NURS 6521 NURS6521 Advanced Pharmacology Midterm Spring Exam 2022
NURS 6521 NURS6521 Advanced Pharmacology Midterm Spring Exam 2022
Question 1
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A female patient is taking 0.125 mg of digoxin daily for heart failure. At a recent clinic visit she reports that since she has been on the drug, she can breathe better and her heart rate has been around 74 beats per minute. The nurse weighs the patient and notices that she has gained 10 pounds since the digoxin therapy was started. The patient is concerned that the additional weight will necessitate an increase in the medication. Which of the following is an appropriate response by the nurse?
Selected Answer: "No, the drug dosage will likely stay the same."
Question 2
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A patient with seasonal allergies is exasperated by her recent nasal congestion and has expressed her desire to treat it by using pseudoephedrine. The nurse should inform the patient that
Selected Answer:
Question 3
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she must be prepared to show identification when buying a drug that contains pseudoephedrine.
A patient has been prescribed a histamine-2 (H2) receptor antagonist for the treatment of GERD. Why are H2RAs more effective than H1 receptor antagonists in the treatment of diseases of the upper GI tract?
Selected Answer: The parietal cells of the stomach have H2 receptors but not H1 receptors.
Question 4
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Which of the following will a Nurse Practitioner inform the patient is one of the most common adverse effects of guaifenesin (Robitussin)?
Selected Answer: Gastrointestinal distress
Question 5
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Frequent episodes of exercise-related chest pain have caused a 79-year-old woman to use her prescribed nitroglycerin spray several times in recent weeks. This patient's age will have what effect on her use of nitroglycerin?
Selected Answer: The woman will be more susceptible to hypotension than a younger patient.
Question 6
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A Nurse Practitioner is teaching an older adult patient about polypharmacy. Which of the following statements best describe this term?
Selected Answer: Taking several drugs simultaneously
Question 7
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A 47-year-old woman has been diagnosed with open-angle glaucoma. Pilocarpine drops are prescribed. The nurse's assessment reveals that the patient has worn soft contact lenses for 15 years. The nurse will instruct the patient to
Selected Answer: remove the contact lenses before applying the drops.
Question 8
1 out of 1 points
A 29-year-old female patient has been prescribed orlistat (Xenical) for morbid obesity. The nurse is providing patient education concerning the drug. An important instruction to the patient would be to
Selected Answer: omit the dose if the meal does not contain fat.
Question 9
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The APRN is seeing Mrs. Smith, age 77, who is here for follow up of hypertension, dyslipidemia, and depression. What should you consider during her follow-up?
Selected Answer:
Age-related changes in renal function are the main cause of adverse drug reactions
Question 10
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A female patient has been taking prednisone for her asthma for 1 month. The nurse will teach her to gradually decrease her dose of prednisone to avoid
Selected Answer: adrenal insufficiency.
Question 11
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A 24-year-old factory worker has been prescribed guaifenesin for the first time. Which of the following will be a priority assessment by the nurse before the patient's first dose?
Selected Answer: The amount of alcohol consumption
Question 12
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A 73-year-old woman has scheduled an appointment with her nurse practitioner to discuss her recurrent constipation. The woman states that she experiences constipation despite the fact that she takes docusate on a daily basis and performs cleansing enemas several times weekly. How should the nurse best respond to this patient's statements?
Selected Answer:
Question 13
"Taking too many laxatives can make your bowels dependent on them, making you more susceptible to constipation."
1 out of 1 points
An expected outcome for a patient who has just taken sublingual nitroglycerin should be Selected Answer: increased heart rate and decreased blood pressure.
Question 14
1 out of 1 points
A Nurse Practitioner is caring for a patient who is taking digoxin and a loop diuretic. Which of the following would be most important for the Nurse Practitioner to monitor?
Selected Answer: Potassium levels
Question 15
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A Nurse Practitioner who provides care on an acute medicine unit has frequently recommended the use of nicotine replacement gum for patients who express a willingness to quit smoking during their admission or following their discharge. For which of the following patients would nicotine gum be contraindicated?
Selected Answer:
Question 16
1 out of 1 points
A patient with a history of angina who experienced a non-ST wave myocardial infarction
A patient has recently been prescribed a drug that treats his hypertension by blocking the sympathetic receptors in his sympathetic nervous system. This action is characteristic of
Selected Answer: an adrenergic antagonist.
Question 17
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A Nurse Practitioner is caring for a 73-year-old man who is receiving drug therapy. He is beginning to exhibit signs of decline in his renal system, yet his current serum creatinine level is normal. The Nurse Practitioner will base the patient's plan of care on the understanding that there is
Selected Answer: a decrease in the effectiveness of the prescribed drugs.
