WGU D116 Final Test: Questions With Correct Answers
A patient diagnosed with chronic pain calls to request an oxycodone
(Oxycontin) refill. Which action should the prescriber take initially? Right
Ans - d. Arrange to schedule an appointment with the patient.
Feedback: Schedule II medications are not eligible for refills, and prescriptions
must be handwritten. It is important to verify the patient's adherence to the
drug regimen and determine the current dosage of medication and pain level;
however, this can be accomplished by scheduling an appointment and
evaluating the patient in person.
A patient is prescribed metronidazole for bacterial vaginosis. Which patient
history finding would be most concerning to the provider? Right Ans - b.
The patient drinks two glasses of wine every night.
Feedback: Patients taking metronidazole should be educated not to drink
alcohol to prevent a disulfiram-like reaction. It would be concerning that the
patient drinks wine daily. History of a yeast infection may indicate increased
risk for recurrence with administration of an antimicrobial. A family history of
cervical cancer is not related to administration of metronidazole.
Unemployment can indicate lack of insurance coverage, which may limit the
patient's ability to purchase medications; however, generic metronidazole is
one of the less expensive medications.
The provider prepares a patient with newly diagnosed type 1 diabetes for
hospital discharge. Which action by the provider will best support the
patient's ability to effectively manage medication therapy? Right Ans - c.
Asking the patient to demonstrate how to measure and administer insulin
Feedback: Because insulin must be given correctly to control symptoms and
prevent an overdose, it is most important for the patient to know how to
measure and administer it. Asking for a demonstration of technique is the best
way to determine whether the patient has understood the teaching. The other
teaching points are important as well, but they are not as critical.
A patient reports that a medication prescribed for recurrent migraine
headaches is not working. Which action is the prescriber's priority when
addressing the patient's concern? Right Ans - b. Ask the patient about the
number and frequency of tablets taken.
Feedback: When evaluating the effectiveness of a drug, it is important to
determine how often the patient is using the drug. Asking the patient to
,identify how many tablets are taken and how often helps the provider
determine effective dosages and adherence to the medication regimen. The
patient has already stated that the medication is not working; the actual level
of pain may determine the degree to which it is not working, but it does not
help the provider to determine why it is not working. The assessment process
should gather as much information about compliance, symptoms, and drug
effectiveness as possible before enacting a change in treatment. Biofeedback
may be an effective adjunct to treatment, but it should not be recommended
without complete information about drug effectiveness.
The drug manual states that older adult patients are at increased risk for
hepatotoxicity. Which action is most important when prescribing this
medication to an 80-year-old patient? Right Ans - d. Obtaining baseline
liver function studies
Feedback: The drug manual indicates that this drug increases risk of
hepatotoxicity for elderly patients. Getting information about liver function
before giving the drug establishes baseline data that can be compared with
posttreatment data to determine whether the drug is affecting the liver.
Taking the correct dose at the correct interval may minimize risk, but without
baseline information, the effects cannot be determined. Drugs are not
routinely contraindicated for an increased risk of adverse effects
A patient with bipolar disorder is prescribed daily lithium. Which action is
most important for the provider to take in order to determine if the
therapeutic level is maintained? Right Ans - . Order periodic laboratory
testing
Feedback: Therapeutic serum levels are determined through periodic
laboratory testing. Preadministration blood work may be necessary to obtain
baseline status prior to initiating treatment, but it will not determine
therapeutic levels. Scheduling medication administration at regular intervals
will help to ensure medication is absorbed and metabolized predictably, but it
will not determine therapeutic blood levels. Assessing the patient for signs
and symptoms of toxicity will help to determine if the therapeutic level has
been exceeded, not maintained.
When prescribing lovastatin, what will a provider advise to decrease the risk
of developing muscle toxicity? Right Ans - B. Substitute grapefruit juice
with orange juice.
