MN 553 Final Exam Review | Questions with 100% Correct Answers | Latest 2023/2024 Graded A+

MN 553 Final Exam Review | Questions with 100% Correct Answers | Latest 2023/2024 Graded A+. Drug choices to treat angina in older adults differ from those of younger adults only in: 1. Consideration of risk factors for diseases associated with and increased in aging 2. The placement of drug therapy as a treatment choice before lifestyle changes are tried 3. The need for at least three drugs in the treatment regimen because of the complexity of angina in the older adult 4. Those with higher risk for silent myocardial infarction 15. Cost of antianginal drug therapy should be considered in drug selection because of all of the following EXCEPT: 1. Patients often require multiple drugs 2. A large number of angina patients are older adults on fixed incomes 3. Generic formulations may be cheaper but are rarely bioequivalent 4. Lack of drug selectivity may result in increased adverse reactions 16. Situations that suggest referral to a specialist is appropriate include: 1. When chronic stable angina becomes unpredictable in its characteristics and precipitating factors 2. When a post-myocardial infarction patient develops new-onset angina 3. When standard therapy is not successful in improving exercise tolerance or reducing the incidence of angina 4. All of the above 17. The rationale for prescribing calcium blockers for angina can be based on the need for: 1. Increased inotropic effect in the heart 2. Increasing peripheral perfusion 3. Keeping heart rates high enough to ensure perfusion of coronary arteries 4. Help with rate control 18. Medications are typically started for angina patients when: 1. The first permanent EKG changes occur 2. The start of class I or II symptoms 3. The events trigger a trip to the emergency department 4. When troponin levels become altered 19. The most common cause of angina is: 1. Vasospasm of the coronary arteries 2. Atherosclerosis 3. Platelet aggregation 4. Low systemic oxygen 20. Ranolazine is used in angina patients to: 1. Dilate plaque-filled arteries 2. Inhibit platelet aggregation 3. Restrict late sodium flow in the myocytes 4. Induce vasoconstriction in the periphery to open coronary vessels 21. When is aspirin (ASA) used in angina patients? 1. All angina patients should be taking ASA unless it is contraindicated for allergy or other medical reasons. 2. ASA should only be used in men. 3. ASA has no role in angina, but is useful in MI prevention. 4. The impact of ASA is best at the time of an angina attack. 6. Robert is a 72-year-old patient who has hypertension and angina. He is at risk for common medication practices seen in the elderly including: 1. Use of another person’s medications 2. Hoarding medications 3. Changing his medication regimen without telling his provider 4. All of the above Angioedema 3. A potentially life-threatening adverse response to angiotensin-converting enzyme inhibitors is angioedema. Which of the following statements is true about this adverse response? 1. Swelling of the tongue or hoarseness are the most common symptoms. 2. It appears to be related to the decrease in aldosterone production. 3. Presence of a dry, hacky cough indicates a high risk for this adverse response. 4. Because it takes time to build up a blood level, it occurs after being on the drug for about 1 week. Antidepressants 17. The tricyclic antidepressants should be prescribed cautiously in patients with: 1. Eczema 2. Asthma 3. Diabetes 4. Heart disease 4. Prior to starting antidepressants, patients should have laboratory testing to rule out: 1. Hypothyroidism 2. Anemia 3. Diabetes mellitus 4. Low estrogen levels 5. David is a 34-year-old patient who is starting on paroxetine (Paxil) for depression. David’s education regarding his medication would include: 1. Paroxetine may cause intermittent diarrhea. 2. He may experience sexual dysfunction beginning a month after he starts therapy. 3. He may have constipation and he should increase fluids and fiber. 4. Paroxetine has a long half-life so he may occasionally skip a dose. 6. Jamison has been prescribed citalopram (Celexa) to treat his depression. Education regarding how quickly selective serotonin reuptake inhibitor (SSRI) antidepressants work would be: 1. Appetite and concentration improve in the first 1 to 2 weeks. 2. Sleep should improve almost immediately upon starting citalopram. 3. Full response to the SSRI may take 2 to 4 months after he reaches the full therapeutic dose. 4. His dysphoric mood will improve in 1 to 2 weeks. 7. An appropriate drug for the treatment of depression with anxiety would be: 1. Alprazolam (Xanax) 2. Escitalopram (Lexapro) 3. Buspirone (Buspar) 4. Amitriptyline (Elavil) 8. An appropriate first-line drug for the treatment of depression with fatigue and low energy would be: 1. Venlafaxine (Effexor) 2. Escitalopram (Lexapro) 3. Buspirone (Buspar) 4. Amitriptyline (Elavil) 9. The laboratory monitoring required when a patient is on a selective serotonin reuptake inhibitor is: 1. Complete blood count every 3 to 4 months 2. Therapeutic blood levels every 6 months after a steady state is achieved 3. Blood glucose every 3 to 4 months 4. There is no laboratory monitoring required 10. Jaycee has been on escitalopram (Lexapro) for a year and is willing to try tapering off of the selective serotonin reuptake inhibitor. What is the initial dosage adjustment when starting a taper off antidepressants? 1. Change dose to every other day dosing for a week 2. Reduce dose by 50% for 3 to 4 days 3. Reduce dose by 50% every other day 4. Escitalopram (Lexapro) can be stopped abruptly due to its long half-life 11. The longer-term Xanax patient comes in and states they need a higher dose of the medication. They deny any additional, new, or accelerating triggers of their anxiety. What is the probable reason? 1. They have become tolerant of the medication, which is characterized by the need for higher and higher doses. 2. They are a drug seeker. 3. They are suicidal. 4. They only need additional counseling on lifestyle modification. 12. What “onset of action” symptoms should be reviewed with patients who have been newly prescribed a selective serotonin reuptake inhibitor? 1. They will have insomnia for a week. 2. They can feel a bit of nausea, but this resolves in a week. 3. They will have an “onset seizure” but this is considered normal. 4. They will no longer dream. 13. Which of the following should not be taken with a selective serotonin reuptake inhibitor? 1. Aged blue cheese 2. Grapefruit 3. Alcohol 4. Green leafy vegetables 14. Why is the consistency of taking paroxetine (Paxil) and never running out of medication more important than with most other selective serotonin reuptake inhibitors (SSRIs)? 1. It has a shorter half-life and withdrawal syndrome has a faster onset without taper. 2. It has the longest half-life and the withdrawal syndrome has a faster onset. 3. It is quasi-addictive in the dopaminergic reward system. 4. It is the most activating of SSRI medications and will cause the person to have sudden deep sadness 15. The patient shares with the provider that he is taking his Prozac at night before going to bed. What is the best response? 1. This is a good idea because this class of medications generally makes people sleepy. 2. Have you noticed that you are having more sleep issues since you started that? 3. This a good way to remember to take your daily medications because it is near your toothbrush. 4. This is a good plan because you can eat grapefruit if there is 8–12 hours difference in the time each are ingested. 20. Suzanne is started on paroxetine (Paxil), a selective serotonin reuptake inhibitor (SSRI), for depression. Education regarding her antidepressant includes: 1. SSRIs may take 2 to 6 weeks before she will have maximum drug effects. 2. Red-green color blindness may occur and should be reported. 3. If she experiences dry mouth or heart rates greater than 80, she should stop taking the drug immediately. 4. She should eat lots of food high in fiber to prevent constipation. 21. Cecilia presents with depression associated with complaints of fatigue, sleeping all the time, and lack of motivation. An appropriate initial antidepressant for her would be: 1. Fluoxetine (Prozac) 2. Paroxetine (Paxil) 3. Amitriptyline (Elavil) 4. Duloxetine (Cymbalta) Aspirin Toxicity 7. Sally has been prescribed aspirin 320 mg per day for her atrial fibrillation. She also takes aspirin four or more times a day for arthritis pain. What are the symptoms of aspirin toxicity for which she would need to be evaluated? 1. Tinnitus 2. Diarrhea 3. Hearing loss 4. Photosensitivity 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 Beers List 13. All of the following statements about the Beer’s List are true except: 1. It is a list of medications or medication classes that should generally be avoided in persons 65 years or older because they are either ineffective or they pose unnecessarily high risk for older persons and a safer alternative is available. 2. It is derived from the expert opinion of one geriatrician and is not evidence-based. 3. These criteria have been adopted by the Centers for Medicare and Medicaid Services for regulation of long-term care facilities. 4. These criteria are directed at the general population of patients over 65 years of age and do not take disease states into consideration. Being an interpreter Beta Blockers 11. Drugs that are receptor antagonists, such as beta blockers, may cause: 1. Downregulation of the drug receptor 2. An exaggerated response if abruptly discontinued 3. Partial blockade of the effects of agonist drugs 4. An exaggerated response to competitive drug agonists 5. Jim is being treated for hypertension. Because he has a history of heart attack, the drug chosen is atenolol. Beta blockers treat hypertension by: 1. Increasing heart rate to improve cardiac output 2. Reducing vascular smooth muscle tone 3. Increasing aldosterone-mediated volume activity 4. Reducing aqueous humor production 8. Beta blockers are the drugs of choice for exertional angina because they: 1. Improve myocardial oxygen supply by vasodilating the coronary arteries 2. Decrease myocardial oxygen demand by decreasing heart rate and vascular resistance 3. Both 1 and 2 4. Neither 1 nor 2 9. Adherence to beta blocker therapy may be affected by their: 1. Short half-lives requiring twice daily dosing 2. Tendency to elevate lipid levels 3. Effects on the male genitalia, which may produce impotence 4. None of the above