MSN571 Pharm Mid Term Questions and Answers 2023/2024, Exams of Nursing

Download MSN571 Pharm Mid Term Questions and Answers 2023/2024 and more Exams Nursing in PDF only on Docsity! Monday, October 16, 2023 1 MSN571 Pharm Mid Term Questions and Answers 2023/2024 1. Which is required for red blood cell production ● All ● Iron ● Folate ● Vitamin B12 2. A female patient has an iron deficiency anemia and GI bleed has been ruled out. You will: ● Refer the patient to hematologist ● Prescribe ferrous sulfate 325mg po TID and schedule the patient to return in 1 month for a repeat CBC, serum iron and TIBC ● Prescribe iron dextran 50mg IM weekly for 4 weeks and schedule weekly office visits for injections. ● Schedule the patient to return in 6 months for additional guaiac stool testing. 3. Most clinically used opioids analgesics are selective for which type of opioid receptor? ● alpha ● delta ● mu ● beta ● kappa 4. Which is true about morphine ● It does not cause tolerance with prolong use ● It promotes nausea and vomiting through direct stimulation of the chemoreceptor trigger zone of the medulla ● It does not cause urinary retention and hesitancy ● Respiratory depression is rare 12. Which of the following medications is a fluroquinolone antibiotic? Monday, October 16, 2023 2 ● Azithromycin ● Ciprofloxacin ● Penicillin ● Amikacin 13. Which of the following terms best describes the mechanism of action of metoprolol? ● Alpha 1 antagonist effects ● Beta 1 selective ( beta-1-adrenergic receptor inhibitor) ● Nonselective Beta with Alpha blocking ● Nonselective Alpha blockers 14. Which antibiotic class disrupts metabolism in bacteria and is often combined with trimethoprim? ● Aminoglycosides ● Cephalosporins ● Macrolides ● Fluoroquinolones ● Sulfonamides 15. Which of the following group of antibiotics has a beta-lactam ring in the molecular structure? ● Cephalosporins ● Fluoroquinolones ● Macrolides ● Sulfonamides ● Tetracycline 16. Which of the following drug classes should be avoided in peptic ulcer disease? ● Avoid antibiotics ● Avoid NSAIDS ● Avoid diuretics ● Avoid proton pump inhibitors 17. Fluroquinolones antibiotics are most likely indicated in which of the following conditions? ● Follicular conjunctivitis Monday, October 16, 2023 5 Only young men through the age of 21 Men with compromised immune systems (including HIV) through age 30 if they did not get the HPV vaccine as teenagers 30. What is the treatment option for a patient who reported small vesicular lesions on the genitals that lasted between 10 and 20 days? Acyclovir (Zovirax) Three injections of penicillin One time dose of azithromycin Test of cure 31. When teaching a pregnant patient about the effects of medication on the fetus, the greatest harm from maternally ingested medications occurs during which time period? Birthing process First trimester Second trimester Third trimester 32. Which concept guides the NP care of infants receiving a variety of medications? Drugs given subcutaneously (subQ) remain in the body longer in infants than in adults Drugs given intravenously (IV) leave the body more quickly in infants than in adults The blood brain barrier protects the infant’s brain from toxic drugs Gastric emptying time is shorter in infants than in children and adults 33. Which of the following is true? Enzyme inducers can enhance clinical responses to prodrug The bioavailability of lipid soluble drugs is increased in the elderly Drug doses may need to be increased in pregnancy All of the above 34. Physiological changes in the elderly that accounts for a small volume of distribution and an increase in the plasma concentration of digoxin are: Increased activity of hepatic enzymes that facilitate drug metabolism Decreased total body water Increased total body of water Decreased total body fat Monday, October 16, 2023 6 Decreased rate of elimination due to decreased renal function 35. Keeping Beers Criteria in mind. Which of the following statements concerning the safety of medication used by older adults is incorrect? Benzo’s have a large volume of distribution and are relatively safe for use in older people Chronic use of Nexium may increase rick for C-Diff infection, decreased bone integrity and fractures Diphenhydramine may exacerbate urinary retention of older men with prostate hypertrophy Meperidine is not an effective oral analgesic in dosages commonly used and may cause neurotoxicity 36. A patient’s INR is 1.2 on warfarin therapy to prevent DVT, how would you interpret his INR level as? INT is within limits, no action indicated INR is too high IV protamine sulfate may be needed INR is too low the dose of warfarin may need to be increased INR is too high Vitamin K may be needed 37 What would you prescribe for warfarin overdose? Phytonadione Calcium Aspirin Potassium 38. The patient is receiving anticoagulant therapy. The INR value for the patient today is 1.5. In response to this. What will you do? Increase the heparin drip rate Hold the next dose of warfarin Prescribe protamine sulfate Prescribe an additional dose of warfarin 39. Patients with rheumatoid arthritis who are on chronic low dose prednisone will need co treatment with which medications to prevent further adverse effects? Vitamin D Calcium Supplementation A bisphosphonate All of the above Monday, October 16, 2023 7 40. A patient has been taking 10mg per day of prednisone for the past 6 months. The