Pharmacolo MSN 571 Pharmacology Questions and Answers Set 1-3- United States University

Pharmacolo MSN 571 Pharmacology Questions and Answers Set 1-3- United States University 1. Why are most statins recommended to be taken in the evening? • Can cause insomnia • Decreases stomach upset • Cholesterol synthesis increases during the night • Cholesterol synthesis decreases during the night 2. What is the mechanism of action of ezetimibe? • It inhibits the absorption of bile, thus causing the liver to produce bile from cholesterol.* • It decreases the adhesion of cholesterol on the arterial walls. • It inhibits absorption of dietary and biliary cholesterol in the small intestine. • (option cutoff) 3. Which of the following is not an expected adverse effect of Niacin? • Arthralgias • Hyperglycemia • Itching • Flushing 4. Which adverse effects would you monitor for a patient receiving a statin to manage cholesterol levels. Select all that apply. • Gallstone development • Increased serum transaminase levels • Unexplained muscle pain or tenderness * • Nonalcoholic fatty liver disease * • Elevated creatinine kinase (CK) level with muscle pain * 5. Which of the following drug classes should be avoided in peptic ulcer disease? • Avoid diuretics • Avoid NSAIDS • Avoid proton pump inhibitors • Avoid antibiotics 6. Which of the following groups of antibiotics is notable for side effects such as nephrotoxicity and ototoxicity? • Cephalosporins • Beta-lactams • Aminoglycoside • Tetracyclines 7. Which of the following is most likely an intervention for otitis media? • Corticosteroids • Aspirin • Immunoglobulins • Amoxicillin 8. Which of the following medications is a fluoroquinolone antibiotic? • Penicillin • Azithromycin • Amikacin • Ciprofloxacin 9. Which of the following best classifieds aminoglycosides, macrolides, and clindamycin? • mycolic acid synthesis inhibitors • protein synthesis inhibitors • cell wall inhibitors • folic acid synthesis inhibitors 10. Which of the following groups of antibiotics binds to the 50S subunit of the bacterial ribosome and includes drugs such as erythromycin and azithromycin? • macrolides • fluoroquinolones • aminoglycosides • tetracyclines 11. Which of the following groups of people are at risk for early hypertension? • African American • Adolescents or young adults • Mexican American Culture • Old females 12. Which of the following drug treatment strategies is associated with peptic ulcer disease? • Opioids • Two antibiotics • Corticosteroids • Hormonal therapy 13. Which of the following medications or drug classes is commonly indicated for managing gestational hypertension? • Spironolactone (Aldactone) • Loop diuretics • Calcium channel blockers • Dobutamine • Calcium gluconate 14. Which antibiotic class disrupts folate metabolism in bacteria and is often combined with trimethoprim? • cephalosporins • fluoroquinolones • Aminoglycosides • Sulfonamides • macrolides 15. Convert 15 lbs 8 oz to kilograms. Round to the nearest 100th. • 7.00 • 34.10 • 33.00 • 7.03 16. A patient receiving intravenous gentamicin has a toxic serum drug level. The prescriber confirms that the dosing is correct. Which possible cause of the situation will the provider explore? • Whether patient is taking a medication that binds to serum albumin • Whether a loading dose was administered • If the ordered dose frequency is longer than the gentamicin half-life • If the drug was completely dissolved in the IV solution 17. The therapeutic index is a measure of drug: • Absorption rate • Safety profile • Bioavailability status • Effectiveness 18. Which science provides primary healthcare providers the opportunity to individualize drug therapy based on a patient's genetic makeup? • Pharmacogenetics • Pharmacogenomics * • Pharmacodynamics • Pharmacokinetics 19. Which of the following is the most appropriate choice to describe age associated changes that can affect pharmacokinetics in older patients? • Increase in total body water • Decrease in creatinine clearance • (option cutoff) • (option cutoff) 20. Drugs that use CYP 3A4 enzymes for metabolism may: • None of the answers are correct • Induce the metabolism of another drug • Inhibit the metabolism of another drug * • Both induce and inhibit the metabolism of another drug. 21. An example of a first-dose reaction that may occur includes: • Orthostatic hypotension that does not occur with repeated doses • Hemolytic anemia from Ceftriaxone use • Contact dermatitis from neomycin use * • Purple glove syndrome with phenytoin use CORRECT CORRECT 22. Your patient is diagnosed with Psoriasis. You can prescribe all except: • Methotrexate • Vitamin E Analogs • Tars * • Glucocorticoids 23. Isotretinoin (Accutane) is a drug employed in the treatment of severe recalcitrant cystic acne. Which one of the following is not an adverse effect associated with its use? • Conjunctivitis • Fetal abnormalities • Hyponatremia * • Hypertriglyceridemia 24. A 14-year-old patient has moderate acne that has not responded to topical Which treatment choice will the NP discuss with the patient and parents? • Doxycycline (vibramycin) * • Combination oral contraceptive medication • Spironolactone • Isotretinoin (Accutane) 25. The renin-angiotensin-aldosterone system plays an important role in maintaining blood pressure. Which compound in this system is most powerful at raising blood pressure? • Angiotensin III • Angiotensin II * • Angiotensin I • Renin 26. A patient who developed hypertension at 28 weeks gestation age. What medication do you anticipate giving? • Any one of these medications listed here may be prescribed to a pregnant * • Methyldopa • Nifedipine • Labetalol CORRECT/VITAMIN D CORRECT CORRECT CORRECT CORRECT 27. A patient has been prescribing furosemide for pulmonary edema secondary to congestive heart failure. What should be included in patient teaching instructions? • Rise Slowly from sitting or reclining positions. • Report any irregular heartbeat, muscle weakness, or cramping. • Report any tenderness or swelling of the joints to your healthcare provider. • All are true * 28. Which calcium channel blocker would be ideally used to treat a dysrhythmia? • Nifedipine • Verapamil * • Amlodipine • Nicardipine 29. A patient has been taking hydrochlorothiazide and lisinopril (Prinzide, Zestoretic) for moderate hypertension. On the following the following signs and symptoms would be most concerned related to this condition? • Fatigue, weakness, dyspnea when supine • Anorexia, mild fever, dark urine • Fatigue, unexplained weight loss, polydipsia • Dull abdominal pain, anorexia, weight loss * 30. The Nurse Practitioner is teaching the NP student about acetaminophen. Which of the following would be included when teaching the student? • All of the answers are correct * • The antidote to acetaminophen overdose is acetylcysteine • Patients need to watch over-the-counter medications for acetaminophen in the product to prevent overdose • Patients with normal kidney and liver function should not take more than 4000mg per day. 31. _________ is an example of an agonist-antagonist opioid. • Morphine • Buprenorphine • Naloxone * • Diprenorphine CORRECT CORRECT CORRECT CORRECT CORRECT 32. A 76-year-old female with renal insufficiency presents to the clinic with severe pain secondary to a compression fracture in the lumbar spine. She reports that the pain has been uncontrolled with tramadol, and it is decided to start treatment with an opioid. Which of the following is the best opioid for this patient? • Fentanyl transdermal patch • Hydrocodone * • Meperidine • Morphine 33. A patient with opioid use disorder has undergone detoxification with buprenorphine. • (option cutoff) • (option cutoff) • “The combination drug contains more buprenorphine” • “Buprenorphine causes more respiratory depression” 34. What are the most