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NURS 5334 ADVANCED PHARM FINAL EXAM QUESTIONS
WITH COMPLETE SOLUTIONS GUARANTEED PASS BRAND
NEW 2025
What are three drugs that can be combined with Hydrocodone? (Pain Management Mod 3) - ANSWER - >Aspirin Acetaminophen Ibuprofen Benzodiazepines and CNS depressants can be paired with acetaminophen-hydrocodone, True or False? - ANSWER - >False, this could lead to respiratory depression Why would you give a patient Buprenorphine for maintenance once they recovered from opioid abuse? - ANSWER - >Partial opioid agonist that activated opioid receptors but produces less degree of euphoria and physical dependence compared to a full agonist Why would you give a patient Naltrexone for maintenance once they recovered from opioid abuse? - ANSWER - >Naltrexone is a opioid antagonist that blocks the euphoric and sedative effects of opioids. What are 3 side effects of Hydrocodone? - ANSWER - >Constipation Respiratory depression Addition What's the MOA of Sumatriptan? (-triptan) - ANSWER - >Selective agonist for serotonin 5HT receptors on intracranial blood vessels and
sensory nerves of the trigeminal system, causes VASOCONSTRICTION and reduces neurogenic inflammation What is the supplement Feverfew used for? - ANSWER - >Migraine Prophylaxis Which types of drugs cannot be combined with Feverfew? - ANSWER -
Antiplatlets Anticoagulants Increased risk of bleeding in patients taking antiplatelets (Aspirin) and anticoagulants (Wafarin) How much Folic acid need to be given for a Folic Acid Deficiency? - ANSWER - >Give 1-2mg/day PO for a deficiency How much folic acid should a woman of child bearing age take? - ANSWER - > 400 - 800 mcg daily How much folic acid is recommended for a pregnant women? - ANSWER - > 400 - 600 mcg/day If a patient comes in using Tacrolimus and Pimecrlimus cream, what is this for? - ANSWER - >Atopic Dermatitis (Eczema) Ace inhibitors are contraindicated in pregnancy. While treatment of heart failure during during pregnancy is best done by a special, which of the following drug classes are considered to be safe at least in the later parts of pregnancy? A. Diuretics B. ARBS C. Beta blockers
How does an increase percentage of body at effect the plasma level of lipid soluble drugs in an elderly individual? - ANSWER - >The higher the body fat percentage the more the plasma levels of lipid soluble drugs will be reduced A decrease in lean mass causes concentration of water soluble drugs to be (inc/dec) in elderly patients? - ANSWER - >Increased For elderly patients that are malnourished (low albumin level) free drug levels of protein binding drugs will (inc/dec)? - ANSWER - >Increase A child is about to get the Proquad Vaccine, which is a mix of the Varicella and MMR vaccine. What education would you need to give to the parents? - ANSWER - >Deposited getting the vaccine there is still a chance your child could get breakthrough chickenpox What is the starting dosage of thyroid medication for a in elderly patient that is 51 with no comorbidities? - ANSWER - >50 mcg What is the starting dosage of thyroid medication for an elderly patient that is 68 years with no comorbidities? - ANSWER - >25 mcg What is the dosage range for thyroid medication for a person with CAD? - ANSWER - > 12 - 25 mcg What is an attenuated vaccine? - ANSWER - >Live Virus, but weakened Immunocompromised patients are able to receive Attenuated Vaccines, True or False? - ANSWER - >False, live vaccines can be dangerous in recipients who are immunocompromised because these people are unable to mount and effective immune response, even against an virulent organism
What is the range in weeks where a pregnant women can receive the TDap vaccine? - ANSWER - > 29 - 36 weeks (Module 10 Transcripts) What does Gardasil protect against in Females? (4) - ANSWER - >HPV 6, 11, 16, 18, 31, 33, 45, 52, 58 Cervical Cancer Vaginal Cancer Vulvar Cancer Genital Warts What does Gardasil protect against in Males? (1) - ANSWER - >HPV 6, 11, 16, 18, 31, 33, 45, 52, 58 Genitals Warts What is the MOA of Haloperidol? - ANSWER - >Blocking the dopamine D2 receptors in the brain, inhibiting the dopamine receptors help reduce the symptoms of psychosis such as hallucinations What are the adverse effects of Haloperidol? - ANSWER -
Extrapyramidal Side Effects What is the MOA of Chlorpromazine? - ANSWER - >Blocking dopamine D2 receptors in the brain What are extrapyramidal symptoms? - ANSWER - >Dystonia Tardive dyskinesia Akathisia Pseudoparkinsonism
Nonpharmalogical Management of Gout - ANSWER - >Low Purine diet Joint rest Weight Reduction Fluid intake of 3Liters What is the first-line treatment for Gout? (Urage Lowering Therapy) - ANSWER - >Allopurinol NSAIDS can be given to a patient with Rheumatoid Arthritis for pain and inflammation, True or False? - ANSWER - >True Patients with Rheumatoid Arthritis should also be put on a DMARD to reduce joint destruction, True or False? - ANSWER - >True Which one of these medications are considered First-line treatment for Rheumatoid Arthritis for Moderate to Severe disease? A. Hydroxychloroquine B. Tramadol C. Acetaminophen D. Methotrexate - ANSWER - >D. Methotrexate Methotrexate is first line treatment of rheumatoid arthritis for moderate to severe disease Which one of these medications are considered First-line treatment for Rheumatoid Arthritis for Mild disease? A. Hydroxychloroquine B. Tramadol C. Acetaminophen D. Methotrexate - ANSWER - >A. Hydroxychloroquine
Hydroxychloroquine is used for Mild disease of RA What education would you give to a patient taking Hydroxychloroquine for Mild RA? - ANSWER - >It's important to get Regular Eye Exams because plaquenil binds to retinal pigment cells and can cause retinal toxicity and destroy the macular NSAIDS and Glucocorticoids can be used for management of acute flare ups for gout, True or False? - ANSWER - >True What is the MOA of Fibrates? - ANSWER - >Fibrates work by activating PPARα which are intracellular receptors that regulate fat and carbohydrate metabolism. Increase the breakdown of triglycerides into fatty acids via beta oxidation Name the Three Fibrates that help lower triglycerides? - ANSWER -
Fenofibrate Gemfibrozil Lovaza "FIBRATES For triGLycerdes " Fibrates have little effect on LDLs, True or False? - ANSWER - >True What two Statins are best for Hyperlipidemia? - ANSWER - Rosuvastatin Atorvastatin What is needed for children with rickets for recovery? - ANSWER - Vitamin D
- GI Disturbances: impaired absorption What natural supplement can help with Osteoarthritis of the knees, hips, and wrists? - ANSWER - >Glucosamine/Chondriton Glucosamine/Chondriton can be used with someone that has a shellfish allergy, True or False? - ANSWER - >False, Glucosamine/Chondriton should be used with caution with people that have a shellfish allergy What medication can be used to reduce the size of the prostate? - ANSWER - >Finasteride Which is the following Diabetes medication is optimal for weight loss? A. Metformin B. Liraglutide C. Pramlintide D. Pioglitazone - ANSWER - >B. Liraglutide Liraglutide is a GLP-1 agonist that is approved for chronic weight management in adults. It acts by slowing gastric emptying, which increases a feeling of fullness, leading to decrease weight loss What is the therapeutic use for Buprenorphine? - ANSWER -
Maintenance therapy for opioid dependence. This is can stimulate opioid receptors and decrease withdrawal symptoms. It given with a full agonist would decrease effects What is the MOA of Buprenorphine? - ANSWER - >Partial mu agonist, kappa antagonist. This produces a lesser degree of euphoria and physical dependence
