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Advanced pharmacology final Exam
With Verified Questions and Answers
Graded A+
A nurse practitioner is caring for a patient who is at 28 weeks gestation and is receiving terbutaline (Brethine) to continue preterm labor. What is the following assessment parameters should the nurse prioritize? Maternal body temperature? Fetal heart rate Correct fetal position. Fetal blood pressure. - Fetal heart rate A 59-year-old man with a recent history of erectile dysfunction, has been assessed and prescribed sildenafil Viagra. When providing patient education to this man, the nurse should tell him which of the following. You might find that your face becomes flushed or you get a headache after you take Viagra You should take your Viagra at the same time each morning ideally on an empty stomach. Make sure that you don't take any other prescription medication's while you're using Viagra If you get some heart palpitations or dizziness after you take Viagra, know that this is normal and will pass with time. - You might find that your face becomes flushed, or you get a headache after you take Viagra A male patient has been brought to the emergency department during an episode of status epilepticus. Diazepam is to be administered intravenously. The APRN Willsher to. Avoid the small veins in the dorsum of the hand or the wrist Inject the diazepam very quickly 15 mg in 10 to 15 seconds. Administered after deleting the drug with gabapentin in intervenous solution. Inject very slowly no faster than 100 mg/min. - Avoid the small veins of the dorsum of the hand or the wrist
A patient reports to a clinic with complaints of breast tenderness, a right lumpy breast, and no breast discharge. The breast tenderness occurs primarily during her menstrual cycle. The nurse practitioner probably suspects. Breast cancer. Cancerous breast tenderness. Pain in the heart. PMS - Pms A 34 year old male has been diagnosed with TB and will be started on INH therapy. The medication history reveals that he currently takes antacids on a regular basis. The nurse will instruct the patient to take. Antacids during the day and INH only at night. Antacids before meals and INH one to two hours after meals. INH before meals and antiacids one to two hours after meals. Antacids not less than one hour before or two hours after taking INH - Antacids, not less than one hour before or two hours after taking INH Alendronate Fosamax is prescribed for a 67-year-old post menopausal woman. In order to help prevent gastrointestinal distress, the nurse will advise the patient two Stand or sit upright for at least 30 minutes after taking Allen donate. Avoid drinking water with the drug Lift weights in the gym at least five times a week. Take calcium and vitamin D supplements. - Stand up or sit upright for at least 30 minutes after taking Alendronate Morphine has been prescribed for a 28 year old man with severe pain due to a back injury. The nurse will advise the patient to avoid. Alcohol. Vitamin C Fatty foods Dairy products. - Alcohol A child is taking permethrin for head lice. The nurse practitioner will instruct her mother two Wash your hair daily with a good shampoo. Increase your daily intake of milk. Maximize the child's fluid intake.
A Nurse Practitioner is caring for a patient who is at 28 weeks gestation and is receiving wrapping terbutaline to control preterm labor. Which of the following assessment parameter should the nurse prioritize Maternal body temperature Fetal heart rate FHR Correct fetal position. Fetal blood pressure. - Fetal heart rate FHR Lilly, the nurse practitioner is seeing Mr. Reynolds today. She would recognize that which of the following is a potential adverse side effects of autonomic anticholinergic agents. Reduced GIM motility Increase symptoms of benign prosthetic hypertrophy. Bradycardia. Photosensitivity. - Reduce G.I. motility A three year old boy has developed otitis media and requires antibiotics in order to increase the chance that the boy will take us prescribe medication. The nurse should. Teach the boy about the fact that he will feel much better after he takes his medication. Have the mother hold the child firmly and see them all the drugs are administered Offer a choice between liquid and chewable medication as possible Insert to Central intravenous line. - Offer a choice between liquid and chewable medication if possible Which of the following medications is most likely to cause a cardiac arrhythmia? Fluoxetine Nefazodone Duloxetine. Amitriptyline. Venlafaxine. - Amitriptyline GABA is an amino acid that functions as the primary inhibitory neurotransmitter in the CNS. The primary excitatory neurotransmitter is. Glutamate. Acetyl choline. Gamma amino butyric acid.