Patient should be assessed for? Gout Iron deficiency anemia Renal dysfunction Osteoporosis 41. Which of the following is (are) useful in the eradication of Tinea organisms? Butoconazole Terbinafine (Lamisil) Griseofulvin None of these are correct Both Griseofulvin and Terbinafine (Lamisil) 42. When teaching a patient about amiodarone, you should advise the patient to avoid which food and drink? Gluten Poultry Whole milk Grapefruit juice 43. Which class of drugs is recommended by the JNC8 as the first line therapy for uncomplicated essential hypertension? Angiotensin converting enzyme inhibitors Thiazide Diuretics Loop diuretics Alpha 1 adrenergic receptor blocking agents 44. A patient has been prescribed amiodarone. What should be included in the patient teaching about this medication? Photophobia and wearing sunglasses Gastrointestinal upset Decrease Fluid intake High fiber diet Monday, October 16, 2023 10 54. The patient is diagnosed with otitis media with perforated ear drum. You want to prescribe an otic preparation. Which if the following is not appropriate? Ciprofloxacin/dexamethasone Ofloxacin otic Acetic acid Otic Ciprofloxacin/Hydrocortisone Ofloxacin and ciprofloxacin are recommended for the patient with a perforated eardrum. These medicines are safe for the patient with a perforated eardrum. Neomycin, polymyxin B, and hydrocortisone are contraindicated in patients with a perforated eardrum because these drugs may cause permanent damage to the ear. 55. A patient is diagnosed with otitis externa. Comorbidities include diabetes mellitus Hypertension, and advanced multiple sclerosis. Which type of education regarding medication administration would you provide? The oral administration of a prescription for fluoroquinolone The oral administration of prescription for hydrocortisone/neomycin/Polymyxin B combination solution The administration of topical medications for a prescription of alcohol plus acetic acid solution The administration of topical combination for a prescription of a fluoroquinolone/glucocorticoid combination solution 56. A 2-year-old child presents to the clinic with otalgia and fever. The left tympanic membrane (TM) is erythematous and bulging: the right TM is perforated and draining. The child’s parent states/ “This is the 5th ear infection this year. What can we do? What action will the provider take to address the child’s ear problem? Prescribe both ceftriaxone (Rocephin) IM with benzocaine ear drops for pain? Discuss beginning prophylactic antibiotic therapy with trimethoprim/sulfamethoxazole Prescribe amoxicillin clavulanate and refer the child to an otolaryngologist Prescribe both high dose amoxicillin and the influenza vaccine 57. What is the mechanism of action of ezetimibe? It inhibits the absorption of bile thus causing the liver to produce bile from cholesterol It inhibits absorption of the dietary and biliary cholesterol in the small intestine (p. 1052) It decreases the adhesion of cholesterol on the arterial walls It inhibits the biosynthesis of cholesterol in the liver Monday, October 16, 2023 11 58. On assessment of a patient with hyperlipidemia you learn that the patient has recently undergone liver transportation. Which antihyperlipidemic drug should be excluded from the patient’s prescription? Gemfibrozil Atorvastatin Cholestyramine Ezetimibe 59. Before prescribing simvastatin, which baseline data are collected to help prevent adverse effects of therapy? Select all that apply Potassium Uric Acid Renal Function Gastric distress Muscle pain Liver enzymes 60. A patient with cardiovascular disease is taking rosuvastatin. Which finding would indicates a potential adverse effect of this drug? Muscle pain and tenderness Blood pressure of 140/90mm Hg Wheezing and shortness of breath Platelet count of 100 x 103mm 3 61. Which of the following labs would you want to order for routine monitoring of a patient receiving the anticoagulant Lovenox (enoxaparin) None of these labs would be used PT/INR Hgb alone PTT 62. A provider is reviewing an older adult patients’ chart during a routine visit. Which patient information is of most concern regarding the renewing of medication prescriptions for highly protein-bound drugs? Low serum Creatinine Increased body fat Monday, October 16, 2023 12 Low serum albumin Chronic constipation 63. you are caring for a patient with bipolar disorder who is taking lithium. Which abnormal lab is most essential for you to reevaluate this patient’s dosage of lithium? Potassium level of 5.0 mEq/L Blood urea nitroglycerin of 20mg/dl Sodium level of 128mEq/L Prothrombin time of 8 secs 64. It is essential for the practitioner to understand the responsibility involved in prescribing a drug or drugs and to consider seriously which class of medication is most appropriate for the patient. The decision is reached based on a thorough knowledge of diagnosis and treatment. True False 65. Nurse practitioner prescriptive authority is regulated by The National Council of State Board of Nursing The State Board of Nursing for each state The state Board of Pharmacy The US Drug Enforcement Administration A post op patient is prescribed fentanyl? What schedule drug is it? A: schedule II Which outcome should the nurse practitioner establish for a patient with trichomoniasis who is receiving flagyl? decrease in yellow green vaginal discharge or absent of painful urination and serous discharge