MN553 Final Exam/ MN 553 Unit 10 Final Exam (Latest): Pharmacology: Kaplan University
Question 1
The Best Pharmaceuticals for Children Act:
 
Includes a pediatric exclusivity rule which extends the patent on drugs studied in children
 
Establishes a committee that writes guidelines for pediatric prescribing
 
Provides funding for new drug development aimed at children
 
Encourages manufacturers specifically to develop pediatric formulations
Question2
 
1 / 1 point
Patient education regarding taking iron replacements includes:
 
Doubling the dose if they miss a dose to maintain therapeutic levels
 
Taking the iron with milk or crackers if it upsets their stomach
 
Iron is best taken on an empty stomach with juice
 
Antacids such as Tums may help the upset stomach caused by iron therapy
Question 3
 
1 / 1 point
The benefits to the patient of having an Advanced Practice Registered Nurse (APRN) prescriber include:
 
Nurses know more about Pharmacology than other prescribers because they take it both in their basic nursing program and in their APRN program.
 
Nurses care for the patient from a holistic approach and include the patient in decision making regarding
their care.
 
APRNs are less likely to prescribe narcotics and other controlled substances.
 
APRNs are able to prescribe independently in all states, whereas a physician’s assistant needs to have a
physician supervising their practice.
Question 4
 
1 / 1 point
Precautions that should be taken when prescribing controlled substances include:
 
Faxing the prescription for a Schedule II drug directly to the pharmacy
 
Using tamper-proof paper for all prescriptions written for controlled drugs
 
Keeping any pre-signed prescription pads in a locked drawer in the clinic
 
Using only numbers to indicate the amount of drug to be prescribed
Question 5
 
1 / 1 point
The reason that two MMR vaccines at least a month apart are recommended is:
 
The second dose of MMR “boosts” the immunity built from the first dose.
 
Two vaccines 1 month apart is the standard dosing for all live virus vaccines.
 
If the two MMR vaccine doses are given too close together there is a greater likelihood of severe localized reaction to the vaccine.
 
Only 95% of patients are fully immunized for measles after the first vaccine, with 99% having immunity after two doses of MMR.
Question 6
 
1 / 1 point
Instructions for the use of nicotine gum include:
 
Chew the gum quickly to get a peak effect.
 
The gum should be “parked” in the buccal space between chewing.
 
Acidic drinks such as coffee help with the absorption of the nicotine.
 
The highest abstinence rates occur if the patient chews the gum when he or she is having cravings.
Question 7
 
1 / 1 point
Leonard is completing a 6-month regimen to treat tuberculosis (TB). Monitoring of a patient on TB therapy includes:
 
Monthly sputum cultures
 
Monthly chest x-ray
 
Bronchoscopy every 3 months
 
All of the above
Question 8
 
1 / 1 point
Severe contact dermatitis caused by poison ivy or poison oak exposure often requires treatment with:
 
Topical antipruritics
 
Oral corticosteroids for 2 to 3 weeks
 
Thickly applied topical intermediate-dose corticosteroids
 
Isolation of the patient to prevent spread of the dermatitis
Question 9
 
1 / 1 point
The role of the NP in the use of herbal medication is to:
 
Maintain competence in the prescribing of common herbal remedies
 
Recommend common over-the-counter herbs to patients
 
Educate patients and guide them to appropriate sources of care
 
Encourage patients to not use herbal therapy due to the documented dangers
Question 10
 
1 / 1 point
Elena Vasquez’s primary language is Spanish, and she speaks very limited English. Which technique would be appropriate to use in teaching her about a new drug you have just prescribed?
 
Use correct medical terminology because Spanish has a Latin base.
 
Use a family member who speaks more English to act as an interpreter.
 
Use a professional interpreter or a reliable staff member who can act as an interpreter.
 
