Download MSN 571 PHARM MIDTERM FINAL EXAM and more Exams Nursing in PDF only on Docsity!
MSN 571 PHARM MIDTERM FINAL EXAM
- Fluoroquinolone antibiotics are most likely indicating in which of the conditions Asthma Genital infections Follicular conjunctivitis GERD
- Which of the following is most likely an intervention for otitis media? Amoxicillin Aspirin Immunoglobulins Corticosteroids
- Which of the following best classifies penicillin, cephalosporins, and Protein synthesis inhibitors Mycolic acid synthesis inhibitors RNA synthesis Cell wall inhibitors
- Beta lactamase inhibitors are often located in which of the following? May decrease absorption First dose effect Often combined with penicillin antibiotics Delayed absorption of oral drugs
- Which of the following drug classes is/are used in initial hypertension management of African American population? Clonidine primary Beta blockers primary Thiazide or calcium channel blocker primary ACE-I primary ARB primary
- Which of the following groups of antibiotics is notable for side effects such as nephrotoxicity or ototoxicity? Beta-lactams Aminoglycosides Tetracyclines
- Which of the following groups of antibiotics has a beta-lactam ring in the molecular
Structure Sulfonamides Macrolides Tetracyclines Fluoroquinolone Cephalosporins
- Which of the follow medication is a fluoroquinolone antibiotic? Ciprofloxacin Azithromycin Amikacin Penicillin
- Which of the following medications or drugs classes is commonly indicated for managing gestational hypertension? Spironolactone (Aldactone) Loop diuretics Calcium channel blockers Dobutamine Calcium gluconate
- Which of the following best classifies aminoglycosides, macrolides and clindamycin? Protein synthesis inhibitor Folic acid synthesis inhibitors Cell wall inhibitors Mycolic acid synthesis inhibitors
- The long half-life of amiodarone contributes to which complications Enhanced therapeutic effects Liver toxicity Decreased dosing Short onset of action
- Pharmacokinetics involves the study of which factor? Distribution rates among various body compartment Physiologic interactions of drugs Interactions among various drugs Adverse reactions to medications
The two medications are contraindicated for use together
- A two year old child presents to the clinic with arthralgia and fever in the last tympanic membrane is erythematous and bulging the right TMS is perforated and draining the child’s parent states “this is fifth year infection this year “what can we do? what action will the provider take to address to Childs ear problems Prescribe amoxicillin/clavulanate and refer the child to an otolaryngologist??? I THINK THIS IS CORRECT Prescribe both ceftriaxone (Rocephin) IM with benzocaine ear drops for pain
- A patient is diagnosed with otitis externa. Comorbidities include diabetes mellitus, hypertension, and advanced multiple sclerosis. Which type of education regarding medication administration would you provide? page 1304 repeat # The oral administration of a prescription for hydrocortisone/neomycin/polymyxin B combination solution The oral administration of a prescription for fluoroquinolone The administration of topical medication for a prescription of alcohol plus acetic acid s solution The administration of topical combination for a prescription of fluoroquinolone/glucocorticoid combination solution
- A patient who has congestive heart failure requires a diuretic. The patient also has a history of chronic kidney disease with a glomerular filtration rate (FGR) of less than 30 ml/min. which drug would you prescribe this patient. Methyclothiazide Metolazone Loop diuretics
- Factors released by platelets contribute to hemostasis by enhancing Fibrinolysis Vasodilation Intrinsic pathway Platelet aggregation
- A patient has been receiving iron replacement therapy for 2 days after hip replacement surgery. The provider is alerted to the following assessment data:
Patient is pale and reports feeling tired Patient’s stools appear black Patients heart rate is 98 beats/min respiration are 20 and the blood pressure is 100/50 mm hg What order will the provider take initially to best assure appropriate care for this patient? Packet red blood cells Hemoglobin and hematocrit Hypertonic fluid bolus Stool guaiac
- A woman taking a drug for high LDL-cholesterol experience muscle tenderness and pain with no apparent cause. Which agent is less likely to cause this adverse effect. Fenofibrate Niacin Atorvastatin Colestipol
- Which drug inhibits the intestinal absorption of cholesterol? Colestipol Fenofibrate Ezetimibe Colesevelam
