NURSING MSN 571 FINAL EXAM.pdf

NURSING MSN 571 FINAL EXAM FINAL EXAM 1) A 40-year old female patient is being followed up for diabetes mellitus. She is currently on Metformin 1 gram twice a day and has been tolerating it well for about six months. Her hemoglobin A1c a week ago was 8.9%. The plan is to initiate liraglutide therapy in addition to the metformin. Which of the following statements is true with regards to liraglutide. ▪ Liraglutide may be stored in the refrigerator or freezer prior to first use. ▪ The brand name is Bydureon ▪ Nausea and/or vomiting are common side effects of therapy ▪ It should be administered intramuscularly into the upper arm. 2) The patient who takes insulin has just been prescribed a beta blocker drug. You recognize that the interaction of the beta blocker and the insulin may have which result? ▪ Decreased activity of the beta blocker drug ▪ Enhanced activity of the beta blocker drug ▪ Masked signs of hypoglycemia ▪ Masked signs of hyperglycemia 3) The drug of choice for type 2 diabetics is metformin. Metformin: ▪ Increases intestinal uptake of glucose ▪ Decreases glycogenolysis by the liver ▪ Increases the release of insulin from beta cells ▪ Prevents weight gain associated with hyperglycemia 4) Which classification of oral hypoglycemic drugs decreases hepatic glucose production and increases insulin sensitivity and peripheral glucose uptake? ▪ Sulfonylureas (glyburide) ▪ Meglitinides (glinides) ▪ Biguanide (metformin) ▪ alpha-glycosidase inhibitor (miglitol) 5) A breast-feeding mother is seen in your clinic wanting contraceptive and plans on breast-feeding for a year. What is an inappropriate choice for this patient? ▪ Depo-Provera 150mg IM every 3 months ▪ Progestin-only OC ▪ Combination OC ▪ Intrauterine device 6) Which of the following is (are) true about oral contraceptives (OCs)? ▪ Estrostep, Ortho Tri-Cyclen, Beyaz, and YAZ are approved for managing acne in women ▪ All the answrs are correct ▪ OCs favorably affect menstrual symptoms: cramps reduction, reduced menstrual flow volume and duration. ▪ OCs decrease the risk for several disorders, including ovarian cancer, endometrial cancer, ovarian cysts, pelvic inflammatory disease, benign breast disease. 7) A patient is prescribed ehtinyl estradiol and norelgestromin transdermal contraceptive patch. Which statement, If made by the patient, indicates an understanding of the use of this drug? ▪ “The patch prevents pregnancy by acting as barrier.” ▪ “I will experience minimal side effects because it is a progestin-only device.” ▪ “I will remove the patch each month and replace it with a new patch 1 week later.” ▪ “I will apply the patch in my vaginal area prior to having sexual intercourse.” 8) The NP at the immunization clinic is reviewing the list of patients who are scheduled to receive the varicella vaccination. The NP will cancel all of the following patients except: ▪ A 21-year old patient who is allergic to neomycin ▪ A 12-year old patient with an allergy to gelatin ▪ An 8-year old patient with asthma ▪ A patient who is pregnant 9) The recommended range for maintaining serum theophylline levels is: ▪ 20 to 25 ug/ml ▪ 30 to 40 ug/ml ▪ 0.05 to 2 ug/ml ▪ 10 to 20 ug/ml 10) For his asthma, a patient is prescribed albuterol in the form of an inhalant. The patient tells you the medication causes shakes and hand tremors. What is the best response? ▪ “I will contact the respiratory therapist about your problem.” ▪ “Tremors are the most common side effect of this inhalant and will usually fade over time.” ▪ “The tremors are probably not related to the medication.” ▪ “ I will contact your provider about your problem.” 11) A patient with COPD is acutely hypercapneic. Which respiratory therapy should you prescribe to lower the patient’s carbon dioxide concentration? ▪ Salmeterol ▪ Oxygen via a nasal cannula 2L/minute ▪ Fluticasone propionate ▪ Albuterol nebulizer 12) A patient has been diagnosed with reflux esophagitis (GERD). What instruction by the NP is most appropriate? ▪ Exercise soon after eating to increase gastric emptying ▪ You need to schedule an upper GI endoscopy soon. ▪ Try these proton-pump inhibitors for 2 weeks. ▪ Over-the- counter antiemetics work well for this condition 13) A patient with peptic ulcers report pain in the stomach. A gastric tissue biopsy reveals the presence of Helicobacter pylori infection. What should be the first-line treatment for the patient? ▪ Cimetidine combined with Metronidazole and Ketoconazole ▪ Omeprazole combined with metronidazole and clarithromycin ▪ Cimetidine combined with sucralfate and clarithromycin ▪ Omeprazole combined with clarithromycin and sucralfate 14) Metoclopramide (Reglan) carries a black box warning that it can cause tardive dyskinesia with long-term therapy. ▪ True