Question 18
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A Nurse Practitioner is caring for a male patient who has a diagnosis of coronary artery disease (CAD). His drug therapy includes lovastatin. Because the patient has a history of severe renal disease, the nurse will assess for which of the following?
Selected Answer: Decrease in LDL
Question 19
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A 56-year-old female patient has been admitted to the hospital with chronic muscle spasms and has been prescribed a new medication to treat the spasms. She has a poorly documented allergy to eggs, synthetic clothes, and perfumes. What is the priority action of the nurse to ensure that prescribed medication does not experience an allergic reaction?
Selected Answer:
Question 20
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Hold the medication for her muscle spasms until she can be treated for a possible allergic reaction
Which of the following statements best defines how a chemical becomes termed a drug? Selected Answer: A chemical must have demonstrated therapeutic value to become a drug.
Question 21
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An elderly postsurgical patient has developed postoperative pneumonia in the days following abdominal surgery and is being treated with a number of medications. Which of the following medications that the nurse will administer has the slowest absorption?
Selected Answer:
Question 22
1 out of 1 points
An oral antidepressant that the patient has been taking daily for several years
A Nurse Practitioner is providing discharge planning for a 45-year-old woman who has a prescription for oral albuterol. The Nurse Practitioner will question the patient about her intake of which of the following?
Selected Answer: Coffee
Question 23
1 out of 1 points
A Nurse Practitioner is providing a patient with a list of drugs as a part of the patient's plan of care. Which of the following drug nomenclatures should the Nurse Practitioner use to list the drugs?
Selected Answer: The drugs' generic names
Question 24
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A 79-year-old woman who takes several medications for a variety of chronic health problems has been prescribed an oral antiplatelet aggregator that is to be taken once daily. The nurse has encouraged the woman to take the pill at the same time of day that she takes some of her other medications. What is the most likely rationale for the nurse's advice?
Selected Answer:
Question 25
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Integrating the new drug into the patient's existing schedule promotes adherence.
A teenage boy has undergone a diagnostic workup following several months of persistent, bloody diarrhea that appears to lack an infectious etiology. The boy has also experienced intermittent abdominal pain and has lost almost 15 pounds this year. Which of the following medications is most likely to treat this boy's diagnosis?
Selected Answer: Mesalamine
Question 26
1 out of 1 points
An unconscious patient has been brought to the hospital, and the Nurse Practitioner has prescribed a life-saving drug to be administered parenterally. Which of the following methods would be the most appropriate for the nurse to use when administering the medication?
Selected Answer: Intravenous infusion.
Question 27
1 out of 1 points
A 53-year-old man has been treated for severe asthma for several years with prednisone. Recently, his physician initiated alternate-day therapy for him. The patient tells the nurse that he would rather take the medication every day to prevent confusion. Which of the following would be the best response by the nurse?
Selected Answer:
Question 28
1 out of 1 points
"This schedule allows rest periods so that adverse effects are decreased but the anti-inflammatory effects continue."
A patient receives 25 units of NPH insulin at 7.AM. At what time of day should the nurse advise the patient to be most alert for a potential hypoglycemic reaction?
Selected Answer: Late afternoon
Question 29
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A 62-year-old man has been prescribed lovastatin. The Nurse Practitioner will instruct the patient to take the medication
Selected Answer: at bedtime.
Question 30
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A female patient has been taking zafirlukast for a week and is experiencing diarrhea. The nurse should instruct her to do which of the following?
Selected Answer: Drink plenty of fluids
Question 31
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The lower respiratory system utilizes a number of different mechanisms that confer protection and maintain homeostasis. Which of the following physiological processes protects the lower respiratory system?
Selected Answer:
Question 32
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Cilia sweep foreign material and mucus upward toward the trachea and larynx where they can then be swallowed.
The parents of a 7-year-old boy who has just been diagnosed with allergic asthma are being taught about their son's medication regimen by the nurse. The nurse is currently teaching the parent's about the appropriate use of a "rescue drug" for acute exacerbations of their son's asthma. What drug should the nurse suggests the parents to use in these situations?
Selected Answer: Albuterol
Question 33
0 out of 1 points
A 62-year-old man is admitted to the hospital with a diagnosis of chest pain. He has an order for
0.3 mg of sublingual nitroglycerin prn for chest pain. Which of the following actions should the nurse do first when he complains of chest pain?
Selected Answer: Have the patient swallow a tablet every 5 minutes for 15 minutes
Question 34
1 out of 1 points
A patient is in the clinic for seasonal allergic rhinitis. Loratadine (Claritin) is prescribed. Which of the following statements will the nurse include when providing patient education concerning this drug?
Selected Answer: "Determine if the drug is going to make you drowsy before you drive."
Question 35
1 out of 1 points
John is a newly diagnosed diabetic that contacts the office with complaints of severe nausea and vomiting. What instructions should the APRN provide related to his insulin doses?
Selected Answer:
Monitor your blood sugar every 4 hours and take regular insulin based on the blood sugar reading.
Question 36
1 out of 1 points
A patient is taking cholestyramine. The Nurse Practitioner will assess for which of the following common adverse effects of the drug?
Selected Answer: Constipation
Question 37
1 out of 1 points
A patient in need of myocardial infarction prophylaxis has been prescribed sulfinpyrazone for gout. Which of the following will the nurse monitor the patient most closely for?
Selected Answer: Bleeding
Question 38
1 out of 1 points
A 46-year-old white American has been prescribed a drug that binds to acid glycoproteins. The nurse understands that white Americans usually receive
Selected Answer: a higher-than-normal dose of drugs that bind to acid glycoproteins.
Question 39
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A nurse practitioner understands when prescribing a medication that there are certain questions to address. Check all that apply.
Selected Answers: Is there a need for the drug in treating the presenting problem?
Is this the best drug for the presenting problem? Can the patient take the prescribed drug?
Question 40
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Advanced practice nurse prescribing of scheduled medications is affected most by:
Selected Answer: Combined state medical / pharmacy / nursing prescribing board regulations
Question 41
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A Nurse Practitioner is administering drugs to a 70-year-old patient who has a reduced plasma albumin level. When assessing the patient for therapeutic outcomes of drug therapy, the Nurse Practitioner will also be careful to observe for
Selected Answer: possible drug toxicity.
Question 42
1 out of 1 points
A male patient is to begin treatment for pneumonia with an albuterol (Ventolin) inhaler. The nurse will advise the patient that he will most likely experience which of the following common adverse effects of the drug?
Selected Answer: Throat irritation
Question 43
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The APRN would use what class of medication to manage COPD?
Selected Answer: Mucolytic agents
Question 44
1 out of 1 points
It is determined that a patient, who is in a hepatic coma, needs a laxative. Lactulose is prescribed. Which of the following should the nurse monitor to assess the efficacy of the lactulose therapy?
Selected Answer: Blood ammonia levels
Question 45
1 out of 1 points
Which of the following patients is most likely to benefit from the administration of an adrenergic agonist?
Selected Answer: A man who is in cardiogenic shock following a myocardial infarction
Question 46
1 out of 1 points
A 20-year-old woman calls the clinic at 5 PM and reports to the Nurse Practitioner that she forgot to take her morning dose of fexofenadine (Allegra). She usually takes her evening dose at 8 PM. She wants to know what she should do. The Nurse Practitioner will instruct her to
Selected Answer: forget about the morning dose and take the evening dose.
Question 47
1 out of 1 points
A 62-year-old woman has been prescribed a fentanyl transdermal patch for chronic cancer pain. The patient asks the nurse how long it will take for her to experience pain relief. The nurse will instruct the patient that she should feel pain relief in approximately
Selected Answer: 24 hours.
Question 48
1 out of 1 points
A Nurse Practitioner is overseeing the care of a young man whose ulcerative colitis is being treated with oral prednisone. Which of the following actions should the Nurse Practitioner take in order to minimize the potential for adverse drug effects and risks associated with prednisone treatment?
Selected Answer: Carefully assess the patient for infections
Question 49
0 out of 1 points
Following an endoscopy, a 66-year-old man has been diagnosed with a duodenal ulcer resulting from Helicobacter pylori infection. Which of the following medications will likely be used in an attempt to eradicate the patient's H. pylori infection? (Select all that apply.)
Selected Answers: A PPI
Question 50
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A Nurse Practitioner is providing patient education to a 35-year-old man who has been prescribed clonidine (Catapres) as part of step 2 antihypertensive therapy. The Nurse Practitioner should anticipate that the drug will be administered
Selected Answer: orally.
Question 51
1 out of 1 points
A patient with type 1 diabetes has been admitted to the hospital for orthopedic surgery and the care team anticipates some disruptions to the patient's blood glucose levels in the days following surgery. Which of the following insulin regimens is most likely to achieve adequate glycemic control?
Selected Answer: Doses of basal insulin twice daily with regular insulin before each meal
Question 52
1 out of 1 points
The Nurse Practitioner's assessment of a community-dwelling adult suggests that the client may have drug allergies that have not been previously documented. What statement by the client would confirm this?
Selected Answer:
Question 53
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"I broke out in hives and got terribly itchy when I started a new prescription last year."
A Nurse Practitioner receives an order to administer a critically ill patient two drugs immediately (stat). The Nurse Practitioner begins the process by
Selected Answer:
Question 54
0 out of 1 points
identifying the patient by checking the armband and asking the patient to state his name.
A Nurse Practitioner is instructing a patient concerning a newly prescribed drug. Which of the following should be included to help improve patient compliance and safety?
Selected Answer: The cost of the brand drug compared with the generic form
Question 55
1 out of 1 points
Mr. Nguyen, age 71, will soon be discharged home from the hospital after a successful coronary artery bypass graft (CABG). During patient education about his drug regimen, Mr. Nguyen's nurse should prioritize teach about
Selected Answer: potential adverse effects of the drugs that Mr. Nguyen will be taking.
Question 56
1 out of 1 points
A Nurse Practitioner has administered a medication to a patient with hypertension. The prescribed drug is supposed to decrease cardiac output. A decrease in cardiac output would most likely
Selected Answer: decrease the amount of circulating blood sent through the kidneys.
Question 57
1 out of 1 points
A Nurse Practitioner is providing discharge instructions to a patient who will be taking fludrocortisone at home. The Nurse Practitioner will encourage the patient to eat a diet that is
Selected Answer: low in sodium, high in potassium.
Question 58
1 out of 1 points
The APRN is treating a patient with type 2 diabetes. The patient is on the maximum dose
of metformin and glucotrol. Current weight 212 pounds. Labs from this morning indicate a fasting blood sugar of 312 and HbA1C of 9. The APRN wants to start the patient on Lantus 0.2 unit/kg. What dose and instructions should the APRN provide?
Selected Answer: Give 19 units of Lantus subcutaneously prior to bedtime.
Question 59
0 out of 1 points
A female patient calls the clinic and reports that since she has been taking dextromethorphan (Robitussin), she has been extremely drowsy and dizzy. The nurse will question the patient about which of the following?
Selected Answer: The number of cups of coffee she has during the day
Question 60
1 out of 1 points
A Nurse Practitioner who provides care in a long-term care facility is documenting a new resident's medication regimen on the resident's intake admission. The Nurse Practitioner is documenting the generic, rather than proprietary, names of the resident's current drugs because
Selected Answer:
Question 61
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there is a potential for confusion and miscommunication if proprietary names are used.
Federal legislation dictates a lengthy and rigorous process of testing for new drugs. What is the primary purpose of this testing process?
Selected Answer: To ensure the safety of the public Question 62
1 out of 1 points
A Nurse Practitioner has been administering a drug to a patient intramuscularly (IM). The physician discontinued the IM dose and wrote an order for the drug to be given orally. The Nurse Practitioner notices that the oral dosage is considerably higher than the parenteral dose and understands that this due to
Selected Answer: first-pass effect.
Question 63
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A 77-year-old patient has a long-standing history of hypertension, a health problem that is being treated with metoprolol and a thiazide diuretic. Before administering the 8 AM dose of these medications, what assessments should the nurse perform and document? (Select all that apply.)
Selected Answers: Respiratory rate
Oxygen saturation Heart rate
Blood pressure
Question 64
1 out of 1 points
A Nurse Practitioner explains to a patient that nitroglycerin patches should be applied in the morning and removed in the evening. This medication schedule reduces the potential for
Selected Answer: nitrate tolerance.
Question 65
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A 62 year old male who had a myocardial infarction one year ago is being seen for hypertension. Which medication has the best evidence in mortality reduction?
Selected Answer: Beta blocker
Question 66
1 out of 1 points
A Nurse Practitioner is caring for a 70-year-old patient who is taking desmopressin (DDAVP). The patient has a history of cardiovascular disease. The nurse will prioritize the assessment of which of the following?
Selected Answer: Electrolyte levels
Question 67
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A patient is taking gabapentin (Neurontin) for spasticity associated with multiple sclerosis. Which of the following should be the priority for monitoring?
Selected Answer: Hepatic function
Question 68
1 out of 1 points
The nurse practitioner orders Amoxicillin 500 mg tid? What is the total amount of medication patient will take per day?
Selected Answer: 1500 mg
Question 69
1 out of 1 points
A patient with bronchial asthma is prescribed a sustained-release preparation of theophylline. To help minimize the adverse effects of the drug, which of the following should the nurse suggest?
Selected Answer: Take it on an empty stomach, 1 hour before or 2 hours after meals [Show Less]