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MN 553 FINAL EXAM 2019(UPDATED 2024) | ACTUAL EXAM WITH
100% CORRECT ANSWERS| BRAND NEW/A+ GRADE
Question 1 4 / 4 points
A potentially life-threatening adverse response to angiotensin-
converting enzyme inhibitors is angioedema. Which of the
following statements is true about this adverse response?
Question options:
Swellings of the tongue or hoarseness are the most common symptoms. It appears to be related to the decrease in aldosterone production. Presence of a dry, hacky cough indicates a high risk for this adverse response. Because it takes time to build up a blood level, it occurs after being on the drug for about 1 week. Question 2
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 options:
Use correct medical terminology because Spanish has a Latin base.
points
The State Board of Nursing for each state Reduce the likelihood of therapeutic failure with tamoxifen treatment Use a family member who speaks more English to act as an interpreter. Question 3 Use careful, detailed explanations.
Medications are typically started for angina patients when:
Question options:
The first permanent EKG changes occur
points Question 4 The events trigger a trip to the emergency department When troponin levels become altered
A provider may consider testing for CYP2D6 variants prior to
starting tamoxifen for breast cancer to:
Question options:
Ensure the patient will not have increased adverse drug reactions to the tamoxifen Identify potential drug-drug interactions that may occur with tamoxifen
points Question 5 Identify poor metabolizers of tamoxifen
Patients who are on chronic long-term proton pump inhibitor
therapy require monitoring for:
Question options:
points Question 6 Folate and magnesium deficiency Elevated uric acid levels leading to gout Hypokalemia and hypocalcemia
Nurse practitioner prescriptive authority is regulated by:
Question options:
The National Council of State Boards of Nursing The U.S. Drug Enforcement Administration
points The State Board of Pharmacy Iron deficiency anemia, vitamin B12 and calcium deficiency The start of class I or II symptoms Use a professional interpreter or a reliable staff member who can act as an interpreter.
Vitamin B12 1,000 mcg IM daily x 1 week then 1,000 mg IM weekly for a month Percentage of fat differs between genders. Question 11
points
The drug of choice for treatment of early latent or tertiary
syphilis is:
Question options:
Ceftriaxone IM Question 12 Oral azithromycin Oral ciprofloxacin 4 / 4 points
A client asks the NP about the differences in drug effects
between men and women. What is known about the
differences between the pharmacokinetics of men and
women?
Question options:
Body temperature varies between men and women. Muscle mass is greater in women. Question 13 Proven subjective factors exist between the genders. 4 / 4 points
Clinical judgment in prescribing includes:
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Question 14 Always prescribing the newest medication available for the disease process Handing out drug samples to poor patients Prescribing all generic medications to cut costs 4 / 4 points
The dosage of Vitamin B12 to initially treat pernicious anemia
is:
Question options:
Nasal cyanocobalamin 1 gram spray in each nostril daily x 1 week then weekly x 1 month Vitamin B12 IM monthly Oral cobalamin 1,000 mcg daily Factoring in the cost to the patient of the medication prescribed Benzathine penicillin G IM
Treatment of thyroid disorders, especially if they are associated with Tachyarrhythmias Question 15
points
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:
Question options:
Question 16 Cardiac output Peripheral edema Skin rash 4 / 4 points
Class I recommendations for stage A heart failure include:
Question options:
Aerobic exercise within tolerance levels to prevent the development of heart failureReduction of sodium intake to less than 2,000 mg/day to prevent fluid retention Beta blockers for all patients regardless of cardiac history Question 17
points
When prescribing a tetracycline or quinolone antibiotic it is
critical to instruct the patient:
Question options:
Not to take their regularly prescribed medications while on these antibiotics Regarding the need for lots of acidic foods and juices, such as orange juice, to enhance absorption Question 18 That there are no drug interactions with these antibiotics 4 / 4 points
Preventative therapy for cluster headaches includes:
Question options:
Massage or relaxation therapy Question 19 Intranasal lidocaine four times a day during “clusters” of headaches Propranolol (Inderal) daily 0 / 4 points Ergotamine nightly before bed Not to take antacids while on these medications, as the antacid decreases absorption Urinary retention
Beta blockers
There is often cross-sensitivity and cross-resistance between
penicillins and cephalosporins because:
Question options:
Renal excretion is similar in both classes of drugs. When these drug classes are metabolized in the liver they both produce resistant enzymes. Question 24 There is not an issue with cross-resistance between the penicillins and cephalosporins. 4 / 4 points
To improve actual effectiveness of oral contraceptives women
should be educated regarding:
Question options:
Question 25 Doubling pills if they have diarrhea during the middle of a pill pack The fact that they will have a normal menstrual cycle if they miss two pills The fact that mid-cycle spotting is not normal and the provider should be contacted immediately 4 / 4 points
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?
