NURS 6521 Midterm Exam Version C, Exams of Health sciences

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NURS 6521 Midterm Exam Version C

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Exam - Week 7

User Course NURS-6521C-2/NURS-6521N-2/NURS-6521D-2-Advanced Pharmacology2020 Summer Qtr 06/01-08/23-PT Test Exam - Week 7 Started 7/19/20 12:45 PM Submitted 7/19/20 2:44 PM Due Date 7/20/20 1:59 AM Status Completed Attempt Score 78 out of 100 points Time Elapsed 1 hour, 59 minutes out of 2 hours Instructions Please answer each question below and click^ Submit^ when you have completed the Exam. Results Displayed Submitted Answers, Incorrectly Answered Questions

 Question 1

1 out of 1 points A Nurse Practitioner is caring for a patient who is diabetic and has been diagnosed with hypertension. An angiotensin-converting enzyme inhibitor, captopril, has been prescribed for her. Which of the following should the Nurse Practitioner assess before beginning drug therapy? Selected Answer: Serum potassium levels

 Question 2

1 out of 1 points A common side effect of metformin (Glucophage) therapy is: Selected Answer: diarrhe a

 Question 3

1 out of 1 points

1 out of 1 points A Nurse Practitioner is caring for a 73-year-old man who is receiving drug therapy. He is beginning to exhibit signs of decline in his renal system, yet his current serum creatinine level is normal. The Nurse Practitioner will base the patient's plan of care on the understanding that there is Selected Answer: a decrease in the amount of creatinine to be filtered.  Question 9 1 out of 1 points During a clinic visit, a patient complains of having frequent muscle cramps in her legs. The nurse's assessment reveals that the patient has been taking over-the-counter laxatives for the past 7 years. The nurse informed the patient that prolonged use of laxatives Selected Answer: may cause nutrient deficiencies.  Question 10 1 out of 1 points A patient comes to the clinic asking for help to quit drinking alcohol. She has a 21-year history of heavy drinking and is worried about developing cirrhosis of the liver. The patient agrees to take disulfiram (Antabuse). The nurse will teach the patient that the combination of alcohol and Antabuse will cause which of the following? Selected Answer: Nausea  Question 11 1 out of 1 points Which effect does the Nurse Practitioner expect may occur when using cholinergic agonists? Selected Answer: increased bladder tone  Question 12 0 out of 1 points

Which of the following is a potential adverse side effect of autonomic-anticholinergic agents? Selected Answer: Reduced GI motility  Question 13 1 out of 1 points Ms. Simpson has a known history of asthma. She is on Theophylline daily. The NP contemplates giving her an antibiotic for her respiratory infection. The NP knows that which choice below could elevate theophylline levels? Selected Answer: Ciprofloxac in  Question 14 1 out of 1 points Some first-generation antihistamines are used: Selected Answer: to prevent motion sickness  Question 15 1 out of 1 points When prescribing an antihypertensive medication for a type 2 diabetic patient, the drug classifications that would tend to reduce insulin sensitivity are: Selected Answer: Diuretics and beta blockers.  Question 16 1 out of 1 points Glargine (Lantus) is an insulin analog that essentially has no peak and is usually administered: Selected Answer: Once a day.  Question 17 1 out of 1 points The side effects of antihistamines are mostly due to their:

Glucocorticoids affect the metabolism of carbohydrates, protein, and fats. Selected Answer: Tru e  Question 23 1 out of 1 points A patient with a known history of benign prostatic hyperplasia (BPH) presents to the clinic 4 days after developing a cold. He tells you he began experiencing a sore throat and nasal congestion and began to take an over the counter decongestant. Today, he complains of not urinating over the last 12 hours. He also has suprapubic fullness on exam. Which of the following medications are most likely responsible for this patient's urinary retention? Selected Answer: Phenylephrii ne  Question 24 0 out of 1 points What drug class will decrease the facial flushing that occurs with niacin? Selected Answer: Vasopresso rs  Question 25 1 out of 1 points The Elderly are at high risk of Adverse Drug Reactions due to: Selected Answer: age related decrease in renal function  Question 26 0 out of 1 points Biguanides control hyperglycemia in type 2 diabetes primarily by acting at which organ? Selected Answer: Pancre as  Question 27

1 out of 1 points A 39 y/o female is diagnosed with Graves disease. She also has a small goiter =. Her symptoms are not deemed to be severe and propylthiouracil is prescribed. Whare is the most serious potential adverse effect of this medication? Selected Answer: Agranulocyto sis  Question 28 0 out of 1 points Which medication class is recognized for the treatment of moderate to severe dementia? Selected Answer: Cholinesterase inhibitors.  Question 29 1 out of 1 points

The nurse practitioner has prescribed elemental iron 6 mg/kg/day in three

divided doses for a toddler diagnosed with iron-deficiency anemia. What

instructions would the family nurse practitioner include for the parents?