- An elderly patient with hypertension and hyperlipidemia who has been prescribed a statin medication comes for a follow up visit after 4 months of therapy. The patient’s laboratory reports show elevated blood cholesterol level and the urine examination reveals rhabdomyolysis. What could be the reason for the condition? Select all the apply The patient is taking amiodarone along with statin The patient is taking grapefruit juice with statins The patient is not responding to the treatment The patient is taking cyclosporine along with statin & verapamil The patient is eating fiber-rich food along with the statins
- Match the correct drug teratogenic effect during pregnancy THIS ONE IS HARD IDK - found a table on the pharm book. Table 8. NSAIDS-Microcephaly; premature closure of the ductus arteriosus Angiotensin-converting enzyme inhibitors- renal failure; renal tubular dysgenesis, skull hypoplasia (from exposure during 2nd & 3rd trimester)
All the answer are Correct Tendinitis and tendon rupture Seizures
- A provider would prescribe which antibiotic to a patient diagnosed with methicillin-resistant Staphylococcus aureus (MRSA) Ciprofloxacin Daptomycin Norfloxacin Levofloxacin
- Which order for furosemide is written appropriately by the prescribe? Furosemide (Lasix) 20 mg po qd Furosemide (Lasix) 20 mg po daily Furosemide (Lasix) 20 mg daily Furosemide (Lasix) 20 mg po QD
- How can the prescriber’s regular collaboration with a pharmacist? Pharmacist can suggest foods that will help with the medications Pharmacists have additional information on drug interaction The pharmacist can suggest adequate medication dosing Pharmacy can alter prescriptions when necessary to prevent patient harm Pharmacists have firsthand knowledge of the facility formulary
- A six-year-old who has never received an inactivated influenza vaccine has been brought to the office by his mother to be vaccinated to help protect his four month-old-baby sister during influenza “season”. You inform the boy’s mother that he will require A single vaccination administered annually Children under age eight years should not receive the inactivation influenza vaccination Two inactivated influenza vaccinations the first scheduled about one month prior to the start of influenza season (October/November) and the second scheduled four weeks after the first. Two inactivated influenza vaccinations scheduled four or more weeks apart
- All the medications are safe to use during pregnancy except Acyclovir Famciclovir Valacyclovir
Foscamet
- Zanamivir is indicated for which of the following? Zanamivir is indicated for both treatment and prophylaxis of influenza Treatment of respiratory syncytial virus (RSV) Treatment of influenza Prophylaxis of influenza
- What is the treatment of option for a patient who reported small vesicular lesions on his genitals that lasted between 10 and 20 days? Acyclovir (Zovirax) One time dose of azithromycin Three injections of penicillin Test of cure
- Which medication will decrease blood pressure by blocking angiotensin II receptor site? Eplerenone Furosemide Valsartan Enalapril
- A patient receiving nifedipine. Which adverse effect should you monitor for in this patient? Ankle edema Diarrhea Pallor Backache
- Why does NP student anticipate administering metoprolol rather than propranolol? Propranolol causes beta 1 and beta 2 blockade Metoprolol helps prevent retinopathy in individuals with diabetes Metoprolol is less likely to cause diabetic neuropathy Propranolol is associated with a higher incidence of foot ulcers.
- When developing a treatment plan for a 65-year-old patient with benign prostatic hyperplasia (BPH), who also takes medication to control hypertension, which medication would you plan to include? Tamsulosin (Flomax) Tadalafil (Cialis, adcircal) Dutasteride (Avodart)
Prescription drugs that cannot be refilled Prescription that is valid for only 1 year
- Which of the following is not a side effect of morphine? Urinary retentions Biliary colic Respiratory depression All are side effect of morphine
- The 4th to the 10th week of gestation is the period time when there is the greatest concern about drug induced Fetal hemorrhage Fetal cardiac arrest Fetal malformation Labor
- Which pediatric client is at gestation risk for medication toxicity? A 10-year-old recovering from an appendectomy A 6-years-old being treated with first degree burn A 15-years-old diagnosed with exercised-induced asthma A 1 - year-old diagnosed with a heart valve problem
- When calculating pediatric dosages, what should you take into consideration? Dosage calculation by body surface area is the most accurate method because it takes into account the difference in size of the child and or neonates Calculated doses based on body weight should be increased by 10% because of immature renal and hepatic functions Dosage calculation according to the body weight is the most accurate method because it takes into account different in maturational development Usage of drug reference recommendation based on milligram per kilogram of the body weight is the preferred method.
