Download NSG 6005 Final Exam Review and more Exams Nursing in PDF only on Docsity!
Answers Latest 2023||Download To Score A plus
- Patients with allergic rhinitis may benefit from a prescription of:
- Fluticasone (Flonase)
- Cetirizine (Zyrtec)
- OTC cromolyn nasal spray (Nasalcrom)
- Any of the above
- Decongestants such as pseudoephedrine (Sudafed):
- Are Schedule III drugs in all states
- Should not be prescribed or recommended for children under 4 years of age
- Are effective in treating the congestion children experience with the common cold
- May cause drowsiness in patients of all ages What drug therapy could a provider select to administer to a client seeking treatment for rhinosinusitis? chloride channel activators nitrofurantoin antimotility agents amoxicillin Allergic Rhinitis – corticosteroids are used to e manage seasonal or perennial allergies; used intranasal 1-2 times daily; Decongestants are used for allergic rhinitis Second-generation antihistamines such as loratadine (Claritin) are prescribed for seasonal allergies because they: A. Are more effective than first-generation antihistamines B. Are less sedating than first-generation antihistamines C. Are prescription products and, therefore, are covered by insurance D. Can be taken with CNS sedatives, such as alcohol B. Are less sedating than first-generation antihistamines Patients with allergic rhinitis may benefit from a prescription of:
- Fluticasone (Flonase)
- Cetirizine (Zyrtec)
Answers Latest 2023||Download To Score A plus
- OTC cromolyn nasal spray (Nasalcrom)
- All of the above Nonpharmacological therapy includes increasing fluid intake, using nonmedicated cough drops, nasal saline spray/drops to decrease viscosity of nasal secretions, and rest. Anorexia is often associated with the common cold and fluids may need to be forced to maintain hydration. Infants who are congested cannot breathe and feed at the same time causing fluid intake to be inadequate. Nasal suctioning may be required to clear secretions. Oral decongestants are used for the temporary relief of nasal congestion from the common cold, sinus infections, and allergic rhinitis. They may be used to promote nasal or sinus drainage and are also indicated in the relief of eustachian tube congestion. Pseudoephedrine for those over 4 y/o Viral URI (the common cold) are self-limiting and require no treatment, the goal is relieving irritating symptoms, specifically nasal congestion. ANTIBIOTICS HAVE NO PLACE IN THE TREATMENT OF VIRAL URIs. They can cause antimicrobial resistances to secondary bacterial infections. Antihistamines have not been shown to change the course of the common cold. But many OTC medications contain antihistamines, most likely for their “drying out” effect. Decongestants are the mainstay treatment for the common cold (systemic or topical). Tylenol/Ibuprofen/ASA can be given for fever and malaise. Topical decongestants are safe for 3 consecutive days of use. Topical decongestants adverse effects – transient stinging, burning, sneezing, dryness, local irritation, rebound congestion with prolonged use. Topical decongestants can symptomatically relieve nasal congestion and relieve ear blockage and pressure pain. Topical decongestant adverse reactions – insomnia, dizziness, weakness, tremor, or irregular heartbeat. Topical decongestant meds – Afrin, phenylephrine, oxylmetazoline, Neo-Synephrine
Answers Latest 2023||Download To Score A plus
Albuterol, beta agonists, is generally considered the first-choice medication for treatment of asthma. Inhaled corticosteroids are recommended as first-line therapy for athletes who have persistent asthma to prevent worsening symptoms with exercise. How is first-line treatment for COPD the same as for asthma? Both diseases require maintenance therapies. Both diseases are treated based on the number of hospitalizations. Both diseases results from first- or second-hand smoking. Both diseases are first always treated with short-acting muscarinic antagonists (SAMAs). Mast cell stabilizer – cromolyn ; works by inhibiting antigen-induced bronchospasm, blocks histamine release, stabilizes mast cells. Monoclonal antibody binds to free IgE and prevents them from responding to relevant allergens
- What is the desired mixed of T3 to T4 drug levels in newly diagnosed endocrine patients?
- 99% of T3 and the rest is T4 to get rapid resolution.
