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NUR 565 Midterm Study Guide Review
Typology: Study Guides, Projects, Research
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diagnose, order and interpret tests, initiate and manage treatments and prescribe medications, including controlled substances without physician oversight.
element of practice by requiring supervision, delegation, or team management by an outside health discipline for the nurse practitioner to provide patient care. ▪ What problems arise when prescriptive authority is limited? Limited prescriptive authority creates numerous barriers to quality, affordable,
history of physical exam needed to establish pretherapy stauts. Emphasis should be placed on risks to
Hydroxychloroquine may cause fetal ocular toxicity; however in some conditions, such as maternal lupus or malaria, the drug decredases fetal risk
associated with the condions it treats. Sulfasalazine is pregnancy risk category B.
persistent hypotension, advanced heart block.
28.What are some contraindications of ACE inhibitors? Hypotension, renal failure, hx of ACEI-induced cough or angioedema 29.What are some contraindication of Ranolazine? Pre-existing QT prolongation 30.What clinical tools are used to determine how to treat hperlipidemia: ASCVD risk calculator , CPGs, AAC/AHA. 31.What range is stage 2 hypertension? > 140 mm Hg or > 90 mm Hg 32.What BP medication should be avoided in African-Americans? ACEIs **** 33.What medication is approved for htn in pregnancy? Labetalol and methyldopa 34.What is the mechanism of action MOA of digoxin? Increase myocardial contractility and CO by inhibiting Na+ K+ 35.What is the mechanism of action of verapamil? Blocks calcium channels in blood vessels and in the heart and causes dilation. 36.What is the mechanism of action of Nitro? Acts on vascular smooth muscle to cause vasodilation and decreases O2 demand. 37.Angina, goals of treatment include? Prevent MI and death, reduction of cardia ischemia and associated pain. 38.Drugs to treat angina include all of the following except? Loop diuretics and ARBs 39.What labs should we order for bp medication monitoring? Serum electrolytes 40.What is the appropriate intervals for medication adjustments? 4-6 weeks. 41.All of the following are true regarding aldosterone and how we manage the effects except: H2O retention is mediated in part by aldosterone through retention of Ca+ All this is true: o We manage with ACE inhibitors and ARBs o We manage with direct renin inhibitors and aldosterone antagonist o H2O retention is mediated in part by aldosterone through retention of Na+ 42.Patient who abruptly stop taking clonidine are at risk for what? **Severe rebound hypertension. 43.Drug interactions to be mindful of, avoid, or adjust dosing with Warfarin include all of the following except? Penicillin, vitamin D, vancomycin, antiviral agents.
o Amiodarone, Azole antifungal agents, Cimetidine, cephalosporin, o Clopidogrel, aspirin, apixaban, OCS, Vitamin K. 45.Drug interaction (pg. 159) to be mindful of with Carbamazepine include: Oral contraceptives, warfarin, grape fruit juice, phenytoin, phenobarbital. 46.Drug interaction (pg. 332) to be mindful of with Digoxin include all except: Calcium channel blockers, penicillin, fenofibrate, Lamictal, abilify. 47.Quinidine can double the levels of what antidysrhythmic? Digoxin. 48.Prescribing and lifespan consideration for the elderly include? Renal dosing may be needed and some meds may have an increased effect. 49.All of the following are contraindications in pregnancy except? Labetalol- renal failure (fatal injury) 50.All of the following are the patient and provider responsibility in opioid drug therapy except? Discuss the PDMP and counsel the patient on “provider hoping”. 51.How would we approach conversation about Opioid use Disorder? Ask the pt. about their drug and alcohol use with open ended questions, (don’t be judgmental). 52.What type of pain can be treated by psychotropic medications? Fibromyalgia, chronic pain, peripheral neuropathy (SSRI, Benzo, TCA). What are some risk factors of opioid use disorder? Recreational use and being prescribed opioids after surgery. 53.The risk factor for overdose and reasons to prescribe Naloxone include all except: concurrent use of any prescription drugs. 54.What is the PEG assessment scale in regards to chronic pain and opioid use? Reasses functionality and pain control, if <30% improvement than wean off 55.What condition do not warrant opioid therapy? Mild to moderate pain. 56.What is a morphine milligram equivalent? Value that represents the potency of an opioid in comparison to MS04. 57.What is the PDMP and when should we use it? Electronic database with patients prescription hx of controlled substances. 58.What are the outcomes of renal and hepatic insufficiency with
opioid therapy? Metabolize is affected and drug stays in body longer. 59.In regards to CYP450 inducers what does CRAP GPS stand for? *** carbamazepine Rifampin Alcohol phenytoin griseofulvn phenobarb sulfonylurea
77.What problems arise when prescriptive authority is limited? Barriers to quality, affordable, and accessible
78.What are some of the responsibilities of prescribing? Safe and competent practice. 79.We can keep patients safe by doing all of the these things except? Don’t consult additional providers. 80.All of these are reasons for medication non-adherence except? Dr. Google said to stop taking it. 81.What type of evidence should prescribers use to make treatment recommendations? CPGs (Clinical Practice Guides) those are go to. 82.All of these physiological changes of aging have an impact on med absorption except.. Increased splanchnic blood flow. These have an impact: -delayed gastric emptying -increased gastric pH -Decreased absorptive surface area 83.All of these physiological changes of aging have an impact on Med distribution except: Increased serum albumin will decrease. These will increase: Increased body fat Decreased lean body mass Decreased total body water 84.All of these physiological changes of aging have an impact on Med metabolism except.. Increased hepatic mass. These have an impact on med metabolism: -Decreased hepatic blood flow -decreased activity of hepatic enzymes -decreased hepatic mass 85.All of these physiological changes of aging have an impact on med excretion except… Increased number of nephrons. These have physiological change in excretion: Decreased renal blood flow Decreased tubular secretion Decreased glomerular filtration rate