NUR 635 Pharm Final Exam 2024 Updated Questions with Correct Answers

Why can NPs prescribe? - ANSWER Increase access to healthcare How do you titrate medications? - ANSWER Monitor plasma levels closely Sam is a 90 y/o pt who requires a new RX. what changes in drug distribution with aging would influence rxing for Sadie - ANSWER Decreased plasma proteins 10mg Percocet vs 10mg oxy one works better because of..? - ANSWER The filler changes metabolism of the medication Medications need albumin to bind to and they are toxic (therapeutic index), is something competing for the albumin? - ANSWER Check other drugs When writing a prescription what is not allowed? - ANSWER Abbreviations that are not allowed Qd What medication causes gray teeth? - ANSWER Tetracycline A patient on seizure medication is still having seizures after a few weeks what do you want to do? - ANSWER Check serum drug levels because of narrow therapeutic index A patient is on phenytoin cannot be started on oral contraceptives they need a barrier method? - ANSWER Anything other than oral contraceptives When do you stop tetragons? - ANSWER Stop before the patient becomes pregnant A pregnant women is taking aspirin why is that bad? - ANSWER Causes PDA premature closure of __ A patient is taking Phenytoin for seizures and has a rash a month later what has happened? - ANSWER hypersensitivity can happen a month later A young healthy female has frequency and burning what do we prescribe? - ANSWER tx with Macrobid What is the 1st line drug choice for a previously healthy adult pt dx with community acquired pneumonia? - ANSWER Azithromycin How do you treat community acquired pneumonia with comorbidities? - ANSWER Tx with Rocephin and Azithromycin (a Macrolide) do NOT tx with LEVAQUIN. Why do we not treat onychomycosis (a fungal infection of the nails) ? - ANSWER Treatment can lead to liver/hepatotoxicity How do we titrate pancreatic enzymes? - ANSWER Look at poop color. Who needs pancreatic enzymes? CF pts & Gastric bypass pts need pancreatic enzymes statarea (color of poop) How do we prescribe for pancreatic enzymes? - ANSWER Prescribe units of lipase for pancreatic enzymes based on your poop color A patients daughter said she took Demerol/Meperidine for her surgery and wants it for her dads hip replacement: - ANSWER We do not give Demerol anymore it is DIRTY! A Lot of side effects. The pt has returned to the floor from surgery after a hip arthroplasty. For the first 48 hrs postoperatively, meperidine (Demerol) is order for pain control. During the time the pt is taking meperidine, frequent monitoring of what is required?A) blood pressureB) pulseC) temperatureD) urine output - ANSWER A ) blood pressure Typical or traditional antipsychotics may cause EPS or pseudoparkinsonism. Which symptom is considered an EPS?A) downward eye movementB) intentional tremorsC) loss of hearingD) shuffling gait - ANSWER D) shuffling gait The pt has a hx of depression and is taking fluoxetine (Prozac). The pt presents to the ED complaining of a severe headache. She is diaphoretic and is unable to sit still. Her family tells the nurse that the pt has been taking "some herb." Which herb does the nurse suspect the pt has been taking?A) ephedraB) feverfewC) garlicD) St. John's wort - ANSWER D) St. John's wort A 35 y/o pt presents to the clinic with a complaint of sore throat. VS are T 39.2, BP 132/60, HR 98, RR 18. She is allergic to dextromethorphan and takes oral contraceptives, vitamin C, and fexofenadine. She is dx with strep throat and prescribed amoxicillin/clavulanate potassium (Augmentin). What instruction should the nurse include in discharge teaching regarding the medication? - ANSWER - C) use an alternate method of birth control When to stop teterogens? - ANSWER Before getting pregnant bc of first trimester A patient it taking Phenytoin for the tx of seizures and experiences a reaction a month later what is happening? - ANSWER hypersensitivity can happen a month later A patient has a back spasm and we prescribe flexeril/ Cyclobenzaprine educate on side effects such as? - ANSWER urinary retention, constipation, dry mouth What is the blackbox warning with Fluroquinolones ex levaquin? - ANSWER leads to tendon rupture! What do we avoid if a patient has an infection? - ANSWER Steroids Immunizations the patient is 11 what does he need now? - ANSWER DON'T NEED HEP B already given, DON'T NEED PCV 23 given later A patient has a new diagnosis of Rheumatoid arthritis what do you start them on? - ANSWER Methotrexate What do we prescribe for chronic gout? - ANSWER Probenecid What do we treat Paget's disease with? - ANSWER calcitonin salmon How do we treat post-menopausal osteoporosis & education? - ANSWER Allegiant and take 30 minutes & drink a lot of water What is a major side effect of Afrin nasal spray? - ANSWER Rebound congestion: intranasal steroids while we withdrawal the Afrin addiction