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DAY 1 - MULTIPLE CHOICE
QuizĀ by JONAH REN
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ā1. What does "OHS" standfor?
CĀ Ā a) Occupational Health and Safety
Ā Ā b) Online Health and Security
Ā Ā c) Organizational Health and Safety
Ā Ā d) Office Hardware and Software
1. What does "OHS" standfor?
Ā Ā a) Occupational Health and Safety
Ā Ā b) Online Health and Security
Ā Ā c) Organizational Health and Safety
Ā Ā d) Office Hardware and Software
ā2. Why is OHS important in computerconfiguration?
Ā Ā a) It ensures computers run faster.
Ā Ā b) It prevents accidents and damage to equipment.
Ā Ā c) It guarantees software compatibility.
Ā Ā d) It reduces electricity consumption.
Ā b) It prevents accidents and damage to equipment.
1. What does "OHS" standfor?
CĀ Ā a) Occupational Health and Safety
Ā Ā b) Online Health and Security
Ā Ā c) Organizational Health and Safety
Ā Ā d) Office Hardware and Software
2. Why is OHS important in computerconfiguration?
Ā Ā a) It ensures computers run faster.
Ā Ā b) It prevents accidents and damage to equipment.
Ā Ā c) It guarantees software compatibility.
Ā Ā d) It reduces electricity consumption.
3. Which of the following is NOT a common OHS procedure when working with computers?
Ā Ā a) Turning off the power and unplugging equipment before opening the case.
Cb) Wearing jewelry and accessories while working.
Ā Ā c) Keeping food and drinks away from the workspace.
Ā Ā d) Lifting heavy objects with sturdy leg support.
4. What should you do if you smellsomething burning while working on a computer?
Ā Ā a) Ignore it; it's probably nothing.
Ā Ā b) Continue working and investigate later.
Ā Ā c) Stop what you're doing and check for burnt components.
Ā Ā d) Spray air freshener to mask the smell.
5. Which of the following actionsshould you take if you encounter an electrical shock due to jewelry?
Ā Ā a) Continue working, it's not a big deal.
Ā Ā b) Remove the jewelry and continue working.
Ā Ā c) Seek medical attention immediately.
Ā Ā d) Ignore it; electrical shocks are common.
6. What should be your first stepwhen dealing with an out-of-control fire in the computer lab?
Ā Ā a) Use a fire extinguisher.
Ā Ā b) Call your friends for help.
Ā Ā c) Attempt to fight the fire yourself.
Ā Ā d) Get out of the building quickly.
7. Which of these items should always be available in the workplace, according to OHS guidelines?
Ā Ā a) Fire extinguisher and first aid kit.
Ā Ā b) Snacks and drinks.
Ā Ā c) Laptop computers for everyone.
Ā Ā d) Office decorations.
8. What's the most important step when working with computers, according to OHS principles?
Ā Ā a) Keeping the workspace clean.
Ā Ā b) Wearing a lab coat.
Ā Ā c) Switching off the power.
Ā Ā d) Using the latest software.
9. Why should you turn off the monitor when leaving your computer unattended?
Ā Ā a) To save electricity.
Ā Ā b) To prevent electrical fires.
Ā Ā c) To protect the monitor from dust.
Ā Ā d) To keep the computer running smoothly.
10. Why is it important to followOHS procedures even if you're a professional in computer servicing?
Ā Ā a) Because professionals are less likely to have accidents.
Ā Ā b) OHS procedures are not relevant to professionals.
Ā Ā c) To prevent accidents, damage, and ensure safe working conditions.
Ā Ā d) Professionals are exempt from OHS regulations.
