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NM 717 Comps > Module 2 Canvas Pharm Practice Questions > Flashcards

Module 2 Canvas Pharm Practice Questions Flashcards

1
Q

Candy is 4 months pregnant and comes to see you for evaluation of her blood pressure. She was told by her former nurse practitioner that she needed to take medication for blood pressure but she denied she had a problem. Today her B/P is 170/96, and her physical exam, other than her blood pressure is normal. What medication will you most likely order?

a. Atenolol (Tenormin)
b. Labetalol (Trandate)
c. Clonidine (Catapres)
d. Methyldopa (Aldomet)

A

b. Labetalol (Trandate)

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2
Q

Which of the following medications have the greatest potential for overdose if prescribed with an opioid?

a. Hydroxyzine (Vistaril- strong antihistamine)
b. Ativan (Benzodiazepine)
c. Prozac (SSRI)

A

b. Ativan (Benzodiazepine)

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3
Q

A patient has been prescribed a topical glucocorticoid for contact dermatitis. The patient should be instructed to:

a. apply the drug every 2 hours while awake.
b. apply only to the mucous membranes.
c. apply a thin film and gently rub it in.
d. cover the applied area with an occlusive dressing.

A

c. apply a thin film and gently rub it in.

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4
Q

Which of the following drugs are contraindicated while taking oral azoles (antifungals)?

a. Antidiabetic agents
b. Cephalosporins
c. Statins

A

c. Statins

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5
Q

The principal indications for benzodiazepines are all EXCEPT:

a. seizure disorders
b. anxiety
c. insomnia
d. bipolar disorder

A

d. bipolar disorder

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6
Q

Absorption of topical corticosteroids is impacted by a variety of factors. All of the following are examples of factors that might impact absorption of topical corticosteroids EXCEPT:

a. amount of skin surface area the medication is applied to
b. the condition of the skin
c. concurrent use of multivitamins
d. vehicle used to deliver the corticosteroid

A

c. concurrent use of multivitamins

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7
Q

Select the best patient teaching for the patient who is given topical metronidazole (Metro-gel) for the treatment of acne rosacea.

a. Topical metronidazole is a category X drug.
b. Anticipate that treatment will continue for a long period of time or, possibly, for life.
c. Expect results in 1-2 weeks of treatment.

A

b. Anticipate that treatment will continue for a long period of time or, possibly, for life.

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8
Q

A type 2 diabetic patient has been well controlled on a sulfonylurea but has recently been experiencing repeated hypoglycemic reactions. The patient should be assessed for the concomitant use of:

a. multivitamins.
b. nonsteroidal antiinflammatory agents.
c. colace.
d. Tylenol.

A

b. nonsteroidal antiinflammatory agents.

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9
Q

Which of the following is TRUE regarding antacids and drug interactions?

a. There are no interactions between antacids and other medications.
b. Antacids increase the absorption of digitalis products.
c. Aluminum hydroxide products decrease the absorption of warfarin (Coumadin)
d. Magnesium products increase the absorption of the phenothiazines.

A

c. Aluminum hydroxide products decrease the absorption of warfarin (Coumadin)

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10
Q

You are prescribing a beta blocker for a patient with hypertension who also suffers from migraine headaches. You tell her that this medication will help both her blood pressure and her migraines. What is the effect of selected beta blockers on migraine headaches?

a. Beta blockers provide complete relief from migraines.
b. Beta blockers reduce the severity of migraines.
c. Beta blockers reduce the duration of migraines.
d. Beta blockers reduce the frequency of migraines.

A

d. Beta blockers reduce the frequency of migraines.

