6521 Advanced Pharmacology Midterm Exam

 6521 Advanced Pharmacology Midterm Exam  

Question 1

A Nurse Practitioner is caring for a 70-year-old patient who is taking desmopressin (DDAVP). The patient has a history of cardiovascular disease. The nurse will prioritize the assessment of which of the following?

		Weight
		Electrolyte levels
		Dehydration
		Body temperature

Question 2

A 46-year-old white American has been prescribed a drug that binds to acid glycoproteins. The nurse understands that white Americans usually receive

		a higher-than-normal dose of drugs that bind to acid glycoproteins.
		a lower-than-normal dose of drugs that bind to acid glycoproteins.
		the recommended normal dose of drugs that bind to acid glycoproteins.
		one half the recommended dose of drugs that bind to acid glycoproteins.

Question 3

A patient on valproic acid may experience which of the following symptoms?

		Weight gain
		Nausea
		Constipation
		All of the above

Question 4

A patient with seasonal allergies is exasperated by her recent nasal congestion and has expressed her desire to treat it by using pseudoephedrine. The nurse should inform the patient that

		under the Combat Methamphetamine Abuse Act, pseudoephedrine now requires a prescription.
		drugs containing pseudoephedrine are available without a prescription but are kept off pharmacy shelves.
		she must be prepared to show identification when buying a drug that contains pseudoephedrine.
		pseudoephedrine is being phased out of the marketplace in order to combat illegal use.

Question 5

You are caring for a patient with CHF and the attending physician has just started the patient on Digoxin 5 days ago. All of these are signs of Digoxin toxicity except:

		Irregular pulse
		A digoxin level of 2.0 ng/ml
		Patient states they are seeing spots
		Nausea/vomiting

Question 6

What is a serious side effect of ibuprofen in the older adult patient?

		rebound headaches
		Impairment of renal function
		neuropathy
		pancreatic failure

Question 7

Some asthmatics have aspirin sensitivity. This is known as:        

		Cross tolerance
		Efficacy
		Placebo effect
		Allergic reaction

Question 8

Which of the following will a Nurse Practitioner inform the patient is one of the most common adverse effects of guaifenesin (Robitussin)?

		Gastrointestinal distress
		Increased blood pressure
		Increased blood glucose
		Urinary retention

Question 9

Absorption of medications is a variable process that is dependent upon all of the following except

		Blood Flow
		pH
		Creatine Clearance
		Surface Area

Question 10

Which of the following patients is most likely to benefit from the administration of an adrenergic agonist?

		A man who is in cardiogenic shock following a myocardial infarction
		A man who has a diagnosis of primary hypertension
		A woman who has been admitted with a suspected ischemic stroke
		A woman who is in labor and may require a caesarean section

Question 11

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?

		Maintain close watch on Intake and Output
		Do not take a multivitamin supplement
		Limit dairy products
		Aerobic exercises are the most effective

Question 12

Shirley, age 58, has been diabetic for 7 years. Her blood pressure for the last three office visits have been 154/100, 144/94, and 144/90. What would you prescribe today during her routine office visit?

		A calcium channel blocker
		An ACE Inhibitor
		No hypertension medication
		A beta blocker

Question 13

A Nurse Practitioner is caring for a female patient who has developed atelectasis because of thick mucus secretions. The Nurse Practitioner is monitoring IV administration of acetylcysteine (Mucomyst) and notices that the patient’s face is flushed. The appropriate nursing action would be to

		stop the administration of acetylcysteine.
		slow the administration of acetylcysteine and administer diphenhydramine if ordered.
		remove any residual drug from the patient’s face.
		dilute the acetylcysteine solution.

Question 14

Which of the following oral medications is the safest to use during pregnancy?

