Nsg 6005 midterm
South University
1. The first-line treatment for cough related to a upper respiratory infection in a five-year-old is:
A. Fluids and symptomatic care
B. Dextromethorphan and guaifenesin syrup (Robitussin DM for kids)
C. Guaifenesin and codeine syrup (Tussin AC)
D. Chlorpheniramine and dextromethorphan syrup (NyQuil for kids)
2. Pregnant patients with asthma may safely use throughout their pregnancies.
A. oral terbutaline
B. prednisone
C. inhaled corticosteroids (budesonide)
D. montelukast (Singulair)
3. A stepwise approach to the pharmacologic management of asthma:
A. Begins with determining the severity of the asthma and assessing asthma control
B. Is used when the asthma is severe and requires daily steroids
C. Allows for each provider to determine his or her 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
4. Infants with reflux are initially treated with:
A. Histamine 2 receptor antagonist (ranitidine)
B. A PPI (omeprazole)
C. Antireflux maneuvers (elevate the head of the bed)
D. Prokinetic (metoclopramide)
5. Many patients self-medicate with antacids. Which patients should be counseled to not take calcium
carbonate antacids without discussing with their providers or a pharmacist first?
A. Patients with kidney stones
B. Pregnant patients
C. Patients with heartburn
D. Postmenopausal women
6. Second-generation antihistamines such as loratadine (Claritin) are prescribed for seasonal allergies
because they:
A. Are more effective than first-generation antihistamines
B. Are less sedating than first-generation antihistamines
C. Are prescription products and, therefore, are covered by insurance
D. Can be taken with CNS sedatives, such as alcohol
7. Decongestants such as pseudoephedrine (Sudafed):
A. Are Schedule III drugs in all states
B. Should not be prescribed or recommended for children under four years of age
C. Are effective in treating the congestion children experience with the common cold
D. May cause drowsiness in patients of all ages
8. Patients with pheochromocytoma should avoid which of the following classes of drugs due to the
, possibility of developing hypertensive crisis?
A. Expectorants
B. Beta 2 agonists
C. Antitussives
D. Antihistamines
9. Education of patients with COPD who use inhaled corticosteroids includes the following:
A. They should double the dose at the first sign of a upper respiratory infection.
B. They should use the inhaled corticosteroid first and then the bronchodilator.
, C. They should rinse their mouths after use.
D. They should not smoke for at least thirty minutes after use.
10. Monitoring a patient with persistent asthma includes:
A. Monitoring how frequently the patient has a upper respiratory infection during treatment
B. Monthly in-office spirometry testing
C. Determining whether the patient has increased use of his or her long-acting beta 2 agonists due to
exacerbations
D. Evaluating the patient every one to six months to determine whether the patient needs to step up
or down in his or her therapy
11. Harold, a forty-two-year-old African American, has moderate persistent asthma. Which of the following
asthma medications should he use cautiously, if at all?
A. Betamethasone, an inhaled corticosteroid
B. Salmeterol, an inhaled long-acting beta-agonist
C. Albuterol, a short-acting beta-agonist
D. Montelukast, a leukotriene modifier
12. When prescribing montelukast (Singulair) for asthma, patients or parents of patients should be instructed
as follows:
A. Montelukast twice a day is started when there is an asthma exacerbation.
B. Patients may experience weight gain on montelukast.
C. Aggression, anxiety, depression, and/or suicidal thoughts may occur when taking montelukast.
D. Lethargy and hypersomnia may occur when taking montelukast.
13. Lifestyle changes are the first step in the treatment of GERD. Foods that may aggravate GERD include:
A. Eggs
B. White bread
C. Chocolate
D. Chicken
14. Christy has exercise and mild persistent asthma and is prescribed two puffs of albuterol fifteen minutes
before exercise and as needed for wheezing. One puff per day of beclomethasone (Qvar) is also
prescribed. Teaching regarding her inhalers includes which one of the following?
A. She should use one to two puffs of albuterol per day to prevent an attack, with no more than eight puffs
per day.
B. Beclomethasone needs to be used every day to treat her asthma.
C. She should report any systemic side effects she is experiencing, such as weight gain.
D. She should use the albuterol MDI immediately after her corticosteroid MDI to facilitate
bronchodilation.
15. One goal of asthma therapy outlined by the NHLBI Expert Panel 3 guidelines is:
A. Use albuterol daily to control symptoms
B. Minimize exacerbations to once a month
C. Keep nighttime symptoms at a maximum of twice a week
D. Require infrequent use of beta 2 agonists (albuterol) for relief of symptoms
16. Treatment failure in patients with PUD associated with H. pylori may be due to:
A. Antimicrobial resistance
B. Ineffective antacid
C. Overuse of PPIs
D. All of the above
17. When using the "step-up" approach in caring for a patient with GERD, the "step up" from OTC antacid
use is:
A. Prokinetic (metoclopramide) for four to eight weeks
B. A PPI (omeprazole) for twelve weeks
, C. Histamine 2 receptor antagonist (ranitidine) for four to eight weeks
D. Cytoprotective drug (misoprostol) for two weeks
18. Long-term use of PPIs may lead to:
A. Hip fractures in at-risk persons
B. Vitamin B6 deficiency
C. Liver cancer
D. All of the above
19. Art is a fifty five year old smoker who has been diagnosed with angina and placed on nitrates. He
complains of headaches after using his nitrate. An appropriate reply might be:
A. "This is a parasympathetic response to the vasodilating effects of the drug."
B. "Headaches are common side effects with these drugs. How severe are they?"
C. "This is associated with your smoking. Let's work on having you stop smoking."
D. "This is not related to your medication. Are you under a lot of stress?"
20. . In teaching about the use of sublingual nitroglycerine, the patient should be instructed:
A. To swallow the tablet with a full glass of water
B. To place one tablet under the tongue if chest pain occurs and allow it to dissolve
C. To take one tablet every five minutes until the chest pain goes away
D. That it should "burn" when placed under the tongue or it is no longer effective
21. A potentially life-threatening adverse response to ACE inhibitors is angioedema. Which of the following
statements is true about this adverse response?
A. Swelling of the tongue and hoarseness are the most common symptoms.
B. It appears to be related to a decrease in aldosterone production.
C. The presence of a dry, hacky cough indicates a high risk for this adverse response.
D. Because it takes time to build up a blood level, it occurs after being on the drug for about one week.
22. Patients who are being treated for folate deficiency require monitoring of:
A. Complete blood count every four weeks
B. Hematocrit and hemoglobin at one week and then at eight weeks
C. Reticulocyte count at one week
D. Folate levels every four weeks until the hemoglobin stabilizes
23. Treatments for heart failure, including drug therapy, are based on the stages developed by the American
Heart Association and the American College of Cardiology. Stage A patients are:
A. Treated with drugs for hypertension and hyperlipidemia, if they exist
B. Taught lifestyle management, including diet, exercise, and smoking cessation only
C. Treated with ACE inhibitors to directly affect the heart failure only
D. Not given any drugs in this early stage
24. Furosemide is added to a treatment regimen for heart failure, which includes digoxin. Monitoring for this
combination includes:
A. Hemoglobin
B. Serum potassium
C. Blood urea nitrogen
D. Serum glucose
25. Isosorbide dinitrate is a long-acting nitrate given twice daily (BID). The schedule for administration is 7
a.m. and 2 p.m. because:
A. Long-acting forms have a higher risk for toxicity.
B. Orthostatic hypotension is a common adverse effect.
C. It must be taken with milk or food.
D. Nitrate tolerance can develop.
26. The New York Heart Association and the Canadian Cardiovascular Society have described grading criteria
for levels of angina. Angina that occurs with unusually strenuous activity or on walking or climbing stair
after meals is:
South University
1. The first-line treatment for cough related to a upper respiratory infection in a five-year-old is:
A. Fluids and symptomatic care
B. Dextromethorphan and guaifenesin syrup (Robitussin DM for kids)
C. Guaifenesin and codeine syrup (Tussin AC)
D. Chlorpheniramine and dextromethorphan syrup (NyQuil for kids)
2. Pregnant patients with asthma may safely use throughout their pregnancies.
A. oral terbutaline
B. prednisone
C. inhaled corticosteroids (budesonide)
D. montelukast (Singulair)
3. A stepwise approach to the pharmacologic management of asthma:
A. Begins with determining the severity of the asthma and assessing asthma control
B. Is used when the asthma is severe and requires daily steroids
C. Allows for each provider to determine his or her 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
4. Infants with reflux are initially treated with:
A. Histamine 2 receptor antagonist (ranitidine)
B. A PPI (omeprazole)
C. Antireflux maneuvers (elevate the head of the bed)
D. Prokinetic (metoclopramide)
5. Many patients self-medicate with antacids. Which patients should be counseled to not take calcium
carbonate antacids without discussing with their providers or a pharmacist first?
A. Patients with kidney stones
B. Pregnant patients
C. Patients with heartburn
D. Postmenopausal women
6. Second-generation antihistamines such as loratadine (Claritin) are prescribed for seasonal allergies
because they:
A. Are more effective than first-generation antihistamines
B. Are less sedating than first-generation antihistamines
C. Are prescription products and, therefore, are covered by insurance
D. Can be taken with CNS sedatives, such as alcohol
7. Decongestants such as pseudoephedrine (Sudafed):
A. Are Schedule III drugs in all states
B. Should not be prescribed or recommended for children under four years of age
C. Are effective in treating the congestion children experience with the common cold
D. May cause drowsiness in patients of all ages
8. Patients with pheochromocytoma should avoid which of the following classes of drugs due to the
, possibility of developing hypertensive crisis?
A. Expectorants
B. Beta 2 agonists
C. Antitussives
D. Antihistamines
9. Education of patients with COPD who use inhaled corticosteroids includes the following:
A. They should double the dose at the first sign of a upper respiratory infection.
B. They should use the inhaled corticosteroid first and then the bronchodilator.
, C. They should rinse their mouths after use.
D. They should not smoke for at least thirty minutes after use.
10. Monitoring a patient with persistent asthma includes:
A. Monitoring how frequently the patient has a upper respiratory infection during treatment
B. Monthly in-office spirometry testing
C. Determining whether the patient has increased use of his or her long-acting beta 2 agonists due to
exacerbations
D. Evaluating the patient every one to six months to determine whether the patient needs to step up
or down in his or her therapy
11. Harold, a forty-two-year-old African American, has moderate persistent asthma. Which of the following
asthma medications should he use cautiously, if at all?
A. Betamethasone, an inhaled corticosteroid
B. Salmeterol, an inhaled long-acting beta-agonist
C. Albuterol, a short-acting beta-agonist
D. Montelukast, a leukotriene modifier
12. When prescribing montelukast (Singulair) for asthma, patients or parents of patients should be instructed
as follows:
A. Montelukast twice a day is started when there is an asthma exacerbation.
B. Patients may experience weight gain on montelukast.
C. Aggression, anxiety, depression, and/or suicidal thoughts may occur when taking montelukast.
D. Lethargy and hypersomnia may occur when taking montelukast.
13. Lifestyle changes are the first step in the treatment of GERD. Foods that may aggravate GERD include:
A. Eggs
B. White bread
C. Chocolate
D. Chicken
14. Christy has exercise and mild persistent asthma and is prescribed two puffs of albuterol fifteen minutes
before exercise and as needed for wheezing. One puff per day of beclomethasone (Qvar) is also
prescribed. Teaching regarding her inhalers includes which one of the following?
A. She should use one to two puffs of albuterol per day to prevent an attack, with no more than eight puffs
per day.
B. Beclomethasone needs to be used every day to treat her asthma.
C. She should report any systemic side effects she is experiencing, such as weight gain.
D. She should use the albuterol MDI immediately after her corticosteroid MDI to facilitate
bronchodilation.
15. One goal of asthma therapy outlined by the NHLBI Expert Panel 3 guidelines is:
A. Use albuterol daily to control symptoms
B. Minimize exacerbations to once a month
C. Keep nighttime symptoms at a maximum of twice a week
D. Require infrequent use of beta 2 agonists (albuterol) for relief of symptoms
16. Treatment failure in patients with PUD associated with H. pylori may be due to:
A. Antimicrobial resistance
B. Ineffective antacid
C. Overuse of PPIs
D. All of the above
17. When using the "step-up" approach in caring for a patient with GERD, the "step up" from OTC antacid
use is:
A. Prokinetic (metoclopramide) for four to eight weeks
B. A PPI (omeprazole) for twelve weeks
, C. Histamine 2 receptor antagonist (ranitidine) for four to eight weeks
D. Cytoprotective drug (misoprostol) for two weeks
18. Long-term use of PPIs may lead to:
A. Hip fractures in at-risk persons
B. Vitamin B6 deficiency
C. Liver cancer
D. All of the above
19. Art is a fifty five year old smoker who has been diagnosed with angina and placed on nitrates. He
complains of headaches after using his nitrate. An appropriate reply might be:
A. "This is a parasympathetic response to the vasodilating effects of the drug."
B. "Headaches are common side effects with these drugs. How severe are they?"
C. "This is associated with your smoking. Let's work on having you stop smoking."
D. "This is not related to your medication. Are you under a lot of stress?"
20. . In teaching about the use of sublingual nitroglycerine, the patient should be instructed:
A. To swallow the tablet with a full glass of water
B. To place one tablet under the tongue if chest pain occurs and allow it to dissolve
C. To take one tablet every five minutes until the chest pain goes away
D. That it should "burn" when placed under the tongue or it is no longer effective
21. A potentially life-threatening adverse response to ACE inhibitors is angioedema. Which of the following
statements is true about this adverse response?
A. Swelling of the tongue and hoarseness are the most common symptoms.
B. It appears to be related to a decrease in aldosterone production.
C. The presence of a dry, hacky cough indicates a high risk for this adverse response.
D. Because it takes time to build up a blood level, it occurs after being on the drug for about one week.
22. Patients who are being treated for folate deficiency require monitoring of:
A. Complete blood count every four weeks
B. Hematocrit and hemoglobin at one week and then at eight weeks
C. Reticulocyte count at one week
D. Folate levels every four weeks until the hemoglobin stabilizes
23. Treatments for heart failure, including drug therapy, are based on the stages developed by the American
Heart Association and the American College of Cardiology. Stage A patients are:
A. Treated with drugs for hypertension and hyperlipidemia, if they exist
B. Taught lifestyle management, including diet, exercise, and smoking cessation only
C. Treated with ACE inhibitors to directly affect the heart failure only
D. Not given any drugs in this early stage
24. Furosemide is added to a treatment regimen for heart failure, which includes digoxin. Monitoring for this
combination includes:
A. Hemoglobin
B. Serum potassium
C. Blood urea nitrogen
D. Serum glucose
25. Isosorbide dinitrate is a long-acting nitrate given twice daily (BID). The schedule for administration is 7
a.m. and 2 p.m. because:
A. Long-acting forms have a higher risk for toxicity.
B. Orthostatic hypotension is a common adverse effect.
C. It must be taken with milk or food.
D. Nitrate tolerance can develop.
26. The New York Heart Association and the Canadian Cardiovascular Society have described grading criteria
for levels of angina. Angina that occurs with unusually strenuous activity or on walking or climbing stair
after meals is:
