NUR 635 FINAL TYLER REVIEW QUESTIONS WITH
VERIFIED CORRECT ANSWERS
Prescribing concerns with SSRI - answer ✔✔-serotonin syndrome caused by drug-drug interactions
what causes carbamazepine levels to drop despite no other change - answer ✔✔-autometabolizes- med
digests itself, need to increase dose
Long-term carbamazepine use requires monitoring of - answer ✔✔-CBC minimum 4 times a year due to
risk of hematological effects
Prescribing SSRI: Educate - When should pts notice a difference - answer ✔✔-Check back in four weeks.
May take some time.
Carbamazepine black box warning - answer ✔✔-Asians are at higher risk for SJS and TEN
Moderate generalized anxiety disorder: good first medication - answer ✔✔-Buspar
Buspar class - answer ✔✔-SNRI
classic migraine, first choice tx - answer ✔✔-triptans
classic migraine, tx after triptans are not working, first choice prophylactic - answer ✔✔-propranolol
(beta blocker)
10mg Percocet and 10mg oxycodone, Pt asks why does the Percocet work faster? - answer ✔✔-
Medication formulations (fillers and other additives) can effect pharmacodynamics
"Sig" on a prescription - answer ✔✔-how you take the medication, Latin for directions. Directions to
pharmacist
Abbreviation not used in rx - answer ✔✔-QD
pts taking teratogen rx and thinking about getting pregnant, when to dc - answer ✔✔-Now. Before
getting pregnant. Most defects occur in first trimester
Pneumonia tx goal: Fever gone in 2-4 days. If fever persists: - answer ✔✔-current AB not targeting the
right pathogen
Adults w/no risk factors with CAP tx: - answer ✔✔-macrolide such as azithromycin, clarithromycin,
erythromycin or doxycycline when allergic to pcn
most common pathogen: s.pneumoniae
Adults with pneumonia and comorbidities i.e. heart/lung/liver disease; dm; etoh; ca; asplenia;
immunosuppressed; or use of ab w/in 3 mos; or other risk for DRSP inf. Tx: - answer ✔✔-respiratory
, fluoroquinolone: levofloxacin(Levaquin) or beta-lactam PLUS macrolide such as amoxicillin or
amoxicillin-clavulanate (Augmentin)
adults older than 60, comorbid w/CAP. Outpt tx: - answer ✔✔-ceftriaxone (Rocephin) IM/IV IM
or
levofloxacin IV daily
switch to oral once pt can tolerate
CAP in preg women tx: - answer ✔✔-w/o comorbidities: erythromycin, azithromycin, clarithromycin
comorbid: azithromycin PLUS pcn
when tx pneumonia how long before leukocytosis should be resolved - answer ✔✔-4 days
Pt taking digoxin. What medication should we be concerned about r/t drug-drug interaction? - answer
✔✔-Albuterol. Albuterol can decrease plamsma levels of digoxin
moderate persistent asthma, in a 42 yo African American. What med am i going to be really cautious
with or avoid? - answer ✔✔-LABA monotherapy is to be avoided. LABA must always be combined with a
glucocorticoid in the tx of asthma
Spiriva Handihaler (tiotropium bromide) indication for use: - answer ✔✔-bronchospasm in COPD
(bronchodilator)
Beclamethasone (Qvar), tx of exercise induced asthma and pt education - answer ✔✔-inhaled
corticosteroid for asthma, not for exercise induced or acute exacerbation of asthma, it is for prevention
of asthma attacks. Maintenance med
Older male w/seasonal allergies, what should he take - answer ✔✔-avoid systemic allergy meds like OTC
Benadryl(diphenhydramine), adverse rxns include urinary retention and CNS effects (sedation)
2nd gen allergy meds preferred like Zyrtec(cetirizine)
Betexalol opthalmic drops. What should be monitored? - answer ✔✔--topical betaxolol- monitor their
intraocular pressure.
-betaxolol can cause decreases in blood pressure and heart rate.
-monitor the patient for the potential systemic adverse effects seen with betaxolol and other beta-
blockers for patients on both topical and oral forms.