important characteristics that any drug can have? • Selectivity • All the answers are correct * • Effectiveness • Safety 35. Which of the following is not consistent with the rules for geriatric prescribing: • Steady state is reached more quickly in the older adult • Adverse drug responses present atypically in the older adult • Reduce the number of drugs in the patient's regimen whenever possible * • Half-life will be longer in older adults 36. The 4th to the 10th week of gestation is the period of time when there is the greatest concern about drug-induced: • Fetal hemorrhage • Fetal cardiac arrest • Fetal malformations * • Labor CORRECT correct/RR depression and QT proCorrect Correct CORRECT 37. A pediatric client is prescribed amoxicillin 25mg/kg/day divided in two daily doses. The medication is available as 125mg/5ml. The client weighs 25 pounds. What is the total daily dose for the client? Round answer to the nearest tenth __________mg. • 205 mg • 280 mg * • 190 mg • 300 mg 38. What changes in drug distribution with aging would influence prescribing a medication in a 90-year old patient? • Decreased plasma proteins * • Increased volume of distribution • Increased muscle-to-fat-ratio • Decreased lipid solubility 39. A patient is diagnosed with otitis externa. Comorbidities include diabetes mellitus, hypertension, and advanced multiple sclerosis. Which type of education regarding medication administration would you provide? • The oral administration of a prescription for hydrocortisone/neomycin/ polymyxin B combination solution • The administration of topical combination medications for a prescription of fluoroquinolones/glucocorticoid com * • The oral administration of a prescription for fluoroquinolone • The administration of topical medications for a prescription of alcohol plus acetic acid solution. 40. A 6-year-old child presents with crying due to ear pain. Tympanic membranes are erythematous, bulging, and immobile, but intact. In addition to antibiotic therapy, what will the provider recommend for pain management? • Prednisone • A tympanostomy to relieve pressure in the middle ear • Low dose aspirin • Lidocaine ear drops * CORRECT CORRECT correct CORRECT 41. The patient asks if there is any other option besides antibiotics to treat acute otitis media. How will you respond? • “Pain management is only necessary when antibiotics are prescribed.” • “Pain management is also part of the treatment plan for otitis media.* • “Antibiotics are the way to cure otitis media.” • “Pain management is reserved for use when the tympanic membrane is burst.” 42. Which drug would most likely be used to treat candidiasis? • Terconazole • Amphotericin B • Tioconazole • Nystatin * 43. A 19-year-old female comes to your clinic with a greenish, malodorous discharge. Vulvar pruritus is also present. On pelvic exam, vaginal mucosa is erythematous. Wet mount of discharge shows a motile organism. The patient is started on an appropriate therapy. Later that evening, the patient develops flushing, nausea and vomiting after eating dinner with a glass of wine. The patient was most likely treated with which of the following medications? • Metronidazole * • Ceftriaxone • Fluconazole • Azithromycin 44. A patient with genital herpes simplex becomes pregnant. What statement made by the patient concerning her prescribed acyclovir would indicate that teaching was effective? • “I should only take this medication during an active outbreak of my herpes,” • “I need to switch to the topical formulation of this medication now that I am pregnant.” • It is best to discontinue the use of this medication until I deliver the baby.” • “I may continue the acyclovir throughout the course of my pregnancy.” * CORRECT CORRECT CORRECT CORRECT 45. Which of the following is a common case of iron deficiency in patients in the United States? • Chronic blood loss through the gastrointestinal tract * • Rapid growth during adolescence • Vegetarian eating patterns • Decreased intestinal uptake of iron 46. Anemia of chronic renal failure is caused by the lack of: • parathyroid hormone • adrenaline • thyroid hormone • Erythropoietin * 47. A 75-year-old woman with hypertension is being treated with a thiazide. Her blood pressure responds well and reads at 120/76mmHg. After several months on the medication, she complains of being tired and weak. An analysis of the blood indicates values for which of the following? • Potassium * • Sodium • Calcium • Glucose 48. The patient is receiving anticoagulant therapy. The INR value for the patient today is 1.5. In response to this, what will you do? • The level cannot be interpreted without knowing the prothrombin time and the international normalized ratio (INR). • The level is outside the expected target therapeutic level of anticoagulation; it is too high. • The level is within the expected target therapeutic level of anticoagulation. • The level is outside the expected target therapeutic level of anticoagulation; it is too low. * 49. A patient with hypercholesterolemia who is taking 20mg of simvastatin as prescribed. After a few days, the patient’s urinalysis reports indicated the presence of myoglobin. How would you manage this patient? • Instruct the patient to take the simvastatin before meals. • Instruct the patient to decrease his dose to 10mg of simvastatin daily. CORRECT CORRECT CORRECT CORRECT • Instruct the patient to drink 250 mL of water with the simvastatin. • Instruct the patient to discontinue the simvastatin. * 50. Which of the following may cause a detrimental potentiate drug interaction? • Propranolol and albuterol • Isoniazid and rifampin • Aspirin and warfarin * • Sulbactam and ampicillin 1. A patient is started on warfarin therapy while also receiving intravenous heparin. The patient is concerned about the risk for bleeding. What would you tell the patient? • “Because of your valve replacement, it is especially important for you to be given anticoagulant therapy. The heparin and warfarin together are more effective than one alone” • “Your concern is valid. I will call the doctor to discontinue the heparin.” • “Because you are now up and walking, you have a higher risk of blood clots and therefore need to be on both medications.” • “It usually takes about 3 days to achieve a therapeutic effect for warfarin, so the heparin is continued until the warfarin is therapeutic.” * 52. The patient is receiving anticoagulant therapy. The INR value for the patient today is 1.5. In response to this, what will you do? • Hold the nest dose of warfarin • Prescribe protamine sulfate • Increase the heparin drip rate • Prescribe an additional dose of warfarin. * 53. Which of the following is most true of nurse practitioner prescribers? • Prescriptive authority is under the full control of the Board of Nursing in all states. * • All states allow nurse practitioners to prescribe controlled substances • All states allow some level of prescription writing by nurse practitioners. • None of the answer choices are correct. CORRECT CORRECT CORRECT CORRECT CORRECT 54. Which prescriber action will have the greatest impact on the patient’s commitment to adherence to any medication therapy? • Assuring that the medication prescription will be covered by the patient's insurance • Providing mediation education that the patient can easily understand* • Scheduling once a day administration • Prescribing the medication in oral form whenever possible 55. The selection of antibiotics for the treatment of infection is based on which understanding of selective toxicity? • The ability to avoid injuring host cells. • The ability to act against a specific microbe. • The ability to suppress bacterial resistance. * • The ability to transfer DNA coding. 