Exam (elaborations) NR 508 Advanced Pharmacology Midterm Sample 3 Study Guide

Exam (elaborations) NR 508 Advanced Pharmacology Midterm Sample 3 Study Guide A Nurse Practitioner explains to a patient that nitroglycerin patches should be applied in the morning and removed in the evening. This medication schedule reduces the potential for Selected Answer: nitrate tolerance.  Question 2 1 out of 1 points Mr. Nguyen, age 71, will soon be discharged home from the hospital after a successful coronary artery bypass graft (CABG). During patient education about his drug regimen, Mr. Nguyen's nurse should prioritize teach about Selected Answer: potential adverse effects of the drugs that Mr. Nguyen will be taking.  Question 3 1 out of 1 points The most effective therapy for a patient who is H. pylori positive with a gastric ulcer is: Selected Answer: Bismuth, Metronidazole, Omeprazole, and Tetracycline  Question 4 1 out of 1 points A 60-year-old African-American man lives with a number of chronic health problems. Genetic factors are likely to influence his etiology and/or treatment of Selected Answer: hypertension.  Question 5 1 out of 1 points 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 Selected Answer: adrenal insufficiency.  Question 6 0 out of 1 points The APRN is treating a 56 year old male with diagnosed atrial fibrillation. He is complaining of being light headed. His vital signs are BP 100/68 HR 144 RR 22. The best choice of medication to treat this patient is: Selected Answer: 3. NR 508 Advanced Pharmacology Midterm Sample 3 Study Guide Cardiac glycoside such as Digoxin  Question 7 1 out of 1 points 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? Selected Answer: Electrolyte levels  Question 8 1 out of 1 points Which of the following will a Nurse Practitioner inform the patient is one of the most common adverse effects of guaifenesin (Robitussin)? Selected Answer: Gastrointestinal distress  Question 9 1 out of 1 points Which of the following is TRUE about long acting beta agonist use in asthma patients? Selected Answer: It can be combined with an inhaled corticosteroid to improve asthma control  Question 10 1 out of 1 points A patient with a variety of chronic health problems is being seen by her nurse practitioner, who is currently reviewing the patient's medication regimen. Which of the patient's medications should prompt the nurse to teach her to avoid drinking grapefruit juice? Selected Answer: Atorvastatin (Lipitor)  Question 11 1 out of 1 points A Nurse Practitioner is instructing a patient who was recently diagnosed with multiple sclerosis about dantrolene (Dantrium). The patient is a 38-year-old-male and the foreman for a construction company. In order to minimize one important adverse effect of the drug, the nurse will give the patient which of the following instructions? Selected Answer: Wear appropriate clothing and sunscreen whenever he is in direct sunlight  Question 12 1 out of 1 points A 66-year-old woman has a complex medical history that includes poorly-controlled 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 13 1 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: Serum potassium levels  Question 14 1 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-the-counter laxatives for the past 7 years. The nurse informed the patient that prolonged use of laxatives Selected Answer: may cause nutrient deficiencies.  Question 15 1 out of 1 points The Nurse Practitioner is conducting a medication reconciliation of a new resident of a long-term care facility. The Nurse Practitioner notes that the resident takes allopurinol on a daily basis for the treatment of gout. What is the primary purpose of this drug? Selected Answer: To balance urate concentration and prevent gout attacks  Question 16 1 out of 1 points A woman has a long history of seasonal allergies that are typically accompanied by rhinorrhea, red eyes, and frequent sneezing. Sneezes are a result of Selected Answer: a CNS reflex that is initiated by receptors in the nasal cavities.  Question 17 1 out of 1 points A patient has been prescribed a Scheduled 5 drug, an example of this drug is Selected Answer: Antitussives  Question 18 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: Coffee  Question 19 1 out of 1 points 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 Selected Answer: inhibits cholesterol syntheses.  Question 20 1 out of 1 points A patient with bronchial asthma is prescribed a sustained-release preparation of theophylline. To help minimize the adverse effects of the drug, which of the following should the nurse suggest? Selected Answer: Take it on an empty stomach, 1 hour before or 2 hours after meals  Question 21 1 out of 1 points A Nurse Practitioner is caring for a 78-year-old patient with renal insufficiency and chronic heart failure who is receiving rapid infusions of high-dose furosemide. It will be a priority for the Nurse Practitioner to monitor for Selected Answer: ototoxicity.  Question 22 1 out of 1 points A 39-year-old African-American male is 25 pounds overweight and has been diagnosed with hypertension after three consecutive above-normal blood pressure readings. The most likely initial drug therapy for this patient will be Selected Answer: a diuretic.  Question 23 1 out of 1 points 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? Selected Answer: The patient's protein deficit will likely increase the levels of the free drug in his blood.  Question 24 1 out of 1 points A 70-year-old man with diabetes mellitus is taking metoprolol (Lopressor) to manage his hypertension. The nurse would be sure to instruct the patient to Selected Answer: understand the signs and symptoms of hypoglycemia.  