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A prescription needs to be written for:

NR552 Advanced Pharmacology

Week 1 Quiz  

A prescription needs to be written for:

 a.Legend drugs

 

 b.Most controlled drugs

 

 c.Medical devices

 

 d.All possible choices

 

Question 2Patient education regarding prescribed medication includes:

 

 a.Instructions written at the high school reading level

 

 b.Discussion of expected adverse drug reactions

 

 c.How to store leftover medication such as antibiotics

 

 d.Verbal instructions that are always in English

 

Question 3Nurse practitioner prescriptive authority is regulated by:

 

 a.The National Council of State Boards of Nursing

 

 b.The U.S. Drug Enforcement Administration

 

 c.The State Board of Nursing for each state

 

 d.The State Board of Pharmacy

 

Question 4U.S. Food and Drug Administration approval is required for:

 

 a.Medical devices, including artificial joints

 

 b.Over-the-counter vitamins

 

 c.Herbal products, such as St. John’s Wort

 

 d.Dietary supplements, such as Ensure

 

Question 5Treatment goals in prescribing should:

 

 a.Always be curative

 

 b.Be patient centered

 

 c.Be convenient for the provider

 

 d.Focus on the cost of therapy

 

Question 6When determining drug treatment, the NP prescriber should:

 

 a.Always use evidence-based guidelines

 

 b.Individualize the drug choice for the specific patient

 

 c.Rely on his or her experience when prescribing for complex patients

 

 d.Use the newest drug on the market for the condition being treated

 

Question 7Write a prescription for (in textbox or attach file if you like):

 

•             Mr. Jones, age 59 who is newly diagnosed with hyperlipidemia.  You are prescribing atorvastatin 20 mg to be taken once a day. He was instructed about a low fat/low cholesterol diet and routine exercise. He is to get follow up bloodwork in 3 months and return to the office to review his results and medication.

 

Atrovastatin 20 mg , PO X 1 DAILY.

 

Cnkwantah.

 

Question 8Clinical judgment in prescribing includes:

 

 a.Factoring in the cost to the patient of the medication prescribed

 

 b.Always prescribing the newest medication available for the disease process

 

 c.Handing out drug samples to poor patients

 

 d.Prescribing all generic medications to cut costs

 

Question 9Phase IV clinical trials in the United States are also known as:

 

 a.Human bioavailability trials

 

 b.Postmarketing research

 

 c.Human safety and efficacy studies

 

 d.The last stage of animal trials before the human trials begin

 

Question 10Drugs that are designated Schedule II by the U.S. Drug Enforcement Administration:

 

 a.Are known teratogens during pregnancy

 

 b.May not be refilled; a new prescription must be written

 

 c.Have a low abuse potential

 

 d.May be dispensed without a prescription unless regulated by the state

 

 

 

NR552 Advanced Pharmacology

 

Week 2 Quiz  

 

Which of the following is a true statement about drug A that reaches maximum effect at 10 mg as opposed to drug B that requires 100 mg to produce the same effect?

 

 a.Drug A is more efficacious

 

 b.Drug B has a lower affinity

 

 c.Drug A is more potent

 

 d.Drug A is more selective

 

Question 2The point in time on the drug concentration curve that indicates the first sign of a therapeutic effect is the:

 

 a.Minimum adverse effect level

 

 b.Peak of action

 

 c.Onset of action

 

 d.Therapeutic range

 

Question 3Which receptor type acts as a binding site for many hormones, adrenoceptors, and chemokines?

 

 a.Transmembrane G-protein coupled receptor

 

 b.Transmembrane Ligand-gated ion Channels

 

 c.Nuclear receptors

 

 d.Enzyme linked receptors

 

Question 4A provider may consider testing for CYP2D6 variants prior to starting tamoxifen for breast cancer to:

 

 a.Ensure the patient will not have increased adverse drug reactions to the tamoxifen

 

 b.Identify potential drug—drug interactions that may occur with tamoxifen

 

 c.Reduce the likelihood of therapeutic failure with tamoxifen treatment

 

 d.Identify poor metabolizers of tamoxifen

 

Question 5What is the effect of drug antagonism?

 

 a.There is an increased physiologic response of endogenous hormones

 

 b.The drug Is modified by the concurrent administration of another drug

 

 c.The drug cannot be metabolized before another dose is administered

 

 d.There is a decreased physiological response when combined with another drug

 

Question 6Pharmacodynamics involves the biological effects of a drug that is exerted on a living system which occurs by ligand complexes. When considering the effect of the drug on the body, the NP know that which of the following is not considered a ligand?

 

 a.Membrane receptors

 

 b.Enzymes

 

 c.Albumin

 

 d.Intracellular receptors

 

Question 7Up to 21% of Asians are ultra-rapid 2D6 metabolizers, leading to:

 

 a.A need to monitor drugs metabolized by 2D6 for toxicity

 

 b.Increased dosages needed of drugs metabolized by 2D6, such as the selective serotonin reuptake inhibitors

 

 c.Decreased conversion of codeine to morphine by CYP2D6

 

 d.The need for lowered dosages of drugs, such as beta blockers

 

Question 8A patient’s nutritional intake and laboratory results reflect hypoalbuminemia. This is critical to prescribing because:

 

 a.Distribution of drugs to target tissue may be affected.

 

 b.The solubility of the drug will not match the site of absorption.

 

 c.There will be less free drug available to generate an effect.

 

 d.Drugs bound to albumin are readily excreted by the kidneys.

 

Question 9Rifampin is a nonspecific CYP450 inducer that may:

 

 a.Lead to toxic levels of rifampin and so must be monitored closely

 

 b.Cause toxic levels of drugs, such as oral contraceptives, when coadministered

 

 c.Induce the metabolism of drugs, such as oral contraceptives, leading to therapeutic failure

 

 d.Cause nonspecific changes in drug metabolism

 

Question 10The nurse practitioner (NP) chooses to give cephalexin every 8 hours based on knowledge of the drug’s:

 

 a.Propensity to go to the target receptor

 

 b.Biological half-life

 

 c.Pharmacodynamics

 

 d.Safety and side effects

 

 

 

NR552 Advanced Pharmacology

 

Week 3 Quiz  

 

Ray has been diagnosed with hypertension and it is determined that an angiotensin-converting enzyme inhibitor is needed. Prior to prescribing this drug, the nurse practitioner (NP) should assess for:

 

 a.Hypokalemia

 

 b.Impotence

 

 c.Decreased renal function

 

 d.Inability to concentrate

 

Question 2Because of their site of action, bile acid sequestering resins:

 

 a.Should be administered separately from other drugs by at least four hours

 

 b.May increase the risk for bleeding

 

 c.Both a. and b.

 

 d.Neither a. or b.

 

Question 3Adherence to beta blocker therapy may be affected by their:

 

 a.Short half-lives requiring twice daily dosing

 

 b.Tendency to elevate lipid levels

 

 c.Effects on the male genitalia, which may produce impotence

 

 d.None of the possible choices

 

Question 4Which 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

 

Question 5While taking an ARB, patients need to avoid certain over-the-counter drugs without first consulting the provider because:

 

 a.Salt substitutes may contain potassium and put the patient at risk for hyperkalemia.

 

 b.Nonsteroidal anti-inflammatory drugs reduce may reduce effect of the ARB.

 

 c.Taking an ARB with an antacid will decrease the effectiveness.

 

 d.Both 1 and 2

 

Question 6The choice of diuretic to use in treating hypertension is based on:

 

 a.Presence of diabetes with loop diuretics being used for these patients

 

 b.Level of kidney function with a thiazide diuretic being used for an estimated glomerular filtration rate higher than the mid-40 mL/min range

 

 c.Ethnicity with aldosterone antagonists best for African Americans and older adults

 

 d.Presence of hyperlipidemia with higher doses needed for patients with low-density lipoproteins (LDL) above 130 mg/dL

 

Question 7Jim is being treated for hypertension. Because he has a history of heart attack, the drug prescribed is atenolol. Beta blockers treat hypertension by:

 

 a.Increasing heart rate to improve cardiac output

 

 b.Reducing vascular smooth muscle tone

 

 c.Increasing aldosterone-mediated volume activity

 

 d.Reducing aqueous humor production

 

Question 8Despite good blood pressure control, an NP might change a patient’s drug from an ACE inhibitor to an angiotensin II receptor blocker (ARB) because the ARB:

 

 a.Is stronger than the ACE inhibitor

 

 b.Does not produce a dry, hacking cough

 

 c.Has no effect on the renal system

 

 d.Reduces sodium and water retention

 

Question 9Which of the following diagnostic results would NOT indicate a problem related to a reductase inhibitor?

 

 a.Elevated serum transaminase

 

 b.Increased serum creatinine

 

 c.Elevated creatinine kinase

 

 d.Increased white blood cell count

 

Question 10To reduce potential adverse effects, patients taking a peripherally acting-1 antagonist should do which of the following?

 

 a.Take the dose at bedtime

 

 b.Take the dose in the am without food.

 

 c.Monitor their blood pressure and skip a dose if the pressure is less than 120/80

 

 d.Weigh themselves daily and report weight gain of greater than two pounds in one day

 

 

 

NR552 Advanced Pharmacology

 

Week 5 Quiz  

 

Question 1 The known drug interactions with the inhaled corticosteroid beclomethasone (Qvar) include:

 

 a. Albuterol

 

 b. Measles, mumps, and rubella (MMR) vaccine

 

 c. Insulin

 

 d. None of the possible choices

 

Question 2When prescribing temazepam (Restoril) for insomnia, patient education includes:

 

 a.Take temazepam nightly approximately 15 minutes before bedtime.

 

 b.Temazepam should not be used more than three times a week for less than three months.

 

 c.Drinking one ounce of alcohol will cause additive effects and the patient will sleep better.

 

 d.Exercise for at least 30 minutes within two hours of bedtime to enhance the effects of temazepam.

 

Question 3A patient is started on paroxetine (Paxil), an SSRI, for depression. Education regarding antidepressants includes:

 

 a.SSRIs may take two to six weeks before they will have maximum drug effects.

 

 b.Red-green color blindness may occur and should be reported.

 

 c.If they experience dry mouth or a heart rate greater than 80, they should stop taking the drug immediately.

 

 d.It is important to eat lots of food high in fiber to prevent constipation.

 

 

 

NR552 Advanced Pharmacology

 

Week 6 Quiz  

 

Patients taking antacids should be educated regarding these drugs, including letting them know that:

 

 a.They may cause constipation or diarrhea.

 

 b.Many are high in sodium.

 

 c.They should separate antacids from other medications by one hour.

 

 d.All possible choices

 

Question 2GLP-1 agonists:

 

 a.Directly bind to a receptor in the pancreatic beta cell

 

 b.Have been approved for monotherapy

 

 c.Speed gastric emptying to decrease appetite

 

 d.Can be given orally once daily

 

Question 3The action of gliptins is different from other antidiabetic agents because they:

 

 a.Have a low risk for hypoglycemia

 

 b.Are not associated with weight gain

 

 c.Close ATP-dependent potassium channels in the beta cell

 

 d.Act on the incretin system to indirectly increase insulin production

 

Question 4A 10-year-old patient presents with uncomfortable constipation. Along with diet changes, a laxative is ordered to provide more rapid relief of constipation. An appropriate choice of medication for a 10-year-old child would be:

 

 a.PEG 3350 (Miralax)

 

 b.Bisacodyl (Dulcolax) suppository

 

 c.Docusate (Colace) suppository

 

 d.Methylnaltrexone

 

Question 5Elderly patients who are on levothyroxine for thyroid replacement should be monitored for:

 

 a.Excessive sedation

 

 b.Tachycardia and angina

 

 c.Weight gain

 

 d.Cold intolerance

 

Question 6Patients who are on chronic long-term proton pump inhibitor therapy require monitoring for:

 

 a.Iron deficiency anemia, vitamin B12 and calcium deficiency

 

 b.Folate and magnesium deficiency

 

 c.Elevated uric acid levels leading to gout

 

 d.Hypokalemia and hypocalcemia

 

Question 7Which characteristic of metformin makes it a popular selection for diabetes care?

 

 a.No gastrointestinal (GI) side effects

 

 b.Only rarely causes hypoglycemia

 

 c.Pain-free injections due to the micro needle

 

 d.Once-weekly dosing

 

Question 8A young adult will be traveling to Mexico with her church group over spring break to build houses. She is concerned she may develop traveler’s diarrhea. Advice includes following normal food and water precautions as well as taking:

 

 a.Loperamide four times a day throughout the trip

 

 b.Bismuth subsalicylate before each meal and at bedtime

 

 c.Prescription diphenoxylate with atropine if she gets diarrhea

 

 d.Calcium carbonate (Tums) four times a day for stomach upset

 

Question 9 Lispro is an insulin analogue produced by recombinant DNA technology. Which of the following statements about this form of insulin is NOT true?

 

 a.Optimal time of preprandial injection is 15 minutes.

 

 b.Duration of action is increased when the dose is increased.

 

 c.It can be used in combination with NPH insulin.

 

 d.It a rapid acting insuln

 

Question 10An elderly person has been prescribed lactulose for treatment of chronic constipation. Monitoring with long-term treatment would include:

 

 a.Electrolytes, including potassium and chloride

 

 b.Bone mineral density for osteoporosis

 

 c.Magnesium level

 

 d.Liver function

 

 

 

NR552 Advanced Pharmacology

 

Week 7 Quiz  

 

Question 1 Both men and women experience bone loss with aging. The bones most likely to demonstrate significant loss that results in major impairment are:

 

a.Cortical bones

 

b.Femoral neck bones

 

c.Cervical vertebrae

 

d.Pelvic bones

 

Question 2Prophylactic use of bisphosphonates is recommended for patients with advancing osteopenia related to long-term use of which of the following drugs?

 

a.Selective estrogen receptor modulators

 

b.Aspirin

 

c.Glucocorticoids

 

d.Calcium supplements

 

Question 3Bisphosphonate administration education includes:

 

a.Taking it on a full stomach

 

b.Sitting erect for at least 30 minutes afterward

 

c.Drinking it with orange juice

 

d.Taking it with H2 blockers or proton pump inhibitors (PPIs) to protect the stomach

 

Question 4Patients who are on or who will be starting chronic corticosteroid therapy need monitoring of:

 

a.Serum glucose

 

b.Stool cultures

 

c.Folate levels

 

d.Vitamin B12

 

Question 5A patient who has been taking 10 mg per day of prednisone for the past six months should be assessed for:

 

a.Gout

 

b.Iron deficiency anemia

 

c.Osteoporosis

 

d.Rena dysfunction

 

Question 6An 82-year-old takes two aspirin every morning to treat the arthritis pain in his back. The patient states the aspirin helps him to “get going” each day. Lately the patient has had some heartburn from the aspirin. After ruling out an acute GI bleed, what would be an appropriate course of treatment for him?

 

a.Add an H2 blocker such as ranitidine to his therapy.

 

b.Discontinue the aspirin and switch him to Vicodin for the pain.

 

c.Decrease the aspirin dose to one tablet daily.

 

d.Instruct the patient to take an antacid 15 minutes before taking the aspirin each day.

 

Question 7Patients who are on long-term aspirin therapy should have ______ annually.

