NR 508 Week 4 Mid-term Exam (Collection)

(NR 508 Week 4 Mid-term Exam)

NR 508 Week 4 Midterm Exam (Spring 2020)

1. Question: A patient may develop neutropenia from using topical Silvadene for burns.
2. Question: Food in GI tract affects absorption by Antacids such as calcium carbonate (Tums) can reduce the absorption of which of the following nutrients?
3. Question: Antacids such as calcium carbonate (Tums) can reduce the absorption of which of the following nutrients?
4. Question: Drug Metabolism; A low-carbohydrate, high-protein diet may-
5. Question: Recommended fiber daily intake?
6. Question: Vitamin that is useful for migraine prophylaxis ;
7. Question: New over-the-counter drug ingredients must undergo the U.S. Food and Drug Administration New Drug Application process, just as prescription drugs do:
8. Question: As drugs near the end of their patent, pharmaceutical companies may apply for the drug to change to over-the-counter status in order to:
9. Question: Adherence to beta blocker therapy may be affected by their:
10. Question: To reduce potential adverse effects, patients taking a peripherally acting alpha₁ antagonist should do all of the following EXCEPT:
11. Question: Which of the following adverse effects are less likely in a beta1-selective blocker?
12. Question: To prevent life-threatening events from rapid withdrawal of a beta blocker:
13. Question: Bethanechol–
14. Question: Beta blockers are prescribed for diabetics with caution because of their ability to produce hypoglycemia and block the common symptoms of it. Which of the following symptoms of hypoglycemia is not blocked by these drugs and so can be used to warn diabetics of possible decreased blood glucose?
15. Question: The benefits to the patient of having an Advanced Practice Registered Nurse (APRN) prescriber include:
16. Question: The route of excretion of a volatile drug will likely be the:
17. Question: Medroxyprogesterone (Depo Provera) is prescribed intramuscularly (IM) to create a storage reservoir of the drug. Storage reservoirs:
18. Question: The NP chooses to give cephalexin every 8 hours based on knowledge of the drug’s:
19. Question: The point in time on the drug concentration curve that indicates the first sign of a therapeutic effect is the:
20. Question: Phenytoin requires that a trough level be drawn. Peak and trough levels are done:
21. Question: Drugs that are receptor agonists may demonstrate what property
22. Question: Factors that affect gastric drug absorption include:
23. Question: Drugs administered via IV:
24. Question: Infants and young children are at higher risk of ADRs due to:
25. Question: The elderly are at high risk of ADRs due to:
26. Question: Digoxin may cause a type A adverse drug reaction due to:
27. Question: Food in the gastrointestinal tract affects drug absorption by:
28. Question: Fasting for an extended period can:
29. Question: Tetracycline needs to be given on an empty stomach because it chelates with:
30. Question: A low-carbohydrate, high-protein diet may:
31. Question: Patients taking warfarin need to be educated about the vitamin K content of foods to avoid therapeutic failure. Foods high in vitamin K that should be limited to no more than one serving per day include:
32. Question: The American Dietetic Association has recommended the use of specific nutritional supplements in the following population(s):
33. Question: There is strong evidence to support that adequate vitamin C intake prevents:
34. Question: Pharmacoeconomics is:
35. Question: When the costs of a specific treatment or intervention are calculated and then compared with the dollar value of the benefit received it is referred to as:
36. Question: Charlie is a 65-year-old male who has been diagnosed with hypertension and benign prostatic hyperplasia. Doxazosin has been chosen to treat his hypertension because it:
37. Question: Richard is 70 years old and has a history of cardiac dysrhythmias. He has been prescribed nadolol. You do his annual laboratory work and find a CrCl of 25 ml/min. What action should you take related to his nadolol?
38. Question: An NP would prescribe the liquid form of ibuprofen for a 6-year-old child because:
39. Question: A comprehensive assessment of a patient should be holistic when trying to determine competence in drug administration. Which of the following factors would the NP omit from this type of assessment?
40. Question: Elena 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?
41. Question: Rod, age 68, has hearing difficulty. Which of the following would NOT be helpful in assuring that he understands teaching about his drug?
42. Question: Ralph’s blood pressure remains elevated despite increased doses of his drug. The NP is concerned that he might not be adhering to his treatment regimen. Which of the following events would suggest that he might not be adherent?
43. Question: Antonia is a 3-year-old child who has a history of status epilepticus. Along with her routine antiseizure medication, she should also have a home prescription for_________ to be used for an episode of status epilepticus.
