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1. Question
:
Nurse practitioner prescriptive authority is regulated by:

The National Council of State Boards of
Nursing
The U.S. Drug Enforcement Administration
The State Board of Nursing for each state
The State Board of Pharmacy

Question 2. Question
:
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 3. Question
:
Azithromycin dosing requires that the first day’s dosage be
twice those of the other 4 days of the prescription. This is considered a
loading dose. A loading dose:

Rapidly achieves drug levels in
the therapeutic range
Requires four- to five-half-lives to attain
Is influenced by renal function
Is directly related to the drug circulating to
the target tissues

Question 4. Question
:
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 5. Question
:
Clinical judgment in prescribing includes:

Factoring in the cost to the patient of the
medication prescribed
Always prescribing the newest medication
available for the disease process
Handing out drug samples to poor patients
Prescribing all generic medications to cut
costs

Question 6. Question
:
Drugs that have a significant first-pass effect:

Must be given by the enteral (oral) route only
Bypass the hepatic circulation
Are rapidly metabolized by the liver and may
have little if any desired action
Are converted by the liver to more active and
fat-soluble forms

Question 7. Question
:
A client asks the NP about the differences in drug effects
between men and women. What is known about the differences between the
pharmacokinetics of men and women?

Body temperature varies between men and women.
Muscle mass is greater in women.
Percentage of fat differs between genders.
Proven subjective factors exist between the
genders.

Question 8. Question
:
Alterations in drug metabolism among Asians may lead to:

Slower metabolism of antidepressants,
requiring lower doses
Faster metabolism
of neuroleptics, requiring higher doses
Altered metabolism of omeprazole, requiring
higher doses
Slower metabolism of alcohol, requiring higher
doses

Question 9. Question
:
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 10. Question
:
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 11. Question
:
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 12. Question
:
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 13. Question
:
An Investigational New Drug is filed with the U.S. Food and
Drug Administration:

When the manufacturer has completed phase III
trials
When a new drug is discovered
Prior to animal testing of any new drug entity
Prior to human testing of any new drug entity

Question 14. Question
:
When determining drug treatment the NP prescriber should:

Always use evidence-based guidelines
Individualize the drug choice for the specific
patient
Rely on his or her experience when prescribing
for complex patients
Use the newest drug on the market for the
condition being treated

Question 15. Question
:
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 16. Question
:
Ginseng, which is taken to assist with memory, may
potentiate:

Aricept
Insulin
Digoxin
Propranolol

Question 17. Question
:
Rabi is being prescribed phenytoin for seizures. Monitoring
includes assessing:

For phenytoin hypersensitivity syndrome 3 to 8
weeks after starting treatment
For pedal edema throughout therapy
Heart rate at each visit and consider altering
therapy if heart rate is less than 60 bpm
For vision changes, such as red-green
blindness, at least annually

Question 18. Question
:
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 19. Question
:
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 20. Question
:
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 21. Question
:
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 22. Question
:
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 23. Question
:
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 24. Question
:
Jim is being treated for hypertension. Because he has a
history of heart attack, the drug chosen is atenolol. Beta blockers treat
hypertension by:

Increasing heart rate to improve cardiac
output
Reducing vascular smooth muscle tone
Increasing aldosterone-mediated volume
activity
Reducing aqueous humor production

Question 25. Question
:
When prescribing a tetracycline or quinolone antibiotic it
is critical to instruct the patient:

Not to take their regularly
prescribed medications while on these antibiotics
Regarding the need for lots of acidic foods
and juices, such as orange juice, to enhance absorption
Not to take antacids while on these
medications, as the antacid decreases absorption
That there are no drug interactions with these
antibiotics

Question 26. Question
:
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 27. Question
:
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 28. Question
:
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 29. Question
:
A potentially life-threatening adverse response to
angiotensin-converting enzyme inhibitors is angioedema. Which of the following
statements is true about this adverse response?

Swelling of the tongue or hoarseness are the
most common symptoms.
It appears to be related to the decrease in
aldosterone production.
Presence of a dry, hacky cough indicates a
high risk for this adverse response.
Because it takes time to build up a blood
level, it occurs after being on the drug for about 1 week.

