pharmacology mid. exam [correct 100 quetions and answers ]

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 Question 1 1 out of 1 points Mr. Penny, age 67, was diagnosed with chronic angina several months ago and has been unable to experience adequate relief of his symptoms. As a result, his physici... an has prescribed ranolazine (Ranexa). Which of the following statements is true regarding the use of ranolazine for the treatment of this patient's angina? Selected Answer: Mr. Penny requires concurrent treatment with a beta blocker, nitrate, or a calcium channel blocker.  Question 2 1 out of 1 points Glucocorticoids affect the metabolism of carbohydrates, protein, and fats. Selected Answer: Tru e  Question 3 1 out of 1 points A patient with a known history of benign prostatic hyperplasia (BPH) presents to the clinic 4 days after developing a cold. He tells you he began experiencing a sore throat and nasal congestion and began to take an over the counter decongestant. Today, he complains of not urinating over the last 12 hours. He also has suprapubic fullness on exam. Which of the following medications are most likely responsible for this patient's urinary retention? Selected Answer: Phenylephrii ne  Question 4 1 out of 1 points A patient on valproic acid may experience which of the following symptoms? Selected Answer: All of the above  Question 5 1 out of 1 points The Nurse Practitioner is preparing to Prescribe a medication regimen for her patient. He or she recognizes that criteria for choosing an effective drug for any disorder include: Selected Answer: Consulting nationally recognized guidelines for disease management  Question 6 0 out of 1 points Classes of medications typically used to treat hyperthyroid conditions include: Selected Answer: ACE inhibitors, anxiolytics, and antithyroid medications.  Question 7 0 out of 1 points A patient has been started on a treatment regimen that includes levothyroxine. Select the dosage regimen that is most appropriate for a mean replacement dosage. The patient has been started on a treatment regimen that includes levothyroxine. Select the dosage regimen that is most appropriate for a mean replacement dosage. Selected Answer: 1.2 mcg/kg of body weight per day  Question 8 1 out of 1 points Which of the following serves to protect the public by ensuring the purity of a drug and its contents? Selected Answer: Federal legislation  Question 9 0 out of 1 points A primary therapy for patients with mild ulcerative colitis is: Selected Answer: Metronidazole (Flagyl).  Question 10 1 out of 1 points The Elderly are at high risk of Adverse Drug Reactions due to: Selected Answer: age related decrease in renal function  Question 11 1 out of 1 points To minimize the risk of adverse effects of glucagon when given to an unconscious diabetic patient, as the patient regains consciousness, the nurse should Selected Answer: administer carbohydrates.  Question 12 0 out of 1 points Which of the following can block the action of heparin? Selected Answer: Vitamin K  Question 13 0 out of 1 points Which of the following statements accurately describes digoxin? Selected Answer: It increases ventricular contraction by activating the AV node.  Question 14 0 out of 1 points Ms. Neely was placed on fluoxetine about 8 weeks ago and is doing well on the medication. When initially prescribed the medication, she asks you about the common side effects of this type of medication. Which choice below is correct? Selected Answer: loss of taste  Question 15 1 out of 1 points Some first-generation antihistamines are used: Selected Answer: to prevent motion sickness  Question 16 0 out of 1 points Which medication class is recognized for the treatment of moderate to severe dementia? Selected Answer: Cholinesterase inhibitors.  