DAY-1 OUTPUT-A-(1. multiple choice 2. multiple possible answers 3. multiple weighted answers 4. scrambled answers 5. jumbled letter answer)Make a multiple choice quiz for my year 8 science students based on the science in this transcript from a video: 3Ā°C 0:04 It can be the difference between snow and sleet 0:08 Wearing a jacket or not 0:11 In your day-to-day life, it may not seem significant 0:15 But 3Ā°C of global warming would be catastrophic 0:20 Heatwaves, droughts, extreme precipitation, even fire 0:25 3Ā°C of warming is really disastrous 0:28 The scary thing is, the world is well on its way there 0:32 Since the industrial revolution, the Earth has warmed between 1.1Ā°C and 1.3Ā°C 0:40 This is a problem that babies you pass in the street will have to live with 0:46 Children born today... 0:47 ...are up to seven times more likely to face extreme weather than their grandparents 0:52 If global temperatures do rise by 3Ā°C... 0:55 ...what would their world look like? Climate change is already having devastating effects 1:03 Rising sea levels 1:05 Desertification 1:07 Hollywood has always enjoyed imagining the end of the world 1:11 While blockbusters like this are clearly fiction... 1:14 ...this film will show the scenario we all face... 1:17 ...unless more drastic measures are taken to stop burning fossil fuels 1:30 In some parts of the world the effects of inaction are already clear 1:35 The slums of Bangladeshās capital are filling up with climate migrants 1:41 Minara comes from Bhola District, an area in southern Bangladesh 1:46 There, like many other parts of the country... 1:49 ...rivers swollen by heavier rain and melting Himalayan glaciers... 1:53 ...are washing away peopleās homes 1:56 Many, like her, have lost everything 2:00 Our home in Bhola had endless amounts of land 2:03 There was lots of space for farming, we had a spacious house 2:08 There were different types of fruits, vegetation and trees growing at home 2:12 We used to eat the fruit from our own trees 2:18 I canāt eat them now because they don't exist anymore 2:21 Since the river flooded for the third time, I had to flee to Dhaka 2:26 Life was much better back home 2:29 It was unbearable to live through, truly intolerable 2:33 We didnāt have the time to save anything at all 2:38 1.1Ā°C to 1.3Ā°C of global warming has already transformed Minaraās life 2:45 Itās one of the reasons why so many migrants like her... 2:47 ...are moving to the city each year... 2:50 ...nearly 400,000 according to the last estimate 2:53 And climate models show there could be much worse to come How climate modelling works 3:02 Climate scientist Joeri Rogelj... 3:04 ...has spent the last ten years modelling future climate scenarios... 3:08 ...for the United Nations 3:10 The models we use to carry out this exercise... 3:13 ...really represent the state of the art... 3:15 ...of our current knowledge of climate change and where we are heading 3:19 Joeriās projections use data collected by hundreds of scientists around the world 3:26 Here this is the 3Ā°C level... 3:28 ...and so there is at least a one-in-four chance that under current policies... 3:32 ...we would hit 3Ā°C by the end of the century 3:36 This is just one of the scenarios Joeri looks at 3:40 Another one imagines that all policy promises are kept 3:44 The most optimistic assumes that all promises have been kept... 3:47 ...and net-zero targets are met 3:50 Where our best estimate ends up around 2Ā°C at the end of the century... 3:54 ...there is still a one-in-20 chance that we end up with 3Ā°C instead 3:59 One would not be entering a plane if there is a one-in-20 chance... 4:03 ...that the plane will crash Nowhere is safe from global warming 4:07 A rise of 3Ā°C would affect everyone 4:10 Even wealthy cities in rich countries wouldnāt be immune to the consequences 4:15 European capitals like Paris and Berlin... 4:18 ...would bake under more extreme heatwaves 4:22 Frequent storm-surges in New York could turn parts of the city desolate 4:27 In many ways, cities magnify, intensify climate events 4:33 Cities are hotter than the places around them... 4:36 ...they tend to be more vulnerable to flooding 4:39 And you can get a really bad event in a city in a way that you canāt in the countryside 4:46 And because of their denser populations... 4:49 ...disasters in a city affect far more people 4:52 Some cities might be badly prepared for the changes coming 4:56 But they have the means to adapt 4:59 Cities tend to be wealthier than surrounding places 5:03 They have a lot of amenities 5:05 A city that has taken seriously the risks of a 3Ā°C world... 5:08 ā¦wouldnāt necessarily be a worse place to be in a 3Ā°C world 5:12 But a city that hasnāt prepared for these sort of eventualities... 5:16 ...that might be a really nasty place The impact of prolonged droughts 5:20 So far, many developed cities have got off lightly... 5:24 ...but some rural parts of the world are suffering disproportionately 5:29 Smallholdersāsmall-scale farmersāare particularly vulnerable to climate change 5:35 And there are over 600 million around the world 5:38 Smallholders with farms under two hectares... 5:40 ...produce around a third of the global food supply 5:46 Central Americaās āDry Corridorā... 5:48 ...supports a mix of smallholdings and medium-sized farms 5:53 Sandwiched between the Pacific Ocean and the Caribbean Sea... 5:56 ...the area is prone to droughts 6:08 Israel RamĆrez Rivera is a smallholder in Guatemala 6:12 Here, climate change is making the dry seasons longer, and more severe 6:18 This is the biggest ear of maize that this plot could deliver 6:23 He depends on his crops of corn and beans 6:26 But theyāre getting harder to grow 6:30 The surrounding mountains... 6:32 ...used to provide us with native food... 6:38 ...and now that isnāt an option anymore... 6:41 ...due to climate change and its effects 6:46 Nearly two-thirds of the smallholders in the Dry Corridor now live in poverty 6:52 The impact of all of this for us... 6:59 ...malnutrition among children 7:03 Weāve lost a few 7:07 For my crops especially, the midsummer heat is harder than before 7:16 The plant dries up and canāt provide us... 7:19 ...with the necessary food provision 7:24 Severe droughts in Central America... 7:26 ...are now four times more likely than they were last century 7:30 Many families from here have gone to the States 7:37 The economic despair and debts... 7:44 ...have pushed many people from this community to do this journey 7:53 Migration from Guatemala to the United States has quadrupled since 1990 7:59 Not all of this has been due to climate change 8:02 But longer droughts would force even more to move 8:05 In a 3Ā°C world, annual rainfall in this region... 8:09 ...could drop by up to 14% 8:12 At 3Ā°C, over a quarter of the worldās population... 8:16 ...could endure extreme droughts for at least a month of the year 8:19 Northern Africa could see droughts that last for years at a time Rising sea levels, storm surges and flooding 8:24 But for some, too much water will be the problem 8:29 10% of the worldās population lives on a coastline... 8:32 ...thatās less than 10 metres above sea level 8:35 For these coastal inhabitants, a 3Ā°C world would spell disaster 8:40 By 2100, global sea levels could have climbed by half a metre from 2005 levels 8:46 Low-lying cities like Lagos would be especially vulnerable... 8:49 ...with up to up to a third of the population displaced 8:54 And in Fiji, rising waters are already upending lives 9:04 You can see the graveyard there, itās all under water now... 9:08 ...due to this rising sea level and climate change 9:15 The village of Togoru in Fiji is being swallowed by the sea 9:19 Barney Dunn, the village headman, has seen over half the village disappear 9:24 Relativesā houses have been abandoned, and family graves are now under water 9:29 We have been asked by the government to relocate... 9:32 ...but no one wants to relocate... 9:34 ...because we have our great-great-grandparents down there in the sea 9:39 This is the place weāve been brought up in 9:41 ...itās not easy to leave 9:44 Past attempts to build a seawall havenāt worked 9:48 But Barney sees building a new one as the villageās only hope 9:52 If they do that, maybe we can save whatever is left 9:56 But if we donāt have the seawall, then it will be keep eroding and time will come... 10:01 ...maybe in ten,15 years, Togoru will be all eroded 10:05 Rising seas also mean storms cause more floods 10:11 And many more countries could suffer 10:14 The Philippines and Myanmar are just two countries... 10:17 ...that will also see an increase in storm surges in a 3Ā°C world 10:21 To escape, many will moveā¦ 10:24 ā¦often, to urban areas Extreme heat and wet-bulb temperatures 10:27 Half the worldās population already lives in cities... 10:31 ...almost a third in slums 10:36 For them, a 3Ā°C world could be deadly 10:40 Minara has moved to Dhaka to escape the impact of climate change 10:44 But life could get even worse for her 10:47 Iām struggling a lot nowadays 10:49 The heat during the day is unbearable 10:52 Even late at night it doesnāt cool down 10:57 The heat is getting more intense every day 10:59 I mean, itās going to get much worse 11:03 I can barely survive it now, how will I live through it in the future? 11:08 Dhaka is getting hotter 11:11 In the last 20 years the average daytime temperature... 11:13 ...has crept up by nearly half a degree 11:17 Days that approach 40Ā°C are now being reported 11:20 And high so-called wet-bulb temperatures are on the rise 11:26 A wet-bulb temperature is a measure of heat and humidity 11:30 Humans cool themselves by sweatingā¦ 11:32 But in these conditions, when relative humidity is near 100%... 11:36 ...sweat doesnāt evaporate well 11:38 So people canāt cool downā¦ 11:41 ...even if given unlimited shade and water 11:45 At a high wet-bulb temperature, the body canāt lose heat... 11:49 ...and so it gets hotter and hotter... 11:51 ...and the body is designed to work at a given temperature 11:53 And if it gets too hot inside, you will die 11:58 The human limit for wet-bulb temperatures is 35Ā°C... 12:02 ...around skin temperature 12:04 Dhaka will have a much higher chance... 12:05 ...of reaching dangerous wet-bulb temperatures... 12:07 ...if global warming reaches 3Ā°C 12:12 You canāt really adapt to that 12:14 You have to get out. If the temperature is so high that you canāt work... 12:20 ...canāt do hard manual labour outside for significant parts of the year... 12:25 ...then many places will become functionally no longer part of the economy 12:33 Jacobabad in Pakistan, and Ras al Khaimah, in the United Arab Emirates... 