NU 553- Final actual questions with 100% correct answers + detailed explanations

The first step in the prescribing process is an

Accurate diagnosis

What are the required components of a prescription

Patient Name

DOB

Drug name

Drug dosage

How much drug to take

Number of tablets

Prescribers signature

License number

DEA number

The best way to dispose of unused prescription drugs is a

Community drug take - back program

Schedule II drugs require a

New prescription prior to each dispense

May alter the value of distribution

Age

Edema

General of the patient

Agonist drugs display an

Affinity for a receptor and stimulate a response

IV route results in

100% bioavailbility

TB medications can cause

Peripheral paresthesia

What helps with peripheral paresthesia in patients taking TB medication?

Supplemental pyridoxine

B6 can help

Cycline antibiotics cause

Increased skin and overall sensitivity to sunlight

When prescribing antibiotics empirically a

Culture and sensitivity is the gold standard for susceptibility

You may have to change the antibiotic if the organism is not susceptible

C-Diff treatment includes

Vancomycin

Must be given orally to address the infection in the gut

Pharmacogenomics refers to

Inherited gene variations on drug therapy and response

When 2 different drugs that bind to the same plasma protein are being taken this

Increases free drug and potential drug toxicity

If a patient's labs such as INR are not responding as a expected and there is excellent compliance genetic testing of the patient's

CYP2C9 may reveal related decreased enzyme activity

Patient with agitated and threatening dementia may require

Antipsychotics

Polypharmacy is

At a higher risk with stockpiling meds, many specialities and meds to treated side effects

When pharmacists change one med for another with provider approval this is called

Therapeutic interchange is usually due to the patient's insurance

This is not about genetic equivalent but therapeutic equivalent

A fetus is susceptible to effects of drugs at

Day 14

Pediatric dosing is based on the

The patient's body weight is usually in kg

Medications with a shorter high life are preferred during

Breast feeding due to reduced risk of harm to the infant

Patient history of HTN, CHF and ulcers must be known before

Prescribing NSAID

Gout pain is

Nociceptive pain

Constipation is likely with

Prolonged opioid use

Treat the condition the patient currently has

IF a new condition

**Do not overtreat old conditions in hopes of a better outcome for a new concern

Ex. Hx of insomnia--> not sleeping with new back pain

Tylenol is a good choice for

Mild pain

Duloxetine is a good choice for

Neuropathic low back pain

Opioid use disorders treatment requires

Consideration of social support

Previous treatment

Comorbidities

Respirator depression risk is higher with

Methadone when considering MAT treatment

THC produces

Psychoactive effects

Order of treatment in depression is

SSRIs

Atypical

TSAs

Fluoxetine is an appropriate choice for

School-aged children with clinical depression

It also has less drowsiness, generally

Duloxetine can worsen

Bipolar mania

**Should be evaluated before using for treatment of depression

St Johns Wort a herbal supplement for depression treatment can interfere with

Anticoagulation meds

Nursing home residents are at a high risk for

Depression

Expect eventual remission of associated symptoms in patient with

No side effects to anxiety treatment

Wellbutrin treats

ADHD

Some sexual dysfunction

Smoking cessation

Wellbutrin is considered a

Dopamine reuptake inhibitors

An atypical

Methylphenidate treats

ADHD in school age chilren

Risk factors for ADHD include

Parental smoking

Siblings with ADHS

Very low birth weight

Pramipexole is first line for

Restless leg syndrome

Itching sensations are more likely associated with

Allergic contact dermatitis

Hydrocortisone cream is first line treatment for

Atopic dermatitis

In older adults what is a common presentation of contact dermatitis

Scaling

Hydrocortisone cream of 1% can effectively treat contact dermatitis in

7 days

Staph Aureus is the bacteria causing

Impetigo

Honey crusted lesions

Intertrigo in pannus folds initially is treated by

Nystatin powder

Herpes Zoster rashes presenting over 72 hours without further spread should NOT have

Antiviral agents due to dissemination ends

Good glycemic control mitigates risk for

Diabetic foot infection

Infliximab IV may be used to treat

Ulcerative colitis

Severe plaque psoriasis

TB skin testing or TB gold serum testing is commonly required before

Initiation of monoclonal antibody therapies

Clindamycin topical rarely causes

Pseudomembranous colitis, a known ADR

Pneumonia accounts for more deaths than

Other vaccine preventable bacterial conditions

Oral tetracycline may be used for treating acne after failure with

Topical agents, including clindamycin for over 6 weeks

Excessive dryness and skin peeling with tretinoin may require

Decreasing use to every other night

The Ipledge programs relates to prescribers writing for

Isotretinoin due to teratogenicity

Rosacea failing topic metronidazole and continuing with existing pustules may advance to

Doxycycline oral

Otitis externa- swimmers ear

Drops

Otitis media- ear infection involving the TM

Oral antibiotics- amoxicillin is first line

Or Cefdinir is patient is allergic to penicillin

Anaphylaxis is a

Type 1 hyerpersensitivity reaction

Cetirizine 2.5 mg dose is appropriate for

4 year old

MAO inhibitor use is contraindicated with

Pseudoephedrine

After failing nasal fluticasone for allergic rhinitis,

Oral fexofenadine would be appropriate

The first step is to remove the allergen if possible in

Treatment of allergic rhinitis

Cyanocobalamin 1000 mcg SQ or IM monthly treats

Pernicious anemia

Folate deficiency before and during pregnancy may lead to

Neural tube defects

Sexual transmission is the most common route of

HIV infection spread

In order of preexposure HIV

Prophylaxis (PrEP) to be effective it must be taken every day

Protease inhibitors are associated with the development of

Lipodystrophy

Human leukocyte antigen (HLA) system has the greatest impact for the risk of

Organ transplant rejection

Swollen and bleeding gums is associated possible side effect of

Cyclosporin post organ transplant

A proximal DVT is a

High risk life threatening emergency

Patients on warfarin must be monitored via

INR labs

When the INR is higher than desired, holding a dose is recommended then re-evaluate

When a D-Dimer is under 450

Thrombus can usually be ruled out

PERC scores help to rule out if further testing is needed for

PE

DOACs use in mechanical heart valves is

Not approved

Treatment of iron deficiency anemia should not

Occur with general vitamin supplements

Augmentin is first line for

Sinusitis

875mg BID x 7-10 days

The beta- lactam is inhibited by the

Clavulanate

Symptoms of CAP include

Tachy heart rate

SOB

Cough

Low grade fever Infiltrates on CXR

Inhaled corticosteroids are the cornerstone of

Asthma management

Budesonide-formoterol is preferred as needed for

Intermittent asthma

Symptom score and severity category should be used to categorize a patient's

Chronic obstructive pulmonary disease (COPD) severity category

Smoking cessation slows progression of

COPD

In COPD what is the first line?

Bronchodilators

Annual influenza vaccine is part of

Chronic conditions, respiratory management unless contraindicated

Montelukast blocks the action of

Leukotriene D4 May be indicated in asthma management.

Fluoroquinolones have a black box warning for

Tendon rupture

Oseltamivir can shorten the duration for

Influenza

Intranasal OTC epinephrine compounds are known to cause

Spike in blood pressure and elevation

Augmentin + a Z pack is indicated for

CAP with comorbiditis

What is the second line for CAP?

Levaquin

A prednisone burst of 40 mg QD x 5 could be one therapy indicated for

Asthma exacerabtion

Z packs may not be as effective for

Smokers

Can cause prolonged QT intervals

Hydralazine is a

Direct vasodilator

Bilateral renal artery stenosis is a contraindication for

ACEs and ARBs

Degradation of bradykinin and the stimulation of prostaglandin may be triggered by

Enalapril

Chlorthalidone and amlodipine are superior to ACEIs

In treating HTN in blacks.

Some drugs that are safe for pregnant women with high blood pressure include,

Methyldopa

**A secondary option for treating hypertension in pregnancy

Spironolactone is contraindicated in

High potassium levels