MN553 Unit 10 Final Exam Latest 2017
Question 1 1 / 1 pointSevere contact dermatitis caused by poison ivy or poison oak exposure often requires treatment with:Question options:Topical antipruriticsOral corticosteroids for 2 to 3 weeksThickly applied topical intermediate-dose corticosteroidsIsolation of the patient to prevent spread of the dermatitisQuestion 2 1 / 1 pointPatrick is a 10-year-old patient who presents with uncomfortable constipation. Along with diet changes, a laxative is ordered to provide more rapid relief of constipation. An appropriate choice of medication for a 10-year-old child would be:Question options:PEG 3350 (Miralax)Bisacodyl (Dulcolax) suppositoryDocusate (Colace) suppositoryPolyethylene glycol electrolyte solutionQuestion 3 1 / 1 pointPatients who are on chronic long-term proton pump inhibitor therapy require monitoring for:Question options:Iron deficiency anemia, vitamin B12 and calcium deficiencyFolate and magnesium deficiencyElevated uric acid levels leading to goutHypokalemia and hypocalcemiaQuestion 4 1 / 1 pointThe drug of choice for treatment of early latent or tertiary syphilis is:Question options:Ceftriaxone IMBenzathine penicillin G IMOral azithromycinOral ciprofloxacinQuestion 5 0 / 1 pointThe optimal maximum time frame for HRT or estrogen replacement therapy (ERT) is:Question options:2 years5 years10 years15 yearsQuestion 6 1 / 1 pointThe Best Pharmaceuticals for Children Act:Question options:Includes a pediatric exclusivity rule which extends the patent on drugs studied in childrenEstablishes a committee that writes guidelines for pediatric prescribingProvides funding for new drug development aimed at childrenEncourages manufacturers specifically to develop pediatric formulationsQuestion 7 1 / 1 pointSophie presents to the clinic with a malodorous vaginal discharge and is confirmed to have Trichomonas infection. Treatment for her would include:Question options:Metronidazole 2 grams PO x 1 doseTopical intravaginal metronidazole daily x 7 daysIntravaginal clindamycin daily x 7 daysAzithromycin 2 grams PO x 1 doseQuestion 8 1 / 1 pointJamison has been prescribed citalopram (Celexa) to treat his depression. Education regarding how quickly selective serotonin reuptake inhibitor (SSRI) antidepressants work would be:Question options:Appetite and concentration improve in the first 1 to 2 weeks.Sleep should improve almost immediately upon starting citalopram.Full response to the SSRI may take 2 to 4 months after he reaches the full therapeutic dose.His dysphoric mood will improve in 1 to 2 weeks.Question 9 1 / 1 pointPatients who have a poor metabolism phenotype will have:Question options:Slowed metabolism of a prodrug into an active drug, leading to accumulation of ProdrugAccumulation of inactive metabolites of drugsA need for increased dosages of medicationsIncreased elimination of an active drugQuestion 10 1 / 1 pointThe drug of choice for type 2 diabetics is metformin. Metformin:Question options:Decreases glycogenolysis by the liverIncreases the release of insulin from beta cellsIncreases intestinal uptake of glucosePrevents weight gain associated with hyperglycemiaQuestion 11 1 / 1 pointThe first-line therapy for mild-persistent asthma is:Question options:High-dose montelukastTheophyllineLow-dose inhaled corticosteroidsLong-acting beta-2-agonistsQuestion 12 1 / 1 pointAll of the following statements about the Beer’s List are true except:Question options:It is a list of medications or medication classes that should generally be avoided in persons 65 years or older because they are either ineffective or they pose unnecessarily high risk for older persons and a safer alternative is available.It is derived from the expert opinion of one geriatrician and is not evidence-based.These criteria have been adopted by the Centers for Medicare and Medicaid Services for regulation of long-term care facilities.These criteria are directed at the general population of patients over 65 years of age and do not take disease states into consideration.Question 13 1 / 1 pointIsosorbide dinitrate is prescribed for a patient with chronic stable angina. This drug is administered twice daily, but the schedule is 7 a.m. and 2 p.m. because:Question options:It is a long-acting drug with potential for toxicity.Nitrate tolerance can develop.Orthostatic hypotension is a common adverse effect.It must be taken with milk or food.Question 14 1 / 1 pointTrue contraindications to diphtheria, tetanus, and acellular pertussis (DTaP or Tdap) vaccine include:Question options:Fever up to 104oF (40.5oC) after previous DTaP vaccineFamily history of seizures after DTaP vaccineAdolescent pregnancyAnaphylactic reaction with a previous doseQuestion 15 1 / 1 pointGender differences between men and women in pharmacokinetics include:Question options:More rapid gastric emptying so that drugs absorbed in the stomach have less exposure to absorption sitesHigher proportion of body fat so that lipophilic drugs have relatively greater volumes of distributionIncreased levels of bile acids so that drugs metabolized in the intestine have higher concentrationsSlower organ blood flow rates so drugs tend to take longer to be excretedQuestion 16 1 / 1 pointDisease states in addition to hypertension in which beta blockade is a compelling indication for the use of beta blockers include:Question options:Heart failureAnginaMyocardial infarctionDyslipidemiaQuestion 17 1 / 1 pointDevelopmental variation in renal function has what impact on prescribing for infants and children?Question options:Lower doses of renally excreted drugs may be prescribed to infants younger than age 6 months.Higher doses of water soluble drugs may need to be prescribed because of increased renal excretion.Renal excretion rates have no impact on prescribing.Parents need to be instructed on whether drugs are renally excreted or not.Question 18 1 / 1 pointWhen a pharmacoeconomic analysis looks at two or more treatment alternatives that are considered equal in efficacy and compares the costs of each it is referred to as:Question options:Cost-minimization analysisCost-of-illness analysisCost-effectiveness analysisCost-benefit analysisQuestion 19 1 / 1 pointAllison is an 18-year-old college student with type 1 diabetes. She is on NPH twice daily and Novolog before meals. She usually walks for 40 minutes each evening as part of her exercise regimen. She is beginning a 30-minute swimming class three times a week at 1 p.m. What is important for her to do with this change in routine?Question options:Delay eating the midday meal until after the swimming class.Increase the morning dose of NPH insulin on days of the swimming class.Adjust the morning insulin injection so that the peak occurs while swimming.Check glucose level before, during, and after swimming.Question 20 0 / 1 pointA woman who is pregnant and has hyperthyroidism is best managed by a specialty team who will most likely treat her with:Question options:MethimazolePropylthiouracil (PTU)Radioactive iodineNothing, treatment is best delayed until after her pregnancy endsQuestion 21 1 / 1 pointWhich of the following is a primary benefit of the use of computerized provider order entry for patient medications?Question options:Reduces time that prescribing drugs takesEliminates the need to chart drugs prescribedDecreases prescribing and transcription errorsHelps keep the number of drugs prescribed to a minimumQuestion 22 1 / 1 pointLisa is a healthy nonpregnant adult woman who recently had a urinary tract infection (UTI). She is asking about drinking cranberry juice to prevent a recurrence of the UTI. The correct answer to give her would be:Question options:Sixteen ounces per day of cranberry juice cocktail will prevent UTIs.100% cranberry juice or cranberry juice extract may decrease UTIs in some patients.There is no evidence that cranberry juice helps prevent UTIs.Cranberry juice only works to prevent UTIs in children.Question 23 1 / 1 pointGinseng, which is taken to assist with memory, may potentiate:Question options:AriceptInsulinDigoxinPropranololQuestion 24 1 / 1 pointWhile on testosterone replacement, hemoglobin and hematocrit levels should be monitored. Levels suggestive of excessive erythrocytosis or abuse are:Question options:Hemoglobin 14 g/dl or hematocrit 39%Hemoglobin 11.5 g/dl or hematocrit 31%Hemoglobin 13 g/dl or hematocrit 38%Hemoglobin 17.5 g/dl or hematocrit 54%Question 25 1 / 1 pointWhat is the role of calcium supplements when patients take bisphosphonates?Question options:They must be restricted to allow the medication to work.They must be taken in sufficient amounts to provide foundational elements for bone growth.They must be taken at the same time as the bisphosphonates.They only work with bisphosphonates if daily intake is restricted.Question 26 1 / 1 pointClinical judgment in prescribing includes:Question options:Factoring in the cost to the patient of the medication prescribedAlways prescribing the newest medication available for the disease processHanding out drug samples to poor patientsPrescribing all generic medications to cut costsQuestion 27 1 / 1 pointThe most cost-effective treatment for two or three impetigo lesions on the face is:Question options:Mupirocin ointmentRetapamulin (Altabax) ointmentTopical clindamycin solutionOral amoxicillin/clavulanate (Augmentin)Question 28 1 / 1 pointMedications are typically started for angina patients when:Question options:The first permanent EKG changes occurThe start of class I or II symptomsThe events trigger a trip to the emergency departmentWhen troponin levels become alteredQuestion 29 0 / 1 pointRabi is being prescribed phenytoin for seizures. Monitoring includes assessing:Question options:For phenytoin hypersensitivity syndrome 3 to 8 weeks after starting treatmentFor pedal edema throughout therapyHeart rate at each visit and consider altering therapy if heart rate is less than 60 bpmFor vision changes, such as red-green blindness, at least annuallyQuestion 30 1 / 1 pointAlterations in drug metabolism among Asians may lead to:Question options:Slower metabolism of antidepressants, requiring lower dosesFaster metabolism of neuroleptics, requiring higher dosesAltered metabolism of omeprazole, requiring higher dosesSlower metabolism of alcohol, requiring higher dosesQuestion 31 1 / 1 pointThe dosage of Vitamin B12 to initially treat pernicious anemia is:Question options:Nasal cyanocobalamin 1 gram spray in each nostril daily x 1 week then weekly x 1 monthVitamin B12 IM monthlyVitamin B12 1,000 mcg IM daily x 1 week then 1,000 mg IM weekly for a monthOral cobalamin 1,000 mcg dailyQuestion 32 1 / 1 pointThere is often cross-sensitivity and cross-resistance between penicillins and cephalosporins because:Question options: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 penicillins and cephalosporins.Question 33 1 / 1 pointThe reason that two MMR vaccines at least a month apart are recommended is:Question options:The second dose of MMR “boosts” the immunity built from the first dose.Two vaccines 1 month apart is the standard dosing for all live virus vaccines.If the two MMR vaccine doses are given too close together there is a greater likelihood of severe localized reaction to the vaccine.Only 95% of patients are fully immunized for measles after the first vaccine, with 99% having immunity after two doses of MMR.Question 34 1 / 1 pointA laboratory result indicates that the peak level for a drug is above the minimum toxic concentration. This means that the:Question options:Concentration will produce therapeutic effectsConcentration will produce an adverse responseTime between doses must be shortenedDuration of action of the drug is too longQuestion 35 1 / 1 pointWhy is the consistency of taking paroxetine (Paxil) and never running out of medication more important than with most other selective serotonin reuptake inhibitors (SSRIs)?Question options:It has a shorter half-life and withdrawal syndrome has a faster onset without taper.It has the longest half-life and the withdrawal syndrome has a faster onset.It is quasi-addictive in the dopaminergic reward system.It is the most activating of SSRI medications and will cause the person to have sudden deep sadness.Question 36 1 / 1 pointChee is a 15-month-old male whose screening hemoglobin is 10.4 g/dL. Treatment for his anemia would be:Question options:18 mg/day of iron supplementation6 mg/kg per day of elemental iron325 mg ferrous sulfate per day325 mg ferrous sulfate tidQuestion 37 1 / 1 pointEducation for patients who use an inhaled beta-agonist and an inhaled corticosteroid includes:Question options:Use the inhaled corticosteroid first, followed by the inhaled beta-agonists.Use the inhaled beta-agonist first, followed by the inhaled corticosteroid.Increase fluid intake to 3 liters per day.Avoid use of aspirin or ibuprofen while using inhaled medications.Question 38 1 / 1 pointAccording to the U.S. Office of Minority Health, poor health outcomes among African Americans are attributed to:Question options:The belief among African Americans that prayer is more powerful than drugsPoor compliance on the part of the African American patientThe genetic predisposition for illness found among African AmericansDiscrimination, cultural barriers, and lack of access to health careQuestion 39 0 / 1 pointPrecautions that should be taken when prescribing controlled substances include:Question options:Faxing the prescription for a Schedule II drug directly to the pharmacyUsing tamper-proof paper for all prescriptions written for controlled drugsKeeping any pre-signed prescription pads in a locked drawer in the clinicUsing only numbers to indicate the amount of drug to be prescribedQuestion 40 1 / 1 pointWhen considering which cholesterol-lowering drug to prescribe, which factor determines the type and intensity of treatment?Question options:Total LDLFasting HDLCoronary artery disease risk levelFasting total cholesterolQuestion 41 1 / 1 pointWhich of the following patients may be treated with a 3-day course of therapy for their urinary tract infection?Question options:Juanita, a 28-year-old pregnant womanSally, a 16-year-old healthy adolescentJamie, a 24-year-old femaleSuzie, a 26-year-old diabeticQuestion 42 1 / 1 pointIf an adult patient with comorbidities cannot reliably take oral antibiotics to treat pneumonia, an appropriate initial treatment option would be:Question options:IV or IM gentamicinIV or IM ceftriaxoneIV amoxicillinIV ciprofloxacinQuestion 43 1 / 1 pointVarenicline (Chantix) may be prescribed for tobacco cessation. Instructions to the patient who is starting varenicline include:Question options:The maximum time varenicline can be used is 12 weeks.Nausea is a sign of varenicline toxicity and should be reported to the provider.The starting regimen for varenicline is start taking 1 mg twice a day a week before the quit date.Neuropsychiatric symptoms may occur.Question 44 0 / 1 pointHarold, a 42-year-old African American, has moderate persistent asthma. Which of the following asthma medications should be used cautiously, if at all?Question options:Betamethasone, an inhaled corticosteroidSalmeterol, an inhaled long-acting beta-agonistAlbuterol, a short-acting beta-agonistMontelukast, a leukotriene modifierQuestion 45 1 / 1 pointAbsolute contraindications that clinicians must consider when initiating estrogen therapy include:Question options:Undiagnosed dysfunctional uterine bleedingDeep vein or arterial thromboemboli within the prior yearEndometriosisBoth a. and b.All of the aboveQuestion 46 1 / 1 pointSeveral classes of drugs have interactions with cholinergic blockers. Which of the following is true about these interactions?Question options:Drugs with a narrow therapeutic range given orally may not stay in the GI tract long enough to produce an action.Additive antimuscarinic effects may occur with antihistamines.Cholinergic blockers may decrease the sedative effects of hypnotics.Cholinergic blockers are contraindicated with antipsychotics.Question 47 1 / 1 pointLeonard is completing a 6-month regimen to treat tuberculosis (TB). Monitoring of a patient on TB therapy includes:Question options:Monthly sputum culturesMonthly chest x-rayBronchoscopy every 3 monthsAll of the aboveQuestion 48 1 / 1 pointThe action of “gliptins” is different from other antidiabetic agents because they:Question options:Have a low risk for hypoglycemiaAre not associated with weight gainClose ATP-dependent potassium channels in the beta cellAct on the incretin system to indirectly increase insulin productionQuestion 49 1 / 1 pointLaboratory values are actually different for TSH when screening for thyroid issues and when used for medication management. Which of the follow holds true?Question options:Screening TSH has a wider range of normal values 0.02-5.0; therapeutic levels need to remain above 5.0.Screening values are much narrower than the acceptable range used to keep a person stable on hormone replacement.Therapeutic values are kept between 0.05 and 3.0 ideally. Screening values are considered acceptable up to 10.Screening values are between 5 and 10, and therapeutic values are greater than 10.Question 50 1 / 1 pointAzithromycin dosing requires that the first day’s dosage be twice those of the other 4 days of the prescription. This is considered a loading dose. A loading dose:Question options:Rapidly achieves drug levels in the therapeutic rangeRequires four- to five-half-lives to attainIs influenced by renal functionIs directly related to the drug circulating to the target tissuesQuestion 51 1 / 1 pointConjunctivitis in a child that is accompanied by acute otitis media is treated with:Question options:Sulfacetamide 10% ophthalmic solution (Bleph-10)Bacitracin/polymyxin B (Polysporin) ophthalmic dropsCiprofloxacin (Ciloxan) ophthalmic dropsHigh-dose oral amoxicillinQuestion 52 1 / 1 pointTo improve actual effectiveness of oral contraceptives women should be educated regarding:Question options:Use of a back-up method if they have vomiting or diarrhea during a pill packetDoubling pills if they have diarrhea during the middle of a pill packThe fact that they will have a normal menstrual cycle if they miss two pillsThe fact that mid-cycle spotting is not normal and the provider should be contacted immediatelyQuestion 53 1 / 1 pointAn acceptable first-line treatment for peptic ulcer disease with positive H. pylori test is:Question options:Histamine2 receptor antagonists for 4 to 8 weeksProton pump inhibitor bid for 12 weeks until healing is completeProton pump inhibitor bid plus clarithromycin plus amoxicillin for 14 daysProton pump inhibitor bid and levofloxacin for 14 daysQuestion 54 1 / 1 pointLarry is taking allopurinol to prevent gout. Monitoring of a patient who is taking allopurinol includes:Question options:Complete blood countBlood glucoseC-reactive proteinBUN, creatinine, and creatinine clearanceQuestion 55 1 / 1 pointWhen discussing with a patient the different start methods used for oral combined contraceptives, the advantage of a Sunday start over the other start methods is:Question options:Immediate protection against pregnancy the first week of using the pillNo back-up method is needed when startingMenses occur during the weekThey can start the pill on the Sunday after the office visitQuestion 56 1 / 1 pointSadie is a 90-year-old patient who requires a new prescription. What changes in drug distribution with aging would influence prescribing for Sadie?Question options:Increased volume of distributionDecreased lipid solubilityDecreased plasma proteinsIncreased muscle-to-fat ratioQuestion 57 1 / 1 pointRose is a 3-year-old patient with an upper respiratory infection (URI). Treatment for her URI would include:Question options:AmoxicillinDiphenhydraminePseudoephedrineNasal saline sprayQuestion 58 1 / 1 pointInstructions for the use of nicotine gum include:Question options:Chew the gum quickly to get a peak effect.The gum should be “parked” in the buccal space between chewing.Acidic drinks such as coffee help with the absorption of the nicotine.The highest abstinence rates occur if the patient chews the gum when he or she is having cravings.Question 59 0 / 1 pointHoward is a 72-year-old male who occasionally takes diphenhydramine for his seasonal allergies. Monitoring for this patient taking diphenhydramine would include assessing for:Question options:Urinary retentionCardiac outputPeripheral edemaSkin rashQuestion 60 0 / 1 pointVicky, age 56 years, comes to the 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 migraines and states one dose usually works to abort her migraine. What is the best care for her?Question options:Switch her to sumatriptan (Imitrex) to treat her migraines.Assess how often she is using Fiorinal and refill her medication.Switch her to a beta blocker such as propranolol to prevent her migraine.Request she return to the original prescriber of Fiorinal as you do not prescribe butalbital for migraines.Question 61 1 / 1 pointDrugs that have a significant first-pass effect:Question options:Must be given by the enteral (oral) route onlyBypass the hepatic circulationAre rapidly metabolized by the liver and may have little if any desired actionAre converted by the liver to more active and fat-soluble formsQuestion 62 1 / 1 pointFirst-line therapy for treating topical fungal infections such as tinea corporis (ringworm) or tinea pedis (athlete’s foot) would be:Question options:OTC topical azole (clotrimazole, miconazole)Oral terbinafineOral griseofulvin microsizeNystatin cream or ointmentQuestion 63 1 / 1 pointA client asks the NP about the differences in drug effects between men and women. What is known about the differences between the pharmacokinetics of men and women?Question options:Body temperature varies between men and women.Muscle mass is greater in women.Percentage of fat differs between genders.Proven subjective factors exist between the genders.Question 64 1 / 1 pointOpiates are used mainly to treat moderate to severe pain. Which of the following is NOT true about these drugs?Question options:All opiates are scheduled drugs which require a DEA license to prescribe.Opiates stimulate only mu receptors for the control of pain.Most of the adverse effects of opiates are related to mu receptor stimulation.Naloxone is an antagonist to opiates.Question 65 1 / 1 pointA potentially life-threatening adverse response to angiotensin-converting enzyme inhibitors is angioedema. Which of the following statements is true about this adverse response?Question options:Swelling of the tongue or hoarseness are the most common symptoms.It appears to be related to the decrease in aldosterone production.Presence of a dry, hacky cough indicates a high risk for this adverse response.Because it takes time to build up a blood level, it occurs after being on the drug for about 1 week.Question 66 1 / 1 pointThe benefits to the patient of having an Advanced Practice Registered Nurse (APRN) prescriber include:Question options:Nurses know more about Pharmacology than other prescribers because they take it both in their basic nursing program and in their APRN program.Nurses care for the patient from a holistic approach and include the patient in decision making regarding their care.APRNs are less likely to prescribe narcotics and other controlled substances.APRNs are able to prescribe independently in all states, whereas a physician’s assistant needs to have a physician supervising their practice.Question 67 1 / 1 pointEducation of women who are being treated with ophthalmic antibiotics for conjunctivitis includes:Question options:Throwing away eye makeup and purchasing newRedness and intense burning is normal with ophthalmic antibioticsWhen applying eye ointment, set the tip of the tube on the lower lid and squeeze in inchUse a cotton swab to apply ointment, spreading the ointment all over the lid and in the conjunctival sacQuestion 68 1 / 1 pointWhen determining drug treatment the NP prescriber should:Question options:Always use evidence-based guidelinesIndividualize the drug choice for the specific patientRely on his or her experience when prescribing for complex patientsUse the newest drug on the market for the condition being treatedQuestion 69 1 / 1 pointClass I recommendations for stage A heart failure include:Question options:Aerobic exercise within tolerance levels to prevent the development of heart failureReduction of sodium intake to less than 2,000 mg/day to prevent fluid retentionBeta blockers for all patients regardless of cardiac historyTreatment of thyroid disorders, especially if they are associated with TachyarrhythmiasQuestion 70 1 / 1 pointMale patients who should not be prescribed phosphodiesterase type 5 (PDE-5) inhibitors include:Question options:DiabeticsThose who have had an acute myocardial infarction in the past 6 monthsPatients who are deafPatients under age 60 years of ageQuestion 71 1 / 1 pointThe first-line drug choice for a previously healthy adult patient diagnosed with community-acquired pneumonia would be:Question options:CiprofloxacinAzithromycinAmoxicillinDoxycyclineQuestion 72 1 / 1 pointIf a patient with symptoms of gastroesophageal reflux disease states that he has been self-treating at home with OTC ranitidine daily, the appropriate treatment would be:Question options:Prokinetic (metoclopramide) for 4 to 8 weeksProton pump inhibitor (omeprazole) for 12 weeksHistamine2 receptor antagonist (ranitidine) for 4 to 8 weeksCytoprotective drug (misoprostol) for 2 weeksQuestion 73 1 / 1 pointPatients who are prescribed exogenous androgens need to be warned that decreased libido:Question options:Is an unusual side effect of androgens and should be reported to the providerIs treated with increased doses of androgens, so the patient should let the provider know if he is having problemsMay be a sign of early prostate cancer and he should make an appointment for a prostate screening examMay occur with androgen therapyQuestion 74 1 / 1 pointWhich diuretic agents typically do not need potassium supplementation?Question options:The loop diureticsThe thiazide diureticsThe aldosterone inhibitorsThey all need supplementationQuestion 75 0 / 1 pointJim is being treated for hypertension. Because he has a history of heart attack, the drug chosen is atenolol. Beta blockers treat hypertension by:Question options:Increasing heart rate to improve cardiac outputReducing vascular smooth muscle toneIncreasing aldosterone-mediated volume activityReducing aqueous humor productionQuestion 76 1 / 1 pointPatient education regarding taking iron replacements includes:Question options:Doubling the dose if they miss a dose to maintain therapeutic levelsTaking the iron with milk or crackers if it upsets their stomachIron is best taken on an empty stomach with juiceAntacids such as Tums may help the upset stomach caused by iron therapyQuestion 77 1 / 1 pointPatient education for a patient who is prescribed antibiotics for sinusitis includes:Question options:Use of nasal saline washesUse of inhaled corticosteroidsAvoiding the use of ibuprofen while illUse of laxatives to treat constipationQuestion 78 1 / 1 pointPatients who are treated with greater than 100 grams per week of topical calcipotriene for psoriasis need to be monitored for:Question options:High vitamin D levelsHyperkalemiaHypercalcemiaHyperuricemiaQuestion 79 1 / 1 pointSook has been prescribed gabapentin to treat neuropathic pain and is complaining of feeling depressed and having “strange” thoughts. The appropriate initial action would be:Question options:Increase her doseAssess for suicidal ideationDiscontinue the medication immediatelyDecrease her dose to half then slowly titrate up the doseQuestion 80 1 / 1 pointNonadherence is especially common in drugs that treat asymptomatic conditions, such as hypertension. One way to reduce the likelihood of nonadherence to these drugs is to prescribe a drug that:Question options:Has a short half-life so that missing one dose has limited effectRequires several dosage titrations so that missed doses can be replaced with lower doses to keep costs downHas a tolerability profile with fewer of the adverse effects that are considered “irritating,” such as nausea and dizzinessMust be taken no more than twice a dayQuestion 81 1 / 1 pointWhich the following persons should not have a statin medication ordered?Question options:Someone with 3 first- or second-degree family members with history of muscle issues when started on statinsSomeone with high lipids, but low BMIPremenopausal woman with recent history of hysterectomyPrediabetic male with known metabolic syndromeQuestion 82 1 / 1 pointThe Combat Methamphetamine Epidemic Act, which is part of the 2006 U.S. Patriot Act:Question options:Requires all providers to screen their patients for methamphetamine useRestricts the prescribing of amphetamines to U.S. citizensRequires a prescription be written for all methamphetamine precursors in all statesRestricts the sales of drugs that contain methamphetamine precursors, including a daily and 30-day limit on salesQuestion 83 0 / 1 pointMonitoring for patients who are on long-term antifungal therapy with ketoconazole includes:Question options:Platelet countBUN and creatinineWhite blood cell countAST, ALT, alkaline phosphatase, and bilirubinQuestion 84 0 / 1 pointWhich of the following holds true for the pharmacokinetics of women?Question options:Gastric emptying is faster than that of men.Organ blood flow is the same as that of men.Evidence is strong concerning renal differences in elimination.Medications that involve binding globulins are impacted by estrogen levels.Question 85 0 / 1 pointHenry is 82 years old and takes two aspirin every morning to treat the arthritis pain in his back. He states the aspirin helps him to “get going” each day. Lately he has had some heartburn from the aspirin. After ruling out an acute GI bleed, what would be an appropriate course of treatment for Henry?Question options:Add an H2 blocker such as ranitidine to his therapy.Discontinue the aspirin and switch him to Vicodin for the pain.Decrease the aspirin dose to one tablet daily.Have Henry take an antacid 15 minutes before taking the aspirin each day.Question 86 1 / 1 pointWhen prescribing a tetracycline or quinolone antibiotic it is critical to instruct the patient:Question options:Not to take their regularly prescribed medications while on these antibioticsRegarding the need for lots of acidic foods and juices, such as orange juice, to enhance absorptionNot to take antacids while on these medications, as the antacid decreases absorptionThat there are no drug interactions with these antibioticsQuestion 87 1 / 1 pointA provider may consider testing for CYP2D6 variants prior to starting tamoxifen for breast cancer to:Question options:Ensure the patient will not have increased adverse drug reactions to the tamoxifenIdentify potential drug-drug interactions that may occur with tamoxifenReduce the likelihood of therapeutic failure with tamoxifen treatmentIdentify poor metabolizers of tamoxifenQuestion 88 1 / 1 pointIV forms of bisphosphonates are used for all the following except:Question options:Severe gastric irritation with oral formsKnown cancer mets into the bonePersons with advancing renal dysfunctionProgression of bone loss on oral formulationsQuestion 89 1 / 1 pointThe New York Heart Association and the Canadian Cardiovascular Society have described grading criteria for levels of angina. Angina that occurs with unusually strenuous activity or on walking or climbing stair after meals is class:Question options:IIIIIIIVQuestion 90 1 / 1 pointACE inhibitors are contraindicated in pregnancy. While treatment of heart failure during pregnancy is best done by a specialist, which of the following drug classes is considered to be safe, at least in the later parts of pregnancy?Question options:DiureticsARBsBeta blockersNitratesQuestion 91 1 / 1 pointPharmacoeconomics is:Question options:The study of the part of the U.S. economy devoted to drug useThe study of the impact of prescription drug costs on the overall economyThe analysis of the costs and consequences of any health-care-related treatment or serviceThe analysis of the clinical efficacy of the drugQuestion 92 1 / 1 pointGoals when treating tuberculosis include:Question options:Completion of recommended therapyNegative purified protein derivative at the end of therapyCompletely normal chest x-rayAll of the aboveQuestion 93 1 / 1 pointElena Vasquez’s primary language is Spanish, and she speaks very limited English. Which technique would be appropriate to use in teaching her about a new drug you have just prescribed?Question options:Use correct medical terminology because Spanish has a Latin base.Use a family member who speaks more English to act as an interpreter.Use a professional interpreter or a reliable staff member who can act as an interpreter.Use careful, detailed explanations.Question 94 1 / 1 pointWhich of the following statements is true about acute pain?Question options:Somatic pain comes from body surfaces and is only sharp and well-localized.Visceral pain comes from the internal organs and is most responsive to acetaminophen and opiates.Referred pain is present in a distant site for the pain source and is based on activation of the same spinal segment as the actual pain site.Acute neuropathic pain is caused by lack of blood supply to the nerves in a given area.Question 95 1 / 1 pointThe role of the NP in the use of herbal medication is to:Question options:Maintain competence in the prescribing of common herbal remediesRecommend common over-the-counter herbs to patientsEducate patients and guide them to appropriate sources of careEncourage patients to not use herbal therapy due to the documented dangersQuestion 96 1 / 1 pointBeing competent in the use of information technology in clinical practice is expected in professional nurses. Advanced practice competence includes the ability to:Question options:Search for information using the most common search enginesServe as content experts in developing, implementing, and evaluating information SystemsWrite programs to assure the integrity of health informationUse information technology to prescribe drugsQuestion 97 0 / 1 pointSally has been prescribed aspirin 320 mg per day for her atrial fibrillation. She also takes aspirin four or more times a day for arthritis pain.What are the symptoms of aspirin toxicity for which she would need to be evaluated?Question options:TinnitusDiarrheaHearing lossPhotosensitivityQuestion 98 1 / 1 pointNurse practitioner prescriptive authority is regulated by:Question options:The National Council of State Boards of NursingThe U.S. Drug Enforcement AdministrationThe State Board of Nursing for each stateThe State Board of PharmacyQuestion 99 1 / 1 pointAn Investigational New Drug is filed with the U.S. Food and Drug Administration:Question options:When the manufacturer has completed phase III trialsWhen a new drug is discoveredPrior to animal testing of any new drug entityPrior to human testing of any new drug entityQuestion 100 1 / 1 pointPreventative therapy for cluster headaches includes:Question options:Massage or relaxation therapyErgotamine nightly before bedIntranasal lidocaine four times a day during “clusters” of headachesPropranolol (Inderal) daily
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