NSG 533 Advanced Pharmacology Exam
Complete Accurate Actual Questions With
Verified Answers (100% correct verified
solutions) Brand-new Version. Graded A+
A provider teaches a patient who has been diagnosed with
hypothyroidism about a new prescription for levothyroxine. Which
statement by the patient indicates a need for further teaching?
a. "I should not take heartburn medication without consulting my
provider first."
,b. "I should report insomnia, tremors, and an increased heart rate to
my provider."
c. "If I take a multivitamin with iron, I should take it 4 hours after the
levothyroxine."
d. "If I take calcium supplements, I may need to decrease my dose of
levothyroxine." - {✔✔ANSWER✔✔}-D. Calcium may reduce
levothyroxine absorption. Further education is needed if the patient
feels she can take half of a prescribed medication.
MC has undiagnosed multiple gastric ulcers. Shortly after consuming a
large meal and alcohol he experiences significant GI distress. He takes
an OTC heartburn remedy. Within a minute or two he develops what he
will later describe as "belching, nausea and a bad bloated feeling".
Several of the ulcers began to bleed and he becomes profoundly
hypotensive from the blood loss and is taken to the ED. Endoscopy
confirms multiple bleeds; the endoscopist remarks that it appears as if
the lesions had been literally stretched apart causing additional tissue
damage. What did the patient most likely take (i.e. what was the OTC
remedy)? - {✔✔ANSWER✔✔}-I would accept Alka-Selzer. I
contains NaHCO3 (as well as ASA). In the presence of HCL it Liberates
CO2, that can cause gastric distention, belching and nausea. The
reaction is fairly swift allowing little time for dissipation. Tums, its
primary ingredient calcium carbonate which when taken cause a
reaction with the stomach acid such as production of carbon dioxide
gas which can cause bloating and the stomach to stretch to tear the
ulcers open.
,On your way to this examination, you experience the vulnerable feeling
that an attack of acute diarrhea is imminent! If you stop at a drug store,
which anti-diarrheal drugs could you buy without a prescription even
though it is chemically related to the strong opioid analgesic
meperidine (but acts only on the peripheral opioid receptor)? -
{✔✔ANSWER✔✔}-Loperamide
JA has multiple medical problems and is taking several drugs including
theophylline, warfarin and phenytoin. His conditions were well
controlled, but recently he started to experience some GI distress for
which of his "well intentioned friends" gave him some medication. He
presents to you with toxic effects of all his other medications and
plasma levels of those medications elevated. What was most likely the
medication he took? - {✔✔ANSWER✔✔}-Cimetidine
What lifestyle modifications should be recommended? -
{✔✔ANSWER✔✔}--losing weight if overweight
-elevating head of bed while asleep
-eating smaller meals
-avoid foods/meds that exacerbate gerd
-stop smoking
-stop drinking alcohol
What medications / foods can contribute to GERD? -
{✔✔ANSWER✔✔}--Medications: anticholinergics, barbituates,
dopamine, estrogen, opioids, progesterone, theophylline, nitrates
, -Foods: cirus fruits/juices, coffee, tomatoes, spicy food, carbonated
drinks
Fried/fatty foods, garlic, onions, chocolate
What is the most effective PPI or H2RA within each of these classes? -
{✔✔ANSWER✔✔}--PPI- bismuth quadruple therapy combined
with proton pump inhibitors
-H2RA- Famotidine 80mg
Other products such as antacids are also available. What are some of
these and what is their place in therapy? - {✔✔ANSWER✔✔}--
Reflux symptoms <2 times a week (infrequent)
-Effective for immediate relief
-Magnesium/Aluminum Hydroxide (Maalox)- can cause constipation
-Alginic Acid
Why would antibiotics be used for PUD caused by H Pylori? What is a
typical regimen and duration of therapy? What patient specific factors
should be considered and how should treatment be monitored? -
{✔✔ANSWER✔✔}-Considerations before regimen choice:
-penicillin allergy
-previous exposure to macroglide antibiotics
Strongest Reccomendation:
-Bismuth Quadruple Therapy 10-14 days
Complete Accurate Actual Questions With
Verified Answers (100% correct verified
solutions) Brand-new Version. Graded A+
A provider teaches a patient who has been diagnosed with
hypothyroidism about a new prescription for levothyroxine. Which
statement by the patient indicates a need for further teaching?
a. "I should not take heartburn medication without consulting my
provider first."
