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NURS 6521 Midterm Exam Spring 2021 (100 out of 100)

1. A patient comes to the clinic asking for help to quit drinking alcohol. She has a 21-year history of heavy drinking and is worried about developing cirrhosis of the liver. The patient agrees to take disulfiram (Antabuse). The nurse will teach the patient that the combination of alcohol and Antabuse will cause which of the following?
2. In order to promote therapeutic drug effects, the Nurse Practitioner should always encourage patients to
3. A clinic Nurse Practitioner is planning care for a 68-year-old man who has been on omeprazole (Prilosec) therapy for heartburn for some time. Regarding the patient’s safety, which of the following would be a priority nursing action?
4. A 62-year-old man has been prescribed lovastatin. The Nurse Practitioner will instruct the patient to take the medication.
5. A Nurse Practitioner who provides care for older adults is aware of the high incidence of drug interactions in this population. When educating a group of seniors about the prevention of drug interactions, the Nurse Practitioner should encourage them to
6. A Nurse Practitioner is teaching an older adult patient about polypharmacy. Which of the following statements best describe this term?
7. Mr. Lastinger was prescribed warfarin sodium (Coumadin). You advise him to avoid eating large amounts of leafy green vegetables because:
8. The nurse practitioner has prescribed elemental iron 6 mg/kg/day in three divided doses for a toddler diagnosed with iron-deficiency anemia. What instructions would the family nurse practitioner include for the parents?
9. A female patient is taking 0.125 mg of digoxin daily for heart failure. At a recent clinic visit she reports that since she has been on the drug, she can breathe better and her heart rate has been around 74 beats per minute. The nurse weighs the patient and notices that she has gained 10 pounds since the digoxin therapy was started. The patient is concerned that the additional weight will necessitate an increase in the medication. Which of the following is an appropriate response by the nurse?
10. A diabetic patient being treated for obesity tells the Nurse Practitioner that he is having adverse effects from his drug therapy. The patient has been taking dextroamphetamine for 2 weeks as adjunct therapy. Which of the following adverse effects would need the Nurse Practitioner’s immediate attention?
11. The point in time on the drug concentration curve that indicates the first sign of a therapeutic effect is the
12. Topical inhaled alpha adrenergic blocking agents or nasal vasoconstricting decongestants should not be used chronically (>5 days) because they can cause
13. Some first-generation antihistamines are used:
14. A Nurse Practitioner is discussing with a patient the efficacy of a drug that his physician has suggested, and he begin taking. Efficacy of a drug means which of the following?
15. A patient receives 25 units of NPH insulin at 7.AM. At what time of day should the nurse advise the patient to be most alert for a potential hypoglycemic reaction?
16. The Nurse Practitioner’s assessment of a community-dwelling adult suggests that the client may have drug allergies that have not been previously documented. What statement by the client would confirm this?
17. A patient has been prescribed a histamine-2 (H2) receptor antagonist for the treatment of GERD. Why are H2RAs more effective than H1 receptor antagonists in the treatment of diseases of the upper GI tract?
18. Which of the following is a side effect or precaution associated with ACE inhibitors?
19. A 39 y/o female is diagnosed with Graves disease. She also has a small goiter =. Her symptoms are not deemed to be severe and propylthiouracil is prescribed. Whare is the most serious potential adverse effect of this medication?
20. The recommended range for maintaining serum theophylline levels is:
21. During a clinic visit, a patient complains of having frequent muscle cramps in her legs. The nurse’s assessment reveals that the patient has been taking over-the-counter laxatives for the past 7 years. The nurse informed the patient that prolonged use of laxatives
22. A 76-year-old woman has a complex medical history that includes emphysema, osteoporosis, malnutrition, and hypothyroidism. Recently, the woman fell outside her home as a result of weakness and suffered a fracture to her femoral head. The woman’s subsequent hip- replacement surgery has been scheduled and the care team recognizes that the use of isoflurane will be most significantly influenced by
23. The Nurse Practitioner is following up on a patient who is experiencing acute asthma problems. Albuterol (Proventil) by metered-dose inhaler (MDI) has been ordered as treatment. Which patient response would indicate to the family nurse practitioner that the patient understands how to take the medication?