What is the therapeutic use for Naltrexone? - ANSWER - >Naltrexone is an opioid antagonist. This is maintenance therapy for opioid dependence and to prevent relapse. An an opioid is taken while a patient is on Naltrexone the opioid will still have a euphoric effect, True or False? - ANSWER - >False, if an opioid is taken while a patient is on naltrexone, it will prevent a euphoric effect What is the correct way to apply Topical Glucocorticoids? - ANSWER -
Topical Glucocorticoids should be applied in a thin film and gently rubbed into the skin. What is the dose of Terbinafine to give to Onchymycosis on one fingernail? - ANSWER - >250 mg daily for 6-12 weeks for fingernail What is the dose of Terbinafine to give to Onchymycosis on one
toenail? - ANSWER - >250 mg daily for 3-6 months for toenail What is the MOA of Denosumab? - ANSWER - >inhibits binding of RANKL to RANK, decrease osteoclast maturation and formation, decrease bone resorption. How do Bisphosphonates work? - ANSWER - >Inhibit osteoclast bone resorption Gallium Nitrate MOA - ANSWER - >inhibits bone resorption What's the ending that all Bisphosphonates have? - ANSWER - >- dronate Name the adverse effects of Bisphosphonates? (8) - ANSWER - >Atrial Fibrillation
parenchyma, True or False? - ANSWER - >True, Pyridoxine stimulates decarboxylase activity of Pyridoxine and can decrease the amount of levodopa available to the CNS A patient has Parkinson's and is dealing with Tardative Dyskinesia, what medication would you recommend to this patient for the symptoms? A. Amantadine B. Methyldopa C. Escitalopram D. Amitriptyline - ANSWER - >A. Amantadine can help with dyskinesia in later stages What are some Adverse Effects of Phenytoin? - ANSWER - >Nystagmus Sedation Ataxia Diplopia Cognitive impairment Gingival Hyperplasia What is an important piece of education that should be given to patients taking Phenytoin for Seizures? - ANSWER - >Make sure to do thorough oral care due to Gingival Hyperplasia What occurs during a a Serotonin Crisis? - ANSWER - >Starts 2 - 72 hrs after treatment Altered mental status Agitation Confusion Disorientation Hallucinations Myoclonus Hyperflexia
Excessive sweating If a patient is experiencing serotonin syndrome, how do you resolve the issue? - ANSWER - >Stop the medication Name two Non-stimulant medication that can be given to a patient with ADHD? - ANSWER - >Atomoxetine Viloxazine Name two Tricyclic antidepressants that can be used for ADHD? - ANSWER - >Desipramine Imipramine Name 3 α-2 Adrenergic Receptor Agonists that can be used for patients with ADHD? - ANSWER - >Clonidine Guanabenz Guanfacine What medication used for smoking cessation can also be used for an adult with ADHD? - ANSWER - >Bupropion In males what do the α-1 receptors trigger? - ANSWER - >Ejaculation How does the activation of α-1 receptors affect the blood vessels? - ANSWER - >Contraction How does the activation of α-1 receptors affect the eye? - ANSWER -
Pupillary dilation How does the activation of α-1 receptors affect the bladder? - ANSWER
Promotes digestion increase motility and relax sphincters Increase Salivation Promotes voiding Increases sweating and lactation. What is the MOA of Bethanechol? - ANSWER - >BethaneCHOL is a muscarinic agonist and activates the Cholinergic receptors. What are therapeutic uses for Bethanechol? (2) - ANSWER - >Treatment of urinary retention Stimulate intestinal Motility in people with Ileus Why is Bethanechol contraindicated in patients with asthma? - ANSWER - >This medication constricts bronchi and brings about exacerbations of asthma Why would Bethanechol be used post surgery? - ANSWER - >To get the patient to pee and poop Bethanechol can be used in patients with hyperthyroidism, True or False? - ANSWER - >False, Bethanechol can cause dysthymias in patients with Hyperthyroidism What is the MOA of Atropine? - ANSWER - >Blocks the ability of Ach to bind to parasympathetics and as a result the sympathetic nervous system take over ↑ HR, BP, & SVR What are the pharmacological effects of Atropine? - ANSWER -
Increased Heart Rate Decreased Secretions Relaxes Bronchi
