Adv Pharm Midterm
A patient reports stopping baclofen the day before being admitted to the hospital. The provider instructs the hospital staff to monitor the patient for which withdrawal effects? Dizziness Fatigue Hallucinations Dyspnea
Hallucinations
An adolescent has recently developed scattered comedones across the forehead and nose. Which medication does the provider recommend to the patient and parents? Benzoyl peroxide Topical clindamycin Topical erythromycin Topical retinoids
Benzoyl peroxide
A patient with open-angle glaucoma has a history of chronic obstructive pulmonary disease. Which ophthalmic blocker will the provider prescribe? Betaxolol Timolol Levobunolol Metipranolol
Betaxolol
A patient has been newly diagnosed with Parkinson disease. Before beginning therapy with pramipexole, the provider will ask the patient which assessment question in order to minimize risk for injury? "Do you have any history of alcohol abuse or compulsive behaviors?" "Have you any previous history of hypertension?" "Do you have any difficulty falling asleep or staying asleep?" "Do you have family history associated with psychoses?"
"Do you have any history of alcohol abuse or compulsive behaviors?"
A provider prescribes the keratolytic agent salicylic acid for a patient with extensive acne on the face, shoulders, trunk, and back. What drug information does the providers give to the patient? "Peeling and drying are desired effects of this drug." "Call the clinic if you develop nausea, vomiting, or ringing in the ears." "Tinnitus is a common side effect of little concern." "The only adverse effect of this drug is some localized stinging with application."
"Call the clinic if you develop nausea, vomiting, or ringing in the ears."
A pregnant patient in her third trimester asks the nurse whether she can take aspirin for headaches. Which response by the nurse is correct? "Yes, but it is safe during only the second and third trimesters of pregnancy." "Aspirin may cause premature closure of the ductus arteriosus in your baby so should be avoided." "Aspirin may induce premature labor and should be avoided in the third trimester." "No, you should use a first-generation nonsteroidal antiinflammatory medication."
"Aspirin may cause premature closure of the ductus arteriosus in your baby so should be avoided."
The provider is assessing an older adult male patient prior to beginning a prescribed anticholinergic drug. Which question concerning preexisting conditions demonstrates the provider's understanding of possible contraindications to this therapy? "Would you say that diarrhea is a problem you deal with regularly?" "Do you have any vision problems that require a prescribed medication?" "Have you ever been treated for prostate cancer?" "Do you have problems with urinary incontinence?"
"Do you have any vision problems that require a prescribed medication?"
A patient reports that the clonidine recently prescribed for hypertension is causing drowsiness. Which response by the provider to this concern is appropriate? "Drowsiness is a common side effect initially, but it will lessen with time." "You may also experience hypotension when you stand along with the drowsiness." "You may be at risk for addiction if you have central nervous system side effects." "You should discontinue the medication and I'll prescribe an alternative medication."
"Drowsiness is a common side effect initially, but it will lessen with time."
A patient with cerebral palsy who has been receiving baclofen for 3 months is admitted to the hospital for evaluation of new-onset seizures. What assessment question will the provider ask to help identify the most likely cause of these seizures? "Have you taken any extra doses of baclofen?" "Are you aware of the most common adverse effect of baclofen?" "Did you know that seizures are an idiopathic response to baclofen?" "Have you missed any doses of baclofen?"
"Have you missed any doses of baclofen?"
A provider provides teaching for a patient with a newly diagnosed partial complex seizure disorder who will begin therapy with an antiepileptic drug (AED). Which statement by the patient indicates to the provider an understanding of the teaching? "I may need to try several drugs before finding one is effective." "I will know that the drug is effective if I am seizure-free for two months." "Serious side effects may occur, and if they do, I should stop taking the medication." "When the drug level is maintained at therapeutic levels, I can expect to be seizure free."
"I may need to try several drugs before finding one is effective."
A provider counsels a patient who is prescribed phenytoin for epilepsy. Which statement by the patient indicates understanding of the teaching? "I should brush and floss my teeth regularly." "Once therapeutic blood levels are reached, they are easy to maintain." "I can consume alcohol in moderation while taking this drug." "Rashes are a common side effect but are not serious."
"I should brush and floss my teeth regularly."
A provider is teaching a patient who has taken glucocorticoids for over a year about glucocorticoid withdrawal. Which statement by the patient indicates a need for further teaching? "I should reduce the dose by half each day until I stop taking the drug." "I will need to have cortisol levels monitored during the withdrawal process." "The withdrawal schedule may take several months." "If I have surgery, I may need to take the drug for a while, even after I have stopped."
"I should reduce the dose by half each day until I stop taking the drug."
The provider is discussing home management with a patient who will begin taking an α-adrenergic antagonist for hypertension. Which statement by the patient indicates understanding of the teaching? "I need to stop the medication if my heart rate increases." "I should not drive while taking this medication." "I should take the first dose at bedtime." "I will stop taking the medication if I feel dizzy."
"I should take the first dose at bedtime."
An adolescent patient with moderate acne has begun a regimen consisting of combination clindamycin/benzoyl peroxide and tretinoin. Which statement by the patient indicates understanding of this medication regimen? "I should apply the Retin-A immediately after bathing." "I should apply the Retin-A twice daily." "I should augment this therapy with an abrasive soap." "I should use sunscreen every day."
"I should use sunscreen every day."
A provider has prescribed the topical anesthetic lidocaine for a patient who has a second-degree burn on one arm. Which statement by the patient indicates understanding of the teaching regarding this treatment? "I will apply a thin layer of the medication to only the burned area." "I will cover the burn with a dressing after applying the medication." "Applying an occlusive dressing is needed to increase absorption to relieve pain." "I need to limit use of the medication to areas where the blisters have ruptured."
"I will apply a thin layer of the medication to only the burned area."
Which patient statement suggests to the provider that the patient's nonadherence with their medication plan is related to dissatisfaction with the therapy? "This medication is too expensive; I can't afford it any longer." "I've been taking this medication for well over a week and I lost only a half a pound." "It's too hard to remember to take the pill every other day; so, I've missed several doses." "I have a very intense, fast paced job; it's hard to make time to take the medication like I should."
"I've been taking this medication for well over a week and I lost only a half a pound."
A patient will begin taking propranolol for hypertension. Which statement made by the prescriber is important when teaching this patient about the medication? "Notify the clinic if you start waking at night with shortness of breath or have difficulty lying flat." "It is safe to take this medication with your calcium channel blocker." "Stop taking the drug if you become short of breath." "Take your pulse and do not take the medication if your heart rate is fast."
"Notify the clinic if you start waking at night with shortness of breath or have difficulty lying flat."
A patient has severe acne that has been refractory to treatment with tetracycline, topical tretinoin, and benzoyl peroxide. The provider plans to begin treatment with isotretinoin. The provider will include which statement when teaching this patient about this drug? "Alcohol may be consumed in moderation when taking this drug." "Skin rash and excessive body hair growth are common with this drug." "Tetracycline must be discontinued before beginning the isotretinoin." "Two pregnancy tests are required before each monthly refill of your prescription."
"Tetracycline must be discontinued before beginning the isotretinoin."
An older adult patient displays confusion, memory loss, and disorientation in familiar surroundings. Although the patient has been taking donepezil 10 mg once daily for 6 months, the symptoms have begun to worsen, and the patient's spouse asks if the medication dose can be increased. What response will the prescriber provide to best address the spouse's concerns? "The dose can be increased, because the patient has been taking the drug for longer than 3 months." "The dose can be increased to twice daily dosing instead of once daily dosing." "The increase in symptoms is the result of hepatotoxicity from the medication's side effects." "The patient must take the drug for longer than 1 year before the dose can be increased."
