Download NURSING 6005pharmacology 2020 final/NSG6005 Final Questions And Answers[(Version-2, New, 2 and more Exams Health sciences in PDF only on Docsity!
(^1) 1)Incorporating IT into a patient encounter takes skill and tact. During the encounter, the provider can make the patient more comfortable with the IT the providers using by: : A Turning the screen around so the patient can see material being recorded B Not placing the computer screen between the provider and the patient C Both A and B 2Nurse practitioner prescriptive authority is regulated by: 1 The National Council of State Boards of Nursing . 2 The U.S. Drug Enforcement Administration . 3 The State Board of Nursing for each state . 4 The State Board of Pharmacy .
- Criteria for choosing an effective drug for a disorder include:
- Asking the patient what drug they think would work best for them
- Consulting nationally recognized guidelines for disease management
- Prescribing medications that are available as samples before writing a prescription
- Following U.S. Drug Enforcement Administration guidelines for prescribing 4Pharmacoeconomics is:
- The study of the part of the U.S. economy devoted to drug use
- The study of the impact of prescription drug costs on the overall economy
- The analysis of the costs and consequences of any health-care-related treatment or service
- The analysis of the clinical efficacy of the drug 5 Prescribing less-expensive generic drugs or drugs off the $4 retail pharmacy lists :
- Increases the complexity of the Pharmacoeconomics of prescribing for the individual patient
- Increases compliance by reducing the financial burden of drug costs to the patient
- Is not sound prescribing practice due to the inferiority of the generic products
- Will increase the overall cost of drugs to the system due to the ease of overprescribing less-expensive drugs 6Np prescribes and off label drug , np understands prescribing off label drug means?
- Off-label prescribing is:
- Regulated by the U.S. Food and Drug Administration
- Illegal by NPs in all states (provinces)
- Legal if there is scientific evidence for the use
- Regulated by the Drug Enforcement Administration 7Cultural factors that must be taken into account when prescribing include(s):
- Who the decision maker is in the family regarding health-care decisions
- The patient’s view of health and illness
- Attitudes regarding the use of drugs to treat illness
- All of the above 8 Amber is a 10 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:
- Amoxicillin
- Amoxicillin/clavulanate
- TMP/SMZ (Septra)
- None 9John is allergic to sulfa antibiotic he most likely will have a cross sensitivity to? **1. Loop diuretics
- Sulfonylureas
- Thiazide diuretics
- All of the above 10Ethnic differences have been found in drug: 1.** Absorption 2. Hepatic metabolism 3. Filtration at the glomerulus 4. Passive tubular reabsorption 11 The U.S. Food and Drug Administration regulates :
- Prescribing of drugs by MDs and NPs
- The official labeling for all prescription and over-the-counter drugs
- Off-label recommendations for prescribing
- Pharmaceutical educational offerings
- Increased contractility
- Edema of the hands and feet 18 a Harrold a 42-year-old African American has moderate to persistent asthma the nurse PRactioner would avoid using which of the following medication? 18b **Harold, a 42-year-old African American, has moderate persistent asthma. Which of the following asthma medications should be used cautiously, if at all?
- Betamethasone, an inhaled corticosteroid
- Salmeterol, an inhaled long-acting beta-agonist
- Albuterol, a short-acting beta-agonist
- Montelukast, a leukotriene modifier 19 Sam is a 72 year old male that takes diphenhydramine for seasonal allergies the NP would instruct the patient to monitor for which of the following** 19b. **Howard is a 72-year-old male who occasionally takes diphenhydramine for his seasonal allergies. Monitoring for this patient taking diphenhydramine would include assessing for:
- Urinary retention
- Cardiac output
- Peripheral edema
- Skin rash** 20The apn understands which medications should be prescribed for COPD exacerbations? **Patients with a COPD exacerbation may require:
- Doubling of inhaled corticosteroid dose
- Systemic corticosteroid burst
- Continuous inhaled beta-2-agonists
- Leukotriene therapy 21 There is often cross-sensitivity and cross-resistance between penicillin’s and cephalosporins because** :
- Renal excretion is similar in both classes of drugs.
- When these drug classes are metabolized in the liver they both produce resistant enzymes.
