NR 565 Advanced PharmacologyFinal
Exam Questions and Answers - (Latest
Update) Chamberlain
1. A patient has a TSH of .28, a free T4 of 3, and a free T3 over 650. What medication
should she be started on?
Answer: Methimazole, PTU, radioactive iodine. These labs indicate
hyperthyroidism. Treatment for thyroid storm: K iodide or strong iodine
solution to suppress thyroid release. Methimazole to suppress thyroid
synthesis.
2. When is it appropriate to increase insulin needs?
Answer: Pregnancy (after first trimester), stress, infection, weight loss,
adolescent growth spurt. DECREASE for exercise and first trimester.
3. A women who is taking Pioglitazone states, "I'm glad that this medication promotes
weight loss."
Answer: First this medication promotes increase in LDL levels, which
increases cardiovascular risk. Also, she's a female so speak about
exercise and weight bearing exercise d/t possible increased risk for
fractures.
4. Monoclonal Antibodies MOA
Answer: Used for allergy-related asthma and Eosinophilic asthma.
Omalizumab for allergy related and Ben ralizumab, mepliz, and resliz
are for eosinophilic
5. methylxanthines MOA
Answer: Maintenance therapy for chronic stable asthma (theophylline).
P. 570. Use ONLY if B2 or anticholinergics are not appropriate.
,6. •Roflumilast (select all that apply)
1. Reduces inflammation
2. Not intended during pregnancy
3. Approved for asthma
4. First-line drug for COPD
Answer: Reduces inflammation, not intended for pregnancy, approved
only for COPD, Second-line drug for COPD
Uses for exacerbations prophylaxis in pts with severe COPD with a
primary chronic bronchitis component.
7. What patient teaching can a provider give when prescribing an H2RA?
Answer: Report lethargy, solmnolance, restlessness, confusion or
hallucinations. (CNS effects). Teach about possible reduced libido,
impotence, gynecomastia, pneumonia. P.594 Cimetidine interacts with
CYP system so check with pt if they are taking warfarin, phenytoin,
theophylline, lidocaine.
8. •A patient who takes NSAIDS almost daily for arthritic pain and refuses to try another
medication is at risk for an NSAID-induced ulcer. The provider states,
1. I will put you on Misoprostol once daily
2. If you reduced the NSAID to 4 times a week, that should help prevent an ulcer
3. I will start you a PPI to prevent an ulcer
4. An H2RA will help prevent an ulcer.
Answer: a PPI is the first-line choice, Misoprostol can cause diarrhea.
9. A patient has tested positive for H.Pylori what are appropriate treatment options?
1. Start a PPI
2. Start antibiotic for 7 days
3. Start antacids to promote ulcer healing
4. Start antibiotic for 10-14 days
Answer: start PPI, Start abx for 10-14.
10. •What TB medication is not safe for pregnancy?
Answer: Ethambutol shows teratogenesis in animal studies and eye
abnormalities in children. Rifabutin is the safest in pregnancy.
,11. •What to assess if Psyllium does not work?
Answer: Fecal impaction
12. Osmotic
Answer: High doses are used for bowel prep
13. patient teaching for metronidazole
Answer: s/e of nausea and vomiting
alcohol must be avoided
should not be taken during pregnancy
black box warning: associated with increased carcinogenic risk in mice
and rats. unnecessary use is to be avoided.
14. Signs and symptoms of hypothyroidism
Answer: Dry hair, puffy face, goiter in the neck, slow heartbeat, weight
gain, constipation, infertility, increased risk of miscarriages, irregular
menstrual cycle, cold intolerance.
15. Drug of choice for hyperthyroidism
Answer: Methimazole (Tapazole)
16. Medication to treat symptoms of hyperthyroidism (notice this is treating symptoms and
not the hyperthyroidism itself):
Answer: Beta blockers (tachycardia) - propranolol/atenolol most
popular.Non-radioactive iodine. ADJUNCTIVE THERAPY.
17. A1c general goals
Answer: <7, patients that experience severe hypoglycemia/have a
limited life expectancy may have an A1C goal of <8.
18. At what time interval should A1c be re-checked? How often should an A1C be monitored
when stable or when unstable?
, Answer: Every 2-3 months and max of 4 times a year. If <7, every 6
months.
At least two times a year if meeting goals and quarterly if meds have
changed or not meeting goals.
19. GLP-1 (abbreviation and examples)
Answer: Glucagonlike Peptide - Subcutaneous injections - Dulaglutide
(Trulicity), Semaglutide (Ozempic), Liraglutide (Victoza).
20. TZD (abbreviation and examples)
Answer: Thiazolidinediones - Rosiglitazone & Pioglitazone
21. How is total daily dose (TDD) of insulin calculated
Answer: TDD is calculated by taking the total weight in kg and multiply
by 0.6 units.
22. DPP-4i MOA
Answer: Enhance the activity of incretins and thereby increase insulin
release, reduce glucagon
23. TZD MOA
Answer: Decreases insulin resistance and increase glucose uptake by
muscle and adipose tissue
24. "As long as the short-acting insulin is drawn up first I can mix my insulin glargine with
it."
Answer: Of the long-acting medications, ONLY NPH the intermediate
duration is suitable for mixing with the short action insulins.