24. The anticoagulant drug that acts as a vitamin K antagonist is:
25. Jillian is a Nurse Practitioner. She recognizes that Nurse Practitioner prescriptive authority Is regulated by:
26. Which of the following conditions is a contraindication for pioglitazone (Actos).
27. A mother brings her 4-year-old child, who is vomiting and has a temperature of 103°F into the emergency department (ED). The ED physician orders acetaminophen (Tylenol) for the fever. The best form of Tylenol to give the child, considering her presentation, would be
28. The Elderly are at high risk of Adverse Drug Reactions due to:
29. A Nurse Practitioner is caring for a 73-year-old man who is receiving drug therapy. He is beginning to exhibit signs of decline in his renal system, yet his current serum creatinine level is normal. The Nurse Practitioner will base the patient’s plan of care on the understanding that there is
30. Which of the following statements best defines how a chemical becomes termed a drug?
31. Which of the following serves to protect the public by ensuring the purity of a drug and its contents?
32. A patient in need of myocardial infarction prophylaxis has been prescribed sulfinpyrazone for gout. Which of the following will the nurse monitor the patient most closely for?
33. A Nurse Practitioner is caring for a patient who is diabetic and has been diagnosed with hypertension. An angiotensin-converting enzyme inhibitor, captopril, has been prescribed for her. Which of the following should the Nurse Practitioner assess before beginning drug therapy?
34. Typical adverse reactions to oral calcium-channel blockers include:
35. Which type of antihistamines are used to inhibit the secretion of gastric acid in patients with gastrointestinal disorders?
36. A physician has ordered subcutaneous injections of morphine, a narcotic, every 4 hours as needed for pain for a motor vehicle accident victim. The nurse is aware that there is a high abuse potential for this drug and that it is categorized as a
37. A patient has a history of tonic-clonic seizures that have been successfully treated with phenytoin (Dilantin) for several years. Phenytoin achieves a therapeutic effect by
38. When prescribing an antihypertensive medication for a type 2 diabetic patient, the drug classifications that would tend to reduce insulin sensitivity are:
39. Which of the following is a potential adverse side effect of autonomic-anticholinergic agents?
40. A 24-year-old factory worker has been prescribed guaifenesin for the first time. Which of the following will be a priority assessment by the nurse before the patient’s first dose?
41. A possible side effect from the use of nifedipine (Procardia XL) is:
42. A patient has a history of tonic-clonic seizures that have been successfully treated with phenytoin (Dilantin) for several years. Phenytoin achieves a therapeutic effect by
43. Jillian is a Nurse Practitioner. She recognizes that Nurse Practitioner prescriptive authority Is regulated by:
44. Successful treatment for an adult patient with Helicobacter pylori (H. pylori)-induced peptic ulcer disease requires therapy with which regimen?
45. Typical adverse reactions to oral calcium-channel blockers include:
46. A common side effect of metformin (Glucophage) therapy is:
47. Biguanides control hyperglycemia in type 2 diabetes primarily by acting at which organ?
48. Which of the following oral medications is the safest to use during pregnancy?
49. A female patient, age 36, is prescribed inhaled corticosteroid (ICS) for daily use. Which of the following adverse effects should the nurse closely monitor for in this patient?
50. 60-year-old male presents to your office with a history of seizure disorder. The patient states that he has been taking valproic acid. Which of the following is a known potential adverse effect of valproic acid?
51. A patient who is a steroid-dependent asthmatic is started on a beclomethasone inhaler. Which should be part of patient education?