Use careful, detailed explanations.
Question 11
 
1 / 1 point
A woman who is pregnant and has hyperthyroidism is best managed by a specialty team who will most likely treat her with:
 
Methimazole
 
Propylthiouracil (PTU)
 
Radioactive iodine
 
Nothing, treatment is best delayed until after her pregnancy ends
Question 12
 
1 / 1 point
The first-line drug choice for a previously healthy adult patient diagnosed with community-acquired pneumonia would be:
 
Ciprofloxacin
 
Azithromycin
 
Amoxicillin
 
Doxycycline
Question 13
 
1 / 1 point
Sadie is a 90-year-old patient who requires a new prescription. What changes in drug distribution with aging would influence prescribing for Sadie?
 
 
Increased volume of distribution
 
Decreased lipid solubility
 
Decreased plasma proteins
 
Increased muscle-to-fat ratio
Question 14
 
1 / 1 point
Patients who are prescribed exogenous androgens need to be warned that decreased libido:
 
Is an unusual side effect of androgens and should be reported to the provider
 
Is treated with increased doses of androgens, so the patient should let the provider know if he is having problems
 
May be a sign of early prostate cancer and he should make an appointment for a prostate screening exam
 
May occur with androgen therapy
Question 15
 
1 / 1 point
Education of women who are being treated with ophthalmic antibiotics for conjunctivitis includes:
 
Throwing away eye makeup and purchasing new
 
Redness and intense burning is normal with ophthalmic antibiotics
 
When applying eye ointment, set the tip of the tube on the lower lid and squeeze in inch
 
Use a cotton swab to apply ointment, spreading the ointment all over the lid and in the conjunctival sac
 
Question 16
 
1 / 1 point
Disease states in addition to hypertension in which beta blockade is a compelling indication for the use of beta blockers include:
 
Heart failure
 
Angina
 
Myocardial infarction
 
Dyslipidemia
Question 17
 
1 / 1 point
What is the role of calcium supplements when patients take bisphosphonates?
 
They must be restricted to allow the medication to work.
 
They must be taken in sufficient amounts to provide foundational elements for bone growth.
 
They must be taken at the same time as the bisphosphonates.
 
They only work with bisphosphonates if daily intake is restricted.
Question 18
 
1 / 1 point
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:
 
It is a long-acting drug with potential for toxicity.
 
Nitrate tolerance can develop.
 
Orthostatic hypotension is a common adverse effect.
 
It must be taken with milk or food.
Question 19
 
1 / 1 point
If an adult patient with comorbidities cannot reliably take oral antibiotics to treat pneumonia, an appropriate initial treatment option would be:
 
IV or IM gentamicin
 
IV or IM ceftriaxone
 
IV amoxicillin
 
IV ciprofloxacin
 
Question 20
 
1 / 1 point
The Combat Methamphetamine Epidemic Act, which is part of the 2006 U.S. Patriot Act:
 
Requires all providers to screen their patients for methamphetamine use
 
Restricts the prescribing of amphetamines to U.S. citizens
 
Requires a prescription be written for all methamphetamine precursors in all states
 
Restricts the sales of drugs that contain methamphetamine precursors, including a daily and 30-day limit on sales
Question 21
 
1 / 1 point
The optimal maximum time frame for HRT or estrogen replacement therapy (ERT) is:
 
2 years
 
5 years
 
10 years
 
15 years
Question 22
 
1 / 1 point
Patrick is a 10-year-old patient who presents with uncomfortable constipation. Along with diet changes, a laxative is ordered to provide more rapid relief of constipation. An appropriate choice of medication for a 10-year-old child would be:
 
PEG 3350 (Miralax)
 
Bisacodyl (Dulcolax) suppository
 
Docusate (Colace) suppository
 
Polyethylene glycol electrolyte solution
Question 23
 
1 / 1 point
Nonadherence is especially common in drugs that treat asymptomatic conditions, such as hypertension. One way to reduce the likelihood of nonadherence to these drugs is to prescribe a drug that:
 
