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NURS 5334 FINAL EXAM 2024/2025 (ACTUAL QUESTIONS AND VERIFIED ANSWERS)
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What are three drugs that can be combined with hydrocodone? (pain management mod 3) Aspirin acetaminophen ibuprofen Benzodiazepines and cns depressants can be paired with acetaminophen- hydrocodone, true or false? False, this could lead to respiratory depression Why would you give a paBent buprenorphine for maintenance once they recovered from opioid abuse? ParBal opioid agonist that acBvated opioid receptors but produces less degree of euphoria and physical dependence compared to a full agonist Why would you give a paBent naltrexone for maintenance once they recovered from opioid abuse? Naltrexone is a opioid antagonist that blocks the euphoric and sedaBve effects of opioids. What are 3 side effects of hydrocodone? ConsBpaBon respiratory depression addiBon What's the moa of sumatriptan? (-triptan)
SelecBve agonist for serotonin 5ht receptors on intracranial blood vessels and sensory nerves of the trigeminal system, causes vasoconstricBon and reduces neurogenic inflammaBon What is the supplement feverfew used for? Migraine prophylaxis Which types of drugs cannot be combined with feverfew? AnBplatlets anBcoagulants increased risk of bleeding in paBents taking anBplatelets (aspirin) and anBcoagulants (wafarin) How much folic acid need to be given for a folic acid deficiency? Give 1-2mg/day po for a deficiency How much folic acid should a woman of child bearing age take? 400 - 800 mcg daily How much folic acid is recommended for a pregnant women? 400 - 600 mcg/day If a paBent comes in using tacrolimus and pimecrlimus cream, what is this for? Atopic dermaBBs (eczema) Ace inhibitors are contraindicated in pregnancy. While treatment of heart failure during during pregnancy is best done by a special, which of the following drug classes are considered to be safe at least in the later parts of pregnancy? A. DiureBcs b. Arbs
Laba + lama Copd group e Laba + lama How does an increase percentage of body at effect the plasma level of lipid soluble drugs in an elderly individual? The higher the body fat percentage the more the plasma levels of lipid soluble drugs will be reduced A decrease in lean mass causes concentraBon of water soluble drugs to be (inc/dec) in elderly paBents? Increased For elderly paBents that are malnourished (low albumin level) free drug levels of protein binding drugs will (inc/dec)? Increase A child is about to get the proquad vaccine, which is a mix of the varicella and mmr vaccine. What educaBon would you need to give to the parents? Deposited ge_ng the vaccine there is sBll a chance your child could get breakthrough chickenpox What is the starBng dosage of thyroid medicaBon for a in elderly paBent that is 51 with no comorbidiBes? 50 mcg What is the starBng dosage of thyroid medicaBon for an elderly paBent that is 68 years with no comorbidiBes? 25 mcg What is the dosage range for thyroid medicaBon for a person with cad? 12 - 25 mcg What is an a`enuated vaccine? Live virus, but weakened
Immunocompromised paBents are able to receive a`enuated vaccines, true or false? False, live vaccines can be dangerous in recipients who are immunocompromised because these people are unable to mount and effecBve immune response, even against an virulent organism What is the range in weeks where a pregnant women can receive the tdap vaccine? 29 - 36 weeks (module 10 transcripts) What does gardasil protect against in females? (4) Hpv 6, 11, 16, 18, 31, 33, 45, 52, 58 cervical cancer vaginal cancer vulvar cancer genital warts What does gardasil protect against in males? (1) Hpv 6, 11, 16, 18, 31, 33, 45, 52, 58 genitals warts What is the moa of haloperidol? Blocking the dopamine d2 receptors in the brain, inhibiBng the dopamine receptors help reduce the symptoms of psychosis such as hallucinaBons What are the adverse effects of haloperidol? Extrapyramidal side effects What is the moa of chlorpromazine? Blocking dopamine d2 receptors in the brain What are extrapyramidal symptoms?
Liver injury bone related disorders Which anBdepressant has the least amount of sexual side effects? Bupropion Nonpharmalogical management of gout Low purine diet joint rest weight reducBon fluid intake of 3liters What is the first-line treatment for gout? (urage lowering therapy) Allopurinol Nsaids can be given to a paBent with rheumatoid arthriBs for pain and inflammaBon, true or false? True PaBents with rheumatoid arthriBs should also be put on a dmard to reduce joint destrucBon, true or false? True Which one of these medicaBons are considered first-line treatment for rheumatoid arthriBs for moderate to severe disease? A. Hydroxychloroquine b. Tramadol c. Acetaminophen d. Methotrexate D. Methotrexate
methotrexate is first line treatment of rheumatoid arthriBs for moderate to severe disease Which one of these medicaBons are considered first-line treatment for rheumatoid arthriBs for mild disease? A. Hydroxychloroquine b. Tramadol c. Acetaminophen d. Methotrexate A. Hydroxychloroquine hydroxychloroquine is used for mild disease of ra What educaBon would you give to a paBent taking hydroxychloroquine for mild ra? It's important to get regular eye exams because plaquenil binds to reBnal pigment cells and can cause reBnal toxicity and destroy the macular Nsaids and glucocorBcoids can be used for management of acute flare ups for gout, true or false? True What is the moa of fibrates? Fibrates work by acBvaBng pparα which are intracellular receptors that regulate fat and carbohydrate metabolism. Increase the breakdown of triglycerides into fa`y acids via beta oxidaBon Name the three fibrates that help lower triglycerides? Fenofibrate gemfibrozil lovaza
B. LiragluBde liragluBde is a glp-1 agonist that is approved for chronic weight management in adults. It acts by slowing gastric emptying, which increases a feeling of fullness, leading to decrease weight loss What is the therapeuBc use for buprenorphine? Maintenance therapy for opioid dependence. This is can sBmulate opioid receptors and decrease withdrawal symptoms. It given with a full agonist would decrease effects What is the moa of buprenorphine? ParBal mu agonist, kappa antagonist. This produces a lesser degree of euphoria and physical dependence What is the therapeuBc use for naltrexone? Naltrexone is an opioid antagonist. This is maintenance therapy for opioid dependence and to prevent relapse. An an opioid is taken while a paBent is on naltrexone the opioid will sBll have a euphoric effect, true or false? False, if an opioid is taken while a paBent is on naltrexone, it will prevent a euphoric effect What is the correct way to apply topical glucocorBcoids? Topical glucocorBcoids should be applied in a thin film and gently rubbed into the skin. What is the dose of terbinafine to give to onchymycosis on one fingernail? 250 mg daily for 6-12 weeks for fingernail What is the dose of terbinafine to give to onchymycosis on one toenail? 250 mg daily for 3-6 months for toenail What is the moa of denosumab?
What is an example of a h2 receptor blocker FamoBdine cimeBdine nizaBdine capsules raniBdine What are some examples of proton pump inhibitors? Omeprazole esomeprazole rabeprazole Pyridoxine (vitamin b6) accelerates the systemic metabolism of levodopa thereby decreasing availability of the amino acid to the brain parenchyma, true or false? True, pyridoxine sBmulates decarboxylase acBvity of pyridoxine and can decrease the amount of levodopa available to the cns A paBent has parkinson's and is dealing with tardaBve dyskinesia, what medicaBon would you recommend to this paBent for the symptoms? A. Amantadine b. Methyldopa c. Escitalopram d. Amitriptyline A. Amantadine can help with dyskinesia in later stages What are some adverse effects of phenytoin? Nystagmus sedaBon ataxia diplopia
cogniBve impairment gingival hyperplasia What is an important piece of educaBon that should be given to paBents taking phenytoin for seizures? Make sure to do thorough oral care due to gingival hyperplasia What occurs during a a serotonin crisis? Starts 2 - 72 hrs aler treatment altered mental status agitaBon confusion disorientaBon hallucinaBons myoclonus hyperflexia excessive sweaBng If a paBent is experiencing serotonin syndrome, how do you resolve the issue? Stop the medicaBon Name two non-sBmulant medicaBon that can be given to a paBent with adhd? AtomoxeBne viloxazine Name two tricyclic anBdepressants that can be used for adhd? Desipramine imipramine Name 3 α- 2 adrenergic receptor agonists that can be used for paBents with adhd?
