United States University MSN 571 PHARM-MIDTERM-FINAL-DRAFT. 100% Correct. Over 170 Questions and Answers-Listed Below in the Description

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HERE IS A LIST OF THE QUESTIONS 1. Fluoroquinolone antibiotics are most likely indicating in which of the conditions Asthma Genital infections Follicular conjunctivitis GERD 2. Which of the foll... owing is most likely an intervention for otitis media? Amoxicillin Aspirin Immunoglobulins Corticosteroids 3. Which of the following best classifies penicillin, cephalosporins, and Protein synthesis inhibitors Mycolic acid synthesis inhibitors RNA synthesis Cell wall inhibitors 4. Beta lactamase inhibitors are often located in which of the following? May decrease absorption First dose effect Often combined with penicillin antibiotics Delayed absorption of oral drugs 5. Which of the following drug classes is/are used in initial hypertension management of African American population? Clonidine primary Beta blockers primary Thiazide or calcium channel blocker primary ACE-I primary ARB primary 6. Which of the following groups of antibiotics is notable for side effects such as nephrotoxicity or ototoxicity? Beta-lactams Aminoglycosides Tetracyclines 7. Which of the following groups of antibiotics has a beta-lactam ring in the molecularStructure Sulfonamides Macrolides Tetracyclines Fluoroquinolone Cephalosporins 8. Which of the follow medication is a fluoroquinolone antibiotic? Ciprofloxacin Azithromycin Amikacin Penicillin 9. Which of the following medications or drugs classes is commonly indicated for managing gestational hypertension? Spironolactone (Aldactone) Loop diuretics Calcium channel blockers Dobutamine Calcium gluconate 10. Which of the following best classifies aminoglycosides, macrolides and clindamycin? Protein synthesis inhibitor Folic acid synthesis inhibitors Cell wall inhibitors Mycolic acid synthesis inhibitors 11. The long half-life of amiodarone contributes to which complications Enhanced therapeutic effects Liver toxicity Decreased dosing Short onset of action 12. Pharmacokinetics involves the study of which factor? Distribution rates among various body compartment Physiologic interactions of drugs Interactions among various drugs Adverse reactions to medications13. Which route of drug administration is used with potent and lipophilic drugs in a patch formulation and avoids first-pass metabolism? Oral Topical Rectal Transdermal 14. Patients who have a poor metabolism phenotype will have: A need for increased dosages of medications Increased elimination of an active drug Accumulation of inactive metabolites of drugs Slowed metabolism of prodrug into an active drug leading to accumulation of prodrug 15. Lower doses of sublingual nitroglycerin can be used effectively because It bypasses the liver The potency is 100 times higher It does not need to be absorbed into the bloodstream It is not catabolized down by gastric acids 16. Which term refers to the ratio between a drugs therapeutic effects and its toxic effects? Cumulative effect Therapeutic index Tolerance Affinity 17. In geriatric patients the percentage of body fat is increased. What are the pharmacologic implications of the physiologic change? A lipid soluble medication will be eliminated more quickly and not work as well Absorption of lipid soluble drugs is impaired in older adults. The bioavailability of the lipid soluble drug will be increased in older adults A lipid soluble medication will accumulate in fat tissue and its duration of action may be prolonged 18. A patient diagnosed with otitis externa and taking a fluoroquinolone with glucocorticoid benefit is taking the medication together you reply The glucocorticoid reduces the swelling caused by the inflammation and ear infection The glucocorticoid decreased likelihood of antibiotic resistant The glucocorticoid decreases the adverse effects of the fluoroquinoloneThe two medications are contraindicated for use together 19. A two year old child presents to the clinic with arthralgia and fever in the last tympanic membrane is erythematous and bulging the right TMS is perforated and draining the child’s parent states “this is fifth year infection this year “what can we do? what action will the provider take to address to Childs ear problems Prescribe amoxicillin/clavulanate and refer the child to an otolaryngologist??? I THINK THIS IS CORRECT Prescribe both ceftriaxone (Rocephin) IM with benzocaine ear drops for pain 20. A patient is diagnosed with otitis externa. Comorbidities include diabetes mellitus, hypertension, and advanced multiple sclerosis. Which type of education regarding medication administration would you provide? page 1304 repeat #20 The oral administration of a prescription for hydrocortisone/neomycin/polymyxin B combination solution The oral administration of a prescription for fluoroquinolone The administration of topical medication for a prescription of alcohol plus acetic acid s solution The administration of topical combination for a prescription of fluoroquinolone/glucocorticoid combination solution 21. A patient who has congestive heart failure requires a diuretic. The patient also has a history of chronic kidney disease with a glomerular filtration rate (FGR) of less than 30 ml/min. which drug would you prescribe this patient. Methyclothiazide Metolazone Loop diuretics 22. Factors released by platelets contribute to hemostasis by enhancing Fibrinolysis Vasodilation Intrinsic pathway Platelet aggregation 23. A patient has been receiving iron replacement therapy for 2 days after hip replacement surgery. The provider is alerted to the following assessment data:Patient is pale and reports feeling tired Patient’s stools appear black Patients heart rate is 98 beats/min respiration are 20 and the blood pressure is 100/50 mm hg What order will the provider take initially to best assure appropriate care for this patient? Packet red blood cells Hemoglobin and hematocrit Hypertonic fluid bolus Stool guaiac 24. A woman taking a drug for high LDL-cholesterol experience muscle tenderness and pain with no apparent cause. Which agent is less likely to cause this adverse effect. Fenofibrate Niacin Atorvastatin Colestipol 25. Which drug inhibits the intestinal absorption of cholesterol? Colestipol Fenofibrate Ezetimibe Colesevelam 26. An elderly patient with hypertension and hyperlipidemia who has been prescribed a statin medication comes for a follow up visit after 4 months of therapy. The patient’s laboratory reports show elevated blood cholesterol level and the urine examination reveals rhabdomyolysis. What could be the reason for the condition? Select all the apply The patient is taking amiodarone along with statin The patient is taking grapefruit juice with statins The patient is not responding to the treatment The patient is taking cyclosporine along with statin & verapamil The patient is eating fiber-rich food along with the statins 27. Match the correct drug teratogenic effect during pregnancy THIS ONE IS HARD IDK - found a table on the pharm book. Table 8.1 NSAIDS-Microcephaly; premature closure of the ductus arteriosus Angiotensin-converting enzyme inhibitors- renal failure; renal tubular dysgenesis, skull hypoplasia (from exposure during 2nd & 3rd trimester)Warfarin-Craniofacial defects; skeletal & CNS defects Isotretinoin- multiple defects (CNS, craniofacial, cardiovascular, others) HMG CoA reductase inhibitors-neural tube defects, facial malformations & CNS anomalies, including holoprosencephaly (single-lobed brain) 28. When planning care for a patient receiving a sulfonaminde antibiotic. Which is the appropriate intervention? Insert foley catheter for accurate input and output measurement Encourage liquids that produce acidic urine Encourage a diet that causes alkaline ash Force fluids to at least 2000 ml/day 29. A 30 years old pregnant female has cellulitis caused by MRSA. Which of the following antibiotics would be the most appropriate option of outpatient therapy? Quinupristin/dalforpristin Doxycycline Clindamycin Tigecycline 30. What is important teaching to a patient taking minocycline? Wear sunscreen as your skin may become sensitive to light This medication can cause an increase in uric acid levels precipitating a gout attack If you have diabetes this medication can worsen hyperglycemia You must take this medication with calcium in order for it to be absorbed better 31. Which answer is true regarding cephalosporin Similar to macrolide structure Bacteriostatic High toxicity Beta-lactam antibiotic. 32. What are the two serious side effects that can occur with Aminoglycoside use? Nephrotoxicity and neurotoxicity Nephrotoxicity and hepatotoxicity Ototoxicity and nephrotoxicity Hepatotoxicity and ototoxicity 33. Adverse effects of fluoroquinolone antibiotics include? QT prolongationAll the answer are Correct Tendinitis and tendon rupture Seizures 34. A provider would prescribe which antibiotic to a patient diagnosed with methicillin-resistant Staphylococcus aureus (MRSA) Ciprofloxacin Daptomycin Norfloxacin Levofloxacin 35. Which order for furosemide is written appropriately by the prescribe? Furosemide (Lasix) 20 mg po qd Furosemide (Lasix) 20 mg po daily Furosemide (Lasix) 20 mg daily Furosemide (Lasix) 20 mg po QD 36. How can the prescriber’s regular collaboration with a pharmacist? Pharmacist can suggest foods that will help with the medications Pharmacists have additional information on drug interaction The pharmacist can suggest adequate medication dosing Pharmacy can alter prescriptions when necessary to prevent patient harm Pharmacists have firsthand knowledge of the facility formulary 37. A six-year-old who has never received an inactivated influenza vaccine has been brought to the office by his mother to be vaccinated to help protect his four month-old-baby sister during influenza “season”. You inform the boy’s mother that he will require A single vaccination administered annually Children under age eight years should not receive the inactivation influenza vaccination Two inactivated influenza vaccinations the first scheduled about one month prior to the start of influenza season (October/November) and the second scheduled four weeks after the first. Two inactivated influenza vaccinations scheduled four or more weeks apart 38. All the medications are safe to use during pregnancy except Acyclovir Famciclovir ValacyclovirFoscamet 39. Zanamivir is indicated for which of the following? Zanamivir is indicated for both treatment and prophylaxis of influenza Treatment of respiratory syncytial virus (RSV) Treatment of influenza Prophylaxis of influenza 40. What is the treatment of option for a patient who reported small vesicular lesions on his genitals that lasted between 10 and 20 days? Acyclovir (Zovirax) One time dose of azithromycin Three injections of penicillin Test of cure 41. Which medication will decrease blood pressure by blocking angiotensin II receptor site? Eplerenone Furosemide Valsartan Enalapril 42. A patient receiving nifedipine. Which adverse effect should you monitor for in this patient? Ankle edema Diarrhea Pallor Backache 43. Why does NP student anticipate administering metoprolol rather than propranolol? Propranolol causes beta 1 and beta 2 blockade Metoprolol helps prevent retinopathy in individuals with diabetes Metoprolol is less likely to cause diabetic neuropathy Propranolol is associated with a higher incidence of foot ulcers. 44. When developing a treatment plan for a 65-year-old patient with benign prostatic hyperplasia (BPH), who also takes medication to control hypertension, which medication would you plan to include? Tamsulosin (Flomax) Tadalafil (Cialis, adcircal) Dutasteride (Avodart)Finasteride (Propecia, Proscar) 45. As you formulate a plan of care for a 72 year-old patient, you recognized this medication causes postural hypotension in the older adult LEAST LIKELY? Amitriptyline (endep, amitril) Lasix Lisinopril (Prinivil, Zestril) Clonidine (catapres, kapvay, nexiclon) 46. Anemia of chronic renal failure is caused by the lack of Adrenaline Parathyroid hormone Thyroid hormone Erythropoietin 47. What is not a common side effect of oral iron therapy? Paresthesia Dark stools Staining of teeth Nausea/Vomiting 48. An 18-year-old male is having difficulty sleeping because of the death of his grandfather. He is given a benzodiazepine that does which of the following? Bind to serotonin 5-HT1 receptors Is an antagonist at alpha-adrenoreceptors Is an antagonist at dopamine D2 receptors Binds to GABAa receptors 49. Which of the following opioid is so lipophilic that it is marketed in a skin patch used to treat chronic pain Methadone Naltrexone Scopolamine Fentanyl 50. Schedule II drugs are (select all that apply) Drugs with a high potential for abuse Drugs that are controlled substance Drug that can be filled without prescriptionPrescription drugs that cannot be refilled Prescription that is valid for only 1 year 51. Which of the following is not a side effect of morphine? Urinary retentions Biliary colic Respiratory depression All are side effect of morphine 52. The 4th to the 10th week of gestation is the period time when there is the greatest concern about drug induced Fetal hemorrhage Fetal cardiac arrest Fetal malformation Labor 53. Which pediatric client is at gestation risk for medication toxicity? A 10-year-old recovering from an appendectomy A 6-years-old being treated with first degree burn A 15-years-old diagnosed with exercised-induced asthma A 1-year-old diagnosed with a heart valve problem 54. When calculating pediatric dosages, what should you take into consideration? Dosage calculation by body surface area is the most accurate method because it takes into account the difference in size of the child and or neonates Calculated doses based on body weight should be increased by 10% because of immature renal and hepatic functions Dosage calculation according to the body weight is the most accurate method because it takes into account different in maturational development Usage of drug reference recommendation based on milligram per kilogram of the body weight is the preferred method. 55. A health care professional advises a pregnant woman to add supplement of which nutrient to her diet prevent birth defects? Iron Vitamin C ZincFolate 56. A parent of a 5-year-old child with allergic rhinitis is seeking an approved treatment to make the child feel better. Which of the following recommended? Diphenhydramine Meclizine Promethazine Cetirizine 57. Which of the following is non-neurotoxin treatment for head lice? Permethrin 1%?jk Malathion (ovide) Benzoyl alcohol (ulesfia) Lindane shampoo 58. Monitoring of a patient who is taking allopurinol for gout includes Blood glucose c-reactive protein Bun, creatinine, and creatinine clearance Complete blood count 59. All of the following are true regarding the treatment of scabies except? Treatment of scabies includes crotamiton, malathion, and lindane Permethrin 5% cream (elimites) is the drug of choice for the treatment of scabies in infants greater than 2 months and approved to use in pregnant women Lindane does not carry risk for toxicity and can be used in children more than 2 years of age. Lindane though usually effective carries a risk for toxicity and should be sued in children 60. Which of the following will you find in a patient taking warfarin and levothyroxine? Cardiac dysrhythmias Shortness of breath Excessive bleeding 61. Idarucizumab is used to reverse the activity of which antithrombotic drugs in cases of Bleeding? Warfarin AlteplaseDalteparin Dabigatran 62. The patient is receiving anticoagulant therapy. The INR value for the patient today is 1.5. in response to this what will you do? Prescribe an additional dose of warfarin Hold the next of warfarin Prescribe protamine sulfate Increase the heparin drip rate 63. A 24 years old patient is diagnosed with genital herpes simplex virus infections. Which of the following agents is indicated for use in this diagnosis? Cidofovir Valacyclovir Zanamivir Lamivudine 64. A 19 years old female is diagnosed with bacterial vaginosis. What is a common treatment Prescribed Amoxicillin Metronidazole Azithromycin Ciprofloxacin 65. A 19-years-old female comes to your clinic with greenish, malodorous discharge Vulvar pruritis is also present. On pelvic exam, vaginal mucosa is erythematous, Wet mount of the discharge shows a motile organism. The patient is started on an appropriate therapy. Later that evening. The patient develops flushing, nausea, and vomiting after eating dinner with a glass of wine. The patient was most likely treated with which of the following medications? Azithromycin Metronidazole Ceftriaxone fluconazole 1. Drugs with a narrow therapeutic window have:a. High risk for toxicity 2. Pharmacokinetics involves the study of A) physiologic interactions of drugs. B) distribution rates among various body compartments. C) interactions between various drugs. D) adverse reactions to medications. 3. What are the properties of an ideal drug? a. Effectiveness, safety, and selectivity 4. Blood concentrations of drugs are variable and are influenced by the: a. Drug metabolism 5. When developing a treatment plan for a 65-year old patient with BPH, who also takes medication to control HTN, which medication would you plan to include? a. Tamusolin (Flomax) B. Tadalafil (Cialis, adcircal) C. dutasteride (avodart) D. finasteride (propecia, proscar) 6. The patients asks if there is any other option besides antibiotics to treat acute otitis media. How will you respond? a. Pain management is also part of the treatment plan for otitis media 7. A patient is diagnosed with otitis externa. Comorbidities include DM, HTN, and advanced MS. Which type of education regarding medication administration would you Provide? a. The administration of topical medications for a prescription of alcohol plus acetic acid solution b. The administration of topical combination medications for a prescription of fluoroquinolone/glucocorticoid combination solution c. The oral administration of a prescription for hydrocortisone/neomycin/polymyxin B combination solution d. The oral administration of a prescription for fluoroquinolone 8. Which instructions should be included in the plan of care of a patient who is prescribed ferrous sulfate? a. Iron should only be taken at night b. Iron does not absorbc. Iron compounds are not taken orally d. Antacids should not be taken with iron 9. What changes in drug distribution with aging would influence prescribing a medication in a 90-year-old patient? Sadie is a 90-year-old patient who requires a new prescription. What changes in drug distribution with aging would influence prescribing for Sadie? ← similar question on quizlet in case its worded that way a. Increased muscle-to-fat ratio b. Increased volume of distribution c. Decreased lipid solubility d. Decreased plasma proteins 10. Gross malformations by teratogens are most likely to occur during which stage of fetal Development? a. Weeks 3-8 b. Weeks 24-30 c. Weeks 12-20 d. Week 1-2 11. Which statements about transdermal absorption in infants are correct? a. Blood flow to the skin is greater in infants than in older patients b. Infants are at increased risk of toxicity compared with older children c. The stratum corneum of the infants is very thin, making absorption through the skin more rapid and complete with infants d. All answers are correct 12. When teaching a pregnant patient about the effects of medication on the fetus, the greatest harm from maternally ingested medications occurs during which time period? a. Birthing process b. Second trimester c. Third trimester d. First trimester 13. Which lab result may be a consequence of therapy with a thiazide diuretic? a. Serum potassium level of 5.3 b. Serum sodium level of 135 c. Serum glucose level of 58d. Serum uric acid level of 10.4 14. Which lab test is an indirect measure of atherosclerotic plaque? a. Erythrocyte sedimentation rate (ESR) b. LDL c. Homocysteine d. CRP 15. What is the MOA of ezetimibe? a. It inhibits absorption of dietary and biliary cholesterol in the small intestine b. It decreases the adhesion of cholesterol on the arterial walls c. It inhibits the absorption of bile, thus causing the liver to produce bile from cholesterol d. It inhibits the biosynthesis of cholesterol in the liver 16. Which drug is the most effective for lowering LDL cholesterol? a. Atorvastatin b. Gemfibrozil c. Cholestyramine d. Ezetimbe 17. Nystatin is used for a variety of conditions. Which condition is not treated with Nystatin? a. Vaginal candidiasis b. Oral candidiasis c. Intestinal candidiasis d. Onychomycosis 18. Isotretinoin (Accutane) is a drug employed in the treatment of severe recalcitrant cystic acne. Which one of the following is NOT an adverse effect associated with its use? a. Conjunctivitis b. Fetal abnormalities c. Hypertriglyceridemia d. Hyponatremia 19. Zanamivir is indicted for which of the following? a. Indicated for both treatment and prophylaxis of influenza b. Treatment of influenza c. Treatment of RSVd. Prophylaxis of influenza 20. What is the treatment option for a patient who reported small, vesicular lesions on his genitals that lasted between 10 and 20 days? a. Acyclovir (Zovirax) b. One-time dose of azithromycin c. Test of cure d. Three injections of penicillin 21. Which microorganism is directly affected by acyclovir? a. Proteus vulgaris b. Staphylococcus aureus c. Pneumocystis jiroveci d. Herpes zoster 22. A 24-year-old patient is diagnosed with genital HSV infection. Which of the following agents is indicated for use in this diagnosis? a. Zanamivir b. Cidofovir c. Maivudine d. Valacyclovir 23. A patient diagnosed with lymphagitis has an allergy to penicillin, the allergy is a rash. What would you give the patient? a. TMP/SMZ b. Penicillin VK PO c. Penicillin G IV d. Clindamycin (In Dr. Hu’s notes) 24. Which of the following statements best explains the observation that morphine is more likely to cause nausea and vomiting in ambulatory patients? a. Opioids cause sedation, which makes walking more difficult b. Morphine inhibits chemoreceptor trigger zones c. Opioids increase vestibular sensitivity d. Morphine sensitizes medulla cough center neurons 25. A patient is given Naloxone for Morphine sulfate who has a respiratory rate of 6 bpm. What is the MOA of Naloxone? a. Naloxone is a partial agonist, requiring a lesser dose to achieve pain reliefb. Naloxone is an agonist, leading to desensitization of the opioid receptors c. Naloxone causes hypersensitivity of the opioid receptors d. Naloxone prevents the activation of opioid receptors 26. Which of the following will you find in a patient taking warfarin and levothyroxine? a. Cardiac dysrhythmias b. SOB c. Weight loss 5 kg d. Excessive bruising 27. There is a pregnant patient in your office that states she was given Gentamicin when she was unknowingly pregnant which of the following adverse effects would you explain to the patient can result from taking Gentamicin in pregnancy? a. Cardiac malformation b. Discoloration of developing teeth c. Irreversible hearing loss d. Vision loss 28. When prescribing Metronidazole (Flagyl) to treat bacterial vaginosis, patient education would include: a. HA are a sign of serious ADR and need immediate evaluation b. Consuming alcohol in any form may cause a severe reaction c. Sexual partners need concurrent therapy d. Metronidazole is safe in the first trimester of pregnancy 29. A patient is to undergo orthopedic surgery, and the prescriber will order a cephalosporin to be given preoperatively as a prophylaxis against infection. Which generation of cephalosporin will the provider order? a. First b. Fourth c. Second d. Third 30. A patient has a penicillin allergy and needs to be treated for strep throat. Which drug can be used as an alternative therapy for patients with a penicillin allergy? a. Linezolid b. Tetracycline c. Clindamycind. Doxycycline 31. The antimicrobial that is recommended and highly effective for the treatment of gonorrhea at all anatomic sites of infection a. Cephalexin b. Ciprofloxacin c. Parental ceftriaxone d. Penicillin 32. Which of the following terms best describes the MOA of metoprolol? a. Alpha-1 antagonist effects b. Beta-1 selective c. Nonselective beta with alpha blockers d. Nonselective alpha-blockers 33. Which of the following disease or disorders are most likely treated with ACE inhibitors? WHO KNOWS. I THINK E a. Hyperthyroidism b. Pulmonary hypertension c. Cushing’s syndrome d. Angina e. Chronic kidney disease (with or without diabetes) *NOT POSITIVE ON THIS ONE?? 34. Which of the following medications or drug classes is commonly indicated for managing gestational hypertension? a. Spironolactone b. Loop diuretics c. CCB d. Dobutamine e. Calcium gluconate 35. Which prescriber action will have the greatest impact of the patient’s commitment to adherence to any type of medication therapy? a. Providing medication education that the patient can easily understand b. Scheduling once a day administration c. Prescribing the medication in oral form whenever possibled. Assuring that the medication prescription will be covered by the patient’s insurance 1. Instructions for applying a topical antibiotic or antiviral ointment include: a. Apply thickly to the infected area, spreading the medication well past the borders of the infection. b. If the rash worsens, apply a thicker layer of medication to settle down the infection. c. Wash hands before and after application of topical antimicrobials d. None of the answer are correct. 2. A patient suspected of having influenza comes to the urgent care for treatment. Which information will the NP need before prescribing Oseltamivir (Tamiflu)? a) Allergies to antibiotics b) Immunization history c) Length of time since symptoms d) OTC medications taken in the last 48 hours 3. Which finding is consistent with Guillain-Barré syndrome? Ascending paralysis a) Patients often experience paresthesia or dysesthesia b) There is progressing descending paralysis c) The symptoms usually begin in the arms and face. d) Sensory nerves are affected more than motor nerves. 4. A medication review of an elderly person’s medications involves: a) All the answers are correct b) Having the patient bring all of their prescription, OTC, and home medications to the visit c) Asking the patient to bring a list of current prescription medications to the visit d) Asking what other providers are writing prescriptions for them 5. Which antibiotic is recommended for the treatment of Chlamydiaa) High dose pcn b) High dose fluoroquinolone c) High dose cephalosporin d) High dose macrolide 6. A patient diagnosed with lymphangitis has an allergy to pcn, the allergy is a rash. What would you give this patient? CX is a 46-year-old patient diagnosed with lymphangitis. CX has a penicillin allergy, the allergy is a rash. Select the best antimicrobial to treat the lymphangitis in CX. A. Penicillin G (IV) B. Penicillin VK (oral) C. Clindamycin (IV) D. Trimethoprim-sulfamethoxazole (IV) E. Vancomycin (oral) 7. MRSA and DRSP (drug-resistant strep pneumoniae) mechanism of bacterial resistance is: a) Altered membrane permeability b) Enzyme destruction with Beta-Lactamase c) None of the answers are correct d) Binding site alteration 8. A patient has localized skin infection, which is most likely caused by positive cocci. Until the culture and sensitivity results are available, you order a ___-spectrum ___ agent a) Narrow; systemic b) Broad; systemic c) Broad; topical d) Narrow; topical9. A patient has glucose-6-phosphate dehydrogenase deficiency (G6PD) and needs an antibiotic. Which class of antibiotic should be avoided in this patient? Sulfonamides, streptomycin, and furazolidone. a) Cephalosporins b) Macrolides c) Sulfonamides d) Penicillins 10. A patient receiving a cephalosporin develops a secondary intestinal infection caused by c-diff. What action will the provider take to the provide effective care for this patient? a) Discontinuing the cephalosporin and beginning metronidazole b) Increasing the dose of the cephalosporin and providing isolation measures c) Discontinuing all antibiotics and providing fluid replacement d) Adding an additional antibiotic to the patient’s regimen 11. Select the term that refers to antibiotics that inhibit bacterial growth: a. Bacteriolytic b. Bacteriogenic c. Bactericidal d. Bacteriostatic 12. A man is brought to the ER complaining of nausea and vomiting, blurred and abnormally colored vision, and palpitations. Which drug is most likely responsible for these? A) dobutamine B) lisinopril C) digoxin D) milrinone E) furosemide 13. Which drug is the most effective for lowering LDL cholesterol?a. Ezetimibe b. Cholestyramine c. Gemfibrozil d. Atorvastatin 14. Which one of the following is the most common side effect of antihyperlipidemia drug therapy? a. Heart palpitations b. GI disturbance c. Elevated BP d. Neurologic problems 15. A patient has been receiving iron supplement therapy for 2 days after hip replacement surgery. The provider is alerted to the following assessment data: Black stools; pale and reports feeling tired; HR 98; RR 20; BP 100/50 What order will the provider take initially to best assure appropriate care for this patient? a. Hypertonic fluid bolus b. H&H c. PRBC d. Stool guaiac 16. Bioconversion of a prodrug to its active derivative may be enhanced by an enzyme inducer. a. True b. False 17. A patient presents to the ED after accidentally taking to much Warfarin. HR 78, BP 120/80. Urine dipstick normal. The patient does not have any obvious hematoma or petechiae and does not report any pain. What will the provider order initially to address the patient’s current condition? a. Protamine sulfateb. A PT and INR c. An APTT d. Vitamin K 18. All of the following are classification of dietary deficiencies causing nutritional anemia except: a. Iron b. Folic acid c. Vitamin B12 (cyanobalamin) d. Vitamin D 19. The patient received an overdose of Morphine. Naloxone is given to block the narcotice response. Which is the effect achieved when Naloxone is administered? a. Synergistic b. Negative c. Antagonist d. Addictive 20. Most clinically used opioid analgesics are selective for which type of opioid receptors? Mu opioid receptor (Pharm book, p. 183-184 a. Beta b. Kappa c. Alpha d. 21. Which route of drug administration is used with potent and lipophilic drugs in a patch formulation and avoids first-pass metabolism? a. Sublingual b. Oral c. Transdermald. Rectal e. Topical 22. A patient receiving IV gentamicin has a toxic serum drug level. The prescriber confirms that the dosing is correct. Which possible cause of this situation will the provider explore? a. If the ordered dose frequency is longer than the gentamicin half-life b. Whether a loading dose was administered c. Whether patient is taking a medication that binds to serum albumin d. If the drug was completely dissolved in the IV solution 23. Which enzyme system is responsible for metabolizing drugs in the liver? a. Ptyalin b. Pancreatic lipase c. Gastric lipase d. CYP450 enzymes 24. You administer 100 mg of a drug by mouth. After the drug moves through the hepatic system, very little active drug is left in general circulation. What concept explains this occurrence? a. Therapeutic range b. Drug half-life c. First-pass effect d. Plasma protein binding 25. The parents of a child with asthma ask the provider why their child cannot use oral corticosteroids more often because they are so effective. The provider will base the discussion with the parents on what fact concerning oral corticosteroids? a. A hypersensitivity reaction to this drug may occur b. Chronic glucocorticoid use can inhibit physical growth c. Frequent use of this drug may lead to a decreased responsed. Systemic steroids are more toxic in children 26. Which statement by a patient about the use of aspirin during pregnancy indicates need for further learning? a. “ASA can be used to relieve pain during pregnancy.” b. “ASA is most harmful when used in late pregnancy.” c. “ASA can affect hemostasis in newborns.” d. “ASA can cause antepartum hemorrhage.” 27. Gross malformations by teratogens are most likely to occur during which stage of fetal development? repeat a. Weeks 12-20 b. Weeks 3-8 c. Week 1-2 d. Weeks 24-30 28. What changes in drug distribution with aging would influence prescribing a medication in a 90 y/o patient? a. Decrease plasma proteins b. Decreased lipid solubility c. Increased volume of distribution d. Increased muscle-to-fat ratio 29. Which of the following disease or disorders are most likely treated with ACE inhibitors? Repeat from above a. Hyperthyroidism b. Pulmonary HTN c. Cushing’s Syndrome d. Angina e. CKD (w/ or w/o diabetes)30. Which of the following terms best describe the mechanism of action of metoprolol? repeat a. Alpha-1 antagonist effects b. Beta-1 selective c. d. Nonselective Alpha-blockers 31. Which of the following medications or drug classes is commonly indicated for managing gestational HTN? repeat a. Spironolactone b. Loop diuretics c. CCBs d. Dobutamine e. Calcium gluconate 32. A patient diagnosed with otitis externa and taking a fluoroquinolone/ glucocorticoid combination medication asks the NP what the benefit is to taking the medications together. You reply? a. “The glucocorticoid reduces the swelling cause by the inflammation and decreased pain, while the fluoroquinolone treats the infection.” b. “The glucocorticoid decreases the adverse effects of the fluoroquinolone.” c. “The two medications are contraindicated for use together.” d. “The glucocorticoid decreased the likelihood of antibiotic resistance developing to the fluoroquinolone.” 33. A 6 y/o child presents with crying d/t ear pain. Tympanic membranes are erythematous, bulging, and immobile, but intact. In addition to antibiotic therapy, what will the provider recommend for pain management? a. Low dose ASA b. Lidocaine for ear drops c. A tympanostomy to relieve pressure in the middle eard. Prednisone 34. Tretinoin is commonly employed in the treatment of which of the following? a. Seborrheic dermatitis b. Psoriasis c. MS d. Acne 35. A 20 y/o female presents to your clinic with nodulocystic acne. You prescribe Isotretinoin. What are the special considerations? a. Obtain LFTs at baseline and as indicated b. Adverse effects of Isotretinoin can be increased by tetracyclines and Vitamin A c. All of the choices are correct d. Pregnancy test at baseline x2 1. When prescribing acyclovir, patients should be educated regarding the: a. Eccentric dosing schedule b. High risk developing diarrhea c. Need to drink lots of fluids during treatment d. Risk for life-threatening rash such as Stevens-Johnson 2. A patient is taking oral ketoconazole for a systemic fungal infection. The medication administration record notes that the patient is also taking omeprazole for reflux disease. What instructions will the provider give the patient to maximize medication effectiveness? a. Take the omeprazole at least 2 hours after the ketoconazole. b. Take the omeprazole 1 hour before the ketoconazole. c. Wear sunglasses when outdoors to manage photosensitivity. d. Restrict intake of dairy products. 3. A patient with a history of congestive heart failure and renal impairment is diagnosed with esophageal candidiasis. Which antifungal agent will the provider prescribe this patient? a. Fluconazole b. Itraconazole c. Voriconazoled. Amphotericin B 4. Regarding the most common causes of adverse reactions in older adults, which of the following would you find to be decreased and the most common cause of these problems in older adults? a. Body fat content INC b. Plasma albumin levels c. Liver function d. Renal function/clearance 5. Which pediatric client is at greatest risk for medication toxicity? a. A 15-year old diagnosed with exercise-induced asthma b. A 6-year old being treated for first degree burns c. A 10-year old recovering from an appendectomy d. A 1-year old diagnosed with a heart valve problem 6. Which type of medication prescribed to a pregnant patient is more likely to have effects on her fetus? a. Ionized drugs b. Lipid-soluble drugs c. Protein-bound drugs d. Drugs that are highly polar 7. A breastfed 2-month old has an infection that requires an antibiotic. What drug factors influence the effect of the drug on the infant? a. Lipid solubility b. All the answers are correct c. Maternal drug levels d. Half-life 8. The Nurse Practitioner is teaching the NP student about acetaminophen. Which of the following would be included when teaching the student? a. All of the answers are correct b. The antidote to acetaminophen overdose is acetylcysteine c. Patients with normal kidney and liver function should not take more than 4000 mg per day. d. Patients need to watch over-the-counter medications for acetaminophen in the product to prevent an overdose.9. Which one of the following schedules of controlled substances is for drugs with the highest abuse potential that have a legitimate medical use? a. Schedule III b. Schedule V c. Schedule II d. Schedule I e. Schedule IV 10. What is plasmin’s role in the clotting process? a. Prevents the conversion of prothrombin to degrade the fibrin within blood clots. b. Stimulates platelet aggregation c. Inhibits platelet adhesion and aggregation. d. Degrades the fibrin within blood clots. 11. Which statements made by the prescriber demonstrate an understanding of effective medication education? (Select all that apply.) a. You need to take the medication as we discussed until all the tablets are gone. b. When you call about a medication refill, be sure to let the pharmacist know you are talking about your heart pill. c. Take 3 tablets daily: 1 with breakfast, 1 with lunch, and one with dinner. d. Call the office immediately if you begin experiencing any itching, headache, or difficulty breathing. e. This medication needs to be stored in the refrigerator. 12. Which of the following is NOT an expected adverse effect of Niacin? a. Arthralgias b. Hyperglycemia c. Flushing d. Itching 13. Which drug inhibits the intestinal absorption of cholesterol? a. Colestipol b. Fenofibrate c. Ezetimibe d. Colesevelam 14. Which instructions should be included in the plan of care for a patient who prescribed ferrous sulfate?a. Iron compounds are not taken orally. b. Antacids should not be taken with iron. c. Iron does not absorb. d. Iron should only be taken at night. 15. A patient is diagnosed with impetigo. Which topical medication will you prescribe? a. Bacitracin b. Hydrocortisone c. Mupirocin d. Polymyxin B 16. Appropriate initial treatment for psoriasis would be: a. An immunodulator (Protropic or Elidel) b. Wet soaks with Burrow’s or Domeboro solution c. Anthralin (Drithocreme) d. Intermittent therapy with intermediate potency topical corticosteroids 17. A patient is diagnosed with lymphagitis has an allergy to penicillin, the allergy is a rash. What would you give this patient? a. Penicillin VK by mouth b. Clindamycin c. Trimethoprim/sulfamethoxazole (TMP/SMZ) d. Penicillin G IV 18. A 19-year old female is diagnosed with bacterial vaginosis. What is common treatment prescribed? a. Amoxicillin b. Azithromycin c. Ciprofloxacin d. Metronidazole 19. A man is brought to the emergency department complaining of nausea and vomiting, blurred and abnormally colored vision, and palpitations. Which drug is most likely responsible for these effects? a. Lisinopril b. Dobutamine c. Mirinone d. Digoxin20. Therapeutic drug levels are drawn when a drug reaches steady state. Drugs reach steady state: a. One hour after IV administration b. After four to five half-lives c. When the patient feels the full effect of the drug d. After the second dose. 21. A generic medication is considered equal, or bioequivalent to its parent brand-name medication, and must undergo stringent safety and equivalency testing and comply with specific criteria established by the U.S. Food and Drug Administration (FDA). a. True b. False 22. Which drug administration routes avoid first-pass metabolism in the liver? a. All the answers are correct b. Intraocular c. Intranasal d. Transdermal 23. When two drugs interact what are the possible outcomes? a. One drug may reduce the effects of the other b. One drug may intensify the effects of the other c. All the answers are correct d. The combination of drugs may produce a new response not seen with either drug alone. 24. Which of the following groups of people are at risk for early hypertension? a. African American b. Adolescents are young adults c. Mexican American culture d. Old females 25. Which of the following terms best describes the mechanism of action of metoprolol? a. Alpha-1 antagonist effects b. Beta-1 selective c. Nonselective beta with alpha blocking d. Nonselective alpha-blockers26. Which of the following drug classes is/are used in initial hypertension managements of African-American population? a. Clonidine primary b. Beta blockers primary c. Thiazide of Calcium channel blocker primary d. ACE-I primary e. ARB primary 27. What is the first rule of antimicrobial therapy? a. Use maximum dose b. Watch for resistance c. Always do sensitive testing d. Match drug with the bug 28. Which statement about Ciprofloxacin is accurate? a. Organisms that commonly cause ear infections are highly resistant b. Most “first-time” urinary tract infections are resistant to Ciprofloxacin c. Ciprofloxacin is active against MRSA strains of staphylococci d. Tendinitis may occur during treatment 29. Risk factors for extended spectrum Beta Lactamase producing organisms include all except: a. Recent abdominal surgery b. A gastrostomy tube c. Attending daycare d. Use of corticosteroids 30. Select the term that refers to antibiotics that inhibit bacterial growth: a. Bacteriocidal b. Bacteriostatic c. Bacteriogenic d. Bacteriolytic 31. Which of the following medications is classified as macrolides? a. Tobramycin b. Gentamycin c. Azithromycin d. Vancomycin32. A patient is diagnosed with otitis externa caused by Aspergillus organisms. All of the therapy is appropriate except? a. 2% acetic acid solution ear drops b. Ciprofloxacin plus hydrocortisone otic solution c. Topical 1% clotrimazole d. Oral fluconazole 33. A 6-year old child presents with crying due to ear pain. Tympanic membranes are erythematous, bulging, and immobile, but intact. In addition to antibiotic therapy, what will the provider recommend for pain management? a. Lidocaine ear drops b. Prednisone c. Low dose aspirin d. A tympanostomy to relieve pressure in the middle ear. 34. Factors released by platelets contribute to hemostasis by enhancing: a. Vasodilation b. Intrinsic pathway c. Fibrinolysis d. Platelet aggregation 35. The patient is receiving warfarin therapy with the INR of 4.0. How will you interpret this finding? a. The level is within the expected therapeutic level of anticoagulation. b. The level is outside the expected target therapeutic level of anticoagulation; it is too high. c. The level cannot be interpreted without knowing the prothrombin time and the activated partial thromboplastin time (aPTT) value. d. The level is outside the expected target therapeutic level of anticoagulation: it is too low. [Show More]

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