		Losartan
		Methyldopa
		Amlodipine
		Lisinopril

Question 15

All are considered the most common antibiotics used to treat H.pylori except:

	A.	Metronidazole
	B.	Azithromycin
	C.	Clarithromycin
	D.	Amoxicillin

Question 16

The effect of two different drugs is greater than one individual drug is known as

	A.	Antagonism
	B.	Synergism
	C.	Polypharmacy
	D.	Mechanism of Action

Question 17

To maximize the therapeutic effect of diphenoxylate HCl with atropine sulfate, the nurse will instruct the patient to take the medication

		once a day.
		twice a day.
		every 2 hours.
		four times a day.

Question 18

Clonidine is a central alpha agonist used in the treatment of hypertension. However, it has a number of off-label uses including treatment for all of the following except 

		hot flashes
		ADHD
		insomnia
		withdrawal from alcohol and narcotics
		asthma

Question 19

A female patient has been taking prednisone for her asthma for 1 month. The nurse will teach her to gradually decrease her dose of prednisone to avoid

		hypokalemia.
		gastrointestinal problems.
		adrenal insufficiency.
		menstrual irregularities.

Question 20

All the following medications can be used to treat Nonalcoholic Fatty Liver Disease (NAFLD) except:

	A.	Metformin
	B.	Vitamin C
	C.	Pioglitazone
	D.	Vitamin E

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Question 21

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:

		Consulting nationally recognized guidelines for disease management
		Asking the patient what drug they think would work best for them
		Prescribing  medications that are available as samples before writing a prescription
		Following U.S. Drug Enforcement Administration guidelines for prescribing

Question 22

When prescribing an antihypertensive medication for a type 2 diabetic patient, the drug classifications that would tend to reduce insulin sensitivity are:

		Diuretics and calcium channel blockers.
		Diuretics and beta blockers.
		Calcium channel blockers and ACE inhibitors.
		Alpha blockers and ACE inhibitors.

Question 23

A 35 year old patient presents with a concern of two high blood pressures at local health fairs in the past month. The patient has a history of Type 2 Diabetes, Chronic Constipation, and Obesity. Today her pressure is 145/93. You will:

		Begin hydrochlorothiazide 12.5 mg daily.
		Ask the patient to monitor their BP’s at home and reduce their sodium intake only.
		Begin amlodipine 10 mg daily.
		Begin furosemide 20 mg daily.

Question 24

NP is a 66-year-old male that is on Omeprazole for GERD and Clopidogrel for TIA prophylaxis. The pharmacist calls to tell you the Omeprazole should be switched due to a drug-drug interaction. What is the safest PPI alternative to change NP to?

		Esomeprazole
		Pantoprazole*
		Rabeprazole
		Lansoprazole

Question 25

You have a patient who complains of 3 months of frequent diarrhea (~40-50% of bowel movements). What is the best medication to start with to help control diarrhea?

		Pepto Bismol Liquid: 1 tbsp after each loose stool
		Dicyclomine 10 mg: 1 capsule four times daily
		Phenergan 25 mg: 1 tablet every 4 hours as needed
		Loperamide 2 mg: 2 tablets after 1st loose stool, then 1 tablets after each subsequent loose stool (max of 8 mg/day)

Question 26

Sam, a 28 yr old male presents to the office for a wellness check.  He has a known history of a psychotic disorder.  Which of the following antipsychotic drugs has the highest rate of extrapyramidal effects?

		Chlorpromazine
		Quetapine
		Ziprasidone
		Haloperidol

Question 27

The  Family nurse practitioner prescribed losartan 50 mg PO daily for a hypertensive patient. This medication promotes vasodilation by:

		Blocking the action of angiotensin II
		Promoting the synthesis of prostaglandins
		Inhibiting calcium influx into smooth muscle cells
		Promoting the release of aldosterone

Question 28

The following factor(s) may reduce drug bioavailability.

• Gastric acid changes
• First pass effect
• Absence of GI flora
• Digestive enzymes

		i only
		i and iii only
		i, ii and iii only
		All of the above

Question 29

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 30

Which laxative can be used to treat opioid-induced constipation:

	A.	Mineral Oil
	B.	Bisacodyl
	C.	Senna
	D.	Docusate

Question 31

What is the primary mechanism of action of the Class III Antiarrhythmic medications such as Amiodarone?

