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2024 MN 553 FINAL EXAM | ACTUAL EXAM WITH 100% CORRECT ANSWERS| BRAND NEW/A+ GRADE, Exams of Nursing

Purdue University GlobalNursing

2024 MN 553 FINAL EXAM | ACTUAL EXAM WITH 100% CORRECT ANSWERS| BRAND NEW/A+ GRADE

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2024 MN 553 FINAL EXAM | ACTUAL EXAM WITH
100% CORRECT ANSWERS| BRAND NEW/A+ GRADE
MN 553 FINAL EXAM VERSION A
1. Which of the following statements is true about acute pain?
1. Somatic pain comes from body surfaces and is only sharp and well-localized.
2. Visceral pain comes from the internal organs and is most responsive to acetaminophen and
opiates.
3. Referred pain is present in a distant site for the pain source and is based on activation of the
same spinal segment as the actual pain site.
4. Acute neuropathic pain is caused by lack of blood supply to the nerves in a given area.
2. One of the main drug classes used to treat acute pain is NSAIDs. They are used because:
1. They have less risk for liver damage than
acetaminophen.
2. Inflammation is a common cause of acute pain.
3. They have minimal GI irritation.
4. Regulation of blood flow to the kidney is not affected by these drugs.
3. The goal of treatment of acute pain is:
1. Pain at a tolerable level where the patient may return to activities of daily living
2. Reduction of pain with a minimum of drug adverse effects
3. Reduction or elimination of pain with minimum adverse reactions
4. Adequate pain relief without constipation or nausea from the drugs
4. Pathological similarities and differences between acute pain and chronic pain include:
1. Both have decreased levels of endorphins.
2. Chronic pain has a predominance of C-neuron stimulation.
3. Acute pain is most commonly associated with irritation of peripheral nerves.
4. Acute pain is diffuse and hard to localize.
17. Which antigout medication is used to treat chronic
tophaceous gout?
a. Allopurinol (Zyloprim)
b. Colchicine
c. Probenecid (Benemid)
d. Sulfinpyrazone (Anturane)
18. The nurse is assessing a patient who has gout who will begin taking allopurinol (Zyloprim).
The nurse reviews the patient’s medical record and will be concerned about which laboratory
result?
a. Elevated BUN and creatinine
b. Increased serum uric acid
c. Slight increase in the white blood count
d. Increased serum glucose
19. The nurse provides teaching for a patient who will begin taking allopurinol. Which
statement by the patient indicates understanding of the teaching?
a. I should increase my vitamin C
intake.
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Download 2024 MN 553 FINAL EXAM | ACTUAL EXAM WITH 100% CORRECT ANSWERS| BRAND NEW/A+ GRADE and more Exams Nursing in PDF only on Docsity!

2024 MN 553 FINAL EXAM | ACTUAL EXAM WITH

100% CORRECT ANSWERS| BRAND NEW/A+ GRADE

MN 553 FINAL EXAM VERSION A

  1. Which of the following statements is true about acute pain?
  2. Somatic pain comes from body surfaces and is only sharp and well-localized.
  3. Visceral pain comes from the internal organs and is most responsive to acetaminophen and opiates.
  4. Referred pain is present in a distant site for the pain source and is based on activation of the same spinal segment as the actual pain site.
  5. Acute neuropathic pain is caused by lack of blood supply to the nerves in a given area.
  6. One of the main drug classes used to treat acute pain is NSAIDs. They are used because:
  7. They have less risk for liver damage than acetaminophen.
  8. Inflammation is a common cause of acute pain.
  9. They have minimal GI irritation.
  10. Regulation of blood flow to the kidney is not affected by these drugs.
  11. The goal of treatment of acute pain is:
  12. Pain at a tolerable level where the patient may return to activities of daily living
  13. Reduction of pain with a minimum of drug adverse effects
  14. Reduction or elimination of pain with minimum adverse reactions
  15. Adequate pain relief without constipation or nausea from the drugs
  16. Pathological similarities and differences between acute pain and chronic pain include:
  17. Both have decreased levels of endorphins.
  18. Chronic pain has a predominance of C-neuron stimulation.
  19. Acute pain is most commonly associated with irritation of peripheral nerves.
  20. Acute pain is diffuse and hard to localize.
  21. Which antigout medication is used to treat chronic tophaceous gout? a. Allopurinol (Zyloprim) b. Colchicine c. Probenecid (Benemid) d. Sulfinpyrazone (Anturane)
  22. The nurse is assessing a patient who has gout who will begin taking allopurinol (Zyloprim). The nurse reviews the patient’s medical record and will be concerned about which laboratory result? a. Elevated BUN and creatinine b. Increased serum uric acid c. Slight increase in the white blood count d. Increased serum glucose
  23. The nurse provides teaching for a patient who will begin taking allopurinol. Which statement by the patient indicates understanding of the teaching? a. I should increase my vitamin C intake.