Question 17 1 out of 1 points Typical adverse reactions to oral calcium-channel blockers include: Selected Answer: edem a  Question 18 0 out of 1 points A 34-year-old male patient is prescribed methimazole (MMI). The Nurse Practitioner will advise him to report which of the following immediately? Selected Answer: Vertig o  Question 19 1 out of 1 points All of the following agents are used to control the inflammatory changes seen in the lungs of asthmatics except: Selected Answer: Albuterol inhaler (proventil)  Question 20 0 out of 1 points What is associated with chronic overtreatment with levothyroxine (Synthroid)? Selected Answer: Sweati ng  Question 21 1 out of 1 points A 53-year-old man has been treated for severe asthma for several years with prednisone. Recently, his physician initiated alternate-day therapy for him. The patient tells the nurse that he would rather take the medication every day to prevent confusion. Which of the following would be the best response by the nurse? Selected Answer: "This schedule allows rest periods so that adverse effects are decreased but the anti-inflammatory effects continue."  Question 22 0 out of 1 points A 39 y/o female is diagnosed with Graves disease. She also has a small goiter =. Her symptoms are not deemed to be severe and propylthiouracil is prescribed. Whare is the most serious potential adverse effect of this medication? Selected Answer: Renal Failure  Question 23 0 out of 1 points The APRN's ability to prescribe controlled substances is regulated by: Selected Answers: DE A  Question 24 0 out of 1 points A common side effect of metformin (Glucophage) therapy is: Selected Hypoglyce mia Answer:  Question 25 1 out of 1 points A Nurse Practitioner is conducting an assessment of a patient who has recently had several changes made to her drug regimen. What assessment question most directly addresses the safety implications of the patient's drug regimen? Selected Answer: "Do you take any herbal supplements or alternative medications?"  Question 26 0 out of 1 points The side effects of antihistamines are mostly due to their: Selected Answer: sedating effects  Question 27 1 out of 1 points What drug class will decrease the facial flushing that occurs with niacin? Selected Answer: NSAID S  Question 28 1 out of 1 points The anticoagulant drug that acts as a vitamin K antagonist is: Selected Answer: coumad in  Question 29 1 out of 1 points Typical adverse reactions to oral calcium-channel blockers include: Selected Answer: edem a  Question 30 0 out of 1 points Advanced practice nurse prescribing of scheduled medications is affected most by: Selected Answer: DE A  Question 31 1 out of 1 points A patient with a history of bronchial asthma is seen in the clinic for increased episodes of difficulty breathing. He has been taking theophylline 100 mg PO tid. He is 40 years old and obese with an 16-pack-year history of cigarette smoking and excessive intake of coffee daily. He eats a low-carbohydrate, high-protein diet. Which identified factors decrease the therapeutic effects of the theophylline? Selected Answer: Smoking history and diet  Question 32 1 out of 1 points A patient in need of myocardial infarction prophylaxis has been prescribed sulfinpyrazone for gout. Which of the following will the nurse monitor the patient most closely for? Selected Answer: Bleeding  Question 33 1 out of 1 points The recommended range for maintaining serum theophylline levels is: Selected Answer: 10 to 20 μg/mL.  Question 34 0 out of 1 points Biguanides control hyperglycemia in type 2 diabetes primarily by acting at which organ? Selected Answer: Pancre as  Question 35 1 out of 1 points The Nurse Practitioner is following up on a patient who is experiencing acute asthma problems. Albuterol (Proventil) by metered-dose inhaler (MDI) has been ordered as treatment. Which patient response would indicate to the family nurse practitioner that the patient understands how to take the medication? Selected Answer: “I will take 1 puff of the medication and then wait a minute before taking the second puff.”  Question 36 0 out of 1 points The Nurse Practitioner is teaching a patient about the role of medications in the treatment of asthma. Which statement by the patient would require further teaching? Selected Answer: “My albuterol is my quick-relief medication.”  Question 37 1 out of 1 points A patient who is a steroid-dependent asthmatic is started on a beclomethasone inhaler. Which should be part of patient education? Selected Answer: Rinse the mouth well after each use  Question 38 1 out of 1 points Mr. Contreras is a 64-year-old patient with Type 2 diabetes. He has recently been diagnosed with hypertension. Which antihypertensive drug is the recommended choice to treat hypertension in patients with diabetes? Selected Answer: ACE Inhibitor  Question 39 1 out of 1 points Which type of antihistamines are used to inhibit the secretion of gastric acid in patients with gastrointestinal disorders? Selected Answer: H2  Question 40 0 out of 1 points When prescribing an antihypertensive medication for a type 2 diabetic patient, the drug classifications that would tend to reduce insulin sensitivity are: Selected Answer: Alpha blockers and ACE inhibitors.  