Pace University NURS 330/NURS330; Exam Review questions and answers_ Updated 100% 2025/2026.

Pace University NURS 330/NURS330; Exam Review questions and answers_ Updated 100% 2025/2026. In advising a 40-year-old woman who is taking ciprofloxacin with a calcium- containing antacid, which of the following statements is correct? A. She should be instructed to take the medications together with a large glass of water. B. This combination will help alleviate the stomach upset often found with fluoroquinolone use. C. Ciprofloxacin absorption will be enhanced because of slower GI motility associated with antacid use. D. The clinical effect of the antimicrobial will be reduced via chelation if the two medications are taken together. When counseling a 58-year-old woman on the use of levothyroxine, the NP advises that the medication: A. Should be taken on an empty stomach. B. Has few drug-drug interactions. C. Should be taken just prior to the first meal of the day. D. Should be taken following the final meal of the day. A 63-year-old man with a history of ventricular arrhythmia is diagnosed with community-acquired pneumonia. Which of the following oral medications should be avoided due to the risk of QT prolongation? A. Amoxicillin-clavulanate B. Doxycycline C. Cefuroxime D. Moxifloxacin Using metformin in a person with advanced renal impairment potentially increases the risk of: A. Hypokalemia. B. Renal failure. C. Poor glycemic control. D. Lactic acidosis The NP is evaluating a 36-year-old woman with type 2 diabetes mellitus currently being treated with metformin. She also has a history of recurrent UTIs. Her BMI is 38 kg/m2 and her A1C today is 7.6%. She expresses a desire to lose weight. In considering adding a new antihyperglycemic medication to her regimen, the most appropriate choice would be a: a. SGLT2 inhibitor. b. GLP-1 agonist. c. TZD. d. Sulfonylurea. The decision-making process where a clinician chooses an agent based on patient characteristics and site of infection is called: a. Prophylactic therapy. b. Empiric therapy. c. Definitive therapy. d. Pre-emptive therapy. The use of which of the following agents should be avoided in children and pregnant women due to the possibility of teeth staining? a. Cefpodoxime b. Gemifloxacin c. Telithromycin d. Tetracycline Which of the following characteristics apply to the macrolides? a. Consistent activity against drug-resistant S. pneumoniae b. Contraindicated in pregnancy c. Effective against atypical pathogens d. Unstable in the presence of beta-lactamase Which of the following best describes the mechanism of action of the macrolides? a. Inhibition of bacterial protein biosynthesis b. Disrupt synthesis of peptidoglycan layer of bacterial cell walls c. Inhibiting DNA replication and transcription d. Inhibiting folate synthesis When counseling a patient taking levothyroxine (Synthroid®, Unithroid®), you advise that the medication should be taken: a. With a dose of an antacid. b. On an empty stomach. c. With a bedtime snack. d. With a meal. Rescue drugs for bronchospasm include all of the following except: a. Albuterol. b. Levalbuterol. c. Pirbuterol. d. Cromolyn. Compared to salmeterol, albuterol has a(n): a. Longer time to clinical effect. b. Approximately similar time to clinical effect. c. Shorter half-life. d. Longer half-life The mechanism of action of long-acting muscarinic agents (LAMAs) for the treatment of asthma is primarily by: a. Preventing the release of type I mediators for allergic reactions. b. Relaxing smooth muscles. c. Reducing amount of acute inflammation during an asthma flare. d. Mucolytic activity. Which of the following best describes asthma? a. Intermittent airway inflammation with occasional bronchospasm b. Relatively fixed airway obstruction c. Chronic disorder with bronchial hyperresponsiveness and underlying inflammation d. A disease of bronchospasm leading to airway inflammation The mechanism of action of oral corticosteroids in the treatment of an acute asthma flare is primarily by: a. Relaxing smooth muscle. b. Reversing cyclic AMP. c. Inhibition of secretions. d. Reducing inflammation. According to the GINA Guidelines, the preferred treatment of mild asthma requiring Step 2 therapy is a(n): a. Leukotriene modifier. b. Short-acting beta2-agonist. c. Long-acting beta2-agonist. d. Inhaled corticosteroid. Tendinopathy has been associated with the use of which antimicrobial class? a. Fluoroquinolones b. Tetracyclines c. Cephalosporins d. Macrolides Oral iron absorption can be enhanced when taken with: a. Vitamin C. b. Vitamin B12. c. Calcium. d. An antacid. The use of which of the following antibiotics is most likely to reduce oral contraceptive