NSG6005 Final Exam / NSG 6005 Final Exam (Version-2, New, 2020 /2021): South University (C, Exams of Nursing

Download NSG6005 Final Exam / NSG 6005 Final Exam (Version-2, New, 2020 /2021): South University (C and more Exams Nursing in PDF only on Docsity! NSG6005 Final Exam A. Beta blockers B. Diuretics C. Nondihydropyridine calcium channel blockers D. Angiotensin II receptor blockers C. Nondihydropyridine calcium channel blockers Adam has type I diabetes and plays tennis for his university. He exhibits knowledge deficit about his insulin and his diagnosis. He should be taught that: A. He should increase his increase his carbohydrate intake during times of exercise intake during times of exercise. B. Each brand of insulin is equal in bioavailability, so buy the least expensive. C. Alcohol produces hypoglycemia and can help control his diabetes when taken in small amounts. D. If he does not want to learn to give himself injections, he may substitute an oral hypoglycemic to control his diabetes. A. He should increase his increase his carbohydrate intake during times of exercise intake during times of exercise. Age is a factor in different responses to pain. Which of the following age-related statements about pain is not true? A. Preterm and newborn infants do not yet have functional pain pathways. B. Painful experiences and prolonged exposure to analgesic drugs during pregnancy may permanently alter neuronal organization in the child. C. Increases in pain threshold in older adults may be related to peripheral neuropathies and changes in skin thickness. D. Decreases in pain tolerance are evident in older adults. A. Preterm and newborn infants do not yet have functional pain pathways. Alterations in drug metabolism among Asians may lead to: A. Slower metabolism of antidepressants, requiring lower doses B. Faster metabolism of neuroleptics, requiring higher doses C. Altered metabolism of omeprazole, requiring higher doses D. Slower metabolism of alcohol, requiring higher doses A. Slower metabolism of antidepressants, requiring lower doses Amiodarone has been prescribed in a patient with a supraventricular dysrhythmia. Patient teaching should include all of the following except: A. Notify your healthcare provider immediately if you have visual change. B. Monitor your own blood pressure and pulse daily. C. Take a hot shower or bath if you feel dizzy. P a g e 1 | 34 NSG6005 Final Exam D. Use a sunscreen on exposed body surfaces. C. Take a hot shower or bath if you feel dizzy. P a g e 2 | 34 NSG6005 Final Exam David presents to clinic with symptoms of allergic conjunctivitis. He is prescribed cromolyn sodium (Opticrom) eyedrops. The education regarding using cromolyn eyedrops includes which one of the following tips? A. He should not wear his soft contacts while using the cromolyn eyedrops. B. Cromolyn drops are instilled once a day to prevent allergy symptoms. C. Long-term use of the eyedrop may cause glaucoma. D. He may experience bradycardia as an adverse effect. A. He should not wear his soft contacts while using the cromolyn eyedrops. The DEA: A. Registers manufacturers and prescribes controlled substances B. Regulates NP prescribing at the state level C. Sanctions providers who prescribe drugs off-label D. Provides prescribers with a number they can use for insurance billing A. Registers manufacturers and prescribes controlled substances Diagnostic criteria for diabetes include: A. Fasting blood glucose greater than 140 mg/dl on two occasions B. Postprandial blood glucose greater than 140 mg/dl C. Fasting blood glucose 100 to 125 mg/dl on two occasions D. Symptoms of diabetes plus a casual blood glucose greater than 200 mg/dl D. Symptoms of diabetes plus a casual blood glucose greater than 200 mg/dl Disease states in addition to hypertension in which beta blockade is a compelling indication for the use of beta blockers include: A. Heart failure B. Angina C. MI D. Dyslipidemia C. MI The drug of choice for type II diabetics is metformin. Metformin: A. Decreases glycogenolysis by the liver B. Increases the release of insulin from beta cells C. Increases intestinal uptake of glucose D. Prevents weight gain associated with hyperglycemia A. Decreases glycogenolysis by the liver The drug recommended as primary prevention of osteoporosis in men over seventy years is: P a g e 5 | 34 NSG6005 Final Exam A. Alendronate (Fosamax) B. Ibandronate (Boniva) C. Calcium carbonate D. Raloxifene (Evista) A. Alendronate (Fosamax) P a g e 6 | 34 NSG6005 Final Exam The