NUR641E
Advanced Pathophysiology & Pharamacology for Nurse Educators
Week 1
Discussion
DQ1 Part 1
What are the differences between primary
and secondary line of defense? What factors interfere with these mechanisms?
How are these levels of immunity affected in a child, an elderly person, or a
person with a chronic disease? Include active, passive, innate, and acquired
immunity.
Part 2
Choose an inflammatory or infectious
process and explain the pathophysiology changes that may occur. What patient
education would need to be included related to this disorder? Choose a medical
condition different from that of your fellow students.
DQ2 Select a medication used in
evidence-based treatment guidelines for the condition chosen in the first
discussion question. Share the mechanism of action of this medication and hints
for monitoring, side effects, and drug interactions of which one should be
aware. Make sure that you select a different medication than your peers.
Include the name of the medication in the subject line so that the medications
can be followed. Include your references in APA style.
NUR641E
Advanced Pathophysiology & Pharamacology for Nurse Educators
Week 2
Discussion
DQ1 The Beer's criteria contain a list of
drugs that are potentially unsafe for use in older persons. Go to
https://www.sigot.org/allegato_docs/1057_Beers-Criteria.pdf. Select a drug on
the "avoid" list that you have administered to an older patient or a
drug that you know is prescribed for an older adult. Relate the outcome of using
this drug to the pharmacokinetics (absorption, metabolism, distribution, and
excretion) of drugs in an older client. In addition to the link, cite one other
reference to support your post.
DQ2 Many people are using herbal
medications and dietary supplements for the prevention and treatment of medical
problems. Review two current research articles about two of these products.
Based on the findings, what would be the implications for you as a nurse? What
additional research needs to be done in this area? Cite the two references to
support your answer.
NUR641E
Advanced Pathophysiology & Pharamacology for Nurse Educators
Week 3
Discussion
DQ1 Choose a medical condition from the
fluid, electrolyte, or acid-base system and explain the pathophysiology changes
that may occur. What patient education would need to be included related to
this disorder? Choose a medical condition different from that of your fellow
students.
DQ2 Select a medication used in
evidence-based treatment guidelines for the condition chosen in the first
discussion question. Share the mechanism of action of this medication and hints
for monitoring, side effects, and drug interactions of which one should be
aware. Make sure that you select a different medication than your peers.
Include the name of the medication in the subject line so that the medications
can be followed. Include your references in APA style.
NUR641E
Advanced Pathophysiology & Pharamacology for Nurse Educators
Week 4
Discussion
DQ1 Choose a medical condition from the
respiratory system or HEENT system and explain the pathophysiology changes that
may occur. What patient education would need to be included related to this
disorder? Choose a medical condition different from that of your fellow
students.
DQ2 Select a medication used in evidence-based
treatment guidelines for the condition chosen in the first discussion question.
Share the mechanism of action of this medication and hints for monitoring, side
effects, and drug interactions of which one should be aware. Make sure that you
select a different medication than your peers. Include the name of the
medication in the subject line so that the medications can be followed. Include
your references in APA style.
NUR641E
Advanced Pathophysiology & Pharamacology for Nurse Educators
Week 5 Discussion
DQ1 Choose a medical condition from the
cardiovascular system and lymphatic system and explain the pathophysiology
changes that may occur. What patient education would need to be included
related to this disorder? Choose a medical condition different from that of
your fellow students.
DQ2 Select a medication used in
evidence-based treatment guidelines for the condition chosen in the first
discussion question. Share the mechanism of action of this medication and hints
for monitoring, side effects, and drug interactions of which one should be
aware. Make sure that you select a different medication than your peers.
Include the name of the medication in the subject line so that the medications
can be followed. Include your references in APA style.
NUR641E
Advanced Pathophysiology & Pharamacology for Nurse Educators
Week 6
Discussion
DQ1 Choose a medical condition from the
gastrointestinal or genitourinary systems and explain the pathophysiology
changes that may occur. What patient education would need to be included
related to this disorder? Choose a medical condition different from that of
your fellow students.
DQ2 Select a medication used in
evidence-based treatment guidelines for the condition chosen in the first
discussion question. Share the mechanism of action of this medication and hints
for monitoring, side effects, and drug interactions of which one should be
aware. Make sure that you select a different medication than your peers.
Include the name of the medication in the subject line so that the medications
can be followed. Include your references in APA style.
NUR641E
Advanced Pathophysiology & Pharamacology for Nurse Educators
Week 7
Discussion
DQ1 Choose a medical condition from the
neurological, musculoskeletal, or integumentary system and explain the
pathophysiology changes that may occur. What patient education would need to be
included related to this disorder? Choose a medical condition different from
that of your fellow students.
DQ2 Select a medication used in
evidence-based treatment guidelines for the condition chosen in the first
discussion question. Share the mechanism of action of this medication and hints
for monitoring, side effects, and drug interactions of which one should be
aware. Make sure that you select a different medication than your peers.
Include the name of the medication in the subject line so that the medications
can be followed. Include your references in APA style.
NUR641E
Advanced Pathophysiology & Pharamacology for Nurse Educators
Week 8 Discussion
DQ1 Choose a medical condition from the
endocrine system and explain the pathophysiology changes that may occur. What
patient education would need to be included related to this disorder? Choose a
medical condition different from that of your fellow students.
