NUR 635 FINAL EXAM | 140 QUESTIONS
WITH COMPLETE SOLUTIONS
The first-line drug choice for a previously healthy adult patient diagnosed with community-
acquired pneumonia would be:
1.Ciprofloxacin
2.Azithromycin
3.Amoxicillin
4.Doxycycline Correct Ans - 2.Azithromycin
Zainab is taking lamotrigine (Lamictal) and presents to the clinic with fever and
lymphadenopathy. Initial evaluation and treatment includes:
1. Reassuring her she has a viral infection and to call if she isn't better in 4 or 5 days
2. Ruling out a hypersensitivity reaction that may lead to multi-organ failure
3. Rapid strep test and symptomatic care if strep test is negative
4. Observation only, with further assessment if she worsens Correct Ans - 2. Ruling
out a hypersensitivity reaction that may lead to multi-organ failure
Jake, a 45-year-old patient with schizophrenia, was recently hospitalized for acute
psychosis due to medication noncompliance. He was treated with IM long-acting
haloperidol. Besides monitoring his schizophrenia symptoms, the patient should be
assessed by his primary care provider:
1. For excessive weight loss
2. With the Abnormal Involuntary Movement Scale (AIMS) for extrapyramidal symptoms
(EPS)
3. Monthly for tolerance to the haloperidol
4. Only by the mental health provider, as most NPs in primary care do not care for mentally
ill patients Correct Ans - 2. With the Abnormal Involuntary Movement Scale (AIMS)
for extrapyramidal symptoms (EPS)
Digoxin levels need to be monitored closely when the following medication is started:
1. Loratadine
2. Diphenhydramine
3. Ipratropium
4. Albuterol Correct Ans - 4. Albuterol
Harold, a 42-year-old African American, 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
C.Albuterol, a short-acting beta-agonist
D.Montelukast, a leukotriene modifier Correct Ans - B.Salmeterol, an inhaled long-
acting beta-agonist
,Tiotropium bromide (Spiriva) is an inhaled anticholinergic:
1. Used for the treatment of chronic obstructive pulmonary disease (COPD)
2. Used in the treatment of asthma
3. Combined with albuterol for treatment of asthma exacerbations
4. Combined with fluticasone for the treatment of persistent asthma Correct Ans - 1.
Used for the treatment of chronic obstructive pulmonary disease (COPD)
Christy has exercise-induced and mild persistent asthma and is prescribed two puffs of
albuterol 15 minutes before exercise and as needed for wheezing. One puff per day of
beclomethasone (QVAR) is also prescribed. Teaching regarding her inhalers includes:
1. Use one to two puffs of albuterol per day to prevent an attack with no more than eight
puffs per day
2. Beclomethasone needs to be used every day to treat her asthma
3. Report any systemic side effects she is experiencing, such as weight gain
4. Use the albuterol metered-dose inhaler (MDI) immediately after her corticosteroid MDI
to facilitate bronchodilation Correct Ans - 2. Beclomethasone needs to be used
every day to treat her asthma
When prescribing montelukast (Singulair) for asthma, patients or parents of patients
should be instructed:
1. Montelukast twice a day is started when there is an asthma exacerbation.
2. Patients may experience weight gain on montelukast.
3. Aggression, anxiety, depression, and/or suicidal thoughts may occur when taking
montelukast.
4. Lethargy and hypersomnia may occur when taking montelukast. Correct Ans - 3.
Aggression, anxiety, depression, and/or suicidal thoughts may occur when taking
montelukast.
When educating patients who are starting on inhaled corticosteroids, the provider should
tell them that:
1. They need to get any live vaccines before starting the medication.
2. Inhaled corticosteroids need to be used daily during asthma exacerbations to be
effective.
3. Patients should rinse their mouths out after using the inhaled corticosteroid to prevent
thrush.
4. They can triple the dose number of inhalations of medication during colds to prevent
needing systemic steroids Correct Ans - 3. Patients should rinse their mouths out
after using the inhaled corticosteroid to prevent thrush.
Howard is a seventy-two-year-old male who occasionally takes diphenhydramine for his
seasonal allergies. Monitoring for this patient taking diphenhydramine would include
assessing for:
Urinary retention
Cardiac output
, Peripheral edema
Skin for rash Correct Ans - Urinary retention
Second generation antihistamines such as loratadine (Claritin) are prescribed for seasonal
allergies because they are:
A.More effective than first generation antihistamines
B.Less sedating than the first generation antihistamines
C.Prescription products, therefore are covered by insurance
D.Able to be taken with CNS sedatives, such as alcohol Correct Ans - B.Less sedating
than the first generation antihistamines
4. Long-acting beta-agonists (LTBAs) received a Black Box Warning from the U.S. Food and
Drug
Administration due to the:
1. Risk of life-threatening dermatological reactions
2. Increased incidence of cardiac events when LTBAs are used
3. Increased risk of asthma-related deaths when LTBAs are used
4. Risk for life-threatening alterations in electrolytes Correct Ans - 3. Increased risk
of asthma-related deaths when LTBAs are used
Prior to developing a plan for the treatment of asthma, the patient's asthma should be
classified according to the NHLBI Expert Panel 3 guidelines. In adults mild-persistent
asthma is classified as asthma symptoms that occur:
1. Daily
2. Daily and limit physical activity
3. Less than twice a week
4. More than twice a week and less than once a day Correct Ans - 4. More than twice
a week and less than once a day
Education for patients who use an inhaled beta-agonist and an inhaled corticosteroid
includes:
1. Use the inhaled corticosteroid first, followed by the inhaled beta-agonists.
2. Use the inhaled beta-agonist first, followed by the inhaled corticosteroid.
3. Increase fluid intake to 3 liters per day.
4. Avoid use of aspirin or ibuprofen while using inhaled medications Correct Ans -
2. Use the inhaled beta-agonist first, followed by the inhaled corticosteroid.
A stepwise approach to the pharmacologic management of asthma:
1. Begins with determining the severity of asthma and assessing asthma control
2. Is used when asthma is severe and requires daily steroids
3. Allows for each provider to determine their personal approach to the care of asthmatic
patients
4. Provides a framework for the management of severe asthmatics, but is not as helpful
when patients have intermittent asthma Correct Ans - 1. Begins with determining
the severity of asthma and assessing asthma contro
WITH COMPLETE SOLUTIONS
The first-line drug choice for a previously healthy adult patient diagnosed with community-
acquired pneumonia would be:
1.Ciprofloxacin
2.Azithromycin
3.Amoxicillin
4.Doxycycline Correct Ans - 2.Azithromycin
Zainab is taking lamotrigine (Lamictal) and presents to the clinic with fever and
lymphadenopathy. Initial evaluation and treatment includes:
1. Reassuring her she has a viral infection and to call if she isn't better in 4 or 5 days
2. Ruling out a hypersensitivity reaction that may lead to multi-organ failure
3. Rapid strep test and symptomatic care if strep test is negative
4. Observation only, with further assessment if she worsens Correct Ans - 2. Ruling
out a hypersensitivity reaction that may lead to multi-organ failure
Jake, a 45-year-old patient with schizophrenia, was recently hospitalized for acute
psychosis due to medication noncompliance. He was treated with IM long-acting
haloperidol. Besides monitoring his schizophrenia symptoms, the patient should be
assessed by his primary care provider:
1. For excessive weight loss
2. With the Abnormal Involuntary Movement Scale (AIMS) for extrapyramidal symptoms
(EPS)
3. Monthly for tolerance to the haloperidol
4. Only by the mental health provider, as most NPs in primary care do not care for mentally
ill patients Correct Ans - 2. With the Abnormal Involuntary Movement Scale (AIMS)
for extrapyramidal symptoms (EPS)
Digoxin levels need to be monitored closely when the following medication is started:
1. Loratadine
2. Diphenhydramine
3. Ipratropium
4. Albuterol Correct Ans - 4. Albuterol
Harold, a 42-year-old African American, 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
C.Albuterol, a short-acting beta-agonist
D.Montelukast, a leukotriene modifier Correct Ans - B.Salmeterol, an inhaled long-
acting beta-agonist
,Tiotropium bromide (Spiriva) is an inhaled anticholinergic:
1. Used for the treatment of chronic obstructive pulmonary disease (COPD)
2. Used in the treatment of asthma
3. Combined with albuterol for treatment of asthma exacerbations
4. Combined with fluticasone for the treatment of persistent asthma Correct Ans - 1.
Used for the treatment of chronic obstructive pulmonary disease (COPD)
Christy has exercise-induced and mild persistent asthma and is prescribed two puffs of
albuterol 15 minutes before exercise and as needed for wheezing. One puff per day of
beclomethasone (QVAR) is also prescribed. Teaching regarding her inhalers includes:
1. Use one to two puffs of albuterol per day to prevent an attack with no more than eight
puffs per day
2. Beclomethasone needs to be used every day to treat her asthma
3. Report any systemic side effects she is experiencing, such as weight gain
4. Use the albuterol metered-dose inhaler (MDI) immediately after her corticosteroid MDI
to facilitate bronchodilation Correct Ans - 2. Beclomethasone needs to be used
every day to treat her asthma
When prescribing montelukast (Singulair) for asthma, patients or parents of patients
should be instructed:
1. Montelukast twice a day is started when there is an asthma exacerbation.
2. Patients may experience weight gain on montelukast.
3. Aggression, anxiety, depression, and/or suicidal thoughts may occur when taking
montelukast.
4. Lethargy and hypersomnia may occur when taking montelukast. Correct Ans - 3.
Aggression, anxiety, depression, and/or suicidal thoughts may occur when taking
montelukast.
When educating patients who are starting on inhaled corticosteroids, the provider should
tell them that:
1. They need to get any live vaccines before starting the medication.
2. Inhaled corticosteroids need to be used daily during asthma exacerbations to be
effective.
3. Patients should rinse their mouths out after using the inhaled corticosteroid to prevent
thrush.
4. They can triple the dose number of inhalations of medication during colds to prevent
needing systemic steroids Correct Ans - 3. Patients should rinse their mouths out
after using the inhaled corticosteroid to prevent thrush.
Howard is a seventy-two-year-old male who occasionally takes diphenhydramine for his
seasonal allergies. Monitoring for this patient taking diphenhydramine would include
assessing for:
Urinary retention
Cardiac output
, Peripheral edema
Skin for rash Correct Ans - Urinary retention
Second generation antihistamines such as loratadine (Claritin) are prescribed for seasonal
allergies because they are:
A.More effective than first generation antihistamines
B.Less sedating than the first generation antihistamines
C.Prescription products, therefore are covered by insurance
D.Able to be taken with CNS sedatives, such as alcohol Correct Ans - B.Less sedating
than the first generation antihistamines
4. Long-acting beta-agonists (LTBAs) received a Black Box Warning from the U.S. Food and
Drug
Administration due to the:
1. Risk of life-threatening dermatological reactions
2. Increased incidence of cardiac events when LTBAs are used
3. Increased risk of asthma-related deaths when LTBAs are used
4. Risk for life-threatening alterations in electrolytes Correct Ans - 3. Increased risk
of asthma-related deaths when LTBAs are used
Prior to developing a plan for the treatment of asthma, the patient's asthma should be
classified according to the NHLBI Expert Panel 3 guidelines. In adults mild-persistent
asthma is classified as asthma symptoms that occur:
1. Daily
2. Daily and limit physical activity
3. Less than twice a week
4. More than twice a week and less than once a day Correct Ans - 4. More than twice
a week and less than once a day
Education for patients who use an inhaled beta-agonist and an inhaled corticosteroid
includes:
1. Use the inhaled corticosteroid first, followed by the inhaled beta-agonists.
2. Use the inhaled beta-agonist first, followed by the inhaled corticosteroid.
3. Increase fluid intake to 3 liters per day.
4. Avoid use of aspirin or ibuprofen while using inhaled medications Correct Ans -
2. Use the inhaled beta-agonist first, followed by the inhaled corticosteroid.
A stepwise approach to the pharmacologic management of asthma:
1. Begins with determining the severity of asthma and assessing asthma control
2. Is used when asthma is severe and requires daily steroids
3. Allows for each provider to determine their personal approach to the care of asthmatic
patients
4. Provides a framework for the management of severe asthmatics, but is not as helpful
when patients have intermittent asthma Correct Ans - 1. Begins with determining
the severity of asthma and assessing asthma contro
