NSG 6320 AGNP BOARD EXAM_RESPIRATORY PRESCRIBING (QUESTIONS 100)
Question:
Treatment of Bordetella pertussis in a patient with a hypersensitivity
... [Show More] to macrolides is: doxycycline.
clindamycin (Cleocin). metronidazole (Flagyl).
sulfamethoxazole/trimethoprim (Bactrim). Correct Explanation:
Sulfamethoxazole/trimethoprim (Bactrim) is an alternative choice for patients in whom a macrolide is contraindicated.
Question:
The mainstay of treatment in the management of mild and moderate croup is symptomatic relief that includes:
antibiotics. beta-2 agonists.
corticosteroids. Correct
decongestants.
Explanation:
The mainstay of treatment in the management of mild and moderate croup is symptomatic relief, which includes corticosteroids (inhaled or oral). Antibiotics, beta-2 agonists and decongestants have not been studied, and their use is discouraged.
Question:
In adults with community-acquired pneumonia in which B-lactamase producing Haemophilus influenzae is identified as the causative organism, the outpatient treatment of choice is:
amoxicillin (Amoxil). azithromycin (Zithromax). Cefixime (Suprax). Correct oseltamivir (Tamiflu).
Explanation:
The treatment of choice in adults with B-lactamase producing Haemophilus influenzae community acquired pneumonia is cefixime (Suprax). Amoxicillin is recommended in the presence of non-B-lactamase producing Haemophilus influenzae. Alternate antibiotics include fluoroquinolones (ie. moxifloxacin [Avelox]), doxycycline, azithromycin and clarithromycin.
Question:
A patient with sinusitis is treated with amoxicillin. Caution is advised with concomitant use of:
lisinopril (Zestril). fexofenadine (Allegra). warfarin (Coumadin). Correct furosemide (Lasix).
Explanation:
Amoxicillin should be used with caution with warfarin (Coumadin). The combination will increase the INR and thus increase the risk of bleeding, possibly due to altered vitamin K production by gut flora. Amoxicillin can be co- administered with lisinopril (Zestril), fexofenadine (Allegra), and furosemide (Lasix).
Question:
A patient with bacterial sinusitis taking an oral penicillin should be instructed: to monitor capillary blood glucose readings if they have diabetes.
that additional protection against pregnancy is necessary if they are taking an oral contraceptive. Correct
to use an anti-diarrheal if they experience diarrhea.
to avoid penicillin if they are pregnant or trying to become pregnant.
Explanation:
Penicillin is a beta-lactam antibiotic. The drug interactions of most concern with the beta-lactam antibiotics are those with oral contraceptive products, methotrexate and valproic acid. In the case oral contraceptives, even though a small percentage of women may potentially experience decreased effectiveness of these birth control products while taking beta-lactam antibiotic, alternative birth control methods should be considered while taking these antibiotics. Anti-diarrheal medicine should not be taken because it may worsen or prolong diarrhea. Most penicillins are safe to use during pregnancy.
Penicillins may cause false readings with some urine glucose tests.
Question:
An example of a beta2-adrenergic receptor agonist used in the treatment of asthma is: dobutamine.
denopamine. xamoterol. albuterol. Correct
Explanation:
ß2 (beta2) adrenergic receptor agonists, also known as adrenergic ß2 receptor agonists, act on the ß2 adrenergic receptor. Like other ß adrenergic agonists, they cause smooth muscle relaxation. ß2 adrenergic agonists' effects on smooth muscle cause dilation of bronchial passages. They are primarily used to treat asthma and other pulmonary disorders, such as COPD. Examples of a beta2-adrenergic receptor agonists are albuterol, xamoterol, and terbutaline. The others are examples of beta1-adrenergic receptor agonists.
Question:
Benzonatate (Tessalon Perles), a non-narcotic antitussive,:
does not cause sedation.
is centrally acting on cough receptors. is safe in children 6 years and older. should be swallowed whole. Correct
Explanation:
Benzonatate (Tessalon Perles) capsules act peripherally by anesthetizing the stretch receptors located in the respiratory passages, lungs, and pleura by dampening their activity and thereby reducing the cough reflex. It is approved for the relief of cough in adults and children older than 10 years. Benzonatate capsules should be swallowed whole. Severe hypersensitivity reactions (including bronchospasm, laryngospasm and cardiovascular collapse) have been reported from sucking or chewing the capsule instead of swallowing it. This is thought to be related to a local anesthetic property of the drug. The most common side effects of benzonatate are sedation, headache and dizziness.
Question:
Which of the following medications, when combined with pulmonary rehabilitation, enhances exercise performance?
Ipratropium bromide (Atrovent). Levalbuterol (Xopenex) inhaled. Salmeterol (Serevent Diskus).
Tiotropium (Spiriva HandiHaler). Correct Explanation:
Tiotropium (Spiriva HandiHaler), a long-acting antimuscarinic antagonist, enhances the effectiveness of pulmonary rehabilitation in increasing exercise performance.
Question:
Which of the following would NOT be a potential adverse reaction of an intramuscular corticosteroid?
anuria. Correct
angioedema.
cardiac arrhythmias. mood swings.
Explanation:
Anuria has not been reported as a potential side effect of intramuscular corticosteroids. Reactions that may occur include anaphylaxis, angioedema, convulsions, depression, emotional instability, euphoria, headache, insomnia, mood swings, neuritis, neuropathy, paresthesia, personality changes, bradycardia, cardiac arrest, cardiac arrhythmias, cardiac enlargement, circulatory collapse, congestive heart failure, and tachycardia.
Question:
Doxycycline (Vibramycin), for the treatment of pneumonia, is classified as a: fluoroquinolone.
penicillin. macrolide.
tetracycline. Correct Explanation:
Doxycycline (Vibramycin), demeclocycline (Declomycin) and minocycline (Minocin) are tetracycline derivatives. Doxycycline (Vibramycin) is the preferred treatment of pneumonia caused by Mycoplasma pneumoniae.
Question:
The main side effect related to the use of long-acting antimuscarinic antagonists is: dry mouth. Correct
headache. tachycardia. watering eyes.
Explanation:
The main side effect is dryness of mouth. Inhaled anticholinergic drugs are poorly absorbed, which limits the troublesome systemic effects observed with atropine.
Extensive use of this class of agents in a wide range of doses and clinical settings has shown them to be very safe.
Question:
Theophylline (Theo-24) relaxes bronchial smooth muscle and: depresses the central nervous system.
decreases renal blood flow. slows the heart rate.
produces anti-inflammatory effects. Correct Explanation:
The main actions of theophylline (Theo-24) are to relax bronchial smooth muscle and exert both positive inotropic and chronotropic actions (increased heart muscle contractility and efficiency and increased heart rate). Theophylline also increases blood pressure and renal blood flow, and produces anti-inflammatory effects. It also stimulates the central nervous system, mainly in the medullary respiratory center.
Question:
Fluticasone/salmeterol is a combination inhaler that is branded as: Advair Diskus. Correct
Pulmicort. Spiriva.
Symbicort.
Explanation:
Fluticasone/salmeterol is a combination inhaler that is branded as Advair Diskus. It is a combination of an inhaled corticosteroid and a long-acting bronchodilator. Symbicort is a combination of budesonide and formoterol. Spiriva is a short-acting antimuscarinic antagonist agent. Budesonide (Pulmicort) is an inhaled corticosteroid.
Question:
The initial bronchodilator in the treatment of chronic bronchitis is: albuterol (ProAir HFA). Correct
fluticasone propionate (Flovent HFA) salmeterol (Serevent).
tiotropium (Spiriva HandiHaler).
Explanation:
The principal initial bronchodilator in the treatment of chronic bronchitis is a short- acting bronchodilator or short-acting antimuscarinic antagonist. Short-acting beta agonists such as albuterol (ProAir HFA) are the initial choices for as needed use. Short- acting antimuscarinic antagonist agents (i.e. ipratropium bromide [Atrovent]) may also be utilized on an as needed basis.
Question:
The treatment of choice in the outpatient setting for an adult with community-acquired pneumonia caused by Mycoplasma pneumoniae or Chlamydophila pneumoniae is a:
aminoglycoside.
cephalosporin (3rd generation). macrolide. Correct
penicillin.
Explanation:
The treatment of choice in the outpatient setting for an adult with community-acquired pneumonia caused by Mycoplasma pneumoniae or Chlamydophila pneumoniae is a macrolide or a tetracycline. If those are contraindicated, an alternative would be a fluoroquinolone.
Question:
A patient with diabetes who is started on corticosteroids for the treatment of chronic bronchitis exacerbation should be instructed to monitor for:
diaphoresis.
increased urination. Correct
weight loss. decreased thirst. [Show Less]