1
NSG 6005 FINAL STUDY GUIDE
FINAL STUDY GUIDE
PREVIOUS EXAM INFO
Guanfacine- used to treat HTN or ADHD, non stimulant. Alpha 2 adrenergic agonist.
Antiarrhythmics start on p. 322
Class I: sodium channel blockers
Class Ia: lengthens action potential (quinidine, procainamide [requires freq. dosing],
disopyramide)
Class Ib: shortens action potential (lidocaine, phenytoin) treats ventricular arrhythmias
Class Ic: minimal or no effect on action potential; severe ventricular tachycardias- where
no other drugs have worked
Class II: beta blockers (propranolol, metoprolol, atenolol)- indirectly reduces slope by blocking
chronotropic impact of norepinephrine
Atenolol has longer half-life than metoprolol
Class III: agents that lengthen action potential (potassium channel blockers) – (amiodarone,
bretyllium) effective in treating re-entry problems, inhibits v-fib due to myocardial ischemia,
improves contractility
Class IV: Calcium channel blockers (verapamil, diltiazem, bepridil) & (amlodipine, felodipine)
2 types of CCB:
type I- non-hydropyridines-affect conduction through AV node, have neg chronotropic effect
(verapamil, diltiazem)
type II: hydorphyridines-do not affect conduction through AV node (nifedipine, amlodipine,
felodipine)
Class IA & IC -what is similar?
Lidocaine-
Amiodaraone effective against supraventricular rhythms
BPH & HTN med
Doxazosin- used to treat BPH & HTN
Mexiletine- only available orally
Valerian has no adverse reactions when used at the recommended level; however, overdosage at
2.5 g or more can cause cardiac disturbance, excitability, headache, insomnia, and nausea. It can
potentiate alcohol and other CNS depressants if taken in large amounts. (p. 139)
Ayurvedic medicine- Although all three doshas exist together, often plants and people are
classified by the one that is most dominant in them, referred to as the person’s “Prakruti,” and
specific to them as an individual. (p. 132)
Glaucoma meds:
Longer eyelashes-lanasoprost or bimatoprost – prostaglandin drugs
Glaucoma med cause blurriness after instilled into eyes for few minutes
Procainamide-short acting; need dose reduction in CHF and renal impairment (p. 325)
VLDL- synthesized in the liver (p. 1130) Drugs that inhibit VLDL synthesis in the liver (niacin,
fibric acid derivatives) also reduce LDLs via the endogenous pathway (p.1130).
Cholesterol meds:
-acted on sterols?
, 2
NSG 6005 FINAL STUDY GUIDE
Inhibitor Hmgcoa- statins
Bile from liver-bile sequestrins
Cost benefit analysis
Cardiotonic
Digoxin with renal failure- contradicted in renal impairment; Digoxin can also be problematic
when treating older adults and patients with renal insufficiency. Renal function may decrease
during heart failure treatment and the drug may not be adequately excreted, allowing it to
increase to toxic levels. Digoxin levels should be closely monitored in these patients. (p. 1072)
Because digoxin is excreted essentially unchanged by the kidneys, severe renal impairment
effectively contraindicates its use. (p. 318)
Treatment with hepatitis C- antiviral meds, NS5A inhibitors
Tacrine-
Timolol-
The nurse concludes that a client newly diagnosed with glaucoma knows the purpose for the
prescribed timolol (Timoptic) blocker when the clients makes which statement:
- REDUCE INTRAOCCULAR PRESSURE
Cromolyn-allergic
David presents to clinic with symptoms of allergic conjunctivitis. He is prescribed cromolyn
sodium (Opticrom) eyedrops. The education regarding using cromolyn eyedrops includes which
one of the following tips
- he should not wear his soft contacts while using the cromolyn eyedrops.
PNA & hypothyroidism- what med don’t give?? -epi inhaler
Which class antiarrhythmic meds treat SVT or VT?
HSV med- answer to do with applying to oral lesion at the first sign of outbreak
Protozoal infection- which type of med antifungal, antimalarial or antiviral plus one other I can’t
remember
Erectile dysfunction- sildenafil or something
It must be noted that phosphodiesterase-5 inhibitors (sildenafil, Viagra; vardenafil, Levitra;
tadalafil, Cialis) used to treat erectile dysfunction, when taken in combination with nitrates used
for chest pain, can cause severe vasodilation resulting in hypotension and syncope. (p. 892)
Patients with Wolff–Parkinson–White (WPW) syndrome can have ventricular responses that are
dangerously rapid. Drugs commonly used to control ventricular response such as diltiazem,
verapamil, and digoxin are ineffective in this situation and can facilitate conduction through the
accessory pathway, increasing the risk for ventricular fibrillation (p. 315)
Final exam pharm
1. Lauren is a 13 year old child who comes to the clinic with a 4 day history of cough, low
grade fever, and rhinorrhea. When she blows her nose or coughs the mucous is greenish