"The dose can be increased, because the patient has been taking the drug for longer than 3 months."
A pregnant patient asks her provider about the safe use of medications during the third trimester. What will the provider tell her about drugs taken at this stage? "They may need to be given in higher doses if they undergo renal clearance." "They require lower doses if they are metabolized by the liver." "They are less likely to cross the placenta and affect the fetus." "Drugs are more likely to cause anatomical defects if they are taken during the second trimester.
"They may need to be given in higher doses if they undergo renal clearance."
The spouse of a patient with Alzheimer disease asks the provider for more information about the rivastigmine transdermal patch that is being used. After the discussion with the provider, which statement by the spouse indicates a need for further explanation? "Doses are lower but more steady with the transdermal patch." "Reduced side effects occur with the transdermal patch." "We only need to change the patch every 2 weeks." "We should remove the old patch before applying the new one."
"We only need to change the patch every 2 weeks."
When a patient with a lower back injury begins experiencing muscle spasms, the provider orders cyclobenzaprine 10 mg three times a day. What information will the provider include when teaching this patient about this drug? "This drug carries some risk of developing hallucinations and psychotic symptoms." "This medication may cause your urine to turn brown, black, or dark green." "You may experience blurred vision, dry mouth, or constipation." "You will need to have liver function tests performed while taking this medication."
"You may experience blurred vision, dry mouth, or constipation."
The provider prescribes hydrocodone with acetaminophen for a patient's postsurgical pain. What instruction will the prescriber include regarding alcohol intake? "If you plan to drink alcohol, I will write an order for acetaminophen without hydrocodone for your pain." "I'd suggest that you substitute ibuprofen for pain on days when you plan to drink alcohol." "You should avoid drinking alcohol while you are taking the pain medication I've ordered." "You should limit your alcohol intake to no more than two servings of alcohol daily while on the pain medication."
"You should avoid drinking alcohol while you are taking the pain medication I've ordered."
A provider prescribed methyldopa for a patient with hypertension. The patient is educated about drug actions, adverse effects, and the ongoing blood tests necessary with this drug. What additional statement should the provider include during the teaching? "If you have a positive Coombs test result, you will need to discontinue the medication, because this means you have hemolytic anemia." "Methyldopa can be used for its analgesic effects and for its hypertensive effects." "Xerostomia and orthostatic hypotension are serious side effects and indications for withdrawing the medication." "You will need to contact the office immediately and stop taking the medication if your eyes look yellow."
"You will need to contact the office immediately and stop taking the medication if your eyes look yellow."
A patient with gout who has increasingly frequent acute gouty attacks will begin receiving allopurinol and colchicine. Which statement will the provider include when teaching the patient about this drug regimen? "Allopurinol helps reduce the gastrointestinal side effects of colchicine." "The colchicine is given to enhance the effects of the allopurinol." "You will take both drugs initially but the colchicine will be discontinued later." "Allopurinol reduces the likelihood of acute gouty attacks that often occur when initiating colchicine therapy."
"You will take both drugs initially but the colchicine will be discontinued later."
choose the warfarin indications (tip: the recommended therapeutic range for most conditions is INR 2.5-3.5) -asymptomatic coronary artery disease -history of deep vein thrombosis -history of transient ischemic attack or stroke -left ventricular dysfunction or thrombus -artificial heart valvue -history of coronary bypass surgery -history of angina or MI -coronary artery disease prevention -atrial fibrillation
-artificial heart valve -hx of transient ischemic attack or stroke -atrial fibrillation -hx of deep vein thrombosis -left ventricular dysfunction or thrombus
choose the aspirin indications: -asymptomatic coronary artery disease -history of deep vein thrombosis -history of transient ischemic attack or stroke -left ventricular dysfunction or thrombus -artificial heart valvue -history of coronary bypass surgery -history of angina or MI -coronary artery disease prevention -atrial fibrillation
-asymptomatic coronary artery disease -history of transient ischemic attack or stroke -history of coronary bypass surgery -history or angina or MI -coronary artery disease prevention -atrial fibrillation
A patient with cerebral palsy has severe muscle spasticity and muscle weakness which makes it difficult to take anything by mouth. The provider will prescribe and educate the patient on which medication for home therapy? Baclofen Dantrolene Diazepam Metaxalone
Baclofen
A provider has prescribed dantrolene for the following patients. Which patient will the provider monitor most closely for risk of injury? A 20-year-old woman with a spinal cord injury A 45-year-old man with a history of malignant hyperthermia A 55-year-old woman with multiple sclerosis An 8-year-old child with cerebral palsy
A 55-year-old woman with multiple sclerosis
A provider is considering prescribing tizanidine for patient who is experiencing localized muscle spasms after an injury. What information in the patient's health history will be concerning enough to the provider to warrant selecting a different drug? Chronic use of aspirin A history of hepatitis A history of malignant hyperthermia Occasional use of alcohol
A history of hepatitis
A patient presents to the emergency department after accidentally taking too much prescribed warfarin. The patient's heart rate is 78 beats/minute and the blood pressure is 120/80 mm Hg. A dipstick urinalysis is normal. The patient does not have any obvious hematoma or petechiae and does not report any pain. What will the provider order initially to address the patient's current condition? Vitamin K Protamine sulfate An activated partial thromboplastin time (aPTT) A prothrombin time (PT) and an international normalized ratio (INR)
A prothrombin time (PT) and an international normalized ratio (INR)
A prescriber orders clonidine ER (Kapvay ER) tablets for a 12-year-old child to treat which condition? ADHD Hypertension Severe pain Tourette syndrome
ADHD
Clonidine is approved for the treatment of which conditions? (Select all that apply.) ADHD Hypertension Opioid withdrawal Severe pain Smoking cessation
ADHD Hypertension Severe pain
A patient has been diagnosed with fungal otitis externa (otomycosis). What will the provider prescribe initially? Acidifying ear drops for 1 week Antifungal ear drops for 14 days Intravenous (IV) antifungal agents Oral antibiotics for 7 days
Acidifying ear drops for 1 week
What is a key role of the sympathetic nervous system? Activation of fight-or-flight response Conservation of energy Control of voluntary motor control Communication between the body and CNS
Activation of fight-or-flight response
An adolescent with acne who uses benzoyl peroxide lotion twice daily reports experiencing drying and burning of the skin. What action will the prescriber take? Recommend applying lotion to the skin after applying the drug. Advise the patient to reduce the frequency to one application a day. Discontinue the medication to prevent further localized allergic reaction. Prescribe a gel formulation of the drug.
Advise the patient to reduce the frequency to one application a day.
A patient with glaucoma will begin using brimonidine for long-term reduction of increased ocular pressure. The medication education provided by the prescriber appears to have been effective when the patient makes which statement? After using the drops, I should wait 15 minutes before putting in contacts." "Because this is a topical medication, drowsiness will not occur." "My blood pressure may increase when using this medication." "If my eyes begin to itch or turn red, it means I am allergic to this drug."
After using the drops, I should wait 15 minutes before putting in contacts."
A male patient with benign prostatic hyperplasia (BPH) has stopped taking his -adrenergic antagonist medication because of ejaculatory difficulties. Which medication will the provider to prescribe to best address the BPH and the patient's concerns? Alfuzosin Prazosin Silodosin Tamsulosin
Alfuzosin
A patient with asthma uses albuterol for wheezing. The provider notes current vital signs of HR, 96 beats/minute; RR, 18 breaths/minute; and BP, 116/78 mm Hg. The patient has clear breath sounds and fine hand tremors. What action will the provider take initially to treat this patient effectively? Ask how often the patient uses the inhaler. Check the patient's blood glucose level. Prescribe isoproterenol to reduce side effects. Substitute isoproterenol to minimize the tremors.
Ask how often the patient uses the inhaler.
A patient who has infrequent migraine headaches wants to prevent them from occurring. What intervention will the provider take? Prescribe prochlorperazine. Prescribe amitriptyline. Ask the patient to keep a headache diary to help determine possible triggers. Schedule the abortive medication to be taken regularly instead of PRN.
Ask the patient to keep a headache diary to help determine possible triggers.
A provider considers prescribing timolol for a patient with primary open-angle glaucoma. Which condition could be worsened if this drug is prescribed? Asthma Hypertension Migraine headaches Supraventricular tachycardia
Asthma
A provider reviews the patient's chart before prescribing bethanechol for postoperative urinary retention. Which preexisting condition would be a contraindication to using this drug? Asthma Gastroesophageal reflux Hypertension Hypothyroidism
Asthma
To provide effective protection against the full range of ultraviolet (UV) radiation, an organic sunscreen must contain which agent? Avobenzone para-Aminobenzoic acid (PABA) Titanium dioxide Zinc oxide
Avobenzone
Tricyclic Antidepressants (TCAs): (Select all that apply) Block the reuptake of serotonin without affecting reuptake of norepinephrine Block the reuptake of both serotonin and norepinephrine Block the reuptake of biogenic amines, including norepinephrine and serotonin Fluoxetine Citalopram Escitalopram Fluvoxamine Paroxitine Reboxetine Sertraline Desvenlafaxine Duloxetine Milnacipran Venlafaxine Amitriptyline Nortriptyline Imipramine
Block the reuptake of biogenic amines, including norepinephrine and serotonin Amitriptyline Nortriptyline Imipramine
Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs): (Select all that apply) Block the reuptake of serotonin without affecting reuptake of norepinephrine Block the reuptake of both serotonin and norepinephrine Block the reuptake of biogenic amines, including norepinephrine and serotonin Fluoxetine Citalopram Escitalopram Fluvoxamine Paroxitine Reboxetine Sertraline Desvenlafaxine Duloxetine Milnacipran Venlafaxine Amitriptyline Nortriptyline Imipramine
Block the reuptake of both serotonin and norepinephrine Reboxetine Desvenlafaxine Duloxetine Milnacipran Venlafaxine
Selective Serotonin Reuptake Inhibitors (SSRIs): (Select all that apply) Block the reuptake of serotonin without affecting reuptake of norepinephrine Block both the reuptake of serotonin and norepinephrine Block the reuptake of biogenic amines, including norepinephrine and serotonin Fluoxetine Citalopram Escitalopram Fluvoxamine Paroxetine Reboxetine Sertraline Desvenlafaxine Duloxetine Milnacipran Venlafaxine Amitriptyline Nortriptyline Imipramine
Block the reuptake of serotonin without affecting reuptake of norepinephrine Fluoxetine Citalopram Escitalopram Fluvoxamine Paroxetine Sertraline
An infant is prescribed a central nervous system (CNS) drug. The parents are concerned that the child exhibits unusual drowsiness and sedation. The provider explains these effects based on an understanding of which difference in the physiology of infants and adults? Blood-brain barrier First-pass effect Gastrointestinal absorption Renal filtration
Blood-brain barrier
A patient receives an epidural anesthetic during labor and delivery. What effect in the newborn in the immediate postpartum period must the provider be prepared to address? Bradycardia Hypoglycemia Jitteriness Tachypnea
Bradycardia
A 60-year-old female patient is about to begin long-term therapy with a glucocorticoid. Which intervention will the provider prescribe to help minimize the patient's risk of developing osteoporosis? Baseline vitamin D level Calcium and vitamin D supplements Estrogen therapy Skeletal x-rays before treatment
Calcium and vitamin D supplements
A patient has a skin infection and the culture reveals methicillin-resistant Staphylococcus aureus (MRSA). What medication treatment should the provider prescribe for this patient? Cefaclor Cefazolin Cefotaxime Ceftaroline
Ceftaroline
Debra is a 50-year-old Caucasian female who presents with a one-day history of sinus congestion and headache. "It's a sinus infection. It always takes an antibiotic to get rid of it. I'm just trying to get ahead of it. I have new grandbabies. I can't be sick." She has no known drug allergies. She has a history of GERD and her only medication is over-the-counter famotidine 20 mg twice a day. A review of her chart indicates that she received Amoxicillin Clavulanate for similar symptoms of 10-day duration with fever of 101 about 18 months ago. She is currently afebrile, and she denies fever. Patient education for antimicrobials includes: Stop the medication immediately when feeling better. Save unused medication for future illnesses. Complete the entire course of treatment unless experiencing an adverse effect. Share the medication with a family member with similar symptoms.
Complete the entire course of treatment unless experiencing an adverse effect.
A prescriber has ordered methyldopa for a female patient diagnosed with hypertension. The nurse understands that which laboratory tests are important before beginning therapy with this drug? (Select all that apply.) Coombs test Hemoglobin and hematocrit (H&H) Liver function tests Pregnancy test Urinalysis
Coombs test Hemoglobin and hematocrit (H&H) Liver function tests
A patient who has recurrent migraine headaches is prescribed sumatriptan. Which condition in this patient's history is of concern to the prescriber? Asthma Coronary artery disease Diabetes Renal disease
Coronary artery disease
A provider is concerned about renal function in an 84-year-old patient who is taking several medications. What laboratory result will the provider order? Creatinine clearance Sodium levels Potassium levels Serum creatinine
Creatinine clearance
Amoxicillin is prescribed for a 12-month-old child who developed a second middle ear infection since age 8 months. Three days later, the parent calls to report that the child continues to have a temperature of 39.5C and is unable to sleep well because of pain. What action will the provider take to provide effective care to this child? Discuss prescribing amoxicillin/clavulanate with the child's parents. Prescribe a medication that promotes sleep. Advise continuing the amoxicillin as ordered and provide a schedule of prn dosing for ibuprofen for pain. Discuss with the parent the child's need for probably surgery for tympanostomy tubes placement to reduce infections.
Discuss prescribing amoxicillin/clavulanate with the child's parents.
A patient who will begin taking colchicine for gout currently takes ibuprofen, simvastatin, amoxicillin, and digoxin. What action will the provider take to manage this medication regime? Prescribe a different antibiotic. Discuss the potential risk of muscle injury. Order cardiorespiratory monitoring. Suggest that the patient discontinue the ibuprofen.
Discuss the potential risk of muscle injury.
A 14-year-old female patient has moderate acne that has not responded to topical drugs. Which treatment will the provider discuss with the patient and parents? Combination oral contraceptives Doxycycline Isotretinoin Spironolactone
Doxycycline
A patient will begin initial treatment for severe acne. Which regimen will the provider order? Clindamycin/benzoyl peroxide and tretinoin Doxycycline and tretinoin Erythromycin and benzoyl peroxide Topical clindamycin and isotretinoin
Doxycycline and tretinoin
A patient who was prescribed cromolyn ophthalmic drops for severe allergic conjunctivitis reports persistence of allergic symptoms after 2 days of treatment. What additional drug will the provider consider prescribing while waiting for cromolyn to reach maximal effectiveness? An ophthalmic demulcent H1-receptor antagonists Glucocorticoid drops Ocular decongestants
H1-receptor antagonists
A provider speaking to a class or a group of pregnant patients correctly teaches that the highest risk of teratogen-induced gross malformations exists during which time period? Immediately before conception During the first trimester During the second trimester During the third trimester
During the first trimester
A patient is prescribed both a diuretic and a dobutamine in the immediate postoperative period. What adverse drug reactions will the prescriber consider as possible in this patient? (Select all that apply.) Angina Dysrhythmias Hypotension Oliguria Tachycardia
Dysrhythmias Oliguria Tachycardia
A patient reports numbness in the extremities. The assessment history notes that the patient's hands and feet are cool and pale and that the patient has a history of migraine headaches. The provider focuses on further assessing for what likely cause of the symptoms? Ergotamine withdrawal Ergotism Severe migraine symptoms Sumatriptan side effects
Ergotism
A patient has been taking oxycodone to manage severe, chronic pain for the last 6 months but now reports that it is no longer effective. The provider will discuss prescribing which medication for the patient? Fentanyl transdermal patch Hydrocodone PO Meperidine PO Pentazocine PO
Fentanyl transdermal patch
Define bioavailability
Fraction of administered drug that reaches systemic circulation
Bethanechol is being investigated for inclusion in treatment for which diagnosis? Gastric ulcers Gastroesophageal reflux Hypotension Intestinal obstruction
Gastroesophageal reflux
A provider considers prescribing sumatriptan for a patient experiencing a migraine headache. Before prescribing this drug, what is the most important information to obtain? Is there a family history of migraines? Has acetaminophen been taken in the past 3 hours? Has the patient taken ergotamine in the past 24 hours? Is the patient allergic to sulfa compounds?
Has the patient taken ergotamine in the past 24 hours?
Within a few minutes of administration a local anesthetic, the patient has a pulse of 54 beats/minute, respirations of 18 breaths/minute, and a blood pressure of 90/42 mm Hg. The provider should monitor the patient for further signs of what condition? Heart block Anaphylaxis Central nervous system excitation Respiratory depression
Heart block
Which assessment finding would be of greatest concern for a provider who is attempting to determine the appropriateness of prescribing the patient a nonselective β agonist? Pulse oximetry reading of 88% Blood pressure of 100/60 mm Hg Respiratory rate of 28 breaths/minute Heart rate of 110 beats/minute
Heart rate of 110 beats/minute
A patient has been receiving iron replacement therapy for 2 days after hip replacement surgery. The provider is alerted to the following assessment data: Patient's stools appear black. Patient is pale and reports feeling tired. Patient's heart rate is 98 beats/minute, respirations are 20 breaths/minute, and the blood pressure is 100/50 mm Hg. What order will the provider take initially to best assure appropriate care for this patient? Packed red blood cells Hemoglobin and hematocrit (H&H) A stool guaiac Hypertonic fluid bolus
Hemoglobin and hematocrit (H&H)
A patient who takes allopurinol for chronic gout develops a rash. Vital signs are within normal limits and there are no signs of patient distress. What action will the provider take? Hold the allopurinol and confirm an existing drug reaction. Discontinue the allopurinol and prescribe colchicine. Prescribe an antihistamine to minimize the drug side effects. Lower the dose of allopurinol.
Hold the allopurinol and confirm an existing drug reaction.
A patient is admitted to the hospital with a diagnosis of vitamin B12 deficiency, hypoxia and anemia. In addition to oxygen therapy, what will the provider order to address these problems? IM cyanocobalamin and folic acid IM cyanocobalamin and antibiotics PO cyanocobalamin and folic acid PO cyanocobalamin and blood transfusions
IM cyanocobalamin and folic acid
List the routes of drug administration in order of fastest to slowest absorption pattern
IV, IM/SQ, PO
A patient reports that Brand X tablets work faster than Brand Y tablets of the same amount of the same drug. Which statement informs the prescriber's response when explaining this phenomenon to the patient? Advertising by pharmaceutical companies can enhance patient expectations of one brand over another, leading to a placebo effect. Because the drug preparations are chemically equivalent, the actions of the two brands must be identical. Inactive ingredients used in composition can result in differing rates of dissolution, which can alter the drug's onset of action. The bioavailability of a drug is determined by the amount of the drug in each dose.
Inactive ingredients used in composition can result in differing rates of dissolution, which can alter the drug's onset of action.
A patient takes a drug that is metabolized by CYP3A4 isoenzymes. If a CYP3A4 inducing drug is prescribed, what drug adjustment may be necessary to maintain a therapeutic level of CYP3A4 substrate? Increase dosage of the CYP3A4 inducer. Decrease dosage of the CYP3A4 inducer. Increase dosage of the CYP3A4 substrate. Decrease dosage of the CYP3A4 substrate.
Increase dosage of the CYP3A4 substrate.
Dopamine is administered to a patient who has hypotension. Other than an increase in blood pressure, which indicator would the provider use to evaluate a successful response? Decrease in pulse Increase in urine output Weight gain Improved gastric motility
Increase in urine output
A patient who has taken warfarin for a year has now been prescribed carbamazepine. What additional action will the provider take to assure the patient's safety? Decrease the usual dose of carbamazepine. Increase the dose of warfarin. Order more frequent activated partial thromboplastin time (aPTT) monitoring. Order extra dietary vitamin K.
Increase the dose of warfarin.
A patient with a seizure disorder is admitted to the hospital after an increase in seizure frequency. The prescriber considers adding carbamazepine 100 mg twice daily to the patient's medication regimen, but notes that the patient is already taking lamotrigine 375 mg twice daily. What changes will the prescriber make to the patient's medication regimen? Reduce the carbamazepine dose to 50 mg twice daily. Reduce the lamotrigine dose to 225 mg twice daily. Increase the carbamazepine dose to 200 mg twice daily. Increase the lamotrigine dose to 500 mg twice daily.
Increase the lamotrigine dose to 500 mg twice daily.
Which of the following administration routes would result in the highest drug bioavailability? Sublingual Intramuscular injection Oral Intravenous
Intravenous
A patient who takes a β blocker reports experiencing shortness of breath and has respirations of 28 breaths/minute, a blood pressure of 78/50 mm Hg, a pulse of 68 beats/minute, and crackles are auscultated in all lung fields. The provider begins treatment for what condition based on the assessment data? Bronchoconstriction Left-sided heart failure Rebound cardiac excitation Sinus bradycardia
Left-sided heart failure
A 6-year-old child presents with crying due to ear pain. Tympanic membranes are erythematous, bulging, and immobile, but intact. In addition to antibiotic therapy, what will the provider recommend for pain management? Low dose aspirin Lidocaine ear drops Prednisone A tympanostomy to relieve pressure in the middle ear
Lidocaine ear drops
A patient with bipolar disorder is prescribed daily lithium. Which action is most important for the provider to take in order to determine if the therapeutic level is maintained? Evaluate pre-administration blood work. Prescribe the lithium to be taken at regular intervals. Order periodic laboratory testing. Assess the patient for signs and symptoms of lithium toxicity.
Order periodic laboratory testing.
