MSN Pharmacology Final Questions with 100% Correct Answers

MSN Pharmacology Final Questions with 100% Correct Answers sitagliptin has been approved for a. monotherapy in once-daily doses b. combination therapy with metformin c. both one and two d. neither one or two c. both one and two when is metformin typically initiated for glucose metabolism issues a. only after the HgA1C is greater than 8.0 b. when the patient is diagnosed with pre-diabetes c. when metabolic syndrome ensues d. when true diabetes mellitus is diagnosed b. when the patient is diagnosed with pre-diabetes when given subcutaneously, how long until neutral protamine Hagedorn insulin begins to take effect (onset of action) after administration a. 15 to 30 minutes b. 60 to 90 minutes c. 3 to 4 hours d. 6 to 8 hours b. 60 to 90 minutes 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 complication risks. which of the following statements is 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 postprandial glucose levels than long-acting insulins d. patients who are not controlled on oral agents and have postprandial hyperglycemia can have NPH insulin added at bedtime c. newer premixed insulins are better at lowering HbA1C and postprandial glucose levels than long-acting insulins avoid concurrent administration of exenatide with which of the following drugs a. digoxin b. warfarin c. lovastatin d. all of the above d. all of the above the decision may be made to switch from twice daily NPH insulin to insulin glargine to improve glycemic 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 a. the initial dose of glargine is reduced by 20% to avoid hypoglycemia 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 b. decreases glycogenolysis by the liver a precaution when sprinkling pancreatic enzymes on food is a. wash off any "dust" that gets on the hands to decrease potential dermatology issues b. keep it on top of food instead of mixing it in c. do not drink fluids during the meal d. keep the powder primarily on the carbohydrate rich foods a. wash off any "dust" that gets on the hands to decrease potential dermatology issues different 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 b. about the same in cost per unit of lipase across brands which of the following statements about pancreatic enzymes is true a. dosing may be titrated according to the decrease of steatorrhea b. the amount of carbohydrates in a meal drives the amount of enzyme used c. the amount of medication used increases with a cystic fibrosis pulmonary flare d. the USFDA and internet-available formulations are bioequivalent a. dosing may be titrated according to the decrease of steatorrhea .elderly patients who are on levothyroxine for thyroid replacement should be monitored for a. excessive sedation b. tachycardia and angina c. weight gain d. cold intolerance b. tachycardia and angina potentially fatal granulocytopenia has been associated with treatment of hyperthyroidism with propythiouracil. 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 b. fever and sore throat a woman who is not pregnant and not breastfeeding has unexplained "milk production" from her left breast. which endocrine abnormality is the most likely cause a. adrenal tumor b. pancreatic cancer c. Cushing's syndrome d. pituitary tumor d. pituitary tumor which of the following is not an indication that growth hormone supplements should be discontinued a. imaging indication of epiphyseal closure b. growth curve increases that have plateaued c. complaints of mild bone pain d. achievement of anticipated height goals c. complaints of mild bone pain 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 a. lipase a postsurgical patient may experience water balance issues for a while due to alteration in which hypothalamic, pituitary, adrenal hormone a. prolactin b. thyroid stimulating hormone c. antidiuretic hormone d. oxytocin c. antidiuretic hormone insulin preparations are divided into categories based on onset, duration, and intensity of action following subcutaneous injection. Which of the following insulin preparations has the shortest onset and duration of action a. lispro b. glulisine c. glargine d. detemir b. glulisine all diabetic patients with known cardiovascular disease should be treated with a. beta blockers to prevent MIs b. angiotensin-converting enzyme inhibitors and aspirin to reduce risk of cardiovascular events c. sulfonylureas to decrease cardiovascular mortality d. pioglitazone to decrease atherosclerotic plaque buildup b. angiotensin-converting enzyme inhibitors and aspirin to reduce risk of cardiovascular events studies have shown that control targets that reduce the HbA1C to less than 7% are associated with fewer long-term complications of diabetes. patients who should have such a target include a. those with long standing diabetes b. older adults c. those with no significant cardiovascular disease d. young children who are early in their disease c. those with no significant cardiovascular disease treatment with insulin for type 1 diabetics a. starts with a total daily dose of 0.2 to 0.4 units per kg of body weight b. divides the total doses into three injections based on meal size c. uses a total daily dose of insulin glargine given once daily with no other insulin required d. based not on the level of blood glucose a. starts with a total daily dose of 0.2 to 0.4 units per kg of body weight a patient on metformin and glipizide arrives at her 11:30 a.m. clinic appointment diaphoretic and dizzy. she reports taking her medication this morning and ate a bagel and coffee for breakfast. BP is 110/70 and random finger-stick glucose is 64. how should this patient be treated a. 12 oz apple juice with 1 tsp sugar b. 10 oz diet soda c. 