Exam 3

Question 1

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.

Answer 1

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

Question 2

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

Answer 2

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

Question 3

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

Answer 3

3 to 4 weeks

Question 4

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

Answer 4

A suboptimal response of insulin-sensitive tissues in the liver

Question 5

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

Answer 5

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

Question 6

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

Answer 6

Mask the signs and symptoms of altered glucose levels

Question 7

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

Answer 7

Decreases glycogenolysis by the liver

Question 8

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.

Answer 8

Check glucose level before, during, and after swimming.

Question 9

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

Answer 9

4.
Stop injectable insulin and change to oral methods only

Question 10

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

Answer 10

2. When the patient is diagnosed with prediabetes

Question 11

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

Answer 11

HbA1C

Question 12

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.

Answer 12

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

Question 13

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

Answer 13

6 to 12 months

Question 14

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

Answer 14

Resting tachycardia, exercise intolerance, and orthostatic hypotension

Question 15

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

Answer 15

All of the above

Question 16

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

Answer 16

HMG-CoA reductase inhibitors

Question 17

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

Answer 17

Blood pressure less than 130/80 mm Hg

Question 18

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.

Answer 18

Eat a granola bar or other snack with CHO.

Question 19

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

Answer 19

3.
GLP-1 therapies

Question 20

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

Answer 20

1.
Lipodystrophy

Question 21

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.

Answer 21

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

Question 22

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)

Answer 22

(B Acetaminophen with hydrocodone (Vicodin)

Question 23

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

Answer 23

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

Question 24

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

Answer 24

Height, weight, and blood pressure

Question 25

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

Answer 25

All of the above

Question 26

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

Answer 26

Insomnia and decreased appetite

Question 27

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

Answer 27

Weight gain

Question 28

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

Answer 28

Hypothyroidism

Question 29

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

Answer 29

Heart disease

Question 30

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

Answer 30

Escitalopram Lexapro

Question 31

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

Answer 31

All of the above

Question 32

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

Answer 32

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

Question 33

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

Answer 33

B) Naproxen Aleve

Question 34

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

Answer 34

A acetaminophen with codeine Tylenol 3

Question 35

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)

Answer 35

Oxygen 100% for 15 to 30 minutes

Question 36

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

Answer 36

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

Question 37

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.

Answer 37

A Zolpidem should be taken just before going to bed.

Question 38

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)

Answer 38

C Buspirone (Buspar)

Question 39

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

Answer 39

All of the above

Question 40

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

Answer 40

A. Sleep issues

Question 41

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.

Answer 41

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

Question 42

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

Answer 42

B Thiamine 250 mg parenterally for 3 to 5 days

Question 43

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

Answer 43

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

Question 44

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)

Answer 44

B naproxen aleve

Question 45

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.

Answer 45

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

Question 46

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

Answer 46

B Decreased response to warfarin

Question 47

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

Answer 47

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

Question 48

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

Answer 48

D 25 md/day

Question 49

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

Answer 49

C 300 mg three times a day

Question 50

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

Answer 50

D all of the above

Question 51

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

Answer 51

Reduce headaches and migraines

Question 52

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

Answer 52

Dronabinol

Question 53

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

Answer 53

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

Question 54

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

Answer 54

D 35 mg/day more than nonsmokers

Question 55

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

Answer 55

A Result in basic drugs being reabsorbed in the renal tubule

Question 56

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

Answer 56

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

Question 57

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

Answer 57

A Increase drug-metabolizing enzymes

Question 58

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

Answer 58

D Microcytic-hypochromic anemia

Question 59

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

Answer 59

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

Question 60

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

Answer 60

A probiotics

Question 61

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.

Answer 61

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

Question 62

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

Answer 62

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

Question 63

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

Answer 63

C Reduce the likelihood of therapeutic failure with tamoxifen treatment

Question 64

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

Answer 64

C Inhibiting intestinal enzymes required for folic acid absorption

Question 65

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

Answer 65

B lead poisoning

Question 66

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

Answer 66

All of the above

Question 67

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

Answer 67

4 to 6 days

Question 68

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.

Answer 68

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

Question 69

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

Answer 69

A complete blood count

Question 70

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

Answer 70

C relief of inflammation

Question 71

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

Answer 71

Tinnitus **

Question 72

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

Answer 72

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

Question 73

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.

Answer 73

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

Question 74

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

Answer 74

D all of the above

Question 75

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.

Answer 75

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

Question 76

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

Answer 76

C Reduction of pain with minimum adverse reaction’s

Question 77

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

Answer 77

D all of the above

Question 78

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.

Answer 78

D Neuropsychiatric symptoms may occur

Question 79

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

Answer 79

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

Question 80

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

Answer 80

B) Smokes within 30 minutes of awakening in the morning

Question 81

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

Answer 81

C) Patients with a perforated tympanic membrane

Question 82

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

Answer 82

Neurokinin A

Question 83

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

Answer 83

(B Inflammation is a common cause of acute pain

Question 84

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

Answer 84

(D Erythromycin ophthalmic ointment

Question 85

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.

Answer 85

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

Question 86

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

Answer 86

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

Question 87

Nicotine withdrawal symptoms include: A Somnolence (B Decreased appetite C Diarrhea D irritability

Answer 87

D Irritability

Question 88

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.

Answer 88

B The additive effects may include bradycardia

Question 89

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.

Answer 89

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

Question 90

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

Answer 90

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