MN553 Final Exam QUESTIONS AND VERIFIED ANSWERS LATEST UPDATE 2023 ASSURED A+, Exams of Nursing

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MN553 Final Exam

QUESTIONS AND

VERIFIED ANSWERS

LATEST UPDATE 2023

ASSURED A+

 Question 1 4 / 4 points  A potentially life-threatening adverse response to angiotensin- converting enzyme inhibitors is angioedema. Which of the following statements is true about this adverse response? Question options:

 Swelling of the tongue or hoarseness are the most common symptoms.  It appears to be related to the decrease in aldosterone production.  Presence of a dry, hacky cough indicates a high risk for this adverse response.  Because it takes time to build up a blood level, it occurs after being on the drug for about 1 week.  Question 2 4 / 4 points  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:

 Appetite and concentration improve in the first 1 to 2 weeks.  Sleep should improve almost immediately upon starting citalopram.  Full response to the SSRI may take 2 to 4 months after he reaches the full therapeutic dose.  His dysphoric mood will improve in 1 to 2 weeks.  Question 3 4 / 4 points  Larry is taking allopurinol to prevent gout. Monitoring of a patient who is taking allopurinol includes: Question options:  Complete blood count  Blood glucose  C-reactive protein

 BUN, creatinine, and creatinine clearance  Question 4 4 / 4 points  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:  Cost- minimization analysis Cost- of-illness analysis

 Cost-effectiveness analysis  Cost-benefit analysis  Question 5 4 / 4 points  Being competent in the use of information technology in clinical practice is expected in professional nurses. Advanced practice competence includes the ability to: Question options:  Search for information using the most common search engines  Serve as content experts in developing, implementing, and evaluating information Systems  Write programs to assure the integrity of health information  Use information technology to prescribe drugs

 Question 6 4 / 4 points  Instructions for the use of nicotine gum include: Question options:  Chew the gum quickly to get a peak effect.  The gum should be “parked” in the buccal space between chewing.  Acidic drinks such as coffee help with the absorption of the nicotine.  The highest abstinence rates occur if the patient chews the gum when he or she is having cravings.  Question 7 4 / 4 points  A laboratory result indicates that the peak level for a drug is above the minimum toxic

concentration. This means that the: Question options:  Concentration will produce therapeutic effects  Concentration will produce an adverse response  Time between doses must be shortened  Duration of action of the drug is too long  Question 8 4 / 4 points  An acceptable first-line treatment for peptic ulcer disease with positive H. pylori test is: Question options:  Histamine2 receptor antagonists for 4 to 8 weeks  Proton pump inhibitor bid for 12 weeks until healing is complete

 Proton pump inhibitor bid plus clarithromycin plus amoxicillin for 14 days  Proton pump inhibitor bid and levofloxacin for 14 days  Question 9 4 / 4 points  Alterations in drug metabolism among Asians may lead to: Question options:  Slower metabolism of antidepressants, requiring lower doses  Faster metabolism of neuroleptics, requiring higher doses  Altered metabolism of omeprazole, requiring higher doses

 Slower metabolism of alcohol, requiring higher doses  Question 10 4 / 4 points  Patients who are prescribed exogenous androgens need to be warned that decreased libido: Question options:  Is an unusual side effect of androgens and should be reported to the provider  Is treated with increased doses of androgens, so the patient should let the provider know if he is having problems  May be a sign of early prostate cancer and he should make an appointment for a prostate screening exam

 May occur with androgen therapy  Question 11 0 / 4 points  A woman who is pregnant and has hyperthyroidism is best managed by a specialty team who will most likely treat her with: Question options:  Methimazole  Propylthiouracil (PTU)  Radioactive iodine  Nothing, treatment is best delayed until after her pregnancy ends  Question 12 4 / 4 points  The dosage of Vitamin B to initially treat pernicious anemia is: Question options:

 Nasal cyanocobalamin 1 gram spray in each nostril daily x 1 week then weekly x 1 month  Vitamin B12 IM monthly  Vitamin B12 1,000 mcg IM daily x 1 week then 1,000 mg IM weekly for a month  Oral cobalamin 1,000 mcg daily  Question 13 4 / 4 points  A provider may consider testing for CYP2D6 variants prior to starting tamoxifen for breast cancer to: Question options:  Ensure the patient will not have increased adverse drug reactions to the tamoxifen

 Identify potential drug-drug interactions that may occur with tamoxifen  Reduce the likelihood of therapeutic failure with tamoxifen treatment  Identify poor metabolizers of tamoxifen  Question 14 4 / 4 points  Disease states in addition to hypertension in which beta blockade is a compelling indication for the use of beta blockers include: Question options:  Heart failure  Angina  Myocardial infarction  Dyslipidemia  Question 15 4 / 4 points

 Developmental variation in renal function has what impact on prescribing for infants and children?  Question options:  Lower doses of renally excreted drugs may be prescribed to infants younger than age 6 months.  Higher doses of water soluble drugs may need to be prescribed because of increased renal excretion.  Renal excretion rates have no impact on prescribing.  Parents need to be instructed on whether drugs are renally excreted or not.  Question 16 4 / 4 points  Allison is an 18-year-old college student with type 1 diabetes. She is

on NPH twice daily and Novolog before meals. She usually walks for 40 minutes each evening as part of her exercise regimen. She is beginning a 30-minute swimming class three times a week at 1 p.m. What is important for her to do with this change in routine? Question options:  Delay eating the midday meal until after the swimming class.  Increase the morning dose of NPH insulin on days of the swimming class.  Adjust the morning insulin injection so that the peak occurs while swimming.

