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Pharmacotherapeutics for Advanced Practice Nurse Prescribers: Questions and Answers, Exams of Nursing

A series of questions and answers related to pharmacotherapeutics for advanced practice nurse prescribers. It covers various topics, including treatment of infections, contraception, and management of common conditions. Useful for students and professionals seeking to enhance their knowledge in this field.

Typology: Exams

2024/2025

Available from 11/02/2024

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Pharmacotherapeutics for Advanced Practice

Nurse Prescribers -questions with answers

Patricia has been prescribed doxycycline for a chlamydia infection. She is healthy and her only medication is an oral combined contraceptive. Patricia's education would include:

  1. Use a back-up method of birth control (condom) until her next menses.
  2. Doxycycline may cause tendonitis and she should report any joint pain.
  3. Her partner will need treatment if her infection doesn't clear with the doxycycline.
  4. Doxycycline is used for one-dose treatment of STIs; take the whole prescription at once. - ** VERIFIED ANSWERS ** โœ”โœ” 1 When prescribing metronidazole (Flagyl) to treat bacterial vaginosis, patient education would include:
  5. Metronidazole is safe in the first trimester of pregnancy.
  6. Consuming alcohol in any form may cause a severe reaction.
  7. Sexual partners need concurrent therapy.
  8. Headaches are a sign of a serious adverse reaction and need immediate evaluation. - ** VERIFIED ANSWERS ** โœ”โœ” 2

The treatment goals when treating urinary tract infection (UTI) include:

  1. Eradication of infecting organism
  2. Relief of symptoms
  3. Prevention of recurrence of the UTI
  4. All of the above - ** VERIFIED ANSWERS ** โœ”โœ” 4 Sally is a 16-year-old female with a urinary tract infection. She is healthy, afebrile, with no use of antibiotics in the previous 6 months and no drug allergies. An appropriate first-line antibiotic choice for her would be:
  5. Azithromycin
  6. Trimethoprim/sulfamethoxazole
  7. Ceftriaxone
  8. Levofloxacin - ** VERIFIED ANSWERS ** โœ”โœ” 2 Jamie is a 24-year-old female with a urinary tract infection. She is healthy, afebrile, and her only drug allergy is sulfa, which gives her a rash. An appropriate first-line antibiotic choice for her would be:
  9. Azithromycin
  10. Trimethoprim/sulfamethoxazole
  1. Ceftriaxone
  2. Ciprofloxacin - ** VERIFIED ANSWERS ** โœ”โœ” 4 Juanita is a 28-year-old pregnant woman at 38 weeks' gestation who is diagnosed with a lower urinary tract infection (UTI). She is healthy with no drug allergies. Appropriate first-line therapy for her UTI would be:
  3. Azithromycin
  4. Trimethoprim/sulfamethoxazole
  5. Amoxicillin
  6. Ciprofloxacin - ** VERIFIED ANSWERS ** โœ”โœ” 3 Which of the following patients may be treated with a 3-day course of therapy for their urinary tract infection?
  7. Juanita, a 28-year-old pregnant woman
  8. Sally, a 16-year-old healthy adolescent
  9. Jamie, a 24-year-old female
  10. Suzie, a 26-year-old diabetic - ** VERIFIED ANSWERS ** โœ”โœ” 3 Nicole is a 4-year-old female with a febrile urinary tract infection (UTI). She is generally healthy and has no drug allergies. Appropriate initial therapy for her UTI would be:
  1. Azithromycin
  2. Trimethoprim/sulfamethoxazole
  3. Ceftriaxone
  4. Ciprofloxacin - ** VERIFIED ANSWERS ** โœ”โœ” 3 Monitoring for a healthy, nonpregnant adult patient being treated for a urinary tract infection is:
  5. Symptom resolution in 48 hours
  6. Follow-up urine culture at completion of therapy
  7. "Test of cure" urinary analysis at completion of therapy
  8. Follow-up urine culture 2 months after completion of therapy - ** VERIFIED ANSWERS ** โœ”โœ” 1 Monitoring for a child who has had a urinary tract infection is:
  9. Symptom resolution in 48 hours
  10. Follow-up urine culture at completion of therapy
  11. "Test of cure" urinary analysis at completion of therapy
  12. Follow-up urine culture 2 months after completion of therapy - ** VERIFIED ANSWERS ** โœ”โœ” 2