DQ2 Select a medication used in
evidence-based treatment guidelines for the condition chosen in the first
discussion question. Share the mechanism of action of this medication and hints
for monitoring, side effects, and drug interactions of which one should be
aware. Make sure that you select a different medication than your peers.
Include the name of the medication in the subject line so that the medications
can be followed. Include your references in APA style.
NUR641E
Advanced Pathophysiology & Pharamacology for Nurse Educators
Week 2 Assignment
Content Lesson Presentation
Create a 7-8 slide presentation with
speaker notes about a selected disease process and drug class. The presentation
should provide content specific information on the selected disease process and
drug class for staff or students in a clinical environment.
Follow these steps:
Select a disease process and a drug class
used to treat the disease process.
Describe pharmacokinetics and
pharmacodynamics of the drug related to the pathophysiology of the disease
process.
Describe the product, its intended use,
side effects, adverse reactions, and safety issues.
Identify ethnic, cultural, and genetic
differences in patients that may affect the safety or efficacy of medications.
How would you monitor the desired affect is
achieved?
Be sure to include three to five
references.
While APA style is not required for the
body of this assignment, solid academic writing is expected, and documentation
of sources should be presented using APA formatting guidelines, which can be
found in the APA Style Guide, located in the Student Success Center.
This assignment uses a rubric. Please
review the rubric prior to beginning the assignment to become familiar with the
expectations for successful completion.
You are not required to submit this
assignment to LopesWrite
NUR641E
Advanced Pathophysiology & Pharamacology for Nurse Educators
Week 3 Assignment
Acid-Base and Electrolyte Case Study
A nurse is taking care of an 85-year-old
woman in a hospital based skilled nursing facility. In report, the nurse is
told the patient has not been breathing well for the past 2 days. She has been
lethargic, her skin is warm and dry, and she has a decreased urine output. The
following laboratory findings were returned from the laboratory immediately
after morning report:
Na: 147
Cl 110
K 4.0
Blood Gases:
pH 7.33
PCO2 48
HCO3 27
Po2 96
Urine:
Urine Specific Gravity 1.040
Address the following:
Identify each of the abnormal laboratory
findings in the above results. Specify how they differ from a normal range and
identify what condition each abnormality indicates.
What specific electrolyte disturbance does
the patient have?
What clinical manifestations would the
nurse expect to see with this electrolyte abnormality presented above?
If the patient had an increase in her
potassium level, what clinical manifestations would the nurse monitor for?
What blood gas abnormality is seen in this
patient? Discuss the rationale for your answer.
What are the three major mechanisms of pH
regulation?
While APA style is not required for the
body of this assignment, solid academic writing is expected, and documentation
of sources should be presented using APA formatting guidelines, which can be
found in the APA Style Guide, located in the Student Success Center.
This assignment uses a rubric. Please
review the rubric prior to beginning the assignment to become familiar with the
expectations for successful completion.
You are not required to submit this
assignment to LopesWrite
NUR641E
Advanced Pathophysiology & Pharamacology for Nurse Educators
Week 6 Assignment
CLC - Staff Training
This is a Collaborative Learning Community
(CLC) assignment.
This assignment requires completion of two
parts: a presentation and an educational resource.
Part I: Presentation
Create a 15- to 20-slide PowerPoint
presentation with speaker notes for a staff training meeting on the
pathophysiology and pharmacologic agents for a select disease process.
Each CLC will choose one disease process
from the following list and obtain instructor approval to avoid duplication:
1.
Alzheimer's disease
2.
Asthma
3.
Diabetes Type 2
4.
Epilepsy
5.
Gastroesophageal reflux disease (GERD)
6.
Hypertension
7.
Hypothyroidism
8.
Multiple sclerosis
9.
Peptic ulcer disease
10.
Tuberculosis
Describe the physiology and pathophysiology
of the disease, clinical manifestations, and evaluation (e.g., labs, imaging).
Describe the pharmacologic treatment of the
disease, including pharmacokinetics, pharmacodynamics, drug interactions, side
effects, adverse reactions, and application of the nursing process in
monitoring the drug therapy.
Part II: Educational Resource
Using your selected disease process from
Part I, develop an educational resource that can assist staff in increasing
patient knowledge of medications and medication compliance.
The vehicle for your educational resource
could include pamphlets, handouts, or any other brief, concise medium to convey
the information to staff.
APA style is not required, but solid
academic writing is expected.
This assignment uses a rubric. Please
review the rubric prior to beginning the assignment to become familiar with the
expectations for successful completion.
You are required to submit this assignment
to LopesWrite. Please refer to the directions in the Student Success Center.
NUR641E
Advanced Pathophysiology & Pharamacology for Nurse Educators
Midterm
Exam
1 Heparin exerts its therapeutic action
by:
upregulating the activity of one of the
body's natural anticoagulant molecules, antithrombin III.
deactivating calcium-dependent clotting
factors.
inducing prothrombin formation.
inducing the formation of fibrin.
2 Which method of
drug administration can have immediate effects and requires lower doses
compared to oral or parenteral administration?
Intravenous
Sublingual
Transdermal
Inhalation
3 High altitudes may
produce hypoxemia by:
right-to-left shunts.
atelectasis.
decreased oxygen inspiration.
emphysema.
All of the above
4 Causes of
hyperkalemia include:
hyperparathyroidism and malnutrition.
vomiting and diarrhea.
renal failure and Addison's disease.
hyperaldosteronism and Cushing's
disease.
5 Hypomagnesemia
occurs when serum magnesium concentration is less than
1.0 mEq/L.
1.5 mEq/L.
2.0 mEq/L.
3.0 mEq/L.
6 When looking at
arterial blood gas readings, you discover the following: pH 7.26, pCO2 56, HCO3
24. What condition are you dealing with?
Respiratory alkalosis
Metabolic acidosis
Metabolic alkalosis
Respiratory acidosis
7 A drug with a
half-life of 10 hours is administered by continuous intravenous infusion. Which
of the following best approximates the time for the drug to reach steady state?
10 hours
30 hours
40 hours
60 hours
8 Which NSAID is
generally considered the safest for use in patients with coronary artery
disease?
Celecoxib
Indomethacin
Naproxen
Acetaminophen
9 Pulmonary
hypertension:
shows an enlarged pulmonary artery.
involves deep vein thrombosis.
shows right ventricular hypertrophy.
A and C are correct
10 Which stage of infection
is occurring when the immune and inflammatory responses are triggered?
Incubation period
Prodromal stage
Invasion period
Convalescence
11 Which of the
following agents is used to treat hypercalcemia of malignancy?
Activated vitamin D
Pamidronate (Aredia)
Hydrochlorothiazide
Kayexalate
12 Which statement is
true regarding the pharmacokinetics of drug administration?
The immature liver or kidneys of the
very young may accelerate drug metabolism and excretion.
Medications enter the body in solid
form and change into solution for absorption and utilization.
It includes medication absorption,
distribution to tissues, metabolism, and elimination from the body.
A therapeutic effect occurs as the
medication reaches the target cell.
13 Which statement is
true regarding the half-life of medications?
Doubling the dose will double the
medication half-life.
Approximately 2 half-lives are required
for a medication to be completely eliminated.
Patients with renal or hepatic disease
usually have decreased half-lives.
The half-life of a drug helps determine
how often the drug is to be administered.
14 Cell wall
inhibitors include all of the following except
penicillins.
cephalosporins.
carbapenems.
tetracylclines.
15 Which of the
following factors do not influence bioavailability?
First-pass hepatic metabolism
Solubility of the drug
Bioequivalence
Chemical instability
16 Which class of
diuretics treats hypertension by increasing sodium and water retention?
Loop diuretics
Thiazide diuretics
Potassium sparing diuretics
Aldosterone inhibiting diuretics
17 What is the action
of calcitonin?
Increases metabolism.
Decreases metabolism.
Increases serum calcium.
Decreases serum calcium.
18 The nurse has a
patient who has been on multidrug therapy for pulmonary tuberculosis. When
planning patient education, the nurse knows the patient needs to watch for
which symptom of an adverse effect of multidrug therapy?
Hearing loss
Changes in vision
Generalized pruritus
Jaundice
19 The spread of
microorganisms from mother to the baby across the placenta is termed
direct transmission.
vertical transmission.
horizontal transmission.
indirect transmission.
20 Which
antimicrobial should be avoided in children because it is deposited in tissues
undergoing calcification and can stunt growth?
Tetracycline
Ciprofloxacin
Vancomycin
Amoxicillin
21 The primary role
of cytochrome p-450, in the liver, is to:
stimulate steroid release as a stress
response.
deactivate and detoxify medications and
other substances.
produce fibrinogen, prothrombin, and
factor V.
eliminate amino acids, forming urea.
22 Death from
influenza usually results from
high temperature.
dehydration.
pneumonia.
metabolic alkalosis.
23 Which of the
following statements is true regarding bioavailability?
It has little effect on the
pharmacokinetics of orally-administered drugs.
It is a drug-specific property;
therefore, bioavailability will be the same regardless of the dosage form used.
IV-administered drugs have a
bioavailability of between 50 and 75 percent.
It is defined as the amount of
administered drug that is available to reach the site of action.
24 Which of the
following agents is considered a CYP3A4 inhibitor and should be used with
caution in patients taking CYP3A4 substrates?
Phenytoin
Amiodarone
Carbamazepine
Rifampin
25 Which of the
following drugs are not considered for use with angina?
Beta blockers
Calcium channel blockers
ACE inhibitors
Nitrates
26 How many months
does it take for the newborn to be sufficiently protected by antibodies
produced by its own B cells?
1 to 2
4 to 5
6 to 8
10 to 12
27 Low plasma albumin
causes edema as a result of a reduction in which pressure?
Capillary hydrostatic
Interstitial hydrostatic
Plasma oncotic
Interstitial oncotic
28 What mechanism can
cause hypernatremia?
Syndrome of inappropriate antidiuretic
hormone
Hypersecretion of aldosterone
Brief bouts of vomiting or diarrhea
Excessive diuretic therapy
29 What is the direct
action of atrial natriuretic hormone? (Select all that apply.)
Sodium retention
Sodium excretion
Water retention
Water excretion
30 Which of the
following increases the potential of cardiac toxicity if taken concurrently
with digoxin?
Chloride
Potassium
Sodium
Zinc
31 Which of the
following corticosteroids has the shortest half-life and thus must be dosed
most frequently?
Dexamethasone
Hydrocortisone
Methylprednisolone
Prednisone
32 What causes
the rapid change in the resting membrane potential to initiate an action potential?
Potassium gates open, and potassium
rushes into the cell, changing the membrane potential from negative to
positive.
Sodium gates open, and sodium rushes
into the cell, changing the membrane potential from negative to positive.
Sodium gates close, allowing potassium
into the cell to change the membrane potential from positive to negative.
Potassium gates close, allowing sodium
into the cell to change the membrane potential from positive to negative.
33 Which factor
is responsible for the hypertrophy of the myocardium associated with
hypertension?
Increased norepinephrine
Adducin
Angiotensin II
Insulin resistance
34 The major
therapeutic actions of NSAIDS include all of the following except
reduction of inflammation.
reduction of pain.
reduction of fever.
reduction of clotting factors.
35 What is an
example of compensatory hyperplasia?
Hepatic cells increase cell division
after part of the liver is excised.
Skeletal muscle cells atrophy as a
result of paralysis.
The heart muscle enlarges as a result
of hypertension.
The size of the uterus increases during
pregnancy.
36 A patient with
type 1 diabetes has been made NPO after midnight for surgery. Knowing that the
patient needs to continue the insulin pump to prevent diabetic ketoacidosis,
what would be an expectation of treatment?
Bedtime snack before midnight
Dextrose containing intravenous fluids
2am glucose check followed by apple
juice if needed
Discontinue the insulin pump
37 Bacteria
that produce endotoxins that stimulate the release of inflammatory mediators
that produce fever are called
pyrogenic bacteria.
true bacteria.
exotoxins.
spirochetes.
38 A 68-year-old male
has COPD with moderate airway obstruction. Despite using salmeterol daily, as
prescribed, he reports continued symptoms of shortness of breath with mild
exertion. Which one of the following agents would be an appropriate addition to
his current therapy?
Systemic corticosteroids
Albuterol
Tiotropium
Roflumilast
Theophylline
39 Aldosterone
directly increases the reabsorption of (select all that apply):
magnesium.
calcium.
sodium.
water.
40 The most common
cause of lower respiratory tract infection is
aspiration of oropharyngeal secretions.
not receiving the vaccine.
refusing to cough and take deep
breaths.
remaining in bed until postop day two.
41 Which of the
following is true regarding prodrugs?
They are affected considerably by renal
function.
They are better than amateur drugs.
They are designed to overcome
undesirable properties of an active drug.
They may be more effective in patients
with liver dysfunction.
42 In the
immediate postnatal period, infants lose approximately 5% of body weight due to
loss of body water
inability of the body to digest
nutrients
hemolysis of red blood cells
poor sucking reflex
43 Which of the
following best describes the mechanism of action of warfarin?
Directly inhibits factor Xa
Inhibits factors II, VII, IX, and X
Blocks the conversion of fibrinogen to
fibrin
Upregulates antithrombin III
44 When looking at
arterial blood gas readings, you discover the following: pH 7.75, pCO2 24, HCO3
40. What condition are you dealing with?
Respiratory alkalosis
Metabolic acidosis
Metabolic alkalosis
Respiratory acidosis
45 In the absence of
susceptibility data for an acute infection, the choice of an antimicrobial drug
is mostly influenced by
the site of infection and the patient's
history.
the sensitivity report and the colony
count.
the source of the infection and the
color of exudate.
the host defense mechanism and the
immune response.
46 All of the
following can be a likely cause of respiratory acidosis except:
emphysema.
pulmonary edema.
barbiturate overdose.
extreme fear and anxiety.
47 An increase of
carbon dioxide in arterial blood causes chemoreceptors to stimulate the
respiratory centers to:
decrease respiratory rate.
increase respiratory rate.
develop hypocapnia.
develop hypercapnia.
48 The leading cause
of death from a curable infectious disease throughout the world is
pneumonia.
tuberculosis.
HIV infection.
influenza.
49 Which condition
poses the highest risk for a cerebrovascular accident (CVA)?
Insulin-resistant diabetes mellitus
Hypertension
Polycythemia
Smoking
50 Pulmonary emboli
do not cause which of the following?
Obstruct blood supply to lung parenchyma
Have origins from thrombi in the legs
Occlude pulmonary vein branches
Occlude pulmonary artery branches
NUR641E
Advanced Pathophysiology & Pharamacology for Nurse Educators
Final Exam
1.
Insulin is used to treat
hyperkalemia because it:
stimulates sodium to be removed from the
cell in exchange for potassium.
binds to potassium to remove it through the
kidneys.
transports potassium from the blood to the
cell along with glucose.
breaks down the chemical components of
potassium, causing it to be no longer effective.
2 What is the central component of the
pathogenic model of multiple sclerosis?
Myelination of nerve fibers in the
peripheral nervous system (PNS)
Demyelination of nerve fibers in the CNS
Development of neurofibrillary tangles in
the CNS
Inherited autosomal dominant trait with
high penetrance
s3Which of the following ICU sedatives
should not be used for greater than 24 hours per the FDA-approved labeling?
Midazolam (Versed)
Diazepam (Valium)
Dexmedetomidine (Precedex)
Propofol (Diprivan)
4
What type of necrosis is associated with
wet gangrene?
Coagulative
Liquefactive
Caseous
Coagulative
5 In the absence of susceptibility data for
an acute infection, the choice of an antimicrobial drug is mostly influenced by
the site of infection and the patient's
history.
the sensitivity report and the colony
count.
the source of the infection and the color
of exudate.
the host defense mechanism and the immune
response.
6 Which statement best describes cystic
fibrosis?
Obstructive airway disease characterized by
reversible airflow obstruction, bronchial hyperreactivity, and inflammation.
Respiratory disease characterized by severe
hypoxemia, decreased pulmonary compliance, and diffuse densities on chest x-ray
imaging.
Pulmonary disorder involving an abnormal
expression of a protein-producing viscous mucus that obstructs the airways,
pancreas, sweat ducts, and vas deferens.
Pulmonary disorder characterized by
atelectasis and increased pulmonary resistance as a result of a surfactant
deficiency.
7 What medical term is used to identify an
inflammatory disorder of the skin that is often considered synonymous with
dermatitis and characterized by pruritus with lesions that have an indistinct
border?
Eczema
Psoriasis
Atopic dermatitis
Pityriasis rosea
8 Identify whether the description of the
skin lesion matches the disorder where it is found. (Select True or False)
Elevated, firm circumscribed area less than
1 cm in diameter: Wart (verruca) or lichen planus
True
False
9 Removal of part of the liver leads to the
remaining liver cells undergoing compensatory
atrophy.
metaplasia.
hyperplasia.
dysplasia.
10 Identify whether the description matches
the disorder. (Select True or False)
Abnormal dilation of the vein within the
spermatic cord – Varicocele
True
False
11 The risk of which cancer is greater if
the man has a history of cryptorchidism?
Penile
Testicular
Prostate
Epididymal
12 Which substance is used to correct the
chronic anemia associated with chronic renal failure?
Iron
Erythropoietin
Cobalamin (vitamin B12)
Folate
13 Diabetes insipidus is a result of:
antidiuretic hormone hyposecretion.
antidiuretic hormone hypersecretion.
insulin hyposecretion.
insulin hypersecretion.
14 Obesity acts as an important risk factor
for type 2 diabetes mellitus by:
reducing the amount of insulin the pancreas
produces.
increasing the resistance to insulin by
cells.
obstructing the outflow of insulin from the
pancreas.
stimulating the liver to increase glucose
production.
15 Which statement best describes Raynaud's
disease?
Inflammatory disorder of small- and medium-sized
arteries in the feet and sometimes in the hands
Neoplastic disorder of the lining of the
arteries and veins of the upper extremities
Vasospastic disorder of the small arteries
and arterioles of the fingers and, less commonly, of the toes
Autoimmune disorder of the large arteries
and veins of the upper and lower extremities
16 What is the medical term for a fungal
infection of the nail plate?
Paronychia
Onychomycosis
Tinea corporis
Tinea capitis
17 Which proton-pump inhibitor should be
avoided in a patient taking clopidogrel?
Omeprazole
Lansoprazole
Pantoprazole
Rabeprazole
18 All of the following are important
considerations when prescribing metronidazole except?
Instruct patient to avoid alcohol intake
during therapy
Can lead to development of C. difficile
infection
Monitor INR closely due a DDI with warfarin
Dose adjustments should be made in patients
with renal or hepatic dysfunction
19 Which clinical manifestations of a
urinary tract infection may be demonstrated in an 85-year-old individual?
Confusion and poorly localized abdominal
discomfort
Dysuria, frequency, and suprapubic pain
Hematuria and flank pain
Pyuria, urgency, and frequency
20 Which hormone is required for water to
be reabsorbed in the distal tubule and collecting duct?
Antidiuretic hormone
Aldosterone
Cortisol
Adrenocorticotropin hormone
21 All of the following are true regarding
antiepileptics except:
Carbamazepine and phenytoin have numerous
drug-drug interactions.
They are safe to use during pregnancy.
Therapeutic drug monitoring is often
required to ensure therapeutic drug levels.
Phenytoin is a highly protein-bound drug.
22 Alpha1 adrenergic stimulation causes:
bronchial constriction
vascular constriction.
constriction of intestinal smooth muscle.
relaxation of intestinal smooth muscle.
23 Losartan (Cozaar) lowers the blood
pressure by:
blocking calcium channels in the heart and
blood vessels.
directly dilating arterioles without
affecting veins.
suppressing the release of
angiotensin-converting enzyme.
blocking angiotensin II at its receptors.
24 One major reason to discontinue
captopril (Capoten), an ACE inhibitor, is:
hypertension.
hypokalemia.
angioedema.
angina.
25 Which of the following drugs works via
antagonism of 5-HT (serotonin) receptors in the GI tract?
Ondansetron
Droperidol
Prochlorperazine
Aprepitant
26 After a person has a subtotal
gastrectomy for chronic gastritis, which type of anemia will result?
