MSN 571 PHARM MIDTERM EXAM 1 VERSION 1 (V1) ANSWERS LATEST RATED A+
1. Why are most statins recommended to be taken in the evening?
• Can cause
... [Show More] insomnia
• Decreases stomach upset
• Cholesterol synthesis increases during the night
• Cholesterol synthesis decreases during the night
2. What is the mechanism of action of ezetimibe?
• It inhibits the absorption of bile, thus causing the liver to produce bile from cholesterol.*
• It decreases the adhesion of cholesterol on the arterial walls.
• It inhibits absorption of dietary and biliary cholesterol in the small intestine.
•(option cutoff)
3. Which of the following is not an expected adverse effect of Niacin?
• Arthralgias
• Hyperglycemia
• Itching
• Flushing
4. Which adverse effects would you monitor for a patient receiving a statin tomanage cholesterol levels. Select all that apply.
• Gallstone development
• Increased serum transaminase levels
• Unexplained muscle pain or tenderness *
• Nonalcoholic fatty liver disease *
• Elevated creatinine kinase (CK) level with muscle pain *
5. Which of the following drug classes should be avoided in peptic ulcer disease?
• Avoid diuretics
• Avoid NSAIDS
• Avoid proton pump inhibitors
• Avoid antibiotics
6. Which of the following groups of antibiotics is notable for side effects such as nephrotoxicity and ototoxicity?
• Cephalosporins
• Beta-lactams
• Aminoglycoside
• Tetracyclines
7. Which of the following is most likely an intervention for otitis media?
• Corticosteroids
• Aspirin
• Immunoglobulins
• Amoxicillin
8. Which of the following medications is a fluoroquinolone antibiotic?
• Penicillin
• Azithromycin
• Amikacin
• Ciprofloxacin
9. Which of the following best classifieds aminoglycosides, macrolides, and clindamycin?
• mycolic acid synthesis inhibitors
• protein synthesis inhibitors
• cell wall inhibitors
• folic acid synthesis inhibitors
10. Which of the following groups of antibiotics binds to the 50S subunit of the bacterial ribosome and includes drugs such as erythromycin and azithromycin?
• macrolides
• fluoroquinolones •aminoglycosides
• tetracyclines
11. Which of the following groups of people are at risk for early hypertension?
• African American
• Adolescents or young adults
• Mexican American Culture
Old females
12. Which of the following drug treatment strategies is associated with pepticulcer disease?
• Opioids
• Two antibiotics
• Corticosteroids
• Hormonal therapy
13. Which of the following medications or drug classes is commonly indicatedfor managing gestational hypertension?
• Spironolactone (Aldactone)
• Loop diuretics
• Calcium channel blockers
• Dobutamine
• Calcium gluconate
14. Which antibiotic class disrupts folate metabolism in bacteria and is often combined with trimethoprim?
• cephalosporins
• fluoroquinolones
• Aminoglycosides
• Sulfonamides
• macrolides
15. Convert 15 lbs 8 oz to kilograms. Round to the nearest 100th.
• 7.00
• 34.10
• 33.00
• 7.03
16. A patient receiving intravenous gentamicin has a toxic serum drug level. The prescriber confirms that the dosing is correct. Which possible cause of the situation will the provider explore?
• Whether patient is taking a medication that binds to serum albumin
• Whether a loading dose was administered
• If the ordered dose frequency is longer than the gentamicin half-life
• If the drug was completely dissolved in the IV solution
17. The therapeutic index is a measure of drug:
• Absorption rate
• Safety profile
• Bioavailability status
• Effectiveness
18. Which science provides primary healthcare providers the opportunity to individualize drug therapy based on a patient's genetic makeup?
• Pharmacogenetics
• Pharmacogenomics *
• Pharmacodynamics
• Pharmacokinetics
19. Which of the following is the most appropriate choice to describe age associated changes that can affect pharmacokinetics in older patients?
• Increase in total body water
• Decrease in creatinine clearance
•(option cutoff) •(option cutoff)
20. Drugs that use CYP 3A4 enzymes for metabolism may:
• None of the answers are correct
• Induce the metabolism of another drug
• Inhibit the metabolism of another drug *
• Both induce and inhibit the metabolism of another drug.
21. An example of a first-dose reaction that may occur includes:
• Orthostatic hypotension that does not occur with repeated doses
• Hemolytic anemia from Ceftriaxone use
• Contact dermatitis from neomycin use *
• Purple glove syndrome with phenytoin use
22. Your patient is diagnosed with Psoriasis. You can prescribe all except:
• Methotrexate
• Vitamin E Analogs
• Tars *
• Glucocorticoids
23. Isotretinoin (Accutane) is a drug employed in the treatment of severe recalcitrant cystic acne. Which one of the following is not an adverse effect associated with its use?
