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MN 553 Final exam part 1 with answers (latest) – Kaplan University

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Question 1 MN 553 Final exam part 1 with answers (latest) – Kaplan University Question 1 The Best Pharmaceuticals for Children Act: Includes a pediatric exclusivity rule which extends th... e patent on drugs studied in children Establishes a committee that writes guidelines for pediatric prescribing Provides funding for new drug development aimed at children Encourages manufacturers specifically to develop pediatric formulations Question 2 1 / 1 point Patient education regarding taking iron replacements includes: Doubling the dose if they miss a dose to maintain therapeutic levels Taking the iron with milk or crackers if it upsets their stomach Iron is best taken on an empty stomach with juice Antacids such as Tums may help the upset stomach caused by iron therapy Question 3 1 / 1 point The benefits to the patient of having an Advanced Practice Registered Nurse (APRN) prescriber include: Nurses know more about Pharmacology than other prescribers because they take it both in their basic nursing program and in their APRN program. Nurses care for the patient from a holistic approach and include the patient in decision making regarding their care. APRNs are less likely to prescribe narcotics and other controlled substances. APRNs are able to prescribe independently in all states, whereas a physician’s assistant needs to have a physician supervising their practice. Question 4 1 / 1 point Precautions that should be taken when prescribing controlled substances include: Faxing the prescription for a Schedule II drug directly to the pharmacy Using tamper-proof paper for all prescriptions written for controlled drugs Keeping any pre-signed prescription pads in a locked drawer in the clinic Using only numbers to indicate the amount of drug to be prescribed Question 5 1 / 1 point The reason that two MMR vaccines at least a month apart are recommended is: The second dose of MMR “boosts” the immunity built from the first dose. Two vaccines 1 month apart is the standard dosing for all live virus vaccines. If the two MMR vaccine doses are given too close together there is a greater likelihood of severe localized reaction to the vaccine. Only 95% of patients are fully immunized for measles after the first vaccine, with 99% having immunity after two doses of MMR. Question 6 1 / 1 point Instructions for the use of nicotine gum include: Chew the gum quickly to get a peak effect. The gum should be “parked” in the buccal space between chewing. Acidic drinks such as coffee help with the absorption of the nicotine. The highest abstinence rates occur if the patient chews the gum when he or she is having cravings. Question 7 1 / 1 point Leonard is completing a 6-month regimen to treat tuberculosis (TB). Monitoring of a patient on TB therapy includes: Monthly sputum cultures Monthly chest x-ray Bronchoscopy every 3 months All of the above Question 8 1 / 1 point Severe contact dermatitis caused by poison ivy or poison oak exposure often requires treatment with: Topical antipruritics Oral corticosteroids for 2 to 3 weeks Thickly applied topical intermediate-dose corticosteroids Isolation of the patient to prevent spread of the dermatitis Question 9 1 / 1 point The role of the NP in the use of herbal medication is to: Maintain competence in the prescribing of common herbal remedies Recommend common over-the-counter herbs to patients Educate patients and guide them to appropriate sources of care Encourage patients to not use herbal therapy due to the documented dangers Question 10 1 / 1 point Elena Vasquez’s primary language is Spanish, and she speaks very limited English. Which technique would be appropriate to use in teaching her about a new drug you have just prescribed? Use correct medical terminology because Spanish has a Latin base. Use a family member who speaks more English to act as an interpreter. Use a professional interpreter or a reliable staff member who can act as an interpreter. Use careful, detailed explanations. Question 11 0 / 1 point A woman who is pregnant and has hyperthyroidism is best managed by a specialty team who will most likely treat her with: Methimazole Propylthiouracil (PTU) Radioactive iodine Nothing, treatment is best delayed until after her pregnancy ends Question 12 1 / 1 point The first-line drug choice for a previously healthy adult patient diagnosed with community-acquired pneumonia would be: Ciprofloxacin Azithromycin Amoxicillin Doxycycline Question 13 1 / 1 point Sadie is a 90-year-old patient who requires a new prescription. What changes in drug distribution with aging would influence prescribing for Sadie? Increased volume of distribution Decreased lipid solubility Decreased plasma proteins Increased muscle-to-fat ratio Question 14 1 / 1 point Patients who are prescribed exogenous androgens need to be warned that decreased libido: Is an unusual side effect of androgens and should be reported to the provider Is treated with increased doses of androgens, so the patient should let the provider know if he is having problems May be a sign of early prostate cancer and he should make an appointment for a prostate screening exam May occur with androgen therapy Question 15 1 / 1 point Education of women who are being treated with ophthalmic antibiotics for conjunctivitis includes: Throwing away eye makeup and purchasing new Redness and intense burning is normal with ophthalmic antibiotics When applying eye ointment, set the tip of the tube on the lower lid and squeeze in inch Use a cotton swab to apply ointment, spreading the ointment all over the lid and in the conjunctival sac Question 16 1 / 1 point Disease states in addition to hypertension in which beta blockade is a compelling indication for the use of beta blockers include: Heart failure Angina Myocardial infarction Dyslipidemia Question 17 1 / 1 point What is the role of calcium supplements when patients take bisphosphonates? They must be restricted to allow the medication to work. They must be taken in sufficient amounts to provide foundational elements for bone growth. They must be taken at the same time as the bisphosphonates. They only work with bisphosphonates if daily intake is restricted. Question 18 1 / 1 point Isosorbide dinitrate is prescribed for a patient with chronic stable angina. This drug is administered twice daily, but the schedule is 7 a.m. and 2 p.m. because: It is a long-acting drug with potential for toxicity. Nitrate tolerance can develop. Orthostatic hypotension is a common adverse effect. It must be taken with milk or food. Question 19 1 / 1 point If an adult patient with comorbidities cannot reliably take oral antibiotics to treat pneumonia, an appropriate initial treatment option would be: IV or IM gentamicin IV or IM ceftriaxone IV amoxicillin IV ciprofloxacin Question 20 1 / 1 point The Combat Methamphetamine Epidemic Act, which is part of the 2006 U.S. Patriot Act: Requires all providers to screen their patients for methamphetamine use Restricts the prescribing of amphetamines to U.S. citizens Requires a prescription be written for all methamphetamine precursors in all states Restricts the sales of drugs that contain methamphetamine precursors, including a daily and 30-day limit on sales Question 21 1 / 1 point The optimal maximum time frame for HRT or estrogen replacement therapy (ERT) is: 2 years 5 years 10 years 15 years Question 22 1 / 1 point Patrick is a 10-year-old patient who presents with uncomfortable constipation. Along with diet changes, a laxative is ordered to provide more rapid relief of constipation. An appropriate choice of medication for a 10-year-old child would be: PEG 3350 (Miralax) Bisacodyl (Dulcolax) suppository Docusate (Colace) suppository Polyethylene glycol electrolyte solution Question 23 1 / 1 point Nonadherence is especially common in drugs that treat asymptomatic conditions, such as hypertension. One way to reduce the likelihood of nonadherence to these drugs is to prescribe a drug that: Has a short half-life so that missing one dose has limited effect Requires several dosage titrations so that missed doses can be replaced with lower doses to keep costs down Has a tolerability profile with fewer of the adverse effects that are considered “irritating,” such as nausea and dizziness Must be taken no more than twice a day Question 24 1 / 1 point Larry is taking allopurinol to prevent gout. Monitoring of a patient who is taking allopurinol includes: Complete blood count Blood glucose C-reactive protein BUN, creatinine, and creatinine clearance Question 25 1 / 1 point A laboratory result indicates that the peak level for a drug is above the minimum toxic concentration. This means that the: Concentration will produce therapeutic effects Concentration will produce an adverse response Time between doses must be shortened Duration of action of the drug is too long Question 26 1 / 1 point The New York Heart Association and the Canadian Cardiovascular Society have described grading criteria for levels of angina. Angina that occurs with unusually strenuous activity or on walking or climbing stair after meals is class: I II III IV Question 27 1 / 1 point Opiates are used mainly to treat moderate to severe pain. Which of the following is NOT true about these drugs? All opiates are scheduled drugs which require a DEA license to prescribe. Opiates stimulate only mu receptors for the control of pain. Most of the adverse effects of opiates are related to mu receptor stimulation. Naloxone is an antagonist to opiates. Question 28 1 / 1 point Several classes of drugs have interactions with cholinergic blockers. Which of the following is true about these interactions? Drugs with a narrow therapeutic range given orally may not stay in the GI tract long enough to produce an action. Additive antimuscarinic effects may occur with antihistamines. Cholinergic blockers may decrease the sedative effects of hypnotics. Cholinergic blockers are contraindicated with antipsychotics. Question 29 1 / 1 point Chee is a 15-month-old male whose screening hemoglobin is 10.4 g/dL. Treatment for his anemia would be: 18 mg/day of iron supplementation 6 mg/kg per day of elemental iron 325 mg ferrous sulfate per day 325 mg ferrous sulfate tid Question 30 1 / 1 point Goals when treating tuberculosis include: Completion of recommended therapy Negative purified protein derivative at the end of therapy Completely normal chest x-ray All of the above Question 31 1 / 1 point The first-line therapy for mild-persistent asthma is: High-dose montelukast Theophylline Low-dose inhaled corticosteroids Long-acting beta-2-agonists Question 32 1 / 1 point Gender differences between men and women in pharmacokinetics include: More rapid gastric emptying so that drugs absorbed in the stomach have less exposure to absorption sites Higher proportion of body fat so that lipophilic drugs have relatively greater volumes of distribution Increased levels of bile acids so that drugs metabolized in the intestine have higher concentrations Slower organ blood flow rates so drugs tend to take longer to be excreted Question 33 1 / 1 point Varenicline (Chantix) may be prescribed for tobacco cessation. Instructions to the patient who is starting varenicline include: The maximum time varenicline can be used is 12 weeks. Nausea is a sign of varenicline toxicity and should be reported to the provider. The starting regimen for varenicline is start taking 1 mg twice a day a week before the quit date. Neuropsychiatric symptoms may occur. Question 34 1 / 1 point Which of the following is a primary benefit of the use of computerized provider order entry for patient medications? Reduces time that prescribing drugs takes Eliminates the need to chart drugs prescribed Decreases prescribing and transcription errors Helps keep the number of drugs prescribed to a minimum Question 35 1 / 1 point The most cost-effective treatment for two or three impetigo lesions on the face is: Mupirocin ointment Retapamulin (Altabax) ointment Topical clindamycin solution Oral amoxicillin/clavulanate (Augmentin) Question 36 1 / 1 point Patients who have a poor metabolism phenotype will have: Slowed metabolism of a prodrug into an active drug, leading to accumulation of Prodrug Accumulation of inactive metabolites of drugs A need for increased dosages of medications Increased elimination of an active drug Question 37 1 / 1 point Monitoring for patients who are on long-term antifungal therapy with ketoconazole includes: Platelet count BUN and creatinine White blood cell count AST, ALT, alkaline phosphatase, and bilirubin Question 38 1 / 1 point When a pharmacoeconomic analysis looks at two or more treatment alternatives that are considered equal in efficacy and compares the costs of each it is referred to as: Cost-minimization analysis Cost-of-illness analysis Cost-effectiveness analysis Cost-benefit analysis Question 39 1 / 1 point When considering which cholesterol-lowering drug to prescribe, which factor determines the type and intensity of treatment? Total LDL Fasting HDL Coronary artery disease risk level Fasting total cholesterol Question 40 1 / 1 point 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? Tinnitus Diarrhea Hearing loss Photosensitivity Question 41 1 / 1 point Patients who are on chronic long-term proton pump inhibitor therapy require monitoring for: Iron deficiency anemia, vitamin B12 and calcium deficiency Folate and magnesium deficiency Elevated uric acid levels leading to gout Hypokalemia and hypocalcemia Question 42 1 / 1 point Which of the following holds true for the pharmacokinetics of women? Gastric emptying is faster than that of men. Organ blood flow is the same as that of men. Evidence is strong concerning renal differences in elimination. Medications that involve binding globulins are impacted by estrogen levels. Question 43 1 / 1 point Jamison has been prescribed citalopram (Celexa) to treat his depression. Education regarding how quickly selective serotonin reuptake inhibitor (SSRI) antidepressants work would be: Appetite and concentration improve in the first 1 to 2 weeks. Sleep should improve almost immediately upon starting citalopram. Full response to the SSRI may take 2 to 4 months after he reaches the full therapeutic dose. His dysphoric mood will improve in 1 to 2 weeks. Question 44 1 / 1 point Being competent in the use of information technology in clinical practice is expected in professional nurses. Advanced practice competence includes the ability to: Search for information using the most common search engines Serve as content experts in developing, implementing, and evaluating information Systems Write programs to assure the integrity of health information Use information technology to prescribe drugs Question 45 1 / 1 point According to the U.S. Office of Minority Health, poor health outcomes among African Americans are attributed to: The belief among African Americans that prayer is more powerful than drugs Poor compliance on the part of the African American patient The genetic predisposition for illness found among African Americans Discrimination, cultural barriers, and lack of access to health care Question 46 1 / 1 point Sook has been prescribed gabapentin to treat neuropathic pain and is complaining of feeling depressed and having “strange” thoughts. The appropriate initial action would be: Increase her dose Assess for suicidal ideation Discontinue the medication immediately Decrease her dose to half then slowly titrate up the dose Question 47 1 / 1 point A provider may consider testing for CYP2D6 variants prior to starting tamoxifen for breast cancer to: Ensure the patient will not have increased adverse drug reactions to the tamoxifen Identify potential drug-drug interactions that may occur with tamoxifen Reduce the likelihood of therapeutic failure with tamoxifen treatment Identify poor metabolizers of tamoxifen Question 48 0 / 1 point Male patients who should not be prescribed phosphodiesterase type 5 (PDE-5) inhibitors include: Diabetics Those who have had an acute myocardial infarction in the past 6 months Patients who are deaf Patients under age 60 years of age Question 49 1 / 1 point True contraindications to diphtheria, tetanus, and acellular pertussis (DTaP or Tdap) vaccine include: Fever up to 104oF (40.5oC) after previous DTaP vaccine Family history of seizures after DTaP vaccine Adolescent pregnancy Anaphylactic reaction with a previous dose Question 50 1 / 1 point Which the following persons should not have a statin medication ordered? Someone with 3 first- or second-degree family members with history of muscle issues when started on statins Someone with high lipids, but low BMI Premenopausal woman with recent history of hysterectomy Prediabetic male with known metabolic syndrome [Show More]

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