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NURS 615 EXAM 3 QUESTIONS AND ANSWERS | 3 Pages | 100 Questions | Best for 2022 Exam Revision | PDF |

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Chapter 41. Hyperthyroidism and Hypothyroidism 1. When methimazole is started for hyperthyroidism it may take to see a total reversal of hyperthyroid symptoms. 1. 2 to 4 weeks 2. 1 to 2 months 3. 3 to 4 months 4. 6 to 12 months ANS: 4 2. In addition to methimazole, a symptomatic patient with hyperthyroidism may need a prescription for: 1. A calcium channel blocker 2. A beta blocker 3. Liothyronine 4. An alpha blocker ANS: 2 3. After starting a patient with Grave’s disease on an antithyroid agent such as methimazole, patient monitoring includes TSH and free T4 every: 1. 1 to 2 weeks 2. 3 to 4 weeks 3. 2 to 3 months 4. 6 to 9 months ANS: 2 4. A woman who is pregnant and has hyperthyroidism is best managed by a specialty team who will most likely treat her with: 1. Methimazole 2. Propylthiouracil (PTU) 3. Radioactive iodine 4. Nothing, treatment is best delayed until after her pregnancy ends ANS: 2 5. Goals when treating hypothyroidism with thyroid replacement include: 1. Normal TSH and free T4 levels 2. Resolution of fatigue 3. Weight loss to baseline 4. All of the above ANS: 4 6. When starting a patient on levothyroxine for hypothyroidism the patient will need follow-up measurement of thyroid function in: 1. 2 weeks 2. 4 weeks 3. 2 months 4. 6 months ANS: 2 7. Once a patient who is being treated for hypothyroidism returns to euthyroid with normal TSH levels, he or she should be monitored with TSH and free T4 levels every: 1. 2 weeks 2. 4 weeks 3. 2 months 4. 6 months ANS: 4 8. Treatment of a patient with hypothyroidism and cardiovascular disease consists of: 1. Levothyroxine 2. Liothyronine 3. Liotrix 4. Methimazole ANS: 1 9. Infants with congenital hypothyroidism are treated with: 1. Levothyroxine 2. Liothyronine 3. Liotrix 4. Methimazole ANS: 1 10. When starting a patient with hypothyroidism on thyroid replacement hormones patient education would include: 1. They should feel symptomatic improvement in 1 to 2 weeks. 2. Drug adverse effects such as lethargy and dry skin may occur. 3. It may take 4 to 8 weeks to get to euthyroid symptomatically and by laboratory testing. 4. Because of its short half-life, levothyroxine doses should not be missed. ANS: 3 11. In hyperthyroid states, what organ system other than CV must be evaluated to establish potential adverse issues? 1. The liver 2. The nails and skin 3. The eye 4. The ear ANS: 3 12. Why are “natural” thyroid products not readily prescribed for most patients? 1. There is no reliability for the amount of hormone per dose. 2. There is higher incidence of allergic reactions. 3. There is a more reliable dose of T3 to T4 per batch. 4. All of the above ANS: 4 13. What is the desired mixed of T3 to T4 drug levels in newly diagnosed endocrine patients? 1. 99% of T3 and the rest is T4 to get rapid resolution. 2. Most needs to be T4 to mimic natural ratios of hormone. 3. The ratio is unimportant. 4. The mix needs to be 50-50 at first. ANS: 2 14. Laboratory values are actually different for TSH when screening for thyroid issues and when used for medication management. Which of the follow holds true? 1. Screening TSH has a wider range of normal values 0.02-5.0; therapeutic levels need to remain above 5.0. 2. Screening values are much narrower than the acceptable range used to keep a person stable on hormone replacement. 3. Therapeutic values are kept between 0.05 and 3.0 ideally. Screening values are considered acceptable up to 10. 4. Screening values are between 5 and 10, and therapeutic values are greater than 10. ANS: 3 15. What happens to the typical hormone replacement dose when a woman becomes pregnant? 1. Most women need less medication. 2. Most women do not require a dose change. 3. The average woman needs more medication during pregnancy. 4. The average woman needs more medication only if carrying multiples. ANS: 3 Chapter 16: Drugs Affecting the Cardiovascular and Renal Systems 1. Ray has been diagnosed with hypertension and an ACE inhibitor is determined to be needed. Prior to prescribing this drug, the NP should assess for: A. Hypokalemia B. Impotence

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NURS 615 EXAM
3 QUESTIONS
AND ANSWERS
Chapter 25. Drugs Used in Treating Inflammatory Processes

1. Henry presents to clinic with a significantly swollen, painful great toe and is diagnosed with gout. Of the
following, which would be the best treatment for Henry?
1. High-dose colchicine
2. Low-dose colchicine
3. High-dose aspirin
4. Acetaminophen with codeine

2. Patient education when prescribing colchicine includes:
1. Colchicine may be constipating.
2. Colchicine always causes some degree of diarrhea.
3. Mild muscle weakness is normal.
4. Moderate amounts of alcohol are safe with colchicine.