- Most needs to be T4 to mimic natural ratios of hormone.
- The ratio is unimportant.
- The mix needs to be 50-50 at first.
- After starting a patient with Grave’s disease on an antithyroid agent such as methimazole, patient monitoring includes TSH and free T4 every:
- 1 to 2 weeks
- 3 to 4 weeks
- 2 to 3 months
- 6 to 9 months
Answers Latest 2023||Download To Score A plus
- Once a patient who is being treated for hypothyroidism returns to euthyroid with normal TSH levels, he or she should be monitored with TSH and free T4 levels every:
- 2 weeks
- 4 weeks
- 2 months
- 6 months TSH levels determine hpyo- or hyperthyroidism. Level is between 0.5-5.0 mU/I. Therapeutic values are kept between 0.05 and 3.0 ideally. Screening values are considered acceptable up to 10.
- When methimazole is started for hyperthyroidism it may take to see a total reversal of hyperthyroid symptoms.
- 2 to 4 weeks
- 1 to 2 months
- 3 to 4 months
- 6 to 12 months Hypothyroidism during pregnancy is safe to treat with thyroid replacement hormones, they are a Pregnancy Cat A drug, and may require higher doses due to increase metabolism.
- What happens to the typical hormone replacement dose when a woman becomes pregnant?
- Most women need less medication.
- Most women do not require a dose change.
- The average woman needs more medication during pregnancy.
- The average woman needs more medication only if carrying multiples. Which of the following is the mechanism of action of oral combined contraceptives that prevent pregnancy? A. Estrogen prevents the LH surge necessary for ovulation. B. Progestins thicken cervical mucous and slow tubal motility. C. Estrogen thins the endometrium, making implantation difficult. D. Progestin suppresses FSH release. Progesterone-only pills are recommended for women who: A. Are breastfeeding B. Have a history of migraine C. Have a medical history that contradicts the use of estrogen D. All of the above
Answers Latest 2023||Download To Score A plus
- Hypertension medication in pregnancy
- How do Beta1 blockers affect the heart
- Beta-adrenergic blockers related to heart failure
- Commonalities of prazosin, terazosin, doxazosin
- Amlodipine vs Nifedipine
- Calcium channel antagonists of DHP vs. NDHP
- Cautions when using NDHP
- Hypertension treatment
- Use of calcium containing antacids
- Antacids related to fluid retention
- Strep throat related to treatment and diarrhea
- IBS related to diarrhea
- Diarrhea related to travel
- IBS treatment
- Inflammatory bowel disease treatment
- Tx of Alzheimer’s Disease
- Tx of Parkinson’s Disease
- Tx of Major Depression
- Tx for anxiety
- Tx for insomnia
- Tx for PTSD
- Z-drugs for insomnia
- Clinical judgement in prescribing
- Reducing costs of medications
- Managed care organizations r/t health improvement
- Managed care organizations r/t quality of life
- Managed care organizations r/t to dollars per life-year saved
- Managed care organizations r/t concrete monetary end-point
- Managed care organizations r/t comparing drug benefits
- Cost effectiveness in prescribing
- Copays from state to state
- Review of drugs recently placed on the market
- Vital signs related to prescribing
- Pentoxifylline
- First vs second generation antihistamines
- Naproxen related to Rheumatoid arthritis
- Medications for muscle spasms
- Prevention of osteoporosis
- Alendronate
- Treatment of acute pain
- Pain related to different ages
- Acute vs chronic pain
- Diarrhea post hospitalization
- Antidiarrheal medications related to stool changes
- Activated charcoal
- Antibiotics related to antacids
- Probiotics
- Bismuth subsalicylate therapy
- Laser trabeculoplasty
- Antiglaucoma agents related to kidney stones
- Uses for ketotifen
- Treatment of Type II DM
- Tx hypothyroidism
- Tx of partial seizures
- Tx of narcolepsy
- Tx of ADHD
- Tx Schizophrenia
- Tx Bipolar disorder
Answers Latest 2023||Download To Score A plus
- Penicillin and Cephalosporin cross sensitivity
- Tx for strep throat
- UTI treatment in pregnancy
- Side effects of amoxicillin
- Cephalosporins related to bacterial bronchitis
- Penicillin allergies
- Doxycycline use/avoidance in children 1) An ACE inhibitor and what other class of drug may reduce proteinuria in patients with diabetes better than either drug alone? A. Beta blockers B. Diuretics C. Nondihydropyridine calcium channel blockers D. Angiotensin II receptor blockers 2) Adam has type I diabetes and plays tennis for his university. He exhibits knowledge deficit about his insulin and his diagnosis. He should be taught that: A. He should increase his increase his carbohydrate intake during times of exercise intake during times of exercise. B. Each brand of insulin is equal in bioavailability, so buy the least expensive. C. Alcohol produces hypoglycemia and can help control his diabetes when taken in small amounts. D. If he does not want to learn to give himself injections, he may substitute an oral hypoglycemic to control his diabetes. 3) Age is a factor in different responses to pain. Which of the following age- related statements about pain is not true? A. Preterm and newborn infants do not yet have functional pain pathways. B. Painful experiences and prolonged exposure to analgesic drugs during pregnancy may permanently alter neuronal organization in the child. C. Increases in pain threshold in older adults may be related to peripheral neuropathies and changes in skin thickness. D. Decreases in pain tolerance are evident in older adults. 4) Alterations in drug metabolism among Asians may lead to:
Answers Latest 2023||Download To Score A plus
C. Altered metabolism of omeprazole, requiring higher doses D. Slower metabolism of alcohol, requiring higher doses 5) Amiodarone has been prescribed in a patient with a supraventricular dysrhythmia. Patient teaching should include all of the following except: A. Notify your healthcare provider immediately if you have visual change. B. Monitor your own blood pressure and pulse daily. C. Take a hot shower or bath if you feel dizzy. D. Use a sunscreen on exposed body surfaces. 6) Anticholinergic agents, such as benztropine (Cogentin), may be given with a phenothiazine to: A. Reduce the chance of tardive dyskinesia. B. Potentiate the effects of the drug. C. Reduce the tolerance that tends to occur. D. Increase CNS depression. 7) An appropriate drug for the treatment of depression with anxiety would be: A. Alprazolam (Xanax) B. Escitalopram (Lexapro) C. Buspirone (Buspar) D. Amitriptyline (Elavil) 8) Cara is taking levetiracetam (Keppra) to treat seizures. Routine education for levetiracetam includes reminding her: A. To not abruptly discontinue levetiracetam due to the risk of withdrawal seizures B. To wear a sunscreen due to photosensitivity from levetiracetam C. To get an annual eye exam while on levetiracetam D. To report weight loss if it occurs 9) 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: A. Fluoxetine (Prozac) B. Paroxetine (Paxil) C. Amitriptyline (Elavil)
Answers Latest 2023||Download To Score A plus
D. Duloxetine (Cymbalta)
Answers Latest 2023||Download To Score A plus
16) The drug of choice for type II diabetics is metformin. Metformin: A. Decreases glycogenolysis by the liver B. Increases the release of insulin from beta cells C. Increases intestinal uptake of glucose D. Prevents weight gain associated with hyperglycemia 17) The drug recommended as primary prevention of osteoporosis in men over seventy years is: A. Alendronate (Fosamax) B. Ibandronate (Boniva) C. Calcium carbonate D. Raloxifene (Evista) 18) The drug recommended as primary prevention of osteoporosis in women over seventy years old is: A. Alendronate (Fosamax) B. Ibandronate (Boniva) C. Calcium carbonate D. Raloxifene (Evista) 19) The drugs recommended by the American Academy of Pediatrics for use in children with diabetes (depending upon type of diabetes) are: A. Metformin and insulin B. Sulfonylureas and insulin glargine C. Split-mixed dose insulin and GLP-1 agonists D. Biguanides and insulin lispro 20) Drugs that have a significant first-pass effect: A. Must be given by the enteral (oral) route only B. Bypass the hepatic circulation C. Are rapidly metabolized by the liver and may have little if any desired action D. Are converted by the liver to more active and fat-soluble forms 21) Dwayne has classic tinea capitis. Treatment for tinea on the scalp is: A. Rubbing in miconazole cream well for four weeks B. Intake of oral griseofulvin for six to eight weeks C. Shampooing with ketoconazole shampoo daily for six weeks D. Using ciclopirox cream daily for four weeks