Pt with new onset of depression. What do we check? - answer ✔✔-Thyroid testing. Hypothyroid
symptoms similar to depression syptoms. T3, T4, TSH
first line meds in depression tx - answer ✔✔-lexapro, zoloft, prozac
Pt would like to dc lexapro, she's been on it for a year with good results. Best approach: - answer ✔✔-
Taper by 50% every three to four days
VERIFIED CORRECT ANSWERS
Prescribing concerns with SSRI - answer ✔✔-serotonin syndrome caused by drug-drug interactions
what causes carbamazepine levels to drop despite no other change - answer ✔✔-autometabolizes- med
digests itself, need to increase dose
Long-term carbamazepine use requires monitoring of - answer ✔✔-CBC minimum 4 times a year due to
risk of hematological effects
Prescribing SSRI: Educate - When should pts notice a difference - answer ✔✔-Check back in four weeks.
May take some time.
Carbamazepine black box warning - answer ✔✔-Asians are at higher risk for SJS and TEN
Moderate generalized anxiety disorder: good first medication - answer ✔✔-Buspar
Buspar class - answer ✔✔-SNRI
classic migraine, first choice tx - answer ✔✔-triptans
classic migraine, tx after triptans are not working, first choice prophylactic - answer ✔✔-propranolol
(beta blocker)
10mg Percocet and 10mg oxycodone, Pt asks why does the Percocet work faster? - answer ✔✔-
Medication formulations (fillers and other additives) can effect pharmacodynamics
"Sig" on a prescription - answer ✔✔-how you take the medication, Latin for directions. Directions to
pharmacist
Abbreviation not used in rx - answer ✔✔-QD
pts taking teratogen rx and thinking about getting pregnant, when to dc - answer ✔✔-Now. Before
getting pregnant. Most defects occur in first trimester
Pneumonia tx goal: Fever gone in 2-4 days. If fever persists: - answer ✔✔-current AB not targeting the
right pathogen
Adults w/no risk factors with CAP tx: - answer ✔✔-macrolide such as azithromycin, clarithromycin,
erythromycin or doxycycline when allergic to pcn
most common pathogen: s.pneumoniae
Adults with pneumonia and comorbidities i.e. heart/lung/liver disease; dm; etoh; ca; asplenia;
immunosuppressed; or use of ab w/in 3 mos; or other risk for DRSP inf. Tx: - answer ✔✔-respiratory
, fluoroquinolone: levofloxacin(Levaquin) or beta-lactam PLUS macrolide such as amoxicillin or
amoxicillin-clavulanate (Augmentin)
adults older than 60, comorbid w/CAP. Outpt tx: - answer ✔✔-ceftriaxone (Rocephin) IM/IV IM
or
levofloxacin IV daily
switch to oral once pt can tolerate
CAP in preg women tx: - answer ✔✔-w/o comorbidities: erythromycin, azithromycin, clarithromycin
comorbid: azithromycin PLUS pcn
when tx pneumonia how long before leukocytosis should be resolved - answer ✔✔-4 days
Pt taking digoxin. What medication should we be concerned about r/t drug-drug interaction? - answer
✔✔-Albuterol. Albuterol can decrease plamsma levels of digoxin
moderate persistent asthma, in a 42 yo African American. What med am i going to be really cautious
with or avoid? - answer ✔✔-LABA monotherapy is to be avoided. LABA must always be combined with a
glucocorticoid in the tx of asthma
Spiriva Handihaler (tiotropium bromide) indication for use: - answer ✔✔-bronchospasm in COPD
(bronchodilator)
Beclamethasone (Qvar), tx of exercise induced asthma and pt education - answer ✔✔-inhaled
corticosteroid for asthma, not for exercise induced or acute exacerbation of asthma, it is for prevention
of asthma attacks. Maintenance med
Older male w/seasonal allergies, what should he take - answer ✔✔-avoid systemic allergy meds like OTC
Benadryl(diphenhydramine), adverse rxns include urinary retention and CNS effects (sedation)
2nd gen allergy meds preferred like Zyrtec(cetirizine)
Betexalol opthalmic drops. What should be monitored? - answer ✔✔--topical betaxolol- monitor their
intraocular pressure.
-betaxolol can cause decreases in blood pressure and heart rate.
-monitor the patient for the potential systemic adverse effects seen with betaxolol and other beta-
blockers for patients on both topical and oral forms.
Pt with new onset of depression. What do we check? - answer ✔✔-Thyroid testing. Hypothyroid
symptoms similar to depression syptoms. T3, T4, TSH
first line meds in depression tx - answer ✔✔-lexapro, zoloft, prozac
Pt would like to dc lexapro, she's been on it for a year with good results. Best approach: - answer ✔✔-
Taper by 50% every three to four days
