Question

Week 1 Assignment 3 Quiz

Question 1. The U.S. Food and Drug Administration (FDA) regulates:

Prescribing of drugs by MDs and NPs

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

Off-label recommendations for prescribing

Pharmaceutical educational offerings

Question 2. The U.S. Drug Enforcement Administration (DEA):

Registers the manufacturers of, and those who are prescribers of controlled substances.

Regulates NP prescribing at the state level

Sanctions providers who prescribe drugs off-label

Provides prescribers with a number they can use for insurance billing

Question 3. Precautions that should be taken when prescribing controlled substances include:

Faxing the prescription for a Schedule II drug directly to the pharmacy

Using tamper-proof papers for all prescriptions written for controlled drugs

Keeping any presigned prescription pads in a locked drawer in the clinic

Using only numbers to indicate the amount of drug to be prescribed

Question 4. Alterations in drug metabolism among Asians may lead to:

Slower metabolism of antidepressants, requiring lower doses

Faster metabolism of neuroleptics, requiring higher doses

Altered metabolism of omeprazole, requiring higher doses

Slower metabolism of alcohol, requiring higher doses

Question 5. Incorporating IT into a patient encounter takes skill and tact. During the encounter, the provider can make the patient more comfortable with the IT the provider is using by:

Turning the screen around so the patient can see material being recorded

Not placing the computer screen between the provider and the patient

Both A and B

Neither A nor B

Question 6. Pharmacokinetics among Asians are universal to all the Asian ethnic groups.

True

False

Question 7. The developmental variation in Phase I enzymes has what impact on pediatric prescribing?

None; Phase I enzymes are stable throughout childhood

Children should always be prescribed lower than adult doses per weight due to low enzyme activity until puberty

Children should always be prescribed higher than adult doses per weight due to high enzyme activity

Prescribing dosages will vary based on the developmental activity of each enzyme, at times requiring lower than adult doses and at other times requiring higher than adult doses based on the age of the child

Question 8. Drugs that are absolutely contraindicated in lactating women include:

Selective serotonin reuptake inhibitors

Antiepileptic drugs such as carbamazepine

Antineoplastic drugs such as methotrexate

All of the above

Question 9. What impact does developmental variation in renal function has on prescribing for infants and children?

Lower doses of renally excreted drugs may be prescribed to infants younger than six months

Higher doses of water-soluble drugs may need to be prescribed due to increased renal excretion

Renal excretion rates have no impact on prescribing

Parents need to be instructed on whether drugs are renally excreted or not

Question 10. Liza is breastfeeding her two-month-old son, and she has an infection that requires an antibiotic. What drug factors influence the effect of the drug on the infant?

Maternal drug levels

Half-life

Lipid solubility

All of the above

Week 2 Assignment 2 Quiz

1. Question :A patient’s nutritional intake and lab work reflect hypoalbuminemia. This is critical to prescribing because:

Distribution of drugs to target tissue may be affected

The solubility of the drug will not match the site of absorption

There will be less free drug available to generate an effect

Drugs bound to albumin are readily excreted by the kidney

Question 2. Drugs that have a significant first-pass effect:

Must be given by the enteral (oral) route only

Bypass the hepatic circulation

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

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

Question 3. An advantage of prescribing a sublingual medication is that the medication is:

Absorbed rapidly

Excreted rapidly

Metabolized minimally

Distributed equally

Question 4. Which one of the following statements about bioavailability is true?

Bioavailability issues are especially important for drugs with narrow therapeutic ranges or sustained release mechanisms.

All brands of a drug have the same bioavailability.

Drugs that are administered more than once a day have greater bioavailability than drugs given once daily.

Combining an active drug with an inert substance does not affect bioavailability.

