Pharm Final

Gastroesophageal reflux disease (GERD) may be aggravated by the following medication that affects lower esophageal sphincter (LES) tone: Calcium carbonate Estrogen Furosemide Metoclopramide

Estrogen

Hypertensive African Americans are typically listed as not being as responsive to which drug groups? ACE inhibitors Calcium channel blockers Diuretics Bidil (hydralazine family of medications)

ACE inhibitors

Which of the following should be avoided while taking an SSRI? Aged blue cheese Grapefruit Alcohol Green leafy vegetables

Alcohol

Both angiotensin-converting enzyme inhibitors and some angiotensin II receptor blockers have been approved in treating: Hypertension in diabetic patients Diabetic nephropathy Both a and b Neither a nor b

Both a & b

Postmenopausal women with an intact uterus should not be prescribed: An estrogen/progesterone combination Intramuscular (IM) medroxyprogesterone (Depo-Provera) Estrogen alone Androgens

Estrogen alone

Lifestyle changes are the first step in treatment of gastroesophageal reflux disease (GERD). Food or drink that may aggravate GERD include: Eggs Caffeine Bread Soda pop

Caffeine

An appropriate drug to initially treat panic disorder is: Alprazolam (Xanax) Diazepam (Valium) Buspirone (Buspar) Amitriptyline (Elavil)

Diazepam (Valium)

Prior to starting antidepressants, patients should have laboratory testing to rule out: Hypothyroidism Anemia Diabetes mellitus Low estrogen levels

Hypothyroidism

Patients with pernicious anemia require treatment with: Iron Folic acid Epogen alfa Vitamin B12

Vitamin B12

A 24-year-old female patient is 32 weeks pregnant and has tested positive for syphilis. The best treatment for her would be: IM ceftriaxone IM benzathine penicillin G Oral azithromycin Any of the above

IM benzathine penicillin G

Metoclopramide improves GERD symptoms by: Reducing acid secretion Increasing gastric pH Increasing lower esophageal tone Decreasing lower esophageal tone

Increasing lower esophageal tone

Leonard is an 18-year-old man who has been taking isotretinoin (Accutane) for the treatment of acne for the past 2 months. Which of the following is the most important question for the clinician to ask at his follow-up office visit? "Are you having any problems remembering to take your medication?" "Have you noticed any dry skin around your mouth since you started using Accutane?" "Do you notice any improvement in your skin?" "Have you noticed any recent changes in your mood?"

"Have you noticed any recent changes in your mood?"

A first-line drug for abortive therapy in simple migraine is: Sumatriptan (Imitrex) Naproxen (Aleve) Butorphanol nasal spray (Stadol NS) Butalbital and acetaminophen (Fioricet)

Naproxen (Aleve)

Direct renin inhibitors have the following properties. They: Are primarily generic drugs Are a renin-angiotensin-aldosterone system (RAAS) medication that is safe during pregnancy Can be used with ACE and ARB medications for stronger impact "Shut down" the entire RAAS cycle

"Shut down" the entire RAAS cycle

Breastfed infants should receive iron supplementation of: 3 mg/kg per day 6 mg/kg per day 1 mg/kg per day Breastfed babies do not need iron supplementation

1 mg/kg per day

An adult female presents to the clinic with menorrhagia. Her hemoglobin is 10.2 and her ferritin is 15 ng/mL. Initial treatment for her anemia is: 18 mg/day of iron supplementation 6 mg/kg per day of iron supplementation 325 mg ferrous sulfate per day 325 mg ferrous sulfate tid

325 mg ferrous sulfate tid

A patient has just had her pregnancy confirmed and is asking about how to ensure a healthy baby. What is the folic acid requirement during pregnancy? 40 mcg/day 200 mcg/day 600 mcg/day 2 g/day

600 mcg/day

A patient on metformin and glipizide arrives at her 11:30 a.m. clinic appointment diaphoretic and dizzy. She reports taking her medication that morning and having a bagel and coffee for breakfast. Blood pressure (BP) is 110/70 and random finger-stick glucose is 64. How should this patient be treated? 12 oz apple juice with 1 tsp sugar 10 oz diet soda 8 oz milk or 4 oz orange juice 4 cookies and 8 oz chocolate milk

8 oz milk or 4 oz orange juice

Low-dose tricyclic antidepressants taken only at bedtime are routinely used for: Correct Answer Sleep issues Mild depression Restless leg syndrome Acute pain control

Restless leg syndrome

Who is the best candidate for isotretinoin (Accutane) therapy? A 17-year-old patient with pustular lesions and poor response to benzoyl peroxide A 20-year-old patient with cystic lesions who has tried various therapies with minimal effect A 14-year-old patient with open and closed comedones and a family history of "ice pick" scars An 18-year-old patient with inflammatory lesions and improvement with tretinoin (Retin-A)

A 20-year-old patient with cystic lesions who has tried various therapies with minimal effect

Which of the following patients may be treated with a three day course of therapy for their UTI? A 28-year-old pregnant woman A six-year-old healthy female A 24-year-old female A 26-year-old female diabetic

A 24-year-old female

Which of the following patients would be at higher risk of experiencing adverse drug reactions (ADRs): A 32-year-old male A 22-year-old female A 3-month-old female A 48-year-old male

A 3-month-old female

An NP would prescribe the liquid form of ibuprofen for a 6-year-old child because: Dugs given in liquid form are less irritating to the stomach. Liquid forms of medication eliminate the concern for first-pass effect. A 6-year-old child may have problems swallowing a pill. Liquid ibuprofen does not have to be dosed as often as the tablet form.

A 6-year-old child may have problems swallowing a pill

If a patient with H. pylori-positive peptic ulcer disease fails first-line therapy, the next step would be: A PPI b.i.d. plus metronidazole plus tetracycline plus bismuth subsalicylate for 14 days To test H. pylori for resistance to common treatment regimens A PPI plus clarithromycin plus amoxicillin for 14 days A PPI and levofloxacin for 14 days

A PPI b.i.d. plus metronidazole plus tetracycline plus bismuth subsalicylate for 14 days

After H. pylori treatment is completed, the next step in peptic ulcer disease therapy is: Testing for H. pylori eradication with a serum enzyme-linked immunosorbent assay (ELISA) test Endoscopy by a specialist A PPI for 8 to 12 weeks until healing is complete All of the above

A PPI for 8 to 12 weeks until healing is complete

In addition to methimazole, a symptomatic patient with hyperthyroidism may need a prescription for: A calcium channel blocker A beta blocker Liothyronine An alpha blocker

A beta-blocker

Providers should use an antibiogram when prescribing. An antibiogram is: The other name for the Centers for Disease Control guidelines for prescribing antibiotics An algorithm used for prescribing antibiotics for certain infections The reference also known as the Pink Book, published by the Centers for Disease Control A chart of the local resistance patterns to antibiotics developed by laboratories

A chart of the local resistance patterns to antibiotics developed by laboratories

Male patients require ______________________ before and during androgen therapy. A digital prostate exam A Doppler exam of testicular blood flow Urine analysis for proteinuria Serial orthostatic blood pressures

A digital prostate exam

When choosing a topical corticosteroid cream to treat diaper dermatitis, the ideal medication would be: Intermediate potency corticosteroid ointment (Kenalog) A combination of a corticosteroid and an antifungal (Lotrisone) A low-potency corticosteroid cream applied sparingly (hydrocortisone 1%) A high-potency corticosteroid cream (Diprolene AF)

A low-potency corticosteriod cream applied sparingly (hydrocortisone 1%)

Which of the following variables is a factor in drug absorption? The smaller the surface area for absorption, the more rapidly the drug is absorbed. A rich blood supply to the area of absorption leads to better absorption. The less soluble the drug, the more easily it is absorbed. Ionized drugs are easily absorbed across the cell membrane.

A rich blood supply to the area of absorption leads to better absorption

JoAnne is a 60-year-old patient with an LDL of 132 and a family history of coronary artery disease. She has already tried diet changes (increasing fiber and plant sterols) to lower her LDL but after six months her LDL is slightly higher. The next step in her treatment would be: A statin Niacin Sterols A fibric acid derivative

A statin

Montelukast (Singulair) may be prescribed for: A six-year-old child with exercise-induced asthma A two-year-old child with moderate persistent asthma An 18-month-old child with seasonal allergic rhinitis None of the above; montelukast is not approved for use in children

A two-year-old child with moderate persistent asthma

A 56-year-old woman is complaining of vaginal dryness and dyspareunia. To treat her symptoms with the lowest adverse effects she should be prescribed: Low-dose oral estrogen A low-dose estrogen/progesterone combination A vaginal estradiol ring Vaginal progesterone cream

A vaginal estradiol ring

Which drug class is replacing beta blockers as the "go to" post-myocardial infarction (MI) medication? Ca channel blockers Central acting alpha blockers ACE inhibitors Newer generation aldosterone inhibitors

ACE inhibitors

A child may warrant "watchful waiting" instead of an antibiotic prescription for acute otitis media if they: Are low risk with temperature of less than 39oC or 102.2oF Have reliable parents with transportation Are older than two years All of the above

All of the above

ART is recommended for HIV-positive patients who: Have a history of acquired immunodeficiency syndrome (AIDS)-defining illness Are pregnant Have a hepatitis B co-infection All of the above

All of the above

In addition to antimicrobial therapy, patients treated for Trichomonas infection should be educated regarding: Necessity of treating sexual partner simultaneously Abstaining from intercourse until both partners are treated Need for retesting in three months due to high reinfection rate All of the above

All of the above

Nicotine replacement therapy should not be used in which patients? Pregnant women Patients with worsening angina pectoris Patients who have just suffered an acute myocardial infarction All of the above