Serotonin. Dopamine. - Glutamate Cindy has been on citalopram Lexapro for a year and is willing to try tapering off of the selective serotonin re-uptake inhibitor. What is the initial dosage adjustment when tapering off anti-depressants? Reduce deuce by 50% for 3 to 4 days? Reduce dose by 50% every other day. Change those to every other day dosing for a week. Lexapro can be stopped abruptly due to its long half-life. - Reduce dosed by 50% for 3 to 4 days I Nurse Practitioner educator who coordinates the staff education on an oncology unit is conducting an in-service on target therapies. What potential benefit of targeted therapy should the nurse highlight in this education session? Targeted therapy is achieve the therapeutic benefits of traditional chemotherapy with no risk of adverse effects. Targeted therapies have the potential to provide prophylactic protection against neoplasia in high-risk individuals. Targeted therapies are significantly more cost-effective than traditional chemotherapeutic drugs. Targeted therapies have the potential to damage cancerous cells while leaving normal body cells less effective. - Targeted therapies have the potential to damage cancerous cells while leaving normal body cells less effective. A 16 year old boy is prescribed cromolyn sodium nasal spray to treat a nasal allergy. To maximize the therapeutic effects of the drug, which of the following will the nurse include in instructions to the patient. Take the drug on a full stomach. Avoid high noise levels. Take the drug for one full week before coming in contact with the allergens. Drink plenty of fluids - Take the drug for one full week before coming in contact with allergens The nurse practitioner orders amoxicillin 500 mg TID? What is the total amount of medication the patient will take per day 500 mg 1000 mg,
I Nurse Practitioner has been assigned to a 55 year old woman who has a malignant brain tumor. The pre-patient is receiving her first dose of carmustine. It will be critical for the nurse to observe for which of the following. Nausea and vomiting. Respiratory difficulty. And ability to drink fluids for six hours. Reddish urine - Respiratory difficulty Mr. lap is a 63 year old man who was diagnosed with colon cancer several weeks ago, who is scheduled to begin chemotherapy. He reports to the nurse that he read about the need for erythropoietin in an online forum for cancer patients and wants to explore the use of erythropoietin with his oncologist. Which of the following facts should underlie the nurse's response to Mr. Lepp? Poorten alpha is normally contraindicated in patients who are receiving radiotherapy her chemotherapy. Treatment with epoetin alfa is likely to begin 46 days before Mr. lepps first round of chemo therapy and continued indefinitely. The potential benefits of epoetin alfa must be weighed carefully against the potential adverse effects in cancer patients. Mr. lepps oncologist should've began treatment with epoetin alfa immediately after he was diagnosed. - The potential benefits of epoetin alfa must be weighed carefully against the potential adverse effects in cancer patients A post menopausal patient is prescribed by phosphonate to treat osteoporosis. The nurse will instruct the patient to take the drug. At bedtime. After meals At any time of the day with tea or coffee First thing in the morning. - First thing in the morning Laboratory testing has confirmed that the patient has Clore, Quinn resistant malaria and the patient's physician has prescribed quinine along with an adjunct of drug. The nurse should question the physicians order if the patient has a history of. Osteoporosis low bone density Chronic obstructive, pulmonary disease, COPD.
Diabetes mellitus. Cardiac arrhythmias. - Cardiac arrhythmias I Nurse Practitioner is reviewing the pre-pregnancy medication regimen of a patient who has just had a positive pregnancy test. The nurse should be aware of which of the following changes in pharmacokinetics that accompanies pregnancy? Hepatic metabolism of drugs that are normally metabolized by the kidneys. Increase drug distribution resulting from hemodynamic changes. Decreased absorption of the inhaled drugs, do to decrease tidal volume. Decrease expression rates, as a result of decrease, glomerular, filtration rate during pregnancy. - Increase drug distribution resulting from hemodynamic changes A male patient is taking finasteride for BPH. Which of the following will the nurse evaluate at each clinic visit? Serum cholesterol levels Bone growth Hemoglobin levels. Urinary elimination patterns. - Urinary elimination patterns Miss Shackleford has been placed on Ambien to help her insomnia. The NP must educate the patient regarding the rapid onset of Ambien. Which statement below is correct? Zolpidem should be taken just before going to bed. Zolpidem may cause dry mouth and constipation They may need to double the dose for effectiveness. They should stop drinking alcohol at least 30 minutes before taking zolpidem. - Zolpidem should be taken just before going to bed Mr. Samuel's has been prescribed olanzapine Zyprexa. The NP knows that he should be monitored for. Weight gain. Insomnia. Hypertension. Galactorrhea - Weight gain A male patient is receiving heparin by continuous intravenous infusion. The nurse will instruct the patient and family members to report which of the following should it up her?
