NR 565 - advanced pharmacology midterm - Chamberlain EXAM; MOCK | 63 Questions and answers

What are two functions of naloxone when a patient is on buprenorphine?

A. Prevention of toxicity

B. Stop c\onstipation caused by Buprenorphine

C. Cannot readily reverse toxicity already occurring

D. Both A and C

D. Both A and C

3 multiple choice options

Why must an NP be cautious when prescribing medications to the elderly population?

A. Due to their diagnosis of dementia.

B. They are high risk for polypharmacy.

C. The elderly population metabolizes medication faster.

D. Prescribe as usual. No difference in elderly patients.

B. They are high risk for polypharmacy.

There are several points of education that should be given to a patient taking acetaminophen. Which of these statements if made by the patient taking acetaminophen is incorrect?

A. "If I take one dose, I should wait at least four hours to take another."

B. "There is no limit to how many tablets I can take each day."

C. "I should not take Tylenol if I have liver disease or chronically drink alcohol."

D. "I can take 325-650mg for mild pain, and 500-1000mg for moderate pain."

B. "There is no limit to how many tablets you can take each day."

What is the point of a prescription drug monitoring program (PDMP)?

A. Help identify patients who may be at risk for overdose

B. Make prescribing faster for providers

C. Educate patients about overdose

D. Provide correct dosing and pricing information for providers

A. Help identify patients who may be at risk for overdose

The purpose of black box warnings is to make providers aware of

A. ways to reduce and prevent harm, such as pregnant women avoiding teratogenic drugs.

B. potential common side effects, such as nausea, vomiting, or upset stomach.

C. potential severe side effects, such as fetal harm, suicidality, or near-fatal dysrhythmias.

D. Both A and C

D. Both A and C

Patients with renal and hepatic insufficiency can experience all of the following effects from medications except:

A. Greater peak effects

B. Longer duration of action

C. Increased risk for respiratory depression

D. Increased dosages of medications

E. Increased risk of overdose

D. Increased dosages of medications

Which of the following is not a guiding principle for prescribers when considering opioid medications?

A. Prescribe opioids only when non-pharmacologic and non-opioid treatments have been ineffective.

B. Use the lowest effective dose for the shortest duration.

C. Assess the patient's risk of overdose.

D. Avoid referring patients to pain specialists for pain management.

D. Avoid referring patients to pain specialists for pain management.

The nurse practitioner will educate their patient on which black box warning associated with methadone?

A. Severe hyperventilation

B. Increased suicidal thoughts in youth

C. Prolonged QT interval

D. Pancreatitis

C. Prolonged QT interval

Which of the following is true regarding prescriptive authority?

A: The Federal Government has total control over the APRN's Prescriptive Authority.

B: APRN Prescriptive Authority is determined by the Individual State.

C: Full Prescriptive Authority is only reached when the APRN has a Doctorate Degree.

D: There are no States where APRNs have Full Prescriptive Authority.

B: APRN Prescriptive Authority is determined by the Individual State.

A black box warning must provide an accurate and concise summary of the drug's adverse effects and the risks associated when taking the medication, even when taken as prescribed.

A. True

B. False

A. True

Which drug class has a side effect of reflex tachycardia?

A. ACE inhibitors

B. Calcium Channel Blockers

C. Thiazide diuretics

D. Beta Blockers

B. Calcium Channel Blockers

Which blood pressure medication is safe for a woman who is pregnant?

A. Lisinopril

B. Amlodipine

C. Labetalol

D. Valsartan

C. Labetalol

Ezetimibe (Zetia) is used to help reduce the absorption of cholesterol in the blood. It is known to help decrease levels of LDL cholesterol, triglycerides, and apolipoprotein B but is known to slightly increase what?

A. CK level

B. Potassium level

C. HDL cholesterol

D. LFTs

C. HDL cholesterol

What are the monitoring needs of thiazide diuretics?

A. Weight

B. Blood Pressure

C. Potassium

D. All of the above

D. All of the above

What medication is the first line recommendation for blood pressure control?

A. ACE Inhibitor

B. ARB

C. Thiazide diuretic

D. Calcium Channel Blocker

C. Thiazide diuretic

When should naloxone be prescribed to a patient?

A. After the patient's first overdose

B. With every opioid prescription

C. At the patient's request

D. After an appointment with a pain specialist

B. With every opioid prescription

What is recommended as first-line drugs for treating hypertension, especially for patients with risk factors for osteoporosis?

A. Thiazides

B. Diuretics.

C. Beta-blockers.

D. ACE inhibitors.

A. Thiazides

When is the appropriate time to recommend that a patient see a pain specialist?

A. 120 mg or more of morphine a day

B. 40 mg morphine daily

C. 25 mcg of fentanyl daily

D. None of the above

A. 120 mg or more of morphine a day

What are the contraindications for ranolazine when treating angina?

A. Hepatic impairment

B. Renal impairment

C. Prior prolonged QT

D. Both A and C

D. Both A and C

The NP understands it is best to avoid prescribing a patient both quinidine and digoxin concurrently because:

A. Digoxin increases increases the rate of absorption of Quinidine

B. Quinidine can promote digoxin toxicity.

C. Quinidine increases renal excretion of digoxin.

D. Digoxin delays the onset of action of Quinidine.

B. Quinidine can promote digoxin toxicity.

Why is the BEERS criteria important?

A. It identifies medications with a high likelihood of causing adverse effects in older adults.

B. Medications on this list should always be given to adults older than 65 years old.

C. It identifies medications that require their dosage to be increased in the presence of impaired kidney function in older adults.

D. It identifies medications frequently prescribed to older adults that are affordable.

A. It identifies drugs with a high likelihood of causing adverse effects in older adults.

Which of the following is a known beta blocker?

A. Labetalol

B. Lisinopril

C. Losartan

D. Amlodipine

A. Labetalol

What class of drugs are the mainstay treatment for heart failure?

A. Aldosterone Receptor Antagonist

B. Loop Diuretics

C. Angiotensin Receptor Neprilysin Inhibitors

D. Thiazide Diuretics

B. Loop Diuretics

In the treatment of hypertension, which drug classification is often preferred for individuals with diabetes due to its potential to improve glucose control while lowering blood pressure?

A. Beta-blockers

B. Calcium channel blockers

C. Angiotensin-converting enzyme (ACE) inhibitors

D. Thiazide diuretics

C. Angiotensin-converting enzyme (ACE) inhibitors

According to CPG Guideline which class of the drugs is first line treatment for the African Americans?

A. Angiotensin-converting enzyme (ACE) inhibitors

B. Thiazide diuretics

C. Calcium Channel Blockers

D. Beta Blockers

B. Thiazide diuretics

How does digoxin effect the heart function?

A. It increases renal excretion of sodium, potassium, and water

B. It acts directly on the vascular smooth muscle promoting vasodilation

C. It can cause QT prolongation

D. It can alter the electrical activity of the heart

D. It can alter the electrical activity of the heart

The patient should be educated to hold digoxin if:

A. Blood pressure is greater than 140/90

B. Respiratory rate is 16

C. Heart rate is lower than 50

D. Febrile

C. Heart rate is lower than 50

Amiodarone should not be taken with grapefruit juice because:

A .Grapefruit juice increases renal excretion of Amiodarone

B. Amiodarone levels can be increased by grapefruit juice.

C. Amiodarone levels can drastically decrease with grapefruit juice.

D. Grapefruit juice delays the onset of action of Amiodarone.

B. Amiodarone levels can be increased by grapefruit juice.

The mechanism of action of Ezetimibe includes

A. Inhibiting reabsorption of cholesterol

B. Reducing cardiac ischemia and the associated pain

C. Increasing the levels of bradykin

D. Increasing the number of LDL receptors on hepatocytes

A. Inhibiting reabsorption of cholesterol

The Atherosclerosis Cardiovascular Disease (ASCVD) Risk Score should be used

A. Evert 2-4 weeks until stabilized

B. Annually

C. At every visit

D. At the initial visit

D. At the initial visit

An 82 year old male visits the clinic complaining that his pain medications "take forever" to work after he takes his pill. What are possible reasons you can explain to him?

A. "Perhaps we need to increase your dosage."

B. "Sometimes as you get older, absorption may be slower resulting in a delayed response."

C. "As we get older the gastric acid decreases and may increase absorption"

D. "Try and lay down after you take the medication."

B. "Sometimes as you get older, absorption may be slower resulting in a delayed response."

When prescribing medication we must understand that liver function declines with age due to what cause?

A. Decreased blood flow to liver

B. Enlarged liver

C. Increased activity of the hepatic enzymes

D. Increased hepatic excretion

A. Decreased blood flow to liver

What is the most important cause of adverse drug reactions in older age?

A. High drug dosages

B. Lack of monitoring medications

C. Decreased renal excretion

D. Overprescribing/polypharmacy

C. Decreased renal excretion

The APRN understands the mechanism of action of calcium channel blockers is to:

A. Increase renal excretion of sodium, potassium, and water

B. Increase levels of bradykin

C. Block angiotensin II in the heart and in the adrenals

D. Act on the arterioles causing dilation and reducing arterial pressure

D. Act on the arterioles causing dilation and reducing arterial pressure

The order of which hypertension medications are typically prescribed:

A. ACE inhibitors, ARBs, BB, CCB

B. Thiazide diuretics, CCB, BB

C. Thiazide diuretics, ACE inhibitors, ARBs, CCB, BB

D. Loop diuretics, ACE inhibitors, ARBs, CCB, BB

C. Thiazide diuretics, ACE inhibitors, ARBs, CCB, BB

Which medication should be prescribed to a patient with hypertension and diabetes?

A. Metoprolol

B. Losartan

C. Carvedilol

D. Amlodipine

B. Losartan

Which of these statements if made by the patient is correct if prescribed Hydrochlorothiazide?

A. "I should monitor my weight daily."

B. "I should hold my dose if my heart rate is less than 50 beats per minute."

C. "This medication may cause a persistent dry cough."

D. "When stopped abruptly, this medication can cause a heart attack."

A. "I should monitor my weight daily."

Which is most important to monitor in patients taking chlorthalidone?

A. no routine labs required

B. hyperkalemia

C. creatinine every 2-4 weeks

D. hypokalemia

D. hypokalemia

Which combination is contraindicated in the treatment of hypertension?

A. hydrochlorothiazide and lisinopril

B. enalapril and valsartan

C. benazepril and amlopdipine

D. chlorthalidone and losartan

B. enalapril and valsartan

When carbamazepine is prescribed with warfarin

A. it can promote warfarin toxicity.

B. it does not require warfarin dosage adjustments.

C. it lowers the effectiveness of warfarin.

D. it increased the effectiveness of warfarin requiring lower dosages.

C. it lowers the effectiveness of warfarin.

A patient dignosed with heart failure should be prescribed

A. pregabalin

B. diltiazem

C. buprenorphine

D. carvedilol

D. carvedilol

The patient requires more education on their prescription of metoprolol if they state:

A. "I did not take it last week because I went out the country."

B. "This medicine helps treat my heart failure and my hypertension."

C. "I may experience erectile dysfunction while taking this medicine."

D. "I should monitor my blood pressure and heart rate"

A. "I did not take it last week because I went out the country."

Patient with heart failure is starting to develop fibrotic changes. Which medication should be prescribed in response to the fibrotic changes?

A. digoxin

B. valsartan

C. furosemide

D. atenolol

B. valsartan

Which diuretic is contraindicated in patient with a reports sulfa allergy?

A. ethercrynic acid

B. torsemide

C. hydrochlorothiazide

D. spironolactone

C. hydrochlorothiazide

A medication reconciliation was done with your patient diagnosed with heart failure. Which medication should be discontinued?

A. digoxin

B. lisinopril

C. propranolol

D. amlodipine

D. amlodipine

Which of the following statements is not true about cardiac glycosides?

A. Does not promote life

B. Alters the electrical activity in the heart

C. Increases myocardial contractile force

D. Negative impact on neurohormonal systems

D. Negative impact on neurohormonal systems

When prescribing medications to neonates it is important to understand that

A. drug absorption in the intestine is delayed due to gastric emptying

B. drug absorption in the stomach is delayed due to gastric emptying

C. drug absorption via intramuscular administration is more rapid compared to adults

D. drug absorption via transdermal administration is slow and erratic

A. drug absorption in the intestine is delayed due to gastric emptying

Your patient has recently discovered she is pregnant. Which medication should be prescribed for the management of her hyperlipemia?

A. nitroglycerin

B. ezetimbie

C. rosuvastatin

D. labetalol

B. ezetimbie

In the treatment of stable angina calcium channel blockers

A. promote relaxation of peripheral arterioles.

B. improve left ventricular ejection fraction

C. reduces the accumulation of sodium and calcium in myocardial cells

D. promote vasodilation on vascular smooth muscle

A. promote relaxation of peripheral arterioles.

Which medication is not a contraindication for ranolazine?

A. ritonavir

B. erythromycin

C. loperamide

D. ketoconazole

C. loperamide

When prescribing opioids the APRN should

A. Prescribe opioids and benzodiazepines concurrently

B. Start opioid dose at the highest effective dose

C. Use immediate release opioids when initiating treatment.

D. Order a urine drug screen 30 days after initiating treatment

C. Use immediate release opioids when initiating treatment.

Which medication should be avoided or used with caution in patients with diabetes?

A. amplodine

B. lisinopril

C. telmisartan

D. hydrochlorothiazide

D. hydrochlorothiazide

Methadone can be used to treat

A. opioid addiction

B. mild pain

C. overdose

D. sedation

A. opioid addiction

When taking Colchicine it is important to avoid what medication group?

A. NSAIDS

B. Statin

C. Sulfa

D. antifungal

B. Statin

The nurse practitioner understands that their patient requires further medication education on their prescription of Alendronate if they state:

A. "I should take this medication with a full glass of water."

B. "I should lay down for 30 minutes after taking this medication."

C. "I should stop taking the medication if I have new or worsening heartburn."

D. "This medication helps prevent and treat osteoporosis in postmenopausal women."

B. "I should lay down for 30 minutes after taking this medication."

Why should Lesinurad always be co administered with allopurinol or febuxostat?

A. it treats gout better

B. it prevents renal failure

C. it helps with GI effects

D. it helps metabolize in the liver

B. it prevents renal failure

What labs need to be routinely monitored for a patient who is prescribed Methotrexate?

A. TSH & SED rate

B. Renal and Hepatic Panels

C. Vitamin D and Calcium

D. Magnesium and Phosphorus

B. Renal and Hepatic Panels

When educating a patient about taking bisphosphonates for osteoporosis, which statement made by the patient demonstrates that more education is needed?

A. "I will not take any antacids, calcium products, or mineral supplements for at least 2 hours after taking the medication".

B. "I will take this medication on an empty stomach first thing in the morning."

C. "I will take medication at night right before I lay down to bed."

D. "I will remain sitting upright for at least 30 minutes after taking the medication."

C. "I will take medication at night right before I lay down to bed."

Which of the following describes the primary mechanism of action for diuretics in the treatment of hypertension and edema?

A. Inhibition of angiotensin-converting enzyme (ACE)

B. Relaxation of blood vessels to reduce peripheral resistance

C. Promotion of sodium and water excretion by the kidneys

D. Blocking of beta-adrenergic receptors in the heart

C. Promotion of sodium and water excretion by the kidneys

Which of the following is not a black box warning for NSAIDs?

A. Thrombotic Events

B. Gastrointestinal Ulceration

C. Liver Cirrhosis

D. Bleeding

C. Liver Cirrhosis

What is the first choice of pharmacological treatment for osteoporosis?

A. Biphosphonates

B. NSAIDs

C. Beta blockers

D. Allopurinol

A. Biphosphonates

Treatment for chronic osteoarthritis includes

A. Allopurinol

B. Hydroxychloroquine

C. Surgery

D. Naproxen

D. Naproxen

Which of the following is a complication of untreated gout?

A. ototoxicity

B. fetal death

C. liver cirrhosis

D. kidney stones

D. kidney stones