Question 5. The route of excretion of a volatile drug will likely be:

The kidneys

The lungs

The bile and feces

The skin

Question 6. The time required for the amount of drug in the body to decrease by 50% is called:

Steady state

Half-life

Phase II metabolism

Reduced bioavailability time

Question 7. The elderly are at high risk of ADRs due to:

Having greater muscle mass than younger adults, leading to higher volume of distribution

The extensive studies that have been conducted on drug safety in this age group

The blood-brain barrier being less permeable, requiring higher doses to achieve therapeutic effect

Age-related decrease in renal function

Question 8. Patient education regarding prescribed medication includes:

Instructions written at the high school reading level

Discussion of expected ADRs

How to store leftover medication such as antibiotics

Verbal instructions always in English

Question 9. Pharmacokinetic factors that affect prescribing include:

Therapeutic index

Minimum effective concentration

Bioavailability

Ease of titration

Question 10. Drugs that use CYP3A4 isoenzymes for metabolism may:

Induce the metabolism of another drug

Inhibit the metabolism of another drug

Both A and B

Neither A nor B

Week 3 Assignment 2 Quiz

Question 1.Ray has been diagnosed with hypertension, and an ACE inhibitor is determined to be needed. Prior to prescribing this drug, the nurse practitioner should assess for:

Hypokalemia

Impotence

Decreased renal function

Inability to concentrate

Question 2. A potentially life-threatening adverse response to ACE inhibitors is angioedema. Which of the following statements is true about this adverse response?

Swelling of the tongue and hoarseness are the most common symptoms.

It appears to be related to a decrease in aldosterone production.

The presence of a dry, hacky cough indicates a high risk for this adverse response.

Because it takes time to build up a blood level, it occurs after being on the drug for about one week.

Question 3. Rodrigo has been prescribed procainamide after an episode of MI. He is monitored for dyspnea, jugular venous distention, and peripheral edema because they may indicate:

Widening of the area of infarction

Onset of congestive heart failure

An electrolyte imbalance involving potassium

Renal dysfunction

Question 4. Which of the following is true about procainamide and its dosing schedule?

It produces bradycardia and should be used cautiously in patients with cardiac conditions that a slower heart rate might worsen.

GI adverse effects are common, so the drug should be taken with food.

Adherence can be improved by using a sustained-release formulation that can be given once daily.

Doses of this drug should be taken evenly spaced around the clock to keep an even blood level.

Question 5. Furosemide is added to a treatment regimen for heart failure, which includes digoxin. Monitoring for this combination includes:

Hemoglobin

Serum potassium

Blood urea nitrogen

Serum glucose

Question 6. Art is a fifty-five-year-old smoker who has been diagnosed with angina and placed on nitrates. He complains of headaches after using his nitrate. An appropriate reply might be:

“This is a parasympathetic response to the vasodilating effects of the drug.”

“Headaches are common side effects with these drugs. How severe are they?”

“This is associated with your smoking. Let’s work on having you stop smoking.”

“This is not related to your medication. Are you under a lot of stress?”

Question 7. Donald has been diagnosed with hyperlipidemia. On the basis of his lipid profile, atorvastatin is prescribed. Rhabdomyolysis is a rare but serious adverse response to this drug. Donald should be told to:

Become a vegetarian since this disorder is associated with eating red meat

Stop taking the drug if abdominal cramps and diarrhea develop

Report muscle weakness or tenderness and dark urine to his provider immediately

Expect “hot flash” sensations during the first two weeks of therapy

Question 8.

Which of the following classes of drugs is contraindicated in heart failure?

Nitrates

Long-acting dihydropyridines

Calcium channel blockers

Alpha-beta blockers

Question 9. First-line therapy for hyperlipidemia is:

Statins

Niacin

Lifestyle changes

Bile acid-binding resins

Question 10. Patients who are being treated for folate deficiency require monitoring of:

Complete blood count every four weeks

Hematocrit and hemoglobin at one week and then at eight weeks

Reticulocyte count at one week

Folate levels every four weeks until the hemoglobin stabilizes

Week 4 Assignment 2 Quiz

1. Question : Many patients self-medicate with antacids. Which patients should be counseled to not take calcium carbonate antacids without discussing with their providers or a pharmacist first?

