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MN 553 Advanced Pharmacology Final Exam
4 / 4 points
Jim 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:
rt rate to improve cardiac output ular smooth muscle tone osterone-mediated volume activity ous humor production
Opiates are used mainly to treat moderate to severe
pain. Which of the following is NOT true about these
drugs?
Question options:
scheduled drugs which require a DEA license to prescribe. ate only mu receptors for the control of pain. verse effects of opiates are related to mu receptor stimulation. antagonist to opiates.
When considering which cholesterol-lowering drug to
prescribe, which factor determines the type and
intensity of treatment?
Question options:
y disease risk level holesterol
Being competent in the use of information technology
in clinical practice is expected in professional nurses.
Advanced practice competence includes the ability to:
Question options:
nt experts in developing, implementing, and evaluating information Systems testing of any new drug entity eaction with a previous dose rmation using the most common search engines s to assure the integrity of health information on technology to prescribe drugs
The 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:
An Investigational New Drug is filed with the U.S. Food
and Drug Administration:
Question
options: ufacturer has completed
phase III trials rug is discovered l testing of any new drug entity
True contraindications to diphtheria, tetanus, and
acellular pertussis (DTaP or Tdap) vaccine include:
Question options:
4oF (40.5oC) after previous DTaP vaccine of seizures after DTaP vaccine egnancy
A provider may consider testing for CYP2D6 variants
prior to starting tamoxifen for breast cancer to:
ightly before bed er half-life and withdrawal syndrome has a faster onset without taper. icidal ideation ycogenolysis by the liver
Preventative therapy for cluster headaches
includes: Question options:
elaxation therapy ocaine four times a day during “clusters” of headaches Inderal) daily
Why 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:
gest half-life and the withdrawal syndrome has a faster onset. dictive in the dopaminergic reward system. activating of SSRI medications and will cause the person to have sudden deep sadness.
Sook 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:
dose he medication immediately dose to half then slowly titrate up the dose
The drug of choice for type 2 diabetics is metformin.
Metformin:
Question options:
release of insulin from beta cells stinal uptake of glucose ght gain associated with hyperglycemia
Gender differences between men and women in
pharmacokinetics include:
Question options:
astric emptying so that drugs absorbed in the stomach have less exposure to absorption sites rtion of body fat so that lipophilic drugs have relatively greater volumes of distribution els of bile acids so that drugs metabolized in the intestine have higher concentrations blood flow rates so drugs tend to take longer to be excreted
Lisa 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:
es per day of cranberry juice cocktail will prevent UTIs. rry juice or cranberry juice extract may decrease UTIs in some patients. vidence that cranberry juice helps prevent UTIs. ce only works to prevent UTIs in children.
ACE 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:
s
Which of the following holds true for the
pharmacokinetics of women?
Question options:
ying is faster than that of men. flow is the same as that of men. trong concerning renal differences in elimination.
17.5 g/dl or hematocrit 54% acil (PTU) um cultures -proof paper for all prescriptions written for controlled drugs
While on testosterone replacement, hemoglobin and
hematocrit levels should be monitored. Levels
suggestive of excessive erythrocytosis or abuse are:
Question options:
14 g/dl or hematocrit 39% 11.5 g/dl or hematocrit 31% 13 g/dl or hematocrit 38%
A woman who is pregnant and has hyperthyroidism is
best managed by a specialty team who will most
likely treat her with:
Question options:
odine tment is best delayed until after her pregnancy ends
Leonard is completing a 6-month regimen to treat
tuberculosis (TB). Monitoring of a patient on TB therapy
includes:
Question options:
st x-ray y every 3 months ove
Precautions that should be taken when prescribing
controlled substances include:
Question options:
escription for a Schedule II drug directly to the pharmacy pre-signed prescription pads in a locked drawer in the clinic umbers to indicate the amount of drug to be prescribed
ith androgen therapy h 3 first- or second-degree family members with history of muscle issues when started on statins zation analysis
Patients who are prescribed exogenous androgens need
to be warned that decreased libido:
Question options:
side effect of androgens and should be reported to the provider h increased doses of androgens, so the patient should let the provider know if he is having problems n of early prostate cancer and he should make an appointment for a prostate screening exam
Which the following persons should not have a statin
medication ordered?
Question options:
h high lipids, but low BMI al woman with recent history of hysterectomy ale with known metabolic syndrome
When 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:
ss analysis eness analysis analysis
Ginseng, which is taken to assist with memory, may
potentiate:
Question options:
ne inhibitors n, cultural barriers, and lack of access to health care locker such as ranitidine to his therapy. committee that writes guidelines for pediatric prescribing retics diuretics supplementation
According to the U.S. Office of Minority Health, poor
health outcomes among African Americans are
attributed to: Question options:
ong African Americans that prayer is more powerful than drugs nce on the part of the African American patient redisposition for illness found among African Americans
Henry 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:
he aspirin and switch him to Vicodin for the pain. aspirin dose to one tablet daily. ake an antacid 15 minutes before taking the aspirin each day.
The Best Pharmaceuticals for Children
Act: Question options:
diatric exclusivity rule which extends the patent on drugs studied in children ding for new drug development aimed at children manufacturers specifically to develop pediatric formulations
Which of the following patients may be treated with a
3-day course of therapy for their urinary tract infection?
ear-old female thyroid disorders, especially if they are associated with Tachyarrhythmias medications or medication classes that should generally be avoided in persons 65 years or older because they are either ineffecti atric symptoms may occur.
Question options:
year-old pregnant woman ar-old healthy adolescent ear-old diabetic
Class I recommendations for stage A heart failure
include: Question options:
cise within tolerance levels to prevent the development of heart failure sodium intake to less than 2,000 mg/day to prevent fluid retention s for all patients regardless of cardiac history
All of the following statements about the Beer’s List are
true except:
Question options:
rom the expert opinion of one geriatrician and is not evidence-based. have been adopted by the Centers for Medicare and Medicaid Services for regulation of long-term care facilities. are directed at the general population of patients over 65 years of age and do not take disease states into consideration.
Varenicline (Chantix) may be prescribed for tobacco
cessation. Instructions to the patient who is starting
varenicline include: Question options:
m time varenicline can be used is 12 weeks. ign of varenicline toxicity and should be reported to the provider. egimen for varenicline is start taking 1 mg twice a day a week before the quit date.
If 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:
riaxone n hypersensitivity syndrome 3 to 8 weeks after starting treatment bolism of a prodrug into an active drug, leading to accumulation of Prodrug of renally excreted drugs may be prescribed to infants younger than age 6 months. tamicin
If an adult patient with comorbidities cannot reliably take oral
antibiotics to treat pneumonia, an appropriate initial
treatment option would be:
Question options:
n cin
Rabi is being prescribed phenytoin for seizures.
Monitoring includes assessing:
Question options:
ma throughout therapy each visit and consider altering therapy if heart rate is less than 60 bpm anges, such as red-green blindness, at least annually
Patients who have a poor metabolism phenotype will
have: Question options:
n of inactive metabolites of drugs creased dosages of medications mination of an active drug
Developmental variation in renal function has what
impact on prescribing for infants and children?
Question options:
of water soluble drugs may need to be prescribed because of increased renal excretion. on rates have no impact on prescribing. to be instructed on whether drugs are renally excreted or not.
sses contain a beta-lactam ring that is vulnerable to beta-lactamase-producing organisms. nfarction ed beta-agonist first, followed by the inhaled corticosteroid.
There is often cross-sensitivity and cross-resistance
between penicillins and cephalosporins because:
Question options:
on is similar in both classes of drugs. rug classes are metabolized in the liver they both produce resistant enzymes. n issue with cross-resistance between the penicillins and cephalosporins.
Disease states in addition to hypertension in which beta
blockade is a compelling indication for the use of beta
blockers include:
Question options:
Sally 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:
ity
Education for patients who use an inhaled beta-agonist
and an inhaled corticosteroid includes:
Question options:
ed corticosteroid first, followed by the inhaled beta-agonists. intake to 3 liters per day. aspirin or ibuprofen while using inhaled medications.
ility profile with fewer of the adverse effects that are considered “irritating,” such as nausea and dizziness advancing renal dysfunction sales of drugs that contain methamphetamine precursors, including a daily and 30-day limit on sales -up method if they have vomiting or diarrhea during a pill packet alf-life so that missing one dose has limited effect eral dosage titrations so that missed doses can be replaced with lower doses to keep costs down n no more than twice a day
IV forms of bisphosphonates are used for all the
following except:
Question options:
c irritation with oral forms r mets into the bone f bone loss on oral formulations
The Combat Methamphetamine Epidemic Act, which is
part of the 2006 U.S. Patriot Act:
Question options:
providers to screen their patients for methamphetamine use prescribing of amphetamines to U.S. citizens escription be written for all methamphetamine precursors in all states
To improve actual effectiveness of oral contraceptives
women should be educated regarding:
Question options:
s if they have diarrhea during the middle of a pill pack they will have a normal menstrual cycle if they miss two pills mid-cycle spotting is not normal and the provider should be contacted immediately
The action of “gliptins” is different from other
antidiabetic agents because they:
Question options:
isk for hypoglycemia
cretin system to indirectly increase insulin production taken in sufficient amounts to provide foundational elements for bone growth. lass I or II symptoms inhibitor bid plus clarithromycin plus amoxicillin for 14 days bolism of antidepressants, requiring lower doses iated with weight gain ependent potassium channels in the beta cell
What is the role of calcium supplements when patients take
bisphosphonates?
Question options:
restricted to allow the medication to work. taken at the same time as the bisphosphonates. ork with bisphosphonates if daily intake is restricted.
Medications are typically started for angina patients
when: Question options:
manent EKG changes occur igger a trip to the emergency department in levels become altered
An acceptable first-line treatment for peptic ulcer
disease with positive H. pylori test is:
Question options:
eceptor antagonists for 4 to 8 weeks inhibitor bid for 12 weeks until healing is complete inhibitor bid and levofloxacin for 14 days
Alterations in drug metabolism among Asians may
lead to: Question options:
olism of neuroleptics, requiring higher doses bolism of omeprazole, requiring higher doses bolism of alcohol, requiring higher doses
f fat differs between genders. kaline phosphatase, and bilirubin tion escribing and transcription errors
A 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:
ature varies between men and women. is greater in women. ctive factors exist between the genders.
Monitoring for patients who are on long-term
antifungal therapy with ketoconazole includes:
Question options:
atinine cell count
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: Question options:
ut ema
Which of the following is a primary benefit of the use of
computerized provider order entry for patient
medications? Question options:
that prescribing drugs takes e need to chart drugs prescribed e number of drugs prescribed to a minimum
on with milk or crackers if it upsets their stomach ntacids while on these medications, as the antacid decreases absorption the cost to the patient of the medication prescribed
The optimal maximum time frame for HRT or estrogen
replacement therapy (ERT) is:
Question options:
Patient education regarding taking iron replacements
includes: Question options:
dose if they miss a dose to maintain therapeutic levels ken on an empty stomach with juice h as Tums may help the upset stomach caused by iron therapy
When prescribing a tetracycline or quinolone antibiotic
it is critical to instruct the patient:
Question options:
eir regularly prescribed medications while on these antibiotics e need for lots of acidic foods and juices, such as orange juice, to enhance absorption e no drug interactions with these antibiotics
Clinical judgment in prescribing
includes: Question options:
ribing the newest medication available for the disease process drug samples to poor patients ll generic medications to cut costs
