MSN 571 PHARMACOLOGY MID-TERM QUESTIONS & ANSWERS (SCORED A+

UPDATED VERSION MSN 571 PHARMACOLOGY MID-TERM QUESTIONS & ANSWERS (SCORED A+) 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 lightcolored 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 side effect b. An Iatrogenic response c. An idiosyncratic effect d. An allergic reaction ? 90. Drugs with a narrow therapeutic window have? a. High risk of allergic reaction ?? b. High risk for toxicity c. High risk for abuse by the patient d. High risk for risk for atypical response. 91. a provider might consider testing for CY92D6 variance prior to starting tamoxifen for breast cancer to A. identify poor metabolizer Of tamoxifen ??? B. ensure the patient one not have increased adverse drug reaction to the tamoxifen C. identify potential drug-drug interaction that might occur with tamoxifen D. would you say likelihood of therapeutic failure with tamoxifen treatment 92. you administer 100mg ever drug by mouth. After the drug moves through the hepatic system very little active drug is left in general circulation. What concept explains this occurrence? First pass effect a. reduced bioavailability time ??? b. steady state c. Phase ll metabolism d. Half-life 93. Which of the following it's not one of the four process of pharmacokinetics A. absorption B. administration C. Distribution D. excretion 94. A patient who is scheduled to begin warfarin treatment and is currently being treated with amiodarone. Based on the information, what changes would be made to the medication regimen? a. The dosage of Amiodarone will be decreased b. The dosage of the warfarin will be decreased BY HALF c. the dosage of amiodarone will be increased d. the dosage of warfarin would be increased 95. What is plasmin role in the clotting process a. inhibits platelet adhesion and aggregation b. stimulates platelet aggregation c. degrades the fibrin within blood clots d. prevents the conversion of prothrombin to degrade the fibrin within blood clots 96. An orally administered drug that directly inhibits thrombin . a. Enoxaparin b. Dabigatran (Pradaxa) 97. A medication review of an elderly person medication involves a. asking the patient to bring a list of current prescription medication to the visit b. asking what other providers are writing prescription for them c. all the answers are correct d. having the patient bring all the prescription over the counter and herbal medication to the visit 98. Prescriptive authority is regulated by the State Board of nursing board of medicine, or board of pharmacy, depending on the state a. true b. False 99. Which of the following medication is a fluroquinolone antibiotics? Ciprofloxacin, germifloxacin, levofloxacin and ofloxacin a. Azithromycin b. Amikacin c. Penicillin d. Ciprofloxacin Set 2& 3 1. Which of the following hypertension medication or drug classes is commonly indicated for managing gestational hypertension a. Spironolactone (Aldactone) b. Loop diuretics c. Calcium channel blockers ?? d. Dobutamine e. Calcium gluconate 2. Beta lactamase inhibitor are often indicated in which of the following a. often combined with penicillin antibiotic ????? b. First dose effect c. may decrease absorption of medication d. delay absorption of oral drugs 3. Which of the following is most likely an intervention for otitis media? a. Aspirin b. Amoxicillin c. Corticosteroids d. immunoglobulins 4. which of the following best classified penicillin, cephalosporins, and carbapenems? a. Mycolic acid Synthesis inhibitors b. cell wall inhibitors c. protein synthesis inhibitors d. RNA synthesis inhibitors 5. Which of the following group of antibiotics with notable for side effects such as nephrotoxicity and ototoxicity b. Aminoglycoside c. Cephalosporins d. Tetracyclines e. Beta-lactams 6. A 17 year old asthmatic patient has been told that marijuana may help his anxiety. Which adverse effect has been associated with marijuana may be the reason for the patient to avoid using marijuana a. hyperthermia b. hepatitis c. short-term memory loss d. hyponatremia 7. A patient with opioid use disorder has undergone detoxification with buprenorphine afterward the provider prescribed buprenorphine and naloxone. When the patient asked why the drug was changed, what response with the prescriber provide? a. It has longer half-life b. Buprenorphine causes more respiratory depression c. the combination drug contains more buprenorphine d. the combination has a lower risk of abuse 8. Which of the following best classifieds aminoglycoside, macrolides, and Clindamycin? a. Cell will inhibitors b. folic acid synthesis inhibitors c. mycolic acid synthesis inhibitors d. protein synthesis inhibitors 9. schedule lll