NUR-635 Pharm Final Exam with
complete solutions latest version
While rational drug selection is based on the individual patient the aspect of rational
drug selection addressing disease-specific information by a national medical or nursing
organization is
A. a guideline.
B. cost.
C. availability.
D. patient hepatic and renal function. - CORRECT ANSWER-A. a guideline
Drugs that alter synaptic transmission are much more selective than those that alter
axonal conduction, why is this? - CORRECT ANSWER-a drug that affects the axonal
conduction - non-selective effect.
Drugs that alter synaptic transmission - very selective because of the differences in
synapses and their specific neurotransmitters
What is phenytoin used for? - CORRECT ANSWER-Seizures
What should you monitor for with phenytoin? - CORRECT ANSWER-Delayed
hypersensitivity - even 1 month later
What is carbamazepine used for? - CORRECT ANSWER-Seizures
What may cause carbamazepine levels to drop despite no other change? What to do? -
CORRECT ANSWER-Autometabolization of drug. Increase dose.
What is the black box warning for carbamazepine? - CORRECT ANSWER-Steven-
Johnson Syndrome & TENS
Monitoring for carbamazepine, and how often? - CORRECT ANSWER-CBC, 3-4 times
a year
What population is most at risk for Steven-Johnson syndrome & TENS when taking
carbamazepine? - CORRECT ANSWER-Asian patients
BRAINSCAPE1
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Main class of medication for depression? - CORRECT ANSWER-Selective serotonin
reuptake inhibitors (SSRIs)
What to watch for with SSRIs? - CORRECT ANSWER-Other medications that can
cause serotonin syndrome
What is lamictal used for? - CORRECT ANSWER-Seizures
Patient on lamictal has fever, rash, swollen lymph nodes. What are we concerned for? -
CORRECT ANSWER-Hypersensitivity in lamictal can lead to MODS
Patient on lamictal wants birth control. What do we need to change? - CORRECT
ANSWER-Increase lamictal dose.
When will pt notice improvement after starting an SSRI? - CORRECT ANSWER-4
weeks later
1st line medication for moderate generalized anxiety - CORRECT ANSWER-Buspar
(SNRI)
1st line med for classic migraines - CORRECT ANSWER-Triptans
2nd line treatment for classic migraines - CORRECT ANSWER-Prophylactic -
propranolol
Why is important that NPs have the authority to prescribe? - CORRECT ANSWER-
Increase access to healthcare
What must be done if a drug has a narrow therapeutic index? - CORRECT ANSWER-
Frequent serum level monitoring
Why would 10mg percocet or 10mg oxy work better than the other? - CORRECT
ANSWER-Differences in pill filler composition
What do medications need in order to be effective: - CORRECT ANSWER-Albumin
(binding to)
If a patient has a toxic drug level, but normal albumin, what could be happening? -
CORRECT ANSWER-Other drugs competing for albumin
What does "Sig" mean on a prescription? - CORRECT ANSWER-Directions to
pharmacist
What items are necessary on a prescription? - CORRECT ANSWER-Drug, dose, route,
frequency, quantity, refills
Abbreviations to not use - CORRECT ANSWER-QD
BRAINSCAPE1
, BRAINSCAPE1
What drug may cause grey teeth? - CORRECT ANSWER-Tetracyclines
Pt reports no improvement in seizures after treatment for a few weeks. What next -
CORRECT ANSWER-Assess drug levels for therapeutic index
If patient on phenytoin wants birth control? - CORRECT ANSWER-Not oral
contraceptives! IUD better
Patient on teratogen med wants to get pregnant. When should they stop? - CORRECT
ANSWER-Before getting pregnant, beware first trimester
Pregnant pt has been taking daily aspirin. Concern for what? - CORRECT ANSWER-
Premature close of PFO
Pain treatment for shingles? - CORRECT ANSWER-Lidocaine after lesions heal
How does reglan help with GERD? - CORRECT ANSWER-Increases esophageal tone
Who should not take calcium carbonate antacids? - CORRECT ANSWER-Pt with
kidney stones
Pt on minocycline with HA. Pt has what? - CORRECT ANSWER-Pseudotumor Cerebri
Why do we rotate off phentermine? - CORRECT ANSWER-Pt will develop tolerance
Education on flagyl? - CORRECT ANSWER-Avoid alcohol - severe reaction
What is minocycline? - CORRECT ANSWER-Tetracycline for acne
Minocycline can be given safely to? - CORRECT ANSWER-Adolescents (no pregnancy
or liver fx)
New dx of GERD. First therapy? How often? - CORRECT ANSWER-H2 blocker - BID
Paxil side effects to educate? - CORRECT ANSWER-Sexual dysfunction, can resolve
on its own
What medication for pregnant UTI? - CORRECT ANSWER-Amoxicillin
Theophylline, NV/HA after starting. What do? - CORRECT ANSWER-See if it resolves
in a couple of days
ICS and beta agonist. Which first? - CORRECT ANSWER-Beta first, then ICS
SSRI Paxil, how long til it works? - CORRECT ANSWER-2-6 weeks
Pt high risk for osteoporosis. Education? - CORRECT ANSWER-Vit D/Calcium + weight
bearing exercise
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