56. When planning care for a patient receiving a sulfonamide antibiotic, which is the appropriate intervention? • Force fluids to at least 2000 mL/day * • Encourage liquids that produce acidic urine. • Insert a Foley catheter for accurate input and output measurement. • Encourage a diet that causes an alkaline ash. 57. A patient presents to your clinic with symptoms of a potentially serious gram-negative infection. You decide to give a cephalosporin antibiotic now while awaiting laboratory results. You choose: • None of the answers are correct. * • 1st generation cephalosporin • 3rd generation cephalosporin • 2nd generation cephalosporin 58. Acute Bacterial Rhinosinusitis Syndrome (ABRS) • Acinetobacter, Enterococcus Faecalis, Campylobacter • Escherichia Coli, klebsiella pneumoniae, proteus Mirabilis • Legionella pneumoniae, Mycoplasma pneumoniae, Chlamydia pneumoniae CORRECT CORRECT CORRECT CORRECT PICMONIC • Streptococcus pneumoniae, Moraxella catarrhalis, Haemophilus, Influenza* 59. The NP explains to the NP students about penicillin. Which is true about penicillin? Select all that apply. • They are known as beta-lactam antibiotics. * • They cause bacteria to take up excess amounts of water and sodium. • They are considered one of the safest antibiotics. • They are active only against bacteria that are growing and dividing. * 60. The patient is taking daptomycin. The NP should obtain a creatine phosphokinase (CPK) level when the patient shows which symptom? • Abdominal bloating and diarrhea • Muscle pain and weakness * • Headache and visual disturbances • Increased urination and urinary urgency 61. Risk factors for extended spectrum Beta Lactamase producing organisms include all except: • Use of corticosteroids • (option cutoff) • They are considered one of the safest antibiotics • They are active only against bacteria that are growing and dividing * 62. Treatment to eradicate nasal MRSA is mupirocin. Patient education regarding nasal MRSA includes: • Nasal MRSA eradication requires at least 4 weeks of therapy, with up to 8 weeks needed in some patients.* • Alternate treating one nare in the morning and the other in the evening. • Take the oral medication exactly as prescribed. • Insert one-half of the dose in each nostril twice a day. 63. A patient suspected of having influenza comes to the urgent care for treatment. Which information will the NP need before prescribing oseltamivir? • Allergies to antibiotics • Length of time since onset of symptoms * • Over-the-counter medications taken in the last 48 hours • Immunization history CORRECT CORRECT CORRECT CORRECT CORRECT CORRECT 64. What is the treatment option for a patient who reported small, vesicular lesions on his genitals that lasted between 10 and 20 days? • Acyclovir (Zovirax) * • Three injections of penicillin • Test of cure • One time dose of azithromycin 65. A provider is about to prescribe prednisone to a patient for tendonitis. What item in the patient’s medical history would cause the provider to reconsider that action? • Systemic fungal infection * • Seborrheic dermatitis • Allergic rhinitis • Gouty arthritis CORRECT ????? 1. A partial agonist is best described as an agent that: -Has low potency but high efficacy -Has affinity but lacks efficacy -Interacts with more than one receptor type. -Cannot produce the full effect, even at high doses 2.Which of the following will you find in a patient taking warfarin and levothyroxine? -Weight loss of 5kg -Cardiac dysrhythmias -Shortness of breath -Excessive bruising 3. A pregnant patient with a history of thrombosis. Which prophylactic treatment will you prescribe? -Clopidogrel -Alteplase -Enoxaparin -Warfarin 4.The patient is receiving warfarin therapy with the INR of 4.0. How will you interpret this finding? -The level is within the expected target therapeutic level of anticoagulation. -The level cannot be interpreted without knowing the prothrombin time and the activated partial thromboplastin (aPTT) value. -The level is outside the expected target therapeutic level of anticoagulation: it is too low. -The level is outside the expected target therapeutic level of anticoagulation; it is too high. 5.What does aldosterone directly increase the reabsorption of? -Calcium -Magnesium -Water -Sodium 6. You are caring for a patient with renal failure who is prescribing a protein-bound drug. Which parameter in the patient must the nurse assess before administration the medication? -Lipid Profile -Hemoglobin Level -Blood glucose level -Serum albumin levels 7. The Beers Criteria is utilized with which population of patients? -Mental Health -Geriatrics -OB/GYN -Pediatrics 7.For the patient with a history of MI and hypercholesterolemia, choose the best drug to add to rosuvastatin therapy for a patient who is taking the maximum tolerated dose of rosuvastatin whose LDL-C is still 200 mg/Dl: -Nicotinic acid -Colesevelam -Fenofibrate -Ezetimib 8. Keeping Beers Criteria in mind. Which of the following statements concerning the safety of medications used by older adults is incorrect? -Meperidine is not an effective oral analgesic in dosages commonly used and may cause neurotoxicity. -Diphenhydramine may exacerbate urinary retention of older men with prostate hypertrophy. -Chronic use of Nexium may Increase risk for Clostridium difficile infection, decreased bone integrity, and fractures. -Benzodiazepines have a large volume of distribution and are relatively safe for use in older people. 8. A patient with cardiovascular disease is taking rosuvastatin. Which finding would indicate a potential adverse effect of this drug? -Platelet count of 100 x 10 3/mm3 -Muscle pain and weakness -Blood pressure of 140/90 mmHg -Wheezing and shortness of breath 9. Which of the following drugs is NOT used to lower LDL? - Ezetimibe -Lovastatin - Colesevelam - Gemfibrozil 9.The NP student is concerned that an older patient’s adverse drug reactions are due to reduced renal excretion. Which laboratory result should be closely monitor? -Serum creatinine levels -Blood urea nitrogen (BUN) -Creatinine clearance -Serum albumin levels 10. Which of the following is a non-neurotoxin treatment for head lice? - Lindane shampoo - Benzoyl alcohol (Ulesfia) - Malathion (Ovide) 10.A medication prescribed for a neonate is eliminated primarily by hepatic metabolism. What action will the prescriber take to minimize risk to the infant? -Prescribe a dose that is relatively higher than an adult dose when adjusted for body surface area. -Prescribe a dose that is relatively lower than an adult dose when adjusted for body surface area. -Increase the frequency of medication dosing. -Discontinue the drug after one or two doses. 11. A patient applies mupirocin topically three times per day to several small vesicle lesions on his feet and legs. What medical condition is he treating? - Common warts -Impetigo - Eczema - Common warts - Actinic keratoses 12. Terbinafine is useful for treating which condition(s)? - Tinea pedis - Onychomycosis -Tenia corporis - All the answers are correct 13. A provider is reviewing an older adult patient’s chart during a routine visit. Which patient information is of most concern regarding the renewing of medication prescriptions for highly protein-bound drugs? - Low serum albumin - Increased body fat - Low serum creatinine - Chronic constipation 14. A patient presents to the emergency department after accidentally taking too much prescribed warfarin. The patient’s heart rate is 78 beats/minute and the blood pressure is 120/80 mmHg. A dipstick urinalysis is normal. The patient does not have any obvious hematoma or petechiae and does not report any pain. What will the provider order initially to address the patients current condition? - An activated thromboplastin (aPTT) - Vitamin K - A prothrombin (PT) and an international normalized ratio (INR) - Protamine sulfate 15. What does aldosterone directly increase the reabsorption of? - Sodium -Magnesium - Calcium - Water 16. A patient received an overdose of morphine. Naloxone is given to block the narcotic response. Which is the effect achieved when naloxone is administered? - Antagonist - Addictive - Synergistic - Negative 17. Naloxone reverses which effects when given to a client experiencing an opioid overdose? Select all that apply. - Pain relief -Respiratory depression - Euphoria - Sedation - Abdominal cramping 17. When prescribing acyclovir, patients should be educated regarding: -Risk for life-threatening rash such as Stevens-Johnson -Need to drink lots of fluids during treatment -High risk of developing diarrhea -Eccentric dosing schedule 17. The NP student recognizes which of the following as examples of the improper use of antibiotic therapy? Select all that apply. -Treating a viral infection -Treating fever in an immunodeficient patient -Basing treatment on sensitivity reports -Using dosing that results in a superinfection -Using surgical drainage as an adjunct to antibiotic therapy 18. 