Nursing MSN 571 PHARM Midterm Final Draft- United State University
1. Fluoroquinolone antibiotics are most likely indicating in which of the
... [Show More] conditions
Asthma
Genital infections
Follicular conjunctivitis
GERD
2. Which of the following is most likely an intervention for otitis media?
Amoxicillin
Aspirin
Immunoglobulins
Corticosteroids
3. Which of the following best classifies penicillin, cephalosporins, and
Protein synthesis inhibitors
Mycolic acid synthesis inhibitors
RNA synthesis
Cell wall inhibitors
4. Beta lactamase inhibitors are often located in which of the following?
May decrease absorption
First dose effect
Often combined with penicillin antibiotics
Delayed absorption of oral drugs
5. Which of the following drug classes is/are used in initial hypertension management of
African American population?
Clonidine primary
Beta blockers primary
Thiazide or calcium channel blocker primary
ACE-I primary
ARB primary
6. Which of the following groups of antibiotics is notable for side effects such as
nephrotoxicity or ototoxicity?
Beta-lactams
Aminoglycosides
Tetracyclines
7. Which of the following groups of antibiotics has a beta-lactam ring in the molecular
Structure
Sulfonamides
Macrolides
Tetracyclines
Fluoroquinolone
Cephalosporins
8. Which of the follow medication is a fluoroquinolone antibiotic?
Ciprofloxacin
Azithromycin
Amikacin
Penicillin
9. Which of the following medications or drugs classes is commonly indicated for
managing gestational hypertension?
Spironolactone (Aldactone)
Loop diuretics
Calcium channel blockers
Dobutamine
Calcium gluconate
10. Which of the following best classifies aminoglycosides, macrolides and clindamycin?
Protein synthesis inhibitor
Folic acid synthesis inhibitors
Cell wall inhibitors
Mycolic acid synthesis inhibitors
11. The long half-life of amiodarone contributes to which complications
Enhanced therapeutic effects
Liver toxicity
Decreased dosing
Short onset of action
12. Pharmacokinetics involves the study of which factor?
Distribution rates among various body compartment
Physiologic interactions of drugs
Interactions among various drugs
Adverse reactions to medications
13. Which route of drug administration is used with potent and lipophilic drugs in a patch
formulation and avoids first-pass metabolism?
Oral
Topical
Rectal
Transdermal
14. Patients who have a poor metabolism phenotype will have:
A need for increased dosages of medications
Increased elimination of an active drug
Accumulation of inactive metabolites of drugs
Slowed metabolism of prodrug into an active drug leading to accumulation of prodrug
15. Lower doses of sublingual nitroglycerin can be used effectively because
It bypasses the liver
The potency is 100 times higher
It does not need to be absorbed into the bloodstream
It is not catabolized down by gastric acids
16. Which term refers to the ratio between a drugs therapeutic effects and its toxic effects?
Cumulative effect
Therapeutic index
Tolerance
Affinity
17. In geriatric patients the percentage of body fat is increased. What are the pharmacologic
implications of the physiologic change?
A lipid soluble medication will be eliminated more quickly and not work as well
Absorption of lipid soluble drugs is impaired in older adults.
The bioavailability of the lipid soluble drug will be increased in older adults
A lipid soluble medication will accumulate in fat tissue and its duration of action may
be prolonged
18. A patient diagnosed with otitis externa and taking a fluoroquinolone with glucocorticoid
benefit is taking the medication together you reply
The glucocorticoid reduces the swelling caused by the inflammation and ear infection
The glucocorticoid decreased likelihood of antibiotic resistant
The glucocorticoid decreases the adverse effects of the fluoroquinolone
The two medications are contraindicated for use together
19. A two year old child presents to the clinic with arthralgia and fever in the last tympanic
membrane is erythematous and bulging the right TMS is perforated and draining the child’s
parent states “this is fifth year infection this year “what can we do? what action will the
provider take to address to Childs ear problems
Prescribe amoxicillin/clavulanate and refer the child to an otolaryngologist??? I THINK
THIS IS CORRECT
Prescribe both ceftriaxone (Rocephin) IM with benzocaine ear drops for pain
20. 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? page 1304 repeat #20
The oral administration of a prescription for hydrocortisone/neomycin/polymyxin B
combination solution
The oral administration of a prescription for fluoroquinolone
The administration of topical medication for a prescription of alcohol plus acetic acid s
solution
The administration of topical combination for a prescription of
fluoroquinolone/glucocorticoid combination solution
21. A patient who has congestive heart failure requires a diuretic. The patient also has a history
of chronic kidney disease with a glomerular filtration rate (FGR) of less than 30 ml/min. which
drug would you prescribe this patient.
Methyclothiazide
Metolazone
Loop diuretics
22. Factors released by platelets contribute to hemostasis by enhancing
Fibrinolysis
Vasodilation
Intrinsic pathway
Platelet aggregation
23. A patient has been receiving iron replacement therapy for 2 days after hip replacement
surgery. The provider is alerted to the following assessment data:
Patient is pale and reports feeling tired
Patient’s stools appear black
Patients heart rate is 98 beats/min respiration are 20 and the blood pressure is 100/50 mm hg
What order will the provider take initially to best assure appropriate care for this patient?