Drug is ordered for patient. The patient asks you what the schedule designation means. How will you reply? a. Schedule lll drugs have high risk of toxicity b. scheduled drugs are designed and number based on their potential for abuse c. Scheduled lll means that more pain relief is provided that scheduled ll drug can provide d. this means that this drug has a low number of adverse effects 10. Which of the following opioids is lipophilic that is marked in the skin patch used to treat chronic pain? a. Methadone b. fentanyl c. Naltrexone d. Scopolamine 11. Acute bacterial rhinosinusitis syndrome (ABRS) A. Streptococcus pneumonia, Moraxella catarrhalis, haemophiles influenzas B. ECOLI, Klebsiella pneumonia, proteus Mirabills C. Legionella pneumonia, mycoplasma pneumonia, chlamydia pneumonia D. Acinetobacter, Enterococcus faecalis, campylobacter 12. The NP explains to the NP students about penicillin . Which is true about penicillin? Select all that apply A. they are bacterialstatic B. they are active only against bacteria that are growing and dividing C. they are considered one of the safest antibiotics D. there are known as beta lactam antibiotics E. they cause bacteria to take up excess amount of water and rupture 13. Which medication classification is used to decrease preload and patient with heart failure a. beta blocker b. calcium channel blocker c. diuretics d. corticosteroids 14. which statement about ciprofloxacin is correct a. organisms that commonly cause ear infection are highly resistant b. tendonitis may occur during treatment c. ciprofloxacin is active against MRSA strains of staphylococci d. most first time urinary tract infection are resistant to ciprofloxacin 15. Aa NP student asked about the mechanism of Bacteriostatic action of tetracycline . Which explanation is correct? A. tetracycline binds to magnesium ions B. tetracycline inhibits protein synthesis C. tetracycline blocks RNA synthesis D. tetracycline degrades the bacterial cell wall 16. MRSA and drug resistant strep pneumonia (DRSP) mechanism of bacterial resistance is: A. None of the answers are correct B. Altered membrane permeability C. binding site alteration D. enzyme destruction with beta lactamase 17. A patient report flashing, itching, hives , anxiety and throat and tongue swelling . Which condition may the patient have as a result of taking the antibiotics a. An allergic anaphylactic reaction 18. which medication would decrease blood pressure by blocking angiotensin 2 receptor sites a. VALSARTAN b. Furosemide c. Eplerenone d. Enalapril 19. Which clinical finding is an adverse effect of patient taking Propranolol A. Wheezing B. blood glucose of 180 mg/dl C. heart rate of 100 beats/min D. urinary urgency 20. Monitoring for patients who are on long term antifungal therapy with ketoconazole includes A. platelet count B. B UN and creatinine C. AST, ALT , alkaline phosphatase , bilirubin D. white blood cell count 21. which antipyretic drug would you prescribe the parent of a child with influenza a. acetaminophen b. ibuprofen c. none of the answers are correct d. naproxen e. aspirin 22. 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 regards to meals b. without any dairy products c. each morning d. an empty stomach 23. Patients who are on chronic long term corticosteroid therapy needs education regarding a. small amount of alcohol are generally tolerated b. reporting black tarry stool or abdominal pain c. receiving all vaccination, specially delivered flu vaccine d. eating a high carbohydrate diet with plenty of fluids 24. A patient diagnosed with lymphangitis has an allergy to penicillin , allergies rash . What would you give to this patient a. penicillin VK by mouth b. Trimethoprim/sulfamethoxazole (TMP/SMZ) c. Penicillin G IV d. Clindamycin 25. 19)An NP student is reviewing information about a drug. The drug is taken orally, and after 12 hours, traces of the drug are found in urine and cerebrospinal fluid. What is the process called? A. Pharmacokinetic 26. W Which enzyme system is responsible for metabolizing drugs in the liver? Answer: P450 enzymes 27. A patient admits that she sometimes forgets to take her medication daily . What type of medication half-life would be better for this patient? a. A four hour half-life b. a long half-life c. short half life d. this is never a consideration 28. amoxicillin is prescribed for a 12 month old child who developed a second middle ear infection since 8 8 month period 3 days later, The parents call to report that the child continues to have a temperature of 39.5 degrees Celsius and is unable to sleep well because of pain. What will the nurse do? Encourage the parent to discuss amoxicillin/clavulanate (augmentin) with the childs provider. 