3. Larry is taking allopurinol to prevent gout. Monitoring of a patient who is taking allopurinol includes:
1. Complete blood count
2. Blood glucose
3. C-reactive protein
4. BUN, creatinine, and creatinine clearance

4. Phil is starting treatment with febuxostat (Uloric). Education of patients starting febuxostat includes:
1. Gout may worsen with therapy.
2. Febuxostat may cause severe diarrhea.
3. He should consume a high-calcium diet.
4. He will need frequent CBC monitoring.


5. Sallie has been taking 10 mg per day of prednisone for the past 6 months. She should be assessed for:
1. Gout
2. Iron deficiency anemia
3. Osteoporosis
4. Renal dysfunction

, 6. Patients whose total dose of prednisone will exceed 1 gram will most likely need a second prescription for:
1. Metformin, a biguanide to prevent diabetes
2. Omeprazole, a proton pump inhibitor to prevent peptic ulcer disease
3. Naproxen, an NSAID to treat joint pain
4. Furosemide, a diuretic to treat fluid retention

7. Daniel has been on 60 mg of prednisone for 10 days to treat a severe asthma exacerbation. It is time to
discontinue the prednisone. How is prednisone discontinued?
1. Patients with asthma are transitioned directly off the prednisone onto inhaled corticosteroids.
2. Prednisone can be abruptly discontinued with no adverse effects.
3. Develop a tapering schedule to slowly wean Daniel off the prednisone.
4. Substitute the prednisone with another anti-inflammatory such as ibuprofen.



8. Patients with rheumatoid arthritis who are on chronic low-dose prednisone will need co-treatment with
which medications to prevent further adverse effects?
1. A bisphosphonate
2. Calcium supplementation
3. Vitamin D
4. All of the above

9. Patients who are on or who will be starting chronic corticosteroid therapy need monitoring of:
1. Serum glucose
2. Stool culture
3. Folate levels
4. Vitamin B12

10. Patients who are on chronic long-term corticosteroid therapy need education regarding:
1. Receiving all vaccinations, especially the live flu vaccine
2. Reporting black tarry stools or abdominal pain
3. Eating a high carbohydrate diet with plenty of fluids
4. Small amounts of alcohol are generally tolerated.

,11. All nonsteroidal anti-inflammatory drugs (NSAIDS) have an FDA Black Box Warning regarding:
1. Potential for causing life-threatening GI bleeds
2. Increased risk of developing systemic arthritis with prolonged use
3. Risk of life-threatening rashes, including Stevens-Johnson
4. Potential for transient changes in serum glucose

Ans: 1

12. Jamie has fractured his ankle and has received a prescription for acetaminophen and hydrocodone (Vicodin).
Education when prescribing Vicodin includes:
1. It is okay to double the dose of Vicodin if the pain is severe.
2. Vicodin is not habit-forming.
3. He should not take any other acetaminophen-containing medications.
4. Vicodin may cause diarrhea; increase his fluid intake.

Ans: 3

13. When prescribing NSAIDS, a complete drug history should be conducted as NSAIDs interact with these
drugs:
1. Omeprazole, a proton pump inhibitor
2. Combined oral contraceptives
3. Diphenhydramine, an antihistamine
4. Warfarin, an anticoagulant

Ans: 4

14. Josefina is a 2-year-old child with acute otitis media and an upper respiratory infection. Along with an
antibiotic she receives a recommendation to treat the ear pain with ibuprofen. What education would
her parent need regarding ibuprofen?
1. They can cut an adult ibuprofen tablet in half to give Josefina.
2. The ibuprofen dose can be doubled for severe pain.
3. Josefina needs to be well-hydrated while taking ibuprofen.
4. Ibuprofen is completely safe in children with no known adverse effects.

Ans: 3

15. Henry is 82 years old and takes two aspirin every morning to treat the arthritis pain in his back. He states the
aspirin helps him to “get going” each day. Lately he has had some heartburn from the aspirin. After ruling
out an acute GI bleed, what would be an appropriate course of treatment for Henry?
1. Add an H2 blocker such as ranitidine to his therapy.
2. Discontinue the aspirin and switch him to Vicodin for the pain.
3. Decrease the aspirin dose to one tablet daily.

, 4. Have Henry take an antacid 15 minutes before taking the aspirin each day.

Ans: 1

16. The trial period to determine effective anti-inflammatory activity when starting a patient on aspirin for
rheumatoid arthritis is:
1. 48 hours
2. 4 to 6 days
3. 4 weeks
4. 2 months

Ans: 2

17. Patients prescribed aspirin therapy require education regarding the signs of aspirin toxicity. An early sign of
aspirin toxicity is:
1. Black tarry stools
2. Vomiting
3. Tremors
4. Tinnitus

Ans: 4

18. Monitoring a patient on a high-dose aspirin level includes:
1. Salicylate level
2. Complete blood count
3. Urine pH
4. All of the above

Ans: 4

19. Patients who are on long-term aspirin therapy should have annually.
1. Complete blood count
2. Salicylate level
3. Amylase
4. Urine analysis

Ans: 1

Chapter 21. Drugs Affecting the Endocrine System

1. Both men and women experience bone loss with aging. The bones most likely to demonstrate significant
loss are:

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