Amercian Sentinel N521 Progress Test 2 Latest 2021 May

Progress Test 2

Question 1A 16-year-old adolescent is 6 weeks pregnant. The pregnancy has exacerbated her acne. She asks her CNM if she can resume taking her isotretinoin (Accutane) prescription, a category X drug, prescribed by her dermatologist. What is the most appropriate response by the CNM:

Select one:

a.“You should reduce the Accutane dosage by half during pregnancy.”

b.“Accutane is known to cause birth defects and should never be taken during pregnancy.”

c.“Since you have a prescription for Accutane, it is safe to resume using it.”

d.“You should consult with your dermatology provider at your next visit.”

Question 2To reduce the effect of a prescribed medication on the infant of a breastfeeding mother, how should the CNM teach the mother to take the medication?

Select one:

a.Immediately before the next feeding

b.At night

c.In divided doses at regular intervals around the clock

d.Immediately after breastfeeding

Question 3To reduce the chance of a duplicate medication order for the older patient who presents for his first outpatient visit with a CNP after a hospitalization, what action should the provider take? (Select all that apply.)

Select one or more:

a.Call in all prescriptions to the patient’s pharmacies rather than relying on paper copies of prescriptions.

b.Give all prescriptions to the patient’s family member.

c.Take a medication history, including all OTC and prescription medications and a pharmacy history.

d.Work with the patient’s other health care providers to limit the number of prescriptions.

e.Perform the process of medication reconciliation before sending the patient home.

Question 4Little human research has explored the safety or harmfulness of herbs in:

Select one:

a.pregnancy

b.lactation

c.Both a and b

d.Neither a nor b

Question 5According to a survey conducted by AARP and the NCCAM in 2006:

Select one:

a.50% of people 50 years of age or older do not talk to their doctors about their use of CAM.

b.69% of people 50 years of age or older do not talk to their doctors about their use of CAM.

c.25% of people 50 years of age or older do not talk to their doctors about their use of CAM.

d.10% of people 50 years of age or older do not talk to their doctors about their use of CAM.

Question 6As with prescribed medications, herbal doses may have to be adjusted in the pediatric population according to:

Select one:

a.weight

b.age

c.Both a and b

d.Neither a nor b

Question 7Some herbs, when combined with pharmaceuticals that have similar or comparable actions, may have an additive effect. Additive effects may be:

Select one:

a.beneficial

b.detrimental

c.Both a and b

d.Neither a nor b

Question 8The best-investigated metabolic interactions are those involving St. John’s Wort. This herb, which is claimed to be effective in the treatment of mild to moderate depression, appears to:

Select one:

a.be a weak inducer of isozyme CYP 3A4.

b.be a potent inducer of isozyme CYP 3A4.

c.be a neutral inducer of isozyme CYP 3A4.

d.have no affect on isozyme CYP 3A4.

Question 9Many practitioners believe that botanical therapies should be used in conjunction with pharmaceuticals to enhance healing by strengthening the body’s immune system to protect against infection and disease. An example of an enhanced combination is:

Select one:

a.a blend of herbals with prescription antipsychotics.

b.a blend of herbals with prescription glucocorticoids.

c.a blend of herbals with prescription antibiotics.

d.a blend of herbals with prescription antiepileptics.

Question 10The patient tells the CNP that he has been using the herbal product saw palmetto. She recognizes that this supplement is often used to treat which condition?

Select one:

a.Urinary tract infection

b.Insomnia

c.Symptoms of menopause

d.Urinary problems associated with prostate enlargement

Question 11Antitussives, which are medications containing dextromethorphan, are common and one of the most commonly abused drugs, especially by:

Select one:

a.adults between the ages of 21-25 years.

b.adults 65 years and older.

c.teenagers.

d.adults between the ages of 35-50 years.

Question 12No evidence indicates that patients who take vitamins:

Select one:

a.live longer.

b.have fewer cancers.

c.Both a and b

d.Neither a nor b

Question 13A family nurse practitioner advises a nursing mother who has postpartum mastitis to take antibiotics as prescribed and:

Select one:

a.continue to nurse with both breasts.

b.take cool showers.

c.pump the unaffected breast with a lactation pump.

d.temporarily switch to formula.

Question 14The drug manual states that older adult patients are at increased risk for hepatic side effects. Which action is most important when prescribing this medication to an 80-year-old patient?

Select one:

a.Ensure that the drug is given in the  dose at the  time to minimize the risk of adverse effects.

b.Obtain pretreatment laboratory work.

c.Discontinue the order; the drug is contraindicated for this patient.

d.Give the medication intravenously so that the drug does not pass through the liver.

Question 15The nurse practitioner is preparing to administer penicillin G intramuscularly to a child. The child’s parents ask why the drug cannot be given in an oral liquid form. What is the nurse practitioner’s reply?

Select one:

a.“This drug causes severe gastric upset if given orally.”

b.“This drug would be inactivated by enzymes in the stomach.”

c.“This drug has a narrow therapeutic range, and the dose must be tightly controlled.”

d.“This drug is absorbed much too quickly in an oral form.”

Question 16A nurse practitioner is caring for a patient and her newborn immediately after delivery. The patient’s medication history includes prenatal vitamins throughout pregnancy, one or two glasses of wine before knowing she was pregnant, occasional use of an albuterol inhaler in her last trimester, and intravenous morphine during labor. What will the nurse practitioner expect to do?

Select one:

a.Monitor the infant’s respirations and prepare to administer naloxone if needed.

b.Note a high-pitched cry and irritability in the infant and observe for seizures.

c.Administer opioids to the infant to prevent withdrawal syndrome.

d.Prepare the patient for motor delays in the infant caused by the alcohol use.

Question 17A nurse practitioner is teaching a class to a group of pregnant patients. The nurse practitioner ly teaches that the highest risk of teratogen-induced gross malformations exists during which time?

Select one:

a.Immediately before conception

b.During the third trimester

c.During the first trimester

d.During the second trimester

Question 18Which types of drugs taken by a pregnant patient are more likely to have effects on a fetus?

Select one:

a.Ionized drugs

b.Lipid-soluble drugs

c.Protein-bound drugs

d.Drugs that are highly polar

Question 19An infant has allergies and often develops a pruritic rash when exposed to allergens. The infant’s parents ask the nurse practitioner about using a topical antihistamine. What should the nurse practitioner tell them?

Select one:

a.The child will also need oral medication to achieve effective results.

b.Applying an antihistamine to the skin can cause toxicity in this age group.

c.Topical medications have fewer side effects than those given by other routes.

d.Antihistamines given by this route are not absorbed as well in children.

Question 20A thin older adult woman is admitted to the hospital after several days of vomiting, diarrhea, and poor intake of foods and fluids. She has not voided since admission. In preparing to care for this patient, the nurse practitioner will look for what laboratory values to help guide medication administration?

Select all that apply.

Select one or more:

a.Creatinine clearance

b.Gastric pH

c.Plasma drug levels

d.Serum albumin