Patients with kidney stones

Pregnant patients

Patients with heartburn

Postmenopausal women

Question 2. A patient with a COPD exacerbation may require:

Doubling of inhaled corticosteroid dose

Systemic corticosteroid burst

Continuous inhaled beta 2 agonists

Leukotriene therapy

Question 3.

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

Montelukast twice a day is started when there is an asthma exacerbation.

Patients may experience weight gain on montelukast.

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

Lethargy and hypersomnia may occur when taking montelukast.

Question 4.

Lifestyle changes are the first step in the treatment of GERD. A food that may aggravate GERD is:

Eggs

Honey Dew

Chocolate

Chicken

Question 5. Kelly has diarrhea and is wondering if she can take loperamide (Imodium) for the diarrhea. Loperamide:

Can be given to patients of all ages, including infants and children, for viral gastroenteritis

Slows gastric motility and reduces fluid and electrolyte loss from diarrhea

Is the treatment of choice for the diarrhea associated with E. coli 0157

May be used in pregnancy and by lactating women

Question 6.

Patients with allergic rhinitis may benefit from a prescription of:

Fluticasone (Flonase)

Cetirizine (Zyrtec)

OTC cromolyn nasal spray (Nasalcrom)

Any of the above

Question 7.

When treating a patient using the “step-down” approach, the patient with GERD is started on ____ first.

antacids

histamine 2 receptor antagonists

prokinetics

PPIs

Question 8.

Cough and cold medications that contain a sympathomimetic decongestant such as phenylephrine should be used cautiously in what population?

Older adults

Hypertensive patients

Infants

All of the above

Question 9. Josie is a five-year-old who presents to the clinic with a forty-eight-hour history of nausea, vomiting, and some diarrhea. She is unable to keep fluids down, and her weight is 4 pounds less than her last recorded weight. Besides intravenous (IV) fluids, her exam warrants the use of an antinausea medication. Which of the following would be the appropriate drug to order for Josie?

Prochlorperazine (Compazine)

Meclizine (Antivert)

Promethazine (Phenergan)

Ondansetron (Zofran)

Question 10. Patients with pheochromocytoma should avoid which of the following classes of drugs due to the possibility of developing hypertensive crisis?

Expectorants

Beta 2 agonists

Antitussives

Antihistamines

Week 5 Assignment 2 Quiz

1. Question : Jake, a forty-five-year-old patient with schizophrenia, was recently hospitalized for acute psychosis due to medication noncompliance. He was treated with intramuscular (IM) long-acting haloperidol. Besides being monitored for his schizophrenia symptoms, the patient should be assessed by his primary care provider:

For excessive weight loss

With the Abnormal Involuntary Movement Scale (AIMS) for extrapyramidal symptoms (EPS) symptoms

Monthly for tolerance to the haloperidol

Only by the mental health provider as most nurse practitioners in primary care do not care for mentally ill patients

Question 2 Sarah, a forty-two-year-old female, requests a prescription for an anorexiant to treat her obesity. A trial of phentermine is prescribed. Prescribing precautions include understanding that:

Obesity is a contraindication to prescribing phentermine.

Anorexiants may cause tolerance and should only be prescribed for six months.

Patients should be monitored for postural hypotension.

Renal function should be monitored closely while the patient is on anorexiants.