Packet red blood cells
Hemoglobin and hematocrit
Hypertonic fluid bolus
Stool guaiac
24. A woman taking a drug for high LDL-cholesterol experience muscle tenderness and pain
with no apparent cause. Which agent is less likely to cause this adverse effect.
Fenofibrate
Niacin
Atorvastatin
Colestipol
25. Which drug inhibits the intestinal absorption of cholesterol?
Colestipol
Fenofibrate
Ezetimibe
Colesevelam
26. An elderly patient with hypertension and hyperlipidemia who has been prescribed a statin
medication comes for a follow up visit after 4 months of therapy. The patient’s laboratory
reports show elevated blood cholesterol level and the urine examination reveals
rhabdomyolysis. What could be the reason for the condition? Select all the apply
The patient is taking amiodarone along with statin
The patient is taking grapefruit juice with statins
The patient is not responding to the treatment
The patient is taking cyclosporine along with statin & verapamil
The patient is eating fiber-rich food along with the statins
27. Match the correct drug teratogenic effect during pregnancy THIS ONE IS HARD IDK - found a
table on the pharm book. Table 8.1
NSAIDS-Microcephaly; premature closure of the ductus arteriosus
Angiotensin-converting enzyme inhibitors- renal failure; renal tubular dysgenesis, skull
hypoplasia (from exposure during 2nd & 3rd trimester)
Warfarin-Craniofacial defects; skeletal & CNS defects
Isotretinoin- multiple defects (CNS, craniofacial, cardiovascular, others)
HMG CoA reductase inhibitors-neural tube defects, facial malformations & CNS anomalies,
including holoprosencephaly (single-lobed brain)
28. When planning care for a patient receiving a sulfonaminde antibiotic. Which is the
appropriate intervention?
Insert foley catheter for accurate input and output measurement
Encourage liquids that produce acidic urine
Encourage a diet that causes alkaline ash
Force fluids to at least 2000 ml/day
29. A 30 years old pregnant female has cellulitis caused by MRSA. Which of the following
antibiotics would be the most appropriate option of outpatient therapy?
Quinupristin/dalforpristin
Doxycycline
Clindamycin
Tigecycline
30. What is important teaching to a patient taking minocycline?
Wear sunscreen as your skin may become sensitive to light
This medication can cause an increase in uric acid levels precipitating a gout attack
If you have diabetes this medication can worsen hyperglycemia
You must take this medication with calcium in order for it to be absorbed better
31. Which answer is true regarding cephalosporin
Similar to macrolide structure
Bacteriostatic
High toxicity
Beta-lactam antibiotic.
32. What are the two serious side effects that can occur with Aminoglycoside use?
Nephrotoxicity and neurotoxicity
Nephrotoxicity and hepatotoxicity
Ototoxicity and nephrotoxicity
Hepatotoxicity and ototoxicity
33. Adverse effects of fluoroquinolone antibiotics include?
QT prolongation
All the answer are Correct
Tendinitis and tendon rupture
Seizures
34. A provider would prescribe which antibiotic to a patient diagnosed with methicillin-resistant
Staphylococcus aureus (MRSA)
Ciprofloxacin
Daptomycin
Norfloxacin
Levofloxacin
35. Which order for furosemide is written appropriately by the prescribe?
Furosemide (Lasix) 20 mg po qd
Furosemide (Lasix) 20 mg po daily
Furosemide (Lasix) 20 mg daily
Furosemide (Lasix) 20 mg po QD
36. How can the prescriber’s regular collaboration with a pharmacist?
Pharmacist can suggest foods that will help with the medications
Pharmacists have additional information on drug interaction
The pharmacist can suggest adequate medication dosing
Pharmacy can alter prescriptions when necessary to prevent patient harm
Pharmacists have firsthand knowledge of the facility formulary
37. A six-year-old who has never received an inactivated influenza vaccine has been brought to
the office by his mother to be vaccinated to help protect his four month-old-baby sister during
influenza “season”. You inform the boy’s mother that he will require
A single vaccination administered annually
Children under age eight years should not receive the inactivation influenza vaccination
Two inactivated influenza vaccinations the first scheduled about one month prior to the
start of influenza season (October/November) and the second scheduled four weeks
after the first.
Two inactivated influenza vaccinations scheduled four or more weeks apart
38. All the medications are safe to use during pregnancy except
Acyclovir
Famciclovir
Valacyclovir
Foscamet
39. Zanamivir is indicated for which of the following?
Zanamivir is indicated for both treatment and prophylaxis of influenza
Treatment of respiratory syncytial virus (RSV)
Treatment of influenza
Prophylaxis of influenza
40. What is the treatment of option for a patient who reported small vesicular lesions on his
genitals that lasted between 10 and 20 days?
Acyclovir (Zovirax)
One time dose of azithromycin
Three injections of penicillin
Test of cure
41. Which medication will decrease blood pressure by blocking angiotensin II receptor site?
Eplerenone
Furosemide
Valsartan
Enalapril
42. A patient receiving nifedipine. Which adverse effect should you monitor for in this patient?
Ankle edema
Diarrhea
Pallor
Backache
43. Why does NP student anticipate administering metoprolol rather than propranolol?
Propranolol causes beta 1 and beta 2 blockade
Metoprolol helps prevent retinopathy in individuals with diabetes
Metoprolol is less likely to cause diabetic neuropathy
Propranolol is associated with a higher incidence of foot ulcers.