8 oz milk or 4 oz orange juice d. 4 cookies and 8 oz chocolate milk c. 8 oz milk or 4 oz orange juice insulin is used to treat both types of diabetes. it acts by a. increasing beta cell response to low blood-glucose levels b. stimulating hepatic glucose production c. increasing peripheral glucose uptake by skeletal muscle and fat d. improving the circulation of free fatty acids c. increasing peripheral glucose uptake by skeletal muscle and fat diabetic autonomic neuropathy is the earliest and most common complication of diabetes. symptoms associated with it include a. resting tachycardia, exercise intolerance, and orthostatic hypotension b. gastroparesis, cold intolerance, and moist skin c. hyperglycemia, erectile dysfunction, and deficiency of free fatty acid d. pain, loss of sensation, and muscle weakness a. resting tachycardia, exercise intolerance, and orthostatic hypotension when methimazole is started for hyperthyroidism it may take months to see a total reversal of hyperthyroid symptoms a. two to four weeks b. one to two months c. three to four months d. six to twelve months d. six to twelve months once a patient who is being treated for hypothyroidism returns to euthyroid with normal TSH levels, he or she should be monitored for TSH and free T4 levels every a. two weeks b. four weeks c. two months d. six months d. six months Infants with congenital hypothyroidism are treated with a. levothyroxine b. liothyronine c. liotrix d. methimazole a. levothyroxine when starting a patient with hypothyroidism on thyroid replacement hormones patient education would include a. they should feel symptomatic improvment within one to two weeks b. drug adverse effects such as lethargy and dry skin may occur c. it may take four to eight weeks to get euthyroid symptomatically, and by laboratory test d. because of its short half life, levothyroxine doses should not be missed c. it may take four to eight weeks to get euthyroid symptomatically, and by laboratory test .what happens to the typical hormone replacement dose when a woman becomes pregnant a. most women need less medication b. most women do not require a dose change c. the average woman needs more medication during pregnancy d. the average woman needs more medication only if carrying multiples c. the average woman needs more medication during pregnancy a woman who is pregnant and has hyperthyroidism is best managed by a specialty team who will most likely treat her with a. methimazole b. propylthiouracil (PTU) c. radioactive iodine d. nothing, because treatment is best delayed until after her pregnancy ends b. propylthiouracil (PTU) when starting a patient on levothyroxine for hypothyroidism the patient will need follow-up measurement of thyroid function in a. two weeks b. four weeks c. two months d. six months b. four weeks treatment of a patient with hypothyroidism and cardiovascular disease consists of a. levothyroxine b. liothyronine c. liotrix d. methimazole a. levothyroxine .after starting a patient with graves disease on an antithyroid agent such as methimazole, patient monitoring includes thyroid-stimulating hormone and free thyroxine every a. 1 to 2 weeks b. 3 to 4 weeks c. 2 to 3 months d. 6 to 9 months b. 3 to 4 weeks lispro 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 neutral protamine Hagedorn insulin d. it has no pronounced peak b. duration of action is increased when the dose is increased long-term injection site skin changes are called a. lipodystrophy b. tuberous sclerosis c. telangiectasia d. medication caveronosa a. lipodystrophy angiotensin-converting enzyme (ACE) inhibitors are considered renal protective in DM, however they must be reduced and/or discontinued when a. the patient reaches stage 3 kidney disease b. creatinine levels reach 1.1 c. potassium levels are consistently found to be below 4 d. the patient first starts spilling protein in their urine a. the patient reaches stage 3 kidney disease what is the desired ratio of T3 to T4 drug levels in newly diagnosed endocrine patients a. 99% of T3 and the rest is T4 to get rapid resolution b. most needs to be T4 to mimic natural ratios of hormones c. the ratio is unimportant d. the mix needs to be 50-50 at first b. most needs to be T4 to mimic natural ratios of hormones .the drugs recommended by the American Academy of Pediatrics for use in children with diabetes (depending upon type of diabetes) are a. metformin and insulin b. sulfonylureas and insulin glargine c. split-mixed dose insulin and GPL-1 agonists d. biguanides and insulin lispro a. metformin and insulin treatment with radioactive iodine requires which precaution in the first few days of therapy a. keeping 100 ft distance from all others b. not bathing c. not sharing dishes, cups, and utensils d. wearing a neck brace c. not sharing dishes, cups, and utensils diagnostic criteria for diabetes includes a. fasting blood glucose greater than 140 mg/dL on two occasions b. postprandial blood glucose greater than 140 mg/dL c. fasting blood glucose 100 to 125 mg/dL on two occasions d. symptoms of diabetes plus a casual blood glucose greater than 200 mg/dL d. symptoms of diabetes plus a casual blood glucose greater than 200 mg/dL the american heart association states that people with diabetes have a two-to-four-fold increase in risk of dying from cardiovascular disease. treatments and targets that do not appear to decrease risk for micro and macro-vascular complications include a. glycemic targets between 7% and 7.5% b. use of insulin in type 2 diabetics c. control of hypertension and hyperlipidemia d. stopping smoking a. glycemic targets between 7% and 7.5% all diabetic patients with hyperlipidemia should be treated with a. HMG-CoA reductase inhibitors b. fibric acid derivatives