yellow. The appropriate antibiotic to prescribe would be
- None
2. Pong-tai is a 12month old child who is being treated with amoxicillin for acute otitis media.
His parents call the clinic and say he has developed diarrhea. The appropriate action would
be to
, 3
NSG 6005 FINAL STUDY GUIDE
- Advise the parents that some diarrhea is normal with amoxicillin and recommend
probiotics daily
3. There is often a cross sensitivity and cross resistance between pcn and cephalosporins
because
- Both drug classes contain a beta lactam ring that is vulnerable to beta lactamase
producing organisms
4. Sara is a 25 year old female who is 8 weeks pregnant and has a uti. What would be the
appropriate antibiotic to prescribe
- Amoxicillin
5. Jonathon has been diagnosed with strep throat and needs a prescription for an antibiotic. He
says the last time he had pcn he developed a red blotchy rash. An appropriate antibiotic to
prescribe would be
- Azithromycin
6. Treatment for herpes simplex 1
- Acyclovir
7. A girl is prescribed fluconazole after being treated with an antibiotic for uti. What is the
purpose of the fluconazole
- Yeast infection
8. What do glaucoma eye drop timilol, lantoprost have in common
- -decrease intraocular pressure
9. What antibiotic is used to treat MRSA
- Vanc
10. What medication to avoid for someone with open angle glaucoma and kidney stones
- Acetylcholine
11. What medications to avoid with closed angle glaucoma
- Acetazolamide
- Topiramate
-
12. Otitis media
- amoxicillin
13. ADR of isoniazid
14. What analysis would a managed care organization use to improve health outcomes
15. What analysis would be used if a managed care organization wanted to compare two drugs
with different benefits
16. You are prescribing drugs using step therapies to cut costs what drug would you prescribe
- Generic
17. Which analysis is expressed in terms of life years
18. What do 1A's treat?
- Atrial/ventricular tach (quinodine, procainamide)
19. Mexiletine
- Only available orally
20. 1b (lidocaine, mexiletine, phenytoin)
- Blocks sodium channels
- Tx ventricular arrythmias
21. 1c (propadenone)
, 4
NSG 6005 FINAL STUDY GUIDE
- Na blocker & BB
- Treats WPW, AFIB
22. Class 2 (BB’S)
- Tx: Supraventricular
23. Class 3 (amio, sotalol)
- Prolonged action potential
24. Class 4 (verapamil, diltiazem)
- Tx: svt
25. I. Sodium channel blockers- 1A, 1B, 1C
II. β-adrenergic antagonists
III. Potassium channel blockers and relatives
IV. Calcium channel blockers
26. Nurse practitioner prescriptive authority is regulated by:
1. The National Council of State Boards of Nursing
2. The U.S. Drug Enforcement Administration
3. The State Board of Nursing for each state
4. The State Board of Pharmacy
30. Clinical judgment in prescribing includes:
1. Factoring in the cost to the patient of the medication prescribed
2. Always prescribing the newest medication available for the disease process
3. Handing out drug samples to poor patients
4. Prescribing all generic medications to cut costs
31. Nurse practitioner practice may thrive under health-care reform because of:
1. The demonstrated ability of nurse practitioners to control costs and improve patient
outcomes
2. The fact that nurse practitioners will be able to practice independently
3. The fact that nurse practitioners will have full reimbursement under health-care
reform
4. The ability to shift accountability for Medicaid to the state level
32. . According to the U.S. Office of Minority Health, poor health outcomes among African
Americans are attributed to:
1. The belief among African Americans that prayer is more powerful than drugs
2. Poor compliance on the part of the African American patient
3. The genetic predisposition for illness found among African Americans
4. Discrimination, cultural barriers, and lack of access to health care
33. The racial difference in drug pharmacokinetics seen in American Indian or Alaskan Natives
are:
1. Increased CYP 2D6 activity, leading to rapid metabolism of some drugs
2. Largely unknown due to lack of studies of this population
3. Rapid metabolism of alcohol, leading to increased tolerance
4. Decreased elimination of opioids, leading to increased risk for addiction
34. Hispanic native healers (curanderas):
1. Are not heavily utilized by Hispanics who immigrate to the United States
2. Use herbs and teas in their treatment of illness
3. Provide unsafe advice to Hispanics and should not be trusted
4. Need to be licensed in their home country in order to practice in the United States
NSG 6005 FINAL STUDY GUIDE
FINAL STUDY GUIDE
PREVIOUS EXAM INFO
Guanfacine- used to treat HTN or ADHD, non stimulant. Alpha 2 adrenergic agonist.