Conjunctivitis
Fetal abnormalities
Hyponatremia *
Hypertriglyceridemia
24. A 14-year-old patient has moderate acne that has not responded to topical Which treatment choice will the NP discuss with the patient and parents?
• Doxycycline (vibramycin) *
• Combination oral contraceptive medication
• Spironolactone
• Isotretinoin (Accutane)
25. The renin-angiotensin-aldosterone system plays an important role in maintaining blood pressure. Which compound in this system is most powerful at raising blood pressure?
• Angiotensin III
• Angiotensin II *
• Angiotensin I
• Renin
26. A patient who developed hypertension at 28 weeks gestation age. What medication do you anticipate giving?
• Any one of these medications listed here may be prescribed to a pregnant *
• Methyldopa
• Nifedipine
• Labetalol
27. A patient has been prescribing furosemide for pulmonary edema secondary to congestive heart failure. What should be included in patient teaching instructions?
• Rise Slowly from sitting or reclining positions.
• Report any irregular heartbeat, muscle weakness, or cramping.
• Report any tenderness or swelling of the joints to your healthcare provider.
• All are true *
28. Which calcium channel blocker would be ideally used to treat a dysrhythmia?
Nifedipine
Verapamil *
Amlodipine
Nicardipine
29. A patient has been taking hydrochlorothiazide and lisinopril (Prinzide, Zestoretic) for moderate hypertension. On the following the following signs and symptoms would be most concerned related to this condition?
• Fatigue, weakness, dyspnea when supine
• Anorexia, mild fever, dark urine
• Fatigue, unexplained weight loss, polydipsia
• Dull abdominal pain, anorexia, weight loss *
30. The Nurse Practitioner is teaching the NP student about acetaminophen. Which of the following would be included when teaching the student?
• All of the answers are correct *
• The antidote to acetaminophen overdose is acetylcysteine
• Patients need to watch over-the-counter medications for acetaminophen in the product to prevent overdose
• Patients with normal kidney and liver function should not take more than 4000mg per day.
31. _________ is an example of an agonist-antagonist opioid.
• Morphine
• Buprenorphine
• Naloxone *
• Diprenorphine
32. A 76-year-old female with renal insufficiency presents to the clinic with severe pain secondary to a compression fracture in the lumbar spine. She reports that the pain has been uncontrolled with tramadol, and it is decided to start treatment with an opioid. Which of the following is the best opioid for this patient?
• Fentanyl transdermal patch
• Hydrocodone *
• Meperidine
• Morphine
33. A patient with opioid use disorder has undergone detoxification with buprenorphine.
(option cutoff)
(option cutoff)
“The combination drug contains more buprenorphine”
“Buprenorphine causes more respiratory depression”
34. What are the most important characteristics that any drug can have?
• Selectivity
• All the answers are correct *
• Effectiveness
• Safety
35. Which of the following is not consistent with the rules for geriatric prescribing:
• Steady state is reached more quickly in the older adult
• Adverse drug responses present atypically in the older adult
• Reduce the number of drugs in the patient's regimen whenever possible *
• Half-life will be longer in older adults
36. The 4th to the 10th week of gestation is the period of time when there is the greatest concern about drug-induced:
• Fetal hemorrhage
• Fetal cardiac arrest
• Fetal malformations *
• Labor
37. A pediatric client is prescribed amoxicillin 25mg/kg/day divided in two daily doses. The medication is available as 125mg/5ml. The client weighs 25 pounds. What is the total daily dose for the client? Round answer to the nearest tenth __________mg.
• 205 mg
• 280 mg *
• 190 mg
• 300 mg
38. What changes in drug distribution with aging would influence prescribing a medication in a 90-year old patient?
• Decreased plasma proteins *
• Increased volume of distribution
• Increased muscle-to-fat-ratio
Decreased lipid solubility
39. A patient is diagnosed with otitis externa. Comorbidities include diabetes mellitus, hypertension, and advanced multiple sclerosis. Which type of education regarding medication administration would you provide?
• The oral administration of a prescription for hydrocortisone/neomycin/polymyxin B combination solution
• The administration of topical combination medications for a prescription of fluoroquinolones/glucocorticoid com *
• The oral administration of a prescription for fluoroquinolone
• The administration of topical medications for a prescription of alcohol plus acetic acid solution. [Show Less]