44. When developing a treatment plan for a 65-year-old patient with benign prostatic
hyperplasia (BPH), who also takes medication to control hypertension, which medication would
you plan to include?
Tamsulosin (Flomax)
Tadalafil (Cialis, adcircal)
Dutasteride (Avodart)
Finasteride (Propecia, Proscar)
45. As you formulate a plan of care for a 72 year-old patient, you recognized this medication
causes postural hypotension in the older adult LEAST LIKELY?
Amitriptyline (endep, amitril)
Lasix
Lisinopril (Prinivil, Zestril)
Clonidine (catapres, kapvay, nexiclon)
46. Anemia of chronic renal failure is caused by the lack of
Adrenaline
Parathyroid hormone
Thyroid hormone
Erythropoietin
47. What is not a common side effect of oral iron therapy?
Paresthesia
Dark stools
Staining of teeth
Nausea/Vomiting
48. An 18-year-old male is having difficulty sleeping because of the death of his grandfather. He
is given a benzodiazepine that does which of the following?
Bind to serotonin 5-HT1 receptors
Is an antagonist at alpha-adrenoreceptors
Is an antagonist at dopamine D2 receptors
Binds to GABAa receptors
49. Which of the following opioid is so lipophilic that it is marketed in a skin patch used to treat
chronic pain
Methadone
Naltrexone
Scopolamine
Fentanyl
50. Schedule II drugs are (select all that apply)
Drugs with a high potential for abuse
Drugs that are controlled substance
Drug that can be filled without prescription
Prescription drugs that cannot be refilled
Prescription that is valid for only 1 year
51. Which of the following is not a side effect of morphine?
Urinary retentions
Biliary colic
Respiratory depression
All are side effect of morphine
52. The 4th to the 10th week of gestation is the period time when there is the greatest concern
about drug induced
Fetal hemorrhage
Fetal cardiac arrest
Fetal malformation
Labor
53. Which pediatric client is at gestation risk for medication toxicity?
A 10-year-old recovering from an appendectomy
A 6-years-old being treated with first degree burn
A 15-years-old diagnosed with exercised-induced asthma
A 1-year-old diagnosed with a heart valve problem
54. When calculating pediatric dosages, what should you take into consideration?
Dosage calculation by body surface area is the most accurate method because it takes
into account the difference in size of the child and or neonates
Calculated doses based on body weight should be increased by 10% because of
immature renal and hepatic functions
Dosage calculation according to the body weight is the most accurate method because it
takes into account different in maturational development
Usage of drug reference recommendation based on milligram per kilogram of the body
weight is the preferred method.
55. A health care professional advises a pregnant woman to add supplement of which nutrient
to her diet prevent birth defects?
Iron
Vitamin C
Zinc
Folate
56. A parent of a 5-year-old child with allergic rhinitis is seeking an approved treatment to make
the child feel better. Which of the following recommended?
Diphenhydramine
Meclizine
Promethazine
Cetirizine
57. Which of the following is non-neurotoxin treatment for head lice?
Permethrin 1%?jk
Malathion (ovide)
Benzoyl alcohol (ulesfia)
Lindane shampoo
58. Monitoring of a patient who is taking allopurinol for gout includes
Blood glucose
c-reactive protein
Bun, creatinine, and creatinine clearance
Complete blood count
59. All of the following are true regarding the treatment of scabies except?
Treatment of scabies includes crotamiton, malathion, and lindane
Permethrin 5% cream (elimites) is the drug of choice for the treatment of scabies in
infants greater than 2 months and approved to use in pregnant women
Lindane does not carry risk for toxicity and can be used in children more than 2 years
of age.
Lindane though usually effective carries a risk for toxicity and should be sued in children
60. Which of the following will you find in a patient taking warfarin and levothyroxine?
Cardiac dysrhythmias
Shortness of breath
Excessive bleeding
61. Idarucizumab is used to reverse the activity of which antithrombotic drugs in cases of
Bleeding?
Warfarin
Alteplase
Dalteparin
Dabigatran
62. The patient is receiving anticoagulant therapy. The INR value for the patient today is 1.5. in
response to this what will you do?
Prescribe an additional dose of warfarin
Hold the next of warfarin
Prescribe protamine sulfate
Increase the heparin drip rate
63. A 24 years old patient is diagnosed with genital herpes simplex virus infections. Which of
the following agents is indicated for use in this diagnosis?
Cidofovir
Valacyclovir
Zanamivir
Lamivudine
64. A 19 years old female is diagnosed with bacterial vaginosis. What is a common treatment
Prescribed
Amoxicillin
Metronidazole
Azithromycin
Ciprofloxacin
65. A 19-years-old female comes to your clinic with greenish, malodorous discharge Vulvar
pruritis is also present. On pelvic exam, vaginal mucosa is erythematous, Wet mount of the
discharge shows a motile organism. The patient is started on an appropriate therapy. Later that
evening. The patient develops flushing, nausea, and vomiting after eating dinner with a glass of
wine. The patient was most likely treated with which of the following medications?
Azithromycin
Metronidazole
Ceftriaxone
fluconazole
1. Drugs with a narrow therapeutic window have:
a. High risk for toxicity
2. Pharmacokinetics involves the study of
A) physiologic interactions of drugs.
B) distribution rates among various body compartments.
C) interactions between various drugs.
D) adverse reactions to medications.
3. What are the properties of an ideal drug?
a. Effectiveness, safety, and selectivity
4. Blood concentrations of drugs are variable and are influenced by the:
a. Drug metabolism
5. When developing a treatment plan for a 65-year old patient with BPH, who also takes
medication to control HTN, which medication would you plan to include?
a. Tamusolin (Flomax)
B. Tadalafil (Cialis, adcircal)
C. dutasteride (avodart)
D. finasteride (propecia, proscar)
6. The patients asks if there is any other option besides antibiotics to treat acute otitis
media. How will you respond?
a. Pain management is also part of the treatment plan for otitis media
7. A patient is diagnosed with otitis externa. Comorbidities include DM, HTN, and
advanced MS. Which type of education regarding medication administration would you
Provide?
a. The administration of topical medications for a prescription of alcohol plus acetic
acid solution
b. The administration of topical combination medications for a prescription of
fluoroquinolone/glucocorticoid combination solution
c. The oral administration of a prescription for
hydrocortisone/neomycin/polymyxin B combination solution
d. The oral administration of a prescription for fluoroquinolone
8. Which instructions should be included in the plan of care of a patient who is prescribed
ferrous sulfate?
a. Iron should only be taken at night
b. Iron does not absorb
c. Iron compounds are not taken orally
d. Antacids should not be taken with iron
9. What changes in drug distribution with aging would influence prescribing a medication
in a 90-year-old patient?
Sadie is a 90-year-old patient who requires a new prescription. What changes in drug distribution
with aging would influence prescribing for Sadie? ← similar question on quizlet in case its worded
that way
a. Increased muscle-to-fat ratio
b. Increased volume of distribution
c. Decreased lipid solubility
d. Decreased plasma proteins
10. Gross malformations by teratogens are most likely to occur during which stage of fetal
Development?
a. Weeks 3-8
b. Weeks 24-30
c. Weeks 12-20
d. Week 1-2
11. Which statements about transdermal absorption in infants are correct?
a. Blood flow to the skin is greater in infants than in older patients
b. Infants are at increased risk of toxicity compared with older children
c. The stratum corneum of the infants is very thin, making absorption through the
skin more rapid and complete with infants
d. All answers are correct
12. 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?
a. Birthing process
b. Second trimester
c. Third trimester
d. First trimester
13. Which lab result may be a consequence of therapy with a thiazide diuretic?
a. Serum potassium level of 5.3
b. Serum sodium level of 135
c. Serum glucose level of 58
d. Serum uric acid level of 10.4
14. Which lab test is an indirect measure of atherosclerotic plaque?
a. Erythrocyte sedimentation rate (ESR)
b. LDL
c. Homocysteine
d. CRP
15. What is the MOA of ezetimibe?
a. It inhibits absorption of dietary and biliary cholesterol in the small intestine
b. It decreases the adhesion of cholesterol on the arterial walls
c. It inhibits the absorption of bile, thus causing the liver to produce bile from
cholesterol
d. It inhibits the biosynthesis of cholesterol in the liver
16. Which drug is the most effective for lowering LDL cholesterol?
a. Atorvastatin
b. Gemfibrozil
c. Cholestyramine
d. Ezetimbe
17. Nystatin is used for a variety of conditions. Which condition is not treated with
Nystatin?
a. Vaginal candidiasis
b. Oral candidiasis
c. Intestinal candidiasis
d. Onychomycosis
18. 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?
a. Conjunctivitis
b. Fetal abnormalities
c. Hypertriglyceridemia
d. Hyponatremia
19. Zanamivir is indicted for which of the following?
a. Indicated for both treatment and prophylaxis of influenza
b. Treatment of influenza
c. Treatment of RSV
d. Prophylaxis of influenza
20. What is the treatment option for a patient who reported small, vesicular lesions on his
genitals that lasted between 10 and 20 days?
a. Acyclovir (Zovirax)
b. One-time dose of azithromycin
c. Test of cure
d. Three injections of penicillin
21. Which microorganism is directly affected by acyclovir?
a. Proteus vulgaris
b. Staphylococcus aureus
c. Pneumocystis jiroveci
d. Herpes zoster
22. A 24-year-old patient is diagnosed with genital HSV infection. Which of the following
agents is indicated for use in this diagnosis?
a. Zanamivir
b. Cidofovir
c. Maivudine
d. Valacyclovir
23. A patient diagnosed with lymphagitis has an allergy to penicillin, the allergy is a rash.
What would you give the patient?
a. TMP/SMZ
b. Penicillin VK PO
c. Penicillin G IV
d. Clindamycin (In Dr. Hu’s notes)
24. Which of the following statements best explains the observation that morphine is more
likely to cause nausea and vomiting in ambulatory patients?
a. Opioids cause sedation, which makes walking more difficult
b. Morphine inhibits chemoreceptor trigger zones
c. Opioids increase vestibular sensitivity
d. Morphine sensitizes medulla cough center neurons
25. A patient is given Naloxone for Morphine sulfate who has a respiratory rate of 6 bpm.
What is the MOA of Naloxone?
a. Naloxone is a partial agonist, requiring a lesser dose to achieve pain relief
b. Naloxone is an agonist, leading to desensitization of the opioid receptors
c. Naloxone causes hypersensitivity of the opioid receptors
d. Naloxone prevents the activation of opioid receptors
26. Which of the following will you find in a patient taking warfarin and levothyroxine?
a. Cardiac dysrhythmias
b. SOB
c. Weight loss 5 kg
d. Excessive bruising
27. There is a pregnant patient in your office that states she was given Gentamicin when she
was unknowingly pregnant which of the following adverse effects would you explain to
the patient can result from taking Gentamicin in pregnancy?
a. Cardiac malformation
b. Discoloration of developing teeth
c. Irreversible hearing loss
d. Vision loss
28. When prescribing Metronidazole (Flagyl) to treat bacterial vaginosis, patient education
would include:
a. HA are a sign of serious ADR and need immediate evaluation
b. Consuming alcohol in any form may cause a severe reaction
c. Sexual partners need concurrent therapy
d. Metronidazole is safe in the first trimester of pregnancy
29. A patient is to undergo orthopedic surgery, and the prescriber will order a cephalosporin
to be given preoperatively as a prophylaxis against infection. Which generation of
cephalosporin will the provider order?
a. First
b. Fourth
c. Second
d. Third
30. A patient has a penicillin allergy and needs to be treated for strep throat. Which drug can
be used as an alternative therapy for patients with a penicillin allergy?
a. Linezolid
b. Tetracycline
c. Clindamycin
d. Doxycycline
31. The antimicrobial that is recommended and highly effective for the treatment of
gonorrhea at all anatomic sites of infection
a. Cephalexin
b. Ciprofloxacin
c. Parental ceftriaxone
d. Penicillin
32. Which of the following terms best describes the MOA of metoprolol?
a. Alpha-1 antagonist effects
b. Beta-1 selective
c. Nonselective beta with alpha blockers
d. Nonselective alpha-blockers
33. Which of the following disease or disorders are most likely treated with ACE inhibitors? WHO
KNOWS. I THINK E
a. Hyperthyroidism
b. Pulmonary hypertension
c. Cushing’s syndrome
d. Angina
e. Chronic kidney disease (with or without diabetes) *NOT POSITIVE ON
THIS ONE??
34. Which of the following medications or drug classes is commonly indicated for managing
gestational hypertension?
a. Spironolactone
b. Loop diuretics
c. CCB
d. Dobutamine
e. Calcium gluconate
35. Which prescriber action will have the greatest impact of the patient’s commitment to
adherence to any type of medication therapy?
a. Providing medication education that the patient can easily understand
b. Scheduling once a day administration
c. Prescribing the medication in oral form whenever possible
d. Assuring that the medication prescription will be covered by the patient’s
insurance
1. Instructions for applying a topical antibiotic or antiviral ointment include:
a. Apply thickly to the infected area, spreading the medication well past the borders of the
infection.
b. If the rash worsens, apply a thicker layer of medication to settle down the infection.
c. Wash hands before and after application of topical antimicrobials
d. None of the answer are correct.
2. A patient suspected of having influenza comes to the urgent care for treatment. Which
information will the NP need before prescribing Oseltamivir (Tamiflu)?
a) Allergies to antibiotics
b) Immunization history
c) Length of time since symptoms
d) OTC medications taken in the last 48 hours
3. Which finding is consistent with Guillain-Barré syndrome? Ascending paralysis
a) Patients often experience paresthesia or dysesthesia
b) There is progressing descending paralysis
c) The symptoms usually begin in the arms and face.
d) Sensory nerves are affected more than motor nerves.
4. A medication review of an elderly person’s medications involves:
a) All the answers are correct
b) Having the patient bring all of their prescription, OTC, and home medications to the visit
c) Asking the patient to bring a list of current prescription medications to the visit
d) Asking what other providers are writing prescriptions for them
5. Which antibiotic is recommended for the treatment of Chlamydia
a) High dose pcn
b) High dose fluoroquinolone
c) High dose cephalosporin
d) High dose macrolide
6. A patient diagnosed with lymphangitis has an allergy to pcn, the allergy is a rash. What would
you give this patient?
CX is a 46-year-old patient diagnosed with lymphangitis. CX has a penicillin allergy, the allergy is a
rash. Select the best antimicrobial to treat the lymphangitis in CX.
A. Penicillin G (IV)
B. Penicillin VK (oral)
C. Clindamycin (IV)
D. Trimethoprim-sulfamethoxazole (IV)
E. Vancomycin (oral)
7. MRSA and DRSP (drug-resistant strep pneumoniae) mechanism of bacterial resistance is:
a) Altered membrane permeability
b) Enzyme destruction with Beta-Lactamase
c) None of the answers are correct
d) Binding site alteration
8. A patient has localized skin infection, which is most likely caused by positive cocci. Until the
culture and sensitivity results are available, you order a ___-spectrum ___ agent
a) Narrow; systemic
b) Broad; systemic
c) Broad; topical
d) Narrow; topical
9. A patient has glucose-6-phosphate dehydrogenase deficiency (G6PD) and needs an
antibiotic. Which class of antibiotic should be avoided in this patient? Sulfonamides,
streptomycin, and furazolidone.
a) Cephalosporins
b) Macrolides
c) Sulfonamides
d) Penicillins
10. A patient receiving a cephalosporin develops a secondary intestinal infection caused by c-diff.
What action will the provider take to the provide effective care for this patient?
a) Discontinuing the cephalosporin and beginning metronidazole
b) Increasing the dose of the cephalosporin and providing isolation measures
c) Discontinuing all antibiotics and providing fluid replacement
d) Adding an additional antibiotic to the patient’s regimen
11. Select the term that refers to antibiotics that inhibit bacterial growth:
a. Bacteriolytic
b. Bacteriogenic
c. Bactericidal
d. Bacteriostatic
12. A man is brought to the ER complaining of nausea and vomiting, blurred and abnormally
colored vision, and palpitations. Which drug is most likely responsible for these?
A) dobutamine
B) lisinopril
C) digoxin
D) milrinone
E) furosemide
13. Which drug is the most effective for lowering LDL cholesterol?
a. Ezetimibe
b. Cholestyramine
c. Gemfibrozil
d. Atorvastatin
14. Which one of the following is the most common side effect of antihyperlipidemia drug
therapy?
a. Heart palpitations
b. GI disturbance
c. Elevated BP
d. Neurologic problems
15. A patient has been receiving iron supplement therapy for 2 days after hip replacement
surgery. The provider is alerted to the following assessment data:
Black stools; pale and reports feeling tired; HR 98; RR 20; BP 100/50
What order will the provider take initially to best assure appropriate care for this patient?
a. Hypertonic fluid bolus
b. H&H
c. PRBC
d. Stool guaiac
16. Bioconversion of a prodrug to its active derivative may be enhanced by an enzyme inducer.
a. True
b. False
17. A patient presents to the ED after accidentally taking to much Warfarin. HR 78, BP 120/80.
Urine dipstick normal. The patient does not have any obvious hematoma or petechiae and does
not report any pain. What will the provider order initially to address the patient’s current
condition?
a. Protamine sulfate
b. A PT and INR
c. An APTT
d. Vitamin K
18. All of the following are classification of dietary deficiencies causing nutritional anemia
except:
a. Iron
b. Folic acid
c. Vitamin B12 (cyanobalamin)
d. Vitamin D
19. The patient received an overdose of Morphine. Naloxone is given to block the narcotice
response. Which is the effect achieved when Naloxone is administered?
a. Synergistic
b. Negative
c. Antagonist
d. Addictive
20. Most clinically used opioid analgesics are selective for which type of opioid receptors? Mu
opioid receptor (Pharm book, p. 183-184
a. Beta
b. Kappa
c. Alpha
d.
21. Which route of drug administration is used with potent and lipophilic drugs in a patch
formulation and avoids first-pass metabolism?
a. Sublingual
b. Oral
c. Transdermal
d. Rectal
e. Topical
22. A patient receiving IV gentamicin has a toxic serum drug level. The prescriber confirms that
the dosing is correct. Which possible cause of this situation will the provider explore?
a. If the ordered dose frequency is longer than the gentamicin half-life
b. Whether a loading dose was administered
c. Whether patient is taking a medication that binds to serum albumin
d. If the drug was completely dissolved in the IV solution
23. Which enzyme system is responsible for metabolizing drugs in the liver?
a. Ptyalin
b. Pancreatic lipase
c. Gastric lipase
d. CYP450 enzymes
24. You administer 100 mg of a drug by mouth. After the drug moves through the hepatic
system, very little active drug is left in general circulation. What concept explains this
occurrence?
a. Therapeutic range
b. Drug half-life
c. First-pass effect
d. Plasma protein binding
25. The parents of a child with asthma ask the provider why their child cannot use oral
corticosteroids more often because they are so effective. The provider will base the discussion
with the parents on what fact concerning oral corticosteroids?
a. A hypersensitivity reaction to this drug may occur
b. Chronic glucocorticoid use can inhibit physical growth
c. Frequent use of this drug may lead to a decreased response
d. Systemic steroids are more toxic in children
26. Which statement by a patient about the use of aspirin during pregnancy indicates need for
further learning?
a. “ASA can be used to relieve pain during pregnancy.”
b. “ASA is most harmful when used in late pregnancy.”
c. “ASA can affect hemostasis in newborns.”
d. “ASA can cause antepartum hemorrhage.”
27. Gross malformations by teratogens are most likely to occur during which stage of fetal
development? repeat
a. Weeks 12-20
b. Weeks 3-8
c. Week 1-2
d. Weeks 24-30
28. What changes in drug distribution with aging would influence prescribing a medication in a
90 y/o patient?
a. Decrease plasma proteins
b. Decreased lipid solubility
c. Increased volume of distribution
d. Increased muscle-to-fat ratio
29. Which of the following disease or disorders are most likely treated with ACE inhibitors?
Repeat from above
a. Hyperthyroidism
b. Pulmonary HTN
c. Cushing’s Syndrome
d. Angina
e. CKD (w/ or w/o diabetes)
30. Which of the following terms best describe the mechanism of action of metoprolol? repeat
a. Alpha-1 antagonist effects
b. Beta-1 selective
c.
d. Nonselective Alpha-blockers
31. Which of the following medications or drug classes is commonly indicated for managing
gestational HTN? repeat
a. Spironolactone
b. Loop diuretics
c. CCBs
d. Dobutamine
e. Calcium gluconate
32. A patient diagnosed with otitis externa and taking a fluoroquinolone/ glucocorticoid
combination medication asks the NP what the benefit is to taking the medications together. You
reply?
a. “The glucocorticoid reduces the swelling cause by the inflammation and
decreased pain, while the fluoroquinolone treats the infection.”
b. “The glucocorticoid decreases the adverse effects of the fluoroquinolone.”
c. “The two medications are contraindicated for use together.”
d. “The glucocorticoid decreased the likelihood of antibiotic resistance developing to
the fluoroquinolone.”
33. A 6 y/o child presents with crying d/t ear pain. Tympanic membranes are erythematous,
bulging, and immobile, but intact. In addition to antibiotic therapy, what will the provider
recommend for pain management?
a. Low dose ASA
b. Lidocaine for ear drops
c. A tympanostomy to relieve pressure in the middle ear
d. Prednisone
34. Tretinoin is commonly employed in the treatment of which of the following?
a. Seborrheic dermatitis
b. Psoriasis
c. MS
d. Acne
35. A 20 y/o female presents to your clinic with nodulocystic acne. You prescribe Isotretinoin.
What are the special considerations?
a. Obtain LFTs at baseline and as indicated
b. Adverse effects of Isotretinoin can be increased by tetracyclines and Vitamin A
c. All of the choices are correct
d. Pregnancy test at baseline x2
1. When prescribing acyclovir, patients should be educated regarding the:
a. Eccentric dosing schedule
b. High risk developing diarrhea
c. Need to drink lots of fluids during treatment
d. Risk for life-threatening rash such as Stevens-Johnson
2. A patient is taking oral ketoconazole for a systemic fungal infection. The medication
administration record notes that the patient is also taking omeprazole for reflux disease.
What instructions will the provider give the patient to maximize medication effectiveness?
a. Take the omeprazole at least 2 hours after the ketoconazole.
b. Take the omeprazole 1 hour before the ketoconazole.
c. Wear sunglasses when outdoors to manage photosensitivity.
d. Restrict intake of dairy products.
3. A patient with a history of congestive heart failure and renal impairment is diagnosed with
esophageal candidiasis. Which antifungal agent will the provider prescribe this patient?
a. Fluconazole
b. Itraconazole
c. Voriconazole
d. Amphotericin B
4. Regarding the most common causes of adverse reactions in older adults, which of the
following would you find to be decreased and the most common cause of these problems in
older adults?
a. Body fat content INC
b. Plasma albumin levels
c. Liver function
d. Renal function/clearance
5. Which pediatric client is at greatest risk for medication toxicity?
a. A 15-year old diagnosed with exercise-induced asthma
b. A 6-year old being treated for first degree burns
c. A 10-year old recovering from an appendectomy
d. A 1-year old diagnosed with a heart valve problem
6. Which type of medication prescribed to a pregnant patient is more likely to have effects on
her fetus?
a. Ionized drugs
b. Lipid-soluble drugs
c. Protein-bound drugs
d. Drugs that are highly polar
7. A breastfed 2-month old has an infection that requires an antibiotic. What drug factors
influence the effect of the drug on the infant?
a. Lipid solubility
b. All the answers are correct
c. Maternal drug levels
d. Half-life
8. The Nurse Practitioner is teaching the NP student about acetaminophen. Which of the
following would be included when teaching the student?
a. All of the answers are correct
b. The antidote to acetaminophen overdose is acetylcysteine
c. Patients with normal kidney and liver function should not take more than 4000 mg
per day.
d. Patients need to watch over-the-counter medications for acetaminophen in the
product to prevent an overdose.
9. Which one of the following schedules of controlled substances is for drugs with the highest
abuse potential that have a legitimate medical use?
a. Schedule III
b. Schedule V
c. Schedule II
d. Schedule I
e. Schedule IV
10. What is plasmin’s role in the clotting process?
a. Prevents the conversion of prothrombin to degrade the fibrin within blood clots.
b. Stimulates platelet aggregation
c. Inhibits platelet adhesion and aggregation.
d. Degrades the fibrin within blood clots.
11. Which statements made by the prescriber demonstrate an understanding of effective
medication education? (Select all that apply.)
a. You need to take the medication as we discussed until all the tablets are gone.
b. When you call about a medication refill, be sure to let the pharmacist know you are
talking about your heart pill.
c. Take 3 tablets daily: 1 with breakfast, 1 with lunch, and one with dinner.
d. Call the office immediately if you begin experiencing any itching, headache, or
difficulty breathing.
e. This medication needs to be stored in the refrigerator.
12. Which of the following is NOT an expected adverse effect of Niacin?
a. Arthralgias
b. Hyperglycemia
c. Flushing
d. Itching
13. Which drug inhibits the intestinal absorption of cholesterol?
a. Colestipol
b. Fenofibrate
c. Ezetimibe
d. Colesevelam
14. Which instructions should be included in the plan of care for a patient who prescribed
ferrous sulfate?
a. Iron compounds are not taken orally.
b. Antacids should not be taken with iron.
c. Iron does not absorb.
d. Iron should only be taken at night.
15. A patient is diagnosed with impetigo. Which topical medication will you prescribe?
a. Bacitracin
b. Hydrocortisone
c. Mupirocin
d. Polymyxin B
16. Appropriate initial treatment for psoriasis would be:
a. An immunodulator (Protropic or Elidel)
b. Wet soaks with Burrow’s or Domeboro solution
c. Anthralin (Drithocreme)
d. Intermittent therapy with intermediate potency topical corticosteroids
17. A patient is diagnosed with lymphagitis has an allergy to penicillin, the allergy is a rash.
What would you give this patient?
a. Penicillin VK by mouth
b. Clindamycin
c. Trimethoprim/sulfamethoxazole (TMP/SMZ)
d. Penicillin G IV
18. A 19-year old female is diagnosed with bacterial vaginosis. What is common treatment
prescribed?
a. Amoxicillin
b. Azithromycin
c. Ciprofloxacin
d. Metronidazole
19. A man is brought to the emergency department complaining of nausea and vomiting,
blurred and abnormally colored vision, and palpitations. Which drug is most likely
responsible for these effects?
a. Lisinopril
b. Dobutamine
c. Mirinone
d. Digoxin
20. Therapeutic drug levels are drawn when a drug reaches steady state. Drugs reach steady
state:
a. One hour after IV administration
b. After four to five half-lives
c. When the patient feels the full effect of the drug
d. After the second dose.
21. A generic medication is considered equal, or bioequivalent to its parent brand-name
medication, and must undergo stringent safety and equivalency testing and comply with
specific criteria established by the U.S. Food and Drug Administration (FDA).
a. True
b. False
22. Which drug administration routes avoid first-pass metabolism in the liver?
a. All the answers are correct
b. Intraocular
c. Intranasal
d. Transdermal
23. When two drugs interact what are the possible outcomes?
a. One drug may reduce the effects of the other
b. One drug may intensify the effects of the other
c. All the answers are correct
d. The combination of drugs may produce a new response not seen with either drug
alone.
24. Which of the following groups of people are at risk for early hypertension?
a. African American
b. Adolescents are young adults
c. Mexican American culture
d. Old females
25. Which of the following terms best describes the mechanism of action of metoprolol?
a. Alpha-1 antagonist effects
b. Beta-1 selective
c. Nonselective beta with alpha blocking
d. Nonselective alpha-blockers
26. Which of the following drug classes is/are used in initial hypertension managements of
African-American population?
a. Clonidine primary
b. Beta blockers primary
c. Thiazide of Calcium channel blocker primary
d. ACE-I primary
e. ARB primary
27. What is the first rule of antimicrobial therapy?
a. Use maximum dose
b. Watch for resistance
c. Always do sensitive testing
d. Match drug with the bug
28. Which statement about Ciprofloxacin is accurate?
a. Organisms that commonly cause ear infections are highly resistant
b. Most “first-time” urinary tract infections are resistant to Ciprofloxacin
c. Ciprofloxacin is active against MRSA strains of staphylococci
d. Tendinitis may occur during treatment
29. Risk factors for extended spectrum Beta Lactamase producing organisms include all except:
a. Recent abdominal surgery
b. A gastrostomy tube
c. Attending daycare
d. Use of corticosteroids
30. Select the term that refers to antibiotics that inhibit bacterial growth:
a. Bacteriocidal
b. Bacteriostatic
c. Bacteriogenic
d. Bacteriolytic
31. Which of the following medications is classified as macrolides?
a. Tobramycin
b. Gentamycin
c. Azithromycin
d. Vancomycin
32. A patient is diagnosed with otitis externa caused by Aspergillus organisms. All of the
therapy is appropriate except?
a. 2% acetic acid solution ear drops
b. Ciprofloxacin plus hydrocortisone otic solution
c. Topical 1% clotrimazole
d. Oral fluconazole
33. A 6-year old child presents with crying due to ear pain. Tympanic membranes are
erythematous, bulging, and immobile, but intact. In addition to antibiotic therapy, what will
the provider recommend for pain management?
a. Lidocaine ear drops
b. Prednisone
c. Low dose aspirin
d. A tympanostomy to relieve pressure in the middle ear.
34. Factors released by platelets contribute to hemostasis by enhancing:
a. Vasodilation
b. Intrinsic pathway
c. Fibrinolysis
d. Platelet aggregation
35. The patient is receiving warfarin therapy with the INR of 4.0. How will you interpret this
finding?
a. The level is within the expected therapeutic level of anticoagulation.
b. The level is outside the expected target therapeutic level of anticoagulation; it
is too high.
c. The level cannot be interpreted without knowing the prothrombin time and the
activated partial thromboplastin time (aPTT) value.
d. The level is outside the expected target therapeutic level of anticoagulation: it is too
low. [Show Less]