effectiveness? a. Amoxicillin b. Ciprofloxacin c. Doxycycline d. Rifampin Due to an increased risk of venous thromboembolism (VTE), drospirenone- containing combined oral contraceptives (COCs) should be avoided in all of the following women except: a. A 33-year-old who smokes 1 PPD. b. A 29-year-old who gave birth to twins in the previous 6 months. c. A 38-year-old with a BMI of 32 kg/m². d. A 42-year-old with a family history of venous thrombosis Which of the following is likely not among the proposed mechanisms of action of levonorgestrel when used as emergency hormonal contraception? a. Inhibits ovulation b. An abortifacient c. Slows sperm transport d. Slows ovum transport When counseling a woman about combined oral contraceptive use, you advise that: a. Long-term use is discouraged. b. Fertility is often delayed for a number of months after discontinuation. c. There is an increase in the rate of endometrial cancer after protracted use. d. Premenstrual syndrome symptoms are often improved. Progestogen therapy encompasses the use of both: a. Progestin and estrogen. b. Progesterone and estrogen. c. Progesterone and testosterone. d. Progesterone and progestin. Compared to tiotropium, ipratropium has which of the following characteristics? Shorter half-life Longer time to Cmax Less frequent dosing Similar dosing interval According to the Beers criteria, older adults treated for iron deficiency anemia should not receive more than mg of ferrous sulfate as a total daily dose. 168.0 325.0 650.0 975.0 Non-contraceptive benefits of oral contraceptives include a decreased risk of all of the following except: Iron deficiency anemia. Pelvic inflammatory disease. Ovarian cancer risk. C. trachomatis cervicitis. Which of the following is the most appropriate response to a 27-year-old woman who is taking phenytoin (Dilantin) for the treatment of a seizure disorder and is requesting hormonal contraception? A barrier method is the only safe and acceptable contraceptive choice. Low-dose oral contraceptive use will provide effective contraceptive protection. Depot medroxyprogesterone acetate (Depo-Provera) will not interact with your seizure medication. Copper-containing IUD use is prohibited. The pharmacologic effects of estrogen include all of the following except: Ovarian inhibition. Pituitary inhibition. Cervical mucous thickening. Endometrial proliferation. The use of which of the following contraceptive options is least appropriate for a 48-year-old woman with recent diagnosis of type 2 diabetes mellitus and who smokes 1 PPD? Depot medroxyprogesterone acetate (DMPA) Progestin-only implant Copper-containing intrauterine device Levonorgestrel intrauterine system (LNG-IUS) When counseling a 56-year-old woman with type 2 diabetes mellitus, the NP mentions which of the following regarding the use of semaglutide? Identical A1C reduction is observed with the oral or injectable formulation The oral form should be taken immediately following the first meal of the day Tablets can be cut in half if a lower dose is needed The oral dose of the medication needed is quite high compared to the injectable for due to issues with GI absorption. 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 Risk factors for developing fluoroquinolone-associated tendinitis and tendon rupture include all of the following except: Recent use of a systemic beta-lactam antimicrobial. 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. 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 4 year old pt w/ sickle cell disease is experiencing a febrile illness. Which hemopoietic lab value will the NP use to evaluate the efficiency of the patient's bone marrow response? B lymphocyte C-reactive protein Prothrombin time Reticulocyte count The NP is reviewing labs for a 27 year old pt w/ decreased energy & oral ulceration. The pt Vit B12 is 215, methylmalonic acid (MMA) is 175 & homocysteine is 18. Which diagnosis is most likely? Folate deficiency Pernicious anemia Normocytic anemia Vitamin B12 deficiency Which of the following tests would you recommend to pt to confirm the dx of beta thalassemia or sickle cell anemia HGB electrophoresis Bone marrow bx Peripheral smear Reticulocyte count A 6 month old w/ normocytic anemia has an electrophoresis result of hemoglobin S w/ 20% concentration of HGB F (fetal HGB). Which additional dx is most likely? Aplastic anemia Hemolytic anemia Sickle cell anemia Thalassemia major Which of the following is an FDA-approved therapeutic agent for treating sickle cell patients? Hydroxyurea Laboratory monitoring for patients on ACE inhibitors or ARBs should include: A. White blood cell counts with the drug dosage increased for elevations above 