drug recommended as primary prevention of osteoporosis in women over seventy years old is: A. Alendronate (Fosamax) B. Ibandronate (Boniva) C. Calcium carbonate D. Raloxifene (Evista) A. Alendronate (Fosamax) The drugs recommended by the American Academy of Pediatrics for use in children with diabetes (depending upon type of diabetes) are: A. Metformin and insulin B. Sulfonylureas and insulin glargine C. Split-mixed dose insulin and GLP-1 agonists D. Biguanides and insulin lispro A. Metformin and insulin Drugs that have a significant first-pass effect: A. Must be given by the enteral (oral) route only B. Bypass the hepatic circulation C. Are rapidly metabolized by the liver and may have little if any desired action D. Are converted by the liver to more active and fat-soluble forms C. Are rapidly metabolized by the liver and may have little if any desired action Dwayne has classic tinea capitis. Treatment for tinea on the scalp is: A. Rubbing in miconazole cream well for four weeks B. Intake of oral griseofulvin for six to eight weeks C. Shampooing with ketoconazole shampoo daily for six weeks D. Using ciclopirox cream daily for four weeks B. Intake of oral griseofulvin for six to eight weeks Dwayne was recently started on carbamazepine to treat seizures. He comes to see you, and you note that while his carbamazepine levels had been in the therapeutic range, they are now low. The possible cause for the low carbamazepine levels is: A. Dwayne hasn't been taking his carbamazepine because it causes insomnia. B. Carbamazepine auto-induces metabolism, leading to lower levels in spite of good compliance. C. Dwayne was not originally prescribed the correct amount of carbamazepine. D. Carbamazepine is probably not the right antiseizure medication for Dwayne. B. Carbamazepine auto-induces metabolism, leading to lower levels in spite of good compliance. Erik presents with a golden-crusted lesion at the site of an insect bite consistent with impetigo. His parents have limited finances and request the least expensive treatment. Which medication would be the best choice for treatment? P a g e 7 | 34 NSG6005 Final Exam D. All of the above P a g e 10 | 34 NSG6005 Final Exam Heart failure is a chronic condition that can be adequately managed in primary care. However, consultation with or referral to a cardiologist is appropriate when: A. Symptoms markedly worsen or the patient becomes hypotensive and has syncope. B. There is evidence of progressive renal insufficiency or failure. C. The patient remains symptomatic on optimal doses of an ACE inhibitor, a beta blocker, and a diuretic. D. All the above options are correct. D. All the above options are correct. Hypoglycemia can result from the action of either insulin or an oral hypoglycemic. Signs and symptoms of hypoglycemia include: A. "Fruity" breath odor and rapid respiration B. Diarrhea, abdominal pain, weight loss, and hypertension C. Dizziness, confusion, diaphoresis, and tachycardia D. Easy bruising, palpitations, cardiac dysrhythmias, and coma C. Dizziness, confusion, diaphoresis, and tachycardia If a patient with H. pylori positive PUD fails first-line therapy, the second-line treatment is: A. A PPI BID plus metronidazole plus tetracycline plus bismuth subsalicylate for fourteen days B. Testing H. pylori for resistance to common treatment regimens C. A PPI plus clarithromycin plus amoxicillin for fourteen days D. A PPI and levofloxacin for fourteen days A. A PPI BID plus metronidazole plus tetracycline plus bismuth subsalicylate for fourteen days In addition to methimazole, a symptomatic patient with hyperthyroidism may need a prescription for: A. A calcium channel blocker B. A beta blocker C. Liothyronine D. An alpha blocker B. A beta blocker Inadequate vitamin D intake can contribute to the development of osteoporosis by: A. Increasing calcitonin production B. Increasing calcium absorption from the intestine C. Altering calcium metabolism D. Stimulating bone formation B. Increasing calcium absorption from the intestine Incorporating IT into a patient encounter takes skill and tact. During the encounter, the provider can make the patient more comfortable with the IT the provider is using by: A. Turning the screen around so the patient can see material being recorded B. Not placing the computer screen between the provider and the patient P a g e 11 | 34 NSG6005 Final Exam C. Both A and B D. Neither A nor B C. Both A and B P a g e 12 | 34 NSG6005 Final Exam Josie is a five-year-old who presents to the