- Both drug classes contain a beta-lactam ring that is vulnerable to beta- lactamase- producing organisms.
- There is not an issue with cross-resistance between the penicillin’s and cephalosporins.
.22 Joanna had a small ventricle septal defect (VSD) repaired when she was 3 years old and has no residual cardiac problems. She is now 28 and is requesting prophylactic antibiotics for an upcoming dental visit. The appropriate antibiotic to prescribe according to current American College of Cardiology and American Heart Association guidelines is :
- None, no antibiotic is required for dental procedures
- Amoxicillin 2 grams 1 hour before the procedure
- Ampicillin 2 grams IM or IV 30 minutes before the procedure
- Azithromycin 1 gram 1 hour before the procedure 23. The goal of antiretroviral therapy in HIV-positive patients is:
- Maximum suppression of HIV replication
- Eradication of HIV virus from the body
- Determining a treatment regimen that is free of adverse effects
- Suppression of CD4 T-cell count 24 Drugs that have a significant first-pass effect:
- Must be given by the enteral (oral) route only
- Bypass the hepatic circulation
- Are rapidly metabolized by the liver and may have little if any desired action
- Are converted by the liver to more active and fat-soluble forms 25An advantage of prescribing a sublingual mediation is that the medication is?
- Absorbed rapidly
- excreted rapidly
- metabolized minimally
- distributed equally 26 Vicky, age 56 years, comes to clinic requesting a refill of her Fiorinal (aspirin and butalbital) that she takes for migraines. She has been taking this medication for over 2 years for migraine and states one dose usually works to abort her migraine. What is the best care for her? A. Switch her to sumatriptan (Imitrex) to treat her migraines B. Assess how often she is using Fiorinal and refill medication C. Switch her to a beta-blocker such as propranolol to prevent her migraine D. request for her to return to the original prescriber 27The nurse practitioner should take the following precautions when prescribing controlled substances? Precautions that should be taken when prescribing controlled substances include:
- Faxing the prescription for a Schedule II drug directly to the pharmacy
- Using tamper-proof paper for all prescriptions written for controlled drugs
- Keeping any pre-signed prescription pads in a locked drawer in the clinic
- Using only numbers to indicate the amount of drug to be prescribed
day Lifestyle and changes first step in treatment of Gerd and Foods that may aggravate would be avoided which is
- eggs
- Tomatoes
- Oatmeal
- Chicken ] **35 The pain management contract is appropriate for which of the following cases
- Patients with a history of chemical dependency**
- Patients with a complex drug regime
- All patient with pain and need for short term use of opioids
- Patients who have history of taking opioids periodically without any issues 35b Example question 17. The Pain Management Contract is appropriate for:
- Patients with cancer who are taking morphine
- Patients with chronic pain who will require long-term use of opiates
- Patients who have a complex drug regimen
- Patients who see multiple providers for pain control 36 .Men who use transdermal testosterone gel (AndroGel) should be advised to avoid: A. Washing their hands after applying the gel B. Wearing occlusive clothing while using the gel C. Exposure to estrogens while using the gel D. Skin-to-skin contact with pregnant women while using the gel 37 An appropriate drug for the treatment of depression with anxiety would be Lexapro … 38 A patient with anxiety and depression may respond to
- Buspar and ssr 39 A patient who are prescribed zyprexa should be monitored for
- Insomnia
- Hypertension 39b Patients who are prescribed olanzapine (Zyprexa) should be monitored for: A. Insomnia B. Weight gain C. Hypertension D. Galactorrhea
40 Nurse practitioners starts low dose Risperdal for a 76 year old patient monitoring for Risperdal includes observing for common side effects such as: 40 b A 19-year-old male was started on risperidone. Monitoring for risperidone includes observing for EXAMPLE QUESTION common side effects, including: A. Bradykinesia, akathisia, and agitation B. Excessive weight gain C. Hypertension D. Potentially fatal agranulocytosis 41 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: A. Chlordiazepoxide (Librium) B. Clonazepam (Klonopin) C. Alprazolam (Xanax) D. Oxazepam (Serax) 42 The ongoing monitoring for patients over age 65 years taking alendronate (Fosamax) or any other bisphosphonate is: A. Annual DEXA scans B. Annual Vitamin D level C. Annual renal function evaluation D. Electrolytes every 3 months 43Shana is receiving her first medroxyprogesterone (Depo Provera) injection. Shana will need to be monitored for: A. Depression B. Hypertension C. Weight loss D. Cataracts 44 The factor that has the greatest effect on males developing male sexual characteristics is