Define an agonist
Molecules that activate receptors & mimic the body's endogenous regulatory molecules
Define an antagonist
Molecules that prevent receptor activation by endogenous regulatory molecules and drugs
A patient who has migraine headaches has been using sumatriptan with good initial results but now reports frequent migraine recurrence 24 hours later. Which medication will the provider order for this patient? Aspirin Ergotamine Naratriptan Zolmitriptan
Naratriptan
The provider used lidocaine with epinephrine as a local anesthetic when suturing a laceration on a patient's hand. Following the procedure, which patient symptom causes the most concern? Difficulty moving the fingers of the affected hand Inability to feel pressure at the suture site Nervousness and tachycardia Sensation of pain returning to the wound
Nervousness and tachycardia
The drug manual states that older adult patients are at increased risk for hepatotoxicity. Which action is most important when prescribing this medication to an 80-year-old patient? Obtaining baseline liver function studies Ensuring that the drug is taken in the correct dose at the correct time Discontinuing the order; the drug is contraindicated for this patient Giving the medication intravenously to avoid first pass metabolism
Obtaining baseline liver function studies
A patient diagnosed with Parkinson disease (PD) begins treatment with levodopa/carbidopa. After several months of therapy, the patient reports no change in symptoms. The provider will implement what action? Prescribing the patient a dopamine agonist Discussing the effects of the "on-off" phenomenon with the patient Increasing the daily dose of levodopa/carbidopa Ordering tests to reevaluate the patient's diagnosis
Ordering tests to reevaluate the patient's diagnosis
An older adult patient who lives alone and admits to being "somewhat forgetful" has an overactive bladder (OAB) and occasional constipation. The patient has tried behavioral therapy to treat the OAB without success. Which treatment will the provider likely prescribe for this patient? Oxybutynin short-acting syrup Oxybutynin [Ditropan XL] extended-release tablets Oxybutynin [Oxytrol] transdermal patch Percutaneous tibial nerve stimulation (PTNS)
Oxybutynin [Oxytrol] transdermal patch
A patient experiences delirium and hallucinations after beginning atropine treatment for bradycardia. Which medication will the provider prescribe to address these signs of possible atropine toxicity? Donepezil Edrophonium Neostigmine Physostigmine
Physostigmine
A patient who takes levodopa/carbidopa for Parkinson disease reports periods of lost drug effect lasting from minutes to several hours with no relationship to the timing of drug administration. What course of action will the provider take? Prescribe a COMT inhibitor, such as entacapone. Add the DA-releasing agent amantadine to the regimen. Prescribe a direct-acting dopamine agonist. Shorten the dosing interval of levodopa/carbidopa.
Prescribe a COMT inhibitor, such as entacapone.
An 18-month-old child with a 24-hour history of fever and otalgia is seen in the clinic. The child's parents tell the provider that the child was inconsolable during the night. The provider examines the child and notes a bulging, immobile, erythematous tympanic membrane. What action will the provider take to provide the child with effective care? Institute watchful waiting and ask the parent to return to the clinic if the child's symptoms worsen. Discuss a referral to an ear, nose, and throat specialist for follow-up treatment. Advise the parent to give analgesics for 3 days while observing for worsening symptoms. Prescribe amoxicillin at 45 mg/kg/dose twice daily.
Prescribe amoxicillin at 45 mg/kg/dose twice daily.
A 2-year-old child presents to the clinic with otalgia and fever. The left tympanic membrane (TM) is erythematous and bulging; the right TMs is perforated and draining. The child's parent states, "This is the fifth ear infection this year. What can we do?" What action will the provider take to address the child's ear problems? Prescribe both ceftriaxone [Rocephin] IM with benzocaine ear drops for pain. Discuss beginning prophylactic antibiotic therapy with trimethoprim/sulfamethoxazole. Prescribe amoxicillin/clavulanate and refer the child to an otolaryngologist. Prescribe both high-dose amoxicillin and the influenza vaccine.
Prescribe amoxicillin/clavulanate and refer the child to an otolaryngologist.
A patient with refractory gout will be admitted for treatment with intravenous pegloticase. What additional action will the prescriber take to manage the patient's treatment? Prescribe an antihistamine and a glucocorticoid to be administered prior to beginning the pegloticase infusion. Initiate allopurinol therapy 24 hours prior to treatment with pegloticase. Screen the patient for folic acid deficiency. Prescribe a short-acting bronchodilator to be used as needed.
Prescribe an antihistamine and a glucocorticoid to be administered prior to beginning the pegloticase infusion.
A patient prescribed phentolamine to treat pheochromocytoma now has a blood pressure of 76/52 mm Hg and a heart rate of 90 beats/minute. Which action will the provider take to provide effective care? Prescribe epinephrine. Ask to be notified if the heart rate increases. Prescribe a β blocker. Prescribe norepinephrine.
Prescribe norepinephrine.
A patient who uses transdermal nitroglycerin for angina reports occasional periods of tachycardia. What intervention will the prescriber order? Order digoxin to slow the heart rate. Discontinue the nitroglycerin. Recommend periods of rest when the heart rate increases. Prescribe verapamil as an adjunct to nitroglycerin therapy.
Prescribe verapamil as an adjunct to nitroglycerin therapy.
A patient has been taking methadone for 5 months to overcome an opioid addiction. The provider will monitor the patient for which electrocardiographic change? Prolonged QT interval Prolonged P-R interval Bundle branch block Elevated ST segment
Prolonged QT interval
Which prescriber action will have the greatest impact on the patient's commitment to adherence to any type of medication therapy? Prescribing the medication in oral form whenever possible Scheduling once a day administration Providing medication education that the patient can easily understand Assuring that the medication prescription will be covered by the patient's insurance
Providing medication education that the patient can easily understand
A patient who uses latanoprost ophthalmic drops tells the provider, "My eyes used to be greenish-brown, but now they're brown." What response will the provider give to address the patient's concern? Reassure the patient that eye-color change is a harmless side effect. Refer the patient to an ophthalmologist. Explain that the eye color is unchanged but color perception is a drug side effect. You Answered Tell the patient that this effect will reverse when the medication is withdrawn.
Reassure the patient that eye-color change is a harmless side effect.
A young female adult who has recently begun taking sumatriptan reports a sensation of chest pressure, without pain, and arm heaviness. What action will the provider take? Focus on identifying any history of hypertension or coronary artery disease. Determine whether the patient might be pregnant. Reassure the patient that this is a transient, reversible side effect of the medication. Discontinue the sumatriptan.
Reassure the patient that this is a transient, reversible side effect of the medication.
The provider prescribes bromocriptine for a patient who takes levodopa/carbidopa. Afterward, the patient becomes agitated and has frequent nightmares. What action will the provider take to manage the patient's symptoms? Add an antipsychotic medication to the patient's medication regimen. Discontinue the bromocriptine and prescribe cabergoline. Reduce the dose of bromocriptine. Reduce the dose of levodopa/carbidopa.
Reduce the dose of bromocriptine.
The patient who is on memantine therapy has a slight elevation in the creatinine clearance. What action will the provider take in response to this laboratory result? Add sodium bicarbonate to the patient's drug regimen. Order a serum creatinine level to validate the creatinine clearance. Discontinue the memantine. Reduce the dose of memantine.
Reduce the dose of memantine.
A client with a history of motion sickness asks the provider about medication to manage this condition during a planned cruise. What medication will the provider likely prescribe? Ipratropium Scopolamine Dicyclomine Atropine
Scopolamine
A patient who takes phenytoin for seizures asks the provider for a prescription for oral contraceptives. What recommendation will the provider make to help assure the effectiveness of the contraception method? She may need to increase her dose of phenytoin while taking oral contraceptives. She should consider a different form of birth control while taking phenytoin. She should adhere strictly to oral contraceptive schedules because phenytoin causes birth defects. She should not take oral contraceptives, because they reduce the effectiveness of phenytoin.
She should consider a different form of birth control while taking phenytoin.
