NRSE 3010(NRSE310) : Pharmacology For Nursing - ETSU, All Quizzes Merged in 1 file_ Answered 100% Updated 2025.

NRSE 3010(NRSE310) : Pharmacology For Nursing - ETSU, All Quizzes Merged in 1 file_ Answered 100% Updated 2025. Quiz 2 - oncology meds. Q UE STI O N 1 1. Bortezomib belongs to which drug class? A Protease inhibitors . B Immunomodulators . C Tyrosin kinase inhibitors . D Topoisomerase inhibitors . Q UE STI O N 2 1. Which of the following monoclonal antibodies targets the CD20 surface antigen on B cells? A Rituximab . B Cetuximab . C Nivolumab . D Bevacizumab . Q UE STI O N 3 1. Alterations that may occurr in genetics that develop sporatic colorectal cancers may involve these pathways: A P53, APC and KRAS . B Chromosomal instability or suppressor pathway . Microsatilite instability or mutator pathway CpG island CIMP or serrated pathway C BRAF gene . D MMR deficiency . Q UE STI O N 4 1. Patient started on Vincristine should be counseled to report which of the following side effects? A Numbness . B Cough . C Headache . D Diarrhea . Q UE STI O N 5 1. Aromatase inhibitors are used to treat ER positive breast cancer in postmenopausal women Ovarian cancer HER 2 negative breast cancer HER 2 positive breast cancer Q UE STI O N 6 1. Which agent has both non-oncological and oncological indications? A Trexall . B Ibrutinib . C Cisplatin . D Docetaxel . Q UE STI O N 7 1. Which of the following Antineoplastic agents can increase a serum concentration of warfarin, potentially leading to an increased risk of bleeding? A Casodex . B Cytarabine . C Bortezomib . D Revlimid . Q UE STI O N 8 1. Nolvadex (tamoxifen) works on ER positive breast cancer through: A Blockage of estrogen receptors and activation of other estrogen receptors in tissues . B Inhibition of estrogen synthesis . C Blockage of . D Blockage of estrogen inducers . Q UE STI O N 9 1. Tamoxifen in a combination with a inhibitor can cause a recurrence of breast cancer. Drugs to avoid in women taking tamoxifen are and CYP2D6, Paxil and Zoloft CYP2D6, Lexapro and serequil CYP3D6, Effexor and Zoloft CYP2D6, Prozac and Cipralex Q UE STI O N 10 1. HER 2 positive breast cancer treated with Ado-trastuzumab emtansine (Kadcyla) may be used in combination with: A Pertuzumab (Perjeta) and docetaxel . B Lapatinib . C Tamoxifin . D Denosumab . Q UE STI O N 11 1. What class of anti-neoplastic agents typically interact with strong CYP3A4 inhibitors and inducers? A Aromatase inhibitors . B Tyrosine kinase inhibitors . C Monoclonal antibodies . D Platinum compounds . Q UE STI O N 12 1. The Karnofsky performance scale is used to assess A The general health of the patient . B The location of the tumor . C The grade of the cancer . D The responsiveness to chemotherapy of the type of the cancer . Q UE STI O N 13 1. is a rare but serious side effects associated with cisplatin A Ototoxicity . B Cardio toxicity . C Immune mediated pneumonitis . D Hypothyroidism . Q UE STI O N 14 1. The management of immune mediated toxicity associated with nivolumab may involve which of the following? A Corticosteroids . B Full a casted . C Leucovorin . D Thiamine . Q UE STI O N 15 1. Prophylactic treatment for hyperuricemia is generally prescribed in patients with leukemia and lymphoma in home hyperuricemia is most likely. Prophylactic treatment of is the standard of care Allopurinol Rasburicase colchicin e NSAIDS Q UE STI O N 16 1. Hepatotoxicity is associated with which of the following agents? Opdivo Herceptin Letrozole Carboplatin Q UE STI O N 17 1. A premenopausal woman has ER-positive breast cancer, and her prescriber has ordered tamoxifen [Nolvadex]. She asks the nurse if anastrozole [Arimidex] would work better for her. What will the nurse tell her? A Anastrozole is more likely to cause hot flushes than tamoxifen . B Anastrozole is more likely to promote endometrial carcinoma. . C Cancer recurrence is higher with anastrozole. . D Until she is postmenopausal, anastrozole will not be effective. . Q UE STI O N 18 1. Ibuprofen must be avoided a couple of days before and after administration of which of the following anti-neoplastic drugs? A Pemetrexed . B Vincristine . C Cyclophosphamide . D Carboplatin . Q UE STI O N 19 1. An echocardiagram should be obtained prior to initiation of which of the following agents? A Trastuzumab . B Cisplatin . C Nivolumah . D Docetaxel . Q UE STI O N 20 1. Nivolumab can be used for the management of which of the following malignancies? A Advanced renal cell carcinoma . B Ovarian cancer . C Thyroid cancer . D Glioblastoma . Quiz 3 - Inflammation, immunity Q UE STI O N 1 1. The pathogenesis of systemic lupus erthematosus is characterized by autoantibody development. This results in: A Increased T-supressor cells . B B-cell increase . C Polyclonal Hypogammaglobulinemia . D Decreased T-suppressor cells and inhibited cellular activity . Q UE STI O N 2 1. Young adults who present with allergic rhinitis due to seasonal allergies often present with A Allergic shiners and Dennie-Morgan lines . B Mouth breathing and skiers nose . C Thick nasal discharge and sneezing . D Flushed face and fever . Q UE STI O N 3 1. A nurse from the operating room comes into the clinic with complaints of SOB, itchy reddened skin and wheezing. He says that he does not seem to have the symptoms when he is not working. Based on this history and presentation the AGPNP would evaluate for: A Indoor toxic mold exposure . B Bronchitis . C Latex allergy . D Contact dermatitis . Q UE STI O N 4 1. What are the cardiovascular effects of anaphylactic shock? A ST segment and T wave changes . B Hypertension . C Prolonged PR and elevated QT segment . D Elevated serum cardiac enzyme levels . Q UE STI O N 5 1. Which of the following is not one of the three main antigen-presenting cell types? A Dendritic cells . B B Lympocytes . C Natural killer cells . D Macrophages . Q UE STI O N 6 1. An adult patient is concerned that she has a significant reaction to poison ivy every Spring with a rash that appears on the ventral surface of the arms in the anticubital fossa. The rash is flat and erythematous and comes on suddenly with exposure to grass. Which statement best describes the trigger of this dermatologic reaction? A Poison ivy is very common in the spring and exposure results in immediate reaction . and symptoms B Plants that flower in the spring are laden with pollen that most likely will cause this type of . symptom C Type IV hypersensitivity reactions are common in the spring with direct exposure to the . antigen D Type I hypersensitivity reactions result in immediate Sx upon exposure to the antigen . Q UE STI O N 7 1. Recognition of self vs. non-self by the adaptive immune system in humans is accomplished in which of the following ways? A Exposure of B cells to the body’s own antigens in the thymus . B Exposure of B cells to the body’s own antigens in the bursa of . Fabricius C Exposure of T cells to the body’s own antigens in the bursa of . Fabricius D Exposure of T cells to the body’s own antigens in the . thymus Q UE STI O N 8 1. After a bone marrow transplant the NP understands the following about graft verses host disease(GVHD) and would select which best response? a The most common sites include skin, GI tract and liver. . b GVHD develops more than100 days post transplant and . immunosuppresive medications are started at diagnosis. c The strategy to prevent GVHD includes prophylactic immunosuppressive medication and . GVHD develops within 100 days post transplant. d Acute GVHD is graded from 1-3 with 3 being the most severe type seen. . Q UE STI O N 9 1. In the developing fetus, prenatal hematopoiesis (the differentiation and development of immune cells) is not generally known to occur in which of the following organs? A Spleen . B Liver . C Lymph nodes . D Appendix . Q UE STI O N 10 1. In older adults H1 histamine blockers may cause which side effect? 1 Ataxia . 2 Nausea . 3 Bradycardia . 4 Gastrointestional effect . Q UE STI O N 11 1. What medications are drugs of choice for secondary treatment of anaphylactic reaction A Antibiotics and anticholonergics . B NSAIDS and decongestants . C Decongestants and expectorants . D Antihistamines and corticosteroids . Q UE STI O N 12 1. A pathology report notes that a granuloma was seen in the lung of your patient. The patient asks for a copy and explanation of this report. What should you say to best explain? A An accumulation of WBCs that fight persistent bacterial infections . B An accumulation of granulocytes including neutrophils, eosinophils, and basophils . C A small area containing pus made up of apoptotic PMNs with liquefactive necrosis . D A small area of pre-scar tissue containing new capillaries and fibroblasts . Q UE STI O N 13 1. Regarding the inflammatory response: A Tissue swelling is the first stage of the inflammatory response. . B Mast cells secrete chemotactic agents that attract lymphocytes . C Macrophages secrete vasoactive materials during the inflammatory . response D The inflammatory response can be triggered by antibody binding to the . surface of micro-organisms. Q UE STI O N 14 1. An adult comes to the clinic reporting that she was at the mall and had a salad at the food court and know she has difficulty breathing. She has a peanut allergy, but has eaten no peanuts. The NP knows that she should give the following medication initially: A Epinephrine . B Lidocaine . C Benedryl . D Prednisone . Q UE STI O N 15 1. A systemic IgE mediated antigen-antibody response resulting in a life-threatening massive release of mediators is: A Recurrent urticaria . B Allergic Rhinitis . C Anaphylaxis . D Contact dermatitis . Q UE STI O N 16 1. Which two tests are the most reliable for detecting IgE antibody? A Skin testing and serum immunoCAP tersting . B Nasal smear for esinophils and urine . C CBC and western blot tesing . D IgE serum immunofixation and esinophil smear . Q UE STI O N 17 1. The release of histamine results in what effects on the body? A Bronchspasm, vasodilation, and vascular permeability . B Bronchdilation, vasodilation, and vascular permeability . C Smooth muscle contraction, decreased vascular permeability and vascoconstriction . D Pain, increased vascular permeability and bronchodilation . Q UE STI O N 18 1. Which of the following cell types of the innate immune system does not perform phagocytosis? A Neutrophils . B Basophils . C Macrophages . D Esinophils . Q UE STI O N 19 1. Humoral immunity is a type of adaptive immunity that results in the circulation of which of the following throughout the blood? A Macrophages . B Antigens . C Antibodies . D Natural killer cells . Q UE STI O N 20 1. Which blood cell is responsible for the activation of the immune response? A Band neutrophil . B T4 Lymphocyte . C Segmented neutrophi . l D B Lymphocyte . Q UE STI O N 21 1. What test is ordered to determine the concentration of gamma globulins that contain the majority of the immunoglobulins A C-Reactive protein . B Complement fixation . C Protein electropheresis . D Antinucular antibody (ANA) . Q UE STI O N 22 1. To diagnose allergic rhinitis the NP would : A Skin testing . B Nasal smear foe esinophils . C Total serum igE testing . D Order a serum radioallergosorbent testing . Q UE STI O N 23 1. What signs and symptoms are indicative of a Type I hypersensitivity reaction? A Contact dermititis . B Immediate flair and wheal formation . C Hematuria . D High Fever . Q UE STI O N 24 1. A patient is scheduled to have a chronic abscess incised and drained. What would you expect microscopic examination of the contents of the abscess to most likely show? A Neutrophils, lymphocytes,& plasma cells . B Lymphocytes and macrophages . C Any area of coagulative necrosis . D An acute inflammatory infiltrate of . PMNs Q UE STI O N 25 1. Myelogenous leukemias are caused by the cancerous production of innate (non-specific) immune system cells: in which tissue is such production most likely to occur? A Bone marrow . B Thymus . C Spleen . D Lymph nodes . Quiz 4 - antibiotics. Q UE STI O N 1 1. Which of the following drugs are know to cause rhabdomyolysis A Cefpodoxime . B Zithromax . C Daptomycin . D Avelox . Q UE STI O N 2 1. Which of the following drugs is recommended for the treatment of Gonorrhea? A Cefdinir . B Levofloxacin . C Ceftriaxone . D Amoxicillin . Q UE STI O N 3 1. Which of the following drugs has a warning for tendon rupture and CNS toxicities? A Linezolid . B Pipercillian-tazobactam . C Tobramycin . D Levofloxacin . Q UE STI O N 4 1. Which of the following drugs is a strong CYP3A4 inducer A Linezolid . B Rifamptin . C Azithromycin . D Levofloxacin . Q UE STI O N 5 1. Which of the following drugs may prolong the QTc interval especially when administered with other QTc prolonging drugs? A Clarithromycin . B Clindamycin . C Ampicillian . D Minocycline . Q UE STI O N 6 1. Tetracyclines 1 are considered safe in pregnancy . 2 are recommended in infancy . 3 should be given with antacids . 4 are active against psuedamonas aeruginosa . 5 are useful against the treatment of chlamydial infections . Q UE STI O N 7 1. Which of the following falsely elevates coagulation tests and its concomitant use with heparin is contraindicated? A Vancomycin . B Orbactiv . C Clindamycin . D Dalbavancin . Q UE STI O N 8 1. Which of the following nucleoside/nucleoside reverse transcripase inhibitors require hepatic dose adjustment? A Lamivudine . B Emtricitabine . C Tenofovir disoproxil fumarat . e D Abacavir . Q UE STI O N 9 1. Trimethoprim-sulfamethoxazole is contraindicated in which of the following conditions? A G6PD deficiency anemia . B Lead poisioning . C Beta Thalassemia anemia . D B 12 deficiency anemia . Q UE STI O N 10 1. Which of the following antiretroviral can not be used with protein pump inbitors? A Efavirenz . B Dolutegravir . C Abacavir . D Rilpivirine . Q UE STI O N 11 1. Which of the following diseases indicates a need for Baloxivir marboxil? A Genital herpes . B Urinary tract infection . C Influenza . D Hepatitis C virus . Q UE STI O N 12 1. A cross sensitivity may occur between penicillin and: 21. tetracycline . 2 erythromyci . n 3 cephalexin . 4 zidovudine . Q UE STI O N 13 1. A patient with a bacterial infection that is susceptible to Meropenem (Merrum) requires treatment. The patient reports uticaria and puritus when administered Merrum in the past. Which of the following is the best action by the NP when no other medications are available? A Administer Ciprofloxacin . B Inform the patient there is no other medication available . C Administer reduced dose Merrum . D Begin desensitization therapy . Q UE STI O N 14 1. A 27 year old man with HIV and hepatitis B is hospitalized for treatment of his Hepatitis B. He is started on interferon. After administration he develops fever, chills and myalgias. PE reveals that lungs are clear to auscultation bilaterally. What is the most likely explanation for this reaction? A Expected adverse reaction . B Drug toxicity . C Underlying bacterial pneumonia . D Underlying viral pneumonia . Q UE STI O N 15 1. A male presents to the clinic complaining of a painful ulcer on his genitals. A close examination reveals that the ulcer is surrounded by a halo. Given the most likely diagnosis, which of the following will NOT be prescribed? A Doxycycline . B Ceftriaxone . C Azithromycin . D Ciprofloxacin . Q UE STI O N 16 1. Which of the following drugs causes oto-toxicity and nephrotoxicity? A Tetracycline . B Amikacin . C Metronidazole . D Daptomycin . Q UE STI O N 17 1. A 35 year old african american male in the military is hospitalized with a MRSA skin infection. The patient is started on an antibiotic and becomes jaundice and anemic. On peripheral blood smear Heinz bodies are seen within the RBC's. What is the mechanism of action of the antibiotic given to this patient? A Acts at the 50s ribosomal subunit to inhibit peptide bond formation . B binds to the 30s ribosomal subunit and prevents tRNA attachment . C Inhibits folic acid metabolism . D Inhibits DNA dependent RNA polymerase . Q UE STI O N 18 1. Which types of toxicity are significant risks associated with the use of aminoglycosides? 