MN533 Unit 10 Final Exam

1. Question :

Nurse practitioner prescriptive authority is regulated by:

The National Council of State Boards of Nursing

The U.S. Drug Enforcement Administration

The State Board of Nursing for each state

The State Board of Pharmacy

Question 2. Question :

The benefits to the patient of having an Advanced Practice tered Nurse (APRN) prescriber include:

Nurses know more about Pharmacology than other prescribers because they take it both in their basic nursing program and in their APRN program.

Nurses care for the patient from a holistic approach and include the patient in decision making regarding their care.

APRNs are less likely to prescribe narcotics and other controlled substances.

APRNs are able to prescribe independently in all states, whereas a physician’s assistant needs to have a physician supervising their practice.

Question 3. Question :

Azithromycin dosing requires that the first day’s dosage be twice those of the other 4 days of the prescription. This is considered a loading dose. A loading dose:

Rapidly achieves drug levels in the therapeutic range

Requires four- to five-half-lives to attain

Is influenced by renal function

Is directly related to the drug circulating to the target tissues

Question 4. Question :

A laboratory result indicates that the peak level for a drug is above the minimum toxic concentration. This means that the:

Concentration will produce therapeutic effects

Concentration will produce an adverse response

Time between doses must be shortened

Duration of action of the drug is too long

Question 5. Question :

Clinical judgment in prescribing includes:

Factoring in the cost to the patient of the medication prescribed

Always prescribing the newest medication available for the disease process

Handing out drug samples to poor patients

Prescribing all generic medications to cut costs

Question 6. Question :

Drugs that have a significant first-pass effect:

Must be given by the enteral (oral) route only

Bypass the hepatic circulation

Are rapidly metabolized by the liver and may have little if any desired action

Are converted by the liver to more active and fat-soluble forms

Question 7. Question :

A client asks the NP about the differences in drug effects between men and women. What is known about the differences between the pharmacokinetics of men and women?

Body temperature varies between men and women.

Muscle mass is greater in women.

Percentage of fat differs between genders.

Proven subjective factors exist between the genders.

Question 8. Question :

Alterations in drug metabolism among Asians may lead to:

Slower metabolism of antidepressants, requiring lower doses

Faster metabolism of neuroleptics, requiring higher doses

Altered metabolism of omeprazole, requiring higher doses

Slower metabolism of alcohol, requiring higher doses

Question 9. Question :

Precautions that should be taken when prescribing controlled substances include:

Faxing the prescription for a Schedule II drug directly to the pharmacy

Using tamper-proof paper for all prescriptions written for controlled drugs

Keeping any pre-signed prescription pads in a locked drawer in the clinic

Using only numbers to indicate the amount of drug to be prescribed

Question 10. Question :

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:

Has a short half-life so that missing one dose has limited effect

Requires several dosage titrations so that missed doses can be replaced with lower doses to keep costs down

Has a tolerability profile with fewer of the adverse effects that are considered “irritating,” such as nausea and dizziness

Must be taken no more than twice a day

Question 11. Question :

According to the U.S. Office of Minority Health, poor health outcomes among African Americans are attributed to:

The belief among African Americans that prayer is more powerful than drugs

Poor compliance on the part of the African American patient

The genetic predisposition for illness found among African Americans

Discrimination, cultural barriers, and lack of access to health care

Question 12. Question :

Elena Vasquez’s primary language is Spanish, and she speaks very limited English. Which technique would be appropriate to use in teaching her about a new drug you have just prescribed?

Use correct medical terminology because Spanish has a Latin base.

Use a family member who speaks more English to act as an interpreter.

Use a professional interpreter or a reliable staff member who can act as an interpreter.

Use careful, detailed explanations.

Question 13. Question :

An Investigational New Drug is filed with the U.S. Food and Drug Administration:

When the manufacturer has completed phase III trials

When a new drug is discovered

Prior to animal testing of any new drug entity

Prior to human testing of any new drug entity

Question 14. Question :

When determining drug treatment the NP prescriber should:

Always use evidence-based guidelines

Individualize the drug choice for the specific patient

Rely on his or her experience when prescribing for complex patients

Use the newest drug on the market for the condition being treated

Question 15. Question :

When a pharmacoeconomic analysis looks at two or more treatment alternatives that are considered equal in efficacy and compares the costs of each it is referred to as:

Cost-minimization analysis

Cost-of-illness analysis

Cost-effectiveness analysis

Cost-benefit analysis

Question 16. Question :

Ginseng, which is taken to assist with memory, may potentiate:

Aricept

Insulin

Digoxin

Propranolol

Question 17. Question :

Rabi is being prescribed phenytoin for seizures. Monitoring includes assessing:

For phenytoin hypersensitivity syndrome 3 to 8 weeks after starting treatment

For pedal edema throughout therapy

Heart rate at each visit and consider altering therapy if heart rate is less than 60 bpm

For vision changes, such as red-green blindness, at least annually

Question 18. Question :

The role of the NP in the use of herbal medication is to:

Maintain competence in the prescribing of common herbal remedies

Recommend common over-the-counter herbs to patients

Educate patients and guide them to appropriate sources of care

Encourage patients to not use herbal therapy due to the documented dangers

Question 19. Question :

A provider may consider testing for CYP2D6 variants prior to starting tamoxifen for breast cancer to:

Ensure the patient will not have increased adverse drug reactions to the tamoxifen

Identify potential drug-drug interactions that may occur with tamoxifen

Reduce the likelihood of therapeutic failure with tamoxifen treatment

Identify poor metabolizers of tamoxifen

Question 20. Question :

Patients who have a poor metabolism phenotype will have:

Slowed metabolism of a prodrug into an active drug, leading to accumulation of Prodrug

Accumulation of inactive metabolites of drugs

A need for increased dosages of medications

Increased elimination of an active drug

Question 21. Question :

The Combat Methamphetamine Epidemic Act, which is part of the 2006 U.S. Patriot Act:

Requires all providers to screen their patients for methamphetamine use

Restricts the prescribing of amphetamines to U.S. citizens

Requires a prescription be written for all methamphetamine precursors in all states

Restricts the sales of drugs that contain methamphetamine precursors, including a daily and 30-day limit on sales

Question 22. Question :

Several classes of drugs have interactions with cholinergic blockers. Which of the following is true about these interactions?

Drugs with a narrow therapeutic range given orally may not stay in the GI tract long enough to produce an action.

Additive antimuscarinic effects may occur with antihistamines.

Cholinergic blockers may decrease the sedative effects of hypnotics.

Cholinergic blockers are contraindicated with antipsychotics.

Question 23. Question :

Which of the following is a primary benefit of the use of computerized provider order entry for patient medications?

Reduces time that prescribing drugs takes

Eliminates the need to chart drugs prescribed

Decreases prescribing and transcription errors

Helps keep the number of drugs prescribed to a minimum

Question 24. Question :

Jim is being treated for hypertension. Because he has a history of heart attack, the drug chosen is atenolol. Beta blockers treat hypertension by:

Increasing heart rate to improve cardiac output

Reducing vascular smooth muscle tone

Increasing aldosterone-mediated volume activity

Reducing aqueous humor production

Question 25. Question :

When prescribing a tetracycline or quinolone antibiotic it is critical to instruct the patient:

Not to take their regularly prescribed medications while on these antibiotics

Regarding the need for lots of acidic foods and juices, such as orange juice, to enhance absorption

Not to take antacids while on these medications, as the antacid decreases absorption

That there are no drug interactions with these antibiotics

Question 26. Question :

Being competent in the use of information technology in clinical practice is expected in professional nurses. Advanced practice competence includes the ability to:

Search for information using the most common search engines

Serve as content experts in developing, implementing, and evaluating information Systems

