Advanced Pharm: Final Exam
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 combined oral contraceptives. What education should
she receive regarding her medications?
1. Separate the oral ingestion of the rifampin and oral contraceptive by at least an hour.
2. Both medications are best tolerated if taken on an empty stomach.
3. She should use a back-up method of birth control such as condoms for the rest of the current
pill pack.
4. If she gets nauseated with the medications she should call the office for an antiemetic
prescription. - ANS-3. She should use a back-up method of birth control such as condoms for
the rest of the current pill pack.
A 19-year-old male was started on risperidone. Monitoring for risperidone include observing for
common side effects, including:
1. Bradykinesia (slow mvmt), akathisia (restlessness), and agitation
2. Excessive weight gain
3. Hypertension
4. Potentially fatal agranulocytosis - ANS-1. Bradykinesia (slow mvmt), akathisia (restlessness),
and agitation
A 22-year-old woman receives a prescription for oral contraceptives. Education for this patient
includes:
1. Counseling regarding decreasing or not smoking while taking oral contraceptives
2. Advising a monthly pregnancy test for the first 3 months she is taking the contraceptive
3. Advising that she may miss two pills in a row and not be concerned about pregnancy
4. Recommending that her next follow-up visit is in 1 year for a refill and annual exam - ANS-1.
Counseling regarding decreasing or not smoking while taking oral contraceptives
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):
1. He should not be prescribed any serotonergic drug such as sumatriptan (Imitrex)
2. MAOIs interact with many common foods, including yogurt, sour cream, and soysauce
3. Symptoms of hypertensive crisis (headache, tachycardia, sweating) require immediate
treatment
4. All of the above - ANS-4. All of the above
A challenge faced with antiretroviral therapy (ART) is - ANS--Drug-resistant mutations of HIV
A contraindication to the use of combined contraceptives is:
A. Adolescence (not approved for this age)
,B. A history of clotting disorder
C. Recent pregnancy
D. Overweight - ANS-B. A history of clotting disorder
A patient presents with a complaint of dark stools and epigastric pain described as gnawing and
burning. Which of the medications is the most likely cause?
1. Acetaminophen
2. Estradiol
3. Donepezil
4. Bethanechol - ANS-4. Bethanechol
A patient with anxiety and depression may respond to:
1. Duloxetine (Cymbalta)
2. Fluoxetine (Prozac)
3. Oxazepam (Serax)
4. Buspirone (Buspar) and an SSRI combined - ANS-4. Buspirone (Buspar) and an SSRI
combined
A test of cure is recommended after treating chlamydia in which patient population? -
ANS-Pregnant patients
A treatment plan for management of chronic pain should include:
1. Negotiation with the patient to set personal goals for pain management
2. Discussion of ways to improve sleep and stress
3. An exercise program to improve function and fitness
4. All of the above - ANS-4. All of the above
A woman who is pregnant and has hyperthyroidism is best managed by a specialty team who
will most likely treat her with:
1. Methimazole
2. Propylthiouracil (PTU)
3. Radioactive iodine
4. Nothing, treatment is best delayed until after her pregnancy ends - ANS-2. Propylthiouracil
(PTU)
A woman who is pregnant tells the nurse she has not had any vaccines but wants to begin so
she can protect her unborn child. Which vaccine(s) may be administered to this patient?
a. Gardasil vaccine
b. Trivalent influenza vaccine
c. MMR vaccine
d. Varivax vaccine - ANS-b. Trivalent influenza vaccine
,-The influenza vaccine is recommended for pregnant women and should be given. Gardasil is
given to young women who are not yet sexually active. The MMR is contraindicated because
rubella can cause serious teratogenic effects. Varivax is contraindicated during pregnancy.
Abrupt withdrawal of beta blockers can be life threatening. Patients at highest risk for serious
consequences of rapid withdrawal are those with:
1. Angina
2. Coronary artery disease
3. Both 1 and 2
4. Neither 1 nor 2 - ANS-3. Both 1 and 2
Absolute contraindications to estrogen therapy include:
1. History of any type of cancer
2. Clotting disorders
3. History of tension headaches
4. Orthostatic hypotension - ANS-2. Clotting disorders
Activation of central alpha2 receptors results in inhibition of cardio acceleration and
______________ centers in the brain.
1. Vasodilation
2. Vasoconstriction
3. Cardiovascular
4. Respiratory - ANS-2. Vasoconstriction
Adam has type 1 diabetes and plays tennis for his university. He exhibits a knowledge deficit
about his insulin and his diagnosis. He should be taught that:
1. He should increase his carbohydrate intake during times of exercise.
2. Each brand of insulin is equal in bioavailability, so buy the least expensive.
3. Alcohol produces hypoglycemia and can help control his diabetes when taken in small
amounts.
4. If he does not want to learn to give himself injections, he may substitute an oral hypoglycemic
to control his diabetes. - ANS-1. He should increase his carbohydrate intake during times of
exercise.
Adherence is improved when a drug can be given once daily. Which of the following drugs can
be given once daily?
1. Tacrine
2. Donepezil
3. Memantine
4. Pyridostigmine - ANS-2. Donepezil
Adherence to beta blocker therapy may be affected by their:
1. Short half-lives requiring twice daily dosing
2. Tendency to elevate lipid levels
, 3. Effects on the male genitalia, which may produce impotence
4. None of the above - ANS-3. Effects on the male genitalia, which may produce impotence
Administration of exenatide is by subcutaneous injection:
1. 30 minutes prior to the morning meal
2. 60 minutes prior to the morning and evening meal
3. 15 minutes after the evening meal
4. 60 minutes before each meal daily - ANS-2. 60 minutes prior to the morning and evening
meal
After starting a patient with Grave's disease on an antithyroid agent such as methimazole,
patient monitoring includes TSH and free T4 every:
1. 1 to 2 weeks
2. 3 to 4 weeks
3. 2 to 3 months
4. 6 to 9 months - ANS-2. 3 to 4 weeks
Age is a factor in different responses to pain. Which of the following age-related statements
about pain is NOT true?
A. Preterm and newborn infants do not yet have functional pain pathways.
B. Painful experiences and prolonged exposure to analgesic drugs during pregnancy may
permanently alter neuronal organization in the child.
C. Increases in pain threshold in older adults may be related to peripheral neuropathies and
changes in skin thickness.
D. Decreases in pain tolerance are evident in older adults. - ANS-A. Preterm and newborn
infants do not yet have functional pain pathways.
All diabetic patients with hyperlipidemia should be treated with:
1. HMG-CoA reductase inhibitors
2. Fibric acid derivatives
3. Nicotinic acid
4. Colestipol - ANS-1. HMG-CoA reductase inhibitors
All diabetic patients with known cardiovascular disease should be treated with:
1. Beta blockers to prevent MIs
2. Angiotensin-converting enzyme inhibitors and aspirin to reduce risk of cardiovascular events
3. Sulfonylureas to decrease cardiovascular mortality
4. Pioglitazone to decrease atherosclerotic plaque buildup - ANS-2. Angiotensin-converting
enzyme inhibitors and aspirin to reduce risk of cardiovascular events
All nonsteroidal anti-inflammatory drugs (NSAIDS) have an FDA Black BoxWarning regarding:
1. Potential for causing life-threatening GI bleeds
2. Increased risk of developing systemic arthritis with prolonged use
3. Risk of life-threatening rashes, including Stevens-Johnson
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 combined oral contraceptives. What education should
she receive regarding her medications?
1. Separate the oral ingestion of the rifampin and oral contraceptive by at least an hour.
2. Both medications are best tolerated if taken on an empty stomach.
3. She should use a back-up method of birth control such as condoms for the rest of the current
pill pack.
4. If she gets nauseated with the medications she should call the office for an antiemetic
prescription. - ANS-3. She should use a back-up method of birth control such as condoms for
the rest of the current pill pack.
A 19-year-old male was started on risperidone. Monitoring for risperidone include observing for
common side effects, including:
1. Bradykinesia (slow mvmt), akathisia (restlessness), and agitation
2. Excessive weight gain
3. Hypertension
4. Potentially fatal agranulocytosis - ANS-1. Bradykinesia (slow mvmt), akathisia (restlessness),
and agitation
A 22-year-old woman receives a prescription for oral contraceptives. Education for this patient
includes:
1. Counseling regarding decreasing or not smoking while taking oral contraceptives
2. Advising a monthly pregnancy test for the first 3 months she is taking the contraceptive
3. Advising that she may miss two pills in a row and not be concerned about pregnancy
4. Recommending that her next follow-up visit is in 1 year for a refill and annual exam - ANS-1.
Counseling regarding decreasing or not smoking while taking oral contraceptives
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):
1. He should not be prescribed any serotonergic drug such as sumatriptan (Imitrex)
2. MAOIs interact with many common foods, including yogurt, sour cream, and soysauce
3. Symptoms of hypertensive crisis (headache, tachycardia, sweating) require immediate
treatment
4. All of the above - ANS-4. All of the above
A challenge faced with antiretroviral therapy (ART) is - ANS--Drug-resistant mutations of HIV
A contraindication to the use of combined contraceptives is:
A. Adolescence (not approved for this age)
,B. A history of clotting disorder
C. Recent pregnancy
D. Overweight - ANS-B. A history of clotting disorder
A patient presents with a complaint of dark stools and epigastric pain described as gnawing and
burning. Which of the medications is the most likely cause?