21. Hepatotoxicity and bone marrow . toxicity 2 Neurotoxicity and ototoxicity . 3 Nephrotoxicity and ototoxicity . 4 Hepatotoxicity and nephrotoxicity . Q UE STI O N 19 1. A 42 year old female who is obese and has a Hx of gallstones and cholecystitis c/o superficial skin swelling and itching. PE by the PCP reveals skin erythema, tenderness and swelling consistent with cellulitis. The pt. is given a prescription for erythromycin. Which of the following effects must the treating provider be aware of? A Cholestatic jaundice . B Tinnitus . C Nausea/vomiting . D Mild abdominal discomfort . Q UE STI O N 20 1. Which of the following inhibits two sequential steps in the folate-synthesis pathway, ultimately inhibiting DNA synthesis? A Piperacillin-tazobactam . B Bactrim . C Unasyn . D Valtrax . Q UE STI O N 21 1. Which of the following drugs can be given by a single IV infusion for the treatment of skin and skin structure infection? A Vancomycin . B Cubicin . C Oritavancin . D Clindamycin . Q UE STI O N 22 1. Which is the primary parameter that drives the decision as to whether to prescribe quinolones? 1 Location of infection . 2 Severity of infection . 3 Patient age . 4 Patient immune status . Q UE STI O N 23 1. A 6 year old boy from CT presents to his PCP with a bulls eye rash on his upper left arm after he went hiking with his family a couple of days ago. He also has had intermittent fevers and muscle aches. The blood test for Lyme disease is positive. He has a Hx of traumatic hearing loss in his left ear. what side effect would prevent the PCP from treating him with doxycycline? A Ototoxicity . B Discoloration of teeth . C Megaloblastic anemia . D Worsening leg cramps and myalgias . Q UE STI O N 24 1. Before initiating darunavir what must be verified? A Sulfa allergy staus . B HLAB*5701 satus . C Renal function . D Patient weight . Q UE STI O N 25 1. Which of the following is a common side effect of atazanavir? Insomnia Dizziness Scleral icterus Renal toxicity Q UE STI O N 26 1. Which of the following requires premedication with diphenhydramine and acetaminophen as well as IV fluids before administration? A Voriconazole . B Diflucan . C vancomycin . D AmBisome . Q UE STI O N 27 1. A 65 years old man with the PMH presents to the clinic with c/o acute onset of chills, and cough that started 2 days ago. The cough is productive and he has rust colored sputum. The patient also c/o sharp chest pain with coughing. He denies any pressure or radiation to his jaw. His vital signs are T-102 F, Pulse 100 beats per minute, and BP 130/80. The UA shows few epithelial cells and no leukocytes. Which of the following drugs would you prescribe for this patient? A Doxycycline 100mg BID X 7 days . B Azithromycin ER 500mg x1 followed by 250mg for total of 5 days . C Bactrim DS BID X 10 days . D Erythromycin BID X 10 days . Q UE STI O N 28 1. Which of the following antiretroviral has the fewest drug-drug interactions? A Atazanavir . B Efavirenz . C darunavir . D Raltegravir . Q UE STI O N 29 1. Which of the following drugs causes a disulfiram like reaction when used with alcohol? A Doxycyline . B Amoxacillian . C Metronidazole . D Clindamycin . Q UE STI O N 30 1. Which of the following drugs has only one approved indication; treatment of uncomplicated UTI? A Rifamptin . B Nitrofurantoin . C Biaxin . D Trimethoprim/Sulfamethoxazole . Q UE STI O N 31 1. Which of the following medications cause a class drug interactions with all intergrase strand transfer inhibitors? A H2 receptor antagonists . B Polyvalent cations . C Protein pump inhibitors . D warfarin . Q UE STI O N 32 1. A 28 year old female presents with a 4 x 5 cm purulent ulcer on her abdomen after a spider bite. A wound culture grows MRSA so IV vancomycin is started. While receiving her first dose, her face, neck and chest flush red. This reaction can best be described as : A Non hypersensitivity mast cell degranulation . B Type I hypersensitivity reaction . C Type II hypersensitivity reaction . D Type III hypersensitivity reaction . Q UE STI O N 33 1. Which of the following should not be used in a urinary tract infection? A Bactrim . B Avelox . C Levofloxacin . D Cipro . Q UE STI O N 34 1. Which of the following antibiotics treats infections caused by Pseudomonas aeruginosa? A Ceftriaxone . B Moxifloxacin . C Linezolid . D Piperacillin-tazobactam . Quiz 5 - Neuro meds. Q UE STI O N 1 1. In the management of acute alcohol withdrawal deliriem which three drugs would the NP consider using? A Wellbutrin, librium, thiamine . B Ativan, Thiamine, Celexa . C Librium, Ativan and Haldol . D Librium, ativan and . thiamine Q UE STI O N 2 1. The NP is aware that the following class of drugs is most likely to precipitate a HTN crisis in an older adult? A MAO inhibitirs . B Narcotic analgesics . C Barbituates . D Phenothiazines . Q UE STI O N 3 1. The most common side effect of selective serotonis reuptake inhibitors is a dry mouth. True False Q UE STI O N 4 1. A 79 year old man with Alzheimers disease is found to have significant elevated LFT's on routine follow-up exam. Which of the following medications should be maintained at current doses in this patient? A Donepezil . B Rivastigmine . C Galantamine . D Tacrolimus . Q UE STI O N 5 1. Which product would be the savest choice to prescribe for an 81-year old patient with insomnia 1 Diphenhydramine (Benedryl) . 2 Oxazepam (Serax) . 3 Ramelteon(Rozerem) . 4 Doxepin (Silenor) . Q UE STI O N 6 1. An 82 year old male who is on a stable dose of Lasix for heart failure comes in with complaints of feeling down after losing his wife. After assessing the patient the NP diagnoses the pt with depression and starts him on citalopram. The NP knows that the patient is at increased risk for : A Hyponatremia . B Hypernatremia . C Hyperkalemia . D Hypokalemia . Q UE STI O N 7 1. Which of the following atypical antipsychotics has the highest incidence of weight gain? A Abilify . B Zyprexa . C Seroquel . D Geodon . Q UE STI O N 8 1. Which of the following antiepileptic drugs can be used in status epilecticus? A lamatrigine . B Levetiracetam . C Topiramate . D Oxcarbazepine . Q UE STI O N 9 1. Adverse effects of typical antipsycotics include cogwheel rigidity. True False Q UE STI O N 10 1. Patients taking monoamine oxidase inhibitors shold not eat fava beans with Chianti. True False Q UE STI O N 11 1. One week into zertraline (Zoloft) therapy, a patient complains of recurrent dull frontal headache that is relieved by acetaminophen. Which is true in this situation? 1 This is a common, transient SE of SSRI therapy . 2 Desipramine should be added . 3 She should discontinue the medication . 