b. I will get yearly eye exams. c. I will increase my protein intake. d. I will limit fluids to prevent edema.

  1. Larry is taking allopurinol to prevent gout. Monitoring of a patient who is taking allopurinol includes:
  2. Complete blood count
  3. Blood glucose
  4. C-reactive protein
  5. BUN, creatinine, and creatinine clearance
  6. Isosorbide dinitrate is prescribed for a patient with chronic stable angina. This drug is administered twice daily, but the schedule is 7 a.m. and 2 p.m. because:
  7. It is a long-acting drug with potential for toxicity.
  8. Nitrate tolerance can develop.
  9. Orthostatic hypotension is a common adverse effect.
  10. It must be taken with milk or food.
  11. Art is a 55 - year-old smoker who has been diagnosed with angina and placed on nitrates. He complains of headaches after using his nitrate. An appropriate reply might be:
  12. This is a parasympathetic response to the vasodilating effects of the drug.
  13. Headaches are common side effects with these drugs. How severe are they?
  14. This is associated with your smoking. Let’s work on having you stop smoking.
  15. This is not related to your medication. Are you under a lot of stress?
  16. Elderly patients who are started on levothyroxine for thyroid replacement should be monitored for:
  17. Excessive sedation
  18. Tachycardia and angina
  19. Weight gain
  20. Cold intolerance
  21. Angina is produced by an imbalance between myocardial oxygen supply (MOS) and demand (MOD) in the myocardium. Which of the following drugs help to correct this imbalance by increasing MOS?
  22. Calcium channel blockers
  23. Beta blockers
  24. Angiotensin-converting-enzyme (ACE) inhibitors
  25. Aspirin
  26. The New York Heart Association and the Canadian Cardiovascular Society have described grading criteria for levels of angina. Angina that occurs with unusually strenuous activity or on walking or climbing stair after meals is class:
  27. I
  28. II
  29. II I 4.
  1. The dose is one sublingual tablet or spray every 5 minutes until the chest pain goes away.
  2. Take one nitroglycerine tablet or spray at the first sign of angina; repeat every 5minutes for no more than two doses. If chest pain is still not relieved, call 911.
  3. All of the above
  4. Combinations of a long-acting nitrate and a beta blocker are especially effective in treating angina because:
  5. Nitrates increase MOS and beta blockers increase MOD.
  6. Their additive effects permit lower doses of both drugs and their adverse reactions cancel each other out.
  7. They address the pathology of patients with exertional angina who have fixed atherosclerotic coronary heart disease.
  8. All of the above
  9. Drug choices to treat angina in older adults differ from those of younger adults only in:
    1. Consideration of risk factors for diseases associated with and increased in aging
  10. The placement of drug therapy as a treatment choice before lifestyle changes are tried
  11. The need for at least three drugs in the treatment regimen because of the complexity of angina in the older adult
  12. Those with higher risk for silent myocardial infarction
  13. Cost of antianginal drug therapy should be considered in drug selection because of all of the following EXCEPT:
  14. Patients often require multiple drugs
  15. A large number of angina patients are older adults on fixed incomes
    1. Generic formulations may be cheaper but are rarely bioequivalent
  16. Lack of drug selectivity may result in increased adverse reactions
  17. Situations that suggest referral to a specialist is appropriate include:
  18. When chronic stable angina becomes unpredictable in its characteristics and precipitating factors
  19. When a post-myocardial infarction patient develops new-onset angina