		Block fast sodium channels and slow action potential
		Block beta receptors and slow heart rate
		Block potassium channels and prolong repolarization
		Block calcium channels causing vasodilation

Question 32

A Nurse Practitioner is caring for a patient who has been diagnosed with hypothyroidism. Levothyroxine (Synthroid) has been prescribed. Before the drug therapy is started, the nurse will assess for which of the following?

		History of taking anticoagulant drugs
		Allergy to seafood
		Hirsutism
		The patient’s age

Question 33

Which of the following is a potential adverse side effect of autonomic-anticholinergic agents? 

		Reduced GI motility
		Bradycardia
		Increased symptoms of benign prostatic hypertrophy
		Photosensitivity

Question 34

Some first generation antihistamines are used: 

		as stimulants
		to prevent motion sickness
		as laxatives
		as anticonvulsants

Question 35

Which of the following is the strongest statin and dosage combination for the treatment of hyperlipidemia?

		atorvastatin 20 mg
		simvastatin 20 mg
		rosuvastatin 10 mg
		pravastatin 40 mg
		fluvastatin 80 mg

Question 36

Non-dihydropyridine calcium channel blockers include:

• Amlodipine
• Nifedipine
• Diltiazem
• Verapamil

		i and ii only
		i, ii and iii only
		iii onlyD
		iii and iv only
		All of the above
		None of the above

Question 37

You have a 31-year-old female rheumatoid arthritis patient who is recently pregnant. Which rheumatoid arthritis medication is contraindicated in pregnancy?

		Plaquenil
		Celebrex
		Etanercept
		Methotrexate

Question 38

Once a patient is started on a medication for thyroid replacement, what is the typical amount of time to wait to repeat lab tests?

		14-16 weeks
		3-4 weeks
		10-12 weeks
		6-8 weeks

Question 39

Metformin (Glucophage) acts by:

		Enhancing insulin secretion
		Decreasing hepatic glucose production with  minor effects on insulin sensitivity in both liver and peripheral tissues
		Increasing sensitivity in the muscle and liver
		Suppressing glucagon producrtion

Question 40

Which of the following is a not a risk associated with the use of Proton Pump Inhibitors:

	A.	Pneumonia
	B.	Hypokalemia
	C.	Fractures
	D.	Hypomagnesemia

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Question 41

A 42-year-old male with asthma has been using beta agonists for years. He has no developed arrhythmias. His PCP has started him on a higher dose of Atenolol. What would you expect to happen?

		Atenolol is a beta agonist so the arrythmia worsened but asthma improved
		Atenolol is beta nonselective to both improved
		Atenolol increases airway obstruction worsening asthma but helped the arrythmia
		Atenolol is cardioselective so it help the arrhythmia but did not exacerbate asthma

Question 42

When adding Spironolactone to a patient’s regimen, the side effect to be most careful of is:

		Hypokalemia
		Urticaria
		Gynecomastia
		Hyponatremia

Question 43

What of the following has the potential to cause a drug interaction of serotonin syndrome?

		dextromethorphan
		phenylephrine
		pseudoephedrine
		guaifenesin
		diphenhydramine

Question 44

In light of her recent high blood pressure readings, a patient has been started on a thiazide diuretic and metoprolol (Lopressor), which is a beta-adrenergic blocker. What is the most likely rationale for using two medications to address the patient’s hypertension?

		The adverse effects of each drug may cancel each other out.
		Using two drugs for a health problem tends to increase patient compliance with the drug regimen.
		Using lower doses of two separate drugs may lessen the risk of adverse reactions.
		Using the two drugs to treat a health problem may create a synergistic effect.

Question 45

Which statement is FALSE regarding the treatment of hyperthyroidism?