, Feedback: Grapefruit juice can inhibit the metabolism of certain drugs
including statins like lovastatin. The juice raises drug levels decreasing the
intestinal metabolism of the drug resulting in increased drug levels which
increases the risk for adverse effects such as muscle toxicity. Taking the drug
with an anti-inflammatory drug and avoiding exercise after administration are
not supported by science. Monitoring AST and ALT detects liver toxicity, not
muscle toxicity.
The provider prescribes hydrocodone with acetaminophen for a patient's
postsurgical pain. What instruction will the prescriber include regarding
alcohol intake? Right Ans - A. "You should avoid drinking alcohol while you
are taking the pain medication I've ordered."
Feedback: Combining a hepatotoxic drug with other hepatotoxic agents
increases the risk of hepatotoxicity. When even therapeutic doses of
acetaminophen are taken with alcohol, the acetaminophen can cause liver
damage. Patients should be cautioned not to drink alcohol; even two drinks
with acetaminophen can produce this effect. Hydrocodone does not contribute
to hepatotoxicity. Ibuprofen is not indicated for postoperative pain unless the
pain is mild. Limiting alcohol intake to two servings per day still increases the
risk of hepatotoxicity.
A drug can cause symptoms that resemble those of Parkinson disease. What
action should the prescriber take to minimize the potential patient risk?
Right Ans - A. Thoroughly educate the patient about recognizing such
symptoms and the need to notify the office immediately.
Feedback: Some drugs can cause iatrogenic conditions, which are conditions
whose symptoms are the same as those of a known disease. The patient
should be prepared for this possibility and be prepared to recognize and
report the symptoms immediately. Such effects are not teratogenic, since
teratogenic effects affect the fetus. Patients with a genetic predisposition to
respond differently to drugs are known to have idiosyncratic effects. Although
reassurance may dispel some fear on the part of the patient, it does provide
the patient with actions (e.g., notifying the provider) that can allow for
symptom management.
A patient reports mild nausea within an hour after taking the first two doses
of a newly approved medication. Nausea is not listed among the known side
effects of this drug. What instructions will the provider give the patient?
A patient diagnosed with chronic pain calls to request an oxycodone
(Oxycontin) refill. Which action should the prescriber take initially? Right
Ans - d. Arrange to schedule an appointment with the patient.
Feedback: Schedule II medications are not eligible for refills, and prescriptions
must be handwritten. It is important to verify the patient's adherence to the
drug regimen and determine the current dosage of medication and pain level;
however, this can be accomplished by scheduling an appointment and
evaluating the patient in person.
A patient is prescribed metronidazole for bacterial vaginosis. Which patient
history finding would be most concerning to the provider? Right Ans - b.
The patient drinks two glasses of wine every night.
Feedback: Patients taking metronidazole should be educated not to drink
alcohol to prevent a disulfiram-like reaction. It would be concerning that the
patient drinks wine daily. History of a yeast infection may indicate increased
risk for recurrence with administration of an antimicrobial. A family history of
cervical cancer is not related to administration of metronidazole.
Unemployment can indicate lack of insurance coverage, which may limit the
patient's ability to purchase medications; however, generic metronidazole is
one of the less expensive medications.
The provider prepares a patient with newly diagnosed type 1 diabetes for
hospital discharge. Which action by the provider will best support the
patient's ability to effectively manage medication therapy? Right Ans - c.
Asking the patient to demonstrate how to measure and administer insulin
Feedback: Because insulin must be given correctly to control symptoms and
prevent an overdose, it is most important for the patient to know how to
measure and administer it. Asking for a demonstration of technique is the best
way to determine whether the patient has understood the teaching. The other
teaching points are important as well, but they are not as critical.
A patient reports that a medication prescribed for recurrent migraine
headaches is not working. Which action is the prescriber's priority when
addressing the patient's concern? Right Ans - b. Ask the patient about the
number and frequency of tablets taken.
Feedback: When evaluating the effectiveness of a drug, it is important to
determine how often the patient is using the drug. Asking the patient to
,identify how many tablets are taken and how often helps the provider
determine effective dosages and adherence to the medication regimen. The
patient has already stated that the medication is not working; the actual level
of pain may determine the degree to which it is not working, but it does not
help the provider to determine why it is not working. The assessment process
should gather as much information about compliance, symptoms, and drug
effectiveness as possible before enacting a change in treatment. Biofeedback
may be an effective adjunct to treatment, but it should not be recommended
without complete information about drug effectiveness.
The drug manual states that older adult patients are at increased risk for
hepatotoxicity. Which action is most important when prescribing this
medication to an 80-year-old patient? Right Ans - d. Obtaining baseline
liver function studies
Feedback: The drug manual indicates that this drug increases risk of
hepatotoxicity for elderly patients. Getting information about liver function
before giving the drug establishes baseline data that can be compared with
posttreatment data to determine whether the drug is affecting the liver.
Taking the correct dose at the correct interval may minimize risk, but without
baseline information, the effects cannot be determined. Drugs are not
routinely contraindicated for an increased risk of adverse effects
A patient with bipolar disorder is prescribed daily lithium. Which action is
most important for the provider to take in order to determine if the
therapeutic level is maintained? Right Ans - . Order periodic laboratory
testing
Feedback: Therapeutic serum levels are determined through periodic
laboratory testing. Preadministration blood work may be necessary to obtain
baseline status prior to initiating treatment, but it will not determine
therapeutic levels. Scheduling medication administration at regular intervals
will help to ensure medication is absorbed and metabolized predictably, but it
will not determine therapeutic blood levels. Assessing the patient for signs
and symptoms of toxicity will help to determine if the therapeutic level has
been exceeded, not maintained.
When prescribing lovastatin, what will a provider advise to decrease the risk
of developing muscle toxicity? Right Ans - B. Substitute grapefruit juice
with orange juice.
, Feedback: Grapefruit juice can inhibit the metabolism of certain drugs
including statins like lovastatin. The juice raises drug levels decreasing the
intestinal metabolism of the drug resulting in increased drug levels which
increases the risk for adverse effects such as muscle toxicity. Taking the drug
with an anti-inflammatory drug and avoiding exercise after administration are
not supported by science. Monitoring AST and ALT detects liver toxicity, not
muscle toxicity.
The provider prescribes hydrocodone with acetaminophen for a patient's
postsurgical pain. What instruction will the prescriber include regarding
alcohol intake? Right Ans - A. "You should avoid drinking alcohol while you
are taking the pain medication I've ordered."
Feedback: Combining a hepatotoxic drug with other hepatotoxic agents
increases the risk of hepatotoxicity. When even therapeutic doses of
acetaminophen are taken with alcohol, the acetaminophen can cause liver
damage. Patients should be cautioned not to drink alcohol; even two drinks
with acetaminophen can produce this effect. Hydrocodone does not contribute
to hepatotoxicity. Ibuprofen is not indicated for postoperative pain unless the
pain is mild. Limiting alcohol intake to two servings per day still increases the
risk of hepatotoxicity.
A drug can cause symptoms that resemble those of Parkinson disease. What
action should the prescriber take to minimize the potential patient risk?
Right Ans - A. Thoroughly educate the patient about recognizing such
symptoms and the need to notify the office immediately.
Feedback: Some drugs can cause iatrogenic conditions, which are conditions
whose symptoms are the same as those of a known disease. The patient
should be prepared for this possibility and be prepared to recognize and
report the symptoms immediately. Such effects are not teratogenic, since
teratogenic effects affect the fetus. Patients with a genetic predisposition to
respond differently to drugs are known to have idiosyncratic effects. Although
reassurance may dispel some fear on the part of the patient, it does provide
the patient with actions (e.g., notifying the provider) that can allow for
symptom management.
A patient reports mild nausea within an hour after taking the first two doses
of a newly approved medication. Nausea is not listed among the known side
effects of this drug. What instructions will the provider give the patient?
