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High-dose oral amoxicillin
MN 553 FINAL EXAM 1 – QUESTION AND ANSWERS Latest
Update 2023 Assured Success.
Saved Conjunctivitis in a child that is accompanied by acute otitis media is treated with: Question 1 options: Sulfacetamide 10% ophthalmic solution (Bleph-10) Bacitracin/polymyxin B (Polysporin) ophthalmic drops Ciprofloxacin (Ciloxan) ophthalmic drops
Question 2 (4 points)
Saved The drug of choice for treatment of early latent or tertiary syphilis is: Question 2 options: Ceftriaxone IM Oral azithromycin Oral ciprofloxacin
Question 3 (4 points)
Saved Clinical judgment in prescribing includes: Question 3 options: Always prescribing the newest medication available for the disease process Handing out drug samples to poor patients Prescribing all generic medications to cut costs Benzathine penicillin G IM Factoring in the cost to the patient of the medication prescribed
Question 4 (4 points)
Saved When considering which cholesterol-lowering drug to prescribe, which factor determines the type and intensity of treatment? Question 4 options:
Amoxicillin Doxycycline
Question 8 (4 points)
Saved Sophie presents to the clinic with a malodorous vaginal discharge and is confirmed to have Trichomonas infection. Treatment for her would include: Question 8 options: Metronidazole 2 grams PO x 1 dose Topical intravaginal metronidazole daily x 7 days Intravaginal clindamycin daily x 7 days Azithromycin 2 grams PO x 1 dose
Question 9 (4 points)
Saved Patrick is a 10-year-old patient who presents with uncomfortable constipation. Along with diet changes, a laxative is ordered to provide more rapid relief of constipation. An appropriate choice of medication for a 10-year-old child would be: Question 9 options: PEG 3350 (Miralax) Bisacodyl (Dulcolax) suppository Docusate (Colace) suppository Polyethylene glycol electrolyte solution
Question 10 (4 points)
Saved Medications are typically started for angina patients when: Question 10 options: The first permanent EKG changes occur The start of class I or II symptoms
The events trigger a trip to the emergency department When troponin levels become altered
Isolation of the patient to prevent spread of the dermatitis
Question 15 (4 points)
Jamison has been prescribed citalopram (Celexa) to treat his depression. Education regarding how quickly selective serotonin reuptake inhibitor (SSRI) antidepressants work would be: Question 15 options: Appetite and concentration improve in the first 1 to 2 weeks. Sleep should improve almost immediately upon starting citalopram. Full response to the SSRI may take 2 to 4 months after he reaches the full therapeutic dose. His dysphoric mood will improve in 1 to 2 weeks.
Question 16 (4 points)
Sook has been prescribed gabapentin to treat neuropathic pain and is complaining of feeling depressed and having “strange” thoughts. The appropriate initial action would be: Question 16 options: Increase her dose Assess for suicidal ideation Discontinue the medication immediately Decrease her dose to half then slowly titrate up the dose
Question 17 (4 points)
Which of the following holds true for the pharmacokinetics of women? Question 17 options: Gastric emptying is faster than that of men. Organ blood flow is the same as that of men. Evidence is strong concerning renal differences in elimination. Medications that involve binding globulins are impacted by estrogen levels.
Question 18 (4 points)
Opiates are used mainly to treat moderate to severe pain. Which of the following is NOT true about these drugs?
Question 18 options: All opiates are scheduled drugs which require a DEA license to prescribe. Opiates stimulate only mu receptors for the control of pain. Most of the adverse effects of opiates are related to mu receptor stimulation. Naloxone is an antagonist to opiates.