All of the above

Patients need to be instructed regarding drug interactions with St. John's Wort, including: MAO inhibitors Serotonin reuptake inhibitors Over-the-counter cough and cold medications All of the above

All of the above

Patients taking antacids should be educated regarding these drugs, including letting them know that: They may cause constipation or diarrhea. Many are high in sodium. They should separate antacids from other medications by one hour. All of the above

All of the above

Patients with rheumatoid arthritis who are on chronic low-dose prednisone will need co-treatment with which medication to prevent adverse effects? A bisphosphonate Calcium supplementation Vitamin D All of the above

All of the above

Progesterone-only pills are recommended for women who: Are breastfeeding Have a history of migraine Have a medical history that contradicts the use of estrogen All of the above

All of the above

Recommended monitoring for children who are started on stimulants for ADHD includes: Height, weight, and blood pressure every three months for the first year Monthly monitoring of symptoms until under control Prescription refill pattern All of the above

All of the above

Strategies prescribers can use to prevent misuse of controlled prescription drugs include: Use of chemical dependency screening tools Firm limit-setting regarding prescribing controlled substances Practicing "just say no" to deal with patients who are pushing the provider to prescribe controlled substances All of the above

All of the above

Tetracycline needs to be given on an empty stomach because it chelates with: Calcium Magnesium Iron All of the above

All of the above

The goals of treatment when prescribing for sexually transmitted infections include: Treatment of infection Prevention of disease spread Prevention of long-term sequelae from the infection All of the above

All of the above

The rotavirus vaccine (RotaTeq, Rotarix): Is a live vaccine that replicates in the small intestine, providing active immunity against rotavirus Should not be administered to infants who are or may be immunocompromised Is not given to an infant who has a febrile illness (temperature greater than 100.5oF) All of the above

All of the above

The elderly are at high risk of ADRs due to: Having greater muscle mass than younger adults, leading to higher volume of distribution The extensive studies that have been conducted on drug safety in this age group The blood-brain barrier being less permeable, requiring higher doses to achieve therapeutic effect Age-related decrease in renal function

Age-related decrease in renal function

Besides prescribing antimicrobial therapy, patients with bacterial vaginosis require education regarding the fact that: The most recent partners in the past 60 days should also be treated. Alcohol should not be consumed during and for 72 hours after metronidazole therapy. Condoms should be used during intercourse if intravaginal clindamycin cream is used. Cotreatment for chlamydia is necessary.

Alcohol should not be consumed during and for 72 hours after metronidazole therapy.

Which diuretic agents typically do not need potassium supplementation? Loop diuretics Thiazide diuretics Aldosterone inhibitors They all need supplementation.

Aldosterone inhibitors

The drug recommended as the primary treatment for osteoporosis in women over age 70 is: Alendronate (Fosamax) Premarin (estrogen) Calcium carbonate Raloxifene (Evista)

Alendronate (Fosamax)

The treatment goals when treating urinary tract infection (UTI) include: Eradication of the infecting organism Relief of symptoms Prevention of recurrence of the UTI All of the above

All above of the above

When writing a prescription of permethrin 5% cream (Elimite) for scabies, patient education would include: All members of the household and personal contacts should also be treated. Infants should have permethrin applied from the neck down. The permethrin is washed off after 10 to 20 minutes. Permethrin is flammable and to avoid open flame while the medication is applied.

All members of the household and personal contacts should also be treated

When prescribing an opioid analgesic such as acetaminophen and codeine (Tylenol #3), instructions to the patient should include: The medication may cause sedation and they should not drive. Constipation is a common side effect and they should increase fluids and fiber. Patients should factor in the total amount of acetaminophen in other acetaminophen-containing medications taken at the same time. All of the above

All of the above

A 24-year-old patient has had migraines for 10 years. She reports a migraine on average of once a month. The migraines are effectively aborted with naratriptan (Amerge). When refilling her naratriptan, education would include: Naratriptan will interact with antidepressants, including selective serotonin reuptake inhibitors (SSRIs) and St. John's Wort, and she should inform any providers she sees that she has migraines. Continue to monitor her headaches, and if the migraines are consistently happening around her menses there is preventive therapy available. Pregnancy is contraindicated when taking a triptan. All of the above

All of the above

Monitoring for patients who are on long-term antifungal therapy with ketoconazole includes: Platelet count Blood urea nitrogen (BUN) and creatinine (Cr) White blood cell count Aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase, and bilirubin

AST, ALT, alkaline phosphatase, & bilirubin

An advantage of prescribing a sublingual medication is that the medication is: Absorbed rapidly Excreted rapidly Metabolized minimally Distributed equally

Absorbed rapidly

Which of the following statements is true about age and pain? Use of drugs that depend heavily on the renal system for excretion may require increased dosage in very young children. Among the NSAIDs, indomethacin is the preferred drug because of a lower adverse effect profile than other NSAIDs. Older adults who have dementia probably do not experience much pain due to loss of pain receptors in the brain. Acetaminophen is especially useful in both children and adults because it has no effect on platelets and has fewer adverse effects than NSAIDs.

Acetaminophen is especially useful in both children and adults because it has no effect on platelets and has fewer adverse effects than NSAIDs.

Migraines in pregnancy may be safely treated with: Acetaminophen with codeine (Tylenol #3) Sumatriptan (Imitrex) Ergotamine tablets (Ergostat) Dihydroergotamine (DHE)

Acetaminophen with codeine (Tylenol #3)

A patient fractured his ankle in two places and is asking for medication for his pain. The appropriate first-line medication would be: Ibuprofen (Advil) Acetaminophen with hydrocodone (Vicodin) Oxycodone (Oxycontin) Oral morphine (Roxanol)

Acetaminophen with hydrocodone (Vicodin)

A patient is taking warfarin and is asking about what they can take for minor aches and pains. The best recommendation is: Ibuprofen 400 mg three times a day Acetaminophen, not to exceed 4 grams per day Prescription acetaminophen with codeine Aspirin 640 mg three times a day

Acetaminophen, not to exceed 4 grams per day

An 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? Add a Proton Pump Inhibitor to his therapy. Discontinue the aspirin and switch him to Vicodin for the pain. Decrease the aspirin dose to one tablet daily. Instruct the patient to take an antacid 15 minutes before taking the aspirin each day.

Add a Proton Pump Inhibitor to his therapy.

In choosing a benzodiazepam to treat anxiety the prescriber needs to be aware of the possibility of dependence. The benzodiazepam with the greatest likelihood of causing rapidly developing dependence is: Chlordiazepoxide (Librium) Clonazepam (Klonopin) Alprazolam (Xanax) Oxazepam (Serax)

Alprazolam (Xanax)

A 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: Clindamycin Amoxicillin Cefadroxil (Duricef) Azithromycin

Amoxicillin

First-line treatment for an afebrile 2-year-old with otitis media would include: Azithromycin Amoxicillin Ceftriaxone Trimethoprim/sulfamethoxazole

Amoxicillin

A 25-year-old female is eight weeks pregnant and has a urinary tract infection. What would be the appropriate antibiotic to prescribe for her? Ciprofloxacin (Cipro) Amoxicillin (Trimox) Doxycycline Trimethoprim-sulfamethoxazole (Septra)

Amoxicillin (Trimox)

First-line therapy for a school-age child with group A streptococcal pharyngitis is: Azithromycin 10 mg/kg on day one, then 5 mg/kg/day on days 2 to 5 Amoxicillin 80 mg/kg/day (maximum of 2 g/day) for 10 days Clindamycin 20 mg/kg/dose b.i.d. for 10 days Amoxicillin 50 mg/kg/day (maximum 1,000 mg/day) for 10 days

Amoxicillin 50mg/kg/day (maximum 1,000 mg/day) for 10 days

Potassium excess risk is highest with which combination of medications: You Answered Aldactone and a beta blocker An ACE and a loop diuretic An ARB and an aldosterone antagonist A direct renin inhibitor and a thiazide

An ARB and an aldosterone antagonist

Women who have migraines with an aura should not be prescribed estrogen because of: The interaction between triptans and estrogen, limiting migraine therapy choices An increased incidence of migraines with the use of estrogen An increased risk of stroke occurring with estrogen use Patients with migraines may be prescribed estrogen without any concerns.

An increased risk of stroke occurring with estrogen use

A 42-year-old female requests a prescription for an anorexiant to treat her obesity. A trial of phentermine is prescribed. Prescribing precautions include: Understanding that obesity is a contraindication to prescribing phentermine Anorexiants may cause tolerance and should only be prescribed for six months Patients should be monitored for postural hypotension Renal function should be monitored closely while on anorexiants

Anorexiants may cause tolerance and should only be prescribed for six months

A 56-year-old female comes to the clinic requesting a refill of her Fiorinal (aspirin and butalbital) that she takes for migraines. She has been taking this medication for over 2 years for migraines and states one dose usually works to abort her migraine. What is the best care for her? Answer Switch her to sumatriptan (Imitrex) to treat her migraines. You Answered Assess how often she is using Fiorinal and refill her medication. Switch her to a beta blocker such as propranolol to prevent her migraine. Recommend she take the Fiorinal daily to prevent migraine.

Answer Switch her to sumatriptan (Imitrex) to treat her migraines.

