Family Nurse Practitioner Pharmacology Mock Exam - 577 Verified Questions

Family Nurse Practitioner Pharmacology

Mock Exam

Course Introduction

Family Nurse Practitioner Pharmacology is an advanced course that focuses on the principles of pharmacology relevant to the family nurse practitioner (FNP) role. The curriculum covers pharmacokinetics, pharmacodynamics, and pharmacotherapeutics of major drug classes used in the treatment of diverse populations across the lifespan. Emphasis is placed on safe prescribing practices, medication management, legal and ethical considerations, drug interactions, and patient education. Students learn to apply evidence-based guidelines in selecting and monitoring pharmacologic therapies for acute and chronic conditions commonly encountered in primary care settings.

Recommended Textbook

Pharmacology for the Primary Care Provider 4th Edition by Edmunds

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73 Chapters

577 Verified Questions

577 Flashcards

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Chapter 1: Prescriptive Authority and Role Implementation: Tradition vsChange

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3 Verified Questions

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Sample Questions

Q1) Which of the following has influenced an emphasis on primary care education in medical schools?

A) Changes in Medicare reimbursement methods recommended in 1992

B) Competition from nonphysicians desiring to meet primary care shortages

C) The need for monopolistic control in the marketplace of primary outpatient care

D) The recognition that nonphysicians have variable success providing primary care

Answer: A

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3

Chapter 2: Historical Review of Prescriptive Authority: The

Role of Nurses (NPs, CNMs, CRNAs, and CNSs)and Physician

Assistants

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6 Verified Questions

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Sample Questions

Q1) A CNM:

A) may treat only women.

B) has prescriptive authority in all 50 states.

C) may administer only drugs used during labor and delivery.

D) may practice only in birthing centers and home birth settings.

Answer: B

Q2) The current trend toward transitioning NP programs to the doctoral level will mean that:

A) NPs licensed in one state may practice in other states.

B) full prescriptive authority will be granted to all NPs with doctoral degrees.

C) NPs will be better prepared to meet emerging health care needs of patients.

D) requirements for physician supervision of NPs will be removed in all states.

Answer: C

Q3) An important difference between physician assistants (PAs)and NPs is PAs:

A) always work under physician supervision.

B) are not required to follow drug treatment protocols.

C) may write for all drug categories with physician co-signatures.

D) have both inpatient and outpatient independent prescriptive authority.

Answer: A

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Chapter 3: General Pharmacokinetic and Pharmacodynamic Principles

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11 Verified Questions

11 Flashcards

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Sample Questions

Q1) A primary care NP is preparing to prescribe a drug and notes that the drug has nonlinear kinetics.The NP should:

A) monitor frequently for desired and adverse effects.

B) administer a much higher initial dose as a loading dose.

C) monitor creatinine clearance at baseline and periodically.

D) administer the drug via a route that avoids the first-pass effect.

Answer: A

Q2) A patient is taking drug A and drug B.The primary care NP notes increased effects of drug B.The NP should suspect that in this case drug A is a cytochrome P450 (CYP450)enzyme:

A) inhibitor.

B) substrate.

C) inducer.

D) metabolizer.

Answer: A

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Chapter 4: Special Populations: Geriatrics

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7 Verified Questions

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Sample Questions

Q1) A thin 90-year-old patient who will begin taking warfarin has experienced a recent weight loss of 15 pounds.The NP caring for this patient should:

A) obtain a baseline liver function test (LFT) before starting the drug.

B) write the initial prescription at the lowest possible dose.

C) encourage the patient to consume a diet high in fat and protein.

D) counsel the patient to take the drug with food to enhance absorption.

Q2) An NP orders an inhaled corticosteroid 2 puffs twice daily and an albuterol metered-dose inhaler 2 puffs every 4 hours as needed for cough or wheezing for a 65-year-old patient with recent onset of reactive airways disease who reports symptoms occurring every 1 or 2 weeks.At a follow-up appointment several months later,the patient reports no change in frequency of symptoms.The NP's initial action should be to:

A) order spirometry to evaluate pulmonary function.

B) prescribe a systemic corticosteroid to help with symptoms.

C) ask the patient to describe how the medications are taken each day.

D) give the patient detailed information about the use of metered-dose inhalers.

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Chapter 5: Special Populations: Pediatrics

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Sample Questions

Q1) An NP sees a preschooler in clinic for the first time.When obtaining a medication history,the NP notes that the child is taking a medication for which safety and effectiveness in children has not been established in drug information literature.The NP should:

A) discontinue the medication.

B) order serum drug levels to evaluate toxicity.

C) report the prescribing provider to the Food and Drug Administration (FDA).

D) ask the parent about the drug's use and side effects.

Q2) The parent of a toddler asks the NP about using a topical antihistamine to treat the child's atopic dermatitis symptoms.The NP should tell the parent that:

A) topical medications have fewer side effects in children.

B) medications given by this route are not absorbed well in young children.

C) topical application of an antihistamine may result in drug toxicity in children.

D) it is important to apply topical medications liberally over a large surface area.

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Chapter 6: Special Populations: Pregnant and Nursing

Women

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8 Verified Questions

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Sample Questions

Q1) A woman is in the 36th week of pregnancy.The nurse practitioner (NP)providing prenatal care learns that the woman has a history of two previous urinary tract infections during this pregnancy.A dipstick urinalysis in the office today is negative for leukocyte esterase and nitrites.The NP should:

A) prescribe a low-dose sulfonamide antibiotic for urinary tract infection prophylaxis.

B) order nitrofurantoin daily to minimize the patient's risk of urinary tract infection late in her pregnancy.

C) encourage the patient to increase daily water intake and to wear only cotton underwear.

D) order a voiding cystourethrogram to rule out structural anomalies that may cause urinary tract infection.

Q2) A woman who is pregnant develops gestational diabetes.The NP's initial action is to:

A) prescribe an oral antidiabetic agent.

B) give her information about diet and exercise.

C) begin treating her with daily insulin injections.

D) reassure her that her glucose levels will return to normal after pregnancy.

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Page 8

Chapter 7: Over-the-Counter Medications

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Sample Questions

Q1) A primary care NP recommends an over-the-counter medication for a patient who has acid reflux.When teaching the patient about this drug,the NP should tell the patient:

A) to take the dose recommended by the manufacturer.

B) not to worry about taking this drug with any other medications.

C) to avoid taking other drugs that cause sedation while taking this drug.

D) that over-the-counter acid reflux medications are generally safe to take with other medications.

Q2) A primary care NP is performing a previsit health history on a new patient.The patient reports taking vitamins every day.The NP should:

A) ask the patient to bring all vitamin bottles to the clinic appointment.

B) recommend natural vitamin products over synthetic vitamin products.

C) reassure the patient that vitamins that are high in folic acid are safe to take.

D) tell the patient that some vitamins, such as vitamin C, are safe in large doses.

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9

Chapter 8: Complementary and Alternative Therapies

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Sample Questions

Q1) A primary care NP is aware that many patients in the community use herbal remedies to treat various conditions.The NP understands the importance of:

A) learning about the actions, uses, doses, and toxicities of these agents.

B) prescribing these agents when possible to ensure safe dosing.

C) counseling patients to stop using herbal products to avoid toxic side effects.

D) teaching patients that these products are unregulated and unsafe to use.

Q2) A patient has been using an herbal supplement for 2 years that the primary care NP knows may have toxic side effects.The NP should:

A) tell the patient to stop taking the supplement immediately.

B) inform the patient of the risks of toxic side effects with this supplement.

C) refer the patient to a CAM provider who can manage this patient's therapy.

D) prescribe another herbal drug that has fewer adverse effects than the one the patient is taking.

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Chapter 9: Establishing the Therapeutic Relationship

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Sample Questions

Q1) A parent brings a child who has moderate-persistent asthma to the clinic and tells the primary care NP that none of the child's medications are working.The parent says,"Everybody tells me something different.I don't know what to do." The NP suspects that the parent is not administering the medications appropriately.The NP should initially: A) perform a careful history of the child's symptoms and the medications that are given. B) provide a written asthma action plan and encourage the parent to call when symptoms are worse.

C) review what other providers have prescribed in the past and explain these interventions to the parent.

D) explain the different purposes of maintenance and rescue medications and give the parent a schedule for medication administration.

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Chapter 10: Practical Tips on Writing Prescriptions

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Sample Questions

Q1) The primary care NP sees a patient covered by Medicaid,writes a prescription for a medication,and is informed by the pharmacist that the medication is "off-formulary." The NP should:

A) inform the patient that an out-of-pocket expense will be necessary.

B) write the prescription for a generic drug if it meets the patient's needs.

C) call the patient's insurance provider to advocate for this particular drug.

D) contact the pharmaceutical company to see if medication samples are available.

Q2) A patient who has chronic pain and who takes oxycodone (Percodan)calls the clinic to ask for a refill of the medication.The primary care NP notes that the medication refill is not due for 2 weeks.The patient tells the NP that the refill is needed because he is going out of town.The NP should:

A) fill the prescription and document the patient's explanation of the reason.

B) review the patient's chart to see if this is a one-time or repeat occurrence.

C) call the patient's pharmacist and report suspicion of drug-seeking behaviors.

D) confront the patient about misuse of narcotics and refuse to fill the prescription.

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12

Chapter 11: Evidence-Based Decision Making and Treatment Guidelines

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9 Verified Questions

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Sample Questions

Q1) A patient comes to the clinic reporting dizziness and fatigue associated with nausea and vomiting.The primary care NP suspects anemia and orders a complete blood count.The patient's hemoglobin is elevated.The NP correctly concludes that the patient is not anemic.The NP has made an error in:

A) context formulation.

B) inappropriate knowledge base.

C) cost-versus-benefit analysis.

D) hypothesis triggering and information processing.

Q2) A patient comes to the clinic with a 2-day history of cough and wheezing.The patient has no previous history of asthma.The patient reports having heartburn for several months,which has worsened considerably.The primary care NP makes a diagnosis of asthma and orders oral steroids and inhaled albuterol.The patient's condition worsens,and a chest radiograph obtained 2 days later shows bilateral infiltrates.The NP has failed to:

A) confirm the diagnosis.

B) determine the aggressiveness of therapy.

C) prescribe an adequate dose of medications.

D) allow the drugs an adequate amount of time to work.

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Chapter 12: Design and Implementation of Patient Education

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7 Verified Questions

7 Flashcards

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Sample Questions

Q1) A patient is diagnosed with asthma.The primary care nurse practitioner (NP)prescribes an inhaled corticosteroid and an inhaled bronchodilator medication and provides education about how to use inhalers.At a follow-up visit 2 weeks later,the patient's pulmonary function tests are worse.The NP should:

A) provide a detailed written asthma action plan for the patient.

B) ask the patient to describe how the medications have been used.

C) review the symptoms of an acute asthma exacerbation with the patient.

D) teach the patient to use the albuterol more often and order an oral steroid.

Q2) A patient who is newly diagnosed with hypertension is to begin taking two antihypertensive medications.The primary care NP gives the patient written drug information and starts to discuss medication side effects.The patient interrupts and says,"I don't want to know all that.Just tell me what to take and when." The NP should:

A) explain that medication side effects can have serious consequences.

B) ask the patient about previous experiences with medication side effects.

C) give the patient a copy of the medication package insert to read at home.

D) refer the patient to a website with information about hypertension drug therapy.

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Chapter 13: Dermatologic Agents

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12 Verified Questions

12 Flashcards

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Sample Questions

Q1) An 18-month-old child who attends day care has head lice and has been treated with permethrin 1% (Nix).The parent brings the child to the clinic 1 week later,and the primary care NP notes live bugs on the child's scalp.The NP should order:

A) lindane.

B) malathion.

C) ivermectin.

D) permethrin 5%.

Q2) A primary care NP is considering using a topical immunosuppressive agent for a patient who has atopic dermatitis that is refractory to treatment with topical corticosteroids.The NP should:

A) begin therapy with pimecrolimus (Elidel).

B) tell the patient that these agents may be used long-term.

C) counsel the patient that these agents are more likely to cause skin atrophy.

D) tell the patient that laboratory monitoring for hypothalamic-pituitary-adrenal (HPA) suppression will be necessary.

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15

Chapter 14: Eye, Ear, Throat, and Mouth Agents

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7 Verified Questions

7 Flashcards

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Sample Questions

Q1) The primary care NP examines an adolescent who complains of severe right ear pain for the past 3 days.When retracting the pinna of the right ear to examine the ear,the NP notes erythema,edema,and pain and a large amount of white exudate in the ear canal.The NP should prescribe:

A) benzocaine otic drops tid.

B) ciprofloxacin otic drops qid.

C) glycerin oil drops weekly.

D) acetic acid, boric acid, and isopropyl alcohol solution.

Q2) A primary care NP examines a patient who complains of chronic,intermittent watery eyes and runny nose.The NP notes cobblestone-like papillae inside the upper eyelid with nonerythematous conjunctivae.The NP should:

A) prescribe intranasal corticosteroids.

B) refer the patient to an ophthalmologist.

C) prescribe trifluridine ophthalmic eye drops.

D) apply fluorescein dye to examine the cornea.

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Chapter 15: Upper Respiratory Agents

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8 Verified Questions

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Sample Questions

Q1) An NP prescribes azelastine for a patient who has allergic rhinitis.The NP will teach the patient that this drug:

A) may cause a bitter aftertaste.

B) will not provide maximum relief for a few weeks.

C) will cause rebound congestion if withdrawn suddenly.

D) can cause many systemic side effects such as drowsiness.

Q2) A parent asks an NP which over-the-counter medication would be best to give to a 5-year-old child who has a viral respiratory illness with nasal congestion and a cough.The NP should recommend which of the following?

A) Diphenhydramine (Benadryl)

B) Increased fluids with a teaspoon of honey

C) Over-the-counter pseudoephedrine with guaifenesin (Sudafed)

D) An antitussive/expectorant combination such as Robitussin DM

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Chapter 16: Asthma and Chronic Obstructive Pulmonary

Disease Medications

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Sample Questions

Q1) A 50-year-old patient who recently quit smoking reports a frequent morning cough productive of yellow sputum.A chest x-ray is clear,and the patient's FEV is 80% of predicted.Pulse oximetry reveals an oxygen saturation of 97%.The primary care NP auscultates clear breath sounds.The NP should:

A) reassure the patient that these symptoms will subside.

B) prescribe a moderate-dose ICS twice daily.

C) order a long-acting anticholinergic with albuterol twice daily.

D) prescribe an albuterol metered-dose-inhaler, 2 puffs every 4 hours as needed.

Q2) A 70-year-old patient who has COPD takes theophylline daily and uses a SABA for exacerbation of symptoms.The patient reports using the SABA three or four times each week when short of breath.The patient reports feeling jittery and nauseated and having trouble sleeping.The primary care NP should:

A) obtain a serum theophylline level.

B) order a creatinine clearance level.

C) prescribe a leukotriene modifier instead of theophylline.

D) discontinue the SABA and change to ipratropium bromide.

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Chapter 17: Hypertension and Miscellaneous

Antihypertensive Medications

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Sample Questions

Q1) A 55-year-old patient with no prior history of hypertension has a blood pressure greater than 140/90 on three separate occasions.The patient does not smoke,has a body mass index of 24,and exercises regularly.The patient has no known risk factors for cardiovascular disease.The primary care NP should:

A) prescribe a thiazide diuretic and an angiotensin-converting enzyme inhibitor.

B) perform a careful cardiovascular physical assessment.

C) counsel the patient about dietary and lifestyle changes.

D) order a urinalysis and creatinine clearance and begin therapy with a b-blocker.

Q2) The primary care NP sees a new patient who has diabetes and hypertension and has been taking a thiazide diuretic for 6 months.The patient's blood pressure at the beginning of treatment was 150/95 mm Hg.The blood pressure today is 138/85 mm Hg.The NP should:

A) order a -blocker.

B) add an angiotensin-converting enzyme inhibitor.

C) continue the current drug regimen.

D) change to an aldosterone antagonist medication.

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Chapter 18: Coronary Artery Disease and Antianginal Medications

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Sample Questions

Q1) A patient who has a history of angina has sublingual nitroglycerin tablets to use as needed.The primary care nurse practitioner (NP)reviews this medication with the patient at the patient's annual physical examination.Which statement by the patient indicates understanding of the medication?

A) "I should call 9-1-1 if chest pain persists 5 minutes after the first dose."

B) "I should take 3 nitroglycerin tablets 5 minutes apart and then call 9-1-1."

C) "I should take aspirin along with the nitroglycerin when I have chest pain."

D) "I should take nitroglycerin and then rest for 15 minutes before taking the next dose."

Q2) The primary care NP is preparing to prescribe isosorbide dinitrate sustained release (Dilatrate SR)for a patient who has chronic,stable angina.The NP should recommend initial dosing of:

A) 60 mg four times daily at 6-hour intervals.

B) 40 mg twice daily 30 minutes before meals.

C) 60 mg on awakening and 40 mg 7 hours later.

D) 80 mg three times daily at 8:00 AM, 1:00 PM, and 6:00 PM.

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Page 20

Chapter 19: Heart Failure and Digoxin

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Sample Questions

Q1) A patient comes to the clinic with a recent onset of nocturnal and exertional dyspnea.The primary care nurse practitioner (NP)auscultates S heart sounds but does not palpate hepatomegaly.The patient has mild peripheral edema of the ankles.The NP should consult a cardiologist to discuss prescribing a(n):

A) -blocker.

B) loop diuretic.

C) angiotensin-converting enzyme (ACE) inhibitor.

D) angiotensin receptor blocker (ARB).

Q2) A primary care NP sees a patient who is being treated for heart failure with digoxin,a loop diuretic,and an ACE inhibitor.The patient reports having nausea.The NP notes a heart rate of 60 beats per minute and a blood pressure of 100/60 mm Hg.The NP should:

A) decrease the dose of the diuretic to prevent further dehydration.

B) obtain a serum potassium level to assess for hyperkalemia.

C) hold the ACE inhibitor until the patient's blood pressure stabilizes.

D) obtain a digoxin level before the patient takes the next dose of digoxin.

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21

Chapter 20: Beta-Blockers

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Sample Questions

Q1) A primary care NP provides teaching for a patient who will begin taking propranolol (Inderal).Which statement by the patient indicates understanding of the teaching?

A) "I should take this medication on an empty stomach."

B) "I should use caution while driving while taking this medication."

C) "I should not take the medication if my pulse is less than 60 beats per minute."

D) "If I have shortness of breath, I should discontinue the medication immediately."

Q2) A patient is in the clinic for an annual physical examination.The primary care NP obtains a medication history and learns that the patient is taking a b-blocker and nitroglycerin.The NP orders laboratory tests,performs a physical examination,and performs a review of systems.Which finding may warrant discontinuation of the -blocker in this patient?

A) Increased triglycerides

B) Decreased exercise tolerance

C) Wheezing, dyspnea, and cough

D) Nausea, vomiting, and anorexia

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22

Chapter 21: Calcium Channel Blockers

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Sample Questions

Q1) A patient who has stable angina pectoris and a history of previous myocardial infarction takes nitroglycerin and verapamil.The patient asks the primary care nurse practitioner (NP)why it is necessary to take verapamil.The NP should tell the patient that verapamil:

A) improves blood flow and oxygen delivery to the heart.

B) increases the rate of contraction of the cardiac muscle.

C) increases the force of contraction of the cardiac muscle.

D) has a positive inotropic effect to increase cardiac output.

Q2) A patient who has angina is taking nitroglycerin and long-acting nifedipine.The primary care NP notes a persistent blood pressure of 90/60 mm Hg at several follow-up visits.The patient reports lightheadedness associated with standing up.The NP should consult with the patient's cardiologist about changing the medication to:

A) amlodipine (Norvasc).

B) isradipine (DynaCirc).

C) verapamil HCl (Calan).

D) short-acting nifedipine (Procardia).

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23

Chapter 22: ACE Inhibitors and Angiotensin Receptor

Blockers

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Sample Questions

Q1) A patient who takes an ACE inhibitor and a thiazide diuretic for hypertension will begin taking spironolactone.The primary care NP should counsel this patient to:

A) avoid foods that are high in potassium.

B) use a salt substitute when seasoning foods.

C) discuss changing the ACE inhibitor to an ARB with the cardiologist.

D) avoid taking antacids containing magnesium while taking these drugs.

Q2) A patient who has type 2 diabetes is seen by a primary care NP for a physical examination.The NP notes a blood pressure of 140/95 mm Hg on three occasions.A urinalysis reveals macroalbuminuria.The patient's serum creatinine is 1.9 mg/dL.Adhering to evidence-based practice,the NP should prescribe:

A) losartan (Cozaar).

B) captopril (Capoten).

C) enalapril maleate (Vasotec).

D) fosinopril sodium (Monopril).

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Chapter 23: Antiarrhythmic Agents

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Sample Questions

Q1) A patient comes to the clinic with a history of syncope and weakness for 2 to 3 days.The primary care NP notes thready,rapid pulses and 3-second capillary refill.An ECG reveals a heart rate of 198 beats per minute with a regular rhythm.The NP should:

A) administer intravenous fluids and obtain serum electrolytes.

B) administer amiodarone in the clinic and observe closely for response.

C) order digoxin and verapamil and ask the patient to return for a follow-up examination in 1 week.

D) send the patient to an emergency department for evaluation and treatment.

Q2) A patient who is taking trimethoprim-sulfamethoxazole for prophylaxis of urinary tract infections tells the primary care NP that a sibling recently died from a sudden cardiac arrest,determined to be from long QT syndrome.The NP should:

A) schedule a treadmill stress test.

