Pharmacotherapeutics For Advanced Practice
Nurse Prescribers 4th Edition – TestBank
latest
MN |553-Final |review
Acute |Pain
6. |Which |of |the |following |statements |is |true |about |acute |pain?
1. Somatic |pain |comes |from |body |surfaces |and |is |only |sharp |and |well-localized.
2. Visceral |pain |comes |from |the |internal |organs |and |is |most |responsive |to |acetaminophen |and |opiates.
3. Referred |pain |is |present |in |a |distant |site |for |the |pain |source |and |is |based |on |activation |of |the |same |spinal |segment|as
|the |actual |pain |site.
4. Acute |neuropathic |pain |is |caused |by |lack |of |blood |supply |to |the |nerves |in |a |given |area.
7. |One |of |the |main |drug |classes |used |to |treat |acute |pain |is |NSAIDs. |They |are |used |because:
1. |They |have |less |risk |for |liver |damage |than |acetaminophen.
|2. |Inflammation |is |a |common |cause |of |acute |pain.
3. They |have |minimal |GI |irritation.
4. Regulation |of |blood |flow |to |the |kidney |is |not |affected |by |these |drugs.
10. |The |goal |of |treatment |of |acute |pain |is:
1. Pain |at |a |tolerable |level |where |the |patient |may |return |to |activities |of |daily |living
2. Reduction |of |pain |with |a |minimum |of |drug |adverse |effects
3. Reduction |or |elimination |of |pain |with |minimum |adverse |reactions
4. Adequate |pain |relief |without |constipation |or |nausea |from |the |drugs
13. |Pathological |similarities |and |differences |between |acute |pain |and |chronic |pain |include:
1. Both |have |decreased |levels |of |endorphins.
2. Chronic |pain |has |a |predominance |of |C-neuron |stimulation.
3. Acute |pain |is |most |commonly |associated |with |irritation |of |peripheral |nerves.
4. Acute |pain |is |diffuse |and |hard |to |localize.
Allopurinol
17. Which |antigout |medication |is |used |to |treat |chronic |tophaceous |gout?
|a. |Allopurinol |(Zyloprim)
b. Colchicine
c. Probenecid |(Benemid)
d. Sulfinpyrazone |(Anturane)
18. The |nurse |is |assessing |a |patient |who |has |gout |who |will |begin |taking |allopurinol |(Zyloprim). |The |nurse |reviews
|the |patient’s |medical |record |and |will |be |concerned |about |which |laboratory |result?
a. Elevated |BUN |and |creatinine
b. Increased |serum |uric |acid
c. Slight |increase |in |the |white |blood |count
d. Increased |serum |glucose
19. The |nurse |provides |teaching |for |a |patient |who |will |begin |taking |allopurinol. |Which |statement |by |the |patient
|indicates |understanding |of |the |teaching?
a. |I |should |increase |my |vitamin |C |intake.
,b. |I |will |get |yearly |eye |exams.
|
c. |I |will |increase |my |protein |intake.
d. |I |will |limit |fluids |to |prevent |edema.
3. |Larry |is |taking |allopurinol |to |prevent |gout. |Monitoring |of |a |patient |who |is |taking |allopurinol |includes:
,1. Complete |blood |count
2. Blood |glucose
3. C-reactive |protein
4. BUN, |creatinine, |and |creatinine |clearance
Angina
20. |Isosorbide |dinitrate |is |prescribed |for |a |patient |with |chronic |stable |angina. |This |drug |is |administered
|twice |daily, |but |the |schedule |is |7 |a.m. |and |2 |p.m. |because:
1. |It |is |a |long-acting |drug |with |potential |for |toxicity.
|2. |Nitrate |tolerance |can |develop.
3. Orthostatic |hypotension |is |a |common |adverse |effect.
4. It |must |be |taken |with |milk |or |food.
21. |Art |is |a |55-year-old |smoker |who |has |been |diagnosed |with |angina |and |placed |on |nitrates. |He
|complains |of |headaches |after |using |his |nitrate. |An |appropriate |reply |might |be:
1. |This |is |a |parasympathetic |response |to |the |vasodilating |effects |of |the |drug.
|2. |Headaches |are |common |side |effects |with |these |drugs. |How |severe |are |they?
3. This |is |associated |with |your |smoking. |Let’s |work |on |having |you |stop |smoking.
4. This |is |not |related |to |your |medication. |Are |you |under |a |lot |of |stress?
20. |Elderly |patients |who |are |started |on |levothyroxine |for |thyroid |replacement |should |be |monitored |for:
1. Excessive |sedation
2. Tachycardia |and |angina
3. Weight |gain
4. Cold |intolerance
1. |Angina |is |produced |by |an |imbalance |between |myocardial |oxygen |supply |(MOS) |and |demand |(MOD) |in |the
|myocardium. |Which |of |the |following |drugs |help |to |correct |this |imbalance |by |increasing |MOS?
1. Calcium |channel |blockers
2. Beta |blockers
3. Angiotensin-converting-enzyme |(ACE) |inhibitors
4. Aspirin
3. |The |New |York |Heart |Association |and |the |Canadian |Cardiovascular |Society |have |described |grading
|criteria |for |levels |of |angina. |Angina |that |occurs |with |unusually |strenuous |activity |or |on |walking |or
|climbing |stair |after |meals |is |class:
1. I
2. II
3. III
|4. |IV
4. Patients |at |high |risk |for |developing |significant |coronary |heart |disease |are |those |with:
1. LDL |values |between |100 |and |130
2. Systolic |blood |pressure |between |120 |and |130
|3. |Class |III |angina
4. Obesity
5. To |reduce |mortality, |all |patients |with |angina, |regardless |of |class, |should |be |on:
|1. |Aspirin |81 |to |325 |mg/d
2. Nitroglycerin |sublingually |for |chest |pain
3. ACE |inhibitors |or |angiotensin |receptor |blockers
4. Digoxin
, 6. |Patients |who |have |angina, |regardless |of |class, |who |are |also |diabetic, |should |be |on:
1. Nitrates
2. Beta |blockers
|3. |ACE |inhibitors
4. |Calcium |channel |blockers
7. |Management |of |all |types |and |grades |of |angina |includes |the |use |of |lifestyle |modification |to |reduce |risk |factors.
|Which |of |these |modifications |are |appropriate |for |which |reason? |Both |the |modification |and |the |reason |for |it |must |be|true
|for |the |answer |to |be |correct.
1. Lose |at |least |10 |pounds |of |body |weight. |Excessive |weight |increases |cardiac |workload.
2. Reduce |sodium |intake |to |no |more |than |2,400 |mg |of |sodium. |Sodium |increases |blood |volume |and |cardiac
|workload.
3. Increase |potassium |intake |to |at |least |100 |mEq/d. |The |heart |needs |higher |levels |of |potassium |to |improve
|contractility |and |oxygen |supply.
4. Intake |a |moderate |amount |of |alcohol. |Moderate |intake |has |been |shown |by |research |to |improve |cardiac |function.
8. |Nitrates |are |especially |helpful |for |patients |with |angina |who |also |have:
1. Heart |failure
2. Hypertension
|3. |Both |1 |and |2
4. |Neither |1 |nor |2
9. |Beta |blockers |are |especially |helpful |for |patients |with |exertional |angina |who |also |have:|1.
|Arrhythmias
2. Hypothyroidism
3. Hyperlipidemia
4. Atherosclerosis
10. |Rapid-acting |nitrates |are |important |for |all |angina |patients. |Which |of |the |following |are |true |statements |about |their
|use?
1. These |drugs |are |useful |for |immediate |symptom |relief |when |the |patient |is |certain |it |is |angina.
2. The |dose |is |one |sublingual |tablet |or |spray |every |5 |minutes |until |the |chest |pain |goes |away.
3. Take |one |nitroglycerine |tablet |or |spray |at |the |first |sign |of |angina; |repeat |every |5minutes |for |no |more |than |two
|doses. |If |chest |pain |is |still |not |relieved, |call |911.
4. All |of |the |above
12. |Combinations |of |a |long-acting |nitrate |and |a |beta |blocker |are |especially |effective |in |treating |angina |because:
1. Nitrates |increase |MOS |and |beta |blockers |increase |MOD.
2. Their |additive |effects |permit |lower |doses |of |both |drugs |and |their |adverse |reactions |cancel |each |other |out.
3. They |address |the |pathology |of |patients |with |exertional |angina |who |have |fixed |atherosclerotic |coronary |heart
|disease.
4. All |of |the |above
13. |Drug |choices |to |treat |angina |in |older |adults |differ |from |those |of |younger |adults |only |in:
|1. |Consideration |of |risk |factors |for |diseases |associated |with |and |increased |in |aging
2. The |placement |of |drug |therapy |as |a |treatment |choice |before |lifestyle |changes |are |tried
3. The |need |for |at |least |three |drugs |in |the |treatment |regimen |because |of |the |complexity |of |angina |in |the |older |adult
4. Those |with |higher |risk |for |silent |myocardial |infarction
15. |Cost |of |antianginal |drug |therapy |should |be |considered |in |drug |selection |because |of |all |of |the |following |EXCEPT:
1. Patients |often |require |multiple |drugs
2. A |large |number |of |angina |patients |are |older |adults |on |fixed |incomes
|3. |Generic |formulations |may |be |cheaper |but |are |rarely |bioequivalent
Nurse Prescribers 4th Edition – TestBank
latest
MN |553-Final |review
Acute |Pain
6. |Which |of |the |following |statements |is |true |about |acute |pain?
1. Somatic |pain |comes |from |body |surfaces |and |is |only |sharp |and |well-localized.
2. Visceral |pain |comes |from |the |internal |organs |and |is |most |responsive |to |acetaminophen |and |opiates.
3. Referred |pain |is |present |in |a |distant |site |for |the |pain |source |and |is |based |on |activation |of |the |same |spinal |segment|as
|the |actual |pain |site.
4. Acute |neuropathic |pain |is |caused |by |lack |of |blood |supply |to |the |nerves |in |a |given |area.
7. |One |of |the |main |drug |classes |used |to |treat |acute |pain |is |NSAIDs. |They |are |used |because:
1. |They |have |less |risk |for |liver |damage |than |acetaminophen.
|2. |Inflammation |is |a |common |cause |of |acute |pain.
3. They |have |minimal |GI |irritation.
4. Regulation |of |blood |flow |to |the |kidney |is |not |affected |by |these |drugs.
10. |The |goal |of |treatment |of |acute |pain |is:
1. Pain |at |a |tolerable |level |where |the |patient |may |return |to |activities |of |daily |living
2. Reduction |of |pain |with |a |minimum |of |drug |adverse |effects
3. Reduction |or |elimination |of |pain |with |minimum |adverse |reactions
4. Adequate |pain |relief |without |constipation |or |nausea |from |the |drugs
13. |Pathological |similarities |and |differences |between |acute |pain |and |chronic |pain |include:
1. Both |have |decreased |levels |of |endorphins.
2. Chronic |pain |has |a |predominance |of |C-neuron |stimulation.
3. Acute |pain |is |most |commonly |associated |with |irritation |of |peripheral |nerves.
4. Acute |pain |is |diffuse |and |hard |to |localize.
Allopurinol
17. Which |antigout |medication |is |used |to |treat |chronic |tophaceous |gout?
|a. |Allopurinol |(Zyloprim)
b. Colchicine
c. Probenecid |(Benemid)
d. Sulfinpyrazone |(Anturane)
18. The |nurse |is |assessing |a |patient |who |has |gout |who |will |begin |taking |allopurinol |(Zyloprim). |The |nurse |reviews
|the |patient’s |medical |record |and |will |be |concerned |about |which |laboratory |result?
a. Elevated |BUN |and |creatinine
b. Increased |serum |uric |acid
c. Slight |increase |in |the |white |blood |count
d. Increased |serum |glucose
19. The |nurse |provides |teaching |for |a |patient |who |will |begin |taking |allopurinol. |Which |statement |by |the |patient
|indicates |understanding |of |the |teaching?
a. |I |should |increase |my |vitamin |C |intake.
,b. |I |will |get |yearly |eye |exams.
|
c. |I |will |increase |my |protein |intake.
d. |I |will |limit |fluids |to |prevent |edema.
3. |Larry |is |taking |allopurinol |to |prevent |gout. |Monitoring |of |a |patient |who |is |taking |allopurinol |includes:
,1. Complete |blood |count
2. Blood |glucose
3. C-reactive |protein
4. BUN, |creatinine, |and |creatinine |clearance
Angina
20. |Isosorbide |dinitrate |is |prescribed |for |a |patient |with |chronic |stable |angina. |This |drug |is |administered
|twice |daily, |but |the |schedule |is |7 |a.m. |and |2 |p.m. |because:
1. |It |is |a |long-acting |drug |with |potential |for |toxicity.
|2. |Nitrate |tolerance |can |develop.
3. Orthostatic |hypotension |is |a |common |adverse |effect.
4. It |must |be |taken |with |milk |or |food.
21. |Art |is |a |55-year-old |smoker |who |has |been |diagnosed |with |angina |and |placed |on |nitrates. |He
|complains |of |headaches |after |using |his |nitrate. |An |appropriate |reply |might |be:
1. |This |is |a |parasympathetic |response |to |the |vasodilating |effects |of |the |drug.
|2. |Headaches |are |common |side |effects |with |these |drugs. |How |severe |are |they?
3. This |is |associated |with |your |smoking. |Let’s |work |on |having |you |stop |smoking.
4. This |is |not |related |to |your |medication. |Are |you |under |a |lot |of |stress?
20. |Elderly |patients |who |are |started |on |levothyroxine |for |thyroid |replacement |should |be |monitored |for:
1. Excessive |sedation
2. Tachycardia |and |angina
3. Weight |gain
4. Cold |intolerance
1. |Angina |is |produced |by |an |imbalance |between |myocardial |oxygen |supply |(MOS) |and |demand |(MOD) |in |the
|myocardium. |Which |of |the |following |drugs |help |to |correct |this |imbalance |by |increasing |MOS?
