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NURS 5334 FINAL EXAMS QUESTIONS WITH COMPLETE SOLUTIONS
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A patient who has Parkinson's disease takes levodopa and carbidopa. The patient reports experiencing and increasing number of "off" periods. The NP will choose entacapone over tolcapone because: A. Tolcapone can cause fatal kidney failure B. Tolcapone can cause fatal liver failure (Black box warning) C. She has samples of entacapone D. It is personal preference Correct Answers B. Tolcapone can cause fatal liver failure (Black box warning) In the treatment of moderate to severe Alzheimer disease memantine is sometimes given concurrent with a cholinesterase inhibitor because: A. Those taking the combination showed fewer side effects B. Those taking the combination showed less cognitive decline (had less decline in cognitive day to day function than those taking donepezil alone) C. The combination can help reverse the disease process D. Those taking the combination helps prevent weight loss Correct Answers B. Those taking the combination showed less cognitive decline (had less decline in cognitive day to day function than those taking donepezil alone) Male with both benign prostatic hypertrophy and HTN. The only medication he takes is lisinopril (ACE Inhibitor). B/P is not quite under control. The NP decides to prescribe Terazosin. Why is this a good choice? A. It is non selective competition antagonist at both alpha 2 and alpha 3 adrenergic receptors
B. It is a non selective competition antagonist at both alpha 1 and alpha 2 adrenergic receptors C. It is a selective competition antagonist at alpha 1 adrenergic receptors D. It is a selective competition antagonist at alpha 2 adrenergic receptors Correct Answers C. It is a selective competition antagonist at alpha 1 adrenergic receptors Patient is taking oxcarbazepine for her seizures. She presents to the NP for birth control pills (contraceptive). What does the NP tell her? A. I will have to prescribe a pill with low dose estrogen. Oxcarbazepine increases estrogen levels. B. I will have to prescribe a pill with low dose progesterone. Oxcarbazepine increases levels of progesterone (not this one) C. I will have to discuss other forms of contraception with you. Oxcarbazepine decreases estrogen and progestin levels. (Trileptal can decrease estrogen by 50% and progesterone by 58%) D. I will prescribe you a progesterone only pill. Oxcarbazepine lowers estrogen levels. (not this one) Correct Answers C. I will have to discuss other forms of contraception with you. Oxcarbazepine decreases estrogen and progestin levels. (Trileptal can decrease estrogen by 50% and progesterone by 58%) Patient taking metoprolol for angina. He wants to stop the medication due to side effects. The NP tells him A. Go ahead and stop B. Abrupt discontinuation can cause exacerbation of angina and increased risk for MI
B. Galantamine C. Memantine (Memantine is indicated only for moderate to severe Alzheimer's dementia) D. Donepezil Correct Answers C. Memantine (Memantine is indicated only for moderate to severe Alzheimer's dementia) Which of the following is a good choice for treatment of Parkinson disease in the early stage A. Pramipexole with levodopa B. Levodopa/carbidopa C. Pramipexole alone (Pramipexole is used alone in early Parkinson with and with Levodopa in advancing Parkinson D. Levodopa alone Correct Answers C. Pramipexole alone (Pramipexole is used alone in early Parkinson with and with Levodopa in advancing Parkinson Which of the following is a possible adverse effect of phenytoin? (Adverse effects include nystagmus, sedation, ataxia, diplopia, cognitive impairment, gingival hyperplasia, skin rash, toxic to a growing fetus in pregnancy and cardiovascular effects. A. Gingival hyperplasia (Gingival hyperplasia presents itself by swelling, tenderness, and bleeding of the gums, and this can be treated with a gingivectomy or with folic acid 0.5 milligrams a daily can help prevent the gum overgrowth. Educate your patients about importance good oral hygiene, including flossing and gum massage. This can help as well. B. Peripheral edema C. CNS stimulation D. Liver toxicity Correct Answers A. Gingival hyperplasia
Which of the following medications is best choice for a person with anxiety with depression? A. Escitalopram (Venlafaxine and duloxetine are SNRIs; paroxetine and escitalopram are SSRIs. These are great medications for those who have depression in addition with GAD. They are also effective without the presence of depression. Initial responses can be seen in one week but optimal responses require several more weeks to develop.) B. Alprazolam C. Buspirone D. Buproprion Correct Answers