Relias RN Pharmacology Test A Relias Actual Exam
with verified Questions and Answers
A 250mg dose of an oral medication has been ordered. The medication is supplied only
in 100mg tablets. How many tablets would you administer? - 2.5
What medication is a leukotriene receptor antagonist? - Montelukast
Which statement made by a person regarding hydrochlorothiazide (HCTZ) is correct? - I
should take extra care when standing up or changing positions.
What medication is considered a potassium-sparing diuretic? - spironolactione
(Aldactone)
A woman who is pregnant develops gestational diabetes. The NP's initial action is to:
a. prescribe an oral antidiabetic agent.
b. give her information about diet and exercise.
c. begin treating her with daily insulin injections.
d. reassure her that her glucose levels will return to normal after pregnancy. - ANS: B
Patients with gestational diabetes should be treated with diet and exercise, with insulin
added as needed for poor control. There is insufficient evidence to support the use of
oral antidiabetic agents during pregnancy, and some of these are pregnancy category
D. Insulin injections may be used but are not the initial intervention. Although glucose
levels will return to prepregnancy values in the postpartum period, the NP must initiate
therapy.
A woman who takes an angiotensin converting enzyme inhibitor for hypertension tells
her primary care NP that she is trying to get pregnant. The NP should:
a. consider replacing her angiotensin converting enzyme inhibitor with methyldopa.
b. lower her angiotensin converting enzyme inhibitor dose during the first trimester.
c. counsel her to increase her antihypertensive medications during pregnancy.
d. add an angiotensin receptor blocker (ARB) during the first trimester of her pregnancy.
- ANS: A
Angiotensin converting enzyme inhibitors, ARBs, and statins are contraindicated during
the first trimester of pregnancy and should be discontinued before conception and
replaced by safer alternatives, such as methyldopa. The use of antihypertensives during
pregnancy remains controversial; increasing the dose is not indicated.
A woman who is pregnant tells an NP that she has been taking sertraline for depression
for several years but is worried about the effects of this drug on her fetus. The NP will
consult with this patient's psychiatrist and will recommend that she:
a. stop taking the sertraline now.
b. continue taking the antidepressant.
,c. change to a monoamine oxidase inhibitor (MAOI).
d. discontinue the sertraline a week before delivery. - ANS: B
Many women are taking medication for depression before becoming pregnant. Abrupt
discontinuation is not recommended, and many clinicians suggest that women at high
risk for serious depression during pregnancy might best be served by continuing
medication throughout pregnancy. MAOIs may limit fetal growth and are generally
discouraged during pregnancy. It is not necessary to discontinue the sertraline just
before delivery.
A woman is 4 weeks pregnant. The primary care NP sees her for her first prenatal visit
and obtains a rubella titer, which is negative. The woman tells the NP that she drinks 2
cups of coffee and smokes 3 to 5 cigarettes each day. She denies alcohol use. The NP
should:
a. administer rubella vaccine.
b. provide smoking cessation information.
c. counsel her to avoid caffeine while pregnant.
d. reassure her that her habits are not likely to cause harm. - ANS: B
Each cigarette smoked decreases maternal blood pressure for up to 15 minutes and
decreases uteroplacental perfusion. The NP should encourage the woman to quit
smoking. Rubella vaccine should be given after the baby is delivered because rubella
vaccine is a live virus, with severe teratogenic effects. There is no conclusive evidence
that women who are pregnant should avoid caffeine completely. Her habits, although
not severe, are not harmless.
A woman who is breastfeeding her infant asks the primary care NP what she can use
for headaches while she is nursing. The NP tells her:
a. most medications enter breast milk and are not safe.
b. most over-the-counter medications are safe for the breastfed infant.
c. she may need to interrupt breastfeeding when taking headache medications.
d. she should consider weaning her infant to formula if her headaches are frequent. -
ANS: B
Most over-the-counter medications are considered safe for the breastfed infant and do
not necessitate a disruption of breastfeeding, even though most medications cross
easily into breast milk. Any interruption of breastfeeding carries a risk of premature
weaning and so is indicated only when the mother must take medications known to
cause serious harm to the baby. It is not recommended that she wean her infant to
formula when she needs medications for her headaches.
A man who has benign prostatic hypertrophy (BPH), in whom prostate carcinoma has
been ruled out, asks the primary care nurse practitioner (NP) about beginning drug
therapy to treat his symptoms. The NP notes that he consistently has blood pressure
readings around 145/90 mm Hg. The NP should prescribe:
a. tadalafil (Cialis).
b. doxazosin (Cardura).
c. tamsulosin (Flomax).
d. finasteride (Proscar). - ANS: B
, Doxazosin is a nonspecific a-blocker, which also lowers blood pressure and should be
considered to treat BPH in patients who also have hypertension. Tadalafil is used to
treat erectile dysfunction. Tamsulosin is a specific á-blocker and is first-line treatment
for patients with BPH who do not have hypertension. Finasteride is a 5a-reductase
inhibitor, which is not a first-line medication.
