Question 1

Question 1

The Best Pharmaceuticals for Children Act:

Includes a pediatric exclusivity rule which extends the patent on drugs studied in children

Establishes a committee that writes guidelines for pediatric prescribing

Provides funding for new drug development aimed at children

Encourages manufacturers specifically to develop pediatric formulations

Question 2

1 / 1 point

Patient education regarding taking iron replacements includes:

Doubling the dose if they miss a dose to maintain therapeutic levels

Taking 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 the upset stomach caused by iron therapy

Question 3

1 / 1 point

The benefits to the patient of having an Advanced Practice Registered Nurse (APRN) prescriber include:

Nurses know more about Pharmacology than other prescribers because they take it both in their basic nursing program and in their APRN program.

Nurses care for the patient from a holistic approach and include the patient in decision making regarding their care.

APRNs are less likely to prescribe narcotics and other controlled substances.

APRNs are able to prescribe independently in all states, whereas a physician’s assistant needs to have a physician supervising their practice.

Question 4

1 / 1 point

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 pre-signed prescription pads in a locked drawer in the clinic

Using only numbers to indicate the amount of drug to be prescribed

Question 5

1 / 1 point

The reason that two MMR vaccines at least a month apart are recommended is:

The second dose of MMR “boosts” the immunity built from the first dose.

Two vaccines 1 month apart is the standard dosing for all live virus vaccines.

If the two MMR vaccine doses are given too close together there is a greater likelihood of severe localized reaction to the vaccine.

Only 95% of patients are fully immunized for measles after the first vaccine, with 99% having immunity after two doses of MMR.

Question 6

1 / 1 point

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 chewing.

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.

Question 7

1 / 1 point

Leonard is completing a 6-month regimen to treat tuberculosis (TB). Monitoring of a patient on TB therapy includes:

Monthly sputum cultures

Monthly chest x-ray

Bronchoscopy every 3 months

All of the above

Question 8

1 / 1 point

Severe contact dermatitis caused by poison ivy or poison oak exposure often requires treatment with:

Topical antipruritics

Oral corticosteroids for 2 to 3 weeks

Thickly applied topical intermediate-dose corticosteroids

Isolation of the patient to prevent spread of the dermatitis

Question 9

1 / 1 point

The role of the NP in the use of 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

Question 10

1 / 1 point

Elena Vasquez’s primary language is Spanish, and she speaks very limited English. Which technique would be appropriate to use in teaching her about a new drug you have just prescribed?

Use correct medical terminology because Spanish has a Latin base.

Use a family member who speaks more English to act as an interpreter.

Use a professional interpreter or a reliable staff member who can act as an interpreter.

Use careful, detailed explanations.

Question 11

0 / 1 point

A woman who is pregnant and has hyperthyroidism is best managed by a specialty team who will most likely treat her with:

Methimazole

Propylthiouracil (PTU)

Radioactive iodine

Nothing, treatment is best delayed until after her pregnancy ends

Question 12

1 / 1 point

The first-line drug choice for a previously healthy adult patient diagnosed with community-acquired pneumonia would be:

Ciprofloxacin

Azithromycin

Amoxicillin

Doxycycline

Question 13

1 / 1 point

Sadie is a 90-year-old patient who requires a new prescription. What changes in drug distribution with aging would influence prescribing for Sadie?

Increased volume of distribution

Decreased lipid solubility

Decreased plasma proteins

Increased muscle-to-fat ratio

Question 14

1 / 1 point

Patients who are prescribed exogenous androgens need to be warned that decreased libido:

Is an unusual side effect of androgens and should be reported to the provider

Is treated with increased doses of androgens, so the patient should let the provider know if he is having problems

May be a sign of early prostate cancer and he should make an appointment for a prostate screening exam

May occur with androgen therapy

Question 15

1 / 1 point

Education of women who are being treated with ophthalmic antibiotics for conjunctivitis includes:

Throwing away eye makeup and purchasing 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 inch

Use a cotton swab to apply ointment, spreading the ointment all over the lid and in the conjunctival sac

Question 16

1 / 1 point

Disease states in addition to hypertension in which beta blockade is a compelling indication for the use of beta blockers include:

Heart failure

Angina

Myocardial infarction

Dyslipidemia

Question 17

1 / 1 point

What is the role of calcium supplements when patients take bisphosphonates?

They must be restricted to allow the medication to work.

They must be taken in sufficient amounts to provide foundational elements for bone growth.

They must be taken at the same time as the bisphosphonates.

They only work with bisphosphonates if daily intake is restricted.

Question 18

1 / 1 point

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.

Question 19

1 / 1 point

If an adult patient with comorbidities cannot reliably take oral antibiotics to treat pneumonia, an appropriate initial treatment option would be:

IV or IM gentamicin

IV or IM ceftriaxone

IV amoxicillin

IV ciprofloxacin

Question 20

1 / 1 point

The Combat Methamphetamine Epidemic Act, which is part of the 2006 U.S. Patriot Act:

Requires all providers to screen their patients for methamphetamine use

Restricts the prescribing of amphetamines to U.S. citizens

Requires a prescription be written for all methamphetamine precursors in all states

Restricts the sales of drugs that contain methamphetamine precursors, including a daily and 30-day limit on sales

Question 21

1 / 1 point

The optimal maximum time frame for HRT or estrogen replacement therapy (ERT) is:

2 years

5 years

10 years

15 years

Question 22

1 / 1 point

Patrick is a 10-year-old patient who presents with uncomfortable constipation. Along with diet changes, a laxative is ordered to provide more rapid relief of constipation. An appropriate choice of medication for a 10-year-old child would be:

PEG 3350 (Miralax)

Bisacodyl (Dulcolax) suppository

Docusate (Colace) suppository

Polyethylene glycol electrolyte solution

Question 23

1 / 1 point

Nonadherence is especially common in drugs that treat asymptomatic conditions, such as hypertension. One way to reduce the likelihood of nonadherence to these drugs is to prescribe a drug that:

Has a short half-life so that missing one dose has limited effect

 Requires several dosage titrations so that missed doses can be replaced with lower doses to keep costs down

Has a tolerability profile with fewer of the adverse effects that are considered “irritating,” such as nausea and dizziness

Must be taken no more than twice a day

Question 24

1 / 1 point

Larry is taking allopurinol to prevent gout. Monitoring of a patient who is taking allopurinol includes:

Complete blood count

Blood glucose

C-reactive protein

BUN, creatinine, and creatinine clearance

Question 25

1 / 1 point

A laboratory result indicates that the peak level for a drug is above the minimum toxic concentration. This means that the:

Concentration will produce therapeutic effects

Concentration will produce an adverse response

Time between doses must be shortened

Duration of action of the drug is too long

Question 26

1 / 1 point

The New York Heart Association and the Canadian Cardiovascular Society have described grading criteria for levels of angina. Angina that occurs with unusually strenuous activity or on walking or climbing stair after meals is class:

I

II

III

IV

Question 27

1 / 1 point

Opiates are used mainly to treat moderate to severe pain. Which of the following is NOT true about these drugs?

All opiates are scheduled drugs which require a DEA license to prescribe.

Opiates stimulate only mu receptors for the control of pain.

Most of the adverse effects of opiates are related to mu receptor stimulation.

Naloxone is an antagonist to opiates.

Question 28

1 / 1 point

Several classes of drugs have interactions with cholinergic blockers. Which of the following is true about these interactions?

Drugs with a narrow therapeutic range given orally may not stay in the GI tract long enough to produce an action.

Additive antimuscarinic effects may occur with antihistamines.

Cholinergic blockers may decrease the sedative effects of hypnotics.

Cholinergic blockers are contraindicated with antipsychotics.

Question 29

1 / 1 point

Chee is a 15-month-old male whose screening hemoglobin is 10.4 g/dL. Treatment for his anemia would be:

18 mg/day of iron supplementation

6 mg/kg per day of elemental iron

325 mg ferrous sulfate per day

325 mg ferrous sulfate tid

Question 30

1 / 1 point

Goals when treating tuberculosis include:

Completion of recommended therapy

Negative purified protein derivative at the end of therapy

Completely normal chest x-ray

All of the above

Question 31

1 / 1 point

The first-line therapy for mild-persistent asthma is:

High-dose montelukast

Theophylline

Low-dose inhaled corticosteroids

Long-acting beta-2-agonists

Question 32

1 / 1 point

Gender differences between men and women in pharmacokinetics include:

More rapid gastric emptying so that drugs absorbed in the stomach have less exposure to absorption sites

Higher proportion of body fat so that lipophilic drugs have relatively greater volumes of distribution

Increased levels of bile acids so that drugs metabolized in the intestine have higher concentrations

Slower organ blood flow rates so drugs tend to take longer to be excreted

Question 33

1 / 1 point

Varenicline (Chantix) may be prescribed for tobacco cessation. Instructions to the 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 start taking 1 mg twice a day a week before the quit date.

Neuropsychiatric symptoms may occur.

Question 34

1 / 1 point

Which of the following is a primary benefit of the use of computerized provider order entry for patient medications?

Reduces time that prescribing drugs takes

Eliminates the need to chart drugs prescribed

Decreases prescribing and transcription errors

Helps keep the number of drugs prescribed to a minimum

Question 35

1 / 1 point

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)

Question 36

1 / 1 point

Patients who have a poor metabolism phenotype will have:

Slowed metabolism of a prodrug into an active drug, leading to accumulation of Prodrug

Accumulation of inactive metabolites of drugs

A need for increased dosages of medications

Increased elimination of an active drug

Question 37

1 / 1 point

Monitoring for patients who are on long-term antifungal therapy with ketoconazole includes:

Platelet count

BUN and creatinine

White blood cell count

AST, ALT, alkaline phosphatase, and bilirubin

Question 38

1 / 1 point

When a pharmacoeconomic analysis looks at two or more treatment alternatives that are considered equal in efficacy and compares the costs of each it is referred to as:

Cost-minimization analysis

Cost-of-illness analysis

Cost-effectiveness analysis

Cost-benefit analysis

Question 39

1 / 1 point

When considering which cholesterol-lowering drug to prescribe, which factor determines the type and intensity of treatment?

Total LDL

Fasting HDL

Coronary artery disease risk level

Fasting total cholesterol

Question 40

1 / 1 point

Sally has been prescribed aspirin 320 mg per day for her atrial fibrillation. She also takes aspirin four or more times a day for arthritis pain. What are the symptoms of aspirin toxicity for which she would need to be evaluated?

Tinnitus

Diarrhea

Hearing loss

Photosensitivity

Question 41

1 / 1 point

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

Question 42

1 / 1 point

Which of the following holds true for the pharmacokinetics of women?

Gastric emptying is faster than that of men.

Organ blood flow is the same as that of men.

Evidence is strong concerning renal differences in elimination.

Medications that involve binding globulins are impacted by estrogen levels.

Question 43

1 / 1 point

Jamison has been prescribed citalopram (Celexa) to treat his depression. Education regarding how quickly selective serotonin reuptake inhibitor (SSRI) antidepressants work would be:

Appetite and concentration improve in the first 1 to 2 weeks.

Sleep should improve almost immediately upon starting citalopram.

Full response to the SSRI may take 2 to 4 months after he reaches the full therapeutic dose.

His dysphoric mood will improve in 1 to 2 weeks.

Question 44

1 / 1 point

Being competent in the use of information technology in clinical practice is expected in professional nurses. Advanced practice competence includes the ability to:

Search for information using the most common search engines

Serve as content experts in developing, implementing, and evaluating information Systems

Write programs to assure the integrity of health information

Use information technology to prescribe drugs

Question 45

1 / 1 point

According to the U.S. Office of Minority Health, poor health outcomes among African Americans are attributed to:

The belief among African Americans that prayer is more powerful than drugs

Poor compliance on the part of the African American patient

The genetic predisposition for illness found among African Americans

Discrimination, cultural barriers, and lack of access to health care

Question 46

1 / 1 point

Sook has been prescribed gabapentin to treat neuropathic pain and is complaining of feeling depressed and having “strange” thoughts. The appropriate initial action would be:

Increase her dose

Assess for suicidal ideation

Discontinue the medication immediately

Decrease her dose to half then slowly titrate up the dose

Question 47

1 / 1 point

A provider may consider testing for CYP2D6 variants prior to starting tamoxifen for breast cancer to:

Ensure the patient will not have increased adverse drug reactions to the tamoxifen

Identify potential drug-drug interactions that may occur with tamoxifen

Reduce the likelihood of therapeutic failure with tamoxifen treatment

Identify poor metabolizers of tamoxifen

Question 48

0 / 1 point

Male patients who should not be prescribed phosphodiesterase type 5 (PDE-5) inhibitors include:

Diabetics

Those who have had an acute myocardial infarction in the past 6 months

Patients who are deaf

Patients under age 60 years of age

Question 49

1 / 1 point

True contraindications to diphtheria, tetanus, and acellular pertussis (DTaP or Tdap) vaccine include:

Fever up to 104oF (40.5oC) after previous DTaP vaccine

Family history of seizures after DTaP vaccine

Adolescent pregnancy

Anaphylactic reaction with a previous dose

Question 50

1 / 1 point

Which the following persons should not have a statin medication ordered?

Someone with 3 first- or second-degree family members with history of muscle issues when started on statins

Someone with high lipids, but low BMI

Premenopausal woman with recent history of hysterectomy

Prediabetic male with known metabolic syndrome