- Curtual belifes
- Effective male role modles
- Adequate intake of estrogen
- androgen production 45 According to the American hart associate the control targets for patient with diabetes include
- A fasting an a1c between 8 and 10
- Fasting glucose betwiin 80 and 100
- Blood pressure 130/
- Lipids less than 150
50 (Glucophage) Metformin is a primary choice of drug to treat hyperglycemia in Type 2 diabetes because it: A. Substitutes for insulin usually secreted by the pancreas B. Decreases glycogenolysis by the liver C. Increases the release of insulin from beta cells D. Decreases peripheral glucose utilization
51 Humalog is an insulin analog produced by the recombinant
deoxyribonucleic acid dna technology which of the following statement
about his for of insulin is not true
- It has no pronounced peak
- It is compatible with nph
- The duration of action is increased is when the dose is increase
- The optimal time of pre-prandial injection is 15 min 52 Prophylactic use of bisphosphonates is recommended for patients with early osteopenia related to long-term use of which of the following drugs? A. Selective estrogen receptor modulators B. Aspirin C. Glucocorticoids D. Calcium supplements 53 Bisphosphonates treat or prevent osteoporosis by: A. Inhibiting osteoclastic activity B. Fostering bone resorption C. Enhancing calcium uptake in bone D. Strengthening the osteoclastic proton pump 54 Sadie is a 72 year old who takes omeprazole for her chronic GERD. Chronic long- term omeprazole use places her at increased risk for: A. Megaloblastic anemia B. Osteoporosis C. Hypertension D. Strokes
55 The np use caution when starting Synthroid for thyroid
replacement therapy on a 73 year old female the np should be
monitoring for
- Excessive sedation
- Tachycardia and angina
- Cold intolerance
- Weight gain
Example question from study guide 55BElderly patients who are started on levothyroxine for thyroid replacement should be monitored for: A. Excessive sedation B. Tachycardia and angina C. Weight gain D. Cold intolerance
56 When starting a 40 year old woman with hypothyroid ism on
thyroid replacement hormones , the np would include the following in
patient education
- She should feel symptomatic improvement in one weeks time
- Drug related adverse effects letergy and dry skin may occure
- Take 4 to 8 weeks to reach euthyroid level
- Due to the short half life of levothyroxine doses should not be
missed
- When starting a patient with hypothyroidism on thyroid replacement hormones patient education would include: A. They should feel symptomatic improvement in 1 to 2 weeks B. Drug adverse effects such as lethargy and dry skin may occur C. It may take 4 to 8 weeks to get to euthyroid symptomatically and by lab testing D. Due to its short half-life, levothyroxine doses should not be missed
57 Infants with congenital hypothyroidism are treated with:
A. Levothyroxine
B. Liothyronine
C. Liotrix
D. Methimazole
58 In addition to methimazole the np will treat a symptomatic patient
with hyperthyroidism may need to prescribe
- Methamasol and Beta blockers
59 Pharmacokinetic factors that affect prescribing include
- No effect
- Minimum effective
- Concentration bioavailabilty
- And eas of titreation of bioavailability
- 59B Example question 10. Pharmacokinetic factors that affect prescribing include: A. Therapeutic index
A. Apply thickly to the infected area, spreading the medication well past the borders
of the infection
B. If the rash worsens, apply a thicker layer of medication to settle down the infection
C. Wash hands before and after application of topical antimicrobials
D. None of the above
65 Donald has been diagnosed with hyperlipidemia. Based on his lipid profile, atorvastatin is prescribed. Rhabdomyolysis is a rare but serious adverse response to this drug. Donald should be told to :
A. Become a vegetarian since this disorder is associated with eating red meat
B. Stop taking the drug if abdominal cramps and diarrhea develop
C. Report muscle weakness or tenderness and dark urine to his provider immediately
D. Expect “hot flash” sensations during the first 2 weeks of therapy
66 The nurse practitioner knows that factors that may
adversely affect a patient’s adherence to a therapeutic drug
regimen
- complexity of the drug regimen
- patient’s perception of the potential adverse effects of the drug
- both a and b
- neither a or b
67 (28.50)Benadryl or topic cream used to treat itching , the
advanced practice nurse would instruct patients or parents on the
use of topical diphenhydramine that
- for maximum effectiveness and treating itch combined topical oral
- (28.51)Topical diphenhydramine is the treatment choice in
treating poison ivy or poison oak
- Topical diphenhydramine should not be used in children younger
than 2
- When applying topical dyphenhydromine apply the cream
liberally to all areas that itch
68 Nurse practitioner prescribes an initial treatment for the
following drug for mild acne
- Topical combined antibiotic minocycline
- Topical retinoid
- Over the counter benzoyl peroxide
69. Nicolas is a football player who presents to clinic with athlete’s foot. Patients with tinea pedis may be treated with:
A. OTC miconazole cream for 4 weeks
B. Oral ketoconazole for 6 weeks
C. Mupirocin ointment for 2 weeks
D. Nystatin cream for 2 weeks
70 Patients with allergic rhinitis may benefit from a prescription of:
A. Fluticasone (Flonase)
B. Cetirizine (Zyrtec)
C. OTC cromolyn nasal spray (Nasalcrom)
D. Any of the above
71Jacob has hypertension for which a calcium channel blocker(amlodipine) has been prescribed. This drug helps control blood pressure because it:
A. Decreases the amount of calcium inside the cell
B. Reduces stroke volume
C. Increases the activity of the Na+/K+/ATPase pump indirectly
D. Decreases heart rate
72 Tucker has hypertension with good blood pressure control was prescribed lisinopril two weeks ago today he reports to the np that he has had a dry cough but denies fever condition or sort of spread the nurse prectioner may change patients lisinopril to Benicar because the angiotensin II receptor blocker is
- Stronger
- Does not produce a dry hacking cough
- Has no effect on the renal system
- Reduces sodium and water retention
73 Stage C patients usually require a combination of three to four drugs to
manage their heart failure. In addition to ACE inhibitors and beta blockers,
diuretics may be added. Which of the following statements about
diuretics is not true?
A. Diuretics reduce preload associated with fluid retention.
B. Diuretics can be used earlier than Stage C when the goal is
control of hypertension.
C. Diuretics may produce problems with electrolyte imbalances and
abnormal glucose and lipid metabolism.
D. Diuretics from the potassium-sparing class should be used when
using an ARB.
- Increasing the frequency of the beta 2 agonist
- and starting singular
79The apn would diagnose mild persistent asthma in an eight year old
when the symptoms
Example question found 79BIn five- to eleven-year-old children, mild-
persistent asthma is diagnosed when asthma symptoms occur:
A.At nighttime one to two times a month
B. At nighttime three to four times a month
C. Less than twice a week
D. Daily
1. At nighttime three to four times a month
80 Decongestants such as pseudoephedrine are schedule three drugs in all
states should not be prescribed for
**- children under four years of age
- are effective in treating congestive children
- experience with the common cold
- cause drowsiness in all patients at any ages** found example question on line 18. Decongestants such as pseudoephedrine (Sudafed): A. Are Schedule III drugs in all states B. Should not be prescribed or recommended for children under 4 years of age C. Are effective in treating the congestion children experience with the common cold D. May• cause drowsiness in patients of all ages
81Long-acting beta-agonists received a black box warning from the US
Food and Drug Administration due to the:
A. Risk of life-threatening dermatological reactions
B. Increased incidence of cardiac events when long-acting beta-
agonists are used
C. Increased risk of asthma-related deaths when long-acting beta-
agonists are used
D. Risk for life-threatening alterations in electrolytes
82 the nurse PR actioner is prescribing continuous prednisone and 40
milligrams daily for a patient with stage three copd who lives in assisted
living facility the NP would monitor
**- serum glucose
- culture folate levels
- b 12 83** Sarah, a 42-year-old female, requests a prescription for an anorexiant to treat her obesity. A trial of phentermine is prescribed. Prescribing precautions include:
- Understanding that obesity is a contraindication to prescribing phentermine
- Anorexiants may cause tolerance and should only be prescribed for 6 months
- Patients should be monitored for postural hypotension
- Renal• function should be monitored closely while on anorexiants
84 Tiotropium bromide (Spiriva) is an inhaled anticholinergic:
A. Used for the treatment of COPD
B. Used in the treatment of asthma
C. Combined with albuterol for treatment of asthma exacerbations
D. Combined with fluticasone for the treatment of persistent asthma
85 Martin is a 60 year old with hypertension. The first-line decongestant to prescribe would be:
A. Oral pseudoephedrine
B. Oral phenylephrine
C. Nasal oxymetazoline
D. Nasal azelastine
86. Cough and cold medications that contain a sympathomimetic decongestant such as phenylephrine should be used cautiously in what population: 1. Older adults 2. Hypertensive patients 3. Infants 4. All of the above 68 year old female 24 year old with htn 3 month old boy All of the above
87. Kelly has diarrhea and is wondering if she can take loperamide (Imodium) for the
diarrhea. Loperamide:
A. Can be given to all age patients, including infants and children, for viral
gastroenteritis
B. Slows gastric motility and reduces fluid and electrolyte loss from diarrhea
C. Is the treatment of choice for the diarrhea associated with E. coli 0157
NSG6005 Final Questions
include asking her to keep a headache diary and prescribes
- Naproxen 95All NSAIDs have an fda black box warning regarding nsaids
- Cardiovascular type events ischemia or heart failure 96 The drug recommended as primary prevention for osteoporosis in men who are over the age of 60 years old is
- Fosamax
- Boniva
- Roys
- Evista 97 Hypoglycemia can result from the action of either insulin or oral hypoglycemia the apn instructs the patient and family the signs and symptoms of hypoglycemia include
- Fruity breath and rapid respiration
- Diarrhea abdominal pain weight loss and hypertension
- Dizziness confusion diaphoresis and tachycardia
- Easy bruising cardiac dysrhythmias and coma
- Hypoglycemia can result from the action of either insulin or an oral 98 A patient is taking a non selective beta blocker with a history of alcohol abuse the Np teaches the patient that the use of the non selective beta blocker and alcohol create serious drug interactions with insulin because they
- Increase blood glucose levels
- Produce unexplained diaphoresis
- Interfere with the ability of the body to metabolize glucose
- Mask the signs and symptoms of altered glucose 99Drugs that are designated scheduled 2 by the department of drug enforcement agencies
- are the known teratogens during pregnancy
- may not be refilled a new prescription must be written
- have lower abuse potential
- may be dispensed without a prescription unless regulated by the state NSG6005 Final Questions The U.S. Food and Drug Administration (FDA) regulates: The official labeling for all prescriptions and over-the-counter drugs Nurse practitioner prescriptive authority is regulated by: The State Board of Nursing for each state
NSG6005 Final Questions
Electronic health records (EHRs) Allow for all patient data to be centralized in one location for access by multiple providers Alterations in drug metabolism among Asians may lead to Slower metabolism of antidepressants, requiring lower doses Pharmacokinetics among Asians are universal to all the Asian ethnic groups. B. False Gender differences between men and women in pharmacokinetics include: Higher proportion of body fat so that lipophilic drugs have relatively greater volumes of distribution The factor that has the greatest effect on males developing male sexual characteristics is: Androgen production An advantage of prescribing a sublingual medication is that the medication is: A. Absorbed rapidly Infants and young children are at higher risk of ADRs due to: B. Lack of safety and efficacy studies in the pediatric population Pharmacokinetic factors that affect prescribing include: C. Bioavailability Carbamazepine has a Black Box warning recommending testing for the HLA-B1502 allele in patients with Asian ancestry prior to starting therapy due to: C. Increased risk for Stevens-Johnson syndrome in Asian patients with HLA-B1502 allele Genetic polymorphisms account for differences in metabolism, including: D. All of the above A patient may develop neutropenia from using topical Silvadene for burns. Neutropenia is a(n): A. Cytotoxic hypersensitivity reaction The elderly are at high risk of ADRs due to: D. Age-related decrease in renal function
