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Advanced Pharmacology- Exam #2 2025 LATEST
QUESTION & ANSWERS VERIFIED
Digoxin levels need to be monitored closely when the following medication is started:
- Loratadine
- Diphenhydramine
- Ipratropium
- Albuterol Albuterol Patients with pheochromocytoma should avoid which of the following classes of drugs because of the possibility of developing hypertensive crisis?
- Expectorants
- Beta- 2 - agonists
- Antitussives
- Antihistamines Beta- 2 - agonists Harold, a 42-year-old African American, has moderate persistent asthma. Which of the following asthma medications should be used cautiously, if at all?
- Betamethasone, an inhaled corticosteroid
- Salmeterol, an inhaled long-acting beta-agonist
- Albuterol, a short-acting beta-agonist
- Montelukast, a leukotriene modifier Salmeterol, an inhaled long-acting beta-agonist
Long-acting beta-agonists (LTBAs) received a Black Box Warning from the U.S. Food and Drug Administration due to the:
- Risk of life-threatening dermatological reactions
- Increased incidence of cardiac events when LTBAs are used
- Increased risk of asthma-related deaths when LTBAs are used
- Risk for life-threatening alterations in electrolytes Increased risk of asthma-related deaths when LTBAs are used The bronchodilator of choice for patients taking propranolol is:
- Albuterol
- Pirbuterol
- Formoterol
- Ipratropium Ipratropium James 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:
- Congratulate him on making a positive change in his life.
- Recommend he try stopping smoking instead of the Atkin's diet.
- Schedule him for regular testing of serum theophylline levels during his diet due to increased excretion of theophylline.
- Decrease his theophylline dose because a high-protein diet may lead to elevated theophylline levels. Recommend he try stopping smoking instead of the Atkin's diet.
When prescribing montelukast (Singulair) for asthma, patients or parents of patients should be instructed:
- Montelukast twice a day is started when there is an asthma exacerbation .2. Patients may experience weight gain on montelukast.
- Aggression, anxiety, depression, and/or suicidal thoughts may occur when taking montelukast.
- Lethargy and hypersomnia may occur when taking montelukast. Aggression, anxiety, depression, and/or suicidal thoughts may occur when taking montelukast. Montelukast (Singulair) may be prescribed for:
- A 6-year-old child with exercise-induced asthma
- A 2-year-old child with moderate persistent asthma
- An 18-month-old child with seasonal allergic rhinitis
- None of the above; montelukast is not approved for use in children A 2-year-old child with moderate persistent asthma The known drug interactions with the inhaled corticosteroid beclomethasone (QVAR) include:
- Albuterol
- MMR vaccine
- Insulin
- None of the above None of the above When educating patients who are starting on inhaled corticosteroids, the provider should tell them that:
- They need to get any live vaccines before starting the medication.
- Inhaled corticosteroids need to be used daily during asthma exacerbations to be effective.
- Patients should rinse their mouths out after using the inhaled corticosteroid to prevent thrush.
- They can triple the dose number of inhalations of medication during colds to prevent needing systemic steroids. Patients should rinse their mouths out after using the inhaled corticosteroid to prevent thrush. Patients with allergic rhinitis may benefit from a prescription of:
- Fluticasone (Flonase)
- Cetirizine (Zyrtec)
- OTC cromolyn nasal spray (Nasalcrom)
- Any of the above Any of the above 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:
- Urinary retention
- Cardiac output
- Peripheral edema
- Skin rash Urinary retention First-generation antihistamines such as loratadine (Claritin) are prescribed for seasonal allergies because they are:
- More effective than first-generation antihistamines
- Less sedating than the first-generation antihistamines
- Prescription products, therefore are covered by insurance
- Able to be taken with central nervous system (CNS) sedatives, such as alcohol
Martin is a 60-year-old patient with hypertension. The first-line decongestant to prescribe would be:
- Oral pseudoephedrine
- Oral phenylephrine
- Nasal oxymetazoline
- Nasal azelastine Nasal oxymetazoline The first-line treatment for cough related to an upper respiratory tract infection (URI) in a 5-year- old child is:
- Fluids and symptomatic care
- Dextromethorphan and guaifenesin syrup (Robitussin DM for Kids)
- Guaifenesin and codeine syrup (Tussin AC)
- Chlorpheniramine and dextromethorphan syrup (Nyquil for Kids) Fluids and symptomatic care Factors that place a patient at risk of developing an antimicrobial-resistant organism include:
- Age over 50 years
- School attendance
- Travel within the U.S.
