NSG 6005 Final Exam/ Questions and Answers

NSG 6005 Final Exam 1. An ACE inhibitor and what other class of drug may reduce proteinuria in patients with diabetes better than either drug alone? 2. Adam has type I diabetes and plays tennis for his university. ...

NSG 6005 Final Exam 1. An ACE inhibitor and what other class of drug may reduce proteinuria in patients with diabetes better than either drug alone? 2. Adam has type I diabetes and plays tennis for his university. He exhibits knowledge deficit about his insulin and his diagnosis. He should be taught that: 3. Age is a factor in different responses to pain. Which of the following age-related statements about pain is not true? 4. Alterations in drug metabolism among Asians may lead to: 5. Amiodarone has been prescribed in a patient with a supraventricular dysrhythmia. Patient teaching should include all of the following except: 6. Anticholinergic agents, such as benztropine (Cogentin), may be given with a phenothiazine to: 7. An appropriate drug for the treatment of depression with anxiety would be: 8. Cara is taking levetiracetam (Keppra) to treat seizures. Routine education for levetiracetam includes reminding her: 9. Cecilia presents with depression associated with complaints of fatigue, sleeping all the time, and lack of motivation. An appropriate initial antidepressant for her would be: 10. Chemical dependency assessment is integral to the initial assessment of chronic pain. Which of the following raises a "red flag" about potential chemical dependency? 11. Common mistakes practitioners make in treating anxiety disorders include: 12. David presents to clinic with symptoms of allergic conjunctivitis. He is prescribed cromolyn sodium (Opticrom) eyedrops. The education regarding using cromolyn eyedrops includes which one of the following tips? 13. The DEA: 14. Diagnostic criteria for diabetes include: 15. Disease states in addition to hypertension in which beta blockade is a compelling indication for the use of beta blockers include: 16. The drug of choice for type II diabetics is metformin. Metformin: 17. The drug recommended as primary prevention of osteoporosis in men over seventy years is: 18. The drug recommended as primary prevention of osteoporosis in women over seventy years old is: 19. The drugs recommended by the American Academy of Pediatrics for use in children with diabetes (depending upon type of diabetes) are: 20. Drugs that have a significant first-pass effect: 21. Dwayne has classic tinea capitis. Treatment for tinea on the scalp is: 22. Dwayne was recently started on carbamazepine to treat seizures. He comes to see you, and you note that while his carbamazepine levels had been in the therapeutic range, they are now low. The possible cause for the low carbamazepine levels is: 23. Erik presents with a golden-crusted lesion at the site of an insect bite consistent with impetigo. His parents have limited finances and request the least expensive treatment. Which medication would be the best choice for treatment? 24. First-line therapy for hyperlipidemia is: 25. First-line therapy for treating topical fungal infections such as tinea corporis (ringworm) or tinea pedis (athlete's foot) would be: 26. Furosemide is added to a treatment regimen for heart failure, which includes digoxin. Monitoring for this combination includes: 27. Genetic polymorphisms account for differences in metabolism, including: 28. Genetic testing for VCORC1 mutation to assess potential warfarin resistance is required prior to prescribing warfarin. 29. Goals of treatment when treating hypothyroidism with thyroid replacement include: 30. Heart failure is a chronic condition that can be adequately managed in primary care. However, consultation with or referral to a cardiologist is appropriate when: 31. Hypoglycemia can result from the action of either insulin or an oral hypoglycemic. Signs and symptoms of hypoglycemia include: 32. If a patient with H. pylori positive PUD fails first-line therapy, the second-line treatment is: 33. In addition to methimazole, a symptomatic patient with hyperthyroidism may need a prescription for: 34. Inadequate vitamin D intake can contribute to the development of osteoporosis by: 35. Incorporating IT into a patient encounter takes skill and tact. During the encounter, the provider can make the patient more comfortable with the IT the provider is using by: 36. Infants with reflux are initially treated with: 37. In five- to eleven-year-old children, mild-persistent asthma is diagnosed when asthma symptoms occur: 38. Jack, eight years old, has attention deficit disorder (ADD) and is prescribed methylphenidate (Ritalin). He and his parents should be educated about the side effects of methylphenidate, which are: 39. Janie presents to clinic with hard ear wax in both ear canals. Instructions regarding home removal of hard cerumen includes: 40. Jim presents with complaints of "heart burn" that is minimally relieved with Tums (calcium carbonate) and is diagnosed with GERD. An appropriate first step therapy would be: 41. Jim presents with fungal infection of two of his toenails (onychomycosis). Treatment for fungal infections of the nail includes: 42. Josie is a five-year-old who presents to the clinic with a forty-eight-hour history of nausea, vomiting, and some diarrhea. She is unable to keep fluids down, and her weight is 4 pounds less than her last recorded weight. Besides intravenous (IV) fluids, her exam warrants the use of an antinausea medication. Which of the following would be the appropriate drug to order for Josie? 43. Kirk sprained his ankle and is asking for pain medication for his mild-to-moderate pain. The appropriate first-line medication would be __________. 44. Liza is breastfeeding her two-month-old son, and she has an infection that requires an antibiotic. What drug factors influence the effect of the drug on the infant? 45. Long-acting beta-agonists received a black box warning from the US Food and Drug Administration due to the: 46. Long-term treatment of moderate atopic dermatitis includes: 47. Medications used in the management of patients with COPD include: 48. Monitoring for a child on methylphenidate for ADHD includes: 49. Narcotics are exogenous opiates. They act by ______. 