NR 508 Week 7 Review Questions with Answers

(NR 508 Week 7 Review Questions)

Pharmacotherapeutics For Advanced Practice Nurse Prescribers: 4th Edition

Chapter 17. Drugs Affecting the Respiratory System

1. Digoxin levels need to … monitored closely when the following medication is started:
2. Patients with pheochromocytoma should avoid which of the following classes of drugs because of the possibility of developing hypertensive crisis?
3. Harold, a 42-year-old African American, has moderate persistent asthma. Which of the following asthma medications should … used cautiously, if at all?
4. Long-acting beta-agonists (LTBAs) received a Black Box Warning from the U.S. Food and Drug Administration due to the:
5. The bronchodilator of choice for patients taking propranolol is:
6. James is a 52-year-old overweight smoker taking theophylline for his persistent asthma. He tells his provider he is going to start the Atkin’s diet for weight loss. The appropriate response would … :
7. Li takes theophylline for his persistent asthma and calls the office with a complaint of nausea, vomiting, and headache. The best advice for him would … to:
8. Tiotropium bromide (Spiriva) is an inhaled anticholinergic:
9. Christy has exercise-induced and mild persistent asthma and is prescribed two puffs of albuterol 15 minutes before exercise and as needed for wheezing. One puff per day of beclomethasone (QVAR) is also prescribed. Teaching regarding her inhalers includes:
10. When prescribing montelukast (Singulair) for asthma, patients or parents of patients should … instructed:
11. Montelukast (Singulair) may … prescribed for:
12. The known drug interactions with the inhaled corticosteroid beclomethasone (QVAR) include:
13. When educating patients who are starting on inhaled corticosteroids, the provider should tell them that:
14. Patients with allergic rhinitis may benefit from a prescription of:
15. 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:
16. First-generation antihistamines such as loratadine (Claritin) are prescribed for seasonal allergies because they are:
17. When recommending dimenhydrinate (Dramamine) to treat motion sickness, patients should … instructed to:
18. Decongestants such as pseudoephedrine (Sudafed):
19. Cough and cold medications that contain a sympathomimetic decongestant such as phenylephrine should … used cautiously in what population:
20. Martin is a 60-year-old patient with hypertension. The first-line decongestant to prescribe would … :
21. The first-line treatment for cough related to an upper respiratory tract infection (URI) in a 5-year-old child is:
    

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Chapter 18. Drugs Affecting the Hematopoietic System

1. Kenneth is taking warfarin and is asking about what he can take for minor aches and pains. The best recommendation is:
2. Juanita had a deep vein thrombosis (DVT) and was on heparin in the hospital and was discharged on warfarin. She asks her primary care provider NP why she was getting both medications while in the hospital. The best response is to:
3. The safest drug to use to treat pregnant women who require anticoagulant therapy is:
4. The average starting dose of warfarin is 5 mg daily. Higher doses of 7.5 mg daily should … considered in which patients?
5. Cecil and his wife are traveling to Southeast Asia on vacation and he has come into the clinic to review his medications. He is healthy with only mild hypertension that is well controlled. He asks about getting “a shot” to prevent blood clots like his friend Ralph did before international travel. The correct respond would … :
6. Robert, age 51 years, has been told by his primary care provider (PCP) to take an aspirin a day. Why would this … recommended?
7. 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 … evaluated?
8. Patient education when prescribing clopidogrel includes:
9. For patients taking warfarin, INRs are best drawn:
10. Patients receiving heparin therapy require monitoring of:
11. The routine monitoring recommended for low molecular weight heparin is:
12. When writing a prescription for warfarin it is common to write _ on the prescription.
13. Education of patients who are taking warfarin includes discussing their diet. Instructions include:
14. Patients who are being treated with epoetin alfa need to … monitored for the development of:
15. The FDA issued a safety announcement regarding the use of erythropoiesis-stimulating agents (ESAs) in 2010 with the recommendation that:
16. When patients are started on darbepoetin alfa (Aranesp) they need monitoring of their blood counts to determine a dosage adjustment in:
17. Jim is having a hip replacement surgery and would like to self-donate blood for the surgery. In addition to being prescribed epogen alpha he should also … prescribed:
18. Monitoring for a patient being prescribed iron for iron deficiency anemia includes:
19. Patient education regarding taking iron replacements includes:
20. Patients with pernicious anemia require treatment with:
21. The first laboratory value indication that vitamin B12 therapy is adequately treating pernicious anemia is:
22. Patients who are beginning therapy with vitamin B12 need to … monitored for: 
    

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Chapter 20. Drugs Affecting the Gastrointestinal System

1. Many patients self-medicate with antacids. Which patients should … counseled to not take calcium carbonate antacids without discussing it with their provider or a pharmacist first?
2. Patients taking antacids should … educated regarding these drugs, including letting them know that:
3. Kelly has diarrhea and is wondering if she can take loperamide (Imodium) for the diarrhea. Loperamide:
4. Bismuth subsalicylate (Pepto Bismol) is a common OTC remedy for gastrointestinal complaints. Bismuth subsalicylate:
5. Hannah will … traveling to Mexico with her church group over spring break to build houses. She is concerned she may develop traveler’s diarrhea. Advice includes following normal food and water precautions as well as taking:
6. Josie is a 5-year-old patient who presents to the clinic with a 48-hour history of nausea, vomiting, and some diarrhea. She is unable to keep fluids down and her weight is 4 pounds less than her last recorded weight. Besides IV fluids, her exam warrants the use of an antinausea medication. Which of the following would … the appropriate drug to order for Josie?
7. Jim presents with complaints of “heartburn” that is minimally relieved with Tums (calcium carbonate) and is diagnosed with gastroesophageal reflux disease (GERD). An appropriate first-step therapy would … :
8. Patients who are on chronic long-term proton pump inhibitor therapy require monitoring for:
9. Sadie is a 72-year-old patient who takes omeprazole for her chronic GERD. Chronic long-term omeprazole use places her at increased risk for:
10. Patrick 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 … :
11. Methylnaltrexone is used to treat constipation in:
12. An elderly person has been prescribed lactulose for treatment of chronic constipation. Monitoring with long-term treatment would include: 
    

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Chapter 21. Drugs Affecting the Endocrine System

1. Both men and women experience bone loss with aging. The bones most likely to demonstrate significant loss are:
2. Bisphosphonates treat or prevent osteoporosis by:
3. Prophylactic use of bisphosphonates is recommended for patients with early osteopenia related to long-term use of which of the following drugs?
4. Patients with cystic fibrosis are often prescribed enzyme replacement for pancreatic secretions. Each replacement drug has lipase, protease, and amylase components, but the drug is prescribed in units of:
5. Brands of pancreatic enzyme replacement drugs are:
6. When given subcutaneously, how long until neutral protamine Hagedorn insulin begins to take effect (onset of action) after administration?
7. Hypoglycemia can result from the action of either insulin or an oral hypoglycemic. Signs and symptoms of hypoglycemia include:
8. Nonselective beta blockers and alcohol create serious drug interactions with insulin because they:
9. Lispro is an insulin analogue produced by recombinant DNA technology. Which of the following statements about this form of insulin is NOT true?
10. The decision may … made to switch from twice daily neutral protamine Hagedorn (NPH) insulin to insulin glargine to improve glycemia control throughout the day. If this is … :
11. When blood glucose levels are difficult to control in type 2 diabetes some form of insulin may … added to the treatment regimen to control blood glucose and limit complication risks. Which of the … statements is accurate based on research?
12. Metformin is a primary choice of drug to treat hyperglycemia in type 2 diabetes because it:
13. Prior to prescribing metformin, the provider should:
14. The action of “gliptins” is different from other antidiabetic agents because they:
15. Sitagliptin has been … for:
16. GLP-1 agonists:
17. Avoid concurrent administration of exenatide with which of the following drugs?
18. Administration of exenatide is by subcutaneous injection:
19. Potentially fatal granulocytopenia has been … with treatment of hyperthyroidism with propylthiouracil. Patients should … taught to report:
20. Elderly patients who are … on levothyroxine for thyroid replacement should … for:
21. Which of the … is not an indication that growth hormone supplements should … discontinued?
22. Besides osteoporosis, IV bisphosphonates are also … for:
23. What is the role of calcium supplements when patients take bisphosphonates?
24. Which of the following statements about pancreatic enzymes is true?
25. Besides cystic fibrosis, which other medical state may trigger the need for pancreatic enzymes? 
    