Question 3. Cara is taking levetiracetam (Keppra) to treat seizures. Routine education for levetiracetam includes reminding her:

To not abruptly discontinue levetiracetam due to the risk of withdrawal seizures

To wear a sunscreen due to photosensitivity from levetiracetam

To get an annual eye exam while on levetiracetam

To report weight loss if it occurs

Question 4. A nineteen-year-old male was started on risperidone. Monitoring for risperidone includes observing for common side effects, including:

Bradykinesia, akathisia, and agitation

Excessive weight gain

Hypertension

Potentially fatal agranulocytosis

Question 5. Prior to starting antidepressants, patients should have laboratory testing to rule out:

Hypothyroidism

Anemia

Diabetes mellitus

Low estrogen levels

Question 6. An appropriate first-line drug to try for mild to moderate generalized anxiety disorder would be:

Alprazolam (Xanax)

Diazepam (Valium)

Buspirone (Buspar)

Amitriptyline (Elavil)

Question 7. Monitoring for a child on methylphenidate for ADHD includes:

ADHD symptoms

Routine height and weight checks

Amount of methylphenidate being used

All of the above

Question 8. Six-year-old Lucy has recently been started on ethosuximide (Zarontin) for seizures. She should be monitored for:

Increased seizure activity as this drug may auto-induce seizures

Altered renal function, including renal failure

Blood dyscrasias, which are uncommon but possible

CNS excitement, leading to insomnia

Question 9. An appropriate first-line drug for the treatment of depression with fatigue and low energy would be:

Venlafaxine (Effexor)

Escitalopram (Lexapro)

Buspirone (Buspar)

Amitriptyline (Elavil)

Question 10. Cecilia presents with depression associated with complaints of fatigue, sleeping all the time, and lack of motivation. An appropriate initial antidepressant for her would be:

Fluoxetine (Prozac)

Paroxetine (Paxil)

Amitriptyline (Elavil)

Duloxetine (Cymbalta)

Week 6 Assignment 2 Quiz

1.Question : Xi, a fifty-four-year-old female, has a history of migraine that does not respond well to OTC migraine medication. She is asking to try Maxalt (rizatriptan) because it works well for her friend. Which of the following actions would you take for appropriate decision making?

Prescribe Maxalt, but to monitor the use, only give her four tablets with no refills.

Prescribe Maxalt and arrange to have her observed in the clinic or urgent care with the first dose.

Explain that rizatriptan is not used for postmenopausal migraines and recommend Fiorinal (aspirin and butalbital).

Prescribe sumatriptan (Imitrex) with the explanation that it is the most effective triptan.

Question 2. Chronic pain is a complex problem. Some specific strategies to deal with it include ________.

telling the patient to “let pain be your guide” to using treatment therapies

prescribing pain medication on a pro re nata (PRN) basis to keep down the amount used

scheduling return visits on a regular basis rather than waiting for poor pain control to drive the need for an appointment

All the given options

Question 3. Phil is starting treatment with febuxostat (Uloric). Education of patients starting febuxostat includes which one of the following instructions?

Gout may worsen with therapy.

Febuxostat may cause severe diarrhea.

The patients should consume a high-calcium diet.

The patients will need frequent CBC monitoring.

Question 4. The Pain Management Contract is most appropriate for:

Patients with a history of chemical dependency or possible inappropriate use of pain medications

All patients with chronic pain who will require long-term use of opiates

Patients who have a complex drug regimen

Patients who see multiple providers for pain control

Question 5. Patients whose total dose of prednisone exceed 1 gram will most likely need a second prescription for _________.

metformin, a biguanide to prevent diabetes

omeprazole, a proton pump inhibitor to prevent peptic ulcer disease

naproxen, an NSAID to treat joint pain

furosemide, a diuretic to treat fluid retention

Question 6. Sallie has been taking 10 mg of prednisone per day for the past six months. She should be assessed for ________.

gout

iron deficiency anemia

osteoporosis

renal dysfunction

Question 7. All NSAIDs have an FDA black box warning regarding __________.

potential for causing life-threatening GI bleeds

increased risk of developing systemic arthritis with prolonged use

risk of life-threatening rashes, including Stevens-Johnson

potential for transient changes in serum glucose

Question 8. Which of the following statements is true about age and pain?

Use of drugs that depend heavily on the renal system for excretion may require dosage adjustments in very young children.

Among the NSAIDs, indomethacin is the preferred drug because of lower adverse effects profiles than other NSAIDs.

