Pharm Final past quizzes
A patient has been prescribed oral azithromycin for a diagnosis of acute sinusitis and is not experiencing the expected results. To best identify the cause of the effective treatment, the health care provider asks the patient what assessment question?
"How close to a meal have you been taking the drug?"
A 73-year-old patient has been recently prescribed a PRN medication for arthritic pain management. The patient reports at a follow-up appointment that "the medication has not helped much." What question should the health care provider managing the patient's care ask the patient initially to assess the cause of the patient's report?
"Since starting the PRN, are you taking any new drugs on a regular basis?"
A patient diagnosed with Parkinson disease (PD) has been prescribed benztropine. What information will the healthcare provider prescribing the medication share with the patient?
"You will feel the effects of the medication in about one hour."
Which patient(s) requiring treatment for anemia presents with the indications required for recombinant erythropoietin (EPO) therapy? Select all that apply.
-35-year-old on zidovudine therapy -16-year-old being treated for bone cancer -54-year-old diagnosed with chronic renal failure
A patient is suspected of experiencing "white coat hypertension" and is prescribed ambulatory blood pressure monitoring (ABPM) reading. The patient should be instructed to follow what instruction(s) prior to the reading? Select all that apply.
-Avoid phenylephrine-based decongestants for at least 3 hours. -Reframe from strenuously exercising for at least 10 minutes. -Avoid ingesting caffeine for at least 60 minutes. -Avoid nicotine use for at least 30 minutes.
What lifestyle change(s) will the healthcare provider discuss with a patient who is experiencing the symptoms associated with slow gastric emptying? Select all that apply.
-Avoid smoking. -Eliminate bedtime snacks. -Sleep with head elevated. -Restrict ingesting spicy foods.
A patient with a heart valve replacement is being treated for an ischemic stroke. Which diagnostic result(s) must be evaluated prior to initiating appropriate treatment? Select all that apply.
-Blood glucose -International normalized ration (INR)
A patient is diagnosed with generalized tonic-clonic seizure activity. Which initial antiepileptic drug(s) (AED) is appropriate for this patient? Select all that apply.
-Levetiracetam -Valproic acid -Phenytoin
A patient is believed to be experiencing the effects of Virchow triad. Which assessment data support this assumption? Select all that apply.
-Oral contraceptive use -Lower leg varicosities note bilaterally -History of a previous venous thrombosis
Which activity(ies) is/are a responsibility of an organization's pharmacy and therapeutics (P&T) committee? Select all that apply.
-Perform drug utilization analyses. -Create medication use policies. -Develop treatment protocols. -Evaluate new medications for formulary consideration. -Provide education for health care providers.
By what mechanism(s) can bacteria form or acquire antibiotic resistance? Select all that apply.
-bacterial enzyme production -alteration of target enzymes -overproduction of target enzymes -bacterial cell membrane -alteration alteration of the antibiotic's target site
What accounts for the increased risk of orthostatic hypotension in older adults? Select all that apply.
-changes in cerebral blood flow -loss of the baroreceptor reflex
A 54-year-old patient who initiated continuous combined hormone therapy for menopausal symptoms 1 year ago presents for an annual visit. The patient denies any vaginal bleeding. In considering whether to renew the patient's prescription, which assessment(s) must the health care provider perform? Select all that apply.
-clinical breast examination and mammogram -pelvic examination -blood pressure measurement -height and weight measurements
Which treatment(s) for psoriasis is contraindicated for use during pregnancy? Select all that apply.
-methotrexate -tazarotene -acitretin
Which element(s) is/are a required component of a prescription? Select all that apply.
-patient's full name and date of birth -prescription date -drug name h-ealth care provider's license number -health care provider's signature
What factor(s) contribute(s) to polypharmacy? Select all that apply.
-patients stockpiling unused medications -patients seeing multiple specialists for disease management -prescribing medications to alleviate side effects of other medications -patients experiencing multiple chronic illnesses
Which patient with acne is the most appropriate candidate for an oral tetracycline?
18-year-old patient who has been using benzoyl peroxide and clindamycin topical for 6 weeks without symptomatic improvement
The patient visits the clinic for a yearly physical examination. This healthy 44-year-old patient has no underlying medical conditions except an occasional tension-type headache, which the patient attributes to a stressful work environment. The patient reports taking 200 to 400 mg of ibuprofen every 4 to 6 hours for relief of the headache. The asks, "How much ibuprofen is safe for me to take in 1 day?" Which is the recommended dosage for over-the-counter ibuprofen?
200 to 400 mg every 4 to 6 hours not to exceed 1,200 mg in 1 day
A patient with a history of hypertension has been newly diagnosed with anemia. What diagnostic test should the healthcare provider ordered for this specific patient to rule out a common cause of anemia?
24-hour urine test
A combination contraceptive pill is an appropriate choice for which patient?
28-year-old patient with hypertension controlled on hydrochlorothiazide
Which patient may use unopposed estrogen therapy?
50-year-old patient with prior hysterectomy
The following patients present with reports of menopause-related symptoms of severe hot flashes and vaginal dryness that are negatively impacting their quality of life. Which patient would be an appropriate candidate for hormonal therapy with estrogen and progestin?
52-year-old patient with migraines
After vaginal cultures confirm a diagnosis of recurrent vulvovaginal candidiasis, the health care provider decides that following induction therapy, maintenance treatment with oral fluconazole will be necessary for this patient. What is the recommended duration of maintenance treatment?
6 months
At what age does a child become eligible for influenza vaccination?
6 months
The health care provider is providing education to a patient who will soon begin treatment for Neisseria gonorrhoeae and Chlamydia trachomatis infection. For at least how many days should the patient refrain from unprotected sexual intercourse after initiating treatment?
7 days
What is an appropriate hemoglobin A1c goal for an older adult patient with moderate comorbidity and a life expectancy of less than 10 years?
8.5% to 9%
On average, what percentage of the human genome is identical between two unrelated individuals?
99.9%
A patient suspected of having a proximal deep vein thrombosis (DVT) has a highly sensitive D-dimer result of 430 ng/mL. The healthcare provider will come to what conclusion based on this result?
A DVT can be ruled out.
Which piece of legislation includes provisions requiring insurers to provide coverage for preexisting conditions?
Affordable Care Act
A 35-year-old pregnant patient has been diagnosed with an asymptomatic urinary tract infection (UTI). Which prescription is safest for the treatment of this infection regardless of trimester?
Amoxicillin
On what criteria will the healthcare provider base the decision to initiate specific treatment for a diagnosis of uncomplicated cystitis in a 15-year-old sexually active female adolescent?
Antibiotic therapy is indicated in all diagnosed cases of urinary tract infection.
A patient who recently had a stent placed following a myocardial infarction undergoes genetic testing. As a result, the health care provider decides that the patient should not be prescribed clopidogrel. Which result appears on the patient's test?
CYP2C19(*2/*2)
Which organism is responsible for most vaginal yeast infections?
Candida albicans
What is the first step in the prescribing process?
Determine an accurate diagnosis.
What initial step will the healthcare provider take when gathering data on a patient demonstrating symptoms suggesting Parkinson disease (PD)?
Determine onset of each demonstrated symptom. AND Identify any neuroleptic medications the patient is currently taking.
The healthcare provider (HCP) is providing care to a patient who is entering the week 30 of gestation. The patient's medical history includes current treatment for rheumatoid arthritis (RA) and inflammatory bowel disease (IBD) What intervention will the HCP implement to best address medication-induced health risks at for this patient?
Educating the patient to the importance of ceasing nonsteroidal anti-inflammatory drug (NSAID) use until the birth
What is the prescribing healthcare provider's goal when considering pharmacotherapy for the 70-year-old patient diagnosed with acute prostatitis?
Eradication of the causative organism to prevent the progression to chronic prostatitis
When assessing for sickle cell anemia, the healthcare provider will prioritize African American patients and patient from what other ethnic group?
Hispanic American
What is the ultimate goal when selecting an antimicrobial regimen?
Identify the causative pathogen.
The patient who presented for an annual well physical 3 months ago had an elevated A1C. Today's HBA1C result is 7.5% (0.75), having only decreased minimally with diet and lifestyle changes alone. What action will the healthcare provider discuss with the patient in response to this information?
Initiating monotherapy using metformin
A healthy 28-year-old patient with no significant gynecologic history presents for evaluation 2 days after a sexual encounter during which the condom broke. The patient does not desire pregnancy and is interested in long-acting reversible contraception. The patient states difficulty remembering to take a daily pill. Which contraceptive would be the best choice for this patient?
Intrauterine copper contraceptive
The healthcare provider discusses medication therapy with a patient newly diagnosed with hypothyroidism. What is the most appropriate first-line drug?
Levothyroxine
A patient was diagnosed with rheumatoid arthritis (RA) 6 weeks ago. Which immediate intervention has provided the greatest potential for reducing the risk of developing associated disabilities?
Oral methotrexate 7.5 mg oral
Which patient is demonstrating an indication of iron-deficiency anemia?
Otherwise healthy patient with a serum ferritin level of 20 ng/mL (20 mcg/L)
A patient diagnosed with Alzheimer disease (AD) was started on cholinesterase inhibitor 3 months ago. Which assessment datum best indicates that the goals of medication therapy are being met?
Patient continues to complete daily hygiene tasks with minimal help from caregiver.
In which phase of clinical trials is the most effective routes of administration and dosage ranges for a drug determined?
Phase I
What diagnosis places the patient at highest risk for experiencing a life-threatening emergency?
Proximal deep vein thrombosis (DVT)
The healthcare provider (HCP) wants to prescribe a bulk-forming laxative to a patient on nifedipine therapy who is reporting constipation. Which medication will the HCP prescribe?
Psyllium hydrophilic mucilloid
Treatment of men with lower urinary tract symptoms sometimes requires medication. One drug class used is called alpha-adrenergic blockers. Which is the best description of the class's mechanism of action?
Relaxation of the smooth muscle in the prostate and bladder neck thereby decreasing bladder resistance to urinary flow
Which type of controlled substances require a new prescription to be written prior to each dispense?
Schedule II
What is the best method for disposing of an unused drug?
Take it to a community drug take-back program.
A patient is prescribed rosuvastatin for management of dyslipidemia. With permission of the health care provider, the pharmacist dispenses atorvastatin at a chemically equivalent dosage because rosuvastatin is not on the patient's insurance formulary. This is an example of what type of formulary management tool?
Therapeutic interchange
Which strategy can reduce the likelihood of a medication error in a pediatric patient?
Verify the patient's body weight.
What medication instructions should the healthcare provider give the patient being prescribed an antacid that will best facilitate maximum therapeutic results?
Wait 1 to 4 hours after taking other medications before taking this medication.
Which set of components is included in the Amsel criteria?
abnormal homogeneous discharge, vaginal pH greater than 4.5, positive amine test, positive clue cells
What three types of patient characteristics may alter the volume of distribution?
age, edema, and gender of the patient
What is the term for a drug that displays a degree of affinity for a receptor and stimulates a response?
agonist
When interviewing the parent of a 7-year-old child with cystic fibrosis, the health care provider discovers that the child's aunt has a history of hearing loss. The health care provider counsels the child's parent that the child may benefit from genetic screening prior to therapy with what class of drugs?
aminoglycosides
A 4-month-old infant is diagnosed with acute otitis media (AOM). What is the most appropriate treatment?
amoxicillin
A 23-year-old patient who has been previously healthy presents for a sick visit. The patient reports persistent nasal discharge, facial pain, headache, fatigue, and an intermittent fever reaching 102.5°F (39.2°C) for nearly 2 weeks. The patient notes feeling slightly better a few days ago, but then symptoms worsened again. The patient has been using ibuprofen as needed, which provides partial relief. The patient is concerned, stating "I thought I would feel better by now." The patient's current temperature is 101°F (38.3°C). Otoscopic examination reveals nasal mucosal edema and purulent discharge. There is worsening of facial pain with percussion of the sinuses. Lungs are clear upon auscultation. The patient has no known allergies. The patient is worried about feeling unwell during a planned trip, for which the patient leaves in 4 days. What is the most appropriate treatment?
amoxicillin-clavulanate 875 mg twice daily for 7 days
Which intervention is recommended in the routine management of asthma in adults? Select all that apply.
annual influenza vaccine
When educating a patient regarding a new prescription, which statement should the nurse use to best define an adverse drug reaction (ADR)?
any noxious, unintended, and undesired effect that occurs at normal drug doses
Which statin is the most likely to decrease low density lipoprotein (LDL) levels by 60%?
atorvastatin
What is the most common method for pediatric dosing?
body weight-based dosing
A patient newly diagnosed with osteoarthritis (OA) in the right knee returns for follow-up and reports that the physical therapy initially prescribed only provides about 10% relief and sleeping is still interrupted by the pain. What initial prescription will the health care provider likely add to this patient's treatment regimen?
capsaicin cream
What type of formulary limits health care providers to prescribing from a list of preferred drugs?
closed
The health care provider has prescribed chlorthalidone for initial treatment of hypertension. What factor would be considered when determining the appropriateness of this prescription?
creatinine clearance of 100 mL/min/1.73 m2
What is considered the gold standard of diagnosis in infectious diseases?
culture and antibiotic susceptibility testing
At what point after conception does a developing fetus become susceptible to the effects of drugs?
day 14
A 66-year-old patient who is prescribed warfarin for atrial fibrillation has a persistently supratherapeutic international normalized ratio (INR) despite multiple dosage adjustments and excellent medication adherence. The patient is taking no other medications. Genetic testing of the patient's CYP2C9 may reveal that the patient's enzyme activity is
decreased.
The health care provider is prescribing an antiarrhythmic drug (AAD) for a newly diagnosed 72-year-old patient. Which intervention should the provider implement to best maximize the patient's participation in a safe drug therapy regimen?
discussing the importance of taking the medication as prescribed
A 60-year-old patient presents for evaluation of an eye problem. The patient reports developing a burning sensation in the right eye and noticed increased tearing and eyelid swelling, about 1 week ago. The patient denies any change in vision and does not recall any ocular trauma. The patient has not experienced these symptoms previously and has not tried any treatment. On examination, the health care provider notes that the eyelids appear pink and irritated with matted deposits. There are multiple eyelashes missing. The conjunctiva appears clear. The patient's medical history includes depression. The patient takes a daily multivitamin and has no allergies. In addition to strict eyelid hygiene and warm compresses, which treatment is appropriate for the patient's condition?
erythromycin ophthalmic ointment
At least how often should an adult receive a booster dose of either tetanus toxoid and reduced diphtheria toxoid and acellular pertussis (Tdap) or tetanus and diphtheria toxoids (Td) vaccine?
every 10 years
Which antihistamine is the least sedating?
fexofenadine
What medication will the health care provider consider adding as second-line therapy for a patient diagnosed with heart failure whose ejection fraction has dropped to less than 40%?
furosemide
Which factor affecting oral absorption of a drug is decreased in pregnant compared to nonpregnant women?
gastrointestinal motility
Which symptom of menopause is most likely to subside over time?
hot flashes
Which treatment is considered first-line pharmacologic treatment for atopic dermatitis (AD)?
hydrocortisone cream
Three weeks after a camping trip, a 24-year-old patient presents for evaluation of fatigue and an expanding rash with a target-like appearance on the lower back. Serologic testing reveals a diagnosis of Lyme disease, and the patient is prescribed a course of doxycycline. Which adverse effect should the patient be aware of when initiating treatment?
increased sensitivity to sunlight
What is the result of the suppression of the luteinizing hormone (LH) surge by progesterone in combination contraceptive agents?
inhibition of ovulation
What is the most effective method of reversible contraception?
intrauterine device (IUD)
Which route of administration guarantees 100% bioavailability?
intravenous
What type of drugs result in a higher volume of distribution because of the low-fat content in the bloodstream?
lipid-soluble drugs
A 73-year-old woman is admitted to the hospital for postoperative management following a fall and hip fracture. The patient typically drinks 3 to 4 alcoholic beverages per day. Which first-line symptom-directed therapy for mild symptoms of alcohol withdrawal most appropriate?
lorazepam
A 22-year-old patient presents to the office with report of malodorous vaginal discharge. The patient has not experienced this previously. A pelvic exam is completed, which reveals thin, grayish-white discharge coating the vaginal walls. On saline microscopy, clue cells are observed, and a fishy odor develops when potassium hydroxide is applied. The patient is not pregnant, has no known allergies, and takes no medication. What is the preferred first-line treatment for this patient?
metronidazole 500 mg PO twice daily for 7 days
A 53-year-old patient presents for evaluation of a rash on the abdominal skin folds. The patient reports that the rash has been present for the past 2 months and describes it as burning and tender with a musty smell. On examination, a patch of skin under the abdominal pannus appears moist and erythematous with a malodorous smell. The patient reports washing the area daily with a mild cleanser and drying thoroughly. The patient's medical history includes hypertension, obesity, and depression. Which pharmacologic treatment would be most appropriate?
nystatin powder
The health care provider is going to prescribe a medication for topical administration. To prevent water absorption or evaporation, which formulation should be used?
ointment
Following a hospitalization for a fall, a 72-year-old patient recovering in a skilled nursing facility develops acute onset of multiple episodes of unformed stool over several days. Diagnostic testing reveals Clostridioides difficile infection. What is the most appropriate treatment?
oral vancomycin
A 65-year-old woman is newly diagnosed with overactive bladder frequency and incontinence. The patient is fearful of having dry mouth that may interfere with wearing dentures. Of the following agents, which is the most likely to result in dry mouth?
oxybutynin IR
Which patient with dementia is an appropriate candidate for consideration of antipsychotic medication?
patient who is agitated and threatening self-harm
Spironolactone drug therapy is contraindicated in which patient?
patient with potassium level of 5.6 mEq/L (5.6 mmol/L)
A 50-year-old premenopausal woman presents with reports of urinary incontinence 2 to 4 times per week. This event occurs with coughing and laughing most of the time. The physical examination is unremarkable. Appropriate initial therapy consists of behavioral modification and which intervention?
pelvic floor exercises
A 22-year-old patient is diagnosed with syphilis via confirmatory testing following initial routine prenatal screening. The patient is allergic to penicillin, which was previously confirmed via skin testing. Which treatment is the most appropriate?
penicillin G benzathine
What term refers to the study of inherited single or a few gene variations on drug therapy and response?
pharmacogenetics
Which class of antiretroviral pharmacotherapy is associated with the development of lipodystrophy?
protease inhibitors (PIs)
Which side effect of topical clindamycin is rare but serious?
pseudomembranous colitis
The health care provider is assuming responsibility for the management of care for a patient who has a history of diabetes and started drug therapy for tuberculosis (TB) 12 months ago. To best address issues related to possible side effects of drug therapy, the patient should be prescribed what supplement?
pyridoxine
A medication with what characteristic is preferred for use during breastfeeding to reduce the risk of harm to the infant?
shorter half-life
A pregnant patient recently diagnosed with HIV was recently prescribed oral zidovudine to help minimize the risk of transferring the infection to the fetus. The patient reports experiencing diarrhea since starting the therapy. What intervention will the health care provider managing the patient's care initially prescribe?
taking the drug as prescribed with a small amount of food
Which term refers to the delivery of remote clinical services?
telemedicine