,b. "I should report insomnia, tremors, and an increased heart rate to
my provider."
c. "If I take a multivitamin with iron, I should take it 4 hours after the
levothyroxine."
d. "If I take calcium supplements, I may need to decrease my dose of
levothyroxine." - {✔✔ANSWER✔✔}-D. Calcium may reduce
levothyroxine absorption. Further education is needed if the patient
feels she can take half of a prescribed medication.
MC has undiagnosed multiple gastric ulcers. Shortly after consuming a
large meal and alcohol he experiences significant GI distress. He takes
an OTC heartburn remedy. Within a minute or two he develops what he
will later describe as "belching, nausea and a bad bloated feeling".
Several of the ulcers began to bleed and he becomes profoundly
hypotensive from the blood loss and is taken to the ED. Endoscopy
confirms multiple bleeds; the endoscopist remarks that it appears as if
the lesions had been literally stretched apart causing additional tissue
damage. What did the patient most likely take (i.e. what was the OTC
remedy)? - {✔✔ANSWER✔✔}-I would accept Alka-Selzer. I
contains NaHCO3 (as well as ASA). In the presence of HCL it Liberates
CO2, that can cause gastric distention, belching and nausea. The
reaction is fairly swift allowing little time for dissipation. Tums, its
primary ingredient calcium carbonate which when taken cause a
reaction with the stomach acid such as production of carbon dioxide
gas which can cause bloating and the stomach to stretch to tear the
ulcers open.
,On your way to this examination, you experience the vulnerable feeling
that an attack of acute diarrhea is imminent! If you stop at a drug store,
which anti-diarrheal drugs could you buy without a prescription even
though it is chemically related to the strong opioid analgesic
meperidine (but acts only on the peripheral opioid receptor)? -
{✔✔ANSWER✔✔}-Loperamide
JA has multiple medical problems and is taking several drugs including
theophylline, warfarin and phenytoin. His conditions were well
controlled, but recently he started to experience some GI distress for
which of his "well intentioned friends" gave him some medication. He
presents to you with toxic effects of all his other medications and
plasma levels of those medications elevated. What was most likely the
medication he took? - {✔✔ANSWER✔✔}-Cimetidine
What lifestyle modifications should be recommended? -
{✔✔ANSWER✔✔}--losing weight if overweight
-elevating head of bed while asleep
-eating smaller meals
-avoid foods/meds that exacerbate gerd
-stop smoking
-stop drinking alcohol
What medications / foods can contribute to GERD? -
{✔✔ANSWER✔✔}--Medications: anticholinergics, barbituates,
dopamine, estrogen, opioids, progesterone, theophylline, nitrates
, -Foods: cirus fruits/juices, coffee, tomatoes, spicy food, carbonated
drinks
Fried/fatty foods, garlic, onions, chocolate
What is the most effective PPI or H2RA within each of these classes? -
{✔✔ANSWER✔✔}--PPI- bismuth quadruple therapy combined
with proton pump inhibitors
-H2RA- Famotidine 80mg
Other products such as antacids are also available. What are some of
these and what is their place in therapy? - {✔✔ANSWER✔✔}--
Reflux symptoms <2 times a week (infrequent)
-Effective for immediate relief
-Magnesium/Aluminum Hydroxide (Maalox)- can cause constipation
-Alginic Acid
Why would antibiotics be used for PUD caused by H Pylori? What is a
typical regimen and duration of therapy? What patient specific factors
should be considered and how should treatment be monitored? -
{✔✔ANSWER✔✔}-Considerations before regimen choice:
-penicillin allergy
-previous exposure to macroglide antibiotics
Strongest Reccomendation:
-Bismuth Quadruple Therapy 10-14 days
