should Alirocumab be administered?
Every 3-4 weeks
Every 15 days
Every 2 weeks or monthly
Daily
126
Which describe cardiac remodeling seen in heart failure? SATA
Spherical ventricle shape
Ventricular hypertrophy
Ventricular dilation
Increased ejection fraction
127
Which condition describes right-sided heart failure?
Blood backs up into the lungs
Pulmonary congestion
Adventitious breath sounds
Blood backs up into the systemic circulation
128
Why is silent myocardial ischemia dangerous? SATA
It always causes chest pain
It increases the risk for sudden cardiac death
It’s usually diagnosed early due to obvious symptoms
It increases the risk for acute MI
129
What is the primary mechanism of action of bile acid sequestrants like Colesevelam?
Inhibits HMG-CoA reductase
Blocks cholesterol absorption in the intestines
Stimulates bile acid production in the liver
Forms a non-absorbable complex with bile acids in the intestine
130
Adverse effects of Ezetimibe (SATA)
Nausea
Constipation
Hepatoxicity
Myopathy
131
What is the mechanism of action of Gemfibrozil and Fenofibrate?
Inhibit HMG-CoA reductase to reduce LDL synthesis
Decrease VLDL by inhibiting lipolysis and hepatic secretion
Inhibit cholesterol absorption in the small intestine
Increase bile acid excretion
132
Which conditions fall under the umbrella of Acute Coronary Syndromes (ACS)? SATA
NSTEMI
STEMI
Stable angina
Unstable angina
133
Statins are generally discontinued in:
Patients with low HDL
Elderly patients
Pregnant patients
Patients with CAD
134
Which of the following ARE adverse effects of Gemfibrozil and Fenofibrate? (SATA)
Gallstones
Diarrhea, Cramping
Dyspepsia, Nausea
Urticaria
Myopathy
Hepatoxicity
135
What should be monitored during Atorvastatin therapy? (SATA)
Complete blood count (CBC)
Blood glucose
Liver function tests
Creatine phosphokinase (CPK)
Lipid panel
Symptoms of Myopathy
136
What is the door-to-needle time goal when administering thrombolytics for a STEMI?
<15 minutes
<120 minutes
<90 minutes
<30 minutes
137
What is the purpose of the TIMI risk score? SATA
To determine if a patient needs CPR
To diagnose STEMI
To guide invasive treatment strategies for unstable angina/NSTEMI
To assess risk of a cardiac event in 14 days
138
What serum level is commonly associated with Digoxin toxicity?
>3.0 ng/ml
>0.9 ng/ml
>2.0 ng/ml
>1.5 ng/ml
139
What is the mechanism of action for aldosterone antagonists (spironolactone)?
Blocks RAAS
Blocks aldosterone effects
Increases sodium retention
Enhances cardiac output
140
Gemfibrozil and Fenofibrate are contraindicated in which patients?
Patients with high HDL
Patients with severe hepatic or renal dysfunction and gallbladder disease
Patients with diabetes
Patients taking ACE inhibitors
141
Which of the following are forms of Acute Coronary Syndrome? SATA
Silent Myocardial Ischemia
NSTEMI
STEMI
Unstable Angina
142
What is the primary mechanism of action of ezetimibe?
Inhibits cholesterol absorption at the brush border of the small intestine
Increases excretion of triglycerides through the kidneys
Binds bile acids in the intestine to prevent reabsorption
Inhibits HMG-CoA reductase to reduce cholesterol synthesis in the liver
143
What scoring tools are used to guide anticoagulation decisions in AFib? SATA
TIMI
NYHA
CHA₂DS₂-VASc
HAS-BLED
144
Which mechanisms describe how nitroglycerin works in stable angina? SATA
Dilates coronary arteries
Decreases oxygen demand
Dilates veins
Increases oxygen demand
145
Atorvastatin helps reduce blood LDL levels by:
Decreasing bile acid production
Blocking intestinal cholesterol absorption
Enhancing kidney filtration
Increasing LDL receptor sites on liver cells
146
Which of the following are forms of Chronic Ischemic Heart Disease? SATA
Variant Angina
Silent Myocardial Ischemia
Stable Angina
Unstable Angina
147
What are possible outcomes of a STEMI? SATA
Increased cardiac output
Dysrhythmias
Cardiogenic shock
Heart failure
148
How do fibrates affect warfarin and hypoglycemic medications?
They reduce their effects
They have no interaction
They block absorption of these drugs
They increase the effects, requiring closer monitoring
149
How should translingual nitroglycerin spray be administered?
Sprayed onto the oral mucosa, not inhaled
Inhaled deeply after spraying
Mixed with food or drink
Sprayed directly into throat
150
Statins have been shown to: (SATA)
Increase water retention
Reduce mortality from cardiovascular disease
Slow the progression of peripheral vascular disease (PVD)
Slow the progression of coronary artery disease (CAD)
151
What is the antidote for Digoxin toxicity?
Activated charcoal
Sodium bicarbonate
Naloxone
Digoxin immune Fab
152
Which medications are used for stable angina? SATA
Calcium channel blockers
Nitrates
Beta blockers
Antiplatelet drugs
153
What does the acronym ACS stand for?
Acute Cardiovascular Syndrome
Arterial Clotting System
Acute Coronary Syndrome
Angina and Cardiac Stress
154
Which drugs are effective for variant angina? SATA
Carvedilol
Metoprolol
Diltiazem
Amlodipine
Aspirin
Nitroglycerin
155
What is the primary mechanism of action of Atorvastatin?
Blocks bile acid reabsorption
Stimulates cholesterol absorption
Inhibits HMG-CoA reductase
Inhibits LDL receptors
156
What is silent myocardial ischemia?
Occlusion of coronary arteries without symptoms
An irregular heartbeat with normal oxygenation
Severe chest pain with no underlying cause
A panic attack triggered by exertion
157
How long does it typically take for scar tissue to form after an MI?
3 weeks
2 days
1 week
6 weeks
158
Which statements are TRUE regarding the nitroglycerin transdermal patch? SATA
Apply to a hairless area of skin
Leave patch on continuously for 24 hours
Can be applied over the same area daily
Remove for a 10–12 hour nitrate-free interval
Remove with alcohol wipes
Rotate application sites
159
Which of the following have NO ST segment elevation? SATA
Unstable Angina
STEMI
Stable Angina
NSTEMI
160
Which calcium channel blockers help in variant angina by promoting coronary vasodilation?
Diltiazem
Amlodipine
Metoprolol
Verapamil
161
Which arteries can be affected by atherosclerosis? (SATA)
Carotid arteries
Pulmonary arteries
Meow
Coronary arteries
Peripheral arteries (arms and legs)
Renal arteries
162
What is the mechanism of action of Digoxin? SATA
Increases calcium influx to improve contractility
Blocks beta receptors
Inhibits sodium/potassium ATPase pump
Increases conduction speed through the AV node
163
What is the purpose of the nitrate-free interval in nitroglycerin therapy?
To prevent tolerance to the medication
To increase blood pressure during the night
To reduce skin irritation
To allow absorption through different tissues
164
What are characteristics of SGLT-2 inhibitors (empagliflozin) in HFrEF? SATA
Only works for patients with diabetes
Decreases preload
Increases potassium excretion
Decreases afterload
165
Which medications are used for variant (Prinzmetal) angina? SATA
Beta blockers
Statins
Nitrates
Calcium channel blockers
166
AFib increases the risk of stroke primarily due to:
Increased heart contractility
Elevated calcium levels
Clotted blood pooling in the atria
Decreased BP
167
Which of the following are adverse effects of Atorvastatin? (SATA)
Liver dysfunction
Hypertension
Hyperglycemia
Myopathy
Memory issues
Rhabdomyolysis
168
Which lab values should be monitored in patients taking Gemfibrozil or Fenofibrate?
Blood pressure and sodium
Potassium and WBC
INR and creatinine only
Liver function, lipid panel, signs of myopathy
169
Most Statins are taken with an evening meal to minimize GI upset.
