NU 578 Unit 4 Exam ( Update) University of South
Alabama, Questions & Answers (Verified Answers) | Complete
A+ Guide
Question 1
A patient is prescribed a uricosuric agent for the treatment of gout. Which of the following medications
works by increasing uric acid excretion?
- A) Allopurinol (Zyloprim)
- B) Colchicine (Colbenemid)
- C) Probenecid (Benemid)
- D) Methylprednisolone
Correct Answer: C) Probenecid (Benemid)
Explanation: Probenecid is a uricosuric agent that works by inhibiting the renal tubular reabsorption of
urates, thereby increasing uric acid excretion. Allopurinol is a xanthine oxidase inhibitor that decreases
uric acid production. Colchicine is used for acute gout flares and works by reducing inflammation.
Methylprednisolone is a corticosteroid used for severe inflammatory flares .
Question 2
A patient is being started on Adalimumab (Humira) for rheumatoid arthritis. Which of the following are
important cautions or contraindications? (Select all that apply)
- A) Heart failure
- B) Use of oral contraceptives
- C) Lymphoma history
- D) Multiple sclerosis
,Correct Answer: A) Heart failure, C) Lymphoma history, D) Multiple sclerosis
Explanation: Adalimumab, a TNF-alpha inhibitor, carries black box warnings for serious infections and
malignancies (including lymphoma). It is contraindicated in patients with moderate to severe heart
failure (NYHA class III/IV) and should be used cautiously in those with demyelinating diseases like
multiple sclerosis. Oral contraceptives do not have a significant interaction .
Question 3
Raloxifene (Evista) is prescribed for a patient with postmenopausal osteoporosis. This medication is
contraindicated in which condition?
- A) Short-bowel syndrome
- B) Breast cancer
- C) A history of venous thromboembolic events (DVT/PE)
- D) Hypertension
Correct Answer: C) A history of venous thromboembolic events (DVT/PE)
Explanation: Raloxifene is a selective estrogen receptor modulator (SERM) that carries a black box
warning for an increased risk of venous thromboembolism (DVT, PE, and retinal vein thrombosis). It is
contraindicated in patients with a history of these events. It is actually used for breast cancer risk
reduction in certain populations, not contraindicated .
Question 4
A patient is prescribed Indomethacin (Indocin) for acute gouty arthritis. The advanced practice nurse
(APN) should counsel the patient to monitor for which common side effect?
- A) Elevated liver enzymes
- B) Renal insufficiency
- C) GI bleeds and abdominal distress
,- D) Prolonged prothrombin time
Correct Answer: C) GI bleeds and abdominal distress
Explanation: Indomethacin is a nonselective NSAID. Common adverse effects include gastrointestinal
distress, ulceration, and bleeding due to COX-1 inhibition reducing protective gastric prostaglandins.
While NSAIDs can affect renal function and liver enzymes, GI bleeding is the most directly associated and
common concern among the options .
Question 5
A patient requests medication for arthritic pain but reports a severe allergy to sulfa antibiotics. Which of
the following medications is contraindicated due to cross-sensitivity?
- A) Celecoxib (Celebrex)
- B) Prednisone
- C) Acetaminophen (Tylenol)
- D) Methotrexate (Trexall)
Correct Answer: A) Celecoxib (Celebrex)
Explanation: Celecoxib is a COX-2 selective NSAID that contains a sulfonamide moiety. It is
contraindicated in patients with known sulfa allergies due to the risk of cross-sensitivity reactions (rash,
anaphylaxis). Prednisone, acetaminophen, and methotrexate do not share this chemical structure .
Question 6
A patient taking Alendronate (Fosamax) for Paget’s disease should be monitored for which adverse
effect?
- A) Cardiac irregularities
, - B) Esophagitis, heartburn, and difficulty swallowing
- C) Elevated creatinine only
- D) Hypocalcemia
Correct Answer: B) Esophagitis, heartburn, and difficulty swallowing
Explanation: Alendronate is a bisphosphonate that is notorious for causing upper GI irritation.
Esophagitis, esophageal ulcers, and dysphagia are significant risks, especially if the medication is not
taken with a full glass of water and the patient does not remain upright for 30-60 minutes after dosing .
Question 7
The APN prescribes Metformin (Glucophage) for a patient with type 2 diabetes. The nurse will remind
the patient that this medication can cause which specific adverse effect that requires monitoring?
- A) Hypoglycemia when used alone
- B) Weight gain
- C) Lactic acidosis (rare but serious)
- D) Pancreatitis
Correct Answer: C) Lactic acidosis (rare but serious)
Explanation: Metformin has a black box warning for lactic acidosis, a rare but fatal complication. It is
most common in patients with renal impairment, hepatic disease, or hypoxic states. Unlike sulfonylureas,
Metformin does not typically cause hypoglycemia when used as monotherapy .
Question 8
A patient on Cyclosporine (Neoral) for rheumatoid arthritis is started on a new antibiotic. Which of the
following antibiotics is known to inhibit CYP450 enzymes and may lead to toxic Cyclosporine levels?
