NSG 6320 AGNP BOARD EXAM QUESTIONS (latest)
Orthopedics Prescribing (103 Questions) – South
University Savannah
Question:
Which medication is NOT a
... [Show More] brand name for acetaminophen?
Mapap
Cetafen
Aleve Correct
Feverall
Explanation:
Brand names for acetaminophen include Mapap, Cetafen, FeverAll and Tylenol. Aleve is
the brand name for naproxen sodium.
Question:
To treat low back pain in a patient for whom nonsteroidal anti-inflammatory drugs
(NSAIDs) are contraindicated, the recommended therapy is:
acetaminophen (Tylenol). Correct
ibuprofen (Motrin).
cyclobenzaprine (Amrix).
tramadol (Ultram).
Explanation:
To treat low back pain in a patient for whom nonsteroidal anti-inflammatory drugs
(NSAIDs) are contraindicated, the recommended therapy is acetaminophen (Tylenol). A
nonsteroidal anti-inflammatory drug (ibuprofen) is recommended as initial therapy for
the treatment of back pain. The trial should be short-term, usually 2 to 4 weeks.Acetaminophen is a reasonable option for initial therapy in patients with
contraindications to NSAIDs.
Question:
The patient at highest risk for side effects from cyclobenzaprine (Amrix) is a:
20-year-old man with spasticity and a history of seizures.
40-year-old woman diagnosed with diabetes mellitus.
50-year-old woman with a history of asthma.
70-year-old man diagnosed with benign prostatic hypertrophy. Correct
Explanation:
Cyclobenzaprine (Amrix) is identified in the Beers Criteria as a potentially inappropriate
medication and should be to be avoided in patients 65 years and older (independent of
diagnosis or condition). This is because most muscle relaxants are poorly tolerated in
older adults due to anticholinergic effects. Amrix may also increase sedation and
fracture risk. Cyclobenzaprine (Amrix) has strong anticholinergic properties. In
addition, efficacy is questionable at doses tolerated by geriatric patients. Although
cyclobenzaprine may lower the seizure threshold, it is not a contraindication. The
provider should weigh the risks versus the benefits.
Question:
When assessing a patient with suspected acetaminophen (Tylenol) overdose, the time of
ingestion can be confirmed by checking:
acetaminophen levels now and in 4 hours. Correct
baseline acetaminophen levels.
liver function studies now and in 4 hours.
acetylcysteine levels.
Explanation:
When assessing a patient with suspected acetaminophen (Tylenol) overdose, the time of
ingestion can be confirmed by checking serum acetaminophen levels at the time ofpresentation and again in 4 hours. This is especially important if the time of
acetaminophen ingestion is unknown.
Question:
A patient with severe osteoarthritis is complaining of a pain exacerbation due to weather
change. Ketorolac should be avoided in this patient due to a drug-drug interaction with:
diclofenac (Zorvolex). Correct
lisinopril (Zestril).
omega-3 fatty acids.
spironolactone (Aldactone).
Explanation:
The concomitant use of ketorolac (Toradol) and other nonsteroidal anti-inflammatory
drugs (NSAIDs), such as diclofenac (Zorvolex), is absolutely contraindicated due to
enhancement of the adverse/toxic effect of NSAIDs. Therapy should be monitored in the
presence of ACE inhibitors, omega-3 fatty acids and potassium-sparing diuretics, but it
is not contraindicated.
Question:
The half-life elimination of colchicine (Colcrys), used in the treatment of gout, is
approximately:
8 hours.
15 hours.
30 hours. Correct
48 hours.
Explanation:
The half-life elimination of colchicine (Colcrys) in an otherwise healthy person is about
27-31 hours. Colchicine is an alkaloid indicated for the treatment of acute gout and for
the prophylactic treatment of gout. It is approved for use in patients aged 16 and older
for gout prophylaxis.
Question:Dantrolene (Dantrium) reduces skeletal muscle spasticity by:
interfering with the release of potassium from the sarcoplasmic reticulum.
interfering with the release of calcium from the sarcoplasmic reticulum. Correct
centrally blocking action potentials.
blocking the actin-myosin binding site in striated muscle.
Explanation:
Dantrolene (Dantrium) reduces skeletal muscle spasticity by acting directly on skeletal
muscle and interfering with release of calcium ion from the sarcoplasmic reticulum. It is
classified as a peripherally-acting muscle relaxant. It is not a centrally-acting muscle
relaxant.
Question:
Which formulation of naproxen would result in fewer GI side effects?
Naprosyn
Naprosyn suspension
Anaprox DS
EC-Naprosyn Correct
Explanation:
EC-Naprosyn dissolves in the small intestine rather than in the stomach. Fewer GI side
effects would be expected with this medication. However, this results in delayed
absorption and thus delayed relief of acute pain could also be anticipated. The other
listed forms of naproxen are absorbed in the stomach and produce a greater risk of GI
upset.
Question:
Salicylates, such as aspirin,:
prevent the formation of clots by affecting blood coagulation.
inhibit vitamin K epoxide reductase and prevent blood clots.
inhibit the synthesis of prostaglandin in the process of inflammation. Correct
block the activity of clotting factor X and prevent blood clots.Explanation:
Salicylates are nonsteroidal anti-inflammatory drugs (i.e. aspirin [Ecotrin] and
magnesium salicylate [Doan's]). Salicylates inhibit the synthesis of prostaglandins and
other mediators in the process of inflammation and have anti-inflammatory, antipyretic
and analgesic properties.
Question:
When evaluating the effectiveness of baclofen (Lioresal), the LEAST appropriate goal is
to:
reduce caregiver challenges such as dressing, feeding, transport, and bathing.
reduce the pain and frequency of muscle contractions.
improve voluntary motor functions such as reaching, releasing and grasping.
significantly reduce muscle spasticity and contractions. Correct
Explanation:
“Reducing spasticity” per se is not an appropriate treatment goal. Appropriate goals
include increasing range of motion, easing care, decreasing pain, improving quality of
life, improving gait, or decreasing the development of contractures. Use with caution
when spasticity is utilized to sustain upright posture and balance in locomotion, or when
spasticity is necessary to obtain increased function.
Question:
The concomitant use of aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs) can
cause:
hypoglycemia.
abnormally high serum levels of potassium. Correct
a decrease in the development of angioedema.
reduced absorption of nonsteroidal anti-inflammatory drugs (NSAIDs).
Explanation:The concomitant use of aspirin and NSAIDs can cause abnormally high serum levels of
potassium by inducing a hyporeninemic hypoaldosteronism state via inhibition of
prostaglandin synthesis.
Question:
Clindamycin (Cleocin) is NOT indicated for the treatment of serious infections, such as
septic arthritis, caused by:
Streptococcus pyogenes.
Staphylococcus aureus.
Streptococcus pneumoniae.
Escherichia coli. Correct
Explanation:
Clindamycin (Cleocin) is not effective against infections caused by Escherichia coli.
Clindamycin (Cleocin) is indicated in the treatment of serious infections caused by
susceptible gram-positive bacteria. Examples include Streptococcus and
Staphylococcus. Septic arthritis may be caused by Neisseria gonorrhea in sexually active
people. Staphylococcus aureus is the cause of the vast majority of cases of acute bacterial
arthritis in adults and in children older than 2 years. Streptococcal species, such as
Streptococcus viridans, S pneumoniae, and group B Streptococcus, account for about
20% of cases.
Question:
Intra-articular steroid injections are NOT contraindicated:
when the skin over the injection site is infected.
in patients with diabetes. Correct
when skin at the injection site is broken.
in the presence of an osteochondral fracture.
Explanation:
Single intra-articular steroid injections have little or no effect on glycemic control. Intraarticular corticosteroid injections are contraindicated for broken skin over the injection
site, known hypersensitivity to intra-articular agents, osteochondral/intra-articular [Show Less]