12:37 ...have already recorded deadly wet-bulb temperatures 12:40 More of the tropics and the Persian Gulf... 12:43 ...as well as parts of Mexico and the south-eastern United States... 12:47 ...could all get to this threshold by the end of the century 12:50 Climate modelling might show us the weather Increased migration and conflict 12:52 But it doesnāt show us its other effects on society 12:56 Established migration patterns could change 12:59 Climate disasters may exacerbate reasons people cross borders 13:03 Within countries, more people will move to cities 13:07 In a 3Ā°C world, tens of millions of people a year... 13:10 ...could be displaced by disasters made worse by climate change 13:15 When people are displaced by climate... 13:18 ā¦they may well go to cities... 13:19 ...because cities are the places that attract people from the countryside already 13:25 A lot of people who can get to the developed world... 13:28 ...not least because the developed world tends to be less hot, will give that a go 13:35 As migration around the world increases... 13:38 ...there could be more competition for fewer resources 13:42 Waterāalready a highly contested resourceāwill be a focal point 13:47 Turkeyās new Ilisu dam has reduced the flow of water into Iraq 13:53 China lays claim to rivers vital to India and Pakistan 13:57 The prospect of a water-conflict makes people very uneasy 14:03 How national tensions would exacerbate those sorts of reactions... 14:08 ...in a 3Ā°C world... 14:09 ...is the sort of thing that no one should really want to find out 14:14 I think youād have to be incredibly sanguine... 14:16 ...not to think that the sort of climate extremes that we talk about... 14:19 ...in a 3Ā°C world wouldnāt lead some places... 14:22 ...to the brink of societal collapse 14:25 Those lucky enough to escape unrest... Adaptation and mitigation are crucial 14:28 ...would still have to adapt to a radically different world 14:32 People can adapt to climate change in all sorts of ways, one of the most obvious ones... 14:37 ...is air conditioning 14:39 But other ways to adapt at a local or regional level... 14:42 ...I mean, one of the most obvious is diversifying agriculture 14:47 There are physical things you can do, like seawalls 14:52 The fact that people can adapt and that adaptation will reduce suffering... 14:57 ...doesnāt mean that it will eliminate suffering 15:00 Suffering is built into this whole process of heating up the planet 15:06 Adaptation will only get the world so far 15:09 The best way to deal with a 3Ā°C world... 15:12 ...is not to go to a 3Ā°C world 15:14 And thatās why increasing efforts on mitigation are important 15:17 Itās why working towards negative emissions... 15:20 ...that could bring down the temperature after it peaks are important 15:25 Once you get to a 3Ā°C world, you are in real bad global trouble 15:33 The scale of change needed... 15:35 ...and the slow progress of governments so far... 15:38 ...means 3Ā°C of warming is uncomfortably likely unless more is done 15:44 Despite existing pledges, greenhouse-gas emissions... 15:48 ...are still set to rise by 16% from 2010 levels by 2030 15:54 The need to act has never been clearer 15:57 Thereās still time to reduce emissions, so that a 3Ā°C world remains fiction... 16:02 ...rather than becoming factBased on the text "Eating colours every day," here is a set of multiple-choice questions using "Wh-" question words (Who, What, Where, When, Why) to test comprehension: Comprehension Quiz: Eating Colours 1. What does the phrase "eating colours" actually mean? A) Eating food with artificial food coloring. B) Choosing a variety of colorful fruits and vegetables. C) Painting your food before you eat it. D) Only eating your favorite color of food. 2. Why should we eat different colours every day? A) To make the plate look pretty for photos. B) Because colorful food tastes sweeter. C) To get different vitamins and minerals that help us stay healthy. D) Because it is easier to cook colorful food. 3. When can you try to include many colours in your diet? A) Only on the weekends. B) Once a month. C) Only for dinner. D) Throughout the day in all your meals. 4. What is a specific benefit mentioned for our bodies when we eat these foods? A) They help us run faster than a car. B) They help our bodies grow, stay strong, and fight illness. C) They change our eye color. D) They help us sleep for 12 hours. 