MSN571 Mid Term Pharm EXAM 2022

MSN571 Mid Term Pharm EXAM 2022 Mid Term Pharm MSN571 1. Which is required for red blood cell production ● All ● Iron ● Folate ● Vitamin B12 2. A female patient has an iron deficiency anemia and GI bleed has been ruled out. You will: ● Refer the patient to hematologist ● Prescribe ferrous sulfate 325mg po TID and schedule the patient to return in 1 month for a repeat CBC, serum iron and TIBC ● Prescribe iron dextran 50mg IM weekly for 4 weeks and schedule weekly office visits for injections. ● Schedule the patient to return in 6 months for additional guaiac stool testing. 3. Most clinically used opioids analgesics are selective for which type of opioid receptor? ● alpha ● delta ● mu ● beta ● kappa 4.Which is true about morphine ● It does not cause tolerance with prolong use ● It promotes nausea and vomiting through direct stimulation of the chemoreceptor trigger zone of the medulla ● It does not cause urinary retention and hesitancy ● Respiratory depression is rare 12. Which of the following medications is a fluroquinolone antibiotic? ● Azithromycin ● Ciprofloxacin ● Penicillin ● Amikacin 13. Which of the following terms best describes the mechanism of action of metoprolol? ● Alpha 1 antagonist effects ● Beta 1 selective ( beta-1-adrenergic receptor inhibitor) ● Nonselective Beta with Alpha blocking ● Nonselective Alpha blockers 14. Which antibiotic class disrupts metabolism in bacteria and is often combined with trimethoprim? ● Aminoglycosides ● Cephalosporins ● Macrolides ● Fluoroquinolones ● Sulfonamides 15. Which of the following group of antibiotics has a beta-lactam ring in the molecular structure? ● Cephalosporins ● Fluoroquinolones ● Macrolides ● Sulfonamides ● Tetracycline 16. Which of the following drug classes should be avoided in peptic ulcer disease? ● Avoid antibiotics ● Avoid NSAIDS ● Avoid diuretics ● Avoid proton pump inhibitors 17. Fluroquinolones antibiotics are most likely indicated in which of the following conditions? ● Follicular conjunctivitis ● GERD ● Asthma ● Genital Infections 18. Which antibiotics binds to the 505 subunit of the bacterial ribosome and could most likely result in the development of pseudomembranous colitis? ● Tetracycline ● Clindamycin ● Amoxicillin ● Vancomycin 19. Beta Lactamase inhibitors are often indicated in which if the following? ● May decrease absorption of medications ● First dose effect ● Often combined with penicillin antibiotics ● Delayed absorption of oral drugs 20. A patient who takes multiple antibiotics starts to experience diarrheal stool. If the stool sample tests positive for C-Diff which antibiotic, would you prescribe? Metronidazole Gemifloxacin Daptomycin Rifaximin 21. Children younger than 8 years of age should not receive tetracyclines because these agents Can cause aplastic anemia Cause rupture of tendons Do not cross into the cerebrospinal fluid Deposits in tissues undergoing calcification 22. Which patient condition would be a contradiction for the administration of the clindamycin? Diabetes Mellitus Ulcerative Colitis Arthritis Skin infection 23. A child with an ear infection is not responding to treatment with amoxicillin. What alternative medication will the provider order? Amoxicillin-clavulanic acid Penicillin G Ampicillin Nafcillin 24. Every antibiotic drug class has resistant organisms that influence prescribing decisions. True False 25. The dosage of Amoxicillin for the treatment of pediatric acute otitis media is Amoxicillin 50mg/kg/day Amoxicillin 90mg/kg/day Amoxicillin 25mg/kg/day Amoxicillin 150mg/kg/day 26. Which antibiotic is in the macrolide class? Minocycline (Minocin) Nitrofurantoin ( Macrobid) Clarithromycin ( Biaxin) Trimethoprim 27. Contraindications to hepatitis B vaccination is: All pregnant and lactating women Previous severe hypersensitivity or anaphylaxis A history of poliomyelitis Mild viral illness 28. Treatment for fungal infections of the toenails (onychomycosis) includes Miconazole Cream Oral Griseofulvin Mupirocin Cream Ketoconazole Cream 29. In which of the following the human papillomavirus (HPV) vaccine is not recommended A 25 year old who did not finish the vaccine series as a teen Men who have sex with men Only young men through the age of 21 Men with compromised immune systems (including HIV) through age 30 if they did not get the HPV vaccine as teenagers 30. What is the treatment option for a patient who reported small vesicular lesions on the genitals that lasted between 10 and 20 days? Acyclovir (Zovirax) Three injections of penicillin One time dose of azithromycin Test of cure 31. When teaching a pregnant patient about the effects of medication on the fetus, the greatest harm from maternally ingested medications occurs during which time period? Birthing process First trimester Second trimester Third trimester 32. Which concept guides the NP care of infants receiving a variety of medications? Drugs given subcutaneously (subQ) remain in the body longer in infants than in adults Drugs given intravenously (IV) leave the body more quickly in infants than in adults The blood brain barrier protects the infant’s brain from toxic drugs Gastric emptying time is shorter in infants than in children and adults 33. Which of the following is true? Enzyme inducers can enhance clinical responses to prodrug The bioavailability of lipid soluble drugs is increased in the elderly Drug doses may need to be increased in pregnancy All of the above 34. Physiological changes in the elderly that accounts for a small volume of distribution and an increase in the plasma concentration of digoxin are: Increased activity of hepatic enzymes that facilitate drug metabolism Decreased total body water Increased total body of water Decreased total body fat Decreased rate of elimination due to decreased renal function 35. Keeping Beers Criteria in mind. Which of the following statements concerning the safety of medication used by older adults is incorrect? Benzo’s have a large volume of distribution and are relatively safe for use in older people Chronic use of Nexium may increase rick for C-Diff infection, decreased bone integrity and fractures Diphenhydramine may exacerbate urinary retention of older men with prostate hypertrophy Meperidine is not an effective oral analgesic in dosages commonly used and may cause neurotoxicity 36. A patient’s INR is 1.2 on warfarin therapy to prevent DVT, how would you interpret his INR level as? INT is within limits, no action indicated INR is too high IV protamine sulfate may be needed INR is too low the dose of warfarin may need to be increased INR is too high Vitamin K may be needed 37 What would you prescribe for warfarin overdose? Phytonadione Calcium Aspirin Potassium 38. The patient is receiving anticoagulant therapy. The INR value for the patient today is 1.5. In response to this. What will you do? Increase the heparin drip rate Hold the next dose of warfarin Prescribe protamine sulfate Prescribe an additional dose of warfarin 39. Patients with rheumatoid arthritis who are on chronic low dose prednisone will need co treatment with which medications to prevent further adverse effects? Vitamin D Calcium Supplementation A bisphosphonate All of the above 40. A patient has been taking 10mg per day of prednisone for the past 6 months. The Patient should be assessed for? Gout Iron deficiency anemia Renal dysfunction Osteoporosis 41. Which of the following is (are) useful in the eradication of Tinea organisms? Butoconazole Terbinafine (Lamisil) Griseofulvin None of these are correct Both Griseofulvin and Terbinafine (Lamisil) 42. When teaching a patient about amiodarone, you should advise the patient to avoid which food and drink? Gluten Poultry Whole milk Grapefruit juice 43. Which class of drugs is recommended by the JNC8 as the first line therapy for uncomplicated essential hypertension? Angiotensin converting enzyme inhibitors Thiazide Diuretics Loop diuretics Alpha 1 adrenergic receptor blocking agents 44. A patient has been prescribed amiodarone. What should be included i