		Methimazole (Tapazole) is the drug of choice for pregnant or lactating females.
		Since methimazole (Tapazole) is stronger than Propylthiouracil (PTU), Methimazole should be initiated at 15 mg/day compared to 300 mg/day for Propylthiouracil for treatment of mild disease
		Propylthiouracil (PTU) reduces peripheral conversion of T4 to the more potent T3
		Long-acting beta-blocking agents are given as adjunctive therapy until Propulthiouracil (PTU) or methimazole (Tapazole) restores the patient to euthyroid

Question 46

Topical inhaled alpha adrenergic blocking agents or nasal vasoconstricting decongestants should not be used chronically (>5 days) because they can cause

		rebound insomnia
		rebound coughing
		rebound rhinitis/congestion
		None of the above

Question 47

Advanced practice nurse prescribing of scheduled medications is affected most by:

		Individual states laws regarding scheduled medications that can be prescribed and for how long
		Combined state medical / pharmacy  / nursing prescribing board regulations
		FDA
		DEA

Question 48

A possible side effect from the use of nifedipine (Procardia XL) is: 

		Hypokalemia
		Hyperkalemia and tetany
		Dry hacking cough and hyperuricemia
		Edema of the ankles and headaches

Question 49

The mechanism of action of Simvastatin is:

		Bile acid binding resin
		Triglyceride binding
		HMG-CoA reductase inhibitor
		NPC1L1/Cholesterol complex inhibitor

Question 50

The Nurse Practitioner is performing patient education for a woman who will soon begin treatment of hyperlipidemia with simvastatin (Zocor). The patient has asked the Nurse Practitioner if there are any “bad side effects” that she should be aware of. Which of the following statements should underlie the nurse’s response?

		Many patients experience gastrointestinal upset with statins, which can be partially alleviated by taking the drug with food.
		The patient may experience a dry cough, especially at night, for the first few weeks after starting to take the simvastatin.
		The patient will have to schedule regular blood work to closely monitor her kidney function for the duration of treatment.
		Most patients tolerate statins well, with minor muscle aches being among the most common adverse effects.

Question 51

A 22-year-old male college senior has lived with a diagnosis of Crohn’s disease for several years and has undergone several courses of treatment with limited benefit. Which of the following targeted therapies has the potential to alleviate the symptoms of Crohn’s disease?

		Tositumomab plus 131I (Bexxar)
		Muromonab-CD3 (Orthoclone OKT3)
		Infliximab (Remicade)
		Eculizumab (Soliris)

Question 52

A 67-year-old man is admitted to the hospital with pneumonia. He reports to the nurse that he has chronic arthritis and circulation problems. Further assessment by the nurse reveals that the patient has a history of mild hypertension. He explains that he owns a business and lives alone. The nurse determines that he is within the normal weight range for his height and age but has a fondness for spicy foods and sweets. Which of the mentioned patient variables will have the greatest impact on the effectiveness of the patient’s drug therapy?

		Vascular impairment
		Mild hypertension
		Dietary habits
		Chronic arthritis

Question 53

A patient asks you what the mechanism of action is of Tizanidine. You tell them:

		It increases inhibition of motor neurons
		The actual mechanism is unknown
		It reduces somatic motor activity in gamma and alpha neurons
		It decreases communication between nerves in the CNS

Question 54

Which are the following antiviral agents are used to treat influenza:

	A.	Valcyclovir
	B.	Oseltamivir
	C.	Ganciclovir
	D.	Sofosbuvir

Question 55

What is associated with chronic overtreatment with levothyroxine (Synthroid)?

		Tachycardia
		Osteoporosis
		Insomnia
		Sweating

Question 56

You are treating a 56-year-old female for diabetes. Her recent labs show a SrCr of 1.5, GFR of 46 and serum glucose of 288. Based on these numbers, the medication you would want to stop is:

		Prednisone
		Allopurinol
		Metformin
		Glipizide

Question 57

Which medication class is recognized for the treatment of moderate to severe dementia?

		Cholinesterase inhibitors.
		NMDA receptor antagonists.
		SSRIs.
		Central alpha2 agonists.

Question 58

The side effects of antihistamines are mostly due to their: 

		Anticholinergic effects
		sedating effects
		Anti-inflammatory effects
		Immune system effects

Question 59

A Nurse Practitioner is the cardiac care unit is preparing to hang an intravenous dose of dofetilide (Tikosyn) for a patient who has just been admitted. What is the most likely goal of this intervention?

		To treat sinus bradycardia accompanied by hypotension
		To resolve the patient’s uncompensated heart failure
		To treat the patient’s ventricular tachycardia
		To convert the patient’s atrial fibrillation to normal sinus rhythm

Question 60

Which of the following are risk factors for hypertension?

		BMI > 30
		Smoking
		Family history
		None of the above
		All of the above

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Question 61

A Nurse Practitioner working for a drug company is involved in phase III drug evaluation studies. Which of the following might the Nurse Practitioner be responsible for during this stage of drug development?

		Working with animals who are given experimental drugs
		Monitoring drug effects in patients who are selected to participate in a study, who have the disease that the drug is meant to treat
		Administering investigational drugs to patients
		Informing healthy, young volunteer participants of possible risks that could occur from taking an experimental drug

Question 62

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?

		Coffee
		Alcohol
		Salt
		Vitamin C

Question 63

Which of the following medications could worsen dementia in an Alzheimer patient?

		Morphine
		Benadryl
		Sertraline
		Atenolol

Question 64

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?

		cough
		loss of taste
		weight loss
		weight gain

Question 65

Which of the following laxatives is available in both a tablet and suppository dosage form:

	A.	Mineral Oil
	B.	Bisacodyl
	C.	Senna
	D.	Docusate

Question 66

A woman with numerous chronic health problems has been diagnosed with a benign gastric ulcer has begun treatment with ranitidine (Zantac). Which of the following teaching points should the nurse provide to this patient?

		“Quitting smoking will significantly increase the chance that this drug will heal your ulcer.”
		“This drug will help to eliminate the bacteria in your stomach that caused your ulcer.”
		“You should eat several small meals each day rather than three larger meals.”
		“Take each dose of ranitidine with an antacid of your choice.”

Question 67

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?

		The amount of the drug that must be given to produce a particular response
		How well a drug produces its desired effect
		A drug’s strength of attraction for a receptor site
		A drug’s ability to stimulate its receptor

Question 68

Which of the following medications does not have a transdermal formulation?

		clonidine
		fentanyl
		ranolazine
		nitroglycerin
		scopolamine

Question 69

You are treating a patient for C. Diff and are discharging them on a course of Metronidazole. The main counseling point you need to address is:

		Avoid alcohol
		Take on an empty stomach
		Separate by 2 hours from all other meds
		Do not crush or chew

Question 70

A 58-year-old man is admitted to the emergency department. A diagnosis of severe digoxin toxicity is made. Bradycardia is present, and an electrocardiogram (ECG) confirms toxicity. The nurse will administer which of the following drugs?

		Furosemide
		Digoxin immune fab
		Captopril
		Dopamine

Question 71

Several months of treatment with a statin accompanied by lifestyle modifications have failed to appreciably improve a patient’s cholesterol levels. Consequently, the patient has been prescribed cholestyramine. The nurse should recognize that this drugs achieves its therapeutic effect by

		binding LDL to HDL.
		mitigating the harmful effects of atherosclerosis by promoting vasodilation.
		inhibiting the synthesis of cholesterol.
		oxidizing cholesterol to bile acids.

Question 72

BP is a 72-year-old male with hyperlipidemia, GERD, A fib and epilepsy. His current meds are Atorvastatin, Eliquis, Phenytoin and Protonix. He is being seen for not “feeling good” for the past week. Blood tests reveal most of his meds are at toxic plasma levels. He states that over the past 2 weeks he has taken extra OTC heart burn medication. Which medication did BP most likely use?