Antiarrhythmics start on p. 322
Class I: sodium channel blockers
Class Ia: lengthens action potential (quinidine, procainamide [requires freq. dosing],
disopyramide)
Class Ib: shortens action potential (lidocaine, phenytoin) treats ventricular arrhythmias
Class Ic: minimal or no effect on action potential; severe ventricular tachycardias- where
no other drugs have worked
Class II: beta blockers (propranolol, metoprolol, atenolol)- indirectly reduces slope by blocking
chronotropic impact of norepinephrine
Atenolol has longer half-life than metoprolol
Class III: agents that lengthen action potential (potassium channel blockers) – (amiodarone,
bretyllium) effective in treating re-entry problems, inhibits v-fib due to myocardial ischemia,
improves contractility
Class IV: Calcium channel blockers (verapamil, diltiazem, bepridil) & (amlodipine, felodipine)
2 types of CCB:
type I- non-hydropyridines-affect conduction through AV node, have neg chronotropic effect
(verapamil, diltiazem)
type II: hydorphyridines-do not affect conduction through AV node (nifedipine, amlodipine,
felodipine)
Class IA & IC -what is similar?
Lidocaine-
Amiodaraone effective against supraventricular rhythms
BPH & HTN med
Doxazosin- used to treat BPH & HTN
Mexiletine- only available orally
Valerian has no adverse reactions when used at the recommended level; however, overdosage at
2.5 g or more can cause cardiac disturbance, excitability, headache, insomnia, and nausea. It can
potentiate alcohol and other CNS depressants if taken in large amounts. (p. 139)
Ayurvedic medicine- Although all three doshas exist together, often plants and people are
classified by the one that is most dominant in them, referred to as the person’s “Prakruti,” and
specific to them as an individual. (p. 132)
Glaucoma meds:
Longer eyelashes-lanasoprost or bimatoprost – prostaglandin drugs
Glaucoma med cause blurriness after instilled into eyes for few minutes
Procainamide-short acting; need dose reduction in CHF and renal impairment (p. 325)
VLDL- synthesized in the liver (p. 1130) Drugs that inhibit VLDL synthesis in the liver (niacin,
fibric acid derivatives) also reduce LDLs via the endogenous pathway (p.1130).
Cholesterol meds:
-acted on sterols?
, 2
NSG 6005 FINAL STUDY GUIDE
Inhibitor Hmgcoa- statins
Bile from liver-bile sequestrins
Cost benefit analysis
Cardiotonic
Digoxin with renal failure- contradicted in renal impairment; Digoxin can also be problematic
when treating older adults and patients with renal insufficiency. Renal function may decrease
during heart failure treatment and the drug may not be adequately excreted, allowing it to
increase to toxic levels. Digoxin levels should be closely monitored in these patients. (p. 1072)
Because digoxin is excreted essentially unchanged by the kidneys, severe renal impairment
effectively contraindicates its use. (p. 318)
Treatment with hepatitis C- antiviral meds, NS5A inhibitors
Tacrine-
Timolol-
The nurse concludes that a client newly diagnosed with glaucoma knows the purpose for the
prescribed timolol (Timoptic) blocker when the clients makes which statement:
- REDUCE INTRAOCCULAR PRESSURE
Cromolyn-allergic
David presents to clinic with symptoms of allergic conjunctivitis. He is prescribed cromolyn
sodium (Opticrom) eyedrops. The education regarding using cromolyn eyedrops includes which
one of the following tips
- he should not wear his soft contacts while using the cromolyn eyedrops.
PNA & hypothyroidism- what med don’t give?? -epi inhaler
Which class antiarrhythmic meds treat SVT or VT?
HSV med- answer to do with applying to oral lesion at the first sign of outbreak
Protozoal infection- which type of med antifungal, antimalarial or antiviral plus one other I can’t
remember
Erectile dysfunction- sildenafil or something
It must be noted that phosphodiesterase-5 inhibitors (sildenafil, Viagra; vardenafil, Levitra;
tadalafil, Cialis) used to treat erectile dysfunction, when taken in combination with nitrates used
for chest pain, can cause severe vasodilation resulting in hypotension and syncope. (p. 892)
Patients with Wolff–Parkinson–White (WPW) syndrome can have ventricular responses that are
dangerously rapid. Drugs commonly used to control ventricular response such as diltiazem,
verapamil, and digoxin are ineffective in this situation and can facilitate conduction through the
accessory pathway, increasing the risk for ventricular fibrillation (p. 315)
Final exam pharm
1. Lauren is a 13 year old child who comes to the clinic with a 4 day history of cough, low
grade fever, and rhinorrhea. When she blows her nose or coughs the mucous is greenish