Answers Latest 2023||Download To Score A plus
22) Dwayne was recently started on carbamazepine to treat seizures. He comes to see you, and you note that while his carbamazepine levels had been in the therapeutic range, they are now low. The possible cause for the low carbamazepine levels is: A. Dwayne hasn't been taking his carbamazepine because it causes insomnia. B. Carbamazepine auto-induces metabolism, leading to lower levels in spite of good compliance. C. Dwayne was not originally prescribed the correct amount of carbamazepine. D. Carbamazepine is probably not the right antiseizure medication for Dwayne. 23) Erik presents with a golden-crusted lesion at the site of an insect bite consistent with impetigo. His parents have limited finances and request the least expensive treatment. Which medication would be the best choice for treatment? A. Mupirocin (Bactroban) B. Bacitracin and polymixin B (generic double antibiotic ointment) C. Retapamulin (Altabax) D. Oral cephalexin (Keflex) 24) First-line therapy for hyperlipidemia is: A. Statins B. Niacin C. Lifestyle changes D. Bile acid-binding resins 25) First-line therapy for treating topical fungal infections such as tinea corporis (ringworm) or tinea pedis (athlete's foot) would be: A. OTC topical azole (clotrimazole, miconazole) B. Oral terbinafine C. Oral griseofulvin microsize D. Nystatin cream or ointment 26) Furosemide is added to a treatment regimen for heart failure, which includes digoxin. Monitoring for this combination includes: A. Hemoglobin B. Serum potassium C. Blood urea nitrogen D. Serum glucose
Answers Latest 2023||Download To Score A plus
33) In addition to methimazole, a symptomatic patient with hyperthyroidism may need a prescription for: A. A calcium channel blocker B. A beta blocker C. Liothyronine D. An alpha blocker 34) Inadequate vitamin D intake can contribute to the development of osteoporosis by: A. Increasing calcitonin production B. Increasing calcium absorption from the intestine C. Altering calcium metabolism D. Stimulating bone formation 35) Incorporating IT into a patient encounter takes skill and tact. During the encounter, the provider can make the patient more comfortable with the IT the provider is using by: A. Turning the screen around so the patient can see material being recorded B. Not placing the computer screen between the provider and the patient C. Both A and B D. Neither A nor B 36) Infants with reflux are initially treated with: A. Histamine 2 receptor antagonist (ranitidine) B. A PPI (omeprazole) C. Antireflux maneuvers (elevate the head of the bed) D. Prokinetic (metoclopramide) 37) In five- to eleven-year-old children, mild-persistent asthma is diagnosed when asthma symptoms occur: A. At nighttime one to two times a month B. At nighttime three to four times a month C. Less than twice a week D. Daily 38) Jack, eight years old, has attention deficit disorder (ADD) and is prescribed methylphenidate (Ritalin). He and his parents should be educated about the side effects of methylphenidate, which are: A. Slurred speech and insomnia B. Bradycardia and confusion C. Dizziness and orthostatic hypotension D. Insomnia and decreased appetite
Answers Latest 2023||Download To Score A plus
39) Janie presents to clinic with hard ear wax in both ear canals. Instructions regarding home removal of hard cerumen includes: A. Moistening a cotton swab (Q-tip) and swabbing the ear canals twice daily B. Instilling tap water in both ears while bathing C. Squirting hydrogen peroxide into ears with each bath D. Instilling carbamide peroxide (Debrox) twice daily until the ear canals are clear 40) Jim presents with complaints of "heart burn" that is minimally relieved with Tums (calcium carbonate) and is diagnosed with GERD. An appropriate first step therapy would be: A. Omeprazole (Prilosec) twice a day B. Ranitidine (Zantac) twice a day C. Famotidine (Pepcid) once a day D. Metoclopramide (Reglan) four times a day 41) Jim presents with fungal infection of two of his toenails (onychomycosis). Treatment for fungal infections of the nail includes: A. Miconazole cream B. Ketoconazole cream C. Oral griseofulvin D. Mupirocin cream 42) Josie is a five-year-old who presents to the clinic with a forty-eight-hour history of nausea, vomiting, and some diarrhea. She is unable to keep fluids down, and her weight is 4 pounds less than her last recorded weight. Besides intravenous (IV) fluids, her exam warrants the use of an antinausea medication. Which of the following would be the appropriate drug to order for Josie? A. Prochlorperazine (Compazine) B. Meclizine (Antivert) C. Promethazine (Phenergan) D. Ondansetron (Zofran) 43) Kirk sprained his ankle and is asking for pain medication for his mild-to- moderate pain. The appropriate first-line medication would be. A. ibuprofen (Advil) B. acetaminophen with hydrocodone (Vicodin)
Answers Latest 2023||Download To Score A plus
B. attaching to receptors in the afferent neuron to inhibit the release of substance P C. blocking neurotransmitters in the midbrain D. increasing beta-lipoprotein excretion from the pituitary 50) A nineteen-year-old male was started on risperidone. Monitoring for risperidone includes observing for common side effects, including: A. Bradykinesia, akathisia, and agitation B. Excessive weight gain C. Hypertension D. Potentially fatal agranulocytosis 51) Nonadherence is especially common in drugs that treat asymptomatic conditions, such as hypertension. One way to reduce the likelihood of nonadherence to these drugs is to prescribe a drug that: A. Has a short half-life so that missing one dose has limited effect B. Requires several dosage titrations so that missed doses can be replaced with lower doses to keep costs down C. Has a tolerability profile with less of the adverse effects that are considered "irritating," such as nausea and dizziness D. Must be taken no more than twice a day 52) Off-Label prescribing is: A. Regulated by the FDA B. Illegal by NPs in all states (provinces) C. Legal if there is scientific evidence for the use D. Regulated by the DEA 53) One goal of asthma management in children is: A. They should independently manage their asthma. B. They should participate in school and sports activities. C. There should be no exacerbations. D. The use of inhaled corticosteroids should be minimal. 54) The ongoing monitoring of patients over the age sixty-five years taking alendronate (Fosamax) or any other bisphosphonate is: A. Annual dual energy X-ray absorptiometry (DEXA) scans B. Annual vitamin D level C. Annual renal function evaluation D. Electrolytes every three month
Answers Latest 2023||Download To Score A plus
55) A patient has been prescribed silver sulfadiazine (Silvadene) cream to treat burns on his or her leg. Normal adverse effects of silver sulfadiazine cream include: A. Transient leukopenia on days two to four that should resolve B. Worsening of burn symptoms briefly before resolution C. A red, scaly rash that will resolve with continued use D. Hypercalcemia 56) Patients who are on or who will be starting chronic corticosteroid therapy need monitoring of. A. serum glucose B. stool culture C. folate levels D. vitamin B 57) Patients who have angina, regardless of class, who are also diabetic should be on: A. Nitrates B. Beta blockers C. ACE inhibitors D. Calcium channel blockers 58) Patients with psychiatric illnesses have adherence rates to their drug regimen between 35% and 60%. To improve adherence in this population, prescribe drugs: A. With a longer half-life so that missed doses produce a longer taper on the drug curve B. In oral formulations that are more easily taken C. That do not require frequent monitoring D. Combined with patient education about the need to adhere even when symptoms are absent 59) A patient with a COPD exacerbation may require: A. Doubling of inhaled corticosteroid dose B. Systemic corticosteroid burst C. Continuous inhaled beta 2 agonists D. Leukotriene therapy 60) Pharmacokinetics among Asians are universal to all the Asian ethnic groups. A. True B. False 61) A potentially life-threatening adverse response to ACE inhibitors is angioedema. Which of the following statements is true about this adverse response?