Question options:
Diuretics ARBs Question 26 Nitrates 4 / 4 points
The Best Pharmaceuticals for Children Act:
Question options:
Includes a pediatric exclusivity rule which extends the patent on drugs studied in children Question 27 Provides funding for new drug development aimed at children Encourages manufacturers specifically to develop pediatric formulations 4 / 4 points Establishes a committee that writes guidelines for pediatric prescribing Use of a back-up method if they have vomiting or diarrhea during a pill packet Both drug classes contain a beta-lactam ring that is vulnerable to beta-lactamase-producing organisms.
Leonard is completing a 6 - month regimen to treat tuberculosis
(TB). Monitoring of a patient on TB therapy includes:
Question options:
Question 28 Monthly chest x-ray Bronchoscopy every 3 months All of the above 4 / 4 points
First-line therapy for treating topical fungal infections such as
tinea corporis (ringworm) or tinea pedis (athlete’s foot) would
be:
Question options:
Question 29 Oral terbinafine Oral griseofulvin microsize Nystatin cream or ointment 4 / 4 points
The most cost-effective treatment for two or three impetigo
lesions on the face is:
Question options:
Question 30 Retapamulin (Altabax) ointment Topical clindamycin solution Oral amoxicillin/clavulanate (Augmentin) 4 / 4 points
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:
Question options:
Sixteen ounces per day of cranberry juice cocktail will prevent UTIs. There is no evidence that cranberry juice helps prevent UTIs. Cranberry juice only works to prevent UTIs in children. 100% cranberry juice or cranberry juice extract may decrease UTIs in some patients. Mupirocin ointment OTC topical azole (clotrimazole, miconazole) Monthly sputum cultures
Iron is best taken on an empty stomach with juice Question 35 Histamine2 receptor antagonist (ranitidine) for 4 to 8 weeks Cytoprotective drug (misoprostol) for 2 weeks 4 / 4 points
The first-line drug choice for a previously healthy adult patient
diagnosed with community-acquired pneumonia would be:
Question options:
Ciprofloxacin Question 36 Amoxicillin Doxycycline 4 / 4 points
Larry is taking allopurinol to prevent gout. Monitoring of a
patient who is taking allopurinol includes:
Question options:
Complete blood count Blood glucose C-reactive protein Question 37
points
The action of “gliptins” is different from other antidiabetic
agents because they:
Question options:
Have a low risk for hypoglycemia Are not associated with weight gain Close ATP-dependent potassium channels in the beta cell Question 38
points
Patient education regarding taking iron replacements includes:
Question options:
Doubling the dose if they miss a dose to maintain therapeutic levels Taking the iron with milk or crackers if it upsets their stomach Act on the incretin system to indirectly increase insulin production BUN, creatinine, and creatinine clearance Azithromycin Proton pump inhibitor (omeprazole) for 12 weeks
Anaphylactic reaction with a previous dose Question 39 Antacids such as Tums may help the upset stomach caused by iron therapy 0 / 4 points
Laboratory values are actually different for TSH when
screening for thyroid issues and when used for medication
management. Which of the follow holds true?
Question options:
Question 40 Screening values are much narrower than the acceptable range used to keep a person stable on hormone replacement. Therapeutic values are kept between 0.05 and 3.0 ideally. Screening values are considered acceptable up to 10. Screening values are between 5 and 10, and therapeutic values are greater than 10. 4 / 4 points
Goals when treating tuberculosis include:
Question options:
Question 41 Negative purified protein derivative at the end of therapy Completely normal chest x-ray All of the above 4 / 4 points
True contraindications to diphtheria, tetanus, and acellular
pertussis (DTaP or Tdap) vaccine include:
Question options:
Fever up to 104oF (40.5oC) after previous DTaP vaccine Family history of seizures after DTaP vaccine Adolescent pregnancy Question 42
points
What is the role of calcium supplements when patients take
bisphosphonates?
Question options:
They must be restricted to allow the medication to work. They must be taken in sufficient amounts to provide foundational elements for bone growth. Completion of recommended therapy Screening TSH has a wider range of normal values 0.02-5.0; therapeutic levels need to remain above 5.0.
The highest abstinence rates occur if the patient chews the gum when he or she is having cravings. Question 47 Increased muscle-to-fat ratio 4 / 4 points
Several classes of drugs have interactions with cholinergic
blockers. Which of the following is true about these
interactions?
Question options:
Question 48 Additive antimuscarinic effects may occur with antihistamines. Cholinergic blockers may decrease the sedative effects of hypnotics. Cholinergic blockers are contraindicated with antipsychotics. 4 / 4 points
The drug of choice for type 2 diabetics is metformin.
Metformin:
Question options:
Question 49 Increases the release of insulin from beta cells Increases intestinal uptake of glucose Prevents weight gain associated with hyperglycemia 0 / 4 points
Instructions for the use of nicotine gum include:
Question options:
Chew the gum quickly to get a peak effect. The gum should be “parked” in the buccal space between chewing. Acidic drinks such as coffee help with the absorption of the nicotine. Question 50
points
Which of the following statements is true about acute pain?
Question 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. Decreases glycogenolysis by the liver Drugs with a narrow therapeutic range given orally may not stay in the GI tract long enough to produce an action.
Question 51 Acute neuropathic pain is caused by lack of blood supply to the nerves in a given area. 4 / 4 points
An acceptable first-line treatment for peptic ulcer disease with
positive H. pylori test is:
Question options:
Histamine2 receptor antagonists for 4 to 8 weeks Proton pump inhibitor bid for 12 weeks until healing is complete Question 52 Proton pump inhibitor bid and levofloxacin for 14 days 4 / 4 points
Education for patients who use an inhaled beta-agonist and an
inhaled corticosteroid includes:
Question options:
Use the inhaled corticosteroid first, followed by the inhaled beta-agonists. Question 53 Increase fluid intake to 3 liters per day. Avoid use of aspirin or ibuprofen while using inhaled medications. 0 / 4 points
Alterations in drug metabolism among Asians may lead to:
Question options:
Slower metabolism of antidepressants, requiring lower doses Question 54 Altered metabolism of omeprazole, requiring higher doses Slower metabolism of alcohol, requiring higher doses 4 / 4 points
Harold, a 42 - year-old African American, has moderate
persistent asthma. Which of the following asthma medications
should be used cautiously, if at all?
Question options:
Betamethasone, an inhaled corticosteroid Albuterol, a short-acting beta-agonist Montelukast, a leukotriene modifier Salmeterol, an inhaled long-acting beta-agonist Faster metabolism of neuroleptics, requiring higher doses Use the inhaled beta-agonist first, followed by the inhaled corticosteroid. Proton pump inhibitor bid plus clarithromycin plus amoxicillin for 14 days
Question 59 Cost-of-illness analysis Cost-effectiveness analysis Cost-benefit analysis 4 / 4 points
Severe contact dermatitis caused by poison ivy or poison oak
exposure often requires treatment with:
Question options:
Topical antipruritics Question 60 Thickly applied topical intermediate-dose corticosteroids Isolation of the patient to prevent spread of the dermatitis 4 / 4 points
The optimal maximum time frame for HRT or estrogen
replacement therapy (ERT) is:
Question options:
2 years Question 61 10 years 15 years 4 / 4 points
Sophie presents to the clinic with a malodorous vaginal
discharge and is confirmed to have Trichomonas infection.
Treatment for her would include:
Question options:
Question 62 Topical intravaginal metronidazole daily x 7 days Intravaginal clindamycin daily x 7 days Azithromycin 2 grams PO x 1 dose 4 / 4 points
Monitoring for patients who are on long-term antifungal
therapy with ketoconazole includes:
Question options:
Metronidazole 2 grams PO x 1 dose 5 years Oral corticosteroids for 2 to 3 weeks Cost-minimization analysis
AST, ALT, alkaline phosphatase, and bilirubin Platelet count BUN and creatinine White blood cell count Question 63
points
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 options:
PEG 3350 (Miralax) Question 64 Docusate (Colace) suppository Polyethylene glycol electrolyte solution 4 / 4 points
When determining drug treatment the NP prescriber should:
Question options:
Always use evidence-based guidelines Question 65 Rely on his or her experience when prescribing for complex patients Use the newest drug on the market for the condition being treated 4 / 4 points
According to the U.S. Office of Minority Health, poor health
outcomes among African Americans are attributed to:
Question options:
The belief among African Americans that prayer is more powerful than drugs Poor compliance on the part of the African American patient The genetic predisposition for illness found among African Americans Question 66
points
Henry is 82 years old and takes two aspirin every morning to
treat the arthritis pain in his back. He states the aspirin helps
Discrimination, cultural barriers, and lack of access to health care Individualize the drug choice for the specific patient Bisacodyl (Dulcolax) suppository
Hypercalcemia Question 70 Must be taken no more than twice a day 4 / 4 points
Patients who are treated with greater than 100 grams per
week of topical calcipotriene for psoriasis need to be
monitored for:
Question options:
High vitamin D levels Hyperkalemia Question 71 Hyperuricemia 0 / 4 points
Rose is a 3 - year-old patient with an upper respiratory infection
(URI). Treatment for her URI would include:
Question options:
Question 72 Diphenhydramine Pseudoephedrine Nasal saline spray 4 / 4 points
The Combat Methamphetamine Epidemic Act, which is part of
the 2006 U.S. Patriot Act:
Question options:
Requires all providers to screen their patients for methamphetamine use Restricts the prescribing of amphetamines to U.S. citizens Requires a prescription be written for all methamphetamine precursors in all states Question 73
points
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:
Restricts the sales of drugs that contain methamphetamine precursors, including a daily and 30 - day limit on sales Amoxicillin and dizziness
Digoxin
Question options:
I
Question 74
III
IV
points
Ginseng, which is taken to assist with memory, may
potentiate:
Question options:
Aricept Insulin Question 75 Propranolol 4 / 4 points
Pharmacoeconomics is:
Question 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 Question 76 The analysis of the clinical efficacy of the drug 4 / 4 points
While on testosterone replacement, hemoglobin and
hematocrit levels should be monitored. Levels suggestive of
excessive erythrocytosis or abuse are:
Question options:
Hemoglobin 14 g/dl or hematocrit 39% Hemoglobin 11.5 g/dl or hematocrit 31% Hemoglobin 13 g/dl or hematocrit 38% Question 77
points
A laboratory result indicates that the peak level for a drug is
above the minimum toxic concentration. This means that the:
Question options:
Hemoglobin 17.5 g/dl or hematocrit 54% The analysis of the costs and consequences of any health-care-related treatment or service
II