		Famotidine
		Cimetidine
		Tums
		Alka Seltzer

Question 73

Which effect does the Nurse Practitioner expect may occur when using cholinergic agonists?

		dry mouth
		tachycardia
		increased bladder tone
		pupil dilation

Question 74

A homeless man who is well known to care providers at the local hospital has been admitted to the emergency department after having a seizure outside a mall. The man is known to be a heavy alcohol user and is malnourished with a very low body mass index. How are this patient’s characteristics likely to influence possible treatment with phenytoin?

		The patient will require oral phenytoin rather than intravenous administration.
		Phenytoin is contraindicated within 48 hours of alcohol use due to the possibility of paradoxical effects.
		The patient’s heavy alcohol use will compete with phenytoin for binding sites and he will require a higher-than-normal dose.
		The patient’s protein deficit will likely increase the levels of the free drug in his blood.

Question 75

A patient with unstable angina pectoris who is NOT controlled with a nitrate would likely benefit most from the addition of:

		Sodium channel blocker
		Beta blocker
		Cardiac glycoside
		Either 1 or 2

Question 76

A Nurse Practitioner is instructing a patient concerning a newly prescribed drug. Which of the following should be included to help improve patient compliance and safety?

		A list of pharmacies where the drug can be obtained
		Measures to alleviate any discomfort associated with adverse effects
		The cost of the brand drug compared with the generic form
		Statistics related to phase III of testing for the prescribed drug

Question 77

Which type of antihistamines are used to inhibit the secretion of gastric acid in patients with gastrointestinal disorders? 

		H1
		H2
		H3
		H4

Question 78

Which antihypertensive has been shown to have mild uricosuric effects in gout patients?

		Losartan
		Lisinopril
		Atenolol
		Amlodipine

Question 79

The American Geriatric Society provides the Beers Criteria to aid providers in knowing

	A.	Dosage Adjustments Necessary in Chronic Renal Disease
	B.	Potentially Inappropriate Medications that Should Be Avoided in the Geriatric Population
	C.	Medications That Cannot be Crushed
	D.	Medications that are Safe to use in the Pediatric Population

Question 80

A patient with diabetes has had a cough for 1 week and has been prescribed a cough syrup (an expectorant). What special instructions should the nurse include in the patient teaching for this situation?

		Wash hands before and after taking the medicine
		Keep track of any gastrointestinal tract infections
		Monitor glucose levels closely
		Note the time the medicine is taken each day

Question 81

A patient comes to primary clinic for strep throat. A throat swab culture is sent to lab. What information is required for the nurse practitioner to disclose on lab transmittal?

		National Provider Identification (NPI)
		Centers for Medicare & Medicaid Services (CMS)
		Health Insurance Portability and Accountability Act of 1996 (HIPPA)
		None of the above

Question 82

Bioavailability is best described as:

		Amount of drug give that is metabolized
		Extent and rate which a drug enters the circulation
		Amount of drug that facilitates effects in the body
		Amount of time drug is present in the body

Question 83

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 physician has prescribed ranolazine (Ranexa). Which of the following statements is true regarding the use of ranolazine for the treatment of this patient’s angina?

		Ranolazine confers protection from myocardial infarction but does not relieve symptoms of angina.
		Amlodipine will now be contraindicated in the treatment of Mr. Penny’s angina.
		Mr. Penny will need to be taught to monitor his blood pressure and heart rate.
		Mr. Penny requires concurrent treatment with a beta blocker, nitrate, or a calcium channel blocker.

Question 84

The pharmacokinetic processes include all the following except:

	A.	Absorption
	B.	Metabolism
	C.	Distribution
	D.	Circulation

Question 85

A 79-year-old patient in a long-term care facility is to receive an intravenous fat emulsion. Which of the following lab values would be a priority for the nurse to assess before administration?

		Blood glucose levels
		Serum potassium levels
		Serum sodium levels
		Triglyceride levels

Question 86

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?

