NGR 6172 Pharmacology Final Exam {2020} – A Grade | NGR6172 Pharmacology Final Exam {2020} – School Graded

NGR 6172 Pharmacology Final Exam {2020} – University of Florida Question 1 A patient takes an oral medication that causes gastrointestinal upset. The patient asks the primary care NP why the drug information insert cautions against using antacids while taking the drug. The NP should explain that the antacid may: A. alter drug absorption. B. alter drug distribution. C. lead to drug toxicity. D. increase stomach upset. 0.3 points Question 2 A patient will begin taking two drugs that are both protein-bound. The primary care NP should: A. stagger the doses of drugs to be given 1 hour apart. B. prescribe increased doses of both drugs. C. monitor drug levels, actions, and side effects. D. teach the patient to increase intake of protein. 0.3 points Question 3 The knowledge of how age, race, and gender may affect drug excretion is based on an understanding of: A. bioavailability. B. pharmacokinetics. C. pharmacodynamics. D. anatomy and physiology. 0.3 points Question 4 A patient receives an inhaled corticosteroid to treat asthma. The patient asks the primary care NP why the drug is given by this route instead of orally. The NP should explain that the inhaled form: A. has reduced bioavailability. B. provides dosing that is easier to regulate. C. is absorbed less quickly. D. has fewer systemic side effects. 0.3 points Question 5 The primary care NP is performing a physical examination on a 6-month-old infant with cerebral palsy who has not had previous immunizations. The NP plans to begin vaccinations and should include: A. TD vaccine only. B. TdaP vaccine. C. tetanus vaccine only. D. DTaP vaccine. 0.3 points Question 6 The primary care NP sees a 4-year-old child who has persistent asthma episodes for a well-child visit in October. The child recently completed a 7-day course of oral steroids. The NP plans to give the child flu vaccine and should: A. wait 4 weeks and administer LAIV. B. administer LAIV today. C. wait 4 weeks and administer 0.5 mg TIV. D. administer 0.5 mg TIV today. 0.3 points Question 7 The primary care NP sees an 11-month-old infant for the first time and notes that the infant has not received the Hib vaccine. The NP should: A. give the Hib vaccine now with no boosters. B. give the Hib vaccine now and booster in 2 to 3 months. C. tell the parents that the child is too old to begin receiving the Hib vaccine. D. give the Hib vaccine now and booster at age 4 to 6 years. 0.3 points Question 8 A 5-year-old child who has no previous history of otitis media is seen in clinic with a temperature of 100° F. The primary care NP visualizes bilateral erythematous, nonbulging, intact tympanic membranes. The child is taking fluids well and is playing with toys in the examination room. The NP should: A. initiate antibiotic therapy if the child’s condition worsens. B.prescribe amoxicillin-clavulanate twice daily for 10 days. C.prescribe amoxicillin twice daily for 10 days. D.prescribe azithromycin once daily for 5 days. Question 9 A patient has urethritis. The primary care NP should prescribe: A.doxycycline. B.minocycline. C.demeclocycline. D.tetracycline. Question 10 A patient is taking tetracycline for a rickettsial infection and reports having heartburn. The primary care NP should: A.tell the patient to use antacids when heartburn occurs. B. ask the patient how the medication is taken. C. tell the patient to take the medication with food. D.recommend drinking milk when taking the medication. Question 11 A woman who takes oral contraceptive pills develops vaginal candidiasis. The primary care NP prescribes a single dose of fluconazole. When counseling the patient about this drug, the NP should tell her: A. that the drug is safe if she were to become pregnant. B. to use a backup contraceptive method for the next 2 months. C. that she may consume alcohol while taking this medication. D. that she may need a lower dose of fluconazole because she takes oral contraceptive pills. Question 12 A 55-year-old patient with no prior history of hypertension has a blood pressure greater than 140/90 on three separate occasions. The patient does not smoke, has a body mass index of 24, and exercises regularly. The patient has no known risk factors for cardiovascular disease. The primary care NP should: A. prescribe a thiazide diuretic and an angiotensin-converting enzyme inhibitor. B.perform a careful cardiovascular physical assessment. C. counsel the patient about dietary and lifestyle changes. D. order a urinalysis and creatinine clearance and begin therapy with a b-blocker. Question 13 A 55-year-old woman has a history of myocardial infarction (MI). A lipid profile reveals LDL of 130 mg/dL, HDL of 35 mg/dL, and triglycerides 150 mg/dL. The woman is sedentary with a body