  20. When standard therapy is not successful in improving exercise tolerance or reducing the incidence of angina
    1. All of the above
  21. The rationale for prescribing calcium blockers for angina can be based on the need for:
  22. Increased inotropic effect in the heart
  23. Increasing peripheral perfusion
  24. Keeping heart rates high enough to ensure perfusion of coronary arteries
  25. Help with rate control
  26. Medications are typically started for angina patients when:
  27. The first permanent EKG changes occur
  28. The start of class I or II symptoms
  29. The events trigger a trip to the emergency department
  30. When troponin levels become altered
  1. The most common cause of angina is:
  2. Vasospasm of the coronary arteries
  3. Atherosclerosis
  4. Platelet aggregation
  5. Low systemic oxygen
  6. Ranolazine is used in angina patients to:
  7. Dilate plaque-filled arteries
  8. Inhibit platelet aggregation
  9. Restrict late sodium flow in the myocytes
  10. Induce vasoconstriction in the periphery to open coronary vessels
  11. When is aspirin (ASA) used in angina patients?
  12. All angina patients should be taking ASA unless it is contraindicated for allergy or other medical reasons.
  13. ASA should only be used in men.
  14. ASA has no role in angina, but is useful in MI prevention.
  15. The impact of ASA is best at the time of an angina attack.
  16. Robert is a 72 - year-old patient who has hypertension and angina. He is at risk for common medication practices seen in the elderly including:
  17. Use of another person’s medications
  18. Hoarding medications
  19. Changing his medication regimen without telling his provider
  20. All of the above
  21. A potentially life-threatening adverse response to angiotensin-converting enzyme inhibitors is angioedema. Which of the following statements is true about this adverse response?
  22. Swelling of the tongue or hoarseness are the most common symptoms.
  23. It appears to be related to the decrease in aldosterone production.
  24. Presence of a dry, hacky cough indicates a high risk for this adverse response.
  25. Because it takes time to build up a blood level, it occurs after being on the drug for about 1 week
  26. The tricyclic antidepressants should be prescribed cautiously in patients with:
  27. Eczema
  28. Asthma
  29. Diabetes
  30. Heart disease
  31. Prior to starting antidepressants, patients should have laboratory testing to rule out:
    1. Hypothyroidism
  32. Anemia
  33. Diabetes mellitus
  34. Low estrogen levels
  35. David is a 34 - year-old patient who is starting on paroxetine (Paxil) for depression. David’s education regarding his medication would include:
    1. Paroxetine may cause intermittent diarrhea.
  1. Which of the following should not be taken with a selective serotonin reuptake inhibitor?
  2. Aged blue cheese
  3. Grapefr uit
    1. Alcohol
  4. Green leafy vegetables
  5. Why is the consistency of taking paroxetine (Paxil) and never running out of medication more important than with most other selective serotonin reuptake inhibitors (SSRIs)?
    1. It has a shorter half-life and withdrawal syndrome has a faster onset without taper.
    2. It has the longest half-life and the withdrawal syndrome has a faster onset.
    3. It is quasi-addictive in the dopaminergic reward system.
    4. It is the most activating of SSRI medications and will cause the person to have sudden deep sadness
  6. The patient shares with the provider that he is taking his Prozac at night before going to bed. What is the best response?
  7. This is a good idea because this class of medications generally makes people sleepy.
  8. Have you noticed that you are having more sleep issues since you started that?
  9. This a good way to remember to take your daily medications because it is near your toothbrush.
  10. This is a good plan because you can eat grapefruit if there is 8 – 12 hours difference in the time each are ingested.
  11. Suzanne is started on paroxetine (Paxil), a selective serotonin reuptake inhibitor (SSRI), for depression. Education regarding her antidepressant includes:
  12. SSRIs may take 2 to 6 weeks before she will have maximum drug effects.
  13. Red-green color blindness may occur and should be reported.
  14. If she experiences dry mouth or heart rates greater than 80, she should stop taking the drug immediately.
  15. She should eat lots of food high in fiber to prevent constipation.
  16. Cecilia presents with depression associated with complaints of fatigue, sleeping all the time, and lack of motivation. An appropriate initial antidepressant for her would be:
  17. Fluoxetine (Prozac)
  18. Paroxetine (Paxil)
  19. Amitriptyline (Elavil) 4. Duloxetine (Cymbalta)
  20. Sally has been prescribed aspirin 320 mg per day for her atrial fibrillation. She also takes aspirin four or more times a day for arthritis pain. What are the symptoms of aspirin toxicity for which she would need to be evaluated?
  21. Tinnitus
  22. Diarrhea
  23. Hearing loss
  24. Photosensitivity
  25. Patients prescribed aspirin therapy require education regarding the signs of aspirin toxicity. An early sign of aspirin toxicity is:
  1. Black tarry stools
  2. Vomiting
  3. Tremo rs 4. Tinnitus
  4. All of the following statements about the Beer’s List are true except:
  5. It is a list of medications or medication classes that should generally be avoided in persons 65 years or older because they are either ineffective or they pose unnecessarily high risk for older persons and a safer alternative is available.
  6. It is derived from the expert opinion of one geriatrician and is not evidence-based.
  7. These criteria have been adopted by the Centers for Medicare and Medicaid Services for regulation of long-term care facilities.
  8. These criteria are directed at the general population of patients over 65 years of age and do not take disease states into consideration.
  9. Drugs that are receptor antagonists, such as beta blockers, may cause:
  10. Downregulation of the drug receptor
  11. An exaggerated response if abruptly discontinued
  12. Partial blockade of the effects of agonist drugs
  13. An exaggerated response to competitive drug agonists
  14. Jim is being treated for hypertension. Because he has a history of heart attack, the drug chosen is atenolol. Beta blockers treat hypertension by:
  15. Increasing heart rate to improve cardiac output 2. Reducing vascular smooth muscle tone
  16. Increasing aldosterone-mediated volume activity
  17. Reducing aqueous humor production
  18. Beta blockers are the drugs of choice for exertional angina because they:
  19. Improve myocardial oxygen supply by vasodilating the coronary arteries
  20. Decrease myocardial oxygen demand by decreasing heart rate and vascular resistance
  21. Both 1 and 2
  22. Neither 1 nor 2
  23. Adherence to beta blocker therapy may be affected by their:
  24. Short half-lives requiring twice daily dosing
  25. Tendency to elevate lipid levels
  26. Effects on the male genitalia, which may produce impotence
  27. None of the above
  28. Beta blockers have favorable effects on survival and disease progression in heart failure. Treatment should be initiated when the:
  29. Symptoms are severe
  30. Patient has not responded to other therapies
  31. Patient has concurrent hypertension
  32. Left ventricular dysfunction is diagnosed
  33. Abrupt withdrawal of beta blockers can be life threatening. Patients at highest risk for serious consequences of rapid withdrawal are those with:
  34. Angina
  35. Coronary artery

who have fixed atherosclerotic coronary heart disease.

  1. All of the above
  2. Stage B patients should have beta blockers added to their heart failure treatment regimen when:
  3. They have an ejection fraction less than 40%
  4. They have had a recent MI 3. Both 1 and 2
  5. Neither 1 nor 2
  6. 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?
  7. Diuretics reduce preload associated with fluid retention.
  8. Diuretics can be used earlier than stage C when the goal is control of hypertension.
  9. Diuretics may produce problems with electrolyte imbalances and abnormal glucose and lipid metabolism.
  10. Diuretics from the potassium-sparing class should be used when using an angiotensin receptor blocker (ARB).
  11. ACE inhibitors are contraindicated in pregnancy. While treatment of heart failure during pregnancy is best done by a specialist, which of the following drug classes is considered to be safe, at least in the later parts of pregnancy?
  12. Diuretics
  13. ARBs
  14. Beta blockers
  15. Nitrates
  16. Beta blockers treat hypertension because they:
  17. Reduce peripheral resistance
  18. Vasoconstrict coronary arteries
  19. Reduce norepinephrine
  20. Reduce angiotensin II production
  21. Which of the following disease processes could be made worse by taking a nonselective beta blocker?
  22. Asthma
  23. Diabetes
  24. Both might worsen
  25. Beta blockade does not affect these disorders
  26. Disease states in addition to hypertension in which beta blockade is a compelling indication for the use of beta blockers include:
  27. Heart failure
  28. Angina
  29. Myocardial infarction
  30. Dyslipidemia
  31. In addition to methimazole, a symptomatic patient with hyperthyroidism may need a prescription for:
  32. A calcium channel blocker 2. A beta blocker
  33. Liothyronine
  34. An alpha blocker
  1. Amiodarone has been prescribed in a patient with a supraventricular dysrhythmia. Patient teaching should include all of the following EXCEPT:
  2. Notify your health-care provider immediately if you have visual change.
  3. Monitor your own blood pressure and pulse daily. 3. Take a hot shower or bath if you feel dizzy.
  4. Use a sunscreen on exposed body surfaces.
  5. The NP orders a thyroid panel for a patient on amiodarone. The patient tells the NP that he does not have thyroid disease and wants to know why the test is ordered. Which is a correct response?
  6. Amiodarone inhibits an enzyme that is important in making thyroid hormone and can cause hypothyroidism.
  7. Amiodarone damages the thyroid gland and can result in inflammation of that gland, causing hyperthyroidism.
  8. Amiodarone is a broad spectrum drug with many adverse effects. Many different tests need to be done before it is given.
  9. Amiodarone can cause corneal deposits in up to 25% of patients.
  10. What dermatological issue is linked to Amiodarone use?
  11. Increased risk of basal cell carcinoma
  12. Flare up of any prior psoriasis problems
  13. Development of plantar warts
  14. Progressive change of skin tone toward a blue spectrum
  15. Bisphosphonates treat or prevent osteoporosis by:
  16. Inhibiting osteoclastic activity
  17. Fostering bone resorption
  18. Enhancing calcium uptake in the bone
  19. Strengthening the osteoclastic proton pump
  20. Prophylactic use of bisphosphonates is recommended for patients with early osteopenia related to long-term use of which of the following drugs?
  21. Selective estrogen receptor modulators
  22. Aspirin
  23. Glucocorticoids
  24. Calcium supplements
  25. Besides osteoporosis, IV bisphosphonates are also indicated for: 1. Paget’s Disease
  26. Early osteopenia
  27. Renal cancer
  28. Early closure of cranial sutures
  29. What is the role of calcium supplements when patients take bisphosphonates?
  30. They must be restricted to allow the medication to work.
  31. They must be taken in sufficient amounts to provide foundational elements for bone growth.
  32. They must be taken at the same time as the bisphosphonates.
  33. They only work with bisphosphonates if daily intake is restricted.
  34. The nurse is caring for an asthmatic patient prescribed zoledronic acid. What important question should the nurse ask this patient? A) Can you take aspirin without experiencing any bad effects?

B) Serum potassium C) Serum calcium D) Serum iron

  1. The drug recommended as primary prevention of osteoporosis in women over age 70 years is: 1. Alendronate (Fosamax)
  2. Ibandronate (Boniva)
  3. Calcium carbonate
  4. Raloxifene (Evista)
  5. The drug recommended as primary prevention of osteoporosis in men over age 70 years is: 1. Alendronate (Fosamax)
  6. Ibandronate (Boniva)
  7. Calcium carbonate
  8. Raloxifene (Evista)
  9. The ongoing monitoring for patients over age 65 years taking alendronate (Fosamax) or any other bisphosphonate is:
  10. Annual dual-energy x-ray absorptiometry (DEXA) scans
  11. Annual vitamin D level
  12. Annual renal function evaluation
  13. Electrolytes every 3 months
  14. Varenicline (Chantix) may be prescribed for tobacco cessation. Instructions to the patient who is starting varenicline include:
  15. The maximum time varenicline can be used is 12 weeks.
  16. Nausea is a sign of varenicline toxicity and should be reported to the provider.
  17. The starting regimen for varenicline is start taking 1 mg twice a day a week before the quit date.
  18. Neuropsychiatric symptoms may occur.
  19. Because of the pattern of cholesterol synthesis, reductase inhibitors are given: 1. In the evening in a single daily dose
  20. Twice daily in the morning and the evening
  21. With each meal and at bedtime
  22. In the morning before eating
  23. Colestipol comes in a powdered form. The patient is taught to:
  24. Take the powder dry and follow it with at least 8 ounces of water
  25. Take it with a meal to enhance its action on fatty food 3. Mix the powder with 4 to 6 ounces of milk or fruit juice
  26. Take after the evening meal to coincide with cholesterol synthesis
  27. When considering which cholesterol-lowering drug to prescribe, which factor determines the type and intensity of treatment?
  28. Total LDL
  29. Fasting HDL
  30. Coronary artery disease risk level
  31. Fasting total cholesterol
  1. Jose is a 12-year-old overweight child with a total cholesterol of 180 mg/dL and LDL of 125 mg/dL. Along with diet education and recommending increased physical activity, a treatment plan for Jose would include with a reevaluation in 6 months.
  2. Statins
  3. Niacin
  4. Sterols
  5. Bile acid-binding resins
  6. Monitoring of a patient who is on a lipid-lowering drug includes:
  7. Fasting total cholesterol every 6 months
  8. Lipid profile with attention to serum LDL 6 to 8 weeks after starting therapy, then again in 6 weeks
  9. Complete blood count, C-reactive protein, and erythrocyte sedimentation rate after 6 weeks of therapy
  10. All of the above
  11. Because of their site of action, bile acid sequestering resins:
  12. Should be administered separately from other drugs by at least 4 hours
  13. May increase the risk for bleeding
  14. Both 1 and 2
  15. Neither 1 nor 2
  16. Jamie is a 34 - year-old pregnant woman with familial hyperlipidemia and elevated LDL levels. What is the appropriate treatment for a pregnant woman?
  17. A statin
  18. Niacin
  19. Fibric acid derivative 4. Bile acid-binding resins
  20. Felicity has been prescribed colestipol to treat her hyperlipidemia. Unlike other anti- lipidemics, this drug:
  21. Blocks synthesis of cholesterol in the liver
  22. Exchanges chloride ions for negatively charged acids in the bowel
  23. Increases HDL levels the most among the classes
  24. Blocks the lipoprotein lipase pathway
  25. Colestipol comes in a powdered form. The patient is taught to:
  26. Take the powder dry and follow it with at least 8 ounces of water
  27. Take it with a meal to enhance its action on fatty food 3. Mix the powder with 4 to 6 ounces of milk or fruit juice
  28. Take after the evening meal to coincide with cholesterol synthesis
  29. Dulcea has type 2 diabetes and a high triglyceride level. She has gemfibrozil prescribed to treat her hypertriglyceridemia. A history of which of the following might contraindicate the use of this drug?
  30. Reactive airway disease/asthma
  31. Inflammatory bowel disease
  32. Allergy to aspirin 4. Gallbladder disease

Community acquired pneumonia

  1. To prevent further development of antibacterial resistance it is recommended that fluoroquinolones be reserved for treatment of:
  2. Urinary tract infections in young women
  3. Upper respiratory infections in adults
  4. Skin and soft tissue infections in adults
  5. Community-acquired pneumonia in patients with comorbidities
  6. The most common bacterial pathogen in community-acquired pneumonia is:
  7. Haemophilus influenzae
  8. Staphylococcus aureus
  9. Mycoplasma pneumoniae 4. Streptococcus pneumoniae
  10. The first-line drug choice for a previously healthy adult patient diagnosed with community- acquired pneumonia would be:

Ciprofloxaci n 2. Azithromyci n

  1. Amoxicillin
  2. Doxycycline
  3. Conjunctivitis in a child that is accompanied by acute otitis media is treated with:
  4. Sulfacetamide 10% ophthalmic solution (Bleph-10)
  5. Bacitracin/polymyxin B (Polysporin) ophthalmic drops
  6. Ciprofloxacin (Ciloxan) ophthalmic drops 4. High-dose oral amoxicillin
  7. Twenty-year-old Annie comes to the clinic complaining of copious yellow-green eye discharge. Gram stain indicates she most likely has gonococcal conjunctivitis. While awaiting the culture results, the plan of care should be:
  8. None, wait for the culture results to determine the course of treatment
  9. Ciprofloxacin (Ciloxan) ophthalmic drops 3. IM ceftriaxone
  10. High-dose oral amoxicillin
  11. Education of women who are being treated with ophthalmic antibiotics for conjunctivitis includes: 1. Throwing away eye makeup and purchasing new
  12. Redness and intense burning is normal with ophthalmic antibiotics
  13. When applying eye ointment, set the tip of the tube on the lower lid and squeeze in inch
  14. Use a cotton swab to apply ointment, spreading the ointment all over the lid and in the conjunctival sac
  15. David presents to the clinic with symptoms of allergic conjunctivitis. He is prescribed cromolyn sodium (Opticrom) eye drops. The education regarding using cromolyn eye drops includes:
  16. He should not wear his soft contacts while using the cromolyn eye drops.
  1. Cromolyn drops are instilled once a day to prevent allergy symptoms.
  2. Long-term use may cause glaucoma.
  3. He may experience bradycardia as an adverse effect.
  4. Pong-tai is a 12 - month-old child who is being treated with amoxicillin for acute otitis media. His parents call the clinic and say he has developed diarrhea. The appropriate action would be to:
  5. Advise the parents that some diarrhea is normal with amoxicillin and recommend probiotics daily.
  6. Change the antibiotic to one that is less of a gastrointestinal irritant.
  7. Order stool cultures for suspected viral pathogens not treated by the amoxicillin.
  8. Recommend increased fluids and fiber in his diet.
  9. Josefina is a 2-year-old child with acute otitis media and an upper respiratory infection. Along with an antibiotic she receives a recommendation to treat the ear pain with ibuprofen. What education would her parent need regarding ibuprofen?
  10. They can cut an adult ibuprofen tablet in half to give Josefina.
  11. The ibuprofen dose can be doubled for severe pain.
  12. Josefina needs to be well-hydrated while taking ibuprofen.
  13. Ibuprofen is completely safe in children with no known adverse effects.
  14. Conjunctivitis in a child that is accompanied by acute otitis media is treated with:
  15. Sulfacetamide 10% ophthalmic solution (Bleph-10)
  16. Bacitracin/polymyxin B (Polysporin) ophthalmic drops
  17. Ciprofloxacin (Ciloxan) ophthalmic drops 4. High-dose oral amoxicillin
  18. Myles is a 2 - year-old patient who has been diagnosed with acute otitis media. He is afebrile and has not been treated with antibiotics recently. First-line treatment for his otitis media would include:

Azithromycin

Amoxicillin

  1. Ceftriaxone
  2. Trimethoprim/sulfamethoxazole
  3. Alyssa is a 15 - month-old patient who has been on amoxicillin for 2 days for acute otitis media. She is still febrile and there is no change in her tympanic membrane examination. What would be the plan of care for her?
  4. Continue the amoxicillin for the full 10 days.
  5. Change the antibiotic to azithromycin.
  6. Change the antibiotic to amoxicillin/clavulanate.
  7. Change the antibiotic to trimethoprim/sulfamethoxazole.
  8. A child that may warrant “watchful waiting” instead of prescribing an antibiotic for acute otitis media includes patients who:
  9. Are low risk with temperature of less than 39oC or 102.2oF
  10. Have reliable parents with transportation
  1. Children with encopresis
  2. Opioid-associated constipation
  3. An elderly person has been prescribed lactulose for treatment of chronic constipation. Monitoring with long-term treatment would include:
  4. Electrolytes, including potassium and chloride
  5. Bone mineral density for osteoporosis
  6. Magnesium level
  7. Liver function Contact dermatitis
  8. Severe contact dermatitis caused by poison ivy or poison oak exposure often requires treatment with:
  9. Topical antipruritics
  10. Oral corticosteroids for 2 to 3 weeks
  11. Thickly applied topical intermediate-dose corticosteroids
  12. Isolation of the patient to prevent spread of the dermatitis
  13. When a patient has contact dermatitis, wet dressings with Domeboro solution are used for:
  14. Cleaning the weeping area of dermatitis
  15. Bathing the patient to prevent infection 3. Relief of inflammation
  16. Providing a barrier layer to protect the surrounding skin Developmental changes in renal function
  17. The elderly are at high risk of ADRs due to:
  18. Having greater muscle mass than younger adults, leading to higher volume of distribution
  19. The extensive studies that have been conducted on drug safety in this age group
  20. The blood-brain barrier being less permeable, requiring higher doses to achieve therapeutic effect 4. Age-related decrease in renal function
  21. Which of the following create a higher risk for digoxin toxicity? Both the cause and the reason for it must be correct.
  22. Older adults because of reduced renal function
  23. Administration of aldosterone antagonist diuretics because of decreased potassium levels
  24. Taking an antacid for gastroesophageal reflux disease because it increases the absorption of digoxin
  25. Doses between 0.25 and 0.5 mg/day
  26. Sadie is an 82 - year-old patient who has herpes zoster (shingles) and would benefit from an antiviral such as valacyclovir. Prior to prescribing valacyclovir she will need an assessment of:
  27. Complete blood count to rule out anemia
  28. Liver function 3. Renal function
  29. Immunocompetence
  1. The ongoing monitoring for patients over age 65 years taking alendronate (Fosamax) or any other bisphosphonate is:
  2. Annual dual-energy x-ray absorptiometry (DEXA) scans
  3. Annual vitamin D level
  4. Annual renal function evaluation
  5. Electrolytes every 3 months
  6. Developmental variation in renal function has what impact on prescribing for infants and children? 1. Lower doses of renally excreted drugs may be prescribed to infants younger than age 6 months.
  7. Higher doses of water soluble drugs may need to be prescribed because of increased renal excretion.
  8. Renal excretion rates have no impact on prescribing.
  9. Parents need to be instructed on whether drugs are renally excreted or not.
  10. You are reviewing the data from several meta-analyses that addressed the most common causes of adverse drug reactions in the older adult. Which of the following would you find to be decreased and the most common cause of these problems in older adults?
  11. Body fat content
  12. Liver function
  13. Renal function/clearance
  14. Plasma albumin levels Diphenhydramine
  15. Patients who need to remain alert are taught to avoid which drug due to its antimuscarinic effects?
  16. Levothyroxine
  17. Prilosec
  18. Dulcolax
  19. Diphenhydramine
  20. Howard is a 72 - year-old male who occasionally takes diphenhydramine for his seasonal allergies. Monitoring for this patient taking diphenhydramine would include assessing for:
  21. Urinary retention
  22. Cardiac output
  23. Peripheral edema
  24. Skin rash
  25. Topical diphenhydramine (Benadryl) is available OTC to treat itching. Patients or parents should be instructed regarding the use of topical diphenhydramine that:
  26. For maximum effectiveness in treating itching, combine topical with oral diphenhydramine.
  27. 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.
  28. When applying topical diphenhydramine, apply the cream liberally to all areas that itch. Diuretics
  29. Licorice root is a common treatment for dyspepsia. Drug interactions with licorice include: 1. Antihypertensives, diuretics, and digoxin