- Inappropriate use of antimicrobials Inappropriate use of antimicrobials Infants and young children are at higher risk of developing antibiotic-resistant infections due to:
- Developmental differences in pharmacokinetics of the antibiotics in children
- The fact that children this age are more likely to be in daycare and exposed to pathogens from other children
- Parents of young children insisting on preventive antibiotics so they don't miss work when their child is sick
- Immunosuppression from the multiple vaccines they receive in the first 2 years of life The fact that children this age are more likely to be in daycare and exposed to pathogens from other children Providers should use an antibiogram when prescribing. An antibiogram is:
- The other name for the Centers for Disease Control guidelines for prescribing antibiotics
- An algorithm used for prescribing antibiotics for certain infections
- The reference also known as the Pink Book, published by the Centers for Disease Control
- A chart of the local resistance patterns to antibiotics developed by laboratories A chart of the local resistance patterns to antibiotics developed by laboratories There is often cross-sensitivity and cross-resistance between penicillins and cephalosporins because:
- Renal excretion is similar in both classes of drugs.
- When these drug classes are metabolized in the liver they both produce resistant enzymes.
- Both drug classes contain a beta-lactam ring that is vulnerable to beta-lactamase-producing organisms.
- There is not an issue with cross-resistance between the penicillins and cephalosporins. Both drug classes contain a beta-lactam ring that is vulnerable to beta-lactamase-producing organisms. Jonathan has been diagnosed with strep throat and needs a prescription for an antibiotic. He says the last time he had penicillin he developed a red, blotchy rash. An appropriate antibiotic to prescribe would be:
- Amoxicillin
- Amoxicillin/clavulanate
- TMP/SMZ (Septra)
- None None Joanna had a small ventricle septal defect (VSD) repaired when she was 3 years old and has no residual cardiac problems. She is now 28 and is requesting prophylactic antibiotics for an upcoming dental visit. The appropriate antibiotic to prescribe according to current American College of Cardiology and American Heart Association guidelines is:
- None, no antibiotic is required for dental procedures
- Amoxicillin 2 grams 1 hour before the procedure
- Ampicillin 2 grams IM or IV 30 minutes before the procedure
- Azithromycin 1 gram 1 hour before the procedure None, no antibiotic is required for dental procedures To prevent further development of antibacterial resistance it is recommended that fluoroquinolones be reserved for treatment of:
- Urinary tract infections in young women
- Upper respiratory infections in adults
- Skin and soft tissue infections in adults
- Community-acquired pneumonia in patients with comorbidities Community-acquired pneumonia in patients with comorbidities Fluoroquinolones have a Black Box Warning regarding ________ even months after treatment.
- Renal dysfunction
- Hepatic toxicity
- Tendon rupture
- Development of glaucoma Tendon rupture Janet was recently treated with clindamycin for an infection. She calls the advice nurse because she is having frequent diarrhea that she thinks may have blood in it. What would be the appropriate care for her?
- Encourage increased fluids and fiber.
- Assess her for pseudomembranous colitis.
- Advise her to eat yogurt daily to help restore her gut bacteria.
- Start her on an antidiarrheal medication. Assess her for pseudomembranous colitis. Keng has chronic hepatitis that has led to mildly impaired liver function. He has an infection that would be best treated by a macrolide. Which would be the best choice for a patient with liver dysfunction?
- Azithromycin (Zithromax)
- Clarithromycin (Biaxin)
- Erythromycin (E-mycin)
- None of the above Erythromycin (E-mycin) Jamie has glucose- 6 - phosphate dehydrogenase deficiency (G6PD) and requires an antibiotic. Which class of antibiotics should be avoided in this patient?
- Penicillins
- Macrolides
- Cephalosporins
Nicole is a 16-year-old female who is taking minocycline for acne. She comes to the clinic complaining of a headache. What would be the plan of care?
- Advise acetaminophen or ibuprofen as needed for headaches.
- Prescribe sumatriptan (Imitrex) to be taken at the onset of the headache.
- Evaluate her for pseudotremor cerebri.
- Assess her caffeine intake and sleep patterns. Evaluate her for pseudotremor cerebri. 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:
- Use a back-up method of birth control (condom) until her next menses.
- Doxycycline may cause tendonitis and she should report any joint pain.
- Her partner will need treatment if her infection doesn't clear with the doxycycline.