Question 25 1 out of 1 points A normal maintenance dose for digoxin is 0.125 to 0.5 mg/day. In which of the following patients would the nurse most likely administer a lower-than-normal maintenance dose of digoxin? Selected Answer: A 79-year-old male with cardiomegaly  Question 26 1 out of 1 points A 72-year-old man is prescribed theophylline for symptomatic relief of bronchial asthma. Which of the following findings would alert the nurse to the need for close monitoring? Selected Answer: Enlarged prostate gland  Question 27 1 out of 1 points A patient with unstable angina pectoris who is NOT controlled with a nitrate would likely benefit most from the addition of: Selected Answer: 2. Beta blocker  Question 28 1 out of 1 points 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? Selected Answer: Digoxin immune fab  Question 29 1 out of 1 points A patient is admitted to the emergency department with severe chest pain. The emergency department physician orders intravenous nitroglycerin 5 mcg/min, titrate dose by 5 mcg/min every 3 to 5 minutes per infusion pump as needed. Before administering the nitroglycerin, the nurse should prioritize which of the following assessments? Selected Answer: Blood pressure  Question 30 1 out of 1 points 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? Selected Answer: An oral antidepressant that the patient has been taking daily for several years  Question 31 1 out of 1 points The lower respiratory system utilizes a number of different mechanisms that confer protection and maintain homeostasis. Which of the following physiological processes protects the lower respiratory system? Selected Answer: Cilia sweep foreign material and mucus upward toward the trachea and larynx where they can then be swallowed.  Question 32 1 out of 1 points A Nurse Practitioner has administered a medication to a patient with hypertension. The prescribed drug is supposed to decrease cardiac output. A decrease in cardiac output would most likely Selected Answer: decrease the amount of circulating blood sent through the kidneys.  Question 33 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 34 1 out of 1 points A patient has been prescribed a drug that can be self-administered at home. Which of the following would be the most important information for the nurse to relate to the patient concerning self-administration of a drug? Selected Answer: The therapeutic effects and possible adverse effects  Question 35 1 out of 1 points The APRN is treating a patient with type 2 diabetes. The patient is on the maximum dose of metformin and glucotrol. Current weight 212 pounds. Labs from this morning indicate a fasting blood sugar of 312 and HbA1C of 9. The APRN wants to start the patient on Lantus 0.2 unit/kg. What dose and instructions should the APRN provide? Selected Answer: Give 19 units of Lantus subcutaneously prior to bedtime.  Question 36 1 out of 1 points 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 Selected Answer: "As long as the ritual does not interfere with the patient's preoperative care, it will be okay."  Question 37 1 out of 1 points A patient has been prescribed rabeprazole (Aciphex). It will be important for the nurse to assess the patient's drug history to determine if the patient is taking which of the following drugs? Selected Answer: Digoxin  Question 38 1 out of 1 points A 46-year-old white American has been prescribed a drug that binds to acid glycoproteins. The nurse understands that white Americans usually receive Selected Answer: a higher-than-normal dose of drugs that bind to acid glycoproteins.  Question 39 1 out of 1 points A patient has GERD and is taking ranitidine (Zantac). She continues to have gastric discomfort and asks whether she can take an antacid. Which of the following is an appropriate response by the nurse? Selected Answer: "Yes, but be sure to wait at least 2 hours to take the antacid after you take the ranitidine."  Question 40 1 out of 1 points A Nurse Practitioner is caring for a patient who is taking digoxin and a loop diuretic. Which of the following would be most important for the Nurse Practitioner to monitor? Selected Answer: Potassium levels  Question 41 1 out of 1 points A 60-year-old man has scheduled a follow-up appointment with his primary care provider stating that the omeprazole (Prilosec) which he was recently prescribed is ineffective. The patient states, "I take it as soon as I feel heartburn coming on, but it doesn't seem to help at all." How should the nurse best respond to this patient's statement? Selected Answer: "Prilosec will help your heartburn but it's not designed to provide immediate relief of specific episodes of heartburn."  Question 42 1 out of 1 points What critical piece of information is missing from the following medication order: Amoxicillin 250 mg every 8 hours? Selected Answer: Route  Question 43 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 44 1 out of 1 points 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? Selected Answer: Carefully assess the patient for infections  Question 45 1 out of 1 points Mr. Tan is a 69-year-old man who prides himself in maintaining an active lifestyle and a healthy diet that includes adequate fluid intake. However, Mr. Tan states that he has experienced occasional constipation in recent months. What remedy should be the nurse's first suggestion? Selected Answer: A bulk-forming (fiber) laxative  Question 46 1 out of 1 points Frequent episodes of exercise-related chest pain have caused a 79-year-old woman to use her prescribed nitroglycerin spray several times in recent weeks. This patient's age will have what effect on her use of nitroglycerin? Selected Answer: The woman will be more susceptible to hypotension than a younger patient.  Question 47 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 48 1 out of 1 points A Nurse Practitioner who provides care in a long-term care facility is documenting a new resident's medication regimen on the resident's intake admission. The Nurse Practitioner is documenting the generic, rather than proprietary, names of the resident's current drugs because Selected Answer: there is a potential for confusion and miscommunication if proprietary names are used.  Question 49 1 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: Oropharyngeal Candida albicans infection  Question 50 1 out of 1 points 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? Selected Answer: Administering the drug intravenously rather than orally  Question 51 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 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? Selected Answer: Mr. Penny requires concurrent treatment with a beta blocker, nitrate, or a calcium channel blocker.  Question 52 1 out of 1 points 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? Selected Answer: History of taking anticoagulant drugs  Question 53 1 out of 1 points A 72-year-old man is taking Adderall XR for the treatment of narcolepsy. He is currently having problems with not being able to swallow large tablets or capsules. The man also wears dentures, which makes it even more difficult for him to swallow medication. He is in the clinic to talk to the nurse about his problem. The nurse will instruct him to Selected Answer: open the capsule and sprinkle the beads in applesauce.  Question 54 1 out of 1 points The APRN should educate a diabetic patient that beta blockers may mask the signs and symptoms of Selected Answer: hypoglycemia  Question 55 1 out of 1 points A Nurse Practitioner is providing patient education to a 35-year-old man who has been prescribed clonidine (Catapres) as part of step 2 antihypertensive therapy. The Nurse Practitioner should anticipate that the drug will be administered Selected Answer: transdermally.  Question 56 1 out of 1 points Mesalamine (Asacol) is prescribed for a 22-year-old woman with Crohn disease. The nurse will discuss with the patient the possibility for which of the following adverse effects related to the new drug therapy? Selected Answer: Hair loss  Question 57 1 out of 1 points Which statement is FALSE regarding the treatment of hyperthyroidism? Selected Answer: Methimazole (Tapazole) is the drug of choice for pregnant or lactating females.  Question 58 1 out of 1 points A Nurse Practitioner is administering drugs to a 70-year-old patient who has a reduced plasma albumin level. When assessing the patient for therapeutic outcomes of drug therapy, the Nurse Practitioner will also be careful to observe for Selected Answer: possible drug toxicity.  Question 59 1 out of 1 points A 79-year-old woman with a medical history that includes osteoporosis has recently moved to a long-term care facility. Medication reconciliation indicates that the woman has been taking calcitonin, salmon for several years. The nurse should recognize that the most likely route for the administration of this drug is Selected Answer: intranasal.  Question 60 1 out of 1 points 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? Selected Answer: Mesalamine  Question 61 1 out of 1 points 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? Selected Answer: Measures to alleviate any discomfort associated with adverse effects  Question 62 1 out of 1 points A 45-year-old man who is a construction worker has been diagnosed with hyperlipidemia and has been prescribed lovastatin. The nurse will advise the patient to Selected Answer: avoid prolonged exposure to sunlight.  Question 63 1 out of 1 points The APRN would use what class of medication to manage COPD? Selected Answer: Short-acting and long acting inhaled beta2 agonists  Question 64 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 65 1 out of 1 points A Nurse Practitioner receives an order to administer a critically ill patient two drugs immediately (stat). The Nurse Practitioner begins the process by Selected Answer: consulting a drug guide for compatibility.  Question 66 1 out of 1 points Following an assessment by her primary care provider, a 70-year-old resident of an assisted living facility has begun taking daily oral doses of levothyroxine. Which of the following assessment findings should prompt the nurse to withhold a scheduled dose of levothyroxine? Selected Answer: The resident's apical heart rate is 112 beats/minute with a regular rhythm  Question 67 1 out of 1 points To maximize the therapeutic effect of diphenoxylate HCl with atropine sulfate, the nurse will instruct the patient to take the medication Selected Answer: four times a day.  Question 68 1 out of 1 points 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? Selected Answer: Most patients tolerate statins well, with minor muscle aches being among the most common adverse effects.  Question 69 1 out of 1 points Mr. Lacuna is an 83-year-old resident of a long-term care facility who has a diagnosis of moderate Alzheimer disease. Mr. Lacuna's physician recently prescribed oral rivastigmine, but he was unable to tolerate the drug due to its gastrointestinal effects. As a result, he has been ordered the transdermal patch form of the medication. When administering this form of rivastigmine, the nurse should Selected Answer: apply the patch to Mr. Lacuna's back to reduce the chance that he will remove it.  Question 70 1 out of 1 points To minimize the risk o