Iron deficiency
Aplastic
Folic acid
Pernicious
27 Orthostatic hypotension refers to a
decrease of at least ___ mmHg in systolic blood pressure or a decrease of at
least _____ mmHg in diastolic blood pressure within 3 minutes of moving to a
standing position.
10; 5
20; 10
30; 15
40; 20
28 Cell wall inhibitors include all of the
following except
penicillins.
cephalosporins.
carbapenems.
tetracylclines.
29 Which of the following agents is
considered a histamine receptor antagonist?
Maalox
Protonix
Zantac
Tums
30 Which of the following drugs is most
likely to reduce the effectiveness of levofloxacin (Levaquin) when given
concomitantly?
Amiodarone (Cordarone)
Metronidazole (Flagyl)
Calcium carbonate (Tums)
Warfarin (Coumadin)
31 Which stage of infection is occurring
when the immune and inflammatory responses are triggered?
Incubation period
Prodromal stage
Invasion period
Convalescence
32 Which of the following is an advantage
of the intravenous route of administration?
Reduced bioavailability
Avoidance of first-pass metabolism
Patient convenience
None of the above are advantages
33 Which of the following antifungal agents
is known to cause significant nephrotoxicity and ototoxicity?
Caspofungin
Fluconazole
Amphotericin B
Nystatin
34 Which NSAID is generally considered the
safest for use in patients with coronary artery disease?
Celecoxib
Indomethacin
Naproxen
Acetaminophen
35 An example of a beta agonist is:
Atenolol (Tenormin)
Clonidine (Catapres)
Isoproterenol (Isuprel)
Amlodipine (Norvasc)
36 Which of the following agents is a
potent vasoconstrictor that can be used to manage acute GI bleeding?
Octreotide
Milrinone
Pantoprazole
Cimetidine
37 What type of fracture occurs at a site
of a preexisting bone abnormality and is a result of a force that would not
normally cause a fracture?
Idiopathic
Incomplete
Pathologic
Greenstick
38 A patient is diagnosed with pulmonary
disease and elevated pulmonary vascular resistance. Which form of heart failure
may result from pulmonary disease and elevated pulmonary vascular resistance?
Right heart failure
Left heart failure
Low-output failure
High-output failure
39 Your patient is taking carbamazepine, a
CYP3A4 substrate, for his seizure disorder. He is experiencing signs of
depression and decides to try St. John's wort, which he purchased
over-the-counter at the local pharmacy. Since St. John's wort is a CYP3A4
inducer, which of the following may occur?
The patient may have an increased risk for
seizure.
The patient may have an increased risk of
carbamazepine-related toxicities.
The patient may need an increased dose of
St. John’s wort.
No clinically-significant drug-drug interaction
is likely to occur.
40 Advair (fluticasone/salmeterol) is a
combination of which of the following?
Short-acting beta agonist and
corticosteroid
Long-acting beta agonist and corticosteroid
Long-acting beta agonist and antihistamine
Short-acting beta agonist and antihistamine
41 Which of the following is true regarding
adverse drug events?
They include medication errors, adverse
effects, allergic reactions, and idiosyncratic reactions.
They are rarely preventable.
They are infrequent in the inpatient
setting.
They are generally over-reported.
42 The function of arachnoid villi is to:
produce cerebrospinal fluid.
provide nutrients to the choroid plexuses.
transmit impulses within the meninges.
absorb cerebrospinal fluid into the
cerebral venous sinuses.
43 The calcium and phosphate balance is
influenced by which three substances?
Parathyroid hormone, ADH, and vitamin D
Parathyroid hormone, calcitonin, and
vitamin D
Thyroid hormone, ADH, and vitamin D
Thyroid hormone, calcitonin, and vitamin D
44 The major therapeutic actions of NSAIDS
include all of the following except
reduction of inflammation.
reduction of pain.
reduction of fever.
reduction of clotting factors.
45 Which of the following agents is
available in an injectable form used to treat acute migraine headaches?
Sumatriptan (Imitrex)T7
Naldolol (Corgard)
Naproxen sodium (Anaprox)
Ergot preparations (Cafergot)
46 A patient presents with vomiting a
coffee-ground looking substance; fatigue, postural hypotension; new onset
systolic murmur; and cool, pale peripheries.
metabolic acidosis with partial respiratory
compensation.
partial respiratory compensation.
metabolic acidosis.
acidosis.
47 Which statements are true regarding
Koplik spots? (Select all that apply.)
Koplik spots are associated with rubeola.
They appear as white spots.
The lesions are surrounded by a red ring.
The lesions of Koplik spots are large in
size.
Koplik spots are primarily found on buccal
mucosa.
48 Which of the following medications is
most likely to increase fall risk in the elderly?
Diazepam (Valium)
Cetirizine (Zyrtec)
Levofloxacin (Levaquin)
Lisinopril (Prinivil)
49 People with gout are at high risk for
which comorbid condition?
Renal calculi
Joint trauma
Anemia
Hearing loss
50 The spread of microorganisms from mother
to the baby across the placenta is termed
direct transmission.
vertical transmission.
horizontal transmission.
indirect transmission.
51 Tissue damage caused by the deposition
of circulating immune complexes containing an antibody against the host DNA is
the cause of which disease?
