Download NURS 617 FINAL EXAM | NEWEST ACTUAL EXAM COMPREHENSIVE QUESTIONS AND VERIFIED ANSWERS and more Exams Nursing in PDF only on Docsity!
NURS 617 FINAL EXAM |
NEWEST ACTUAL EXAM COMPREHENSIVE
QUESTIONS AND VERIFIED ANSWERS
GRADED A+ | 2025 - 2026 UPDATE!
When should patients begin to exhibit signs of improvement when being treated for CAP - โโโ Correct Answer > 48 - 72 hours What are some adverse effects of aminoglycosides? - โโโ Correct Answer > ototoxicity and nephrotoxicity First line treatment of S.Pneumoniae bacterial pneumonia in children - โโโ Correct Answer > High dose amoxicillin If highly resistant pneumococci are in the community then use IV or IM ceftriaxone or cefotaxime Contraindications to use of aminoglycosides - โโโ Correct Answer
patients with Myasthenia Gravis due to neuromuscular blockade First line treatment of CAP in pregnant patients - โโโ Correct Answer > Azithromycin or Erythromycin; if recently treated with abx or with comorbidities use beta lactam+macrolide
First line treatment of chlamydial pneumonia in children - โโโ Correct Answer > Erythromycin or Azithromycin First line treatment of S. Aureus bacterial pneumonia in children - โโโ Correct Answer > Vancomycin if methicillin resistant and cephalexin if methicillin susceptible First line treatment of Mycoplasma pneumonia in children - โโโ Correct Answer > Azithromycin alternatives are clarithromycin or erythromycin Drug of choice for MRSA - โโโ Correct Answer > Vancomycin Drug of choice for syphillis - โโโ Correct Answer > Penicillin G Drug of choice for PCP in AIDS patients - โโโ Correct Answer > TMP/SMZ Drug of choice for surgical prophylaxis - โโโ Correct Answer > 1st generation cephalosporins (Cefazolin, Cefalexin, Cefadroxil) Drug of choice for N. Gonorrhea - โโโ Correct Answer > Ceftriaxone
Which antibiotic drug classes are contraindicated in pregnancy - โโโ Correct Answer > Tetracyclines, Fluoroquinilones, Metronidazole (1st trimester), 3rd generation cephalosporins, Nitrofurantoin ( 1st trimester) What are some serious adverse effects of Sulfonamides - โโโ Correct Answer > Crystaluria leading to nephrotoxicity Photosensitivity Stevens-Johnson syndrome hemolytic anemia, granulocytosis, thrombocytopenia What medication is used to treat drug resistant Staph, VRE, and PCN resistant strep - โโโ Correct Answer > Streptogramin (Quinupristin/Dalfopristin) Which medications can cause a disulfiram-like reaction when taken with alcohol - โโโ Correct Answer > 2nd generation cephalosporins and metronidazole What are some adverse effects of Tetracyclines - โโโ Correct Answer > discoloration of permanent teeth, photosensitivity , alteration of the intestinal and vaginal flora, diarrhea, vaginal candidiasis ,coagulation irregularities, blue grey pigmentation of skin, pseudotumor cerebri, Stevens-Johnson syndrome.
What drug-drug interaction occurs with tetracyclines and divalent/trivalent cations - โโโ Correct Answer > Coadministration of tetracyclines and antacids, iron salts, sevelamer, or Mg containing laxatives decreases the antibiotic activity and these medications should be given at least 2 hours apart. Contraindications for use of Tetracyclines - โโโ Correct Answer > Renal failure (except Doxycycline/Vibramycin) No children under 8 Pregnancy Cat X What are some adverse effects of Vancomycin - โโโ Correct Answer > ototoxicity, nephrotoxicity, red man syndrome 2nd line treatment of MRSA - โโโ Correct Answer > gentamycin Considerations when using Linezolid - โโโ Correct Answer > Can interact with MAOIs, SSRIs, and serotonin agonists Follow low tyramine diet Do not use any OTC cold meds with adrenergic drugs in them do not use longer than 28 days due to increase risk of peripheral and optic neuropathy.
Oxazolidinone (for MRSA) How long do you wait between dosing changes for Levothyroxine - โโโ Correct Answer > start low and go slow method. For adults, start at 50mcg daily and increase in incr. of 25 every 2-4 weeks. For older adults, start at 25 - 50 mcg and increase by 12.5- 25 mcg every 6 - 8 weeks. Lower doses and longer intervals are recommended for those with CV disease or long standing hypothyroidism. How to determine appropriate dosage size for Levothyroxine - โโโ Correct Answer > For adults with no CV impairment start at 50mcg/day and increase by 25mcg every 2-4 weeks. For Older adults with no CV impairment start at 25 - 50mcg and increase by 12.5-25 mcg every 6-8 weeks Lower doses and longer intervals are recommended for those with CV impairment and those with long standing hypothyroidism. Therapy is decided by TSH levels as well. Most adults require a dose less than 200mcg and a dose of >300mcg lack of adherence or malabsorption. What drugs are capable of having a drug-drug interaction with Synthroid. - โโโ Correct Answer > Potentiates effects of adrenergic agonists. May inhibit adrenergic blocking drugs
Which medication is best for chronic hypothyroidism - โโโ Correct Answer > Levothyroxine Which thyroid medication is most cardiotoxic - โโโ Correct Answer
Liothyronine Which thyroid medication has the disadvantage of not having content stability - โโโ Correct Answer > Liotrix What are some advantages of Liothyronine over Levothyroxine - โโโ Correct Answer > Liothyronine has a faster onset of action and is more potent. Advantage of using Levothyroxine over Liothyronine - โโโ Correct Answer > Less cardiotoxic and has a longer duration of action meaning that even if some doses are missed thyroid levels can remain therapeutic. What are some signs of Thyroid medication toxicity? - โโโ Correct Answer > irritability, insomnia, tachycardia, arrhythmias, elevated blood pressure, anxiety, weight loss, all similar signs of hyperthyroidism.
Which anti-diabetics require dosage adjustments for renal impairment.
- โโโ Correct Answer > DPP- 4 (gliptins) and SGLT- 2 inhibitors require dosage adjustments while Metformin and Sulfonylureas are contraindicated in patients with renal failure. Which anti-diabetic medications are contraindicated in Liver disease - โโโ Correct Answer > Metformin, Sulfonylureas, and Thiazolidinediones What oral hypoglycemic is preferred in pregnancy - โโโ Correct Answer > Metformin Which oral hypoglycemic drug has a black box warning for CHF - โโโ Correct Answer > Thiazolidinediones (zones) Special consideration when treating DM with an alpha glucosidase inhibitor and another hypoglycemic drug - โโโ Correct Answer > If hypoglycemia occurs you cannot treat with oral complex sugars; can still treat with glucose. Which anti-diabetic medication can be used for both type 1 and type 2 diabetes. - โโโ Correct Answer > Amylin Analogs (Pramlintide)
Which anti-diabetics are contraindicated in diabetic gastroparesis? - โโโ Correct Answer > Amylin analogs (pramlintide) and DPP- 4 inhibitors (gliptins) Which anti-diabetic drug causes mycotic infections? - โโโ Correct Answer > SGLT-2 inhibitors (flozins) Which anti-diabetics carry a black box warning for Thyroid tumors? - โโโ Correct Answer > GLP- 1 analogs (tides) What is the most effective medication-induced contraceptive - โโโ Correct Answer > Estrogen-Progesterone combo What is the least effective medication-induced contraceptive - โโโ Correct Answer > Progesterone only pill Possible long term effects of estrogen-progesterone combo contraceptives. - โโโ Correct Answer > Increased risk for thromboembolism, stroke, M.I May cause or increase risk for hypertension Possible increased risk for endometrial and breast cancer May cause risk of benign hepatic tumors Small possibility of post-pill infertility or amenorrhea
Disadvantages of ERT - โโโ Correct Answer > Can cause vaginal bleeding Commonly causes breast tenderness Can cause nausea and vomiting when therapy is initiated May cause headache, migraine, dizziness May produce weight gain Associated with an increased risk of breast cancer, endometrial cancer, myocardial infarction, stroke and deep venous thrombosis First line therapy for Sinusitis - โโโ Correct Answer > amoxicillin with or without clavulanate (Alternativeโcefuroxime, cefpodoxime, azithromycin) If allergic to PCN use doxycycline or Levofloxacin. What medication do you give if there is no improvement of sinusitis treated with Amoxicillin? - โโโ Correct Answer > Children who do not get better while on first line treatment should be given high dose amoxicillin-clavulanate, cefdinir, cefuroxime, or cefpodoxime. Adults who do not get better with first line treatment give levofloxacin. First line treatment for Upper UTI - โโโ Correct Answer > Cefixime Second line therapy is amoxicillin, TMP-SMZ, ciprofloxacin, or levofloxacin
First line treatment for uncomplicated Lower UTI in a non pregnant patient - โโโ Correct Answer > Nitrofurantoin or TMP-SMZ 2nd line is fosfomycin First line treatment for lower UTI with known or suspected antibiotic resistance - โโโ Correct Answer > Amoxicillin-Clavulanate 2nd line is ciprofloxacin or levofloxacin First line treatment for complicated UTI suitable for outpatient treatment - โโโ Correct Answer > TMP/SMZ for 7 - 14 days 2nd line is Amoxicillin-clavulanate, levofloxacin, or ciprofloxacin First line treatment for complicated UTI in pregnancy suitable for outpatient treatment - โโโ Correct Answer > Cephalexin 2nd line-Nitrofurantoin as long as patient is in 2nd trimester First line therapy of UTI in an afebrile child >1 month old - โโโ Correct Answer > TMP/SMZ or cephalexin First line therapy of UTI in a febrile child >1 month old - โโโ Correct Answer > Ceftriaxone, cefotaxime, or ceftazidime given parenterally until afebrile or for first 24 hours.
Voriconazole Caspofungin Terbinafine Which antifungal drugs are only used for superficial infections - โโโ Correct Answer > Nystatin Clotrimazole Miconazole What is the drug of choice for vaginal, esophageal, urinary and oropharyngeal candidiasis - โโโ Correct Answer > Fluconazole Drug of choice for invasive aspergillosis - โโโ Correct Answer > Voriconazole Treatment for Candidemia - โโโ Correct Answer > IV fluconazole or IV Capsofungin Advantage of taking Glargine and aspart instead of a premixed insulin - โโโ Correct Answer > More prandial coverage for lunch and snacks. What types of patients are likely to have the greatest challenges using insulin - โโโ Correct Answer > Patients with neuropathy and retinopathy might find it difficult to draw up their insulin and might
benefit from prefilled insulin syringes with aids such as clicks and magnifiers. Which anti-fungal drugs cannot be used in pregnancy - โโโ Correct Answer > fluconazole itraconazole voriconazole anidulafungin caspofungin micafungin Which antifungals are safe during pregnancy - โโโ Correct Answer
Terbinafine Miconazole Clotrimazole Advantage to using premixed insulin compared to taking Glargine and Aspart - โโโ Correct Answer > Less injections
