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NURS 6521 Midterm Exam-latest with 100%

verified

solutions-2024-

•

A physician has ordered subcutaneous injections of morphine, a

narcotic, every 4 hours as needed for pain for a motor vehicle accident

victim. The nurse is aware that there is a high abuse potential for this

drug and that it is categorized as a

Selecte

d

Answer

:

C-II drug.

• Question

2 1 out of 1

points

Glargine (Lantus) is an insulin analog that essentially has no peak and is usually administered:

Selecte

d

Answer

:

Once a day.

• Question

3 0 out of 1

points

The NP is examining a 34-year-old obese man with a body mass index (BMI) of 35 who complains of almost daily indigestion and heartburn for the past year with a strong acid taste in the mouth about an hour after meals, and frequent belching and awakening at night with choking. The history is negative for chronic illnesses and alarm symptoms. A diagnosis of gastroesophageal reflux disease (GERD) is made. What is the best initial treatment for the patient?

Selecte

d

Answer

:

Ranitidine (Zantac) 150 mg bid.

• Question

4 1 out of 1

points

A patient comes to the clinic asking for help to quit drinking alcohol.

She has a 21-year history of heavy drinking and is worried about

developing cirrhosis of the liver. The patient agrees to take disulfiram

(Antabuse). The nurse will teach the patient that the combination of

alcohol and Antabuse will cause which of the following?

Selecte

d

Answer

:

Nausea

- Question (^5) 1 out of 1

points

Typical adverse reactions to oral calcium-channel blockers include:

Selecte

d

Answer

:

ed e ma

- Question (^6) 1 out of 1

points

Mr. Contreras is a 64-year-old patient with Type 2 diabetes. He has recently been

diagnosed with hypertension. Which antihypertensive drug is the recommended choice to treat hypertension in patients with diabetes?

Selecte

d

Answer

:

ACE

Inhibitor

- Question (^7) 1 out of 1

points

Mr. Johnson is an 80 year old male who is on Digoxin therapy. The Nurse Practitioner knows they should monitor the older adult patient for which of the most common adverse reactions of digoxin?

Selecte

d

Answer

:

confusi on

- Question (^8) 1 out of 1

points

/Jillian is a Nurse Practitioner. She recognizes that Nurse Practitioner prescriptive authority Is regulated by:

Selecte

d

Answer

:

The state board of nursing for each state

- Question (^9) 1 out of 1

points

A Nurse Practitioner is conducting an assessment of a patient who has recently had several changes made to her drug regimen. What assessment question most directly addresses the safety implications of the patient's drug regimen?

Selecte

d

Answer

:

"Do you take any herbal supplements or alternative medications?"

- Question (^10) 0 out of 1

points

A patient has been started on a treatment regimen that includes levothyroxine. Select the dosage regimen that is most appropriate for a mean replacement dosage. The patient has been started on a treatment regimen that includes levothyroxine. Select the dosage regimen that is most appropriate for a mean replacement dosage.

Selecte

d

Answer

:

1.2 mcg/kg of body weight per day

- Question (^11) 1 out of 1

points

A Nurse Practitioner is caring for a patient who is diabetic and has been diagnosed with hypertension. An angiotensin-converting enzyme inhibitor, captopril, has been prescribed for her. Which of the following should the Nurse Practitioner assess before beginning drug therapy?

Selecte

d

Answer

:

Serum potassium levels

- Question (^12) 1 out of 1

points

A 76-year-old woman has a complex medical history that includes

emphysema, osteoporosis, malnutrition, and hypothyroidism.

Recently, the woman fell outside her home as a result of weakness

and suffered a fracture to her femoral head. The woman's subsequent

hip-replacement surgery has been scheduled and the care team

recognizes that the use of isoflurane will be most significantly

influenced by

Selecte

d

Answer

:

her history of emphysema.

- Question 13 A common side effect of metformin (Glucophage) therapy is:

1 out of 1

points

Selecte

d

Answer

:

diarr h ea

- Question 14 The side effects of antihistamines are mostly due to their:

0 out of 1

points

Selecte

d

Answer

:

sedatin g effects

- Question 15 The APRN's ability to prescribe controlled substances is regulated by:

Selected DE

Answers: A

- Question 16

0 out of 1

points

1 out of 1

points

Which type of antihistamines are used to inhibit the

secretion of gastric acid in patients with gastrointestinal

disorders?

Selected

H 2 Answer:

- Question 17 The recommended range for maintaining serum theophylline levels is:

1 out of 1

points

Selecte

d

Answer

:

10 to 20 μg/mL.

