NURS 615 EXAM 3 QUESTIONS AND ANSWERS

NURS 615 EXAM 3 QUESTIONS AND ANSWERS Chapter 25. Drugs Used in Treating Inflammatory Processes 1. Henry presents to clinic with a significantly swollen, painful great toe and is diagnosed with gout. Of the following, which would be the best treatment for Henry? 1. High-dose colchicine 2. Low-dose colchicine 3. High-dose aspirin 4. Acetaminophen with codeine 2. Patient education when prescribing colchicine includes: 1. Colchicine may be constipating. 2. Colchicine always causes some degree of diarrhea. 3. Mild muscle weakness is normal. 4. Moderate amounts of alcohol are safe with colchicine. 3. Larry is taking allopurinol to prevent gout. Monitoring of a patient who is taking allopurinol includes: 1. Complete blood count 2. Blood glucose 3. C-reactive protein 4. BUN, creatinine, and creatinine clearance 4. Phil is starting treatment with febuxostat (Uloric). Education of patients starting febuxostat includes: 1. Gout may worsen with therapy. 2. Febuxostat may cause severe diarrhea. 3. He should consume a high-calcium diet. 4. He will need frequent CBC monitoring. 5. Sallie has been taking 10 mg per day of prednisone for the past 6 months. She should be assessed for: 1. Gout 2. Iron deficiency anemia 3. Osteoporosis 4. Renal dysfunction 6. Patients whose total dose of prednisone will exceed 1 gram will most likely need a second prescription for: 1. Metformin, a biguanide to prevent diabetes 2. Omeprazole, a proton pump inhibitor to prevent peptic ulcer disease 3. Naproxen, an NSAID to treat joint pain 4. Furosemide, a diuretic to treat fluid retention 7. Daniel has been on 60 mg of prednisone for 10 days to treat a severe asthma exacerbation. It is time to discontinue the prednisone. How is prednisone discontinued? osteroids. 8. Patients with rheumatoid arthritis who are on chronic low-dose prednisone will need co-treatment with which medications to prevent further adverse effects? 1. A bisphosphonate 2. Calcium supplementation 3. Vitamin D 4. All of the above 9. Patients who are on or who will be starting chronic corticosteroid therapy need monitoring of: 1. Serum glucose 2. Stool culture 3. Folate levels 4. Vitamin B12 10. Patients who are on chronic long-term corticosteroid therapy need education regarding: 1. Receiving all vaccinations, especially the live flu vaccine 2. Reporting black tarry stools or abdominal pain 3. Eating a high carbohydrate diet with plenty of fluids 4. Small amounts of alcohol are generally tolerated. 11. All nonsteroidal anti-inflammatory drugs (NSAIDS) have an FDA Black Box Warning regarding: 1. Potential for causing life-threatening GI bleeds 2. Increased risk of developing systemic arthritis with prolonged use 3. Risk of life-threatening rashes, including Stevens-Johnson 4. Potential for transient changes in serum glucose Ans: 1 12. Jamie has fractured his ankle and has received a prescription for acetaminophen and hydrocodone (Vicodin). Education when prescribing Vicodin includes: 1. It is okay to double the dose of Vicodin if the pain is severe. 2. Vicodin is not habit-forming. 3. He should not take any other acetaminophen-containing medications. 4. Vicodin may cause diarrhea; increase his fluid intake. Ans: 3 13. When prescribing NSAIDS, a complete drug history should be conducted as NSAIDs interact with these drugs: 1. Omeprazole, a proton pump inhibitor 2. Combined oral contraceptives 3. Diphenhydramine, an antihistamine 4. Warfarin, an anticoagulant Ans: 4 14. Josefina is a 2-year-old child with acute otitis media and an upper respiratory infection. Along with an antibiotic she receives a recommendation to treat the ear pain with ibuprofen. What education would her parent need regarding ibuprofen? 1. They can cut an adult ibuprofen tablet in half to give Josefina. 2. The ibuprofen dose can be doubled for severe pain. 3. Josefina needs to be well-hydrated while taking ibuprofen. 4. Ibuprofen is completely safe in children with no known adverse effects. Ans: 3 15. Henry is 82 years old and takes two aspirin every morning to treat the arthritis pain in his back. He states the aspirin helps him to “get going” each day. Lately he has had some heartburn from the aspirin. After ruling out an acute GI bleed, what would be an appropriate course of treatment for Henry? 1. Add an H2 blocker such as ranitidine to his therapy. 2. Discontinue the aspirin and switch him to Vicodin for the pain. 3. Decrease the aspirin dose to one tablet daily. 4. Have Henry take an antacid 15 minutes before taking the aspirin each day. Ans: 1 16. The trial period to determine effective anti-inflammatory activity when starting a patient on aspirin for rheumatoid arthritis is: 1. 48 hours 2. 4 to 6 days 3. 4 weeks 4. 2 months Ans: 2 17. Patients prescribed aspirin therapy require education regarding the signs of aspirin toxicity. An early sign of aspirin toxicity is: 1. Black tarry stools 2. Vomiting 3. Tremors 4. Tinnitus Ans: 4 18. Monitoring a patient on a high-dose aspirin level includes: 1. Salicylate level 2. Complete blood count 3. Urine pH 4. All of the above Ans: 4 19. Patients who are on long-term aspirin therapy should have annually. 1. Complete blood count 2. Salicylate level 3. Amylase 4. Urine analysis Ans: 1 Chapter 21. Drugs Affecting the Endocrine System 1. Both men and women experience bone loss with aging. The bones most likely to demonstrate significant loss are: 1. Cortical bones 2. Femoral neck bones 3. Cervical vertebrae 4. Pelvic bones Ans: 2 2. Bisphosphonates treat or prevent osteoporosis by: 1. Inhibiting osteoclastic activity 2. Fostering bone resorption 3. Enhancing calcium uptake in the bone 4. Strengthening the osteoclastic proton pump Ans: 1 3. Prophylactic use of bisphosphonates is recommended for patients with early osteopenia related to long-term use of which of the following drugs? 1. Selective estrogen receptor modulators 2. Aspirin 3. Glucocorticoids 4. Calcium supplements Ans: 3 4. Patients with cystic fibrosis are often prescribed enzyme replacement for pancreatic secretions. Each replacement drug has lipase, protease, and amylase components, but the drug is prescribed in units of: 1. Lipase 2. Protease 3. Amylase 4. Pancreatin Ans: 1 5. Brands of pancreatic enzyme replacement drugs are: 1. Bioequivalent 2. About the same in cost per unit of lipase across brands 3. Able to be interchanged between generic and brand-name products to reduce cost 4. None of the above Ans: 2 6. When given subcutaneously, how long until neutral protamine Hagedorn insulin begins to take effect (onset of action) after administration? 1. 15 to 30 minutes 2. 60 to 90 minutes 3. 3 to 4 hours 4. 6 to 8 hours Ans: 2 7. Hypoglycemia can result from the action of either insulin or an oral hypoglycemic. Signs and symptoms of hypoglycemia include: 1. “Fruity” breath odor and rapid respiration -HYPER 2. Diarrhea, abdominal pain, weight loss, and hypertension 3. Dizziness, confusion, diaphoresis, and tachycardia 4. Easy bruising, palpitations, cardiac dysrhythmias, and coma Ans: 3 8. Nonselective beta blockers and alcohol create serious drug interactions with insulin because they: 1. Increase blood glucose levels 2. Produce unexplained diaphoresis 3. Interfere with the ability of the body to metabolize glucose 4. Mask the signs and symptoms of altered glucose levels Ans: 4 9. Lispro is an insulin analogue produced by recombinant DNA technology. Which of the following statements about this form of insulin is NOT true? 1. Optimal time of preprandial injection is 15 minutes. 2. Duration of action is increased when the dose is increased. 3. It is compatible with neutral protamine Hagedorn insulin. 4. It has no pronounced peak. Ans: 2 10. The decision may be made to switch from twice daily neutral protamine Hagedorn (NPH) insulin to insulin glargine to improve glycemia control throughout the day. If this is done: .