Older adults who have dementia probably do not experience much pain due to loss of pain receptors in the brain.

Acetaminophen is especially useful in both children and adults because it has no effect on platelets and has fewer adverse effects than NSAIDs.

Question 9. Kirk sprained his ankle and is asking for pain medication for his mild-to-moderate pain. The appropriate first-line medication would be __________.

ibuprofen (Advil)

acetaminophen with hydrocodone (Vicodin)

oxycodone (OxyContin)

oral morphine (Roxanol)

Question 10. Patients who are on or who will be starting chronic corticosteroid therapy need monitoring of __________.

serum glucose

stool culture

folate levels

vitamin B12

Week 7 Assignment 2 Quiz

1.Question :

A twenty-two-year-old woman receives a prescription for oral contraceptives. Education for this patient includes:

Counseling regarding decreasing or not smoking while taking oral contraceptives

Advising a monthly pregnancy test for the first three months she is taking the contraceptive

Advising that she may miss two pills in a row and not be concerned about pregnancy

Informing her that her next follow-up visit is in one year for a refill and “annual exam”

Question 2. Sallie has been diagnosed with osteoporosis and is asking about the once-a-month pill to treat her condition. How do bisphosphonates treat osteoporosis?

By selectively activating estrogen pathways in the bone

By reducing bone resorption by inhibiting PTH

By reducing bone resorption and inhibiting osteoclastic activity

By increasing PTH production

Question 3. Elderly patients who are started on levothyroxine for thyroid replacement should be monitored for:

Excessive sedation

Tachycardia and angina

Weight gain

Cold intolerance

Question 4. Intranasal calcitonin is used in the treatment of osteoporosis. For which patient is Calcitonin therapy appropriate?

Thin, Caucasian perimenopausal women

Men over the age of sixty-five years with osteoporosis

Women over the age of sixty-five years with osteopenia

Women over the age of sixty-five years with severe osteoporosis

Question 5. The ongoing monitoring of patients over the age sixty-five years taking alendronate (Fosamax) or any other bisphosphonate is:

Annual dual energy X-ray absorptiometry (DEXA) scans

Annual vitamin D level

Annual renal function evaluation

Electrolytes every three months

Question 6. When starting a patient with hypothyroidism on thyroid replacement hormones, patient education would include the following:

He or she should feel symptomatic improvement in one to two weeks.

Drug-related adverse effects such as lethargy and dry skin may occur.

It may take four to eight weeks to get to euthyroid symptomatically and by lab testing.

Due to the short half-life of levothyroxine, its doses should not be missed.

Question 7. Medroxyprogesterone (Depo Provera) injection has an US Food and Drug Administration (FDA) black box warning due to:

Development of significant hypertension

Increased risk of strokes when on Depo

Decreased bone density while on Depo

Risk of life-threatening rash such as Stevens-Johnson

Question 8. A woman who has migraine with aura:

Should not be prescribed estrogen due to the interaction between triptans and estrogen, limiting migraine therapy choices

Should not be prescribed estrogen due to an increased incidence of migraines with the use of estrogen

Should not be prescribed estrogen due to an increased risk of stroke occurring with estrogen use

May be prescribed estrogen without any concerns

Question 9. The drug recommended as primary prevention of osteoporosis in women over seventy years old is:

Alendronate (Fosamax)

Ibandronate (Boniva)

Calcium carbonate

Raloxifene (Evista)

Question 10. The drug recommended as primary prevention of osteoporosis in men over seventy years is:

Alendronate (Fosamax)

Ibandronate (Boniva)

Calcium carbonate

Raloxifene (Evista)

Week 8 Assignment 2 Quiz

1.Question :

When blood glucose levels are difficult to control in type II diabetes, some form of insulin may be added to the treatment regimen to control blood glucose and limit complications risks. Which of the following statements are accurate based on research?

Premixed insulin analogues are better at lowering hemoglobin A1c and have less risk for hypoglycemia.

Premixed insulin analogues and the newer premixed insulins are associated with more weight gain than the oral antidiabetic agents.

Newer premixed insulins are better at lowering hemoglobin A1c and postprandial glucose levels than are long-acting insulins.

Patients who are not controlled on oral agents and have postprandial hyperglycemia can have NPH insulin added at bedtime.

Question 2. Lispro is an insulin analogue produced by recombinant deoxyribonucleic acid (DNA) technology. Which of the following statements about this form of insulin is not true?

The optimal time of preprandial injection is fifteen minutes.

The duration of action is increased when the dose is increased.

It is compatible with NPH insulin.

It has no pronounced peak.

Question 3. Unlike most type II diabetics where obesity is a major issue, older adults with low body weight have higher risks for morbidity and mortality. The most reliable indicator of poor nutritional status in older adults is:

Weight loss in previously overweight persons

Involuntary loss of 10% of body weight in less than six months

Decline in lean body mass over a twelve-month period

Increase in central versus peripheral body adiposity

Question 4. Sulfonylureas may be added to a treatment regimen for type II diabetics when lifestyle modifications and metformin are insufficient to achieve target glucose levels. Sulfonylureas have been moved to Step 2 therapy because they:

Increase endogenous insulin secretion.

Have a significant risk for hypoglycemia.

Address the insulin resistance found in type II diabetics.

Improve insulin binding to receptors.

Question 5. The drugs recommended by the American Academy of Pediatrics for use in children with diabetes (depending upon type of diabetes) are:

Metformin and insulin

Sulfonylureas and insulin glargine

Split-mixed dose insulin and GLP-1 agonists

Biguanides and insulin lispro

Question 6. Nonselective beta blockers and alcohol create serious drug interactions with insulin because they:

Increase blood glucose levels.

Produce unexplained diaphoresis.

Interfere with the ability of the body to metabolize glucose.

Mask the signs and symptoms of altered glucose levels.

Question 7. Diagnostic criteria for diabetes include:

Fasting blood glucose greater than 140 mg/dl on two occasions

Postprandial blood glucose greater than 140 mg/dl

Fasting blood glucose 100 to 125 mg/dl on two occasions

Symptoms of diabetes plus a casual blood glucose greater than 200 mg/dl

Question 8. Adam has type I diabetes and plays tennis for his university. He exhibits a knowledge deficit about his insulin and his diagnosis. He should be taught that:

He should increase his CHO intake during times of exercise.

Each brand of insulin is equal in bioavailability, so buy the least expensive.

Alcohol produces hypoglycemia and can help control his diabetes when taken in small amounts.

If he does not want to learn to give himself injections, he may substitute an oral hypoglycemic to control his diabetes.

Question 9. Both ACE inhibitors and some angiotensin-II receptor blockers have been approved in treating:

Hypertension in diabetic patients

Diabetic nephropathy

Both A and B

Neither A nor B

Question 10. Before prescribing metformin, the provider should:

Draw a serum creatinine level to assess renal function.

Try the patient on insulin.

Prescribe a thyroid preparation if the patient needs to lose weight.

All of the above options are .

Week 9 Assignment 3 Quiz

Question 1. Jonathan has been diagnosed with strep throat and needs a prescription for an antibiotic. He says the last time he had penicillin he developed a red, blotchy rash. The appropriate antibiotic to prescribe would be:

Penicillin VK, since his rash does not sound like a serious rash

Amoxicillin

Cefadroxil (Duricef)

Erythromycin

Question 2. Tetracyclines are contraindicated in children younger than 8 years because of:

Risk of developing cartilage problems

Development of significant diarrhea

Risk of kernicterus

Adverse effects on bone growth

Question 3. Lisa is a healthy non-pregnant adult woman who recently had a UTI. She is asking about drinking cranberry juice to prevent a recurrence of the UTI. The answer to give her would be:

“Sixteen ounces per day of cranberry juice cocktail will prevent UTIs.”

