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NURS 540 test 2 test questions exam with correct answers

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NURS 540 test 2 test questions exam with correct answers

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NURS 540 test 2 test questions exam |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




with correct answers |||\\\ |||\\\




The nurse practitioner is seeing a patient for an acute exacerbation of asthma. The patient
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reports increasing shortness of breath and wheezing the last two days. He ran out of his
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




albuterol inhaler and has been using his grandmothers inhaler (fomoterol) with no |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




improvement. What is the best rationale for the ineffectiveness of the fomoterol? |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




A. His grandmother may have used all of the medication in her inhaler
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B. Fomoterol is a long-acting beta-agonist and is not effective for acute symptoms
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C. Fomoterol is an inhaled corticosteroid and is not effective for acute symptoms
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D. He is not using the inhaler correctly - correct answer✔✔B. Fomoterol is a long-acting beta-
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




agonist and is not effective for actue symptoms |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




An 18 year old female presents as a new patient to your clinic. Her medical history is significant
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only for asthma, currently managed with albuterol (Proventil) inhaler two puffs 4 times daily as
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




needed for wheezing/coughing. According to her pharmacy refill records her past 2 inhaler
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




refills lasted approximately 50 days each. (Each inhaler has 200 puffs).
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For what classification of asthma is her current treatment suitable?
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A. Mild intermittent
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B. Mild persistent
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C. Moderate persistent
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D. Severe persistent - correct answer✔✔A. Mild intermittent
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You examine Jane, a 24-year-old woman who has an acute asthma flare following a 3-day
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




history of upper respiratory tract symptoms (clear nasal discharge, dry cough, no fever). She
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




has a history of moderate persistent asthma that is in good control and an acceptable peak
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




expiratory flow (PEF). She is using budesonide (Pulmicort) and albuterol as directed and |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




continues to have difficulty with coughing and wheezing. At home, her PEF is 55% of personal |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




best. In the office, her forced expiratory volume at 1 second (FEV1) is 65% of predicted. Her
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




medication regimen should be adjusted to include: |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\

,A. theophylline.
|||\\\




B. salmeterol (Serevent).
|||\\\ |||\\\




C. prednisone.
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D. montelukast (Singulair). - correct answer✔✔C. Prednisone
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




A 58-year-old man recently began taking antihypertensive medication and reports that his
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




"heartburn" has become much worse. He is most likely taking: |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




A. Atenolol|||\\\




B. Trandolapril
|||\\\




C. Amlodipine
|||\\\




D. Losartan - correct answer✔✔C. amlodipine
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




You prescribe a fluroquinolone antibiotic to a 54 year old woman who has occasional GERD
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




symptoms that she treats with an antacid. When discussing appropriate medication use, you
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




advise that she should take the antimicrobial:
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




A. with the antacid.
|||\\\ |||\\\ |||\\\




B. separated from the antacid by 2 to 4 hours before or 4 to 6 hours after taking the
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




fluroquinolone.



C. without regard to antacid use.
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D. apart from the antacid by about 1 hour on either side of the fluroquinolone dose. - correct
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




answer✔✔B. separated by the antacid by 2 to 4 hours before or 4 to 6 hours after taking the |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




fluroquinolone.

,you prescribe nasal corticosteroid spray for a pt with perennial allergic rhinitis. what is the
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




anticipated onset of sx relief with its use? |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




a. immediately with the first spray
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\




b. 1 to 2 days
|||\\\ |||\\\ |||\\\ |||\\\




c. a few days to a week
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




d. 2 or more weeks - correct answer✔✔C. a few days to a week
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




Which medication has the following mechanism of action: decreases inflammation and mucus
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




production and causes bronchodilitation by selectively binding leukotriene receptors? |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




A. Zafirlukast (Accolate)
|||\\\ |||\\\




B. Omalizumab (Xolair)
|||\\\ |||\\\




C. Ciclesonide (Alvesco)
|||\\\ |||\\\




D. Cromolyn sodium (Intel) - correct answer✔✔A. Zafirlukast (Accolate)
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




Which of the following medications is most appropriate for allergic rhinitis therapy in an
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




acutely symptomatic 24-yr-old machine operator?
|||\\\ |||\\\ |||\\\ |||\\\




A. Nasal cromolyn
|||\\\ |||\\\




B. Diphenhydramine
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C. Flunisolide nasal spray
|||\\\ |||\\\ |||\\\




D. Loratadine - correct answer✔✔D. Loratadine
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




What side effect is most likely from her current albuterol use?
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




A. Bradyarrhythmia
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B. CNS depression
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C. Hypertension
|||\\\




D. Hypokalemia - correct answer✔✔D. Hypokalemia
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\

, Antihistamines work primarily through |||\\\ |||\\\ |||\\\




A. Vasoconstriction
|||\\\




B. Action on the histamine-1 (H1) receptor sites
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




C. Inflammatory mediation
|||\\\ |||\\\




D. Peripheral vasodilitation - correct answer✔✔B. Action on the histamine-1 (H1) receptor
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




sites



You find that previous patient has been using her albuterol inhaler twice each day to prevent
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




exercise induced asthma. She is also having nocturnal symptoms 3-4 times per month, and she
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




uses the inhaler at least twice weekly for exacerbations. Her FEV1 is 65% of the value predicted
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




and her FEV1/FVC ratio is reduced to 78%. Which regimen below would most appropriately
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




manage this patient? |||\\\ |||\\\




A. Montelukast each morning + salmeterol twice daily + ipratropium prn
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




B. Low dose budesonide inhaler twice daily + albuterol prn
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




C. Low dose budesonide inhaler twice daily + salmeterol twice daily + albuterol prn
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




D. Medium dose budesonide + cromolyn inhaler + intranasal fluticasone + albuterol prn -
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




correct answer✔✔C. Low dose budesonide inhaler twice daily + salmeterol twice daily +
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




albuterol prn |||\\\




Decongestants work primarily through: |||\\\ |||\\\ |||\\\




A. Vasoconstriction
|||\\\




B. Action on H1 receptor sites
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\




C. Inflammatory mediation
|||\\\ |||\\\




D. Peripheral vasodilitation - correct answer✔✔A. Vascoconstriction
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




Which medication would cause concern prior to prescribing ipratropium bromide (Atrovent)?
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




A. Albuterol (Proair)
|||\\\ |||\\\




B. Fluoxetine (Prozac)
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