29. The therapeutic index is measure of drug a. safety profile b. bioavailability status c. absorption rate d. effectiveness 30. Drugs that are prone to cause adverse drug effects include: a. insulins b. stimulants c. inhaled anticholinergics d. diuretics 31. convert 15 lbs 8 OZ to kilograms. Round to the nearest 100th a. 7.00 b. 7.03 c. 34.10 d. 33.00 32. A patient Who has been taking warfarin is admitted with coffee ground emesis. How would how will you manage this patient? a. Administer vitamin K b. administer protamine sulfate c. administer calcium gluconate d. administer vitamin E 33. a pregnant patient with history of Thrombosis . Which prophylactic treatment would you prescribe a. enoxaparin b. alteplase c. warfarin d. clopidogrel 34. how does simvastatin exert its action? By inhibiting the enzyme HMG-CoA reductase 35. Patients ask if there is any other option beside antibiotics to treat acute otitis media. How will you respond? a. pain management is also part of the treatment plan for otitis media b. pain management is only necessary when antibiotics are prescribed c. pain management is reserved for use when the tympanic membrane is burst d. antibiotics are the only way to cure otitis media 36. a patient is being treated for pernicious anemia with signal plumbing reports new onset of muscle weakness and states “my heart is escaping beats” which laboratory value most likely is contributing to this new symptoms? a. Serum glucose level of 185mg/dl b. Serum potassium level of 2.3 37. What occurs when a drug binds to a receptor in the body? A. It increases or decreases the activity of that receptor B. It gives the receptor a new function C. it prevents the action of receptor altering its responses to chemical mediators D. it alters the receptor to become non responsive to its usual endogenous molecules 38. which science provides Primary Health care providers that opportunity to individualize drug therapy based on patient's genetic makeup a. pharmacogenomics b. pharmacogenetics c. pharmacokinetics d. pharmacodynamic 39. A patient has taken narcotics analgesic for chronic pain several months. At a follow up appointments the provider notes that the patient has been taking more than the prescribed dosage. The patient has normal vital signs is awake and alert and reports mild pain. What does the provider suspect is responsible for the patient's response? A. the patient has developed pharmacodynamic tolerance which has increased the minimal effective concentration (MEC) needed for ANALGESIC effect B. the patient has developed tachyphylaxis because they repeated exposure to the drug C. the patient has increased hepatic enzyme production as a result of prolonged exposure to the drug D. the patient exhibits in negative placeable effects with reduced response to the drug 40. Your patient is diagnosed with psoriasis. Can prescribe all except a. vitamin E Analogs b. glucocorticoids c. Methotrexate d. Tars 41. )A patient is given a drug that ha a half-life of 8 hours. The peak level of this drug is 100mg/L. What is the concentration of the drug after two half-lives? Answer: 25mg 42. Which of the following term best describes the mechanism of action of metoprolol a. A1 antagonist effects b. beta one selective c. non selective beta with alpha blocking d. non selective alpha blocker 43. Beta lactamase inhibitors are often indicated in which of the following? a. Delayed absorption of oral drugs b. first dose effect c. often combined with penicillin antibiotics d. may decrease absorption of medication 44. which of the following drug classes should be avoided in peptic ulcer disease? a. Avoid proton pump inhibitors b. avoid NSAIDs c. avoid antibiotics d. avoid diuretics 45. Which of the following groups of antibiotics has a beta lactam ring in the molecular structure? a. Macrolides b. Sulfonamides c. Cephalosporins d. Fluoroquinolones e. Tetracyclines 46. Which of the following drug classes is/are used an initial hypertension Med management of African American population? a.Clonidine primary b. beta blockers primary c. Thiazides or calcium channel blockers primary d. ACE-I primary e. ARB primary 47. Which of the following disease or disorder most likely treated with ACE inhibitors? A. Hyperthyroidism B. pulmonary hypertension C. Cushing syndrome D. angina E. chronic kidney disease (with or without diabetes) 48. Pediatrics patient presents with one golden crusted lesion at the site of the insect bite consistent with impetigo . His parents have limited finances and request the least expensive treatment. Which medication would be the best choice of treatment? a. Oral cephalexin (Keflex) b. Mupirocin (Bactroban) c. Retapamulin (Altabax) d. Bacitracin and polymyxin B (generic double antibiotics ointment) 49. A bleeding patient receiving warfarin has an INR of 6 . What is the best course of action? a. Administer Phytonadione, Vitamin K b. stop the IV drip c. wait for INR to decrease d. administer protamine sulfate 50. Which of the following will you find in a patient taking warfarin and levothyroxine? Monitor the patient for increased risk of bleeding. 51. Treatment for fungal infection of the toenails (onychomycosis) include a. Ketoconazole cream b. Oral Griseofulvin c. Mupirocin cram d. Miconazole cream 52. The recommended immunization for health young adults are a. Influenza, hepatitis B, rubella, measles, and tetanus ? b. Tetanus, influenzas, varicella, pneumovax, and hepatitis B c. Measles, rubella, varicella and hepatitis B d. Pneumovax, influenza and rubella 53. The antimicrobial that is recommended and highly effective for the treatment of gonorrhea at all anatomic sites of infection A. ciprofloxacin B. Penicillin C. Parental Ceftriaxone D. cephalexin 54. Which statement about “once-daily” dosing with aminoglycoside is accurate a. It results in underdosing b. extra nursing time is required for Drug Administration c. dose adjustment is important in renal dysfunction d. it is inconvenient for outpatient treatment 55. which route of administration is most likely to lead to rapid anaphylaxis if it is used to administer penicillin? A. Intravenous B. subcutaneous C. oral D. intramuscular 56. The NP explained to the NP student about penicillin. which is true about penicillin? Select all that apply A. They are active only agonist bacteria that are growing and dividing B. they cause bacteria to take up excess amount of water and rapture C. they are bacteriostatic D. they are considered one of the safest antibiotics E. there are known as beta lactam antibiotics 57. A patient started on warfarin therapy while also receiving intravenous heparin . The patient is concerned about the risk for bleeding . What would you tell the patient? a. Because you are now up and walking you have high risk of blood clots and therefore need to be on both medication b. your concern is valid I'll call the doctor discontinued the heparin c. it is usually takes about three days to achieve a therapeutic effects for warfarin so the heparin is continued until the warfarin is therapeutic d. because of your valve replacement it is especially important for you to be given anticoagulant therapy period the heparin and warfarin together are more effective than the one alone 58. which is the appropriate antimicrobial selection for acute bacterial rhinosinusitis syndrome (ARBS)? A. Cephalosporin B. Augmentin C. Azithromycin D. Amoxicillin 59. Agonist act on the cell by: a. Blocking the cell action b. activating the cell action c. neutralizing the cell action d. reducing the cell action 60. The patient lists this food as daily part of his diet and will require you to discuss potential drug interaction: a. Apple juice b. Orange juice c. Grapefruit juice d. Chocolate 61. The definition of pharmacokinetic is: a. The drug movement throughout the body and what the body does to the drug b. what the drug does to the body c. adverse reaction to the drugs d. impacts of foods on drugs 62. Which of the following is known to increase the serum concentration of penicillin? a. Probenecid b. Theophylline c. Hydrochlorothiazide d. Clonidine 63. A patient's INR is 1.2 on warfarin therapy to prevent DVT. How would you interpret his INR level as? a. INR Is too high vitamin K may be needed b. IRN is within limits no action is indicated c. INR Is too high: IV protamine sulfate may be needed d. INR is too low ; the dose of warfarin may need to be increased 64. A 45 year old man with type 2 diabetes is noted to have blood pressure of 145 / 90 and 115 / 96 mm hg on two separate occasions which of the following is the best initial therapy for this patient a. beta blocker b. beta blockers in hydrochlorothiazide c. ACE inhibitors -----FOR CKD and DM pt. d. hydrochlorothiazide 65. The NP determined that the patient is experiencing an adverse effects of Enalapril, if which affect is noted? A. Patient serum sodium is 140mEq/l B. patient serum potassium is 4.2mEq/l C. patient has a dry, hacking cough D. patient complains of persistent dry mouth 66. The renin-angiotensin aldosterone system plays an important role in maintaining blood pressure. Which compound in the system is most powerful at raising blood pressure? a. Angiotensin l b. angiotensin lll c. angiotensin ll d. rennin 67. Thiazide diuretics are used to treat hypertension because they: A. decrease blood viscosity B. increase renin secretion C. decrease the production of aldosterone D. deplete body sodium and reduce fluid volume 68. Nurse practitioner practice may thrive under the health care reform because of a. the demonstrated ability of nurse practitioner to control costs and improve patient outcomes b. the fact that the nurse practitioner will be able to practice independently c. the ability to shift accountability for Medicaid to the state level d. the fact that nurse practitioner will have full imbursement under health care reform 69. which antilipemic medication reduced serum cholesterol by inhibiting its absorption and small intestine? A. Cholestyramine B. Niacin C. Rosuvastatin D. Ezetimibe 70. A 19 year old female comes to your clinic with greenish malodorous discharge valvular pruritus is also present. on pelvic exam vaginal mucosa is erythematous . Wet mount of the discharge shows motile Organism. The patient is started on an appropriate therapy. later that evening, the patient develops flushing , nausea, vomiting after eating dinner with a glass of wine. The patient was most likely treated with which of the following medication a. Ceftriaxone b. Metronidazole ?? c. Azithromycin d. Fluconazole 71. Which part of the loop of Henle is completely permeable to water? a. Descending b. Proximal c. Distal d. Ascending 72. A 60 year old male patient suffered an MI three months ago and has been treated for hypercholesterolemia for the last 10 years . His current LDL-C level is 172mg/dL which of the following drugs is the most appropriate treatment for this patient? A. Pravastatin ??? not sure B. Fenofibrate C. Rosuvastatin D. Ezetimibe E. Alirocumab 73. Steps to avoid polypharmacy include: A. Evaluate the duplication and drug therapy and discontinue that any duplications B. prescribe two or fewer drugs from each drug class C. encouraging the elderly patient to coordinate their care with all their providers D. Reviewing a complete drug history every 12 to 18 months 74. The volume of distribution of a drug would be greater if the drug a. has poor lipid solubility b. is more ionized inside the cell than in plasma c. is highly ionized in plasma d. is administer very rapidly 75. a partial agonist is best described as an agent that: a. has affinity but lacks efficacy b. has low potency but high efficacy c. interact with more than one receptor type d. cannot produce the full effect, even at high doses *** has some agonist effect 76. which is required for red blood cell production a. all answers are correct b. folate c. iron d. vitamin B12 77. Which of the following antibiotics would have a drug interaction with ferrous sulfate ? a. Erythromycin b. Clindamycin c. Cephalexin d. Tetracycline ?? 78. Which is the strongest safety warning a drug can have and still prescribed safely? a. Brown box morning b. white box warning c. Gray box warning d. black box warning 79. a generic drug: a. is not bioaccumulate or identical to the reference drug b. is approved by the FDA but the researchers must demonstrate a different route or administration for efficacy c. is bioequivalent or identical to the reference drug d. in clinical studies it has been demonstrated to have the same therapeutic effects as a reference drug ??? 80. Pharmacokinetics of what the study of which factor? a. Interaction among various drugs b. distribution rates among various body compartment c. adverse reaction to medication d. physiologic interaction of drugs 81. A patient is diagnosed with otitis externa caused by aspergillus organisms. All the therapies appropriate except a. Oral fluconazole b. Topical 1% clotrimazole c. 2% acetic acid solution ear drops d. Ciprofloxacin hydrocortisone otic solution. *****Ciprofloxacin is effective against bacteria. Aspergillus spp. are fungi and must be treated with agents that have an antifungal effect, such as fluconazole, 2% acetic acid, or 1% clotrimazole. 82. The provider is discussing the management of prescribed , controlled substance with patient. Which statement by the patient indicates understanding of the information provided? a. Prescription for drugs and schedule III and IV may be written to include up to five refills ??? b. to reduce the possibility of abuse of drugs that is scheduled II, the prescriber should call this prescription to the pharmacy c. if there is a difference between state and federal law governing a scheduled drug the federal law takes precedence d. schedule one drugs may only be given to hospitalized patients 83. A patient who has a long term addiction to opioids are believed to have taken it overdose of barbiturates . The provider will anticipate which likely outcome? a. Paradoxical excitation resulting from a drug-drug interaction b. minimal respiratory depression because the patient has developed a tolerance to opioids c. severe abstinence syndrome with the effects of barbiturates or reversed d. Pinpoint pupils, respiratory depression, and possibly coma 84. Which of the following medication is used a adjuvant treatment in patient with cancer pain? a. Sertraline b. Citalopram c. Aminophylline d. Amitriptyline ??? 85. The dosage of amoxicillin for the treatment of pediatrics acute otitis media is: A. Amoxicillin 25mg/kg/day B. Amoxicillin 90mg/kg/day ??? C. Amoxicillin 150mg/kg/day D. Amoxicillin 50mg/kg/day 86. Which antibiotics is in the macrolide class? a. Trimethoprim b. Minocycline (Minocin) c. Nitrofurantoin (Macrobid) d. Clarithromycin (Biaxin) 87. Which of the following medication is classified as macrolides? a. All are macrolides b. Erythromycin c. Azithromycin d. Clarithromycin 88. Which statement about transdermal absorption in infants are correct a. all the answers are correct b. the stratum corneum of the infant skin is very thin making absorption through the skin more rapid and complete with infants c. infants are an increased risk for toxicity compared with older children d. blood flow to the skin is greater in infant than in older patients 89. Which pediatric client is a greatest risk for medication toxicity? 13 C 14 D 23 a 27 B 28 D 1. What should be included in the plan of care for a patient prescribed ferrous sulfate? Iron should not be taken at night Iron does not absorb antiacids should not be taken with iron iron compounds are not taken orally 2. anemia of chronic renal failure is caused by lack of A. Erythropoietin B. Adrenaline C. Parathyroid hormone D. Thyroid hormone 3. Diagnosed with histoplasmosis is being treated with itraconazole probable teach the patient to report which symptoms a. Visual disturbances b. Gynecomastia and decreased libido c. Nausea, vomiting, and anorexia d. Headache and rash 4. How to maintenance recommendation for a 51-year-old patient who is playing activities a. T dab/TD vaccine b. pneumococcal vaccine c. hepatitis B vaccine d. Varicella vaccine 1. When prescribing a acyclovir patient should be educated regarding a. E centric dosing schedule b. Need to drink lots of fluids during treatment 2. Contraindication to hepatitis B vaccination is a. a history of poliomyelitis b. mild viral illness c. previous severe hypersensitivity or an anaphylaxis d. all pregnant and lactation woman 3. You are providing care for an adolescent patient with the acne vulgaris who developed serious side effects with isotretinoin. You have since prescribed azelaic acid Venezia as Alex ass and alternative treatment what time factor is important to evaluate the effectiveness of this treatment regiment a. Improvement typically occurs after 4 to 6 week of therapy b. if no improvement is noted prior to week 4 treatment should be discontinued c. improvement should be expected within a few days of beginning the treatment d. no improvement will occur until after 12 weeks of treatment 4. No quesiont 5. Patient will you provide a patient who starting treatment with the Febuxostat (Uloric) a. the patient should consume a high calcium diet b. the patient will need frequent CBC monitoring c. gout my worsen with therapy d. Febuxostat (Uloric) may cause severe diarrhea 6. Amoxicillin is prescribed for a 12 month old child who developed a second middle ear infection since age 8 months. Three days later the parents called to report that the child continues to have a temperature of 39.5 Celsius and is unable to sleep well because of pain. What should action will the provider take to provide effective care to this child? A. Advise continued amoxicillin as ordered and provide a schedule of PRN dosing for ibuprofen for pain B. discussed prescribing amoxicillin clavulanate with the child’s parents C. prescribe a medication that promotes sleep D. discussed with the parent the child needs for probably surgery for tympanostomy tubes placement to reduce infection 7. The patient is diagnosed with a otitis media with perforated eardrum. Do you want to prescribe an attic preparation? Which of the following is not appropriate? a. Ciprofloxacin/Hydrocortisone otic b. ofloxacin otic c. Acetic acid otic??? d. ciprofloxacin/dexamethasone 8. Tretinoin is commonly employed in the treatment of which of the following? A. Multiple sclerosis B. Acne C. Psoriasis D. Seborrheic dermatitis 9. Drugs that stimulate the synthesis of CYP ice to enzyme are referred to as in a. rapid metabolizer b. normal metabolizer c. inducing agent d. reduction agent 10. Which of the following is true about the pharmacokinetic process in infants? A. All the true statements B. the blood brain barrier is not fully developed at birth therefore drugs are capable of producing CNS toxicity as a side effect C. gastric acidity is very low after birth and does not reach adult values for two years D. Drug metabolizing capacity of newborn is low. Complete maturation of the liver does not fully develop until one year of age. E. Binding of drugs to albumin and other plasma proteins is limited. Therefore here levels of drugs made intensely effects 15. 16. What is the properties of an ideal drug? a. Effectiveness safety and selectivity b. effectiveness safety and responsiveness c. safety selectivity and responsiveness d. selectivity and responsiveness 17. Which enzyme system is responsible for metabolizing drug in the liver? A. Gastric lipase B. Ptyalin C. pancreatic lipase D. CYP 450 enzyme 18. Which action occurs the most of the fatal medication error select all that apply a. writing a prescription illegibly b. administering a drug that sounds like the prescribing drug c. confusing drugs with similar packaging d. giving drugs intravenously instead of intramuscularly e. using an infusion device that malfunction 19. Term refers to the ratio between a drugs therapeutic fact and it’s toxic effect a. therapeutic index b. cumulative affect c. tolerance d. affinity 21. A 60-year-old patient has been treated for hypocholesterolemia for the last 10 years and has recently suffered an MRI. The patient’s current LDL -C is 180 MG of a deal. Which of the following medication is the most appropriate treatment for this patient? E a. ezetimibe b. fenofibrate c. pravastatin d. Alirucomab e. Rosuvastatin ???? 22. One of the following is the most common side effect of anti-hyperlipidemic drug therapy? A. neurological problems B. elevated blood pressure C. heart palpitations D. gastrointestinal disturbances 23. A patient with cardiovascular disease is taking rosuvastatin. Which finding would indicate a potential adverse effect of this drug? a. Muscle pain and tenderness b. blood pressure of 140/90 mm hg c. platelet a count of 100×10.3/MM3 d. wheezing and shortness of breath 24. What are the upper acceptable value for cholesterol within the blood? a. Total cholesterol level of 200 MG/DLHDL of 160 MG /DL and LDL a 40 mg/dl b. total cholesterol level of 200 MG DL HDL 40 MG DL and LDL of 160 MG DL c. total cholesterol level of 40 mg/dL, HDL of 200 mg/dL and LDL of 160mg/dL d. cholesterol level of 40 MG/DL, HDL of 160 MG/DL and LDL of 200 MG/DL 25. A frail older adult patient is admitted to the hospital after several days of vomiting. Diarrhea poor intake of foods and fluids and anuria for eight hours. What laboratory studies will the provider order to help guide medication administration select all that apply (quizlet) a. plasma drug levels a. serum creatinine b. Creatinine clearance c. Gastric pH d. Serum Albumin 26. The patient who has been prescribed lithium for a diagnosis of bipolar disorder asks why blood test can I required on a regular basis which provide responses demonstrate an understanding of why this patient requires a variety of laboratory test select all that apply a. this medication can’t can cause you to lose sodium so we need to need to major sodium b. level we need to monitor kidney function while you are on this drug c. lithium can cause you to lose potassium so we so we need to regularly monitor your blood potassium levels d. your liver can be damaged by lithium regular testing helps us monitor for that e. we need to monitor how your thyroid is functioning 27. Hey 70-year-old patient with penicillin sensitivity is receiving digoxin and warfarin therapy. A macrolide antibiotic is required to treat a streptococcal infection. Which of the following medication would be best for this patient? A. Clarithromycin B. Erythromycin C. Telithromycin D. Azithromycin 28. Which patient condition would be contraindication for the administration of Clindamycin? a. Arthritis a. diabetes mellitus b. skin infection c. ulcerative colitis 30. Which cephalosporin made a prescriber order to treat meningitis? a. Cefazolin b. Cefaclor c. Cefoxitin d. Cefotaxime 31. What drug makes of Augmentin a. amoxicillin +clavulanic acid b. ampicillin + sulbactam c. piperacillin + Tazobactam d. cephalexin + probenecid 32. A patient who is taking doxycycline for a serious infection reports and anal itching what action will the provider take? a. prescribing an antifungal drug to treat a super infection b. testing the patient for a C.DifF secondary infection c. prescribing an anti-histamine to the patient’s existing drug regimen d. ordering liver function test to test for hepatotoxicity 33. Describing metronidazole Flagyl to treat bacterial vaginosis patient education would include a. sexual partners need a concurrent therapy b. headache or a sign of serious adverse reaction and need immediate evaluation c. Flagyl is safe in the first trimester of pregnancy d. consuming alcohol in any form because severe reaction 34. A pharmacokinetic parameters that is altered and obese patient is a. metabolism b. volume of distribution c. absorption d. clearance 35. The parent of a child with asthma ask the provider why their child can I use oral corticosteroids more often because they are so effective. The provider will base the discussion with the patient on what fact concerning oral corticosteroids? a. Systemic steroids are more toxic in children b. frequent use of this drug may lead to decreased response c. chronic glucocorticoid use can inhibit physical growth d. A hypersensitivity reaction to this drug may occur 36. Which statement by a patient about the use of aspirin during pregnancy indicated a need for further learning? a. Aspirin is most harmful when used in late pregnancy b. aspirin can be used to relieve pain during pregnancy c. aspirin can affect hemostatic in the newborn d. aspirin can cause antepartum hemorrhage 37. Missing 38. Which resources will the NP use to determine after a drug was on the market? a. The phase 1 trial of the drug b. Ethnopharmacological studies c. the phase 2 trials of the drug ? d. the black box warning 40. Which antibiotic is recommended for the treatment of chlamydia? a. high dose of macrolide b. high dose penicillin c. high dose of cephalosporin d. high dose fluoroquinolone 41. Female patient who is being treated for chronic hepatitis B group and develops nephrotoxicity while on treatment what is the most likely medication she is taking? a. Entecavir b. Adefovir c. Lamivudine d. telbivudine 42. Statement by the prescriber demonstrates an understanding of affective medication education select all that apply a. take three tablets daily one with breakfast one with lunch and one with dinner b. when you call about a medication refill be sure to let the pharmacist know you are talking your heart pill c. this medication need to be stored in refrigerator d. call the office immediately if you begin experiencing any itching headache or difficulty breathing e. you need to take the medication as we discussed until all the tablets are gone 43. When writing a prescription for Tylenol number three acetaminophen with codeine. The FNP is aware of the state law that he or she needs which of the following to be able to prescribe this medication? a. State license and NPI registration number b. state controlled substance license and a state government license for schedule II to IV drugs c. a federal government license to practice and a state license allowing to prescribe schedule I and II drugs d. a state controlled substance license and a DEA registration certification for schedule III drugs ?? 44. Which agent is most likely to cause serious respiratory depression as a potential adverse reaction a. naltrexone b. Hydrocodone c. morphine d. Pentazocine 45. What is true about transdermal fentanyl? a. Transdermal patch maybe cut and a half to minimize adverse effects such as respiratory depression sedation constipation urinary tension and nausea b. it is not as potent as morphine c. it may be applied anywhere on the skin that is not exposed to sunlight d. transdermal fentanyl should never be cut or manipulated because this case lead to serious harm or death 46. Narcan is considered an a. partial agonist b. agonist c. inhibitor d. inducer antagonist 47. The pain management contract is appropriate for; a. patient with chronic pain who will require long-term use of opiates b. patient will see multiple prior for pain control c. patient with cancer who are taking morphine d. patient who have complex drug regimen 49. Which of the following groups of antiabiotic is notable for side effects such as nephrotoxicity and auto toxicity? a. Cephalosporins b. Beta-lactam c. tetracycline d. aminoglycoside 50. Which of the following groups of antibiotics binds to the 50 S subunit of bacterial ribosomes and include drugs such as erthromycin and azithromycin? Macrolides tetracycline fluoroquinolones aminoglycoside 51. Which of the following drug treatment strategies associated with peptic ulcer disease a. opioids b. antibiotics amoxicillin and Clarithromycin c. hormonal therapy d. corticosteroids??? 54. Floraquinolone antibiotic or most likely indicated in which of the following conditions? a. GERD b. asthma c. genital infection d. follicular conjunctivitis 55. Which antibiotic bind to the 50 S subunit of the bacterial ribosome and could most likely result in the development of pseudomembranous colitis? a. Vancomycin b. Clindamycin ???? c. tetracycline d. amoxicillin