An older adult patient with Alzheimer disease is prescribed a cholinesterase inhibitor drug. When providing medication education to the care giver, the prescriber will prioritize which possible side effects? (Select all that apply.) Confusion Memory impairment Constipation Slowed heart rate Lightheadedness
Slowed heart rate Lightheadedness
When prescribing lovastatin, what will a provider advise to decrease the risk of developing muscle toxicity? Avoid exercise for 2 hours after administration. Substitute grapefruit juice with orange juice. Monitor aspartate aminotransferase (AST) and alanine aminotransferase (ALT). Take the medication with an NSAID or other anti-inflammatory drug.
Substitute grapefruit juice with orange juice.
A patient is wheezing and short of breath with a heart rate of 88 beats/minute, a respiratory rate of 24 breaths/minute, and a blood pressure of 124/78 mm Hg. The primary health care prescriber orders a nonselective β agonist medication. Besides evaluating the patient for a reduction in respiratory distress, which side effect is of primary concern? Hypotension Tachycardia Tachypnea Urinary retention
Tachycardia
A 60-year-old patient asks about using tretinoin to minimize wrinkles. What response will the provider give? This drug is only approved for treating acne. Results may be visible within a few weeks of starting therapy. Systemic toxicity is a common side effect in patients with sensitive skin. The drug is not effective on coarse wrinkles or sun-damaged skin.
The drug is not effective on coarse wrinkles or sun-damaged skin.
The prescriber has ordered neostigmine for a patient with myasthenia gravis. What physiological process would be assessed to best assure patient safety and the long-term effectiveness of the medication therapy? The patient's ability to raise the eyelids The level of fatigue the patient generally experiences Current skeletal muscle strength the patient possesses The patient's current swallowing ability
The patient's current swallowing ability
A patient experiences an acute gouty episode despite taking nonsteroidal antiinflammatory drugs for several months. The prescriber and patient had planned to begin therapy with probenecid. What effect will the acute episode have on the patient's planned medication therapy? Probenecid will be prescribed as planned, but colchicine will be added to the medication regimen. The provider will need to prescribe allopurinol instead of probenecid. Probenecid therapy can begin but the patient must commit to increasing fluid intake. The probenecid therapy will be delayed until the acute episode has subsided.
The probenecid therapy will be delayed until the acute episode has subsided.
For what purpose will a provider prescribe pilocarpine? To reduce excessive secretions in a postoperative patient To lower intraocular pressure in a patient with glaucoma To inhibit muscular activity in a patient with an overactive bladder To prevent a hypertensive crisis in a patient with chronic hypertension
To lower intraocular pressure in a patient with glaucoma
A child with eczema has been treated unsuccessfully with a topical glucocorticoid for a year and now has skin atrophy and hypopigmentation. What change in therapy will the provider recommend to the parents? Higher potency topical glucocorticoids Topical keratolytic agents Topical immunosuppressants Topical nonsteroidal anti-inflammatory drugs (NSAIDs)
Topical keratolytic agents
A patient with a history of asthma experiences three or four migraine headaches each month, uses sumatriptan as an abortive medication but has developed medication-overuse headaches. When asked what can be done to prevent migraines, the provider suggests prescribing which medication? Botulinum toxin Meperidine Timolol Topiramate
Topiramate
A hospitalized patient newly diagnosed with Parkinson disease is prescribed apomorphine but develops medication-related nausea and vomiting. What drug will the provider prescribe to manage these side effects effectively? Levodopa Ondansetron Prochlorperazine Trimethobenzamide
Trimethobenzamide
A patient has had three gouty flare-ups in the past year. Which type of drug will the provider prescribe to decrease the frequency of flare-ups? Antigout antiinflammatory drug Glucocorticoid Nonsteroidal antiinflammatory drug Urate-lowering drug
Urate-lowering drug
A client is about to begin anticholinergic medication therapy. What instructions will the provider give to best minimize common side effects? Wear dark glasses both indoors and outdoors. Void just prior to taking the medication. Minimize fiber intake to avoid diarrhea. Hydrate well before engaging in outdoor exercise.
Void just prior to taking the medication.
A patient who has been taking an antiepileptic drug for several weeks reports little change in seizure frequency, what action will the provider take to provide effective care? Ask the patient to complete a seizure frequency chart for the past few weeks. Write an order for serum drug levels. Reinforce to the patient the need to take the medications as prescribed. Increase the dose of the antiepileptic drug.
Write an order for serum drug levels.
Nancy, a 35-year-old Caucasian female, presents for treatment of migraine headache with aura. She was diagnosed at age 18 years. She describes onset of symptoms as scotoma that she perceives in her right upper outer visual field. Symptoms include photophobia, nausea, and pain behind her eyes and throughout her head. She has had MRI and complete visual field testing with no deficits noted. Her usual treatment includes caffeine intake, acetaminophen 650 mg by mouth at onset of symptoms, and sleep in a dark room. She experiences migraine two to three times per month. She does not feel the headaches correlate with her menses. She has NKDA. Her current medication is Paraguard®, a nonhormonal intrauterine contraceptive device. Current first-line options for treatment of migraine include addition of an aspirin or aspirin-like drug to her current plan. metoclopramide in addition to the acetaminophen. opioid analgesics. an antiemetic alone.
addition of an aspirin or aspirin-like drug to her current plan.
what do alpha 1 antagonists do?
alpha blockers (antagonists) relax certain muscles and help small blood vessels remain open.. improving blood flow and lowering blood pressure. adrenaline and noradrenaline are hormones affected by alpha 1 receptors. these are used to treat conditions such as high blood pressure and benign prostatic hyperplasia
what do alpha 1 agonists do?
alpha-adrenoceptor agonists (alpha agonists) bind to alpha receptors on vascular smooth muscle (arteries) and induce smooth contraction and vasoconstriction when stimulated by epinephrine or norepinephrine. this increases blood pressure thus increasing blood flow to the heart
explain the difference between anticoagulants and antiplatelet drugs
anticoagulants slow down clotting, thereby reducing fibrin formation and preventing clots from forming and growing antiplatelet agents prevent platelets from clumping and also prevent clots from forming and growing
Courtney is a 12-year-old African-American female who presents with her mother for treatment of acne. Her symptoms began with onset of menses last year. She currently has comedones, pustules on her forehead, cheeks, neck, and back. She has tried topical treatments including benzoyl peroxide and nonmedicated treatments with little relief. Patient education for Courtney and other patients being treated for acne include sing strong astringent cleansers on skin. applying treatments to damp skin. avoiding sun and ultraviolet light exposure. continuing to use the prescription on irritated or sunburned skin.
avoiding sun and ultraviolet light exposure.
what do beta 2 agonists do?
beta 2 adrenergic agonists' effects on smooth muscle cause dilation of bronchial passages. these also cause vasodilation in muscle and liver, relaxation of uterine muscle, and release of insulin. primarily used to treat asthma and other pulmonary disorders, such as COPD
what do beta 1 agonists do?
beta-adrenoceptors typically bind to norepinephrine release by sympathetic adrenergic nerves and to circulating epinephrine. the effect of B adrenoceptors is cardiac stimulation, such as increased heart rate, heart contractility, heart conduction, velocity, and heart relaxation
Preganglionic neurons in the parasympathetic system release acetylcholine which then: binds to nicotinic receptors on postganglionic cells binds to muscarinic receptors on effector organs transmits response back to the central nervous system triggers release of norepinephrine to communicate with target organs
binds to nicotinic receptors on postganglionic cells
What is the benefit of administering nitroglycerin sublingually? absorbs slowly in the body, allowing for cumulative effects with repeated doses requires fewer doses over time due to long half life bypasses first pass effect and allows higher concentrations to reach the heart activates through enzymes in the liver to allow for rapid systemic distribution
bypasses first pass effect and allows higher concentrations to reach the heart
which topical corticosteroid is most appropriate for the use of minor eczema on a child? 1 prednicarbate 0.25% ointment 2 hydrocortisone acetate 0.1% cream 3 clobetasol propionate 0.05% ointment 4 betamethasone dipropionate 0.05% cream
hydrocortisone acetate 0.1% cream
Lonnie, a 72-year-old Caucasian male, presents for cognitive decline. He is unable to maintain his checkbook. He fails the clock draw test in the office. He has had no recent injuries and takes no medications. He is accompanied by his wife who claims he has always been in good health. A review of his office health record supports this claim. Even as the advanced practice prescriber arranges further diagnostic testing for Alzheimer's disease, they are aware that current medications reverse the cognitive decline completely. restore independent function in all patients. can slow the cognitive decline but not reverse it. have statistical significance and marked clinical improvement in symptoms.
can slow the cognitive decline but not reverse it.
The movement of a drug within the body from one area to another across a membrane occurs through different channels. Active transport occurs when: lipid-soluble drugs are moved through membranes movement of a drug occurs by diffusion across membranes without cellular energy morphogenesis occurs and mutates the cellular membrane of an organism cellular energy is required to move a drug through a concentration gradient
cellular energy is required to move a drug through a concentration gradient
which topical corticosteroid is most appropriate for the treatment of severe poison ivy on the leg requiring super potent treatment? 1 prednicarbate 0.25% ointment 2 clobetasol propionate 0.05% ointment 3 desonide 0.05% cream 4 hydrocortisone acetate 0.1% cream
clobetasol propionate 0.05% ointment
choose all the antiplatelet medications: 1 warfarin (Coumadin) 2 rivaroxaban (Xarelto) 3 aspirin 4 Clopidogrel (Plavix)
clopidogrel (Plavix) aspirin
Jackie is a 55-year-old nurse who works on the Medical-Surgical floor of the local hospital. She is experiencing symptoms of overactive bladder (OAB) with frequency and urge incontinence. A urinalysis is negative for infection, protein, or glucose. She has no known drug allergies. Past medical history includes hypertension. Current medication is Losartan 50 mg daily. She denies the use of over-the-counter medications or supplements. Common side effects of muscarinic antagonists include: constipation, dry mouth, and tachycardia. diarrhea, dry mouth, urinary retention. urinary retention, diarrhea, tachycardia. diarrhea, dry mouth, dry eyes.
constipation, dry mouth, and tachycardia.
when drugs are bound to protein in the body, the result is: 1 inactivation of the drug 2 rapid distribution of the drug 3 slower metabolism of the drug 4 increased therapeutic effects
inactivation of the drug
drug potency refers to the: 1 dose required to produce 50% of the desired therapeutic effect 2 efficacy of a drug to achieve a therapeutic response 3 limit of the dose-response relation 4 maximum efficacy of a drug
dose required to produce 50% of the desired therapeutic effect
Courtney is a 12-year-old African-American female who presents with her mother for treatment of acne. Her symptoms began with onset of menses last year. She currently has comedones, pustules on her forehead, cheeks, neck, and back. She has tried topical treatments including benzoyl peroxide and nonmedicated treatments with little relief. Considering treatment for Courtney, the prescriber knows that drug selection is based on severity. diet changes may improve symptoms. vigorous scrubbing of the skin may improve symptoms. moisturizing the skin and using oil-based make-up may improve symptoms.
drug selection is based on severity.
The first pass effect refers to: drugs excreted by the kidneys after the first cycle through the body the amount of drug remaining after the passing of a drug's first half-life the amount of a drug absorbed by surrounding adipose tissues drugs metabolized in the liver before entering circulation
drugs metabolized in the liver before entering circulation
Jackie is a 55-year-old nurse who works on the Medical-Surgical floor of the local hospital. She is experiencing symptoms of overactive bladder (OAB) with frequency and urge incontinence. A urinalysis is negative for infection, protein, or glucose. She has no known drug allergies. Past medical history includes hypertension. Current medication is Losartan 50 mg daily. She denies the use of over-the-counter medications or supplements. Medications affecting the peripheral nervous system have limited effects on the majority of body systems. have limited clinical applications. are less studied than medications affecting the central nervous system. have widespread use in all systems of the body.
have widespread use in all systems of the body.
What is the target organ when a beta1 agonist is administered? heart kidneys lungs liver
heart
Pharmacokinetics is best described as: the affinity for drugs to bind to receptors the attractions between a drug and specific receptors the effects of a drug on the body how the body affects a drug as it moves throughout and leaves the body
how the body affects a drug as it moves throughout and leaves the body
what do alpha 2 agonists do?
located in the brain stem and in the periphery, these receptors inhibit sympathetic activity, lowering blood pressure, such as clonidine or guanabenz reduce central and peripheral sympathetic overflow and via peripheral presynaptic receptors may reduce peripheral neurotransmitter relase
what are alpha 2 antagonists?
mainly used in research, finding limited clinical application in human medicine. increases the noradrenaline release due to blockade of alpha 2 receptors
Nancy, a 35-year-old Caucasian female, presents for treatment of migraine headache with aura. She was diagnosed at age 18 years. She describes onset of symptoms as scotoma that she perceives in her right upper outer visual field. Symptoms include photophobia, nausea, and pain behind her eyes and throughout her head. She has had MRI and complete visual field testing with no deficits noted. Her usual treatment includes caffeine intake, acetaminophen 650 mg by mouth at onset of symptoms, and sleep in a dark room. She experiences migraine two to three times per month. She does not feel the headaches correlate with her menses. She has NKDA. Her current medication is Paraguard®, a nonhormonal intrauterine contraceptive device. The advanced practice prescriber inquires about the use of aspirin and aspirin-like medications. If the patient reveals that she uses these medications for headache relief daily, the prescriber should suspect medication overuse headache. worsening migraine. other pathology. malingering.
medication overuse headache.
Jackie is a 55-year-old nurse who works on the Medical-Surgical floor of the local hospital. She is experiencing symptoms of overactive bladder (OAB) with frequency and urge incontinence. A urinalysis is negative for infection, protein, or glucose. She has no known drug allergies. Past medical history includes hypertension. Current medication is Losartan 50 mg daily. She denies the use of over-the-counter medications or supplements. When selecting treatment for Jackie the advanced practice provider knows the treatments for OAB are classified as muscarinic agonists. muscarinic antagonists. cholinesterase inhibitors. neuromuscular blocking agents.
muscarinic antagonists.