5. Which of these is an example of a "purple" food mentioned for dessert? A) Red peppers B) Dates C) Purple grapes D) Carrot soup 6. What "Wh-" category does the carrot soup fall into for the suggested daily menu? A) What you eat for breakfast. B) What you eat for lunch. C) What you eat for dessert. D) What you eat for a midnight snack.Multiple Choice Questions A6. Youāve hired a third-party to gather information about your companyās servers and data. The third-party will not have direct access to your internal network but can gather information from any other source. Which of the following would BEST describe this approach? ā A. Backdoor testing ā B. Passive footprinting ā C. OS fingerprinting ā D. Partially known environment A7. Which of these protocols use TLS to provide secure communication? (Select TWO) ā A. HTTPS ā B. SSH ā C. FTPS ā D. SNMPv2 ā E. DNSSEC ā F. SRTP A8. Which of these threat actors would be MOST likely to attack systems for direct financial gain? ā A. Organized crime ā B. Hacktivist ā C. Nation state ā D. Competitor A9. A security incident has occurred on a file server. Which of the following data sources should be gathered to address file storage volatility? (Select TWO) ā A. Partition data ā B. Kernel statistics ā C. ROM data ā D. Temporary file systems ā E. Process table Quick Answer: 33 The Details: 43 Quick Answer: 33 The Details: 44 Quick Answer: 33 The Details: 45 Quick Answer: 33 The Details: 46 6 Practice Exam A - Questions A10. An IPS at your company has found a sharp increase in traffic from all-in-one printers. After researching, your security team has found a vulnerability associated with these devices that allows the device to be remotely controlled by a third-party. Which category would BEST describe these devices? ā A. IoT ā B. RTOS ā C. MFD ā D. SoC A11. Which of the following standards provides information on privacy and managing PII? ā A. ISO 31000 ā B. ISO 27002 ā C. ISO 27701 ā D. ISO 27001 A12. Elizabeth, a security administrator, is concerned about the potential for data exfiltration using external storage drives. Which of the following would be the BEST way to prevent this method of data exfiltration? ā A. Create an operating system security policy to prevent the use of removable media ā B. Monitor removable media usage in host-based firewall logs ā C. Only allow applications that do not use removable media ā D. Define a removable media block rule in the UTM Quick Answer: 33 The Details: 47 Quick Answer: 33 The Details: 48 Quick Answer: 33 The Details: 49 Practice Exam A - Questions 7 A13. A CISO (Chief Information Security Officer) would like to decrease the response time when addressing security incidents. Unfortunately, the company does not have the budget to hire additional security engineers. Which of the following would assist the CISO with this requirement? ā A. ISO 27701 ā B. PKI ā C. IaaS ā D. SOAR A14. An insurance company has created a set of policies to handle data breaches. The security team has been given this set of requirements based on these policies: ā¢ Access records from all devices must be saved and archived ā¢ Any data access outside of normal working hours must be immediately reported ā¢ Data access must only occur inside of the country ā¢ Access logs and audit reports must be created from a single database Which of the following should be implemented by the security team to meet these requirements? (Select THREE) ā A. Restrict login access by IP address and GPS location ā B. Require government-issued identification during the onboarding process ā C. Add additional password complexity for accounts that access data ā D. Conduct monthly permission auditing ā E. Consolidate all logs on a SIEM ā F. Archive the encryption keys of all disabled accounts ā G. Enable time-of-day restrictions on the authentication server Quick Answer: 33 The Details: 50 Quick Answer: 33 The Details: 51 8 Practice Exam A - Questions A15. Rodney, a security engineer, is viewing this record from the firewall logs: UTC 04/05/2018 03:09:15809 AV Gateway Alert 136.127.92.171 80 -> 10.16.10.14 60818 Gateway Anti-Virus Alert: XPACK.A_7854 (Trojan) blocked. Which of the following can be observed from this log information? ā A. The victim's IP address is 136.127.92.171 ā B. A download was blocked from a web server ā C. A botnet DDoS attack was blocked ā D. The Trojan was blocked, but the file was not A16. A user connects to a third-party website and receives this message: Your connection is not private. NET::ERR_CERT_INVALID Which of the following attacks would be the MOST likely reason for this message? ā A. Brute force ā B. DoS ā C. On-path ā D. Disassociation A17. Which of the following would be the BEST way to provide a website login using existing credentials from a third-party site? ā A. Federation ā B. 802.1X ā C. PEAP ā D. EAP-FAST Quick Answer: 33 The Details: 53 Quick Answer: 33 The Details: 54 Quick Answer: 33 The Details: 55 Practice Exam A - Questions 9 A18. A system administrator, Daniel, is working on a contract that will specify a minimum required uptime for a set of Internet-facing firewalls. Daniel needs to know how often the firewall hardware is expected to fail between repairs. Which of the following would BEST describe this information? ā A. MTBF ā B. RTO ā C. MTTR ā D. MTTF A19. An attacker calls into a companyās help desk and pretends to be the director of the companyās manufacturing department. The attacker states that they have forgotten their password and they need to have the password reset quickly for an important meeting. What kind of attack would BEST describe this phone call? ā A. Social engineering ā B. Tailgating ā C. Watering hole ā D. On-path A20. A security administrator has been using EAP-FAST wireless authentication since the migration from WEP to WPA2. The companyās network team now needs to support additional authentication protocols inside of an encrypted tunnel. Which of the following would meet the network teamās requirements? ā A. EAP-TLS ā B. PEAP ā C. EAP-TTLS ā D. EAP-MSCHAPv2 Quick Answer: 33 The Details: 56 Quick Answer: 33 The Details: 57 Quick Answer: 33 The Details: 58 10 Practice Exam A - Questions A21. Which of the following would be commonly provided by a CASB? (Select TWO) ā A. List of all internal Windows devices that have not installed the latest security patches ā B. List of applications in use ā C. Centralized log storage facility ā D. List of network outages for the previous month ā E. Verification of encrypted data transfers ā F. VPN connectivity for remote users A22. The embedded OS in a companyās time clock appliance is configured to reset the file system and reboot when a file system error occurs. On one of the time clocks, this file system error occurs during the startup process and causes the system to constantly reboot. Which of the following BEST describes this issue? ā A. DLL injection ā B. Resource exhaustion ā C. Race condition ā D. Weak configuration A23. A recent audit has found that existing password policies do not include any restrictions on password attempts, and users are not required to periodically change their passwords. Which of the following would correct these policy issues? (Select TWO) ā A. Password complexity ā B. Password expiration ā C. Password history ā D. Password lockout ā E. Password recovery Quick Answer: 33 The Details: 59 Quick Answer: 33 The Details: 60 Quick Answer: 33 The Details: 61 Practice Exam A - Questions 11 A24. What kind of security control is associated with a login banner? ā A. Preventive ā B. Deterrent ā C. Corrective ā D. Detective ā E. Compensating ā F. Physical A25. A security team has been provided with a noncredentialed vulnerability scan report created by a thirdparty. Which of the following would they expect to see on this report? ā A. A summary of all files with invalid group assignments ā B. A list of all unpatched operating system files ā C. The version of web server software in use ā D. A list of local user accounts A26. A business manager is documenting a set of steps for processing orders if the primary Internet connection fails. Which of these would BEST describe these steps? ā A. Communication plan ā B. Continuity of operations ā C. Stakeholder management ā D. Tabletop exercise A27. A security administrator is concerned about data exfiltration resulting from the use of malicious phone charging stations. Which of the following would be the BEST way to protect against this threat? ā A. USB data blocker ā B. Personal firewall ā C. MFA ā D. FDE Quick Answer: 33 The Details: 62 Quick Answer: 33 The Details: 63 Quick Answer: 33 The Details: 64 Quick Answer: 33 The Details: 65 12 Practice Exam A - Questions A28. A company would like to protect the data stored on laptops used in the field. Which of the following would be the BEST choice for this requirement? ā A. MAC ā B. SED ā C. CASB ā D. SOAR A29. A file server has a full backup performed each Monday at 1 AM. Incremental backups are performed at 1 AM on Tuesday, Wednesday, Thursday, and Friday. The system administrator needs to perform a full recovery of the file server on Thursday afternoon. How many backup sets would be required to complete the recovery? ā A. 2 ā B. 3 ā C. 4 ā D. 1Chapter 22 Antihypertensive Drugs Hypertension Defined (JNC-8) Pharmacology Overview 7 main categories of drugs to treat HTN Adrenergic drugs (old friend) Angiotensin-converting enzyme (ACE) inhibitors Angiotensin II receptor blockers (ARBs) Calcium channel blockers (CCBs) Diuretics Vasodilators Direct renin inhibitors A. Adrenergic Drugs: 5 Subcategories and where they act A1. Adrenergic neuron blockers (central and peripheral)- we wonāt talk about this A2. Alpha1 receptor blockers (peripheral) A3. Alpha2 receptor agonists (central) A4. Beta receptor blockers (peripheral) A5. Combined Ī± and Ī² receptor blockers (peripheral) A2. Peripherally Acting Adrenergic Drug Alpha1 Blockers (weāve met these) Doxazosin, prazosin, alfuzosin Block alpha1-receptors which causes BP to decrease Reduces peripheral vascular resistance and BP by dilating both arterial and venous blood vessels Main Use: benign prostatic hyperplasia (BPH) Alpha1 Blockers REMEMBER Tamsulosin (Flomax)* is an Ī±1 blocker BUT *Tamsulosin is not used to control BP, just for BPH. A3. Centrally Acting Adrenergic Drugs Alpha 2 agonist Clonidine and methyldopa 1- Stimulate alpha2-adrenergic receptors. in the brain Decreases sympathetic outflow from the CNS which decreases NE production 2. Stimulate alpha2-adrenergic receptors in kidneys remember alpha 2 opposes alpha 1 Dilates peripheral blood vessels ā lowers peripheral resistance āĀ Results in decreased BP So ā¦.Clonidine (Catapres) Used primarily for its ability to decrease blood pressure in an urgent setting Also use in opioid withdrawal as previously discussed Oral (multiple times a day), and topical patch formulations Do not stop abruptly as it may lead to rebound hypertension In reality, Clonidine and methyldopa Not prescribed as first-line home antiHTN drugs High incidence of unwanted adverse effects: orthostatic hypotension, fatigue, and dizziness MIGHT be uses