True
False
170
Which of the following are precipitating factors of stable angina? SATA
Exertion
Eating
Emotional distress
Extreme temperatures
171
Which instructions should a nurse provide to a patient taking Colesevelam? (SATA)
Separate other medications by several hours
Eat a low-fiber diet to prevent bloating
Take with food and 8 oz. of water
Not this one :)
Avoid taking vitamins A, D, E, and K
Increase fluid and fiber intake to prevent constipation
172
How do beta blockers help treat stable angina?
Decrease HR and contractility, reducing oxygen demand
Increase heart rate and oxygen supply
Dilate coronary arteries
Promote vasospasm
173
What are used to diagnose Heart Failure? SATA
Ejection fraction
Blood pressure trends
Natriuretic peptide levels
Clinical manifestations
174
Which drugs are considered thrombolytics used in STEMI if PCI isn’t available? SATA
Tenecteplase
Alteplase
Enalapril
Clopidogrel
175
Which of the following best describes Heart Failure?
A state where the heart cannot pump enough blood to meet metabolic needs
A type of arrhythmia
Temporary increase in cardiac output
A condition where the heart pumps too fast
176
Why are beta blockers or some calcium channel blockers used with nitroglycerin?
To suppress reflex tachycardia
To improve absorption of nitrates
To treat hypertension only
To replace nitrates in case of allergy
177
What are the three goals of pharmacologic cardioversion in AFib?
Stroke prevention via anticoagulation
Rate control
Electrolyte replacement
Rhythm control
178
What is the significance of a STEMI in ACS?
It indicates unstable angina
It represents partial blockage of a coronary artery
Is a complete coronary artery blockage with irreversible myocardial damage
It always resolves on its own
179
What does a chest X-ray help identify in a patient with suspected heart failure?
Ejection fraction
Heart size and fluid around lungs
Myocardial perfusion
Renal function
180
Which are components of the diagnostic workup for ACS? SATA
BMP and CBC
Chest X-ray
Hemoglobin
12-lead ECG
Troponin levels
Coronary angiography
181
What treatment strategy is used for a STEMI patient?
Reperfusion via PCI or thrombolytics
Only discharge medications
Risk score and outpatient monitoring
Fluid resuscitation
182
What rhythm is typical of atrial fibrillation on ECG?
Irregularly irregular rhythm
Wide QRS with peaked T waves
Regular rhythm with narrow QRS
Slow sinus rhythm
183
Which LVEF value is consistent with HF with reduced ejection fraction (HFrEF)?
60–75%
>50%
<40%
41–49%
184
What are effects of ACE inhibitors, ARBs, and ARNI in treating HFrEF? SATA
Decrease potassium retention
Reduce water volume
Inhibit RAAS
Promote vasodilation
185
What should a nurse monitor for in a patient using Ezetimibe? (SATA)
Myopathy
Lipid panel
Complete blood count (CBC)
Liver function tests
186
Which of the following statements about nitroglycerin tolerance is true?
It is not a concern with topical forms
A nitrate-free period should be included in maintenance therapy
It only occurs in elderly patients
It can be prevented by taking the drug with food
187
Which blood tests are typically used to support heart failure diagnosis? SATA
CBC
TSH
BNP or NT-proBNP
BMP
188
What LVEF range indicates HF with preserved ejection fraction (HFpEF)?
41–49%
>50%
<40%
30–39%
189
What is the maximum number of sublingual nitroglycerin tablets that can be used within 15 minutes?
2
4
5
3
190
Which of the following are adverse effects of Colesevelam? (SATA)
Raises blood glucose levels
Constipation/bloating
Nausea
Raised triglycerides
Impaired absorption of vitamins A, D, E, and K
Increased HDL
191
Which lab values should be monitored during Colesevelam therapy?
Liver function tests, lipid panel, blood glucose
Troponin and BNP
Electrolytes and calcium
INR and platelets
192
What are common symptoms of atrial fibrillation? SATA
Lightheadedness
Palpitations
Fatigue
Cold extremities
193
How does nitroglycerin help relieve symptoms in stable angina?
Decreases afterload
Dilates veins, reducing preload
Increases oxygen demand
Increases heart rate
194
Which drugs may interact with Digoxin? SATA
Thiazide diuretics
ACE inhibitors
Loop diuretics
Beta blockers

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