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2024 - 615-Pharm Exam 4 questions with answers tested and verified updated solutions best, Exams of Nursing

Harrisburg Area Community College (HACC) - LancasterNursing

2024 - 615-Pharm Exam 4 questions with answers tested and verified updated solutions best for final with A+ grade

Typology: Exams

2023/2024

Available from 01/30/2024

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2024 - 615-Pharm Exam 4 questions with answers tested and
verified updated solutions best for final with A+ grade
1. Digoxin levels need to be monitored closely when the following medication
is started:
1
.
Loratadine
2
.
Diphenhydramine
3
.
Ipratropium
4
.
Albuterol
Albuterol
2. Patients with pheochromocytoma should avoid which of the following classes
of drugs because of the possibility of developing hypertensive crisis?
1
.
Expectorants
2
.
Beta-2-agonists
3
.
Antitussives
4
.
Antihistamines
Beta 2-agonists
3. Stan, a 42-year-old African American, has moderate persistent asthma. Which
of the following asthma medications should be used cautiously, if at all?
1
.
Betamethasone, an inhaled corticosteroid
2
.
Salmeterol, an inhaled long-acting beta-agonist
3
.
Albuterol, a short-acting beta-agonist
4
.
Montelukast, a leukotriene modifier
Salmeterol, an inhaled long-acting beta-agonist
4. Long-acting beta-agonists (LTBAs) received a Black Box Warning from the
U.S. Food and Drug Administration due to the:
1
.
Risk of life-threatening dermatological reactions
2 Increased incidence of cardiac events when LTBAs are used
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pf9
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pf13
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Partial preview of the text

Download 2024 - 615-Pharm Exam 4 questions with answers tested and verified updated solutions best and more Exams Nursing in PDF only on Docsity!

2024 - 615-Pharm Exam 4 questions with answers tested and

verified updated solutions best for final with A+ grade

  1. Digoxin levels need to be monitored closely when the following medication is started: 1 . Loratadine 2 . Diphenhydramine 3 . Ipratropium 4 . Albuterol Albuterol
  2. Patients with pheochromocytoma should avoid which of the following classes of drugs because of the possibility of developing hypertensive crisis? 1 . Expectorants 2 . Beta-2-agonists 3 . Antitussives 4 . Antihistamines Beta 2-agonists
  3. Stan, a 42-year-old African American, has moderate persistent asthma. Which of the following asthma medications should be used cautiously, if at all? 1 . Betamethasone, an inhaled corticosteroid 2 . Salmeterol, an inhaled long-acting beta-agonist 3 . Albuterol, a short-acting beta-agonist 4 . Montelukast, a leukotriene modifier Salmeterol, an inhaled long-acting beta-agonist
  4. Long-acting beta-agonists (LTBAs) received a Black Box Warning from the U.S. Food and Drug Administration due to the: 1 . Risk of life-threatening dermatological reactions 2 Increased incidence of cardiac events when LTBAs are used

Increased risk of asthma-related deaths when LTBAs are used 4 . Risk for life-threatening alterations in electrolytes Increased risk of asthma-related deaths when LTBAs are used

  1. The bronchodilator of choice for patients taking propranolol is: 1 . Albuterol 2 . Pirbuterol 3 . Formoterol 4 . Ipratropium Ipratropium
  2. Mathew is a 52-year-old overweight smoker taking theophylline for his persistent asthma. He tells his provider he is going to start the Atkin’s diet for weight loss. The appropriate response would be: 1 . Congratulate him on making a positive change in his life. 2 . Recommend he try stopping smoking instead of the Atkin’s diet. 3 . Schedule him for regular testing of serum theophylline levels during his diet due to increased excretion of theophylline. 4 . Decrease his theophylline dose because a high-protein diet may lead to elevated theophylline levels. Recommend smoking cessation
  3. Marty takes theophylline for his persistent asthma and calls the office with a complaint of nausea, vomiting, and headache. The best advice for him would be to: 1 . Reassure him this is probably a viral infection and should be better soon 2 . Have him seen the same day for an assessment and theophylline level 3 . Schedule him for an appointment in 2 to 3 days, which he can cancel if he is better 4 . Order a theophylline level at the laboratory for him Schedule him an appointment in 2-3 days
  1. The known drug interactions with the inhaled corticosteroid beclomethasone (QVAR) include:
  2. Albuterol
  3. MMR vaccine
  4. Insulin 4 . None of the above Insulin
  5. When educating patients who are starting on inhaled corticosteroids, the provider should tell them that: 1 They need to get any live vaccines before starting the . medication. 2 Inhaled corticosteroids need to be used daily during asthma . exacerbations to be effective. 3 Patients should rinse their mouths out after using the . inhaled corticosteroid to prevent thrush. 4 They can triple the dose number of inhalations of . medication during colds to prevent needing systemic steroids. Patients should rinse their mouth out to prevent thrush.
  6. Patients with allergic rhinitis may benefit from a prescription of:
  7. Fluticasone (Flonase)
  8. Cetirizine (Zyrtec)
  9. OTC cromolyn nasal spray (Nasalcrom) 4 . Any of the above All of the above
  10. William is a 72-year-old male who occasionally takes diphenhydramine for his seasonal allergies. Monitoring for this patient taking diphenhydramine would include assessing for: 1 . Urinary retention 2 . Cardiac output 3 . Peripheral edema 4 . Skin rash Urinary retention
  1. First-generation antihistamines such as loratadine (Claritin) are prescribed for seasonal allergies because they are: 1 . More effective than first-generation antihistamines 2 . Less sedating than the first-generation antihistamines 3 . Prescription products, therefore are covered by insurance 4 . Able to be taken with central nervous system (CNS) sedatives, such as alcohol Less sedating than 1 st^ generation antihistamines
  2. When recommending dimenhydrinate (Dramamine) to treat motion sickness, patients should be instructed to: 1 . Take the dimenhydrinate after they get nauseated 2 . Drink lots of water while taking the dimenhydrinate 3 . Take the dimenhydrinate 15 minutes before it is needed 4 . Double the dose if one tablet is not effective Be sure to take it 15 minutes before it is needed
  3. Decongestants such as pseudoephedrine (Sudafed): 1 . Are Schedule III drugs in all states 2 . Should not be prescribed or recommended for children under 4 years of age 3 . Are effective in treating the congestion children experience with the common cold 4 . May cause drowsiness in patients of all ages Should be avoided in children young than 4 years old
  4. Cough and cold medications that contain a sympathomimetic decongestant such as phenylephrine should be used cautiously in what population:
  5. Older adults
  6. Hypertensive patients
  7. Infants 4 . All of the above

At nighttime three to four times a month 3 . Less than twice a week 4 . Daily At nighttime 3-4 times a month

  1. One goal of asthma therapy outlined by the NHLBI Expert Panel 3 guidelines is: 1 . Ability to use albuterol daily to control symptoms 2 . Minimize exacerbations to once a month 3 . Keep nighttime symptoms at a maximum of twice a week 4 . Require infrequent use of beta 2 agonists (albuterol) for relief of symptoms Require infrequent use of beta2-agonists for relief of symptoms
  2. A stepwise approach to the pharmacologic management of asthma: 1 . Begins with determining the severity of asthma and assessing asthma control 2 . Is used when asthma is severe and requires daily steroids 3 . Allows for each provider to determine their personal approach to the care of asthmatic patients 4 . Provides a framework for the management of severe asthmatics, but is not as helpful when patients have intermittent asthma Begins with determining the severity of asthma and assessing asthma control
  3. Treatment for mild intermittent asthma is: 1 . Daily inhaled medium-dose corticosteroids 2 . Short-acting beta-2-agonists (albuterol) as needed 3 . Long-acting beta-2-agonists every morning as a preventative 4 . Montelukast (Singulair) daily Albuterol, a short-acting beta2-agonist
  1. The first-line therapy for mild-persistent asthma is: 1 . High-dose montelukast 2 . Theophylline 3 . Low-dose inhaled corticosteroids 4 . Long-acting beta-2-agonists Low-dose inhaled corticosteroids
  2. Monitoring a patient with persistent asthma includes: 1 . Monitoring how frequently the patient has an upper respiratory infection (URI) during treatment 2 . Monthly in-office spirometry testing 3 . Determining if the patient has increased use of his or her long-acting beta-2-agonist due to exacerbations 4 . Evaluating the patient every 1 to 6 months to determine if the patient needs to step up or down in their therapy Evaluating the patient every 1 to 6 months
  3. Asthma exacerbations at home are managed by the patient by: 1 . Increasing frequency of beta-2-agonists and contacting their provider 2 . Doubling inhaled corticosteroid doses 3 . Increasing frequency of beta-2-agonists 4 . Starting montelukast (Singulair) Increasing frequency of their beta2-agonist and contacting their provider
  4. Patients who are at risk of a fatal asthma attack include patients: 1 . With moderate persistent asthma 2 . With a history of requiring intubation or ICU admission for asthma 3 . Who are on daily inhaled corticosteroid therapy 4 . Who are pregnant Those with a history of intubation/ICU admissions for their asthma
  1. Patients with COPD require monitoring of: 1 . Beta-2-agonist use 2 . Serum electrolytes 3 . Blood pressure 4 . Neuropsychiatric effects of montelukast Their beta2-agonist use
  2. Education of patients with COPD who use inhaled corticosteroids includes: 1 . Doubling the dose at the first sign of a URI 2 . Using their inhaled corticosteroid first and then their bronchodilator 3 . Rinsing their mouth after use 4 . Abstaining from smoking for at least 30 minutes after using Must teach them to rinse their mouth after use
  3. Education for patients who use an inhaled beta-agonist and an inhaled corticosteroid includes: 1 . Use the inhaled corticosteroid first, followed by the inhaled beta-agonists. 2 . Use the inhaled beta-agonist first, followed by the inhaled corticosteroid. 3 . Increase fluid intake to 3 liters per day. 4 . Avoid use of aspirin or ibuprofen while using inhaled medications. Must teach them to use the inhaled beta-agonist first, followed by the inhaled corticosteroid
  4. The most common bacterial pathogen in community-acquired pneumonia is: 1 . Haemophilus influenzae 2 . Staphylococcus aureus 3 . Mycoplasma pneumoniae 4 Streptococcus pneumoniae

Streptococcus pneumoniae

  1. The first-line drug choice for a previously healthy adult patient diagnosed with community-acquired pneumonia would be: 1 . Ciprofloxacin 2 . Azithromycin 3 . Amoxicillin 4 . Doxycycline Azithromycin
  2. The first-line antibiotic choice for a patient with comorbidities or who is immunosuppressed who has pneumonia and can be treated as an outpatient would be: 1 . Levofloxacin 2 . Amoxicillin 3 . Ciprofloxacin 4 . Cephalexin Levofloxacin
  3. If an adult patient with comorbidities cannot reliably take oral antibiotics to treat pneumonia, an appropriate initial treatment option would be: 1 . IV or IM gentamicin 2 . IV or IM ceftriaxone 3 . IV amoxicillin 4 . IV ciprofloxacin IV or IM ceftriaxone
  4. Jennifer is 34 weeks pregnant and has been diagnosed with pneumonia. She is stable enough to be treated as an outpatient. What would be an appropriate antibiotic to prescribe? 1 Levofloxacin
  1. Charlie is a 4-year-old patient who has suspected bacterial pneumonia. He has a temperature of 102°F, oxygen saturation level of 95%, and is taking fluids adequately. What would be appropriate initial treatment for his pneumonia? 1 . Ceftriaxone 2 . Azithromycin 3 . Cephalexin 4 . Levofloxacin Ceftriaxone
  2. Bailey is a 14-year-old patient who presents to the clinic with symptoms consistent with mycoplasma pneumonia. What is the treatment for suspected mycoplasma pneumonia in an adolescent? 1 . Ceftriaxone 2 . Azithromycin 3 . Ciprofloxacin 4 . Levofloxacin Azithromycin
  3. Drug resistant tuberculosis (TB) is defined as TB that is resistant to: 1 . Fluoroquinolones 2 . Rifampin and isoniazid 3 . Amoxicillin 4 . Ceftriaxone Rifampin and isoniazid
  4. Goals when treating tuberculosis include:
  5. Completion of recommended therapy
  6. Negative purified protein derivative at the end of therapy
  7. Completely normal chest x-ray 4 . All of the above

Completion of therapy

  1. The principles of drug therapy for the treatment of tuberculosis include:
  2. Patients are treated with a drug to which M. tuberculosis is sensitive.
  3. Drugs need to be taken on a regular basis for a sufficient amount of time.
  4. Treatment continues until the patient’s purified protein derivative is negative. 4 . All of the above Drugs need to be taken on a regular basis for a sufficient amount of time to be effective.
  5. Lilliana has confirmed tuberculosis and is placed on a 6-month treatment regimen. The 6-month regimen consists of:
  6. Two months of four-drug therapy (INH, rifampin, pyrazinamide, and ethambutol) followed by Four months of INH and rifampin
  7. Six months of INH with daily pyridoxine throughout therapy
  8. Six months of INH, rifampin, pyrazinamide, and ethambutol 4 . Any of the above 2 months of a 4-drug therapy followed by 4 months of INH and rifampin
  9. Jordan has extensively resistant tuberculosis (TB). Treatment for extensively resistant TB would include: 1 . INH, rifampin, pyrazinamide, and ethambutol for at least 12 months 2 . INH, ethambutol, kanamycin, and rifampin 3 . Treatment with at least two drugs to which the TB is susceptible 4 . Levofloxacin Tx of at least 2 drugs to which the TB is susceptible
  10. Sunny is 24 weeks pregnant and has been diagnosed with tuberculosis (TB). Treatment regimens for a pregnant patient with TB would include: 1 . Streptomycin 2 . Levofloxacin 3 Kanamycin