Hemolytic anemia
Pernicious anemia
Systemic lupus erythematosus
Myasthenia gravis
52 Thomas is admitted for symptoms of acute
coronary syndrome. You determine that a nitroglycerin drip is indicated for his
chest pain. What medication must you make sure he is not taking before writing
this order?
An antihistamine
Sildenafil
A long-acting opioid
An anticoagulant
53 Which of the following laxatives is
safest for long-term use?
Mineral oil
Methylcellulose (Citrucel)
Magnesium hydroxide (Milk of Magnesia)
Sennosides (Ex-lax)
54 Identify whether the term matches the
corresponding characteristics. (Select True or False)
Gluten sensitivity - Celiac sprue
True
False
55 Identify whether the description of the
skin lesion matches the disorder where it is found. (Select True or False)
Elevated, firm, and rough lesion with a
flat top surface greater than 1 cm in diameter: Psoriasis or seborrheic and
actinic keratoses
True
False
56 During the history portion of a
respiratory assessment, it is particularly important to ask if the patient
takes which of the following drugs that may contribute to symptoms of a chronic
cough?
Beta-2 agonists
Calcium channel blockers
Angiotensin-converting enzyme (ACE)
inhibitor
Birth control pills
57 Which laboratory value is consistently
low in a patient with diabetes insipidus (DI)?
Urine-specific gravity
Serum sodium
Urine protein
58 Which compensatory mechanism is
spontaneously used by children diagnosed with Tetralogy of Fallot to relieve
hypoxic spells?
Lying on their left side
Performing the Valsalva maneuver
Squatting
59 When considering hemolytic anemia, which
statement is true regarding the occurrence of jaundice?
Erythrocytes are destroyed in the spleen.
Heme destruction exceeds the liver’s
ability to conjugate and excrete bilirubin.
The patient has elevations in aspartate
transaminase (AST) and alanine transaminase (ALT).
The erythrocytes are coated with an
immunoglobulin.
60 The nurse has a patient who has been on
multidrug therapy for pulmonary tuberculosis. When planning patient education,
the nurse knows the patient needs to watch for which symptom of an adverse
effect of multidrug therapy?
Hearing loss
Changes in vision
Generalized pruritus
Jaundice
61 The drug of choice for a patient with
right-sided infective endocarditis caused by S. aureus is
vancomycin.
Daptomycin
Telavancin
Clindamycin
62 Which of the following side effects is
not commonly seen with ondansetron (Zofran)?
Constipation
Headache
QT-prolongation
Movement disorders
63 Which age group should be targeted for
testicular cancer education and screening?
15 to 35 year olds
20 to 45 year olds
30 to 55 year olds
45 to 70 year olds
64 The collateral blood flow to the brain
is provided by the:
carotid arteries.
basal artery.
Circle of Willis.
vertebral arteries.
65 Which of the following drugs acts on the
parasympathetic nervous system?
Epinephrine
Atropine
Dopamine
Dobutamine
66 What is the primary cause of respiratory
distress syndrome (RDS) of the newborn?
Immature immune system
Small alveoli
Surfactant deficiency
Anemia
67 Which of the following drugs has
coverage against pseudomonas?
Ceftriaxone (Rocephin)
Linezolid (Zyvox)
Piperacillin/Tazobactam (Zosyn)
Azithromycin (Zithromax)
68 Which of the following agents is
considered first-line for management of opioid-induced constipation?
Methylcellulose
Mineral oil
Polyethylene glycol
Docusate
69 Sylvia, age 59, has acute hepatitis. You
are told it is from a drug overdose. Which drug do you suspect?
Metronidazole (Flagyl)
Acetaminophen (Tylenol)
Sumatriptan (Imitrex)
Hydrocortisone (Cortisone)
70 What are the primary adverse effects
associated with SSRIs?
Weight gain and decreased libido
Weight loss and decreased appetite
Sedation and QT-prolongation
Insomnia and hypertension
71 Identify whether the description of the
skin lesion matches the disorder where it is found. (Select True or False)
Elevated circumscribed, superficial lesion
filled with serous fluid, less than 1 cm in diameter: Urticaria, allergic
reaction
True
False
72 An insufficient dietary intake of which
vitamin can lead to rickets in children?
C
B12
B6
D
73 Bacteria that produce endotoxins that
stimulate the release of inflammatory mediators that produce fever are called
pyrogenic bacteria.
true bacteria.
Exotoxins.
Spirochetes.
74 Serum levels of which of the following
antiseizure drugs must be corrected based on the patient's albumin level due to
its high protein binding?
Valproic acid (Depakote)
Phenobarbital (Luminal)
Phenytoin (Dilantin)
Carbamazepine (Tegretol)
75 After a partial gastrectomy or
pyloroplasty, clinical manifestations that include increased pulse,
hypotension, weakness, pallor, sweating, and dizziness are the results of which
mechanism?
Anaphylactic reaction in which chemical
mediators, such as histamine, prostaglandins, and leukotrienes, relax vascular
smooth muscles, causing shock
Postoperative hemorrhage during which a
large volume of blood is lost, causing hypotension with compensatory
tachycardia
Concentrated bolus that moves from the
stomach into the small intestine, causing hyperglycemia and resulting in
polyuria and eventually hypovolemic shock
Rapid gastric emptying and the creation of
a high osmotic gradient in the small intestine, causing a sudden shift of fluid
from the blood vessels to the intestinal lumen
76 A person diagnosed with type 1 diabetes
experiences hunger, lightheadedness, tachycardia, pallor, headache, and confusion.
The most probable cause of these symptoms is:
hyperglycemia caused by incorrect insulin
administration.
dawn phenomenon from eating a snack before
bedtime.
hypoglycemia caused by increased exercise.
Somogyi effect from insulin sensitivity.
77 Which of the following agents is
preferred for the treatment of a patient who is asymptomatic with a serum
sodium of 126?
3% NaCl
Tolvaptan
0.45% NaCl
0.9% NaCl
78 What is the most common cause of
uncomplicated urinary tract infections?
Staphylococcus
Klebsiella
Proteus
Escherichia coli
79 Renal failure is the most common cause
of which type of hyperparathyroidism?
Primary
Secondary
Exogenous
Inflammatory
80 Dilation of the ipsilateral pupil,
following herniation, is the result of pressure on which cranial nerve (CN)?
Optic (CN I)
Abducens (CN VI)
Oculomotor (CN III)
Trochlear (CN IV)
81 Which of the following places a patient
at risk for polypharmacy?
Lack of understanding of their medication
regimen
Using multiple pharmacies
Seeing multiple providers
All of the above place a patient at risk
for polypharmacy
82 Where is antidiuretic hormone (ADH)
synthesized, and where does it act?
Hypothalamus; renal tubular cells
Renal tubules; renal collecting ducts
Anterior pituitary; posterior pituitary
Posterior pituitary; loop of Henle
83 Which diuretic acts by inhibiting sodium
chloride reabsorption in the thick ascending limb of the loop of Henle?
Furosemide (Lasix)
Mannitol (Osmitrol)
Hydrochlorathiazide (HCTZ)
Acetazolamide (Diamox)
84 Which medical diagnosis is described as
a chronic inflammatory joint disease characterized by stiffening and fusion of
the spine and sacroiliac joints?
Ankylosing spondylitis
Rheumatoid arthritis
Paget disease
Fibromyalgia
85 Which antimicrobial should be avoided in
children because it is deposited in tissues undergoing calcification and can
stunt growth?
Tetracycline
Ciprofloxacin
Vancomycin
Amoxicillin
86 The nurse is caring for a patient who
has chronic renal failure and hypertension. The correct classification for the
hypertension is
primary.
secondary.
tertiary.
87 What type of immunity is produced when
an immunoglobulin crosses the placenta?
Passive-acquired immunity
Active-acquired immunity
Passive-innate immunity
Active-innate immunity
88 Which agent is used to treat hepatic encephalopathy
and works via "ion trapping,' converting ammonia into ammonium in the GI
tract?
Rifaximin
Lactulose
Octreotide
Neomycin
89 Which of the following is a potential
risk associated with overuse of proton-pump inhibitors?
C. difficile infection
Gastroparesis
Hyponatremia
Esophageal cancer
90 What is the effect of increased
secretions of epinephrine, glucagon, and growth hormone?
Hyperglycemia
Hypertension
Bronchodilation
Pupil dilation
91 Identify whether the description matches
the disorder. (Select True or False)
Rotation of a testis, which twists blood
vessels of the spermatic cord - Testicular torsion
True
False
92 Which of the following agents is useful
to treat COPD because of its anticholinergic effects?
Salmeterol (Serevent)
Tiotropium (Spiriva)
Albuterol (Proventil)
Prednisone (Deltasone)
93 Which disorder is characterized by the
formation of abnormal new bone at an accelerated rate beginning with excessive
resorption of spongy bone?
Osteomalacia
Paget's disease
Osteoporosis
Osteosarcoma
94 Jaundice can be attributed to the
following except?
Cholecystitis
Pyelonephritis
Sickle-cell anemia
Pancreatitis
95 Which of the following agents is
considered a long-acting beta-agonist (LABA)?
Albuterol
Salmeterol
Fluticasone
Ipratropium
96 An infant has a continuous machine-type
murmur best heard at the left upper sternal border throughout systole and
diastole, as well as a bounding pulse and a thrill on palpation. These clinical
findings are consistent with which congenital heart defect?
Atrial septal defect (ASD)
Ventricular septal defect (VSD)
Patent ductus arteriosus (PDA)
Atrioventricular canal (AVC) defect
97 Which of the following best describes a
Phase IV clinical trial?
Dose-finding study in healthy volunteers
Post-marketing study to detect potentially
rare adverse effects
Randomized clinical trial in patients with
the disease of interest done prior to FDA approval
Exploratory study done in animals to assess
potential toxicities
98 Which second-generation antipsychotic
comes in an injectable formulation approved for use in acute psychosis?
Olanzapine
Quetiapine
Aripiprazole
Ziprasidone
99 Which of the following benzodiazepines
is preferred for the treatment of alcohol withdrawal in the inpatient setting
due to its short half-life?
Lorazepam
Chlordiazepoxide
Clonazepam
100 Stress-induced sympathetic stimulation
of the adrenal medulla causes the secretion of:
epinephrine and aldosterone.
norepinephrine and cortisol.
epinephrine and norepinephrine.
acetylcholine and cortisol.
