Advanced pharmacology for NP Exam
Questions with Answers | Latest 2023/2024
Ray has been diagnosed with hypertension and it is determined that an
angiotensin-converting enzyme inhibitor is needed. Prior to prescribing this drug,
the nurse practitioner (NP) should assess for: - ANSWER>>Decreased renal
function
Angiotensin-converting enzyme (ACE) inhibitors are the drug of choice in treating
hypertension in diabetic patients because they: - ANSWER>>All of the above:
Improve insulin sensitivity
Improve renal hemodynamics
Reduce the production of angiotensin II
A potentially life-threatening adverse response to an ACE inhibitor is angioedema.
Which of the following statements is true about this adverse response? -
ANSWER>>Swelling of the tongue and hoarseness are the most common
symptoms.
ACE inhibitors are useful in a variety of disorders. Which of the following
statements is true about both their usefulness in a particular disorder and the
reason for their use? - ANSWER>>Both 1 and 2 are true:
1. They are useful to prevent stable angina because they decrease the thickening
of vascular walls due to decreased modified release.
2. They are useful to prevent heart failure because they reduce remodeling of
injured myocardial tissues.
Despite good blood pressure control, an NP might change a patient's drug from an
ACE inhibitor to an angiotensin II receptor blocker (ARB) because the ARB: -
ANSWER>>Does not produce a dry, hacking cough
,While taking an ARB, patients need to avoid certain over-the-counter drugs
without irst consulting the provider because: - ANSWER>>Both 1 and 2:
1. Cimetidine is metabolized by the CYP3A4 isoenzymes
2. Nonsteroidal anti-inflammatory drugs reduce prostaglandin levels
Laboratory monitoring for patients on ACE inhibitors or ARBs should include: -
ANSWER>>Serum creatinine levels with the drug dosage reduced for values
greater than 2.5 mg/dL
Jacob has hypertension, for which a calcium channel blocker has been prescribed.
This drug helps control blood pressure because it: - ANSWER>>Decreases the
amount of calcium inside the cell
Which of the following adverse effects may occur due to a dihydropyridine-type
calcium channel blocker? - ANSWER>>Edema of the hands and feet
Patient teaching related to amlodipine includes: - ANSWER>>Avoid grapefruit
juice as it affects the metabolism of this drug.
Vera, age 70, has isolated systolic hypertension. Calcium channel blocker dosages
for her should be: - ANSWER>>Started at about half the usual dosage
Larry has heart failure, which is being treated with digoxin because it exhibits: -
ANSWER>>Negative inotropism
Furosemide is added to a treatment regimen for heart failure that includes
digoxin. Monitoring for this combination includes: - ANSWER>>Serum potassium
Which of the following create a higher risk for digoxin toxicity? Both the cause
and the reason for it must be correct. - ANSWER>>Administration to older adults
because of reduced renal function
,Serum digoxin levels are monitored for potential toxicity. Monitoring should
occur: - ANSWER>>Because a reference point is needed to adjust dosage
Which of the following is true about procainamide and its dosing schedule? -
ANSWER>>
Rodrigo has been prescribed procainamide after a myocardial infarction. He is
monitored for dyspnea, jugular venous distention, and peripheral edema because
they may indicate: - ANSWER>>Onset of congestive heart failure
Amiodarone has been prescribed in a patient with a supraventricular
dysrhythmia. Patient teaching should include all of the following EXCEPT: -
ANSWER>>Take a hot shower or bath if you feel dizzy.
The NP orders a thyroid panel for a patient on amiodarone. The patient tells the
NP that he does not have thyroid disease and wants to know why the test has
been ordered. Which is a correct response? - ANSWER>>Amiodarone inhibits an
enzyme that is important in making thyroid hormone and can cause
hypothyroidism.
Isosorbide dinitrate is prescribed for a patient with chronic stable angina. This
drug is administered twice daily, but the schedule is 7 a.m. and 2 p.m. because: -
ANSWER>>Nitrate tolerance can develop.
Art is a 55-year-old smoker who has been diagnosed with angina and placed on
nitrates. He complains of headaches after using his nitrate. An appropriate reply
might be: - ANSWER>>
In teaching about the use of sublingual nitroglycerine, the patient should be
instructed: - ANSWER>>To place one tablet under the tongue if chest pain occurs
and allow it to dissolve
, Donald has been diagnosed with hyperlipidemia. Based on his lipid profile,
atorvastatin is prescribed. Rhabdomyolysis is a rare but serious adverse response
to this drug. Donald should be told to: - ANSWER>>Report muscle weakness or
tenderness and dark urine to his provider immediately.
Which of the following diagnostic results would NOT indicate a problem related to
a reductase inhibitor? - ANSWER>>Increased white blood cell count
Because of the pattern of cholesterol synthesis, reductase inhibitors are given -
ANSWER>>In the evening in a single daily dose
Niaspan, an extended-release form of niacin, was previously prescribed to treat a
patient's hypertriglycerides. However, the FDA withdrew its approval of the drug.
Which of the following drugs with research efficacy should be substituted? -
ANSWER>>1 or 2:
1. Statins
2. Fibrates
Niaspan is less likely to cause which side effect that is common to niacin? -
ANSWER>>Cutaneous flushing
Dulcea has type 2 diabetes and a high triglyceride level. She has been prescribed
gemfibrozil to treat her hypertriglyceridemia. A history of which of the following
might contraindicate the use of this drug? - ANSWER>>Gallbladder disease
Many patients with hyperlipidemia are treated with more than one drug.