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Chapter 22. Drugs Affecting the Reproductive System

Multiple Choice

Identify the choice that best completes the statement or answers the question.

1. Men who use transdermal testosterone gel (AndroGel) should … advised to avoid:
2. Education when prescribing androgens to male patients includes advising that:
3. Patients who are … exogenous androgens need to … warned that decreased libido:
4. The U.S. Food and Drug Administration warns that androgens may cause:
5. Monitoring for a patient who is using androgens includes evaluation of:
6. Male patients require __ before and during androgen therapy.
7. Absolute contraindications to estrogen therapy include:
8. Postmenopausal women with an intact uterus should not … prescribed:
9. Women who have migraines with an aura should not … prescribed estrogen because of:
10. A 22-year-old woman receives a prescription for oral contraceptives. Education for this patient includes:
11. A 19-year-old female is a nasal Staph aureus carrier and is placed on 5 days of rifampin for treatment. Her only other medication is … oral contraceptives. What education should she receive regarding her medications?
12. A 56-year-old woman is complaining of vaginal dryness and dyspareunia. To treat her symptoms with the lowest adverse effects she should … prescribed:
13. Shana is receiving her first medroxyprogesterone (Depo Provera) injection. Shana will need to … monitored for:
14. When prescribing medroxyprogesterone (Depo Provera) injections, essential education would include advising of the following potential adverse drug effects:
15. The medroxyprogesterone (Depo Provera) injection has a Black Box Warning due to:
16. Shana received her first medroxyprogesterone (Depo Provera) injection 6 weeks ago and calls the clinic with a concern that she has been having a light “period” off and on since receiving her Depo shot. What would … the management of Shana?
17. William is a 62-year-old male who is requesting a prescription for sildenafil (Viagra). He should … screened for before prescribing sildenafil.
18. Men who are … sildenafil (Viagra) need ongoing monitoring for:
19. Men who are … an erectile dysfunction drug such as sildenafil (Viagra) should … warned about the risk for:
20. Androgens are … for:
21. Long-term use of androgens requires specific laboratory monitoring of:
22. Effects of estrogen include:
23. Absolute contraindications that clinicians must consider when initiating estrogen therapy include:
24. Patients taking hormonal contraceptives and hormone replacement therapy need to take the drug daily at the same time to prevent: 
    

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Chapter 23. Drugs Affecting the Integumentary System

1. Erik presents with one golden-crusted lesion at the site of an insect bite consistent with impetigo. His parents have limited finances and request the least expensive-treatment. Which medication would … the best choice for treatment?
2. Juakeem is a nasal methicillin resistant staphylococcus aureus (MRSA) carrier. Treatment to eradicate nasal MRSA is mupirocin. Patient education regarding treating nasal MRSA includes:
3. Instructions for applying a topical antibiotic or antiviral ointment include:
4. When Sam used clotrimazole (Lotrimin AF) for athlete’s foot he developed a red, itchy rash consistent with a hypersensitivity reaction. He now has athlete’s foot again. What would … a good choice of antifungal for Sam?
5. When prescribing griseofulvin (Grifulvin V) to treat tinea capitis it is critical to instruct the patient or parent to:
6. First-line therapy for treating topical fungal infections such as tinea corporis (ringworm) or tinea pedis (athlete’s foot) would … :
7. When prescribing topical penciclovir (Denavir) for the treatment of herpes labialis (cold sores) patient education would include:
8. Erika has been … isotretinoin (Accutane) by her dermatologist and is presenting to her primary care provider with symptoms of sadness and depression. A Beck’s Depression Scale indicates she has mild to moderate depression. What would … the best care for her at this point?
9. Drew is a 17-year-old competitive runner who presents with complaint of pain in his hip that occurred after he fell while running. His only medical problem is severe acne for which he takes isotretinoin (Accutane). With this history what would you … concerned for?
10. Catherine calls the clinic with concerns that her acne is worse 1 week after starting topical tretinoin. What would … the appropriate care for her?
11. Li is a 6-month-old infant with severe eczema. She would benefit from topical corticosteroid therapy. Instructions for using topical corticosteroids in children include:
12. Jose has had eczema for many years and reports that he thinks his corticosteroid cream is not working as well as it was previously. He may … experiencing tolerance to the corticosteroid. Treatment options include:
13. When prescribing tacrolimus (Protopic) to treat atopic dermatitis patients should … informed that:
14. Patients who are … with greater than 100 grams per week of topical calcipotriene for psoriasis need to .. monitored for:
15. Jesse is … tazarotene for his psoriasis. Patient education regarding topical tazarotene includes instructing them:
16. Instructions for the use of selenium sulfide shampoo (Selsun) to treat scalp seborrhea include:
17. Topical diphenhydramine (Benadryl) is available OTC to treat itching. Patients or parents should … instructed regarding the use of topical diphenhydramine that:
18. A patient has been … silver sulfadiazine (Silvadene) cream to treat burns on his leg. Normal adverse effects of silver sulfadiazine cream include:
19. Instructions for the use of malathion (Ovide) for head lice include:
20. When writing a prescription of permethrin 5% cream (Elimite) for scabies, patient education would include:
    

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Chapter 24. Drugs Used in Treating Infectious Diseases

1. Factors that place a patient at risk of developing an antimicrobial-resistant organism include:
2. Infants and young children are at higher risk of developing antibiotic-resistant infections due to:
3. Providers should use an antibiogram when prescribing. An antibiogram is:
4. There is often cross-sensitivity and cross-resistance between penicillins and cephalosporins because:
5. Jonathan has been … with strep throat and needs a prescription for an antibiotic. He says the last time he had penicillin he developed a red, blotchy rash. An appropriate antibiotic to prescribe would … :
6. Sarah is a 25-year-old female who is 8 weeks pregnant and has a urinary tract infection. What would … the appropriate antibiotic to prescribe for her?
7. Pong-tai is a 12-month-old child who is being … with amoxicillin for acute otitis media. His parents call the clinic and say he has developed diarrhea. The appropriate action would … to:
8. Lauren is a 13-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 … :
9. 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:
10. To prevent further development of antibacterial resistance it is … that fluoroquinolones … reserved for treatment of:
11. Fluoroquinolones have a Black Box Warning regarding even months after treatment.
12. Janet was recently … with clindamycin for an infection. She calls the advice nurse because she is having frequent diarrhea that she thinks may have blood in it. What would … the appropriate care for her?
13. Keng has chronic hepatitis that has led to mildly impaired liver function. He has an infection that would … best treated by a macrolide. Which would … the best choice for a patient with liver dysfunction?
14. Jamie has glucose-6-phosphate dehydrogenase deficiency (G6PD) and requires an antibiotic. Which class of antibiotics should … avoided in this patient?
15. If a patient is allergic to sulfonamide antibiotics, he or she will most likely have cross-sensitivity to:
16. Tetracyclines such as minocycline are safe to use in:
17. Tetracyclines should not … prescribed to children younger than 8 years due to:
18. Nicole is a 16-year-old female who is taking minocycline for acne. She comes to the clinic complaining of a headache. What would … the plan of care?
19. Patricia has been … doxycycline for a chlamydia infection. She is healthy and her only medication is an oral … contraceptive. Patricia’s education would include:
20. To prevent the development of peripheral neuropathy in patients taking isoniazid for tuberculosis the patient is also … :
21. Sadie is an 82-year-old patient who has herpes zoster (shingles) and would benefit from an antiviral such as valacyclovir. Prior to prescribing valacyclovir she will need an assessment of:
22. When prescribing acyclovir, patients should … educated regarding the:
23. Nicholas has been … with type A influenza. Appropriate prescribing of oseltamivir (Tamiflu) would include:
24. Monitoring for patients who are on long-term antifungal therapy with ketoconazole includes:
25. When prescribing metronidazole (Flagyl) to treat bacterial vaginosis, patient education would include:
26. Every antibiotic drug class has resistant organisms that influence prescribing decisions.