MN 553 Advanced Pharmacology Final Exam - Question and Answers, Exams of Nursing

Download MN 553 Advanced Pharmacology Final Exam - Question and Answers and more Exams Nursing in PDF only on Docsity!

AND ANSWERS

MN 553 Advanced Pharmacology Final Exam

4 / 4 points

Jim is being treated for hypertension. Because he has a

history of heart attack, the drug chosen is atenolol. Beta

blockers treat hypertension by:

Question options:

rt rate to improve cardiac output ular smooth muscle tone osterone-mediated volume activity ous humor production

Opiates are used mainly to treat moderate to severe

pain. Which of the following is NOT true about these

drugs?

Question options:

scheduled drugs which require a DEA license to prescribe. ate only mu receptors for the control of pain. verse effects of opiates are related to mu receptor stimulation. antagonist to opiates.

When considering which cholesterol-lowering drug to

prescribe, which factor determines the type and

intensity of treatment?

Question options:

y disease risk level holesterol

Being competent in the use of information technology

in clinical practice is expected in professional nurses.

Advanced practice competence includes the ability to:

AND ANSWERS

Question options:

nt experts in developing, implementing, and evaluating information Systems testing of any new drug entity eaction with a previous dose

AND ANSWERS

rmation using the most common search engines s to assure the integrity of health information on technology to prescribe drugs

The New York Heart Association and the Canadian

Cardiovascular Society have described grading criteria

for levels of angina. Angina that occurs with unusually

strenuous activity or on walking or climbing stair after

meals is class: Question options:

An Investigational New Drug is filed with the U.S. Food

and Drug Administration:

Question

options: ufacturer has completed

phase III trials rug is discovered l testing of any new drug entity

True contraindications to diphtheria, tetanus, and

acellular pertussis (DTaP or Tdap) vaccine include:

Question options:

4oF (40.5oC) after previous DTaP vaccine of seizures after DTaP vaccine egnancy

A provider may consider testing for CYP2D6 variants

AND ANSWERS

prior to starting tamoxifen for breast cancer to:

elihood of therapeutic failure with tamoxifen treatment narrow therapeutic range given orally may not stay in the GI tract long enough to produce an action. . azole (clotrimazole, miconazole)

AND ANSWERS

Question options:

ient will not have increased adverse drug reactions to the tamoxifen tial drug-drug interactions that may occur with tamoxifen metabolizers of tamoxifen

Several classes of drugs have interactions with

cholinergic blockers. Which of the following is true

about these interactions?

Question options:

muscarinic effects may occur with antihistamines. lockers may decrease the sedative effects of hypnotics. lockers are contraindicated with antipsychotics.

Absolute contraindications that clinicians must consider

when initiating estrogen therapy include:

Question options:

dysfunctional uterine bleeding arterial thromboemboli within the prior year s ove

First-line therapy for treating topical fungal infections

such as tinea corporis (ringworm) or tinea pedis

(athlete’s foot) would be:

Question options:

ine lvin microsize m or ointment

ightly before bed er half-life and withdrawal syndrome has a faster onset without taper. icidal ideation ycogenolysis by the liver

AND ANSWERS

Preventative therapy for cluster headaches

includes: Question options:

elaxation therapy ocaine four times a day during “clusters” of headaches Inderal) daily

Why is the consistency of taking paroxetine (Paxil) and

never running out of medication more important than

with most other selective serotonin reuptake inhibitors

(SSRIs)?

Question options:

gest half-life and the withdrawal syndrome has a faster onset. dictive in the dopaminergic reward system. activating of SSRI medications and will cause the person to have sudden deep sadness.

Sook has been prescribed gabapentin to treat

neuropathic pain and is complaining of feeling

depressed and having “strange” thoughts. The

appropriate initial action would be: Question options:

dose he medication immediately dose to half then slowly titrate up the dose

The drug of choice for type 2 diabetics is metformin.

Metformin:

Question options:

release of insulin from beta cells stinal uptake of glucose ght gain associated with hyperglycemia

AND ANSWERS

Gender differences between men and women in

pharmacokinetics include:

Question options:

astric emptying so that drugs absorbed in the stomach have less exposure to absorption sites rtion of body fat so that lipophilic drugs have relatively greater volumes of distribution els of bile acids so that drugs metabolized in the intestine have higher concentrations blood flow rates so drugs tend to take longer to be excreted

Lisa is a healthy nonpregnant adult woman who recently

had a urinary tract infection (UTI). She is asking about

drinking cranberry juice to prevent a recurrence of the

UTI. The correct answer to give her would be:

Question options:

es per day of cranberry juice cocktail will prevent UTIs. rry juice or cranberry juice extract may decrease UTIs in some patients. vidence that cranberry juice helps prevent UTIs. ce only works to prevent UTIs in children.

ACE inhibitors are contraindicated in pregnancy. While

treatment of heart failure during pregnancy is best done

by a specialist, which of the following drug classes is

considered to be safe, at least in the later parts of

pregnancy?

Question options:

s

Which of the following holds true for the

pharmacokinetics of women?

Question options:

ying is faster than that of men.

AND ANSWERS

flow is the same as that of men. trong concerning renal differences in elimination.

that involve binding globulins are impacted by estrogen levels. ine, and creatinine clearance ntment is present in a distant site for the pain source and is based on activation of the same spinal segment as the actual pain site. n will produce an adverse response

AND ANSWERS

od count e

Larry is taking allopurinol to prevent gout. Monitoring of a

patient who is taking allopurinol includes:

Question options:

otein

The most cost-effective treatment for two or three

impetigo lesions on the face is:

Question options:

(Altabax) ointment amycin solution llin/clavulanate (Augmentin)

Which of the following statements is true about acute

pain? Question options:

comes from body surfaces and is only sharp and well-localized. comes from the internal organs and is most responsive to acetaminophen and opiates. athic pain is caused by lack of blood supply to the nerves in a given area.

A laboratory result indicates that the peak level for a

drug is above the minimum toxic concentration. This

means that the: Question options:

n will produce therapeutic effects n doses must be shortened ction of the drug is too long

17.5 g/dl or hematocrit 54% acil (PTU) um cultures -proof paper for all prescriptions written for controlled drugs

AND ANSWERS

While on testosterone replacement, hemoglobin and

hematocrit levels should be monitored. Levels

suggestive of excessive erythrocytosis or abuse are:

Question options:

14 g/dl or hematocrit 39% 11.5 g/dl or hematocrit 31% 13 g/dl or hematocrit 38%

A woman who is pregnant and has hyperthyroidism is

best managed by a specialty team who will most

likely treat her with:

Question options:

odine tment is best delayed until after her pregnancy ends

Leonard is completing a 6-month regimen to treat

tuberculosis (TB). Monitoring of a patient on TB therapy

includes:

Question options:

st x-ray y every 3 months ove

Precautions that should be taken when prescribing

controlled substances include:

Question options:

escription for a Schedule II drug directly to the pharmacy

AND ANSWERS

pre-signed prescription pads in a locked drawer in the clinic umbers to indicate the amount of drug to be prescribed

ith androgen therapy h 3 first- or second-degree family members with history of muscle issues when started on statins zation analysis

AND ANSWERS

Patients who are prescribed exogenous androgens need

to be warned that decreased libido:

Question options:

side effect of androgens and should be reported to the provider h increased doses of androgens, so the patient should let the provider know if he is having problems n of early prostate cancer and he should make an appointment for a prostate screening exam

Which the following persons should not have a statin

medication ordered?

Question options:

h high lipids, but low BMI al woman with recent history of hysterectomy ale with known metabolic syndrome

When a pharmacoeconomic analysis looks at two or

more treatment alternatives that are considered

equal in efficacy and compares the costs of each it is

referred to as: Question options:

ss analysis eness analysis analysis

Ginseng, which is taken to assist with memory, may

potentiate:

Question options:

AND ANSWERS

Male patients who should not be prescribed

phosphodiesterase type 5 (PDE-5) inhibitors

include: Question options:

ave had an acute myocardial infarction in the past 6 months are deaf r age 60 years of age

Jamison has been prescribed citalopram (Celexa) to

treat his depression. Education regarding how quickly

selective serotonin reuptake inhibitor (SSRI)

antidepressants work would be:

Question options:

concentration improve in the first 1 to 2 weeks. improve almost immediately upon starting citalopram. to the SSRI may take 2 to 4 months after he reaches the full therapeutic dose. c mood will improve in 1 to 2 weeks.

Patrick is a 10-year-old patient who presents with

uncomfortable constipation. Along with diet changes, a

laxative is ordered to provide more rapid relief of

constipation. An appropriate choice of medication for a

10-year-old child would be:

Question options:

iralax) ulcolax) suppository lace) suppository glycol electrolyte solution

Which diuretic agents typically do not need potassium

supplementation?