 

a.Complete blood count

 

b.Salicylate level

 

c.Amylase

 

d.Urine analysis

 

Question 8When prescribing NSAIDs, a complete drug history should be conducted as NSAIDs interact with these drugs:

 

a.Omeprazole, a proton pump inhibitor

 

b.Combined oral contraceptives

 

c.Diphenhydramine, an antihistamine

 

d.Warfarin, an anticoagulant

 

Question 9Write the prescription for your patient who is requiring a 5 day burst of prednisone for an asthma exacerbation. You want them to have 50 mg per day.

 

Question 10Drugs that increase the risk of osteoporosis include:

 

a.Oral combined contraceptives

 

b.Carbamazepines

 

c.Calcium channel blockers

 

d.High doses of vitamin D

 

 

 

NR552 Advanced Pharmacology

 

Week 9 Quiz  

 

Question 1A 2-year-old child with asthma has been diagnosed with influenza A. Appropriate treatment would be:

 

a.Amantadine (Symmetrel)

 

 b.Zanamivir (Relenza)

 

 c.Oseltamivir phosphate (Tamiflu)

 

 d.Symptomatic care

 

Question 2A patient with glucose-6-phosphate dehydrogenase deficiency (G6PD) requires an antibiotic. Which class of antibiotics should be avoided in this patient?

 

a.Penicillins

 

 b.Macrolides

 

 c.Cephalosporins

 

 d.Sulfonamides

 

Question 3 Fluoroquinolones have a black box warning regarding ________ even months after treatment.

 

a.Renal dysfunction

 

 b.Hepatic toxicity

 

 c.Tendon rupture

 

 d.Development of glaucoma

 

Question 4A child has been diagnosed with strep throat and needs a prescription for an antibiotic. The parent says the last time they had penicillin they developed a pink, blotchy rash five or six days after starting the antibiotic. An appropriate antibiotic to prescribe would be:

 

 a.Clindamycin

 

 b.Amoxicillin

 

 c.Cefadroxil (Duricef)

 

 d.Azithromycin

 

Question 5 When prescribing metronidazole (Flagyl) to treat bacterial vaginosis, patient education would include:

 

a.Metronidazole is safe in the first trimester of pregnancy.

 

 b.Consuming alcohol in any form may cause a severe reaction.

 

 c.Sexual partners need concurrent therapy.

 

 d.Headaches are a sign of a serious adverse reaction and need immediate evaluation.

 

Question 6Infants and young children are at higher risk of developing antibiotic-resistant infections due to:

 

a.Developmental differences in pharmacokinetics of the antibiotics in children

 

 b.The fact that children this age are more likely to be in daycare and exposed to pathogens from other children

 

 c.Parents of young children insisting on preventive antibiotics so they don’t miss work when their child is sick

 

 d.Immunosuppression from the multiple vaccines they receive in the first two years of life

 

Question 7Tetracyclines should not be prescribed to children younger than 8 years due to:

 

a.Risk of developing cartilage problems

 

 b.Development of significant diarrhea

 

 c.Risk of kernicterus

 

 d.Adverse effects on bone growth

 

Question 8 A 13-year-old child comes to the clinic with a four-day history of cough, low-grade fever, and rhinorrhea. When she blows her nose or coughs the mucous is greenish-yellow. The appropriate treatment would be:

 

a.Amoxicillin

 

 b.Amoxicillin/clavulanate

 

 c.TMP/SMZ (Septra)

 

 d.Symptomatic care

 

Question 9 When prescribing acyclovir, patients should be educated regarding the:

 

a.High risk of developing diarrhea

 

 b.Need to drink lots of fluids during treatment

 

 c.Risk for life-threatening rash such as Stevens-Johnson syndrome

 

 d.Eccentric dosing schedule

 

Question 10 Selection of drug therapy for hepatitis C (HCV) infection is based on:

 

a.Patient cardiac function

 

 b.Genotype and stage of disease

 

 c.Age of the patient

 

 d.Availability of generic preparation

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