NSG 6005 Final Exam | Questions with Verified Answers

NSG 6005 Final Exam | Questions with Verified Answers An ACE inhibitor and what other class of drug may reduce proteinuria in patients with diabetes better than either drug alone? Nondihydropyridine calcium channel blockers An appropriate drug for the treatment of depression with anxiety would be escitalopram (Lexapro) Dwayne was recently started on carbamazepine to treat seizures. He comes to see you, and you not that while his carbamazepine levels had been in the therapeutic range, they are now low. The possible cause for the low carbamazepine level is: Carbamazepine auto-induces metabolism, leading to lower levels in spite of good compliance First line therapy for hyperlipidemia is lifestyle changes Genetic testing for VCORC1 mutation to assess potential warfarin resistance is required prior to prescribing warfarin False Goals of treatment when treating hypothyroidism with thyroid replacement include: A. Normal TSH and free T4 levels B. Resolution of fatigue C. Weight loss to baseline D. all of the above Jack, eight years old, has attention deficit disorder (ADD) and is prescribed methylphenidate (Ritalin). He and his parents should be educated about the side effects of methylphenidate, which are insomnia and decreased appetite Medications used in the management of patients with COPD include A. Inhaled beta-2-agonists B. Inhaled anticholinergics (ipratropium) C. Inhaled corticosteroids D. All of the above A patient with a COPD exacerbation may require: systemic corticosteroid burts Scott is presenting for follow-up on his lipid panel. He had elevated total cholesterol, elevated triglycerides, and an LDL of 122mg/dL. He has already implemented diet changes and increased physical activity. he has mildly elevated liver studies. An appropriate next step for therapy would be; Niacin Second-generation antihistamines such as loratadine (Claritin) are prescribed for seasonal allergies because they: Are less sedating than first-generation antihistamines A stepwise approach to the pharmacologic management of asthma: Begins with determining the severity of the asthma and assessing asthma control Tiotropium bromide (Spiriva) is an inhaled anticholinergic: Used for the treatment of COPD Warfarin resistance may be seen in patients with VCORC1 mutation, leading to: decreased response to warfarin When starting a patient with hypothyroidism on thyroid replacement hormones, patient education would include the following: It may take four to eight weeks to get to euthyroid symptomatically and by lab testing Which of the following adverse effects may occur due to a dihydropyridine- type calcium channel blocker? Edema of the hands and feet Jamie is a thirty-four-year-old pregnant woman with familial hyperlipidemia and elevated LDL levels. What is the appropriate treatment for a pregnant woman? Bile acid-binding resins Dosage changes of conjugated equine estrogen (Premarin) are made at _ intervals. 6 to 8 weeks Jonathan has been diagnosed with strep throat and needs a prescription for an antibiotic. He says the last time he had penicillin he developed a red, blotchy rash. An appropriate antibiotic to prescribe would be: Azithromycin Sarah is a 25-year-old female who is 8 weeks pregnant and has a urinary tract infection. What would be the appropriate antibiotic to prescribe for her? Amoxicillin (Trimox) John has clonidine, a centrally acting adrenergic blocker, prescribed for his hypertension. He should: Not miss a dose or stop taking the drug because of potential rebound hypertension Clonidine has several off-label uses including A. Alcohol and nicotine withdrawal B. Post-herpetic neuralgia C. Both A and B D. Neither A nor B Potentially fatal granulocytopenia has been associated with treatment of hyperthyroidism with propylthiouracil. Patients should be taught to report: fever and sore throat Elderly patients who are started on levothyroxine for thyroid replacement should be monitored for: Tachycardia and angina Cost-effectiveness analysis compares two or more treatments or programs that are Not necessarily therapeutically equivalent When the costs of a specific treatment or intervention are calculated and then compared with the dollar value of the benefit received it is referred to as: Cost-benefit analysis what analysis would a managed care organization use to improve health outcomes cost- effectiveness analysis what analysis would be used if a manage care organization wanted to compare two drugs with different benefits cost-minimization analysis which analysis is expressed terms of life years cost-utility analysis Adam has type I diabetes and plays tennis for his university. He exhibits knowledge deficit about his insulin and his diagnosis. He should be taught that: He should increase his increase his carbohydrate intake during times of exercise intake during times of exercise. Age is a factor in different responses to pain. Which of the following age related statements about pain is not true? Preterm and newborn infants do not yet have functional pain pathways. Alterations in drug metabolism among Asians may lead to: Slower metabolism of antidepressants, requiring lower doses Amiodarone has been prescribed in a patient with a supraventricular dysrhythmia. Patient teaching should include all of the following except: Take a hot shower or bath if you feel dizzy. Anticholinergic agents, such as benztropine (Cogentin), may be given with a phenothiazine to: Reduce the chance of tardive dyskinesia. An appropriate drug for the treatment of depression with anxiety would be: Escitalopram (Lexapro) Cara is taking levetiracetam (Keppra) to treat seizures. Routine education for levetiracetam includes reminding her: To not abruptly discontinue levetiracetam due to the risk of withdrawal seizure Cecilia presents with depression associated with complaints of fatigue, sleeping all the time, and lack of motivation. An appropriate initial antidepressant for her would be: Duloxetine (Cymbalta) Chemical dependency assessment is integral to the initial assessment of chronic pain. Which of the following raises a "red flag" about potential chemical dependency? Multiple times when prescriptions are lost with requests to refill Common mistakes practitioners make in treating anxiety disorders include: Thinking a partial response to medication is acceptable David presents to clinic with symptoms of allergic conjunctivitis. He is prescribed cromolyn sodium (Opticrom) eyedrops. The education regarding using cromolyn eyedrops includes which one of the following tips? He should not wear his soft contacts while using the cromolyn eyedrops. The DEA: registers manufactures and prescribes controlled substances Diagnostic criteria for diabetes include: Symptoms of diabetes plus a casual blood glucose greater than 200 mg/dl Disease states in addition to hypertension in which beta blockade is a compelling indication for the use of beta blockers include: MI The drug of choice for type II diabetics is metformin. Metformin: Decreases glycogenolysis by the liver The drug recommended as primary prevention of osteoporosis in men over seventy years is: alendronate (Fosamax) The drug recommended as primary prevention of osteoporosis in women over seventy years old is: alendronate (Fosamax) The drugs recommended by the American Academy of Pediatrics for use in children with diabetes (depending upon type of diabetes) are: metformin and insulin Drugs that have a significant first-pass effect: Are rapidly metabolized by the liver and may have little if any desired action Dwayne has classic tinea capitis. Treatment for tinea on the scalp is: intake of oral griseofulvin for six to eight weeks Dwayne was recently started on carbamazepine to treat seizures. He comes to see you, and you note that while his carbamazepine levels had been in the therapeutic range, they are now low. The possible cause for the low carbamazepine levels is: Carbamazepine auto-induces metabolism, leading to lower levels in spite of good compliance. Erik presents with a golden-crusted lesion at the site of an insect bite consistent with impetigo. His parents have limited finances and request the least expensive treatment. Which medication would be the best choice for treatment? bacitracin and polymyxin B (generic double antibiotic ointment) First-line therapy for hyperlipidemia is: Lifestyle changes First-line therapy for treating topical fungal infections such as tinea corporis (ringworm) or tinea pedis (athlete's foot) would be: OTC topical azole (clotrimazole, miconazole) Furosemide is added to a treatment regimen for heart failure, which includes digoxin. Monitoring for this combination includes: Serum potassium Genetic polymorphisms account for differences in metabolism, including: A. Poor metabolizers (PMs) who lack a working enzyme B. Intermediate metabolizers (IMs) who have one working, wild-type allele and one mutant allele C. Extensive metabolizers (EMs), with two normally functioning alleles D. all of the above Genetic testing for VCORC1 mutation to assess potential warfarin resistance is required prior to prescribing warfarin. False Heart failure is a chronic condition that can be adequately managed in primary care. However, consultation with or referral to a cardiologist is appropriate when: A. Symptoms markedly worsen or the patient becomes hypotensive and has syncope B. There is evidence of progressive renal insufficiency or failure C. The patient remains symptomatic on optimal doses of an ACE inhibitor, a beta blocker, and a diuretic D. All of the above Hypoglycemia can result from the action of either insulin or an oral hypoglycemic. Signs and symptoms of hypoglycemia include: dizziness, confusion, diaphoresis and tachycardia If a patient with H. pylori positive PUD fails first-line therapy, the second-line treatment is: A PPI BID plus metronidazole plus tetracycline plus bismuth subsalicylate for fourteen days In addition to methimazole, a symptomatic patient with hyperthyroidism may need a prescription for: beta blockers Inadequate vitamin D intake can contribute to the development of osteoporosis by: Increasing calcium absorption from the intestine Incorporating IT into a patient encounter takes skill and tact. During the encounter, the provider can make the patient more comfortable with the IT the provider is using by: A. Turning the screen around so the patient can see material being recorded B. Not placing the computer screen between the provider and the patient C. Both A and B D. Neither A nor B Infants with reflux are initially treated with: Anti reflux maneuvers (elevate the head of the bed) In five- to eleven-year-old children, mild persistent asthma is diagnosed when asthma symptoms occur: at night time three to four times a month