Question 19 (4 points)
The role of the NP in the use of herbal medication is to: Question 19 options: Maintain competence in the prescribing of common herbal remedies Recommend common over-the-counter herbs to patients Educate patients and guide them to appropriate sources of care Encourage patients to not use herbal therapy due to the documented dangers
Question 20 (4 points)
Gender differences between men and women in pharmacokinetics include: Question 20 options: More rapid gastric emptying so that drugs absorbed in the stomach have less exposure to absorption sites Higher proportion of body fat so that lipophilic drugs have relatively greater volumes of distribution Increased levels of bile acids so that drugs metabolized in the intestine have higher concentrations Slower organ blood flow rates so drugs tend to take longer to be excreted
Question 21 (4 points)
Jim is being treated for hypertension. Because he has a history of heart attack, the drug chosen is atenolol. Beta blockers treat hypertension by: Question 21 options: Increasing heart rate to improve cardiac output Reducing vascular smooth muscle tone Increasing aldosterone-mediated volume activity Reducing aqueous humor production
Question 22 (4 points)
Larry is taking allopurinol to prevent gout. Monitoring of a patient who is taking allopurinol includes: Question 25 options: Complete blood count Blood glucose C-reactive protein BUN, creatinine, and creatinine clearance
Question 26 (4 points)
Which the following persons should not have a statin medication ordered? Question 26 options: Someone with 3 first- or second-degree family members with history of muscle issues when started on statins Someone with high lipids, but low BMI Premenopausal woman with recent history of hysterectomy Prediabetic male with known metabolic syndrome
Question 27 (4 points)
Allison is an 18-year-old college student with type 1 diabetes. She is on NPH twice daily and Novolog before meals. She usually walks for 40 minutes each evening as part of her exercise regimen. She is beginning a 30-minute swimming class three times a week at 1 p.m. What is important for her to do with this change in routine? Question 27 options: Delay eating the midday meal until after the swimming class. Increase the morning dose of NPH insulin on days of the swimming class. Adjust the morning insulin injection so that the peak occurs while swimming. Check glucose level before, during, and after swimming.
Question 28 (4 points)
The optimal maximum time frame for HRT or estrogen replacement therapy (ERT) is: Question 28 options: 2 years
5 years 10 years 15 years
Question 29 (4 points)
Patients who are treated with greater than 100 grams per week of topical calcipotriene for psoriasis need to be monitored for: Question 29 options: High vitamin D levels Hyperkalemia Hypercalcemia Hyperuricemia
Question 30 (4 points)
There is often cross-sensitivity and cross-resistance between penicillins and cephalosporins because: Question 30 options: 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.
Question 31 (4 points)
Which of the following statements is true about acute pain? Question 31 options: Somatic pain comes from body surfaces and is only sharp and well-localized. Visceral pain comes from the internal organs and is most responsive to acetaminophen and opiates. 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. Acute neuropathic pain is caused by lack of blood supply to the nerves in a given area.
Question 32 (4 points)
Topical clindamycin solution Oral amoxicillin/clavulanate (Augmentin)
Question 36 (4 points)
Disease states in addition to hypertension in which beta blockade is a compelling indication for the use of beta blockers include: Question 36 options: Heart failure Angina Myocardial infarction Dyslipidemia
Question 37 (4 points)
Male patients who should not be prescribed phosphodiesterase type 5 (PDE-5) inhibitors include: Question 37 options: Diabetics Those who have had an acute myocardial infarction in the past 6 months Patients who are deaf Patients under age 60 years of age
Question 38 (4 points)
Preventative therapy for cluster headaches includes: Question 38 options: Massage or relaxation therapy Ergotamine nightly before bed Intranasal lidocaine four times a day during “clusters” of headaches Propranolol (Inderal) daily
Question 39 (4 points)
The Best Pharmaceuticals for Children Act: Question 39 options: Includes a pediatric exclusivity rule which extends the patent on drugs studied in children Establishes a committee that writes guidelines for pediatric prescribing
Provides funding for new drug development aimed at children Encourages manufacturers specifically to develop pediatric formulations
Question 40 (4 points)
Rabi is being prescribed phenytoin for seizures. Monitoring includes assessing: Question 40 options: For phenytoin hypersensitivity syndrome 3 to 8 weeks after starting treatment For pedal edema throughout therapy Heart rate at each visit and consider altering therapy if heart rate is less than 60 bpm For vision changes, such as red-green blindness, at least annually
Question 41 (4 points)
Patients who are on chronic long-term proton pump inhibitor therapy require monitoring for: Question 41 options: Iron deficiency anemia, vitamin B12 and calcium deficiency Folate and magnesium deficiency Elevated uric acid levels leading to gout Hypokalemia and hypocalcemia
Question 42 (4 points)
Which diuretic agents typically do not need potassium supplementation? Question 42 options: The loop diuretics The thiazide diuretics The aldosterone inhibitors They all need supplementation
Question 43 (4 points)
Patients who are prescribed exogenous androgens need to be warned that decreased libido: Question 43 options:
Is treated with increased doses of androgens, so the patient should let the provider know if he is having problems May be a sign of early prostate cancer and he should make an appointment for a prostate screening exam May occur with androgen therapy
Question 44 (4 points)
Being competent in the use of information technology in clinical practice is expected in professional nurses. Advanced practice competence includes the ability to: Question 44 options: Search for information using the most common search engines Serve as content experts in developing, implementing, and evaluating information Systems Write programs to assure the integrity of health information Use information technology to prescribe drugs
Question 45 (4 points)
Monitoring for patients who are on long-term antifungal therapy with ketoconazole includes: Question 45 options: Platelet count BUN and creatinine White blood cell count AST, ALT, alkaline phosphatase, and bilirubin
Question 46 (4 points)
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: Question 46 options: It is a long-acting drug with potential for toxicity. Nitrate tolerance can develop. Orthostatic hypotension is a common adverse effect. It must be taken with milk or food.