An adult female patient presents to the clinic with vulvovaginal candidiasis. Appropriate treatment for her would be: Over-the-counter (OTC) intravaginal clotrimazole OTC intravaginal miconazole Oral fluconazole one-time dose Any of the above

Any of the above

Treatment failure in patients with peptic ulcer disease associated with H. pylori may be because of: Antimicrobial resistance An ineffective antacid Overuse of PPIs All of the above

Antimicrobial resistance

Infants with reflux are initially treated with: Histamine-2 receptor antagonist (ranitidine) PPI (omeprazole) Antireflux maneuvers (such as elevating the head of the bed) Prokinetic (metoclopramide)

Antireflux maneuvers (such as elevating the head of the bed)

Diabetes screening for children who meet the following criteria should begin at age 10 and occur every three years thereafter: BMI above the 85th percentile for age and sex Family history of diabetes in first- or second-degree relative Hypertension based on criteria for children Any of the above

Any of the above

Patients with allergic rhinitis may benefit from a prescription of: Fluticasone (Flonase) Cetirizine (Zyrtec) Over-the-counter (OTC) cromolyn nasal spray (Nasalcrom) Any of the above

Any of the above

Treatment for chancroid in a nonpregnant patient would be: Oral azithromycin IM ceftriaxone Oral ciprofloxacin Any of the above

Any of the above

Pregnant women who are HIV positive: Are treated with AZT alone to prevent birth defects Are treated with a combination antiretroviral therapy (ART) regimen Should not be treated with ART due to teratogenicity of the drugs Are at high risk of developing resistance to ART drugs

Are treated with a combination antiretroviral (ART) regimen

A 51-year-old male has been told by his PCP to take an aspirin a day. Why would this be recommended? He has arthritis and this will help with the inflammation and pain. Aspirin has antiplatelet activity and prevents clots that cause strokes. Aspirin acidifies the urine and he needs this for prostrate health. He has a history of gastrointestinal (GI) bleed, and one aspirin a day is a safe dosage.

Aspirin has antiplatelet activity and prevents clots that cause strokes.

A 14-year-old patient presents to the clinic with symptoms consistent with mycoplasma pneumonia. What is the treatment for suspected mycoplasma pneumonia in an adolescent? Ceftriaxone Azithromycin Ciprofloxacin Levofloxacin

Azithromycin

A 34-week-pregnant female has been diagnosed with pneumonia. She is stable enough to be treated as an outpatient. What would be an appropriate antibiotic to prescribe? Levofloxacin Azithromycin Amoxicillin Doxycycline

Azithromycin

When treating suspected gonorrhea in a nonpregnant patient, the patient should be concurrently treated for chlamydia with: Azithromycin 1 g PO x 1 Amoxicillin 500 mg PO x 1 Ciprofloxacin 500 mg PO x 1 Penicillin G 2.4 million units IM x 1

Azithromycin 1 g PO x 1

Obese women may have increased risk of failure with which contraceptive method? Combined oral contraceptives Progestin-only oral contraceptive pill Injectable progestin Combined topical patch

Combined topical patch

Isoniazid (INH) may induce a deficiency of which vitamin? B6 C D E

B6

Treatment goals in prescribing should: Always be curative Be patient centered Be convenient for the provider Focus on the cost of therapy

Be patient centered

A patient with exercise-induced and mild persistent asthma is prescribed two puffs of albuterol 15 minutes before exercise and as needed for wheezing. One puff per day of beclomethasone (Qvar) is also prescribed. Teaching regarding her inhaler includes: Use one to two puffs of albuterol per day to prevent an attack with no more than eight puffs per day. Beclomethasone needs to be used every day to treat her asthma. Report any systemic side effects she experiences, such as weight gain. Use the albuterol metered-dose inhaler (MDI) immediately after her corticosteroid MDI to facilitate bronchodilation.

Beclomethasone needs to be used every day to treat her asthma

The drug of choice for treatment of primary or secondary syphilis is: Ceftriaxone intramuscular (IM) Benzathine penicillin G IM Oral azithromycin Oral ciprofloxacin

Benzathine penicillin G IM

Which antihypertensive is safe during pregnancy? ACE Beta blocker Direct renin inhibitor ARB

Beta blocker

A young adult will be traveling to Mexico with her church group over spring break to build houses. She is concerned she may develop traveler's diarrhea. Advice includes following normal food and water precautions as well as taking: Loperamide four times a day throughout the trip Bismuth subsalicylate before each meal and at bedtime Prescription diphenoxylate with atropine if she gets diarrhea Calcium carbonate (Tums) four times a day for stomach upset

Bismuth subsalicylate before each meal and at bedtime

Drugs that are receptor antagonists, such as beta blockers, may cause: Down-regulation of the drug receptor Block an endogenous action Partial blockade of the effects of agonist drugs An exaggerated response to competitive drug agonists

Block an endogenous action

ACE inhibitors are useful in a variety of disorders. Which of the following statements is true about both their usefulness in a particular disorder and the reason for their use? They are useful to prevent stable angina because they decrease the thickening of vascular walls due to decreased modified release. They are useful to prevent heart failure because they reduce remodeling of injured myocardial tissues. Both a and b are true Neither a nor b are true.

Both a & b are true

When comparing ACE and ARB medications, which of the following holds true? Both may produce a dry, irritating cough Both contribute to some retention of potassium ARBs have a stronger impact on hypertension control than ACE medications ARBs have stronger diabetes mellitus renal protection properties than ACE medications

Both contribute to some retention of potassium

The following disease processes could be made worse by taking a nonselective beta blocker? Asthma PVD Both might worsen Beta blockade does not affect these disorders.

Both might worsen

If prescribing bupropion (Zyban) for tobacco cessation, the instructions to the patient include: Bupropion (Zyban) is started 1 to 2 weeks before the quit date. Nicotine replacement products should not be used with bupropion. If they smoke when taking bupropion they may have increased anxiety and insomnia. Because they are not using bupropion as an antidepressant, they do not need to worry about increased suicide ideation when starting therapy.

Bupropion (Zyban) is started 1 to 2 weeks before the quit date.

An appropriate first-line drug to try for mild to moderate generalized anxiety disorder is: Alprazolam (Xanax) Diazepam (Valium) Buspirone (Buspar) Amitriptyline (Elavil)

Buspirone (Buspar)

A patient with anxiety and depression may respond to: Duloxetine (Cymbalta) Fluoxetine (Prozac) Oxazepam (Serax) Buspirone (Buspar) and an SSRI combined

Buspirone (Buspar) and an SSRI combined

A 45-year-old patient with schizophrenia was recently hospitalized for acute psychosis due to medication noncompliance. They were treated with intramuscular (IM) long-acting haloperidol. Besides monitoring schizophrenia symptoms, the patient should be assessed: By his primary care provider, for excessive weight loss By his primary care provider, using the Abnormal Involuntary Movement Scale (AIMS) for extrapyramidal symptoms (EPS) By his primary care provider, monthly for tolerance to the haloperidol Only by a mental health provider, as most NPs in primary care do not care for mentally ill patients

By his primary care provider, using the Abnormal Involuntary Movement Scale (AIMS) for extrapyramidal symptoms (EPS)

To prevent further development of antibacterial resistance it is recommended that fluoroquinolones be reserved for treatment of: Urinary tract infections in young women Upper respiratory infections in adults Skin and soft tissue infections in adults Community-acquired pneumonia in patients with comorbidities

Community-acquired pneumonia in patients with comorbidities

Which drug class is recommended for first-line treatment of hypertension in African Americans? Beta blockers Angiotensin II receptor blocker (ARB) medications Calcium channel blockers Alpha blockers

Calcium channel blockers

A child, Dwayne, has recently started on carbamazepine to treat seizures. He comes to see you and you note that while his carbamazepine levels had been in the therapeutic range, they are now low. The possible cause for the low carbamazepine levels may be: Dwayne hasn't been taking his carbamazepine because it causes insomnia. Carbamazepine autoinduces metabolism, leading to lower levels in spite of good compliance. Dwayne was not originally prescribed the correct amount of carbamazepine. Carbamazepine is probably not the right antiseizure medication for Dwayne.

Carbamazepine autoinduces metabolism, leading to lower levels in spite of good compliance.

A four-year-old patient has suspected bacterial pneumonia. He has a temperature of 102°F, oxygen saturation level of 95%, and is taking fluids adequately. What would be appropriate initial treatment for his pneumonia? Ceftriaxone Azithromycin You Answered Cephalexin Levofloxacin

Ceftriaxone

Appropriate initial therapy for a four-year-old female with a febrile UTI would be: Azithromycin Trimethoprim/sulfamethoxazole Ceftriaxone Ciprofloxacin

Ceftriaxone

Treatment for suspected gonorrhea is: Ceftriaxone 250 mg IM x 1 Ceftriaxone 2 g IM x 1 Ciprofloxacin 500 mg PO x 1 Doxycycline 100 mg bid x 7 days

Ceftriaxone 250 mg IM x 1

Drugs are metabolized mainly by the liver via phase I or phase II reactions. The purpose of both of these types of reactions is to: Inactivate prodrugs before they can be activated by target tissues Change the drugs so they can cross plasma membranes Change drug molecules to a form that an excretory organ can excrete Make these drugs more ionized and polar to facilitate excretion

Change drug molecules to a form that an excretory organ can excrete

Medical conditions that can predispose a patient to ADRs include: Chronic kidney disease Asthma Chronic daily headache Pneumonia

Chronic kidney disease

First-line therapy for a patient with acute otitis externa (swimmer's ear) and an intact tympanic membrane includes: Swim-Ear drops Ciprofloxacin and hydrocortisone drops Amoxicillin Gentamicin ophthalmic drops

Ciprofloxacin and hydrocortisone drops

Absolute contraindications to estrogen therapy include: History of any type of cancer Clotting disorders History of tension headaches Orthostatic hypotension

Clotting disorders

Long-term monitoring of patients who are taking carbamazepine includes: Routine testing of troponin levels to assess for cardiac damage Annual eye examinations to assess for cataract development Monthly pregnancy tests for all women of childbearing age Complete blood count every three to four months

Complete blood count every 3-4 months

Process for choosing an effective drug for a disorder include: Asking the patient what drug they think would work best for them Consulting nationally recognized guidelines for disease management Prescribing medications that are available as samples before writing a prescription Following U.S. Drug Enforcement Administration guidelines for prescribing

Consulting nationally recognized guidelines for disease management

You have initiated therapy for an 18-year-old man with acne vulgaris and have prescribed doxycycline. He returns in 3 weeks, complaining that his skin is "no better." Your next action is to: Counsel him that 6 to 8 weeks of treatment is often needed before significant improvement is achieved. Discontinue the doxycycline and initiate minocycline therapy Advise him that antibiotics are likely not an effective treatment for him and should not be continued. Add a second antimicrobial agent such as trimethoprim-sulfamethoxazole.

Counsel him that 6-8 weeks of treatment is often needed before significant improvement is achieved

A 22-year-old woman receives a prescription for oral contraceptives. Education for this patient includes: Counseling regarding decreasing or not smoking while taking oral contraceptives Advising a monthly pregnancy test for the first three months she is taking the contraceptive Advising that she may miss two pills in a row and not be concerned about pregnancy Recommending that her next follow-up visit is in one year for a refill and annual exam

Counseling regarding decreasing or not smoking while taking oral contraceptives

Niaspan is less likely to cause which side effect that is common to niacin? Gastrointestinal irritation Cutaneous flushing Dehydration Headaches

Cutaneous flushing

Metformin is a primary choice of drug to treat hyperglycemia in type 2 diabetes because it: Substitutes for insulin usually secreted by the pancreas Decreases gluconeogenesis by the liver Increases the release of insulin from beta cells Decreases peripheral glucose utilization

Decreases gluconeogenesis by the liver

Jacob has hypertension, for which a calcium channel blocker has been prescribed. This drug helps control blood pressure because it: Decreases the amount of calcium inside the cell Reduces stroke volume Increases the activity of the Na+/K+/ATPase pump indirectly Decreases heart rate

Decreases the amount of calcium inside the cell

Sarah is receiving her first medroxyprogesterone (Depo-Provera) injection. Sarah will need to be monitored for: Depression Hypertension Weight loss Cataracts

Depression

Men who are prescribed sildenafil (Viagra) need ongoing monitoring for: Development of chest pain or dizziness Weight gain Priapism Renal function

Development of chest pain or dizzines

A female patient is pregnant and has tested HIV positive. Which ART drug should be avoided in women who are pregnant? Didanosine Zidovudine Ritonavir Lopinavir/ritonavir

Didanosine

If not chosen as the first drug in hypertension treatment, which drug class should be added as a second step because it will enhance the effects of most other agents? ACE inhibitors Beta blockers Calcium channel blockers Diuretics

Diurectics

Patient education when prescribing clopidogrel includes: Do not take any herbal products without first discussing this with the provider. Monitor urine output closely and contact the provider if it decreases. Clopidogrel can be constipating; use a stool softener if needed. The patient will need regular anticoagulant studies while on clopidogrel.

Do not take any herbal products without first discussing this with the provider.

Despite good blood pressure control, an NP might change a patient's drug from an ACE inhibitor to an angiotensin II receptor blocker (ARB) because the ARB: Is stronger than the ACE inhibitor Does not produce a dry, hacking cough Has no effect on the renal system Reduces sodium and water retention

Does not produce a dry, hacking cough

Prior to prescribing metformin, the provider should: Draw a serum creatinine to assess renal function Try the patient on insulin Tell the patient to increase iodine intake Have the patient stop taking any sulfonylurea to avoid dangerous drug interactions

Draw a serum creatinine to assess renal function

An adult is taking lithium for bipolar disorder. They should be taught to: Take lithium with food Eat a diet with consistent levels of salt (sodium) Drink at least two quarts of water if they are in a hot environment Monitor blood glucose levels

Eat a diet with consistent levels of salt (sodium)

Allison is an 18-year-old college student with type 1 diabetes. Allison's premeal blood glucose (BG) at 11:30 a.m. is 130. She eats an apple and has a sugar-free soft drink. At 1 p.m. before swimming her BG is 80. What should she do? Proceed with the swimming class. Recheck her BG immediately. Eat a granola bar or other snack with carbohydrates (CHO). Take an additional dose of insulin.

Eat a granola bar or other snack with carbohydrates (CHO).

The role of the nurse practitioner (NP) with regards to herbal medication is to: Maintain competence in the prescribing of common herbal remedies Recommend common over-the-counter herbs to patients Educate patients and guide them to appropriate sources of care Encourage patients to not use herbal therapy due to the documented dangers

Educate patients and guide them to appropriate sources of care

An elderly person has been prescribed lactulose for treatment of chronic constipation. Monitoring with long-term treatment would include: Electrolytes, including potassium and chloride Bone mineral density for osteoporosis Magnesium level Liver function

Electrolytes, including potassium and chloride

An appropriate drug for the treatment of depression with anxiety would be: Alprazolam (Xanax) Escitalopram (Lexapro) Buspirone (Buspar) Amitriptyline (Elavil)

Escitalopram (Lexapro)

A patient had a deep vein thrombosis (DVT) and was on heparin and warfarin in the hospital and discharged home on warfarin. She asks her primary care nurse practitioner (NP) why she was getting both medications while in the hospital. The best response is to: Contact the hospitalist as this is not the normal guideline for prescribing these two medications and she may have had a more complicated case. Explain that warfarin is often started while a patient is still on heparin because warfarin takes a few days to reach effectiveness. Encourage the patient to contact the customer service department at the hospital, as this was most likely a medication error during her admission. Draw anticoagulation studies to make sure she does not have dangerously high bleeding times.

Explain that warfarin is often started while a patient is still on heparin because warfarin takes a few days to reach effectiveness.

There is a narrow margin between first appearance of adverse reaction to AChE inhibitors and serious toxic effects. Adverse reactions that require immediate action include: Dizziness and headache Nausea Decreased salivation Fasciculations of voluntary muscles

Fasciculations of voluntary muscles

Men who are prescribed an erectile dysfunction drug such as sildenafil (Viagra) should be warned about the risk for: Impotence when combined with antihypertensives Fatal hypotension if combined with nitrates Weight gain if combined with antidepressants All of the above

Fatal hypotension if combined with nitrates

Potentially fatal granulocytopenia has been associated with treatment of hyperthyroidism with propylthiouracil. Patients should be taught to report: Tinnitus and decreased salivation Fever and sore throat Hypocalcemia and osteoporosis Laryngeal edema and difficulty swallowing

Fever and sore throat

The optimal maximum time frame for HRT or estrogen replacement therapy (ERT) is: Two years Five years 10 years 15 years

Five years

A 10-year-old child is diagnosed with major depression. The appropriate first-line antidepressant for children is: Fluoxetine Fluvoxamine Sertraline Amitriptyline

Fluoxetine

Monitoring for a child who has had a UTI is: Symptom resolution in 48 hours Follow-up urine culture at completion of therapy Test of cure urinary analysis at completion of therapy Follow-up urine culture two months after completion of therapy

Follow-up urine culture at completion of therapy

Monitoring for a pregnant woman who has had a UTI is: Symptom resolution in 48 hours Follow-up urine culture at completion of therapy Test of cure urinary analysis at completion of therapy Follow-up urine culture every two weeks until delivery

Follow-up urine culture every two weeks until delivery

Thyroid medullary cancer risk has been linked with: Chronic sulfonylurea use Later addition of basal insulin to oral therapy GLP-1 therapies SGLT-2 medication

GLP-1 therapies

When the total daily insulin dose is split and given twice daily, which of the following rules may be followed? Give two-thirds of the total dose in the morning and one-third in the evening. Give 0.3 units per kilogram of premixed 70/30 insulin with one-third in the morning and two-thirds in the evening. Give 50% of an insulin glargine dose in the morning and 50% in the evening. Give long-acting insulin in the morning and short-acting insulin at bedtime.

Give two-thirds of the total dose in the morning and one-third in the evening.

Insulin preparations are divided into categories based on onset time, duration of action, and intensity of action following subcutaneous injection. Which of the following insulin preparations has the shortest onset and duration of action? Humulin N Glulisine Glargine Detemir

Glulisine

All diabetic patients with hyperlipidemia should be treated with: HMG-CoA reductase inhibitors Fibric acid derivatives Nicotinic acid Colestipol

HMG-CoA reductase inhibitors

The time required for the amount of drug in the body to decrease by 50% is called: Steady state Half-life Phase II metabolism Reduced bioavailability time

Half-life

Drugs administered via IV: Need to be lipid soluble in order to be easily absorbed Have 100% bioavailability Are easily absorbed if they are nonionized May use pinocytosis to be absorbed

Have 100% bioavailability

David is a 34-year-old patient who is starting on paroxetine (Paxil) for depression. David's education regarding his medication would include: Paroxetine may cause intermittent diarrhea. He may experience sexual dysfunction beginning a month after he starts therapy. He may have constipation and he should increase fluids and fiber. Paroxetine has a long half-life so he may occasionally skip a dose.

He may experience sexual dysfunction beginning a month after he starts therapy.

Adam has type 1 diabetes and plays tennis for his university. He exhibits a knowledge deficit about his insulin and his diagnosis. He should be taught that: He should increase his carbohydrate intake during times of exercise. Each brand of insulin is equal in bioavailability, so he can buy the least expensive. Alcohol produces hypoglycemia and can help control his diabetes when taken in small amounts. If he does not want to learn to give himself injections, he may substitute an oral hypoglycemic to control his diabetes.

He should increase his carbohydrate intake during times of exercise.

Art is a 55-year-old smoker who has been diagnosed with angina and placed on nitrates. He complains of headaches after using his nitrate. An appropriate reply might be: This is a parasympathetic response to the vasoconstricting effects of the drug. Headaches are common side effects with these drugs. How severe are they? This is associated with your smoking. Let's work on having you stop smoking. This is not related to your medication. Are you under a lot of stress?

Headaches are common side effects with these drugs. How severe are they?

Tricyclic antidepressants should be prescribed cautiously in patients with: Eczema Asthma Diabetes Heart disease

Heart Disease

The safest drug to use to treat pregnant women who require anticoagulant therapy is: Brilinta Warfarin Rivaroxaban Heparin

Heparin

Long-term use of PPIs may lead to: Hip fractures in at-risk persons Vitamin B6 deficiency Liver cancer All of the above

Hip fractures in at-risk persons

A patient with PUD is treated with a regiment that includes bismuth subsalicylate (Pepto-Bismol), tetracycline, and metronidazole (Flagyl). The patient calls the nurse practitioner to report that his stools are unusually dark. He is not experiencing any gastric discomfort, orthostatic hypotension, or increased lethargy. How would the NP interpret this information? He is probably bleeding and should come in immediately He ate something to affect the color of his stool His stools are dark secondary to Pepto-Bismol The stool discoloration is caused by metronidazole

His stools are dark secondary to Pepto-Bismol

A patient sprained his ankle and is asking for pain medication for his mild-to-moderate pain. The appropriate first-line medication would be: Ibuprofen (Advil) Acetaminophen with hydrocodone (Vicodin) Oxycodone (Oxycontin) Oral morphine (Roxanol)

Ibuprofen (Advil)

Because of the pattern of cholesterol synthesis, reductase inhibitors are given: In the evening in a single daily dose Twice daily in the morning and the evening With each meal and at bedtime In the morning before eating

In the evening in a single daily dose

Pregnant women should receive the Tdap vaccine: In the first trimester Once every 10 years In the third trimester of every pregnancy Tdap is contraindicated in pregnancy

In the third trimester of every pregnancy

Medroxyprogesterone (Depo-Provera) is prescribed intramuscularly (IM) in order to: Undergo the first-pass effect. Ensure a proper loading dose Increase the absorption of the drug Allow distribution into collagen tissues

Increase the absorption of the drug

Sulfonylureas may be added to a treatment regimen for type 2 diabetics when lifestyle modifications and metformin are insufficient to achieve target glucose levels. Sulfonylureas have been moved to step 2 therapy because they: Stabilize endogenous insulin secretion Increase the risk for hypoglycemia Address the insulin resistance found in type 2 diabetics Improve insulin binding to receptors

Increase the risk for hypoglycemia

Antacids treat GERD by: Increasing lower esophageal tone Increasing gastric pH Increasing gastric acid secretion Increasing serum calcium level

Increasing gastric pH

Insulin is used to treat both types of diabetes. It acts by: Increasing beta cell response to low blood-glucose levels Stimulating hepatic glucose production Increasing peripheral glucose uptake by skeletal muscle and fat Improving the circulation of free fatty acid

Increasing peripheral glucose uptake by skeletal muscle and fat

One of the main drug classes used to treat acute pain is nonsteroidal anti-inflammatory drug (NSAIDs). They are used because: They have more risk for liver damage than acetaminophen. Inflammation is a common cause of acute pain. They have minimal gastrointestinal (GI) irritation. Regulation of blood flow to the kidneys is not affected by these drugs.

Inflammation is a common cause of acute pain.

Pregnant patients with asthma may safely use ________ throughout their pregnancy. Oral terbutaline Prednisone Inhaled corticosteroids (budesonide) Montelukast (Singulair)

Inhaled corticosteroids (budesonide)

Bisphosphonates treat or prevent osteoporosis by: Inhibiting osteoclastic activity Fostering bone resorption Enhancing calcium uptake in the bone Strengthening the osteoclastic proton pump

Inhibiting osteoclastic activity

An 8-year-old male has attention deficit disorder (ADD) and is prescribed methylphenidate (Ritalin). He and his parents should be educated about the side effects of methylphenidate, which are: Slurred speech and insomnia Bradycardia and confusion Dizziness and orthostatic hypotension Insomnia and decreased appetite

Insomnia and decreased appetite

Antacids such as calcium carbonate (Tums) can reduce the absorption of which of the following nutrients? Protein Calcium Iron Vitamin K

Iron

Patients who are on chronic long-term proton pump inhibitor therapy require monitoring for: Iron deficiency anemia, vitamin B12 and calcium deficiency Folate and magnesium deficiency Elevated uric acid levels leading to gout Hypokalemia and hypocalcemia

Iron deficiency anemia, vitamin B12 and calcium deficiency

Patient education regarding taking iron replacements includes: Double the dose if they miss a dose to maintain therapeutic levels. Take the iron with milk or crackers if it upsets their stomach. Iron is best taken on an empty stomach with juice. Antacids such as Tums may help an upset stomach caused by iron therapy.

Iron is best taken on an empty stomach with juice.

Bismuth subsalicylate (Pepto-Bismol) is a common over-the-counter (OTC) remedy for gastrointestinal complaints. Bismuth subsalicylate: May lead to toxicity if taken with ibuprofen Is contraindicated in children with flu-like illness Has no antimicrobial effects against bacterial and viral enteropathogens May cause stools to turn reddish color

Is contraindicated in children with flu-like illness

Why is taking paroxetine (Paxil) consistently and never running out of medication more important with this drug than with most other SSRIs? It has a shorter half-life and withdrawal syndrome has a faster onset without taper. It has the longest half-life and the withdrawal syndrome has a faster onset. It is quasi-addictive in the dopaminergic reward system. It is the most activating of SSRI medications and a sudden stop to taking it will cause the person to have sudden deep sadness.

It has a shorter half-life and withdrawal syndrome has a faster onset without taper.

When starting a patient with hypothyroidism on thyroid replacement hormones patient education would include: They should feel symptomatic improvement in 1 to 2 weeks. Drug adverse effects such as lethargy and dry skin may occur. It may take 4 to 8 weeks to get to euthyroid symptomatically and by laboratory testing. Because of its short half-life, levothyroxine doses should not be missed.

It may take 4 to 8 weeks to get to euthyroid symptomatically and by laboratory testing.

Digoxin may cause a type A ADR due to: Idiosyncratic effects Its narrow therapeutic index Being a teratogen Being a carcinogen

Its narrow therapeutic index

Infants and young children are at higher risk of ADRs due to: Immature renal function in school-age children Lack of safety and efficacy studies in the pediatric population Children's skin being thicker than adults, requiring higher dosages of topical medication Infant boys having a higher proportion of muscle mass, leading to a higher volume of distribution

Lack of safety and efficacy studies in the pediatric population

Patients who are taking antiretroviral therapy need to have the following monitored: Lipid levels Sexual functioning Platelet count None of the above

Lipid levels

Before starting therapy with a statin, the following baseline laboratory values should be evaluated: Complete blood count Liver function [alanine aminotransferase/aspartate aminotransferase (ALT/AST)] and creatine kinase C-reactive protein None of the above

Liver function (ALT/AST) and creatinine kinase

Dipeptidyl peptidase-4 inhibitors (gliptins) act on the incretin system to improve glycemic control. Advantages of these drugs include: Better reduction in glucose levels than other classes Less weight gain than with sulfonylurea use Low risk for hypoglycemia Can be given twice daily

Low risk for hypoglycemia

The first-line therapy for mild-persistent asthma is: High-dose montelukast Theophylline Low-dose inhaled corticosteroids Long-acting beta 2 agonists

Low-dose inhaled corticosteriods

The goal of ART in HIV-positive patients is: Maximum suppression of HIV replication Eradication of HIV virus from the body Determining a treatment regimen that is free of adverse effects Suppression of CD4 T-cell count

Maximum suppression of HIV replication

Drugs that are designated Schedule II by the U.S. Drug Enforcement Administration: Are known teratogens during pregnancy May not be refilled; a new prescription must be written Have a low abuse potential May be dispensed without a prescription unless regulated by the state

May not be refilled; a new prescription must be written

Which of the following drugs used to treat Alzheimer's disease is not an anticholinergic? Donepezil Memantine Rivastigmine Galantamine

Memantine

When discussing with a patient the different start methods used for oral combined contraceptives, the advantage of a Sunday start over the other start methods is: Immediate protection against pregnancy the first week of using the pill No back-up method is needed when starting Menses occur during the week They can start the pill on the Sunday after the office visit

Menses occur during the week

The drugs recommended by the American Academy of Pediatrics for use in children with diabetes (depending upon type of diabetes) are: Metformin and insulin Sulfonylureas and insulin glargine Split-mixed dose insulin and glucagon-like peptide-1 (GLP-1) agonists Biguanides and insulin lispro

Metformin and insulin

First-line therapy for a school-aged child diagnosed with attention deficit-hyperactivity disorder (ADHD) is: Atomoxetine Clonidine patch Methylphenidate Lisdexamfetamine

Methylphenidate

An adult female presents with a malodorous vaginal discharge and is confirmed to have a Trichomonas infection. Treatment for her would include: Metronidazole 2 g PO x 1 dose Topical intravaginal metronidazole daily x 7 days Intravaginal clindamycin daily x 7 days Azithromycin 2 g PO x 1 dose

Metronidazole 2 g PO x 1 dose

A female patient presents with a complaint of vaginal discharge that when tested meets the criteria for bacterial vaginosis. Treatment of bacterial vaginosis in nonpregnant symptomatic women would be: Metronidazole 500 mg PO b.i.d. x 7 days Doxycycline 100 mg PO b.i.d. x 7 days Intravaginal tinidazole daily x 5 days Metronidazole 2 g PO x 1 dose

Metronidazole 500 mg PO b.i.d. x 7 days

Chemical dependency assessment is integral to the initial assessment of chronic pain. Which of the following raises a "red flag" about potential chemical dependency? Use of more than one drug to treat the pain Multiple times when prescriptions are lost with requests to refill Preferences for treatments that include alternative medicines Presence of a family member who has abused drugs

Multiple times when prescriptions are lost with requests to refill

The most cost-effective treatment for two or three impetigo lesions on the face is: Mupirocin ointment Retapamulin (Altabax) ointment Topical clindamycin solution Oral amoxicillin/clavulanate (Augmentin)

Mupirocin ointment

A patient presents to the clinic with a complaint of headaches off and on for months. She reports she feels like someone is "squeezing" her head. She occasionally takes Tylenol for the pain, but usually just "toughs it out." Initial treatment for tension headache includes asking her to keep a headache diary and giving her a prescription for: Sumatriptan (Imitrex) Naproxen (Aleve) Ergotamine (Ergostat) Tylenol with codeine (Tylenol #3)

Naproxen (Aleve)

A 3-year-old patient presents with a URI. Treatment for their URI would include: Amoxicillin Topical oxymetazoline Pseudoephedrine Nasal saline spray

Nasal saline spray

Varenicline (Chantix) may be prescribed for tobacco cessation. Instructions to a patient who is starting varenicline include: The maximum time varenicline can be used is 12 weeks. Nausea is a sign of varenicline toxicity and should be reported to the provider. The starting regimen for varenicline is 1 mg twice a day a week before the quit date. Neuropsychiatric symptoms may occur.

Neuropsychiatric symptoms may occur.

Instructions for a patient who is starting nicotine replacement therapy include: Smoke less than 10 cigarettes a day when starting nicotine replacement. Nicotine replacement will help with the withdrawal cravings associated with quitting tobacco. Nicotine replacement can be used indefinitely. Nicotine replacement therapy is generally safe for all patients.

Nicotine replacement will help with the withdrawal cravings associated with quitting tobacco.

Isosorbide dinitrate is prescribed for a patient with chronic stable angina. This drug is administered twice daily, but the schedule is 7 a.m. and 2 p.m. because: It is a long-acting drug with potential for toxicity. Nitrate tolerance can develop. Orthostatic hypotension is a common adverse effect. It must be taken with milk or food.

Nitrate tolerance can develop

A 28-year-old pregnant woman at 38 weeks gestation is diagnosed with a lower UTI. She is healthy with no drug allergies. Appropriate first-line therapy for her UTI would be: Azithromycin Trimethoprim/sulfamethoxazole Nitrofurantoin Ciprofloxacin

Nitrofurantoin

Pharmacological treatment for uncomplicated chicken pox in an immunocompetent child is: Acyclovir within 48 hours of onset of varicella rash Varicella-zoster immune globulin within 72 hours of onset of varicella rash Famciclovir within 24 hours of onset of varicella rash No pharmacologic treatment is indicated.

No pharmacologic treatment is indicated

Lauren is a 13-year-old child who comes to clinic with a 4-day history of cough, low-grade fever, and rhinorrhea. When she blows her nose or coughs the mucous is greenish-yellow. The appropriate antibiotic to prescribe would be: Amoxicillin Amoxicillin/clavulanate TMP/SMZ (Septra) None

None

If 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? NSAIDs, opiates, corticosteroids Low-dose opiates, salicylates, increased dose of opiates Opiates, nonopiates, increased dose of nonopiates Nonopiates, increased dose of nonopiates, opiates

Nonopiates, increased dose of nonopiates, opiates

Vitamin B12 deficiency may lead to: Hair loss Insomnia Dry scales on the scalp Numbness and tingling of the hands

Numbness and tingling of the hands

An adolescent football player presents to the clinic with athlete's foot. Patients with tinea pedis may be treated with: OTC miconazole cream for four weeks Oral ketoconazole for six weeks Mupirocin ointment for two weeks Nystatin cream for two weeks

OTC miconazole cream for four weeks

First-line therapy for treating topical fungal infections such as tinea corporis (ringworm) or tinea pedis (athlete's foot) would be: Over-the-counter (OTC) topical azole (clotrimazole, miconazole) Oral terbinafine Oral griseofulvin microsize Nystatin cream or ointment

OTC topical azole (clotrimazole, miconazole)

Which of the following medications places a patient at increased risk of developing chronic kidney disease? Ranitidine Omeprazole Loperamide Ondansetron

Omeprazole

A 15-year-old patient presents to the clinic with a 48-hour history of nausea, vomiting, and some diarrhea. She is unable to keep fluids down and her weight is four pounds less than her last recorded weight. Besides intravenous (IV) fluids, the exam warrants the use of an antinausea medication. Which of the following would be the appropriate drug to order? Prochlorperazine (Compazine) Meclizine (Antivert) Promethazine (Phenergan) Ondansetron (Zofran)

Ondansetron (Zofran)

A 28-year-old woman presents to your practice with chief complaint of a cat bite sustained on her right ankle. Her pet cat had bitten her after she inadvertently stepped on its paw while she was in her home. Her cat is 3 years old, is up to date on immunizations, and does not go outside. Physical examination reveals pinpoint superficial puncture wounds on the right ankle consistent with the presenting history. She washed the wound with soap and water immediately and asks whether she needs additional therapy. Treatment for this patient's cat bite wound should include standard wound care with the addition of: Oral erythromycin Topical bacitracin Oral amoxicillin-clavulanate Parenteral rifampin

Oral amoxicillin-clavulante

A child has classic tinea capitis. Treatment for tinea on the scalp is: Miconazole cream thoroughly rubbed in for four weeks Oral griseofulvin for 6 to 8 weeks Ketoconazole shampoo daily for six weeks Ciclopirox cream daily for four weeks

Oral griseofulvin for 6-8 weeks

The average starting dose of warfarin is 5 mg daily. Higher doses of 7.5 mg daily should be considered in which patients? Pregnant women Elderly men Overweight or obese patients Patients with multiple comorbidities

Overweight or obese patients

If a patient with GERD who is taking a PPI daily is not improving, the plan of care would be: Prokinetic (metoclopramide) for 8 to 12 weeks PPI (omeprazole) twice a day for 4 to 8 weeks Histamine-2 receptor antagonist (ranitidine) for 4 to 8 weeks Cytoprotective drug (misoprostol) for 4 to 8 weeks

PPI (omeprazole) twice a day for 4 to 8 weeks

An acceptable first-line treatment for peptic ulcer disease with positive Helicobacter pylori (H. pylori) test is: Histamine-2 receptor antagonists for 4 to 8 weeks PPI bid for 12 weeks until healing is complete PPI bid plus clarithromycin plus amoxicillin for 14 days PPI bid and levofloxacin for 14 days

PPI bid plus clarithromycin plus amoxicillin for 14 days

Many patients self-medicate with antacids. Which patients should be counseled to not take calcium carbonate antacids without discussing it with their provider or a pharmacist first? Patients with kidney stones Pregnant patients Patients with heartburn Postmenopausal women

Patients with kidney stones

Methylnaltrexone is used to treat constipation in: Patients with functional constipation Patients with irritable bowel syndrome-associated constipation Children with encopresis Patients with opioid-associated constipation

Patients with opioid-associated constipation

An adult female presents with genital warts on her labia. Patient-applied topical therapy for genital warts includes: Podofilox 0.5% gel Podophyllin 10% resin Trichloroacetic acid Any of the above

Podofilox 0.5% gel

All NSAIDs have a U.S. Food and Drug Administration (FDA) black box warning regarding: Potential for causing life-threatening gastrointestinal (GI) bleeds Increased risk of developing systemic arthritis with prolonged use Risk of life-threatening rashes, including Stevens-Johnson syndrome Potential for transient changes in serum glucose

Potential for causing life-threatening gastrointestinal (GI) bleeds

A 14-year-old patient presents to the clinic with a classic migraine. She says she is having a headache two to three times a month. The initial plan would be: Prescribe nonsteroidal anti-inflammatory drug (NSAIDs) as abortive therapy and have her keep a headache diary to identify her triggers. Prescribe zolmitriptan (Zomig) as abortive therapy and recommend relaxation therapy to reduce her stress. Prescribe acetaminophen with codeine (Tylenol #3) for her to take at the first onset of her migraine. Prescribe sumatriptan (Imitrex) nasal spray and arrange for her to receive the first dose in the clinic.

Prescribe nonsteroidal anti-inflammatory drug (NSAIDs) as abortive therapy and have her keep a headache diary to identify her triggers.

Ashley comes to the clinic with a request for oral contraceptives. She has successfully used oral contraceptives before and has recently started dating a new boyfriend so would like to restart contraception. She denies recent intercourse and has a negative urine pregnancy test in the clinic. An appropriate plan of care would be: Recommend she return to the clinic at the start of her next menses to get a Depo- Provera shot. Prescribe oral combined contraceptives and recommend she start them at the beginning of her next period and use a back-up method for the first seven days. Prescribe oral contraceptives and have her start them the same day as the visit with a back-up method used for the first seven days. Discuss the advantages of using the topical birth control patch and recommend she consider using it.

Prescribe oral contraceptives and have her start them the same day as the visit with a back-up method used for the first seven days.

Trazodone has an adverse drug effect in men called: Priapism Gynecomastia Blue vision syndrome Pyronnie Disease

Priapism

Commercials on TV for erectile dysfunction (ED) medications warn about mixing them with nitrates. Why? Increased risk of priapism Profound hypotension Development of blue discoloration to the visual field Inactivation of the ED medication effect

Profound hypotension

The mechanism of action of oral combined contraceptives that prevents pregnancy is: Estrogen prevents the luteinizing hormone surge necessary for ovulation. Progestins thicken cervical mucus and slow tubal motility. Estrogen thins the endometrium making implantation difficult. Progestin suppresses follicle stimulating hormone release.

Progestins thicken cervical mucus and slow tubal motility.

A patient with mild GERD may be started on any of the following except _______ first. Antacids Prokinetics Histamine-2 receptor antagonists Proton pump inhibitors (PPIs)

Prokinetics

To prevent the development of peripheral neuropathy in patients taking isoniazid for tuberculosis the patient is also prescribed: Niacin (vitamin B3) Pyridoxine (vitamin B6) Riboflavin (vitamin B2) Thiamine (vitamin B1)

Pyridoxine (vitamin B6)

Phenothiazines may produce all of the following adverse reactions except: Raise the seizure threshold YProduce Parkinsonian symptoms Evoke extra-pyramidal symptoms Cause excessive drowsiness

Raise the seizure threshold

One goal of asthma therapy outlined by the NHLBI Expert Panel 3 guidelines is: Control of symptoms using albuterol daily Minimize exacerbations to once a month Keep nighttime symptoms at a maximum of twice a week Require infrequent use of beta 2 agonists (albuterol) for relief of symptoms

Require infrequent use of beta 2 agonists (albuterol) for relief of symptoms

Shana received her first medroxyprogesterone (Depo-Provera) injection six weeks ago and calls the clinic, concerned that she has been having a light period off and on since receiving her Depo shot. What should the provider do? Reassure her that some spotting is normal the first few months of Depo and it should improve. Schedule an appointment for an exam as this is not normal. Prescribe four weeks of estrogen to treat the abnormal vaginal bleeding. Order a pregnancy test and suggest she use a back-up method of contraception until she has her next shot.

Reassure her that some spotting is normal the first few months of Depo and it should improve.

An overweight patient recently started taking topiramate for seizures and at her follow-up visit you note she has lost 3 kg. The appropriate action would be: Tell her to increase her caloric intake to counter the effects of the topiramate. Consult with a neurologist, as this is not a common adverse effect of topiramate. Decrease her dose of topiramate. Reassure her that this is a normal side effect of topiramate and continue to monitor her weight.

Reassure her that this is a normal side effect of topiramate and continue to monitor her weight.

When prescribing any headache therapy, appropriate use of medications needs to be discussed to prevent medication-overuse headaches. A clinical characteristic of medication-overuse headaches is that they: Increase in frequency at night Increase in intensity at night Recur when medication wears off Begin to "cluster" into a pattern

Recur when medication wears off

A young adult female has severe cystic acne and is requesting treatment with Accutane. The appropriate treatment for her would be: Order a pregnancy test and if it is negative prescribe the isotretinoin (Accutane). Prescribe Accutane after educating her on the adverse effects. Recommend she try oral antibiotics (minocycline). Refer her to a dermatologist for treatment.

Refer her to a dermatologist for treatment

The next step in treatment when a patient has been on PPIs twice daily for 12 weeks and not improving is: Add a prokinetic (metoclopramide). Refer the patient for endoscopy. Switch to another PPI. Add a cytoprotective drug.

Refer the patient for endoscopy.

The U.S. Drug Enforcement Administration: Registers manufacturers and prescribers of controlled substances Regulates NP prescribing at the state level Sanctions providers who prescribe drugs off-label Provides prescribers with a number they can use for insurance billing

Registers manufacturers and prescribers of controlled substances

Charlie is a 65-year-old male who has been diagnosed with hypertension and benign prostatic hyperplasia. Doxazosin has been chosen to treat his hypertension because it: Increases peripheral vasoconstriction Decreases detrusor muscle contractility Lowers supine blood pressure more than standing pressure Relaxes smooth muscle in the bladder neck

Relaxes smooth muscle in the bladder neck

An 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: Complete blood count to rule out anemia Liver function Renal function Immunocompetence

Renal function

Donald has been diagnosed with hyperlipidemia. Based on his lipid profile, atorvastatin is prescribed. Rhabdomyolysis is a rare but serious adverse response to this drug. Donald should be told to: Become a vegetarian because this disorder is associated with eating red meat. Stop taking the drug if abdominal cramps and diarrhea develop. Report muscle weakness or tenderness and dark urine to his provider immediately. Expect "hot flash" sensations during the first 2 weeks of therapy.

Report muscle weakness or tenderness & dark urine to his provider immediately

Monitoring for a patient prescribed iron for iron deficiency anemia includes: Reticulocyte count one week after therapy is started Complete blood count every two weeks throughout therapy Hemoglobin level at one week of therapy INR weekly throughout therapy

Reticulocyte count one week after therapy is started

Education of patients with COPD who use inhaled corticosteroids includes: Doubling the dose at the first sign of a URI Using their inhaled corticosteroid first and then their bronchodilator Rinsing their mouth after inhaler use Abstaining from smoking for at least 30 minutes after using

Rinsing their mouth after inhaler use

Genital yeast infections are increased with: GLP-1 therapies SGLT-2 therapies Amylin-based treatment Weekly noninsulin-based therapies

SGLT-2 therapies

A patient is started on paroxetine (Paxil), an SSRI, for depression. Education regarding antidepressants includes: SSRIs may take two to six weeks before she will have maximum drug effects. Red-green color blindness may occur and should be reported. If she experiences dry mouth or a heart rate greater than 80, she should stop taking the drug immediately. She should eat lots of food high in fiber to prevent constipation.

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

Documented reduction in cardiovascular (CV) risk is linked with: Selective sodium-dependent glucose cotransporters-2 (SGLT-2) medications Metformin replacement with insulin Early adoption of basal insulin Sulfonylurea reduction

Selective sodium-dependent glucose cotransporters-2 (SGLT-2) medications

Patients who are on or who will be starting chronic corticosteroid therapy need monitoring of: Serum glucose Stool cultures Folate levels Vitamin B12

Serum glucose

Furosemide is added to a treatment regimen for heart failure that includes digoxin. Monitoring for this combination includes: Hemoglobin Serum potassium Blood urea nitrogen Serum glucose

Serum potassium

Treatment for mild-intermittent asthma is: Daily inhaled medium-dose corticosteroids Short-acting beta 2 agonists (albuterol) as needed Long-acting beta 2 agonists every morning as a preventative measure Montelukast (Singulair) daily

Short-acting beta 2 agonists (albuterol) as needed

Decongestants such as pseudoephedrine (Sudafed): Are Schedule III drugs in all states Should not be prescribed or recommended for children under four years of age Are effective in treating the congestion children experience with the common cold May cause drowsiness in patients of all ages

Should not be prescribed or recommended for children four years of age

Administration of exenatide is by subcutaneous injection: Thirty minutes prior to the morning meal Sixty minutes prior to the morning and evening meal Fifteen minutes after the evening meal Sixty minutes before each meal daily

Sixty minutes prior to the morning and evening meal

Men who use transdermal testosterone gel (AndroGel) should be advised to avoid: Washing their hands after applying the gel Wearing occlusive clothing while using the gel Exposure to estrogens while using the gel Skin-to-skin contact with pregnant women while using the gel

Skin-to-skin contact with pregnant women while using the gel

A patient has diarrhea and is wondering if they can take loperamide (Imodium). Loperamide: Can be given to patients of all ages, including infants and children, for viral gastroenteritis Slows gastric motility and reduces fluid and electrolyte loss from diarrhea Is the treatment of choice for the diarrhea associated with E. coli 0157 May be used in pregnancy and by lactating women

Slows gastric motility and reduces fluid and electrolyte loss from diarrhea

Patients taking warfarin need to be educated about the vitamin K content of foods to avoid therapeutic failure. Foods high in vitamin K that should be limited to no more than one serving per day include: Spinach Milk Romaine lettuce Cauliflower

Spinach

What herbal supplement must be avoided when taking SSRI or serotonin-norepinephrine reuptake inhibitors (SNRI) medications? Saw palmetto Niacin St. John's Wort Ginseng

St. John's Wort

A patient has been diagnosed with type A influenza. Appropriate prescribing of oseltamivir (Tamiflu) would include: Starting oseltamivir within the first 48 hours of influenza symptoms Advising the patient he can stop the oseltamivir when his symptoms resolve Educating the patient that oseltamivir will cure influenza Prophylactic treatment of all social contacts

Starting oseltamivir within the first 48 hours of influenza symptoms

Treatment with insulin for type 1 diabetics: Starts with a total daily dose of 0.2 to 0.4 units per kilogram of body weight Divides the total doses into three injections based on meal size Uses a total daily dose of insulin glargine given once daily with no other insulin required Is based on the level of blood glucose

Starts with a total daily dose of 0.2 to 0.4 units per kilogram of body weight

Behaviors predictive of addiction to controlled substances include the patient: Stealing or borrowing another patient's drugs Requiring increasing doses of opiates for pain associated with malignancy Receiving refills of a Schedule II prescription on a regular basis Requesting that only their own primary care provider prescribe for them

Stealing or borrowing another patient's drugs

When prescribing for migraines, patient education includes: Triptans are safe to use as often as needed as long as the patient is healthy. Use triptan before trying OTC meds such as acetaminophen or naproxen. Stress reduction and regular sleep are integral to migraine treatment. If migraines worsen they are to increase their medication frequency.

Stress reduction and regular sleep are integral to migraine treatment.

Which formulation of nitrate is appropriate for acute anginal pain? Transdermal Sublingual Oral extended release Ointment

Sublingual

Monitoring for a healthy, nonpregnant adult patient being treated for a UTI is: Symptom resolution in 48 hours Follow-up urine culture at completion of therapy Test of cure urinary analysis at completion of therapy

Symptom resolution in 48 hours

When prescribing temazepam (Restoril) for insomnia, patient education includes: Take temazepam nightly approximately 15 minutes before bedtime. Temazepam should not be used more than three times a week for less than three months. Drinking one ounce of alcohol will cause additive effects and the patient will sleep better. Exercise for at least 30 minutes within two hours of bedtime to enhance the effects of temazepam.

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

A patient was prescribed betaxolol ophthalmic drops by their ophthalmologist to treat glaucoma. Oral beta blockers should be avoided in patients who use ophthalmic beta blockers because: There may be an antagonistic reaction between the two. The additive effects may include bradycardia. They may potentiate each other and cause respiratory depression. The additive effects may cause metabolic acidosis.

The additive effects may include bradycardia

What happens to the typical thyroid hormone replacement dose when a woman becomes pregnant? Most women need less medication. Most women do not require a dose change. The average woman needs more medication during pregnancy. The average woman needs more medication only if carrying multiples.

The average woman needs more medication during pregnancy.

In hyperthyroid states, what, other than the cardiovascular (CV), must be evaluated to establish potential adverse issues? The liver The nails and skin The eyes The ears

The eyes

Instructions for the use of nicotine gum include: Chew the gum quickly to get a peak effect. The gum should be "parked" in the buccal space between chews. Acidic drinks such as coffee help with the absorption of the nicotine. The highest abstinence rates occur if the patient chews the gum when he or she is having cravings.

The gum should be "parked" in the buccal space between chews.

Nurse practitioner prescriptive authority is regulated by: The National Council of State Boards of Nursing The U.S. Drug Enforcement Administration The State Board of Nursing for each state The State Board of Pharmacy

The state board of nursing for each state

Laboratory values are different for TSH when screening for thyroid issues and when used for medication management. Which of the following holds true? Screening TSH has a wider range of normal values (0.02 to 5.0); therapeutic levels need to remain above 5.0. Screening values are much narrow than the acceptable range used to keep a person stable on hormone replacement. Therapeutic values are kept between 0.05 and 3.0 ideally. Screening values are considered acceptable up to 10. Screening values are between 5 and 10, and therapeutic values are greater than 10.

Therapeutic values are kept between 0.05 and 3.0 ideally.

The MMR vaccine is not recommended for pregnant women because: Pregnant women do not build adequate immunity to the vaccine. There is a risk of pregnant women developing measles encephalopathy. There is a risk of the fetus developing congenital rubella syndrome. Pregnant women can receive the MMR vaccine.

There is a risk of the fetus developing congenital rubella syndrome.

A patient's nutritional intake and laboratory results reflect hypoalbuminemia. This is critical to prescribing because: The solubility of the drug will not match the site of absorption. There will be more free drug available to generate an effect. There will be less free drug available to generate an effect. Drugs bound to albumin are readily excreted by the kidneys.

There will be more free drug available to generate an effect

The long-term Xanax patient comes in and states they need a higher dose of the medication. They deny any additional, new, or accelerating triggers of their anxiety. What is the probable reason they want a higher dose? They have become tolerant of the medication, which is characterized by the need for higher and higher doses. They are a drug seeker. They are suicidal. They need additional counseling on lifestyle modification.

They have become tolerant of the medication, which is characterized by the need for higher and higher doses

A patient has fractured their ankle and has received a prescription for acetaminophen and hydrocodone (Vicodin). Education when prescribing Vicodin includes: It is okay to double the dose of Vicodin if the pain is severe. Vicodin is not habit forming. They should not take any other acetaminophen-containing medications to exceed 3 gram/day. Vicodin may cause diarrhea; increase fluid intake.

They should not take any other acetaminophen-containing medications to exceed 3 gram/day

Drugs that are receptor agonists may demonstrate what property? Irreversible binding to the drug receptor site Block an endogenous action They stimulate a response Inverse relationship between drug concentration and drug action

They stimulate a response

Patients prescribed aspirin therapy require education regarding the signs of aspirin toxicity. An early sign of aspirin toxicity is: Black tarry stools Vomiting Tremors Tinnitus

Tinnitus

First-line treatment of impetigo with fewer than five lesions of 1-2 centimeters in diameter on the legs of a 9-year-old girl is: Topical mupirocin Topical neomycin Oral cefixime Oral doxycycline

Topical mupirocin

Which of the following is recommended for preventing a burn wound infection? Topical corticosteroid Topical silver sulfadiazine Oral erythromycin Oral moxifloxacin

Topical silver sulfadiazine

Which of the following is an oral antimicrobial option for the treatment of a community-acquired methicillin-resistant S. aureus cutaneous infection? Amoxicillin Dicloxacillin Cephalexin Trimethoprim-sulfamethoxazole

Trimethoprim-sulfamethoxazole

Drugs that have a significant first-pass effect: Undergo extensive metabolism in the liver and have decreased bioavailability Bypass the hepatic circulation Are administered by the parenteral route Are converted by the liver to more active and fat-soluble forms

Undergo extensive metabolism in the liver and have decreased bioavailability

William is a 62-year-old male who is requesting a prescription for sildenafil (Viagra). He should be screened for ________________ before receiving a prescription for sildenafil. Renal dysfunction Unstable coronary artery disease Benign prostatic hypertrophy History of priapism

Unstable coronary artery disease

Once-daily diuretics are typically suggested to be taken: At bedtime With every meal Upon awakening Whenever convenient

Upon awakening

A 72-year-old male occasionally takes diphenhydramine for his seasonal allergies. Monitoring for this patient would include assessing for: Urinary retention Cardiac output Peripheral edema Skin rash

Urinary retention

An adult female has been prescribed doxycycline for a chlamydia infection. She is healthy and her only medication is an oral combined contraceptive. Education would include: Use a back-up method of birth control (condom) until her next menses. Doxycycline may cause tendonitis and she should report any joint pain. Her partner will need treatment if her infection doesn't clear with the doxycycline. Doxycycline is used for one-dose treatment of sexually transmitted infections (STIs); take the whole prescription at once.

Use a back-up method of birth control (condom) until her next menses

Education for patients who use an inhaled beta agonist and an inhaled corticosteroid includes: Use the inhaled corticosteroid first, followed by the inhaled beta agonist. Use the inhaled beta agonist first, followed by the inhaled corticosteroid. Increase fluid intake to 3 L per day. Avoid use of aspirin or ibuprofen while using inhaled medications.

Use the inhaled beta agonist first, followed by the inhaled corticosteriod

Precautions that should be taken when prescribing controlled substances include: Faxing the prescription for a Schedule II drug directly to the pharmacy Using tamper-proof paper for all prescriptions written for controlled drugs Keeping any presigned prescription pads in a locked drawer in the clinic Using only numbers to indicate the amount of drug to be prescribed

Using tamper-proof paper for all prescription written for controlled drugs

The dosage of Vitamin B12 to initially treat pernicious anemia is: Nasal cyanocobalamin 1 g spray in each nostril daily for one week then weekly for one month Vitamin B12 IM monthly Vitamin B12 1,000 mcg IM daily for one week then 1,000 mg IM weekly for a month Oral cobalamin 1,000 mcg daily

Vitamin B12 1,000 mcg IM daily for one week then 1,000 mg IM weekly for a month

When prescribing NSAIDs, a complete drug history should be conducted as NSAIDs interact with these drugs: Omeprazole, a proton pump inhibitor Combined oral contraceptives Diphenhydramine, an antihistamine Warfarin, an anticoagulant

Warfarin, anticoagulant

Patients should be instructed regarding the rapid onset of zolpidem (Ambien) because: Zolpidem should be taken just before going to bed. Zolpidem may cause dry mouth and constipation. They may need to double the dose for effectiveness. They should stop drinking alcohol at least 30 minutes before taking zolpidem.

Zolpidem should be taken just before going to bed.

Absolute contraindications that clinicians must consider when initiating estrogen therapy include: Undiagnosed dysfunctional uterine bleeding Deep vein or arterial thromboemboli within the prior year Endometriosis a and b

a and b

Angiotensin-converting enzyme (ACE) inhibitors are the drug of choice in treating hypertension in diabetic patients because they: Improve insulin sensitivity Improve renal hemodynamics Reduce the production of angiotensin II All of the above

all of the above

Medications used in the management of chronic obstructive pulmonary disease (COPD) include: Inhaled beta 2 agonists Inhaled anticholinergics (ipratropium) Inhaled corticosteroids All of the above

all of the above

Drugs that use CYP 3A4 isoenzymes for metabolism may: Induce the metabolism of another drug Inhibit the metabolism of another drug Both a and b Neither a nor b

both a & b

Conjunctivitis in a child that is accompanied by acute otitis media is treated with: Sulfacetamide 10% ophthalmic solution (Bleph-10) Bacitracin/polymyxin B (Polysporin) ophthalmic drops Ciprofloxacin (Ciloxan) ophthalmic drops High-dose oral amoxicillin-clavulanate

high-dose oral amoxicilln-clavulanate

Second generation antihistamines such as loratadine (Claritin) are prescribed for seasonal allergies because they are: More effective than first generation antihistamines Less sedating than the first generation antihistamines Prescription products, and therefore covered by insurance Able to be taken with central nervous system (CNS) sedatives, such as alcohol

less sedating than the first generation antihistamines

Education of women who are being treated with ophthalmic antibiotics for conjunctivitis includes: Throw away eye makeup and purchase new. Redness and intense burning is normal with ophthalmic antibiotics. When applying eye ointment, set the tip of the tube on the lower lid and squeeze in 1/4 inch. Use a cotton swab to apply ointment, spreading the ointment all over the lid and in the conjunctival sac.

throw away eye makeup and purchase new