mass index of 26. The woman asks the primary care NP about using a statin medication. The NP should: A. begin therapy with atorvastatin 10 mg per day. B. recommend dietary and lifestyle changes first. C. discuss quality-of-life issues as part of the decision to begin medication. D. tell her there is no clinical evidence of efficacy of statin medication in her case. Question 14 A patient is in the clinic for a follow-up examination after a myocardial infarction (MI). The patient has a history of left ventricular systolic dysfunction. The primary care NP should expect this patient to be taking: A. timolol (Blocadren). B. carvedilol (Coreg). C. propranolol (Inderal). D. nadolol (Corgard). Question 15 A patient is in the clinic for an annual physical examination. The primary care NP obtains a medication history and learns that the patient is taking a b-blocker and nitroglycerin. The NP orders laboratory tests, performs a physical examination, and performs a review of systems. Which finding may warrant discontinuation of the b-blocker in this patient? A. Wheezing, dyspnea, and cough B. Increased triglycerides C. Decreased exercise tolerance D. Nausea, vomiting, and anorexia Question 16 A patient who has been taking digoxin 0.25 mg daily for 6 months reports that it is not working as well as it did initially. The primary care NP should: A. hold the next dose of digoxin and obtain a serum digoxin level. B. increase the dose of digoxin to 0.5 mg daily. C. contact the patient’s pharmacy to ask if generic digoxin was dispensed. D. recommend a reduced potassium intake. Question 17 A patient who has heart failure has been treated with furosemide and an ACE inhibitor. The patient’s cardiologist has added digoxin to the patient’s medication regimen. The primary care NP who cares for this patient should expect to monitor: A. complete blood counts (CBCs). B. serum potassium levels. C. blood glucose levels. D. serum thyroid levels. Question 18 A patient who is taking an oral anticoagulant is in the clinic in the late afternoon and reports having missed the morning dose of the medication because the prescription was not refilled. The primary care NP should counsel this patient to: A. skip today’s dose and resume a regular dosing schedule in the morning. B. take a double dose of the medication the next morning. C. refill the prescription and take today’s dose immediately. D. avoid foods that are high in vitamin K for several days. Question 19 ******NO ANSWER MADE SENSE ON THIS ONE******* A patient who takes spironolactone for heart failure has begun taking digoxin (Lanoxin) for atrial fibrillation. The primary care NP provides teaching for this patient and asks the patient to repeat back what has been learned. Which statement by the patient indicates understanding of the teaching? A. “I do not need to use a salt substitute while taking these medications.” B. “I should eat foods high in potassium.” C. “I need to take a calcium supplement every day.” D. “I should eat foods high in sodium.” Question 20 A 75-year-old patient requires frequent use of corticosteroids to control COPD exacerbations. To monitor adverse drug effects in this patient, the primary care NP should: A. order a bone density study. B. order an electrocardiogram to assess for arrhythmias. C. order routine chest radiographs to watch for pneumonia. D. monitor the patient’s renal function at every visit. Question 21 A child with chronic allergic symptoms uses an intranasal steroid for control of symptoms. At this child’s annual well-child checkup, the NP should carefully review this child’s: A. liver function tests. B. urinalysis. C. blood pressure. D. height and weight. Question 22 A patient who was recently diagnosed with COPD comes to the clinic for a follow-up evaluation after beginning therapy with a SABA as needed for dyspnea. The patient reports occasional mild exertional dyspnea but is able to sleep well. The patient’s FEV1 in the clinic is 85% of predicted, and oxygen saturation is 96%. The primary care NP should recommend: A. a combination LABA/ICS twice daily. B. influenza and pneumococcal vaccines. C. home oxygen therapy as needed for dyspnea. D. ipratropium bromide (Atrovent) twice daily. Question 23 A primary care nurse practitioner (NP) sees a patient who has a 1-week history of watery, painful eyes with copious amounts of clear discharge and a sore throat. The NP observes bilateral erythema of the conjunctivae and palpates enlarged preauricular lymph nodes. The NP should prescribe _____ drops. A. sympathomimetic ophthalmic B. nonsteroidal antiinflammatory C. ophthalmic antibiotic D. ganciclovir Question 24 A patient comes to the clinic and reports having insomnia that began within the last year. The primary care nurse practitioner (NP) learns that the patient often lies awake worrying about