10,000 feet B. Liver function tests with the drug dosage stopped for alanine aminotransferase values twice that of normal C. Serum creatinine levels with the drug dosage reduced for values greater than 2.5 mg/dL D. Serum glucose levels with the drug dosage increased for levels greater than 120 mg/dL While taking an ARB, patients need to avoid certain over-the-counter drugs without first consulting the provider because: A. Cimetidine is metabolized by the CYP3A4 isoenzymes. B. Nonsteroidal anti-inflammatory drugs reduce prostaglandin levels. C. Both A and B D. Neither A nor B The choice of diuretic to use in treating hypertension is based on: A. Presence of diabetes with loop diuretics being used for these patients B. Level of kidney function with a thiazide diuretic being used for an estimated glomerular filtration rate higher than the mid-40 mL/min range C. Ethnicity with aldosterone antagonists best for African Americans and older adults D. Presence of hyperlipidemia with higher doses needed for patients with low-density lipoproteins (LDL) above 130 mg/dL When comparing ACE and ARB medications, which of the following holds true? A. Both may produce a dry, irritating cough. B. Both contribute to some retention of potassium. C. ARBs have a stronger impact on hypertension control than ACE medications. How is diabetic renal protection affected by ACE medications? Diabetes mellitus patients: A. Have a reduced rate of renal progression, but ACE medications still need to be discontinued when advanced renal issues are present B. Who start these medications never progress to renal nephropathy C. Who have early renal dysfunction will see it reverse when on ACE medications D. Without renal issues are the only ones who benefit from ACE protection When educating patients who are starting on inhaled corticosteroids, the provider should tell them that: A. They should get any needed live vaccines before starting the medication. B. Inhaled corticosteroids need to be used daily during asthma exacerbations to be effective. C. Patients should rinse their mouths out after using the inhaled corticosteroid to prevent thrush. D. They can triple the dose number of inhalations of medication during colds to prevent needing systemic steroids. Digoxin levels need to be monitored closely when the following medication is started: A. Loratadine B. Diphenhydramine C. Ipratropium D. Albuterol Patients with pheochromocytoma should avoid which of the following classes of drugs because of the possibility of developing hypertensive crisis? A. Expectorants B. Beta-2 agonists C. Antitussives D. Antihistamines A 42-year-old patient has moderate persistent asthma. Which of the following asthma medications should be used cautiously, if at all? A. Betamethasone, an inhaled corticosteroid B. Salmeterol, an inhaled long-acting beta agonist (LTBA) C. Albuterol, a short-acting beta agonist D. Montelukast, a leukotriene modifier The bronchodilator of choice for patients taking propranolol is: A. Albuterol B. Pirbuterol C. Formoterol D. Ipratropium Montelukast (Singulair) may be prescribed for: A. A 6-year-old child with exercise-induced asthma B. A 2-year-old child with moderate persistent asthma C. An 18-month-old child with seasonal allergic rhinitis D. None of the above; montelukast is not approved for use in children 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 To prevent further development of antibacterial resistance, it is recommended that fluoroquinolones be reserved for treatment of: A. Urinary tract infections in young women B. Upper respiratory infections in adults C. Skin and soft tissue infections in adults D. Community-acquired pneumonia in patients with comorbidities Tetracyclines such as minocycline are safe to use in: A. Pregnant women B. Adolescents C. Patients with renal dysfunction D. Patients with hepatic dysfunction Tetracyclines should not be prescribed to children younger than 8 years due to: A. Risk of developing cartilage problems B. Development of significant diarrhea C. Risk of kernicterus D. Adverse effects on bone growth An adult female has been prescribed doxycycline for a chlamydia infection. She is healthy and her only medication is an oral combined contraceptive. Education would include: A. She should use a back-up method of birth control (condom) until her next menses. B. Doxycycline may cause tendonitis and she should report any joint pain. C. Her partner will need treatment if her infection doesn’t clear with the doxycycline. D. Doxycycline is used for one-dose treatment of sexually transmitted infections (STIs); take the whole prescription at once. Factors that place a patient at risk of developing an antimicrobial-resistant