NSG6005 ADVANCED PHARMACOLOGY FINAL EXAM TEST BANK. ALL CHAPTERS COVERED. ( QUESTIONS AND ANSWERS GRADED A+ 2022.

14. Preventative therapy for cluster headaches includes: A. Massage or relaxation therapy B. Ergotamine nightly before bed C. Intranasal lidocaine four times a day during “clusters” of headaches D. Propranolol (Inderal) daily 15. When prescribing any headache therapy, appropriate use of medications needs to be discussed to prevent medication-overuse headaches. A clinical characteristic of medication-overuse headaches is that they: A. Are increasing in frequency B. Are increasing in intensity C. Recur when medication wears off D. Begin to “cluster” into a pattern Chapter 36. Heart Failure 1. Angiotensin-converting-enzyme(ACE) inhibitors are a central part of the treatment of heart failure because they have more than one action to address the pathological changes in this disorder. Which of the following pathological changes in heart failure is NOT addressed by ACE inhibitors? A. Changes in the structure of the left ventricle so that it dilates, hypertrophies, & uses energy less efficiently. B. Reduced formation of cross-bridges so that contractile force decreases. C. Activation of the sympathetic nervous system that increases heart rate & preload. D. Decreased renal blood flow that decreases oxygen supply to the kidneys. 2. One of the three types of heart failure involves systolic dysfunction. Potential causes of this most common form of heart failure include: A. Myocardial ischemia & injury secondary to myocardial infarction B. Inadequate relaxation & loss of muscle fiber secondary to valvular dysfunction C. Increased demos of the heart beyond its ability to adapt secondary to anemia D. Slower filling rate & elevated systolic pressures secondary to uncontrolled hypertension 3. The American Heart Association & the American College of Cardiology have devised a classification system for heart failure that can be used to direct treatment. Patients with symptoms & underlying disease are classified as stage: 1.A 2.B 3 .C 4.D 4. Diagnosis of heart failure cannot be made by symptoms alone because many disorders share the same symptoms. The most specific & sensitive diagnostic test for heart failure is: A. Chest x-rays that show cephalization & measure heart size B. Two-dimensional echocardiograms that identify structural anomalies & cardiac dysfunction C. Complete blood count, blood urea nitrogen, & serum electrolytes that facilitate staging for end-organ damage D. Measurement of brain natriuretic peptide to distinguish between systolic & diastolic dysfunction 5. Treatments for heart failure, including drug therapy, are based on the stages developed by the ACC/AHA. Stage A patients are treated with: A. Drugs for hypertension & hyperlipidemia, if they exist B. Lifestyle management including diet, exercise, & smoking cessation only C. Angiotensin-converting enzyme(ACE) inhibitors to directly affect the heart failure only D. No drugs are used in this early stage 6. Class I recommendations for stage A heart failure include: A. Aerobic exercise within tolerance levels to prevent the development of heart failure B. Reduction of sodium intake to less than 2,000 mg/day to prevent fluid retention C. Beta blockers for all patients regardless of cardiac history D. Treatment of thyroid disorders, especially if they are associated with tachyarrhythmias 7. Stage B patients should have beta blockers added to their heart failure treatment regimen when: 1. They have an ejection fraction less than 40% 2. They have had a recent MI 3. Both 1 & 2 4. Neither 1 nor 2 8. Increased life expectancy for patients with heart failure has been associated with the use of: A. ACE inhibitors, especially when started early in the disease process B. All beta blockers regardless of selectivity C. Thiazide & loop diuretics D. Cardiac glycosides 9. Stage C patients usually require a combination of three to four drugs to manage their heart failure. In addition to ACE inhibitors & beta blockers, diuretics may be added. Which of the following statements about diuretics is NOT true? A. Diuretics reduce preload associated with fluid retention. B. Diuretics can be used earlier than stage C when the goal is control of hypertension. C. Diuretics may produce problems with electrolyte imbalances & abnormal glucose & lipid metabolism. D. Diuretics from the potassium-sparing class should be used when using an angiotensin receptor blocker(ARB). 10. Digoxin has a very limited role in treatment of heart failure. It is used mainly for patients with: A. Ejection fractions above 40% B. An audible S3 C. Mitral stenosis as a primary cause for heart failure D. Renal insufficiency