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: -Complete blood count to rule out anemia -Liver Function -Renal Function -Immunocompetence 18. A six-year-old who has never received an inactivated influenza vaccine has been brought to the office by his mother to be vaccinated to help protect his four-mouth-old-baby sister during influenza “season”. You inform the boy’s mother that he will require: -Children under age eight years should not receive the inactivated influenza vaccination -Two inactivated influenza vaccinations, the first scheduled about one month prior to the start of influenza season (October/November), and the second scheduled four weeks after the first. -Two inactivated influenza vaccinations, scheduled four or more weeks apart -A single vaccination administered annually 19. Your patients calls your office to report blurry vision and has lost the ability to distinguish color. He reported that he is currently taking an antifungal medication. Which of the following medications would result in these effects? -Griseofulvin -Terbinafine -Nystatin -Voriconazole 20. Which of the following diseases or disorders are most likely treated with ACE inhibitors? -Hyperthyroidism -Pulmonary hypertension -Cushing’s Syndrome -Angina 20. The definition of pharmacokinetics is: - What the drug does to the body. - Adverse reactions to drugs. - The drug movement throughout the body and what the body does to the drug. - Impact of foods on drugs. -Chronic kidney disease (with or without diabetes) 21. Which of the following drug classes is/are used in initial hypertension management of African American population? -Clonidine primary -Beta blockers primary -Thiazide or Calcium Channel blocker primary -ACE-I primary -ARB primary 21. Which form of a drug name is most likely known by patients from exposure to drug advertisements? - chemical name - nonproprietray name - Generic name -Trade name 22.First pass effect is: - Dissolution of the stomach - - - 22.Beta Lactamase inhibitors are often indicated in which of the following? -First dose effect -Often combined with penicillin antibiotics -May decrease absorption of medications -Delayed absorption of oral drugs 23.Which antibiotic binds of the 50S subunit of the bacterial ribosome and could most likely result in the development of pseudomembranous colitis? -tetracycline -clindamycin -amoxicillin -vancomycin 24.Which of the following best classifies penicillins, cephalosporins, and carbapenems? -RNA synthesis inhibitors -cell wall inhibitors -mycolic acid synthesis inhibitors -protein synthesis inhibitors 25. Which of the following medications is a fluroquinolone antibiotic? -Azithromycin - - - 28. A patient with a history of HTN, GERD, and allergic rhinitis is currently on diltiazem 240 mg daily, HCTZ 25, Loratadine 10 mg daily, and omeprazole 20 mg daily. Based on his cardiovascular profile, the decision is made to start simvastatin. Which of the following is true regarding dosing of simvastatin with the patient’s current medication regimen? -The dose of simvastatin should not exceed 5 mg daily -The dose of simvastatin should not exceed 10 mg daily -The dose of simvastatin should not exceed 20 mg daily -The dose of simvastatin should not exceed 40 mg daily 29. A patient is diagnosed with otitis externa. Comorbidities include diabetes mellitus, hypertension, and advanced multiple sclerosis. Which type of education regrading medication administration would you provide? - The oral administration of a prescription for fluoroquinolone - The administration of topical combination medications for a prescription of fluoroquinolone/ glucocorticoid combination solution - The administration of topical medications for a prescription of alcohol plus acetic acid solution. - The oral administration of a prescription for hydrocortisone/neomycin/polymyxin B combination solution 30. The parents of a child with asthma ask the provider why their child cannot use oral corticosteroids more often, because they are so effective. The provider will base the discussion with parents on what fact concerning oral corticosteroids? - - - - 31.Anemia of chronic renal failure is caused by the lack of: -adrenaline -thyroid hormone -erythropoietin -parathyroid hormone 32.Which statement made by a client suggests the need for further education regarding a newly prescribed medication? - “I’m paying for this prescription, so I’d like it written for the generic form.” - “There seems to be several brand names for this medication; it’s confusing.” - “I prefer a trade named version of the medication since they are generally more effective.” - “I’m glad I don’t have to use the medication’s chemical name when refilling the prescription” 32.What is the mechanism by which Irbesartan lowers blood pressure? -inhibiting renin -inhibiting formation of angiotensin II -decreasing calcium entry into smooth muscle -blocking angiotensin AT1 receptors 32.Which of the following drugs is NOT used to lower LDL? -Ezetimibe -Lovastatin -Colesevelam -Gemfibrozil 33.A provider may consider testing for CYP2D6 variants prior to starting tamoxifen for breast cancer to: -Identify poor metabolizers of tamoxifen -Identify potential drug-drug interactions that may occur with tamoxifen -Reduce the likelihood of therapeutic failure with tamoxifen treatment -Ensure the patient will not have increased adverse drug reactions to the tamoxifen 34.Which one of the following routes of administration does not have an absorption phase? -intramuscular -inhalation -intravenous -sublingual -subcutaneous 34.What makes losartan different from other ARBs? -Losartan has the shortest half-life -Losartan is renally eliminated -Losartan has a small volume of distraction -Losartan has an active metabolite 35.A medication has a half-life of 12 hours. How would you interpret this to guide therapy? -The medication will be 50 % eliminated in 12 hours. -The patient will require two extra doses of medication before there is an effect. -The medication will not work for the first 12 hours. -The medication will be administered every 6 hours to maintain consistent blood levels. 