- Doxycycline is used for one-dose treatment of STIs; take the whole prescription at once. Use a back-up method of birth control (condom) until her next menses. To prevent the development of peripheral neuropathy in patients taking isoniazid for tuberculosis the patient is also prescribed:
- Niacin (vitamin B3)
- Pyridoxine (vitamin B6)
- Riboflavin (vitamin B2)
- Thiamine (vitamin B1) Pyridoxine (vitamin B6) 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:
- Complete blood count to rule out anemia
- Liver function
- Renal function
- Immunocompetence Renal function When prescribing acyclovir, patients should be educated regarding the:
- High risk of developing diarrhea
- Need to drink lots of fluids during treatment
- Risk for life-threatening rash such as Stevens-Johnson
- Eccentric dosing schedule Need to drink lots of fluids during treatment Nicholas has been diagnosed with type A influenza. Appropriate prescribing of oseltamivir (Tamiflu) would include:
- Starting oseltamivir within the first 48 hours of influenza symptoms
- Advising the patient he can stop the oseltamivir when his symptoms resolve
- Educating the patient that oseltamivir will cure influenza
- Prophylactic treatment of all family members Starting oseltamivir within the first 48 hours of influenza symptoms Monitoring for patients who are on long-term antifungal therapy with ketoconazole includes:
- Platelet count
- BUN and creatinine
- White blood cell count
- AST, ALT, alkaline phosphatase, and bilirubin AST, ALT, alkaline phosphatase, and bilirubin
c. liver function tests (LFTs). d. prophylactic antitubercular drugs. a TB skin test. A patient who has tuberculosis asks the nurse why three drugs are used to treat this disease. The nurse will explain that multi-drug therapy is used to reduce the likelihood of a. disease relapse. b. drug hypersensitivity reactions. c. drug resistance. d. drug adverse effects drug resistance. A patient is being treated with isoniazid (INH), rifampin, and pyrazinamide in phase I of treatment for tuberculosis. The organism develops resistance to isoniazid. Which drug will the nurse anticipate the provider will order to replace the isoniazid? a. Ciprofloxacin (Cipro) b. Ethambutol (Myambutol) c. Kanamycin d. Streptomycin sulfate Ethambutol (Myambutol) The nurse is caring for a patient who is diagnosed with tuberculosis. The patient tells the nurse that the provider plans to order a prophylactic antitubercular drug for family members and asks which drug will be ordered. The nurse will expect the provider to order which drug? a. Isoniazid (INH) b. Pyrazinamide c. Rifampin (Rifadin)
d. Streptomycin Isoniazide The nurse caring for a patient who has tuberculosis and who is taking isoniazid, rifampin, and streptomycin reviews the medical record and notes the patients sputum cultures reveal resistance to streptomycin. The nurse will anticipate that the provider will take which action? a. Add ethambutol (Myambutol). b. Change the streptomycin to clarithromycin. c. Change the streptomycin to kanamycin. d. Order renal function tests. Change the streptomycin to kanamycin. A patient who is taking isoniazid (INH) as part of a two-drug tuberculosis treatment regimen reports tingling of the fingers and toes. The nurse will recommend discussing which treatment with the provider? a. Adding pyrazinamide b. Changing to ethambutol c. Increasing oral fluid intake d. Taking pyridoxine (B6) Taking pyridoxine (B6) The nurse is teaching a patient about rifampin. Which statement by the patient indicates understanding of the teaching? a. I should not wear soft contact lenses while taking rifampin. b. I will need regular eye examinations while taking this drug. c. I will report orange urine to my provider immediately. d. I understand that renal toxicity is a common adverse effect.
A patient will begin taking streptomycin as part of the medication regimen to treat tuberculosis. Before administering this medication, the nurse will review which laboratory values in the patients medical record? a. Complete blood count (CBC) with differential white cell count b. Blood urea nitrogen (BUN) and creatinine c. Potassium and magnesium levels d. Serum fasting glucose Blood urea nitrogen (BUN) and creatinine The nurse is preparing to administer an intravenous polymyxin antibiotic. The patient reports dizziness along with numbness and tingling of the hands and feet. The nurse will perform which action? a. Administer the drug since these are harmless side effects. b. Hold the drug and notify the provider of these adverse reactions. c. Obtain an order for an oral form of this medication. d. Request an order for serum electrolytes. Hold the drug and notify the provider of these adverse reactions. A young adult female who is taking metronidazole (Flagyl) to treat trichomoniasis calls the nurse to report severe headache, flushing, palpitations, cramping, and nausea. What will the nurse do next? a. Ask about alcohol consumption. b. Reassure her that these are harmless side effects. c. Tell her that this signals a worsening of her infection. d. Tell her to go to the emergency department immediately. Ask about alcohol consumption.
A patient who is taking metronidazole (Flagyl) reports reddish-brown urine. Which action will the nurse take? a. Obtain an order for BUN and creatinine levels. b. Reassure the patient that this is a harmless effect. c. Request an order for a urinalysis. d. Test her urine for occult blood. Reassure the patient that this is a harmless effect. A patient is diagnosed with histoplasmosis and will begin taking ketoconazole. What information will the nurse include when teaching this patient about this medication? a. Take the medicine twice daily. b. Take the medication with food. c. You may consume small amounts of alcohol. d. You will not need lab tests while taking this drug. Take the medication with food. A patient who has AIDS is at risk to contract aspergillosis. The nurse will anticipate that which antifungal medication will be ordered prophylactically for this patient? a. Metronidazole (Flagyl) b. Micafungin (Mycamine) c. Posaconazole (Noxafil) d. Voriconazole (Vfend) Posaconazole (Noxafil) A patient is diagnosed with tinea capitis. The provider will order which systemic antifungal medication for this patient?