A patient has a localized skin infection, which is most likely caused by a gram-positive cocci. Until the culture and sensitivity results are available, the provider will order a ____-spectrum ____ agent. broad; systemic broad; topical narrow; systemic narrow; topical
narrow; topical
Nancy, a 35-year-old Caucasian female, presents for treatment of migraine headache with aura. She was diagnosed at age 18 years. She describes onset of symptoms as scotoma that she perceives in her right upper outer visual field. Symptoms include photophobia, nausea, and pain behind her eyes and throughout her head. She has had MRI and complete visual field testing with no deficits noted. Her usual treatment includes caffeine intake, acetaminophen 650 mg by mouth at onset of symptoms, and sleep in a dark room. She experiences migraine two to three times per month. She does not feel the headaches correlate with her menses. She has NKDA. Her current medication is Paraguard®, a nonhormonal intrauterine contraceptive device. The preferred opioid treatment for migraine headache is oral hydrocodone-acetaminophen tablets. injectable hydromorphone. nasal butorphanol spray. oral codeine-acetaminophen tablets.
nasal butorphanol spray.
what form of terbinafine is preferred for long term (up to 12 weeks) treatment of onychomycosis of the toenails? 1 powder 2 gel 3 spray 4 oral
oral
the APRN diagnoses uncomplicated staph cellulitis in an otherwise healthy adult. what is an appropriate treatment for this patient? 1 cephalexin 500 mg PO q12 x 7 days 2 cefuroxime 1 g PO single dose 3 ceclor 125 mg PO BID x 7 days 4 penicillin V 500 mg PO QID x 10 days
penicillin V 500 mg PO QID x 10 days
Lonnie, a 72-year-old Caucasian male, presents for cognitive decline. He is unable to maintain his checkbook. He fails the clock draw test in the office. He has had no recent injuries and takes no medications. He is accompanied by his wife who claims he has always been in good health. A review of his office health record supports this claim. The action of the cholinesterase inhibitors is thought to prevent the breakdown of acetylcholine by acetylcholinesterase (AChE), increasing the availability of acetylcholine at cholinergic synapses. enhance the breakdown of acetylcholine by acetylcholinesterase (AChE) and increase the availability of acetylcholine at cholinergic synapses. reduce transmission by central cholinergic neurons that have not yet been destroyed. build new central cholinergic neurons.
prevent the breakdown of acetylcholine by acetylcholinesterase (AChE), increasing the availability of acetylcholine at cholinergic synapses.
what do beta 2 antagonists do?
primarily in the lungs, block norepinephrine & epinephrine; cause muscle constriction, like bronchoconstriction/bronchospasm
what is the action of a partial agonist? 1 reaches full binding potential at higher medication doses 2 achieves no independent action without accompanying a full agonist 3 produces a biological response at 50-80% of maximum effect 4 completes with full agonist for receptor sites
produces a biological response at 50-80% of maximum effect
A patient being treated with warfarin to prevent thrombus develops hyperuricemia, and the provider orders allopurinol. The provider will discuss ____ the ____ dose with the patient. increasing; allopurinol increasing; warfarin reducing; allopurinol reducing; warfarin
reducing; warfarin
Functions of sympathetic nervous system (3)
regulates cardiovascular system regulates body temperature implements "Fight or Flight" reaction
Functions of parasympathetic nervous system (6)
slows HR increases gastric secretion emptying of bladder/bowel focusing eye for near vision constricting pupil contracting bronchial smooth muscle
Drug efficacy refers to: the ability of a drug to produce the maximal therapeutic effect the concentration of a drug existing in the body the amount of a drug able to bind to specific receptors the length of time a drug produces a therapeutic effect
the ability of a drug to produce the maximal therapeutic effect
Lonnie, a 72-year-old Caucasian male, presents for cognitive decline. He is unable to maintain his checkbook. He fails the clock draw test in the office. He has had no recent injuries and takes no medications. He is accompanied by his wife who claims he has always been in good health. A review of his office health record supports this claim. The advanced practice prescriber is cognizant that the exact mechanism of action of most CNS agents for therapeutic results is unknown. there are only three neurotransmitters in the CNS system. the CNS system is well researched with sound information for disorder treatment. no evidence supports the use of norepinephrine or dopamine in treatment plans.
the exact mechanism of action of most CNS agents for therapeutic results is unknown.
Debra is a 50-year-old Caucasian female who presents with a one-day history of sinus congestion and headache. "It's a sinus infection. It always takes an antibiotic to get rid of it. I'm just trying to get ahead of it. I have new grandbabies. I can't be sick." She has no known drug allergies. She has a history of GERD and her only medication is over-the-counter famotidine 20 mg twice a day. A review of her chart indicates that she received Amoxicillin Clavulanate for similar symptoms of 10-day duration with fever of 101 about 18 months ago. She is currently afebrile, and she denies fever. When selecting an antimicrobial agent, the prescriber considers the likely organism, sensitivity of the organism to the drug, host characteristics. the likely organism, personal opinion of drug of choice, location of infection. the host immune characteristics and likelihood of developing toxicity, the medications that seem to be working in the local area. the patient's expectations, the likely organism, sensitivity of the organism to the drug.
the likely organism, sensitivity of the organism to the drug, host characteristics.
Pharmacodynamics refers to: the process through which the body affects drugs the removal of a drug from the body the process through which drugs affect the body the distribution of a drug in the body
the process through which drugs affect the body
what do beta 1 antagonists (beta blockers) do?
these medications reduce your blood pressure. beta blockers work by blocking the effects of the hormone epinephrine, also known as adrenaline. when you take beta blockers, your heart beats more slowly and with less force, thereby reducing blood pressure
when prescribing an antifungal cream for a male with tinea pedis (athlete's foot), what will you explain to your patient? 1 you need to follow up in 6 months 2 you do not need to wear sandals at the pool showers 3 use the cream once daily for 1 week 4 this may take 4-6 weeks to completely heal
this may take 4-6 weeks to completely heal
Courtney is a 12-year-old African-American female who presents with her mother for treatment of acne. Her symptoms began with onset of menses last year. She currently has comedones, pustules on her forehead, cheeks, neck, and back. She has tried topical treatments including benzoyl peroxide and nonmedicated treatments with little relief. After benzoyl peroxide has been tried and failed, the prescriber may consider adding topical antibiotic alone. ultraviolet light treatments. witch hazel cleanser. topical antibiotic combined with benzoyl peroxide.
topical antibiotic combined with benzoyl peroxide.
Debra is a 50-year-old Caucasian female who presents with a one-day history of sinus congestion and headache. "It's a sinus infection. It always takes an antibiotic to get rid of it. I'm just trying to get ahead of it. I have new grandbabies. I can't be sick." She has no known drug allergies. She has a history of GERD and her only medication is over-the-counter famotidine 20 mg twice a day. A review of her chart indicates that she received Amoxicillin Clavulanate for similar symptoms of 10-day duration with fever of 101 about 18 months ago. She is currently afebrile, and she denies fever. As the prescriber considers treatment options for Debra they are aware that use of narrow-spectrum agents does the most to facilitate emergence of antimicrobial resistance. use of broad-spectrum agents does the most to facilitate emergence of antimicrobial resistance. all respiratory infections require treatment with antimicrobial agents. antimicrobials inhibit overgrowth of normal flora that possess mechanisms for resistance.
use of broad-spectrum agents does the most to facilitate emergence of antimicrobial resistance.
Nancy, a 35-year-old Caucasian female, presents for treatment of migraine headache with aura. She was diagnosed at age 18 years. She describes onset of symptoms as scotoma that she perceives in her right upper outer visual field. Symptoms include photophobia, nausea, and pain behind her eyes and throughout her head. She has had MRI and complete visual field testing with no deficits noted. Her usual treatment includes caffeine intake, acetaminophen 650 mg by mouth at onset of symptoms, and sleep in a dark room. She experiences migraine two to three times per month. She does not feel the headaches correlate with her menses. She has NKDA. Her current medication is Paraguard®, a nonhormonal intrauterine contraceptive device. The action of sumatriptan in headache relief is vasodilation and reduction of perivascular inflammation. vasoconstriction and reduction of perivascular inflammation. vasoconstriction alone. vasodilation alone.
vasoconstriction and reduction of perivascular inflammation.
choose all anticoagulant medications: 1 warfarin (Coumadin) 2 rivaroxaban (Xarelto) 3 aspirin 4 Clopidogrel (Plavix)
warfarin (Coumadin) rivaroxaban (Xarelto)
A pregnant patient is in premature labor. Which class of drug will her provider prescribe in an attempt to stop the contractions? α1 agonist Anticholinergic β2 agonist β2 antagonist
β2 agonist