4 Fluoxetine should be substituted . Q UE STI O N 12 1. Tricyclic antidepressants can cause cardiac arrythmias in overdose True False Q UE STI O N 13 1. An older adult presents with acute confusion over the last 24 hours. Which assessment would be a priority for the NP to evaluate during the exam? A Medication review . B EKG . C Mini mental exam . D Thyroid profile . Q UE STI O N 14 1. Which medication would cause the NP the greatest concern based on a review of a medication list belonging to a 68 year old male who fell from a ladder hitting his right parietal region on asphalt? Ginseng Skelaxin Omeprazole Acetaminophen Q UE STI O N 15 1. What laboratory tests would be important to assess before placing a patient on Lithium? A TSH, T4, T3 Electrolytes, BUN and . creatinine B Fasting lipids, electrolytes . C ESR, CRP and lipid panel . D ALT, AST, LDH, Thyroid panel . Q UE STI O N 16 1. Which medications class is recognized for the treatment of moderate to severe dementia? A Cholinesterase inhibitors . B NMDA receptor antagonists . C SSRI's . D Central alpha 2 agonists . Q UE STI O N 17 1. Current pharmacological therapy for relapsing-remitting multiple sclerosis is: Interferon B (betaseron) High dose steroids Baclofen (Lioresal) Benzodiazepines Q UE STI O N 18 1. The preferred antidepressant for an older adult is : A Amitriptylline . B Citalopram . C Trazadone . D haloperidol . Q UE STI O N 19 1. A patient is taking antiepileptic medication. The NP understands that the antiepilectic medication: A Must be taken indefinitely . B Is usually discontinued after 4 years of no seizure activity, and EEG confirms lack of seizures . C Is usually given in combination with other antielileptics or sedatives to reduce the seizure . threshold. D Must be given to all patients who have a seizure . Q UE STI O N 20 1. A patient is on Depakote for bipolar disease. The NP knows that what tests need to be monitored? A Liver functions and CBC . B Pulmonary function tests . C EKG . D Urinanalysis . Q UE STI O N 21 1. A patient comes to a rural clinic having taken an undetermined amount of heroin. Before transferring the patient to a psychiatric treatment facility, the NP anticipates the drug of choice for an opioid overdose is: A Clonidine . B Methadone . C Naloxone . D Naltrexone . Q UE STI O N 22 1. An older adult has a diagnosis of dementia and is taking Haldol 2 mg every evening. The NP observes her engaging in a restless repetitive with her legs. The patient states that not only does she have ongoing movement but she also feels jittery. The NP would interperet this activity of movement as : A Ataxia . B Akathisia . C Agitation . D Dyskinesia . Q UE STI O N 23 1. What medication group is considered first line treatment for anxiety in the older adult? A Benzodiazepine . B Selective serotonin reuptake inhibitor . C Tricyclic antidepressants . D Atypical antipsychotics . Q UE STI O N 24 1. The NP is aware that patients that take atypical antipsychiatics have a higher risk of which three conditions? Choose all that apply A Weight loss . B Hypercholesteremia . C Diabetes . D Metabolic Syndrome . E. Pulmonary infection Q UE STI O N 25 1. Which of the following seizure medications is used to treat fibromyalgia? A Phenytoin . B Pregabalin . C Phenobarbital . D Carbamazepine . Q UE STI O N 26 1. A NP is prescribing an antidepressant medication for an older adult. What is the important consideration about starting doses? A Reduce starting dose by 50% . B Reduce starting dose by 10% . C Increase starting dose by 25% . D Order the normal theraputic dose . Q UE STI O N 27 1. The family of a patient with Parkinson disease brings him to the clinic because he is experiencing increasing difficulty with ambulation. The NP increases the pt's dose of Carbidopa25mg/levodopa 100mg from 3x day to 4x day. What is the important for the NP to teach the family regarding the increase in dose of this medication? A Sleep disorders are common side effects of carbidopa/levodopa . B Carbidopa/levodopa has shown efficacy in slowing down the progression of disease . C Orthostatic hypotension can be problematic at higher doses . D The medication should be given on an empty stomach . Q UE STI O N 28 1. What is the best initial treatment plan for a sleep disorder in an older patient? A Medicate with amitriptyline . B Medicate with trazodone . C Discuss the importance of naps daily . D decrease noise and light in the sleeping environment . Quiz 6 - Pain Meds Q UE STI O N 1 1. A medication which is effective when administered in a transdermal patch is which of the following? 1 codeine . 2 morphine . 3 fentanyl . 4 meperdine . Q UE STI O N 2 1. Which of the following is an advantage of Celecoxib over other NSAIDS? A Less GI side effects . B Safer in pregnancy . C Fewer CV effects . D Safer in renal impairment . Q UE STI O N 3 1. Hydrocodene-Ibuprofen is contraindicated in which of the following situations? A Stroke within the last 30 days . B Active tobacco use . C Asthma, urticaria, or allergic resections to aspirin or other NSAIDS . D Concomitant use of lidocaine products . Q UE STI O N 4 1. A patient tells you that he takes two acetaminophen every four hours while awake for pain from a bad back. You are concerned that he may be close to the maximum adult dose. You know that this is: 1 1to 2 grams/day . 2 2to 3 grams/day . 3 3 to 4 grams/day . 4 5 to 6 grams/day . Q UE STI O N 5 1. Which of the following should be included in an assessment before prescribing an opiod analgesic? Choose all that apply. 1 blood clotting times . 2 the level of pain rated on a scale . 3 prior analgesic use (time, type, amount and effectiveness) . 4 dietary history . 5 allergies . 6 concurrent medications . Q UE STI O N 6 1. A symptom of chronic opiod use/abuse is: 1 dialated pupils . 2 agitation . 3 diarrhea . 4 constricted pupils . Q UE STI O N 7 1. The NP is examining an older adolescent who has been a long term IV cocaine abuser. What other findings would alert the NP to a frequent complication of abuse of this drug? A Epistaxis and chronic rhinorrhea . B cardiac arrhythmias and HTN . C Chest congestion and wheezing . D Hepatitis and cellulitis . Q UE STI O N 8 1. First line therapy for acute low back pain would include use of which of the following? 1 NSAIDS . 2 muscle relaxants . 3 opiods . 4 a combination of the above . Q UE STI O N 9 1. The NP physical exam on an adolescent is as follows: disheveled appearance, 5 lb weight loss since the last visit 2 months ago, pulse strong and regular at 128, + 4 DTR, nasal mucosa erythematous and ulcerated. Her mother relates that she has been getting into trouble at school, has no appetite and is not sleeping much at night. The NP suspects: A Heroin abuse . B Crack Cocaine abuse . C LSD abuse . D Marijuana abuse . Q UE STI O N 10 1. While taking a history, the NP is aware that the following drug most commonly used y adolescents first is: A Nicotine . B Alcohol . C Marijuana . D Crack Cocaine . Q UE STI O N 11 1. Concomitant administration of NSAIDS and ACE inhibitors can increase the risk of which of the following? A Renal toxicity . B Hepatotoxicity . C Bleeding . D Hypotension . Q UE STI O N 12 1. A centrally acting alpha 2 adrenergic agonist that assists with opioid withdrawal is Clonidine Narcan Vivitrol Antiabuse Q UE STI O N 13 1. Illicit drug use is greater in which age group? A 18 to 25 year olds . B 14 to 23 year olds . C 22-28 year olds . D 16-26 year olds . Q UE STI O N 14 1. Nonsteroidal anti-inflammatory medications are frequently used in the treatment of low back pain. It is important to remind a patient to: exercise at least 1/2 hour after taking medication take medication once a day take antacids 1 hour after taking NSAID Take NSAID's with food Q UE STI O N 15 1. Prescription Drug Monitoring Systems were implemented in 2011. Prior to prescribing a controlled substance for longer than hours a prescriber must log on to the system and check a patients history regarding controlled substances. 48 (2 days) 24 (1 day) 72 (3 days) 168 (one week) Q UE STI O N 16 1. Moderate to severe pain is best treated with which of the following? 1 acetaminophen . 