All of the above All of the above

  1. Many patients self-medicate with antacids. Which patients should be counseled to not take calcium carbonate antacids without discussing it with their provider or a pharmacist first? 1 . Patients with kidney stones 2 . Pregnant patients 3 . Patients with heartburn 4 . Postmenopausal women Avoided in patients with kidney stones
  2. Patients taking antacids should be educated regarding these drugs, including letting them know that:
  3. They may cause constipation or diarrhea
  4. Many are high in sodium
  5. They should separate antacids from other medications by 1 hour 4 . All of the above All of the above
  6. Charlotte has diarrhea and is wondering if she can take loperamide (Imodium) for the diarrhea. Loperamide: 1 . Can be given to patients of all ages, including infants and children, for viral gastroenteritis 2 . Slows gastric motility and reduces fluid and electrolyte loss from diarrhea 3 . Is the treatment of choice for the diarrhea associated with E. coli 0157 4 . May be used in pregnancy and by lactating women Slows gastric motility and reduces fluid and electrolyte loss from diarrhea
  7. Bismuth subsalicylate (Pepto Bismol) is a common OTC remedy for gastrointestinal complaints. Bismuth subsalicylate:
  8. May lead to toxicity if taken with aspirin
  9. Is contraindicated in children with flu-like illness
  1. Has antimicrobial effects against bacterial and viral enteropathogens 4 . All of the above All of the above
  2. Jaide will be traveling to Mexico with her church group over spring break to build houses. She is concerned she may develop traveler’s diarrhea. Advice includes following normal food and water precautions as well as taking:
  3. Loperamide four times a day throughout the trip
  4. Bismuth subsalicylate with each meal and at bedtime
  5. A prescription for diphenoxylate with atropine to use if she gets diarrhea 4 . None of the above Bismuth subsalicylate with each meal and at bedtime
  6. Angela is a 5-year-old patient who presents to the clinic with a 48-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 IV fluids, her exam warrants the use of an antinausea medication. Which of the following would be the appropriate drug to order for Angela? 1 . Prochlorperazine (Compazine) 2 . Meclizine (Antivert) 3 . Promethazine (Phenergan) 4 . Ondansetron (Zofran) Ondansetron (Zofran)
  7. Joe presents with complaints of “heartburn” that is minimally relieved with Tums (calcium carbonate) and is diagnosed with gastroesophageal reflux disease (GERD). An appropriate first-step therapy would be: 1 . Omeprazole (Prilosec) twice a day 2 . Ranitidine (Zantac) twice a day 3 . Famotidine (Pepcid) once a day 4 . Metoclopramide (Reglan) four times a day

. constipation 3 . Children with encopresis 4 . Opioid-associated constipation Opioid-associated constipation

  1. An elderly person has been prescribed lactulose for treatment of chronic constipation. Monitoring with long-term treatment would include: 1 . Electrolytes, including potassium and chloride 2 . Bone mineral density for osteoporosis 3 . Magnesium level 4 . Liver function Electrolytes including potassium and chloride
  2. Gastroesophageal reflux disease may be aggravated by the following medication that affects lower esophageal sphincter (LES) tone: 1 . Calcium carbonate 2 . Estrogen 3 . Furosemide 4 . Metoclopramide Estrogen
  3. Lifestyle changes are the first step in treatment of gastroesophageal reflux disease (GERD). Food or drink that may aggravate GERD include: 1 . Eggs 2 . Caffeine 3 . Chocolate 4 . Soda pop Caffeine
  1. Metoclopramide improves gastroesophageal reflux disease symptoms by: 1 . Reducing acid secretion 2 . Increasing gastric pH 3 . Increasing lower esophageal tone 4 . Decreasing lower esophageal tone Increasing lower esophageal tone
  2. Antacids treat gastroesophageal reflux disease by: 1 . Increasing lower esophageal tone 2 . Increasing gastric pH 3 . Inhibiting gastric acid secretion 4 . Increasing serum calcium level Increasing gastric pH
  3. When treating patients using the “Step-Down” approach the patient with gastroesophageal reflux disease is started on first. 1 . Antacids 2 . Histamine 2 receptor antagonists 3 . Prokinetics 4 . Proton pump inhibitors Proton pump inhibitors
  4. If a patient with symptoms of gastroesophageal reflux disease states that he has been self-treating at home with OTC ranitidine daily, the appropriate treatment would be: 1 . Prokinetic (metoclopramide) for 4 to 8 weeks 2 . Proton pump inhibitor (omeprazole) for 12 weeks 3 . Histamine 2 receptor antagonist (ranitidine) for 4 to 8 weeks 4 Cytoprotective drug (misoprostol) for 2 weeks