Exam Questions and Answers - (Latest
Update) Chamberlain
1. A patient has a TSH of .28, a free T4 of 3, and a free T3 over 650. What medication
should she be started on?
Answer: Methimazole, PTU, radioactive iodine. These labs indicate
hyperthyroidism. Treatment for thyroid storm: K iodide or strong iodine
solution to suppress thyroid release. Methimazole to suppress thyroid
synthesis.
2. When is it appropriate to increase insulin needs?
Answer: Pregnancy (after first trimester), stress, infection, weight loss,
adolescent growth spurt. DECREASE for exercise and first trimester.
3. A women who is taking Pioglitazone states, "I'm glad that this medication promotes
weight loss."
Answer: First this medication promotes increase in LDL levels, which
increases cardiovascular risk. Also, she's a female so speak about
exercise and weight bearing exercise d/t possible increased risk for
fractures.
4. Monoclonal Antibodies MOA
Answer: Used for allergy-related asthma and Eosinophilic asthma.
Omalizumab for allergy related and Ben ralizumab, mepliz, and resliz
are for eosinophilic
5. methylxanthines MOA
Answer: Maintenance therapy for chronic stable asthma (theophylline).
P. 570. Use ONLY if B2 or anticholinergics are not appropriate.
,6. •Roflumilast (select all that apply)
1. Reduces inflammation
2. Not intended during pregnancy
3. Approved for asthma
4. First-line drug for COPD
Answer: Reduces inflammation, not intended for pregnancy, approved
only for COPD, Second-line drug for COPD
Uses for exacerbations prophylaxis in pts with severe COPD with a
primary chronic bronchitis component.
7. What patient teaching can a provider give when prescribing an H2RA?
Answer: Report lethargy, solmnolance, restlessness, confusion or
hallucinations. (CNS effects). Teach about possible reduced libido,
impotence, gynecomastia, pneumonia. P.594 Cimetidine interacts with
CYP system so check with pt if they are taking warfarin, phenytoin,
theophylline, lidocaine.
8. •A patient who takes NSAIDS almost daily for arthritic pain and refuses to try another
medication is at risk for an NSAID-induced ulcer. The provider states,
1. I will put you on Misoprostol once daily
2. If you reduced the NSAID to 4 times a week, that should help prevent an ulcer
3. I will start you a PPI to prevent an ulcer
4. An H2RA will help prevent an ulcer.
Answer: a PPI is the first-line choice, Misoprostol can cause diarrhea.
9. A patient has tested positive for H.Pylori what are appropriate treatment options?
1. Start a PPI
2. Start antibiotic for 7 days
3. Start antacids to promote ulcer healing
4. Start antibiotic for 10-14 days
Answer: start PPI, Start abx for 10-14.
10. •What TB medication is not safe for pregnancy?
Answer: Ethambutol shows teratogenesis in animal studies and eye
abnormalities in children. Rifabutin is the safest in pregnancy.
,11. •What to assess if Psyllium does not work?
Answer: Fecal impaction
12. Osmotic
Answer: High doses are used for bowel prep
13. patient teaching for metronidazole
Answer: s/e of nausea and vomiting
alcohol must be avoided
should not be taken during pregnancy
black box warning: associated with increased carcinogenic risk in mice
and rats. unnecessary use is to be avoided.
14. Signs and symptoms of hypothyroidism
Answer: Dry hair, puffy face, goiter in the neck, slow heartbeat, weight
gain, constipation, infertility, increased risk of miscarriages, irregular
menstrual cycle, cold intolerance.
15. Drug of choice for hyperthyroidism
Answer: Methimazole (Tapazole)
16. Medication to treat symptoms of hyperthyroidism (notice this is treating symptoms and
not the hyperthyroidism itself):
Answer: Beta blockers (tachycardia) - propranolol/atenolol most
popular.Non-radioactive iodine. ADJUNCTIVE THERAPY.
17. A1c general goals
Answer: <7, patients that experience severe hypoglycemia/have a
limited life expectancy may have an A1C goal of <8.
18. At what time interval should A1c be re-checked? How often should an A1C be monitored
when stable or when unstable?
, Answer: Every 2-3 months and max of 4 times a year. If <7, every 6
months.
At least two times a year if meeting goals and quarterly if meds have
changed or not meeting goals.
19. GLP-1 (abbreviation and examples)
Answer: Glucagonlike Peptide - Subcutaneous injections - Dulaglutide
(Trulicity), Semaglutide (Ozempic), Liraglutide (Victoza).
20. TZD (abbreviation and examples)
Answer: Thiazolidinediones - Rosiglitazone & Pioglitazone
21. How is total daily dose (TDD) of insulin calculated
Answer: TDD is calculated by taking the total weight in kg and multiply
by 0.6 units.
22. DPP-4i MOA
Answer: Enhance the activity of incretins and thereby increase insulin
release, reduce glucagon
23. TZD MOA
Answer: Decreases insulin resistance and increase glucose uptake by
muscle and adipose tissue
24. "As long as the short-acting insulin is drawn up first I can mix my insulin glargine with
it."
Answer: Of the long-acting medications, ONLY NPH the intermediate
duration is suitable for mixing with the short action insulins.
