Pharmacology NSG 6005 WK 4 actual questions with 100% correct answers + detailed explanations

Asthma exacerbations at home are managed by the patient by:

CORRECT Increasing the frequency of beta 2 agonists and contacting his or her provider

Doubling inhaled corticosteroid dose

Increasing the frequency of beta 2 agonists

Starting montelukast (Singulair)

Howard is a seventy-two-year-old male who occasionally takes diphenhydramine for his seasonal allergies. Monitoring for this patient taking diphenhydramine would include assessing for:

CORRECT Urinary retention

Cardiac output

Peripheral edema

Skin for rash

A patient with a COPD exacerbation may require

Doubling of inhaled corticosteroid dose

CORRECT Systemic corticosteroid burst

Continuous inhaled beta 2 agonists

Leukotriene therapy

Decongestants such as pseudoephedrine (Sudafed):

Are Schedule III drugs in all states

CORRECT Should not be prescribed or recommended for children under four years of age

Are effective in treating the congestion children experience with the common cold

May cause drowsiness in patients of all ages

Many patients self-medicate with antacids. Which patients should be counseled to not take calcium carbonate antacids without discussing with their providers or a pharmacist first?

CORRECT Patients with kidney stones

Pregnant patients

Patients with heartburn

Postmenopausal women

An acceptable first-line treatment for PUD disease with positive H. pylori test is:

Histamine 2 receptor antagonists for four to eight weeks

A PPI twice daily (BID) for twelve weeks until healing is complete

CORRECT A PPI BID plus clarithromycin plus amoxicillin for fourteen days

A PPI BID and levofloxacin for fourteen days

In five- to eleven-year-old children, mild-persistent asthma is diagnosed when asthma symptoms occur:

At nighttime one to two times a month

CORRECT At nighttime three to four times a month

Less than twice a week

Daily

When treating a patient using the "step-down" approach, the patient with GERD is started on ____ first

antacids

histamine 2 receptor antagonists

prokinetics

CORRECT PPIs

A stepwise approach to the pharmacologic management of asthma:

CORRECT Begins with determining the severity of the asthma and assessing asthma control

Is used when the asthma is severe and requires daily steroids

Allows for each provider to determine his or her personal approach to the care of asthmatic patients

Provides a framework for the management of severe asthmatics but is not as helpful when patients have intermittent asthma

Monitoring a patient with persistent asthma includes:

Monitoring how frequently the patient has a upper respiratory infection during treatment

Monthly in-office spirometry testing

Determining whether the patient has increased use of his or her long-acting beta 2 agonists due to exacerbations

CORRECT Evaluating the patient every one to six months to determine whether the patient needs to step up or down in his or her therapy

Infants with reflux are initially treated with:

Histamine2 receptor antagonist (ranitidine)

Proton pump inhibitor (omeprazole)

CORRECT Anti-reflux maneuvers (elevate the head of the bed)

Prokinetic (metoclopramide)

Education of patients with COPD who use inhaled corticosteroids includes the following:

They should double the dose at the first sign of a upper respiratory infection.

They should use the inhaled corticosteroid first and then the bronchodilator.

CORRECT They should rinse their mouths after use.

They should not smoke for at least thirty minutes after use

Patients with pheochromocytoma should avoid which of the following classes of drugs due to the possibility of developing hypertensive crisis?

Expectorants

CORRECT Beta 2 agonists

Antitussives

Antihistamines

One goal of asthma therapy outlined by the NHLBI Expert Panel 3 guidelines is

Use albuterol daily to control symptoms

Minimize exacerbations to once a month

Keep nighttime symptoms at a maximum of twice a week

CORRECT Require infrequent use of beta 2 agonists (albuterol) for relief of symptoms

Metoclopramide improves GERD symptoms by:

Reducing acid secretion

Increasing gastric pH

CORRECT Increasing lower esophageal tone

Decreasing lower esophageal tone

Pregnant patients with asthma may safely use ____ throughout their pregnancies

oral terbutaline

prednisone

CORRECT inhaled corticosteroids (budesonide)

montelukast (Singulair)

Medications used in the management of patients with COPD include:

Inhaled beta 2 agonists

Inhaled anticholinergics (ipratropium)

Inhaled corticosteroids

CORRECT All of the above

Patients who are on chronic long-term PPI therapy require monitoring for:

CORRECT Iron deficiency anemia, vitamin B12, and calcium deficiency

Folate and magnesium deficiency

Elevated uric acid levels leading to gout

Hypokalemia and hypocalcemia