 Check glucose level before, during, and after swimming.  Question 17 4 / 4 points  Sophie presents to the clinic with a malodorous vaginal discharge and is confirmed to have Trichomonas infection. Treatment for her would include: Question options:  Metronidazole 2 grams PO x 1 dose  Topical intravaginal metronidazole daily x 7 days  Intravaginal clindamycin daily x 7 days  Azithromycin 2 grams PO x 1 dose  Question 18 4 / 4 points  True contraindications to diphtheria, tetanus, and acellular

pertussis (DTaP or Tdap) vaccine include: Question options:  Fever up to 104oF (40.5oC) after previous DTaP vaccine  Family history of seizures after DTaP vaccine  Adolescent pregnancy  Anaphylactic reaction with a previous dose  Question 19 4 / 4 points  Patients who have a poor metabolism phenotype will have: Question options:  Slowed metabolism of a prodrug into an active drug, leading to accumulation of Prodrug

 Accumulation of inactive metabolites of drugs  A need for increased dosages of medications  Increased elimination of an active drug  Question 20 4 / 4 points  The role of the NP in the use of herbal medication is to: Question options:  Maintain competence in the prescribing of common herbal remedies  Recommend common over-the- counter herbs to patients  Educate patients and guide them to appropriate sources of care

 Encourage patients to not use herbal therapy due to the documented dangers  Question 21 4 / 4 points  Vicky, age 56 years, comes to the clinic requesting a refill of her Fiorinal (aspirin and butalbital) that she takes for migraines. She has been taking this medication for over 2 years for migraines and states one dose usually works to abort her migraine. What is the best care for her? Question options:  Switch her to sumatriptan (Imitrex) to treat her migraines.  Assess how often she is using Fiorinal and refill her medication.

 Switch her to a beta blocker such as propranolol to prevent her migraine.  Request she return to the original prescriber of Fiorinal as you do not prescribe butalbital for migraines.  Question 22 4 / 4 points  Ginseng, which is taken to assist with memory, may potentiate: Question options:  Aricept  Insulin  Digoxin  Propranolol  Question 23 4 / 4 points  The most cost-effective treatment for two or three impetigo lesions on the face is: Question options:

 Mupirocin ointment  Retapamulin (Altabax) ointment  Topical clindamycin solution  Oral amoxicillin/clavulanate (Augmentin)  Question 24 4 / 4 points  The reason that two MMR vaccines at least a month apart are recommended is: Question options:  The second dose of MMR “boosts” the immunity built from the first dose.  Two vaccines 1 month apart is the standard dosing for all live virus vaccines.  If the two MMR vaccine doses are given too close together there is a

greater likelihood of severe localized reaction to the vaccine.  Only 95% of patients are fully immunized for measles after the first vaccine, with 99% having immunity after two doses of MMR.  Question 25 4 / 4 points  The first-line therapy for mild-persistent asthma is: Question options:  High-dose montelukast  Theophylline  Low-dose inhaled corticosteroids  Long-acting beta-2-agonists  Question 26 4 / 4 points

 The benefits to the patient of having an Advanced Practice Registered Nurse (APRN) prescriber include:  Question options:  Nurses know more about Pharmacology than other prescribers because they take it both in their basic nursing program and in their APRN program.  Nurses care for the patient from a holistic approach and include the patient in decision making regarding their care.  APRNs are less likely to prescribe narcotics and other controlled substances.  APRNs are able to prescribe independently in all states, whereas a

physician’s assistant needs to have a physician supervising their practice.  Question 27 4 / 4 points  Which the following persons should not have a statin medication ordered? Question options:  Someone with 3 first- or second- degree family members with history of muscle issues when started on statins  Someone with high lipids, but low BMI  Premenopausal woman with recent history of hysterectomy  Prediabetic male with known metabolic syndrome  Question 28 4 / 4 points

 Azithromycin dosing requires that the first day’s dosage be twice those of the other 4 days of the prescription. This is considered a loading dose. A loading dose: Question options:  Rapidly achieves drug levels in the therapeutic range  Requires four- to five-half-lives to attain  Is influenced by renal function  Is directly related to the drug circulating to the target tissues  Question 29 4 / 4 points  An Investigational New Drug is filed with the U.S. Food and Drug Administration: Question options:

 When the manufacturer has completed phase III trials  When a new drug is discovered  Prior to animal testing of any new drug entity  Prior to human testing of any new drug entity  Question 30 4 / 4 points  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:  Tinnitus  Diarrhea  Hearing loss