problems at work. The patient feels fatigued during the day and experiences frequent stomach discomfort. The NP should prescribe: A. diphenhydramine. B. buspirone. C. melatonin. D. alprazolam. Question 25 A patient is identified as having stage 2 Alzheimer’s disease and elects to take donepezil (Aricept). The patient asks the primary care nurse practitioner (NP) how long the medication will be needed. The NP should tell the patient that donepezil must be taken: A. until symptoms improve. B. indefinitely because it is not curative. C. for 24 weeks, which is when cognitive function improves in most patients. D. until symptoms worsen, when a switch to memantine (Namenda) will be needed. Question 26 A patient who has partial seizures has been taking phenytoin (Dilantin). The patient has recently developed thrombocytopenia. The primary care nurse practitioner (NP) should contact the patient’s neurologist to discuss changing the patient’s medication to: A. zonisamide (Zonegran). B. topiramate (Topamax). C. levetiracetam (Keppra). D. carbamazepine (Tegretol). Question 27 A patient who takes valproic acid for a seizure disorder is preparing to have surgery. The primary care NP should order: A. a complete blood count. B. coagulation studies. C. an EEG. D. a creatinine clearance test. Question 28 A 12-year-old patient has acute diarrhea and an upper respiratory infection. Other family members have had similar symptoms, which have resolved. The primary care NP should recommend: A. diphenoxylate (Lomotil). B. bismuth subsalicylate (Pepto-Bismol). C. an electrolyte solution (Pedialyte). D. attapulgite (Kaopectate). Question 29 A patient has been taking antibiotics to treat recurrent pneumonia. The patient is in the clinic after having diarrhea for 5 days with six to seven liquid stools each day. The primary care NP should: A. reassure the patient that diarrhea is a common side effect of antibiotic therapy. B. order testing for Clostridium difficile and consider metronidazole therapy. C. prescribe diphenoxylate (Lomotil) to provide symptomatic relief. D. obtain a stool specimen and order vancomycin. Question 30 A patient who has GERD with erosive esophagitis has been taking a PPI for 4 weeks and reports a decrease in symptoms. The patient asks the primary care NP if the medication may be discontinued. The NP should tell the patient that: A. antireflux surgery must be done before the PPI can be discontinued. B. once the symptoms have cleared completely, the medication may be discontinued. C. the condition may eventually be cured, but therapy must continue for years. D. the dose may be decreased for long-term therapy. Question 31 A patient who has severe arthritis and who takes nonsteroidal antiinflammatory drugs (NSAIDs) daily develops a duodenal ulcer. The patient has tried a cyclooxygenase-2 selective NSAID in the past and states that it is not as effective as the current NSAID. The primary care nurse practitioner (NP) should: A. prescribe cimetidine (Tagamet). B. teach the patient about a bland diet. C. prescribe omeprazole (Prilosec). D. change the NSAID to a corticosteroid. Question 32 A primary care nurse practitioner (NP) sees a patient who is concerned about constipation. The NP learns that the patient has three to four bowel movements per week with occasional hard stools but no straining with defecation. The NP should recommend: A. increased intake of fluids and fiber. B. polyethylene glycol (MiraLAX) as needed. C. psyllium (Metamucil) on a daily basis. D. docusate sodium (Colace) as needed. Question 33 A 40-year-old woman asks the advanced practitioner what she can do to minimize her risk of osteoporosis. She takes 800 mg of calcium and drinks 2 cups of skim milk each day. The advanced practitioner should recommend that she: A. drink diet instead of sugary sodas. B. limit her caffeine intake. C. consume a high-protein diet. D. decrease dietary fat. Question 34 A child has honey-crusted lesions with areas of erythema around the nose and mouth. The child’s parent has been applying Polysporin ointment for 5 days and reports no improvement in the rash. What would be an appropriate medication for treatment: A. neomycin. B. Polysporin with a corticosteroid. C. a systemic antibiotic. D. mupirocin. Question 35 A patient is seen by a primary care NP to evaluate a rash. The NP notes three ring-shaped lesions with elevated, erythematous borders and two smaller, scaly patches on the patient’s abdomen. The patient has not used any over-the-counter medications on the rash. The NP should prescribe: A. ketoconazole (Nizoral). B. oxiconazole (Oxistat). C. miconazole (Lotrimin AF). D. terbinafine (Lamisil). Question 36 A primary care NP is performing a well-child checkup on an adolescent patient and notes approximately 20 papules and comedones and 10 pustules on the patient’s face, chest, and back. The patient has not tried any over-the-counter products to treat these lesions. The NP should begin treatment with: A. benzoyl peroxide and topical clindamycin. B. oral antibiotics. C. topical tretinoin. D. salicylic acid. Question 37 An adolescent girl has decided to become a vegetarian. The advanced practitioner should counsel her about iron intake and considering a vitamin containing: A. potassium. B. vitamin A. C. vitamin C. D. zinc. Question 38 A patient has acute low back pain caused by lifting a heavy object. The patient reports having one or two drinks with meals each day. The primary care NP should prescribe: A. metaxalone (Skelaxin). B. acetaminophen (Tylenol). C. diazepam (Valium). D. an NSAID. Question 39 A patient who has a previous history of renal stones will begin taking probenecid for gout. The primary care NP should: A. add colchicine to the patient’s drug regimen. B. counsel the patient to use high-dose aspirin for pain. C. tell the patient to stop taking the medication when symptoms subside. D. teach the patient to drink plenty of acidic fluids such as juice. Question 40 The primary care NP is performing a medication reconciliation on a patient who takes digoxin for congestive heart failure and learns that the patient uses ibuprofen as needed for joint pain. The NP should counsel this patient to: A. increase the dose of digoxin while taking the ibuprofen. B. take potassium supplements to minimize the effects of the ibuprofen. C. use naproxen (Naprosyn) instead of ibuprofen. D. use an increased dose of ibuprofen while taking the digoxin. Question 41 A 40-year-old woman tells the primary care nurse practitioner (NP) that she does not want more children and would like a contraceptive. She does not smoke and has no personal or family history of cardiovascular disease. She has frequent tension headaches. For this patient, the NP should prescribe: A. tubal ligation. B. low-estrogen COCP. C. condoms. D. monophasic combined oral contraceptive pill (COCP). Question 42 A patient who has diabetes reports intense discomfort when needing to void. A urinalysis is normal. To treat this, the primary care NP should consider prescribing: A. phenazopyridine (Pyridium). B. flavoxate (Urispas). C. oxybutynin chloride (Ditropan XL). D. bethanechol (Urecholine). Question 43 A primary care NP prescribes a COCP for a woman who is taking them for the first time. After teaching, the woman should correctly state the need for using a backup form of contraception if she: A. has recurrent headaches or insomnia. B. delays taking a pill by 5 or 6 hours. C. takes nonsteroidal antiinflammatory drugs several days in a row. D. is having vomiting or diarrhea. Question 44 A serious side effect associated with desmopressin is: A. hyponatremia. B. urinary retention. C. dehydration. D. hypotension. Question 45 A woman who has been taking a COCP for 2 months tells the primary care NP that she has had several headaches, breakthrough bleeding, and nausea. The NP should counsel the woman: A. that these effects will likely decrease in another month. B. to stop taking the COCP immediately. C. to change to a progestin-only pill. D. to use a backup form of contraception. Question 46 An adolescent girl has chosen Depo-Provera as a contraceptive method and tells the primary care NP that she likes the fact that she won’t have to deal with pills or periods. The primary care NP should tell her that she: A. will have to take oral contraceptive pills in addition to Depo-Provera when she takes antibiotics. B. may have irregular bleeding, especially in the first month or so. C. will need to take calcium and vitamin D every day while using this method. D. should consider another form of contraception after 1 year. Question 47 An NP is prescribing a drug that is known to be safe in children but is unable to find recommendations about drug dosing. The recommended adult dose is 100 mg per dose. The child weighs 14 kg. Using Clark's rule, the NP should order _____ mg per dose. a. 20 b. 10 c. 14 d. 9.3 Question 48 A child who weighs 22 lb, 2 oz needs a medication. The NP learns that the recommended dosing for this drug is 25 to 30 mg per kg per day in three divided doses. The NP should order: a. 100 mg daily b. 100 mg TID c. 300 mg daily d. 300 mg TID Question 49 The recommended pediatric dose of Ampicillin is 25 mg/kg/day q8h. Your patient is a 4-week old infant who weighs 8.7 pounds. Which is the best dose for this patient? ________________ a. 15 mg b. 25 mg c. 33 mg d. 45 mg Question 50 A child, weighing 76 pounds, is prescribed the antibiotic, Cefaclor. It is recommended for children to receive 20 mg/kg/day in divided doses every 8 hours. How many mg should the child take per dose? Dosage forms are 250, 500. 187, 250, 375/5mls susp a. 250 mg b. 300 mg c. 500 mg d. 700 mg