NURS 6521 / NURS6521 Advanced Pharmacology Midterm Exam (GRADEDA) Question and Answers | Latest 2020 / 2021 / Scored 99/100

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NURS 6521 / NURS6521 Advanced Pharmacology Midterm Exam A patient with bronchial asthma is prescribed a sustained-release preparation of theophylline. To help minimize the adverse effects of t... he drug, which of the following should the nurse suggest? Selected Answer: Take it on an empty stomach, 1 hour before or 2 hours after meals Selected Answer: Amoxicillin, Metronidazole, and Bismuth A diabetic patient being treated for obesity tells the Nurse Practitioner that he is having adverse effects from his drug therapy. The patient has been taking dextroamphetamine for 2 weeks as adjunct therapy. Which of the following adverse effects would need the Nurse Practitioner's immediate attention? Selected Answer: Increased blood glucose A Nurse Practitioner is a member of a research team that is exploring unique differences in responses to drugs that each individual possesses, based on genetic make-up. This area of study is called Selected Answer: pharmacogenom ics. An older adult who lives in a long-term care facility has recently begun taking losartan (Cozaar) for the treatment of hypertension. The nurse who provides care for this resident should recognize that this change in the resident's medication regimen make create a risk for Selected Answer: falls. A 39-year-old African-American male is 25 pounds overweight and has been diagnosed with hypertension after three consecutive above-normal blood pressure readings. The most likely initial drug therapy for this patient will be Selected Answer: a diuretic. A 62-year-old man is admitted to the hospital with a diagnosis of chest pain. He has an order for 0.3 mg of sublingual nitroglycerin prn for chest pain. Which of the following actions should the nurse do first when he complains of chest pain? Selected Answer: Administer a tablet under his tongue and repeat the action in 5 and 10 minutes if the pain has not subsided A Nurse Practitioner working for a drug company is involved in phase III drug evaluation studies. Which of the following might the Nurse Practitioner be responsible for during this stage of drug development? Selected Answer: Administering investigational drugs to patients After a recent history of shortness of breath that has become increasingly severe, a woman has been prescribed ipratropium by MDI while she undergoes a diagnostic workup. What patient teaching should the nurse provide to this patient? Selected Answer: "Make sure that you take this at the scheduled times, regardless of whether you feel short of breath." Selected Answer: A man who is in cardiogenic shock following a myocardial infarction A 73-year-old woman has scheduled an appointment with her nurse practitioner to discuss her recurrent constipation. The woman states that she experiences constipation despite the fact that she takes docusate on a daily basis and performs cleansing enemas several times weekly. How should the nurse best respond to this patient's statements? Selected Answer: "Taking too many laxatives can make your bowels dependent on them, making you more susceptible to constipation." A Nurse Practitioner who provides care in a busy clinic is aware of the high incidence and prevalence of hyperlipidemia and the consequent need for antihyperlipidemics in many patients. Treatment of high cholesterol using statins would be contraindicated in which of the following patients? Selected Answer: An obese male client who is a heavy alcohol user and who has cirrhosis of the liver During a clinic visit, a patient complains of having frequent muscle cramps in her legs. The nurse's assessment reveals that the patient has been taking over-the- counter laxatives for the past 7 years. The nurse informed the patient that prolonged use of laxatives Selected Answer: may cause nutrient deficiencies. The lower respiratory system utilizes a number of different mechanisms that confer protection and maintain homeostasis. Which of the following physiological processes protects the lower respiratory system? Selected Answer: The carina, where the trachea bifurcates into two bronchi, closes off the lower airway in response to noxious stimuli. A 70-year-old man who enjoys good health began taking low-dose aspirin several months ago based on recommendations that he read in a magazine article. During the man's most recent visit to his care provider, routine blood work was ordered and the results indicated an unprecedented rise in the man's serum creatinine and blood urea nitrogen (BUN) levels. How should a nurse best interpret these findings? Selected Answer: The man may be experiencing nephrotoxic effects of aspirin Selected Answer: "This is a long acting medication for your asthma and should be used once every 12 hours" Selected Answer: A Proton Pump Inhibitor A patient has been prescribed a drug that can be self-administered at home. Which of the following would be the most important information for the nurse to relate to the patient concerning self-administration of a drug? Selected Answer: The therapeutic effects and possible adverse effects A man who smokes one pack of cigarettes daily has been diagnosed with chronic bronchitis. He has been prescribed theophylline by his family doctor. What effect will the patient's smoking status have on the therapeutic use of theophylline? Selected Answer: The patient may require higher doses