“100% cranberry juice or cranberry juice extract may decrease UTIs in some patients.”

“There is no evidence that cranberry juice helps prevent UTIs.”

“Cranberry juice only works to prevent UTIs in children.”

Question 4. Rose is a 3 year old with an upper respiratory infection (URI). Treatment for her URI would include:

Amoxicillin

Diphenhydramine

Pseudoephedrine

Nasal saline spray

Question 5. Patient education for a patient who is prescribed antibiotics for sinusitis includes:

Use of nasal saline washes

Use of inhaled corticosteroids

Avoiding the use of ibuprofen while ill

Use of laxatives to treat constipation

Question 6. Patients who should be cautious about using decongestants for an upper respiratory infection include:

School-age children

Patients with asthma

Patients with cardiac disease

Patients with allergies

Question 7. Janet was recently treated with clindamycin for an infection. She calls the advice nurse because she is having frequent diarrhea that she thinks may have blood in it. What would be the appropriate care for her?

Encourage increased fluids and fiber

Assess for pseudomembranous colitis

Advise her to eat yogurt daily to help restore her gut bacteria

Start her on an antidiarrheal medication

Question 8. To prevent further development of antibacterial resistance it is recommended fluoroquinolones be reserved for treatment of:

Urinary tract infections in young women

Upper respiratory infections in adults

Skin and soft tissue infections in adults

Community-acquired pneumonia in patients with comorbidities

Question 9. Nicole is a 4-year-old female with a febrile urinary tract infection. She is generally healthy and has no drug allergies. Appropriate initial therapy for her UTI would be:

Azithromycin

Trimethoprim/sulfamethoxazole

Ceftriaxone

Ciprofloxacin

Question 10. Sally is a 16-year-old female with a urinary tract infection. She is healthy, afebrile, with no use of antibiotics in the previous 6 months and no drug allergies. An appropriate first-line antibiotic choice for her would be:

Azithromycin

Trimethoprim/sulfamethoxazole

Ceftriaxone

Levofloxacin

Week 10 Assignment 2 Final Exam

1. Question :

The drug recommended as primary prevention of osteoporosis in men over seventy years is:

Alendronate (Fosamax)

Ibandronate (Boniva)

Calcium carbonate

Raloxifene (Evista)

Question 2. Question :

Alterations in drug metabolism among Asians may lead to:

Slower metabolism of antidepressants, requiring lower doses

Faster metabolism of neuroleptics, requiring higher doses

Altered metabolism of omeprazole, requiring higher doses

Slower metabolism of alcohol, requiring higher doses

Question 3. Question :

Some research supports that testosterone replacement therapy may be indicated in which of the following diagnoses in men?

Age-related decrease in cognitive functioning

Metabolic syndrome

Decreased muscle mass in aging men

All of the above

Question 4. Question :

The chemicals that promote the spread of pain locally include _________.

serotonin

norepinephrine

enkephalin

neurokinin A

Question 5. Question :

The DEA:

Registers manufacturers and prescribes controlled substances

Regulates NP prescribing at the state level

Sanctions providers who prescribe drugs off-label

Provides prescribers with a number they can use for insurance billing

Question 6. Question :

The trial period to determine effective anti-inflammatory activity when starting a patient on aspirin for RA is _____.

forty-eight hours

four to six days

four weeks

two months

Question 7. Question :

The route of excretion of a volatile drug will likely be:

The kidneys

The lungs

The bile and feces

The skin

Question 8. Question :

Compelling indications for an ACE inhibitor as treatment for hypertension based on clinical trials include:

Pregnancy

Renal parenchymal disease

Stable angina

Dyslipidemia

Question 9. Question :

The American Diabetic Association has recommended which of the following tests for ongoing management of diabetes?

Fasting blood glucose

Hemoglobin A1c

Thyroid function tests

Electrocardiograms

Question 10. Question :

The angiotensin converting enzyme (ACE) inhibitor lisinopril is a known teratogen. Teratogens cause Type ____ ADR.

