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1. A patient presents to an emer- YES With food or an empty stomach
gency room complaining of palpita-
tions and irregular heartbeat. The
advanced practice registered nurse
(APRN) places the patient on a car-
diac monitor and observes atrial fibril-
lation. The APRN orders dofetilide.
How should the APRN recommend this
medication be taken?
2. A 70-year-old male calls a clinic com- Do not take the nitroglycerin and call 911
plaining of chest pain that started after
having sexual activity. He took silde- Taking the medications together can cause a seri-
nafil 50 mg about eight hours ago. He ous drop in blood pressure leading to cardiovas-
has nitroglycerin 0.3 mg on hand. cular collapse.
How should the advanced practice reg-
istered nurse respond?
3. A patient diagnosed with bipolar disor- A baseline blood urea nitrogen (BUN) and crea-
der who is in a mental health clinic is tinine (CREA) level needs to be drawn to assess
discussing the possibility of beginning kidney function prior to treatment.
lithium with an advanced practice reg-
istered nurse (APRN). The patient ex- This drug can cause decreased renal function,
presses understanding and wishes to and a baseline should be drawn for future com-
proceed with treatment. The APRN ex- parison.
plains to the patient that this medica-
tion requires specific lab monitoring
and wants to draw baseline labs. The
patient asks why the test is needed.
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Which explanation should the APRN
provide to this patient?
4. An advanced practice registered nurse YES A 54-year-male with a medical history of hy-
(APRN) is reviewing the medications pertension, mild eczema, and previous history of
that will be commonly experienced a urolithiasis where all is well controlled and there
with a new nurse to determine are no current complications
whether the drugs are safe for the pa-
tients. The new nurse is given a sce-
nario where a patient is being pre-
scribed sildenafil 25 mg po prn, a pro-
totype drug for erectile dysfunction.
Which patient may take this drug safe-
ly?
5. A 30-year-old patient presents to a pri- YES Influences receptor activity on target cells
mary care clinic with a history of anxi-
ety. The advanced practice registered Correct! This medication influences the activity in
nurse reviews the mechanism of ac- the receptors, and it targets cells.
tion by which many neuropharmaco-
logical agents act and decides to pre-
scribe citalopram.
What is the mechanism of action of
this medication?
6. A patient is admitted with a diagno- NO Modulates the effects of glutamate at NMDA
sis of Huntington disease. On admis- receptors
sion, the patient exhibits uncontrolled YES Inhibits neurotransmitter GABA
twitching, difficulty walking, trouble NO Halts the breakdown of acetylcholine by
swallowing, confusion, and memory acetylcholinesterase
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loss. The advanced practice registered Alters the synthesis and release of norepineph-
nurse (APRN) prescribes baclofen. rine, serotonin, and dopamine
What is the mechanism of action of Incorrect. Cholinesterase inhibitors prevent
this medication? the breakdown of acetylcholine by acetyl-
cholinesterase. They are used in patients with
Alzheimer's.
Correct! Huntington's disease involves a defi-
ciency of the neurotransmitters acetylcholine and
y-aminobutyric acid in the basal ganglia and ex-
trapyramidal system.
7. A 21-year-old patient accompanied by Atonic
a parent comes to a clinic for an emer- NO Myoclonic
gency visit with an advanced practice YES Tonic-clonic
registered nurse (APRN) following a Absence
seizure. Upon interviewing the patient Incorrect. Myoclonic seizures consist of a sudden
and the parent, the APRN determines muscle contraction that lasts for just one second.
that the seizure is classified by marked Correct! A tonic-clonic seizure is a type of seizure
impairment of consciousness and is that is also called a convulsion. This type of seizure
followed by a period of central nervous can include muscle stiffness, loss of conscious-
system (CNS) depression. ness, and body jerking.
Which type of seizure is this patient
experiencing?
8. A patient has been taking oral oxy- YES Physical dependence
codone every six hours for back pain Correct! The patient suddenly stopping the med-
during the past three years. The pa- ication will cause physical symptoms that can
tient suddenly decides to stop taking range from nausea to seizures.
the pain medication and is trying an al-
ternative therapy without a clinician's
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approval.
Which risk is of clinical concern?
9. An advanced practice registered nurse YES Bupropion
has diagnosed a 44-year-old male with
depression. A plan is developed to Correct! Bupropion does not cause sexual dys-
start treatment with medication. The function. This will help the patient with a history of
patient has a history of sexual dys- sexual dysfunction. This will enhance the patient's
function and is concerned about tak- libido, which will help with both depression and
ing medication that may worsen this sexual dysfunction.
condition.
Which antidepressant has the benefit
of enhancing libido?
10. A patient is wheezing and short of YES Tachycardia
breath. The nurse assesses a heart
rate of 88 beats per minute, a respi- Correct! Beta-agonists are used for asthma be-
ratory rate of 24 breaths per minute, cause of their beta2 effects on bronchial smooth
and a blood pressure of 124/78 mm muscle, causing dilation. Beta1 effects cause
Hg. The prescriber orders a nonspecif- tachycardia and hypertension. Beta receptors do
ic beta-agonist medication. not exert effects on the bladder.
Besides evaluating the patient for a
reduction in respiratory distress, the
nurse should monitor for which side
effect?
11. A patient is experiencing toxic side ef- YES Physostigmine
fects from atropine, including deliri-
um and hallucinations. Which medica- Correct! Physostigmine is the drug of choice for
tion should the provider administer? treating poisoning from atropine and other drugs
that cause muscarinic blockade. Donepezil is used