36.A partial agonist is best described as an agent that: -Cannot produce the full effect even at high doses. -Has low potency but high efficacy. -Interacts with more than once receptor type. -Has affinity but lacks efficacy 37.A patient has an infection affecting a central nervous system (CNS) component. Which structure makes the delivery of antibiotics therapy more difficult? -Blood-brain barrier -Neuropeptide receptors -Chemotherapeutic trigger zone -Thalamic synapses 38. A generic medication is considered equal, or bioequivalent to its parent brand medication, and must undergo stringent safety and equivalency testing and with specific criteria established by the U.S. Food and Dug Administration (FDA) -True -False 39.A patient has been diagnosed with onychomycosis. The patient dislikes the yellow discoloration of his toenails and requests an oral form of ketoconazole. How would you respond? - “Ketoconazole only treats viral infection” - “Ketoconazole is only available in a topical formulation - “Ketoconazole taken orally has a higher risk of liver injury” - “The discoloration will subside without treatment in the next few days” 40. Oral retinoids such as Vitamin A and its derivatives reduce cell growth and can be used in psoriasis, but may be teratogenic. Oral and topical retinoids are also used for acne. -True -False 41. Terbinafine is useful for treating which condition(s)? -Tinea pedis -All the answers are correct -Tenia corporis -Onychomycosis 42. Which antibiotic is recommended for prophylaxis of recurrent UTIs? -Nitrofurantoin -Levofloxacin -Amoxicillin/clavulanic acid -Moxifloxacin 43. Which of the following is recommended treatment for erythema migrans or early Lyme disease? -Erythromycin 33mg po for 10 days -Ciprofloxacin 250mg for po 14 days -Dicloxacillin 500mg po for 10 days -Doxycycline 100mg po for 21 days 44. Which of the following is known to increase the serum concentration of penicillin? -Theophyline -Probenecid -Hydrochlorothiazide -Clonidine 45. A patient has glucose-6-phosphate dehydrogenase deficiency (G6PD) and requires an antibiotic. Which class of antibiotics should be avoided in this patient? -Sulfonamides -Cephalosporins -Macrolides -Penicillins 46. Which antibiotic is considered first-line therapy for pediatric community acquired pneumonia? -Bacitracin -Amoxicillin -Erythromycin -Gentamycin 47. A type 1 hypersensitivity reaction is an immediate or anaphylactic hypersensitivity reaction involving preferential production of IgE in response to certain antigens such as medication: -Only involves skin (urticaria) -Involves the skin (urticaria), eyes (angioedema), bronchopulmonary tissues (wheeze, cough), and/or GI tract (gastroenteritis) -Immediate reactions to medications causing an anaphylactic response are considered a type 3 hypersensitivity reactions -Involves the skin (urticaria) and bronchopulmonary tissue (wheezing and cough) 48.What are the differences between the tetracyclines? -Bacterial Resistance -The newer ones are more broad spectrum -The older generation cause teeth discoloration but newer generation do -Pharmacokinetic differences 49.The provider is discussing the management of prescribed, controlled substances a patient. Which statement by the patient indicates understanding of the information provided? -“Prescriptions for drugs Schedules III and IV may be written to include up to 5 refills.” -“Schedule I drugs may only be given to hospitalized patients. -“To reduce the possibility of abuse of a drug that is Schedule II, the prescriber should call the prescription to the pharmacy.” -“If there is a difference between state and federal laws governing a scheduled drug, the federal law precedence.” 50.A 76-year-old female with renal insufficiency presets to the clinic with severe pain secondary to a compression fracture in the lumbar spine. She reports that the pain has been uncontrolled with tramadol, and it is decided to start treatment with an opioid. Which of the following is the best opioid for this patient? -Meperidine -Fentanyl transdermal patch -Hydrocodone -Morphine 51.The term “off-label prescribing “ refers to: -Writing “use as directed” in the signature section of the prescription instead of a structured signature. -A prescription drug being prescribed for a population or diagnosis other than what it was originally FDA approved for. -Prescribing a medication without telling the patient/child the reason for the prescription. 52.While obtaining a medication history for a newly admitted patient, the NP notes that the patient has been taking prescribed naltrexone. Upon further question, the patient tells you he has a history of what type of abuse? -Amphetamine abuse -Steroid abuse -Barbiturate abuse -Opioid abuse 53.A patient is found to have “strawberry spots” on the vagina and cervix. What is the treatment option? -Lindane 1% cream -Tetracycline -Metronidazole -Acyclovir 54.A patient with genital herpes simples becomes pregnant. What statement made by the patient concerning her prescribed acyclovir would indicate that teaching was effective? - “It is best to discontinue the use of thus medication until I deliver the baby.” - “I need to switch to the topical formulation of this medication now that I am pregnant.” - “I may continue the acyclovir throughout the course of my pregnancy.” - “I should only take this medication during active outbreak of my herpes.” 55.A patient has been prescribed doxycycline for a chlamydia infection. She is healthy and her only medication is an oral combined contraceptive. Her education would include: -Use a back-up method of birth control (condom) until her next menses. -Doxycycline is used for one-dose treatment of STIs; take the whole prescription at once. -Her partner will need treatment if her infection doesn’t clear with the doxycycline. -Doxycycline may cause tendonitis and she should report any joint pain. 56.To improve positive outcomes when prescribing for the elderly the NP should: -None of the answers are correct -Encourage the patient to cut drugs in half with a knife to lower costs. -Assess cognitive functioning in the elder -Encourage the patient to take a weekly “drug holiday” to keep drug costs down -All the answers are correct 57. Naloxone reverses which effects when given to a client experiencing an opioid overdose? Select all that apply. -Pain relief -Respiratory depression -Euphoria -Sedation -Abdominal cramping 58.A patient is diagnosed with otitis externa by Aspergillus organism. All of this therapy is appropriate except? -Topical 1% clotrimazole -Oral fluconazole -2% acetic acid solution ear drops -Ciprofloxacin plus hydrocortisone otic solution 59. The patient is diagnosed with otitis media with perforated eardrum. You want to prescribe an otic preparation. Which of the following is not appropriate? -Ciprofloxacin/hydrocortisone otic 60. You are caring for an adolescent who weighs 72 pounds. Which is the most precise method for adjusting dosage of this patient’s medication? -Body surface area -Body fat percentage -Body weight -Body mass index -Giving the patient of family samples from a clinic stock without writing a prescription. 61. Elderly persons may have altered drug disposition because of: -An accelerated renal excretion of ionized drugs -A reduced capacity of oxidize drugs -A markedly reduced absorption of many drugs -Higher volumes of distribution for water-soluble drugs 62. An infant developed a pruritic rash following exposure to an allergen. The infant’s parents ask the provider about using a topical antihistamine. What information should the provider use to address the parent’s question? -Applying an antihistamine to the skin can cause toxicity in this age group -Topical medications have fewer side effects than those given by other routes -Antihistamines given by this route are not absorbed as well in children -The child will also need oral medication to achieve effective results 63. Which of the following correctly describes the intramuscular route of parental drug administration? -used to administer drug suspensions that are slowly absorbed -cannot be used for drugs that undergo a high degree of first-pass metabolism -drug absorption is erratic and unpredictable -bypasses the process of drug absorption to achieve an immediate effect 64.A patient is diagnosed with otitis. Comorbidities include diabetes mellitus, hypertension, and advanced multiple sclerosis. Which type of education regarding medication administration would you provide? -The oral administration of prescription for fluoroquinolone -The administration of topical combination medications for a prescription of fluoroquinolone/glucocorticoid combination solution -The administration of topical medications for a prescription of alcohol plus acetic acid solution -The oral administration of a prescription for hydrocortisone/neomycin/polymyxin B combination solution 64.What does aldosterone directly increase the reabsorption of? -Sodium -Magnesium -Calcium -Water 65.A patient with cardiovascular disease is taking rosuvastatin. Which finding would indicate a potential adverse effect of this drug? -Platelet count of 100 x 10 3/ mm3 -Wheezing and shortness of breath -Blood pressure of 140/90 mm Hg -Muscle pain and tenderness MID-TERM PHARMACOLOGY QUESTIONS 1. Which of the following is a common cause of iron deficiency in patient? a. Rapid grown during adolescence b. Vegetarian eating pattern c. Decreased intestinal uptake of iron d. Chronic blood loss through the gastrointestinal tract. 