NR 508 ADV PHARMACOLOGY EXAM Q AND A
1. A patient has been using an herbal supplement for 2 years that
the primary care NP knows may have toxic side effects. The
NP should: (Points : 2)
tell the patient to stop taking the supplement immediately.
inform the patient of the risks of toxic side effects with
this supplement.? refer the patient to a CAM provider
who can manage this patient’s therapy.
prescribe another herbal drug that has fewer adverse effects
than the one the patient is taking.
2. A 45-year-old patient who has a positive family history but no
personal history of coronary artery disease is seen by the
primary care NP for a physical examination. The patient has a
body mass index of 27 and a blood pressure of 130/78 mm Hg.
Laboratory tests reveal low-density lipoprotein, 110 mg/dL; high-
density lipoprotein, 70 mg/dL; and triglycerides, 120 mg/dL. The
patient does not smoke but has a sedentary lifestyle. The NP
should recommend: (Points : 2)
30 minutes of aerobic
exercise daily. taking 81
to 325 mg of aspirin daily.
, beginning therapy with a statin medication.
starting a thiazide diuretic to treat hypertension.
3. The primary care NP refers a patient to a cardiologist who
diagnoses long QT syndrome. The cardiologist has prescribed
propranolol (Inderal). The patient exercises regularly and is not
obese. The patient asks the NP what else can be done to
minimize risk of sudden cardiac arrest. The NP should counsel the
patient to: (Points : 2)
drink extra fluids when exercising.
reduce stress with yoga and hot baths.
ask the cardiologist about an implantable defibrillator.
ask the cardiologist about adding procainamide to the drug
regimen.
4. A child who has congenital hypothyroidism takes levothyroxine 75
mcg/day. The child weighs 15 kg. The primary care NP sees the
child for a 3-year-old check-up. The NP should consult with a
pediatric endocrinologist to discuss: (Points : 2)
increasing the dose to 90
mcg/day. decreasing the
dose to 30 mcg/day.
stopping the medication and checking TSH and T4 in 4 weeks.
discussing the need for lifetime replacement therapy with the
,child’s parents.
5. A 5-year-old child has chronic constipation. The primary care NP
plans to prescribe a laxative for long-term management. In
addition to pharmacologic therapy, the NP should also
recommend g of fiber per day. (Points : 2)
10
15
20
25
6. A patient who has angina is taking nitroglycerin and long-acting
nifedipine. The primary care NP notes a persistent blood pressure
of 90/60 mm Hg at several follow-up visits. The patient reports
lightheadedness associated with standing up. The NP should
consult with the patient’s cardiologist about changing the
medication to: (Points : 2)
amlodipine
(Norvasc).
isradipine
(DynaCirc).
, verapamil HCl
(Calan).
short-acting nifedipine (Procardia).
1. A patient asks a primary care NP whether over-the-counter drugs
are safer than prescription drugs. The NP should explain that over-the-
counter drugs are: (Points : 2)
generally safe when label information is understood and
followed.
safer because over-the-counter doses are lower than prescription
doses of the same
drug
.
less safe because they are not well regulated by the Food and
(FDA
Drug Administration not extensively tested, so claims made by
).
manufacturers cannot be substantiated.
Question 2.2. A woman who is being treated with radiotherapy for
breast cancer asks her primary care nurse practitioner (NP) about
using dietary supplements to improve her chance of recovery. The NP
should tell her that: (Points : 2)
vitamin E is not harmful but has not been shown to change
outcomes.
no supplements have been shown to alter outcomes or
response to therapy. folic acid and other B vitamins may
improve ability to tolerate chemotherapy.
1. A patient has been using an herbal supplement for 2 years that
the primary care NP knows may have toxic side effects. The
NP should: (Points : 2)
tell the patient to stop taking the supplement immediately.
inform the patient of the risks of toxic side effects with
this supplement.? refer the patient to a CAM provider
who can manage this patient’s therapy.
prescribe another herbal drug that has fewer adverse effects
than the one the patient is taking.
2. A 45-year-old patient who has a positive family history but no
personal history of coronary artery disease is seen by the
primary care NP for a physical examination. The patient has a
body mass index of 27 and a blood pressure of 130/78 mm Hg.
Laboratory tests reveal low-density lipoprotein, 110 mg/dL; high-
density lipoprotein, 70 mg/dL; and triglycerides, 120 mg/dL. The
patient does not smoke but has a sedentary lifestyle. The NP
should recommend: (Points : 2)
30 minutes of aerobic
exercise daily. taking 81
to 325 mg of aspirin daily.
, beginning therapy with a statin medication.
starting a thiazide diuretic to treat hypertension.
3. The primary care NP refers a patient to a cardiologist who
diagnoses long QT syndrome. The cardiologist has prescribed
propranolol (Inderal). The patient exercises regularly and is not
obese. The patient asks the NP what else can be done to
minimize risk of sudden cardiac arrest. The NP should counsel the
patient to: (Points : 2)
drink extra fluids when exercising.
reduce stress with yoga and hot baths.
ask the cardiologist about an implantable defibrillator.
ask the cardiologist about adding procainamide to the drug
regimen.
4. A child who has congenital hypothyroidism takes levothyroxine 75
mcg/day. The child weighs 15 kg. The primary care NP sees the
child for a 3-year-old check-up. The NP should consult with a
pediatric endocrinologist to discuss: (Points : 2)
increasing the dose to 90
mcg/day. decreasing the
dose to 30 mcg/day.
stopping the medication and checking TSH and T4 in 4 weeks.
discussing the need for lifetime replacement therapy with the
,child’s parents.
5. A 5-year-old child has chronic constipation. The primary care NP
plans to prescribe a laxative for long-term management. In
addition to pharmacologic therapy, the NP should also
recommend g of fiber per day. (Points : 2)
10
15
20
25
6. A patient who has angina is taking nitroglycerin and long-acting
nifedipine. The primary care NP notes a persistent blood pressure
of 90/60 mm Hg at several follow-up visits. The patient reports
lightheadedness associated with standing up. The NP should
consult with the patient’s cardiologist about changing the
medication to: (Points : 2)
amlodipine
(Norvasc).
isradipine
(DynaCirc).
, verapamil HCl
(Calan).
short-acting nifedipine (Procardia).
1. A patient asks a primary care NP whether over-the-counter drugs
are safer than prescription drugs. The NP should explain that over-the-
counter drugs are: (Points : 2)
generally safe when label information is understood and
followed.
safer because over-the-counter doses are lower than prescription
doses of the same
drug
.
less safe because they are not well regulated by the Food and
(FDA
Drug Administration not extensively tested, so claims made by
).
manufacturers cannot be substantiated.
Question 2.2. A woman who is being treated with radiotherapy for
breast cancer asks her primary care nurse practitioner (NP) about
using dietary supplements to improve her chance of recovery. The NP
should tell her that: (Points : 2)
vitamin E is not harmful but has not been shown to change
outcomes.
no supplements have been shown to alter outcomes or
response to therapy. folic acid and other B vitamins may
improve ability to tolerate chemotherapy.
