NR 565||(NR 565 ) Final Exam/
MIDTERM EXAM Questions
with accurate answers 100%
GUARANTEED PASS
Pioglitazone contraindications - correct answer Pioglitazone is contraindicated in patients with
severe heart failure and should be used with caution in patients with mild heart failure. Should
not be used in patients that have active bladder cancer or history of bladder cancer
Be familiar with abbreviations of diabetic drug classifications (GLP-1, TZD, DPP4-I, SGLT2i) -
correct answer GLP-1: Glucagon-like Peptide -1 Receptor Agonist
TZD: Thiazolidinediones (Glitazones)
DPP-4i: Dipeptidyl Peptidase- 4 Inhibitors (Gliptins)
SGLT2i: Sodium-Glucose Cotransporter 2 Inhibitors
Which drug class should be considered for diabetes prior to insulin? - correct answer Biguanides
(Metformin)
Ratio of basal insulin to rapid-acting insulin in total daily dose (TDD) of insulin - correct answer
•Basal insulin replacement encompasses approximately 50% of the total daily insulin dose
which replaces insulin from fasting (overnight) and between meals. This dose is usually
constant. Bolus insulin replacement encompasses approximately 50% of the total daily insulin
dose
Know the carbohydrate-to insulin ratio when calculating basal insulin - correct answer 500 /
TDD : 1 unit
TDD = 0.6 units/kg/day
,Mechanism of Action o GLP-1 - correct answer GLP-1: Augment effects of incretin hormone GLP-
1 can ↑ insulin production and inhibits postprandial glucagon release
Which diabetic medication(s) come with a concern of hypoglycemia? - correct answer
sulfonylureas, glinides, GLP-1, amylin mimetics, glitazones
Methylxanthines o Who is at risk for toxicity and why? - correct answer Older patients are at
much higher risk for toxicity when taking methylxanthines (Systemic anticholinergics are
included in BEERS criteria for potentially inappropriate use for older adult Wk. 6 module.)
Patients with liver dysfunction (increased risk for toxicity)
Untreated seizure disorder or peptic ulcer disease
Asthma & COPD o Step 1 therapy - correct answer •SABA → PRN
Complete this sentence: Manage with a ______ as needed. - correct answer SABA
Symptoms associated with Intermittent classification of asthma
*Symptoms
*Nighttime Awakening
*SABA USE - correct answer *2 d/week or less
*2 times/month or less
*2 d/week or less
Know examples of drug classes (SABA) - correct answer oAlbuterol (Proventil), Levalbuterol
(Xopenex)
, SABA Benefits of use - correct answer Activate the beta-adrenergic receptors in smooth muscle
of the lung, thereby promoting bronchodilation and relieving bronchospasm. Beta 2 agonist
limit role in suppressing histamine release in the lung and increasing ciliary motility
Why is it important to know the frequency a patient is using their SABA? - correct answer To be
able to assess the severity of asthma symptoms in each patient, and if they need adjunct
treatment in more severe cases
LABA Benefits of use Use in COPD by Category - correct answer A (few symptoms low risk)
Symptom control SABA, 1st Choice LAMA or LABA
B (Increased symptoms, low risk) Symptom control SABA, 1st Choice LAMA or LABA and
management of persistent symptoms of further exacerbations combination LAMA/LABA
C (few symptoms, high risk) Symptom control SABA, 1st Choice LAMA and management of
persistent symptoms of further exacerbations combination LAMA/LABA or LABA/IGC
D (Increased symptoms, high risk) Symptom control SABA, 1st Choice LAMA or LAMA/LABA or
IGC/LABA and management of persistent symptoms of further exacerbations combination
LAMA/LABA/IGC, if exacerbations continue, consider adding Roflumilast Azithromycin
Inhaled Corticosteroid (ICS) Benefits of use - correct answer reduction and suppression of
inflammation of airway
At what point would an oral steroid be prescribed? - correct answer Only when symptoms
cannot be controlled with safer medications.
May be required for patients with moderate to severe persistent asthma or for management of
acute exacerbations of asthma or COPD.
When would roflumilast be indicated for a COPD patient? - correct answer *Not 1st Line.
*Used for exacerbation prophylaxis in patients with severe COPD with a primary chronic
bronchitis and Hx of frequent exacerbations.