2. Which of the most common type of anemia? a. Iron deficiency anemia 3. A patient is taking oral ketoconazole for a systemic fungal infection. The medication administration record notes that the patient is also taking ho MEPRAZOL for reflux disease . What instruction will the provider give the patient to maximize medication effectiveness? a. Take the omeprazole one hour before the ketoconazole b. Wear sunglasses when outdoors to manage photo sensitivity c. Take omeprazole at least two hours after keto ketoconazole d. Restrict intake of dietary products 4. A 70 year old patient with penicillin sensitivity is receiving digoxin and warfarin therapy hey mark holiday antibiotic is required to treat streptococcal infection which of the following medication would be best for this patient a. Clarithromycin b. Telithromycin c. Azithromycin d. Erythromycin ???/ 5. You are teaching a patient to promptly report any diarrhea after prescribing which of the following drug is the patient likely being prescribed. Clindamycin 6. which of the following is true about prescriptive authority a. all the answers are correct b. some MP's have restricted prescriptive authority c. some MP's have full prescriptive authority d. prescriptive authority is the legal right to prescribe drugs 7. which patient statement suggests to the provider that the patient nonadherence with their medication plan is related to dissatisfaction with the therapy I have been taking this medication for well ove a week and I lost only a half a pound. 8. which was the first antibiotic class available for the treatment of systemic bacterial infection a. sulfonamides b. cephalosporinase c. penicillin’s d. tetracycline 9. risk factors for extended spectrum beta lactamase producing Organism include except 10. monitoring for patients who are on long term antifungal therapy with ketoconazole Includes a. platelet count b. bun & creatinine c. AST ALT, alkaline phosphate, and bilirubin d. WBC 11. Which antipyretic drug would you prescribe the patient of a child with influenza A. Acetaminophen ? B. ibuprofen C. none of the answers are correct D. naproxen E. aspirin 12. a patient comes to the clinic and receive valacyclovir for herpes zoster virus when will the provider instruct the patient to take the medication a. Without regard to meals b. without any dairy product c. each morning d. an empty stomach 13. A patient has been diagnosed with onychomycosis the patient disliked the yellow discoloration of the toenails and request an oral form of ketoconazole. How would you respond? a. ketoconazole only treats viral infection b. ketoconazole taken orally has a higher risk of liver injury c. ketoconazole is only available in topical formulation d. the discoloration will subside without treatments in the next few days 14. The Beers criteria is utilized with which population of patient A. Ob/gyn B. Pediatrics C. mental health D. geriatris ? 15. a Pediatrics provider is teaching nursing student to calculate medication doses for children using a formula based on body surface area. which statement nursing student indicates understanding of teaching? a. This formula can determine medication dosing for a child of any age b. this formula accounts for pharmacokinetics factors that are different in children c. this formula helps approximate the first dose other doses should be based on clinical observations d. using this formula will prevent side effects of medication and children 16. A 6 month old infant is brought into the clinic with rash on the face and eye. That consists of linear erythematous burrows. An older sibling has similar rash on his wrist in between his fingers and appropriate intervention would be? a. mycitracin ointment b. Permethrin 5% cream (elimite)? c. bacitracin ointment d. ACITRETIN (SORIATANE) 17. Patient on chronic long term corticosteroid therapy, needs education regarding a. Small amount of alcohol are generally tolerated b. reporting black tarry stools or abdominal pain c. receiving all vaccination specially delivered flu vaccine d. eating high carbohydrate diet with plenty of fluids 18. physiological change in elderly that accounts for small volume of distribution and an increase in plasma concentration of digoxin is a. decreased total body fat b. increase total body water c. increased activity of hepatic enzymes that facilitate drug metabolism d. decrease rate of elimination due to decreased renal function 19. regarding the most common causes of adverse reaction in older adults which of the following would you find to be decreased in the most common cause of this problem in older adults a. liver function b. plasma albumin level c. body fat content d. renal function/clearance 20. an infant develop a pruritic following exposure to an allergen. The infant's parent asked the provider about using a topical antihistamine. what information should that provider use to address the parents question a. anti histamine given by this route are not absorbed as well as in children b. the child will also need oral medication to achieve effective results c. applying anti histamine to the skin can cause toxicity in the age group d. topical medication have fewer side effects than those given by other routes 21. a patient who has congestive heart failure requires a diuretic the patient also has a history of chronic kidney disease with GFR of less than 30ML per minute which drug prescribed for this patient a. Metolazone b. Methyclothiazide c. Furosemide d. Hydrochlorothiazide 22. Which outcomes should the NP establish for patient with trichomoniasis who is receiving metronidazole? A. improvement in pain in the back of the testicles B. decrease in yellow green, odorous vaginal discharge C. resolution of genital and perianal warts D. Absence of painful urination and watery discharge 23. a patient is diagnosed with lymphangitis has an allergy to penicillin the allergies are rash. What would you give to this patient? A. Clindamycin IV 24. which laboratory tests should be done at baseline when initiating a statin therapy A. platelets B. urinalysis C. LFTs LIVER ENZYME D. TSH 25. The patient is receiving anticoagulant therapy the INR value of the patients today is 1.5 in response to this what will you do a. the level is within the expected target therapeutic level of anticoagulation b. the level outside the expected target therapeutic level of anticoagulation, it is too low c. The level cannot be interpreted without knowing the PT and the INR ratio d. the level is outside the expected target therapeutic level of anticoagulation it's too high 26. A patient with alcohol abuse disorder is admitted to the hospital for surgery the provider is most concerned when the admission interview determines the patient regularly used to what medication a. morphine b. acetaminophen c. diazepam d. thiamine 27. which agent is often found as an adulterant in heroin and has