A

B

C

D

Question 11. Question :

The goals of therapy when prescribing HRT include reducing:

Cardiovascular risk

Risk of stroke or other thromboembolic event

Breast cancer risk

Vasomotor symptoms

Question 12. Question :

Patients who have angina, regardless of class, who are also diabetic should be on:

Nitrates

Beta blockers

ACE inhibitors

Calcium channel blockers

Question 13. Question :

The New York Heart Association and the Canadian Cardiovascular Society have described grading criteria for levels of angina. Angina that occurs with unusually strenuous activity or on walking or climbing stair after meals is:

Class I

Class II

Class III

Class IV

Question 14. Question :

Patients with allergic rhinitis may benefit from a prescription of:

Fluticasone (Flonase)

Cetirizine (Zyrtec)

OTC cromolyn nasal spray (Nasalcrom)

Any of the above

Question 15. Question :

Kyle has Crohn’s disease and has a documented folate deficiency. Drug therapy for folate deficiency anemia is:

Oral folic acid 1 to 2 mg/day

Oral folic acid 1 gm/day

IM folate weekly for at least six months

Oral folic acid 400 mcg daily

Question 16. Question :

The treatment for vitamin B12 deficiency is:

1,000 mcg daily of oral cobalamin

2 gm/day of oral cobalamin

100 mcg/day vitamin B12 IM

500 mcg/dose nasal cyanocobalamin two sprays once a week

Question 17. Question :

Nonadherence is especially common in drugs that treat asymptomatic conditions, such as hypertension. One way to reduce the likelihood of nonadherence to these drugs is to prescribe a drug that:

Has a short half-life so that missing one dose has limited effect

Requires several dosage titrations so that missed doses can be replaced with lower doses to keep costs down

Has a tolerability profile with less of the adverse effects that are considered “irritating,” such as nausea and dizziness

Must be taken no more than twice a day

Question 18. Question :

Type II diabetes is a complex disorder involving:

Absence of insulin production by the beta cells

A suboptimal response of insulin-sensitive tissues in the liver

Increased levels of GLP in the postprandial period

Too much fat uptake in the intestine

Question 19. Question :

Metformin is a primary choice of drug to treat hyperglycemia in type II 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

Question 20. Question :

Gender differences between men and women in pharmacokinetics include:

More rapid gastric emptying so that drugs absorbed in the stomach have less exposure to absorption sites

Higher proportion of body fat so that lipophilic drugs have relatively greater volumes of distribution

Increased levels of bile acids so that drugs metabolized in the intestine have higher concentrations

Slower organ blood flow rates so that drugs tend to take longer to be excreted

Question 21. Question :

If not chosen as the first drug in hypertension treatment, which drug class should be added as the second step because it will enhance the effects of most other agents?

ACE inhibitors

Beta blockers

Calcium channel blockers

Diuretics

Question 22. Question :

A nineteen-year-old male was started on risperidone. Monitoring for risperidone includes observing for common side effects, including:

Bradykinesia, akathisia, and agitation

Excessive weight gain

Hypertension

Potentially fatal agranulocytosis

Question 23. Question :

Levetiracetam has known drug interactions with:

Oral contraceptives

Carbamazepine

Warfarin

Few, if any, drugs

Question 24. Question :

When the total daily insulin dose is split and given twice daily, which of the following rules may be followed?

Give two-thirds of the total dose in the morning and one-third in the evening.

Give 0.3 units/kg of premixed 70/30 insulin, with one-third in the morning and two-thirds in the evening.

Give 50% of an insulin glargine dose in the morning and 50% in the evening.

Give long-acting insulin in the morning and short-acting insulin at bedtime.

Question 25. Question :

Which of the following factors may adversely affect a patient’s adherence to a therapeutic drug regimen?

Complexity of the drug regimen

Patient’s perception of the potential adverse effects of the drugs

Both A and B

Neither A nor B

ter the first trimester if necessary.

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