1. Calcium |channel |blockers
2. Beta |blockers
3. Angiotensin-converting-enzyme |(ACE) |inhibitors
4. Aspirin
3. |The |New |York |Heart |Association |and |the |Canadian |Cardiovascular |Society |have |described |grading
|criteria |for |levels |of |angina. |Angina |that |occurs |with |unusually |strenuous |activity |or |on |walking |or
|climbing |stair |after |meals |is |class:
1. I
2. II
3. III
|4. |IV
4. Patients |at |high |risk |for |developing |significant |coronary |heart |disease |are |those |with:
1. LDL |values |between |100 |and |130
2. Systolic |blood |pressure |between |120 |and |130
|3. |Class |III |angina
4. Obesity
5. To |reduce |mortality, |all |patients |with |angina, |regardless |of |class, |should |be |on:
|1. |Aspirin |81 |to |325 |mg/d
2. Nitroglycerin |sublingually |for |chest |pain
3. ACE |inhibitors |or |angiotensin |receptor |blockers
4. Digoxin
, 6. |Patients |who |have |angina, |regardless |of |class, |who |are |also |diabetic, |should |be |on:
1. Nitrates
2. Beta |blockers
|3. |ACE |inhibitors
4. |Calcium |channel |blockers
7. |Management |of |all |types |and |grades |of |angina |includes |the |use |of |lifestyle |modification |to |reduce |risk |factors.
|Which |of |these |modifications |are |appropriate |for |which |reason? |Both |the |modification |and |the |reason |for |it |must |be|true
|for |the |answer |to |be |correct.
1. Lose |at |least |10 |pounds |of |body |weight. |Excessive |weight |increases |cardiac |workload.
2. Reduce |sodium |intake |to |no |more |than |2,400 |mg |of |sodium. |Sodium |increases |blood |volume |and |cardiac
|workload.
3. Increase |potassium |intake |to |at |least |100 |mEq/d. |The |heart |needs |higher |levels |of |potassium |to |improve
|contractility |and |oxygen |supply.
4. Intake |a |moderate |amount |of |alcohol. |Moderate |intake |has |been |shown |by |research |to |improve |cardiac |function.
8. |Nitrates |are |especially |helpful |for |patients |with |angina |who |also |have:
1. Heart |failure
2. Hypertension
|3. |Both |1 |and |2
4. |Neither |1 |nor |2
9. |Beta |blockers |are |especially |helpful |for |patients |with |exertional |angina |who |also |have:|1.
|Arrhythmias
2. Hypothyroidism
3. Hyperlipidemia
4. Atherosclerosis
10. |Rapid-acting |nitrates |are |important |for |all |angina |patients. |Which |of |the |following |are |true |statements |about |their
|use?
1. These |drugs |are |useful |for |immediate |symptom |relief |when |the |patient |is |certain |it |is |angina.
2. The |dose |is |one |sublingual |tablet |or |spray |every |5 |minutes |until |the |chest |pain |goes |away.
3. Take |one |nitroglycerine |tablet |or |spray |at |the |first |sign |of |angina; |repeat |every |5minutes |for |no |more |than |two
|doses. |If |chest |pain |is |still |not |relieved, |call |911.
4. All |of |the |above
12. |Combinations |of |a |long-acting |nitrate |and |a |beta |blocker |are |especially |effective |in |treating |angina |because:
1. Nitrates |increase |MOS |and |beta |blockers |increase |MOD.
2. Their |additive |effects |permit |lower |doses |of |both |drugs |and |their |adverse |reactions |cancel |each |other |out.
3. They |address |the |pathology |of |patients |with |exertional |angina |who |have |fixed |atherosclerotic |coronary |heart
|disease.
4. All |of |the |above
13. |Drug |choices |to |treat |angina |in |older |adults |differ |from |those |of |younger |adults |only |in:
|1. |Consideration |of |risk |factors |for |diseases |associated |with |and |increased |in |aging
2. The |placement |of |drug |therapy |as |a |treatment |choice |before |lifestyle |changes |are |tried
3. The |need |for |at |least |three |drugs |in |the |treatment |regimen |because |of |the |complexity |of |angina |in |the |older |adult
4. Those |with |higher |risk |for |silent |myocardial |infarction
15. |Cost |of |antianginal |drug |therapy |should |be |considered |in |drug |selection |because |of |all |of |the |following |EXCEPT:
1. Patients |often |require |multiple |drugs
2. A |large |number |of |angina |patients |are |older |adults |on |fixed |incomes
|3. |Generic |formulations |may |be |cheaper |but |are |rarely |bioequivalent
