NSG 3036 Week 1 Quiz (Ch 1,3,4,5,6,7)
- A client asks the NP about the differences in drug effects between men and women. What is known about the differences between the pharmacokinetics of men and women?
- Factors in chronic conditions that contribute to nonadherence include:
- James has hypothalamic-pituitary-adrenal axis suppression from chronic prednisone (a corticosteroid) use. He is at risk for what type of adverse drug reaction?
- Many disorders require multiple drugs to treat them. The more complex the drug regimen, the less likely the patient will adhere to it. Which of the following interventions will NOT improve adherence?
- Off-label prescribing is:
- Passive monitoring of drug effectiveness includes:
- Pharmaceutical promotion may affect prescribing. To address the impact of pharmaceutical promotion, the following recommendations have been made by the Institute of Medicine:
- Pharmacologic interventions are costly. Patients for whom the cost/benefit variable is especially important include:
- Rod, age 68, has hearing difficulty. Which of the following would NOT be helpful in assuring that he understands teaching about his drug?
- Sarah developed a rash after using a topical medication. This is a type __ allergic drug reaction.
- The benefits to the patient of having an Advanced Practice Registered Nurse (APRN) prescriber include:
- The National Standards of Culturally and Linguistically Appropriate Services are required to be implemented in all:
- The U.S. Drug Enforcement Administration:
- The U.S. Food and Drug Administration approval is required for:
- The U.S. Food and Drug Administration MedWatch system is activated when:
- The U.S. Food and Drug Administration regulates:
- When determining drug treatment the NP prescriber should:
- Which of the following factors may adversely affect a patient’s adherence to a therapeutic drug regimen?
- Which of the following patients would be at higher risk of experiencing adverse drug reactions (ADRs):
- While patient education about their drugs is important, information alone does not necessarily lead to adherence to a drug regimen. Patients report greater adherence when:
NSG 3036 Week 3 Quiz
- Azithromycin dosing requires that the first day’s dosage be twice those of the other 4 days of the prescription. This is considered a loading dose. A loading dose:
- Steady state is:
- Medroxyprogesterone (Depo Provera) is prescribed intramuscularly (IM) to create a storage reservoir of the drug. Storage reservoirs:
- The NP chooses to give cephalexin every 8 hours based on knowledge of the drug’s:
- The point in time on the drug concentration curve that indicates the first sign of a therapeutic effect is the:
- The time required for the amount of drug in the body to decrease by 50% is called:
- A genetic variation in how the metabolite of the cancer drug irinotecan SN-38 is inactivated by the body may lead to:
- Inhibition of P-glycoprotein by a drug such as quinidine may lead to:
- Rifampin is a nonspecific CYP450 inducer that may:
- Warfarin resistance may be seen in patients with VCORC1 mutation, leading to:
- Carbamazepine has a Black Box Warning recommending testing for the HLA-B*1502 allele in patients with Asian ancestry prior to starting therapy due to:
- Up to 21% of Asians are ultra-rapid 2D6 metabolizers, leading to:
13. Data in the electronic health record that the provider reviews prior to a patient encounter varies with the clinic setting. In an urgent care clinic, the provider should review:
14. Factors that facilitate keeping patient information confidential in an electronic health record (EHR) system include:
15. Which of the following is a primary benefit of the use of computerized provider order entry for patient medications?
16. You are going to prescribe a drug and the electronic health record (EHR) alerts you that there is a potential drug-drug interaction. The alert is generated by:
17. Indirect costs associated with drug therapy include:
18. Mary has a two-tiered prescription benefit plan, which means:
19. Pharmacoeconomics is:
20. The “donut hole” in Medicare Part D:
NSG 3036 Week 4 Midterm Exam
1. Hepatitis B immune globulin is administered to provide passive immunity to:
2.Hepatitis B vaccine is contraindicated in patients who:
3. Human papillomavirus (HPV) vaccine (Gardasil, Cervarix):
4. Live attenuated influenza vaccine (FluMist) may be administered to:
5. Pregnant women should receive the Tdap vaccine:
6. Rho(D) immune globulin (RhoGAM) is given to:
7. The MMR vaccine is not recommended for pregnant women because:
8. The rotavirus vaccine (RotaTeq, Rotarix):
9. True contraindications to diphtheria, tetanus, and acellular pertussis (DTaP or Tdap) vaccine include:
10. Tuberculin purified protein derivative:
11. Factors that place a patient at risk of developing an antimicrobial-resistant organism include:
12. Fluoroquinolones have a Black Box Warning regarding ________ even months after treatment.
13. Jamie has glucose-6-phosphate dehydrogenase deficiency (G6PD) and requires an antibiotic. Which class of antibiotics should be avoided in this patient?
14. 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?