Combining a fibric acid derivative such as gemfibrozil with which of the following
is not recommended? The drug and the reason must both be correct for the
ANSWER to be correct. - ANSWER>>Reductase inhibitors, due to an increased risk
for rhabdomyolysis
Questions with Answers | Latest 2023/2024
Ray has been diagnosed with hypertension and it is determined that an
angiotensin-converting enzyme inhibitor is needed. Prior to prescribing this drug,
the nurse practitioner (NP) should assess for: - ANSWER>>Decreased renal
function
Angiotensin-converting enzyme (ACE) inhibitors are the drug of choice in treating
hypertension in diabetic patients because they: - ANSWER>>All of the above:
Improve insulin sensitivity
Improve renal hemodynamics
Reduce the production of angiotensin II
A potentially life-threatening adverse response to an ACE inhibitor is angioedema.
Which of the following statements is true about this adverse response? -
ANSWER>>Swelling of the tongue and hoarseness are the most common
symptoms.
ACE inhibitors are useful in a variety of disorders. Which of the following
statements is true about both their usefulness in a particular disorder and the
reason for their use? - ANSWER>>Both 1 and 2 are true:
1. They are useful to prevent stable angina because they decrease the thickening
of vascular walls due to decreased modified release.
2. They are useful to prevent heart failure because they reduce remodeling of
injured myocardial tissues.
Despite good blood pressure control, an NP might change a patient's drug from an
ACE inhibitor to an angiotensin II receptor blocker (ARB) because the ARB: -
ANSWER>>Does not produce a dry, hacking cough
,While taking an ARB, patients need to avoid certain over-the-counter drugs
without irst consulting the provider because: - ANSWER>>Both 1 and 2:
1. Cimetidine is metabolized by the CYP3A4 isoenzymes
2. Nonsteroidal anti-inflammatory drugs reduce prostaglandin levels
Laboratory monitoring for patients on ACE inhibitors or ARBs should include: -
ANSWER>>Serum creatinine levels with the drug dosage reduced for values
greater than 2.5 mg/dL
Jacob has hypertension, for which a calcium channel blocker has been prescribed.
This drug helps control blood pressure because it: - ANSWER>>Decreases the
amount of calcium inside the cell
Which of the following adverse effects may occur due to a dihydropyridine-type
calcium channel blocker? - ANSWER>>Edema of the hands and feet
Patient teaching related to amlodipine includes: - ANSWER>>Avoid grapefruit
juice as it affects the metabolism of this drug.
Vera, age 70, has isolated systolic hypertension. Calcium channel blocker dosages
for her should be: - ANSWER>>Started at about half the usual dosage
Larry has heart failure, which is being treated with digoxin because it exhibits: -
ANSWER>>Negative inotropism
Furosemide is added to a treatment regimen for heart failure that includes
digoxin. Monitoring for this combination includes: - ANSWER>>Serum potassium
Which of the following create a higher risk for digoxin toxicity? Both the cause
and the reason for it must be correct. - ANSWER>>Administration to older adults
because of reduced renal function
,Serum digoxin levels are monitored for potential toxicity. Monitoring should
occur: - ANSWER>>Because a reference point is needed to adjust dosage
Which of the following is true about procainamide and its dosing schedule? -
ANSWER>>
Rodrigo has been prescribed procainamide after a myocardial infarction. He is
monitored for dyspnea, jugular venous distention, and peripheral edema because
they may indicate: - ANSWER>>Onset of congestive heart failure
Amiodarone has been prescribed in a patient with a supraventricular
dysrhythmia. Patient teaching should include all of the following EXCEPT: -
ANSWER>>Take a hot shower or bath if you feel dizzy.
The NP orders a thyroid panel for a patient on amiodarone. The patient tells the
NP that he does not have thyroid disease and wants to know why the test has
been ordered. Which is a correct response? - ANSWER>>Amiodarone inhibits an
enzyme that is important in making thyroid hormone and can cause
hypothyroidism.
Isosorbide dinitrate is prescribed for a patient with chronic stable angina. This
drug is administered twice daily, but the schedule is 7 a.m. and 2 p.m. because: -
ANSWER>>Nitrate tolerance can develop.
Art is a 55-year-old smoker who has been diagnosed with angina and placed on
nitrates. He complains of headaches after using his nitrate. An appropriate reply
might be: - ANSWER>>
In teaching about the use of sublingual nitroglycerine, the patient should be
instructed: - ANSWER>>To place one tablet under the tongue if chest pain occurs
and allow it to dissolve
, Donald has been diagnosed with hyperlipidemia. Based on his lipid profile,
atorvastatin is prescribed. Rhabdomyolysis is a rare but serious adverse response
to this drug. Donald should be told to: - ANSWER>>Report muscle weakness or
tenderness and dark urine to his provider immediately.
Which of the following diagnostic results would NOT indicate a problem related to
a reductase inhibitor? - ANSWER>>Increased white blood cell count
Because of the pattern of cholesterol synthesis, reductase inhibitors are given -
ANSWER>>In the evening in a single daily dose
Niaspan, an extended-release form of niacin, was previously prescribed to treat a
patient's hypertriglycerides. However, the FDA withdrew its approval of the drug.
Which of the following drugs with research efficacy should be substituted? -
ANSWER>>1 or 2:
1. Statins
2. Fibrates
Niaspan is less likely to cause which side effect that is common to niacin? -
ANSWER>>Cutaneous flushing
Dulcea has type 2 diabetes and a high triglyceride level. She has been prescribed
gemfibrozil to treat her hypertriglyceridemia. A history of which of the following
might contraindicate the use of this drug? - ANSWER>>Gallbladder disease
Many patients with hyperlipidemia are treated with more than one drug.
Combining a fibric acid derivative such as gemfibrozil with which of the following
is not recommended? The drug and the reason must both be correct for the
ANSWER to be correct. - ANSWER>>Reductase inhibitors, due to an increased risk
for rhabdomyolysis