A 73 year old woman has osteoporosis and has prescribed alondronate. She takes calcium and vitamin D, supplements, drinks, lots of water, and has just quit smoking. The nurse should advise the patient to also. Include adequate amounts of vitamin C in the diet. Drink at least 68 ounces of milk daily. Stop using artificial sweeteners while taking alendronate. Perform light weight exercises and go for walks. - Reform light weight exercises, and go for walks Which of the following pharmacologic agents can be used to treat nicotine dependence/smoking cessation? Multivitamins Metoprolol Sertraline. Bupropion. - Bupropion Off label prescribing is. Illegal. Regulated by the FDA Common and necessary. Based on state legislation. For investigational purposes - Common and necessary A 45-year-old female patient is prescribed ciprofloxacin to treat a bronchial infection. A nursing assessment revealed that she has started taking daily vitamin supplements about two years ago. To maximize the therapeutic effect of the ciprofloxacin therapy, the nurse should advise the patient to. Take the vitamins at least two hours before or after taking ciprofloxacin Alternate the dosage of Cipro and vitamin supplements Reduce the dosage of vitamin supplements. Reduce the dosage of vitamin supplements and double dosage of Cipro. - Take the vitamins, at least two hours before or after taking Cipro Which of the following patients will be at the greatest risk for anemia, and would be the most likely candidate for epoetin Alfa therapy? A 20 year old female A 30 year old pregnant women. A 60-year-old male with cancer
40 year-old male with a high white blood cell count. - A 60-year-old male with cancer A 45-year-old woman with acute leukemia is going to begin chemotherapy with vincristine. The nurse is aware that vincristine must always be administered. At a rapid infusion rate At a slow infusion rate Through an IV line primed with vincristine Through a central line. - Through a central line A 56 year old woman will soon begin treatment of her overactive bladder with tolterodine Detrol what patient teaching should the nurse provide to this woman? It is good to measure your heart rate before you take your Detrol each day and withhold it if your heart rate is below 60 bpm. You'll probably need to stop taking your hormone replacement therapy when you're taking Detrol. You'll likely find that you have scant amounts of blood in your urine for the first few days but this is not unusual or problematic. You might find that you get a dry mouth or headache from this drug but it does not mean it has to be discontinued.. - You might find that you get a dry mouth or headache from this for drug, but it does not mean it has to be discontinued Mr. CW has his routine appointment today at your clinic. He has been taking 10 mg of prednisone per day for the past six months he should be assessed for. Gout. Iron deficiency anemia. Kidney stones. Osteoporosis. - Osteoporosis A patient has been taking Docs is Austin Cardura 2 mg PO daily for three weeks for treatment of BPH. He returns to clinic and he is complaining of feeling dizzy when he stands up. Which action would the family nurse practitioner take? Order your analysis to determine maturation presence of bacteria. Determine blood pressure with patient lying down standing and sitting. Reviewed with patient his symptoms over the past three weeks. Per.form digital rectal exam to determine if prostate a smaller than previously noted - Determine blood pressure with patient, lying down, standing and sitting
Increased intracranial, pressure or changes in cognition. Anemia, or impaired erythropoiesis - Oto, toxicity, or nephrotoxicity A 60 year old patient experience a sudden onset of chest, pain and shortness of breath and was subsequently diagnosed with a pulmonary embolus in the emergency department. The patient has been started on an intravenous heparin infusion. How does this drug achieve therapeutic affects? By promoting the rapid excretion of vitamin K by the Gastro intestinal mucosa By inhibiting the action of vitamin K at the sites of action By inhibiting platelet aggregation on vessel, walls and promoting fibrinolysis By inactivating, clotting factors, and thus stopping the coagulation cascade. - Why inactivating clotting factors, and thus stopping the coagulation cascade Which of the following should not be taken with selective serotonin reuptake inhibitor? Grapefruit. Alcohol. Aged cheese Green leafy vegetables. - Grapefruit A woman who is in the second trimester of her first pregnancy has been experiencing frequent headaches and has sought advice from her nurse practitioner about safe treatment options. What analgesic and the nurse most safely recommend Aspirin. Diflunisal Acetaminophen. Ibuprofen. - Acetaminophen Miss TW is a 47-year-old female with known rheumatoid arthritis RA. She was placed on prednisone, 5 mg POQD. And teaching a patient about her medication, it would be important for the nurse practitioner to include what information? When the symptoms of arthritis subside, she will be able to quit taking her medication. Increase fluid intake is important to prevent renal damaged by the steroids. The medication should be taken about 30 minutes before eating.