2 opioid antagonists . 3 benzodiazapines . 4 opiod analgesigics . Quiz 7 - Cardiac meds. 1. A patient arrives in the ED of a small rural hospital c/o feeling like his heart is racing. He is connected to a cardac monitor and it reveals supraventricular tachycardia at a rate of 184 bpm. QRS is < 0.10 seconds and BP of 112/62. Which treatment modality is indicated? A Synchronized cardioversion . B Adenosine . C Amiodarone . D Cardizem . Q UE STI O N 2 1. Which of the following drugs are available OTC as a dietary supplement? Select all that apply Fish oils Niacin Exetimibe Lipitor Q UE STI O N 3 1. Which of the following drugs does JNC 8 recommend for white adults with microalbuminuria? A Ace inhibitors . B Diuretics . C Calcium Channel Blockers . D Beta Blockers . Q UE STI O N 4 1. An elderly woman has been on Digoxin for 15 years. Her EKG now shows new onset atrial fibrillation. She c/o nausea, vomiting, anorexia and abdomial pain and appears confused. All of the following are appropriate interventions except: Order a serum potassium level and creatinine Order a CXR Order a digoxin level Order a fingerstick for glucose Q UE STI O N 5 1. A 60 year old male presents too the ED with a Hx of unstable angina and increased chest pain. that is not relieved by NTG. During the assessment the NP notes elevation of the ST segment on the patients EKG. His BP is 130/90 and HR 82. O2 therapy is started and an IV line is inserted. What other theraoy should be initiated while arranging transfer to a different facility? A Lidocaine drip and ASA . B Lopressor 100mg po and ASA . C Morphine 2 mg IVP and Lopressor 5 mg IVP . D ASA and Morphine 2 mg IVP . Q UE STI O N 6 1. Thiazide diuretics have been shown to have an efect on the bones making then a desirable treatment option in women with HTN who have osteopenia and osteoporosis. What is the mechanism of action for their effect on the bones? A Thiazide diuretics decrease calcium excretion and stimulate osteoclast production . B Thiazide diuretics increase both calcium and magnesium by the kidneys . C Thiazide diuretics increase bone mineral density . D Thiazide diuretics influence electrolyte excretion by the kidneys . Q UE STI O N 7 1. A middle aged Hispanic patient with Type 2 DM, chronic bronchitis and HTN is currently on HCTZ 12.5 mg daily, and has gained 6 pounds. His BP is 140/90 and pulse 82 bpm with RR 12 breaths per minute. Which of the following is the best choice for this patient? A Beta Blockers . B Ace inhibitors . C Calcium Channel Blockers . D Alpha Blockers . Q UE STI O N 8 1. A 55 year old women has been diagnosed with Stage 2 HTN. Her PMH involves migraine headaches. Her EKG reveals second degree heart block. The CXR is normal. Which of the following drugs should this Pt avoid? A Calcium channel blockers . B Ace inhibitors . C Diurectics . D ARB's . Q UE STI O N 9 1. A middle aged male with no known risk factors for CAD presents with total cholesterol levels of 255 mg/dl. The AGPCNP would: A Start him on a HMG-CoA reductase inhibitor . B Re-evaluate the total cholesterol in 8 weeks . C Repeat total cholesterol and obtain HDL and calculated LDL levels . D Do nothing because the patient does not have risk factors . Q UE STI O N 10 1. A women is in her first trimester of pregnancy and develops HTN. The NP knows that the drug she should order is : A Labetolol . B Metroprolol . C HCTZ . D Cardizem . Q UE STI O N 11 1. The most current JNC8 recommendation for Blood Pressure control in diabetic patients is: A <140/90 . B < 130/85 . C < 130/80 . D < 125/75 . Q UE STI O N 12 1. Agranulocytosis, pancytopenia and hyperglycemia can all be side effects of the following diuretic? A ??? Furosemide . B Diamox . C Zaroxolyn . D HCTZ . Q UE STI O N 13 1. Which of the following antihypertensive classes should be weaned off when discontinuing the drug in patients that have been taking it for many years? A Diurectics . B Beta blockers . C Ace inhibitors . D Calcium channel blockers . Q UE STI O N 14 1. A hypertensive middle aged native american has recently been diagnosed with renal insufficiency.He has been on lisinopril (Accupril) for many years. Which of the following laboratory tests should be monitored carefully? A Hg, HCT, and MCV . B Serum creatinine and GFR (glomerular filtration rate) . C AST and ALT . D Serum sodium, potassium and magnesium . Q UE STI O N 15 1. A possible side effect of an ace inhibitor is: A Dry hacking cough . B Mild wheezing . C Hypokalemia . D Increased serum uric acid level . Q UE STI O N 16 1. Which of the following drugs can be used for binding toxicologic agents? A Cholestyramine . B Fenofibrate . C Simvastatin . D Omega-3 fatty acids . Q UE STI O N 17 1. Mr Barker is a 62 year old male with a PMH of HTN, Stage 3 kidney disease and stage 3 heart failure. It is increasing difficult for him to complete his ADL's. His cardiologist prescribes Entresto. What important parameters should be monitored in this patient? A Pro BNP and LFT's . B Thyroid function and electrolytes . C LFT's and electrolytes . D Electrolytes and renal function . Q UE STI O N 18 1. Which of the following antihypertensive medications should the NP avoid in a patient that has emphysema? A Calium channel . blockers B Ace inhibitors . C Diurectics . D Beta Blockers . Q UE STI O N 19 1. based on the ACC/AHA guidelines the following statins doses are considered high intensity? A Atorvastatin 80 mg daily . B Rosuvastatin 40 mg daily . C Simvastatin 20 mg Qhs . D Lovastatin 40 mg Qhs . Q UE STI O N 20 1. Before starting therapy with HMG-CoA reductase inhibitors which of the following laboratory tests should be checked? A Liver function tests . B CBC . C Lupus anticoagulant . D EKG . Q UE STI O N 21 1. During an episode visit blood pressure readings of 170/90 are obtained on a women with a 10 year history of controlled Stage 1 HTN and osteoporosis. Her knees are slightly deformed and she is c/o severe pain in her left knee. She has been self-treating with over the counter naproxen sodium (Aleve) BID for the past 2 months. How do non-steroidal anti inflammatory drugs affect blood pressure in the body? A They cause vasoconstriction of the arterioles . B They have an adverse effect on the kidneys and can elevate blood pressure . C A drug-drug interaction is a common finding in these patients . D They are not associated with adverse effects in HTN patients . Q UE STI O N 22 1. A 54 year old women with severe refractory HTN to treatment is switched to a new drug regime one month ago. Her blood pressure is currently under control. She comes in now c/o excessive hair growth. What antihypertensive is she taking? A Hydrochlorthiazide . B Isosorbide dintrate . C Minoxidil . D Nifedipine . Q UE STI O N 23 1. Which tubule produces the greatest diuresis? A Proximal . B Loop of Henle . C Distal . D Cortical Collecting Tubicles . Q UE STI O N 24 1. A 63 year old male is currently taking carvedilol. He returns to his PCP for follow-up. His BP is 130/70 at this office visit. His cardiac, pulmonary and abdominal exams are all within normal limits. Additional beneficial effects of this medication may be which of the following? A Hypoglycemia . B Improved vascular wall thickening . C Increased lipid peroxidation . D vasoconstriction . Q UE STI O N 25 1. A 63 year old man presents to the ED with worsening heart failure following a MI 2 weeks previously. The pt c/o SOB. PE reveals +2 pitting edema at ankles, and an S3. PMH is significant for an allergic reaction to trimethoprim-sulfamethoxazole. The NP wants to order furosamide as part of this patients regimen. Which drug should the NP order? A Actazolamide . B Ethacrynic acid . C Hydrochlorothiazide . D The best drug to use in this case is the