Decreases Bladder Tone Decrease GI Tract Motility How does Atropine affect people with asthma? - ANSWER - >Atropine can worsen asthma. The drying of the secretions making it harder to breathe How can Atropine be beneficial to use for an eye exam? - ANSWER -
Atropine dilated pupils in preparation for an eye exam What medication can be used to combat Cholinergic effects? - ANSWER
Atropine What are side effects of Atropine? - ANSWER - >dry mouth, decreased perspiration, blurred vision, tachycardia, constipation, and urinary retention For patient self-identified as African American with NYHA class III-IV HFrEF who are receiving OPTIMAL medical therapy the combination of which two medications is recommended? - ANSWER - >Hydralazine + Isosorbide Dinitrate All patients with hypertension benefit from diuretic therapy but the patients that benefit the most are? A. Diabetes patients B. African Americans C. Patients with Orthostatic Hypotension D. Those with stable angina - ANSWER - >B. African Americans, controlled trials have shown that diuretics can decrease the morbidity
and mortality of African Americans
What is the MOA of Sulfonylureas? - ANSWER - >Stimulate insulin release from pancreatic beta cells. Sulfonylureas can cause extreme Hypoglycemia when taken, but also help patients lose weight, True or False? - ANSWER - >False, a major side effect of Sulfonylureas is Sever Hypoglycemia BUT they do not cause weight loss, they cause WEIGHT GAIN What are the names of 3 Sulfonylureas? - ANSWER - >Glipizide Glyburide Glimepiride Sulfonylurea are an oral medication reduces blood sugar and increases insulin production, True or False? - ANSWER - >True, stimulate insulin releases from the beta cells of the pancreas. They bind to sulfonurea receptors in the pancreatic beta cells, which lead to the closing of potassium channels and the opening of the calcium channels. This influx of calcium ions stimulate the exocytosis of insulin containing granulates. What is the MOA of Repaglinide and Nateglinide? - ANSWER -
Stimulate rapid, short term insulin secretion. Helpful in controlling postprandial blood glucose levels Do Meglitinides reduce blood sugar and increase insulin production? - ANSWER - >Yes What is the MOA of Glitazones? - ANSWER - >Increase insulin sensitivity in peripheral tissues such as muscles and adipose tissues. Activation of PPAR-γ increases the transcription of insulin responsive genes, leading to improved insulin action, increase glucose uptake, decrease gluconeogenesis in the liver.
What is the MOA of DPP-4 inhibitors? - ANSWER - >Increase incretin levels (GLP-1 and GIP), which inhibit glucagon release, which in turn increases insulin secretion, decreases gastric emptying, and decreases blood glucose levels. Sitagliptin is an oral medication that reduces blood sugar and increases insulin production, True or False? - ANSWER - >True, Sitagliptin increases insulin production and decrease glucose production by inhibiting the enzyme DPP-4, which results in prolonged activity of incretin hormones What is the MOA of Canagliflozin? - ANSWER - >Increases urinary excretion of glucose What is the MOA of Semaglutide? - ANSWER - >GLP-1 receptor agonist Slow digestion and glucose absorption. Often associated with weight loss. Liraglutide is an oral medication that reduces blood sugar and increases insulin production, True and False? - ANSWER - >False, Liraglutide is a injection How do you distinguish a Cholinergic and Myasthenia crisis? - ANSWER
Give the patient edrophonium
- If the symptoms are alleviated, the crisis is Myasthenic
- If the symptoms intensify, the crisis is Cholinergic and needs to be treated with atropine Why is Levadopa and Carbidopa combined for Parkinson's Disease? - ANSWER - >Very Little Levadopa reaches the brain due to peripheral metabolism if given alone, Carbidopa decreases the decarboxylation in the periphery so that more of the drug can enter the system. Caridopa allows less Levadopa to be given