vasodilaBon build and burn glucose glycogenolysis gluconeogenesis increase insulin How does acBvaBon of the m1 muscarinic receptors affect the body? Salivary glands gi secreBons cns How does the m2 receptor affect the heart? Decreases hr decreases conducBon How do the m3 muscarinic receptors affect the body when acBvated? (6) Eye constricBon and accomodaBon lungs: bronchiolar contracBon and secreBon promotes digesBon increase moBlity and relax sphincters increase salivaBon promotes voiding increases sweaBng and lactaBon. What is the moa of bethanechol? Bethanechol is a muscarinic agonist and acBvates the cholinergic receptors. What are therapeuBc uses for bethanechol? (2) Treatment of urinary retenBon sBmulate intesBnal moBlity in people with ileus Why is bethanechol contraindicated in paBents with asthma? This medicaBon constricts bronchi and brings about exacerbaBons of asthma Why would bethanechol be used post surgery?
To get the paBent to pee and poop Bethanechol can be used in paBents with hyperthyroidism, true or false? False, bethanechol can cause dysthymias in paBents with hyperthyroidism What is the moa of atropine? Blocks the ability of ach to bind to parasympatheBcs and as a result the sympatheBc nervous system take over ↑ hr, bp, & svr What are the pharmacological effects of atropine? Increased heart rate decreased secreBons relaxes bronchi decreases bladder tone decrease gi tract moBlity How does atropine affect people with asthma? Atropine can worsen asthma. The drying of the secreBons making it harder to breathe How can atropine be beneficial to use for an eye exam? Atropine dilated pupils in preparaBon for an eye exam What medicaBon can be used to combat cholinergic effects? Atropine What are side effects of atropine? Dry mouth, decreased perspiraBon, blurred vision, tachycardia, consBpaBon, and urinary retenBon For paBent self-idenBfied as african american with nyha class iii-iv hfref who are receiving opBmal medical therapy the combinaBon of which two medicaBons is recommended?
Alpha 1 antagonist block alpha 1 receptors in the bladder neck, prostate capsule, and prostaBc urethra, causing smooth muscle relaxaBon and decreased urethral resistance What is the moa of meiormin? It inhibits glucose producBon by the liver and decreases insulin resistance. What are adverse effects of meiormin? Gi disturbances lacBc acidosis Meiormin is an oral medicaBon that reduces blood sugar and increases insulin producBon, true or false? False, meiormin primarily reduces hepaBc glucose producBon and improves insulin sensiBvity, but does not directly increase insulin producBon What is the moa of sulfonylureas? SBmulate insulin release from pancreaBc beta cells. Sulfonylureas can cause extreme hypoglycemia when taken, but also help paBents lose weight, true or false? False, a major side effect of sulfonylureas is sever hypoglycemia but they do not cause weight loss, they cause weight gain What are the names of 3 sulfonylureas? Glipizide glyburide glimepiride Sulfonylurea are an oral medicaBon reduces blood sugar and increases insulin producBon, true or false? True, sBmulate insulin releases from the beta cells of the pancreas. They bind to sulfonurea receptors in the pancreaBc beta cells, which lead to the closing of
potassium channels and the opening of the calcium channels. This influx of calcium ions sBmulate the exocytosis of insulin containing granulates. What is the moa of repaglinide and nateglinide? SBmulate rapid, short term insulin secreBon. Helpful in controlling postprandial blood glucose levels Do megliBnides reduce blood sugar and increase insulin producBon? Yes What is the moa of glitazones? Increase insulin sensiBvity in peripheral Bssues such as muscles and adipose Bssues. AcBvaBon of ppar-γ increases the transcripBon of insulin responsive genes, leading to improved insulin acBon, increase glucose uptake, decrease gluconeogenesis in the liver. What is the moa of dpp-4 inhibitors? Increase increBn levels (glp-1 and gip), which inhibit glucagon release, which in turn increases insulin secreBon, decreases gastric emptying, and decreases blood glucose levels. SitaglipBn is an oral medicaBon that reduces blood sugar and increases insulin producBon, true or false? True, sitaglipBn increases insulin producBon and decrease glucose producBon by inhibiBng the enzyme dpp-4, which results in prolonged acBvity of increBn hormones What is the moa of canagliflozin? Increases urinary excreBon of glucose What is the moa of semagluBde? Glp-1 receptor agonist slow digesBon and glucose absorpBon. Olen associated with weight loss.