44. Question: Long-term monitoring of patients who are taking carbamazepine includes:
45. Question: Six-year-old Lucy has recently been started on ethosuximide (Zarontin) for seizures. She should be monitored for:
46. Question: Monitoring of a patient on gabapentin to treat seizures includes:
47. Question: Levetiracetam has known drug interactions with:
48. Question: Samantha is taking lamotrigine (Lamictal) for her seizures and requests a prescription for combined oral contraceptives (COCs), which interact with lamotrigine and may cause:
49. Question: A 66-year-old male was prescribed phenelzine (Nardil) while in an acute psychiatric unit for recalcitrant depression. The NP managing his primary health care needs to understand the following regarding phenelzine and other monoamine oxidase inhibitors (MAOIs):
50. Question: Isosorbidedinitrate is a long-acting nitrate given twice daily. The schedule for administration is 7 a.m. and 2 p.m. because:.
    

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NR 508 Week 4 Mid-term Exam (Retired 2018-19)

1. Question: A primary care NP prescribes levothyroxine for a patient to treat thyroid deficiency. When teaching this patient about the medication, the NP should:
2. Question: An African-American patient is taking captopril (Capoten) 25 mg twice daily. When performing a physical examination, the primary care nurse practitioner (NP) learns that the patient continues to have blood pressure readings of 135/90 mm Hg. The NP should:
3. Question: A primary care NP sees a patient who is about to take a cruise and reports having had motion sickness with nausea on a previous cruise. The NP prescribes the scopolamine transdermal patch and should instruct the patient to apply the patch:
4. Question: A 12-year-old patient who is obese develops type 2 diabetes mellitus. The primary care NP should order
5. Question: A patient who has had four to five liquid stools per day for 4 days is seen by the primary care NP. The patient asks about medications to stop the diarrhea. The NP tells the patient that antidiarrheal medications are:
6. Question: In every state, prescriptive authority for NPs includes the ability to write prescriptions
7. Question: A 55-year-old woman has a history of myocardial infarction (MI). A lipid profile reveals LDL of 130 mg/dL, HDL of 35 mg/dL, and triglycerides 150 mg/dL. The woman is sedentary with a body mass index of 26. The woman asks the primary care NP about using a statin medication. The NP should:
8. Question: A patient develops hypertension. The primary care nurse practitioner (NP) plans to begin diuretic therapy for this patient. The NP notes clear breath sounds, no organomegaly, and no peripheral edema. The patient’s serum electrolytes are normal. The NP should prescribe:
9. Question: The primary care nurse practitioner (NP) is using critical thinking skills when
10. Question: A patient comes to the clinic and asks the primary care NP about using a newly developed formulation of the drug the patient has been taking for a year. When deciding whether or not to prescribe this formulation, the NP should:
11. Question: A patient takes a cardiac medication that has a very narrow therapeutic range. The primary care NP learns that the particular brand the patient is taking is no longer … by the patient’s medical plan. The NP knows that the bioavailability of the drug varies from brand to brand. The NP should:
12. Question: In this case, the NP should advocate for the desired drug because changing the drug can have life-threatening consequences. If this fails, other options may have to … explored.
13. Question: To increase the likelihood of successful pharmacotherapy, when teaching a patient about using a medication, the primary care nurse practitioner (NP) should:
14. Question: A patient in the clinic develops sudden shortness of breath and tachycardia. The primary care NP notes thready pulses, poor peripheral perfusion, and a decreased level of consciousness. The NP activates the emergency medical system and should anticipate that this patient will receive:
15. Question: A primary care nurse practitioner (NP) prescribes a drug to an 80-year-old African-American woman. When selecting a drug and determining the correct dose, the NP should understand that the knowledge of how age, race, and gender may affect drug excretion is based on an understanding of:
16. Question: An 80-year-old female patient with a history of angina has increased TSH and decreased T4. The primary care NP should prescribe _____ mcg of _____.
