PHARMACOLOGY MSN 571 P RACTICE QUESTIONS WITH CORRECT ANSWERS A pediatric patient prescribed ampicillin for streptococcal pharyngitis reports new onset of a pruritic, dull red, maculopapular rash on the chest and neck. Which action is most important for the provider to take to minimize this patient's risk for injury? - answer -Discontinue the ampicillin. Which prescriber action will have the greatest impact on the patient's commitment to adherence to any type of medication therapy? - answer -
Providing medication education that the patient can easily understand Which patient statement suggests to the provider tha t the patient's nonadherence with their medication plan is related to dissatisfaction with the therapy? - answer -"I've been taking this medication for well over a week and I lost only a half a pound." How can the prescriber's regular collaboration with a pharmacist improve positive outcomes for patients? - answer -Pharmacists have additional information on drug interactions. The pharmacist can suggest adequate medication dosing. Pharmacists have firsthand knowledge of the facility formulary. Which statemen ts made by the prescriber demonstrate an understanding of effective medication education? - answer -"This medication needs to be stored in the refrigerator. "Take 3 tablets daily: 1 with breakfast, 1 with lunch, and one with dinner." "You need to take the m edication as we discussed until all the tablets are gone." "Call the office immediately if you begin experiencing any itching, headache, or difficulty breathing." A patient diagnosed with chronic pain calls to request an oxycodone (Oxycontin) refill. Which action should the prescriber take initially? - answer -Arrange to schedule an appointment with the patient. A metered -dose albuterol inhaler is prescribed for ast hma management. The patient reports feeling jittery sometimes when taking the medication, and does not feel that the medication is always effective. Which action will the provider take to best minimize patient risks and maximize medication effectiveness? - answer -Auscultate the patient's lung sounds and obtain other relevant vital signs. A patient is prescribed metronidazole for bacterial vaginosis. Which patient history finding would be most concerning to the provider? - answer -The patient drinks two glas ses of wine every night. The provider prepares a patient with newly diagnosed type 1 diabetes for hospital discharge. Which action by the provider will best support the patient's ability to effectively manage medication therapy? - answer -Asking the patien t to demonstrate how to measure and administer insulin A patient reports that a medication prescribed for recurrent migraine headaches is not working. Which action is the prescriber's priority when addressing the patient's concern? - answer -Ask the patien t about the number and frequency of tablets taken. The drug manual states that older adult patients are at increased risk for hepatotoxicity. Which action is most important when prescribing this medication to an 80 -year -old patient? - answer -Obtaining bas eline liver function studies A patient with bipolar disorder is prescribed daily lithium. Which action is most important for the provider to take in order to determine if the therapeutic level is maintained? - answer -Order periodic laboratory testing. Which factor best supports an increase for full prescriptive authority for both advanced practice registered nurses (APRNs) and physician assistants (PAs)? - answer -More patients will have access to health care. The patient who has been prescribed lithium for a diagnosis of bipolar disorder asks why blo od tests are required on a regular basis. Which provider responses demonstrate an understanding of why the patient requires a variety of laboratory tests? - answer -"We need to monitor how your thyroid is functioning." "We need to monitor kidney function wh ile you are on this drug. This medication can cause you to lose sodium, so we need to measure sodium levels." When prescribing lovastatin, what will a provider advise to decrease the risk of developing muscle toxicity? - answer -Substitute grapefruit juice with orange juice When prescribing drugs with a narrow therapeutic index, what intervention does the provider take to decrease risk to the patient? - answer -Monitor the patient's plasma drug levels at regular intervals. A patient reports that a medication no longer effecti vely alleviates symptoms. What process informs the provider's response to the patient's concerns? - answer -Desensitization of receptor sites results from continual exposure to the drug. A patient reports that Brand X tablets work faster than Brand Y table ts of the same amount of the same drug. Which statement informs the prescriber's response when explaining this phenomenon to the patient? - answer -Inactive ingredients used in composition can result in differing rates of dissolution, which can alter the dr ug's onset of action. A patient receiving intravenous gentamicin has a toxic serum drug level. The prescriber confirms that the dosing is correct. Which possible cause of this situation will the provider explore? - answer -Whether patient is taking a medic ation that binds to serum albumin. A patient takes a drug that is metabolized by CYP3A4 isoenzymes. If a CYP3A4 inducing drug is prescribed, what drug adjustment may be necessary to maintain a therapeutic level of CYP3A4 substrate? - answer -Increase dosag e of the CYP3A4 substrate The provider prescribes hydrocodone with acetaminophen for a patient's postsurgical pain. What instruction will the prescriber include regarding alcohol intake? - answer -"You should avoid drinking alcohol while you are taking the pain medication I've ordered." Which order for furosemide is written appropriately by the prescriber? - answer -
Furosemide [Lasix] 20 mg PO daily A drug can cause symptoms that resemble those of Parkinson disease. What action should the prescriber take t o minimize the potential patient risk? - answer -Thoroughly educate the patient about recognizing such symptoms and the need to notify the office immediately. A patient who has been taking sertraline for depression was prescribed azithromycin to treat an i nfection by a provider at an after -hours clinic. What action will the primary care provider take to address the risk this combination of medication has posed for the patient? - answer -Discontinue the azithromycin and write an order for an alternative antib iotic. A patient reports mild nausea within an hour after taking the first two doses of a newly approved medication. Nausea is not listed among the known side effects of this drug. What instructions will the provider give the patient? - answer -"Take the n ext dose with food and call the office if the nausea reoccurs or if other symptoms develop." A patient develops shortness of breath shortly after taking the initial dose of a newly prescribed medication. The patient's heart rate is 86 beats/minute, the respiratory rate is 24 breaths/minute, and the blood pressure is 120/70 mm Hg. The prescriber will discontinue the drug based on the assumption the patient experienced what medication induced effect? - answer -A side effect
Providing medication education that the patient can easily understand Which patient statement suggests to the provider tha t the patient's nonadherence with their medication plan is related to dissatisfaction with the therapy? - answer -"I've been taking this medication for well over a week and I lost only a half a pound." How can the prescriber's regular collaboration with a pharmacist improve positive outcomes for patients? - answer -Pharmacists have additional information on drug interactions. The pharmacist can suggest adequate medication dosing. Pharmacists have firsthand knowledge of the facility formulary. Which statemen ts made by the prescriber demonstrate an understanding of effective medication education? - answer -"This medication needs to be stored in the refrigerator. "Take 3 tablets daily: 1 with breakfast, 1 with lunch, and one with dinner." "You need to take the m edication as we discussed until all the tablets are gone." "Call the office immediately if you begin experiencing any itching, headache, or difficulty breathing." A patient diagnosed with chronic pain calls to request an oxycodone (Oxycontin) refill. Which action should the prescriber take initially? - answer -Arrange to schedule an appointment with the patient. A metered -dose albuterol inhaler is prescribed for ast hma management. The patient reports feeling jittery sometimes when taking the medication, and does not feel that the medication is always effective. Which action will the provider take to best minimize patient risks and maximize medication effectiveness? - answer -Auscultate the patient's lung sounds and obtain other relevant vital signs. A patient is prescribed metronidazole for bacterial vaginosis. Which patient history finding would be most concerning to the provider? - answer -The patient drinks two glas ses of wine every night. The provider prepares a patient with newly diagnosed type 1 diabetes for hospital discharge. Which action by the provider will best support the patient's ability to effectively manage medication therapy? - answer -Asking the patien t to demonstrate how to measure and administer insulin A patient reports that a medication prescribed for recurrent migraine headaches is not working. Which action is the prescriber's priority when addressing the patient's concern? - answer -Ask the patien t about the number and frequency of tablets taken. The drug manual states that older adult patients are at increased risk for hepatotoxicity. Which action is most important when prescribing this medication to an 80 -year -old patient? - answer -Obtaining bas eline liver function studies A patient with bipolar disorder is prescribed daily lithium. Which action is most important for the provider to take in order to determine if the therapeutic level is maintained? - answer -Order periodic laboratory testing. Which factor best supports an increase for full prescriptive authority for both advanced practice registered nurses (APRNs) and physician assistants (PAs)? - answer -More patients will have access to health care. The patient who has been prescribed lithium for a diagnosis of bipolar disorder asks why blo od tests are required on a regular basis. Which provider responses demonstrate an understanding of why the patient requires a variety of laboratory tests? - answer -"We need to monitor how your thyroid is functioning." "We need to monitor kidney function wh ile you are on this drug. This medication can cause you to lose sodium, so we need to measure sodium levels." When prescribing lovastatin, what will a provider advise to decrease the risk of developing muscle toxicity? - answer -Substitute grapefruit juice with orange juice When prescribing drugs with a narrow therapeutic index, what intervention does the provider take to decrease risk to the patient? - answer -Monitor the patient's plasma drug levels at regular intervals. A patient reports that a medication no longer effecti vely alleviates symptoms. What process informs the provider's response to the patient's concerns? - answer -Desensitization of receptor sites results from continual exposure to the drug. A patient reports that Brand X tablets work faster than Brand Y table ts of the same amount of the same drug. Which statement informs the prescriber's response when explaining this phenomenon to the patient? - answer -Inactive ingredients used in composition can result in differing rates of dissolution, which can alter the dr ug's onset of action. A patient receiving intravenous gentamicin has a toxic serum drug level. The prescriber confirms that the dosing is correct. Which possible cause of this situation will the provider explore? - answer -Whether patient is taking a medic ation that binds to serum albumin. A patient takes a drug that is metabolized by CYP3A4 isoenzymes. If a CYP3A4 inducing drug is prescribed, what drug adjustment may be necessary to maintain a therapeutic level of CYP3A4 substrate? - answer -Increase dosag e of the CYP3A4 substrate The provider prescribes hydrocodone with acetaminophen for a patient's postsurgical pain. What instruction will the prescriber include regarding alcohol intake? - answer -"You should avoid drinking alcohol while you are taking the pain medication I've ordered." Which order for furosemide is written appropriately by the prescriber? - answer -
Furosemide [Lasix] 20 mg PO daily A drug can cause symptoms that resemble those of Parkinson disease. What action should the prescriber take t o minimize the potential patient risk? - answer -Thoroughly educate the patient about recognizing such symptoms and the need to notify the office immediately. A patient who has been taking sertraline for depression was prescribed azithromycin to treat an i nfection by a provider at an after -hours clinic. What action will the primary care provider take to address the risk this combination of medication has posed for the patient? - answer -Discontinue the azithromycin and write an order for an alternative antib iotic. A patient reports mild nausea within an hour after taking the first two doses of a newly approved medication. Nausea is not listed among the known side effects of this drug. What instructions will the provider give the patient? - answer -"Take the n ext dose with food and call the office if the nausea reoccurs or if other symptoms develop." A patient develops shortness of breath shortly after taking the initial dose of a newly prescribed medication. The patient's heart rate is 86 beats/minute, the respiratory rate is 24 breaths/minute, and the blood pressure is 120/70 mm Hg. The prescriber will discontinue the drug based on the assumption the patient experienced what medication induced effect? - answer -A side effect