as adjunct drugs after other drugs have failed, in conjunction with other antiHTN such as diuretics A4. Adrenergic Drugs Selective Beta 1 Blockers Metoprolol, Atenolol Reduction of HR through Ī²1 receptor blockade (remember adrenergic blocking of this receptor???) HR results in BP Cause reduced secretion of renin = BP A4. Adrenergic Drugs Selective Beta1 Blockers Nebivolol (Bystolic) Uses: hypertension and HF Action: blocks Ī²1 receptors and produces vasodilatation, which results in a decrease in SVR High doses loses selectivity and blocks both Ī²1 and Ī²2 Less sexual dysfunction All BB- Do not stop abruptly; must be tapered over 1 to 2 weeks A4. Adrenergic Drugs NONSelective Beta Blockers Propranolol Acts equally on Ī²1 and Ī²2 Other uses include situational anxiety associated with public speaking, test taking As mentioned on previous slide, nebivolol at high doses becomes beta nonselective A5. Dual-Action Adrenergic Drugs Ī±1 and Ī² Receptor Blockers Dual antihypertensive effects of reduction in heart rate (beta1 receptor blockade) and vasodilation (alpha1 receptor blockade) Examples are carvedilol (common) and labetalol (not as common) A5. Dual-Action Adrenergic Drugs Ī±1 and Ī² Receptor Blockers Carvedilol (Coreg) Widely used drug that is well tolerated Uses: HTN, mild to moderate HF in conjunction with digoxin, diuretics, and ACE inhibitors Contraindications: severe bradycardia or unstable HF, bronchospastic conditions such as asthma, and various cardiac conduction problems Adrenergic Drugs Indications - HTN But also for Glaucoma (topical) BPH: doxazosin, prazosin, and terazosin (2 for 1) Management of severe HF when used with cardiac glycosides and diuretics Contraindications Acute HF- have to stabilize first MOAIs- yeah doesnāt everything interact with MAOIs? Peptic ulcers Severe liver/kidney disease Asthma (with beta blockers) Adrenergic Drugs: Adverse Effects Orthostatic hypotension 1st-dose syncope Rebound hypertension with abrupt discontinuation Most common: Dry mouth, drowsiness, constipation, sedation Interactions- always check for specific drug interactions Can cause additive CNS depression with alcohol, benzodiazepines, opioids Question #1 When administering an alpha-adrenergic drug for hypertension, it is most important for the nurse to assess the patient for the development of what response? Hypotension Hyperkalemia Oliguria Respiratory distress Answer A Hypotension This is a key point in patient education These drugs have strong vasodilating properties and may cause severe hypotension, especially at the beginning of therapy. B. Angiotensin-Converting Enzyme Inhibitors aka ACE Inhibitors or ACEi Large group of safe and effective drugs Currently are 10 ACEi Often used as first-line drugs for HF and hypertension May be combined with a thiazide diuretic, loop diuretic, or Calcium Channel Blocker (CCB) You need to understand the basics ACE Inhibitors: Review RAAS ACE converts angiotensin I, formed through the action of renin, to angiotensin II Angiotensin 2 is a potent vasoconstrictor and also induces aldosterone secretion by the adrenal glands Aldosterone stimulates sodium resorption (H20 follows Na Both act to raise BP which causes kidneys to reduce renin production ACEi= Great drug to treat HTN BUT contraindicated in pregnancy (2nd,3rd trimester due to fetal renal damage) and breastfeeding first few weeks after birth B. ACE Inhibitors - PRIL Lisinopril (Prinivil) super common, often the 1st drug Enalapril (Vasotec) also common Captopril (Capoten) great if liver disease present Benazepril (Lotensin) Fosinopril (Monopril) Perindopril (Aceon) Quinapril (Accupril) Ramipril (Altace) Trandolapril (Mavik) Primary Effects of the ACE Inhibitors Prevent Na (and H2O) resorption by inhibiting aldosterone secretion (volume reduction) (GO BACK TO RAAS DIAGRAM) blood volume decreases work of the heart preload, or the left ventricular end-diastolic volume which is important in HF ACE SUMMARY OF ACTIVITY 1) Prevent vasoconstriction caused by angiotensin 2 (2) Prevent aldosterone secretion ļØ less sodium and water resorption Cardioprotective Effects of ACEi They slow progression of left ventricular hypertrophy (ventricular remodeling) after MI so considered cardioprotective ACE inhibitors have been shown to decrease morbidity and mortality in patients with HF Renal Protective Effects of ACEi ACE inhibitors: reduce glomerular filtration pressure by volume reduction Cardiovascular drug of choice for patients with diabetes since it helps protect kidneys by reducing pressure. Sometimes used low dose for kidney protection with DM without HTN B. ACEi Enalapril (Vasotec) Only ACEi available in both oral and IV Enalapril IV does not require cardiac monitoring Oral enalapril: prodrug (metabolized in liver) Improves patientās chances of survival after an MI Reduces the incidence of HF B. ACEi Captopril (Capoten) Uses: prevention of ventricular remodeling after MI; reduce the risk of HF after MI Shortest half-lifeļØ Must be administered multiple times throughout the day so this limits its use Not a prodrug so good for patient with liver disease Question #2 A patient with diabetes has a new prescription for the ACE inhibitor lisinopril. She questions this order because her provider