of theophylline than a nonsmoker A 24-year-old factory worker has been prescribed guaifenesin for the first time. Which of the following will be a priority assessment by the nurse before the patient's first dose? Selected Answer: The number of cigarettes smoked per day A 22 year old patient is transitioning from oral agents to insulin. He will be taking 20 units of lantus at bedtime and regular insulin before meals. What instructions should the NP provide about the timing and dose of regular insulin? Selected Answer: Take 1 unit of regular insulin for each 10 grams of carbohydrate to be consumed 15 minutes before each meal A patient has been admitted to the ICU because of multiple traumas due to a motor vehicle accident. The physician has ordered propofol (Diprivan) to be used for maintenance of sedation. Before administration of propofol, a priority assessment by the nurse would be to check for a history of Selected Answer: low blood pressure. A 68-year-old man complains of a chronic, nonproductive cough. He states that he has to have relief, that he has been coughing every 2 to 3 minutes, and he is worn out. Dextromethorphan is prescribed for him. Before he leaves the clinic he asks how long it will take for the medicine to work. The nurse will advise him that he should experience therapeutic effects in Selected Answer: 15 to 30 minutes. A Nurse Practitioner is caring for a patient who is diabetic and has been diagnosed with hypertension. An angiotensin-converting enzyme inhibitor, captopril, has been prescribed for her. Which of the following should the Nurse Practitioner assess before beginning drug therapy? Selected Answer: Blood glucose levels A patient comes to primary clinic for strep throat. A throat swab culture is sent to lab. What information is required for the nurse practitioner to disclose on lab transmittal? Selected Answer: None of the above A patient has a history of tonic-clonic seizures that have been successfully treated with phenytoin (Dilantin) for several years. Phenytoin achieves a therapeutic effect by Selected Answer: decreasing the influx of sodium into neurons. Advanced practice nurse prescribing of scheduled medications is affected most by: Selected Answer: Combined state medical / pharmacy / nursing prescribing board regulations A teenage boy has undergone a diagnostic workup following several months of persistent, bloody diarrhea that appears to lack an infectious etiology. The boy has also experienced intermittent abdominal pain and has lost almost 15 pounds this year. Which of the following medications is most likely to treat this boy's diagnosis? Selected Answer: Mesalamin e A 79-year-old patient in a long-term care facility is to receive an intravenous fat emulsion. Which of the following lab values would be a priority for the nurse to assess before administration? Selected Answer: Triglyceride levels A Nurse Practitioner is providing discharge planning for a 45-year-old woman who has a prescription for oral albuterol. The Nurse Practitioner will question the patient about her intake of which of the following? Selected Answer: Coffe e An unconscious patient has been brought to the hospital, and the Nurse Practitioner has prescribed a life-saving drug to be administered parenterally. Which of the following methods would be the most appropriate for the nurse to use when administering the medication? Selected Answer: Intravenous infusion. Selected Answers: Is there a need for the drug in treating the presenting problem? Is this the best drug for the presenting problem? Can the patient take the prescribed drug? A 70-year-old woman with a history of atrial fibrillation takes digoxin and verapamil to control her health problem. Verapamil achieves a therapeutic effect by Selected Answer: inhibiting the movement of calcium ions across the cardiac muscle cell membrane. A Nurse Practitioner has been administering a drug to a patient intramuscularly (IM). The physician discontinued the IM dose and wrote an order for the drug to be given orally. The Nurse Practitioner notices that the oral dosage is considerably higher than the parenteral dose and understands that this due to Selected Answer: first-pass effect. Drugs have a high potential for abuse. There is no routine therapeutic use for these drugs and they are not available for regular use. They may be obtained for "investigational use only" by applying to the U.S. Drug Enforcement Agency. Examples include heroin and LSD. Which scheduled drug is this? Selected Answer: Schedule 1 A 22-year-old male college senior has lived with a diagnosis of Crohn's disease for several years and has undergone several courses of treatment with limited benefit. Which of the following targeted therapies has the potential to alleviate the symptoms of Crohn's disease? Selected Answer: Infliximab (Remicade) The APRN is caring for a patient taking a calcium channel blockers for hypertension. The APRN should monitor the patient for what common side effects of this medication? Selected Answer: peripheral edema, constipation, dizziness The APRN is seeing Mrs. Smith, age 77, who is here for follow up of hypertension, dyslipidemia, and depression. What should you consider during her follow-up? Selected Answer: Age-related changes in renal function are the main cause of adverse drug reactions A female patient is taking 0.125 mg of digoxin daily for heart failure. At a recent clinic visit she reports that since she has been on the drug, she can breathe better and her heart rate has been around 74 beats per minute. The nurse weighs the patient and notices that she has gained 10 pounds since the digoxin therapy was started. The patient is concerned that the additional weight will necessitate an increase in the medication. Which of the following is an appropriate response by the nurse? Selected Answer: "Yes, the drug dosage will probably have to be increased." A Nurse Practitioner is discussing with a patient the efficacy of a drug that his physician has suggested, and he begin taking. Efficacy of a drug means which of the following? Selected Answer: How well a drug produces its desired effect A Nurse Practitioner is providing care for a patient who suffered extensive burns to his extremities during a recent industrial accident. Topical lidocaine gel has been ordered to be applied to the surfaces of all his burns in order to achieve adequate pain control. When considering this order, the Nurse Practitioner should be aware that Selected Answer: there is a risk of systemic absorption of the lidocaine through the patient's traumatized skin. A Nurse Practitioner is teaching an older adult patient about polypharmacy. Which of the following statements best describe this term? Selected Answer: Taking several drugs simultaneously A Nurse Practitioner is caring for a female patient who has developed atelectasis because of thick mucus secretions. The Nurse Practitioner is monitoring IV administration of acetylcysteine (Mucomyst) and notices that the patient's face is flushed. The appropriate nursing action would be to Selected Answer: slow the administration of acetylcysteine and administer diphenhydramine if ordered. Which statement is FALSE regarding the treatment of hyperthyroidism? Selected Answer: Methimazole (Tapazole) is the drug of choice for pregnant or lactating females. Selected Answer: rebound rhinitis/congestion A 58-year-old man is prescribed dicyclomine (Bentyl) for irritable bowel syndrome. In which of the following conditions is dicyclomine therapy contraindicated? Selected Answer: Glaucoma A 58-year-old man is admitted to the emergency department. A diagnosis of severe digoxin toxicity is made. Bradycardia is present, and an electrocardiogram (ECG) confirms toxicity. The nurse will administer which of the following drugs? Selected Answer: Digoxin immune fab administering the 8 AM dose of these medications, what assessments should the nurse perform and document? (Select all that apply.) Selected Answers: Heart rate Blood pressure A 67-year-old man is admitted to the hospital with pneumonia. He reports to the nurse that he has chronic arthritis and circulation problems. Further assessment by the nurse reveals that the patient has a history of mild hypertension. He explains that he owns a business and lives alone. The nurse determines that he is within the normal weight range for his height and age but has a fondness for spicy foods and sweets. Which of the mentioned patient variables will have the greatest impact on the effectiveness of the patient's drug therapy? Selected Answer: Vascular impairment An elderly patient with a history of congestive heart failure has been admitted to hospital with failure to thrive and admission blood work reveals a hemoglobin level of 6.9 g/dL. The care team has consequently administered two units of packed red blood cells, but auscultation of the client's lungs now reveals diffuse crackles. Administration of what drug is likely to resolve the patient's pulmonary edema? Selected Answer: Furosemide Selected Answer: Drink plenty of fluids A 62-year-old woman has been prescribed a fentanyl transdermal patch for chronic cancer pain. The patient asks the nurse how long it will take for her to experience pain relief. The nurse will instruct the patient that she should feel pain relief in approximately Selected Answer: 24 hours. A patient has been prescribed a histamine-2 (H2) receptor antagonist for the treatment of GERD. Why are H2RAs more effective than H1 receptor antagonists in the treatment of diseases of the upper GI tract? Selected Answer: The parietal cells of the stomach have H2 receptors but not H1 receptors. A Nurse Practitioner is instructing a patient in the administration of regular insulin by the subcutaneous route. Which of the following strategies would the Nurse Practitioner suggest if the goal is to promote absorption of the regular insulin? Selected Answer: Rotate injection sites by using the arm one day, the stomach the next day, and the thigh the day after and then repeating the cycle. A Nurse Practitioner who is responsible for administering medications should understand that the goals of the MedWatch program are to (Select all that apply.) Selected Answers: increase awareness of serious reactions caused by drugs or medical devices. A male patient is to begin treatment for pneumonia with an albuterol (Ventolin) inhaler. The nurse will advise the patient that he will most likely experience which of the following common adverse effects of the drug? Selected Answer: Throat irritation A Nurse Practitioner is instructing a patient who was recently diagnosed with multiple sclerosis about dantrolene (Dantrium). The patient is a 38-year-old-male and the foreman for a construction company. In order to minimize one important adverse effect of the drug, the nurse will give the patient which of the following instructions? Selected Answer: Wear appropriate clothing and sunscreen whenever he is in direct sunlight A 76-year-old woman has a complex medical history that includes emphysema, osteoporosis, malnutrition, and hypothyroidism. Recently, the woman fell outside her home as a result of weakness and suffered a fracture to her femoral head. The woman's subsequent hip-replacement surgery has been scheduled and the care team recognizes that the use of isoflurane will be most significantly influenced by Selected Answer: her advanced age. A resident of a long-term care facility receives 12.5 mg metoprolol (Lopressor) at 8 AM and 8 PM daily. Before administering this drug, the nurse should perform and document what assessments? Selected Answer: Heart rate and blood pressure A Nurse Practitioner is caring for a 70-year-old patient who is taking desmopressin (DDAVP). The patient has a history of cardiovascular disease. The nurse will prioritize the assessment of which of the following? Selected Answer: Weig ht A patient is bothered with nighttime episodes of bronchoconstriction related to asthma. Which of the following medications can be administered to decrease the nighttime episodes and prevent asthma attacks? Selected Answer: Leukotriene modifiers A patient with seasonal allergies is exasperated by her recent nasal congestion and has expressed her desire to treat it by using pseudoephedrine. The nurse should inform the patient that Selected Answer: she must be prepared to show identification when buying a drug that contains pseudoephedrine. The Nurse Practitioner is performing patient education for a woman who will soon begin treatment of hyperlipidemia with simvastatin (Zocor). The patient has asked the Nurse Practitioner if there are any "bad side effects" that she should be aware of. Which of the following statements should underlie the nurse's response? Selected Answer: Many patients experience gastrointestinal upset with statins, which can be partially alleviated by taking the drug with food. A patient receives 25 units of NPH insulin at 7.AM. At what time of day should the nurse advise the patient to be most alert for a potential hypoglycemic reaction? Selected Answer: Late afternoon A patient is being treated for respiratory infection. He is a recovering alcoholic and has impaired liver function. The nurse will instruct the patient to be especially cautious when taking Selected Answer: an elixir. A Nurse Practitioner is providing patient education to a 35-year-old man who has been prescribed clonidine (Catapres) as part of step 2 antihypertensive therapy. The Nurse Practitioner should anticipate that the drug will be administered Selected Answer: transdermal ly. A 33-year-old woman has irritable bowel syndrome (IBS). The physician has prescribed simethicone (Mylicon) for her discomfort. Which of the following will the nurse monitor most closely during the patient's drug therapy? Selected Answer: Increased abdominal pain and vomiting A Nurse Practitioner is caring for a 61-year-old man who has had a severe attack of gout while in the hospital for food poisoning. The Nurse Practitioner administers colchicine intravenously in order to Selected Answer: avoid aggravating the gastrointestinal tract. A patient has been prescribed an oral drug that is known to have a high first- pass effect. Which of the following measures has the potential to increase the amount of the free drug that is available to body cells? Selected Answer: Administering the drug intravenously rather than orally Mr. Penny, age 67, was diagnosed with chronic angina several months ago and has been unable to experience adequate relief of his symptoms. As a result, his physician has prescribed ranolazine (Ranexa). Which of the following statements is true regarding the use of ranolazine for the treatment of this patient's angina? Selected Answer: Amlodipine will now be contraindicated in the treatment of Mr. Penny's angina. Selected Answer: four times a day. Selected Answer: patients with otitis media A patient with a variety of chronic health problems is being seen by her nurse practitioner, who is currently reviewing the patient's medication regimen. Which of the patient's medications should prompt the nurse to teach her to avoid drinking grapefruit juice? Selected Answer: Atorvastatin (Lipitor) A homeless man who is well known to care providers at the local hospital has been admitted to the emergency department after having a seizure outside a mall. The man is known to be a heavy alcohol user and is malnourished with a very low body mass index. How are this patient's characteristics likely to influence possible treatment with phenytoin? Selected Answer: The patient's heavy alcohol use will compete with phenytoin for binding sites and he will require a higher-than-normal dose. A Nurse Practitioner is providing care for a 71-year-old woman who was sponsored to emigrate from Mexico to the United States 6 months ago. Earlier this week, the woman slipped while getting off a bus and fractured her hip. How should the woman's nurse best exemplify cultural competence in the care of this patient? Selected Answer: Consider dimensions of the woman's cultural background when planning care. A Nurse Practitioner is overseeing the care of a young man whose ulcerative colitis is being treated with oral prednisone. Which of the following actions should the Nurse Practitioner take in order to minimize the potential for adverse drug effects and risks associated with prednisone treatment? Selected Answer: Carefully assess the patient for infections A 53-year-old man has been treated for severe asthma for several years with prednisone. Recently, his physician initiated alternate-day therapy for him. The patient tells the nurse that he would rather take the medication every day to prevent confusion. Which of the following would be the best response by the nurse? Selected Answer: "This schedule allows rest periods so that adverse effects are decreased but the anti-inflammatory effects continue." A Nurse Practitioner has administered a medication to a patient with hypertension. The prescribed drug is supposed to decrease cardiac output. A decrease in cardiac output would most likely Selected Answer: increase the synergistic effect of the drug. Which of the following patients should be advised by the Nurse Practitioner to avoid over-the-counter cold and allergy preparations that contain phenylephrine? Selected Answer: A 47-year-old female with hypertension Selected Answer: Beta blocker Selected Answer: Route Selected Answers: All of the above A Nurse Practitioner is teaching a patient about his newly prescribed drug, colchicine, for gout. The Nurse Practitioner will instruct the patient to avoid which of the following foods? Selected Answer: Shrim p Selected Answer: It can be combined with an inhaled corticosteroid to improve asthma control A Nurse Practitioner is caring for a patient who is taking digoxin and a loop diuretic. Which of the following would be most important for the Nurse Practitioner to monitor? Selected Answer: Potassium levels Selected Answer: understand the signs and symptoms of hypoglycemia. A 79-year-old woman with a medical history that includes osteoporosis has recently moved to a long-term care facility. Medication reconciliation indicates that the woman has been taking calcitonin, salmon for several years. The nurse should recognize that the most likely route for the administration of this drug is Selected Answer: subcutaneous. Selected Answer: liver damage. A 77-year-old man's chronic heart failure is being treated with a regimen of quinapril (Accupril) and furosemide (Lasix). Which of the following assessment findings would suggest that the loop diuretic is contributing to a therapeutic effect? Selected Answer: The man's chest sounds are clear and his ankle edema is lessened. Shirley, age 58, has been diabetic for 7 years. Her blood pressure for the last three office visits have been 154/100, 144/94, and 144/90. What would you prescribe today during her routine office visit? Selected Answer: An ACE Inhibitor A Nurse Practitioner is caring for a male patient who has a diagnosis of coronary artery disease (CAD). His drug therapy includes lovastatin. Because the patient has a history of severe renal disease, the nurse will assess for which of the following? Selected Answer: Increase in plasma concentration of lovastatin A patient with diabetes has had a cough for 1 week and has been prescribed a cough syrup (an expectorant). What special instructions should the nurse include in the patient teaching for this situation? Selected Answer: Monitor glucose levels closely A Nurse Practitioner is administering drugs to a 70-year-old patient who has a reduced plasma albumin level. When assessing the patient for therapeutic outcomes of drug therapy, the Nurse Practitioner will also be careful to observe for Selected Answer: [None Given] A patient has been prescribed lovastatin for a high cholesterol level. The nurse's teaching plan will include a basic explanation of how the drug produces its therapeutic effect. The nurse will explain that lovastatin lowers cholesterol levels because it Selected Answer: inhibits cholesterol syntheses. A patient comes to the clinic asking for help to quit drinking alcohol. She has a 21-year history of heavy drinking and is worried about developing cirrhosis of the liver. The patient agrees to take disulfiram (Antabuse). The nurse will teach the patient that the combination of alcohol and Antabuse will cause which of the following? Selected Answer: Nausea A 72-year-old female patient is prescribed ipratropium aerosol for pulmonary emphysema. The nurse will instruct her to "test spray" the new metered-dose inhaler (MDI) three times before using it to prevent which of the following? Selected Answer: Paradoxic acute bronchospasm A female patient calls the clinic and reports that since she has been taking dextromethorphan (Robitussin), she has been extremely drowsy and dizzy. The nurse will question the patient about which of the following? Selected Answer: The amount of water she drinks every day Selected Answer: Epigastric distress A Nurse Practitioner is caring for a patient who has recently moved from Vermont to south Florida. The patient has been on the same antihypertensive drug for 6 years and has had stable blood pressures and no adverse effects. Since her move, however, she reports "dizzy spells and weakness" and feels that the drug is no longer effective. The Nurse Practitioner suspects that the change in the effectiveness of the drug is related to Selected Answer: the impact of the warmer climate on the patient's physical state. A child with sinusitis has been on antibiotics for seven days and his symptoms are not improving. All of the following are options to prescribe for the patient now EXCEPT: Selected Answer: Azithromycin (Zithromycin) When completing this exam, did you comply with Walden University’s Code of Conduct including the expectations for academic integrity? Selected Ye Answer: s [Show More]

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