NUR 635 FINAL LATEST UPDATE

NUR 635 FINAL LATEST UPDATE 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 ANSWER 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 ANSWER 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 ANSWER 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 NUR 635 FINAL LATEST UPDATE 2 | P a g e 3. Ipratropium 4. Albuterol - CORRECT ANSWER 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 ANSWER B.Salmeterol, an inhaled longacting 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 ANSWER 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 ANSWER 2. Beclomethasone needs to be used every day to treat her asthma NUR 635 FINAL LATEST UPDATE 3 | P a g e 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 ANSWER 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 ANSWER 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 ANSWER 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