A patient who has BPH is taking tamsulosin and dutasteride and asks the primary care
NP why he needs to take both medications. The NP should tell him:
a. the combination helps reduce the risk of prostate carcinoma.
b. two-drug therapy is required before corrective prostatectomy surgery.
c. both drugs are given so that smaller doses of each drug may be administered.
d. one gives faster symptom relief, whereas the other shrinks the size of the prostate. -
ANS: D
A 5a-reductase inhibitor is given to shrink the size of the prostate, but maximum benefit
is not achieved until 6 months of therapy. The a-blocker is given to provide more rapid
relief. The combination does not decrease the risk of carcinoma. The drug therapy is not
a prerequisite to surgery, although it may be used before surgical intervention. The
combination therapy does not affect the dose of either drug.
A patient who has BPH is taking alfuzosin (Uroxatral) and finasteride (Proscar). The
patient has had two urinary tract infections (UTIs) in the past 2 months. A urinalysis in
the clinic is negative for leukocyte esterase but positive for hematuria. The primary care
NP should:
a. discontinue finasteride.
b. refer the patient to a urologist.
c. change alfuzosin to tamsulosin.
d. add doxazosin to the drug regimen. - ANS: B
Surgery is indicated for patients who are refractory to treatment with medications or who
have recurrent UTIs or hematuria. The NP should refer the patient to a urologist. All a-
blockers are considered equally efficacious, so changing the drug regimen is not
indicated.
A patient who has BPH is taking doxazosin and finasteride. The patient asks the
primary care NP whether he has an increased risk of prostate cancer. The NP should
tell him:
a. his overall cancer risk is increased.
b. he has an increased risk of a certain type of cancer.
c. his cancer risk is the same as any other man his age.
d. doxazosin will increase his cancer risk, but only slightly. - ANS: B
There is an overall reduction in prostate cancer risk for patients taking 5a-reductase
inhibitors, such as finasteride, but there is an increased risk of high-grade prostate
cancer. His overall cancer risk is less. Doxazosin does not affect cancer risk.
A patient tells the primary care NP that he has difficulty getting and maintaining an
erection. The NP's initial response should be to:
a. prescribe sildenafil (Viagra).
with verified Questions and Answers
A 250mg dose of an oral medication has been ordered. The medication is supplied only
in 100mg tablets. How many tablets would you administer? - 2.5
What medication is a leukotriene receptor antagonist? - Montelukast
Which statement made by a person regarding hydrochlorothiazide (HCTZ) is correct? - I
should take extra care when standing up or changing positions.
What medication is considered a potassium-sparing diuretic? - spironolactione
(Aldactone)
A woman who is pregnant develops gestational diabetes. The NP's initial action is to:
a. prescribe an oral antidiabetic agent.
b. give her information about diet and exercise.
c. begin treating her with daily insulin injections.
d. reassure her that her glucose levels will return to normal after pregnancy. - ANS: B
Patients with gestational diabetes should be treated with diet and exercise, with insulin
added as needed for poor control. There is insufficient evidence to support the use of
oral antidiabetic agents during pregnancy, and some of these are pregnancy category
D. Insulin injections may be used but are not the initial intervention. Although glucose
levels will return to prepregnancy values in the postpartum period, the NP must initiate
therapy.
A woman who takes an angiotensin converting enzyme inhibitor for hypertension tells
her primary care NP that she is trying to get pregnant. The NP should:
a. consider replacing her angiotensin converting enzyme inhibitor with methyldopa.
b. lower her angiotensin converting enzyme inhibitor dose during the first trimester.
c. counsel her to increase her antihypertensive medications during pregnancy.
d. add an angiotensin receptor blocker (ARB) during the first trimester of her pregnancy.
- ANS: A
Angiotensin converting enzyme inhibitors, ARBs, and statins are contraindicated during
the first trimester of pregnancy and should be discontinued before conception and
replaced by safer alternatives, such as methyldopa. The use of antihypertensives during
pregnancy remains controversial; increasing the dose is not indicated.
A woman who is pregnant tells an NP that she has been taking sertraline for depression
for several years but is worried about the effects of this drug on her fetus. The NP will
consult with this patient's psychiatrist and will recommend that she:
a. stop taking the sertraline now.
b. continue taking the antidepressant.
,c. change to a monoamine oxidase inhibitor (MAOI).
d. discontinue the sertraline a week before delivery. - ANS: B
Many women are taking medication for depression before becoming pregnant. Abrupt
discontinuation is not recommended, and many clinicians suggest that women at high
risk for serious depression during pregnancy might best be served by continuing
medication throughout pregnancy. MAOIs may limit fetal growth and are generally
discouraged during pregnancy. It is not necessary to discontinue the sertraline just
before delivery.
