Nursing MSN 571 Midterm Practice- United State University
Mid Term Pharm MSN571
1. Which is required for red blood cell production
● All
●
... [Show More] Iron
● Folate
● Vitamin B12
2. A female patient has an iron deficiency anemia and GI bleed has been ruled out. You will:
● Refer the patient to hematologist
● Prescribe ferrous sulfate 325mg po TID and schedule the patient to return in 1
month for a repeat CBC, serum iron and TIBC
● Prescribe iron dextran 50mg IM weekly for 4 weeks and schedule weekly office
visits for injections.
● Schedule the patient to return in 6 months for additional guaiac stool testing.
3. Most clinically used opioids analgesics are selective for which type of opioid receptor?
● alpha
● delta
● mu
● beta
● kappa
4.Which is true about morphine
● It does not cause tolerance with prolong use
● It promotes nausea and vomiting through direct stimulation of the chemoreceptor
trigger zone of the medulla
● It does not cause urinary retention and hesitancy
● Respiratory depression is rare
12. Which of the following medications is a fluroquinolone antibiotic?
● Azithromycin
● Ciprofloxacin
● Penicillin
● Amikacin
13. Which of the following terms best describes the mechanism of action of metoprolol?
● Alpha 1 antagonist effects
● Beta 1 selective ( beta-1-adrenergic receptor inhibitor)
● Nonselective Beta with Alpha blocking
● Nonselective Alpha blockers
14. Which antibiotic class disrupts metabolism in bacteria and is often combined with
trimethoprim?
● Aminoglycosides
● Cephalosporins
● Macrolides
● Fluoroquinolones
● Sulfonamides
15. Which of the following group of antibiotics has a beta-lactam ring in the molecular
structure?
● Cephalosporins
● Fluoroquinolones
● Macrolides
● Sulfonamides
● Tetracycline
16. Which of the following drug classes should be avoided in peptic ulcer disease?
● Avoid antibiotics
● Avoid NSAIDS
● Avoid diuretics
● Avoid proton pump inhibitors
17. Fluroquinolones antibiotics are most likely indicated in which of the following conditions?
● Follicular conjunctivitis
● GERD
● Asthma
● Genital Infections
18. Which antibiotics binds to the 505 subunit of the bacterial ribosome and could most likely
result in the development of pseudomembranous colitis?
● Tetracycline
● Clindamycin
● Amoxicillin
● Vancomycin
19. Beta Lactamase inhibitors are often indicated in which if the following?
● May decrease absorption of medications
● First dose effect
● Often combined with penicillin antibiotics
● Delayed absorption of oral drugs
20. A patient who takes multiple antibiotics starts to experience diarrheal stool. If the stool
sample tests positive for C-Diff which antibiotic, would you prescribe?
Metronidazole
Gemifloxacin
Daptomycin
Rifaximin
21. Children younger than 8 years of age should not receive tetracyclines because these agents
Can cause aplastic anemia
Cause rupture of tendons
Do not cross into the cerebrospinal fluid
Deposits in tissues undergoing calcification
22. Which patient condition would be a contradiction for the administration of the clindamycin?
Diabetes Mellitus
Ulcerative Colitis
Arthritis
Skin infection
23. A child with an ear infection is not responding to treatment with amoxicillin. What
alternative medication will the provider order?
Amoxicillin-clavulanic acid
Penicillin G
Ampicillin
Nafcillin
24. Every antibiotic drug class has resistant organisms that influence prescribing decisions.
True
False
25. The dosage of Amoxicillin for the treatment of pediatric acute otitis media is
Amoxicillin 50mg/kg/day
Amoxicillin 90mg/kg/day
Amoxicillin 25mg/kg/day
Amoxicillin 150mg/kg/day
26. Which antibiotic is in the macrolide class?
Minocycline (Minocin)
Nitrofurantoin ( Macrobid)
Clarithromycin ( Biaxin)
Trimethoprim
27. Contraindications to hepatitis B vaccination is:
All pregnant and lactating women
Previous severe hypersensitivity or anaphylaxis
A history of poliomyelitis
Mild viral illness
28. Treatment for fungal infections of the toenails (onychomycosis) includes
Miconazole Cream
Oral Griseofulvin
Mupirocin Cream
Ketoconazole Cream
29. In which of the following the human papillomavirus (HPV) vaccine is not recommended
A 25 year old who did not finish the vaccine series as a teen
Men who have sex with men
Only young men through the age of 21
Men with compromised immune systems (including HIV) through age 30 if they did not get the
HPV vaccine as teenagers
30. What is the treatment option for a patient who reported small vesicular lesions on the genitals
that lasted between 10 and 20 days?
Acyclovir (Zovirax)
Three injections of penicillin
One time dose of azithromycin
Test of cure
31. When teaching a pregnant patient about the effects of medication on the fetus, the greatest
harm from maternally ingested medications occurs during which time period?
Birthing process
First trimester
Second trimester
Third trimester
32. Which concept guides the NP care of infants receiving a variety of medications?
Drugs given subcutaneously (subQ) remain in the body longer in infants than in adults
Drugs given intravenously (IV) leave the body more quickly in infants than in adults
The blood brain barrier protects the infant’s brain from toxic drugs
Gastric emptying time is shorter in infants than in children and adults
33. Which of the following is true?
Enzyme inducers can enhance clinical responses to prodrug
The bioavailability of lipid soluble drugs is increased in the elderly
Drug doses may need to be increased in pregnancy
All of the above
34. Physiological changes in the elderly that accounts for a small volume of distribution and an
increase in the plasma concentration of digoxin are:
Increased activity of hepatic enzymes that facilitate drug metabolism
Decreased total body water
Increased total body of water
Decreased total body fat
Decreased rate of elimination due to decreased renal function
35. Keeping Beers Criteria in mind. Which of the following statements concerning the safety of
medication used by older adults is incorrect?
Benzo’s have a large volume of distribution and are relatively safe for use in older people
Chronic use of Nexium may increase rick for C-Diff infection, decreased bone integrity and
fractures
Diphenhydramine may exacerbate urinary retention of older men with prostate hypertrophy
Meperidine is not an effective oral analgesic in dosages commonly used and may cause
neurotoxicity
36. A patient’s INR is 1.2 on warfarin therapy to prevent DVT, how would you interpret his INR
level as?
INT is within limits, no action indicated
INR is too high IV protamine sulfate may be needed
INR is too low the dose of warfarin may need to be increased
INR is too high Vitamin K may be needed
37 What would you prescribe for warfarin overdose?
Phytonadione
Calcium
Aspirin
Potassium
38. The patient is receiving anticoagulant therapy. The INR value for the patient today is 1.5. In
response to this. What will you do?
Increase the heparin drip rate
Hold the next dose of warfarin
Prescribe protamine sulfate
Prescribe an additional dose of warfarin
39. Patients with rheumatoid arthritis who are on chronic low dose prednisone will need co
treatment with which medications to prevent further adverse effects?
Vitamin D
Calcium Supplementation
A bisphosphonate
All of the above
40. A patient has been taking 10mg per day of prednisone for the past 6 months. The Patient
should be assessed for?
Gout
Iron deficiency anemia
Renal dysfunction
Osteoporosis
41. Which of the following is (are) useful in the eradication of Tinea organisms?
Butoconazole
Terbinafine (Lamisil)
Griseofulvin
None of these are correct
Both Griseofulvin and Terbinafine (Lamisil)
42. When teaching a patient about amiodarone, you should advise the patient to avoid which
food and drink?
Gluten
Poultry
Whole milk
Grapefruit juice
43. Which class of drugs is recommended by the JNC8 as the first line therapy for uncomplicated
essential hypertension?
Angiotensin converting enzyme inhibitors
Thiazide Diuretics
Loop diuretics
Alpha 1 adrenergic receptor blocking agents
44. A patient has been prescribed amiodarone. What should be included in the patient teaching
about this medication?
Photophobia and wearing sunglasses
Gastrointestinal upset
Decrease Fluid intake
High fiber diet
Sunscreen use
45 Sublingual nitroglycerin can be used in lower dosages than with the other routes
The potency is 100 times higher
It bypasses the liver
It is not a catabolized down by gastric acids
It does not need to be absorbed into the bloodstream
46. A patient requires rapid diuresis and is not urinating well. Which diuretic would be the most
effective?
Lasix
Spironolactone
Triamterene
HCTZ
47 An elderly patient has problems remembering to take her medication three times a day.
Which one of the drug formulations might be particularly might be particularly useful in this
case?
Skin patch
Extended release
Suppository
Suspension
48. The major reason for not crushing a sustained release capsule is that, if crushed the coated
beads of the drugs could possibly result in:
Disintegration
Malabsorption
Deterioration
Toxicity
49. Patients who have a poor metabolism phenotype will have
A need for increased dosages of medications
Slowed metabolism of a prodrug into an active drug, leading to accumulation prodrug
Accumulation of inactive metabolites of drugs
Increased elimination of an active drug
50. Drugs that are prone to cause adverse effects include:
Insulin
Stimulants
Inhaled anticholinergics
Diuretics
51. An NP is reviewing information about a drug. The drug is taken orally, and after 12 hours,
traces of the drug are found in urine and cerebrospinal fluid. What is this process called?
Pharmacokinetic
Pharmacotherapeutics
Pharmaceutics
Pharmacodynamics
Rationale: The interactions between the body and a drug are studied in two ways:
pharmacokinetics and pharmacodynamics. Pharmacokinetics is the study of the
processes of absorption, distribution, metabolism, and excretion of a drug.
Pharmaceutics is the science of how drugs are made in proper forms and dosages and
then supplied to the market. Pharmacodynamics is the study of how a drug acts on the
body and its effects on various systems in the body. Pharmacotherapeutics is the study
of uses of drugs to prevent and treat diseases
52. Which of the following is the most appropriate choice to describe age associated changes that
can affect pharmacokinetics in older patients?
Changes in gastrointestinal function that lead to reduced drug absorption
Decrease in body fat
Increase in total body water
Decrease in Creatinine clearance
53. What occurs when a drug binds to a receptor in the body?
It gives the receptor a new function
It increases or decreases the activity of that receptor
It prevents the action of the receptor by altering its response to chemical mediators.
It alters the receptor to become nonresponsive to its usual endogenous molecules
54. The patient is diagnosed with otitis media with perforated ear drum. You want to prescribe an
otic preparation. Which if the following is not appropriate?
Ciprofloxacin/dexamethasone
Ofloxacin otic
Acetic acid Otic
Ciprofloxacin/Hydrocortisone
Ofloxacin and ciprofloxacin are recommended for the patient with a perforated eardrum.
These medicines are safe for the patient with a perforated eardrum. Neomycin,
polymyxin B, and hydrocortisone are contraindicated in patients with a perforated
eardrum because these drugs may cause permanent damage to the ear.
55. 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 fluoroquinolone
The oral administration of prescription for hydrocortisone/neomycin/Polymyxin B combination
solution
The administration of topical medications for a prescription of alcohol plus acetic acid solution
The administration of topical combination for a prescription of a fluoroquinolone/glucocorticoid
combination solution
56. A 2-year-old child presents to the clinic with otalgia and fever. The left tympanic membrane
(TM) is erythematous and bulging: the right TM is perforated and draining. The child’s parent
states/ “This is the 5th ear infection this year. What can we do? What action will the provider take
to address the child’s ear problem?
Prescribe both ceftriaxone (Rocephin) IM with benzocaine ear drops for pain?
Discuss beginning prophylactic antibiotic therapy with trimethoprim/sulfamethoxazole
Prescribe amoxicillin clavulanate and refer the child to an otolaryngologist
Prescribe both high dose amoxicillin and the influenza vaccine
57. What is the mechanism of action of ezetimibe?
It inhibits the absorption of bile thus causing the liver to produce bile from cholesterol
It inhibits absorption of the dietary and biliary cholesterol in the small intestine (p. 1052)
It decreases the adhesion of cholesterol on the arterial walls
It inhibits the biosynthesis of cholesterol in the liver
58. On assessment of a patient with hyperlipidemia you learn that the patient has recently
undergone liver transportation. Which antihyperlipidemic drug should be excluded from the
patient’s prescription?
Gemfibrozil
Atorvastatin
Cholestyramine
Ezetimibe
59. Before prescribing simvastatin, which baseline data are collected to help prevent adverse
effects of therapy? Select all that apply
Potassium
Uric Acid
Renal Function
Gastric distress
Muscle pain
Liver enzymes
60. A patient with cardiovascular disease is taking rosuvastatin. Which finding would indicates a
potential adverse effect of this drug?
Muscle pain and tenderness
Blood pressure of 140/90mm Hg
Wheezing and shortness of breath
Platelet count of 100 x 103mm 3
61. Which of the following labs would you want to order for routine monitoring of a patient
receiving the anticoagulant Lovenox (enoxaparin)
None of these labs would be used
PT/INR
Hgb alone
PTT
62. A provider is reviewing an older adult patients’ chart during a routine visit. Which patient
information is of most concern regarding the renewing of medication prescriptions for highly
protein-bound drugs?
Low serum Creatinine
Increased body fat
Low serum albumin
Chronic constipation
63. you are caring for a patient with bipolar disorder who is taking lithium. Which abnormal lab
is most essential for you to reevaluate this patient’s dosage of lithium?
Potassium level of 5.0 mEq/L
Blood urea nitroglycerin of 20mg/dl
Sodium level of 128mEq/L
Prothrombin time of 8 secs
64. It is essential for the practitioner to understand the responsibility involved in prescribing a
drug or drugs and to consider seriously which class of medication is most appropriate for the
patient. The decision is reached based on a thorough knowledge of diagnosis and treatment.
True
False
65. Nurse practitioner prescriptive authority is regulated by
The National Council of State Board of Nursing
The State Board of Nursing for each state
The state Board of Pharmacy
The US Drug Enforcement Administration
A post op patient is prescribed fentanyl? What schedule drug is it?
A: schedule II
Which outcome should the nurse practitioner establish for a patient with trichomoniasis who is receiving
flagyl?
decrease in yellow green vaginal discharge
or
absent of painful urination and serous discharge
A 19 year old that comes with a greenish odorish discharge with vaginal itching. During vaginal exam,
vaginal mucosa is erythemas, wet mount of discharge shows motile organism. The patient is started on
appropriate therapy. Later that evening, a patient has flushing, nausea, vomiting after drinking wine.
Which of the following medications has she been treated with?
Flagyl
diflucan
azithromycin
ceftriaxone
A 19 yr old w/ bacterial vaginosis. What is the common treatment prescribed?
cipro
amoxicillin
flagyl
azithromycin
Which of the following groups of people are at risk for early hypertension?
African American
Mexican American
Mediterranean
Older women
Which of the following diseases or disorders are likely treated with ACE inhibitors?
hyperthyroidism
pulmonary hypertension
cushing syndrome
angina
chronic kidney disease with or without diabetes [Show Less]