15. 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. An appropriate antibiotic to prescribe would be:
16. Lauren is a 13-year-old child who comes to clinic with a 4-day history of cough, low-grade fever, and rhinorrhea. When she blows her nose or coughs the mucous is greenish-yellow. The appropriate antibiotic to prescribe would be:
17. Patricia has been prescribed doxycycline for a chlamydia infection. She is healthy and her only medication is an oral combined contraceptive. Patricia’s education would include:
18. Providers should use an antibiogram when prescribing. An antibiogram is:
19. Tetracyclines should not be prescribed to children younger than 8 years due to:
20. Predictors for successful treatment with antiretroviral therapy (ART) in HIV-positive patients include:
21. The Combat Methamphetamine Epidemic Act, which is part of the 2006 U.S. Patriot Act:
22. When obtaining a drug history from Harold, he gives you a complete list of his prescription medications. He denies taking any other drugs, but you find that he occasionally takes aspirin for his arthritis flare ups. This is an example of:
23. When prescribing a tetracycline or quinolone antibiotic it is critical to instruct the patient:
24. Decongestants such as pseudoephedrine (Sudafed):
25. Harold, a 42-year-old African American, has moderate persistent asthma. Which of the following asthma medications should be used cautiously, if at all?
26. Long-acting beta-agonists (LTBAs) received a Black Box Warning from the U.S. Food and Drug Administration due to the:
27. The first-line treatment for cough related to an upper respiratory tract infection (URI) in a 5-year-old child is:
28. When educating patients who are starting on inhaled corticosteroids, the provider should tell them that:
29. When prescribing montelukast (Singulair) for asthma, patients or parents of patients should be instructed:
30. Education for patients who use an inhaled beta-agonist and an inhaled corticosteroid includes:
31. The first-line therapy for mild-persistent asthma is:
32. Treatment for mild intermittent asthma is:
33. Giselle is a 14-year-old patient who presents to the clinic with symptoms consistent with mycoplasma pneumonia. What is the treatment for suspected mycoplasma pneumonia in an adolescent?
34. The first-line antibiotic choice for a patient with comorbidities or who is immunosuppressed who has pneumonia and can be treated as an outpatient would be:
35. If prescribing bupropion (Zyban) for tobacco cessation, the instructions to the patient include:
36. Varenicline (Chantix) may be prescribed for tobacco cessation. Instructions to the patient who is starting varenicline include:
37. Ezekiel is a 9-year-old patient who lives in a household with a family member newly diagnosed with tuberculosis (TB). To prevent Ezekiel from developing TB he should be treated with:
38. Isabella has confirmed tuberculosis and is placed on a 6-month treatment regimen. The 6-month regimen consists of:
39. A child that may warrant “watchful waiting” instead of prescribing an antibiotic for acute otitis media includes patients who:
40. First-line therapy for a patient with acute otitis externa (swimmer’s ear) and an intact tympanic membrane includes:
NSG 3036 Week 5 QUIZ
1. Elderly patients who are started on levothyroxine for thyroid replacement should be monitored for:
2. Patients with cystic fibrosis are often prescribed enzyme replacement for pancreatic secretions. Each replacement drug has lipase, protease, and amylase components, but the drug is prescribed in units of:
3. Potentially fatal granulocytopenia has been associated with treatment of hyperthyroidism with propylthiouracil. Patients should be taught to report:
4. Prior to prescribing metformin, the provider should:
5. The decision may be made to switch from twice daily neutral protamine Hagedorn (NPH) insulin to insulin glargine to improve glycemia control throughout the day. If this is done:
6. Bart is a 67-year-old male with T2 DM. He is on glipizide and metformin. He presents to the clinic with confusion, sluggishness, and extreme thirst. His wife tells you Bart does not follow his meal plan or exercise regularly, and hasn’t checked his BG for 1 week. A random glucose is drawn and it is 500. What is a likely diagnosis based on preliminary assessment? (HINT: see article NIH in Moodle)
7. Both angiotensin converting enzyme inhibitors and some angiotensin II receptor blockers have been approved in treating:
8. Drugs used to treat diabetic peripheral neuropathy include:
9. Insulin is used to treat both types of diabetes. It acts by:
10. Insulin preparations are divided into categories based on onset, duration, and intensity of action following subcutaneous injection. Which of the following insulin preparations has the shortest onset and duration of action?
11. A patient on metformin and glipizide arrives at her 11:30 a.m. clinic appointment diaphoretic and dizzy. She reports taking her medication this morning and ate a bagel and coffee for breakfast. BP is 110/70 and random finger-stick glucose is 64. How should this patient be treated?
12. Sulfonylureas may be added to a treatment regimen for type 2 diabetics when lifestyle modifications and metformin are insufficient to achieve target glucose levels. Sulfonylureas have been moved to Step 2 therapy because they:
13. The drugs recommended by the American Academy of Pediatrics for use in children with diabetes (depending upon type of diabetes) are:
14. The drugs recommended for older adults with type 2 diabetes include:
15. When the total daily insulin dose is split and given twice daily, which of the following rules may be followed?
17. In hyperthyroid states, what organ system other than CV must be evaluated to establish potential adverse issues?
18. Infants with congenital hypothyroidism are treated with:
19. What happens to the typical thyroid hormone replacement dose when a woman becomes pregnant?
20. When starting a patient with hypothyroidism on thyroid replacement hormones patient education would include:
NSG 3036 Week 6
1. A patient with a new onset of systolic ejection murmur should be assessed for which nutritional deficiency?
2. Adequate vitamin D is needed for:
3. Food can alter the pH of the stomach, leading to:
4. It is reasonable to add ___________ to a Helicobacter pylori treatment regimen to improve eradication rates of H. pylori.