led to increase in overdose death a. spice b. marijuana c. fentanyl d. cathinone’s 28. What are the three main classes of opioid receptors a. Theta mu Kappa b. Kappa delta Theta c. delta mu Theta d. delta mu Kappa 29. the providers conducting a smoking session class in the community. which effects will be included in the discussion about physiological effect on nicotine( select that all apply) a. Decrease gastric acid b. increase blood pressure c. increased alertness d. suppression of appetite e. Suppression of nausea f. vomiting 30. the patient is taking DEPOMYCIN. The NP should obtain a creatinine phosphokinase level when the patient shows which symptoms a. Abdominal bloating and diarrhea b. headache and visual disturbance c. muscle pain or weakness d. increase urination and urinary urgency 31. you are taking care of a patient that has an allergy to Bactrim. which of the following medication would not potentially cause a cross hypersensitivity reaction 32. The Primary Health care provider prescribes a medication along with ampicillin to enhance the effectiveness of the antibiotic which medication would enhance the effectiveness of the ampicillin a. Clavulanic acid b. Carbamazepine c. Calcium citrate d. Acetaminophen 33. which of the following is not an indication for macrolide antibiotic a. chlamydia b. whooping cough c. M. pneumonia d. Lyme disease 34. treatment of moderate non purulent and Cellulitis include all of the following except a. Trimethoprim/sulfamethoxazole b. Doxycycline c. Nitrofurantoin ? d. Clindamycin 35. Her patient who is receiving IV Ciprofloxacin for pneumonia develops diarrhea. Stool cultures positive for C- diff what action will provider take? a. prescribe metronidazole b. restrict dairy products c. increase the dose of ciprofloxacin d. switch to Gemifloxacin 36. what are the upper acceptable values for cholesterol within the blood a. total cholesterol level 40mg/dl HDL OF 160MG/DL AND LDL of 200mg/dl b. tcl 200, HDL 160 AND LDL 40 c. TCL 200, HDL 40, AND LDL 60 d. TCL 40, HDL 200 AND LDL 160 37. Bioconversion of prodrug to its active derivative may be enhanced by an enzyme inducer true or false 38. a patient is being assessed for muscle weakness cramping and leg discomfort. this patient has been taking hydrochlorothiazide. what else would you do for this patient? A. Administer calcium supplement B. give a lower dose of medication C. assess the serum potassium level D. reduce salt and patients diet 39. 85 year old male patient with no known drug allergies has been diagnosed With community acquired pneumonia. The patient was recently treated with ceftriaxone Rocephin for sinusitis. which of the following information is relevant to related to a risk for drug resistance S. pneumonia infection? 40. Isotretinoin (ACCUTANE) Is a drug employed in the treatment of severe recalcitrant cystic acne which of the following is not adverse effect associated with its use a. Fetal abnormalities b. hyponatremia c. Hypertriglyceridemia d. conjunctivitis 41. your first line treatment for scabies and five year old would be all of the following except a. permethrin b. malathion c. crotamiton d. lindane 42. How can the prescriber regular collaboration with pharmacist improve positive outcome for patient (select all that apply) a. the pharmacist could suggest adequate medication dosing b. pharmacist have additional information on drug interaction c. pharmacist have first-hand knowledge of the facility formulary d. pharmacy can alter prescription when necessary to prevent patient harm 43. prescriptive authority is work related by the State Board of nursing board of medicine 44. what would you prescribe for warfarin overdose a. aspirin b. calcium c. potassium d. Vitamin K 45. which antibiotic is recommended for the treatment of chlamydia a. high dose fluoroquinolone b. high dose Cephalosporin c. high dose penicillin d. high dose macrolide 46. a patient is found to have “strawberry spots “ under vagina and cervix. what is the treatment option? a. Acyclovir b. Metronidazole c. Lindane 1% cream d. Tetracycline 47. The drugs that produces irreversible blockade of platelet adenosine diphosphate P2Y receptors? A. Eptifibatide B. Clopidogrel AND Prasugrel C. Enoxaparin D. Dabigatran 48. The drug heparin acts in hemostasis by which process? a. inhibiting thrombin and antithrombin III (AT-III) b. preventing the conversion of prothrombin to thrombin c. shortening the fibrin stands to retract the blood clot d. degrading the fibrin within blood clots 49. as you formulate a plan for a 72 year old patient you recognize that of the following medications. Which is the least likely to cause postural hypotension and the older adult? A. Furosemide B. Amitriptyline (endep, amitril ? C. Lisinopril (prinvial, Zesril D. Clonidine (catapres, Kapvay, nexiclon 50. A pregnant patient who developed hypertension at 28 weeks gestational age. what medication do you anticipate giving? a. Methyldopa b. Any of the medication listed here maybe prescribed to a pregnant patient with gestational HTN c. Nifedipine d. Labetalol 51. Which of the following group of antibiotic has a beta-lactam ring in the molecular structure a. Fluroquinolones b. Macrolides c. Cephalosporins d. Sulfonamides e. Tetrcyclines 52. By what mechanism does Losartan 50 milligram PO daily promote vasodilation? a. It blocks the action of angiotensin ll b. it promotes the release of aldosterone c. it inhibits calcium influx into the cardiac smooth muscle cell d. it promotes prostaglandin synthesis 53. the patient is taking an Alpha 1 blocker, Doxazosin 1mg. Of which potential dangerous side effects should the patient be made aware? a. Increased urinary flow rate b. decreased heart rate c. increased urinary output d. orthostatic hypotension 54. a patient taking an angiotensin converting enzyme (ACE)inhibitor to treat hypertension tells the provider that she wants to become pregnant what responses will the provider give to the patient A. let's discuss using methyldopa instead of the ACE Inhibitor while you are pregnant B. controlling your blood pressure or decrease your risk of preeclampsia C. it will be safe to continue taking the ACE inhibitor during your pregnancy D. we need to consider changing you to an angiotensin receptor blocker during pregnancy 55. which of the following terms best describes the mechanism of action of metropolol a. Alpha l antagonist effect b. Beta1 selective c. nonselective beta with alpha blocking d. nonselective alpha blocker 56. which of the following best classifieds aminoglycoside, macrolides and Clindamycin a. folic acid synthesis inhibitor b. cell wall inhibitor c. protein synthesis inhibitor d. Mycolic acid synthesis inhibitor OK 57. which of the following is most likely an intervention for otitis media a. immunoglobulins b. aspirin c. amoxicillin d. corticosteroids 58. which of the following drug classes should be avoided in peptic ulcer disease a. avoid proton pump inhibitors b. avoid diuretics c. avoid antibiotics d. avoid NSAIDs 59. which antibiotics bind to the 50S subunit of the bacterial ribosomes and could most likely result in development of pseudomembranous colitis A. amoxicillin B. tetracycline C. Clindamycin D. Vancomycin 60. which of the following medication of drug classes is commonly indicated for in managing gestational hypertension. For emergency treatment in gestational hypertension, IV hydralazine, labetalol and oral nifedipine can be used. 61. Which of the following drug treatment strategies associated with peptic ulcer disease A. opioid B. antibiotics amoxicillin and clarithromycin C. corticosteroids D. hormonal therapy 62. which of the following groups of people are at risk of early hypertension a. African Americans b. adolescents and young adults c. Mexican American culture d. Mediterranean population e. old females 63. Which of the following disease or disorder are most likely treated with ACE inhibitors? a. Hyperthyroidism b. pulmonary hypertension c. Cushing syndrome d. angina e. chronic kidney disease (with or without diabetes)????? 64. Opiates are used mainly to treat moderate to severe pain. Which of the following is not true about this drugs? a. All opiate are scheduled drugs which require a DEA license to prescribe b. Most of the adverse effects of opiates are related to mu receptor stimulation c. Opiate stimulate only mu receptor for the control of pain d. Naloxone is an antagonist to opiates 65. Which of the following drug correctly match its clinical use? a. Naltrexone is used as an appetite stimulant b. methadone is for opiate toxicity c. Naloxone is used for opioid overdose d. Morphine is used for mild pain 66. A patient comes to your clinic having taken undermined amount of heroin. The drug of choice for heroin overdoses is? Naolxone/Narcan 67. A patient ask you how drug works….. a. it inhibits the absorption of dietary cholesterol in the small intestine b. system needs to be re system to increase the acceleration of dietary cholesterol c. it binds to bile in the intestinal tract forming an insoluble complex that is excreted in the feces. d. it inhabits hydroxymethylgulutaryl-coenzyme A (HMG-CoA) reductase to reduce the biosynthesis of cholesterol liver 68. Which of the following is not unexpected adverse effect of niacin A. hyperglycemia B. itching C. Atrhralgias D. flushing 69. What is the first line therapy when treating hyperlipidemia a. statin therapy b. bile acid sequestrants c. Niacin d. lifestyle modification 70. VT has a history of subtherapeutic anticoagulation on warfarin due to poor adherence and to the administration time was changed from evening to morning the patient also frequently skips meals and takes antacid for reflex the patient wants to take all medication at the same time every day. Select the Statin that is optimal for this patient wanting to take medication in the morning a. Atorvastatin (Lipitor) b. Lovastatin (Altoprev) c. Fluvastatin (lescol) d. Pravastatin (Pravachol). 71. All of the following are classification of dietary deficiencies causing nutritional anemia except A. vitamin B12 (cyanocobalamin) B. folic acid C. Iron D. vitamin D ?? 72. anemia of chronic renal failures caused by the lack of a. Parathyroid hormone b. Thyroid hormone c. Erythropoietin d. Adrenaline 73. You reviewed the laboratory test results for a patient prescribed atorvastatin. Which laboratory value is most useful for monitoring this drug a. Blood urea nitrogen (BUN) b. C-reactive protein (CRP) c. aspirate aminotransferases (AST) d. international normalized ratio (INR) 74. The provider orders Furosemide for a patient who takes digoxin and is admitted to the hospital for treatment of heart failure. Morning assessment identifies an irregular heart rate of 86 beats payment respiratory rate 22 breaths per minute and a blood pressure of 130/ 82. Crackles are heard in both lungs which laboratory result would be upgrade is concerning to the provider A. Potassium level of 3.4 meq/l B. sodium level 140 meq/l C. oxygen saturation of 90% D. Blood glucose level of 120mg/dl 75. A patient presents to your clinic with jaundice he complains of having dark urine light- colored stool, experience malaise, nausea and vomiting. What is the possible draw complication he's likely experiencing a. An allergic reaction b. an idiosyncratic drug effects on the bone marrow c. Tetrogenic disease of the kidney d. drug toxicity of the liver 76. When prescribing medication for the elderly the NP should a. all the answers are correct b. none of the answers are correct c. encourage the patient to cut drugs in half with a knife to lower cost d. assess cognitive functioning in the elderly e. encourage the patient to take weekly drug holiday to keep drug costs down 77. which of the following is not required element of the written prescription a. patient allergies b. quantity of drugs to be dispensed c. drug name d. patient name 78. at which of the following age would it be safe to prescribe tetracycline a. age 2 b. age 7 c. age 6 d. age 9 79. treatment of moderate non Purulent Cellulitis includes all of the following except a. Nitrofurantoin b. Clindamycin c. Doxycycline d. Trimethoprim/Sulfamethrozole 80. Primary advantage of using loratadine (Claritin) in treating patients with seasonal allergy is that it a. decrease nasal secretion significantly b. may be prescribed for daily dosing c. cost less than the other medication used for seasonal allergies d. may be taken PRN 81. which statement about ciprofloxacin is accurate a. Ciprofloxacin is active against MRSA strain of Staphylococci b. Organisms that commonly causes ear infections are highly resistant c. Most first time UTI are resistant to Ciprofloxacin d. Tendonitis may occur during treatment 82. Which anti-microbial is ineffective due to beta lactamase producing Organism a. Doxycycline b. Levofloxacin c. Penicillin d. Azithromycin 83. Which is considered the most widely used group of antibiotics because of their bacterial nature resistance to beta lactamase and activity against broad spectrum of pathogen a. Penicillin b. Cephalosporin c. Aminoglycoside d. Tetracycline 84. Which Cephalosporin can induce a state of alcohol intolerance select that all play a. Cefotetan b. Ceftroline c. Cefazolin d. Cefdinir e. Ceftriaxone 85. A patient diagnosed with otitis externa in taking fluroquinolone/ glucocorticoid combination medication ask that NP was the benefit is taking the medication together. You reply? a. glucocorticoid decreases the adverse effect of the fluoroquinolone b. the glucocorticoid reduces the swelling caused by the inflammation and decreases pain while the fluroquinolone treats the infection ? c. the two medications are contraindicated for use together d. the glucocorticoid decreases the likelihood of antibiotics resistance developing to the fluoroquinolone 86. Amoxicillin is prescribed for a 12 month child who develop a second middle ear infection since age a month. three days later the parents call to report that the child continues to have temperature of 39.5 Celsius and is unable to sleep well because of pain. What action would the provider take to provide effective care to this child? A. Discuss prescribing amoxicillin/clavulanate with the child's parent B. prescribe a medication that promotes sleep C. discuss with the parents the child needs for probable surgery of tympanostomy tubes placement to reduce infection D. advice continuing the amoxicillin as order and provide a schedule PRN dosing ibuprofen for pain 87. A 2 year old child present to the clinic with otalgia and fever the left tympanic membrane is a erythematous and bulging the Right TM’s is perforated in draining. The child parent states “this is the fifth year infection of the year. what can you do? “What action will the provider take to address the child's ear problem A. Prescribe amoxicillin and refer the child to An otolaryngologist B. prescribe both Ceftriaxone (Rocephin) IM with benzocaine ear drops for pain C. have discuss beginning prophylactic antibiotic therapy with trimethoprim/sulfamethoxazole D. prescribed both high dose amoxicillin and the influenza vaccine 88. Pharmacokinetics involve the study of which factor a. distribution rates among various body compartment b. adverse reaction to the medication c. interaction among various drugs d. physiologic interaction of drugs 89. Patient develops short of breath shortly after taking the initial does of a newly prescribed medication . The patient heart rate is 86 beats/minute the respiratory is 24 breaths/minute , and the blood pressure is 120/70 . The prescriber would discontinue the drug based on the assumption to the patient experienced what medication induced effect? a. A