organism include: A. Age over 50 years B. School attendance C. Travel within the United States D. Inappropriate use of antimicrobials Infants and young children are at higher risk of developing antibiotic-resistant infections due to: A. Developmental differences in pharmacokinetics of the antibiotics in children B. The fact that children this age are more likely to be in daycare and exposed to pathogens from other children C. Parents of young children insisting on preventive antibiotics so they don’t miss work when their child is sick D. Immunosuppression from the multiple vaccines they receive in the first 2 years of life A child has been diagnosed with strep throat and needs a prescription for an antibiotic. The parent says the last time they had penicillin, they developed a pink, blotchy rash 5 or 6 days after starting the antibiotic. An appropriate antibiotic to prescribe would be: A. Clindamycin B. Amoxicillin C. Cefadroxil (Duricef) D. Azithromycin An adult female has been prescribed iron to treat her anemia. Education of patients prescribed iron would include: A. She should take the iron with milk if it upsets her stomach. B. Antacids may help with the nausea and gastrointestinal (GI) upset caused by iron. C. She should increase fluids and fiber to treat constipation. D. Iron is best tolerated if it is taken at the same time as her other medications. A patient with Crohn disease has a documented folate deficiency. Drug therapy for folate deficiency anemia is: A. Oral folic acid 1 to 2 mg per day B. Oral folic acid 1 g per day C. Intramuscular (IM) folate weekly for at least 6 months D. Oral folic acid 400 mcg daily Patients who are being treated for folate deficiency require monitoring of: A. Complete blood count every 4 weeks B. Hematocrit and hemoglobin at 1 week and then at 8 weeks C. Reticulocyte count at 1 week D. Folate levels every 4 weeks until hemoglobin stabilizes Prior to developing a plan for the treatment of asthma, the patient’s asthma should be classified according to the National Heart, Lung, and Blood Institute (NHLBI) Expert Panel 3 guidelines. In adults, mild-persistent asthma is classified as asthma symptoms that occur: A. Daily B. Daily and limit physical activity C. Less than twice a week D. More than twice a week and less than once a day In children aged 5 to 11 years mild-persistent asthma is diagnosed when asthma symptoms occur: A. At nighttime one to two times a month B. At nighttime three to four times a month C. Less than twice a week D. Daily One goal of asthma therapy outlined by the NHLBI Expert Panel 3 guidelines is: A. Control symptoms using albuterol daily B. Minimize exacerbations to once a month C. Keep nighttime symptoms to a maximum of twice a week D. Require infrequent use of beta 2 agonists (albuterol) for relief of symptoms A stepwise approach to the pharmacologic management of asthma: A. Begins with determining the severity of asthma and assessing asthma control B. Is used when asthma is severe and requires daily steroids C. Allows for each provider to determine their personal approach to the care of asthmatic patients D. Provides a framework for the management of severe asthmatics, but is not as helpful when patients have intermittent asthma Treatment for mild-intermittent asthma is: A. Daily inhaled medium-dose corticosteroids B. Short-acting beta 2 agonists (albuterol) as needed C. Long-acting beta 2 agonists every morning as a preventative measure D. Montelukast (Singulair) daily The first-line therapy for mild-persistent asthma is: A. High-dose montelukast B. Theophylline C. Low-dose inhaled corticosteroids D. Long-acting beta 2 agonists Monitoring a patient with persistent asthma includes: A. Monitoring how frequently the patient has an upper respiratory infection (URI) during treatment B. Spirometry testing monthly in-office C. Determining if the patient has increased use of his or her long-acting beta 2 agonist due to exacerbations D. Evaluating the patient every 2 to 3 months to determine if the patient needs to step up or down in their therapy Asthma exacerbations at home are managed by the patient by: A. Increasing frequency of beta 2 agonists and contacting their provider B. Tripling inhaled corticosteroid dose C. Using inhaled beta 2 agonists every 20 minutes for 2 hours D. Starting montelukast (Singulair) SMART dosing as introduced by the GINA guidelines includes which of the following as the mainstay of both reliever and controller therapy? A. The short acting beta agonist B. ICS/formoterol only C. The ICS/LABA combination D. The inhaled corticosteroid . Medications used in the management of chronic obstructive pulmonary disease (COPD) include: A. Inhaled beta 2 agonists B. Inhaled anticholinergics (ipratropium) C. Inhaled corticosteroids D. All of the above Patients with a COPD exacerbation may require: A. Doubling of inhaled corticosteroid dose B. Systemic corticosteroid burst C. Continuous inhaled beta 2 agonists D. Leukotriene therapy Patients with COPD require monitoring of: A. Beta 2 agonist use B. Serum electrolytes C. Blood pressure D. Neuropsychiatric effects of montelukast Education of patients with COPD who use inhaled corticosteroids includes: A. Doubling the dose at the first sign of a URI B. Using their inhaled corticosteroid first and then their bronchodilator C. Rinsing their mouth after inhaler use D. Abstaining from smoking for at least 30 minutes after using Education for patients who use an inhaled beta agonist and an inhaled corticosteroid includes: A. Use the inhaled corticosteroid first, followed by the inhaled beta agonist B. Use the inhaled beta agonist first, followed by the inhaled corticosteroid C. Increase fluid intake to 3 L per day D. Avoid use of aspirin or ibuprofen while using inhaled medications The preferred choice of therapy for most patients with COPD includes: A. A LABA/LAMA combination B. Monotherapy with a LABA C. Monotherapy with a LAMA D. A SABA/SAMA combination Which of the following statements best characterizes the use of antibiotics in COPD? A. Several studies have demonstrated the utility of azithromycin for prophylactic use. B. Antibiotics are typically indicated in COPD exacerbation. C. They are more beneficial in patients who continue to smoke. D. There is no clear role for the use of antibiotics in COPD. Progesterone-only pills are recommended for women who: A. Are breastfeeding B. Have a history of migraine C. Have a medical history that contradicts the use of estrogen D. All of the above Women who are prescribed progestin-only contraception need education regarding which common adverse drug effects? A. Increased migraine headaches B. Increased risk of developing blood clots C. Irregular vaginal bleeding for the first few months D. Increased risk for hypercalcemia To improve actual effectiveness of oral contraceptives, women should be educated regarding: A. They should use a back-up method if they have vomiting or diarrhea during a pill packet. B. Pills should be doubled if they have diarrhea during the middle of a pill pack. C. They will have a normal menstrual cycle if they miss two pills. D. Mid-cycle spotting is not normal and the provider should be contacted immediately. A contraindication to the use of combined contraceptives is: A. Adolescence (not approved for this age) B. A history of clotting disorder C. Recent pregnancy D. Being overweight Goals when treating hypothyroidism with thyroid replacement include: A. Normal TSH and free T4 levels B. Resolution of fatigue C. Weight loss to baseline D. All of the above 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 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. Four weeks B. Two months C. Six months D. Annually Patients without thyroid disease should be routinely screened for hypothyroidism when taking all of the following medications except: A. Angiotensin converting enzyme inhibitors B. Lithium C. Amiodarone D. Interferon Which body system is most impacted if congenital hypothyroid is not rapidly recognized after birth? A. Central nervous system B. CV system C. Gastrointestinal (GI) system D. Immune system Long-term use of levothyroxine therapy has been associated with: A. Cataracts B. Osteoporosis C. Cancer D. Dementia Opioids are exogenous enkephalins. They act by: A. Inhibiting pain transmission in the spinal cord B. Attaching to receptors in the afferent neuron to inhibit the release of substance P C. Blocking neurotransmitters in the midbrain D. Increasing beta-lipoprotein excretion from the pituitary gland The most common bacterial pathogen in community-acquired pneumonia is: A. Haemophilus influenzae B. Staphylococcus aureus C. Mycoplasma pneumoniae D. Streptococcus pneumoniae The first-line drug choice for a previously healthy adult patient diagnosed with community-acquired pneumonia would be: A. Ciprofloxacin B. Azithromycin C. Trimethoprim/sulfamethoxazole D. Dicloxacillin The first-line antibiotic choice for a patient with comorbidities or who is immunosuppressed who has pneumonia and can be treated as an outpatient would be: A. Levofloxacin B. Amoxicillin C. Ciprofloxacin D. Cephalexin If an adult patient with comorbidities cannot reliably take oral antibiotics to treat pneumonia,an appropriate initial treatment option would be: A. Intravenous (IV) or intramuscular (IM) B. IV or IM ceftriaxone C. IV amoxicillin D. IV ciprofloxacin