Monitoring for a pregnant woman who has had a urinary tract infection is:

  1. Symptom resolution in 48 hours
  2. Follow-up urine culture at completion of therapy
  3. "Test of cure" urinary analysis at completion of therapy
  4. Follow-up urine culture every 2 weeks until delivery - ** VERIFIED ANSWERS ** โœ”โœ” 4 Along with an antibiotic prescription, lifestyle education for a nonpregnant adult female who has had a urinary tract infection includes:
  5. Increasing her intake of vitamin C-containing orange juice
  6. Voiding 10 to 15 minutes after intercourse
  7. Avoiding ingesting urinary irritants, such as asparagus
  8. All of the above - ** VERIFIED ANSWERS ** โœ”โœ” 2 Lisa is a healthy nonpregnant adult woman who recently had a urinary tract infection (UTI). She is asking about drinking cranberry juice to prevent a recurrence of the UTI. The correct answer to give her would be:
  9. Sixteen ounces per day of cranberry juice cocktail will prevent UTIs.
  10. 100% cranberry juice or cranberry juice extract may decrease UTIs in some patients.
  1. There is no evidence that cranberry juice helps prevent UTIs.
  2. Cranberry juice only works to prevent UTIs in children. - ** VERIFIED ANSWERS ** โœ”โœ” 2 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?
  3. Miconazole (Micatin) powder
  4. Ketoconazole (Nizoral) cream
  5. Terbinafine (Lamisil) cream
  6. Griseofulvin (Grifulvin V) suspension - ** VERIFIED ANSWERS ** โœ”โœ” 3 When prescribing topical penciclovir (Denavir) for the treatment of herpes labialis (cold sores) patient education would include:
  7. Spread penciclovir liberally all over lips and area surrounding lips.
  8. Penciclovir therapy is started at the first sign of a cold sore outbreak.
  9. Skin irritation is normal with penciclovir and it should resolve.
  10. The penciclovir should be used a minimum of 2 weeks to prevent recurrence. - ** VERIFIED ANSWERS ** โœ”โœ” 2

Topical diphenhydramine (Benadryl) is available OTC to treat itching. Patients or parents should be instructed regarding the use of topical diphenhydramine that:

  1. For maximum effectiveness in treating itching, combine topical with oral diphenhydramine.
  2. Topical diphenhydramine is the treatment of choice in treating poison ivy or poison oak.
  3. Topical diphenhydramine should not be used in children younger than age 2 years.
  4. When applying topical diphenhydramine, apply the cream liberally to all areas that itch. - ** VERIFIED ANSWERS ** โœ”โœ” 3 Absolute contraindications to estrogen therapy include:
  5. History of any type of cancer
  6. Clotting disorders
  7. History of tension headaches
  8. Orthostatic hypotension - ** VERIFIED ANSWERS ** โœ”โœ” 2 Women who have migraines with an aura should not be prescribed estrogen because of:
  9. The interaction between triptans and estrogen, limiting migraine therapy choices
  10. An increased incidence of migraines with the use of estrogen
  1. An increased risk of stroke occurring with estrogen use
  2. Patients with migraines may be prescribed estrogen without any concerns - ** VERIFIED ANSWERS ** โœ”โœ” 3 A 19-year-old female is a nasal Staph aureus carrier and is placed on 5 days of rifampin for treatment. Her only other medication is combined oral contraceptives. What education should she receive regarding her medications?
  3. Separate the oral ingestion of the rifampin and oral contraceptive by at least an hour.
  4. Both medications are best tolerated if taken on an empty stomach.
  5. She should use a back-up method of birth control such as condoms for the rest of the current pill pack.
  6. If she gets nauseated with the medications she should call the office for an antiemetic prescription. - ** VERIFIED ANSWERS ** โœ”โœ” 3 A 56-year-old woman is complaining of vaginal dryness and dyspareunia. To treat her symptoms with the lowest adverse effects she should be prescribed:
  7. Low-dose oral estrogen
  8. A low-dose estrogen/progesterone combination
  9. A vaginal estradiol ring
  10. Vaginal progesterone cream - ** VERIFIED ANSWERS ** โœ”โœ” 3