Question 47 (4 points)
While on testosterone replacement, hemoglobin and hematocrit levels should be monitored. Levels suggestive of excessive erythrocytosis or abuse are: Question 47 options: Hemoglobin 14 g/dl or hematocrit 39% Hemoglobin 11.5 g/dl or hematocrit 31% Hemoglobin 13 g/dl or hematocrit 38% Hemoglobin 17.5 g/dl or hematocrit 54%
Question 48 (4 points)
A provider may consider testing for CYP2D6 variants prior to starting tamoxifen for breast cancer to: Question 48 options: Ensure the patient will not have increased adverse drug reactions to the tamoxifen Identify potential drug-drug interactions that may occur with tamoxifen Reduce the likelihood of therapeutic failure with tamoxifen treatment Identify poor metabolizers of tamoxifen
Question 49 (4 points)
True contraindications to diphtheria, tetanus, and acellular pertussis (DTaP or Tdap) vaccine include: Question 49 options: Fever up to 104oF (40.5oC) after previous DTaP vaccine Family history of seizures after DTaP vaccine Adolescent pregnancy Anaphylactic reaction with a previous dose
Question 50 (4 points)
Pharmacoeconomics is: Question 50 options: The study of the part of the U.S. economy devoted to drug use The study of the impact of prescription drug costs on the overall economy
Precautions that should be taken when prescribing controlled substances include: Question 51 options: Faxing the prescription for a Schedule II drug directly to the pharmacy Using tamper-proof paper for all prescriptions written for controlled drugs Keeping any pre-signed prescription pads in a locked drawer in the clinic Using only numbers to indicate the amount of drug to be prescribed
Question 52 (4 points)
Patients who have a poor metabolism phenotype will have: Question 52 options: Slowed metabolism of a prodrug into an active drug, leading to accumulation of Prodrug Accumulation of inactive metabolites of drugs A need for increased dosages of medications Increased elimination of an active drug
Question 53 (4 points)
The drug of choice for type 2 diabetics is metformin. Metformin: Question 53 options: Decreases glycogenolysis by the liver Increases the release of insulin from beta cells Increases intestinal uptake of glucose Prevents weight gain associated with hyperglycemia
Question 54 (4 points)
Rose is a 3-year-old patient with an upper respiratory infection (URI). Treatment for her URI would include: Question 54 options: Amoxicillin Diphenhydramine Pseudoephedrine Nasal saline spray
Question 55 (4 points)
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? Question 55 options: Tinnitus Diarrhea Hearing loss Photosensitivity
Question 56 (4 points)
Elena Vasquez’s primary language is Spanish, and she speaks very limited English. Which technique would be appropriate to use in teaching her about a new drug you have just prescribed? Question 56 options: Use correct medical terminology because Spanish has a Latin base. Use a family member who speaks more English to act as an interpreter. Use a professional interpreter or a reliable staff member who can act as an interpreter. Use careful, detailed explanations.
Question 57 (4 points)
Drugs that have a significant first-pass effect: Question 57 options: Must be given by the enteral (oral) route only Bypass the hepatic circulation Are rapidly metabolized by the liver and may have little if any desired action Are converted by the liver to more active and fat-soluble forms
Question 58 (4 points)
If an adult patient with comorbidities cannot reliably take oral antibiotics to treat pneumonia, an appropriate initial treatment option would be: Question 58 options:
