Advanced Pharmacology Revised Midterm Exam 2025

Nurse practitioner prescriptive authority is regulated by: A. The national council of safe board of nursing B. The state board of nursing for each state C. The u. S. Drug enforcement administration D. The state board of pharmacy - -b. The state board of nursing for each state Eight information needed for the prescription - - 1. Date of prescribing; 2. Name of patient(s); 3. Prescriber's name; 4. Name, strength, and dosage of drug or device; 5. Number of refills, if applicable; 6. Quantity prescribed in weight, volume, or number of units; 7. An indication of whether generic substitution has been authorized by the prescriber; 8. Any change or alteration made to the prescription dispensed on contact with the prescriber must show a clear audit trail. Three additional required information for controlled substances - - 1. Address of the prescriber and patient; 2. The prescriber's dea number; 3 controlled prescriptions shall also comply with all requirements of federal and state controlled substance laws. Who oversees the aprn's prescribing of controlled substances? A. The pharmaceutical board of the state B. The federal government (dea) C. The practice protocols of the hospital D. Practice agreements - -b. The federal government (dea) The USFDA regulates: A. Prescribing of drugs by medical doctors and nurse practitioners B. The official labeling for all prescription and over-the-counter drugs C. Off-label recommendations for prescribing D. Pharmaceutical educational offering - -b. The official labeling for all prescription and over-the-counter drugs Medication agreements or "pain medication contracts" are recommended to be used: Pharm Pharm A. Universally for all prescribing for chronic pain B. For patients who have repeated requests for pain medication C. When you suspect a patient is exhibiting drug-seeking behavior D. For patients with pain associated with malignancy - -a. Universally for all prescribing for chronic pain Anaphylactic shock is a: A. Type i reaction, called immediate hypersensitivity reaction B. Type ii reaction, called cytotoxic hypersensitivity reaction C. Type iii reaction, called immune complex hypersensitivity D. Type iv reaction, called delayed hypersensitivity reaction - -a. Type i reaction, called immediate hypersensitivity reaction The role of the nurse practitioner with regards to herbal medication is to: A. Maintain competence in the prescribing of common herbal remedies. B. Recommend common over-the-counter herbs to patients. C. Educate patients and guide them to appropriate sources of care. D. Encourage patients to not use herbal therapy due to the documented dangers. - -c. Educate patients and guide them to appropriate sources of care. Prescribing for women during their childbearing years requires constant awareness of the possibility of: A. High risk for developmental disorders in their infants B. Decreased risk for abuse during this time C. Possible unknown pregnancy D. Possibility of drug allergies - -c. Possible unknown pregnancy Dysmenorrhea is one of the most common gynecological complaints in young women. The first-line of drug treatment for this disorder is: A. Oral contraceptive pills B. Caffeine C. NSAIDS D. Aspirin - -c. NSAIDS A medication review of an elderly person's medications involves: A. Asking the patient to bring a list of current prescription medications to the visit. B. Having the patient bring all their prescription, over-the-counter, and herbal medications to the visit. C. Asking what other providers are writing prescriptions for them. D. All of the above. - -d. All of the above. Pharm Pharm What is this skin condition of child? A. Impetigo B. Hand, foot, and mouth disease C. Allergic/hypersensitive reaction D. Tinea corporis - -a. Impetigo Ace-is are the drug of choice in treating htn in diabetic patient because they: A. Improve insulin sensitivity B. Improve renal hemodynamics C. Reduce the production of angiotensin ii D. All of above - -d. All of above 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 the correct response? A. Amiodarone inhibits an enzyme that is important in making thyroid hormone and can cause hypothyroidism. B. Amiodarone damages the thyroid gland and can result in inflammation of that gland, causing hyperthyroidism C. Amiodarone is a broad spectrum drug with many adverse effects, many different tests need to be done before it is given. D. Amiodarone can cause corneal deposits in up to 25% of patients. - -a. Amiodarone inhibits an enzyme that is important in making thyroid hormone and can cause hypothyroidism. To reduce mortality, all patients with angina, regardless of class, should be on: A. ASA 81 to 325 mg/day B. Nitroglycerin sublingually for chest pain C. Ace inhibitors or angiotensin receptor blockers D. Dixoxin - -a. ASA 81 to 325 mg/day Beta-blockers are especially helpful for patients with exertional angina who also have: A. Arrhythmia B. Hypothyroidism C. Hyperthyroidism D. Atherosclerosis - -a. Arrhythmia What assessment that can be done at home is the most reliable to use for making decisions to change hf medications? Pharm Pharm A. Weight B. BP C. HR D. Serum glucose - -a. Weight What can chest x-rays contribute to the diagnosis and management of hf? A. They have no role. B. They can give very precise pictures of pulmonary fluid status. C. They provide an idea of general cardiac size and pulmonary great vessel distribution. D. They can confirm the diagnosis. - -c. They provide an idea of general cardiac size and pulmonary great vessel distribution. Jamie is a 34-year-old pregnant woman with familial hyperlipidemia and elevated ldl levels. What is the appropriate treatment for a pregnant woman? A. A statin B. Niacin C. Fibric acid derivative D. Bile acid-binding resins - -d. Bile acid-binding resins Jose is a 12-year-old overweight child with a total cholesterol of 180 mg/dl and ldl of 125 mg/dl. Along with diet education and recommending increased physical activity, a treatment plan for jose would include _____ with a reevaluation in 6 months. A. Statins B. Niacin C. Sterols D. Bile acid-binding resins - -sterols Which antihypertensive is safe to use in pregnancy? A. Ace-is B. Bbs C. Dris D. Arbs - -b. Bbs A potentially life-threatening adverse response to ace-is is angioedema. Which of the following statements true about this adverse response? A. Swelling of the tongue and hoarseness are the most common symptoms. B. It appears to be related to the decrease in aldosterone production. C. Presence of a dry, hacking cough indicates a high risk for this adverse response. D. Because it takes time to build up a blood level, it occurs after being on the drug for about one week. - -a. Swelling of tongue and hoarseness are the most common symptoms. Pharm Pharm Appropriate treatment for impetigo is: A. Miconazole topical B. Mupirocin (bactroban) C. Keflex D. Benadryl - -b. Mupirocin (bactroban) A 42-year old man presents to you for follow-up treatment of a furuncle. He came in 3 days earlier and the area was 1.5 cm in size. At that time, he was afebrile and without pain, redness, or swelling. He was sent home with instructions to apply a warm compress and was not given antibiotics. When should a furuncle be treated with systemic antibiotics? A. If the area is painful B. If the area is red, along with the surrounding tissues C. Patient is febrile D. All of above - -d. All of above When writing a prescription of permethrin 5% cream (elimite) for scabies, patient education would include: A. All members of the household and personal contacts should be treated. B. Infants should have permethrin applied from the neck down. C. The permethrin is washed off after 10 to 20 minutes. D. Permethrin is flammable and to avoid open flame while the medication is applied. - a. All members of the household and personal contacts should be treated. Bisphosphonate administration education includes: A. Taking it on a full stomach B. Sitting erect for at least 30 minutes afterward C. Drinking it with orange juice D. Taking it with h2 blockers or ppis to protect stomach - -b. Sitting erect for at least 30 minutes afterward Besides osteoporosis, iv bisphosphonates are also indicated for: A. Paget's disease B. Early osteopenia C. Renal cancer D. Early closure of cranial sutures - -a. Paget's disease Selective estrogen receptor modifiers (serms) treat osteoporosis by selectively: A. Inhibiting magnesium resorption in the kidneys Pharm Pharm B. Increasing calcium absorption from the gi tract C. Acting on the bone to inhibit osteoblast activity D. Acting on the estrogen receptors in the bone - -d. Acting on the estrogen receptors in the bone Whether prescribing an antibiotic for a child with acute otitis media or not, the parents should be educated about: A. Using decongestants to provide faster symptom relief B. Providing adequate pain relief for at least the first 24 hours C. Using complementary treatments for acute otitis media, such as garlic oil D. Administering an antihistamine/decongestant combination (dimetapp) so the child can sleep better - -b. Providing adequate pain relief for at least 24 hours First-line therapy for a patient with acute otitis externa (swimmer's ear) and an intact tympanic membrane includes: A. Swim-ear drops B. Ciprofloxacin and hydrocortisone drops C. Amoxicillin D. Gentamicin ophthalmic drops - -b. Ciprofloxacin and hydrocortisone drops Treatment for sinusitis in an adult who has a child in daycare is: A. Azithromycin 500 mg a day for 5 days B. Amoxicillin-clavulanate 500 mg bid for 7 days C. Ciprofloxacin 500 mg bid for 5 days D. Cephalexin 500 mg qid for 5 days - -b. Amoxicillin-clavulanate 500 mg bid for 5 days A stepwise approach to the pharmacologic management of asthma: A. Allows for each provider to determine their personal approach to the care of asthmatic patients B. Is used when asthma is severe and required daily steroids C. Begins with determining the severity of asthma and assessing asthma control D. Provides a framework for the management of severe asthmatics, but is not helpful when patients have intermittent asthma - -c. Begins with determining the severity of asthma and assessing asthma control Asthma exacerbations at home are managed by the patient by: A. Starting montelukast (singulair) B. Increasing frequency of beta 2 agonists and contacting their provider C. Inhaling beta 2 agonists every 20 minutes for two hours D. Tripling inhaled corticosteroid dose - -b. Increasing frequency of beta 2 agonists and contacting their provider Pharm Pharm One goal of asthma management in children is: A. Minimal use of inhaled corticosteroids B. Participation in school and sports activities C. They independently manage their asthma D. No exacerbations - -b. Participation in school and sport activities Pregnant patients with asthma may safely use _____ throughout their pregnancy. A. Oral terbutaline B. Prednisone C. Inhaled corticosteroids (budesonide) D. Montelukast (singular) - -c. Inhaled corticosteroids (budesonide) Cough and cold medications that contain a sympathomimetic decongestant such as phenylephrine should be used cautiously in what population: A. Older adults B. Hypertensive patients C. Infants D. All of the above - -d. All of the above The first-line treatment for cough related to an upper respiratory tract infection