5. Pregnant patients who are taking isoniazid (INH) should take 25 mg/day of vitamin B6 (pyridoxine) to prevent:
6. The American Heart Association and the American Dietetic Association recommend a minimum daily fiber intake of ______ for cardiovascular health:
7. A thorough understanding of herbs is critical to patient safety. An example is the use of cinnamon to treat type II diabetes. It is important the patient uses Ceylon cinnamon, as the commercially available cassia cinnamon contains:
8. Herbs and supplements are regulated by the U.S. Food and Drug Administration.
9. Patients need to be instructed regarding the drug interactions with St John’s wort, including:
10. When melatonin is used to induce sleep, the recommendation is that the patient:
11. An elderly person has been prescribed lactulose for treatment of chronic constipation. Monitoring with long-term treatment would include:
12. Bismuth subsalicylate (Pepto Bismol) is a common OTC remedy for gastrointestinal complaints. Bismuth subsalicylate:
13. Josie is a 5-year-old patient who presents to the clinic with a 48-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 IV fluids, her exam warrants the use of an antinausea medication. Which of the following would be the appropriate drug to order for Josie?
14. Patients taking antacids should be educated regarding these drugs, including letting them know that:
15. Sadie is a 72-year-old patient who takes omeprazole for her chronic GERD. Chronic long-term omeprazole use places her at increased risk for:
16. An acceptable first-line treatment for peptic ulcer disease with positive H. pylori test is:
17. Gastroesophageal reflux disease may be aggravated by the following medication that affects lower esophageal sphincter (LES) tone:
18. If a patient with symptoms of gastroesophageal reflux disease states that he has been self-treating at home with OTC ranitidine daily, the appropriate treatment would be:
19. Metoclopramide improves gastroesophageal reflux disease symptoms by:
20. The next step in treatment when a patient has been on proton pump inhibitors twice daily for 12 weeks and not improving is:
NSG 3036 Week 7 Quiz
1. Despite good blood pressure control, an NP might change a patient’s drug from an angiotensin-converting enzyme (ACE) inhibitor to an angiotensin II receptor blocker (ARB) because the ARB:
2. Donald has been diagnosed with hyperlipidemia. Based on his lipid profile, atorvastatin is prescribed. Rhabdomyolysis is a rare but serious adverse response to this drug. Donald should be told to:
Report muscle weakness or tenderness and dark urine to his provider immediately.
3. Furosemide is added to a treatment regimen for heart failure that includes digoxin. Monitoring for this combination includes:
4. Isosorbide dinitrate is prescribed for a patient with chronic stable angina. This drug is administered twice daily, but the schedule is 7 a.m. and 2 p.m. because:
5. Ray has been diagnosed with hypertension and an angiotensin-converting enzyme inhibitor is determined to be needed. Prior to prescribing this drug, the NP should assess for:
6. Rodrigo has been prescribed procainamide after a myocardial infarction. He is monitored for dyspnea, jugular venous distention, and peripheral edema because they may indicate:
7. Which of the following adverse effects may occur due to a dihydropyridine-type calcium channel blocker?
8. While taking an angiotensin II receptor blocker (ARB), patients need to avoid certain over-the-counter drugs without first consulting the provider because:
9. Combinations of a calcium channel blocker and a beta blocker are especially effective in treating angina because:
10. Angina is produced by an imbalance between myocardial oxygen supply (MOS) and demand (MOD) in the myocardium. Which of the following drugs help to correct this imbalance by increasing MOS?
11. When is aspirin (ASA) used in angina patients?
12. Increased life expectancy for patients with heart failure has been associated with the use of:
13. Treatments for heart failure, including drug therapy, are based on the stages developed by the ACC/AHA. Stage A patients are treated with:
14. Which of the following classes of drugs are used with considerable caution in heart failure?
15. First-line therapy for hyperlipidemia is:
16. James is a 45-year-old patient with an LDL level of 120 and normal triglycerides. Appropriate first-line therapy for James may include diet counseling, increased physical activity, and:
17. Joanne is a 60-year-old patient with an LDL of 132 and a family history of coronary artery disease. She has already tried diet changes (increased fiber and plant sterols) to lower her LDL and after 6 months her LDL is slightly higher. The next step in her treatment would be:
18. What is considered the order of statin strength from lowest effect to highest?
19. If not chosen as the first drug in hypertension treatment, which drug class should be added as a second step because it will enhance the effects of most other agents?
20. Which of the following disease processes could be made worse by taking a nonselective beta blocker?