50. A nineteen-year-old male was started on risperidone. Monitoring for risperidone includes observing for common side effects, including: 51. 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: 52. Off-Label prescribing is: 53. One goal of asthma management in children is: 54. The ongoing monitoring of patients over the age sixty-five years taking alendronate (Fosamax) or any other bisphosphonate is: 55. A patient has been prescribed silver sulfadiazine (Silvadene) cream to treat burns on his or her leg. Normal adverse effects of silver sulfadiazine cream include: 56. Patients who are on or who will be starting chronic corticosteroid therapy need monitoring of __________. 57. Patients who have angina, regardless of class, who are also diabetic should be on: 58. Patients with psychiatric illnesses have adherence rates to their drug regimen between 35% and 60%. To improve adherence in this population, prescribe drugs: 59. A patient with a COPD exacerbation may require: 60. Pharmacokinetics among Asians are universal to all the Asian ethnic groups. 61. A potentially life-threatening adverse response to ACE inhibitors is angioedema. Which of the following statements is true about this adverse response? 62. Prescribing for women during their childbearing years requires constant awareness of the possibility of: 63. Prior to prescribing metformin, the provider should: 64. Progesterone-only pills are recommended for women who: 65. Sadie is a seventy-two-year-old who takes omeprazole for her chronic GERD. Chronic long-term omeprazole use places her at increased risk for: 66. Sarah, a forty-two-year-old female, requests a prescription for an anorexiant to treat her obesity. A trial of phentermine is prescribed. Prescribing precautions include understanding that: 67. Scott is presenting for follow-up on his lipid panel. He had elevated total cholesterol, elevated triglycerides, and an LDL of 122 mg/dL. He has already implemented diet changes and increased physical activity. He has mildly elevated liver studies. An appropriate next step for therapy would be: 68. Second-generation antihistamines such as loratadine (Claritin) are prescribed for seasonal allergies because they: 69. Severe contact dermatitis caused by poison ivy or poison oak exposure often requires treatment with: 70. Sitagliptin has been approved for: 71. A sixty-six-year-old male was prescribed phenelzine (Nardil) while in an acute psychiatric unit for recalcitrant depression. The nurse practitioner managing his primary healthcare needs to understand the following regarding phenelzine and other monoamine oxidase inhibitors (MAOIs): 72. Six-year-old Lucy has recently been started on ethosuximide (Zarontin) for seizures. She should be monitored for: 73. Stage C patients usually require a combination of three to four drugs to manage their heart failure. In addition to ACE inhibitors and beta blockers, diuretics may be added. Which of the following statements about diuretics is not true? 74. A stepwise approach to the pharmacologic management of asthma: 75. Studies have shown that control targets that reduce the hemoglobin A1c to less than 7% are associated with fewer long-term complications of diabetes. Patients who should have such a target include: 76. Tiotropium bromide (Spiriva) is an inhaled anticholinergic: 77. To reduce mortality, all patients with angina, regardless of class, should be on: 78. The treatment for vitamin B12 deficiency is: 79. Treatment of a patient with hypothyroidism and cardiovascular disease consists of: 80. The trial period to determine effective anti-inflammatory activity when starting a patient on aspirin for RA is _____. 81. A twenty-four-year-old male received multiple fractures in a motor vehicle accident that required significant amounts of opioid medication to treat his pain. He is at risk for Type __ ADR when he no longer requires the opioids. 82. The type of ADR that is the result of an unwanted but otherwise normal pharmacological action of a drug given in the usual therapeutic doses is: 83. Unlike most type II diabetics where obesity is a major issue, older adults with low body weight have higher risks for morbidity and mortality. The most reliable indicator of poor nutritional status in older adults is: 84. Vicky, age fifty-six years, comes to clinic requesting a refill of her Fiorinal (aspirin and butalbital) that she takes for migraines. She has been taking this medication for over two years for migraine and states one dose usually works to abort her migraine. What is the best care for her? 85. Warfarin resistance may be seen in patients with VCORC1 mutation, leading to: 86. What impact does developmental variation in renal function has on prescribing for infants and children? 87. When a patient is on selective-serotonin reuptake inhibitors: 88. When obtaining a drug history from Harold, he gives you a complete list of his prescription medications. He denies taking any other drugs, but you find that he occasionally takes aspirin for his arthritis flare-ups. This is an example of: 89. When prescribing any headache therapy, appropriate use of medications needs to be discussed to prevent medication-overuse headaches. The clinical characteristics of medication-overuse headaches include ________. 90. When Sam used clotrimazole (Lotrimin AF) for athlete's foot, he developed a red, itchy rash consistent with a hypersensitivity reaction. He now has athlete's foot again. What would be a good choice of antifungal for Sam? 91. When starting a patient with hypothyroidism on thyroid replacement hormones, patient education would include the following: 92. Which of the following adverse effects may occur due to a dihydropyridine-type calcium channel blocker? 93. Which of the following classes of drugs is contraindicated in heart failure? 94. Which of the following disease processes could be made worse by taking a nonselective beta blocker? 95. Which of the following factors may adversely affect a patient's adherence to a therapeutic drug regimen? 96. Which of the following is the goal of treatment of acute pain? 97. Which of the following is the mechanism of action of oral combined contraceptives that prevent pregnancy? 98. Which of the following statements is true about age and pain? 99. A woman who has migraine with aura: 100. A woman with an intact uterus should not be prescribed: