MSN 611 Midterm Exam With 100% Correct Answers 2023, Exams of Advanced Education

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MSN 611 Midterm Exam With 100% Correct Answers 2023 Histamine that is not found within mast cells functions - Correct Answer-as a neurotransmitter in the brain and is involved with neuroendocrine control, cardiovascular functions, thermal and weight regulation, and sleep and arousal balance what cells release histamine in the stomach? - Correct Answer-enterochromaffin- like (ECL) cells Toxicity of antihistamines has been reported in incidents of interactions with: - Correct Answer-liver enzymes Toxic effect of first-generation antihistamines - Correct Answer-convulsions, postural hypotension, and cardiac arrhythmias Know anaphylaxis - Correct Answer- Central nervous system side effect of antihistamines in the elderly - Correct Answer-BEERs list, Indication H2 antihistamines - Correct Answer-used to inhibit secretion of gastric cid with GI disorders Know initial selection of antimicrobial therapy - Correct Answer- Mechanism of food-drug or drug-drug interactions with antibacterial medications - Correct Answer- Know multiple drug combination treatment for tuberculosis - Correct Answer- isoniazid, rifampin, pyrazinamide and ethambutol for up to 9 months Know about description of IFN-β - Correct Answer-(fibroblast interferon) IFNs are biological response modifiers w an antiviral and immunolodulatory activity. IFN-B is released by human cells infected with certain viruses- help create resistance to viral infections by acting on the host tissue cells Type of pathogen causes malaria - Correct Answer-plasmodium parasite? Why systemic chemotherapy that is given prior to surgery or radiation is given - Correct Answer-neoadjuvant therapy is used to reduce the tumor burden and to increase the effectiveness of the local txt (126) Tumor lysis syndrome management in leukemia patients - Correct Answer- adequate IV hydration therapy, & give allopurinol if hyperuricemia is anticipated (129) Acrolein is a toxic metabolite of cyclophosphamide and ifosfamide that can cause what - Correct Answer-hemorrhagic cystitis (131) Category of antineoplastic drugs offers an alternative when traditional treatments fail - Correct Answer-immunosuppressant antineoplastic agents may offer an alternative (137) Topoisomerase inhibitors target enzymes that control changes in DNA - Correct Answer-by altering the phosphodiester structure of the strands during the normal life cycle of the cell Effects of cholinesterase inhibitors have on the sinoatrial and atrioventricular nodes - Correct Answer-they have vagotonic effects on the SA and AV nodes, leading to bradycardia and AV block which may exacerbate syncope or hypotensive events Mechanism of action of "mixed acting" sympathomimetic drugs - Correct Answer- may directly activate the release of NE while also indirectly causing a release of NE (222) Disease that GABA-derivative antispasmodic agents used effectively to control muscle spasm - Correct Answer-multiple sclerosis (227) FDA-approved use for belladonna - Correct Answer-for mod-severe pain associated with ureteral spasm (bladder spasm) that is not responsive to non- narcotic analgesics Interval for therapeutic effect of initial warfarin therapy - Correct Answer-5-7 days after first dose Function of plasmin - Correct Answer-promotes hydrolysis of cross linked fibrin polymers Derivation of antihemorrhagic agents - Correct Answer-human sources- so monitor for infusion-related reactions Know anticoagulant therapy - Correct Answer-p. 273 FDA-approved drug use in thrombocytopenia - Correct Answer-anagrelide Oprelvekin CNS- SE: dyskinesisas or hallucinations- GI se like nausea or anorexia- monitor LFT Under what two circumstances may second-generation antihistamines cause drowsiness? - Correct Answer-If used concurrently with medications that cause CNS depression or with alcohol some first gen antihistamines are used - Correct Answer-to prevent motion sickness in the stomach histamine is released by - Correct Answer-enterochromaffin-like cells first or second generation antihistamines cross the BBB more? - Correct Answer- first Under what two circumstances may second-generation antihistamines cause drowsiness? - Correct Answer-with alchohol or other meds that cause CNS depression Second-generation antihistamines are preferred for treating which patient category? - Correct Answer-Children Which type of antihistamines are used to inhibit the secretion of gastric acid in patients with gastrointestinal disorders? - Correct Answer-H2 The first drugs typically used to treat the symptoms of an allergic reaction or allergic rhinitis are: - Correct Answer-Oral H1 antihistamines Eosinophils, neutrophils, and T cells contain the type of histamine receptors referred to as ____. - Correct Answer-H4 Toxicity of antihistamines has been reported in incidents of interactions with: - Correct Answer- Choose the correct statement describing antibacterial drugs. - Correct Answer- Penicillinase-resistant penicillins are the agents of choice for most staphylococcal disease. Albendazole is the treatment of choice for infection with which parasite? - Correct Answer-Trichuris trichiura Which of the following statements pertains to