Selected Answer: Give the medication through a straw to decrease the staining of the teeth.  Question 30 1 out of 1 points A patient who is a steroid-dependent asthmatic is started on a beclomethasone inhaler. Which should be part of patient education? Selected Answer: Rinse the mouth well after each use  Question 31 1 out of 1 points A 66-year-old woman has a complex medical history that includes poorly- controlled type 1 diabetes, renal failure as a result of diabetic nephropathy and chronic heart failure (CHF). Her care provider has recently added spironolactone (Aldactone) to the woman's medication regimen. The nurse should consequently assess for signs and symptoms of

mean replacement dosage. Selected Answer: 1.7 mcg/kg of body weight per day  Question 37 1 out of 1 points You decide to start your pt, Ms. Rodrigues, on spironolactone (Aldactone) 50 mg PO daily. As the NP, you will instruct the patient to call the clinic if which symptoms are experienced? Selected Answer: Muscle twitching, numbness, tingling, burning sensations of the limbs, and diarrhea  Question 38 1 out of 1 points What is a serious side effect of ibuprofen in the older adult patient? Selected Answer: Impairment of renal function  Question 39 0 out of 1 points Drugs that use CYP 3A4 isoenzymes for metabolism may: Selected Answer: Induce the metabolism of another drug  Question 40 1 out of 1 points A physician has ordered subcutaneous injections of morphine, a narcotic, every 4 hours as needed for pain for a motor vehicle accident victim. The nurse is aware that there is a high abuse potential for this drug and that it is categorized as a Selected Answer: C-II drug.  Question 41 1 out of 1 points /Jillian is a Nurse Practitioner. She recognizes that Nurse Practitioner prescriptive authority Is regulated by:

Selected Answer: The state board of nursing for each state  Question 42 1 out of 1 points A male patient who is hypertensive takes Hydrochlorothiazide for his blood pressure. He presents with red, painful swelling of the great toe. In addition to treating gout, you recognize that you may need to: Selected Answer: Change his thiazide antihypertensive medication  Question 43 1 out of 1 points Mr. Lastinger was prescribed warfarin sodium (Coumadin). You advise him to avoid eating large amounts of leafy green vegetables because: Selected Answer: The high vitamin K levels will decrease the INR  Question 44 1 out of 1 points Acetazolamide is categorized as which of the following? Selected Answer: Carbonic anhydrase inhi bitor  Question 45 1 out of 1 points The anticoagulant drug that acts as a vitamin K antagonist is: Selected Answer: coumad in  Question 46 1 out of 1 points A patient in need of myocardial infarction prophylaxis has been prescribed sulfinpyrazone for gout. Which of the following will the nurse monitor the patient most closely for? Selected Bleeding

Selected Answer: "No, the drug dosage will likely stay the same."  Question 52 0 out of 1 points A patient is recovering from an acute episode of thrombophlebitis and is being treated with warfarin (Coumadin) 5 mg PO daily. In reviewing medication information, the Nurse Practitioner would include what information in their teaching? Selected Answer: Aerobic exercises are the most effective  Question 53 0 out of 1 points 60-year-old male presents to your office with a history of seizure disorder. The patient states that he has been taking valproic acid. Which of the following is a known potential adverse effect of valproic acid? Selected Answer: Weight loss  Question 54 0 out of 1 points Mr. Johnson is an 80 year old male who is on Digoxin therapy. The Nurse Practitioner knows they should monitor the older adult patient for which of the most common adverse reactions of digoxin? Selected Answer: blurred vision  Question 55 1 out of 1 points Which of the following can block the action of heparin? Selected Answer: Protamine sulfate  Question 56 1 out of 1 points

A Nurse Practitioner is discussing with a patient the efficacy of a drug that his physician has suggested, and he begin taking. Efficacy of a drug means which of the following? Selected Answer: How well a drug produces its desired effect  Question 57 1 out of 1 points To minimize the risk of adverse effects of glucagon when given to an unconscious diabetic patient, as the patient regains consciousness, the nurse should Selected Answer: administer carbohydrates.  Question 58 0 out of 1 points An adult male comes to the clinic with complaints that he is experiencing increased difficulty breathing over the past few days. He has a history of asthma and coronary artery disease. He was recently diagnosed with hypertension. Examination reveals no jugular vein distention and no productive cough. Breath sounds are present, but expiratory wheezes are noted bilaterally, and he denies any chest pain. His vital signs are pulse of 74 beats/min, respirations of 32 breaths/min, and BP of 160/100 mm Hg. His current medications are albuterol (Proventil) inhaler 2 puffs every 4 hours prn for wheezing, nitroglycerin transdermal patch, and propranolol (Inderal) 60 mg PO bid. What is the best treatment for this patient? Selected Answer: Begin theophylline (Theo-24; methylxanthine) 200 mg q12h PO.  Question 59 1 out of 1 points A patient with type 1 diabetes has been admitted to the hospital for orthopedic surgery and the care team anticipates some disruptions to the patient's blood glucose levels in the days following surgery. Which of the following insulin regimens is most likely to achieve adequate glycemic control? Selected Answer: Doses of basal insulin twice daily with regular insulin before each meal  Question 60 1 out of 1 points Which of the following conditions is a contraindication for pioglitazone (Actos).

