Nursing6005 Final exam review Updated Questions With Answers Graded A+, Exams of Nursing

Download Nursing6005 Final exam review Updated Questions With Answers Graded A+ and more Exams Nursing in PDF only on Docsity! Nursing6005 Final exam review Updated Questions With Answers Graded A+ 1) An ACE inhibitor and what other class of drug may reduce proteinuria in patients with diabetes better than either drug alone? A. Beta blockers B. Diuretics C. Nondihydropyridine calcium channel blockers D. Angiotensin II receptor blockers 2) Adam has type I diabetes and plays tennis for his university. He exhibits knowledge deficit about his insulin and his diagnosis. He should be taught that: A. He should increase his increase his carbohydrate intake during times of exercise intake during times of exercise. B. Each brand of insulin is equal in bioavailability, so buy the least expensive. C. Alcohol produces hypoglycemia and can help control his diabetes when taken in small amounts. D. If he does not want to learn to give himself injections, he may substitute an oral hypoglycemic to control his diabetes. 3) Age is a factor in different responses to pain. Which of the following age- related statements about pain is not true? A. Preterm and newborn infants do not yet have functional pain pathways. B. Painful experiences and prolonged exposure to analgesic drugs during pregnancy may permanently alter neuronal organization in the child. C. Increases in pain threshold in older adults may be related to peripheral neuropathies and changes in skin thickness. D. Decreases in pain tolerance are evident in older adults. 4) Alterations in drug metabolism among Asians may lead to: A. Slower metabolism of antidepressants, requiring lower doses B. Faster metabolism of neuroleptics, requiring higher doses C. Altered metabolism of omeprazole, requiring higher doses D. Slower metabolism of alcohol, requiring higher doses 5) Amiodarone has been prescribed in a patient with a supraventricular dysrhythmia. Patient teaching should include all of the following except: A. Notify your healthcare provider immediately if you have visual change. B. Monitor your own blood pressure and pulse daily. C. Take a hot shower or bath if you feel dizzy. D. Use a sunscreen on exposed body surfaces. 6) Anticholinergic agents, such as benztropine (Cogentin), may be given with a phenothiazine to: A. Reduce the chance of tardive dyskinesia. B. Potentiate the effects of the drug. C. Reduce the tolerance that tends to occur. D. Increase CNS depression. 7) An appropriate drug for the treatment of depression with anxiety would be: A. Alprazolam (Xanax) B. Escitalopram (Lexapro) C. Buspirone (Buspar) D. Amitriptyline (Elavil) 8) Cara is taking levetiracetam (Keppra) to treat seizures. Routine education for levetiracetam includes reminding her: A. To not abruptly discontinue levetiracetam due to the risk of withdrawal seizures B. To wear a sunscreen due to photosensitivity from levetiracetam C. To get an annual eye exam while on levetiracetam D. To report weight loss if it occurs 9) Cecilia presents with depression associated with complaints of fatigue, sleeping all the time, and lack of motivation. An appropriate initial antidepressant for her would be: A. Fluoxetine (Prozac) B. Paroxetine (Paxil) C. Amitriptyline (Elavil) D. Duloxetine (Cymbalta) 22) Dwayne was recently started on carbamazepine to treat seizures. He comes to see you, and you note that while his carbamazepine levels had been in the therapeutic range, they are now low. The possible cause for the low carbamazepine levels is: A. Dwayne hasn't been taking his carbamazepine because it causes insomnia. B. Carbamazepine auto-induces metabolism, leading to lower levels in spite of good compliance. C. Dwayne was not originally prescribed the correct amount of carbamazepine. D. Carbamazepine is probably not the right antiseizure medication for Dwayne. 23) Erik presents with a golden-crusted lesion at the site of an insect bite consistent with impetigo. His parents have limited finances and request the least expensive treatment. Which medication would be the best choice for treatment? A. Mupirocin (Bactroban) B. Bacitracin and polymixin B (generic double antibiotic ointment) C. Retapamulin (Altabax) D. Oral cephalexin (Keflex) 24) First-line therapy for hyperlipidemia is: A. Statins B. Niacin C. Lifestyle changes D. Bile acid-binding resins 25) First-line therapy for treating topical fungal infections such as tinea corporis (ringworm) or tinea pedis (athlete's foot) would be: A. OTC topical azole (clotrimazole, miconazole) B. Oral terbinafine C. Oral griseofulvin microsize D. Nystatin cream or ointment 26) Furosemide is added to a treatment regimen for heart failure, which includes digoxin. Monitoring for this combination includes: A. Hemoglobin B. Serum potassium C. Blood urea nitrogen D. Serum glucose 27) Genetic polymorphisms account for differences in metabolism, including: A. Poor metabolizers (PMs) that lack a working enzyme B. Intermediate metabolizers (IMs) that have one working, wild-type allele and one mutant allele C. Extensive metabolizers (EMs), with two normally functioning alleles D. All of the above 28) Genetic testing for VCORC1 mutation to assess potential warfarin resistance is required prior to prescribing warfarin. A. True B. False 29) Goals of treatment when treating hypothyroidism with thyroid replacement include: A. Normal TSH and free T4 levels B. Resolution of fatigue C. Weight loss to baseline D. All of the above 30) Heart failure is a chronic condition that can be adequately managed in primary care. However, consultation with or referral to a cardiologist is appropriate when: A. Symptoms markedly worsen or the patient becomes hypotensive and has syncope. B. There is evidence of progressive renal insufficiency or failure. C. The patient remains symptomatic on optimal doses of an ACE inhibitor, a beta blocker, and a diuretic. D. All the above options are correct. 31) Hypoglycemia can result from the action of either insulin or an oral hypoglycemic. Signs and symptoms of hypoglycemia include: A. "Fruity" breath odor and rapid respiration B. Diarrhea, abdominal pain, weight loss, and hypertension C. Dizziness, confusion, diaphoresis, and tachycardia D. Easy bruising, palpitations, cardiac dysrhythmias, and coma 32) If a patient with H. pylori positive PUD fails first-line therapy, the second- line treatment is: A. A PPI BID plus metronidazole plus tetracycline plus bismuth subsalicylate for fourteen days B. Testing H. pylori for resistance to common treatment regimens C. A PPI plus clarithromycin plus amoxicillin for fourteen days D. A PPI and levofloxacin for fourteen days 33) In addition to methimazole, a symptomatic patient with hyperthyroidism may need a prescription for: A. A calcium channel blocker B. A beta blocker C. Liothyronine D. An alpha blocker 34) Inadequate vitamin D intake can contribute to the development of osteoporosis by: A. Increasing calcitonin production B. Increasing calcium absorption from the intestine C. Altering calcium metabolism D. Stimulating bone formation 35) Incorporating IT into a patient encounter takes skill and tact. During the encounter, the provider can make the patient more comfortable with the IT the provider is using by: A. Turning the screen around so the patient can see material being recorded B. Not placing the computer screen between the provider and the patient C. Both A and B D. Neither A nor B 36) Infants with reflux are initially treated with: A. Histamine 2 receptor antagonist (ranitidine) B. A PPI (omeprazole) C. Antireflux maneuvers (elevate the head of the bed) D. Prokinetic (metoclopramide) 37) In five- to eleven-year-old children, mild-persistent asthma is diagnosed when asthma symptoms occur: A. At nighttime one to two times a month B. At nighttime three to four times a month C. Less than twice a week D. Daily 38) Jack, eight years old, has attention deficit disorder (ADD) and is prescribed methylphenidate (Ritalin). He and his parents should be educated about the side effects of methylphenidate, which are: A. Slurred speech and insomnia B. Bradycardia and confusion C. Dizziness and orthostatic hypotension D. Insomnia and decreased appetite B. attaching to receptors in the afferent neuron to inhibit the release of substance P C. blocking neurotransmitters in the midbrain D. increasing beta-lipoprotein excretion from the pituitary 50) A nineteen-year-old male was started on risperidone. Monitoring for risperidone includes observing for common side effects, including: A. Bradykinesia, akathisia, and agitation B. Excessive weight gain C. Hypertension D. Potentially fatal agranulocytosis 51) Nonadherence is especially common in drugs that treat asymptomatic conditions, such as hypertension. One way to reduce the likelihood of nonadherence to these drugs is to prescribe a drug that: A. Has a short half-life so that missing one dose has limited effect B. Requires several dosage titrations so that missed doses can be replaced with lower doses to keep costs down C. Has a tolerability profile with less of the adverse effects that are considered "irritating," such as nausea and dizziness D. Must be taken no more than twice a day 52) Off-Label prescribing is: A. Regulated by the FDA B. Illegal by NPs in all states (provinces) C. Legal if there is scientific evidence for the use D. Regulated by the DEA 53) One goal of asthma management in children is: A. They should independently manage their asthma. B. They should participate in school and sports activities. C. There should be no exacerbations. D. The use of inhaled corticosteroids should be minimal. 54) The ongoing monitoring of patients over the age sixty-five years taking alendronate (Fosamax) or any other bisphosphonate is: A. Annual dual energy X-ray absorptiometry (DEXA) scans B. Annual vitamin D level C. Annual renal function evaluation D. Electrolytes every three month 55) A patient has been prescribed silver sulfadiazine (Silvadene) cream to treat burns on his or her leg. Normal adverse effects of silver sulfadiazine cream include: A. Transient leukopenia on days two to four that should resolve B. Worsening of burn symptoms briefly before resolution C. A red, scaly rash that will resolve with continued use D. Hypercalcemia 56) Patients who are on or who will be starting chronic corticosteroid therapy need monitoring of . A. serum glucose B. stool culture C. folate levels D. vitamin B12 57) Patients who have angina, regardless of class, who are also diabetic should be on: A. Nitrates B. Beta blockers C. ACE inhibitors D. Calcium channel blockers 58) Patients with psychiatric illnesses have adherence rates to their drug regimen between 35% and 60%. To improve adherence in this population, prescribe drugs: A. With a longer half-life so that missed doses produce a longer taper on the drug curve B. In oral formulations that are more easily taken C. That do not require frequent monitoring D. Combined with patient education about the need to adhere even when symptoms are absent 59) A patient with a COPD exacerbation may require: A. Doubling of inhaled corticosteroid dose B. Systemic corticosteroid burst C. Continuous inhaled beta 2 agonists D. Leukotriene therapy 60) Pharmacokinetics among Asians are universal to all the Asian ethnic groups. A. True B. False 61) A potentially life-threatening adverse response to ACE inhibitors is angioedema. Which of the following statements is true about this adverse response? A. Swelling of the tongue and hoarseness are the most common symptoms. B. It appears to be related to a decrease in aldosterone production. C. The presence of a dry, hacky cough indicates a high risk for this adverse response. D. Because it takes time to build up a blood level, it occurs after being on the drug for about one week. 62) Prescribing for women during their childbearing years requires constant awareness of the possibility of: A. Pregnancy unless the women is on birth control B. Risk for silent bacterial or viral infections of the genitalia C. High risk for developmental disorders in their infants D. Decreased risk for abuse during this time 63) Prior to prescribing metformin, the provider should: A. Draw a serum creatinine to assess renal function. B. Try the patient on insulin. C. Tell the patient to increase iodine intake. D. Have the patient stop taking any sulfonylurea to avoid dangerous drug interactions. 64) Progesterone-only pills are recommended for women who: A. Are breastfeeding B. Have a history of migraine C. Have a medical history that contradicts the use of estrogen D. All of the above 65) Sadie is a seventy-two-year-old who takes omeprazole for her chronic GERD. Chronic long-term omeprazole use places her at increased risk for: A Megaloblastic anemia B. Osteoporosis C. Hypertension D. Strokes 66) Sarah, a forty-two-year-old female, requests a prescription for an anorexiant to treat her obesity. A trial of phentermine is prescribed. Prescribing precautions include understanding that: A. Obesity is a contraindication to prescribing phentermine. B. Anorexiants may cause tolerance and should only be prescribed for six months. C. Patients should be monitored for postural hypotension. D. Renal function should be monitored closely while the patient is on anorexiants. A. Aspirin 81 to 325 mg/d B. Nitroglycerin sublingually for chest pain C. ACE inhibitors or ARBs D. Digoxin 78) The treatment for vitamin B12 deficiency is: A. 1,000 mcg daily of oral cobalamin B. 2 gm/day of oral cobalamin C. 100 mcg/day vitamin B12 IM D. 500 mcg/dose nasal cyanocobalamin two sprays once a week 79) Treatment of a patient with hypothyroidism and cardiovascular disease consists of: A. Levothyroxine B. Liothyronine C. Liotrix D. Methimazole 80) The trial period to determine effective anti-inflammatory activity when starting a patient on aspirin for RA is . A. forty-eight hours B. four to six days C. four weeks D. two months 81) A twenty-four-year-old male received multiple fractures in a motor vehicle accident that required significant amounts of opioid medication to treat his pain. He is at risk for Type ADR when he no longer requires the opioids. A. A B. C C. E D. G 82) The type of ADR that is the result of an unwanted but otherwise normal pharmacological action of a drug given in the usual therapeutic doses is: A. Type A B. Type B C. Type C D. Type D 83) Unlike most type II diabetics where obesity is a major issue, older adults with low body weight have higher risks for morbidity and mortality. The most reliable indicator of poor nutritional status in older adults is: A. Weight loss in previously overweight persons B. Involuntary loss of 10% of body weight in less than six months C. Decline in lean body mass over a twelve-month period D. Increase in central versus peripheral body adiposity 84) Vicky, age fifty-six years, comes to clinic requesting a refill of her Fiorinal (aspirin and butalbital) that she takes for migraines. She has been taking this medication for over two years for migraine and states one dose usually works to abort her migraine. What is the best care for her? A. Switch her to sumatriptan (Imitrex) to treat her migraines. B. Assess how often she is using Fiorinal and refill medication. C. Switch her to a beta-blocker such as propranolol to prevent her migraine. D. Request her to return to the original prescriber of Fiorinal as you do not prescribe butalbital for migraines 85) Warfarin resistance may be seen in patients with VCORC1 mutation, leading to: A. Toxic levels of warfarin building up B. Decreased response to warfarin C. Increased risk for significant drug interactions with warfarin D. Less risk of drug interactions with warfarin 86) What impact does developmental variation in renal function has on prescribing for infants and children? A. Lower doses of renally excreted drugs may be prescribed to infants younger than six months B. Higher doses of water-soluble drugs may need to be prescribed due to increased renal excretion C. Renal excretion rates have no impact on prescribing D. Parents need to be instructed on whether drugs are renally excreted or not 87) When a patient is on selective-serotonin reuptake inhibitors: A. The complete blood count must be monitored every three to four months B. Therapeutic blood levels must be monitored every six months after a steady state is achieved. C. Blood glucose must be monitored every three to four months. D. There is no laboratory monitoring required. 88) When obtaining a drug history from Harold, he gives you a complete list of his prescription medications. He denies taking any other drugs, but you find that he occasionally takes aspirin for his arthritis flare-ups. This is an example of: A. His appropriately only telling you about his regularly prescribed medications B. His hiding information regarding his inappropriate use of aspirin from you C. A common misconception that intermittently taken OTC medications are not an important part of his drug history D. A common misuse of OTC aspirin 89) When prescribing any headache therapy, appropriate use of medications needs to be discussed to prevent medication-overuse headaches. The clinical characteristics of medication-overuse headaches include . A. headaches increasing in frequency B. headaches increasing in intensity C. headaches recurring when medication wears off D. headaches beginning to "cluster" into a pattern 90) When Sam used clotrimazole (Lotrimin AF) for athlete's foot, he developed a red, itchy rash consistent with a hypersensitivity reaction. He now has athlete's foot again. What would be a good choice of antifungal for Sam? A. Miconazole (Micatin) powder B. Ketoconazole (Nizoral) cream C. Terbinafine (Lamisil) cream D. Griseofulvin (Grifulvin V) suspension 91) When starting a patient with hypothyroidism on thyroid replacement hormones, patient education would include the following: A. He or she should feel symptomatic improvement in one to two weeks. B. Drug-related adverse effects such as lethargy and dry skin may occur. C. It may take four to eight weeks to get to euthyroid symptomatically and by lab testing. D. Due to the short half-life of levothyroxine, its doses should not be missed. 92) Which of the following adverse effects may occur due to a dihydropyridine- type calcium channel blocker? A. Bradycardia B. Hepatic impairment C. Increased contractility D. Edema of the hands and feet 93) Which of the following classes of drugs is contraindicated in heart failure? A. Nitrates