Week 8 Quiz
Question 1Human papillomavirus (HPV) vaccine (Gardasil):
a.Is a live virus vaccine that provides immunity to six strains of HPV virus
b.Has a common adverse effect of syncope within 15 minutes of giving the vaccine
c.Should not be given to males younger than age 12 years
d.May be given to pregnant women
Question 2The most common adverse effect of the transdermal nicotine replacement patch is:
a.Nicotine toxicity
b.Tingling at the site of patch application
c.Skin irritation under the patch site
d.Life-threatening dysrhythmias
Question 3If a patient is exhibiting signs of nicotine toxicity when using transdermal nicotine, they should remove the patch and:
a.Wash the area thoroughly with soap and water.
b.Flush the area with clear water.
c.Reapply a new patch in eight hours.
d.Take acetaminophen for the headache associated with toxicity.
Question 4Which formulation of nitrate may be most cost effective for the patient who rarely has the need for dosing?
a.Oral
b.Sublingual tablets
c.Sublingual spray
d.Transdermal patches
Question 5Diagnosis of heart failure cannot be made by symptoms alone because many disorders share the same symptoms. The most specific and sensitive diagnostic test for Heart Failure is:
a.Chest x-rays that show cephalization and measure heart size
b.Two-dimensional echocardiograms that identify structural anomalies and cardiac dysfunction
c.Complete blood count, blood urea nitrogen, and serum electrolytes that facilitate staging for end-organ damage
d.Measurement of brain natriuretic peptide to distinguish between systolic and diastolic dysfunction
Question 6James is a 45-year-old patient with a very high cardiovascular (CV) risk profile, an LDL level of 120, and normal triglycerides. Appropriate first-line therapy for James may include diet counseling, increased physical activity, and:
a.A statin
b.Niacin
c.Sterols
d.A fibric acid derivative
Question 7Treatments for heart failure, including drug therapy, are based on the stages developed by the ACC/AHa) Stage A patients are treated with:
a.Drugs for hypertension and hyperlipidemia, if they exist
b.Lifestyle management including diet, exercise, and smoking cessation only
c.ACE inhibitors to directly prevent the heart failure only
d.No drugs are used in this early stage
Question 8Sharlene is a 65-year-old patient who has been on a lipid-lowering diet and using plant sterol margarine daily for the past three months. Her LDL is 135 mg/dL. An appropriate treatment for her would be:
a.A statin
b.Niacin
c.A fibric acid derivative
d.Determined by her risk factors
Question 9A lipid profile done on a newly diagnosed hypertensive patient shows a triglyceride level of 650 mg/dL, total cholesterol 240 mg/dL, LDL 145 mg/dL, and an HDL of 35 mg/dL. What is the best intervention for this patient?
a.Educate the patient about lifestyle changes that will help lower cholesterol levels
b.Initiate a prescription of pravastatin (Pravachol)
c.Recommend that the patient exercise at least every other day and avoid eating fatty or fried foods
d.Initiate a prescription of nicotinic acid (Niacin, Niaspan)
Question 10Before starting therapy with a statin, the following baseline laboratory values should be evaluated:
a.Complete blood count
b.Liver function [alanine aminotransferase/aspartate aminotransferase (ALT/AST)] and creatine kinase
c.C-reactive protein
d.All of the answers are
Question 11When comparing ACE and ARB medications, which of the following holds true?
a.Both may produce a dry, irritating cough
b.Both contribute to some retention of potassium
c.ARBs have a stronger impact on hypertension control than ACE medications
d.ARBs have stronger diabetes mellitus renal protection properties than ACE medications
Question 12Evidence is strong that HEART FAILURE interventions are best initiated when:
a.The person enters stage C
b.The person has functional disabilities
c.At the earliest indication
d.Stage IV is determined
Question 13One of the three types of heart failure involves systolic dysfunction. Potential causes of this most common form of heart failure include:
a.Myocardial ischemia and injury secondary to myocardial infarction (MI)
b.Inadequate relaxation and loss of muscle fiber secondary to valvular dysfunction
c.Increased demands of the heart beyond its ability to adapt secondary to anemia
d.Slower filling rate and elevated systolic pressures secondary to uncontrolled hypertension
Question 14Patients with pernicious anemia require treatment with:
a.Iron
b.Folic acid
c.Epogen alfa
d.Vitamin B12
Question 15Angiotensin-converting-enzyme (ACE) inhibitors are a central part of the treatment of heart failure (HEART FAILURE) because they have more than one action to address the pathological changes in this disorder. Which of the following pathological changes that take place in HEART FAILURE is NOT addressed by ACE inhibitors?
a.Changes in the structure of the left ventricle so that it dilates, hypertrophies, and uses energy less efficiently
b.Reduced formation of cross-bridges so that contractile force decreases
c.Activation of the sympathetic nervous system that increases heart rate and preload
d.Decreased renal blood flow that decreases oxygen supply to the kidneys
Question 16Patients who are being treated with epoetin alfa need to be monitored for the development of:
a.Thrombocytopenia
b.Neutropenia
c.Hypertension
d.Gout
Question 17Which of the following antihypertensive medications has bene?cial effects for an elderly White female with osteoporosis?
a.Calcium channel blocker
b.Angiotensin-converting enzyme (ACE) inhibitor
: Calcium channel blockers act by blocking the calcium channels in the heart muscle and the blood vessels, thereby keeping more calcium in the bones.
c.Beta-blocker
d.Diuretic
Question 18The first laboratory value indication that vitamin B12 therapy is adequately treating pernicious anemia is:
a.Hematocrit levels start to rise.
b.Hemoglobin levels return to normal.
c.Reticulocyte count begins to rise.
d.Vitamin B12 levels return to normal.
Question 19An 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 20After H. pylori treatment is completed, the next step in peptic ulcer disease therapy is:
a.Testing for H. pylori eradication with a serum enzyme-linked immunosorbent assay (ELISA) test
b.Endoscopy by a specialist
c.A proton pump inhibitor (PPI) for 8 to 12 weeks until healing is complete
d.All of the answers are
Question 21A patient with mild GERD is started on _______ first.
a.Antacids
b.Histamine-2 receptor antagonists
.c.Prokinetics
d.Proton pump inhibitors (PPIs)
Question 22An 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
Question 23What would be the appropriate treatment for H. pylori in a patient who recently took azithromycin for “bronchitis”?
a.PPI b)i.d) plus clarithromycin plus amoxicillin for 14 days
b.Quadruple therapy with a PPI, bismuth, tetracycline, and metronidazole for 10 to 14 days
c.PPI and levofloxacin for 14 days
d.Triple therapy with PPI, bismuth, and levofloxacin
Question 24Jill is a 32-year-old female who is in her second trimester. Her only medication is a prenatal multivitamin that she takes with food to avoid stomach upset. She presents for a routine visit and is complaining of constipation. You decide that she is indicated for laxative treatment. Which of the following is the safest and most appropriate for the duration of her pregnancy?
a.Psyllium (Metamucil) orally
b.Bisacodyl (Dulcolax) orally
c.Magnesium citrate solution orally
d.Polyethylene glycol (PEG) 3350 (MiraLAX) orally
Question 25Drug resistant tuberculosis (Tb) is defined as TB that is resistant to at least:
a.Fluoroquinolones
b.Rifampin and isoniazid
c.Amoxicillin
d.Ceftriaxone
Question 26
Before initiating treatment of ethambutol, what baseline tests should be performed?
a.Comprehensive Metabolic Panel & Complete Blood Count
b.Pulmonary Function Test
c.Pulmonary Function Test and Ophthalmology exam are
d.Ophthalmology exam
Question 27The length of treatment for sinusitis in a low-risk adult patient should be:
a.5 to 7 days
b.7 to 10 days
c.14 to 21 days
d.Seven days beyond when symptoms cease
Question 28Patient is currently taking metoprolol and you will be prescribing an albuterol inhaler. What should you advise patient of?
a.Bronchodilators may increase risk of tachycardia
b.Beta blockers can diminish effects of bronchodilation
c.Bronchodilators may increase risk of tachycardia and beta blockers can diminish effects of bronchodilation
d.Albuterol & metoprolol are contraindicated.
Question 29The first-line drug choice for a previously healthy adult patient diagnosed with community-acquired pneumonia would be:
a.Ciprofloxacin
b.Azithromycin
c.Amoxicillin
d.Doxycycline
Question 30Second generation antihistamines such as loratadine (Claritin) are prescribed for seasonal allergies because they are:
a.More effective than first generation antihistamines
b.Less sedating than the first generation antihistamines
c.Prescription products, and therefore covered by insurance
d.Able to be taken with central nervous system (CNS) sedatives, such as alcohol
Question 31A 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 32A 25 yo female presents today 100.5F temp with 10 days of sinus pressure in forehead with thick yellow nasal congestion. She reports no improvement with OTC decongestants. On exam, you find sinus tenderness to frontal sinuses. She denies any recent antibiotic use and no allergies to medications. What is recommended for medication?
a.Levofloxacin
b.Amoxicillin
c.Azithromycin
d.Doxycycline
Question 33When educating a parent on decreasing risk of AOM, what would you advise them?
a.Reduce exposure to tobacco smoke
b.Avoid feeding baby with bottle when they are lying flat
c.Encourage breastfeeding for at least first 6 months of life
d.All of the answers are
Question 34What is the safest medication for a pregnant woman with pneumonia, who has no medication allergies?
a.doxycycline- pregnancy category D
b.Levaquin- pregnancy category C
c.erythromycin- Pregnancy category B
d.clarithromycin - pregnancy category C
Question 35A 1 year old pediatric patient needs to be prescribed a second-generation antihistamine. Which medication would be appropriate?
a.Benadryl
b.Loratadine
c.Cetirizine
d.Fluticasone
Question 36For a child age 5 years and older who is diagnosed with suspected M. Pneumoniae, what is the recommended medication and dosing? (no medication allergies)
a.Azithromycin 10mg/kg on day 1 and 5mg/kg on day 2-5
b.Azithromycin 20/mg/kg for 3 days
c.Clarithromycin 20mg/kg per day for 5 days
d.Erythromycin 10mg/kg/ day for 7 days.
Question 37A 12-month-old patient presents today with 101F, decreased appetite, and runny nose. On exam, you find that the patient has erythematous and bulging Tympanic membranes bilaterally. You diagnose her with a bilateral Acute Otitis Media. What would be your next course of action?
a.Prescribe a WASP and advise parents give patient Motrin for discomfort.
b.Initiate amoxicillin 90mg/kg/day
c.Treat with Augmentin
d.Advise parents to alternate Motrin and Tylenol and call back clinic if symptoms persist.
Question 38Education of patients with COPD who use inhaled corticosteroids includes:
a.Doubling the dose at the first sign of a URI
b.Using their inhaled corticosteroid first and then their bronchodilator
c.Rinsing their mouth after inhaler use
d.Abstaining from smoking for at least 30 minutes after using
Question 39Goals when treating TB include:
a.Completion of recommended therapy
b.Negative purified protein derivative (PPd) at the end of therapy
c.Completely normal chest x-ray
d.All of the answers are
Question 40A 53 yo male with past medical history of hypertension presents today with complaint of feeling like his heart is racing. He reports that he is taking over the counter medication for his nasal congestion, but reports it is a combo medication and can’t recall the ingredients. He is currently taking blood pressure medications. What medication do you suspect may be causing tachycardia?
a.guaifenesin
b.pseudoephedrine
c.Delsym
d.Coricidin
Question 41If interventions to resolve the cause of pain (e.g., rest, ice, compression, and elevation) are insufficient, pain medications are given based on the severity of pain. Drugs are given in which order of use?
a.NSAIDs, opiates, corticosteroids
b.Low-dose opiates, salicylates, increased dose of opiates
c.Opiates, non-opiates, increased dose of non-opiates
d.Non-opiates, increased dose of non-opiates, opiates
Question 42The drug recommended as the primary treatment for osteoporosis in women over age 70 is:
a.Alendronate (Fosamax)
b.Premarin (estrogen)
c.Calcium carbonate
d.Raloxifene (Evista)
Question 43One of the main drug classes used to treat acute pain is nonsteroidal anti-inflammatory drug (NSAIDs). They are used because:
a.They have less risk for liver damage than acetaminophen.
b.Inflammation is a common cause of acute pain.
c.They have minimal gastrointestinal (GI) irritation.
d.Regulation of blood flow to the kidneys is not affected by these drugs.
Question 44Angela is a black woman who has heard that women of African descent do not need to worry about osteoporosis. What education would you provide to Angela about her risk?
a.She is . Black women do not have much risk of developing osteoporosis due to their dark skin.
b.Black women as a group are at risk of developing osteoporosis due to their lower calcium intake when young.
c.If she doesn’t drink alcohol, her risk of developing osteoporosis is low.
d.If she has not lost more than 10% of her weight lately, her risk is low.
Question 45Acetaminophen is NOT the drug of choice for mild to moderate pain in which of the following patients?
a.Patients with a blood coagulation disorder
b.Patient who have chronic liver dysfunction/alcoholics
c.Pregnant patients
d.B and C
Question 46A patient is taking warfarin and is asking about what they can take for minor aches and pains. The best recommendation is:
a.Ibuprofen 400 mg three times a day
b.Acetaminophen, not to exceed 4 grams per day
c.Prescription acetaminophen with codeine
d.Aspirin 640 mg three times a day
Question 47An 82-year-old patient has herpes zoster (shingles) and would benefit from an antiviral such as valacyclovir. Prior to prescribing valacyclovir they will need an assessment of:
a.Complete blood count to rule out anemia
b.Liver function
c.Renal function
d.Immunocompetence
Question 48Steps to avoid polypharmacy include:
a.Prescribing two or fewer drugs from each drug class
b.Reviewing a complete drug history every 12 to 18 months
c.Encouraging the elderly patient to coordinate their care with all of their providers
d.Evaluating for duplications in drug therapy and discontinuing any duplications
Question 49The goals of treatment when prescribing antiretroviral therapy (ART) medication to patients with human immunodeficiency virus (HIV) include:
a.Prevention of vertical HIV transmission
b.Improvement in quality of life
c.Prolonging of survival
d.All of the answers are
Question 50Patient education regarding prescribed medication includes: 1
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