1. Acetaminophen
2. Estradiol
3. Donepezil
4. Bethanechol - ANS-4. Bethanechol
A patient with anxiety and depression may respond to:
1. Duloxetine (Cymbalta)
2. Fluoxetine (Prozac)
3. Oxazepam (Serax)
4. Buspirone (Buspar) and an SSRI combined - ANS-4. Buspirone (Buspar) and an SSRI
combined
A test of cure is recommended after treating chlamydia in which patient population? -
ANS-Pregnant patients
A treatment plan for management of chronic pain should include:
1. Negotiation with the patient to set personal goals for pain management
2. Discussion of ways to improve sleep and stress
3. An exercise program to improve function and fitness
4. All of the above - ANS-4. All of the above
A woman who is pregnant and has hyperthyroidism is best managed by a specialty team who
will most likely treat her with:
1. Methimazole
2. Propylthiouracil (PTU)
3. Radioactive iodine
4. Nothing, treatment is best delayed until after her pregnancy ends - ANS-2. Propylthiouracil
(PTU)
A woman who is pregnant tells the nurse she has not had any vaccines but wants to begin so
she can protect her unborn child. Which vaccine(s) may be administered to this patient?
a. Gardasil vaccine
b. Trivalent influenza vaccine
c. MMR vaccine
d. Varivax vaccine - ANS-b. Trivalent influenza vaccine
,-The influenza vaccine is recommended for pregnant women and should be given. Gardasil is
given to young women who are not yet sexually active. The MMR is contraindicated because
rubella can cause serious teratogenic effects. Varivax is contraindicated during pregnancy.
Abrupt withdrawal of beta blockers can be life threatening. Patients at highest risk for serious
consequences of rapid withdrawal are those with:
1. Angina
2. Coronary artery disease
3. Both 1 and 2
4. Neither 1 nor 2 - ANS-3. Both 1 and 2
Absolute contraindications to estrogen therapy include:
1. History of any type of cancer
2. Clotting disorders
3. History of tension headaches
4. Orthostatic hypotension - ANS-2. Clotting disorders
Activation of central alpha2 receptors results in inhibition of cardio acceleration and
______________ centers in the brain.
1. Vasodilation
2. Vasoconstriction
3. Cardiovascular
4. Respiratory - ANS-2. Vasoconstriction
Adam has type 1 diabetes and plays tennis for his university. He exhibits a knowledge deficit
about his insulin and his diagnosis. He should be taught that:
1. He should increase his carbohydrate intake during times of exercise.
2. Each brand of insulin is equal in bioavailability, so buy the least expensive.
3. Alcohol produces hypoglycemia and can help control his diabetes when taken in small
amounts.
4. If he does not want to learn to give himself injections, he may substitute an oral hypoglycemic
to control his diabetes. - ANS-1. He should increase his carbohydrate intake during times of
exercise.
Adherence is improved when a drug can be given once daily. Which of the following drugs can
be given once daily?
1. Tacrine
2. Donepezil
3. Memantine
4. Pyridostigmine - ANS-2. Donepezil
Adherence to beta blocker therapy may be affected by their:
1. Short half-lives requiring twice daily dosing
2. Tendency to elevate lipid levels
, 3. Effects on the male genitalia, which may produce impotence
4. None of the above - ANS-3. Effects on the male genitalia, which may produce impotence
Administration of exenatide is by subcutaneous injection:
1. 30 minutes prior to the morning meal
2. 60 minutes prior to the morning and evening meal
3. 15 minutes after the evening meal
4. 60 minutes before each meal daily - ANS-2. 60 minutes prior to the morning and evening
meal
After starting a patient with Grave's disease on an antithyroid agent such as methimazole,
patient monitoring includes TSH and free T4 every:
1. 1 to 2 weeks
2. 3 to 4 weeks
3. 2 to 3 months
4. 6 to 9 months - ANS-2. 3 to 4 weeks
Age is a factor in different responses to pain. Which of the following age-related statements
about pain is NOT true?
A. Preterm and newborn infants do not yet have functional pain pathways.
B. Painful experiences and prolonged exposure to analgesic drugs during pregnancy may
permanently alter neuronal organization in the child.
C. Increases in pain threshold in older adults may be related to peripheral neuropathies and
changes in skin thickness.
D. Decreases in pain tolerance are evident in older adults. - ANS-A. Preterm and newborn
infants do not yet have functional pain pathways.
All diabetic patients with hyperlipidemia should be treated with:
1. HMG-CoA reductase inhibitors
2. Fibric acid derivatives
3. Nicotinic acid
4. Colestipol - ANS-1. HMG-CoA reductase inhibitors
All diabetic patients with known cardiovascular disease should be treated with:
1. Beta blockers to prevent MIs
2. Angiotensin-converting enzyme inhibitors and aspirin to reduce risk of cardiovascular events
3. Sulfonylureas to decrease cardiovascular mortality
4. Pioglitazone to decrease atherosclerotic plaque buildup - ANS-2. Angiotensin-converting
enzyme inhibitors and aspirin to reduce risk of cardiovascular events
All nonsteroidal anti-inflammatory drugs (NSAIDS) have an FDA Black BoxWarning regarding:
1. Potential for causing life-threatening GI bleeds
2. Increased risk of developing systemic arthritis with prolonged use
3. Risk of life-threatening rashes, including Stevens-Johnson