*Not prescribed alone, needs to have a LAMA or SABA with it
MIDTERM EXAM Questions
with accurate answers 100%
GUARANTEED PASS
Pioglitazone contraindications - correct answer Pioglitazone is contraindicated in patients with
severe heart failure and should be used with caution in patients with mild heart failure. Should
not be used in patients that have active bladder cancer or history of bladder cancer
Be familiar with abbreviations of diabetic drug classifications (GLP-1, TZD, DPP4-I, SGLT2i) -
correct answer GLP-1: Glucagon-like Peptide -1 Receptor Agonist
TZD: Thiazolidinediones (Glitazones)
DPP-4i: Dipeptidyl Peptidase- 4 Inhibitors (Gliptins)
SGLT2i: Sodium-Glucose Cotransporter 2 Inhibitors
Which drug class should be considered for diabetes prior to insulin? - correct answer Biguanides
(Metformin)
Ratio of basal insulin to rapid-acting insulin in total daily dose (TDD) of insulin - correct answer
•Basal insulin replacement encompasses approximately 50% of the total daily insulin dose
which replaces insulin from fasting (overnight) and between meals. This dose is usually
constant. Bolus insulin replacement encompasses approximately 50% of the total daily insulin
dose
Know the carbohydrate-to insulin ratio when calculating basal insulin - correct answer 500 /
TDD : 1 unit
TDD = 0.6 units/kg/day
,Mechanism of Action o GLP-1 - correct answer GLP-1: Augment effects of incretin hormone GLP-
1 can ↑ insulin production and inhibits postprandial glucagon release
Which diabetic medication(s) come with a concern of hypoglycemia? - correct answer
sulfonylureas, glinides, GLP-1, amylin mimetics, glitazones
Methylxanthines o Who is at risk for toxicity and why? - correct answer Older patients are at
much higher risk for toxicity when taking methylxanthines (Systemic anticholinergics are
included in BEERS criteria for potentially inappropriate use for older adult Wk. 6 module.)
Patients with liver dysfunction (increased risk for toxicity)
Untreated seizure disorder or peptic ulcer disease
Asthma & COPD o Step 1 therapy - correct answer •SABA → PRN
Complete this sentence: Manage with a ______ as needed. - correct answer SABA
Symptoms associated with Intermittent classification of asthma
*Symptoms
*Nighttime Awakening
*SABA USE - correct answer *2 d/week or less
*2 times/month or less
*2 d/week or less
Know examples of drug classes (SABA) - correct answer oAlbuterol (Proventil), Levalbuterol
(Xopenex)
, SABA Benefits of use - correct answer Activate the beta-adrenergic receptors in smooth muscle
of the lung, thereby promoting bronchodilation and relieving bronchospasm. Beta 2 agonist
limit role in suppressing histamine release in the lung and increasing ciliary motility
Why is it important to know the frequency a patient is using their SABA? - correct answer To be
able to assess the severity of asthma symptoms in each patient, and if they need adjunct
treatment in more severe cases
LABA Benefits of use Use in COPD by Category - correct answer A (few symptoms low risk)
Symptom control SABA, 1st Choice LAMA or LABA
B (Increased symptoms, low risk) Symptom control SABA, 1st Choice LAMA or LABA and
management of persistent symptoms of further exacerbations combination LAMA/LABA
C (few symptoms, high risk) Symptom control SABA, 1st Choice LAMA and management of
persistent symptoms of further exacerbations combination LAMA/LABA or LABA/IGC
D (Increased symptoms, high risk) Symptom control SABA, 1st Choice LAMA or LAMA/LABA or
IGC/LABA and management of persistent symptoms of further exacerbations combination
LAMA/LABA/IGC, if exacerbations continue, consider adding Roflumilast Azithromycin
Inhaled Corticosteroid (ICS) Benefits of use - correct answer reduction and suppression of
inflammation of airway
At what point would an oral steroid be prescribed? - correct answer Only when symptoms
cannot be controlled with safer medications.
May be required for patients with moderate to severe persistent asthma or for management of
acute exacerbations of asthma or COPD.
When would roflumilast be indicated for a COPD patient? - correct answer *Not 1st Line.
*Used for exacerbation prophylaxis in patients with severe COPD with a primary chronic
bronchitis and Hx of frequent exacerbations.
*Not prescribed alone, needs to have a LAMA or SABA with it