Question options:

ne inhibitors n, cultural barriers, and lack of access to health care locker such as ranitidine to his therapy. committee that writes guidelines for pediatric prescribing

AND ANSWERS

retics diuretics supplementation

According to the U.S. Office of Minority Health, poor

health outcomes among African Americans are

attributed to: Question options:

ong African Americans that prayer is more powerful than drugs nce on the part of the African American patient redisposition for illness found among African Americans

Henry is 82 years old and takes two aspirin every

morning to treat the arthritis pain in his back. He states

the aspirin helps him to “get going” each day. Lately he

has had some heartburn from the aspirin. After ruling

out an acute GI bleed, what would be an appropriate

course of treatment for Henry? Question options:

he aspirin and switch him to Vicodin for the pain. aspirin dose to one tablet daily. ake an antacid 15 minutes before taking the aspirin each day.

The Best Pharmaceuticals for Children

Act: Question options:

diatric exclusivity rule which extends the patent on drugs studied in children ding for new drug development aimed at children manufacturers specifically to develop pediatric formulations

Which of the following patients may be treated with a

3-day course of therapy for their urinary tract infection?

ear-old female thyroid disorders, especially if they are associated with Tachyarrhythmias medications or medication classes that should generally be avoided in persons 65 years or older because they are either ineffecti atric symptoms may occur.

AND ANSWERS

Question options:

year-old pregnant woman ar-old healthy adolescent ear-old diabetic

Class I recommendations for stage A heart failure

include: Question options:

cise within tolerance levels to prevent the development of heart failure sodium intake to less than 2,000 mg/day to prevent fluid retention s for all patients regardless of cardiac history

All of the following statements about the Beer’s List are

true except:

Question options:

rom the expert opinion of one geriatrician and is not evidence-based. have been adopted by the Centers for Medicare and Medicaid Services for regulation of long-term care facilities. are directed at the general population of patients over 65 years of age and do not take disease states into consideration.

Varenicline (Chantix) may be prescribed for tobacco

cessation. Instructions to the patient who is starting

varenicline include: Question options:

m time varenicline can be used is 12 weeks. ign of varenicline toxicity and should be reported to the provider. egimen for varenicline is start taking 1 mg twice a day a week before the quit date.

If a patient with symptoms of gastroesophageal reflux

disease states that he has been self-treating at home

AND ANSWERS

with OTC ranitidine daily, the appropriate treatment

would be:

AND ANSWERS

Question options:

etoclopramide) for 4 to 8 weeks inhibitor (omeprazole) for 12 weeks eceptor antagonist (ranitidine) for 4 to 8 weeks e drug (misoprostol) for 2 weeks

Laboratory values are actually different for TSH when

screening for thyroid issues and when used for

medication management. Which of the follow holds

true?

Question options:

H has a wider range of normal values 0.02-5.0; therapeutic levels need to remain above 5.0. lues are much narrower than the acceptable range used to keep a person stable on hormone replacement. values are kept between 0.05 and 3.0 ideally. Screening values are considered acceptable up to 10. lues are between 5 and 10, and therapeutic values are greater than 10.

Harold, a 42-year-old African American, has moderate

persistent asthma. Which of the following asthma

medications should be used cautiously, if at all?

Question options:

ne, an inhaled corticosteroid n inhaled long-acting beta-agonist hort-acting beta-agonist a leukotriene modifier

The dosage of Vitamin B12 to initially treat pernicious

anemia is:

Question options:

obalamin 1 gram spray in each nostril daily x 1 week then weekly x 1 month IM monthly 1,000 mcg IM daily x 1 week then 1,000 mg IM weekly for a month in 1,000 mcg daily

riaxone n hypersensitivity syndrome 3 to 8 weeks after starting treatment bolism of a prodrug into an active drug, leading to accumulation of Prodrug of renally excreted drugs may be prescribed to infants younger than age 6 months.

AND ANSWERS

tamicin

If an adult patient with comorbidities cannot reliably take oral

antibiotics to treat pneumonia, an appropriate initial

treatment option would be:

Question options:

n cin

Rabi is being prescribed phenytoin for seizures.

Monitoring includes assessing:

Question options:

ma throughout therapy each visit and consider altering therapy if heart rate is less than 60 bpm anges, such as red-green blindness, at least annually

Patients who have a poor metabolism phenotype will

have: Question options:

n of inactive metabolites of drugs creased dosages of medications mination of an active drug

Developmental variation in renal function has what

impact on prescribing for infants and children?