furosamide . Q UE STI O N 26 1. A 65 year old man has been on atorvastatin 60 mg daily for the past 3 months. Two weeks ago he started to take high dose B complex vitamin. He is c/o fatigue and denies lack of sleep. He has noticed that his appetite is is poor and his urine has been a darker color for the past 2 weeks. He denies dysuria, frequency or nocturia. The NP notices that there is a slight yellow tinge to his sclera. You would: A Discontinue atorvastatin and check LFT's . B Continue atorvastatin but half the dose . C Schedule him for a complete physical exam . D Schedule him for LFT's . Q UE STI O N 27 1. The maximum dose of Furosimide is /day A 600 mg/day . B 240 mg/day . C 160 mg/day . D 80 mg/day . Quiz 8 - Respiratory meds. Q UE STI O N 1 1. An otherwise recentley healthy non-smoking patient presents with a dry cough for the last 5 months. She has a history of HTN and GERD. She is on ranitidine (Zantac) 150 mg po BID and Lisinopril ( Zestril) 20 mg po daily. The treatment that may yield the highest probability of success include: Discontinue ranitidine Starting albuterol (Proventil) inhaler, 90 mcg every 4 -6 hours as needed Starting dextromethorphan 20 mg every 4 hours as needed Discontinuing lisinopril Q UE STI O N 2 1. A long acting bronchodilator used in the treatment of asthma is: 1 epinephine . 2 zafirlukast . 3 theophylline . 4 salmeterol . Q UE STI O N 3 1. A patient with a long history of COPD has noticed an increase in dyspnea and a change in sputum over the past few days, with increased amounts of thick, yellow-green mucus and congestion. What would be the appropriate therapy? A Loratadine (Claritin ) 10mg po daily . B Amoxicillian/clavulanate (Augmentin) 500mg/125mg po 3 x daily for 10 days . C Acetaminophen with codiene 300mg/30mg po every 6 hours as needed . D Beclomethasone (Qvar) 40 mcg MDI 2 puffs every 4 hours as needed . Q UE STI O N 4 1. Frequent use of bronchodialators may cause which adverse effects? Choose all that apply 1 blurred vision . 2 increased heart rate . 3 decreased heart rate . 4 nausea . 5 nervousness . 6 tremors . 7 headache . Q UE STI O N 5 1. With the goal of loosening bronchial secretions so that they can be eliminated by coughing, the best medication to prescribe would be which of the following? 1 benzonate (Tessalon) . 2 guaifenesin (Robitussin) . 3 hydrocodone (Hycodan) . 4 phenylephrine (Neo-Synephrine) . Q UE STI O N 6 1. The NP knows that one of the following over the counter preparations in high doses can cause euphoria, disorientation, paranoia, and hallucinations and has been know to be abused by adolesants? A Pseudoephedrine . B Diphenhydramine . C Guaifeneesin . D Dextromethorphen . Q UE STI O N 7 1. For patients taking a leukotrine antagonist, the nurse should include which of the following in patient teaching? 1 if a dose is missed, the patient may double the dose to maintain blood levels . 2 the patient should gargle and rinse after taking the medication . 3 the medication should be taken at the first sign of a bronchospasm . 4 improvement should be seen within a week of use . Q UE STI O N 8 1. Which of the following agents is used to treat nicotine dependance? A Ativan . B Multivitamins . C Zoloft . D Bupropion . Q UE STI O N 9 1. The side effects of antihistamines are mostly due to there side effects of: A Immune system effects . B Sedating effects . C Anti inflammatory effects . D Anticholinergic effects . Q UE STI O N 10 1. A side effect of drugs administered by inhalation is which of the following? 1 dizziness . 2 sweating . 3 bradycardia . 4 inflammatory response . Q UE STI O N 11 1. All of the following drugs can interact with Theophylline except A Montelukast . B Erythromycin . C Cimetidine . D Phenytoin . Q UE STI O N 12 1. Sue is a 32 year old female who comes to your practice c/o increased difficulty breathing during exercise and she also feels it is worst at night. She has a PMH of tobacco abuse in her 20's but she quit 5 years ago. She denies sputum production. PMH- asthma as child, hypothyroidism, GERD. Her exam shows some expiratory wheezing and chest tightness, minimal secretions. You preform a pulmonary function test and find that her FEVI/FVC is reduced. What do you think the diagnosis is A Pneumonia . B COPD . C Asthma . D Empysema . Q UE STI O N 13 1. The NP has diagnosed community acquired pneumonia in a healthy adult with no comorbidities and no previous antibiotic use within the last 3 months. The NP should prescribe: A Doxycycline 100 mg po BID x 10 days . B Amoxicillin 500 mg po TID X 10 days . C Azithromycin 500mg po once then 250mg daily for 4 days . D Ciprofloxacin 500mg po daily X 7 days . Q UE STI O N 14 1. The diagnostic gold standard for COPD is a change in FEVI of between prebroncodilaters and post A 12% . B 14% . C 25% . D 20% . Q UE STI O N 15 1. An asthmatic 20 year old woman who was seen for a viral upper respiratory infection 2 weeks ago presents to the NP office complaining of a recent onset of SOB, inspiratory and expiratory wheezing and chest tightness. She has been using her albuterol inhaler 4-6 times a day with poor relief.She is unable to speak in full sentences. When the NP quickly evaluates her she notices that she is pale, diaphorectic, fatigued and using accessary muscles. Her RR is 32 and pulse 130. Which of the following interventions is not indicated? Administer oxygen by nasal cannula Give the patient a nebulized Beta 2 agonist Quickly assess the patient with oxygen saturation and breath sounds Start CPR immediately Q UE STI O N 16 1. What medications are used in the treatment of allergic rhinitis? A Antihistamines, corticosteroids and environmental control . B Antihistamines, analgesics and allergen control . C Anticholinergics, antibiotics and oral prednisone . D Nasal saline rinses, corticosteroids and antibiotics . Q UE STI O N 17 1. Which of the following drug classes is useful in the management of COPD? Anticholinergics Antibiotics Systemic Corticosteriods Antimalarial Drugs Q UE STI O N 18 1. Antitussive drugs are administered for: A Non productive coughs . B Productive coughs . C Dry hacky cough . Q UE STI O N 19 1. Susan goes to her PCP c/o sinus tenderness, stuffy nose with occasional thick white drainage. This started a week ago. She has had sick contacts because she teaches at a Daycare. She has no previous medical Hx. What would you prescribe her? ?? Saline drops A. B. Flonase C. Erythromycin D. Zithromax Q UE STI O N 20 1. An adult male comes to the clinic with c/o difficulty breathing over the past couple of days. He has a history of asthma and CAD. He was recently diagnosed with HTN. Exam reveals no JVD and no productive cough. Breath sounds are present, but expiratory wheezes are present bilaterally, and he denies chest pain. His vital signs are HR 72, RR 34, and BP 172/100mm Hg. His current medications include Proventil inhaler 2 puffs every 4 hours as needed for wheezing, NTG transdermel patch for CAD and propranolol (Inderal) 60 mg po BID, for his HTN. What is the best treatment for this patient? A Discontinue propranolol and begin amlodipine (Norvasc) 5 mg PO daily. . B Start a Prednisone burst with taper over 1 week. . C Discontinue Propranolol and start atenolol 50 mg PO daily. . D Start beclomethasone (Beclovent) inhaler 2 puffs 3-4 times daily . Q UE STI O N 21 1. In adults with asthma, the most common reason outpatient treatments fail, resulting in hospitializations is: A Exposure to allergens . B Increased use of steroids . C Improper inhaler technique . D Use of cromolyn inhalers . Q UE STI O N 22 1. According to the 2021 GOLD guidelines COPD should be considered in a patient presenting with which of the 3 symptoms: choose all that apply A Smoking History . B Chronic Cough . C Shortness of breath . D FEV1/FVC ratio of 0.75 . E History of alcohol and drug use . Q UE STI O N 23 1. Advair Diskus contains a combination of which medications? 1 salmeterol and epinephrine . 2 acetycysteine and fluticasone . 3 cromolyn and salmeterol . 4 salmeterol and fluticasone . Q UE STI O N 24 1. Which statements are true about prescribing anti-tussive medications (mark all that apply) most have a side effect of some sedation they can be given for productive coughs they are good for cough suppression patient taking chewable tablets or lozenges should not eat or drink for an hour after ingesting the medication Q UE STI O N 25 1. Which medication is most effective in promoting a decrease in airway inflammation as well as providing long term medication coverage in a patient with asthma? Montelukast ( Singular) Beclomethasone ( Vanceril); Beclovent) Albuterol Salmeterol (Serevent) Q UE STI O N 26 1. During a first time office visit the NP sees an adult female patient with a history of asthma. She had been using Proventil MDI once inhalation 2x monthly over the past several years. More recently she has been using her MDI inhaler 5-7 times per week. Based on the global initiative for asthma ( GINA) guidelines, the NP diagnoses partly controlled asthma and starts her on Step 2 therapy which includes: A Fluticasone and salmeterol ( Advair) 250mg/50mg one inhalation BID . B Fluticasone ( Flovent) 44 mcg 2 inhalations daily . C Fluticasone and (salmeterol) 100mg/50mg one inhalation BID Advair . D Salmeterol (serevent) 42 mcg one inhalation BID . Q UE STI O N 27 1. Your patient comes in complaining of increased SOB and wheezing x 2 days. Her present medications include albuterol prn (which she has used 5 times in the past 24 hours) and Advair 250/50 one puff bid. On examination you hear expiratory wheezes in both lungs. Recalling the stepwise management of asthma, what do you choose to do? send her to the ER Start her on a tapering dose of prednisone give an in office nebulizer treatment, increase her Advair to 2 puffs bid, continue the Albuterol and bring her back for evaluation in 2 days give her another puff of her Albuterol in the office and start her on an antibiotic (Avelox 400 mg qd x 7 days) Quiz 10 - Endo, bone, joint Q UE STI O N 1 1. Mr. Samules is a 58 year old Type 2 DM who is using a single 10 unit daily dose of the long acting insulin glargine. His fasting blood glucose has been between 141 - 180 mg/dl. Which of the following best describes the next step in his therapy? A Increase his glargine dose by 4 units per day . B increase his glargine dose by 8 units per day . C Continue on the current glargine dose . D Increase his glargine dose by 2 units per day . Q UE STI O N 2 1. What is associated with chronic overtreatment with Levothyroxine (Synthyroid)? A Tachycardia . B Osteoporosis . C Insomia . D Sweating . Q UE STI O N 3 1. Which type of antidiabetic agents act by increasing insulin production? 21. Sulfonylureas . 2 Alpha-glucosidase inhibitors . 3 Biguanides . 4 Thiazolidinediones . Q UE STI O N 4 1. A a nurse practitioner you know that all of the following are insulin analogs that can be used to manage diabetes except: A Lispro . B Sitagliptin . C Glargine . D Aspart . Q UE STI O N 5 1. After use, the onset of lispro (Humalog) occurs in: A less than 30 minutes . B approximately 1 hour . C 1-2 hours . D 3-4 hours . Q UE STI O N 6 1. A Patient with RA is placed on prednisone 5 mg PO daily. In teaching the patient about her medication, it would be important for the NP to include what information? A When the Sx subside she will be able to quit taking the medication . B It is important to take the medication as prescribed even after the redness and swelling . decrease. C Increased fluid intake is important to prevent renal damage by the steroids . D The medication should be taken about 30 minutes before eating . Q UE STI O N 7 1. Disease modifying drugs for RA in adults include: A Ibuprofen, sulindac (clinoril), Aspirin . B Misoprostol ( Cytotec) . C Corticosteroids . D Plaquenil, Sulfasalazine . Q UE STI O N 8 1. The sodium-glucose cotransporter 2 (SGLT2) inhibitor medications are known to contribute to which of the two following outcomes in patients with Type 2 diabetes? A Reduced A1C level and weight loss . B Weight gain and decreased FBS . C Decreased risk of vaginal yeast infections and increased risk of medullary thyroid cancer . D Urinary retention and UTI . Q UE STI O N 9 1. The action of oral hypoglycemic agents is which of the following? 21. stimulate the alpha cells in the pancreas . 2 decrease the number of insulin cell . receptors 3 decrease the peripheral uptake of glucosse . 4 suppress hepatic glucose production . Q UE STI O N 10 1. A middle-aged male presents for a diabetes follow-up exam. He has been in good health without identified complications of diabetes. His FBS is 100 mg/dl and his personal records indicate that he is taking insulin at the prescribed amounts and times. His vital signs are BP 142/98 mm Hg, pulse 80 beats per minute and RR 20 breaths/min. What actions would be included in todays plan? A Begin diuretic and a beta blocker . B Begin ACE inhibitor and consider a diurectic . C Obtain ECG and CXR . D Order a serum creatinine, urine microalbuminuria and return for BP check in 5-7 days . Q UE STI O N 11 1. In an older adult with Type 2 DM with gastroparesis, the use of which of the following medications should be avoided? A Byetta . B Novalog . C Amaryl . D Lantus . Q UE STI O N 12 1. Your patient Franklin age 64 has the following lab values: Elevated TSH, Low T4 and decreased T3. Which of the following drugs should be prescribed to treat his condition? A Methimazole . B Propranolol . C Levothyroxine . D Propylthiouracil . Q UE STI O N 13 1. For which patient would metformin be contraindicated? A A 30-year-old woman with type 2 diabetes . B A 45-year-old woman with a creatinine level of 1.2 mg/dL . C A 65-year-old man with respiratory alkalosis . D A 58-year-old man on digoxin for CHF . Q UE STI O N 14 1. Because of its effect on lactate metabolism, alcoholism or binge drinking contraindicates the use of which type of drug? 21. Meglitinides . 2 Triazolidinediones . 3 Glucosidase inhibitors . 4 Biguanides . Q UE STI O N 15 1. You consider prescribing insulin glargine (Lantus) because of its: A extended duration of action . B ability to prevent end organ damage . C ability to preserve pancreatic function . D rapid onset of action . Q UE STI O N 16 1. The NP is performing a preoperative exam on a man scheduled to undergo CABG. PE reveals mild facial puffiness, hoarse voice and dry skin. The results of a TSH show the patient has a TSH level of 34 mU/L. What is the recommended treatment for this patient? Give loading dose of IV bolus levothyroxine 500 mcg and proceed with surgery Cancel surgery and send him home to begin levothyroxine po 0.1 mg, then reschedule surgery. Begin po levothyroxine and monitor the patient in the hospital until he is euthyroid Proceed with surgery and treat the patients hypothyroidism postoperatively Q UE STI O N 17 1. The adult NP has a male patient with a creatinine of 1.8mg/dl. Which of the following drugs is contraindicated? A Actos . B Glucopage . C Prandin . D Precose . Q UE STI O N 18 1. What is the initial drug of choice for a patient with rhematoid arthritis? A Tramadol . B Aspirin . C Methotrexate . D Hydrocortisone . Q UE STI O N 19 1. An elderly women who is post menopausal complains about sores in her mouth from several inflammed ulcers near her gums and lips. Which medication would likely be causing this? Allegra Teriparatide Tymlos Alendronate Q UE STI O N 20 1. Insulins are identified by onset, peak and duration. Which of the following has an onset of 15 min, peak of 1 hour and duration of 3-5 hours? 