It is important to take the medication as prescribed, even after the redness and swelling decreases. - Increase fluid intake is important to prevent renal damage by the steroids A nurse practitioner is explaining to the parents of a six-year-old child suffering from angina why nitroglycerin patches for chest pain would not be appropriate. Which of the following will the nurse include in an explanation? A child has an erratic blood flow from an immature peripheral circulation which increases drug absorption, causing an increase in adverse effects. A child's gastric pH is decreased, causing less of the drug to be absorbed from the subcutaneous skin, therefore producing more adverse effects. A child has a greater body body surface area, creating greater permeability resulting in an increased in absorption and topical agents which may result in more adverse effects. A child has a smaller body surface areas resulting in an increase in topical absorption, which can cause more adverse effects. - A child has a greater body surface area, creating greater permeability, resulting an increase in absorption and topical agents, which may result in more adverse effects An immuno compromised cancer patient has developed cryptococcal meningitis and has been admitted to the intensive care unit for treatment with amphotericin B. How should the nurse most safely administer this drug? Hang the drug by piggyback with LR and a fuse over several hours to minimize the risk of infusion reaction. Infuse the drug over 2 to 4 hours into a central line using an infusion pump. Flush the patient central line with normal saline infuse the amphotericin B by intervenous push over 5 to 7 Minutes. Place the patient on a constant infusion of amphotericin B at a rate determined by the patient's body weight. - Infused the drug over 2 to 4 hours into a central line, using an infusion pump A patient who is at risk for DVT tells the NP that she has learned she is pregnant. The NP should expect that this patient will use which of the following anticoagulant medication's. Aspirin. Heparin Dabigitran Warfarin. - Heparin
Lover Gastrointestinal track. Kidney. - Kidney An NP is seeing a child who weighs 25 pounds to ounces and needs medication then he learns at the recommended dosing for this drug is 30 to 35 mg per kilogram per day in three divided doses the NP should order 110 mg daily. 110 mg TID. 330 mg once a day 330 mg TID. - 110 mg TID During ongoing assessment of a patient receiving 5FU therapy, the nurse finds the patient's platelet count to be 92,000 cells per MM3. The nurse should do which of the following. Consult the prescriber for an increase in dosage. Consult the prescriber for a decrease in dosage. Consult a prescriber for discontinuation of the drug. Continue the therapy as prescribed. - Cancel the prescriber for a discontinuation of the drug Which of the following statements is false about a cute conjunctivitis Up to 80% of a cute conjunctivitis is viral. Bacterial conjunctivitis is typically a self limited infection that resolved without treatment antibiotics me speed recovery time. In general, most patients are prescribed antibiotic drops because there is no pathognomonic feature that distinguishes between bacterial and viral conjunctivitis. No clinical evidence suggest superiority of one antibiotic over another. None of the above. - No clinical evidence, suggest superiority of one antibiotic over another A patient has acquired primary hypogonadism and has been prescribed testosterone transdermal patches. When educating a patient on how to administer the drug, the nurse will instruct him 2 Pl. the patch on the back of them in upper arms or thighs Place to patch on the scrotum Place the patch on a bony areas such as the shoulder or hip
Leave the patch in place for 15 days before replacing it. - Please the patch on the back of them in upper arms or thighs Which of the following medication classes should be avoided in men with BPH Fluoroquinolones. Alpha blockers. nasal decongestant Beta blockers. - Nasal decongestants A patient has completed for weeks of treatment with epoetin alfa. Which of the following assessment findings would most strongly indicate that the treatment has been effective? The patient white blood cell count is within reference ranges. The patient's hemoglobin level is 11 The patient maintains an oxygen saturation of 92 on room air. Capillary refill of the patients nail beds is less than or equal to three seconds. - The patient's hemoglobin level is 11 Which of the following drugs can a person with G6PD deficiency take safely? Nitrofurantoin Aceta medicine. Trimethoprim, sulfamethoxazole. Aspirin. - Acetaminophen A patient ask the nurse practitioner about food sources such as soy beans and soy products. The nurse practitioner understands that these foods are considered Taboo. Inappropriate. Phytoestrogens. Monotherapy. - Phytoestrogens A nurse practitioner is working with a 57-year-old man who is a former intravenous drug abuser. He has been prescribed a weekly dosage of methotrexate for his RA. Which of the following will the nurse include in her teaching plan for this patient? Avoid high fat foods. Drink plenty of water every day Take the tablets before bedtime. Avoid red meat. - Drink plenty of water every day
The presence of rails are bronchi and oxygen saturation, less than or equal to 80% on room air. Maternal bradycardia, accompanied by a prolonged QT interval. Systolic blood pressure readings in excess of 190.mmgHg - Systolic blood pressure readings in excess of 190 mmHg A patient with chronic heart failure has begun treatment with epoetin Alfa. Was she will receive in her own home from a home health nurse. The nurse should teach the patient to supplement this treatment with a diet that is high end. Iron rich foods, such as beans and leafy green vegetables. Complex carbohydrates in vegetable sorts proteins. Calcium, such as dairy products, fish and vegetables Protein and low in carbohydrates - Iron rich foods, such as beans and leafy green vegetables A child is admitted to the burn unit with second and third-degree burns on both arms and part of his or her face. When administering topical medication's to the burned areas the nurse should. Call the medication prior to administration. Use sterile technique when applying the medication. Allow the child to apply the medication if possible. Use clean technique only when applying the medication. - You sterile technique when applying the medication Terra Zosyn patron is classified under which of the following drug class. Beta blockers. Tricyclic blockers. Alpha blockers. Calcium channel blockers. - Alpha blockers A Nurse Practitioner has questioned why a patient physician has prescribed a narrow spectrum antibiotic rather than a broad-spectrum drug in the treatment of a patient's infection, which of the following sax provides the best rationale for the use of narrow spectrum antibiotics whenever possible. Broad-spectrum antibiotics, confounded the results of subsequent culture and sensitivity testing. Narrow spectrum antibiotics normally require a shorter duration of treatment.
The efficacy of most narrow spectrum antibiotics has not been proven next line. The use of broad-spectrum antibiotics can create a risk for a super infection. - They use a broad-spectrum antibiotics can create a risk for a Super infection Which of the following would a nurse practitioner assess for in a patient who is taking polymyxin B system Mickley Peripheral neuropathy Nephrotoxicity and hepatotoxicity. Hyperkalemia, hyponatremia. Endocarditis and hypertension. - Nephrotoxicity and hepatotoxicity A 20 year old woman will soon begin taking oral contraceptives for the first time. What if I should the nurse provide this patient? Make sure to seek quick care if you experience bad headaches, calf pain or changes and vision. It will take 10 to 12 weeks before the birth control pills will actually prevent pregnancy so be vigilant with other contraceptives until then. Some women get some pain in their chest or optimum when they take oral contraceptives but this will pass as your body gets used to them. You need to carefully consider whether you might want to get pregnant later in your life - Make sure to seek care quickly if you experience bad headaches, calf pain, or changes and vision A nurse practitioner is explaining to a pregnant 21-year-old college student why she cannot continue to take ibuprofen for her headaches. The nurse draws a picture, depicting drug molecules, crossing the placental membrane and entering into the fetal circulation the nurse tells the patient that the main reason this happens is because. There's a 40% increase in blood volume during pregnancy. The mothers heart rate is 10 to 15 bpm faster during pregnancy. Drugs compete with the hormones of pregnancy for albumin binding sites. Hemodilution of plasma albumin occurs. - Drugs compete with the hormones, a pregnancy for albumin binding sites A Nurse Practitioner orders 150 mg of coral fluconazole for a patient with vulvovaginal candidiasis. The patient should expect to take the medication. Every day until the infection is gone. Once a day