The goals of treatment when prescribing for sexually transmitted infections include:

  1. Treatment of infection
  2. Prevention of disease spread
  3. Prevention of long-term sequelae from the infection
  4. All of the above - ** VERIFIED ANSWERS ** โœ”โœ” 4 The drug of choice for treatment of primary or secondary syphilis is:
  5. Ceftriaxone IM
  6. Benzathine penicillin G IM
  7. Oral azithromycin
  8. Oral ciprofloxacin - ** VERIFIED ANSWERS ** โœ”โœ” 2 The drug of choice for treatment of early latent or tertiary syphilis is:
  9. Ceftriaxone IM
  10. Benzathine penicillin G IM
  11. Oral azithromycin
  1. Oral ciprofloxacin - ** VERIFIED ANSWERS ** โœ”โœ” 2 Demione is a 24-year-old patient who is 32 weeks pregnant and has tested positive for syphilis. The best treatment for her would be:
  2. IM ceftriaxone
  3. IM benzathine penicillin G
  4. Oral azithromycin
  5. Any of the above - ** VERIFIED ANSWERS ** โœ”โœ” 2 Treatment for suspected gonorrhea is:
  6. Ceftriaxone 250 mg IM x 1
  7. Ceftriaxone 2 grams IM x 1
  8. Ciprofloxacin 500 mg PO x 1
  9. Doxycycline 100 mg bid x 7 days - ** VERIFIED ANSWERS ** โœ”โœ” 1 When treating suspected gonorrhea in a nonpregnant patient, the patient should be concurrently treated for chlamydia with:
  10. Azithromycin 1 gram PO x 1
  11. Amoxicillin 500 mg PO x 1
  1. Ciprofloxacin 500 mg PO x 1
  2. Penicillin G 2.4 million units IM x 1 - ** VERIFIED ANSWERS ** โœ”โœ” 1 Ongoing monitoring is essential after treating for gonorrhea. The patient should be rescreened for gonorrhea and chlamydia in:
  3. 4 weeks
  4. 3 to 6 weeks
  5. 3 to 6 months
  6. 1 year - ** VERIFIED ANSWERS ** โœ”โœ” 3 A test of cure is recommended after treating chlamydia in which patient population?
  7. Men who have sex with men
  8. Adolescent females
  9. Pregnant patients
  10. All of the above - ** VERIFIED ANSWERS ** โœ”โœ” 3 Treatment for chancroid in a nonpregnant patient would be:
  11. Oral azithromycin
  1. IM ceftriaxone
  2. Oral ciprofloxacin
  3. Any of the above - ** VERIFIED ANSWERS ** โœ”โœ” 4 Jamie was treated for chancroid. Follow-up testing after treatment of chancroid would be:
  4. Syphilis and HIV testing at 3-month intervals
  5. Chancroid-specific antigen test every 3 months
  6. Urine testing for Haemophilus ducreyi in 3 to 6 months for test of cure
  7. Annual HIV testing if engaging in high-risk sexual behavior - ** VERIFIED ANSWERS ** โœ”โœ” 1 Helima presents with a complaint of vaginal discharge that when tested meets the criteria for bacterial vaginosis. Treatment of bacterial vaginosis in nonpregnant symptomatic women would be:
  8. Metronidazole 500 mg PO bid x 7 days
  9. Doxycycline 100 mg PO bid x 7 days
  10. Intravaginal tinidazole daily x 5 days
  11. Metronidazole 2 grams PO x 1 dose - ** VERIFIED ANSWERS ** โœ”โœ” 1

Besides prescribing antimicrobial therapy, patients with bacterial vaginosis require education regarding the fact that:

  1. The most recent partners in the past 60 days should also be treated.
  2. Alcohol should not be consumed during and for 1 day after metronidazole is taken.
  3. Condoms should be used during intercourse if intravaginal clindamycin cream is used.
  4. Co-treatment for chlamydia is necessary. - ** VERIFIED ANSWERS ** โœ”โœ” 2 Sydney presents to the clinic with vulvovaginal candidiasis. Appropriate treatment for her would be:
  5. OTC intravaginal clotrimazole
  6. OTC intravaginal miconazole
  7. Oral fluconazole one-time dose
  8. Any of the above - ** VERIFIED ANSWERS ** โœ”โœ” 4 If a woman presents with recurrent vulvovaginal candidiasis she may be treated with:
  9. Weekly intravaginal butoconazole for 3 months
  10. Fluconazole 150 mg PO daily x 7 doses then monthly for 6 months
  1. Weekly fluconazole 150 mg PO x 6 months
  2. Intravaginal tioconazole x 14 days - ** VERIFIED ANSWERS ** โœ”โœ” 3 Zoe presents with genital warts present on her labia. Patient-applied topical therapy for warts includes:
  3. Podofilox 0.5% gel
  4. Podophyllin 10% resin
  5. Trichloracetic acid
  6. Any of the above - ** VERIFIED ANSWERS ** โœ”โœ” 1 Sophie presents to the clinic with a malodorous vaginal discharge and is confirmed to have Trichomonas infection. Treatment for her would include:
  7. Metronidazole 2 grams PO x 1 dose
  8. Topical intravaginal metronidazole daily x 7 days
  9. Intravaginal clindamycin daily x 7 days
  10. Azithromycin 2 grams PO x 1 dose - ** VERIFIED ANSWERS ** โœ”โœ” 1 In addition to antimicrobial therapy, patients treated for Trichomonas infection should be educated regarding:
  11. Necessity of treating sexual partner simultaneously
  1. Abstaining from intercourse until both partners are treated
  2. Need for retesting in 3 months due to high reinfection rate
  3. All of the above - ** VERIFIED ANSWERS ** โœ”โœ” 4 Prescribing for women during their childbearing years requires constant awareness of the possibility of:
  4. Pregnancy unless the women is on birth control
  5. Risk for silent bacterial or viral infections of the genitalia
  6. High risk for developmental disorders in their infants
  7. Decreased risk for abuse during this time - ** VERIFIED ANSWERS ** โœ”โœ” 2 Intimate partner violence is a serious public health problem. It should be screened for:
  8. At every encounter within the health-care system
  9. When a women is being seen for symptoms of depression
  10. Throughout pregnancy
  11. If a sexually transmitted disease is diagnosed - ** VERIFIED ANSWERS ** โœ”โœ” 1

Paige has a history of chronic migraines and would benefit from preventative medication. Education regarding migraine preventive medication includes:

  1. Medication is taken at the beginning of the headache to prevent it from getting worse.
  2. Medication alone is the best preventative against migraines occurring.
  3. Medication should not be used more than four times a month.
  4. The goal of treatment is to reduce migraine occurrence by 50%. - ** VERIFIED ANSWERS ** โœ”โœ” 4 A first-line drug for abortive therapy in simple migraine is:
  5. Sumatriptan (Imitrex)
  6. Naproxen (Aleve)
  7. Butorphanol nasal spray (Stadol NS)
  8. Butalbital and acetaminophen (Fioricet) - ** VERIFIED ANSWERS ** โœ”โœ” 2 Vicky, age 56 years, comes to the clinic requesting a refill of her Fiorinal (aspirin and butalbital) that she takes for migraines. She has been taking this medication for over 2 years for migraines and states one dose usually works to abort her migraine. What is the best care for her?
  9. Switch her to sumatriptan (Imitrex) to treat her migraines.
  10. Assess how often she is using Fiorinal and refill her medication.
  1. Switch her to a beta blocker such as propranolol to prevent her migraine.
  2. Request she return to the original prescriber of Fiorinal as you do not prescribe butalbital for migraines. - ** VERIFIED ANSWERS ** โœ”โœ” 2 When prescribing ergotamine suppositories (Wigraine) to treat acute migraine, patient education would include:
  3. Ergotamine will briefly make the migraine worse before the migraine resolves.
  4. The patient may experience bradycardia and dizziness.
  5. They may need premedication with an antinausea medication.
  6. Ergotamine works best if the patient starts off with a full suppository to get the full effect. - ** VERIFIED ANSWERS ** โœ”โœ” 3 Migraines in pregnancy may be safely treated with:
  7. Acetaminophen with codeine (Tylenol #3)
  8. Sumatriptan (Imitrex)
  9. Ergotamine tablets (Ergostat)
  10. Dihydroergotamine (DHE) - ** VERIFIED ANSWERS ** โœ”โœ” 1 Xi, a 54-year-old female, has a history of migraines that do not respond well to OTC migraine medication. She is asking to try Maxalt (rizatriptan) because it works well for her friend. Appropriate decision making would be:
  1. Prescribe the Maxalt, but only give her four tablets with no refills to monitor the use.
  2. Prescribe Maxalt and arrange to have her observed in the clinic or urgent care with the first dose.
  3. Explain that rizatriptan is not used for postmenopausal migraines and recommend Fiorinal (aspirin and butalbital).
  4. Prescribe sumatriptan (Imitrex) with the explanation that it is the most effective triptan. - ** VERIFIED ANSWERS ** โœ”โœ” 2 Kelly is a 14-year-old patient who presents to the clinic with a classic migraine. She says she is having a headache two to three times a month. The initial plan would be:
  5. Prescribe NSAIDs as abortive therapy and have her keep a headache diary to identify her triggers.
  6. Prescribe zolmitriptan (Zomig) as abortive therapy and recommend relaxation therapy to reduce her stress.
  7. Prescribe acetaminophen with codeine (Tylenol #3) for her to take at the first onset of her migraine.
  8. Prescribe sumatriptan (Imitrex) nasal spray and arrange for her to receive the first dose in the clinic. - ** VERIFIED ANSWERS ** โœ”โœ” 1 Jayla is a 9-year-old patient who has been diagnosed with migraines for almost 2 years. She is missing up to a week of school each month. Her headache diary

confirms she averages four or five migraines per month. Which of the following would be appropriate?

  1. Prescribe amitriptyline (Elavil) daily, start at a low dose and increase dosage slowly every 2 weeks until it's effective in eliminating migraines.
  2. Encourage her mother to give her Excedrin Migraine (aspirin, acetaminophen, and caffeine) at the first sign of a headache to abort the headache.
  3. Prescribe propranolol (Inderal) to be taken daily for at least 3 months.
  4. Explain that it is rare for a 9-year-old child to get migraines and she needs an MRI to rule out a brain tumor. - ** VERIFIED ANSWERS ** โœ”โœ” 3 Amber is a 24-year-old patient who has had migraines for 10 years. She reports a migraine on average of once a month. The migraines are effectively aborted with naratriptan (Amerge). When refilling Amber's naratriptan, education would include:
  5. Naratriptan will interact with antidepressants, including selective serotonin reuptake inhibitors (SSRIs) and St John's wort, and she should inform any providers she sees that she has migraines.
  6. Continue to monitor her headaches, if the migraine is consistently happening around her menses there is preventive therapy available.
  7. Pregnancy is contraindicated when taking a triptan.
  8. All of the above - ** VERIFIED ANSWERS ** โœ”โœ” 4 When prescribing for migraines, patient education includes:
  9. Triptans are safe to be used as often as needed as long as the patient is healthy.
  1. Use triptan before trying OTC meds such as acetaminophen or naproxen.
  2. Stress reduction and regular sleep are integral to migraine treatment.
  3. If migraines worsen they are to increase their medication. - ** VERIFIED ANSWERS ** โœ”โœ” 3 Juanita presents to the clinic with a complaint of headaches off and on for months. She reports they feel like someone is "squeezing" her head. She occasionally takes Tylenol for the pain, but usually just "toughs it out." Initial treatment for tension headache includes asking her to keep a headache diary and a prescription for:
  4. Sumatriptan (Imitrex)
  5. Naproxen (Aleve)
  6. Ergotamine (Ergostat)
  7. Tylenol with codeine (Tylenol #3) - ** VERIFIED ANSWERS ** โœ”โœ” 2 Nonpharmacologic therapy for tension headaches includes:
  8. Biofeedback
  9. Stress management
  10. Massage therapy
  11. All of the above - ** VERIFIED ANSWERS ** โœ”โœ” 4

James has been diagnosed with cluster headaches. Appropriate acute therapy would be:

  1. Butalbital and aspirin (Fiorinal)
  2. Meperidine IM (Demerol)
  3. Oxygen 100% for 15 to 30 minutes
  4. Indomethacin (Indocin) - ** VERIFIED ANSWERS ** โœ”โœ” 3 Preventative therapy for cluster headaches includes:
  5. Massage or relaxation therapy
  6. Ergotamine nightly before bed
  7. Intranasal lidocaine four times a day during "clusters" of headaches
  8. Propranolol (Inderal) daily - ** VERIFIED ANSWERS ** โœ”โœ” 2 When prescribing any headache therapy, appropriate use of medications needs to be discussed to prevent medication-overuse headaches. A clinical characteristic of medication-overuse headaches is that they:
  9. Are increasing in frequency
  10. Are increasing in intensity
  1. Recur when medication wears off
  2. Begin to "cluster" into a pattern - ** VERIFIED ANSWERS ** โœ”โœ” 3 The goals of treatment when prescribing antiretroviral medication to patients with HIV include:
  3. Prevent vertical HIV transmission
  4. Improve quality of life
  5. Prolong survival
  6. All of the above - ** VERIFIED ANSWERS ** โœ”โœ” 4 A challenge faced with antiretroviral therapy (ART) is:
  7. Patients abusing ART
  8. Drug-resistant mutations of HIV
  9. Reduction of transmissibility of HIV
  10. Lack of efficacy data - ** VERIFIED ANSWERS ** โœ”โœ” 2 Predictors for successful treatment with antiretroviral therapy (ART) in HIV- positive patients include:
  11. They respond to a low-potency treatment regimen
  1. They have demonstrated resistance in the past and should respond to newer ART drugs
  2. The patient is strictly adherent to the ART treatment regimen
  3. Lower baseline CD4 T-cell count at baseline - ** VERIFIED ANSWERS ** โœ”โœ” 3 The goal of antiretroviral therapy in HIV-positive patients is:
  4. Maximum suppression of HIV replication
  5. Eradication of HIV virus from the body
  6. Determining a treatment regimen that is free of adverse effects
  7. Suppression of CD4 T-cell count - ** VERIFIED ANSWERS ** โœ”โœ” 1 Pregnant women who are HIV positive:
  8. Are treated with AZT alone to prevent birth defects
  9. Are treated with a combination antiretroviral therapy (ART) regimen
  10. Should not be treated with ART due to teratogenicity of the drugs
  11. Are at high risk of developing resistance to ART drugs - ** VERIFIED ANSWERS ** โœ”โœ” 2 Antiretroviral therapy is recommended for HIV-positive patients with:
  1. A history of AIDS-defining illness
  2. Pregnant women
  3. Hepatitis B co-infection
  4. All of the above - ** VERIFIED ANSWERS ** โœ”โœ” 4 If considering starting a patient on the nucleoside reverse transcriptase inhibitor abacavir, the following testing is recommended prior to prescribing:
  5. Renal function
  6. HLA B*5701 testing
  7. Pancreatic enzyme levels
  8. CYP 450 enzyme activity - ** VERIFIED ANSWERS ** โœ”โœ” 2 Suzanne is pregnant and has tested HIV positive. Which antiretroviral drug should be avoided in women who are pregnant?
  9. Lopinavir/r
  10. Zidovudine
  11. Ritonavir
  12. Lopinavir/ritonavir - ** VERIFIED ANSWERS ** โœ”โœ” 1

The cost of HIV treatment can be prohibitive for any patient. Patients can receive assistance from the:

  1. Best Pharmaceuticals for HIV/AIDS Patient Act
  2. Ryan White HIV/AIDS Treatment Modernization Act
  3. National Institute of Health HIV/AIDS Assistance Fund
  4. Centers for Disease Control HIV/AIDS Treatment Fund - ** VERIFIED ANSWERS ** โœ”โœ” 2 Resistance to antiretroviral therapy (ART) is measured by:
  5. Measuring the DNA viral load in the serum
  6. Determining plasma viral RNA on two successive measurements
  7. Phenotype assays of the combination of ART the patient is on
  8. Elevation of T4 counts - ** VERIFIED ANSWERS ** โœ”โœ” 2 Phenotype assays are used to measure _______ of antiretroviral therapy.
  9. Effectiveness
  10. Genotype
  11. Sensitivity