Has a short half-life so that missing one dose has limited effect
 
Requires several dosage titrations so that missed doses can be replaced with lower doses to keep costs down
 
Has a tolerability profile with fewer of the adverse effects that are considered “irritating,” such as nausea and dizziness
 
Must be taken no more than twice a day
Question 24
 
1 / 1 point
Larry is taking allopurinol to prevent gout. Monitoring of a patient who is taking allopurinol includes:
 
Complete blood count
 
Blood glucose
 
C-reactive protein
 
BUN, creatinine, and creatinine clearance
Question 25
 
1 / 1 point
A laboratory result indicates that the peak level for a drug is above the minimum toxic concentration. This means that the:
 
Concentration will produce therapeutic effects
 
Concentration will produce an adverse response
 
Time between doses must be shortened
 
Duration of action of the drug is too long
Question 26
 
1 / 1 point
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:
 
I
 
II
 
III
 
IV
Question 27
 
1 / 1 point
Opiates are used mainly to treat moderate to severe pain. Which of the following is NOT true about these drugs?
 
All opiates are scheduled drugs which require a DEA license to prescribe.
 
Opiates stimulate only mu receptors for the control of pain.
 
Most of the adverse effects of opiates are related to mu receptor stimulation.
 
Naloxone is an antagonist to opiates.
Question 28
 
1 / 1 point
Several classes of drugs have interactions with cholinergic blockers. Which of the following is true about these interactions?
 
Drugs with a narrow therapeutic range given orally may not stay in the GI tract long enough to produce an action.
 
Additive antimuscarinic effects may occur with antihistamines.
 
Cholinergic blockers may decrease the sedative effects of hypnotics.
 
Cholinergic blockers are contraindicated with antipsychotics.
Question 29
 
1 / 1 point
Chee is a 15-month-old male whose screening hemoglobin is 10.4 g/dL. Treatment for his anemia would be:
 
18 mg/day of iron supplementation
 
6 mg/kg per day of elemental iron
 
325 mg ferrous sulfate per day
 
325 mg ferrous sulfate tid
Question 30
 
1 / 1 point
Goals when treating tuberculosis include:
 
Completion of recommended therapy
 
Negative purified protein derivative at the end of therapy
 
Completely normal chest x-ray
 
All of the above
Question 31
 
1 / 1 point
The first-line therapy for mild-persistent asthma is:
 
High-dose montelukast
 
Theophylline
 
Low-dose inhaled corticosteroids
 
Long-acting beta-2-agonists
Question 32
 
1 / 1 point
Gender differences between men and women in pharmacokinetics include:
 
More rapid gastric emptying so that drugs absorbed in the stomach have less exposure to absorption sites
 
Higher proportion of body fat so that lipophilic drugs have relatively greater volumes of distribution
 
Increased levels of bile acids so that drugs metabolized in the intestine have higher concentrations
 
Slower organ blood flow rates so drugs tend to take longer to be excreted
Question 33
 
1 / 1 point
Varenicline (Chantix) may be prescribed for tobacco cessation. Instructions to the patient who is starting varenicline include:
 
The maximum time varenicline can be used is 12 weeks.
 
Nausea is a sign of varenicline toxicity and should be reported to the provider.
 
The starting regimen for varenicline is start taking 1 mg twice a day a week before the quit date.
 
Neuropsychiatric symptoms may occur.
Question 34
 
1 / 1 point
Which of the following is a primary benefit of the use of computerized provider order entry for patient medications?
 
Reduces time that prescribing drugs takes
 
Eliminates the need to chart drugs prescribed
 
Decreases prescribing and transcription errors
 
Helps keep the number of drugs prescribed to a minimum
Question 35
 
1 / 1 point
The most cost-effective treatment for two or three impetigo lesions on the face is:
 
Mupirocin ointment
 
Retapamulin (Altabax) ointment
 
Topical clindamycin solution
 
Oral amoxicillin/clavulanate (Augmentin)
Question 36
 
1 / 1 point
Patients who have a poor metabolism phenotype will have:
 
Slowed metabolism of a prodrug into an active drug, leading to accumulation of Prodrug
 
Accumulation of inactive metabolites of drugs
 
A need for increased dosages of medications
 
Increased elimination of an active drug
Question 37
 
1 / 1 point
Monitoring for patients who are on long-term antifungal therapy with ketoconazole includes:
 
Platelet count
 
BUN and creatinine
 
White blood cell count
 
AST, ALT, alkaline phosphatase, and bilirubin
Question 38
 
1 / 1 point
When a pharmacoeconomic analysis looks at two or more treatment alternatives that are considered equal in efficacy and compares the costs of each it is referred to as:
 
Cost-minimization analysis
 
Cost-of-illness analysis
 
Cost-effectiveness analysis
 
Cost-benefit analysis
Question 39
 
1 / 1 point
When considering which cholesterol-lowering drug to prescribe, which factor determines the type and intensity of treatment?
 
Total LDL
 
Fasting HDL
 
Coronary artery disease risk level
 
Fasting total cholesterol
Question 40
 
1 / 1 point
Sally has been prescribed aspirin 320 mg per day for her atrial fibrillation. She also takes aspirin four or more times a day for arthritis pain. What are the symptoms of aspirin toxicity for which she would need to be evaluated?
 
Tinnitus
 
Diarrhea
 
Hearing loss
 
Photosensitivity
Question 41
 
1 / 1 point
Patients who are on chronic long-term proton pump inhibitor therapy require monitoring for:
 
Iron deficiency anemia, vitamin B12 and calcium deficiency
 
Folate and magnesium deficiency
 
Elevated uric acid levels leading to gout
 
Hypokalemia and hypocalcemia
Question 42
 
1 / 1 point
Which of the following holds true for the pharmacokinetics of women?
 
Gastric emptying is faster than that of men.
 
Organ blood flow is the same as that of men.
 
Evidence is strong concerning renal differences in elimination.
 
Medications that involve binding globulins are impacted by estrogen levels.
Question 43
 
1 / 1 point
Jamison has been prescribed citalopram (Celexa) to treat his depression. Education regarding how quickly selective serotonin reuptake inhibitor (SSRI) antidepressants work would be:
 
Appetite and concentration improve in the first 1 to 2 weeks.
 
Sleep should improve almost immediately upon starting citalopram.
 
Full response to the SSRI may take 2 to 4 months after he reaches the full therapeutic dose.
 
His dysphoric mood will improve in 1 to 2 weeks.
 
Question 44
 
1 / 1 point
Being competent in the use of information technology in clinical practice is expected in professional nurses. Advanced practice competence includes the ability to:
 
Search for information using the most common search engines
 
Serve as content experts in developing, implementing, and evaluating information Systems
 
Write programs to assure the integrity of health information
 
Use information technology to prescribe drugs
Question 45
 
1 / 1 point
According to the U.S. Office of Minority Health, poor health outcomes among African Americans are attributed to:
 
The belief among African Americans that prayer is more powerful than drugs
 
Poor compliance on the part of the African American patient
 
The genetic predisposition for illness found among African Americans
 
Discrimination, cultural barriers, and lack of access to health care
Question 46
 
1 / 1 point
Sook has been prescribed gabapentin to treat neuropathic pain and is complaining of feeling depressed and having “strange” thoughts. The appropriate initial action would be:
 
Increase her dose
 
Assess for suicidal ideation
 
Discontinue the medication immediately
 
Decrease her dose to half then slowly titrate up the dose
Question 47
 
1 / 1 point
A provider may consider testing for CYP2D6 variants prior to starting tamoxifen for breast cancer to:
 
Ensure the patient will not have increased adverse drug reactions to the tamoxifen
 
Identify potential drug-drug interactions that may occur with tamoxifen
 
Reduce the likelihood of therapeutic failure with tamoxifen treatment
 
Identify poor metabolizers of tamoxifen
Question 48
 
1 / 1 point
Male patients who should not be prescribed phosphodiesterase type 5 (PDE-5) inhibitors include:
 
Diabetics
 
Those who have had an acute myocardial infarction in the past 6 months
 
Patients who are deaf
 
Patients under age 60 years of age
Question 49
 
1 / 1 point
True contraindications to diphtheria, tetanus, and acellular pertussis (DTaP or Tdap) vaccine include:
 
Fever up to 104oF (40.5oC) after previous DTaP vaccine
 
Family history of seizures after DTaP vaccine
 
Adolescent pregnancy
 
Anaphylactic reaction with a previous dose
Question 50
 
1 / 1 point
Which the following persons should not have a statin medication ordered?
 
Someone with 3 first- or second-degree family members with history of muscle issues when started on statins
 
Someone with high lipids, but low BMI
 
Premenopausal woman with recent history of hysterectomy
 
Prediabetic male with known metabolic syndrome
 
Question 51
An acceptable first-line treatment for peptic ulcer disease with positive H. pylori test is:
 
Histamine2 receptor antagonists for 4 to 8 weeks
 
Proton pump inhibitor bid for 12 weeks until healing is complete
 
Proton pump inhibitor bid plus clarithromycin plus amoxicillin for 14 days
 
Proton pump inhibitor bid and levofloxacin for 14 days
Question 52
 
1 / 1 point
 
While on testosterone replacement, hemoglobin and hematocrit levels should be monitored. Levels suggestive of excessive erythrocytosis or abuse are:
 
Hemoglobin 14 g/dl or hematocrit 39%
 
Hemoglobin 11.5 g/dl or hematocrit 31%
 
Hemoglobin 13 g/dl or hematocrit 38%
 
Hemoglobin 17.5 g/dl or hematocrit 54%
Question 53
 
1 / 1 point
 
When determining drug treatment the NP prescriber should:
 
Always use evidence-based guidelines
 
Individualize the drug choice for the specific patient
 
Rely on his or her experience when prescribing for complex patients
 
Use the newest drug on the market for the condition being treated
Question 54
 
1 / 1 point
 
Which of the following patients may be treated with a 3-day course of therapy for their urinary tract infection?
 
Juanita, a 28-year-old pregnant woman
 
Sally, a 16-year-old healthy adolescent
 
Jamie, a 24-year-old female
 
Suzie, a 26-year-old diabetic
Question 55
 
1 / 1 point
 
An Investigational New Drug is filed with the U.S. Food and Drug Administration:
 
When the manufacturer has completed phase III trials
 
When a new drug is discovered
 
Prior to animal testing of any new drug entity
 
Prior to human testing of any new drug entity
Question 56
 
1 / 1 point
 
When prescribing a tetracycline or quinolone antibiotic it is critical to instruct the patient:
 
Not to take their regularly prescribed medications while on these antibiotics
 
Regarding the need for lots of acidic foods and juices, such as orange juice, to enhance absorption
 
Not to take antacids while on these medications, as the antacid decreases absorption
 
That there are no drug interactions with these antibiotics
Question 57
 
1 / 1 point
 
Lisa is a healthy nonpregnant adult woman who recently had a urinary tract infection (UTI). She is asking about drinking cranberry juice to prevent a recurrence of the UTI. The correct answer to give her would be:
 
Sixteen ounces per day of cranberry juice cocktail will prevent UTIs.
 
100% cranberry juice or cranberry juice extract may decrease UTIs in some patients.
 
There is no evidence that cranberry juice helps prevent UTIs.
 
Cranberry juice only works to prevent UTIs in children.
Question 58
 
1 / 1 point
Education for patients who use an inhaled beta-agonist and an inhaled corticosteroid includes:
 
Use the inhaled corticosteroid first, followed by the inhaled beta-agonists.
 
Use the inhaled beta-agonist first, followed by the inhaled corticosteroid.
 
Increase fluid intake to 3 liters per day.
 
Avoid use of aspirin or ibuprofen while using inhaled medications.
 
Question 59
 
1 / 1 point
 
Vicky, age 56 years, comes to the clinic requesting a refill of her Fiorinal (aspirin and butalbital) that she takes for migraines. She has been taking this medication for over 2 years for migraines and states one dose usually works to abort her migraine. What is the best care for her?
 
Switch her to sumatriptan (Imitrex) to treat her migraines.
 
Assess how often she is using Fiorinal and refill her medication.
 
Switch her to a beta blocker such as propranolol to prevent her migraine.
 
Request she return to the original prescriber of Fiorinal as you do not prescribe butalbital for migraines.
Question 60
 
1 / 1 point
 
Developmental variation in renal function has what impact on prescribing for infants and children?
 
Lower doses of renally excreted drugs may be prescribed to infants younger than age 6 months.
 
Higher doses of water soluble drugs may need to be prescribed because of increased renal excretion.
 
Renal excretion rates have no impact on prescribing.
 
Parents need to be instructed on whether drugs are renally excreted or not.
Question 61
 
1 / 1 point
 
Preventative therapy for cluster headaches includes:
 
Massage or relaxation therapy
 
Ergotamine nightly before bed
 
Intranasal lidocaine four times a day during “clusters” of headaches
 
Propranolol (Inderal) daily
 
Question 62
 
1 / 1 point
 
ACE inhibitors are contraindicated in pregnancy. While treatment of heart failure during pregnancy is best done by a specialist, which of the following drug classes is considered to be safe, at least in the later parts of pregnancy?
 
Diuretics
 
ARBs
 
Beta blockers
 
Nitrates
Question 63
 
1 / 1 point
 
To improve actual effectiveness of oral contraceptives women should be educated regarding:
 
Use of a back-up method if they have vomiting or diarrhea during a pill packet
 
Doubling pills if they have diarrhea during the middle of a pill pack
 
The fact that they will have a normal menstrual cycle if they miss two pills
 
The fact that mid-cycle spotting is not normal and the provider should be contacted immediately
Question 64
 
1 / 1 point
 
Absolute contraindications that clinicians must consider when initiating estrogen therapy include:
 
Undiagnosed dysfunctional uterine bleeding
 
Deep vein or arterial thromboemboli within the prior year
 
Endometriosis
 
Both a. and b.
 
All of the above
 
 
Question 65
 
1 / 1 point
 
Sophie presents to the clinic with a malodorous vaginal discharge and is confirmed to have Trichomonas infection. Treatment for her would include:
 
Metronidazole 2 grams PO x 1 dose
 
Topical intravaginal metronidazole daily x 7 days
 
Intravaginal clindamycin daily x 7 days
 
Azithromycin 2 grams PO x 1 dose
Question 66
 
1 / 1 point
 
Jim is being treated for hypertension. Because he has a history of heart attack, the drug chosen is atenolol. Beta blockers treat hypertension by:
 
Increasing heart rate to improve cardiac output
 
Reducing vascular smooth muscle tone
 
Increasing aldosterone-mediated volume activity
 
Reducing aqueous humor production
Question 67
 
1 / 1 point
 
There is often cross-sensitivity and cross-resistance between penicillins and cephalosporins because:
 
Renal excretion is similar in both classes of drugs.
 
When these drug classes are metabolized in the liver they both produce resistant enzymes.
 
Both drug classes contain a beta-lactam ring that is vulnerable to beta-lactamase-producing organisms.
 
There is not an issue with cross-resistance between the penicillins and cephalosporins.
Question 68
 
1 / 1 point
 
Drugs that have a significant first-pass effect:
 
Must be given by the enteral (oral) route only
 
Bypass the hepatic circulation
 
Are rapidly metabolized by the liver and may have little if any desired action
 
Are converted by the liver to more active and fat-soluble forms
Question 69
 
1 / 1 point
 
Harold, a 42-year-old African American, has moderate persistent asthma. Which of the following asthma medications should be used cautiously, if at all?
 
Betamethasone, an inhaled corticosteroid
 
Salmeterol, an inhaled long-acting beta-agonist
 
Albuterol, a short-acting beta-agonist
 
Montelukast, a leukotriene modifier
Question 70
 
1 / 1 point
 
Rose is a 3-year-old patient with an upper respiratory infection (URI). Treatment for her URI would include:
 
Amoxicillin
 
Diphenhydramine
 
Pseudoephedrine
 
Nasal saline spray
Question 71
 
1 / 1 point
 
Rabi is being prescribed phenytoin for seizures. Monitoring includes assessing:
 
For phenytoin hypersensitivity syndrome 3 to 8 weeks after starting treatment
 
For pedal edema throughout therapy
 
Heart rate at each visit and consider altering therapy if heart rate is less than 60 bpm
 
For vision changes, such as red-green blindness, at least annually
Question 72
 
1 / 1 point
 
Which diuretic agents typically do not need potassium supplementation?
 
The loop diuretics
 
The thiazide diuretics
 
The aldosterone inhibitors
 
They all need supplementation
Question 73
 
1 / 1 point
 
The dosage of Vitamin B12 to initially treat pernicious anemia is:
 
Nasal cyanocobalamin 1 gram spray in each nostril daily x 1 week then weekly x 1 month
 
Vitamin B12 IM monthly
 
Vitamin B12 1,000 mcg IM daily x 1 week then 1,000 mg IM weekly for a month
 
Oral cobalamin 1,000 mcg daily
Question 74
 
1 / 1 point
 
Pharmacoeconomics is:
 
The study of the part of the U.S. economy devoted to drug use
 
The study of the impact of prescription drug costs on the overall economy
 
The analysis of the costs and consequences of any health-care-related treatment or service
 
The analysis of the clinical efficacy of the drug
 
 
Question 75
 
1 / 1 point
 
Why is the consistency of taking paroxetine (Paxil) and never running out of medication more important than with most other selective serotonin reuptake inhibitors (SSRIs)?
 
It has a shorter half-life and withdrawal syndrome has a faster onset without taper.
 
It has the longest half-life and the withdrawal syndrome has a faster onset.
 
It is quasi-addictive in the dopaminergic reward system.
 
It is the most activating of SSRI medications and will cause the person to have sudden deep sadness.
Question 76
 
1 / 1 point
 
Alterations in drug metabolism among Asians may lead to:
 
Slower metabolism of antidepressants, requiring lower doses
 
Faster metabolism of neuroleptics, requiring higher doses
 
Altered metabolism of omeprazole, requiring higher doses
 
Slower metabolism of alcohol, requiring higher doses
Question 77
 
1 / 1 point
 
Conjunctivitis in a child that is accompanied by acute otitis media is treated with:
 
Sulfacetamide 10% ophthalmic solution (Bleph-10)
 
Bacitracin/polymyxin B (Polysporin) ophthalmic drops
 
Ciprofloxacin (Ciloxan) ophthalmic drops
 
High-dose oral amoxicillin
Question 78
 
1 / 1 point
 
Medications are typically started for angina patients when:
 
The first permanent EKG changes occur
 
The start of class I or II symptoms
 
The events trigger a trip to the emergency department
 
When troponin levels become altered
Question 79
 
1 / 1 point
 
A potentially life-threatening adverse response to angiotensin-converting enzyme inhibitors is angioedema. Which of the following statements is true about this adverse response?
 
Swelling of the tongue or hoarseness are the most common symptoms.
 
It appears to be related to the decrease in aldosterone production.
 
Presence of a dry, hacky cough indicates a high risk for this adverse response.
 
Because it takes time to build up a blood level, it occurs after being on the drug for about 1 week.
Question 80
 
0 / 1 point
 
Class I recommendations for stage A heart failure include:
 
Aerobic exercise within tolerance levels to prevent the development of heart failure
 
Reduction of sodium intake to less than 2,000 mg/day to prevent fluid retention
 
Beta blockers for all patients regardless of cardiac history
 
Treatment of thyroid disorders, especially if they are associated with Tachyarrhythmias
Question 81
 
1 / 1 point
 
Azithromycin dosing requires that the first day’s dosage be twice those of the other 4 days of the prescription. This is considered a loading dose. A loading dose:
 
Rapidly achieves drug levels in the therapeutic range
 
Requires four- to five-half-lives to attain
 
Is influenced by renal function
 
Is directly related to the drug circulating to the target tissues
Question 82
 
1 / 1 point
 
Patient education for a patient who is prescribed antibiotics for sinusitis includes:
 
Use of nasal saline washes
 
Use of inhaled corticosteroids
 
Avoiding the use of ibuprofen while ill
 
Use of laxatives to treat constipation
Question 83
 
1 / 1 point
 
A client asks the NP about the differences in drug effects between men and women. What is known about the differences between the pharmacokinetics of men and women?
 
Body temperature varies between men and women.
 
Muscle mass is greater in women.
 
Percentage of fat differs between genders.
 
Proven subjective factors exist between the genders.
Question 84
 
1 / 1 point
 
The drug of choice for type 2 diabetics is metformin. Metformin:
 
Decreases glycogenolysis by the liver
 
Increases the release of insulin from beta cells
 
Increases intestinal uptake of glucose
 
Prevents weight gain associated with hyperglycemia
Question 85
 
1 / 1 point
 
All of the following statements about the Beer’s List are true except:
 
It is a list of medications or medication classes that should generally be avoided in persons 65 years or older because they are either ineffective or they pose unnecessarily high risk for older persons and a safer alternative is available.
 
It is derived from the expert opinion of one geriatrician and is not evidence-based.
 
These criteria have been adopted by the Centers for Medicare and Medicaid Services for regulation of  long-term care facilities.
 
These criteria are directed at the general population of patients over 65 years of age and do not take  disease states into consideration.
Question 86
 
1 / 1 point
 
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)
 
Oral terbinafine
 
Oral griseofulvin microsize
 
Nystatin cream or ointment
Question 87
 
1 / 1 point
 
The action of “gliptins” is different from other antidiabetic agents because they:
 
Have a low risk for hypoglycemia
 
Are not associated with weight gain
 
Close ATP-dependent potassium channels in the beta cell
 
Act on the incretin system to indirectly increase insulin production
Question 88
 
1 / 1 point
 
Henry is 82 years old and takes two aspirin every morning to treat the arthritis pain in his back. He states the aspirin helps him to “get going” each day. Lately he has had some heartburn from the aspirin. After ruling out an acute GI bleed, what would be an appropriate course of treatment for Henry?
 
Add an H2 blocker such as ranitidine to his therapy.
 
Discontinue the aspirin and switch him to Vicodin for the pain.
 
Decrease the aspirin dose to one tablet daily.
 
Have Henry take an antacid 15 minutes before taking the aspirin each day.
Question 89
 
1 / 1 point
 
Allison is an 18-year-old college student with type 1 diabetes. She is on NPH twice daily and Novolog before meals. She usually walks for 40 minutes each evening as part of her exercise regimen. She is beginning a 30-minute swimming class three times a week at 1 p.m. What is important for her to do with this change in routine?
 
Delay eating the midday meal until after the swimming class.
 
Increase the morning dose of NPH insulin on days of the swimming class.
 
Adjust the morning insulin injection so that the peak occurs while swimming.
 
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