NUR 635 - Master Pharm Final Review
Pt in premature labor - what do you give to stop contractions? - correct answer B2 agonist
A 35-year-old man recently immigrated from Guatemala, presents with fatigue, lethargy and
mouth sores. The NP suspects scurvy and prepares which medication? - correct answer ascorbic
acid
First line drug of choice for Community Acquired Pneumonia in a previously healthy adult
would include: - correct answer azithromycin (macrolide)
One month after starting phenytoin for seizures, pt complains with fever, rash, swollen lymph
nodes. NP suspects? - correct answer Phenytoin hypersensitivity reaction (can happen even
after 1 month)
When is phenytoin hypersensitivity reaction most likely - correct answer 3-8 weeks after
starting treatment. Provider should see pt within a month of starting it
Patient with previous compliant level of carbamazepine levels now presents with
subtherapeutic levels. NP suspects: - correct answer Carbamazepine will auto-induce
metabolism, so this is an expected lab finding - need to
increase the dose.
Black box warning on carbamazepine. Educate patient to report signs and symptoms of: -
correct answer Skin reactions - because it can cause steven Johnson syndrome, TEN (toxic
epidermis
necrosis).
Carbamazepine monitoring should include all except: - correct answer Include all - Routine CBC,
Drug levels, osteoporosis screening. Do not need to include monthly glucose.
What lab should be drawn before starting carbamazepine? - correct answer CBC and then every
3-4 months
A patient taking lamotrigine (Lamictal) presents with fever, cough, swollen lymph nodes. NP
suspects: - correct answer Lamictal hypersensitivity reaction
A pt has a reaction to lamotrigine and complains of a rash formation that is not SJS or TENS -
what could this be? - correct answer drug reaction with eosinophils and systemic syndrome
(DRESS) - this can be fatal and associated with HLA-B1502. Characterized by skin eruptions,
lymphadenopathy, fever, and multiorgan involvement (renal, hepatic, hematologic)
A young woman taking lamotrigine (Lamictal) for seizures presents in the office requesting Birth
control. She has decided she wants daily oral contraceptive. NP educates patient regarding: -
correct answer lamictal dose must be increased while taking oral contraceptives
,Tricyclic antidepressants (TCAs) should be avoided in: - correct answer Heart failure patients -
as TCAs will increase cardiac contractility and can make ischemia worse because not enough
blood flow to sustain the contractility.
When educating patients regarding antidepressants, the NP should include: - correct answer It
may take 2-3 weeks for medications to take effect.
After ordering IM haldol for a pt, the NP should know to assess for EPS which using which tool: -
correct answer AIMS test - abnormal involuntary movement scale
What are you assessing for after giving Haldol - correct answer extra pyramidal symptoms
Prior to administering albuterol + Digoxin for an acute asthma attack, NP understands: - correct
answer Digoxin dosage will need to be increased - albuterol decreases dig levels by 16-22 %
How should SSRIs be taperd - correct answer
If pt with peptic ulcer disease cant tolerate amoxicillin and clarithromycin together what do you
do - correct answer prescribe clarithromycin for 5 days followed by amoxicillin for 5 dats
the prescriber prescribes what for a pt with comorbities that is diagnosed with pneumonia.
When will you see improvment? - correct answer Levofloxacin - 2-3 days
Community acquired MRSA is treated with - correct answer Trimethoprim-sulfamethoxazole
(Bactrim)
If pt with community acquired MRSA also has cellulitis. What do you treat with - correct answer
Cephalexin (Keflex) and Trimethoprim-sulfamethoxazole (Bactrim)
If taking pancreatic enzymes, the provider can tell if they are appropriately dosed on their
what? - correct answer Steatorrhea (poop color)
how are pancreatic enzymes given to pts with cystic fibrosis and gastric bypass? - correct
answer Prescribed in units of lipase
A pt with history of pagets disease, will have increased pain. What should the provider
prescribe - correct answer Calcitonin Salmon
the recommendation for azithromycin is... - correct answer using a z pack to titrate the dosing
down each day
long term use of PPI can lead to what: - correct answer
Tamiflu should be started when for the flu - correct answer within 48 hrs of S/S (75 mg BID)
DO not prescribe pseudoephedrine, phenylephrine or a nasal decongestant to a pt with what? -
correct answer HTN - give azelastine or oxymetazolime instead
, A pregnant woman with lots of GERD can be caused by what and why? - correct answer
Estrogen - it decrease the tightness of the lower esophageal sphrincter
What do you do with warfarin, it a pt is also on alopurinol for gout flare ups? - correct answer
reduce
When G6PD deficiency pts are exposed to what...it can cause anemia - correct answer FAVA
Beans and sulfonamides
An adult with CAP with comorbidities and fluoroquinolines are not an option. what do you give
- correct answer Beta lactam + macrolide - Azithromycin plus ceftriaxone
Pt with scattered comedones what do you give - correct answer Benzoyl peroxide
Reglan is given for GERD bc it... - correct answer increases lower esophageal tone to help with
GERD symptoms
guaifensisin works by - correct answer thinning secretions to make them easier to cough up
pt is complaining of flushing, the provider should check to see if they are taking.... - correct
answer Niacin
Medications for pt with pain from a sprained finger? - correct answer NSAIDS or Tylenol
treat shingles with - correct answer acyclovir
a pt with mild persistent asthma should have what added - correct answer low dose inhaled
corticosteroid
Why is it important for pt taking Paroxetine (Paxil), an SSRI, to refill their prescription on time,
not run out of their med and take it at the same time everyday? - correct answer Unlike other
SSRIs, paroxetine has a short half life.
When should asthma medication be adjusted? - correct answer if the pt is using their short
acting bronchodilator more than 2 times a week.
if an asthma pt has 2 different inhalers one is an inhaled beta agonist and the other is a
corticosteroid, which should they take first? - correct answer Bronchodilator - dilates so more
of the steroid can be absorbed.
Treatment plan for asthma, what does the provider need to know about the pts symptoms? -
correct answer 1. severity of symptoms
2. how often are they having symptoms
3. how long are symptoms lasting
TX for mild intermittent asthma? - correct answer Short acting beta agonist (SABA) - albuterol.
Then you can add on a low dose inhaled corticosteroid.
Pt in premature labor - what do you give to stop contractions? - correct answer B2 agonist
A 35-year-old man recently immigrated from Guatemala, presents with fatigue, lethargy and
mouth sores. The NP suspects scurvy and prepares which medication? - correct answer ascorbic
acid
First line drug of choice for Community Acquired Pneumonia in a previously healthy adult
would include: - correct answer azithromycin (macrolide)
One month after starting phenytoin for seizures, pt complains with fever, rash, swollen lymph
nodes. NP suspects? - correct answer Phenytoin hypersensitivity reaction (can happen even
after 1 month)
When is phenytoin hypersensitivity reaction most likely - correct answer 3-8 weeks after
starting treatment. Provider should see pt within a month of starting it
Patient with previous compliant level of carbamazepine levels now presents with
subtherapeutic levels. NP suspects: - correct answer Carbamazepine will auto-induce
metabolism, so this is an expected lab finding - need to
increase the dose.
Black box warning on carbamazepine. Educate patient to report signs and symptoms of: -
correct answer Skin reactions - because it can cause steven Johnson syndrome, TEN (toxic
epidermis
necrosis).
Carbamazepine monitoring should include all except: - correct answer Include all - Routine CBC,
Drug levels, osteoporosis screening. Do not need to include monthly glucose.
What lab should be drawn before starting carbamazepine? - correct answer CBC and then every
3-4 months
A patient taking lamotrigine (Lamictal) presents with fever, cough, swollen lymph nodes. NP
suspects: - correct answer Lamictal hypersensitivity reaction
A pt has a reaction to lamotrigine and complains of a rash formation that is not SJS or TENS -
what could this be? - correct answer drug reaction with eosinophils and systemic syndrome
(DRESS) - this can be fatal and associated with HLA-B1502. Characterized by skin eruptions,
lymphadenopathy, fever, and multiorgan involvement (renal, hepatic, hematologic)
A young woman taking lamotrigine (Lamictal) for seizures presents in the office requesting Birth
control. She has decided she wants daily oral contraceptive. NP educates patient regarding: -
correct answer lamictal dose must be increased while taking oral contraceptives
,Tricyclic antidepressants (TCAs) should be avoided in: - correct answer Heart failure patients -
as TCAs will increase cardiac contractility and can make ischemia worse because not enough
blood flow to sustain the contractility.