antimicrobial therapy? - Correct Answer-in sepsis- lab speci isnt required Why it is important for antiviral compounds to be able to discriminate between host and viral functions with a high degree of specificity - Correct Answer-To avoid attacking host cells, since viruses replicate intracellularly and often use host cell enzymes, macromolecules, and organelles to make their own particles The desired response to antimicrobial therapy within the first 24 to 48 hours includes: - Correct Answer-WBC begins to normalize The available modes of action of antihelmintic drugs is/are: - Correct Answer- locally within the gut lumen to cause explosion of worms from the GI tract and systemically against helminths residing outside the GI tract The ability of an agent to continually suppress growth of an organism after concentrations have decreased to below the minimal inhibitory concentration is known as ___________________. - Correct Answer-post antibiotic effect Which of the following protozoal diseases is associated with as many as 500 million new infections and 2 million deaths annually worldwide? - Correct Answer-malaria Most systemic fungal infections are acquired via: - Correct Answer-inhalation why is combination therapy needed in the treatment of mycobacterial infections? - Correct Answer-because of their slow growth Describe the mechanism of action of aromatase inhibitors. - Correct Answer- block the conversion of androgens into estrogens Which antineoplastic effect do monoclonal antibodies achieve by binding to human vascular growth factor receptors? - Correct Answer-they inhibit metastatic disease progression Which of the following is a disadvantage of targeted cancer therapies? - Correct Answer-fewer diseases for these drugs second gen tyrosine kinase inhibitors are commonly associated with which complication? - Correct Answer-skin toxicity Which of the following is a disadvantage of targeted cancer therapies? - Correct Answer-SE r more severe What activity of carmustine and lomustine make them unique among alkylating agents? - Correct Answer-able to cross the BBB Histones are positively charged proteins that associate with negatively charged DNA to condense the DNA into units called ___________, which make up chromatin. - Correct Answer-nucleosomes Describe the basic mechanisms of action of the antitumor antibiotics bleomycin, dactinomycin, and mitomycin. - Correct Answer-Bleomycin, dactinomycin, and mitomycin cause breaks in single- and double-strand DNA, intercalate between DNA, and cause cross-linking of DNA. Folate antimetabolites are eliminated primarily through the: - Correct Answer-liver or kidney?? Leukemic cells lack the enzyme necessary to produce which amino acid that healthy cells are capable of producing? - Correct Answer-Asparagine In addition to their antineoplastic effects, topoisomerase inhibitors can also function as _______________ agents. - Correct Answer-antibacterial agents a pt diagnosed w chronic pain calls to request an oxycodone (Oxycontin) refill. Which action should the prescriber take initially? - Correct Answer-Arrange to schedule an apt w the pt The provider prepares a patient with newly diagnosed type 1 diabetes for hospital discharge. Which action by the provider will best support the patient's ability to effectively manage medication therapy? - Correct Answer-Asking the pt to demonstrate how to measure and admin insulin The drug manual states that older adult patients are at increased risk for hepatotoxicity. Which action is most important when prescribing this medication to an 80-year-old patient? - Correct Answer-obtain baseline LFTs A patient with bipolar disorder is prescribed daily lithium. Which action is most important for the provider to take in order to determine if the therapeutic level is maintained? - Correct Answer-periodic lab testing Joseph Little (DOB 7/13/1990) is seen in your clinical for symptoms of a sinus infection. After your assessment, you will prescribe Mr. Little an antibiotic and a decongestant. Mr. Little has no other medical conditions and states he takes a multivitamin once a day but no other medications. He has no allergies. Which of the following medications prescribed for Mr. Little requires a prescription? - Correct Answer-abx Which two (2) forms of patient identification are the most often included on the prescription? - Correct Answer-name and DOB Which of the following statements accurately describes an activity or function of acetylcholine? - Correct Answer-It is the primary neurotransmitter within the peripheral nervous system How many muscarinic receptors have been identified? - Correct Answer-5 Which of the following is a potential adverse side effect of autonomic- anticholinergic agents? - Correct Answer-Increased symptoms of benign prostatic hypertrophy and reduced hyperotility in GI Which of the following statements accurately describes centrally acting skeletal muscle relaxants? - Correct Answer-Most evidence does not support their effectiveness. Which of the following drugs is FDA-approved for Alzheimer's disease? - Correct Answer-Donepezil Some hemostatic agents carry black box warnings for the risk of __________ events, and each of these agents should be used under the advice of a physician. - Correct Answer-thromboembolic What