- A health care professional advises a pregnant woman to add supplement of which nutrient to her diet prevent birth defects? Iron Vitamin C Zinc
Folate
- A parent of a 5-year-old child with allergic rhinitis is seeking an approved treatment to make the child feel better. Which of the following recommended? Diphenhydramine Meclizine Promethazine Cetirizine
- Which of the following is non-neurotoxin treatment for head lice? Permethrin 1%?jk Malathion (ovide) Benzoyl alcohol (ulesfia) Lindane shampoo
- Monitoring of a patient who is taking allopurinol for gout includes Blood glucose c-reactive protein Bun, creatinine, and creatinine clearance Complete blood count
- All of the following are true regarding the treatment of scabies except? Treatment of scabies includes crotamiton, malathion, and lindane Permethrin 5% cream (elimites) is the drug of choice for the treatment of scabies in infants greater than 2 months and approved to use in pregnant women Lindane does not carry risk for toxicity and can be used in children more than 2 years of age. Lindane though usually effective carries a risk for toxicity and should be sued in children
- Which of the following will you find in a patient taking warfarin and levothyroxine? Cardiac dysrhythmias Shortness of breath Excessive bleeding
- Idarucizumab is used to reverse the activity of which antithrombotic drugs in cases of Bleeding? Warfarin Alteplase
a. High risk for toxicity
- Pharmacokinetics involves the study of A) physiologic interactions of drugs. B) distribution rates among various body compartments. C) interactions between various drugs. D) adverse reactions to medications.
- What are the properties of an ideal drug? a. Effectiveness, safety, and selectivity
- Blood concentrations of drugs are variable and are influenced by the: a. Drug metabolism
- When developing a treatment plan for a 65-year old patient with BPH, who also takes medication to control HTN, which medication would you plan to include? a. Tamusolin (Flomax) B. Tadalafil (Cialis, adcircal) C. dutasteride (avodart) D. finasteride (propecia, proscar)
- The patients asks if there is any other option besides antibiotics to treat acute otitis media. How will you respond? a. Pain management is also part of the treatment plan for otitis media
- A patient is diagnosed with otitis externa. Comorbidities include DM, HTN, and advanced MS. Which type of education regarding medication administration would you Provide? a. The administration of topical medications for a prescription of alcohol plus acetic acid solution b. The administration of topical combination medications for a prescription of fluoroquinolone/glucocorticoid combination solution c. The oral administration of a prescription for hydrocortisone/neomycin/polymyxin B combination solution d. The oral administration of a prescription for fluoroquinolone
- Which instructions should be included in the plan of care of a patient who is prescribed ferrous sulfate? a. Iron should only be taken at night b. Iron does not absorb
c. Iron compounds are not taken orally d. Antacids should not be taken with iron
- What changes in drug distribution with aging would influence prescribing a medication in a 90-year-old patient? Sadie is a 90-year-old patient who requires a new prescription. What changes in drug distribution with aging would influence prescribing for Sadie? ← similar question on quizlet in case its worded that way a. Increased muscle-to-fat ratio b. Increased volume of distribution c. Decreased lipid solubility d. Decreased plasma proteins
- Gross malformations by teratogens are most likely to occur during which stage of fetal Development? a. Weeks 3 - 8 b. Weeks 24- c. Weeks 12- d. Week 1-
- Which statements about transdermal absorption in infants are correct? a. Blood flow to the skin is greater in infants than in older patients b. Infants are at increased risk of toxicity compared with older children c. The stratum corneum of the infants is very thin, making absorption through the skin more rapid and complete with infants d. All answers are correct
- When teaching a pregnant patient about the effects of medication on the fetus, the greatest harm from maternally ingested medications occurs during which time period? a. Birthing process b. Second trimester c. Third trimester d. First trimester
- Which lab result may be a consequence of therapy with a thiazide diuretic? a. Serum potassium level of 5. b. Serum sodium level of 135 c. Serum glucose level of 58
d. Prophylaxis of influenza
- What is the treatment option for a patient who reported small, vesicular lesions on his genitals that lasted between 10 and 20 days? a. Acyclovir (Zovirax) b. One-time dose of azithromycin c. Test of cure d. Three injections of penicillin
- Which microorganism is directly affected by acyclovir? a. Proteus vulgaris b. Staphylococcus aureus c. Pneumocystis jiroveci d. Herpes zoster