When educating patients regarding antidepressants, the NP should include: - correct answer It
may take 2-3 weeks for medications to take effect.
After ordering IM haldol for a pt, the NP should know to assess for EPS which using which tool: -
correct answer AIMS test - abnormal involuntary movement scale
What are you assessing for after giving Haldol - correct answer extra pyramidal symptoms
Prior to administering albuterol + Digoxin for an acute asthma attack, NP understands: - correct
answer Digoxin dosage will need to be increased - albuterol decreases dig levels by 16-22 %
How should SSRIs be taperd - correct answer
If pt with peptic ulcer disease cant tolerate amoxicillin and clarithromycin together what do you
do - correct answer prescribe clarithromycin for 5 days followed by amoxicillin for 5 dats
the prescriber prescribes what for a pt with comorbities that is diagnosed with pneumonia.
When will you see improvment? - correct answer Levofloxacin - 2-3 days
Community acquired MRSA is treated with - correct answer Trimethoprim-sulfamethoxazole
(Bactrim)
If pt with community acquired MRSA also has cellulitis. What do you treat with - correct answer
Cephalexin (Keflex) and Trimethoprim-sulfamethoxazole (Bactrim)
If taking pancreatic enzymes, the provider can tell if they are appropriately dosed on their
what? - correct answer Steatorrhea (poop color)
how are pancreatic enzymes given to pts with cystic fibrosis and gastric bypass? - correct
answer Prescribed in units of lipase
A pt with history of pagets disease, will have increased pain. What should the provider
prescribe - correct answer Calcitonin Salmon
the recommendation for azithromycin is... - correct answer using a z pack to titrate the dosing
down each day
long term use of PPI can lead to what: - correct answer
Tamiflu should be started when for the flu - correct answer within 48 hrs of S/S (75 mg BID)
DO not prescribe pseudoephedrine, phenylephrine or a nasal decongestant to a pt with what? -
correct answer HTN - give azelastine or oxymetazolime instead
, A pregnant woman with lots of GERD can be caused by what and why? - correct answer
Estrogen - it decrease the tightness of the lower esophageal sphrincter
What do you do with warfarin, it a pt is also on alopurinol for gout flare ups? - correct answer
reduce
When G6PD deficiency pts are exposed to what...it can cause anemia - correct answer FAVA
Beans and sulfonamides
An adult with CAP with comorbidities and fluoroquinolines are not an option. what do you give
- correct answer Beta lactam + macrolide - Azithromycin plus ceftriaxone
Pt with scattered comedones what do you give - correct answer Benzoyl peroxide
Reglan is given for GERD bc it... - correct answer increases lower esophageal tone to help with
GERD symptoms
guaifensisin works by - correct answer thinning secretions to make them easier to cough up
pt is complaining of flushing, the provider should check to see if they are taking.... - correct
answer Niacin
Medications for pt with pain from a sprained finger? - correct answer NSAIDS or Tylenol
treat shingles with - correct answer acyclovir
a pt with mild persistent asthma should have what added - correct answer low dose inhaled
corticosteroid
Why is it important for pt taking Paroxetine (Paxil), an SSRI, to refill their prescription on time,
not run out of their med and take it at the same time everyday? - correct answer Unlike other
SSRIs, paroxetine has a short half life.
When should asthma medication be adjusted? - correct answer if the pt is using their short
acting bronchodilator more than 2 times a week.
if an asthma pt has 2 different inhalers one is an inhaled beta agonist and the other is a
corticosteroid, which should they take first? - correct answer Bronchodilator - dilates so more
of the steroid can be absorbed.
Treatment plan for asthma, what does the provider need to know about the pts symptoms? -
correct answer 1. severity of symptoms
2. how often are they having symptoms
3. how long are symptoms lasting
TX for mild intermittent asthma? - correct answer Short acting beta agonist (SABA) - albuterol.
Then you can add on a low dose inhaled corticosteroid.