- Question (^18) 1 out of 1

points

The anticoagulant drug that acts as a vitamin K antagonist is:

Selecte

d

Answer

:

couma din

- Question (^19) 0 out of 1

points

Which of the following is a potential adverse side effect of

autonomic- anticholinergic agents?

Selecte

d

Answer

:

Reduced GI motility

- Question (^20) 0 out of 1

points

The first drugs typically used to treat the symptoms of an

allergic reaction or allergic rhinitis are:

Selecte

d

Answer

:

intranasal

H 1 antihistamines.

- Question (^21) 1 out of 1

points

The point in time on the drug concentration curve that indicates the first sign of a therapeutic effect is the

Selecte

d

Answer

:

onset of action

- Question (^22) 1 out of 1

points

Mr. Lastinger was prescribed warfarin sodium (Coumadin). You advise him to avoid eating large amounts of leafy green vegetables because:

Selecte

d

Answer

:

The high vitamin K levels will decrease the INR

- Question 23

Some first-generation antihistamines are

used:

1 out of 1

points

Selecte

d

Answer

:

to prevent motion sickness

- Question (^24) 1 out of 1

points

All of the following agents are used to control the inflammatory changes seen in the lungs of asthmatics except:

Selecte

d

Answer

:

Albuterol inhaler (proventil)

- Question 25

1 out of 1

points

Which of the following oral medications is the safest to use during pregnancy?

Selecte

d

Answer

:

Methyldo pa

- Question (^26) 1 out of 1

points

Ginger, a 25 year old female presents at the clinic with known history of depression. She reports taking an SSRI with only partial relief. Which of the following drugs can be used safely at any dose in conjunction with an SSRI?

Selecte

d

Answer

:

None of the aboive

- Question (^27) 1 out of 1

points

Jillian is a Nurse Practitioner. She recognizes that Nurse Practitioner prescriptive authority Is regulated by:

Selecte

d

Answer

:

The state board of nursing for each state

- Question 28 Biguanides control hyperglycemia in type 2 diabetes primarily by acting at which organ?

1 out of 1

points

Selecte

d

Answer

:

Liv e r

- Question 29 A possible side effect from the use of nifedipine (Procardia XL) is:

0 out of 1

points

Selecte

d

Answer

:

Hyperkalemia and tetany

- Question 30 Metformin (Glucophage) acts by:

1 out of 1

points

Selecte

d

Answer

:

Decreasing hepatic glucose production with minor effects on insulin sensitivity in both liver and peripheral tissues

- Question (^31) 1 out of 1

points

A Nurse Practitioner is discussing with a patient the efficacy of a drug that his physician has suggested, and he begin taking. Efficacy of a drug means which of the following?

Selecte

d

Answer

:

How well a drug produces its desired effect

- Question 32 The Elderly are at high risk of Adverse Drug Reactions due to:

1 out of 1

points

Selecte

d

Answer

:

age related decrease in renal function

- Question (^33) 1 out of 1

points

A 34-year-old male patient is prescribed methimazole (MMI). The Nurse Practitioner will advise him to report which of the following immediately?

Selecte

d

Answer

:

Intolerance to cold

- Question (^34) 0 out of 1

points

A patient with type 1 diabetes has been admitted to the hospital for

orthopedic surgery and the care team anticipates some disruptions to

the patient's blood glucose levels in the days following surgery. Which

of the following insulin regimens is most likely to achieve adequate

glycemic control?

Selecte

d

Answer

:

Divided doses of intermediate-acting insulin every 2

hours, around the clock

- Question (^35) 1 out of 1

points

A patient in need of myocardial infarction prophylaxis has been

prescribed sulfinpyrazone for gout. Which of the following will the nurse

monitor the patient most closely for?

Selecte

d

Answer:

Bleeding

- Question (^36) 1 out of 1

points

A female patient is taking 0.125 mg of digoxin daily for heart failure.

At a recent clinic visit she reports that since she has been on the

drug, she can breathe better and her heart rate has been around 74

beats per minute. The nurse weighs the patient and notices that she

has gained 10 pounds since the digoxin therapy was started. The

patient is concerned that the additional weight will necessitate an

increase in the medication. Which of the following is an appropriate

response by the nurse?

Selecte

d

Answer

:

"No, the drug dosage will likely stay the

same."

- Question 37 Which of the following is a contraindication for antimuscarinic drugs?

0 out of 1

points

Selecte

d

Answer

:

Parkinson disease

- Question (^38) 0 out of 1

points

Which medication class is recognized for the treatment of moderate to severe dementia?

Selecte

d

Answer

:

Cholinesterase inhibitors.

