United States University MSN 571 Midterm Practice MSN 571. Contains over 70 Questions and Answers. Rated 100%.

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Mid Term Pharm MSN571 1. Which is required for red blood cell production ● All ● Iron ● Folate ● Vitamin B12 2. A female patient has an iron deficiency anemia and GI bleed has been ruled... out. You will: ● Refer the patient to hematologist ● Prescribe ferrous sulfate 325mg po TID and schedule the patient to return in 1 month for a repeat CBC, serum iron and TIBC ● Prescribe iron dextran 50mg IM weekly for 4 weeks and schedule weekly office visits for injections. ● Schedule the patient to return in 6 months for additional guaiac stool testing. 3. Most clinically used opioids analgesics are selective for which type of opioid receptor? ● alpha ● delta ● mu ● beta ● kappa 4.Which is true about morphine ● It does not cause tolerance with prolong use ● It promotes nausea and vomiting through direct stimulation of the chemoreceptor trigger zone of the medulla ● It does not cause urinary retention and hesitancy ● Respiratory depression is rare 12. Which of the following medications is a fluroquinolone antibiotic?● Azithromycin ● Ciprofloxacin ● Penicillin ● Amikacin 13. Which of the following terms best describes the mechanism of action of metoprolol? ● Alpha 1 antagonist effects ● Beta 1 selective ( beta-1-adrenergic receptor inhibitor) ● Nonselective Beta with Alpha blocking ● Nonselective Alpha blockers 14. Which antibiotic class disrupts metabolism in bacteria and is often combined with trimethoprim? ● Aminoglycosides ● Cephalosporins ● Macrolides ● Fluoroquinolones ● Sulfonamides 15. Which of the following group of antibiotics has a beta-lactam ring in the molecular structure? ● Cephalosporins ● Fluoroquinolones ● Macrolides ● Sulfonamides ● Tetracycline 16. Which of the following drug classes should be avoided in peptic ulcer disease? ● Avoid antibiotics ● Avoid NSAIDS ● Avoid diuretics ● Avoid proton pump inhibitors 17. Fluroquinolones antibiotics are most likely indicated in which of the following conditions? ● Follicular conjunctivitis● GERD ● Asthma ● Genital Infections 18. Which antibiotics binds to the 505 subunit of the bacterial ribosome and could most likely result in the development of pseudomembranous colitis? ● Tetracycline ● Clindamycin ● Amoxicillin ● Vancomycin 19. Beta Lactamase inhibitors are often indicated in which if the following? ● May decrease absorption of medications ● First dose effect ● Often combined with penicillin antibiotics ● Delayed absorption of oral drugs 20. A patient who takes multiple antibiotics starts to experience diarrheal stool. If the stool sample tests positive for C-Diff which antibiotic, would you prescribe? Metronidazole Gemifloxacin Daptomycin Rifaximin 21. Children younger than 8 years of age should not receive tetracyclines because these agents Can cause aplastic anemia Cause rupture of tendons Do not cross into the cerebrospinal fluid Deposits in tissues undergoing calcification 22. Which patient condition would be a contradiction for the administration of the clindamycin? Diabetes Mellitus Ulcerative Colitis Arthritis Skin infection 23. A child with an ear infection is not responding to treatment with amoxicillin. What alternative medication will the provider order?Amoxicillin-clavulanic acid Penicillin G Ampicillin Nafcillin 24. Every antibiotic drug class has resistant organisms that influence prescribing decisions. True False 25. The dosage of Amoxicillin for the treatment of pediatric acute otitis media is Amoxicillin 50mg/kg/day Amoxicillin 90mg/kg/day Amoxicillin 25mg/kg/day Amoxicillin 150mg/kg/day 26. Which antibiotic is in the macrolide class? Minocycline (Minocin) Nitrofurantoin ( Macrobid) Clarithromycin ( Biaxin) Trimethoprim 27. Contraindications to hepatitis B vaccination is: All pregnant and lactating women Previous severe hypersensitivity or anaphylaxis A history of poliomyelitis Mild viral illness 28. Treatment for fungal infections of the toenails (onychomycosis) includes Miconazole Cream Oral Griseofulvin Mupirocin Cream Ketoconazole Cream 29. In which of the following the human papillomavirus (HPV) vaccine is not recommended A 25 year old who did not finish the vaccine series as a teen Men who have sex with menOnly young men through the age of 21 Men with compromised immune systems (including HIV) through age 30 if they did not get the HPV vaccine as teenagers 30. What is the treatment option for a patient who reported small vesicular lesions on the genitals that lasted between 10 and 20 days? Acyclovir (Zovirax) Three injections of penicillin One time dose of azithromycin Test of cure 31. When teaching a pregnant patient about the effects of medication on the fetus, the greatest harm from maternally ingested medications occurs during which time period? Birthing process First trimester Second trimester Third trimester 32. Which concept guides the NP care of infants receiving a variety of medications? Drugs given subcutaneously (subQ) remain in the body longer in infants than in adults Drugs given intravenously (IV) leave the body more quickly in infants than in adults The blood brain barrier protects the infant’s brain from toxic drugs Gastric emptying time is shorter in infants than in children and adults 33. Which of the following is true? Enzyme inducers can enhance clinical responses to prodrug The bioavailability of lipid soluble drugs is increased in the elderly Drug doses may need to be increased in pregnancy All of the above 34. Physiological changes in the elderly that accounts for a small volume of distribution and an increase in the plasma concentration of digoxin are: Increased activity of hepatic enzymes that facilitate drug metabolism Decreased total body water Increased total body of water Decreased total body fatDecreased rate of elimination due to decreased renal function 35. Keeping Beers Criteria in mind. Which of the following statements concerning the safety of medication used by older adults is incorrect? Benzo’s have a large volume of distribution and are relatively safe for use in older people Chronic use of Nexium may increase rick for C-Diff infection, decreased bone integrity and fractures Diphenhydramine may exacerbate urinary retention of older men with prostate hypertrophy Meperidine is not an effective oral analgesic in dosages commonly used and may cause neurotoxicity 36. A patient’s INR is 1.2 on warfarin therapy to prevent DVT, how would you interpret his INR level as? INT is within limits, no action indicated INR is too high IV protamine sulfate may be needed INR is too low the dose of warfarin may need to be increased INR is too high Vitamin K may be needed 37 What would you prescribe for warfarin overdose? Phytonadione Calcium Aspirin Potassium 38. The patient is receiving anticoagulant therapy. The INR value for the patient today is 1.5. In response to this. What will you do? Increase the heparin drip rate Hold the next dose of warfarin Prescribe protamine sulfate Prescribe an additional dose of warfarin 39. Patients with rheumatoid arthritis who are on chronic low dose prednisone will need co treatment with which medications to prevent further adverse effects? Vitamin D Calcium Supplementation A bisphosphonate All of the above40. A patient has been taking 10mg per day of prednisone for the past 6 months. The Patient should be assessed for? Gout Iron deficiency anemia Renal dysfunction Osteoporosis 41. Which of the following is (are) useful in the eradication of Tinea organisms? Butoconazole Terbinafine (Lamisil) Griseofulvin None of these are correct Both Griseofulvin and Terbinafine (Lamisil) 42. When teaching a patient about amiodarone, you should advise the patient to avoid which food and drink? Gluten Poultry Whole milk Grapefruit juice 43. Which class of drugs is recommended by the JNC8 as the first line therapy for uncomplicated essential hypertension? Angiotensin converting enzyme inhibitors Thiazide Diuretics Loop diuretics Alpha 1 adrenergic receptor blocking agents 44. A patient has been prescribed amiodarone. What should be included in the patient teaching about this medication? Photophobia and wearing sunglasses Gastrointestinal upset Decrease Fluid intake High fiber dietSunscreen use 45 Sublingual nitroglycerin can be used in lower dosages than with the other routes The potency is 100 times higher It bypasses the liver It is not a catabolized down by gastric acids It does not need to be absorbed into the bloodstream 46. A patient requires rapid diuresis and is not urinating well. Which diuretic would be the most effective? Lasix Spironolactone Triamterene HCTZ 47 An elderly patient has problems remembering to take her medication three times a day. Which one of the drug formulations might be particularly might be particularly useful in this case? Skin patch Extended release Suppository Suspension 48. The major reason for not crushing a sustained release capsule is that, if crushed the coated beads of the drugs could possibly result in: Disintegration Malabsorption Deterioration Toxicity 49. Patients who have a poor metabolism phenotype will have A need for increased dosages of medications Slowed metabolism of a prodrug into an active drug, leading to accumulation prodrug Accumulation of inactive metabolites of drugsIncreased elimination of an active drug 50. Drugs that are prone to cause adverse effects include: Insulin Stimulants Inhaled anticholinergics Diuretics 51. An NP is reviewing information about a drug. The drug is taken orally, and after 12 hours, traces of the drug are found in urine and cerebrospinal fluid. What is this process called? Pharmacokinetic Pharmacotherapeutics Pharmaceutics Pharmacodynamics Rationale: The interactions between the body and a drug are studied in two ways: pharmacokinetics and pharmacodynamics. Pharmacokinetics is the study of the processes of absorption, distribution, metabolism, and excretion of a drug. Pharmaceutics is the science of how drugs are made in proper forms and dosages and then supplied to the market. Pharmacodynamics is the study of how a drug acts on the body and its effects on various systems in the body. Pharmacotherapeutics is the study of uses of drugs to prevent and treat diseases 52. Which of the following is the most appropriate choice to describe age associated changes that can affect pharmacokinetics in older patients? Changes in gastrointestinal function that lead to reduced drug absorption Decrease in body fat Increase in total body water Decrease in Creatinine clearance 53. What occurs when a drug binds to a receptor in the body? It gives the receptor a new function It increases or decreases the activity of that receptor It prevents the action of the receptor by altering its response to chemical mediators. It alters the receptor to become nonresponsive to its usual endogenous molecules54. The patient is diagnosed with otitis media with perforated ear drum. You want to prescribe an otic preparation. Which if the following is not appropriate? Ciprofloxacin/dexamethasone Ofloxacin otic Acetic acid Otic Ciprofloxacin/Hydrocortisone Ofloxacin and ciprofloxacin are recommended for the patient with a perforated eardrum. These medicines are safe for the patient with a perforated eardrum. Neomycin, polymyxin B, and hydrocortisone are contraindicated in patients with a perforated eardrum because these drugs may cause permanent damage to the ear. 55. A patient is diagnosed with otitis externa. Comorbidities include diabetes mellitus Hypertension, and advanced multiple sclerosis. Which type of education regarding medication administration would you provide? The oral administration of a prescription for fluoroquinolone The oral administration of prescription for hydrocortisone/neomycin/Polymyxin B combination solution The administration of topical medications for a prescription of alcohol plus acetic acid solution The administration of topical combination for a prescription of a fluoroquinolone/glucocorticoid combination solution 56. A 2-year-old child presents to the clinic with otalgia and fever. The left tympanic membrane (TM) is erythematous and bulging: the right TM is perforated and draining. The child’s parent states/ “This is the 5th ear infection this year. What can we do? What action will the provider take to address the child’s ear problem? Prescribe both ceftriaxone (Rocephin) IM with benzocaine ear drops for pain? Discuss beginning prophylactic antibiotic therapy with trimethoprim/sulfamethoxazole Prescribe amoxicillin clavulanate and refer the child to an otolaryngologist Prescribe both high dose amoxicillin and the influenza vaccine 57. What is the mechanism of action of ezetimibe? It inhibits the absorption of bile thus causing the liver to produce bile from cholesterol It inhibits absorption of the dietary and biliary cholesterol in the small intestine (p. 1052) It decreases the adhesion of cholesterol on the arterial walls It inhibits the biosynthesis of cholesterol in the liver58. On assessment of a patient with hyperlipidemia you learn that the patient has recently undergone liver transportation. Which antihyperlipidemic drug should be excluded from the patient’s prescription? Gemfibrozil Atorvastatin Cholestyramine Ezetimibe 59. Before prescribing simvastatin, which baseline data are collected to help prevent adverse effects of therapy? Select all that apply Potassium Uric Acid Renal Function Gastric distress Muscle pain Liver enzymes 60. A patient with cardiovascular disease is taking rosuvastatin. Which finding would indicates a potential adverse effect of this drug? Muscle pain and tenderness Blood pressure of 140/90mm Hg Wheezing and shortness of breath Platelet count of 100 x 103mm 3 61. Which of the following labs would you want to order for routine monitoring of a patient receiving the anticoagulant Lovenox (enoxaparin) None of these labs would be used PT/INR Hgb alone PTT 62. A provider is reviewing an older adult patients’ chart during a routine visit. Which patient information is of most concern regarding the renewing of medication prescriptions for highly protein-bound drugs? Low serum Creatinine Increased body fatLow serum albumin Chronic constipation 63. you are caring for a patient with bipolar disorder who is taking lithium. Which abnormal lab is most essential for you to reevaluate this patient’s dosage of lithium? Potassium level of 5.0 mEq/L Blood urea nitroglycerin of 20mg/dl Sodium level of 128mEq/L Prothrombin time of 8 secs 64. It is essential for the practitioner to understand the responsibility involved in prescribing a drug or drugs and to consider seriously which class of medication is most appropriate for the patient. The decision is reached based on a thorough knowledge of diagnosis and treatment. True False 65. Nurse practitioner prescriptive authority is regulated by The National Council of State Board of Nursing The State Board of Nursing for each state The state Board of Pharmacy The US Drug Enforcement Administration A post op patient is prescribed fentanyl? What schedule drug is it? A: schedule II Which outcome should the nurse practitioner establish for a patient with trichomoniasis who is receiving flagyl? decrease in yellow green vaginal discharge or absent of painful urination and serous dischargeA 19 year old that comes with a greenish odorish discharge with vaginal itching. During vaginal exam, vaginal mucosa is erythemas, wet mount of discharge shows motile organism. The patient is started on appropriate therapy. Later that evening, a patient has flushing, nausea, vomiting after drinking wine. Which of the following medications has she been treated with? Flagyl diflucan azithromycin ceftriaxone A 19 yr old w/ bacterial vaginosis. What is the common treatment prescribed? cipro amoxicillin flagyl azithromycin Which of the following groups of people are at risk for early hypertension? African American Mexican American Mediterranean Older women Which of the following diseases or disorders are likely treated with ACE inhibitors? hyperthyroidism pulmonary hypertension cushing syndrome angina chronic kidney disease with or without diabetes [Show More]

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