Alabama, Questions & Answers (Verified Answers) | Complete
A+ Guide
Question 1
A patient is prescribed a uricosuric agent for the treatment of gout. Which of the following medications
works by increasing uric acid excretion?
- A) Allopurinol (Zyloprim)
- B) Colchicine (Colbenemid)
- C) Probenecid (Benemid)
- D) Methylprednisolone
Correct Answer: C) Probenecid (Benemid)
Explanation: Probenecid is a uricosuric agent that works by inhibiting the renal tubular reabsorption of
urates, thereby increasing uric acid excretion. Allopurinol is a xanthine oxidase inhibitor that decreases
uric acid production. Colchicine is used for acute gout flares and works by reducing inflammation.
Methylprednisolone is a corticosteroid used for severe inflammatory flares .
Question 2
A patient is being started on Adalimumab (Humira) for rheumatoid arthritis. Which of the following are
important cautions or contraindications? (Select all that apply)
- A) Heart failure
- B) Use of oral contraceptives
- C) Lymphoma history
- D) Multiple sclerosis
,Correct Answer: A) Heart failure, C) Lymphoma history, D) Multiple sclerosis
Explanation: Adalimumab, a TNF-alpha inhibitor, carries black box warnings for serious infections and
malignancies (including lymphoma). It is contraindicated in patients with moderate to severe heart
failure (NYHA class III/IV) and should be used cautiously in those with demyelinating diseases like
multiple sclerosis. Oral contraceptives do not have a significant interaction .
Question 3
Raloxifene (Evista) is prescribed for a patient with postmenopausal osteoporosis. This medication is
contraindicated in which condition?
- A) Short-bowel syndrome
- B) Breast cancer
- C) A history of venous thromboembolic events (DVT/PE)
- D) Hypertension
Correct Answer: C) A history of venous thromboembolic events (DVT/PE)
Explanation: Raloxifene is a selective estrogen receptor modulator (SERM) that carries a black box
warning for an increased risk of venous thromboembolism (DVT, PE, and retinal vein thrombosis). It is
contraindicated in patients with a history of these events. It is actually used for breast cancer risk
reduction in certain populations, not contraindicated .
Question 4
A patient is prescribed Indomethacin (Indocin) for acute gouty arthritis. The advanced practice nurse
(APN) should counsel the patient to monitor for which common side effect?
- A) Elevated liver enzymes
- B) Renal insufficiency
- C) GI bleeds and abdominal distress
,- D) Prolonged prothrombin time
Correct Answer: C) GI bleeds and abdominal distress
Explanation: Indomethacin is a nonselective NSAID. Common adverse effects include gastrointestinal
distress, ulceration, and bleeding due to COX-1 inhibition reducing protective gastric prostaglandins.
While NSAIDs can affect renal function and liver enzymes, GI bleeding is the most directly associated and
common concern among the options .
Question 5
A patient requests medication for arthritic pain but reports a severe allergy to sulfa antibiotics. Which of
the following medications is contraindicated due to cross-sensitivity?
- A) Celecoxib (Celebrex)
- B) Prednisone
- C) Acetaminophen (Tylenol)
- D) Methotrexate (Trexall)
Correct Answer: A) Celecoxib (Celebrex)
Explanation: Celecoxib is a COX-2 selective NSAID that contains a sulfonamide moiety. It is
contraindicated in patients with known sulfa allergies due to the risk of cross-sensitivity reactions (rash,
anaphylaxis). Prednisone, acetaminophen, and methotrexate do not share this chemical structure .
Question 6
A patient taking Alendronate (Fosamax) for Paget’s disease should be monitored for which adverse
effect?
- A) Cardiac irregularities
, - B) Esophagitis, heartburn, and difficulty swallowing
- C) Elevated creatinine only
- D) Hypocalcemia
Correct Answer: B) Esophagitis, heartburn, and difficulty swallowing
Explanation: Alendronate is a bisphosphonate that is notorious for causing upper GI irritation.
Esophagitis, esophageal ulcers, and dysphagia are significant risks, especially if the medication is not
taken with a full glass of water and the patient does not remain upright for 30-60 minutes after dosing .
Question 7
The APN prescribes Metformin (Glucophage) for a patient with type 2 diabetes. The nurse will remind
the patient that this medication can cause which specific adverse effect that requires monitoring?
- A) Hypoglycemia when used alone
- B) Weight gain
- C) Lactic acidosis (rare but serious)
- D) Pancreatitis
Correct Answer: C) Lactic acidosis (rare but serious)
Explanation: Metformin has a black box warning for lactic acidosis, a rare but fatal complication. It is
most common in patients with renal impairment, hepatic disease, or hypoxic states. Unlike sulfonylureas,
Metformin does not typically cause hypoglycemia when used as monotherapy .
Question 8
A patient on Cyclosporine (Neoral) for rheumatoid arthritis is started on a new antibiotic. Which of the
following antibiotics is known to inhibit CYP450 enzymes and may lead to toxic Cyclosporine levels?