- Question (^39) 1 out of 1

points

You are seeing a 65 year old male with a long history of COPD who has recently developed hypertension. Which class of antihypertensive agents should the Nurse Practitioner avoid for this patient?

Selecte

d

Answer

:

Beta- Blocker s

- Question (^40) 0 out of 1

points

Advanced practice nurse prescribing of scheduled medications is affected most by:

Selected DE

Answer: A

- Question 41

1 out of 1

points

A male patient who is hypertensive takes Hydrochlorothiazide for his blood pressure. He presents with red, painful swelling of the great toe. In addition to treating gout, you recognize that you may need to:

Selecte

d

Answer

:

Change his thiazide antihypertensive medication

- Question (^42) 1 out of 1

points

A mother brings her 4-year-old child, who is vomiting and has a

temperature of 103°F into the emergency department (ED). The ED

physician orders acetaminophen (Tylenol) for the fever. The best form

of Tylenol to give the child, considering her presentation, would be

Selected suppository.

Answer:

- Question 43

1 out of 1

points

Ms. Simpson has a known history of asthma. She is on Theophylline daily. The NP contemplates giving her an antibiotic for her respiratory infection. The NP knows that which choice below could elevate theophylline levels?

Selecte

d

Answer

:

Ciprofloxa cin

- Question (^44) 0 out of 1

points

To minimize the risk of adverse effects of glucagon when given to

an unconscious diabetic patient, as the patient regains

consciousness, the nurse should

Selecte

d

Answer

:

monitor for nausea and vomiting.

- Question (^45) 1 out of 1

points

A patient who is a steroid-dependent asthmatic is started on a beclomethasone inhaler. Which should be part of patient education?

Selecte

d

Answer

:

Rinse the mouth well after each use

- Question (^46) 1 out of 1

points

A Nurse Practitioner is providing care for a patient who suffered extensive burns to his extremities during a recent industrial accident. Topical lidocaine gel has been ordered to be applied to the surfaces of all his burns in order to achieve adequate pain control. When considering this order, the Nurse Practitioner should be aware that

Selecte

d

Answer

:

there is a risk of systemic absorption of the lidocaine through the patient's traumatized skin.

- Question 47

1 out of 1

points

During a clinic visit, a patient complains of having frequent muscle

cramps in her legs. The nurse's assessment reveals that the patient has

been taking over-the- counter laxatives for the past 7 years. The nurse

informed the patient that prolonged use of laxatives

Selecte

d

Answer

:

may cause nutrient deficiencies.

- Question (^48) 1 out of 1

points

Which antihypertensive agent is associated with hair growth?

Selecte

d

Answer

:

Minoxid il

- Question (^49) 0 out of 1

points

A patient with a history of bronchial asthma is seen in the clinic for increased episodes of difficulty breathing. He has been taking theophylline 100 mg PO tid. He is 40 years old and obese with an 16-pack-year history of cigarette smoking and excessive intake of coffee daily. He eats a low- carbohydrate, high-protein diet. Which identified factors decrease the therapeutic effects of the theophylline?

Selecte

d

Answer

:

Coffee intake and weight

- Question 50 Autonomic drugs have little effect when administered:

0 out of 1

points

Selecte

d

Answer

:

by inhalation

- Question 51 Which can elevate theophylline levels?

1 out of 1

points

Selecte

d

Answer

:

Concomitant treatment with cimetidine (Tagamet).

- Question 52 A patient on valproic acid may experience which of the following symptoms?

1 out of 1

points

Selecte

d

Answer

:

All of the above

- Question 53

1 out of 1

points

What information would the Nurse Practitioner include in teaching a patient about the treatment of vitamin B 12 deficiency following a total gastrectomy?

Selecte

d

Answer

:

The patient will receive monthly cyanocobalamin (vitamin B 12 ) injections (^) for life (after being given daily weekly injections for the first month).

- Question (^54) 1 out of 1

points

The Nurse Practitioner is following up on a patient who is experiencing acute asthma problems. Albuterol (Proventil) by metered-dose inhaler (MDI) has been ordered as treatment. Which patient response would indicate to the family nurse practitioner that the patient understands how to take the medication?

Selecte

d

Answer

:

“I will take 1 puff of the medication and then wait a minute before taking the second puff.”

- Question (^55) 0 out of 1

points

Which effect does the Nurse Practitioner expect may occur when using cholinergic agonists?