52. A patient has been started on a treatment regimen that includes levothyroxine. Select the dosage regimen that is most appropriate for a mean replacement dosage. The patient has been started on a treatment regimen that includes levothyroxine. Select the dosage regimen that is most appropriate for a mean replacement dosage.
53. Which of the following is a contraindication for antimuscarinic drugs?
54. A 76-year-old woman has a complex medical history that includes emphysema, osteoporosis, malnutrition, and hypothyroidism. Recently, the woman fell outside her home as a result of weakness and suffered a fracture to her femoral head. The woman’s subsequent hip- replacement surgery has been scheduled and the care team recognizes that the use of isoflurane will be most significantly influenced by
55. Which of the following statements best defines how a chemical becomes termed a drug?
56. When prescribing an antihypertensive medication for a type 2 diabetic patient, the drug classifications that would tend to reduce insulin sensitivity are:
57. A Nurse Practitioner is discussing with a patient the efficacy of a drug that his physician has suggested, and he begin taking. Efficacy of a drug means which of the following?
58. A Nurse Practitioner is conducting an assessment of a patient who has recently had several changes made to her drug regimen. What assessment question most directly addresses the safety implications of the patient’s drug regimen?
59. How does cholestyramine lowers blood cholesterol?
60. A 66-year-old woman has a complex medical history that includes poorly-controlled type 1 diabetes, renal failure as a result of diabetic nephropathy and chronic heart failure (CHF). Her care provider has recently added spironolactone (Aldactone) to the woman’s medication regimen. The nurse should consequently assess for signs and symptoms of
61. During a clinic visit, a patient complains of having frequent muscle cramps in her legs. The nurse’s assessment reveals that the patient has been taking over-the-counter laxatives for the past 7 years. The nurse informed the patient that prolonged use of laxatives
62. Which antihypertensive agent is associated with hair growth?
63. A Nurse Practitioner is providing discharge planning for a 45-year-old woman who has a prescription for oral albuterol. The Nurse Practitioner will question the patient about her intake of which of the following?
64. The recommended range for maintaining serum theophylline levels is:
65. Some first-generation antihistamines are used:
66. A 65-year-old male presents with a history of worsening urinary urgency, frequency, and hesitancy. He also tells you that he has to “push really hard” to urinate and that his urine dribbles a little after he is done urinating. What medication should be avoided
67. The side effects of antihistamines are mostly due to their:
68. The point in time on the drug concentration curve that indicates the first sign of a therapeutic effect is the
69. A patient is recovering from an acute episode of thrombophlebitis and is being treated with warfarin (Coumadin) 5 mg PO daily. In reviewing medication information, the Nurse Practitioner would include what information in their teaching?
70. A 39 y/o female is diagnosed with Graves disease. She also has a small goiter =. Her symptoms are not deemed to be severe and propylthiouracil is prescribed. Whare is the most serious potential adverse effect of this medication?
71. Which of the following can block the action of heparin?
72. What is a serious side effect of ibuprofen in the older adult patient?
73. A mother brings her 4-year-old child, who is vomiting and has a temperature of 103°F into the emergency department (ED). The ED physician orders acetaminophen (Tylenol) for the fever. The best form of Tylenol to give the child, considering her presentation, would be
74. A female patient is taking 0.125 mg of digoxin daily for heart failure. At a recent clinic visit she reports that since she has been on the drug, she can breathe better and her heart rate has been around 74 beats per minute. The nurse weighs the patient and notices that she has gained 10 pounds since the digoxin therapy was started. The patient is concerned that the additional weight will necessitate an increase in the medication. Which of the following is an appropriate response by the nurse?
75. Ginger, a 25 year old female presents at the clinic with known history of depression. She reports taking an SSRI with only partial relief. Which of the following drugs can be used safely at any dose in conjunction with an SSRI?
