NURS6521 Advanced Pharmacology
Week 7 Midterm Exam
• Question 1 Following an assessment by her primary care provider, a 70-year-old resident of an assisted living facility has begun taking daily oral doses of levothyroxine. Which of the following assessment findings should prompt the nurse to withhold a scheduled dose of levothyroxine?
• Question 2 A 33-year-old woman has irritable bowel syndrome (IBS). The physician has prescribed simethicone (Mylicon) for her discomfort. Which of the following will the nurse monitor most closely during the patient's drug therapy?
• Question 3 The lower respiratory system utilizes a number of different mechanisms that confer protection and maintain homeostasis. Which of the following physiological processes protects the lower respiratory system?
• Question 4 Which of the following patients is most likely to benefit from the administration of an adrenergic agonist?
• Question 5 The APRN is treating a 56 year old male with diagnosed atrial fibrillation. He is complaining of being light headed. His vital signs are BP 100/68 HR 144 RR 22. The best choice of medication to treat this patient is:
• Question 6 A Nurse Practitioner is teaching an older adult patient about polypharmacy. Which of the following statements best describe this term?
• Question 7 A Nurse Practitioner is teaching a patient about his newly prescribed drug, colchicine, for gout. The Nurse Practitioner will instruct the patient to avoid which of the following foods?
• Question 8 A 58-year-old man is prescribed dicyclomine (Bentyl) for irritable bowel syndrome. In which of the following conditions is dicyclomine therapy contraindicated?
• Question 9 A 60-year-old African-American man lives with a number of chronic health problems. Genetic factors are likely to influence his etiology and/or treatment of
• Question 10 A patient will begin three new medications as part of her treatment plan. The nurse practitioner understands that proper disposal of medications is key when the nurse practitioner states
• Question 11 A Nurse Practitioner who provides care in a busy clinic is aware of the high incidence and prevalence of hyperlipidemia and the consequent need for antihyperlipidemics in many patients. Treatment of high cholesterol using statins would be contraindicated in which of the following patients?
• Question 12 A 58-year-old man is admitted to the emergency department. A diagnosis of severe digoxin toxicity is made. Bradycardia is present, and an electrocardiogram (ECG) confirms toxicity. The nurse will administer which of the following drugs?
• Question 13 A patient with bronchial asthma is prescribed a sustained-release preparation of theophylline. To help minimize the adverse effects of the drug, which of the following should the nurse suggest?
• Question 14 A Nurse Practitioner is caring for a 70-year-old patient who is taking desmopressin (DDAVP). The patient has a history of cardiovascular disease. The nurse will prioritize the assessment of which of the following?
• Question 15 A Nurse Practitioner is overseeing the care of a young man whose ulcerative colitis is being treated with oral prednisone. Which of the following actions should the Nurse Practitioner take in order to minimize the potential for adverse drug effects and risks associated with prednisone treatment?
• Question 16 A 42-year-old man is being treated for a peptic ulcer with ranitidine (Zantac) taken PO at bedtime. Even though few adverse effects are associated with this drug, one common adverse effect that can be severe is
• Question 17 A female patient, age 36, is prescribed inhaled corticosteroid (ICS) for daily use. Which of the following adverse effects should the nurse closely monitor for in this patient?
• Question 18 Frequent episodes of exercise-related chest pain have caused a 79-year-old woman to use her prescribed nitroglycerin spray several times in recent weeks. This patient's age will have what effect on her use of nitroglycerin?
• Question 19 A Nurse Practitioner is providing care for a patient who suffered extensive burns to his extremities during a recent industrial accident. Topical lidocaine gel has been ordered to be applied to the surfaces of all his burns in order to achieve adequate pain control. When considering this order, the Nurse Practitioner should be aware that
• Question 20 The Nurse Practitioner is conducting a medication reconciliation of a new resident of a long-term care facility. The Nurse Practitioner notes that the resident takes allopurinol on a daily basis for the treatment of gout. What is the primary purpose of this drug?
• Question 21 You are seeing a 55 year old patient recently diagnosed with a bleeding ulcer. What should be the initial treatment choice for this patient?
• Question 22 Federal legislation dictates a lengthy and rigorous process of testing for new drugs. What is the primary purpose of this testing process?
• Question 23 A 53-year-old man has been treated for severe asthma for several years with prednisone. Recently, his physician initiated alternate-day therapy for him. The patient tells the nurse that he would rather take the medication every day to prevent confusion. Which of the following would be the best response by the nurse?
• Question 24 A Nurse Practitioner receives an order to administer a critically ill patient two drugs immediately (stat). The Nurse Practitioner begins the process by
• Question 25 A patient has been prescribed a Scheduled 5 drug, an example of this drug is
• Question 26 A 67-year-old man is admitted to the hospital with pneumonia. He reports to the nurse that he has chronic arthritis and circulation problems. Further assessment by the nurse reveals that the patient has a history of mild hypertension. He explains that he owns a business and lives alone. The nurse determines that he is within the normal weight range for his height and age but has a fondness for spicy foods and sweets. Which of the mentioned patient variables will have the greatest impact on the effectiveness of the patient's drug therapy?
• Question 27 A 46-year-old white American has been prescribed a drug that binds to acid glycoproteins. The nurse understands that white Americans usually receive
• Question 28 A normal maintenance dose for digoxin is 0.125 to 0.5 mg/day. In which of the following patients would the nurse most likely administer a lower-than-normal maintenance dose of digoxin?
• Question 29 A 49-year-old woman has been diagnosed with myalgia. The physician has recommended aspirin. The patient is concerned that the aspirin will upset her stomach. The nurse will encourage the patient to
• Question 30 Mr. Nguyen, age 71, will soon be discharged home from the hospital after a successful coronary artery bypass graft (CABG). During patient education about his drug regimen, Mr. Nguyen's nurse should prioritize teach about
• Question 31 A 39-year-old African-American male is 25 pounds overweight and has been diagnosed with hypertension after three consecutive above-normal blood pressure readings. The most likely initial drug therapy for this patient will be
• Question 32 During a clinic visit, a patient complains of having frequent muscle cramps in her legs. The nurse's assessment reveals that the patient has been taking over-the-counter laxatives for the past 7 years. The nurse informed the patient that prolonged use of laxatives
• Question 33 A 24-year-old factory worker has been prescribed guaifenesin for the first time. Which of the following will be a priority assessment by the nurse before the patient's first dose?
• Question 34 The Nurse Practitioner is prescribing Salmeterol (Serevent) inhaler for a patient with asthma. What instructions would be correct to provide the patient?
• Question 35 A high school student was diagnosed with asthma when he was in elementary school and has become accustomed to carrying and using his "puffers". In recent months, he has become more involved in sports and has developed a habit of administering albuterol up to 10 times daily. The nurse should teach the student that overuse of albuterol can lead to
• Question 36 In which of the following patients would a Nurse Practitioner expect to experience alterations in drug metabolism?
• Question 37 The APRN is prescribing a medication that is known to induce hepatic enzymes. What effect should you anticipate?
• Question 38 A female patient with a diagnosis of type 1 diabetes mellitus has been experiencing increasing neuropathic pain in recent months, a symptom that has not responded appreciably to conventional analgesics. The patient's care provider has begun treatment with gabapentin (Neurontin). How is the addition of this drug likely to influence the management of the patient's existing drug regimen?
• Question 39 A patient comes to the clinic asking for help to quit drinking alcohol. She has a 21-year history of heavy drinking and is worried about developing cirrhosis of the liver. The patient agrees to take disulfiram (Antabuse). The nurse will teach the patient that the combination of alcohol and Antabuse will cause which of the following?
• Question 40 A patient has recently been prescribed a drug that treats his hypertension by blocking the sympathetic receptors in his sympathetic nervous system. This action is characteristic of
Question 41 A patient is taking cholestyramine. The Nurse Practitioner will assess for which of the following common adverse effects of the drug?
Question 42 A Nurse Practitioner is caring for a patient who has recently moved from Vermont to south Florida. The patient has been on the same antihypertensive drug for 6 years and has had stable blood pressures and no adverse effects. Since her move, however, she reports "dizzy spells and weakness" and feels that the drug is no longer effective. The Nurse Practitioner suspects that the change in the effectiveness of the drug is related to
• Question 43 An elderly postsurgical patient has developed postoperative pneumonia in the days following abdominal surgery and is being treated with a number of medications. Which of the following medications that the nurse will administer has the slowest absorption?
• Question 44 A Nurse Practitioner is providing discharge instructions to a patient who will be taking fludrocortisone at home. The Nurse Practitioner will encourage the patient to eat a diet that is
• Question 45 A woman with numerous chronic health problems has been diagnosed with a benign gastric ulcer has begun treatment with ranitidine (Zantac). Which of the following teaching points should the nurse provide to this patient?
• Question 46 A patient is admitted to the emergency department with severe chest pain. The emergency department physician orders intravenous nitroglycerin 5 mcg/min, titrate dose by 5 mcg/min every 3 to 5 minutes per infusion pump as needed. Before administering the nitroglycerin, the nurse should prioritize which of the following assessments?
• Question 47 A patient in need of myocardial infarction prophylaxis has been prescribed sulfinpyrazone for gout. Which of the following will the nurse monitor the patient most closely for?
• Question 48 A mother brings her 4-year-old child, who is vomiting and has a temperature of 103°F into the emergency department (ED). The ED physician orders acetaminophen (Tylenol) for the fever. The best form of Tylenol to give the child, considering her presentation, would be
• Question 49 A woman has a long history of seasonal allergies that are typically accompanied by rhinorrhea, red eyes, and frequent sneezing. Sneezes are a result of
• Question 50 A nurse practitioner understands when prescribing a medication that there are certain questions to address. Check all that apply.
• Question 51 A teenage boy has undergone a diagnostic workup following several months of persistent, bloody diarrhea that appears to lack an infectious etiology. The boy has also experienced intermittent abdominal pain and has lost almost 15 pounds this year. Which of the following medications is most likely to treat this boy's diagnosis?
• Question 52 A 45-year-old man who is a construction worker has been diagnosed with hyperlipidemia and has been prescribed lovastatin. The nurse will advise the patient to
• Question 53 A patient who takes aluminum hydroxide with magnesium hydroxide (Mylanta) frequently for upset stomach, heartburn, and sour stomach is seen regularly in the clinic. The nurse should assess which of the following?
• Question 54 The APRN would use what class of medication to manage COPD?
• Question 55 A 77-year-old patient has a long-standing history of hypertension, a health problem that is being treated with metoprolol and a thiazide diuretic. Before administering the 8 AM dose of these medications, what assessments should the nurse perform and document? (Select all that apply.)
• Question 56 Mesalamine (Asacol) is prescribed for a 22-year-old woman with Crohn disease. The nurse will discuss with the patient the possibility for which of the following adverse effects related to the new drug therapy?
• Question 57 A patient with unstable angina pectoris who is NOT controlled with a nitrate would likely benefit most from the addition of:
• Question 58 A patient with a long history of alcohol abuse has been admitted to an acute medical unit with signs and symptoms of hepatic encephalopathy. His current medication orders include QID doses of oral lactulose. What desired outcomes should the nurse associate with this drug order?
• Question 59 A 22-year-old male college senior has lived with a diagnosis of Crohn's disease for several years and has undergone several courses of treatment with limited benefit. Which of the following targeted therapies has the potential to alleviate the symptoms of Crohn's disease?
• Question 60 A Nurse Practitioner who provides care in a long-term care facility is documenting a new resident's medication regimen on the resident's intake admission. The Nurse Practitioner is documenting the generic, rather than proprietary, names of the resident's current drugs because
• Question 61 The APRN is caring for a patient taking a calcium channel blockers for hypertension. The APRN should monitor the patient for what common side effects of this medication?
• Question 62 A Nurse Practitioner is providing discharge planning for a 45-year-old woman who has a prescription for oral albuterol. The Nurse Practitioner will question the patient about her intake of which of the following?
• Question 63 A clinic Nurse Practitioner has been assigned a 49-year-old female patient who has a history of diabetes. A recent diagnosis of hypertension has been made, and the patient has been prescribed a thiazide diuretic and labetalol. The patient will be scheduled to return to the clinic once a month for the next 6 months. A priority action by the Nurse Practitioner will be to
• Question 64 A patient has a history of tonic-clonic seizures that have been successfully treated with phenytoin (Dilantin) for several years. Phenytoin achieves a therapeutic effect by
Question 65 A 72-year-old man is taking Adderall XR for the treatment of narcolepsy. He is currently having problems with not being able to swallow large tablets or capsules. The man also wears dentures, which makes it even more difficult for him to swallow medication. He is in the clinic to talk to the nurse about his problem. The nurse will instruct him to
• Question 66 A patient taking Metformin (Glucophage) is scheduled for a cardiac cath. The patient asks why he can't take his metformin the day of the test. What is the most appropriate reply?
• Question 67 A female patient has been taking prednisone for her asthma for 1 month. The nurse will teach her to gradually decrease her dose of prednisone to avoid
• Question 68 A 72-year-old man is prescribed theophylline for symptomatic relief of bronchial asthma. Which of the following findings would alert the nurse to the need for close monitoring?
• Question 69 A 62-year-old man is admitted to the hospital with a diagnosis of chest pain. He has an order for 0.3 mg of sublingual nitroglycerin prn for chest pain. Which of the following actions should the nurse do first when he complains of chest pain?
• Question 70 A Nurse Practitioner is caring for a 73-year-old man who is receiving drug therapy. He is beginning to exhibit signs of decline in his renal system, yet his current serum creatinine level is normal. The Nurse Practitioner will base the patient's plan of care on the understanding that there is
• Question 71 The APRN should educate a diabetic patient that beta blockers may mask the signs and symptoms of
• Question 72 To minimize the risk of adverse effects of glucagon when given to an unconscious diabetic patient, as the patient regains consciousness, the nurse should
• Question 73 A 72-year-old female patient is prescribed ipratropium aerosol for pulmonary emphysema. The nurse will instruct her to "test spray" the new metered-dose inhaler (MDI) three times before using it to prevent which of the following?
• Question 74 A Nurse Practitioner is caring for a patient who is taking digoxin and a loop diuretic. Which of the following would be most important for the Nurse Practitioner to monitor?
• Question 75 A patient with class-IV CHF has a medication regimen consisting of metoprolol (Lopressor), enalapril (Vasotec), and furosemide (Lasix). In addition to regularly assessing the patient s heart rate, the nurse should prioritize assessment of the patient's
Question 76 Topical inhaled alpha adrenergic blocking agents or nasal vasoconstricting decongestants should not be used chronically (>5 days) because they can cause
• Question 77 A 70-year-old man who enjoys good health began taking low-dose aspirin several months ago based on recommendations that he read in a magazine article. During the man's most recent visit to his care provider, routine blood work was ordered and the results indicated an unprecedented rise in the man's serum creatinine and blood urea nitrogen (BUN) levels. How should a nurse best interpret these findings?
• Question 78 A 66-year-old woman has a complex medical history that includes poorly-controlled type 1 diabetes, renal failure as a result of diabetic nephropathy and chronic heart failure (CHF). Her care provider has recently added spironolactone (Aldactone) to the woman's medication regimen. The nurse should consequently assess for signs and symptoms of
• Question 79 A homeless man who is well known to care providers at the local hospital has been admitted to the emergency department after having a seizure outside a mall. The man is known to be a heavy alcohol user and is malnourished with a very low body mass index. How are this patient's characteristics likely to influence possible treatment with phenytoin?
• Question 80 A Nurse Practitioner is caring for a male patient who has a diagnosis of coronary artery disease (CAD). His drug therapy includes lovastatin. Because the patient has a history of severe renal disease, the nurse will assess for which of the following?
• Question 81 Which of the following statements best defines how a chemical becomes termed a drug?
• Question 82 A patient has GERD and is taking ranitidine (Zantac). She continues to have gastric discomfort and asks whether she can take an antacid. Which of the following is an appropriate response by the nurse?
• Question 83 Following an endoscopy, a 66-year-old man has been diagnosed with a duodenal ulcer resulting from Helicobacter pylori infection. Which of the following medications will likely be used in an attempt to eradicate the patient's H. pylori infection? (Select all that apply.)
• Question 84 A 34-year-old male patient is prescribed methimazole (MMI). The Nurse Practitioner will advise him to report which of the following immediately?
• Question 85 John is a newly diagnosed diabetic that contacts the office with complaints of severe nausea and vomiting. What instructions should the APRN provide related to his insulin doses?
• Question 86 A patient comes to primary clinic for strep throat. A throat swab culture is sent to lab. What information is required for the nurse practitioner to disclose on lab transmittal?
• Question 87 Mr. Lacuna is an 83-year-old resident of a long-term care facility who has a diagnosis of moderate Alzheimer disease. Mr. Lacuna's physician recently prescribed oral rivastigmine, but he was unable to tolerate the drug due to its gastrointestinal effects. As a result, he has been ordered the transdermal patch form of the medication. When administering this form of rivastigmine, the nurse should
• Question 88 A patient has been prescribed rabeprazole (Aciphex). It will be important for the nurse to assess the patient's drug history to determine if the patient is taking which of the following drugs?
• Question 89 A 20-year-old woman calls the clinic at 5 PM and reports to the Nurse Practitioner that she forgot to take her morning dose of fexofenadine (Allegra). She usually takes her evening dose at 8 PM. She wants to know what she should do. The Nurse Practitioner will instruct her to
• Question 90 A physician has ordered subcutaneous injections of morphine, a narcotic, every 4 hours as needed for pain for a motor vehicle accident victim. The nurse is aware that there is a high abuse potential for this drug and that it is categorized as a
• Question 91 A child is prescribed an inhaled corticosteroid agent to decrease respiratory inflammation related to exposure to an animal. The patient’s parent administers a higher than prescribe dose of the medication for 5 days. What should the APRN monitor the child for?
• Question 92 The Nurse Practitioner is performing patient education for a woman who will soon begin treatment of hyperlipidemia with simvastatin (Zocor). The patient has asked the Nurse Practitioner if there are any "bad side effects" that she should be aware of. Which of the following statements should underlie the nurse's response?
• Question 93 Mr. Tan is a 69-year-old man who prides himself in maintaining an active lifestyle and a healthy diet that includes adequate fluid intake. However, Mr. Tan states that he has experienced occasional constipation in recent months. What remedy should be the nurse's first suggestion?
• Question 94 A 62-year-old man has been prescribed lovastatin. The Nurse Practitioner will instruct the patient to take the medication
Question 95 A 70-year-old woman with a history of atrial fibrillation takes digoxin and verapamil to control her health problem. Verapamil achieves a therapeutic effect by
• Question 96 Decongestants are recommended to use in which of the following patients?
• Question 97 A patient has been prescribed zolpidem (Ambien) for short-term treatment of insomnia. Which of the following will the nurse include in a teaching plan for this patient? (Select all that apply.)
• Question 98 A Nurse Practitioner has been following a male patient who is taking hydralazine, clonidine, and a diuretic for hypertension. After 2 weeks of medication therapy, the patient begins to complain of numbness and tingling in his hands and feet. The Nurse Practitioner suspects that these signs or symptoms are
• Question 99 A Nurse Practitioner is conducting an assessment of a patient who has recently had several changes made to her drug regimen. What assessment question most directly addresses the safety implications of the patient's drug regimen?
• Question 100 A 70-year-old woman has a complex medical and a current drug regimen that includes calcium and vitamin D supplements for osteoporosis, metformin (Glucophage) for type 2 diabetes, phenelzine (Nardil) for depression, and metoprolol (Lopressor) and furosemide (Lasix) for hypertension. The woman is requesting dextromethorphan for the treatment of a recurrent cough. What component of her drug regimen contraindicates the use of dextromethorphan?
• Question 101 When completing this exam, did you comply with Walden University’s Code of Conduct including the expectations for academic integrity?