Selecte

d

Answer

:

dry mouth

- Question (^56) 1 out of 1

points

The NP knows that lithium levels should be measured while patients are on lithium therapy. The NP also recognizes that lithium has a

Selecte

d

Answer

:

has a low therapeutic index and toxicity can occur at doses close to therapeutic levels

- Question (^57) 1 out of 1

points

Mr. Penny, age 67, was diagnosed with chronic angina several months

ago and has been unable to experience adequate relief of his

symptoms. As a result, his physician has prescribed ranolazine

(Ranexa). Which of the following statements is true regarding the use

of ranolazine for the treatment of this patient's angina?

Selecte

d

Answer

:

Mr. Penny requires concurrent treatment with a beta

blocker, nitrate, or a calcium channel blocker.

- Question (^58) 0 out of 1

points

The Nurse Practitioner is teaching a patient about the role of medications in the treatment of asthma. Which statement by the patient would require further teaching?

Selecte

d

Answer

:

“The salmeterol that I take provides me with long-term control.”

- Question 59 A primary therapy for patients with mild ulcerative colitis is:

1 out of 1

points

Selecte

d

Answer

:

Mesalamine (Pentasa).

- Question (^60) 1 out of 1

points

Which of the following conditions is a contraindication for pioglitazone (Actos).

Selecte

d

Answer

:

Severe congestive heart failure

- Question (^61) 0 out of 1

points

The nurse practitioner has prescribed elemental iron 6 mg/kg/day in

three divided doses for a toddler diagnosed with iron-deficiency

anemia. What instructions would the family nurse practitioner include

for the parents?

Selecte

d

Answer

:

Give the iron with food to increase the absorption of the medication

- Question (^62) 0 out of 1

points

An adult male comes to the clinic with complaints that he is experiencing increased difficulty breathing over the past few days. He has a history of asthma and coronary artery disease. He was recently diagnosed with hypertension. Examination reveals no jugular vein distention and no productive cough. Breath sounds are present, but expiratory wheezes are noted bilaterally, and he denies any chest pain. His vital signs are pulse of 74 beats/min, respirations of 32 breaths/min, and BP of 160/100 mm Hg. His current medications are albuterol (Proventil) inhaler 2 puffs every 4 hours prn for wheezing, nitroglycerin transdermal patch, and propranolol (Inderal) 60 mg PO bid. What is the best treatment for this patient?

Selecte

d

Answer

:

Start beclomethasone (Beclovent) inhaler 2 puffs 3 to 4 times daily

- Question (^63) 1 out of 1

points

Glucocorticoids affect the metabolism of carbohydrates, protein, and fats.

Selecte

d

Answer

:

Tr

u

e

- Question (^64) 0 out of 1

points

A 39 y/o female is diagnosed with Graves disease. She also has a small goiter =. Her symptoms are not deemed to be severe and propylthiouracil is prescribed. Whare is the most serious potential adverse effect of this medication?

Selecte

d

Answer

:

Hemato u ria

- Question (^65) 1 out of 1

points

The Family nurse practitioner prescribed losartan 50 mg PO daily for a hypertensive patient. This medication promotes vasodilation by:

Selecte

d

Answer

:

Blocking the action of angiotensin II

- Question (^66) 1 out of 1

points

When prescribing an antihypertensive medication for a type 2 diabetic patient, the drug classifications that would tend to reduce insulin sensitivity are:

Selecte

d

Answer

:

Diuretics and beta blockers.

- Question (^67) 0 out of 1

points

Ms. Neely was placed on fluoxetine about 8 weeks ago and is doing well on the medication. When initially prescribed the medication, she asks you about the common side effects of this type of medication. Which choice below is correct?

Selecte

d

Answer

:

weight loss

- Question (^68) 1 out of 1

points

A Nurse Practitioner is providing discharge planning for a 45-year-old woman who has a prescription for oral albuterol. The Nurse Practitioner will question the patient about her intake of which of the following?

Selecte

d

Answer

:

Coffe e

- Question (^69) 1 out of 1

points

Which of the following serves to protect the public by ensuring the

purity of a drug and its contents?

Selecte

d

Answer

:

Federal legislation

- Question (^70) 1 out of 1

points

What is associated with chronic overtreatment with levothyroxine (Synthroid)?

Selecte

d

Answer

:

Osteoporo sis

- Question 71 Drugs that use CYP 3A4

isoenzymes for metabolism may:

1 out of 1

points

Selecte

d

Answer

:

Both 1 and 2

- Question (^72) 1 out of 1

points

A male patient is to begin glyburide (Diabeta) for type 2 diabetes.

Before the drug therapy begins, a priority action by the nurse will be

to assess the patient's

Selecte

d

Answer

:

use of alcohol.

- Question 73