Question options:

of water soluble drugs may need to be prescribed because of increased renal excretion. on rates have no impact on prescribing. to be instructed on whether drugs are renally excreted or not.

sses contain a beta-lactam ring that is vulnerable to beta-lactamase-producing organisms. nfarction ed beta-agonist first, followed by the inhaled corticosteroid.

AND ANSWERS

There is often cross-sensitivity and cross-resistance

between penicillins and cephalosporins because:

Question options:

on is similar in both classes of drugs. rug classes are metabolized in the liver they both produce resistant enzymes. n issue with cross-resistance between the penicillins and cephalosporins.

Disease states in addition to hypertension in which beta

blockade is a compelling indication for the use of beta

blockers include:

Question options:

Sally has been prescribed aspirin 320 mg per day for

her atrial fibrillation. She also takes aspirin four or more

times a day for arthritis pain. What are the symptoms of

aspirin toxicity for which she would need to be

evaluated?

Question options:

ity

Education for patients who use an inhaled beta-agonist

and an inhaled corticosteroid includes:

Question options:

ed corticosteroid first, followed by the inhaled beta-agonists.

AND ANSWERS

intake to 3 liters per day. aspirin or ibuprofen while using inhaled medications.

AND ANSWERS

Patients who are on chronic long-term proton pump

inhibitor therapy require monitoring for:

Question options:

cy anemia, vitamin B12 and calcium deficiency agnesium deficiency acid levels leading to gout and hypocalcemia

Isosorbide dinitrate is prescribed for a patient with

chronic stable angina. This drug is administered twice

daily, but the schedule is 7 a.m. and 2 p.m. because:

Question options:

ting drug with potential for toxicity. nce can develop. ypotension is a common adverse effect. en with milk or food.

Elena Vasquez’s primary language is Spanish, and she

speaks very limited English. Which technique would be

appropriate to use in teaching her about a new drug

you have just prescribed?

Question options:

edical terminology because Spanish has a Latin base. member who speaks more English to act as an interpreter. ional interpreter or a reliable staff member who can act as an interpreter. detailed explanations.

Nonadherence is especially common in drugs that treat

asymptomatic conditions, such as hypertension. One

way to reduce the likelihood of nonadherence to these

drugs is to prescribe a drug that:

AND ANSWERS

Question options:

ility profile with fewer of the adverse effects that are considered “irritating,” such as nausea and dizziness advancing renal dysfunction sales of drugs that contain methamphetamine precursors, including a daily and 30-day limit on sales -up method if they have vomiting or diarrhea during a pill packet

AND ANSWERS

alf-life so that missing one dose has limited effect eral dosage titrations so that missed doses can be replaced with lower doses to keep costs down n no more than twice a day

IV forms of bisphosphonates are used for all the

following except:

Question options:

c irritation with oral forms r mets into the bone f bone loss on oral formulations

The Combat Methamphetamine Epidemic Act, which is

part of the 2006 U.S. Patriot Act:

Question options:

providers to screen their patients for methamphetamine use prescribing of amphetamines to U.S. citizens escription be written for all methamphetamine precursors in all states

To improve actual effectiveness of oral contraceptives

women should be educated regarding:

Question options:

s if they have diarrhea during the middle of a pill pack they will have a normal menstrual cycle if they miss two pills mid-cycle spotting is not normal and the provider should be contacted immediately

The action of “gliptins” is different from other

antidiabetic agents because they:

Question options:

AND ANSWERS

isk for hypoglycemia

cretin system to indirectly increase insulin production taken in sufficient amounts to provide foundational elements for bone growth. lass I or II symptoms inhibitor bid plus clarithromycin plus amoxicillin for 14 days bolism of antidepressants, requiring lower doses

AND ANSWERS

iated with weight gain ependent potassium channels in the beta cell

What is the role of calcium supplements when patients take

bisphosphonates?

Question options:

restricted to allow the medication to work. taken at the same time as the bisphosphonates. ork with bisphosphonates if daily intake is restricted.

Medications are typically started for angina patients

when: Question options:

manent EKG changes occur igger a trip to the emergency department in levels become altered

An acceptable first-line treatment for peptic ulcer

disease with positive H. pylori test is:

Question options:

eceptor antagonists for 4 to 8 weeks inhibitor bid for 12 weeks until healing is complete inhibitor bid and levofloxacin for 14 days

Alterations in drug metabolism among Asians may

lead to: Question options:

olism of neuroleptics, requiring higher doses bolism of omeprazole, requiring higher doses