conditions would require therapy with erythropoietin-stimulating agents? - Correct Answer-Chronic renal insufficiency or anemia resulting from chronic disease would require erythropoietin-stimulating agents because these conditions are associated with deficiencies in red blood cell production. Describe the protocol for dextran administration. - Correct Answer-Initiate therapy with smaller bolus volumes ranging from 500 to 1000 mL Dextran 40. Evaluate patient's volume status with regard to blood pressure, heart rate, renal function, urine output Monitor other relevant markers before graduating to additional bolus doses. In the sequential thrombin amplification process, activated thrombin induces production of: - Correct Answer-fibriin Which step in the clotting cascade allows prothrombin to be converted to thrombin? - Correct Answer-activation of factor X into factor Xa The anticoagulant drug that acts as a vitamin K antagonist is: - Correct Answer- coumadin Which mechanism of platelet inhibition is exhibited by aspirin? - Correct Answer- Cyclooxygenase (COX) inhibition This question has been regraded. Which of the following is an important factor to consider with regard to the intravenous and subcutaneous dosing methods used for hematopoietic agents? - Correct Answer-underlying disease state What do hemorrheologic agents do? - Correct Answer-decrease the viscosity of blood Which of the following statements about iron therapy is accurate? - Correct Answer-Anaphylactic-type hypersensitivity reactions have occurred from parenteral replacement. Calcium-channel blocking agents that are selective for cardiac myocytes are classified as _________________. - Correct Answer-nondihydropyridines (NDHD) Describe the mechanisms of action of Class IA antiarrhythmics and their resulting effects. - Correct Answer-Class IA agents work by blocking both sodium and potassium. The results are an increased action potential duration and an increase in the effective refractory period. Explain how bile acid sequestrants lower LDL levels, and discuss their side effects. - Correct Answer-Bile acid sequestrants bind bile acids in the intestinal lumen, thereby promoting the elimination of bile acids through the feces. Bile acids effectively lowers LDL levels, GI side effects such as constipation, nausea, bloating, and flatulence limit the use of bile acid sequestrants. Bile acid sequestrants may prevent absorption of other medications, including levothyroxine, hydrochlorothiazide, and warfarin, as well as fat-soluble vitamins and iron. The best way to increase HDL levels is through: - Correct Answer-exercise Choose the correct statement regarding heart failure. - Correct Answer- Evidence-based treatments are available to decrease morbidity and mortality for patients with HFrEF but not for patients with HfpEF. (R- recovery) Which of the following statements accurately describes digoxin? - Correct Answer-blocks the NA-K ATPase pump Which of the following statements describes clonidine? - Correct Answer-SE can be reduced by using transdermal administration Nitrates promote the release of nitric oxide from: - Correct Answer-endothelium Beta2 receptors are found in: - Correct Answer-smooth muscle Which of the following is a side effect or precaution associated with ACE inhibitors? - Correct Answer-angioedema Which statement accurately describes the organization of the autonomic nervous system? - Correct Answer-epi activates both alpha and beta types of receptors equally. Which of the following describes the activity of naloxone? - Correct Answer-It may induce immediate withdrawal symptoms in chronic opiate users. A simple partial seizure is characterized by: - Correct Answer-specific focal site of origin Which of the following is an important consideration when prescribing antidepressants? - Correct Answer-siezures have been reported in some antideppressant trials Choose the correct statement describing stimulants. - Correct Answer-They are used in concert with behavioral therapy for ADHD. Secondary uses for anxiolytic medications may include: - Correct Answer-ethanol withdrawl Arthritis, cancer pain, and back pain are characterized as forms of _______ pain. - Correct Answer-chronic and radiate The first anticonvulsant medication to be used as a mood stabilizer was ______________. - Correct Answer-carbemazapine What is the pathology of Parkinson's disease, the hallmark symptoms associated with the disease, and the challenges associated with dosing to manage symptoms. - Correct Answer-Parkinson's disease is caused by impaired dopamine activity in the basal ganglia. Characteristic symptoms include tremor, muscle rigidity, and slowness or absence of voluntary movement. The treatment challenge is determining a dose that increases dopamine activity without resulting in excess dopamine activity, which can lead to persistent writhing, dyskinetic, or choreiform movements that some patients find more objectionable than the Parkinsonian symptoms. Auras associated with migraine headaches: - Correct Answer-may respond to serotonergic agents in patients with severe migraines. Which of the following is a symptom of excess water retention? - Correct Answer- difficulty breathing What percentage of the body's water is intracellular? - Correct Answer-70%