United States University NURSING MSN 571MSN 571 midterm. over 80Questions and Answers. Graded A.

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Note: Please share, add questions (with answers) to get as many from the test bank as possible Green Highlight – correct; Yellow – maybe but not confirmed; Red - Wrong MSN 571 – Midterm What... is the first line therapy when treating hyperlipidemia? A. Bile Acide Sequestrants B. Statin Therapy C. Lifestyle modifications D. Niacin A patient asks you how does the statin drugs work. How would you respond? A. “It inhibits the absorption of dietary cholesterol in the small intestine” B. “it inhibits hydroxymethyl lutaryl- coenzyme A (HMG-CoA) reductase to reduce the biosynthesis of cholesterol in the liver” C. “it binds to bile in the intestinal track forming an insoluble complex that is excreted in the feces” D. “It stimulates the biliary system to increase the excretion of dietary cholesterol” Which drug is the most effective for lowering low density lipoprotein (LDL) cholesterol? A. Atorvastatin B. Gemfibrozil C. Ezetimibe D. Cholestyramine A patient tells you that she gets red after taking her niacin. What advice do you give her? A. Discontinue the medication B. Drink plenty of water C. premedicate with aspirin You are managing a stable middle-aged adult with emphysema. In addition to reinforcing smoking cessation and medication schedules which annual intervention will you recommend? A. Pneumococcal polysaccharide vaccine (PPSV23) B. Pneumococcal conjugate vaccine (PCV13) C. Quadrivalent inactivated influenza vaccine (QIV) D. Live attenuated influenza vaccine (LAV) A patient who is taking OTC proton pump inhibitors was recently placed on an oral antifungal for a fungal infection. After a week, the patient reported that the fungal infection has not improved. Which antifungal medication was the patient taking? A. Fluconazole B. Caspofungin C. Intraconazole D. Amphotericin BA patient diagnosed with hepatitis B begins treatment with Adefovir and ask how long the drug therapy will last. what time frame will the prescriber give the patient? A. Until nephrotoxicity occurs B. A lifetime C. 48 weeks D. An indefinite, prolonged period of time When prescribing acyclovir patients should be educated regarding the: A. Need to drink lots of fluids during treatment B. High risk of developing diarrhea C. ? D. ? Idarucizumab is used to reverse the activity of which antithrombotic drug in cases of bleeding? A. Dalteparin B. Warfarin C. Alteplase D. Dabigatran The patient is receiving anticoagulant therapy period the INR value for the patient today is 1.5. In response to this, what will you do? A. ? B. ? C. ? D. Prescribe an additional dose of warfarin Warfarin’s primary mechanism of action is inhibition of the synthesis of vitamin K dependent clotting factors. These factors include which of the following? A. Factors II, IX, and X and proteins C and S B. Factors VII, IX, X, and XII and protein 5 C. Factors II, VII, VIII, and XII and proteins C and S D. Factors II, VII, VIII, and X and protein C In which of the following patients will you prescribe appropriate therapy for lice infestation? A. Spinosad to a 6 year old patient with head lice B. Lindane to a 105lb patient with lice C. Malathion to a 3 year old patient with head lice D. Ivermectin to a 12kg patient with lice Tretinoin is commonly employed in the treatment of which of the following? A. Psoriasis B. Seborrheic dermatitis C. AcneD. Multiple Sclerosis Which of the following is correct regarding the use of isotretinoin in the treatment of acne? A. Isotretinoin is given intravenously in the treatment of acne B. Isotretinoin is contraindicated in pregnancy due to its high risk of birth defects C. ? D. ? Which of these medications orders are complete? Select all that apply A. Vitamin D 2000 units PO B. Multivitamin C. Promethazine 50mg IV q3-6h PRN for nausea D. Ciprofloxacin hydrochloride (Cipro) 500mg PO q12h x7d E. Aspirin 81 mg PO daily Which of the following is not a required element of the written prescription? A. Quantity of a drug to be dispensed B. Number of refills C. Disease state being treated D. Route of administration A patient diagnosed with otitis externa and taking fluoroquinolone/glucocorticoid combination medication asks the NP what benefit is to taking the medications together. You reply? A. The two medications are contraindicated to use together B. The glucocorticoid reduces the swelling caused by the inflammation and decreases pain, while the fluoroquinolone treats infection C. The glucocorticoid decreases the adverse effects of the fluoroquinolone D. the glucocorticoid decreases the likelihood of antibiotic resistance developing to the fluoroquinolone The NSAIDs are used on a chronic basis by many who suffer headache and inflammation. Many individuals do not require chronic use of these compounds can lead to major adverse effects on which organ system(s)? A. Cardiovascular B. Hepatic C. None are correct D. Gastrointestinal E. Renal Which of the following cardiovascular changes associated with aging is false? A. reduced ventricular compliance B. Preserved sympathetic and vagal resting tone C. Desensitization of carotid and aortic baroreceptors D. Decreased blood vessel contractilityBelow question: don’t know the correct combination. Below is what was picked but incorrect. When prescribing medication to infants, it is important for the provider to consider which fact? (Select all that apply) A. Oral medications are contraindicated in infants B. Breastfeeding infants are more likely to develop toxicity when the mother is taking lipid soluble drugs C. Infants have immature livers, which slows drug metabolism D. Immaturity of renal function in infancy causes infants to excrete drugs less efficiently E. Infants are more sensitive to medications that act on the central nervous system which best describes the action of ACE inhibitors on the failing heart? A. ACE inhibitors increase aldosterone B. ACE inhibitors increased vascular resistance C. ACE inhibitors decreased cardiac output D. ACE inhibitors reduced preload A patient who previously reported feeling better on the current drug regimen suddenly reports that the drug seems to have stopped working. This is known as: A. Tachyphylaxis B. Side effect C. Adverse effect D. Tolerance Regarding genetic variants that alter drug metabolism. Which of the following statements is true? a. All the statements are true b. Drugs with a narrow therapeutic index, small increases in drug levels can lead to toxicity or small decreases in drug levels can lead to failure of drug therapy c. Drugs with a high therapeutic index such as warfarin is not a concern since it is not inactivated by CYP2C9 d. Drugs with a high therapeutic index, altered rates of metabolism will have significant effects on clinical outcomes When administering a drug, which of the following is not necessarily as important to determine the response of a drug? A. timing of administration B. Dosage C. Route D. Frequency A patient has been diagnosed with strep throat and needs a prescription for an antibiotic. The patient stated that the last time he took penicillin, he developed a red, blotchy rash. An appropriate antibiotic to prescribe would be:A. penicillin VK B. azithromycin C. amoxicillin D. Cefadroxil (Duricef) Which of the following drug treatment strategies is associated with peptic ulcer disease? A. opioids B. Corticosteroids C. antibiotics (amoxicillin and clarithromycin) D. hormonal therapy Which of the following diseases or disorders are most likely treated with ACE inhibitors? A. Hyperthyroidism B. Pulmonary hypertension C. Cushing’s syndrome D. Angina E. Chronic kidney disease (with or without diabetes) Your 23 year old female patient is pregnant and has gonorrhea. The medical history includes anaphylaxis following exposure to amoxicillin. The most appropriate drug to use is: A. ciprofloxacin B. ceftriaxone C. cefixime D. Doxycycline The patient is receiving anticoagulant therapy. the INR value for the patient today is 1.5. In response to do this, what will you do? A. the level is outside the expected target therapeutic level of anticoagulation; It is too high B. the level cannot be interpretated without knowing the prothrombin time and the international normalized ratio (INR). C. The level is outside the expected target therapeutic level of anticoagulation; It is too low. D. The level is within the expected target therapeutic level of anticoagulation Which laboratory test is an indirect measure of atherosclerotic plaque? A. Homocysteine B. C-reactive protein (CRP) C. Low density lipoprotein (LDL) D. Erythrocyte sedimentation rate (ESR) Below question: don’t know the correct combination. Below is what was picked but incorrect. The patient who has been prescribed lithium for a diagnosis of bipolar disorder asked why blood tests are required on a regular basis. Which provider responses demonstrate an understanding of why the patient requires a variety of laboratory tests? Select all that apply A. we need to monitor how your thyroid is functioningB. lithium can cause you to lose potassium; So we regularly monitor your blood potassium level C. We need to monitor kidney function while you are on this drug D. This medication can cause you to lose sodium, so we need to measure sodium levels E. Your liver can be damaged by lithium regular testing helps us monitor for that Which statement by a patient about the use of aspirin during pregnancy indicates a need for further learning? A. aspirin can affect hemostasis in the newborn B. aspirin can be used to relieve pain during pregnancy C. Aspirin can cause antepartum hemorrhage D. Aspirin is most harmful when used late in pregnancy elderly patients are known to have a number of medications, what is the highest priority for these patients related to polypharmacy? A. drug interactions B. cost of medications C. Schedule of medications D. Nonadherence to drug regimen The NP student is concerned than an older patient’s adverse drug reactions are due to reduced renal excretion. Which laboratory result should be closely monitor? A. Serum creatinine levels B. Serum albumin levels C. Creatinine clearance D. Blood urea nitrogen (BUN) A parent of a 5 year old child with allergic rhinitis is seeking an approved treatment to make the child feel better. which of the following is recommended? A. Diphenhydramine B. Meclizine C. Cetirizine D. Promethazine What is the term for the study of the way drugs influence the body? A. Pharmacotherapeutics B. Pharmacology C. Pharmacokinetics D. Pharmacodynamics Which term refers to the ratio between the drugs therapeutic effects and its toxic effects? A. cumulative effect B. therapeutic index C. ToleranceD. Affinity Which science provides Primary Health care providers the opportunity to individualize drug therapy based on a patient's genetic makeup? A. Pharmacodynamics B. Pharmacogenomics C. Pharmacokinetics D. Pharmac0genetics The administration of a drug influences cell physiology. What is the term for this concept? A. Pharmacotherapeutics B. Pharmacokinetics C. Pharmacology D. Pharmacodynamics A provider may consider testing for CYP2D6 variants prior to starting tamoxifen for breast cancer to: A. Identify poor metabolizers of tamoxifen B. Ensure the patient will not have increased adverse drug reactions to the tamoxifen C. Identify potential drug-drug interactions that may occur with tamoxifen D. Reduce the likelihood of therapeutic failure with tamoxifen treatment ED50 refers to: A. half-life of the drug B. Half of the drug dose should be prescribed C. The median effective dose D. Half of the drug is eliminated Which of the follow is not one of the four processes of pharmacokinetics? A. Administration B. Absorption C. Distribution D. Excretion Which medication classification is used to decrease preload in patients with heart failure? A. Diuretics B. Corticosteroids C. Beta blockers D. Calcium channel blockers Which patient population benefits the most from diuretic therapy? A. Those with orthostatic hypertension B. Diabetics C. Those with stable anginaD. African American A patient diagnosed with heart failure (HF) and taking an angiotensin-converting enzyme (ACE) inhibitor, has developed fibrotic changes in the heart and vessels. Which type of medication will the provider order to counter this development? A. Beta blocker B. Angiotensin II receptor blocker (ARB) C. Direct renin inhibitor (DRI) D. Aldosterone antagonist What makes Losartan different from other ARBs? a. Losartan has the shortest half life b. Losartan has a small volume of distribution c. Losartan has an active metabolite d. Losartan is renally eliminated a patient has a blood pressure of 150/95 mm HG and 148/90 mm Hg on two separate office visits. This is consistent with a blood pressure of 145/92 mm Hg taken in an ambulatory setting. The patient's diagnostic tests are all normal. What will the patient’s provider order to best manage the patient’s hypertension? A. A thiazide diuretic B. A loop diuretic and Spironolactone C. A beta blocker D. ? Which condition is generally treated with oral antifungal agents? A. Tinea cruris B. Tinea capitis C. Tinea pedis D. Tinea corporis What are vaccines against viruses created from? A. live organisms weakened to produce antigens B. Recombinant pathogenic protein C. Purified toxins that have been chemically detoxified D. killed organisms or extracts of antigens Which hepatitis virus is most commonly known to be sexually transmitted? A. A B. C C. B D. DWhat is a treatment option for patient who reported small, vascular lesions on his genitals that lasted between 10 and 20 days? A. Test of cure B. Three injections of penicillin C. One time dose of azithromycin D. Acyclovir (Zovirax) The patient asks if there is any other option besides antibiotics to treat acute otitis media. How will you respond? A. Pain management is only necessary when antibiotics are prescribed B. Antibiotics are the only way to cure otitis media C. Pain management is reserved for those when the tympanic membrane is burst D. Pain management is also part of the treatment plan for otitis media A 2-year-old presents to the clinic with otalgia and fever. The left tympanic membrane (TM) is erythematous and bulging; The right TMs is perforated and draining. The child’s parents states, “this is the fifth ear infection this year. What can we do?” What action will the provider take to address the child's ear problems? A. Prescribe both high dose amoxicillin and the influenza vaccine B. discuss beginning prophylactic antibiotic therapy with trimethoprim/sulfamethoxazole C. Prescribe both ceftriaxone (Rocephin) IM with benzocaine ear drops for pain D. prescribe amoxicillin/clavulanate and refer the child to an otolaryngologist Fluoroquinolone antibiotics are most likely indicated in which of the following conditions? A. Asthma B. Follicular conjunctivitis C. GERD D. Genital infections In groups of people are at high risk for early hypertension? A. African American B. Adolescents or young adults C. Mexican American culture D. Mediterranean populations E. Old females Which of the following just rug strategies is associated with peptic ulcer disease? A. Corticosteroids B. Hormonal therapy C. Antibiotics (amoxicillin and clarithromycin) D. Opioids Which of the following groups of antibiotics finds to the 50S subunit of the bacterial ribosome and includes drugs such as Erythromycin and azithromycin?A. Fluoroquinolones B. Macrolides C. Aminoglycosides D. Tetracyclines Which antibiotic binds to the 50S subunit of the bacterial ribosome and could most likely result in the development of pseudomembranous colitis? A. Clindamycin B. Tetracycline C. vancomycin D. Amoxicillin Beta lactamase inhibitors are often indicated in which of the following? A. Often combined with penicillin antibiotics B. May decrease absorption of medications C. First dose effect D. Delayed absorption of oral drugs Which of the following terms best describes the mechanism of action of metoprolol? A. A1 antagonist effects B. Beta one selective C. Nonselective beta with alpha blocking D. Nonselective alpha-blockers Which of the following drug classes is/are used in initial hypertension management of African American population? A. Clonidine primary B. Betablockers primary C. thiazide or calcium channel blocker primary D. ACE- I primary Which of the following medications or drugs? Passes is commonly indicated for managing just stational hypertension? A. Spironolactone (Aldactone) B. Loop diuretics C. Calcium channel blockers D. ? A patient is administered cefotetan for a urinary tract infection. After two days, the patient complains of stomach cramps, nausea, vomiting, excessive sweating, itching, and headache. The patient also has decreased blood pressure. How would you interpret the assessment? A. The patient has taken ranitidine in addition to the cefotetan B. The patient has taken probenecid in addition to the cefotetan C. The patient has taken methotrexate in addition to the cefotetanD. The patient has taken ethanol (alcohol) in addition to the cefotetan The antimicrobial that is recommended and highly effective for the treatment of gonorrhea at all anatomic sites of infection: A. Cephalexin B. Parental Ceftriaxone C. Ciprofloxacin D. Penicillin Below question: don’t know the correct combination. Below is what was picked but incorrect. The NP explains to the NP students about penicillin. Which is true about penicillin? Select all that apply A. They cause bacteria to take up excess amounts of water and rupture B. They are known as beta lactam antibiotics C. They are active only against bacteria that are growing and dividing D. They are bacterial static E. There are considered one of the safest antibiotics Your patient is allergic to penicillin and sulfa medications. Which antibiotic can be given safely to the patient? A. Keflex B. Bactrim DS C. Zithromycin D. Cephalasporin born first in second generation Acute bacterial rhinosinusitis syndrome (ABRS) A. Escherichia Coli, Klebsiella pneumoniae, Proteus Mirabilis B. Acinetobacter, Enterococcus Faecalis, Campylobacter C. Streptococcus pneumoniae, Moraxella catarrhalis, Haemophilus influenzae D. Legionella pneumoniae, mycoplasma pneumoniae, chlamydia pneumoniae This selection of antibiotics for the treatment of infections, is based on which understanding of selective toxicity? A. The ability to avoid injuring host cells B. The ability to suppress bacterial resistance C. the ability to transfer DNA coding D. The ability to act against a specific microbe Don’t know the question, but here are the options: A. Nitrofurantoin B. Trimethoprim/Sulfamethoxazole C. Doxycycline D. ClindamycinWhile conducting a well child checkup for a 2 year old, you note the presence of three superficial pustular vesicles on her neck. Which medication will you plan to prescribe as treatment? A. Oral penicillin B. Topical mupirocin C. Oral erythromycin D. Topical neomycin Mild acne may be initially treated with: A. OTC benzoyl perioxide B. Minocycline C. Topical combined antibiotic D. Topical retinoid Which Organism is a common sexually transmitted bacterial infection? A. Clostridium perfringens B. Helicobacter pylori C. Treponema pallidum D. Staphylococcus aureus A 19 year old female is diagnosed with bacterial vaginosis. What is a common treatment prescribed? A. Metronidazole B. Azithromycin C. Amoxicillin D. Ciprofloxacin A 24 year old patient is diagnosed with genital herpes simplex virus infection. Which of the following agents is indicated for use in this diagnosis?\ A. Lamivudine B. Cidofovir C. Valacyclovir D. Zanamivir Tolerance may be caused by desensitization, internalization or downregulation of receptors, requiring higher drug doses to maintain the same response. Tolerance also often results from enhanced drug elimination that alters the concentrations of drugs available to interact with receptor. True False A patient comes to your clinic having taken an undetermined amount of heroin. The drug of choice for heroin overdose is:A. Naltrexone HCL (Revia) B. Methadone (Dolophine) C. Naloxone (Narcan) D. Clonidine (Catapress) A 17 year old asthmatic patient has been told that marijuana may help with his anxiety. Which adverse effect has been associated with marijuana and may be a reason for this patient to avoid use of marijuana? A. Short term memory loss B. Hepatitis C. Hyperthermia D. Hyponatremia ____________ is an example of an agonist-antagonist opioid. A. Diprenorphine B. Naloxone C. Morphine D. Buprenorphine Which is the most common type of anemia? A. Folic acid deficiency B. Iron deficiency C. B12 deficiency D. Sickle cell anemia Anemia chronic renal failure is caused by the lack of: A. Adrenaline B. Erythropoietin C. Parathyroid hormone D. thyroid hormone VT has a history of subtherapeutic anticoagulation on warfarin (due to poor adherence) until the administration time was changed from evening to morning. The patient also frequently skips meals and takes antacids for reflux. The patient wants to take all medications at the same time of day. Select the statin that is optimal for this patient wanting to take medications in the morning. A. Lovastatin (Altoprev) B. Fluvastatin (lescol) C. Provastatin (Pravachol) D. Atrovastatin (Lipitor) Will reviewing the medical records of a patient who is scheduled for surgery, you ascertain that the patient is at risk for which of the following related to a prescription or metformin (glumetza, riomet, Glucophage, fortamet)?A. Hypoglycemia B. Hemorrhage C. ? D. ? What of the following is not a Bile acid sequestrant? A. Chlorpheniramine B. Colesevelam C. Colestipol D. Cholestyramine Below question: don’t know the correct combination. Below is what was picked but incorrect. An elderly patient with hypertension and hyperlipidemia who has been prescribed a statin medication comes for a follow up visit after four months of therapy. The patient's laboratory reports show elevated blood cholesterol levels, in the urine examination reveals rhabdomyolysis. What would be the reasons for this condition? Select all that apply A. The patient is taking cyclosporine along with statins B. The patient is taking grapefruit juice along with statins C. The patient is eating fiber rich foods along with statins D. The patient is taking amiodarone along with the statins E. The patient is not responding to the treatment A pregnant patient with a history of thrombosis. With prophylactic treatment would you prescribe? A. Enoxaparin B. alteplase C. Clopidogrel D. Warfarin Which patient statement suggests to the provider that the patient’s nonadherence with their medication plan is related to dissatisfaction with the therapy? A. This medication is too expensive; I can't afford it any longer. B. I have a very intense, fast paced job; It's hard to make time to take the medication like I should C. It's too hard to remember to take the pill every other day; So I've missed several doses D. I've been taking this medication for well over a week and I lost only a half a pound Which prescriber action will have the greatest impact on the patient's commitment to adherence to any type of medication therapy? A. Assuring that the medication prescription will be covered by the patient's insurance B. Prescribing the medication in oral form whenever possible C. Scheduling once a day administration D. Providing medication education that the patient can easily understand [Show More]

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