Question 30. Question
:
Pharmacoeconomics is:

The study of the part of the U.S. economy
devoted to drug use
The study of the impact of prescription drug
costs on the overall economy
The analysis of the costs and consequences of
any health-care-related treatment or service
The analysis of the clinical efficacy of the
drug

Question 31. Question
:
Conjunctivitis in a child that is accompanied by acute
otitis media is treated with:

Sulfacetamide 10% ophthalmic solution
(Bleph-10)
Bacitracin/polymyxin B (Polysporin) ophthalmic
drops
Ciprofloxacin (Ciloxan) ophthalmic drops
High-dose oral amoxicillin

Question 32. Question
:
Howard is a 72-year-old male who occasionally takes
diphenhydramine for his seasonal allergies. Monitoring for this patient taking
diphenhydramine would include assessing for:
Urinary retention
Cardiac output
Peripheral edema
Skin rash

Question 33. Question
:
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 34. Question
:
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 35. Question
:
Harold, a 42-year-old African American, has moderate
persistent asthma. Which of the following asthma medications should be used
cautiously, if at all?

Betamethasone, an inhaled corticosteroid
Salmeterol, an inhaled long-acting
beta-agonist
Albuterol, a short-acting beta-agonist
Montelukast, a leukotriene modifier

Question 36. Question
:
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 37. Question
:
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 38. Question
:
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 39. Question
:
The first-line therapy for mild-persistent asthma is:

High-dose montelukast
Theophylline
Low-dose inhaled corticosteroids
Long-acting beta-2-agonists

Question 40. Question
:
Patients who are treated with greater than 100 grams per
week of topical calcipotriene for psoriasis need to be monitored for:

High vitamin D levels
Hyperkalemia
Hypercalcemia
Hyperuricemia

Question 41. Question
:
The action of “gliptins” is different from other
antidiabetic agents because they:

Have a low risk for hypoglycemia
Are not associated with weight gain
Close ATP-dependent potassium channels in the
beta cell
Act on the incretin system to indirectly
increase insulin production

Question 42. Question
:
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 43. Question
:
Why is the consistency of taking paroxetine (Paxil) and
never running out of medication more important than with most other selective
serotonin reuptake inhibitors (SSRIs)?
It has a shorter half-life and withdrawal
syndrome has a faster onset without taper.
It has the longest half-life and the
withdrawal syndrome has a faster onset.
It is quasi-addictive in the dopaminergic
reward system.
It is the most activating of SSRI medications
and will cause the person to have sudden deep sadness.

Question 44. Question
:
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 45. Question
:
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 46. Question
:
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 47. Question
:
When discussing with a patient the different start methods
used for oral combined contraceptives, the advantage of a Sunday start over the
other start methods is:

Immediate protection against pregnancy the
first week of using the pill
No back-up method is needed when starting
Menses occur during the week
They can start the pill on the Sunday after
the office visit

Question 48. Question
:
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 49. Question
:
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 50. Question
:
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 51. Question
:
Medications are typically started for angina patients when:

The first permanent EKG changes occur
The start of class I or II symptoms
The events trigger a trip to the emergency
department
When troponin levels become altered

Question 52. Question
:
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 53. Question
:
Absolute contraindications that clinicians must consider
when initiating estrogen therapy include:

:
Undiagnosed dysfunctional uterine bleeding
Deep vein or arterial thromboemboli within the
prior year
Endometriosis
Both a. and b.
All of the above

Question 54. Question
:
The dosage of Vitamin B12 to initially treat pernicious
anemia is:

Nasal cyanocobalamin 1 gram spray in each
nostril daily x 1 week then weekly x 1 month
Vitamin B12 IM monthly
Vitamin B12 1,000 mcg IM daily x 1 week then
1,000 mg IM weekly for a month
Oral cobalamin 1,000 mcg daily

Question 55. Question
:
Education for patients who use an inhaled beta-agonist and
an inhaled corticosteroid includes:
Use the inhaled corticosteroid first, followed
by the inhaled beta-agonists.
Use the inhaled beta-agonist first, followed
by the inhaled corticosteroid.
Increase fluid intake to 3 liters per day.
Avoid use of aspirin or ibuprofen while using
inhaled medications.

Question 56. Question
:
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 57. Question
:
Henry is 82 years old and takes two aspirin every morning to
treat the arthritis pain in his back. He states the aspirin helps him to “get
going” each day. Lately he has had some heartburn from the aspirin. After
ruling out an acute GI bleed, what would be an appropriate course of treatment
for Henry?

Add an H2 blocker such as ranitidine to his
therapy.
Discontinue the aspirin and switch him to
Vicodin for the pain.
Decrease the aspirin dose to one tablet daily.
Have Henry take an antacid 15 minutes before
taking the aspirin each day.

Question 58. Question
:
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 59. Question
:
First-line therapy for treating topical fungal infections
such as tinea corporis (ringworm) or tinea pedis (athlete’s foot) would be:

OTC topical azole (clotrimazole, miconazole)
Oral terbinafine
Oral griseofulvin microsize
Nystatin cream or ointment

Question 60. Question
:
There is often cross-sensitivity and cross-resistance
between penicillins and cephalosporins because:

Renal excretion is similar in both classes of
drugs.
When these drug classes are metabolized in the
liver they both produce resistant enzymes.
Both drug classes contain a beta-lactam ring
that is vulnerable to beta-lactamase-producing organisms.
There is not an issue with cross-resistance
between the penicillins and cephalosporins.

Question 61. Question
:
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 62. Question
:
To improve actual effectiveness of oral contraceptives women
should be educated regarding:

Use of a back-up method if they
have vomiting or diarrhea during a pill packet
Doubling pills if they have diarrhea during
the middle of a pill pack
The fact that they will have a normal
menstrual cycle if they miss two pills
The fact that mid-cycle spotting is not normal
and the provider should be contacted immediately

Question 63. Question
:
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 64. Question
:
ACE inhibitors are contraindicated in pregnancy. While
treatment of heart failure during pregnancy is best done by a specialist, which
of the following drug classes is considered to be safe, at least in the later
parts of pregnancy?

Diuretics
ARBs
Beta blockers
Nitrates

Question 65. Question
:
The optimal maximum time frame for HRT or estrogen
replacement therapy (ERT) is:

2 years
5 years
10 years
15 years

Question 66. Question
:
Developmental variation in renal function has what impact on
prescribing for infants and children?

Lower doses of renally excreted drugs may be
prescribed to infants younger than age 6 months.
Higher doses of water soluble drugs may need
to be prescribed because of increased renal excretion.
Renal excretion rates have no impact on
prescribing.
Parents need to be instructed on whether drugs
are renally excreted or not.

Question 67. Question
:
The drug of choice for type 2 diabetics is metformin.
Metformin:

Decreases glycogenolysis by the liver
Increases the release of insulin from beta
cells
Increases intestinal uptake of glucose
Prevents weight gain associated with
hyperglycemia

Question 68. Question
:
The drug of choice for treatment of early latent or tertiary
syphilis is:

Ceftriaxone IM
Benzathine penicillin G IM
Oral azithromycin
Oral ciprofloxacin

Question 69. Question
:
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 70. Question
:
All of the following statements about the Beer’s List are
true except:

It is a list of medications or medication
classes that should generally be avoided in persons 65 years or older because
they are either ineffective or they pose unnecessarily high risk for older
persons and a safer alternative is available.
It is derived from the expert opinion of one
geriatrician and is not evidence-based.
These criteria have been adopted by the
Centers for Medicare and Medicaid Services for regulation of long-term care
facilities.
These criteria are directed at the general
population of patients over 65 years of age and do not take disease states into
consideration.

Question 71. Question
:
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 72. Question
:
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 73. Question
:
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 74. Question
:
Laboratory values are actually different for TSH when
screening for thyroid issues and when used for medication management. Which of
the follow holds true?

Screening TSH has a wider range of normal
values 0.02-5.0; therapeutic levels need to remain above 5.0.
Screening values are much narrower than the
acceptable range used to keep a person stable on hormone replacement.
Therapeutic values are kept between 0.05 and
3.0 ideally. Screening values are considered acceptable up to 10.
Screening values are between 5 and 10, and
therapeutic values are greater than 10.

Question 75. Question
:
Preventative therapy for cluster headaches includes:

Massage or relaxation therapy
Ergotamine nightly before bed
Intranasal lidocaine four times a day during
“clusters” of headaches
Propranolol (Inderal) daily

Question 76. Question
:
Class I recommendations for stage A heart failure include:

Aerobic exercise within tolerance levels to
prevent the development of heart failure
Reduction of sodium intake to less than 2,000
mg/day to prevent fluid retention
Beta blockers for all patients regardless of
cardiac history
Treatment of thyroid disorders, especially if
they are associated with Tachyarrhythmias

Question 77. Question
:
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 78. Question
:
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 79. Question
:
Patient education for a patient who is prescribed
antibiotics for sinusitis includes:

Use of nasal saline washes
Use of inhaled corticosteroids
Avoiding the use of ibuprofen while ill
Use of laxatives to treat constipation

Question 80. Question
:
An acceptable first-line treatment for peptic ulcer disease
with positive H. pylori test is:

Histamine2 receptor antagonists for 4 to 8
weeks
Proton pump inhibitor bid for 12 weeks until
healing is complete
Proton pump inhibitor bid plus clarithromycin
plus amoxicillin for 14 days
Proton pump inhibitor bid and levofloxacin for
14 days

Question 81. Question
:
Sophie presents to the clinic with a malodorous vaginal
discharge and is confirmed to have Trichomonas infection. Treatment for her
would include:
Metronidazole 2 grams PO x 1 dose
Topical intravaginal metronidazole daily x 7
days
Intravaginal clindamycin daily x 7 days
Azithromycin 2 grams PO x 1 dose

Question 82. Question
:
Vicky, age 56 years, comes to the clinic requesting a refill
of her Fiorinal (aspirin and butalbital) that she takes for migraines. She has
been taking this medication for over 2 years for migraines and states one dose
usually works to abort her migraine. What is the best care for her?

Switch her to sumatriptan (Imitrex) to treat
her migraines.
Assess how often she is using Fiorinal and
refill her medication.
Switch her to a beta blocker such as
propranolol to prevent her migraine.
Request she return to the original prescriber
of Fiorinal as you do not prescribe butalbital for migraines.

Question 83. Question
:
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 84. Question
:
Which of the following patients may be treated with a 3-day
course of therapy for their urinary tract infection?

Juanita, a 28-year-old pregnant woman
Sally, a 16-year-old healthy adolescent
Jamie, a 24-year-old female
Suzie, a 26-year-old diabetic

Question 85. Question
:
Rose is a 3-year-old patient with an upper respiratory
infection (URI). Treatment for her URI would include:

Amoxicillin
Diphenhydramine
Pseudoephedrine
Nasal saline spray

Question 86. Question
:
Allison is an 18-year-old college student with type 1
diabetes. She is on NPH twice daily and Novolog before meals. She usually walks
for 40 minutes each evening as part of her exercise regimen. She is beginning a
30-minute swimming class three times a week at 1 p.m. What is important for her
to do with this change in routine?

Delay eating the midday meal until after the
swimming class.
Increase the morning dose of NPH insulin on
days of the swimming class.
Adjust the morning insulin injection so that
the peak occurs while swimming.
Check glucose level before, during, and after
swimming.

Question 87. Question
:
IV forms of bisphosphonates are used for all the following
except:

Severe gastric irritation with oral forms
Known cancer mets into the bone
Persons with advancing renal dysfunction
Progression of bone loss on oral formulations

Question 88. Question
:
The first-line drug choice for a previously healthy adult
patient diagnosed with community-acquired pneumonia would be:

Ciprofloxacin
Azithromycin
Amoxicillin
Doxycycline

Question 89. Question
:
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

Question 90. Question
:
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 91. Question
:
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 92. Question
:
Which of the following statements is true about acute pain?

Somatic pain comes from body surfaces and is
only sharp and well-localized.
Visceral pain comes from the internal organs
and is most responsive to acetaminophen and opiates.
Referred pain is present in a distant site for
the pain source and is based on activation of the same spinal segment as the
actual pain site.
Acute neuropathic pain is caused by lack of
blood supply to the nerves in a given area.

Question 93. Question
:
If a patient with symptoms of gastroesophageal reflux
disease states that he has been self-treating at home with OTC ranitidine
daily, the appropriate treatment would be:

Prokinetic (metoclopramide) for 4 to 8 weeks
Proton pump inhibitor (omeprazole) for 12
weeks
Histamine2 receptor antagonist (ranitidine)
for 4 to 8 weeks
Cytoprotective drug (misoprostol) for 2 weeks

Question 94. Question
:
Which diuretic agents typically do not need potassium
supplementation?

The loop diuretics
The thiazide diuretics
The aldosterone inhibitors
They all need supplementation

Question 95. Question
:
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 96. Question
:
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 97. Question
:
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 98. Question
:
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 99. Question
:
Lisa is a healthy nonpregnant adult woman who recently had a
urinary tract infection (UTI). She is asking about drinking cranberry juice to
prevent a recurrence of the UTI. The correct answer to give her would be:

Sixteen ounces per day of cranberry juice
cocktail will prevent UTIs.
100% cranberry juice or cranberry juice
extract may decrease UTIs in some patients.
There is no evidence that cranberry juice
helps prevent UTIs.
Cranberry juice only works to prevent UTIs in
children.

Question 100. Question
:
While on testosterone replacement, hemoglobin and hematocrit
levels should be monitored. Levels suggestive of excessive erythrocytosis or
abuse are:

Hemoglobin 14 g/dl or hematocrit 39%
Hemoglobin 11.5 g/dl or hematocrit 31%
Hemoglobin 13 g/dl or hematocrit 38%
Hemoglobin 17.5 g/dl or
hematocrit 54%

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