clinic with a forty-eight-hour history of nausea, vomiting, and some diarrhea. She is unable to keep fluids down, and her weight is 4 pounds less than her last recorded weight. Besides intravenous (IV) fluids, her exam warrants the use of an antinausea medication. Which of the following would be the appropriate drug to order for Josie? A. Prochlorperazine (Compazine) B. Meclizine (Antivert) C. Promethazine (Phenergan) D. Ondansetron (Zofran) D. Ondansetron (Zofran) Kirk sprained his ankle and is asking for pain medication for his mild-to-moderate pain. The appropriate first-line medication would be . A. ibuprofen (Advil) B. acetaminophen with hydrocodone (Vicodin) C. oxycodone (OxyContin) D. oral morphine (Roxanol) A. ibuprofen (Advil) Liza is breastfeeding her two-month-old son, and she has an infection that requires an antibiotic. What drug factors influence the effect of the drug on the infant? A. Maternal drug levels B. Half-life C. Lipid solubility D. All of the above D. All of the above Long-acting beta-agonists received a black box warning from the US Food and Drug Administration due to the: A. Risk of life-threatening dermatological reactions B. Increased incidence of cardiac events when long-acting beta-agonists are used C. Increased risk of asthma-related deaths when long-acting beta-agonists are used D. Risk for life-threatening alterations in electrolytes C. Increased risk of asthma-related deaths when long-acting beta-agonists are used Long-term treatment of moderate atopic dermatitis includes: A. Topical corticosteroids and emollients B. Topical corticosteroids alone C. Topical antipruritics D. Oral corticosteroids for exacerbations of atopic dermatitis A. Topical corticosteroids and emollients Medications used in the management of patients with COPD include: P a g e 15 | 34 NSG6005 Final Exam A. Inhaled beta 2 agonists B. Inhaled anticholinergics (ipratropium) C. Inhaled corticosteroids D. All of the above P a g e 16 | 34 NSG6005 Final Exam D. All of the above Monitoring for a child on methylphenidate for ADHD includes: A. ADHD symptoms B. Routine height and weight checks C. Amount of methylphenidate being used D. All of the above D. All of the above Narcotics are exogenous opiates. They act by . A. inhibiting pain transmission in the spinal cord B. attaching to receptors in the afferent neuron to inhibit the release of substance P C. blocking neurotransmitters in the midbrain D. increasing beta-lipoprotein excretion from the pituitary B. attaching to receptors in the afferent neuron to inhibit the release of substance P A nineteen-year-old male was started on risperidone. Monitoring for risperidone includes observing for common side effects, including: A. Bradykinesia, akathisia, and agitation B. Excessive weight gain C. Hypertension D. Potentially fatal agranulocytosis A. Bradykinesia, akathisia, and agitation 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: A. Has a short half-life so that missing one dose has limited effect B. Requires several dosage titrations so that missed doses can be replaced with lower doses to keep costs down C. Has a tolerability profile with less of the adverse effects that are considered "irritating," such as nausea and dizziness D. Must be taken no more than twice a day C. Has a tolerability profile with less of the adverse effects that are considered "irritating," such as nausea and dizziness Off-Label prescribing is: A. Regulated by the FDA B. Illegal by NPs in all states (provinces) C. Legal if there is scientific evidence for the use D. Regulated by the DEA C. Legal if there is scientific evidence for the use One goal of asthma management in children is: P a g e 17 | 34 NSG6005 Final Exam A patient with a COPD exacerbation may require: A. Doubling of inhaled corticosteroid dose B. Systemic corticosteroid burst C. Continuous inhaled beta 2 agonists D. Leukotriene therapy P a g e 20 | 34 NSG6005 Final Exam B. Systemic corticosteroid burst Pharmacokinetics among Asians are universal to all the Asian ethnic groups. A. True B. False B. False A potentially life-threatening adverse response to ACE inhibitors is angioedema. Which of the following statements is true about this adverse response? A. Swelling of the tongue and hoarseness are the most common symptoms. B. It appears to be related to a decrease in aldosterone production. C. The presence of a dry, hacky cough indicates a high risk for this adverse response. D. Because it takes time to build up a blood level, it occurs after being on the drug for about one week. A. Swelling of the tongue and hoarseness are the most common symptoms. Prescribing for women during their childbearing years requires constant awareness of the possibility of: A. Pregnancy unless the women is on birth control B. Risk for silent bacterial or viral infections of the genitalia C. High risk for developmental disorders in their infants D. Decreased risk for abuse during this time B. Risk for silent bacterial or viral infections of the genitalia Prior to prescribing metformin, the provider should: A. Draw a serum creatinine to assess renal function. B. Try the patient on insulin. C. Tell the patient to increase iodine intake. D. Have the patient stop taking any sulfonylurea to avoid dangerous drug interactions. A. Draw a serum creatinine to assess renal function. Progesterone-only pills are recommended for women who: A. Are breastfeeding B. Have a history of migraine C. Have a medical history that contradicts the use of estrogen D. All of the above D. All of the above Sadie is a seventy-two-year-old who takes omeprazole for her chronic GERD. Chronic long-term omeprazole use places her at increased risk for: A Megaloblastic anemia B. Osteoporosis C. Hypertension P a g e 21 | 34 NSG6005 Final Exam D. Strokes B. Osteoporosis P a g e 22 | 34 NSG6005 Final Exam D. All the above options are correct. Six-year-old Lucy has recently been started on ethosuximide (Zarontin) for seizures. She should be monitored for: A. Increased seizure activity as this drug may auto-induce seizures B. Altered renal function, including renal failure C. Blood dyscrasias, which are uncommon but possible D. CNS excitement, leading to insomnia C. Blood dyscrasias, which are uncommon but possible Stage C patients usually require a combination of three to four drugs to manage their heart failure. In addition to ACE inhibitors and beta blockers, diuretics may be added. Which of the following statements about diuretics is not true? A. Diuretics reduce preload associated with fluid retention. B. Diuretics can be used earlier than Stage C when the goal is control of hypertension. C. Diuretics may produce problems with electrolyte imbalances and abnormal glucose and lipid metabolism. D. Diuretics from the potassium-sparing class should be used when using an ARB. D. Diuretics from the potassium-sparing class should be used when using an ARB. A stepwise approach to the pharmacologic management of asthma: A. Begins with determining the severity of the asthma and assessing asthma control B. Is used when the asthma is severe and requires daily steroids C. Allows for each provider to determine his or her personal approach to the care of asthmatic patients D. Provides a framework for the management of severe asthmatics but is not as helpful when patients have intermittent asthma A. Begins with determining the severity of the asthma and assessing asthma control Studies have shown that control targets that reduce the hemoglobin A1c to less than 7% are associated with fewer long-term complications of diabetes. Patients who should have such a target include: A. Those with long-standing diabetes B. Older adults C. Those with no significant cardiovascular disease D. Young children who are early in their disease C. Those with no significant cardiovascular disease Tiotropium bromide (Spiriva) is an inhaled anticholinergic: A. Used for the treatment of COPD B. Used in the treatment of asthma C. Combined with albuterol for the treatment of asthma exacerbations D. Combined with fluticasone for the treatment of persistent P a g e 25 | 34 NSG6005 Final Exam asthma A. Used for the treatment of COPD P a g e 26 | 34 NSG6005 Final Exam To reduce mortality, all patients with angina, regardless of class, should be on: A. Aspirin 81 to 325 mg/d B. Nitroglycerin sublingually for chest pain C. ACE inhibitors or ARBs D. Digoxin A. Aspirin 81 to 325 mg/d The treatment for vitamin B12 deficiency is: A. 1,000 mcg daily of oral cobalamin B. 2 gm/day of oral cobalamin C. 100 mcg/day vitamin B12 IM D. 500 mcg/dose nasal cyanocobalamin two sprays once a week A. 1,000 mcg daily of oral cobalamin Treatment of a patient with hypothyroidism and cardiovascular disease consists of: A. Levothyroxine B. Liothyronine C. Liotrix D. Methimazole A. Levothyroxine The trial period to determine effective anti-inflammatory activity when starting a patient on aspirin for RA is . A. forty-eight hours B. four to six days C. four weeks D. two months B. four to six days A twenty-four-year-old male received multiple fractures in a motor vehicle accident that required significant amounts of opioid medication to treat his pain. He is at risk for Type ADR when he no longer requires the opioids. A. A B. C C. E D. G C. E The type of ADR that is the result of an unwanted but otherwise normal pharmacological action of a drug given in the usual therapeutic doses is: A. Type A P a g e 27 | 34 NSG6005 Final Exam When obtaining a drug history from Harold, he gives you a complete list of his prescription medications. He denies taking any other drugs, but you find that he occasionally takes aspirin for his arthritis flare- ups. This is an example of: A. His appropriately only telling you about his regularly prescribed medications B. His hiding information regarding his inappropriate use of aspirin from you C. A common misconception that intermittently taken OTC medications are not an important part of his drug history D. A common misuse of OTC aspirin C. A common misconception that intermittently taken OTC medications are not an important part of his drug history When prescribing any headache therapy, appropriate use of medications needs to be discussed to prevent medication-overuse headaches. The clinical characteristics of medication-overuse headaches include . A. headaches increasing in frequency B. headaches increasing in intensity C. headaches recurring when medication wears off D. headaches beginning to "cluster" into a pattern C. headaches recurring when medication wears off When Sam used clotrimazole (Lotrimin AF) for athlete's foot, he developed a red, itchy rash consistent with a hypersensitivity reaction. He now has athlete's foot again. What would be a good choice of antifungal for Sam? A. Miconazole (Micatin) powder B. Ketoconazole (Nizoral) cream C. Terbinafine (Lamisil) cream D. Griseofulvin (Grifulvin V) suspension C. Terbinafine (Lamisil) cream When starting a patient with hypothyroidism on thyroid replacement hormones, patient education would include the following: A. He or she should feel symptomatic improvement in one to two weeks. B. Drug-related adverse effects such as lethargy and dry skin may occur. C. It may take four to eight weeks to get to euthyroid symptomatically and by lab testing. D. Due to the short half-life of levothyroxine, its doses should not be missed. C. It may take four to eight weeks to get to euthyroid symptomatically and by lab testing. Which of the following adverse effects may occur due to a dihydropyridine-type calcium channel blocker? P a g e 30 | 34 NSG6005 Final Exam A. Bradycardia B. Hepatic impairment C. Increased contractility D. Edema of the hands and feet D. Edema of the hands and feet P a g e 31 | 34 NSG6005 Final Exam Which of the following classes of drugs is contraindicated in heart failure? A. Nitrates B. Long-acting dihydropyridines C. Calcium channel blockers D. Alpha-beta blockers C. Calcium channel blocker Which of the following disease processes could be made worse by taking a nonselective beta blocker? A. Asthma might worsen. B. Diabetes might worsen. C. Both might worsen. D. Beta blockade does not affect these disorders. C. Both might worsen. Which of the following factors may adversely affect a patient's adherence to a therapeutic drug regimen? A. Complexity of the drug regimen B. Patient's perception of the potential adverse effects of the drugs C. Both A and B D. Neither A nor B C. Both A and B Which of the following is the goal of treatment of acute pain? A. Pain at a tolerable level where patient may return to activities of daily living B. Reduction of pain with a minimum of drug adverse effects C. Reduction or elimination of pain with minimum adverse reactions D. Adequate pain relief without constipation or nausea from the drugs C. Reduction or elimination of pain with minimum adverse reactions Which of the following is the mechanism of action of oral combined contraceptives that prevent pregnancy? A. Estrogen prevents the LH surge necessary for ovulation. B. Progestins thicken cervical mucous and slow tubal motility. C. Estrogen thins the endometrium, making implantation difficult. D. Progestin suppresses FSH release. B. Progestins thicken cervical mucous and slow tubal motility. Which of the following statements is true about age and pain? A. Use of drugs that depend heavily on the renal system for excretion may require dosage adjustments in very young children. B. Among the NSAIDs, indomethacin is the preferred drug because of lower adverse effects profiles than P a g e 32 | 34