DNRS6521 or NURS6521N midterm exam 2022 oct latest all 100 answers

1 Question 1

The Nurse Practitioner is preparing to Prescribe a medication regimen for her patient. He or she recognizes that criteria for choosing an effective drug for any disorder include:

 

              Consulting nationally recognized guidelines for disease management

 

              Asking the patient what drug they think would work best for them

 

              Prescribing medications that are available as samples before writing a prescription

 

              Following U.S. Drug Enforcement Administration guidelines for prescribing

Question 2

NP is a 66-year-old male that is on Omeprazole for GERD and Clopidogrel for TIA prophylaxis. The pharmacist calls to tell you the Omeprazole should be switched due to a drug-drug interaction. This interaction is:

 

              Clopidogrel increases protein binding of Omeprazole, thus decreasing effectiveness of the Omeprazole

 

              Clopidogrel decreases clearance of Omeprazole, thus increasing the concentration and side effects of Omeprazole

 

              Omeprazole decreases hepatic CYP2C19, thus decreasing Clopidogrel effectiveness

 

              Omeprazole increases production of platelets and decreases Clopidogrel efficacy requiring larger doses

Question 3

The Family nurse practitioner prescribed losartan 50 mg PO daily for a hypertensive patient. This medication promotes vasodilation by:

 

              Blocking the action of angiotensin II

 

              Promoting the synthesis of prostaglandins

 

              Inhibiting calcium influx into smooth muscle cells

 

              Promoting the release of aldosterone

uestion 4

Proton Pump Inhibitors such as Protonix and Omeprazole are very effective at suppressing gastric acid but are associated with the risk of which of the conditions:

 

              Rhinitis

 

              Migraines

 

              Clostridium difficile

 

              Otitis Media

Question 5

An elderly patient with a history of congestive heart failure has been admitted to hospital with failure to thrive and admission blood work reveals a hemoglobin level of 6.9 g/dL. The care team has consequently administered two units of packed red blood cells, but auscultation of the client’s lungs now reveals diffuse crackles. Administration of what drug is likely to resolve the patient’s pulmonary edema?

 

              Furosemide

 

              Hydrochlorothiazide

 

              Mannitol

 

              Triamterene

Question 6

Which of the following does not come in an oral formulation for asthma?

 

              albuterol

 

              theophylline

 

              zafirlukast

 

              ipratropium

 

              Singulair

Question 7

A Nurse Practitioner is providing discharge instructions to a patient who will be taking fludrocortisone at home. The Nurse Practitioner will encourage the patient to eat a diet that is

 

              low in sodium and potassium.

 

              low in sodium, high in potassium.

 

              high in iron.

 

              low in proteins.

Question 8

KS is a 45-year-old female with current lipid levels of: TC: 282; HDL: 61; LDL: 122; TG: 163. What is the best initial treatment for KS if she has an ASCVD risk of 38%?

 

              Atorvastatin 20 mg daily

 

              Simvastatin 80 mg daily

 

              Tricor 45 mg daily

 

              Zetia 10 mg daily

Question 9

You are treating a patient for C. Diff and are discharging them on a course of Metronidazole. The main counseling point you need to address is:

 

              Avoid alcohol

 

              Take on an empty stomach

 

              Separate by 2 hours from all other meds

 

              Do not crush or chew

Question 10

A Nurse Practitioner is discussing with a patient the efficacy of a drug that his physician has suggested, and he begin taking. Efficacy of a drug means which of the following?

 

              The amount of the drug that must be given to produce a particular response

 

              How well a drug produces its desired effect

 

              A drug’s strength of attraction for a receptor site

 

              A drug’s ability to stimulate its receptor

Question 11

Destiny presents with a history of depression.  Her parents believe she took an overdose of an antidepressant medication.  Her temperature is 40.1 degrees C.  On exam, her pupils are dilated and she has hyperreflexia. Which of the following symptoms would not be expected?

 

              Agitation

 

              Bradycardia

 

              Confusion

 

              Diarrhea

Question 12

Drugs that use CYP 3A4 isoenzymes for metabolism may:

 

A.           Induce the metabolism of another drug

 

B.           Inhibit the metabolism of another drug

 

C.           Both 1 and 2

 

D.           Neither 1 nor 2

Question 13

NP is a 72-year-ol female with Parkinson’s x 3 years. She has been controlled on Amantadine until recently when she has been having more rigidity. You decide to put her on a dopamine agonist. Counseling on the new dopamine agonist would include:

•            i. Delusions and hallucinations are common

•            ii. The medication can slow disease progression

•            iii. Doses should be tapered slowly if discontinuing

•            iv. Dyskinesias are common

•            v. Sleep attacks are a possible side effect

 

              i only

 

              i and iii only

 

              ii and iv only

 

              i, iii and v only

 

              All of the above

Question 14

What is the main difference between a first- and second-generation antihistamine drug?

 

              First generation antihistamines cause less drowsiness

 

              First generation antihistamines case more dry mouth

 

              Second generation antihistamines cause more dry eyes

 

              Second generation antihistamines cause less headaches

Question 15

A patient on valproic acid may experience which of the following symptoms?

 

              Weight gain

 

              Nausea

 

              Constipation

 

              All of the above

Question 16

Which laxative when used may cause aspiration pneumonia especially in the elderly:

 

              Bisacodyl

 

              Glycerin Suppository

 

              Polyethylene Glycol

 

              Mineral Oil

Question 17

A physician has ordered subcutaneous injections of morphine, a narcotic, every 4 hours as needed for pain for a motor vehicle accident victim. The nurse is aware that there is a high abuse potential for this drug and that it is categorized as a

 

              C-I drug.

 

              C-II drug.

 

              C-III drug.

 

              C-IV drug.

Question 18

A female patient has been taking zafirlukast for a week and is experiencing diarrhea. The nurse should instruct her to do which of the following?

 

              Take nonnarcotic analgesics

 

              Schedule blood tests

 

              Drink plenty of fluids

 

              Take the drug with food

Question 19

Which of the following is a 5HT3 receptor blocker for use in nausea/vomiting?

 

              Ondansetron

 

              Metoclopramide

 

              Promethazine

 

              Dicyclomine

Question 20

What is the primary source of histamine in the body during an allergic reaction?

 

              Mast cells

 

              T-lymphocytes

 

              White blood cells

 

              B-cells

A 46-year-old white American has been prescribed a drug that binds to acid glycoproteins. The nurse understands that white Americans usually receive

 

              a higher-than-normal dose of drugs that bind to acid glycoproteins.

 

              a lower-than-normal dose of drugs that bind to acid glycoproteins.

 

              the recommended normal dose of drugs that bind to acid glycoproteins.

 

              one half the recommended dose of drugs that bind to acid glycoproteins.

Question 22

NP is a 72-year-ol female with Parkinson’s x 3 years. She has been controlled on Amantadine until recently when she has been having more rigidity. You decide to put her on a dopamine agonist. You know the following are dopamine agonists except:

 

              Carbidopa/Levodopa

 

              Ropinirole

 

              Pramipexole

 

              Bromocriptine

Question 23

A 22-year-old male college senior has lived with a diagnosis of Crohn’s disease for several years and has undergone several courses of treatment with limited benefit. Which of the following targeted therapies has the potential to alleviate the symptoms of Crohn’s disease?

 

              Tositumomab plus 131I (Bexxar)

 

              Muromonab-CD3 (Orthoclone OKT3)

 

              Infliximab (Remicade)

 

              Eculizumab (Soliris)

Question 24

A nurse practitioner understands when prescribing a medication that there are certain questions to address. Check all that apply.

 

              Is there a need for the drug in treating the presenting problem?

 

              Is this the best drug for the presenting problem?

 

              Can the patient take the prescribed drug?

 

              None of the above.

Question 25

You are discharging a patient home after postoperative DVT. They ask you why they have to use Lovenox and Warfarin at the same time. You answer:

 

              Warfarin onset is delayed

 

              Warfarin affects platelets

 

              LMWH has a longer half life

 

              LMWH has few side effects than Warfarin

Question 26

Laxatives help to do all of the following except:

 

              Softening the stool

 

              Decrease the amount of strain needed to defecate

 

              Increase the presence of impaction of stool the colon

 

              Reduce the painful elimination that may be associated with hemorrhoids

Question 27

A patient has been prescribed an oral drug that is known to have a high first-pass effect. Which of the following measures has the potential to increase the amount of the free drug that is available to body cells?

 

              Giving the drug with food in order to delay absorption

 

              Administering the drug in small, frequent doses

 

              Limiting the patient’s protein intake and encouraging fluids

 

              Administering the drug intravenously rather than orally

Question 28

A patient with a known history of benign prostatic hyperplasia (BPH) presents to the clinic 4 days after developing a cold. He tells you he began experiencing a sore throat and nasal congestion and began to take an over the counter decongestant.  Today, he complains of not urinating over the last 12 hours.  He also has suprapubic fullness on exam.  Which of the following medications are most likely responsible for this patient’s urinary retention?

 

              Tamsulosin

 

              Phenylephriine

 

              Clonazepam

 

              Finasteride

 

 

1 points  

Question 29

The American Geriatric Society provides the Beers Criteria to aid providers in knowing

 

              Dosage adjustments necessary in chronic renal disease

 

              Potentially inappropriate medications that should be avoided in the geriatric population

 

              Medications that cannot be crushed

 

              Medications that are safe to use in the pediatric population

Question 30

A high school student was diagnosed with asthma when he was in elementary school and has become accustomed to carrying and using his “puffers”. In recent months, he has become more involved in sports and has developed a habit of administering albuterol up to 10 times daily. The nurse should teach the student that overuse of albuterol can lead to

 

              permanent liver damage.