has never told her that she has hypertension. What is the best explanation for this order? The doctor knows best The patient is confused This medication has cardioprotective properties This medication has a protective effect on the kidneys for patients with diabetes Answer D ACE inhibitors have been shown to have a protective effect on the kidneys because they reduce glomerular filtration pressure. This property makes them the cardiovascular drug of choice for patients with diabetes. Question #3 A patient with a history of pancreatitis and cirrhosis is also being treated for hypertension. Which drug will most likely be ordered for this patient? Clonidine Prazosin Diltiazem Captopril Answer D Captopril Captopril is not a prodrug; therefore, it does not need to be metabolized by the liver to be effective. This is an advantage in patients with liver disease. ACE Inhibitors: Adverse Effects *Dry, nonproductive cough, which reverses when therapy is stopped. This is a class effect Dizziness- Note: First-dose hypotensive effect may occur Headache & Fatigue Possible hyperkalemia ** Angioedema: rare but potentially fatal Not safe in pregnancy-areĀ contraindicated during the second and third trimesters of pregnancyĀ because of increased risk of fetal renal damage C. Angiotensin II Receptor Blockers (ARB) Considered an alternative to ACEi Less likely to cause a dry cough and hyper K+ that is common with ACE inhibitors Angiotensin II Receptor Blockers: Mechanism of Action Go back to RAAS diagram! ARBs affect primarily 2 places 1. Vascular smooth muscle - blocks vasoconstriction 2. Adrenal gland -Selectively blocks the binding of Ang 2 to certain Ang 2 receptors inhibiting secretion of aldosterone Lowers volume retention and BP Angiotensin II Receptor Blockers -ARTAN Losartan (Cozaar)- very common Eprosartan (Teveten) Valsartan (Diovan) Irbesartan (Avapro) Candesartan (Atacand) Olmesartan (Benicar) Telmisartan (Micardis) Azilsartan (Edarbi) C. ARB Losartan (Cozaar) Beneficial in patients with HTN and HF Used with caution in patients with kidney or liver dysfunction and in patients with renal artery stenosis ***Not safe for breastfeeding women and should not be used in pregnancy (Cat C 1st trimester, Cat D 2nd-3rd trimester), potential fetal toxicity Appear to be equally effective for the treatment of hypertension and well tolerated ARBs less likely to cause cough and hyperK+ but can still happen Evidence that ARBs are associated with lower mortality after MI than ACE inhibitors Never take ACEi and ARBs at the same time* 5. Calcium Channel Blockers (CCB) Primary use: HTN, angina, some dysrhythmias Cause smooth muscle relaxation by blocking the binding of calcium to its receptors, preventing muscle contraction Results in: Relaxed blood vessels to the heart Decreased peripheral smooth muscle tone Decreased SVResistance Decreased BP E. Diuretics First-line antiHTN in JNC 8 guidelines Decreases fluid volume The results from diuresis: preload, Peripheral resistance Overall effect ļ Decreased workload of the heart and decreased BP Thiazide diuretics are the most commonly used diuretics for HTN Ie hydrochlorothiazide (HCTZ), chlorthalidone We will discuss diuretics further in the chapter on diuretics F. Vasodilators Directly relax arterial or venous smooth muscle (or both) Results in: Decreased SVR Decreased afterload Peripheral vasodilation Indicated for treatment of HTN May be used in combination with other drugs F. Vasodilators Hydralazine (Apresoline) Orally: routine cases of essential hypertension Injectable: hypertensive emergencies BiDil: specifically indicated as an adjunct for treatment of HF in African-American patients F. Vasodilators Sodium Nitroprusside (Nitropress) *Sodium nitroprusside and IV diazoxide are reserved for the management of hypertensive emergencies. Contraindications: severe HF, known inadequate cerebral perfusion (especially during neurosurgical procedures) F. Vasodilators Adverse Effects Hydralazine: dizziness, headache, tachycardia, edema, dyspnea, N/V/D, vitamin B6 deficiency, rash Sodium nitroprusside: hypotension, bradycardia, decreased platelet aggregation, rash G. Direct Renin Inhibitors Aliskirin (Tekturna) Blocks theĀ RASĀ pathway at the point of activation. Inhibiting renin production prevents the downstream production of Ang II (potent vasoconstrictor) Adverse effects: N/V, severe hypotension, hyponatremia, hyperkalemiaā¦ Contraindicated in patients with DM taking ACEi or ARB Miscellaneous Antihypertensives Eplerenone (Inspra) Newer class of drugs called selective aldosterone blockers (remember RAAS?) Reduces BP by blocking the actions of aldosterone at its corresponding receptors in the kidney, heart, blood vessels, and brain Indications: routine treatment of hypertension and for post-MI HF Contraindicated if serum potassium levels are high (above 5.6 mEq/L) A Special Form of HTN Treatment of Pulmonary Hypertension Sildenafil and Tadalafil Commonly used for erectile dysfunction Used for pulmonary hypertension but with different trade names Sildenafil: Revatio* (Viagra for ED) Tadalafil: Adcirca* (Cialis for ED)Day 1 Multiple Weighted AnswerQuizalize Activity Day 1 - Multiple Weighted AnswersQUIZALIZE Training Day 1 _Multiple Weighted Answers