FITZGERALD PHARM MIDTERM EXAM 2025

The plaintiff's establishment of a relationship between the breach and the injuries is known as: - -Proximate cause When writing a prescription, the APRN must do all of the following EXCEPT: - -Consider whether the selected medication is available in generic form Which of the following statements regarding damages and negligence is correct? - Damages require proof of physical or emotional harm. Malpractice requires all of the following EXCEPT: - -Intentional misconduct. A drug's mechanism of action is part of its: - -Pharmacodynamics. Cmax is best described as: - -Maximum or peak concentration of a drug observed after its administration. Bioavailability is defined as the: - -Fraction of the administered drug that reaches systemic circulation. A 37-year-old woman with a history of migraines requests a migraine treatment. She describes that her migraines tend to develop slowly and will last several hours. The NP recommends which of the following triptans? - -Frovatriptan Which of the following statins would be preferred for a 67-year-old man with hypercholesterolemia and who likes to have a glass of grapefruit juice every morning? - -Pravastatin A 57-year-old woman with a history of intracerebral hemorrhage and who is taking warfarin requires treatment with metronidazole. Aside from close clinical monitoring and periodic checking of INR, the NP considers which of the following adjustments to therapy? - -Decrease the warfarin dose by 25% for the duration of antimicrobial therapy Anticipated age-related changes that impact drug effect include: - -Loss of B-2 receptor sites. Creatinine clearance usually: - -Approximates glomerular filtration rate. CYP450 1A2's activity is influenced by the presence or absence of estrogen in women. - -True FITZGERALD FITZGERALD Compared to younger adults (20-30-year-olds), older adults (60-80-year-olds) tend to have: - -Lower average serum albumin. According to Hale's Lactation Risk Category, a medication in which there is evidence of risk for its use in lactation but may be used if there is a maternal life-threatening situation is assigned category: - -L4 In order to remove a drug from breast milk via "pump and dump," the process must be continued for: - -3-5 drug-free half-lives. Which drug is most likely to pass through to the mammary alveolar tissue? - -A lipophilic drug of 200 Da When considering medications during pregnancy, drugs with a molecular weight over ______ will typically fail to pass through to the placenta. - -1000 Da A drug with demonstrated safety for use in pregnancy is assigned risk category - -A In a healthy person, basal insulin accounts for what percentage of the body's total daily physiologic insulin secretion? - -50% Signs of hypoglycemia include all of the following except: - -Bradycardia. The thiazolidinediones should not be used concomitantly with a(n): - -Nitrate The mechanism of action of sulfonylureas is as a(n): - -Product that enhances insulin release. For a patient who is newly diagnosed with type 2 diabetes and A1C 10%, intensive insulin therapy should be considered to reverse the effects of glucose toxicity. The recommended duration of intensive insulin therapy is: - -2 to 3 weeks. In counseling a patient on the use of short-acting insulin to better manage post-prandial hyperglycemia, the NP advises: - -It should be administered 10 minutes prior to each meal The NP is evaluating a 58-year-old man with type 2 diabetes mellitus that is being treated with metformin monotherapy. Today, his A1C is7.3%. The patient expresses concern about hypoglycemia. In considering adding a new antihyperglycemic agent to her regimen, the NP considers which of the following to be the least appropriate option? - -GLP-1 agonist Unless contraindicated, an additional therapy to be routinely prescribed for the patient with type 2 diabetes includes all of the following except: - -Fibrate. FITZGERALD FITZGERALD Which of the following best describes the mechanism of action of beta-lactams? - Disrupt synthesis of the peptidoglycan layer of bacterial cell walls The decision-making process where a clinician chooses an agent based on patient characteristics and site of infection is called: - -Empiric therapy. Which of the following best describes the mechanism of action of sulfonamides? - Inhibiting folate synthesis The use of which of the following agents should be avoided in children and pregnant women due to the possibility of teeth staining? - -Tetracycline The lowest concentration of an antimicrobial that will prevent growth of 99.9% of an organism after subculture onto antibiotic-free media is called: - -Minimum inhibitory concentration. In geographic areas where E. coli resistance to TMP/SMX is 20%, alternative treatments include phenazopyridine plus all of the following except: - -Amoxicillin. A 46-year-old man who is currently smoking 1 PPD and has a 30-packyear cigarette smoking history with penicillin allergy presents with acute bacterial rhinosinusitis. Three weeks ago, he was treated with a macrolide for "bronchitis." You now prescribe: - Levofloxacin. A 35-year-old woman who is not pregnant was initiated on high-dose amoxicillin 4 days ago to treat acute bacterial rhinosinusitis. She returns complaining of no change in symptoms. You recommend switching her treatment to: - -Levofloxacin. Risk factors for developing fluoroquinolone-associated tendinitis and tendon rupture include all of the following except: - -Recent use of a systemic beta-lactam antimicrobial. All of the following antimicrobials would be expected to exhibit in vitro activity against beta-lactamase-producing Moraxella catarrhalis except: - -Amoxicillin. Which of the following is most accurate regarding the finding of a solitary thyroid nodule? - -A benign or malignant thyroid lesion will present in a similar manner. In prescribing an initial prescription of thyroxine therapy, which of the following statements is true? - -The anticipated thyroxine dose can be calculated using an age- and weight-based formula. Which of the following medications has been associated with serious liver injury? - Propylthiouracil When counseling a patient taking levothyroxine (Synthroid®,Unithroid®), you advise that the medication should be taken: - -On an empty stomach. FITZGERALD FITZGERALD Which of the following combination of supplements is a possible treatment option for migraines? - -Magnesium and riboflavin Under the DSHEA regulations, the labeling of a calcium supplement would likely read as follows: - -This product helps in supporting bone health. Butterbur's mechanism of action in migraine prophylaxis is as a(n): - -Antispasmodic. Regarding the use of glucosamine and chondroitin for the treatment of symptomatic osteoarthritis of the knee, the American Association of Orthopedic Surgeons (AAOS): - Cannot recommend the use of these agents. Compared to salmeterol, albuterol has a(n): - -Shorter half-life A 32-year-old man with asthma and is being treated with a LABA has an Asthma Control Test score of 14 at his most recent follow-up visit. This would suggest that his asthma is: - -Very poorly controlled. The mechanism of action of long-acting muscarinic agents (LAMAs) for the treatment of asthma is primarily by: - -Relaxing smooth muscles. Mepolizumab and reslizumab inhibit eosinophil maturation and activation by targeting: - -IL-5. You see a 24-year-old woman with acute asthma flare. She is using fluticasone and albuterol as directed and continues to have difficulty with coughing and wheezing. Her PEF is 55% of predicted. Her medication regimen should be adjusted to include: - Short course of oral prednisone to be taken for the next 5 days. A 22-year-old female is being treated in-office for a moderate asthma flare. Before considering discharge, all of the following criteria should be achieved except: - -Oxygen saturation 85% on controlled oxygen therapy. Compared to tiotropium, ipratropium has which of the follo