 

              rebound bronchoconstriction.

 

              community-acquired pneumonia.

 

              severe anticholinergic effects.

Question 31

Drugs have a high potential for abuse. There is no routine therapeutic use for these drugs and they are not available for regular use. They may be obtained for “investigational use only” by applying to the U.S. Drug Enforcement Agency. Examples include heroin and LSD. Which scheduled drug is this?

 

              Schedule 1

 

              Schedule 2

 

              Schedule 3

 

              Schedule 4

Question 32

A Nurse Practitioner is providing patient education to a 35-year-old man who has been prescribed clonidine (Catapres) as part of step 2 antihypertensive therapy. The Nurse Practitioner should anticipate that the drug will be administered

 

              intravenously.

 

              subcutaneously.

 

              transdermally.

 

              orally.

Question 33

A female patient has been taking prednisone for her asthma for 1 month. The nurse will teach her to gradually decrease her dose of prednisone to avoid

 

              hypokalemia.

 

              gastrointestinal problems.

 

              adrenal insufficiency.

 

              menstrual irregularities.

Question 34

After a recent history of shortness of breath that has become increasingly severe, a woman has been prescribed ipratropium by MDI while she undergoes a diagnostic workup. What patient teaching should the nurse provide to this patient?

 

              “Make sure that you take this at the scheduled times, regardless of whether you feel short of breath.”

 

              “Most people find that ipratropium cures their lung disease within a few months.”

 

              “You should think of this as an ’emergency drug’, and it should only be used when you experience symptoms.”

 

              “It’s important that you perform deep breathing exercises before and after taking ipratropium.”

Question 35

JJ is a 62-year-old male who has hypertension. He currently takes HCTZ 25 mg daily, Amlodipine 5 mg daily and Lisinopril 10 mg daily. He has developed a dry cough that has persisted. Which med could this potentially be due to and what is an acceptable alternative?

 

              HCTZ; change to Diltiazem

 

              Lisinopril; change to Spironolactone

 

              Amlodipine; stop Amlodipine

 

              Lisinopril; change to Losartan

Question 36

The hypersecretion of gastric acid and development of peptic ulcers is a characterization of what condition:

 

              Cystic Fibrosis

 

              Huntington’s Disease

 

              Sickle Cell Anemia

 

              Zollinger-Ellison Syndrome

Question 37

A patient is taking cholestyramine. The Nurse Practitioner will assess for which of the following common adverse effects of the drug?

 

              Abdominal pain

 

              Headache

 

              Constipation

 

              Indigestion

Question 38

Phenytoin acts to reduce seizures by:

 

              Blocking K+ channels that open and close at low frequencies

 

              Blocking K+ channels that open and close at high frequencies

 

              Blocking Na+ channels that open and close at low frequencies

 

              Blocking Na+ channels that open and close at high frequencies

Question 39

Which of the following affects drug distribution throughout the body?

 

              Presence of food in the gastrointestinal tract

 

              Increase in hepatic enzymes

 

              Protein binding

 

              High blood levels

Question 40

A 72-year-old man is prescribed theophylline for symptomatic relief of bronchial asthma. Which of the following findings would alert the nurse to the need for close monitoring?

 

              Enlarged prostate gland

 

              Need for additional bronchodilation

 

              Signs of an active lung infection

 

              Hypersensitivity to povidone

Question 41

A 49-year-old woman has been diagnosed with myalgia. The physician has recommended aspirin. The patient is concerned that the aspirin will upset her stomach. The nurse will encourage the patient to

 

              crush the tablet before swallowing.

 

              swallow the tablet whole.

 

              swallow the tablet with milk or food.

 

              avoid drinking milk for 3 hours after swallowing the tablet.

Question 42

A female patient is taking 0.125 mg of digoxin daily for heart failure. At a recent clinic visit she reports that since she has been on the drug, she can breathe better and her heart rate has been around 74 beats per minute. The nurse weighs the patient and notices that she has gained 10 pounds since the digoxin therapy was started. The patient is concerned that the additional weight will necessitate an increase in the medication. Which of the following is an appropriate response by the nurse?

 

              “Yes, the drug dosage will probably have to be increased.”

 

              “No, the drug dosage will likely stay the same.”

 

              “No, the drug dosage will have to be decreased.”

 

              “I don’t know; I will have to ask your physician.”

Question 43

A patient will begin three new medications as part of her treatment plan. The nurse practitioner understands that proper disposal of medications is k