Unit 3 MN553 Exam 2022 Questions and Answers

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Many patients self-medicate with antacids. Which patients should be counseled to not take calcium carbonate antacids without discussing it with their provider or a pharmacist first? Question options:... Patients with kidney stones Pregnant patients Patients with heartburn Postmenopausal women - ANSWER Patients with kidney stones Kelly has diarrhea and is wondering if she can take loperamide (Imodium) for the diarrhea. Loperamide: Question options: Can be given to patients of all ages, including infants and children, for viral gastroenteritis Slows gastric motility and reduces fluid and electrolyte loss from diarrhea Is the treatment of choice for the diarrhea associated with E. coli 0157 May be used in pregnancy and by lactating women - ANSWER Slows gastric motility and reduces fluid and electrolyte loss from diarrhea Josie is a 5-year-old patient who presents to the clinic with a 48-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 IV fluids, her exam warrants the use of an antinausea medication. Which of the following would be the appropriate drug to order for Josie? Question options: Prochlorperazine (Compazine) Meclizine (Antivert) Promethazine (Phenergan) Ondansetron (Zofran) I - ANSWER Ondansetron (Zofran) I Gastroesophageal reflux disease may be aggravated by the following medication that affects lower esophageal sphincter (LES) tone: Question options: Calcium carbonate Estrogen Furosemide Metoclopramide - ANSWER Estrogen Metoclopramide improves gastroesophageal reflux disease symptoms by: Question options: Reducing acid secretion Increasing gastric pH Increasing lower esophageal tone Decreasing lower esophageal tone - ANSWER Increasing lower esophageal tone Antacids treat gastroesophageal reflux disease by: Question options: Increasing lower esophageal tone Increasing gastric pH Inhibiting gastric acid secretion Increasing serum calcium level - ANSWER Increasing gastric pH Erik presents with one 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? Question options: Mupirocin (Bactroban) Bacitracin and polymixin B (generic double antibiotic ointment) Retapamulin (Altabax) Oral cephalexin (Keflex) - ANSWER Bacitracin and polymixin B (generic double antibiotic ointment) Juakeem is a nasal methicillin resistant staphylococcus aureus (MRSA) carrier. Treatment to eradicate nasal MRSA is mupirocin. Patient education regarding treating nasal MRSA includes: Question options: Take the oral medication exactly as prescribed. Insert one-half of the dose in each nostril twice a day. Alternate treating one nare in the morning and the other in the evening. Nasal MRSA eradication requires at least 4 weeks of therapy, with up to 8 weeks needed in some patients. - ANSWER Insert one-half of the dose in each nostril twice a day. 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? Question options: Miconazole (Micatin) powder Ketoconazole (Nizoral) cream Terbinafine (Lamisil) cream Griseofulvin (Grifulvin V) suspension - ANSWER Terbinafine (Lamisil) cream Long-term treatment of moderate atopic dermatitis includes: Question options: Topical corticosteroids and emollients Topical corticosteroids alone Topical antipruritics Oral corticosteroids for exacerbations of atopic dermatitis - ANSWER Topical corticosteroids and emollients Josie has severe cystic acne and is requesting treatment with Accutane. The appropriate treatment for her would be: Question options: Order a pregnancy test and if it is negative prescribe the isotretinoin (Accutane). Order Accutane after educating her on the adverse effects. Recommend she try oral antibiotics (minocycline). Refer her to a dermatologist for treatment. - ANSWER Refer her to a dermatologist for treatment. Appropriate initial treatment for psoriasis would be: Question options: An immunomodulator (Protopic or Elidel) Wet soaks with Burrow's or Domeboro solution Intermittent therapy with intermediate potency topical corticosteroids Anthralin (Drithocreme) - ANSWER Intermittent therapy with intermediate potency topical corticosteroids Twenty-year-old Annie comes to the clinic complaining of copious yellow-green eye discharge. Gram stain indicates she most likely has gonococcal conjunctivitis. While awaiting the culture results, the plan of care should be: Question options: None, wait for the culture results to determine the course of treatment Ciprofloxacin (Ciloxan) ophthalmic drops IM ceftriaxone High-dose oral amoxicillin - ANSWER IM ceftriaxone Sadie was prescribed betaxolol ophthalmic drops by her ophthalmologist to treat her glaucoma. Oral beta blockers should be avoided in patients who use ophthalmic beta blockers because: Question options: There may be an antagonistic reaction between the two. The additive effects may include