that Selected Answer: there is a risk of systemic absorption of the lidocaine through the patient's traumatized skin.  Question 66 1 out of 1 points Ginger, a 25 year old female presents at the clinic with known history of depression. She reports taking an SSRI with only partial relief. Which of the following drugs can be used safely at any dose in conjunction with an SSRI? Selected Answer: None of the aboive  Question 67 1 out of 1 points Jillian is a Nurse Practitioner. She recognizes that Nurse Practitioner prescriptive authority Is regulated by: Selected Answer: The state board of nursing for each state  Question 68 1 out of 1 points Which of the following is a contraindication for antimuscarinic drugs? Selected Answer: pyloric stenosis  Question 69 1 out of 1 points Which of the following statements accurately describes digoxin? Selected Answer: It blocks the Na-K ATPase pump.  Question 70 0 out of 1 points

The APRN's ability to prescribe controlled substances is regulated by: Selected Answers:

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A

 Question 71 0 out of 1 points A 34-year-old male patient is prescribed methimazole (MMI). The Nurse Practitioner will advise him to report which of the following immediately? Selected Answer: Epigastric distress  Question 72 1 out of 1 points Metformin (Glucophage) acts by: Selected Answer: Decreasing hepatic glucose production with minor effects on insulin sensitivity in both liver and peripheral tissues  Question 73 1 out of 1 points The NP is examining a 34-year-old obese man with a body mass index (BMI) of 35 who complains of almost daily indigestion and heartburn for the past year with a strong acid taste in the mouth about an hour after meals, and frequent belching and awakening at night with choking. The history is negative for chronic illnesses and alarm symptoms. A diagnosis of gastroesophageal reflux disease (GERD) is made. What is the best initial treatment for the patient? Selected Answer: Omeprazole (Prilosec) 20 mg every morning 30 minutes before breakfast.  Question 74 1 out of 1 points Which of the following is a side effect or precaution associated with ACE inhibitors? Selected Answer: Angioede ma  Question 75 1 out of 1 points

1 out of 1 points Mr. Penny, age 67, was diagnosed with chronic angina several months ago and has been unable to experience adequate relief of his symptoms. As a result, his physician has prescribed ranolazine (Ranexa). Which of the following statements is true regarding the use of ranolazine for the treatment of this patient's angina? Selected Answer: Mr. Penny requires concurrent treatment with a beta blocker, nitrate, or a calcium channel blocker.  Question 81 1 out of 1 points Some first generation antihistamines are used: Selected Answer: to prevent motion sickness  Question 82 1 out of 1 points You are seeing a 65 year old male with a long history of COPD who has recently developed hypertension. Which class of antihypertensive agents should the Nurse Practitioner avoid for this patient? Selected Answer: Beta- Blockers  Question 83 1 out of 1 points Typical adverse reactions to oral calcium-channel blockers include: Selected Answer: edem a  Question 84 0 out of 1 points Ms. Neely was placed on fluoxetine about 8 weeks ago and is doing well on the medication. When initially prescribed the medication, she asks you about the common side effects of this type of medication. Which choice below is correct? Selected Answer: loss of taste

 Question 85 1 out of 1 points Typical adverse reactions to oral calcium-channel blockers include: Selected Answer: edem a  Question 86 1 out of 1 points Advanced practice nurse prescribing of scheduled medications is affected most by: Selected Answer: Individual states laws regarding scheduled medications that can be prescribed and for how long  Question 87 1 out of 1 points The Nurse Practitioner is following up on a patient who is experiencing acute asthma problems. Albuterol (Proventil) by metered-dose inhaler (MDI) has been ordered as treatment. Which patient response would indicate to the family nurse practitioner that the patient understands how to take the medication? Selected Answer: “I will take 1 puff of the medication and then wait a minute before taking the second puff.”  Question 88 1 out of 1 points A primary therapy for patients with mild ulcerative colitis is: Selected Answer: Mesalamine (Pentasa).  Question 89 1 out of 1 points A possible side effect from the use of nifedipine (Procardia XL) is: Selected Answer: Edema of the ankles and headaches  Question 90