- A 24-year-old patient is diagnosed with genital HSV infection. Which of the following agents is indicated for use in this diagnosis? a. Zanamivir b. Cidofovir c. Maivudine d. Valacyclovir
- A patient diagnosed with lymphagitis has an allergy to penicillin, the allergy is a rash. What would you give the patient? a. TMP/SMZ b. Penicillin VK PO c. Penicillin G IV d. Clindamycin (In Dr. Hu’s notes)
- Which of the following statements best explains the observation that morphine is more likely to cause nausea and vomiting in ambulatory patients? a. Opioids cause sedation, which makes walking more difficult b. Morphine inhibits chemoreceptor trigger zones c. Opioids increase vestibular sensitivity d. Morphine sensitizes medulla cough center neurons
- A patient is given Naloxone for Morphine sulfate who has a respiratory rate of 6 bpm. What is the MOA of Naloxone? a. Naloxone is a partial agonist, requiring a lesser dose to achieve pain relief
b. Naloxone is an agonist, leading to desensitization of the opioid receptors c. Naloxone causes hypersensitivity of the opioid receptors d. Naloxone prevents the activation of opioid receptors
- Which of the following will you find in a patient taking warfarin and levothyroxine? a. Cardiac dysrhythmias b. SOB c. Weight loss 5 kg d. Excessive bruising
- There is a pregnant patient in your office that states she was given Gentamicin when she was unknowingly pregnant which of the following adverse effects would you explain to the patient can result from taking Gentamicin in pregnancy? a. Cardiac malformation b. Discoloration of developing teeth c. Irreversible hearing loss d. Vision loss
- When prescribing Metronidazole (Flagyl) to treat bacterial vaginosis, patient education would include: a. HA are a sign of serious ADR and need immediate evaluation b. Consuming alcohol in any form may cause a severe reaction c. Sexual partners need concurrent therapy d. Metronidazole is safe in the first trimester of pregnancy
- A patient is to undergo orthopedic surgery, and the prescriber will order a cephalosporin to be given preoperatively as a prophylaxis against infection. Which generation of cephalosporin will the provider order? a. First b. Fourth c. Second d. Third
- A patient has a penicillin allergy and needs to be treated for strep throat. Which drug can be used as an alternative therapy for patients with a penicillin allergy? a. Linezolid b. Tetracycline c. Clindamycin
d. Assuring that the medication prescription will be covered by the patient’s insurance
- Instructions for applying a topical antibiotic or antiviral ointment include:
a. Apply thickly to the infected area, spreading the medication well past the borders of the infection. b. If the rash worsens, apply a thicker layer of medication to settle down the infection. c. Wash hands before and after application of topical antimicrobials d. None of the answer are correct.
- A patient suspected of having influenza comes to the urgent care for treatment. Which information will the NP need before prescribing Oseltamivir (Tamiflu)?
a) Allergies to antibiotics b) Immunization history c) Length of time since symptoms d) OTC medications taken in the last 48 hours
- Which finding is consistent with Guillain-Barré syndrome? Ascending paralysis
a) Patients often experience paresthesia or dysesthesia b) There is progressing descending paralysis c) The symptoms usually begin in the arms and face. d) Sensory nerves are affected more than motor nerves.
- A medication review of an elderly person’s medications involves:
a) All the answers are correct b) Having the patient bring all of their prescription, OTC, and home medications to the visit c) Asking the patient to bring a list of current prescription medications to the visit d) Asking what other providers are writing prescriptions for them
- Which antibiotic is recommended for the treatment of Chlamydia
a) High dose pcn b) High dose fluoroquinolone c) High dose cephalosporin d) High dose macrolide
- A patient diagnosed with lymphangitis has an allergy to pcn, the allergy is a rash. What would you give this patient?
CX is a 46-year-old patient diagnosed with lymphangitis. CX has a penicillin allergy, the allergy is a rash. Select the best antimicrobial to treat the lymphangitis in CX.
A. Penicillin G (IV) B. Penicillin VK (oral) C. Clindamycin (IV) D. Trimethoprim-sulfamethoxazole (IV) E. Vancomycin (oral)
- MRSA and DRSP (drug-resistant strep pneumoniae) mechanism of bacterial resistance is:
a) Altered membrane permeability b) Enzyme destruction with Beta-Lactamase c) None of the answers are correct d) Binding site alteration
- A patient has localized skin infection, which is most likely caused by positive cocci. Until the culture and sensitivity results are available, you order a -spectrum agent
a) Narrow; systemic b) Broad; systemic c) Broad; topical d) Narrow; topical