17. Question: A patient who has a history of chronic constipation uses a bulk laxative to prevent episodes of acute constipation. The patient reports having an increased frequency of episodes. The primary care NP should recommend:
18. Question: A patient comes to the clinic to discuss weight loss. The primary care NP notes a BMI of 32 and performs a health risk assessment that reveals no obesity-related risk factors. The NP should recommend:
19. Question: A primary care NP sees a 3-year-old patient who has been vomiting for several days. The child has had fewer episodes of vomiting the past day and is now able to take sips of fluids without vomiting. The child has dry oral mucous membranes, 2-second capillary refill, and pale but warm skin. The child’s blood pressure is 88/46 mm Hg, the heart rate is 110 beats per minute, and the temperature is 37.2° C. The NP should:
20. Question: A primary care NP sees a 5-year-old child who is morbidly obese. The child has an elevated hemoglobin A1c and increased lipid levels. Both of the child’s parents are overweight but not obese, and they tell the NP that they see nothing wrong with their child. They both state that it is difficult to refuse their child’s requests for soda or ice cream. The NP should:
21. Question: The primary care NP refers a patient to a cardiologist who diagnoses long QT syndrome. The cardiologist has prescribed propranolol (Inderal). The patient exercises regularly and is not obese. The patient asks the NP what else can be done to minimize risk of sudden cardiac arrest. The NP should counsel the patient to:
22. Question: A 55-year-old patient with no prior history of hypertension has a blood pressure greater than 140/90 on three separate occasions. The patient does not smoke, has a body mass index of 24, and exercises regularly. The patient has no known risk factors for cardiovascular disease. The primary care NP should:
23. Question: The primary care NP sees a patient who has a history of hypertension and alcoholism. The patient is not taking any medications. The NP auscultates crackles in both lungs and palpates the liver 2 cm below the costal margin. Laboratory tests show an elevated creatinine level. The NP will refer this patient to a cardiologist and should prescribe:
24. Question: An 80-year-old patient has begun taking propranolol (Inderal) and reports feeling tired all of the time. The primary care NP should:
25. Question: A patient reports having occasional acute constipation with large, hard stools and pain and asks the primary care NP about medication to treat this condition. The NP learns that the patient drinks 1500 mL of water daily; eats fruits, vegetables, and bran; and exercises regularly. The NP should recommend:
26. Question: A 40-year-old patient is in the clinic for a routine physical examination. The patient has a body mass index (BMI) of 26. The patient is active and walks a dog daily. A lipid profile reveals low-density lipoprotein (LDL) of 100 mg/dL, high-density lipoprotein (HDL) of 30 mg/dL, and triglycerides of 250 mg/dL. The primary care nurse practitioner (NP) should:
27. Question: An 80-year-old patient asks a primary care NP about OTC antacids for occasional heartburn. The NP notes that the patient has a normal complete blood count and normal electrolytes and a slight elevation in creatinine levels. The NP should recommend:
28. Question: A primary care NP sees a 60-year-old woman for a physical examination. The woman tells the NP she is taking tamoxifen for treatment of breast cancer. To monitor her response to this medication, the NP should order:
29. Question: The primary care NP sees a patient who has heart failure following an MI 6 months before this visit. The patient has been taking an ACE inhibitor, nitroglycerin, furosemide, and hydrochlorothiazide. The NP auscultates crackles in both lungs and notes pitting edema of both feet. The NP should prescribe:
30. Question: A primary care NP prescribes a COCP for a woman who has never taken oral contraceptives before. The woman is in a monogamous relationship, and she and her partner have been using condoms and wish to stop using them. Her last period was 1 week ago. The NP should:
31. Question: A woman is in her first trimester of pregnancy. She tells the primary care nurse practitioner (NP) that she continues to have severe morning sickness on a daily basis. The NP notes a weight loss of 1 pound from her previous visit 2 weeks prior. The NP should consult an obstetrician and prescribe:
32. Question: A thin 52-year-old woman who has recently had a hysterectomy tells the primary care NP she is having frequent hot flashes and vaginal dryness. A recent bone density study shows early osteopenia. The woman’s mother had CHD. She has no family history of breast cancer. The NP should prescribe:
33. Question: Persistent atrial fibrillation (AF) is diagnosed in a patient who has valvular disease, and the cardiologist has prescribed warfarin (Coumadin). The patient is … for electrical cardioversion in 3 weeks. The patient asks the primary care nurse practitioner (NP) why the procedure is necessary. The NP should tell the patient:
34. Question: A patient reports having episodes of dizziness, nausea, and lightheadedness and describes a sensation of the room spinning when these occur. The primary care NP will refer the patient to a specialist who, after diagnostic testing, is likely to prescribe:
35. Question: The primary care NP is seeing a patient for a hospital follow-up after the patient has had a first myocardial infarction. The patient has a list of the prescribed medications and tells the NP that “no one explained anything about them.” The NP’s initial response should be to:
36. Question: A patient who has hypothyroidism has been taking levothyroxine 50 mcg daily for 2 weeks. The patient reports continued fatigue. The primary care NP should:
37. Question: A patient has been taking levothyroxine 100 mcg daily for several months. The patient comes to the clinic with complaints of insomnia and irritability. The primary care NP notes a heart rate of 92 beats per minute. The NP should:
38. Question: A woman with a family history of breast cancer had her last menstrual period 12 months ago and is experiencing hot flashes. She has not had a hysterectomy. The primary care NP should recommend:
39. Question: A patient who has migraine headaches has begun taking timolol and 2 months after beginning this therapy reports no change in frequency of migraines. The patient’s current dose is 30 mg once daily. The primary care NP should:
40. Question: A patient who takes a thiazide diuretic will begin taking an ACE inhibitor. The primary care NP should counsel the patient to:
41. Question: A parent brings a child who has moderate-persistent asthma to the clinic and tells the primary care NP that none of the child’s medications are working. The parent says, “Everybody tells me something different. I don’t know what to do.” The NP suspects that the parent is not administering the medications appropriately. The NP should initially:
42. Question: A patient has been … with IBS and tells the primary care NP that symptoms of diarrhea and cramping are worsening. The patient asks about possible drug therapy to treat the symptoms. The NP should prescribe:
43. Question: A patient who is taking an ACE inhibitor sees the primary care NP for a follow-up visit. The patient reports having a persistent cough. The NP should:
44. Question: The primary care NP is reviewing evidence-based recommendations about the off-label use of a particular drug. Which recommendation should influence the NP’s decision about prescribing the medication?
45. Question: A 50-year-old woman who is postmenopausal is taking an aromatase inhibitor as part of a breast cancer treatment regimen. She calls her primary care NP to report that she has had hot flashes and increased vaginal discharge but no bleeding. The NP should:
46. Question: Which of the following has influenced an emphasis on primary care education in medical schools?
47. Question: A patient who is newly … with type 2 diabetes mellitus has not … to changes in diet or exercise. The patient is mildly obese and has a fasting blood glucose of 130 mg/dL. The patient has normal renal function tests. The primary care NP plans to prescribe a combination product. Which of the following is … for this patient?
48. Question: A patient who has stable angina is taking nitroglycerin and a β-blocker. The patient tells the primary care NP that the cardiologist is considering adding a calcium channel blocker. The NP should anticipate that the cardiologist will prescribe:
49. Question: An adolescent girl has chosen Depo-Provera as a contraceptive method and tells the primary care NP that she likes the fact that she won’t have to deal with pills or periods. The primary care NP should tell her that she:
50. Question: A patient comes to the clinic reporting dizziness and fatigue associated with nausea and vomiting. The primary care NP suspects anemia and orders a complete blood count. The patient’s hemoglobin is … The NP correctly concludes that the patient is not anemic. The NP has made an error in:
51. Question: A patient who takes digoxin reports taking psyllium (Metamucil) three or four times each month for constipation. The primary care NP should counsel this patient to:
52. Question: A patient bursts into tears when the primary care NP diagnoses diabetes. The NP should:
53. Question: A primary care NP orders thyroid function tests. The patient’s TSH is 1.2 microunits/mL, and T4 is 1.7 ng/mL. The NP should:
54. Question: A patient who is obese is preparing to have surgery. To help prevent venous thromboembolism (VTE), the primary care NP should prescribe:
55. Question: CRNAs in most states:
56. Question: A patient who has GERD with erosive esophagitis has been taking a PPI for 4 weeks and reports a decrease in symptoms. The patient asks the primary care NP if the medication may … discontinued. The NP should tell the patient that:
57. Question: A patient with type 2 diabetes mellitus takes metformin (Glucophage) 1000 mg twice daily and glyburide (Micronase) 12 mg daily. At an annual physical examination, the BMI is 29 and hemoglobin A1c is 7.3%. The NP should:
58. Question: The primary care NP prescribes an inhaled corticosteroid for a patient who has asthma. The third-party payer for this patient denies coverage for the brand that comes in the specific strength the NP prescribes. The NP should:
59. Question: A 30-year-old white woman has a BMI of 26 and weighs 150 lb. At an annual physical examination, the patient’s fasting plasma glucose is 130 mg/dL. The patient walks 1 mile three or four times weekly. She has had two children who weighed 7 lb and 8 lb at birth. Her personal and family histories are noncontributory. The primary care NP should:
60. Question: A primary care NP is preparing to prescribe a drug and notes that the drug has nonlinear kinetics. The NP should: