NURS6521 midterm exam 2022 Advanced Pharmacology- latest all 101 answers

Question 1

 

A Nurse Practitioner is overseeing the care of a young man whose ulcerative colitis is being treated with oral prednisone. Which of the following actions should the Nurse Practitioner take in order to minimize the potential for adverse drug effects and risks associated with prednisone treatment?

 

 

 

              Avoid OTC antacids for the duration of treatment

 

 

 

              Advocate for intravenous, rather than oral, administration

 

 

 

              Teach the patient strategies for dealing with headaches

 

 

 

              Carefully assess the patient for infections

 

Question 2

 

A resident of a long-term care facility receives 12.5 mg metoprolol (Lopressor) at 8 AM and 8 PM daily. Before administering this drug, the nurse should perform and document what assessments?

 

 

 

              Oxygen saturation and respiratory rate

 

 

 

              Heart rate and blood pressure

 

 

 

              Level of consciousness and pain level

 

 

 

              Temperature and respiratory rate

 

 

 

Question 3

 

JJ is a 62-year-old male who has hypertension. He currently takes HCTZ 25 mg daily, Amlodipine 5 mg daily and Lisinopril 10 mg daily. He has developed a dry cough that has persisted. Which med could this potentially be due to and what is an acceptable alternative?

 

 

 

              HCTZ; change to Diltiazem

 

 

 

              Lisinopril; change to Spironolactone

 

 

 

              Amlodipine; stop Amlodipine

 

 

 

              Lisinopril; change to Losartan

 

Question 5

 

You get bloodwork back on a patient and results show a TSH of 8.68. You diagnose this patient with _____ and start _____.

 

 

 

              Hyperthyroidism; Propylthiouracil 50 mg daily

 

 

 

              Hypothyroidism; Levothyroxine 50 mcg daily

 

 

 

              Hyperthyroidism; Methimazole 15 mg daily

 

 

 

              Hypothyroidism; Liothyronine 5 mcg daily

 

 

 

 

 

Question 4

 

An elderly postsurgical patient has developed postoperative pneumonia in the days following abdominal surgery and is being treated with a number of medications. Which of the following medications that the nurse will administer has the slowest absorption?

 

 

 

              A sublingual benzodiazepine that has been prescribed to help the patient sleep

 

 

 

              An intravenous (IV) antibiotic that is being administered by IV piggyback at 150 mL/hour

 

 

 

              An oral antidepressant that the patient has been taking daily for several years

 

 

 

              An intramuscular (IM) injection of an opioid analgesic

 

 

 

 

 

 

 

uestion 6

 

A patient is being discharged home on Lantus Solostar insulin pens. You counsel the patient:

 

 

 

              Prime the pen with 2 units at each dose to insure proper insulin dose

 

 

 

              Prime the pen with 5 units at each dose to insure proper insulin dose

 

 

 

              Use the same injection site each time medication is given

 

 

 

              Time of injection each day is irrelevant

 

Question 7

 

Which of the following medications is considered a Mucosal Protectant that can be used in treating H.pylori:

 

 

 

A.           Sucralfate

 

 

 

B.           Famotidine

 

 

 

C.           Amoxicillin

 

 

 

D.           Pantoprazole

 

Question 8

 

The mechanism of action of Simvastatin is:

 

 

 

              Bile acid binding resin

 

 

 

              Triglyceride binding

 

 

 

              HMG-CoA reductase inhibitor

 

 

 

              NPC1L1/Cholesterol complex inhibitor

 

 

 

 

 

 

 

Question 9

 

Drugs that use CYP 3A4 isoenzymes for metabolism may:

 

 

 

A.           Induce the metabolism of another drug

 

 

 

B.           Inhibit the metabolism of another drug

 

 

 

C.           Both 1 and 2

 

 

 

D.           Neither 1 nor 2

 

Question 10

 

Drugs have a high potential for abuse. There is no routine therapeutic use for these drugs and they are not available for regular use. They may be obtained for "investigational use only" by applying to the U.S. Drug Enforcement Agency. Examples include heroin and LSD. Which scheduled drug is this?

 

 

 

              Schedule 1

 

 

 

              Schedule 2

 

 

 

              Schedule 3

 

 

 

              Schedule 4

 

uestion 11

 

A 41-year-old African-American male is 30 pounds overweight and has been diagnosed with hypertension. The most likely initial drug therapy for this patient will be

 

 

 

              Calcium channel blocker

 

 

 

              Statin

 

 

 

              ACE inhibitor

 

 

 

              ARB

 

 

 

              Beta blocker

 

 

 

 

 

•                Question 12 of 101   

 

•              Moving to another question will save this response.

 

Question 12

 

You are giving a presentation to medical students and one of them asks you to explain the mechanism of action of Jardiance. You tell them:

 

 

 

              The medication stimulate beta cells to increase insulin production

 

 

 

              The medication decreases gluconeogenesis in the live

 

 

 

              The medication increases uptake of glucose into muscle cells for use and storage

 

 

 

              The medication decreases glucose reabsorption in the renal tubule

 

Question 13

 

A 62-year-old man has been prescribed lovastatin. The Nurse Practitioner will instruct the patient to take the medication

 

 

 

              at bedtime.

 

 

 

              in the early morning.

 

 

 

              in the evening.

 

 

 

              in the afternoon.

 

uestion 14

 

A Nurse Practitioner is caring for a male patient who has a diagnosis of coronary artery disease (CAD). His drug therapy includes lovastatin. Because the patient has a history of severe renal disease, the nurse will assess for which of the following?

 

 

 

              Decrease in plasma concentration of lovastatin

 

 

 

              Increase in the statin tolerance level

 

 

 

              Decrease in LDL

 

 

 

              Increase in plasma concentration of lovastatin

 

Question 15

 

CC is on max doses of Allopurinol but is still having occasional gout flares. You know that there is a med that can be added to his regimen that inhibits anionic transport in the proximal tubule, which decreases renal reabsorption of uric acid by 30-40%. This medication is:

 

 

 

              Colchicine

 

 

 

              Febuxostat

 

 

 

              Azathioprine

 

 

 

              Probenecid

 

Question 16

 

A Nurse Practitioner receives an order to administer a critically ill patient two drugs immediately (stat). The Nurse Practitioner begins the process by

 

 

 

              washing his or her hands before handling the medications.

 

 

 

              consulting a drug guide for compatibility.

 

 

 

              questioning the patient concerning allergies.

 

 

 

              identifying the patient by checking the armband and asking the patient to state his name.

 

uestion 17

 

The following are all categories of drugs used to treat Hypertension except:

 

 

 

A.           Diuretics

 

 

 

B.           ACE Inhibitors

 

 

 

C.           Dipeptyl Peptidase-IV Inhibitors

 

 

 

D.           Calcium Channel Blockers

 

Question 18

 

Which laxative when used may cause aspiration pneumonia especially in the elderly:

 

 

 

A.           Bisacodyl

 

 

 

B.           Glycerin Suppository

 

 

 

C.           Polyethylene Glycol

 

 

 

D.           Mineral Oil

 

Question 19

 

Which of the following statements accurately describes digoxin?

 

 

 

              It is widely used to augment cardiac output.

 

 

 

              It blocks the Na-K ATPase pump. 

 

 

 

              It is broken down by the liver.

 

 

 

              It increases ventricular contraction by activating the AV node.

 

Question 20

 

Proton Pump Inhibitors such as Protonix and Omeprazole are very effective at suppressing gastric acid but are associated with the risk of which of the conditions:

 

 

 

A.           Rhinitis

 

 

 

B.           Migraines

 

 

 

C.           Clostridium difficile

 

 

 

D.           Otitis Media

 

Question 21

 

Which of the following drug employs its antiemetic effect by blocking muscarinic receptors in the pathway from the inner ear to the vomiting center:

 

 

 

A.           Scopolamine

 

 

 

B.           Ondansetron

 

 

 

C.           Dexamethasone

 

 

 

D.           Dronabinol

 

Question 22

 

A 33-year-old woman has irritable bowel syndrome (IBS). The physician has prescribed simethicone (Mylicon) for her discomfort. Which of the following will the nurse monitor most closely during the patient's drug therapy?

 

 

 

              Drug toxicity

 

 

 

              Anorexia

 

 

 

              Increased abdominal pain and vomiting

 

 

 

              Increased urine output

 

Question 23

 

A Native American man who lives a traditional lifestyle is scheduled to have heart surgery. The tribal chief has requested that the tribe's medicine man perform a ritual before the patient goes to surgery. The nurse's response to this request should be

 

 

 

              "I'm sorry, but that will not be possible."

 

 

 

              "I will need to inform the doctor and see if he will allow this."

 

 

 

              "As long as the ritual does not interfere with the patient's preoperative care, it will be okay."

 

 

 

              "I don't think that will help, but you have the right to perform the ritual."

 

Question 24

 

You are treating a patient with asthma, and they also need something for HTN. You know the following beta blocker is safe for this patient:

 

 

 

              Metoprolol

 

 

 

              Nadolol

 

 

 

              Atenolol

 

 

 

              Propranolol

 

Question 25

 

Which combination of drugs is considered first line therapy in the treatment of nausea and vomiting in pregnancy:

 

 

 

A.           Lorazepam and Scopolamine

 

 

 

B.           Dronabinol and Diphenhydramine

 

 

 

C.           Doxylamine and Vitamin B6

 

 

 

D.           Metoclopramide and Vitamin B6

 

Question 26

 

Opioids can cause constipation and may in some cases act as an antidiarrheal agent through all of the following mechanisms except:

 

 

 

A.           Activating opioid receptors in the GI tract

 

 

 

B.           Increasing intestinal motility

 

 

 

C.           Allows for more time for absorption of fluids and electrolytes

 

 

 

D.           Reduces the fluidity and volume of stools

 

Question 27

 

Which of the following conditions is a contraindication for pioglitazone (Actos).

 

 

 

              Chronic infections

 

 

 

              Severe congestive heart failure

 

 

 

              Underweight patients

 

 

 

              Patients with severe depression

 

Question 28

 

When treating a patient with Furosemide, which electrolyte is most important to monitor?

 

 

 

              Calcium

 

 

 

              Potassium

 

 

 

              Sodium

 

 

 

              Magnesium

 

Question 29

 

The Elderly are at high risk of  Adverse Drug Reactions due to:

 

 

 

              having greater muscle mass than younger adults, leading to higher volume of distribution

 

 

 

              the extensive studies that have been conducted on drug safety in this age group

 

 

 

              age related decrease in renal function

 

 

 

              the blood-brain barrier being less permeable, requiring higher doses to achieve therapeutic effects

 

Question 30

 

A patient has been prescribed lovastatin for a high cholesterol level. The nurse's teaching plan will include a basic explanation of how the drug produces its therapeutic effect. The nurse will explain that lovastatin lowers cholesterol levels because it

 

 

 

              is a hormone.

 

 

 

              is a bile-acid resin.

 

 

 

              inhibits cholesterol syntheses.

 

 

 

              consists of a fibric acid derivative.