21. Lantus . 2 Humulin 50/50 . 3 Humalog . 4 Levimir . Q UE STI O N 21 1. All of the following conditions are contraindicated for Metformin (Glucophage) except: A Renal disease . B Gross obesity . C Alcoholism . D Liver disease . Q UE STI O N 22 1. Daily ingestion of large amounts of calcium places the individual at risk for which problem? 21. Hypervitaminosis D . 2 Cholelithiasis . 3 Impaired absorption of . iron 4 Hypermagnesemia . Q UE STI O N 23 1. A 65 year old post menopausal women has been RX with alendronate for 6 years. Current screening indicates no increase in risk factors. Based on clinical guidelines, which treatment option would the NP suggest to the patient? A Discontinue medication at this time . B Switch medication from oral to sc route in order to maintain adequate coverage . C Add Vitamin D 500IU/ day to the treatment regime . D Increase calcium supplements to 1500mg/day . Q UE STI O N 24 1. Patient teaching for a patient prescribed antithyroid medications should include the need to avoid which foods? A processed meats and cheese . B dairy products . C Soy products and seafoods . D bananas and oranges . Q UE STI O N 25 1. Patients who begin therapy with levothyroxine should be told to expect effects from the medication. A within a few days . B immediately . C within a few months . D within a few weeks . Q UE STI O N 26 1. You are treating a patient who is recovering from Thyroid Storm. When reviewing the patients medications that they take as needed you advise the patient to avoid which of the following medications to avoid to decrease the risk of another thyroid storm crisis? A Naproxen . B Acetaminiphen . C Aspirin . D Ibuprofen . Quiz 11 - Hormones, renal, BPH Q UE STI O N 1 1. All of the following are true about the combined oral contraceptive except: 1 it is a mixture of a steroid and a peptide hormone . 2 it inhibits gonadotropin release . 3 it produces changes in the fallopian tubes, uterus and cervix . 4 often contains ethinyl estradiol . Q UE STI O N 2 1. An example of a urinary antiseptic is: 1 metolazone . 2 furosemide . 3 spironolactone . 4 nitrofurantoin . Q UE STI O N 3 1. A 30 year old woman develops secondary amenorrhea. An evaluation of hormone concentrations reveals low gonadotropins, low estradiol, mildly elevated prolactin, normal growth hormone, low thyroid hormone, normal thyroid simulating hormone, and normal corticol. Pituitary imaging reveals a large pituitary tumor with deviation of the pituitary salk. Which treatment would you recommend? 1 a gopamineric agonist in addition to estrogen and thyroid replacement therapy . 2 surgery followed by hormone replacement therapy . 3 a long acting dopamine agonist alone . 4 estrogen replacement therapy . 5 octreotide therapy . Q UE STI O N 4 1. All of the following systemic drugs interfere with the metabolism of oral contraceptives except: A tetracycline . B Ketoconazole . C Carbamazepine . D Corticosteroids . Q UE STI O N 5 1. Desmopressin acetate is useful in the treatment of which condition: 1 urinary tract infections . 2 prostatic hypertrophy . 3 erectile dysfunction . 4 enuresis . Q UE STI O N 6 1. Tocolytic drugs such as terbutaline (Brethine) and ritodrine (Yutopar) are used in which situation? 21. Prevention of preterm labor in the fifteenth week of a pregnancy. . 2 Prevention of preterm labor in the twenty-second week of a . pregnancy 3 Stimulation of contractions in prolonged labor. . 4 Stimulation of ovulation as part of infertility treatments. . Q UE STI O N 7 1. All of the following statements about hormone replacement therapy are true except: 1 should consist of both estrogen and progestogen components if the woman has an intact . uterus 2 may protect against cardiovascular disease . 3 protects against osteoporosis . 4 often contains ethinyl estadiol . Q UE STI O N 8 1. During the administration of finasteride (Proscar), the nurse practitoner must remember which important precaution when giving patient education? 21. It must be taken on an empty stomach. . 2 Finasteride should not be handled by pregnant women. . 3 It is given by deep IM injection to avoid tissue irritation. . 4 The patient should be warned that alopecia is a common adverse . effect Q UE STI O N 9 1. Pyridium is used in place of antibiotic for treating UTI's. True False Q UE STI O N 10 1. Tofranil 25 mg po q hs may be used as first line treatment for urge incontinence. True False Q UE STI O N 11 1. A patient is being treated for primary amenorrhea. The nurse expects which of the following drugs to be used to treat this problem? 21. oxytocin (Pitocin) . 2 estradiol transdermal (Estraderm) . 3 raloxifene (Evista) . 4 medroxyprogesterone (Provera) . Q UE STI O N 12 1. The funcitonal unit of the kidney is the: 1 nephron . 2 renal artery . 3 ureter . 4 posterior pituitary hormone . Q UE STI O N 13 1. The second dose of emergency contraceptive pills should be taken how many hours after the first dose? 1 12 . 2 4 . 3 6 . 4 24 . Q UE STI O N 14 1. A 30 year old woman experiences cessation of previously normal menses. An evaluation of hormone concentrations reveals low etradiol, low gonadotropins, elevated prolactin, normal cortisol, normal growth hormone, and normal thyroid hormone. Pituitary imagining reveals a small adenoma in the anterior pituitary. Which treatment would you recommend? 1 estrogen replacement therapy . 2 a long -acting dopaminergic agonist . 3 gonadotropin replacement therapy . 4 surgery . Q UE STI O N 15 1. If a 24 hour urine test indicates that a patient i secreting too much uric acid (>900mg/day) the NP would prescribe: A ASA 325mg po daily . B Tylenol 325 mg po q4-6h prn . C Indomethacin 25 mg po q 8h, then increase at weekly intervals by 25 mg daily . D Allopurinol (Zyloprim) 100mg po QID x 1 week then increase daily dose by 100mg to a . maximum of 300mg/day Q UE STI O N 16 1. The patient taking an oral contraceptive should be aware of potential drug interactions with which of the following medications? Select all that apply. a. doxycycline (Doryx), an antibiotic b. guaifenesin (Robitussin), an antitussive c. warfarin (Coumadin), an anticoagulant d. atenolol (Tenormin), a beta-blocker e. isoniazid (INH), an antitubercular drug f. ibuprofen (Motrin), an NSAID g. theophylline (Theo-Dur), a bronchodilator h. omeprazole (Prilosec), a proton pump inhibitor 21. D, G, H . 2 A, C, D, E, G . 3 all of the above . 4 A, B, C . Q UE STI O N 17 1. What is the correct drug therapy for an adult with an acute episode of gout? A Indomethacin 25mg po prn . B Naproxen 100mg po BID . C Colchicine 0.6mg 2 tablets po x1 then repeat in 1 hour x1 . D Indomethacin 50 mg q8hrs x 6-8 doses then 25 mg q 8 hrs until resolution . Q UE STI O N 18 1. When combination oral contraceptives are given to provide post coital emergency contraception ("morning after pill"), the NP should remember which of the following facts. 1 they are not effective if the woman was previously already pregnant . 2 they should be taken within 12 hours of unprotected intercourse . 3 they are given in one dose . 4 they are inteded to terminate pregnancy . Q UE STI O N 19 1. The urinary tract analgesic used to treat interstitial cystitis is which of the following? 21. Ditropan . 2 Elmiron . 3 Pyridium . 4 Ciprofloxin . Q UE STI O N 20 1. A patient should receive a tetanus booster if they have not had one in the last ? 1 6 months . 2 5 years . 3 10 years . 4 2 years . Q UE STI O N 21 1. Which patient(s) is appropriate to receive a herpes zoster immunization? (choose all that apply) 1 an 18 year old college freshman . 2 a 65 year old grandfather with CHF . 3 a 42 year old woman with a URI . 4 an 82 year old