A woman is 4 weeks pregnant. The primary care NP sees her for her first prenatal visit
and obtains a rubella titer, which is negative. The woman tells the NP that she drinks 2
cups of coffee and smokes 3 to 5 cigarettes each day. She denies alcohol use. The NP
should:
a. administer rubella vaccine.
b. provide smoking cessation information.
c. counsel her to avoid caffeine while pregnant.
d. reassure her that her habits are not likely to cause harm. - ANS: B
Each cigarette smoked decreases maternal blood pressure for up to 15 minutes and
decreases uteroplacental perfusion. The NP should encourage the woman to quit
smoking. Rubella vaccine should be given after the baby is delivered because rubella
vaccine is a live virus, with severe teratogenic effects. There is no conclusive evidence
that women who are pregnant should avoid caffeine completely. Her habits, although
not severe, are not harmless.
A woman who is breastfeeding her infant asks the primary care NP what she can use
for headaches while she is nursing. The NP tells her:
a. most medications enter breast milk and are not safe.
b. most over-the-counter medications are safe for the breastfed infant.
c. she may need to interrupt breastfeeding when taking headache medications.
d. she should consider weaning her infant to formula if her headaches are frequent. -
ANS: B
Most over-the-counter medications are considered safe for the breastfed infant and do
not necessitate a disruption of breastfeeding, even though most medications cross
easily into breast milk. Any interruption of breastfeeding carries a risk of premature
weaning and so is indicated only when the mother must take medications known to
cause serious harm to the baby. It is not recommended that she wean her infant to
formula when she needs medications for her headaches.
A man who has benign prostatic hypertrophy (BPH), in whom prostate carcinoma has
been ruled out, asks the primary care nurse practitioner (NP) about beginning drug
therapy to treat his symptoms. The NP notes that he consistently has blood pressure
readings around 145/90 mm Hg. The NP should prescribe:
a. tadalafil (Cialis).
b. doxazosin (Cardura).
c. tamsulosin (Flomax).
d. finasteride (Proscar). - ANS: B
, Doxazosin is a nonspecific a-blocker, which also lowers blood pressure and should be
considered to treat BPH in patients who also have hypertension. Tadalafil is used to
treat erectile dysfunction. Tamsulosin is a specific á-blocker and is first-line treatment
for patients with BPH who do not have hypertension. Finasteride is a 5a-reductase
inhibitor, which is not a first-line medication.
A patient who has BPH is taking tamsulosin and dutasteride and asks the primary care
NP why he needs to take both medications. The NP should tell him:
a. the combination helps reduce the risk of prostate carcinoma.
b. two-drug therapy is required before corrective prostatectomy surgery.
c. both drugs are given so that smaller doses of each drug may be administered.
d. one gives faster symptom relief, whereas the other shrinks the size of the prostate. -
ANS: D
A 5a-reductase inhibitor is given to shrink the size of the prostate, but maximum benefit
is not achieved until 6 months of therapy. The a-blocker is given to provide more rapid
relief. The combination does not decrease the risk of carcinoma. The drug therapy is not
a prerequisite to surgery, although it may be used before surgical intervention. The
combination therapy does not affect the dose of either drug.
A patient who has BPH is taking alfuzosin (Uroxatral) and finasteride (Proscar). The
patient has had two urinary tract infections (UTIs) in the past 2 months. A urinalysis in
the clinic is negative for leukocyte esterase but positive for hematuria. The primary care
NP should:
a. discontinue finasteride.
b. refer the patient to a urologist.
c. change alfuzosin to tamsulosin.
d. add doxazosin to the drug regimen. - ANS: B
Surgery is indicated for patients who are refractory to treatment with medications or who
have recurrent UTIs or hematuria. The NP should refer the patient to a urologist. All a-
blockers are considered equally efficacious, so changing the drug regimen is not
indicated.
A patient who has BPH is taking doxazosin and finasteride. The patient asks the
primary care NP whether he has an increased risk of prostate cancer. The NP should
tell him:
a. his overall cancer risk is increased.
b. he has an increased risk of a certain type of cancer.
c. his cancer risk is the same as any other man his age.
d. doxazosin will increase his cancer risk, but only slightly. - ANS: B
There is an overall reduction in prostate cancer risk for patients taking 5a-reductase
inhibitors, such as finasteride, but there is an increased risk of high-grade prostate
cancer. His overall cancer risk is less. Doxazosin does not affect cancer risk.
A patient tells the primary care NP that he has difficulty getting and maintaining an
erection. The NP's initial response should be to:
a. prescribe sildenafil (Viagra).