Write programs to assure the integrity of health information

Use information technology to prescribe drugs

Question 27. Question :

Sook has been prescribed gabapentin to treat neuropathic pain and is complaining of feeling depressed and having “strange” thoughts. The appropriate initial action would be:

Increase her dose

Assess for suicidal ideation

Discontinue the medication immediately

Decrease her dose to half then slowly titrate up the dose

Question 28. Question :

Isosorbide dinitrate is prescribed for a patient with chronic stable angina. This drug is administered twice daily, but the schedule is 7 a.m. and 2 p.m. because:

It is a long-acting drug with potential for toxicity.

Nitrate tolerance can develop.

Orthostatic hypotension is a common adverse effect.

It must be taken with milk or food.

Question 29. Question :

A potentially life-threatening adverse response to angiotensin-converting enzyme inhibitors is angioedema. Which of the following statements is true about this adverse response?

Swelling of the tongue or hoarseness are the most common symptoms.

It appears to be related to the decrease in aldosterone production.

Presence of a dry, hacky cough indicates a high risk for this adverse response.

Because it takes time to build up a blood level, it occurs after being on the drug for about 1 week.

Question 30. Question :

Pharmacoeconomics is:

The study of the part of the U.S. economy devoted to drug use

The study of the impact of prescription drug costs on the overall economy

The analysis of the costs and consequences of any health-care-related treatment or service

The analysis of the clinical efficacy of the drug

Question 31. Question :

Conjunctivitis in a child that is accompanied by acute otitis media is treated with:

Sulfacetamide 10% ophthalmic solution (Bleph-10)

Bacitracin/polymyxin B (Polysporin) ophthalmic drops

Ciprofloxacin (Ciloxan) ophthalmic drops

High-dose oral amoxicillin

Question 32. Question :

Howard is a 72-year-old male who occasionally takes diphenhydramine for his seasonal allergies. Monitoring for this patient taking diphenhydramine would include assessing for:

Urinary retention

Cardiac output

Peripheral edema

Skin rash

Question 33. Question :

Larry is taking allopurinol to prevent gout. Monitoring of a patient who is taking allopurinol includes:

Complete blood count

Blood glucose

C-reactive protein

BUN, creatinine, and creatinine clearance

Question 34. Question :

The reason that two MMR vaccines at least a month apart are recommended is:

The second dose of MMR “boosts” the immunity built from the first dose.

Two vaccines 1 month apart is the standard dosing for all live virus vaccines.

If the two MMR vaccine doses are given too close together there is a greater likelihood of severe localized reaction to the vaccine.

Only 95% of patients are fully immunized for measles after the first vaccine, with 99% having immunity after two doses of MMR.

Question 35. Question :

Harold, a 42-year-old African American, has moderate persistent asthma. Which of the following asthma medications should be used cautiously, if at all?

Betamethasone, an inhaled corticosteroid

Salmeterol, an inhaled long-acting beta-agonist

Albuterol, a short-acting beta-agonist

Montelukast, a leukotriene modifier

Question 36. Question :

Patients who are prescribed exogenous androgens need to be warned that decreased libido:

Is an unusual side effect of androgens and should be reported to the provider

Is treated with increased doses of androgens, so the patient should let the provider know if he is having problems

May be a sign of early prostate cancer and he should make an appointment for a prostate screening exam

May occur with androgen therapy

Question 37. Question :

Patients who are on chronic long-term proton pump inhibitor therapy require monitoring for:

Iron deficiency anemia, vitamin B12 and calcium deficiency

Folate and magnesium deficiency

Elevated uric acid levels leading to gout

Hypokalemia and hypocalcemia

Question 38. Question :

Monitoring for patients who are on long-term antifungal therapy with ketoconazole includes:

Platelet count

BUN and creatinine

White blood cell count

AST, ALT, alkaline phosphatase, and bilirubin

Question 39. Question :

The first-line therapy for mild-persistent asthma is:

High-dose montelukast

Theophylline

Low-dose inhaled corticosteroids

Long-acting beta-2-agonists

Question 40. Question :

Patients who are treated with greater than 100 grams per week of topical calcipotriene for psoriasis need to be monitored for:

High vitamin D levels

Hyperkalemia

Hypercalcemia

Hyperuricemia

Question 41. Question :

The action of “gliptins” is different from other antidiabetic agents because they:

Have a low risk for hypoglycemia

Are not associated with weight gain

Close ATP-dependent potassium channels in the beta cell

Act on the incretin system to indirectly increase insulin production

Question 42. Question :

Severe contact dermatitis caused by poison ivy or poison oak exposure often requires treatment with:

Topical antipruritics

Oral corticosteroids for 2 to 3 weeks

Thickly applied topical intermediate-dose corticosteroids

Isolation of the patient to prevent spread of the dermatitis

Question 43. Question :

Why is the consistency of taking paroxetine (Paxil) and never running out of medication more important than with most other selective serotonin reuptake inhibitors (SSRIs)?

It has a shorter half-life and withdrawal syndrome has a faster onset without taper.

It has the longest half-life and the withdrawal syndrome has a faster onset.

It is quasi-addictive in the dopaminergic reward system.

It is the most activating of SSRI medications and will cause the person to have sudden deep sadness.

Question 44. Question :

Jamison has been prescribed citalopram (Celexa) to treat his depression. Education regarding how quickly selective serotonin reuptake inhibitor (SSRI) antidepressants work would be:

Appetite and concentration improve in the first 1 to 2 weeks.

Sleep should improve almost immediately upon starting citalopram.

Full response to the SSRI may take 2 to 4 months after he reaches the full therapeutic dose.

His dysphoric mood will improve in 1 to 2 weeks.

Question 45. Question :

Sally has been prescribed aspirin 320 mg per day for her atrial fibrillation. She also takes aspirin four or more times a day for arthritis pain. What are the symptoms of aspirin toxicity for which she would need to be evaluated?

Tinnitus

Diarrhea

Hearing loss

Photosensitivity

Question 46. Question :

Patient education regarding taking iron replacements includes:

Doubling the dose if they miss a dose to maintain therapeutic levels

Taking the iron with milk or crackers if it upsets their stomach

Iron is best taken on an empty stomach with juice

Antacids such as Tums may help the upset stomach caused by iron therapy

Question 47. Question :

When discussing with a patient the different start methods used for oral combined contraceptives, the advantage of a Sunday start over the other start methods is:

Immediate protection against pregnancy the first week of using the pill

No back-up method is needed when starting

Menses occur during the week

They can start the pill on the Sunday after the office visit

Question 48. Question :

The most cost-effective treatment for two or three impetigo lesions on the face is:

Mupirocin ointment

Retapamulin (Altabax) ointment

Topical clindamycin solution

Oral amoxicillin/clavulanate (Augmentin)

Question 49. Question :

Education of women who are being treated with ophthalmic antibiotics for conjunctivitis includes:

Throwing away eye makeup and purchasing new

Redness and intense burning is normal with ophthalmic antibiotics

When applying eye ointment, set the tip of the tube on the lower lid and squeeze in inch

Use a cotton swab to apply ointment, spreading the ointment all over the lid and in the conjunctival sac

Question 50. Question :

True contraindications to diphtheria, tetanus, and acellular pertussis (DTaP or Tdap) vaccine include:

Fever up to 104oF (40.5oC) after previous DTaP vaccine

Family history of seizures after DTaP vaccine

Adolescent pregnancy

Anaphylactic reaction with a previous dose

Question 51. Question :

Medications are typically started for angina patients when:

The first permanent EKG changes occur

The start of class I or II symptoms

The events trigger a trip to the emergency department

When troponin levels become altered

Question 52. Question :

Patrick is a 10-year-old patient who presents with uncomfortable constipation. Along with diet changes, a laxative is ordered to provide more rapid relief of constipation. An appropriate choice of medication for a 10-year-old child would be:

PEG 3350 (Miralax)

Bisacodyl (Dulcolax) suppository

Docusate (Colace) suppository

Polyethylene glycol electrolyte solution

Question 53. Question :

Absolute contraindications that clinicians must consider when initiating estrogen therapy include:

: Undiagnosed dysfunctional uterine bleeding

Deep vein or arterial thromboemboli within the prior year

Endometriosis

Both a. and b.

All of the above

Question 54. Question :

The dosage of Vitamin B12 to initially treat pernicious anemia is:

Nasal cyanocobalamin 1 gram spray in each nostril daily x 1 week then weekly x 1 month

Vitamin B12 IM monthly

Vitamin B12 1,000 mcg IM daily x 1 week then 1,000 mg IM weekly for a month

Oral cobalamin 1,000 mcg daily

Question 55. Question :

Education for patients who use an inhaled beta-agonist and an inhaled corticosteroid includes:

Use the inhaled corticosteroid first, followed by the inhaled beta-agonists.

Use the inhaled beta-agonist first, followed by the inhaled corticosteroid.

Increase fluid intake to 3 liters per day.

Avoid use of aspirin or ibuprofen while using inhaled medications.

Question 56. Question :

What is the role of calcium supplements when patients take bisphosphonates?

They must be restricted to allow the medication to work.

They must be taken in sufficient amounts to provide foundational elements for bone growth.

They must be taken at the same time as the bisphosphonates.

They only work with bisphosphonates if daily intake is restricted.

Question 57. Question :

Henry is 82 years old and takes two aspirin every morning to treat the arthritis pain in his back. He states the aspirin helps him to “get going” each day. Lately he has had some heartburn from the aspirin. After ruling out an acute GI bleed, what would be an appropriate course of treatment for Henry?

Add an H2 blocker such as ranitidine to his therapy.

Discontinue the aspirin and switch him to Vicodin for the pain.

Decrease the aspirin dose to one tablet daily.

Have Henry take an antacid 15 minutes before taking the aspirin each day.

Question 58. Question :

Chee is a 15-month-old male whose screening hemoglobin is 10.4 g/dL. Treatment for his anemia would be:

18 mg/day of iron supplementation

6 mg/kg per day of elemental iron

325 mg ferrous sulfate per day

325 mg ferrous sulfate tid

Question 59. Question :

First-line therapy for treating topical fungal infections such as tinea corporis (ringworm) or tinea pedis (athlete’s foot) would be:

OTC topical azole (clotrimazole, miconazole)

Oral terbinafine

Oral griseofulvin microsize

Nystatin cream or ointment

Question 60. Question :

There is often cross-sensitivity and cross-resistance between penicillins and cephalosporins because:

Renal excretion is similar in both classes of drugs.

When these drug classes are metabolized in the liver they both produce resistant enzymes.

Both drug classes contain a beta-lactam ring that is vulnerable to beta-lactamase-producing organisms.

There is not an issue with cross-resistance between the penicillins and cephalosporins.

Question 61. Question :

The New York Heart Association and the Canadian Cardiovascular Society have described grading criteria for levels of angina. Angina that occurs with unusually strenuous activity or on walking or climbing stair after meals is class:

I

II

III

IV

Question 62. Question :

To improve actual effectiveness of oral contraceptives women should be educated regarding:

Use of a back-up method if they have vomiting or diarrhea during a pill packet

Doubling pills if they have diarrhea during the middle of a pill pack

The fact that they will have a normal menstrual cycle if they miss two pills

The fact that mid-cycle spotting is not normal and the provider should be contacted immediately

Question 63. Question :

Which of the following holds true for the pharmacokinetics of women?

Gastric emptying is faster than that of men.

Organ blood flow is the same as that of men.

Evidence is strong concerning renal differences in elimination.

Medications that involve binding globulins are impacted by estrogen levels.

Question 64. Question :

ACE inhibitors are contraindicated in pregnancy. While treatment of heart failure during pregnancy is best done by a specialist, which of the following drug classes is considered to be safe, at least in the later parts of pregnancy?

Diuretics

ARBs

Beta blockers

Nitrates

Question 65. Question :

The optimal maximum time frame for HRT or estrogen replacement therapy (ERT) is:

2 years

5 years

10 years

15 years

Question 66. Question :

Developmental variation in renal function has what impact on prescribing for infants and children?

Lower doses of renally excreted drugs may be prescribed to infants younger than age 6 months.

Higher doses of water soluble drugs may need to be prescribed because of increased renal excretion.

Renal excretion rates have no impact on prescribing.

Parents need to be instructed on whether drugs are renally excreted or not.

Question 67. Question :

The drug of choice for type 2 diabetics is metformin. Metformin:

Decreases glycogenolysis by the liver

Increases the release of insulin from beta cells

Increases intestinal uptake of glucose

Prevents weight gain associated with hyperglycemia

Question 68. Question :

The drug of choice for treatment of early latent or tertiary syphilis is:

Ceftriaxone IM

Benzathine penicillin G IM

Oral azithromycin

Oral ciprofloxacin

Question 69. Question :

Leonard is completing a 6-month regimen to treat tuberculosis (TB). Monitoring of a patient on TB therapy includes:

Monthly sputum cultures

Monthly chest x-ray

Bronchoscopy every 3 months

All of the above

Question 70. Question :

All of the following statements about the Beer’s List are true except:

It is a list of medications or medication classes that should generally be avoided in persons 65 years or older because they are either ineffective or they pose unnecessarily high risk for older persons and a safer alternative is available.

It is derived from the expert opinion of one geriatrician and is not evidence-based.

These criteria have been adopted by the Centers for Medicare and Medicaid Services for regulation of long-term care facilities.

These criteria are directed at the general population of patients over 65 years of age and do not take disease states into consideration.

Question 71. Question :

Gender differences between men and women in pharmacokinetics include:

More rapid gastric emptying so that drugs absorbed in the stomach have less exposure to absorption sites

Higher proportion of body fat so that lipophilic drugs have relatively greater volumes of distribution

Increased levels of bile acids so that drugs metabolized in the intestine have higher concentrations

Slower organ blood flow rates so drugs tend to take longer to be excreted

Question 72. Question :

Disease states in addition to hypertension in which beta blockade is a compelling indication for the use of beta blockers include:

Heart failure

Angina

Myocardial infarction

Dyslipidemia

Question 73. Question :

A woman who is pregnant and has hyperthyroidism is best managed by a specialty team who will most likely treat her with:

Methimazole

Propylthiouracil (PTU)

Radioactive iodine

Nothing, treatment is best delayed until after her pregnancy ends

Question 74. Question :

Laboratory values are actually different for TSH when screening for thyroid issues and when used for medication management. Which of the follow holds true?

Screening TSH has a wider range of normal values 0.02-5.0; therapeutic levels need to remain above 5.0.

Screening values are much narrower than the acceptable range used to keep a person stable on hormone replacement.

Therapeutic values are kept between 0.05 and 3.0 ideally. Screening values are considered acceptable up to 10.

Screening values are between 5 and 10, and therapeutic values are greater than 10.

Question 75. Question :

Preventative therapy for cluster headaches includes:

Massage or relaxation therapy

Ergotamine nightly before bed

Intranasal lidocaine four times a day during “clusters” of headaches

Propranolol (Inderal) daily

Question 76. Question :

Class I recommendations for stage A heart failure include:

Aerobic exercise within tolerance levels to prevent the development of heart failure

Reduction of sodium intake to less than 2,000 mg/day to prevent fluid retention

Beta blockers for all patients regardless of cardiac history

Treatment of thyroid disorders, especially if they are associated with Tachyarrhythmias

Question 77. Question :

The Best Pharmaceuticals for Children Act:

Includes a pediatric exclusivity rule which extends the patent on drugs studied in children

Establishes a committee that writes guidelines for pediatric prescribing

Provides funding for new drug development aimed at children

Encourages manufacturers specifically to develop pediatric formulations

Question 78. Question :

Goals when treating tuberculosis include:

Completion of recommended therapy

Negative purified protein derivative at the end of therapy

Completely normal chest x-ray

All of the above

Question 79. Question :

Patient education for a patient who is prescribed antibiotics for sinusitis includes:

Use of nasal saline washes

Use of inhaled corticosteroids

Avoiding the use of ibuprofen while ill

Use of laxatives to treat constipation

Question 80. Question :

An acceptable first-line treatment for peptic ulcer disease with positive H. pylori test is:

Histamine2 receptor antagonists for 4 to 8 weeks

Proton pump inhibitor bid for 12 weeks until healing is complete

Proton pump inhibitor bid plus clarithromycin plus amoxicillin for 14 days

Proton pump inhibitor bid and levofloxacin for 14 days

Question 81. Question :

Sophie presents to the clinic with a malodorous vaginal discharge and is confirmed to have Trichomonas infection. Treatment for her would include:

Metronidazole 2 grams PO x 1 dose

Topical intravaginal metronidazole daily x 7 days

Intravaginal clindamycin daily x 7 days

Azithromycin 2 grams PO x 1 dose

Question 82. Question :

Vicky, age 56 years, comes to the clinic requesting a refill of her Fiorinal (aspirin and butalbital) that she takes for migraines. She has been taking this medication for over 2 years for migraines and states one dose usually works to abort her migraine. What is the best care for her?

Switch her to sumatriptan (Imitrex) to treat her migraines.

Assess how often she is using Fiorinal and refill her medication.

Switch her to a beta blocker such as propranolol to prevent her migraine.

Request she return to the original prescriber of Fiorinal as you do not prescribe butalbital for migraines.

Question 83. Question :

If an adult patient with comorbidities cannot reliably take oral antibiotics to treat pneumonia, an appropriate initial treatment option would be:

IV or IM gentamicin

IV or IM ceftriaxone

IV amoxicillin

IV ciprofloxacin

Question 84. Question :

Which of the following patients may be treated with a 3-day course of therapy for their urinary tract infection?

Juanita, a 28-year-old pregnant woman

Sally, a 16-year-old healthy adolescent

Jamie, a 24-year-old female

Suzie, a 26-year-old diabetic

Question 85. Question :

Rose is a 3-year-old patient with an upper respiratory infection (URI). Treatment for her URI would include:

Amoxicillin

Diphenhydramine

Pseudoephedrine

Nasal saline spray

Question 86. Question :

Allison is an 18-year-old college student with type 1 diabetes. She is on NPH twice daily and Novolog before meals. She usually walks for 40 minutes each evening as part of her exercise regimen. She is beginning a 30-minute swimming class three times a week at 1 p.m. What is important for her to do with this change in routine?

Delay eating the midday meal until after the swimming class.

Increase the morning dose of NPH insulin on days of the swimming class.

Adjust the morning insulin injection so that the peak occurs while swimming.

Check glucose level before, during, and after swimming.

Question 87. Question :

IV forms of bisphosphonates are used for all the following except:

Severe gastric irritation with oral forms

Known cancer mets into the bone

Persons with advancing renal dysfunction

Progression of bone loss on oral formulations

Question 88. Question :

The first-line drug choice for a previously healthy adult patient diagnosed with community-acquired pneumonia would be:

Ciprofloxacin

Azithromycin

Amoxicillin

Doxycycline

Question 89. Question :

Which the following persons should not have a statin medication ordered?

Someone with 3 first- or second-degree family members with history of muscle issues when started on statins

Someone with high lipids, but low BMI

Premenopausal woman with recent history of hysterectomy

Prediabetic male with known metabolic syndrome

Question 90. Question :

Varenicline (Chantix) may be prescribed for tobacco cessation. Instructions to the patient who is starting varenicline include:

The maximum time varenicline can be used is 12 weeks.

Nausea is a sign of varenicline toxicity and should be reported to the provider.

The starting regimen for varenicline is start taking 1 mg twice a day a week before the quit date.

Neuropsychiatric symptoms may occur.

Question 91. Question :

Opiates are used mainly to treat moderate to severe pain. Which of the following is NOT true about these drugs?

All opiates are scheduled drugs which require a DEA license to prescribe.

Opiates stimulate only mu receptors for the control of pain.

Most of the adverse effects of opiates are related to mu receptor stimulation.

Naloxone is an antagonist to opiates.

Question 92. Question :

Which of the following statements is true about acute pain?

Somatic pain comes from body surfaces and is only sharp and well-localized.

Visceral pain comes from the internal organs and is most responsive to acetaminophen and opiates.

Referred pain is present in a distant site for the pain source and is based on activation of the same spinal segment as the actual pain site.

Acute neuropathic pain is caused by lack of blood supply to the nerves in a given area.

Question 93. Question :

If a patient with symptoms of gastroesophageal reflux disease states that he has been self-treating at home with OTC ranitidine daily, the appropriate treatment would be:

Prokinetic (metoclopramide) for 4 to 8 weeks

Proton pump inhibitor (omeprazole) for 12 weeks

Histamine2 receptor antagonist (ranitidine) for 4 to 8 weeks

Cytoprotective drug (misoprostol) for 2 weeks

Question 94. Question :

Which diuretic agents typically do not need potassium supplementation?

The loop diuretics

The thiazide diuretics

The aldosterone inhibitors

They all need supplementation

Question 95. Question :

Male patients who should not be prescribed phosphodiesterase type 5 (PDE-5) inhibitors include:

Diabetics

Those who have had an acute myocardial infarction in the past 6 months

Patients who are deaf

Patients under age 60 years of age

Question 96. Question :

Instructions for the use of nicotine gum include:

Chew the gum quickly to get a peak effect.

The gum should be “parked” in the buccal space between chewing.

Acidic drinks such as coffee help with the absorption of the nicotine.

The highest abstinence rates occur if the patient chews the gum when he or she is having cravings.

Question 97. Question :

Sadie is a 90-year-old patient who requires a new prescription. What changes in drug distribution with aging would influence prescribing for Sadie?

Increased volume of distribution

Decreased lipid solubility

Decreased plasma proteins

Increased muscle-to-fat ratio

Question 98. Question :

When considering which cholesterol-lowering drug to prescribe, which factor determines the type and intensity of treatment?

Total LDL

Fasting HDL

Coronary artery disease risk level

Fasting total cholesterol

Question 99. Question :

Lisa is a healthy nonpregnant adult woman who recently had a urinary tract infection (UTI). She is asking about drinking cranberry juice to prevent a recurrence of the UTI. The correct answer to give her would be:

Sixteen ounces per day of cranberry juice cocktail will prevent UTIs.

100% cranberry juice or cranberry juice extract may decrease UTIs in some patients.

There is no evidence that cranberry juice helps prevent UTIs.

Cranberry juice only works to prevent UTIs in children.

Question 100. Question :

While on testosterone replacement, hemoglobin and hematocrit levels should be monitored. Levels suggestive of excessive erythrocytosis or abuse are:

Hemoglobin 14 g/dl or hematocrit 39%

Hemoglobin 11.5 g/dl or hematocrit 31%

Hemoglobin 13 g/dl or hematocrit 38%

Hemoglobin 17.5 g/dl or hematocrit 54%