Question 41 1 out of 1 points Acetazolamide is categorized as which of the following? Selected Answer: Carbonic anhydrase inhi bitor  Question 42 1 out of 1 points An adult male comes to the clinic with complaints that he is experiencing increased difficulty breathing over the past few days. He has a history of asthma and coronary artery disease. He was recently diagnosed with hypertension. Examination reveals no jugular vein distention and no productive cough. Breath sounds are present, but expiratory wheezes are noted bilaterally, and he denies any chest pain. His vital signs are pulse of 74 beats/min, respirations of 32 breaths/min, and BP of 160/100 mm Hg. His current medications are albuterol (Proventil) inhaler 2 puffs every 4 hours prn for wheezing, nitroglycerin transdermal patch, and propranolol (Inderal) 60 mg PO bid. What is the best treatment for this patient? Selected Answer: Discontinue propranolol and begin verapamil (Calan) 80 mg PO tid qd.  Question 43 1 out of 1 points A patient with type 1 diabetes has been admitted to the hospital for orthopedic surgery and the care team anticipates some disruptions to the patient's blood glucose levels in the days following surgery. Which of the following insulin regimens is most likely to achieve adequate glycemic control? Selected Answer: Doses of basal insulin twice daily with regular insulin before each meal  Question 44 1 out of 1 points The Family nurse practitioner prescribed losartan 50 mg PO daily for a hypertensive patient. This medication promotes vasodilation by: Selected Answer: Blocking the action of angiotensin II  Question 45 1 out of 1 points Mr. Lastinger was prescribed warfarin sodium (Coumadin). You advise him to avoid eating large amounts of leafy green vegetables because: Selected Answer: The high vitamin K levels will decrease the INR  Question 46 0 out of 1 points A Nurse Practitioner is caring for a patient who is diabetic and has been diagnosed with hypertension. An angiotensin-converting enzyme inhibitor, captopril, has been prescribed for her. Which of the following should the Nurse Practitioner assess before beginning drug therapy? Selected Answer: Blood glucose levels  Question 47 0 out of 1 points Ms. Simpson has a known history of asthma. She is on Theophylline daily. The NP contemplates giving her an antibiotic for her respiratory infection. The NP knows that which choice below could elevate theophylline levels? Selected Answer: Augment in  Question 48 1 out of 1 points A Nurse Practitioner is providing care for a patient who suffered extensive burns to his extremities during a recent industrial accident. Topical lidocaine gel has been ordered to be applied to the surfaces of all his burns in order to achieve adequate pain control. When considering this order, the Nurse Practitioner should be aware that Selected Answer: there is a risk of systemic absorption of the lidocaine through the patient's traumatized skin.  Question 49 1 out of 1 points A 66-year-old woman has a complex medical history that includes poorlycontrolled type 1 diabetes, renal failure as a result of diabetic nephropathy and chronic heart failure (CHF). Her care provider has recently added spironolactone (Aldactone) to the woman's medication regimen. The nurse should consequently assess for signs and symptoms of Selected Answer: hyperkalemia.  Question 50 1 out of 1 points Metformin (Glucophage) acts by: Selected Answer: Decreasing hepatic glucose production with minor effects on insulin sensitivity in both liver and peripheral tissues  Question 51 1 out of 1 points Susie is a 40 year old female with Type 2 Diabetes. She reports that over the last several days, she has been having some hypoglycemic episodes and feels it is related to medication. Her medication list is as follows: Victoza (liraglutide) 1.8 mg SC daily Metformin 500mg p.o. Twice a Day Glyburide 5 mg p.o. Twice a day Lisinopril 10mg p.o. dailo Which medication most likely is contributing to her hypoglycemic episodes Selected Answer: glyburid e  Question 52 1 out of 1 points Which of the following is a contraindication for antimuscarinic drugs? Selected Answer: pyloric stenosis  Question 53 1 out of 1 points The NP knows that lithium levels should be measured while patients are on lithium therapy. The NP also recognizes that lithium has a Selected Answer: has a low therapeutic index and toxicity can occur at doses close to therapeutic levels  Question 54 1 out of 1 points A clinic Nurse Practitioner is planning care for a 68-year-old man who has been on omeprazole (Prilosec) therapy for heartburn for some time. Regarding the patient's safety, which of the following would be a priority nursing action? Selected Answer: Coordinate bone density testing for the patient.  Question 55 0 out of 1 points The first drugs typically used to treat the symptoms of an allergic reaction or allergic rhinitis are: Selected Answer: oral H1 antihistamines.  Question 56 1 out of 1 points Some first generation antihistamines are used: Selected Answer: to prevent motion sickness  Question 57 1 out of 1 points Which of the following statements best defines how a chemical becomes termed a drug? Selected Answer: A chemical must have a proven therapeutic value or efficacy without severe toxicity or damaging properties to become a drug.  Question 58 1 out of 1 points How does cholestyramine lowers blood cholesterol? Selected Answer: Sequestering bile salts and thus decreasing absorption and increasing catabolism  Question 59 1 out of 1 points A patient has a history of tonic-clonic seizures that have been successfully treated with phenytoin (Dilantin) for several years. Phenytoin achieves a therapeutic effect by Selected Answer: decreasing the influx of sodium into neurons.  Question 60 1 out of 1 points You are seeing a 65 year old male with a long history of COPD who has recently developed hypertension. Which class of antihypertensive agents should the Nurse Practitioner avoid for this patient? Selected Answer: BetaBlockers  Question 61 0 out of 1 points Which of the following is a potential adverse side effect of autonomicanticholinergic agents? Selected Answer: Reduced GI motility  Question 62 1 out of 1 points A female patient is taking 0.125 mg of digoxin daily for heart failure. At a recent clinic visit she reports that since she has been on the drug, she can breathe better and her heart rate has been around 74 beats per minute. The nurse weighs the patient and notices that she has gained 10 pounds since the digoxin therapy was started. The patient is concerned that the additional weight will necessitate an increase in the medication. Which of the following is an appropriate response by the nurse? Selected Answer: "No, the drug dosage will likely stay the same."  Question 63 1 out of 1 points The point in time on the drug concentration curve that indicates the first sign of a therapeutic effect is the Selected Answer: onset of action  Question 64 0 out of 1 points During a clinic visit, a patient complains of having frequent muscle cramps in her legs. The nurse's assessment reveals that the patient has been taking over-thecounter laxatives for the past 7 years. The nurse informed the patient that prolonged use of laxatives Selected Answer: inhibits biotransformation of drugs.  Question 65 0 out of 1 points Jillian is a Nurse Practitioner. She recognizes that Nurse Practitioner prescriptive authority Is regulated by: Selected Answer: The U.S. Drug Enforcement Administration  Question 66 1 out of 1 points The nurse practitioner has prescribed elemental iron 6 mg/kg/day in three divided doses for a toddler diagnosed with iron-deficiency anemia. What instructions would the family nurse practitioner include for the parents? Selected Answer: Give the medication through a straw to decrease the staining of the teeth.  Question 67 0 out of 1 points A Nurse Practitioner is discussing with a patient the efficacy of a drug that his physician has suggested, and he begin taking. Efficacy of a drug means which of the following? Selected Answer: The amount of the drug that must be given to produce a particular response  Question 68 1 out of 1 points What information would the Nurse Practitioner include in teaching a patient about the treatment of vitamin B12 deficiency following a total gastrectomy? Selected Answer: The patient will receive monthly cyanocobalamin (vitamin B12) injections for life (after being given daily weekly injections for the first month).  Question 69 1 out of 1 points Drugs that use CYP 3A4 isoenzymes for metabolism may: Selected Both Answer: 1 and 2  Question 70 0 out of 1 points Which mechanism of platelet inhibition is exhibited by aspirin? Selected Answer: Adenosine diphosphate (ADP) antagonism  Question 71 0 out of 1 points Successful treatment for an adult patient with Helicobacter pylori (H. pylori)-induced peptic ulcer disease requires therapy with which regimen? Selected Answer: Amoxicillin, bismuth (Pepto-Bismol), metronidazole (Flagyl), and cimetidine (Tagamet).  Question 72 0 out of 1 points Which can elevate theophylline levels? Selected Answer: Heavy smoking.  Question 73 1 out of 1 points Autonomic drugs have little effect when administered: Selected Answer: orall y  Question 74 1 out of 1 points A 76-year-old woman has a complex medical history that includes emphysema, osteoporosis, malnutrition, and hypothyroidism. Recently, the woman fell outside her home as a result of weakness and suffered a fracture to her femoral head. The woman's subsequent hip-replacement surgery has been scheduled and the care team recognizes that the use of isoflurane will be most significantly influenced by Selected Answer: her history of emphysema.  Question 75 0 out of 1 points Your patient is on Atorvastatin 40 mg daily, and presents for their routine follow up appointment. They complain of extreme fatigue, muscle aches, and dark colored urine. What is your best course of action given presentation? Selected Obtain a liver function Answer: test  Question 76 1 out of 1 points A mother brings her 4-year-old child, who is vomiting and has a temperature of 103°F into the emergency department (ED). The ED physician orders acetaminophen (Tylenol) for the fever. The best form of Tylenol to give the child, considering her presentation, would be Selected Answer: suppository.  Question 77 1 out of 1 points 60-year-old male presents to your office with a history of seizure disorder. The patient states that he has been taking valproic acid. Which of the following is a known potential adverse effect of valproic acid? Selected Answer: Pancreatit is  Question 78 1 out of 1 points A patient is recovering from an acute episode of thrombophlebitis and is being treated with warfarin (Coumadin) 5 mg PO daily. In reviewing medication information, the Nurse Practitioner would include what information in their teaching? Selected Answer: Do not take a multivitamin supplement  Question 79 0 out of 1 points Ginger, a 25 year old female presents at the clinic with known history of depression. She reports taking an SSRI with only partial relief. Which of the following drugs can be used safely at any dose in conjunction with an SSRI? Selected Answer: MAOI (MAO Inhibitor)  Question 80 1 out of 1 points What is a serious side effect of ibuprofen in the older adult patient? Selected Answer: Impairment of renal function  Question 81 1 out of 1 points A Nurse Practitioner is providing discharge planning for a 45-year-old woman who has a prescription for oral albuterol. The Nurse Practitioner will question the patient about her intake of which of the following? Selected Answer: Coffe e  Question 82 0 out of 1 points Which effect does the Nurse Practitioner expect may occur when using cholinergic agonists? Selected Answer: pupil dilation  Question 83 1 out of 1 points A male patient is to begin glyburide (Diabeta) for type 2 diabetes. Before the drug therapy begins, a priority action by the nurse will be to assess the patient's Selected Answer: use of alcohol.  Question 84 0 out of 1 points /Jillian is a Nurse Practitioner. She recognizes that Nurse Practitioner prescriptive authority Is regulated by: Selected Answer: The U.S. Drug Enforcement Administration  Question 85 1 out of 1 points A physician has ordered subcutaneous injections of morphine, a narcotic, every 4 hours as needed for pain for a motor vehicle accident victim. The nurse is aware that there is a high abuse potential for this drug and that it is categorized as a Selected Answer: C-II drug.  Question 86 0 out of 1 points Mr. Johnson is an 80 year old male who is on Digoxin therapy. The Nurse Practitioner knows they should monitor the older adult patient for which of the most common adverse reactions of digoxin? Selected Answer: diarrhe a  Question 87 1 out of 1 points The NP is examining a 34-year-old obese man with a body mass index (BMI) of 35 who complains of almost daily indigestion and heartburn for the past year with a strong acid taste in the mouth about an hour after meals, and frequent belching and awakening at night with choking. The history is negative for chronic illnesses and alarm symptoms. A diagnosis of gastroesophageal reflux disease (GERD) is made. What is the best initial treatment for the patient? Selected Answer: Omeprazole (Prilosec) 20 mg every morning 30 minutes before breakfast.  Question 88 1 out of 1 points Which of the following oral medications is the safest to use during pregnancy? Selected Answer: Methyldo pa  Question 89 1 out of 1 points A possible side effect from the use of nifedipine (Procardia XL) is: Selected Answer: Edema of the ankles and headaches  Question 90 0 out of 1 points A 65-year-old male presents with a history of worsening urinary urgency, frequency, and hesitancy. He also tells you that he has to "push really hard" to urinate and that his urine dribbles a little after he is done urinating. What medication should be avoided Selected Answer: paroxeti ne  Question 91 1 out of 1 points A Nurse Practitioner is caring for a 73-year-old man who is receiving drug therapy. He is beginning to exhibit signs of decline in his renal system, yet his current serum creatinine level is normal. The Nurse Practitioner will base the patient's plan of care on the understanding that there is Selected Answer: a decrease in the amount of creatinine to be filtered.  Question 92 1 out of 1 points The family of a Parkinson’s patient brings him to the clinic because he is experiencing increasing difficulty with ambulation. The family nurse practitioner increases the patient’s dose of carbidopa (25 mg)/levodopa (100 mg) (Sinemet 25–100 mg) from three to four times daily. What is important for the family nurse practitioner to teach the family regarding the increase in the dose of this medication? Selected Answer: Orthostatic hypotension can be problematic at higher dosing ranges.  Question 93 1 out of 1 points A 24-year-old factory worker has been prescribed guaifenesin for the first time. Which of the following will be a priority assessment by the nurse before the patient's first dose? Selected Answer: The amount of alcohol consumption  Question 94 0 out of 1 points A 39 y/o female is diagnosed with Graves disease. She also has a small goiter =. Her symptoms are not deemed to be severe and propylthiouracil is prescribed. Whare is the most serious potential adverse effect of this medication? Selected Answer: Renal Failure  Question 95 1 out of 1 points Glargine (Lantus) is an insulin analog that essentially has no peak and is usually administered: Selected Answer: Once a day.  Question 96 0 out of 1 points A female patient, age 36, is prescribed inhaled corticosteroid (ICS) for daily use. Which of the following adverse effects should the nurse closely monitor for in this patient? Selected Answer: Suppression of the hypothalamic-pituitary-adrenal axis  Question 97 0 out of 1 points A male patient who is hypertensive takes Hydrochlorothiazide for his blood pressure . He presents with red, painful swelling of the great toe. In addition to treating gout, you recognize that you may need to: Selected Answer: Order laboratory studies for diabetes  Question 98 0 out of 1 points You decide to start your pt, Ms. Rodrigues, on spironolactone (Aldactone) 50 mg PO daily. As the NP, you will instruct the patient to call the clinic if which symptoms are experienced? Selected Answer: Weight gain, excessive thirst, and fever.  Question 99 0 out of 1 points Which of the following conditions is a contraindication for pioglitazone (Actos). Selected Answer: Underweight patients  Question 100 1 out of 1 points Which of the following is a side effect or precaution associated with ACE inhibitors? Selected Answer: Angioede ma  Question 101 0 out of 0 points When completing this exam, did you comply with Walden University’s Code of Conduct including the expectations for academic integrity? Selected Answer: Ye s Friday, July 17, 2020 3:04:02 PM EDT [Show More]

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