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Pharmacotherapeutics > Exam 3 > Flashcards

Exam 3 Flashcards

1
Q

Lispro is an insulin analogue produced by recombinant DNA technology. Which of the following statements about this form of insulin is NOT true?
A. Optimal time of preprandial injection is 15 minutes.
B. Duration of action is increased when the dose is increased.
C. It is compatible with neutral protamine Hagedorn insulin.
D. It has no pronounced peak.

A

B. Duration of action is increased when the dose is increased.

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2
Q

The action of “gliptins” is different from other antidiabetic agents because they:
A. Have a low risk for hypoglycemia
B. Are not associated with weight gain
C. Close ATP-dependent potassium channels in the beta cell
D. Act on the incretin system to indirectly increase insulin production

A

D. Act on the incretin system to indirectly increase insulin production

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3
Q

After starting a patient with Grave’s disease on an antithyroid agent such as methimazole, patient monitoring includes TSH and free T4 every:
1 to 2 weeks
3 to 4 weeks
2 to 3 months
6 to 9 months

A

3 to 4 weeks

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4
Q

Type 2 diabetes is a complex disorder involving:
A. absence of insulin production by beta cells
B. A suboptimal response of insulin-sensitive tissues in the liver
C. Increased levels of glucagon-like peptide in postprandial period
D. Too much fat uptake in intestine

A

A suboptimal response of insulin-sensitive tissues in the liver

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5
Q

Prevention of conversion from prediabetes to diabetes in young children must take highest priority and should focus on:
A. Aggressive dietary manipulation to prevent obesity
B. Fostering LDL levels less than 100 mg/dl and total cholesterol less than 170 mg/dl to prevent cardiovascular disease
C. Maintaining a blood pressure that is less than 80% based on weight and height to prevent hypertension
D. All of the above

A

B. Fostering LDL levels less than 100 mg/dl and total cholesterol less than 170 mg/dl to prevent cardiovascular disease

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6
Q

Nonselective beta blockers and alcohol create serious drug interactions with insulin because they:
A. Increase blood glucose levels
B. Produce unexplained diaphoresis
C. Interfere with the ability of the body to metabolize glucose
D. Mask the signs and symptoms of altered glucose levels

A

Mask the signs and symptoms of altered glucose levels

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7
Q

Metformin is a primary choice of drug to treat hyperglycemia in type 2 diabetes because it:
Substitutes for insulin usually secreted by the pancreas
Decreases glycogenolysis by the liver
Increases the release of insulin from beta cells
Decreases peripheral glucose utilization

A

Decreases glycogenolysis by the liver

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8
Q

Allison is an 18-year-old college student with type 1 diabetes. She is on NPH twice daily and Novolog before meals. She usually walks for 40 minutes each evening as part of her exercise regimen. She is beginning a 30-minute swimming class three times a week at 1 p.m. What is important for her to do with this change in routine?
Delay eating the midday meal until after the swimming class.
Increase the morning dose of NPH insulin on days of the swimming class.
Adjust the morning insulin injection so that the peak occurs while swimming.
Check glucose level before, during, and after swimming.

A

Check glucose level before, during, and after swimming.

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9
Q

All of the following are options for insulin injections when each dose is close to 100 units except:
1.
Split dosing
2.
Move to insulin pen use
3.
Change to U500 insulin
4.
Stop injectable insulin and change to oral methods only

A

4.
Stop injectable insulin and change to oral methods only

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10
Q

When is metformin typically initiated for glucose metabolism issues?
1. Only after the HgA1C is greater than 8.0
2. When the patient is diagnosed with prediabetes
3. When metabolic syndrome ensues
4. When true diabetes mellitus (DM_ is diagnosed

A
  1. When the patient is diagnosed with prediabetes
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11
Q

The American Diabetic Association has recommended which of the following tests for ongoing management of diabetes?
Fasting blood glucose
HbA1C
Thyroid function tests
Electrocardiograms

A

HbA1C

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12
Q

What is the desired ratio of T3 to T4 drug levels in newly diagnosed endocrine patients?
A. 99% of T3 and the rest is T4 to get rapid resolution.
B. Most needs to be T4 to mimic natural ratios of hormone.
C. The ratio is unimportant.
D. The mix needs to be 50-50 at first.

A

Most needs to be T4 to mimic natural ratios of hormone.

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13
Q

When methimazole is started for hyperthyroidism it may take ________ to see a total reversal of hyperthyroid symptoms.
2 to 4 weeks
1 to 2 months
3 to 4 months
6 to 12 months

A

6 to 12 months

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14
Q

Diabetic autonomic neuropathy (DAN) is the earliest and most common complication of diabetes. Symptoms associated with DAN include:
Resting tachycardia, exercise intolerance, and orthostatic hypotension
Gastroparesis, cold intolerance, and moist skin
Hyperglycemia, erectile dysfunction, and deficiency of free fatty acids
Pain, loss of sensation, and muscle weakness

A

Resting tachycardia, exercise intolerance, and orthostatic hypotension

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15
Q

Goals when treating hypothyroidism with thyroid replacement include:
A. Normal TSH and free T4 levels
B. Resolution of fatigue
C. Weight loss to baseline
D. All of the above

A

All of the above

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16
Q

All diabetic patients with hyperlipidemia should be treated with:
HMG-CoA reductase inhibitors
Fibric acid derivatives
Nicotinic acid
Colestipol

A

HMG-CoA reductase inhibitors

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17
Q

Control targets for patients with diabetes include:
HbA1C between 7 and 8
Fasting blood glucose levels between 100 and 120 mg/dl
Blood pressure less than 130/80 mm Hg
LDL lipids less than 130 mg/dl

A

Blood pressure less than 130/80 mm Hg

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18
Q

Allison is an 18-year-old college student with type 1 diabetes. Allison’s pre-meal BG at 11:30 a.m. is 130. She eats an apple and has a sugar-free soft drink. At 1 p.m. before swimming her BG is 80. What should she do?
Proceed with the swimming class.
Recheck her BG immediately.
Eat a granola bar or other snack with CHO.
Take an additional dose of insulin.

A

Eat a granola bar or other snack with CHO.

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19
Q

Thyroid medullary cancer risk has been linked with:
1.
Chronic sulfonylurea use
2.
Later addition of basal insulin to oral therapy
3.
GLP-1 therapies
4.
SGLT-2 medication

A

3.
GLP-1 therapies

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20
Q

Long-term injection site skin changes are called:
1.
Lipodystrophy
2.
Tuberous sclerosis
3.
Telangiectasia
4.
Medication caveronosa

A

1.
Lipodystrophy

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21
Q

A patient is started on paroxetine (Paxil), an SSRI, for depression. Education regarding antidepressants includes:
SSRIs may take two to six weeks before she will have maximum drug effects.
(B Red-green color blindness may occur and should be reported.
(C) if she experiences dry mouth or a heart rate greater than 80, she should stop taking the drug immediately.
(D She should eat lots of food high in fiber to prevent constipation.

A

SSRIs may take two to six weeks before she will have maximum drug effects.

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22
Q

A patient fractured his ankle in two places and is asking for medication for his pain. The appropriate first-line medication would be:

Ibuprofen (Advil)
(B Acetaminophen with hydrocodone (Vicodin)
(C) Oxycodone (Oxycontin)
(b) Oral morphine (Roxanol)

A

(B Acetaminophen with hydrocodone (Vicodin)

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23
Q

An adult is taking lithium for bipolar disorder. They should be taught to:
(A) Take lithium with food
(B) Eat a diet with consistent levels of salt (sodium)
C Drink at least two quarts of water if they are in a hot environment
(D Monitor blood glucose levels

A

(B) Eat a diet with consistent levels of salt (sodium)

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24
Q

Baseline assessment prior to starting a child on stimulants for ADHD includes
(A Height, weight, and blood pressure
(B Fasting glucose
C) Liver enzymes

A

Height, weight, and blood pressure

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25
Q

Nonpharmacologic therapy for tension headaches includes:
(A) Biofeedback
B) Stress management
(C) Massage therapy
D) All of the above

A

All of the above

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26
Q

An 8-year-old male has attention deficit disorder (ADD) and is prescribe methylphenidate (Ritalin). He and his parents should be educated about side effects of methylphenidate, which are:
(A) Slurred speech and insomni
B Bradycardia and con fusion
(C Dizziness and orthostatic hypotensio
(D Insomnia and decreased appetite

A

Insomnia and decreased appetite

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27
Q

Patients who are prescribed olanzapine (Zyprexa) should be monitored for:
A) Insor mnia
(B Weight gain
C Hypertension
(D Galactorrhea

A

Weight gain

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28
Q

Prior to starting antidepressants, patients should have laboratory testing to rule out:
Hypothyroidism
(B Anemia
(C Diabetes mellitus
(D) Low estrogen levels

A

Hypothyroidism

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29
Q

Tricyclic antidepressants should be prescribed cautiously in patients with:
Eczema
(B Asthma
(C) Diabetes
(D Heart disease

A

Heart disease

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30
Q

An appropriate drug for the treatment of depression with anxiety would be:
Alprazolam (Xanax)
(B Escitalopram (Lexapro)
(c) Buspirone (Buspar)
D) Amitriptyline (Elavil)

A

Escitalopram Lexapro

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31
Q

A 66-year-old male was prescribed phenelzine (Nardil) while in an acute psychiatric unit for recalcitrant depression. The nurse practitioner (NP) managing his primary health care needs to understand the following regarding phenelzine and other monoamine oxidase inhibitors (MAOIs):

(A) He should not be prescribed any serotonergic drug such as sumatriptan (Imitrex).
(B MAOIs interact with many common foods, including yogurt, sour cream, and soy sauce.
C) Symptoms of hypertensive crisis (headache, tachycardia, sweating) require immediate treatment.
D) All of the above

A

All of the above

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32
Q

Scott’s seizures are well controlled on topiramate and he wants to start playing baseball. Education for Scott regarding his topiramate includes:
(A)
He should not play sports due to the risk of increased seizures
(B He should monitor his temperature and ability to sweat in the heat while playing
(C Reminding him that he may need higher doses of topiramate when exercising
(D) Encouraging him to use sunscreen due to photosensitivity from topiramate

A

(B He should monitor his temperature and ability to sweat in the heat while playing

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33
Q

Question 13
A first-line drug for abortive therapy in simple migraine is:
(A) Sumatriptan (Imitrex)
(B) Naproxen (Aleve)
(C Butorphanol nasal spray (Stadol NS)
D Butolbital and acetaminophen Fiorecet

A

B) Naproxen Aleve

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34
Q

Migraines in pregnancy may be safely treated with:
(A) Acetaminophen with codeine (Tylenol #3)
(B) Sumatriptan (Imitrex)
(C Ergotamine tablets (Ergostat)
(D Dihydroergotamine (DHE)

A

A acetaminophen with codeine Tylenol 3

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35
Q

A patient has been diagnosed with cluster headaches. Appropriate acute therapy would be:
(A Butalbital and aspirin (Fiorinal)
(B) Intramuscular (IM) meperidine (Demerol)
(C Oxygen 100% for 15 to 30 minutes
(D) Indomethacin (Indocin)

A

Oxygen 100% for 15 to 30 minutes

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36
Q

Carbamazepine has a black box warning due to life threatening:
Renal toxicity, leading to renal failure
(B Hepatotoxicity, leading to liver failure
( Dermatologic reaction, including Steven’s Johnson and toxic epidermal necrolysis
(D) Cardiac effects, including supraventricular tachycardia

A

Dermatologic reaction, including Steven’s Johnson and toxic epidermal necrolysis

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37
Q

Patients should be instructed regarding the rapid onset of zolpidem (Ambien) because:
A Zolpidem should be taken just before going to bed.
(B) Zolpidem may cause dry mouth and constipation.
(C They may need to double the dose for effectiveness.
(D) They should stop drinking alcohol at least 30 minutes before taking zolpidem.

A

A Zolpidem should be taken just before going to bed.

38
Q

An appropriate first-line drug to try for mild to moderate generalized anxiety disorder is:
(A) Alprazolam (Xanax)
B) Diazepam (Valium)
C Buspirone (Buspar)
D Amitriptyline (Elavil)

A

C Buspirone (Buspar)

39
Q

A 24-year-old patient has had migraines for 10 years. She reports a migraine on average of once a month. The migraines are effectively aborted with naratriptan (Amerge). When refilling her naratriptan, education would include:
A Naratriptan will interact with antidepressants, including selective serotonin reuptake inhibitors (SSRIs) and St. John’s Wort, and she should inform any providers she sees that she has migraines.
B Continue to monitor her headaches, and if the migraines are consistently happening around her menses there is preventive therapy available.
C Pregnancy is contraindicated when taking a triptan.
(D) All of the above

A

All of the above

40
Q

Low-dose tricyclic antidepressants taken only at bedtime are routinely used for:
A Sleep issues
(B Mild depression
C Restless leg syndrome
D) Acute pain control

A

A. Sleep issues

41
Q

The patient shares with the provider that he is taking his Prozac at night before going to bed. What is the best response?
(A
This is a good idea because this class of medications generally makes people sleepy.
B Have you noticed that you are having more sleep issues since you started that?
(C This a good way to remember to take your daily medications because it is near your toothbrush.
D) This is a good plan because you can eat grapefruit as long as Prozac and grapefruit are ingested 8 to 12 hours apart.

A

B Have you noticed that you are having more sleep issues since you started that?

42
Q

Patients with chronic alcoholism in severe alcohol withdrawal should be treated with:
) Thiamine 100 mg orally daily for seven days
B
Thiamine 250 mg parenterally for 3 to 5 days
C) Calcium 500 mg parenterally daily for seven days
(D Calcium 1000 mg orally daily for 3 to 5 days

A

B Thiamine 250 mg parenterally for 3 to 5 days

43
Q

A patient who is receiving medication-assisted treatment for opioid use disorder with clonidine should begin treatment by:
(A) Applying a clonidine patch three days before quit date
B. Using oral clonidine for three days until the clonidine patch reaches effective dosing
C. Taking clonidine 0.2 mg three times a day if the Clinical Opiate Withdrawal Scale (COWs) score is over 12
D. Maintaining clonidine dose at a steady state for a week then tapering over two weeks

A

C. Taking clonidine 0.2 mg three times a day if the Clinical Opiate Withdrawal Scale (COWs) score is over 12

44
Q

A patient presents to the clinic with a complaint of headaches off and on for months. She reports she feels like someone is “squeezing” her head. She occasionally takes Tylenol for the pain, but usually just “toughs it out.” Initial treatment for tension headache includes asking her to keep a headache diary and giving her a prescription for:
A) Sumatriptan (Imitrex)
(B Naproxen (Aleve)
(C) Ergotamine (Ergostat)
(D) Tylenol with codeine (Tylenol #3)

A

B naproxen aleve

45
Q

When prescribing for migraines, patient education includes:
(A) Triptans are safe to use as often as needed as long as the patient is healthy.
(B) Use triptan before trying OTC meds such as acetaminophen or naproxen
C)
Stress reduction and regular sleep are integral to migraine treatment.
(D) if migraines worsen they are to increase their medication.

A

C)
Stress reduction and regular sleep are integral to migraine treatment.

46
Q

Warfarin resistance may be seen in patients with a VKORC1 mutation, leading to:
(A Toxic levels of warfarin building up
B Decreased response to warfarin
c) Increased risk for significant drug interactions with warfarin
D) Less risk of drug interactions with warfarin

A

B Decreased response to warfarin

47
Q

Cruciferous vegetables may alter drug pharmacokinetics by:
(A Enhancing absorption of weakly acidic drugs
(B Altering CYPBA4 activity, leading to elevated levels of drugs, such as the statins
C Inducing CYP1A2, possibly leading to therapeutic failure of drugs metabolized by CYPIAZ
D Decreasing first-pass metabolism of drugs

A

C Inducing CYP1A2, possibly leading to therapeutic failure of drugs metabolized by CYPIAZ

48
Q

The American Heart Association and the American Dietetic Association recommend a minimum dailv fiber intake of
for cardiovascular health:
(A) 10 mg/day
B) 15 mg/day
C 20 mg/day
D 25 md/day

A

D 25 md/day

49
Q

The standard dosage of St. John’s Wort for the treatment of mild depression is:
(A 300 mg dally
(B) 100 mg three times a day
C 300 mg three times a day
D 600 mg three times a day

A

C 300 mg three times a day

50
Q

Patients need to be instructed regarding drug interactions with St. John’s Wort, including:
A MAO inhibitors
B Serotonin reuptake inhibitors
C Over-the-counter cough and cold medications
D All of the above

A

D all of the above

51
Q

Vitamin B2 (riboflavin) may be prescribed to:
Decrease the incidence of beriberi
Reduce headaches and migraines
Prevent pernicious anemia
Treat hyperlipidemia

A

Reduce headaches and migraines

52
Q

Synthetic cannabinoid products include:
Cannabis sativa
(B Dronabinol
C Cannabidiol CBD oil
(D) Epidiolex

A

Dronabinol

53
Q

Decision support systems often provide medication alerts that tell the prescriber:
A Patient history data with a summary of their diagnoses
B) The usual dosage for the drug being prescribed
C The patient’s latest laboratory values, such as potassium levels
D Potential drug-to-drug interactions with other medications the patient is taking

A

D Potential drug-to-drug interactions with other medications the patient is taking

54
Q

Smokers are at risk for vitamin C deficiency. It is recommended that smokers take vitamin C supplement.
A) 100 mg/day
B) 500 mg/day
(C) 1,000 mg/day
D 35 mg/day more than nonsmokers

A

D 35 mg/day more than nonsmokers

55
Q

Milk and other foods that alkalinize the urine may:
A
Result in basic drugs being reabsorbed in the renal tubule
B Increase the elimination of basic drugs in the urine
(C Decrease the elimination of acidic drugs
(D Not alter drug elimination due to the minimal change in urine pH

A

A
Result in basic drugs being reabsorbed in the renal tubule

56
Q

The advantages of using IT for patient education include:
A The ability to track the number of times you have given the patient the same instructions regarding their medication
B Standardized and individualized patient education that are simultaneously recorded into the patient record
C Easy access to private patient information specific to populations with a similar diagnosis
D The ability to download and interpret patient information in multiple languages, easily and accurately

A

B Standardized and individualized patient education that are simultaneously recorded into the patient record

57
Q

A low-carbohydrate, high-protein diet may:
A Increase drug-metabolizing enzymes
B Decrease drug absorption from the gastrointestinal (Gl) tract
(C Alter drug binding to plasma proteins
(D Enhance drug elimination

A

A Increase drug-metabolizing enzymes

58
Q

Patients with iron deficiency will develop:
A Hemolytic anemia
B Megaloblastic anemia
Macrocytic-hypochromic anemia
D Microcytic-hypochromic anemia

A

D Microcytic-hypochromic anemia

59
Q

Computerized order entry can help reduce medication errors. Which of the following is not a benefit of computerized order entry?
A Having a clarified order that is complete with dose, route, and schedule
B Written orders are scanned into a computerized file that can be viewed as written
C Alerts to alterations from standard guideline dosing to make providers reconsider choices
(D Abbreviations are standardized

A

B Written orders are scanned into a computerized file that can be viewed as written

60
Q

It is reasonable to add ___ to a Helicobacter pylori treatment regimen to improve eradication rates of H. pylori.
A Probiotics
B Omega-3 fatty acids
C Plant sterols
D Fiber

A

A probiotics

61
Q

IT can also be used to interact with a patient between encounters. Which of the following statements about such interactions is true?

A Patients feel the provider does not care about them if they are not seen in a face-to-face encounter.
B Data collected from patients between encounters via IT are less accurate and complete.
C Collecting data between encounters via IT may mean a more efficient face-to-face encounter.
(D Between encounters is a good time to collect screening data.

A

C Collecting data between encounters via IT may mean a more efficient face-to-face encounter.

62
Q

IT can be a time-saving device in a busy practice if it is used wisely. One way to make it a help rather than a hindrance is to:
A) Prioritize what is needed information and avoid spending time reading “interesting” information not central to the problem at hand
(B) Integrate professional and personal searching so that the same browser does not need to be accessed repeatedly
(C Check e-mail frequently so that patient questions can be addressed promptly
(D) Check for viruses, spyware, and malware

A

A) Prioritize what is needed information and avoid spending time reading “interesting” information not central to the problem at hand

63
Q

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 tamoxiten
B Identify potential drug-drug interactions that may occur with tamoxifen
C Reduce the likelihood of therapeutic failure with tamoxifen treatment
(D) Identify poor metabolizers of tamoxifen

A

C Reduce the likelihood of therapeutic failure with tamoxifen treatment

64
Q

Phenytoin decreases folic acid absorption by:
(A) Altering the ph of the stomach
(B Increasing gastric emptying time
C Inhibiting intestinal enzymes required for folic acid absorption
D Chelation of the
folic acid into inactive ingredients

A

C Inhibiting intestinal enzymes required for folic acid absorption

65
Q

A potential harmful effect on patients who take some kinds of herbal medication is:
(A Constipation
B Lead poisoning
(C Diarrhea

A

B lead poisoning

66
Q

Monitoring a patient on a high-dose aspirin includes:
(A Salicylate level
B) Complete blood count
(C) Urine pH
All of the above

A

All of the above

67
Q

The trial period to determine effective anti-inflammatory activity when starting a patient on aspirin for rheumatoid arthritis is:

48 hours
4 to 6 days
4 weeks
Two months

A

4 to 6 days

68
Q

A 2-year-old child is diagnosed with acute otitis media and an upper respiratory infection. Along with an antibiotic they receive a recommendation to treat the ear pain with ibuprofen. What education would their parent need regarding ibuprofen?
A They can cut an adult ibuprofen tablet in half to give the child.
B The ibuprofen dose can be doubled for severe pain.
C The child needs to be well hydrated while taking ibuprofen.
D Ibuprofen is completely safe in children with no known adverse effects.

A

C The child needs to be well hydrated while taking ibuprofen.

69
Q

Patients who are on long-term aspirin therapy should have
A Complete blood count
(B Liver function test
annually.
(C Amylase
(D) Urine analysis

A

A complete blood count

70
Q

When a patient has contact dermatitis, wet dressings with Domeboro solution are used for:

A Cleaning the weeping area of dermatitis
B Bathing the patient to prevent infection
C Relief of inflammation
D Providing a barrier layer to protect the surrounding skin

A

C relief of inflammation

71
Q

Patients prescribed aspirin therapy require education regarding the signs of aspirin toxicity. An early sign of aspirin toxicity is:
Black tarry stools
Vomiting
Tremors
Tinnitus

A

Tinnitus **

72
Q

All NSAIDs have a U.S. Food and Drug Administration (FDA) black box warning regarding:
(A Potential for causing life-threatening gastrointestinal (Gl) bleeds
B) Increased risk of developing systemic arthritis with prolonged use
(C) Risk of life-threatening rashes, including Stevens-Johnson syndrome
(D
Potential for transient changes in serum glucose

A

(A Potential for causing life-threatening gastrointestinal (Gl) bleeds

73
Q

instructions for the use of selenium sulfide shampoo (Selsun) to treat scalp seborrhea include:
A Shampoo daily and rinse well.
(B Worsening of seborrhea for the first week is normal.
C Seborrhea usually clears up after a few weeks of treatment.
D Shampoo twice a week for two weeks, then weekly.

A

D Shampoo twice a week for two weeks, then weekly.

74
Q

Patients with rheumatoid arthritis who are on chronic low-dose prednisone will need cotreatment with which medication to prevent adverse effects?

A bisphosphonate
B Calcium supplementation
C Vitamin D
D All of the above

A

D all of the above

75
Q

When writing a prescription of permethrin 5% cream (Elimite) for scabies, patient education would include:
(A) All members of the household and personal contacts should also be treated.
B) Infants should have permethrin applied from the neck down.
C The permethrin is washed off after 10 to 20 minutes.
(D Permethrin is flammable and to avoid open flame while the medication is applied.

A

(A) All members of the household and personal contacts should also be treated.

76
Q

The goal of treatment of acute pain is:
A Pain at a tolerable level where the patient may return to activities of daily living
(B Elimination of all pain
C Reduction of pain with minimum adverse reaction’s
D Adequate pain relief without constipation or nausea from the drugs

A

C Reduction of pain with minimum adverse reaction’s

77
Q

A treatment plan for management of chronic pain should include:

A Negotiation with the patient to set personal goals for pain management
B Discussion of ways to improve sleep and stress levels
C An exercise program to improve function and fitness
D All of the above

A

D all of the above

78
Q

Varenicine (Chantix) may be prescribed for tobacco cessation. Instructions to a patient who is starting varenicline include:

A The maximum time varenicline can be used is 12 weeks.
B) Nausea is a sign of varenicine toxicity and should be reported to the provider.
C The starting regimen for varenicine is 1 mg twice a day a week before the quit date.
D Neuropsychiatric symptoms may occur.

A

D Neuropsychiatric symptoms may occur

79
Q

Narcotics are exogenous opiates. They act by:

A Inhibiting pain transmission in the spinal cord
B Attaching to receptors in the afferent neuron to inhibit the release of substance P
C) Blocking neurotransmitters in the midbrain
(D) Increasing beta-lipoprotein excretion from the pituitary gland

A

B Attaching to receptors in the afferent neuron to inhibit the release of substance P

80
Q

If a patient wants to quit smoking, nicotine replacement therapy is recommended if the patient.
A Smokes more than 10 cigarettes a day
B) Smokes within 30 minutes of awakening in the morning
C Smokes when drinking alcohol
D “Binge smokes” while out with friends

A

B) Smokes within 30 minutes of awakening in the morning

81
Q

Ciprofloxacin otic drops that are combined with any steroid, such as hydrocortisone and dexamethasone, are contraindicated in:
(A) Children
(B Patients with acute otitis externa
C) Patients with a perforated tympanic membrane
(D) Patients with swimmer’s ear

A

C) Patients with a perforated tympanic membrane

82
Q

The chemicals that promote the spread of pain locally include:
(A) Serotonin
(B) Norepinephrine
(C) Enkephalin
Neurokinin A

A

Neurokinin A

83
Q

One of the main drug classes used to treat acute pain is nonsteroidal anti-inflammatory drug (NSAIDs). They are used because:
(A) They have less risk for liver damage than acetaminophen.
(B Inflammation is a common cause of acute pain.
(C They have minimal gastrointestinal (Gl) irritation.
(D Regulation of blood flow to the kidneys is not affected by these drugs

A

(B Inflammation is a common cause of acute pain

84
Q

The Centers for Disease Control recommends all newborn infants receive prophylactic administration of hour of birth.
A Gentamicin ophthalmic ointment
(B Ciprofloxacin ophthalmic drops
C Erythromycin oral suspension
(D Erythromycin ophthalmic ointment

A

(D Erythromycin ophthalmic ointment

85
Q

Patients need to be questioned about all pain sites because:

A Patients tend to report the most severe or important in their perception.
В Pain tolerance generally decreases with repeated exposure.
(C The reported pain site is usually the most important to treat.
D Pain may be referred from a different site to the one reported.

A

A Patients tend to report the most severe or important in their perception.

86
Q

When obtaining a drug history from Harold, he gives you a complete list of his prescription medications. He denies taking any other drugs, but you find that he occasionally takes aspirin for his arthritis flare ups. This is an example of:
(A His appropriately only telling you about his regularly prescribed medications
(B His hiding information regarding his inappropriate use of aspirin from you
C A common misconception that intermittently taken over-the counter medications are not an important part of his drug history
(D A common misuse of over-the-counter aspirin

A

C A common misconception that intermittently taken over-the counter medications are not an important part of his drug history

87
Q

Nicotine withdrawal symptoms include:

A Somnolence
(B Decreased appetite
C Diarrhea
D irritability

A

D Irritability

88
Q

A patient was prescribed betaxolol ophthalmic drops by their ophthalmologist to treat glaucoma. Oral beta blockers should be avoided in patients who use ophthalmic beta blockers because:
A There may be an antagonistic reaction between the two.
B The additive effects may include bradycardia.
(C They may potentiate each other and cause respiratory depression.
(D) The additive effects may cause metabolic acidosis.

A

B The additive effects may include bradycardia

89
Q

Which statement is true regarding acute and chronic pain?
A Both have decreased levels of endorphins.
B Chronic pain has a predominance of C-neuron stimulation.
C Acute pain is most commonly associated with irritation of peripheral nerves.
(D Acute pain is diffuse and hard to localize.

A

B Chronic pain has a predominance of C-neuron stimulation.

90
Q

The Combat Methamphetamine Epidemic Act, which is part of the 2006 U.S. Patriot Act:
A Requires all providers to screen their patients for methamphetamine use
B Restricts the prescribing of amphetamines to U.S. citizens
C Requires a prescription be written for all methamphetamine precursors in all states
D Restricts the sales of drugs that contain methamphetamine precursors, including a daily and 30-day limit on sales

A

D Restricts the sales of drugs that contain methamphetamine precursors, including a daily and 30-day limit on sales

Pharmacotherapeutics (2 decks)

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