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Test bank pharmaco.docx NURSING NGR 5035 Chapter 21-25

Test bank NURSING NGR 5035 Chapter 21-25 Chapter 21: Drugs Affecting the Endocrine System Multiple Choice Identify the choice that best completes the statement or answers the question. ____ 1. Both men and women experience bone loss with aging. The bones most likely to demonstrate significant loss are: A. Cortical bone B. Femoral neck C. Cervical vertebrae D. Pelvic bones ____ 2. Bisphosphonates treat or prevent osteoporosis by: A. Inhibiting osteoclastic activity B. Fostering bone resorption C. Enhancing calcium uptake in bone D. Strengthening the osteoclastic proton pump ____ 3. Prophylactic use of bisphosphonates is recommended for patients with early osteopenia related to long-term use of which of the following drugs? A. Selective estrogen receptor modulators B. Aspirin C. Glucocorticoids D. Calcium supplements ____ 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: A. Lipase B. Protease C. Amylase D. Pancreatin ____ 5. Brands of pancreatic enzyme replacement drugs are: A. Bioequivalent B. About the same in cost per unit of lipase across brands C. Able to be interchanged between generic and brand-name products to reduce cost D. None of the above ____ 6. When given subcutaneously, NPH insulin begins to take effect (onset of action): A. 15 to 30 minutes after administration B. 60 to 90 minutes after administration C. 3 to 4 hours after administration D. 6 to 8 hours after administration ____ 7. Hypoglycemia can result from the action of either insulin or an oral hypoglycemic. Signs and symptoms of hypoglycemia include: A. “Fruity” breath odor and rapid respiration B. Diarrhea, abdominal pain, weight loss, and hypertension C. Dizziness, confusion, diaphoresis, and tachycardia D. Easy bruising, palpitations, cardiac dysrhythmias, and coma ____ 8. Nonselective beta blockers and alcohol create serious drug interactions with insulin because they: A. Increase blood glucose levels B. Produce unexplained diaphoresis C. Interfere with the ability of the body to metabolize glucose D. Mask the signs and symptoms of altered glucose levels ____ 9. Lipro is an insulin analogue produced by recombinant DNA technology. Which of the following statements about this form of insulin is NOT true? A. Optimal time of preprandial injection is 15 minutes. B. Duration of action is increased when the dose is increased. C. It is compatible with NPH insulin. D. It has no pronounced peak. ____ 10. The decision may be made to switch from BID NPH insulin to insulin glargine to improve glycemia control throughout the day. If this is done: A. The initial dose of glargine is reduced by 20% to avoid hypoglycemia B. The initial dose of glargine is 2 to 10 Units per day C. Patients who have been on high doses of NPH will need tests for insulin antibodies D. Obese patients may require more than 100 Units per day ____ 11. When blood glucose levels are difficult to control in Type 2 diabetes some form of insulin may be added to the treatment regimen to control blood glucose and limit complications risks. Which of the following statements are accurate based on research? A. Premixed insulin analogues are better at lowering HbA1C and have less risk for hypoglycemia. B. Premixed insulin analogues and the newer premixed insulins are associated with more weight gain than the oral antidiabetic agents. C. Newer premixed insulins are better at lowering HbA1C and post-prandial glucose levels than are long-acting insulins. D. Patients who are not controlled on oral agents and have post-prandial hyperglycemia can have NPH insulin added at bedtime. ____ 12. Metformin is a primary choice of drug to treat hyperglycemia in Type 2 diabetes because it: A. Substitutes for insulin usually secreted by the pancreas B. Decreases glycogenolysis by the liver C. Increases the release of insulin from beta cells D. Decreases peripheral glucose utilization ____ 13. Prior to prescribing metformin, the provider should: A. Draw a serum creatinine to assess renal function B. Try the patient on insulin C. Tell the patient to increase iodine intake D. Have the patient stop taking any sulfonylurea to avoid dangerous drug interactions ____ 14. The action of “gliptins” is different from other antidiabetic agents because they: A. Have a low risk for hypoglycemia B. Are not associated with weight gain C. Close ATP-dependent potassium channels in the beta cell D. Act on the incretin system to indirectly increase insulin production ____ 15. Sitagliptin has been approved for: A. Monotherapy in once daily doses B. Combination therapy with metformin C. Both A and B D. Neither A nor B ____ 16. GLP-1 agonists: A. Directly bind to a receptor in the pancreatic beta cell B. Have been approved for monotherapy C. Speed gastric emptying to decrease appetite D. Can be given orally once daily ____ 17. Avoid concurrent administration of exenatide with which of the following drugs? A. Digoxin B. Warfarin C. Lovastatin D. All of the above ____ 18. Administration of exenatide is by subcutaneous injection: A. 30 minutes prior to the morning meal B. 60 minutes prior to the morning and evening meal C. 15 minutes after the evening meal D. 60 minutes before each meal daily ____ 19. Potentially fatal granulocytopenia has been associated with treatment of hyperthyroidism with propylthiouracil. Patients should be taught to report: A. Tinnitus and decreased salivation B. Fever and sore throat C. Hypocalcemia and osteoporosis D. Laryngeal edema and difficulty swallowing ____ 20. Elderly patients who are started on levothyroxine for thyroid replacement should be monitored for: A. Excessive sedation B. Tachycardia and angina C. Weight gain D. Cold intolerance Chapter 22: Drugs Affecting the Reproductive System Multiple Choice Identify the choice that best completes the statement or answers the question. ____ 1. Men who use transdermal testosterone gel (AndroGel) should be advised to avoid: A. Washing their hands after applying the gel B. Wearing occlusive clothing while using the gel C. Exposure to estrogens while using the gel D. Skin-to-skin contact with pregnant women while using the gel ____ 2. Education when prescribing androgens to male patients includes: A. Short-term use places the patient at risk for hepatocellular carcinoma B. Cholestatic hepatitis and jaundice may occur with low doses of androgens C. Gynecomastia is a rare occurrence with the use of androgens D. Low sperm levels only occur with long-term use of androgens ____ 3. Patients who are prescribed exogenous androgens need to be warned that decreased libido: A. Is an unusual side effect of androgens and should be reported to the provider B. Is treated with increased doses of androgens, so the patient should let the provider know if he is having problems C. May be a sign of early prostate cancer and he should make an appointment for a prostate screening exam D. May occur with androgen therapy ____ 4. The U.S. Food and Drug Administration (FDA) warns that androgens may cause: A. Peliosis hepatis B. Orthostatic hypotension C. Menstrual irregularities D. Acne ____ 5. Monitoring for a patient who is using androgens includes: A. Complete blood count and C-reactive protein level B. Lipid levels and liver function tests C. Serum potassium and magnesium levels D. Urine protein and potassium levels ____ 6. Male patients require ____ before and during androgen therapy. A. A digital prostate exam B. A Doppler exam of testicular blood flow C. Urine analysis for proteinuria D. Serial orthostatic blood pressures ____ 7. Absolute contraindications to estrogen therapy include: A. History of any type of cancer B. Clotting disorders C. History of tension headache D. Orthostatic hypotension ____ 8. Women with an intact uterus should not be prescribed: A. Estrogen/progesterone combination B. IM medroxyprogesterone (Depo Provera) C. Estrogen alone D. Androgens ____ 9. Women who have migraine with aura should not be prescribed estrogen due to: A. The interaction between triptans and estrogen, limiting migraine therapy choices B. An increased incidence of migraines with the use of estrogen C. An increased risk of stroke occurring with estrogen use D. Patients with migraines may be prescribed estrogen without any concerns ____ 10. A 22-year-old women receives a prescription for oral contraceptives. Education for this patient includes: A. Counseling regarding decreasing or not smoking while taking oral contraceptives B. Advising a monthly pregnancy test for the first 3 months she is taking the contraceptive C. She may miss two pills in a row and not be concerned about pregnancy D. Her next follow-up visit is in 1 year for a refill and “annual exam” ____ 11. A 19-year-old female is a nasal Staph aureus carrier and is placed on 5 days of rifampin for treatment. Her only other medication is combined oral contraceptives. What education should she receive regarding her medications? A. Separate the oral ingestion of the rifampin and oral contraceptive by at least an hour. B. Both medications are best tolerated if taken on an empty stomach. C. She should use a back-up method of birth control such as condoms for the rest of the current pill pack. D. If she gets nauseated with the medications she should call the office for an antiemetic prescription. ____ 12. A 56-year-old women is complaining of vaginal dryness and dyspareunia. To treat her symptoms with the lowest adverse effects she should be prescribed: A. Low-dose oral estrogen B. Low-dose estrogen/progesterone combination C. Vaginal estradiol ring D. Vaginal progesterone cream ____ 13. Shana is receiving her first medroxyprogesterone (Depo Provera) injection. Shana will need to be monitored for: A. Depression B. Hypertension C. Weight loss D. Cataracts ____ 14. When prescribing medroxyprogesterone (Depo Provera) injections, essential education would include the adverse drug effects of: A. Hypertension and dysuria B. Depression and weight gain C. Abdominal pain and constipation D. Orthostatic hypotension and dermatitis ____ 15. Medroxyprogesterone (Depo Provera) injection has an FDA Black Box warning due to: A. Development of significant hypertension B. Increased risk of strokes when on Depo C. Decreased bone density while on Depo D. Risk of life-threatening rash such as Stevens-Johnson ____ 16. Shana received her first medroxyprogesterone (Depo Provera) injection 6 weeks ago and calls the clinic with a concern that she has been having a light “period” off and on since receiving her Depo shot. What would be the management of Shana? A. Reassurance that some spotting is normal the first few months of Depo and it should improve. B. Schedule an appointment for an exam as this is not normal. C. Prescribe 4 weeks of estrogen to treat the abnormal vaginal bleeding. D. Order a pregnancy test and suggest she use a back-up method of contraception until she has her next shot. ____ 17. William is a 62-year-old male who is requesting a prescription for sildenafil (Viagra). He should be screened for ____ before prescribing sildenafil. A. Renal dysfunction B. Unstable coronary artery disease C. Benign prostatic hypertrophy D. History of priapism ____ 18. Men who are prescribed sildenafil (Viagra) need ongoing monitoring for: A. Development of chest pain or dizziness B. Weight gain C. Priapism D. Renal function ____ 19. Men who are prescribed an erectile dysfunction drug such as sildenafil (Viagra) should be warned about the risk for: A. Impotence when combined with antihypertensives B. Fatal hypotension if combined with nitrates C. Weight gain if combined with antidepressants D. All of the above Chapter 23: Drugs Affecting the Integumentary System Multiple Choice Identify the choice that best completes the statement or answers the question. ____ 1. Erik presents with one golden-crusted lesion at the site of an insect bite consistent with impetigo. His parents have limited finances and request the least expensive treatment. Which medication would be the best choice for treatment? A. Mupirocin (Bactroban) B. Bacitracin and polymixin B (generic double antibiotic ointment) C. Retapamulin (Altabax) D. Oral cephalexin (Keflex) ____ 2. Juakeem is a nasal MRSA carrier. Treatment to eradicate nasal MRSA is mupirocin. Patient education regarding treating nasal MRSA includes: A. Take the oral medication exactly as prescribed B. Insert one-half of the dose in each nostril twice a day C. Alternate treating one nare in the morning and the other in the evening D. Nasal MRSA eradication requires at least 4 weeks of therapy, with up to 8 weeks needed in some patients ____ 3. Instructions for applying a topical antibiotic or antiviral ointment include: A. Apply thickly to the infected area, spreading the medication well past the borders of the infection B. If the rash worsens, apply a thicker layer of medication to settle down the infection C. Wash hands before and after application of topical antimicrobials D. None of the above ____ 4. When Sam used clotrimazole (Lotrimin AF) for athlete’s foot he developed a red, itchy rash consistent with a hypersensitivity reaction. He now has athlete’s foot again. What would be a good choice of antifungal for Sam? A. Miconazole (Micatin) powder B. Ketoconazole (Nizoral) cream C. Terbinafine (Lamisil) cream D. Griseofulvin (Grifulvin V) suspension ____ 5. When prescribing griseofulvin (Grifulvin V) to treat tinea capitis it is critical to instruct the patient or parent to: A. Mix the griseofulvin with ice cream before administering B. Take the griseofulvin until the tinea clears, in approximately 4 to 5 weeks C. Shampoo with baby shampoo daily while taking the griseofulvin D. Griseofulvin is best absorbed if ingested with a high-fat food ____ 6. First-line therapy for treating topical fungal infections such as tinea corporis (ringworm) or tinea pedis (athlete’s foot) would be: A. OTC topical azole (clotrimazole, miconazole) B. Oral terbinafine C. Oral griseofulvin microsize D. Nystatin cream or ointment ____ 7. When prescribing topical penciclovir (Denavir) for the treatment of herpes labialis (cold sores) patient education would include: A. Spread penciclovir liberally all over lips and area surrounding lips B. Penciclovir therapy is started at the first sign of cold sore outbreak C. Skin irritation is normal with penciclovir and it should resolve D. The penciclovir should be used a minimum of 2 weeks to prevent recurrence ____ 8. Erika has been prescribed isotretinoin (Accutane) by her dermatologist and is presenting to her primary care provider with symptoms of sadness and depression. A Beck’s Depression Scale indicates she has mild to moderate depression. What would be the best care for her at this point? A. Prescribe an SSRI antidepressant B. Refer her to a mental health therapist C. Contact her dermatologist about discontinuing the isotretinoin D. Reassure her that mood swings are normal and schedule follow up in a week ____ 9. Drew is a 17-year-old competitive runner who presents with complaint of pain in his hip that occurred after he fell while running. His only medical problem is severe acne for which he takes isotretinoin (Accutane). With this history what would you be concerned for? A. He may have pulled a muscle and needs to rest to recover. B. He is at risk for bony injuries and needs to be evaluated for fracture. C. Isotretinoin interacts with ibuprofen which is the pain medication of choice. D. Teen athletes are at risk for repetitive stress injuries. ____ 10. Catherine calls the clinic with concerns that her acne is worse 1 week after starting topical tretinoin. What would be the appropriate care for her? A. Change her to a different topical acne medication as she is having an adverse reaction to the tretinoin. B. Switch her to an oral antibiotic to treat her acne. C. Advise her to apply an oil-based lotion to her face to soothe the redness. D. Reassure her that the worsening of acne is normal and it should improve with continued use. ____ 11. Li is a 6 month old with severe eczema. She would benefit from topical corticosteroid therapy. Instructions for using topical corticosteroids in children include: A. Apply liberally to all areas with eczema B. Double the frequency of application when the eczema is severe C. Apply sparingly to eczema areas D. Cover the eczema area with an occlusive dressing after applying corticosteroid ____ 12. Jose has had eczema for many years and reports he thinks his corticosteroid cream is not working as well as previously. He may be experiencing tolerance to the corticosteroid. Treatment options include: A. Increase the potency of the corticosteroid cream B. Recommend an interrupted or cyclic schedule of application C. Increase the frequency of dosing of the corticosteroid D. Discontinue the corticosteroid since it isn’t working any longer ____ 13. When prescribing tacrolimus (Protopic) to treat atopic dermatitis patients should be informed that: A. Tacrolimus is the most effective if it is used continuously for 4 to 6 months B. Tacrolimus should be spread generously over the affected area C. The FDA has issued a Black Box warning about the use of tacrolimus and the development of cancer in animals and humans D. The FDA recommends patients be screened for cancer before prescribing tacrolimus ____ 14. Patients who are treated with greater than 100 grams per week of topical calcipotriene for psoriasis need to be monitored for: A. High vitamin D levels B. Hyperkalemia C. Hypercalcemia D. Hyperuricemia ____ 15. Jesse is prescribed tazarotene for his psoriasis. Patient education regarding topical tazarotene includes: A. Tazarotene is applied in a thin film to the psoriasis plaque lesions B. Apply liberally to all psoriatic lesions C. Apply tazarotene to non-affected areas to prevent breakout D. Tazarotene may cause hypercalcemia if overused ____ 16. Instructions for the use of selenium sulfide shampoo (Selsun) to treat scalp seborrhea includes: A. Shampoo daily and rinse well B. Worsening of seborrhea for the first week is normal C. Seborrhea usually clears up after a few weeks of treatment D. Shampoo twice a week for 2 weeks then weekly ____ 17. Topical diphenhydramine (Benadryl) is available OTC to treat itching. Patients or parents should be instructed regarding the use of topical diphenhydramine that: A. For maximum effectiveness in treating itching, combine topical with oral diphenhydramine B. Topical diphenhydramine is the treatment of choice in treating poison ivy or poison oak C. Topical diphenhydramine should not be used in children younger than age 2 years D. When applying topical diphenhydramine, apply the cream liberally to all areas that itch ____ 18. A patient has been prescribed silver sulfadiazine (Silvadene) cream to treat burns on his leg. Normal adverse effects of silver sulfadiazine cream include: A. Transient leukopenia on days 2 to 4 that should resolve B. Worsening of burn symptoms briefly before resolution C. A red, scaly rash that will resolve with continued use D. Hypercalcemia ____ 19. Instructions for the use of malathion (Ovide) for head lice include: A. Use a blow dryer to dry the hair after applying B. Malathion (Ovide) is used daily for a week until all lice are dead C. Rinse the malathion (Ovide) off and shampoo hair after 8 to 12 hours D. Use gloves to apply the malathion (Ovide) ____ 20. When writing a prescription of permethrin 5% cream (Elimite) for scabies, patient education would include: A. All members of the household and personal contacts should also be treated B. Infants should have permethrin applied from the neck down C. The permethrin is washed off after 10 to 20 minutes D. Permethrin is flammable and to avoid open flame while the medication is applied Chapter 24: Drugs Used in Treating Infectious Diseases Multiple Choice Identify the choice that best completes the statement or answers the question. ____ 1. Factors that place a patient at risk of developing an antimicrobial resistant organism include: A. Age over 50 years B. School attendance C. Travel within the United States D. Inappropriate use of antimicrobials ____ 2. Infants and young children are at higher risk of developing antibiotic-resistant infections due to: A. Developmental differences in pharmacokinetics of the antibiotics in children B. Children this age are more likely to be in daycare and exposed to pathogens from other children C. Parents of young children insist on preventive antibiotics so they don’t miss work when their child is sick D. Immunosuppression from the multiple vaccines they receive in the first 2 years of life ____ 3. Providers should use an antibiogram when prescribing. An antibiogram is: A. The other name for the Centers for Disease Control guidelines for prescribing antibiotics B. An algorithm used for prescribing antibiotics for certain infections C. The reference also known as the Pink Book, published by the Centers for Disease Control D. A chart of the local resistance patterns to antibiotics developed by laboratories ____ 4. There is often cross-sensitivity and cross-resistance between penicillins and cephalosporins due to: A. Similar renal excretion of both classes of drugs B. When these drug classes are metabolized in the liver they both produce resistant enzymes C. Both drug classes contain a beta-lactam ring that is vulnerable to beta-lactamase producing organisms D. There is not an issue with cross-resistance between the penicillins and cephalosporins ____ 5. Jonathan has been diagnosed with strep throat and needs a prescription for an antibiotic. He says the last time he had penicillin he developed a red, blotchy rash. The appropriate antibiotic to prescribe would be: A. Penicillin VK, since his rash does not sound like a serious rash B. Amoxicillin C. Cefadroxil (Duricef) D. Erythromycin ____ 6. Sarah is a 25-year-old female who is 8 weeks pregnant and has a urinary tract infection. What would be the appropriate antibiotic to prescribe for her? A. Ciprofloxacin (Cipro) B. Amoxicillin (Trimox) C. Doxycycline D. Trimethoprim-sulfamethoxazole (Septra) ____ 7. Pong-tai is a 12 month old who is being treated with amoxicillin for acute otitis media. His parents call the clinic and say he has developed diarrhea. The appropriate action would be to: A. Advise the parents that some diarrhea is normal with amoxicillin and try feeding him yogurt daily B. Change the antibiotic to one that is less of a gastrointestinal irritant C. Order stool cultures for suspected viral pathogens not treated by the amoxicillin D. Recommend increased fluids and fiber in his diet ____ 8. Lauren is a 13 year old who comes to clinic with a 4-day history of cough, low grade fever, and rhinorrhea. When she blows her nose or coughs the mucous is greenish-yellow. The appropriate antibiotic to prescribe would be: A. Amoxicillin B. Amoxicillin/clavulanate C. TMP/SMZ (Septra) D. None ____ 9. Joanna had a small ventricle septal defect (VSD) repaired when she was 3 years old and has no residual cardiac problems. She is now 28 and is requesting prophylactic antibiotics for an upcoming dental visit. The appropriate antibiotic to prescribe according to current American College of Cardiology and the American Heart Association guidelines is: A. No antibiotic required for dental procedures B. Amoxicillin 2 grams 1 hour before the procedure C. Ampicillin 2 grams IM or IV 30 minutes before the procedure D. Azithromycin 1 gram 1 hour before the procedure ____ 10. To prevent further development of antibacterial resistance it is recommended fluoroquinolones be reserved for treatment of: A. Urinary tract infections in young women B. Upper respiratory infections in adults C. Skin and soft tissue infections in adults D. Community-acquired pneumonia in patients with comorbidities ____ 11. Fluoroquinolones have a Black Box warning regarding ____ even months after treatment. A. Renal dysfunction B. Hepatic toxicity C. Tendon rupture D. Development of glaucoma ____ 12. Janet was recently treated with clindamycin for an infection. She calls the advice nurse because she is having frequent diarrhea that she thinks may have blood in it. What would be the appropriate care for her? A. Encourage increased fluids and fiber B. Assess for pseudomembranous colitis C. Advise her to eat yogurt daily to help restore her gut bacteria D. Start her on an antidiarrheal medication ____ 13. Keng has chronic hepatitis that has led to mildly impaired liver function. He has an infection that would be best treated by a macrolide. Which would be the best choice for a patient with liver dysfunction? A. Azithromycin (Zithromax) B. Clarithromycin (Biaxin) C. Erythromycin (E-mycin) D. None of the above ____ 14. Jamie has glucose-6-phosphate dehydrogenase deficiency (G6PD) and requires an antibiotic. Which class of antibiotics should be avoided in this patient? A. Penicillins B. Macrolides C. Cephalosporins D. Sulfonamides ____ 15. If a patient is allergic to sulfonamide antibiotics, he or she will most likely have cross-sensitivity to: A. Loop diuretics B. Sulfonylureas C. Thiazide diuretics D. All of the above ____ 16. Tetracyclines such as minocycline are safe to use in: A. Pregnant women B. Adolescents C. Patients with renal dysfunction D. Patients with hepatic dysfunction ____ 17. Tetracyclines should not be prescribed to children younger than 8 years due to: A. Risk of developing cartilage problems B. Development of significant diarrhea C. Risk of kernicterus D. Adverse effects on bone growth ____ 18. Nicole is a 16 year old who is taking minocycline for acne. She comes to the clinic complaining of a headache. What would be the plan of care? A. Advise acetaminophen or ibuprofen as needed for headaches B. Prescribe sumatriptan (Imitrex) to be taken at the onset of the headache C. Evaluate for pseudotremor cerebri D. Assess her caffeine intake and sleep patterns ____ 19. Patricia has been prescribed doxycycline for a Chlamydia infection. She is healthy and her only medication is an oral combined contraceptive. Patricia’s education would include: A. Use a back-up method of birth control (condom) until her next menses B. Doxycycline may cause tendonitis and she should report any joint pain C. Her partner will need treatment if her infection doesn’t clear with the doxycycline D. Doxycycline is used for one dose treatment of STIs; take the whole prescription at once ____ 20. To prevent the development of peripheral neuropathy in patients taking isoniazid for tuberculosis the patient is also prescribed: A. Niacin (Vitamin B3) B. Pyridoxine (Vitamin B6) C. Riboflavin (Vitamin B2) D. Thiamine (Vitamin B1) ____ 21. Sadie is 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 assessment of: A. Complete blood count to rule out anemia B. Liver function C. Renal function D. Immunocompetence ____ 22. When prescribing acyclovir, patients should be educated regarding: A. High risk of developing diarrhea B. Need to drink lots of fluids during treatment C. Risk for life-threatening rash such as Stevens-Johnson D. Eccentric dosing schedule ____ 23. Nicholas has been diagnosed with Type A influenza. Appropriate prescribing of oseltamivir (Tamiflu) would include: A. Starting oseltamivir within the first 48 hours of influenza symptoms B. Advising the patient he can stop the oseltamivir when his symptoms resolve C. Educating the patient that oseltamivir will cure influenza D. Prophylactic treatment of all family members ____ 24. Monitoring for patients who are on long-term antifungal therapy with ketoconazole includes: A. Platelet count B. BUN and creatinine C. White blood cell count D. AST, ALT, alkaline phosphatase, and bilirubin ____ 25. When prescribing metronidazole (Flagyl) to treat bacterial vaginosis, patient education would include: A. Metronidazole is safe in the first trimester of pregnancy B. Consuming alcohol in any form may cause a severe reaction C. Sexual partners need concurrent therapy D. Headaches are a sign of a serious adverse reaction and need immediate evaluation True/False Indicate whether the statement is true or false. ____ 1. As of 2011 every antibiotic drug class has resistant organisms which influence prescribing decisions. . ANS: T PTS: 1 Chapter 25: Drugs Used in Treating Inflammatory Processes Multiple Choice Identify the choice that best completes the statement or answers the question. ____ 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? A. High-dose colchicine B. Low-dose colchicine C. High-dose aspirin D. Acetaminophen with codeine ____ 2. Patient education when prescribing colchicine includes: A. Colchicine may be constipating B. Colchicine always causes some degree of diarrhea C. Mild muscle weakness is normal D. 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: A. Complete blood count B. Blood glucose C. C-reactive protein D. BUN, creatinine, and creatinine clearance ____ 4. Phil is starting treatment with febuxostat (Uloric). Education of patients starting febuxostat includes: A. Gout may worsen with therapy B. Febuxostat may cause severe diarrhea C. He should consume a high-calcium diet D. 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: A. Gout B. Iron deficiency anemia C. Osteoporosis D. Renal dysfunction ____ 6. Patients whose total dose of prednisone will exceed 1 gram will most likely need a second prescription for: A. Metformin, a biguanide to prevent diabetes B. Omeprazole, a proton pump inhibitor to prevent peptic ulcer disease C. Naproxen, an NSAID to treat joint pain D. 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? A. Patients with asthma are transitioned directly off the prednisone onto inhaled corticosteroids B. Prednisone can be abruptly discontinued with no adverse effects C. Develop a tapering schedule to slowly wean Daniel off the prednisone D. Substitute the prednisone with another anti-inflammatory such as ibuprofen ____ 8. Patients with rheumatoid arthritis who are on chronic low-dose prednisone will need co-treatment with which medications to prevent further adverse effects? A. A bisphosphonate B. Calcium supplementation C. Vitamin D D. All of the above ____ 9. Patients who are on or who will be starting chronic corticosteroid therapy need monitoring of: A. Serum glucose B. Stool culture C. Folate levels D. Vitamin B12 ____ 10. Patients who are on chronic long-term corticosteroid therapy need education regarding: A. Receiving all vaccinations, especially the live flu vaccine B. Reporting black tarry stools or abdominal pain C. Eating a high carbohydrate diet with plenty of fluids D. Small amounts of alcohol are generally tolerated ____ 11. All nonsteroidal anti-inflammatory drugs (NSAIDS) have an FDA Black Box warning regarding: A. Potential for causing life-threatening GI bleeds B. Increased risk of developing systemic arthritis with prolonged use C. Risk of life-threatening rashes, including Stevens-Johnson D. Potential for transient changes in serum glucose ____ 12. Jamie has fractured his ankle and has received a prescription for acetaminophen and hydrocodone (Vicodin). Education when prescribing Vicodin includes: A. It is OK to double the dose of Vicodin if the pain is severe B. Vicodin is not habit forming C. He should not take any other acetaminophen-containing medications D. Vicodin may cause diarrhea; increase his fluid intake ____ 13. When prescribing NSAIDS, a complete drug history should be conducted as NSAIDs interact with these drugs: A. Omeprazole, a proton pump inhibitor B. Combined oral contraceptive C. Diphenhydramine, an antihistamine D. Warfarin, an anticoagulant ____ 14. Josefina is a 2 year old with acute otitis media and 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? A. They can cut an adult ibuprofen tablet in half to give Josefina B. Ibuprofen dose can be doubled for severe pain C. Josefina needs to be well hydrated while taking ibuprofen D. Ibuprofen is completely safe in children with no known adverse effects ____ 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? A. Add an H2 blocker such as ranitidine to his therapy B. Discontinue the aspirin and switch him to Vicodin for the pain C. Decrease the aspirin dose to one tablet daily D. Have Henry take an antacid 15 minutes before taking the aspirin each day ____ 16. The trial period to determine effective anti-inflammatory activity when starting a patient on aspirin for rheumatoid arthritis is: A. 48 hours B. 4 to 6 days C. 4 weeks D. 2 months ____ 17. Patients prescribed aspirin therapy require education regarding the signs of aspirin toxicity. An early sign of aspirin toxicity is: A. Black tarry stools B. Vomiting C. Tremors D. Tinnitus ____ 18. Monitoring a patient on a high dose aspirin level includes: A. Salicylate level B. Complete blood count C. Urine pH D. All of the above ____ 19. Patients who are on long-term aspirin therapy should have ____ annually. A. Complete blood count B. Salicylate level C. Amylase D. Urine analysis

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