76. Drugs that use CYP 3A4 isoenzymes for metabolism may:
77. Mr. Lastinger was prescribed warfarin sodium (Coumadin). You advise him to avoid eating large amounts of leafy green vegetables because:
78. Glargine (Lantus) is an insulin analog that essentially has no peak and is usually administered:
79. Typical adverse reactions to oral calcium-channel blockers include:
80. A primary therapy for patients with mild ulcerative colitis is:
81. Jillian is a Nurse Practitioner. She recognizes that Nurse Practitioner prescriptive authority Is regulated by:
82. A patient comes to the clinic asking for help to quit drinking alcohol. She has a 21-year history of heavy drinking and is worried about developing cirrhosis of the liver. The patient agrees to take disulfiram (Antabuse). The nurse will teach the patient that the combination of alcohol and Antabuse will cause which of the following?
83. The NP is examining a 34-year-old obese man with a body mass index (BMI) of 35 who complains of almost daily indigestion and heartburn for the past year with a strong acid taste in the mouth about an hour after meals, and frequent belching and awakening at night with choking. The history is negative for chronic illnesses and alarm symptoms. A diagnosis of gastroesophageal reflux disease (GERD) is made. What is the best initial treatment for the patient?
84. A Nurse Practitioner is caring for a patient who is diabetic and has been diagnosed with hypertension. An angiotensin-converting enzyme inhibitor, captopril, has been prescribed for her. Which of the following should the Nurse Practitioner assess before beginning drug therapy?
85. A 53-year-old man has been treated for severe asthma for several years with prednisone. Recently, his physician initiated alternate-day therapy for him. The patient tells the nurse that he would rather take the medication every day to prevent confusion. Which of the following would be the best response by the nurse?
86. What information would the Nurse Practitioner include in teaching a patient about the treatment of vitamin B12 deficiency following a total gastrectomy?
87. Which of the following is a potential adverse side effect of autonomic-anticholinergic agents?
88. A patient with a known history of benign prostatic hyperplasia (BPH) presents to the clinic 4 days after developing a cold. He tells you he began experiencing a sore throat and nasal congestion and began to take an over the counter decongestant. Today, he complains of not urinating over the last 12 hours. He also has suprapubic fullness on exam. Which of the following medications are most likely responsible for this patient’s urinary retention?
89. A patient with a history of bronchial asthma is seen in the clinic for increased episodes of difficulty breathing. He has been taking theophylline 100 mg PO tid. He is 40 years old and obese with an 16-pack-year history of cigarette smoking and excessive intake of coffee daily. He eats a low-carbohydrate, high-protein diet. Which identified factors decrease the therapeutic effects of the theophylline?
90. The nurse practitioner has prescribed elemental iron 6 mg/kg/day in three divided doses for a toddler diagnosed with iron-deficiency anemia. What instructions would the family nurse practitioner include for the parents?
91. What drug class will decrease the facial flushing that occurs with niacin?
92. Which of the following conditions is a contraindication for pioglitazone (Actos).
93. To minimize the risk of adverse effects of glucagon when given to an unconscious diabetic patient, as the patient regains consciousness, the nurse should
94. Which of the following serves to protect the public by ensuring the purity of a drug and its contents?
95. A patient in need of myocardial infarction prophylaxis has been prescribed sulfinpyrazone for gout. Which of the following will the nurse monitor the patient most closely for?
96. Which type of antihistamines are used to inhibit the secretion of gastric acid in patients with gastrointestinal disorders?
97. Which can elevate theophylline levels?
98. A Nurse Practitioner is caring for a 73-year-old man who is receiving drug therapy. He is beginning to exhibit signs of decline in his renal system, yet his current serum creatinine level is normal. The Nurse Practitioner will base the patient’s plan of care on the understanding that there is
99. A 39 y/o female is diagnosed with Graves disease. She also has a small goiter =. Her symptoms are not deemed to be severe and propylthiouracil is prescribed. Whare is the most serious potential adverse effect of this medication?
100. The Family nurse practitioner prescribed losartan 50 mg PO daily for a hypertensive patient. This medication promotes vasodilation by: