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NURS 615 PHARM EXAM 2||2025-2026|| REAL EXAM QUESTIONS AND CORRECT ANSWERS COMPLETE EXAM, Exams of Pharmacology

Maryville University of Saint LouisPharmacology

NURS 615 PHARM EXAM 2||2025-2026|| REAL EXAM QUESTIONS AND CORRECT ANSWERS COMPLETE EXAM|A+GRADE (MARYVILLE UNIVERSITY)

Typology: Exams

2024/2025

Available from 04/17/2025

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NURS 615 PHARM EXAM 2||2025-2026|| REAL
EXAM QUESTIONS AND CORRECT ANSWERS
COMPLETE EXAM|A+GRADE (MARYVILLE
UNIVERSITY)
1. Henry has 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 include:
Carbamazepine auto-induces metabolism, leading to lower levels despite good
compliance.
2. Carbamazepine has a Black Box Warning due to life-threatening:
Dermatologic reaction, including Steven’s Johnson and toxic epidermal necrolysis
3. Long-term monitoring of patients who are taking carbamazepine includes:
Complete blood count every 3 to 4 months (can be a decrease in WBC &
platelets)
4. Six-year-old Felisha has recently been started on ethosuximide (Zarontin) for
seizures. She should be monitored for:
Blood dyscrasias, which are uncommon but possible
5. What should families be taught regarding seizure activity monitoring?
Prevention of seizures, patient safety, quality of life issues, reach acceptable goals for
treatment, & do not abruptly stop taking seizure meds
6. What electrolyte imbalance is associated with topiramate?
Decreased sodium bicarb leading to hyperchloremic metabolic acidosis
7. Lisa, who is overweight, recently started taking topiramate for seizures and at her follow-
up visit you note she has lost 4 kg. The appropriate action would be:
Reassure her that this is a normal side effect of topiramate and continue to monitor her
weight.
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Download NURS 615 PHARM EXAM 2||2025-2026|| REAL EXAM QUESTIONS AND CORRECT ANSWERS COMPLETE EXAM and more Exams Pharmacology in PDF only on Docsity!

NURS 615 PHARM EXAM 2|| 2025 - 2026|| REAL

EXAM QUESTIONS AND CORRECT ANSWERS

COMPLETE EXAM|A+GRADE (MARYVILLE

UNIVERSITY)

  1. Henry has 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 include: Carbamazepine auto-induces metabolism, leading to lower levels despite good compliance.
  2. Carbamazepine has a Black Box Warning due to life-threatening: Dermatologic reaction, including Steven’s Johnson and toxic epidermal necrolysis
  3. Long-term monitoring of patients who are taking carbamazepine includes: Complete blood count every 3 to 4 months (can be a decrease in WBC & platelets)
  4. Six-year-old Felisha has recently been started on ethosuximide (Zarontin) for seizures. She should be monitored for: Blood dyscrasias, which are uncommon but possible
  5. What should families be taught regarding seizure activity monitoring? Prevention of seizures, patient safety, quality of life issues, reach acceptable goals for treatment, & do not abruptly stop taking seizure meds
  6. What electrolyte imbalance is associated with topiramate? Decreased sodium bicarb leading to hyperchloremic metabolic acidosis
  7. Lisa, who is overweight, recently started taking topiramate for seizures and at her follow- up visit you note she has lost 4 kg. The appropriate action would be: Reassure her that this is a normal side effect of topiramate and continue to monitor her weight.
  1. Travis’s seizures are well controlled on topiramate and he wants to start playing baseball. Education for Travis regarding his topiramate includes: He should monitor his temperature and ability to sweat in the heat while playing
  2. Brandy is taking valproate (Depakote) for seizures and would like to get pregnant. What advice would you give her? Valproate is a known teratogen, but may be taken after the first trimester if necessary. Keppra is a better drug to be on until the second trimester, then she can go back to valproate.
  3. What category is valproate? Category X
  4. The tricyclic antidepressants should be prescribed cautiously in patients with: Heart disease
  5. A 64 - year-old male was prescribed phenelzine (Nardil) while in an acute psychiatric unit for recalcitrant depression. The NP managing his primary health care needs to understand the following regarding phenelzine and other monoamine oxidase inhibitors (MAOIs): He should not be prescribed any serotonergic drug such as sumatriptan (Imitrex), MAOIs interact with many common foods, including yogurt, sour cream, and soy sauce, and symptoms of hypertensive crisis (headache, tachycardia, sweating) require immediate treatment
  6. What are the precautions and contraindications for tricyclic antidepressants? Side effects are similar to anticholinergic activity such as dry mouth, sedation, constipation, increased appetite, blurred vision, tinnitus, euphoria, and mania. Caution in patients with cardiac disease (terminate ventricular fibrillation, decrease cardiac contractility, increase collateral blood circulation to ischemic heart muscles).
  7. Marla is started on paroxetine (Paxil), a selective serotonin reuptake inhibitor (SSRI),
  1. An appropriate drug for the treatment of depression with anxiety would be: Escitalopram (Lexapro)
  2. One major drug used to treat bipolar disease is lithium. Because lithium has a narrow therapeutic range, it is important to recognize symptoms of toxicity, such as: Drowsiness and nausea
  3. Simon is taking lithium for bipolar disorder. He should be taught to: Eat a diet with consistent levels of salt (sodium)
  4. What are the side effects of tricyclic antidepressants? Dry mouth, constipation, urinary hesitancy or retention, blurred vision, sedation, orthostatic hypotension, weight gain, N/V, gynecomastia, and changes in libido. Remember it is similar to anticholinergic side effects-“can’t see, can’t pee, can’t spit, can’t shit.”
  5. What are the side effects of SSRIs? N/V, H/A, light-headedness, dizziness, dry mouth, increased sweating, weight changes, exacerbation of anxiety, agitation, and sexual side effects. Side effects are generally minor.
  6. What are the side effects of SNRIs? (serotonin and norepinephrine reuptake inhibitor) H/A, somnolence, dizziness, insomnia, nervousness, nausea, dry mouth, constipation, abnormal ejaculations, anorexia/weight loss, and elevated BP at higher doses.
  7. What are the side effects of MOIs? Insomnia, anxiety, agitation are initial adverse reactions. Common side effects include dizziness, H/A, restlessness, and hypotension. Also, dry mouth, blurred vision, urinary retention and constipation
  8. In choosing a benzodiazepam to treat anxiety the prescriber needs to be aware of the possibility of dependence. The benzodiazepam with the greatest likelihood of rapidly

developing dependence is: Alprazolam (Xanax)

  1. What receptors do benzodiazepines act on? Enhance the effect of the neurotransmitter gamma-aminobutyric acid (GABA-A) receptors which results in a sedative hypnotic anxiolytics/anticonvulsant/muscle relaxer properties.
  2. Long-acting benzos are prescribed for? Treatment of anxiety
  3. Short and intermediate-acting benzos are prescribed for? Treatment of insomnia
  4. An appropriate drug to initially treat panic disorder is: Diazepam (Valium)
  5. Bernadette, a 42 - year-old female, requests a prescription for an anorexiant to treat her obesity. A trial of phentermine is prescribed. Prescribing precautions include: Anorexiants may cause tolerance and should only be prescribed for 6 months
  6. Before prescribing phentermine to Bernadette, a thorough drug history should be taken including assessing for the use of serotonergic agents such as selective serotonin reuptake inhibitors (SSRIs) and St John’s wort due to: The risk of serotonin syndrome
  7. Outside the brain phentermine releases norepi & epi causing what to break down? Fat cells to break down stored fat
  8. When prescribing phentermine what should you assess for? You must inquire if the patient is taking St. John’s Wort and or an SSRI as these things can increase the risk of serotonin syndrome (H/A, agitation, hyomania, mental confusion, hallucinations, & coma). Wait, there’s more…you also get autonomic effects like shivering, sweating, hyperthermia, vasoconstriction, tachycardia, nausea, diarrhea,

potassium clavulanate, it’s a beta-lactamse inhibitor. This combination results in an ABX with increased spectrum of action and restored efficacy against amoxicillin-resistant bacteria that produce beta-lactamase

  1. What ABX are appropriate to prescribe to children? Penicillins and cephalosporins are generally regarded as safe
  2. Which ABX class of drugs should be avoided in children? Fluoroquinolones and tetracyclines are to be avoided in childhood
  3. Jaide is a 12 - month-old child who is being treated with amoxicillin for acute otitis media. Her parents call the clinic and say she has developed diarrhea. The appropriate action would be to: Advise the parents that some diarrhea is normal with amoxicillin and recommend probiotics daily
  4. Allison is a 13 - year old child who comes to clinic with a 4 - day history of cough, low- grade fever, and rhinorrhea. When she blows her nose or coughs the mucous is greenish- yellow. The appropriate antibiotic to prescribe would be: No ABX should be prescribed because this is a virus (mucous is greenish-yellow)
  1. Cindy was recently treated with clindamycin for an infection. She calls the advice nurse because she is having frequent diarrhea that she thinks may have blood in it. What would be the appropriate care for her? Assess her for pseudomembranous colitis
  2. MEMORIZE: the American College of Cardiology and the American Heart Association’s guide to ABX prophylactic use for dental appointments. See below…
  3. According to the American College of Cardiology and the American Heart Association, what are the guidelines related to prophylactic antibiotics prior to a dental appointment? a. This is a very important question. This will be on your exam. If you go to the American Heart Association and look up the guideline, I would memorize this because these questions can be very tricky. b. Antibiotic prophylaxis with dental procedures is reasonable only for patients with cardiac conditions associated with the highest risk of adverse outcomes from endocarditis including: i. Prosthetic cardiac valve or prosthetic material used in valve repair ii. Previous endocarditis iii. Congenital heart disease only in the following categories:
  4. Unrepaired cyanotic congenital heart disease including those with palliative shunts and conduits
  5. Completely repaired congenital heart disease with prosthetic material device, whether place by surgery or catheter intervention during the six months after the procedure
  6. Repaired congenital heart disease with residual effects at the site or adjacent to the site of a prosthetic patch or prosthetic device, which inhibit endothelialization
  7. Cardiac transplantation recipients with cardiac valvular disease c. Pay very close attention to those subtypes d. The treatment used for a dental appointment is amoxicillin orally two grams. In children it would be 50 milligrams per kilogram e. Dental Procedures and Infective Endocarditis In the past, patients with nearly every type of congenital heart defect needed to receive antibiotics one hour before dental procedures or operations on the mouth, throat, gastrointestinal genital, or urinary tract. However, in 2007 the American Heart Association simplified its recommendations. Today, antibiotics before dental procedures are only recommended for patients with the highest risk of IE, those who have:
  1. To prevent further development of antibacterial resistance it is recommended that fluoroquinolones be reserved for treatment of: Community-acquired pneumonia in patients with comorbidities
  2. Fluoroquinolones have a Black Box Warning regarding even months after treatment. Tendon rupture
  3. Fluoroquinolones have been reported to enhance the effective of and appropriate laboratory tests should be routinely monitored. It’s postulated to affect gut flora, which displaces warfarin from albumin and interfere with hepatic metabolism by inhibiting the cytochrome P450 enzyme system. Warfarin
  4. Tetracyclines should not be prescribed to children younger than 8 years due to: Adverse effects on bone growth
  5. Tetracyclines such as minocycline are safe to use in: Adolescents
  6. Hanna is a 17 - year-old female who is taking minocycline for acne. She comes to the clinic complaining of a headache. What would be the plan of care? Evaluate her for pseudotremor cerebri
  7. Valerie has been prescribed doxycycline for a chlamydia infection. She is healthy and her only medication is an oral combined contraceptive. Patricia’s education would include: Use a back-up method of birth control (condom) until her next menses. Recent research has shown no significant loss of effectiveness of oral contraceptives while using most tetracycline ABX but most practitioners still encourage another barrier method.
  8. Adverse effects of tetracycline ABX use include: Can stain developing teeth when taken by the mother during pregnancy and can impair bone growth in children.
  9. Interactions and precautions with tetracycline include: Can be inactivated by calcium ions and are NOT to be taken with milk, yogurt, or other dairy products. Can cause skin photosensitivity, drug-induced lupus and hepatitis.

Tetracyclines can also cause microvassicular fatty liver, tinnitus, and can interfere with methotrexate by displacing it from various protein binding sites they can cause breathing complications such as anaphylactic shock in some individuals.

  1. What are the most common drug interactions with levofloxacin? Potential tendon damage, black box warning (pregnancy), caution with older population and cortical steroid use, and interaction with warfarin
  2. A patient is administered gentamicin and complains of sudden hearing loss. What should the NP do? The NP should immediately instruct the patient to stop the medication as there is a concern for ototoxicity
  3. Which medications interact with linezolid (a weak MAO inhibitor)? Should not be used with other MAOIs, tyramine rich foods such as pork, aged cheese, alcohol, smoked or pickled foods, or serotonergic drugs (all the good stuff). It should also not be given with pethidine or meperidine (Demerol) under any circumstance d/t risk of serotonin syndrome.
  4. What is the treatment of Lyme Disease? Doxycylcline 100 mg PO q12 hrs x days
  5. To prevent the development of peripheral neuropathy in patients taking isoniazid for tuberculosis the patient is also prescribed: Pyridoxine (vitamin B 6 )
  6. Mary is an 82 - year-old patient who has herpes zoster (shingles) and would benefit from an antiviral such as valacyclovir. Prior to prescribing valacyclovir she will need an assessment of: Renal function
  7. When prescribing acyclovir, patients should be educated regarding the: Need to drink lots of fluids during treatment (need to flush the kidneys as this class of drug can be nephrotoxic)
  8. Michael has been diagnosed with type A influenza. Appropriate prescribing of oseltamivir (Tamiflu) would include:
  1. When prescribing metronidazole (Flagyl) to treat bacterial vaginosis, patient education would include: Consuming alcohol in any form may cause a severe reaction
  2. Every antibiotic drug class has resistant organisms that influence prescribing decisions. T or F? True
  3. Identify which antihelmintic is used to treat intestinal parasitic worms. Mebendazole and agromectin
  4. Identify which antihelmintic is used to treat tissue parasites (apparently there is a difference). Mebendazole, albendazole or ivermectin
  5. What antifungal medications can be used topically to treat fungal infections? Clotrimazole (treatment for candidiasis)
  6. What medication is used to treat scabies? Ivermectin and permethrin cream (can also treat lice)
  7. What is pyrazinamide used to treat? TB and the most common side effect is joint pain. Can precipitate gout flares by decreasing renal excretion of uric acid. Most dangerous side effect is hepatotoxicity.
  8. If a patient is allergic to sulfonamide antibiotics, he or she will most likely have cross- sensitivity to: Loop diuretics, sulfonylureas, and thiazide diuretics
  9. Sulfa ABX when used in large doses has the potential to cause? Strong allergic reactions including Stevens-Johnson syndrome and toxic epidermal necrolysis