		“This schedule will be more convenient for you.”
		“This schedule will enable you to lose weight.”
		“This schedule will decrease the cost of your medication.”
		“This schedule allows rest periods so that adverse effects are decreased but the anti-inflammatory effects continue.”

Question 87

Tylenol with codeine is what controlled substance schedule?

		C-II
		C-III
		C-IV
		C-V
		C-VI

Question 88

Which of the following can block the action of heparin?

		Phytomenadione
		Vitamin K
		Idarucizumab
		Protamine sulfate

Question 89

An elderly patient with a history of congestive heart failure has been admitted to hospital with failure to thrive and admission blood work reveals a hemoglobin level of 6.9 g/dL. The care team has consequently administered two units of packed red blood cells, but auscultation of the client’s lungs now reveals diffuse crackles. Administration of what drug is likely to resolve the patient’s pulmonary edema?

		Furosemide
		Hydrochlorothiazide
		Mannitol
		Triamterene

Question 90

You are on rounds and the nurse lets you know that after the patient’s last asthma medication dose they because tachycardic and nervous. The likely medication that caused this was:

		Albuterol
		Isoproterenol
		Terbutaline
		None of the above

Question 91

A teenage boy has undergone a diagnostic workup following several months of persistent, bloody diarrhea that appears to lack an infectious etiology. The boy has also experienced intermittent abdominal pain and has lost almost 15 pounds this year. Which of the following medications is most likely to treat this boy’s diagnosis?

		Lubiprostone
		Mesalamine
		Docusate
		Bismuth subsalicylate

Question 92

How does cholestyramine lowers blood cholesterol?

		Feedback inhibition of its synthesis
		Hormonal repression of cholesterol synthesis in the liver
		Speeding conversion to steroid hormones
		Sequestering bile salts and thus decreasing absorption and increasing catabolism

Question 93

A Nurse Practitioner who is responsible for administering medications should understand that the goals of the MedWatch program are to (Select all that apply.)

		provide regular feedback about product safety issues.
		accredit new medical facilities and hospitals.
		facilitate the reporting of adverse reactions of drugs.
		increase awareness of serious reactions caused by drugs or medical devices.
		report medication errors that occur in hospitals.

Question 94

The most effective therapy for a patient  who is H. pylori positive with a gastric ulcer is:

		Amoxicillin, Metronidazole, and Bismuth
		Cephalexin, Bismuth, Omeprazole, and Ranitidine
		Bismuth, Metronidazole, Omeprazole, and Tetracycline
		Amoxicillin, Cefzil, and omeprazole

Question 95

A 34-year-old male patient is prescribed methimazole (MMI). The Nurse Practitioner will advise him to report which of the following immediately?

		Vertigo
		Intolerance to cold
		Loss of appetite
		Epigastric distress

Question 96

A patient has been prescribed an oral drug that is known to have a high first-pass effect. Which of the following measures has the potential to increase the amount of the free drug that is available to body cells?

		Giving the drug with food in order to delay absorption
		Administering the drug in small, frequent doses
		Limiting the patient’s protein intake and encouraging fluids
		Administering the drug intravenously rather than orally

Question 97

The parents of a 7-year-old boy who has just been diagnosed with allergic asthma are being taught about their son’s medication regimen by the nurse. The nurse is currently teaching the parent’s about the appropriate use of a “rescue drug” for acute exacerbations of their son’s asthma. What drug should the nurse suggests the parents to use in these situations?

		Theophylline
		Albuterol
		Beclomethasone
		Acetylcysteine

Question 98

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.

Question 99

Typical adverse reactions to oral calcium-channel blockers include: 

		dyspnea
		edema
		fatigue
		cough

Question 100

Which statement about a partial drug agonist is correct?

		Partial agonists always cause a maximal response
		Partial agonists have affinity for the target receptor, but no efficacy
		Partial agonists have affinity and efficacy at the target receptor
		Partial agonists have an agonistic effect on the receptor, but only achieve a suboptimal response

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