yellow. The appropriate antibiotic to prescribe would be
- None
2. Pong-tai is a 12month old child who is being treated with amoxicillin for acute otitis media.
His parents call the clinic and say he has developed diarrhea. The appropriate action would
be to
, 3
NSG 6005 FINAL STUDY GUIDE
- Advise the parents that some diarrhea is normal with amoxicillin and recommend
probiotics daily
3. There is often a cross sensitivity and cross resistance between pcn and cephalosporins
because
- Both drug classes contain a beta lactam ring that is vulnerable to beta lactamase
producing organisms
4. Sara is a 25 year old female who is 8 weeks pregnant and has a uti. What would be the
appropriate antibiotic to prescribe
- Amoxicillin
5. Jonathon has been diagnosed with strep throat and needs a prescription for an antibiotic. He
says the last time he had pcn he developed a red blotchy rash. An appropriate antibiotic to
prescribe would be
- Azithromycin
6. Treatment for herpes simplex 1
- Acyclovir
7. A girl is prescribed fluconazole after being treated with an antibiotic for uti. What is the
purpose of the fluconazole
- Yeast infection
8. What do glaucoma eye drop timilol, lantoprost have in common
- -decrease intraocular pressure
9. What antibiotic is used to treat MRSA
- Vanc
10. What medication to avoid for someone with open angle glaucoma and kidney stones
- Acetylcholine
11. What medications to avoid with closed angle glaucoma
- Acetazolamide
- Topiramate
-
12. Otitis media
- amoxicillin
13. ADR of isoniazid
14. What analysis would a managed care organization use to improve health outcomes
15. What analysis would be used if a managed care organization wanted to compare two drugs
with different benefits
16. You are prescribing drugs using step therapies to cut costs what drug would you prescribe
- Generic
17. Which analysis is expressed in terms of life years
18. What do 1A's treat?
- Atrial/ventricular tach (quinodine, procainamide)
19. Mexiletine
- Only available orally
20. 1b (lidocaine, mexiletine, phenytoin)
- Blocks sodium channels
- Tx ventricular arrythmias
21. 1c (propadenone)
, 4
NSG 6005 FINAL STUDY GUIDE
- Na blocker & BB
- Treats WPW, AFIB
22. Class 2 (BB’S)
- Tx: Supraventricular
23. Class 3 (amio, sotalol)
- Prolonged action potential
24. Class 4 (verapamil, diltiazem)
- Tx: svt
25. I. Sodium channel blockers- 1A, 1B, 1C
II. β-adrenergic antagonists
III. Potassium channel blockers and relatives
IV. Calcium channel blockers
26. Nurse practitioner prescriptive authority is regulated by:
1. The National Council of State Boards of Nursing
2. The U.S. Drug Enforcement Administration
3. The State Board of Nursing for each state
4. The State Board of Pharmacy
30. Clinical judgment in prescribing includes:
1. Factoring in the cost to the patient of the medication prescribed
2. Always prescribing the newest medication available for the disease process
3. Handing out drug samples to poor patients
4. Prescribing all generic medications to cut costs
31. Nurse practitioner practice may thrive under health-care reform because of:
1. The demonstrated ability of nurse practitioners to control costs and improve patient
outcomes
2. The fact that nurse practitioners will be able to practice independently
3. The fact that nurse practitioners will have full reimbursement under health-care
reform
4. The ability to shift accountability for Medicaid to the state level
32. . According to the U.S. Office of Minority Health, poor health outcomes among African
Americans are attributed to:
1. The belief among African Americans that prayer is more powerful than drugs
2. Poor compliance on the part of the African American patient
3. The genetic predisposition for illness found among African Americans
4. Discrimination, cultural barriers, and lack of access to health care
33. The racial difference in drug pharmacokinetics seen in American Indian or Alaskan Natives
are:
1. Increased CYP 2D6 activity, leading to rapid metabolism of some drugs
2. Largely unknown due to lack of studies of this population
3. Rapid metabolism of alcohol, leading to increased tolerance
4. Decreased elimination of opioids, leading to increased risk for addiction
34. Hispanic native healers (curanderas):
1. Are not heavily utilized by Hispanics who immigrate to the United States
2. Use herbs and teas in their treatment of illness
3. Provide unsafe advice to Hispanics and should not be trusted
4. Need to be licensed in their home country in order to practice in the United States