bradycardia. They may potentiate each other and cause respiratory depression. The additive effects may cause metabolic acidosis. - ANSWER The additive effects may include bradycardia. David presents to the clinic with symptoms of allergic conjunctivitis. He is prescribed cromolyn sodium (Opticrom) eye drops. The education regarding using cromolyn eye drops includes: Question options: He should not wear his soft contacts while using the cromolyn eye drops. Cromolyn drops are instilled once a day to prevent allergy symptoms. Long-term use may cause glaucoma. He may experience bradycardia as an adverse effect - ANSWER He should not wear his soft contacts while using the cromolyn eye drops. Jim presents with complaints of "heartburn" that is minimally relieved with Tums (calcium carbonate) and is diagnosed with gastroesophageal reflux disease (GERD). An appropriate first-step therapy would be: Question options: Omeprazole (Prilosec) twice a day Ranitidine (Zantac) twice a day Famotidine (Pepcid) once a day Metoclopramide (Reglan) four times a day - ANSWER Ranitidine (Zantac) twice a day An elderly person has been prescribed lactulose for treatment of chronic constipation. Monitoring with long-term treatment would include: Question options: Electrolytes, including potassium and chloride Bone mineral density for osteoporosis Magnesium level Liver function - ANSWER Electrolytes, including potassium and chloride The next step in treatment when a patient has been on proton pump inhibitors twice daily for 12 weeks and not improving is: Question options: Add a prokinetic (metoclopramide) Referral for endoscopy Switch to another proton pump inhibitor Add a cytoprotective drug - ANSWER Referral for endoscopy If a patient with H. pylori-positive peptic ulcer disease fails first-line therapy, the second-line treatment is: Question options: Proton pump inhibitor bid plus metronidazole plus tetracycline plus bismuth subsalicylate for 14 days Test H. pylori for resistance to common treatment regimens Proton pump inhibitor plus clarithromycin plus amoxicillin for 14 days Proton pump inhibitor and levofloxacin for 14 days - ANSWER Proton pump inhibitor bid plus metronidazole plus tetracycline plus bismuth subsalicylate for 14 days Erika has been prescribed isotretinoin (Accutane) by her dermatologist and is presenting to her primary care provider with symptoms of sadness and depression. A Beck's Depression Scale indicates she has mild to moderate depression. What would be the best care for her at this point? Question options: Prescribe a select serotonin reuptake inhibitor (SSRI) antidepressant Refer her to a mental health therapist Contact her dermatologist about discontinuing the isotretinoin Reassure her that mood swings are normal and schedule follow up in a week - ANSWER Contact her dermatologist about discontinuing the isotretinoin Jesse is prescribed tazarotene for his psoriasis. Patient education regarding topical tazarotene includes instructing them: Question options: That tazarotene is applied in a thin film to the psoriasis plaque lesions To apply it liberally to all psoriatic lesions To apply tazarotene to nonaffected areas to prevent breakout That tazarotene may cause hypercalcemia if it is overused - ANSWER That tazarotene is applied in a thin film to the psoriasis plaque lesions Nicolas is a football player who presents to the clinic with athlete's foot. Patients with tinea pedis may be treated with: Question options: OTC miconazole cream for 4 weeks Oral ketoconazole for 6 weeks Mupirocin ointment for 2 weeks Nystatin cream for 2 weeks - ANSWER OTC miconazole cream for 4 weeks Vanessa has been diagnosed with scabies. Her education would include: Question options: She should apply the scabies treatment cream for an hour and wash it off. Scabies may need to be retreated in a week after initial treatment. All members of the household and close personal contacts should be treated. Malathion is flammable and she should take care until the solution dries. - ANSWER All members of the household and close personal contacts should be treated. Ciprofloxacin otic drops are contraindicated in: Question options: Children Patients with acute otitis externa Patients with a perforated tympanic membrane Swimmer's ear - ANSWER Patients with a perforated tympanic membrane Janie presents to the clinic with hard ear wax in both ear canals. Instructions regarding home removal of hard cerumen include: Question options: Moisten a cotton swab (Q-tip) and swab the ear canal twice daily. Instill tap water in both ears while bathing. Squirt hydrogen peroxide into ears with each bath. Instill carbamide peroxide (Debrox) twice daily until canals are clear. - ANSWER Instill carbamide peroxide (Debrox) twice daily until canals are clear. [Show More]

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