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11
Q

When prescribing the decongestant/antihistamine combination, cetirizine/pseudoephedrine (Zyrtec-D) the following instructions would be appropriate:

a. Avoid use with antibiotics
b. May cause insomnia if taken at bedtime
c. Avoid use with steroid nasal spray
d. Avoid use of this preparation if there is a history of asthma

A

b. May cause insomnia if taken at bedtime

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12
Q

The class of medications used to treat osteoporosis that is identified with the rare risk of osteonecrosis of the jaw is:

a. Calcitonins
b. Diphosphonates
c. Bisphosphonates
d. Selective Estrogen Receptor Modulators (SERMs)

A

c. Bisphosphonates

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13
Q

Mindy is a 32 year old multipara who sees you for her first office visit since discovering she is pregnant with her 5th child. Since learning of her pregnancy, she has increased her vitamin A supplement to 1200 RAEs per day. Your response based on this information is to:

a. encourage the patient to increase the dose to 1500 RAEs to promote the development of the central nervous system of the fetus.
b. Inform her that supplementation of Vitamin A above what is found in prenatal vitamins may be teratogenic and she should only take her prenatal vitamin
c. confirm that this dose is appropriate during pregnancy.
d. inform the patient that because vitamin A is water soluble, large doses are needed to maintain the vitamin in the system.

A

b. Inform her that supplementation of Vitamin A above what is found in prenatal vitamins may be teratogenic and she should only take her prenatal vitamin

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14
Q

Your patient who suffers from chronic depression and takes paroxetine (Paxil)states she is going to be attempting pregnancy within the next few months. She asks if she may continue taking paroxetine during her pregnancy and lactation. What will be your response?

a. You should discontinue Paxil and not take any medication while you are pregnant and breastfeeding
b. If a medication is necessary during pregnancy and lactation sertraline (Zoloft) is a drug that may be used both during pregnancy & lactation.
c. Paxil is not safe during pregnancy but you may take this when breastfeeding
d. Paxil is safe to take during pregnancy but not breastfeeding

A

b. If a medication is necessary during pregnancy and lactation sertraline (Zoloft) is a drug that may be used both during pregnancy & lactation.

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15
Q

Which of the following is true regarding anti-virals?

a. Antivirals mechanism of action is increasing cell wall permeability and osmosis and causing the virus to rupture.
b. When considering using an antiviral, it is best practice to wait 72 hours to see if body will clear virus on its own.
c. Anti-viral agents work by reducing viral shedding.

A

c. Anti-viral agents work by reducing viral shedding.

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16
Q

The antacid that would be a good choice for a healthy post-menopausal woman at risk for osteoporosis is:

a. aluminum hydroxide
b. calcium carbonate
c. magnesium hydroxide
d. sodium bicarbonate

A

b. calcium carbonate

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17
Q

All of the following statements regarding bulk laxatives are true EXCEPT:

a. Results are generally seen in 2-3 hours
b. It is important to drink plenty of fluids
c. They are appropriate for long term therapy
d. Sudden increases in fiber may cause flatulence

A

a. Results are generally seen in 2-3 hours

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18
Q

Doxycyline (Vibramycin) is being used by an 18-year-old woman for acne. She discovers she is pregnant. The health care provider advises the client:

a. Discontinue doxycycline (Vibramycin) due to potential effect on the fetus’ teeth
b. Change the medication to levofloxacin (Levaquin) as acne can be treated with less risk to the fetus
c. Stop the doxycycline (Vibramycin) immediately as it increases risk for spontaneous abortion
d. Decrease doxycycline (Vibramycin) as it can be taken during pregnancy at lower doses

A

a. Discontinue doxycycline (Vibramycin) due to potential effect on the fetus’ teeth

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19
Q

A side effect of a broad spectrum antibiotic that may lead women to stop taking it is:

a. Discoloration of skin
b. Metallic taste
c. Constipation
d. Moniliasis (aka Yeast infection or Candidiasis)

A

d. Moniliasis (aka Yeast infection or Candidiasis)

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20
Q

A 30 year old pregnant female with hypothyroidism has been treated with levothyroxine for several years. How might you need to adjust her levothyroxine in the first trimester?

a. Increase the dosage
b. Maintain the current dose
c. Increase the dose during the first trimester and then decreasing during second and third trimesters
d. Decrease the dosage

A

a. Increase the dosage

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21
Q

Your patient was started on levothyroxine (Synthroid) six months ago and her TSH is now WNL. She returns for a follow-up visit and tells you that she is 6 weeks pregnant.You start her on prenatal vitamins with iron. The teaching intervention that should be reviewed with the patient regarding taking these 2 medications is:

a. Allow at least two hours between the times you take these two drugs.
b. A dangerous interaction could occur; these drugs should not be used concurrently.
c. Alternate days when taking the Synthroid and the prenatal vitamins with iron.
d. The medications can be taken at the same time without any adverse effects

A

a. Allow at least two hours between the times you take these two drugs.

The iron in the prenatal vitamins may prevent absorption of the Synthroid.

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22
Q

When considering initiating a HMG-CoA reductase inhibitors (statins), routine laboratory values include:

a. Creatine phosphokinase (CPK levels)
b. Liver function tests (LFTs)
c. Serum electrolytes

A

b. Liver function tests (LFTs)

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23
Q

All of the following are fat soluble vitamins except:

a. B
b. A
c. D
d. E

A

a. B

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24
Q

Which of the following drugs is the most likely to cause orthostatic hypotension and dizziness?

a. Azithromycin (macrolide antibiotic)
b. Metoprolol (beta-blocker)
c. Budesonide (inhaled glucocorticoid)

A

b. Metoprolol (beta-blocker)

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25
Q

Your patient is an insulin dependent diabetic and is planning to become pregnant. She asks regarding the advisability of breastfeeding. Your response best response is:

a. You can breastfeed. Newborn exposure to insulin in breast milk may help prevent type 1 DM in infants.
b. It is not advisable. Newborn exposure to insulin in breast milk may increase risk for type 1 DM in infants
c. The use of insulin is contraindicated with breastfeeding
d. You would need to use only a basal insulin to decrease the risk of hypoglycemia in the infant.

A

a. You can breastfeed. Newborn exposure to insulin in breast milk may help prevent type 1 DM in infants.

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26
Q

You recently prescribe misoprostol (Cytotec) for A 30-year-old female patient for treatment of a gastric ulcer secondary to long-term ibuprofen (Motrin) use. Which of the following will you include in the instructions to this patient?

a. “Use a reliable method of birth control.”
b. “Take indomethacin (Indocin) instead of ibuprophen for pain relief.”
c. “Start taking the drug at the end of your next menstrual period.”
d. “Take the medication 1 hour before meals.”

A

a. “Use a reliable method of birth control.”

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27
Q

Amoxicillin (Amoxil) is being used by an 18 year old woman for a skin infection. She discovers she is pregnant. The provider advises the patient to:

a. Continue the amoxicillin (Amoxil) as it can be taken during pregnancy without known fetal risk
b. Stop the amoxicillin (Amoxil) immediately as it increases risk for spontaneous abortion
c. Discontinue the amoxicillin (Amoxil) due to potential effect on the fetus’ teeth
d. Switch to an alternate therapy such as tetracycline to reduce fetal risk

A

a. Continue the amoxicillin (Amoxil) as it can be taken during pregnancy without known fetal risk

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28
Q

Teaching patients about unexpected side effect(s) of short acting beta agonists is important. Which answer describes one or more common side effect(s) of short acting beta agonists?

a. Diarrhea
b. Bradycardia
c. Tremors and cardiac stimulation
d. Constipation

A

c. Tremors and cardiac stimulation

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29
Q

When teaching patients about the mechanism of action of statin drugs it is correct to state that statin-type drugs are useful in the reduction of serum cholesterol levels because they:

a. affect enteric absorption of cholesterol and triglycerides
b. prevent entero-hepatic recirculation of cholesterol.
c. increase the production of bile salts containing cholesterol.
d. inhibit the synthesis of cholesterol by the liver.

A

d. inhibit the synthesis of cholesterol by the liver.

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30
Q

According to the CDC, which is the best first-line treatment of a MRSA abscess?

a. Bactroban cream with oral macrolide
b. Macrolide antibiotic
c. Incision and Drainage

A

c. Incision and Drainage

31
Q

Which of the following GI drugs has the greatest potential for drug to drug interactions?

a. Omeprazole (Prilosec)
b. Ranitidine (Zantac)
c. Cimetidine (Tagamet)

A

c. Cimetidine (Tagamet)

32
Q

The advanced practice nurse would AVOID ordering bisacodyl (Dulcolax) for:

a. an other wise healthy geriatric patient who is constipated
b. a patient with abdominal pain of unknown origin.
c. a patient with an allergy to shellfish
d. a patient with irritable bowel syndrome.

A

b. a patient with abdominal pain of unknown origin.

33
Q

What is the mechanism of action (MOA) of Promethazine (Phenergan) in the treatment of nausea?

a. It stimulates cholinergic receptors.
b. It blocks dopamine in the chemo trigger zone(CTZ), blocks cholinergic, and histamine receptor sites.
c. It blocks kappa one receptors.

A

b. It blocks dopamine in the chemo trigger zone(CTZ), blocks cholinergic, and histamine receptor sites.

34
Q

Which of the following are signs and symptoms of metformin-induced lactic acidosis?

a. Respiratory distress
b. All of the following
c. Abdominal distress

A

b. All of the following

35
Q

What is a shared contraindication of all laxative classes?

a. Use in a patient with nausea, vomiting, and or un-diagnosed abdominal pain.
b. Previous history of appendicitis.
c. Concomitant use of oral probiotics.

A

a. Use in a patient with nausea, vomiting, and or un-diagnosed abdominal pain.

36
Q

Which is TRUE about Schedule I drugs?

a. Compared to Schedule III drugs, there is a lower potential for abuse with Schedule I drugs.
b. Prescriptions for Schedule I drugs must be written and signed each month.
c. Schedule I are not prescribed by APRNs.

A

c. Schedule I are not prescribed by APRNs.

37
Q

Metoclopramide (Reglan) works in the treatment of heartburn by:

a. Promoting the gastric emptying process and toning the lower esophageal sphincter.
b. Binding the H2 receptor sites to block gastric acid secretion.
c. It is a dopamine agonist.

A
38
Q

What is the mechanism of action of Misoprostol (Cytotec) in the treatment of GI complaints?

a. It immediately neutralizes acid and raises stomach pH.
b. It is a prokinetic.
c. It is a prostaglandin E1 analogue that protects gastric mucosa by binding to prostaglandin receptors.

A

c. It is a prostaglandin E1 analogue that protects gastric mucosa by binding to prostaglandin receptors.

39
Q

Which laboratory test should be done before beginning a systemic antifungal medication for tinea unguium?

a. Sedimentation rate
b. Liver function tests
c. Serum cobalamin level

A

b. Liver function tests

Both Liver function tests and CBC are performed before terbinafine (Lamisil) and again at 6 weeks. Obj:Plan / Management

40
Q

Which of the following is/are true regarding corticosteroid use for dermatological conditions?

a. occlusive dressings can potentiate absorption and cause adverse side effects
b. use the lowest effective dose possible
c. prescribing classes 1, 2, & 3 should be done in consultation
d. all of the provided answers are true

A

d. all of the provided answers are true

41
Q

The APRN chooses to give cephalexin (an antibiotic) every 8 hours based on knowledge of the drug’s:

a. Biological half-life
b. Safety and side effects
c. Propensity to go to the target receptor

A

a. Biological half-life

42
Q

Which of the following drugs must a prescriber be registered in the iPLEDGE risk management program in order to prescribe?

a. Adapalene (Differin)
b. Isotretinoin (Accutane)
c. Tazarotene (Tazoric)

A

b. Isotretinoin (Accutane)

43
Q

When prescribing for the elderly, which physiologic change must be considered?

a. Increased renal function.
b. Decreased production of CYP 450 enzymes.
c. Increased liver mass.

A

b. Decreased production of CYP 450 enzymes.

44
Q

Drugs that are protein bound:

a. Activate receptors
b. Are called albumin
c. Do not activate receptors

A

c. Do not activate receptors

Correct answer: Do not activate receptors. They must be free.

Module one reading and video.

45
Q

Your drug is an agonist. In response to an agonist you would expect receptor sites to be:

a. Fully activated
b. No activation
c. Partial activation

A

a. Fully activated

46
Q

An elderly patient is on anti-depressants. This patient suddenly experiences a decrease in renal function and glomerular filtration rate (GFR). Given these changes, what can the APRN expect will be the result drug blood plasma levels?

a. Increased anti-depressant blood plasma levels.
b. Decreased anti-depressant blood plasma levels.
c. No change in anti-depressant blood plasma levels.

A

a. Increased anti-depressant blood plasma levels.

47
Q

For a diabetic patient on the oral antihyperglycemic agent metformin, which supplement may lessen the risk of paresthesias?

a. Vitamin B-12
b. Calcium
c. Vitamin D

A

a. Vitamin B-12

48
Q

Thiazide diuretics have which of the following potential side effect(s)?

a. Hypokalemia
b. Hyporuricemia
c. Hypoglycemia

A

a. Hypokalemia

49
Q

Which is true regarding safe prescribing of off-label medications?

a. It is not legal for APRNs to prescribe off-label.
b. Safe off-label prescribing must be supported by scientific evidence.
c. Safety and efficacy information may be found in the Physician’s Desk Reference (PDR), a collaboration between the FDA and the drug manufacturer.

A

b. Safe off-label prescribing must be supported by scientific evidence.

Proper off-label prescribing must be supported by scientific evidence. Even proper off-label prescribing may result in increased or unknown patient risks. The PDR is a collaboration between the FDA and the drug manufacturer; however, the information in the PDR is not supported by scientific information; therefore, it is not considered a safe and reliable resource for clinical practice. Also, the PDR does not cover off-label use.

50
Q

A client has been prescribed permethrin (Elimite) and told to apply the medication all over her body overnight from the neck down. What is she being treated for?

a. Bed bugs
b. Scabies
c. Chiggers

A

b. Scabies

51
Q

Decongestants cause which side effects?

a. Orthostatic hypotension
b. Elevated blood pressure
c. Bradycardia

A

b. Elevated blood pressure

52
Q

Which of the following is true regarding cardioselective beta-blockers?

a. They have greater effects on renin-angiotensin-aldosterone system (RAAS)
b. They have greater beta-2 receptor affects
c. They have greater beta-1 receptor affects

A

c. They have greater beta-1 receptor affects

53
Q

Bioavaliability is:

a. The maximum blood level of the drug following administration.
b. The percentage of drug that enters the blood brain barrier over one hour.
c. The percentage of administered drug that enters the bloodstream that is available at the site of action.

A

c. The percentage of administered drug that enters the bloodstream that is available at the site of action.

54
Q

Which of the following tools/actions help combat inappropriate narcotic prescribing?

a. Review of prescription drug monitoring system prior to prescribing.
b. Use of benzodiazepines (ex: Valium) in addition to opioids to decrease overall opioid daily dose.
c. Review of regional opioid biogram prior to prescribing.

A

a. Review of prescription drug monitoring system prior to prescribing.

55
Q

Which of the following drug class has good gram negative coverage?

a. Sulfonamides (example Bactrim)
b. Both of the answers in this set have good gram negative coverage.
c. Penicillin (not extended coverage)

A

a. Sulfonamides (example Bactrim)

PCN does not have gram negative coverage- you need extended spectrum PCN for any gram neg coverage

56
Q

Which of the following drug classes works most effectively as monotherapy for hypertension in the black population?

a. Beta-Blockers
b. Angiotensin II receptor blockers (ARBs)
c. Calcium Channel Blockers (CCB)

A

c. Calcium Channel Blockers (CCB)

57
Q

Which medication is the current treatment of choice for hives?

a. hydrocortisone cream (Dynarex)
b. loratadine (Claritin)
c. ketoconazole (Nizaral)

A

b. loratadine (Claritin)

Nonsedating H1 blockers, such as, loratadine (Claritan) have become treatment of choice, but older H1 receptor antagonists can also be used. Obj:Plan / Mgt.

58
Q

Which is true regarding the tapering of corticosteroids?

a. Tapering allows the adrenal glands to resume their normal function.
b. Tapering is required only when prescribing at dosages greater than 30 mg for more than 3 days.
c. Tapering is no longer recommended.

A

a. Tapering allows the adrenal glands to resume their normal function.

59
Q

Metoclopramide (Reglan) has this black box warning:

a. There is no black box warning.
b. Risk of developing tardive dyskinesia.
c. May cause paralytic ileus

A

b. Risk of developing tardive dyskinesia.

60
Q

A common cause of black, tarry stool that is negative for occult blood is

a. Aluminum hydroxide (Mylanta)
b. Ranitidine (Zantac)
c. acetaminophen (Tylenol)
d. Bismuth subsalicylate (Pepto-Bismol)

A

d. Bismuth subsalicylate (Pepto-Bismol)

Some harmless causes of stool color changes include:

bismuth-containing medications (such as Pepto-Bismol) and also

certain vegetables with deep colors, green foods, food dyes (especially red, green, purple), and iron pills.

61
Q

Which medication treats the tremor and tachycardia associated with hyperthyroidism?

a. diazepam (Valium) -a benzodiazepine
b. propranolol (Inderal XL) -a beta blocker
c. lisinopril (Zestril)- an ACE inhibitor

A

b. propranolol (Inderal XL) -a beta blocker

62
Q

Angiotensin-converting enzyme inhibitors are not routinely combined with angiotensin II receptor blockers because the combination of these two classes can lead to:

a. Worsening kidney function
b. Hypokalemia
c. Hypercalcemia

A

a. Worsening kidney function

Correct Answer: Worsening kidney function. Combining ACE and ARB is not routinely recommended as combining several RAS-acting agents can worsen kidney function and cause hyperkalemia.

63
Q

Metformin (Glucophage) has a small risk of causing fatal lactic acidosis. It is contraindicated in patients with:

a. Severe renal disease
b. Hypertension
c. Factor V Leiden deficiency

A

a. Severe renal disease

64
Q

A medication with a half-life of 12 hours is administered at noon. According to general prescribing guidelines, when should the next dose be administered?

a. Noon the next day
b. 18:00 (6 p.m.)
c. Midnight

A

c. Midnight

65
Q

Angiotensin-converting enzyme (ACE) inhibitors should be avoided in patients with:

a. Severe kidney disease
b. Persistent asthma
c. Hypokalemia
d. Alcohol use disorder

A

a. Severe kidney disease

66
Q

What is the definition of volume of distribution?

a. A value that reflects the volume in which a drug would need to be dissolved to explain the relationship between dosage and blood levels.
b. Transporters that facilitate movement of molecules.
c. Plasma protein binding material.

A

a. A value that reflects the volume in which a drug would need to be dissolved to explain the relationship between dosage and blood levels.

67
Q

In an effort to avoid sexual function problems, the clinician could prescribe which if the following for the depressed patient?

a. paroxetine (Paxil)
b. citalopram (Celexa)
c. bupropion (Wellbutrin)
d. fluoxetine (Prozac)

A

c. bupropion (Wellbutrin)

Bupropion (Wellbutrin) is in the “very low” category of causing sexual function side effects.

68
Q

Metabolism by the liver after oral administration of a drug is called:

a. First-pass metabolism.
b. Mixed function oxidase reaction.
c. CYP3A4 prominent reduction.

A

a. First-pass metabolism.

69
Q

Enzyme induction results in:

a. Increased pharmacological action of drug
b. No effect on drug
c. Decreased pharmacological action of drug

A

c. Decreased pharmacological action of drug

70
Q

Which of the following are true regarding oral decongestants?

a. Both of the answers in this set are true
b. They cause vasoconstriction of the nasal blood vessels
c. They should be avoided in individuals who have uncontrolled hypertension

A

a. Both of the answers in this set are true

71
Q

Your drug is an antagonist. In response to this drug, you expect the receptor site to be:

a. Fully activated
b. No activation
c. Partially activated

A

b. No activation

72
Q

Why are antihistamines recommended for the common cold?

a. They are non-sedating.
b. They dry secretions of the mouth and nose.
c. They treat the cause of rhinorrhea and sneezing.

A

b. They dry secretions of the mouth and nose.

73
Q

What is the mechanism of action of H2 Receptor Antagonists (example Famotadine Pepcid) in the treatment of GI complaints?

a. It immediately neutralizes acid and raises stomach pH.
b. It blocks Cox 1 and some Cox 2.
c. It competitively binds to histamine receptors in parietal cells stop acid secretion.

A

c. It competitively binds to histamine receptors in parietal cells stop acid secretion.

NM 717 Comps (31 decks)

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