Pharmacology Final Review

Question 1

Nurse practitioner prescriptive authority is regulated by:

The state board of pharmacy

The U.S. drug Enforcement Administration

The National Council of State Boards of Nursing

The state board of nursing for each state

Answer 1

The state board of nursing for each state

Question 2

Drugs that have a significant first-pass effect:

Are rapidly metabolized by the liver and may have little, if any desired action

Must be given by the enteral (oral) route only

Are converted by the liver to more active and fat soluble forms

Bypass the hepatic circulation

Answer 2

Are rapidly metabolized by the liver and may have little, if any, desired action

Question 3

Factors that affect gastric drug absorption include:

Protein- binding properties of the drug molecule

Lipid solubility of the drug

liver enzyme activity

ability to chew and swallow

Answer 3

Lipid solubility of the drug

Question 4

Under new U.S. Food and Drug Administration labeling, pregnancy categories have been:

Eliminated and replaced w/ a link to the National Library of Medicine TOXNET Web site for in-depth information regarding pregnancy concerns

Clarified to include information such as safe dosages in each trimester of pregnancy

Changed to incorporate a pregnancy risk summary and clinical considerations on the drug label

Strengthened with a new coding such as C+ or C- to discern when a drug is more or less toxic to the fetus

Answer 4

Changed to incorporate a pregnancy risk summary and clinical considerations on the drug label

Question 5

The U.S. Food and Drug administration regulates:

Off-label recommendation for prescribing

The official labeling for all prescription and OTC drugs

Prescribing drugs by medical doctors (MDs) and nurse practioners (NPs)

Pharmaceutical educational offerings

Answer 5

The official labeling for all prescription and over-the-counter drugs

Question 6

A 13-year-old child comes to the clinic with a four-day history of cough, low-grade fever and rhinorrhea. When she blows her nose or coughs the mucous is greenish-yellow. The appropriate treatment would be:

Answer 6

Symptomatic care

Question 7

The GFRs for a 91-year-old woman who weighs 93 lbs and is 5’1 with a serum creatinine of 1.1 and for a 202 pound, 25-year-old male who is 5’9 with the same serum creatinine according to the Cockcroft Gault formula are:

Answer 7

25 and 103mL/min, respectively

Question 8

A 16 year old female who is taking minocycline for acne comes to the clinic complaining of a headache. What would be the appropriate care?

Answer 8

Evaluate her for pseudotumor cerebri

Question 9

Sadie is a 90-year-old patient who require a new prescription. What changes in drug distribution with aging would influence prescribing for Sadie?

Answer 9

Decreased plasma proteins

Question 10

Steps to avoid polypharmacy include:

Answer 10

Evaluating for duplication in drug therapy and discontinuing any duplications

Question 11

Conjunctivitis in a child that is accompanied by acute otitis media is treated with:

Answer 11

High-dose oral amoxicillin-clavulanate

Question 12

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:

Answer 12

The additive effects may include bradycardia

Question 13

A patient presents to the clinic with hard earwax in both ear canals. Instructions regarding home removal of hard cerumen include:

Answer 13

Instill carbamide peroxide (Debrox) twice daily until canals are clear

Question 14

A 3-year-old present with a URI. Treatment for their URI would include:

Answer 14

Nasal saline spray

Question 15

Patient education for a patient who is prescribed antibiotics for sinusitis includes:

Answer 15

Use of nasal saline washes

Question 16

First-line therapy for a school-age child with group A streptococcal pharyngitis is:

Answer 16

Amoxicillin 50mg/kg (maximum 1,000 mg/day) for 10 days

Question 17

When melatonin is used to induce sleep, the recommendation is that the patient:

Answer 17

Not take melatonin more than three nights a week

Question 18

Digoxin levels need to be monitored closely when the following medication is started:

Answer 18

Albuterol

Question 19

When prescribing Montelukast (Singulair) for asthma, patients or parents of patients should be instructed:

Answer 19

Aggression, anxiety, depression, and/or suicidal thoughts may occur when taking Montelukast

Question 20

A stepwise approach to the pharmacologic management of asthma:
Begins with determining the severity of asthma and assessing asthma control. One goal of asthma management in children is:

Answer 20

Participation in school and sports activities

Question 21

Education for patients who use an inhaled beta agonist and an inhaled corticosteroid includes:

Answer 21

Use of the inhaled beta agonist first, followed by the inhaled corticosteroid

Question 22

A stepwise approach to the pharmacologic management of asthma

Answer 22

Begins with determining the severity of asthma and assess asthma control

Question 23

Patient taking warfarin need to be educated about the vitamin k content of foods to avoid therapeutic failure. Foods high in vitamins k that should be limited to no more than one serving per day include:

Answer 23

Spinach

Question 24

When starting a patient on a statin, education would include:

Answer 24

All of the above

If they stop the medication their lipid levels will return to pretreatment levels

Medication is a supplement to diet therapy and exercise

If they have any muscle aches or pains, they should contact their provider

Question 25

Medications are typically started for angina patients when:

Answer 25

Class I or II symptoms begin

Question 26

When is ASA used in angina patients?

Answer 26

All angina patients should be taking ASA unless it is contraindicated for allergy or other medical reasons

Question 27

Pernicious anemia is treated with

Answer 27

Vitamin B12

Question 28

The treatment of vitamin B12 deficiency is

Answer 28

1,000 mcg daily of oral cobalamin

Question 29

A 10-year-old patient 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:

Answer 29

PEG 3350 (Miralax)

Question 30

A patient has diarrhea and is wondering if they can take loperamide (Imodium). Loperamide

Answer 30

Slows gastric motility and reduces fluid and electrolyte loss from diarrhea

Question 31

Patients who are on chronic long-term proton pump inhibitor therapy require monitoring for

Answer 31

Iron deficiency anemia, vitamin B12 and calcium deficiency

Question 32

Metoclopramide improves GERD symptoms by:

Answer 32

Increasing lower esophageal tone

Question 33

After H. pylori treatment is completed, the next step in peptic ulcer disease therapy is:

Answer 33

A PPI for 8 to 12 weeks until healing is complete

Question 34

GLP-1 agonists:

Answer 34

Directly bind to a receptor in the pancreatic beta cell

Question 35

Metformin is a primary choice of drug to treat hyperglycemia in type 2 diabetes because it:

Answer 35

Decreases glycogenolysis by the liver

Question 36

The action of gliptins is different from other antidiabetic agents because they:

Answer 36

Act on the incretin system to indirectly increase insulin production

Question 37

Elderly patients who are on levothyroxine for thyroid replacement should be monitored for

Answer 37

Tachycardia and angina

Question 38

Besides cystic fibrosis, which other medical state may trigger the need for pancreatic enzymes?

Answer 38

Some bariatric surgeries

Question 39

Why must steroids be tapered after long-term use?

Answer 39

So that the resolution of longer-term adrenal suppression is not rapid

Question 40

When methimazole is started for hyperthyroidism it may take __________ to see a total reversal if hyperthyroid symptoms.

Answer 40

6 to 12 months

Question 41

The drug of choice for treatment of primary or secondary syphilis is:

Answer 41

Benzathine penicillin G IM

Question 42

A 24-year old female present with a UTI. She is healthy, afebrile, and her only drug allergy is sulfa, which gives her a rash. An appropriate first-line antibiotic choice for her would be:

Answer 42

Nitrofurantoin