B) order genetic testing for this patient.

C) discontinue the trimethoprim-sulfamethoxazole.

D) refer the patient to a cardiologist for further evaluation.

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25

Chapter 24: Antihyperlipidemic Agents

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Sample Questions

Q1) A 55-year-old woman has a history of myocardial infarction (MI).A lipid profile reveals LDL of 130 mg/dL,HDL of 35 mg/dL,and triglycerides 150 mg/dL.The woman is sedentary with a body mass index of 26.The woman asks the primary care NP about using a statin medication.The NP should:

A) recommend dietary and lifestyle changes first.

B) begin therapy with atorvastatin 10 mg per day.

C) discuss quality-of-life issues as part of the decision to begin medication.

D) tell her there is no clinical evidence of efficacy of statin medication in her case.

Q2) The primary care nurse practitioner (NP)sees a patient for a physical examination and orders laboratory tests that reveal low-density lipoprotein (LDL)of 100 mg/dL,high-density lipoprotein (HDL)of 30 mg/dL,and triglycerides of 350 mg/dL.The patient has no previous history of coronary heart disease.The NP should consider prescribing:

A) ezetimibe (Zetia).

B) gemfibrozil (Lopid).

C) simvastatin (Zocor).

D) nicotinic acid (Niaspan).

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Chapter 25: Agents that Act on Blood

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Sample Questions

Q1) A patient who has disabling intermittent claudication is not a candidate for surgery.Which of the following medications should the primary care NP prescribe to treat this patient?

A) Cilostazol (Pletal)

B) Warfarin (Coumadin)

C) Pentoxifylline (Trental)

D) Low-dose, short-term aspirin

Q2) A patient who has had a new onset of AF the day prior will undergo cardioversion that day.The primary care NP will expect the cardiologist to:

A) give clopidogrel after administering cardioversion.

B) administer cardioversion without using anticoagulants.

C) give warfarin and aspirin before attempting cardioversion.

D) give low-dose aspirin before administering cardioversion.

Q3) A patient who is obese is preparing to have surgery.To help prevent venous thromboembolism (VTE),the primary care NP should prescribe:

A) low-dose aspirin once daily.

B) clopidogrel (Plavix) 75 mg once daily.

C) enoxaparin (Lovenox) 30 mg twice daily.

D) warfarin (Coumadin) titrated to achieve an INR of 3.5.

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Page 27

Chapter 26: Antacids and the Management of GERD

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Sample Questions

Q1) A patient in the clinic reports heartburn 30 minutes after meals,a feeling of fullness,frequent belching,and a constant sour taste.The patient has a normal weight and reports having a high-stress job.The primary care NP should recommend: A) antacid therapy as needed.

B) changes in diet to avoid acidic foods.

C) daily treatment with a PPI.

D) consultation with a gastroenterologist for endoscopy.

Q2) A patient undergoes endoscopy,and a diagnosis of erosive esophagitis is made.The patient does not have health insurance and asks the primary care NP about using OTC antacids such as Tums.The NP should tell the patient that Tums: A) can help to heal erosions in esophageal tissue.

B) do not help reduce symptoms of erosive esophagitis.

C) neutralize stomach acid as well as proton pump inhibitors (PPIs).

D) help reduce symptoms in conjunction with PPIs.

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Chapter 27: Histamine-2 Blockers and Proton Pump

Inhibitors

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Q1) A patient has NSAID-induced ulcer and has started taking ranitidine (Zantac).At a follow-up appointment 3 days later,the patient reports no alleviation of symptoms.The primary care NP should:

A) order cimetidine (Tagamet).

B) add metronidazole to the drug regimen.

C) change from ranitidine to omeprazole (Prilosec).

D) reassure the patient that drug effects take several weeks.

Q2) A patient who has severe arthritis and who takes nonsteroidal antiinflammatory drugs (NSAIDs)daily develops a duodenal ulcer.The patient has tried a cyclooxygenase-2 selective NSAID in the past and states that it is not as effective as the current NSAID.The primary care nurse practitioner (NP)should:

A) prescribe cimetidine (Tagamet).

B) prescribe omeprazole (Prilosec).

C) teach the patient about a bland diet.

D) change the NSAID to a corticosteroid.

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Page 29

Chapter 28: Laxatives

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Sample Questions

Q1) A 5-year-old child has chronic constipation.The primary care NP plans to prescribe a laxative for long-term management.In addition to pharmacologic therapy,the NP should also recommend _____ g of fiber per day.

A) 10

B) 15

C) 20

D) 25

Q2) A primary care NP sees a patient who reports having decreased frequency of stools over the past few months.In the clinic today,the patient has severe abdominal cramping and an abdominal radiograph shows an increased stool load in the sigmoid colon and rectum.The NP should:

A) give magnesium hydroxide (Milk of Magnesia).

B) start daily methylcellulose (Citrucel) and increased fluids.

C) order a sodium phosphate enema and psyllium (Metamucil).

D) recommend polyethylene glycol (MiraLAX) and 2000 mL of fluid daily.

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Chapter 29: Antidiarrheals

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Sample Questions

Q1) A 2-year-old child has chronic "toddler's" diarrhea,which has an unknown but benign etiology.The child's parent asks the primary care NP if a medication can be used to treat the child's symptoms.The NP should recommend giving:

A) diphenoxylate (Lomotil).

B) attapulgite (Kaopectate).

C) an electrolyte solution (Pedialyte).

D) bismuth subsalicylate (Pepto-Bismol).

Q2) A patient comes to the clinic with a 4-day history of 10 to 12 liquid stools each day.The patient reports seeing blood and mucus in the stools.The patient has had nausea but no vomiting.The primary care NP notes a temperature of 37.9° C,a heart rate of 96 beats per minute,and a blood pressure of 90/60 mm Hg.A physical examination reveals dry oral mucous membranes and capillary refill of 4 seconds.The NP's priority should be to:

A) obtain stool cultures.

B) begin rehydration therapy.

C) consider prescribing metronidazole.

D) administer opioid antidiarrheal medications.

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Chapter 30: Antiemetics

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Q1) A woman is in her first trimester of pregnancy.She tells the primary care nurse practitioner (NP)that she continues to have severe morning sickness on a daily basis.The NP notes a weight loss of 1 pound from her previous visit 2 weeks prior.The NP should consult an obstetrician and prescribe:

A) aprepitant (Emend).

B) ondansetron (Zofran).

C) scopolamine transdermal.

D) prochlorperazine (Compazine).

Q2) A primary care NP sees a patient 2 days after an outpatient surgical procedure.The patient reports using ondansetron for nausea.The NP notes a blood pressure of 88/56 mm Hg,and the patient reports feeling faint.The NP should suspect:

A) hemorrhage.

B) dehydration.

C) drug toxicity.

D) drug interaction.

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Chapter 31: Medications for Irritable Bowel Syndrome and Other Gastrointestinal Problems

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Sample Questions

Q1) A patient who has IBS experiences diarrhea,bloating,and pain but does not want to take medication.The primary care NP should recommend:

A) 25 g of fiber each day.

B) avoiding gluten and lactose in the diet.

C) increasing water intake to eight to ten glasses per day.

D) beginning aerobic exercise, such as running, every day.

Q2) A patient in the clinic reports frequent episodes of bloating,abdominal pain,and loose stools to the primary care nurse practitioner (NP).An important question the NP should ask about the abdominal pain is:

A) the relation of the pain to stools.

B) what time of day the pain occurs.

C) whether the pain is sharp or diffuse.

D) the age of the patient when the pain began.

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33

Chapter 32: Diuretics

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Sample Questions

Q1) A patient who has congestive heart failure and arthritis has been taking chlorthalidone (Zaroxolyn)25 mg daily for 6 months.The primary care NP notes a persistent blood pressure of 145/90 mm Hg.The NP should:

A) ask the patient which medications are used for pain.

B) add furosemide (Lasix) to the patient's drug regimen.

C) increase the dose of chlorthalidone to 100 mg daily.

D) recommend that the patient use salt substitutes to season foods.

Q2) The primary care NP sees a patient who has a history of hypertension and alcoholism.The patient is not taking any medications.The NP auscultates crackles in both lungs and palpates the liver 2 cm below the costal margin.Laboratory tests show an elevated creatinine level.The NP will refer this patient to a cardiologist and should prescribe:

A) albuterol metered-dose inhaler.

B) furosemide (Lasix).

C) spironolactone (Aldactone).

D) chlorthalidone (Zaroxolyn).

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Chapter 33: Male Genitourinary Agents

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Sample Questions

Q1) The primary care NP is preparing to prescribe sildenafil for a man who has erectile dysfunction.The NP should remember to tell this patient:

A) to avoid oral nitrates while taking this medication.

B) that the drug may cause penile aching.

C) to use a condom if his sexual partner is pregnant.

D) dyspepsia may occur and may warrant discontinuation of the drug.

Q2) A patient who has BPH is taking alfuzosin (Uroxatral)and finasteride (Proscar).The patient has had two urinary tract infections (UTIs)in the past 2 months.A urinalysis in the clinic is negative for leukocyte esterase but positive for hematuria.The primary care NP should:

A) discontinue finasteride.

B) refer the patient to a urologist.

C) change alfuzosin to tamsulosin.

D) add doxazosin to the drug regimen.

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Chapter 34: Drugs for Urinary Incontinence and Urinary Analgesia

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Sample Questions

Q1) A patient reports dribbling small amounts of urine but also has difficulty initiating a urine stream.The primary care NP should prescribe:

A) solifenacin (VESIcare).

B) bethanechol (Urecholine).

C) phenazopyridine (Pyridium).

D) oxybutynin chloride (Ditropan XL).

Q2) A primary care NP prescribes oxybutynin chloride for an 80-year-old patient to treat urinary incontinence.When teaching this patient about this medication,the NP should tell the patient:

A) to increase intake of fluids and fiber.

B) that alcohol may be consumed in moderation.

C) that drowsiness may be a transient adverse effect.

D) that hypertension may occur and to report headaches.

Q3) A serious side effect associated with desmopressin is:

A) dehydration.

B) hypotension.

C) hyponatremia.

D) urinary retention.

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Chapter 35: Acetaminophen

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Sample Questions

Q1) An adult patient who has a viral upper respiratory infection asks the primary care nurse practitioner (NP)about taking acetaminophen for fever and muscle aches.To help ensure against possible drug toxicity,the NP should first:

A) determine the patient's height and weight.

B) ask the patient how high the temperature has been.

C) tell the patient to take 325 mg initially and increase as needed.

D) ask the patient about any other over-the-counter (OTC) cold medications being used.

Q2) An 80-year-old patient with congestive heart failure has a viral upper respiratory infection.The patient asks the primary care NP about treating the fever,which is 38.5° C.The NP should:

A) recommend acetaminophen.

B) recommend high-dose acetaminophen.

C) tell the patient that antibiotics are needed with a fever that high.

D) tell the patient a fever less than 40° C does not need to be treated.

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Chapter 36: Aspirin and Nonsteroidal Antiinflammatory Drugs

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Sample Questions

Q1) An 80-year-old patient has been taking naproxen (Naprosyn)for osteoarthritis for 6 months.The patient reports adequate pain relief but complains of feeling tired.The primary care NP will order:

A) liver function tests.

B) a serum potassium level.

C) a complete blood count (CBC).

D) a creatinine clearance and urinalysis.

Q2) A patient who has rheumatoid arthritis begins taking naproxen (Naprosyn)500 mg once daily for pain.After 1 week,the patient calls the primary care NP to report no change in inflammation.The NP should:

A) change the medication to tramadol.

B) change the medication to ketorolac (Toradol).

C) increase the dose of naproxen to 1000 mg daily.

D) counsel the patient that pain relief may not occur for another week.

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Chapter 37: Disease-Modifying Antirheumatic Drugs and Immune Modulators

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Sample Questions

Q1) A patient has recent weight loss,fatigue,and recurrent low-grade fever along with pain and stiffness of knees and hands.The primary care nurse practitioner (NP)notes symmetric joint swelling and warmth of these joints.The NP should:

A) refer the patient to a specialist.

B) order erythrocyte sedimentation rate (ESR), rheumatoid factor (RF), and antinuclear antibody (ANA) tests.

C) begin therapy with methotrexate.

D) order x-rays of the affected joints.

Q2) A patient has been taking a COX-2 selective NSAID to treat pain associated with a recent onset of RA.The patient tells the primary care NP that the pain and joint swelling are becoming worse.The patient does not have synovitis or extraarticular manifestations of the disease.The NP will refer the patient to a rheumatologist and should expect the specialist to prescribe:

A) methotrexate.

B) corticosteroids.

C) opioid analgesics.

D) hydroxychloroquine.

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Page 39

Chapter 38: Gout Medications

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Sample Questions

Q1) A patient who is obese and has hypertension is taking a thiazide diuretic and develops gouty arthritis,which is treated with probenecid.At a follow-up visit,the patient's serum uric acid level is 7 mg/dL,and the patient denies any current symptoms.The primary care NP should discontinue the probenecid and:

A) prescribe colchicine.

B) prescribe febuxostat.

C) tell the patient to use an NSAID if symptoms recur.

D) counsel the patient to report recurrence of symptoms.

Q2) A patient who has hypertension is taking a thiazide diuretic.The patient has a serum uric acid level of 8 mg/dL.The primary care nurse practitioner (NP)caring for this patient should:

A) prescribe colchicine.

B) discontinue the thiazide diuretic.

C) order a 24-hour urine collection.

D) refer the patient to a rheumatologist.

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Chapter 39: Osteoporosis Treatment

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Sample Questions

Q1) A 60-year-old woman is in the clinic for an annual well-woman examination.She has been taking alendronate (Fosamax)10 mg daily for 4 years.Her last bone density test yielded a T-score of 2.0.Her urine NTx level today is 22.She walks daily.Her fracture risk is low.The primary care NP should recommend that she:

A) take a 1- to 2-year drug holiday.

B) change to 70 mg of alendronate weekly.

C) decrease the alendronate dose to 5 mg daily.

D) change to ibandronate (Boniva) 3 mg IV every 3 months.

Q2) A 70-year-old patient who has a high fracture risk has been taking alendronate (Fosamax)and calcium for 6 months.The primary care NP orders a urine NTx level,which is 42.The NP should discontinue the alendronate and prescribe:

A) raloxifene (Evista).

B) teriparatide (Forteo).

C) calcitonin (Miacalcin nasal spray).

D) ibandronate sodium (Boniva).

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Chapter 40: Muscle Relaxants

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Sample Questions

Q1) A patient who was in a motor vehicle accident has been treated for lower back muscle spasms with metaxalone (Skelaxin)for 1 week and reports decreased but persistent pain.A computed tomography scan is normal.The primary care NP should:

A) suggest ice and rest.

B) order physical therapy.

C) prescribe diazepam (Valium).

D) add an opioid analgesic medication.

Q2) A patient reports having an acute onset of low back pain associated with lifting a heavy object the day before.Besides advising the patient to rest and apply ice,the primary care NP should prescribe:

A) an opioid analgesic.

B) metaxalone (Skelaxin)

C) cyclobenzaprine (Flexeril).

D) a nonsteroidal antiinflammatory drug (NSAID).

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42

Chapter 41: Medications for Attention Deficit/Hyperactivity

Disorder

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Sample Questions

Q1) The parent of an 8-year-old child recently diagnosed with AD/HD verbalizes concerns about giving the child stimulants.The primary care NP should recommend:

A) modafinil (Provigil).

B) guanfacine (Intuniv).

C) bupropion (Wellbutrin).

D) atomoxetine (Strattera).

Q2) A primary care NP sees a child for an annual well-child check-up.The child has been taking methylphenidate for AD/HD for 3 months.The NP should discontinue the medication if which symptom is present?

A) Motor tics

B) Decreased appetite

C) Occasional headaches

D) Decreased blood pressure

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43

Chapter 42: Medications for Dementia

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Sample Questions

Q1) A patient is identified as having stage 2 Alzheimer's disease and elects to take donepezil (Aricept).The patient asks the primary care nurse practitioner (NP)how long the medication will be needed.The NP should tell the patient that donepezil must be taken:

A) until symptoms improve.

B) indefinitely because it is not curative.

C) for 24 weeks, which is when cognitive function improves in most patients.

D) until symptoms worsen, when a switch to memantine (Namenda) will be needed.

Q2) A patient who has Alzheimer's disease has been taking donepezil for 1 year.The patient's spouse reports a worsening of symptoms.The primary care NP should consider:

A) switching to ginkgo biloba.

B) adding an antidepressant medication.

C) changing to galantamine (Razadyne).

D) adding memantine hydrochloride (Namenda).

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44

Chapter 43: Analgesia and Pain Management

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Sample Questions

Q1) A patient has been taking an opioid analgesic for 2 weeks after a minor outpatient procedure.At a follow-up clinic visit,the patient tells the primary care NP that he took extra doses for the past 2 days because of increased pain and wants an early refill of the medication.The NP should suspect:

A) dependence.

B) drug addiction.

C) possible misuse.

D) increasing pain.

Q2) A patient who is taking an antibiotic to treat bronchitis reports moderate rib pain associated with frequent coughing.The primary care NP should consider prescribing: A) morphine.

B) hydrocodone.

C) hydromorphone.

D) oxycodone CR.

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Chapter 44: Migraine Medications

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Sample Questions

Q1) A patient who has migraine headaches without an aura reports difficulty treating the migraines in time because they come on so suddenly.The patient has been using over-the-counter NSAIDs.The primary care NP should prescribe:

A) frovatriptan (Frova).

B) sumatriptan (Imitrex).

C) cyproheptadine (Periactin).

D) dihydroergotamine (D.H.E. 45).

Q2) A patient comes to the clinic concerned about possible migraine headaches.The primary care NP conducts a history and physical examination,and the patient describes vise-like pressure in the back of the head that occurs almost daily during the work week.The NP should recommend:

A) acetaminophen.

B) topiramate.

C) sumatriptan.

D) ergotamine.

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Chapter 45: Antiepileptics

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Q1) A 20-kg child takes valproic acid (Depakote)for seizures and has had regular dose increases with a current dose of 250 mg twice daily.The child continues to have one to two seizures each week along with significant drowsiness that interferes with school participation.The primary care NP should contact the child's neurologist to discuss:

A) obtaining a serum valproic acid level.

B) changing the medication to gabapentin (Neurontin).

C) increasing the valproic acid by 5 mg per kg of weight.

D) adding lamotrigine (Lamictal) to this child's drug regimen.

Q2) A patient who takes valproic acid for a seizure disorder is preparing to have surgery.The primary care NP should order:

A) coagulation studies.

B) a complete blood count.

C) an EEG.

D) a creatinine clearance test.

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Chapter 46: Antiparkinson Agents

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Sample Questions

Q1) A patient who has Parkinson's disease and who takes levodopa reports that the drug effects wear off more quickly than before.The primary care NP should:

A) add carbidopa.

B) add amantadine.

C) increase the dose of levodopa.

D) add a monoamine oxidase B inhibitor (MAO-B).

Q2) A 55-year-old patient develops Parkinson's disease characterized by unilateral tremors only.The primary care NP will refer the patient to a neurologist and should expect initial treatment to be:

A) levodopa.

B) carbidopa.

C) pramipexole.

D) carbidopa/levodopa.

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Chapter 47: Antidepressants

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Sample Questions

Q1) A patient has been taking fluoxetine (Prozac)for depression and comes to the clinic to report nausea and jitteriness.The primary care NP notes tremors and sees that the patient is confused.The patient has a heart rate of 95 beats per minute.The NP should:

A) change to bupropion (Wellbutrin).

B) ask the patient about other medications.

C) discontinue the fluoxetine immediately.

D) add mirtazapine (Remeron) to treat anxiety.

Q2) A patient reports having feelings of hopelessness and anxiety for the past few months.The primary care nurse practitioner (NP)performs a history and learns that these feelings occur almost daily.The patient also reports having headaches and difficulty concentrating at work along with wanting to sleep all the time.The patient has gained 5 lb in the past 6 months.The NP should:

A) tell the patient that these symptoms should resolve on their own.

B) reassure the patient that these are symptoms of minor depression.

C) tell the patient that an exercise regimen alone should be effective.

D) assess the patient for alcohol and drug use and for suicidal ideation.

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49

Chapter 48: Antianxiety and Insomnia Agents

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Q1) A patient is in the clinic with acute symptoms of anxiety.The patient is restless and has not slept in 3 days.The primary care NP observes that the patient is irritable and has moderate muscle tension.The patient's spouse reports that similar symptoms have occurred before in varying degrees for several years.The NP should refer the patient to a psychologist and should prescribe which drug for short-term use?

A) Alprazolam

B) Buspirone

C) Melatonin

D) Zolpidem

Q2) A patient comes to the clinic and reports having insomnia that began within the last year.The primary care nurse practitioner (NP)learns that the patient often lies awake worrying about problems at work.The patient feels fatigued during the day and experiences frequent stomach discomfort.The NP should prescribe:

A) buspirone.

B) melatonin.

C) alprazolam.

D) diphenhydramine.

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Chapter 49: Antipsychotics

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Q1) An elderly patient with dementia exhibits hostility and uncooperativeness.The primary care NP prescribes clozapine (Clozaril)and should counsel the family about:

A) a decreased risk of extrapyramidal symptoms.

B) improved cognitive function.

C) the need for long-term use of the medication.

D) a possible increased risk of heart disease and stroke.

Q2) A patient who is newly diagnosed with schizophrenia is overweight and has a positive family history for type 2 diabetes mellitus.The primary care NP should consider initiating antipsychotic therapy with:

A) ziprasidone (Geodon).

B) olanzapine (Zyprexa).

C) risperidone (Risperdal).

D) chlorpromazine (Thorazine).

Q3) A patient who is overweight is diagnosed with schizophrenia.The primary care NP should consider prescribing:

A) olanzapine (Zyprexa).

B) ziprasidone (Geodon).

C) quetiapine (Seroquel).

D) aripiprazole (Abilify).

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Page 51

Chapter 50: Substance Abuse

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Sample Questions

Q1) A patient is brought to the clinic by a spouse because of increased somnolence and disorientation.The spouse tells the primary care NP that the patient has been taking oxycodone for postoperative pain.The NP notes a respiratory rate of 8 to 10 breaths per minute.The NP should:

A) activate the emergency medical service (EMS) and administer oxygen.

B) administer oral methadone (Dolophine).

C) administer intramuscular naltrexone (ReVia).

D) administer sublingual buprenorphine (Subutex).

Q2) A patient who is an alcoholic is seen in the clinic,and the primary care NP admits the patient to the hospital for acute withdrawal.The patient has elevated liver enzymes.The NP should expect the inpatient provider to prescribe:

A) lorazepam (Ativan).

B) diazepam (Valium).

C) acamprosate (Campral).

D) chlordiazepoxide (Librium).

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Chapter 51: Glucocorticoids

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Q1) A patient is being tapered from long-term therapy with prednisolone and reports weight loss and fatigue.The primary care NP should counsel this patient to:

A) consume foods high in vitamin D and calcium.

B) begin taking dexamethasone because it has longer effects.

C) expect these side effects to occur as the medication is tapered.

D) increase the dose of prednisolone to the most recent amount taken.

Q2) A 70-year-old patient with COPD who is new to the clinic reports taking 10 mg of prednisone daily for several years.The primary care NP should:

A) tell the patient to take the drug every other day before 9:00 AM.

B) order a serum glucose, potassium level, and bone density testing.

C) perform pulmonary function tests to see if the medication is still needed.

D) begin a gradual taper of the prednisone to wean the patient off the medication.

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Chapter 52: Thyroid Medications

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Q1) A patient who has hypothyroidism has been taking levothyroxine 50 mcg daily for 2 weeks.The patient reports continued fatigue.The primary care NP should:

A) order a T₄ level today.

B) increase the dose to 100 mcg.

C) check the TSH level in 1 week.

D) reassure the patient that this will improve in several weeks.

Q2) A primary care NP prescribes levothyroxine for a patient to treat thyroid deficiency.When teaching this patient about the medication,the NP should:

A) counsel the patient to take the medication with food.

B) tell the patient that changing brands of the medication should be avoided.

C) instruct the patient to stop taking the medication if signs of thyrotoxicosis occur.

D) tell the patient that the drug may be stopped when thyroid function tests stabilize.

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Chapter 53: Diabetes Mellitus Agents

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Sample Questions

Q1) A patient who has type 2 diabetes mellitus takes metformin (Glucophage).The patient tells the primary care NP that he will have surgery in a few weeks.The NP should recommend:

A) taking the metformin dose as usual the morning of surgery.

B) using insulin during the perioperative and postoperative periods.

C) that the patient stop taking metformin several days before surgery.

D) adding a sulfonylurea medication until recovery from surgery is complete.

Q2) A patient who has insulin-dependent type 2 diabetes reports having difficulty keeping blood glucose within normal limits and has had multiple episodes of both hypoglycemia and hyperglycemia.As adjunct therapy to manage this problem,the primary care NP should prescribe:

A) pramlintide (Symlin).

B) repaglinide (Prandin).

C) glyburide (Micronase).

D) metformin (Glucophage).

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Chapter 54: Contraceptives

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Sample Questions

Q1) A 40-year-old woman tells the primary care nurse practitioner (NP)that she does not want more children and would like a contraceptive.She does not smoke and has no personal or family history of cardiovascular disease.She has frequent tension headaches.For this patient,the NP should prescribe:

A) condoms.

B) tubal ligation.

C) monophasic combined oral contraceptive pill (COCP).

D) low-estrogen COCP.

Q2) A woman who uses a transdermal contraceptive calls the primary care NP to report that while dressing that morning she discovered that the patch had come off and she was unable to find the patch.The NP should tell her to apply a new patch and:

A) take one cycle of COCPs.

B) take a home pregnancy test.

C) use condoms for the next 7 days.

D) contact the clinic if she misses a period.

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Chapter 55: Hormone Replacement Therapy

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12 Flashcards

Source URL: https://quizplus.com/quiz/19031

Sample Questions

Q1) A 50-year-old woman with a family history of CHD is experiencing occasional hot flashes and is having periods every 3 to 4 months.She asks the primary care NP about HT to relieve her symptoms.The NP should:

A) prescribe estrogen-only therapy.

B) initiate oral contraceptive pills now.

C) discuss using bioidentical HT.

D) plan to use estrogen-progesterone therapy when menopause begins.

Q2) A 50-year-old woman reports severe,frequent hot flashes and vaginal dryness.She is having irregular periods.She has no family history of CHD or breast cancer and has no personal risk factors.The primary care NP should recommend:

A) estrogen-only HT.

B) low-dose oral contraceptive therapy.

C) selective serotonin reuptake inhibitor therapy until menopause begins.

D) estrogen-progesterone HT.

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Chapter 56: Drugs for Breast Cancer

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5 Verified Questions

5 Flashcards

Source URL: https://quizplus.com/quiz/19032

Sample Questions

Q1) A patient who has breast cancer has been taking toremifene for 2 weeks.She tells her primary care NP that she thinks her tumor has grown larger.The NP should:

A) schedule her for a breast ultrasound.

B) reassure her that this is common and will subside.

C) tell her she may need an increased dose of this medication.

D) contact her oncologist to discuss adding another medication.

Q2) A 50-year-old woman who is postmenopausal is taking an aromatase inhibitor as part of a breast cancer treatment regimen.She calls her primary care NP to report that she has had hot flashes and increased vaginal discharge but no bleeding.The NP should:

A) schedule her for a gynecologic examination.

B) recommend that she use a barrier method of contraception.

C) tell her to stop taking the medication and call her oncologist.

D) reassure her that these are normal side effects of the medication.

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Chapter 57: Principles for Prescribing Antiinfectives

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Source URL: https://quizplus.com/quiz/19033

Sample Questions

Q1) A patient who has had two recent urinary tract infections is in the clinic with dysuria and fever.The primary care NP reviews the patient's chart and notes that in both previous cases the causative organism and sensitivity were the same.The NP should:

A) treat the patient empirically without a culture.

B) order a microscopic evaluation of the urine and an antibiotic.

C) order a urine culture and treat empirically pending culture results.

D) order a urine culture and sensitivity and wait for results before treating.

Q2) The primary care NP sees a patient who has a 1-week history of nasal congestion; red,watery eyes; cough; and a temperature ranging from 99.1° F to 100.5° F.The NP notes thin,white nasal discharge and an erythematous oropharynx without swelling or exudates.The NP should:

A) begin empiric antibiotic therapy to treat sinusitis.

B) reassure the patient that this is likely a viral infection.

C) prescribe antiviral medications and decongestants.

D) obtain a nasal culture and consider antibiotic therapy.

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59

Chapter 58: Treatment of Specific Infections and Miscellaneous Antibiotics

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10 Verified Questions

10 Flashcards

Source URL: https://quizplus.com/quiz/19034

Sample Questions

Q1) A patient comes to the clinic several days after an outpatient surgical procedure complaining of swelling and pain at the surgical site.The primary care NP notes a small area of erythema but no abscess or induration.The NP should:

A) prescribe TMP-SMX.

B) prescribe topical mupirocin four times daily.

C) suggest that the patient apply warm soaks three times daily.

D) refer the patient to the surgeon for further evaluation.

Q2) A patient has recently returned from travel in Central America and reports having seven to eight liquid stools each day with severe tenesmus.The primary care NP notes a temperature of 102° F.A stool specimen is Hemoccult positive with leukocytes present.The NP will:

A) order tests for Clostridium difficile.

B) prescribe tinidazole 2000 mg for 3 days.

C) give 750 mg of ciprofloxacin one time only.

D) order a stool culture and begin therapy with a fluoroquinolone.

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Page 60

Chapter 59: Penicillins

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Source URL: https://quizplus.com/quiz/19035

Sample Questions

Q1) A patient is taking dicloxacillin (Dynapen)500 mg every 6 hours to treat a severe penicillinase-resistant infection.At a 1-week follow-up appointment,the patient reports nausea,vomiting,and epigastric discomfort.The primary care NP should:

A) change the medication to a cephalosporin.

B) decrease the dose to 250 mg every 6 hours.

C) reassure the patient that these are normal adverse effects of this drug.

D) order blood cultures, a white blood cell (WBC) count with differential, and liver function tests (LFTs).

Q2) The primary care NP administers penicillin G (Bicillin)to a 75-year-old patient who has COPD and heart failure.The patient takes digoxin,warfarin,and spironolactone.To help prevent drug interactions,the NP should order:

A) serum electrolytes.

B) coagulation studies.

C) creatinine clearance.

D) liver transaminases aspartate aminotransferase and alanine aminotransferase.

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Chapter 60: Cephalosporins

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7 Flashcards

Source URL: https://quizplus.com/quiz/19036

Sample Questions

Q1) An adult patient has cellulitis.The patient is a single parent with health insurance who works and is attending classes at a local university.To treat this infection,the primary care nurse practitioner (NP)should prescribe:

A) cefdinir (Omnicef).

B) cephalexin (Keflex).

C) cefadroxil (Duricef).

D) ceftriaxone (Rocephin).

Q2) A patient is taking an aminoglycoside and a cephalosporin.The primary care NP should consider _____ the dose of _____.

A) increasing; cephalosporin

B) decreasing; cephalosporin

C) increasing; aminoglycoside

D) decreasing; aminoglycoside

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Chapter 61: Tetracyclines

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Source URL: https://quizplus.com/quiz/19037

Sample Questions

Q1) A patient is taking tetracycline for a rickettsial infection and reports having heartburn.The primary care NP should:

A) ask the patient how the medication is taken.

B) tell the patient to take the medication with food.

C) tell the patient to use antacids when heartburn occurs.

D) recommend drinking milk when taking the medication.

Q2) A young woman will begin taking minocycline.The primary care NP should tell this patient to:

A) avoid taking antacids while taking this drug.

B) expect headaches while taking this medication.

C) always take the medication on an empty stomach.

D) use a backup form of contraception if currently taking oral contraceptive pills.

Q3) A woman has a Chlamydia infection.Before initiating treatment with a tetracycline antibiotic,the primary care nurse practitioner (NP)should:

A) perform a pregnancy test.

B) obtain baseline liver function and renal function tests.

C) check her bilirubin and serum amylase levels.

D) tell her she must stop using oral contraceptive pills.

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Chapter 62: Macrolides

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Source URL: https://quizplus.com/quiz/19038

Sample Questions

Q1) Which antibiotic requires administration of a loading dose?

A) Ilosone

B) E-Mycin

C) Erythrocin

D) Zithromax

Q2) A primary care NP is preparing to prescribe a macrolide antibiotic for a patient who has a history of a prolonged QT interval on electrocardiogram.Which macrolide antibiotic should the NP prescribe?

A) Erythromycin

B) Azithromycin

C) Clarithromycin

D) Telithromycin

Q3) A primary care nurse practitioner (NP)is prescribing once-daily azithromycin to a 25-year-old woman.When teaching her about the drug,the NP should tell her to:

A) take the medication on an empty stomach.

B) use a backup contraception method other than oral contraceptive pills.

C) expect severe gastrointestinal side effects while taking this drug.

D) cut the pill in half and take twice daily if side effects are severe.

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64

Chapter 63: Fluoroquinolones

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7 Flashcards

Source URL: https://quizplus.com/quiz/19039

Sample Questions

Q1) A primary care NP sees a patient who has fever,flank pain,and dysuria.The patient has a history of recurrent urinary tract infections (UTIs)and completed a course of trimethoprim-sulfamethoxazole (TMP/SMX)the week before.A urine test is positive for leukocyte esterase.The NP sends the urine for culture and should treat this patient empirically with:

A) gemifloxacin.

B) ciprofloxacin.

C) azithromycin.

D) TMP/SMX.

Q2) A patient who has been taking ciprofloxacin for 14 days for treatment of a UTI is seen in the clinic for a follow-up urinalysis.The urinalysis reveals crystalluria.The primary care NP should:

A) discontinue the ciprofloxacin.

B) decrease the dose of ciprofloxacin.

C) change the antibiotic to norfloxacin.

D) counsel the patient to increase fluid intake.

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Chapter 64: Aminoglycosides

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Source URL: https://quizplus.com/quiz/19040

Sample Questions

Q1) A patient who was recently hospitalized and treated with gentamicin tells the primary care NP,"My kidney function test was abnormal and they stopped the medication." The patient is worried about long-term effects.The NP should:

A) monitor renal function for several months.

B) reassure the patient that complete recovery should occur.

C) refer the patient to a nephrologist for follow-up evaluation.

D) monitor serum electrolytes and serum creatinine and BUN.

Q2) A primary care NP sees a patient who was recently hospitalized for infection and treated with gentamicin for 10 days.The patient tells the NP that the drug was discontinued early because "my blood level was too high." The NP should order:

A) a serial audiometric test.

B) a serum blood urea nitrogen (BUN) and creatinine.

C) a urinalysis and complete blood count.

D) serum calcium, magnesium, and sodium.

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Chapter 65: Sulfonamides

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Source URL: https://quizplus.com/quiz/19041

Sample Questions

Q1) When prescribing TMP/SMX to children,the primary care NP should recall that:

A) dosing is based on the trimethoprim component of the drug.

B) TMP/SMX should not be prescribed for children younger than 2 years.

C) folic acid supplements must be given to children who take this medication.

D) the medication should be given three or four times per day because of rapid metabolism.

Q2) A patient has been taking trimethoprim-sulfamethoxazole (TMP/SMX)for 14 days.The patient calls the primary care nurse practitioner (NP)to report fever,rash,and enlarged lymph nodes.The NP should suspect:

A) serum sickness reaction.

B) immediate sensitivity reaction.

C) cytotoxic hypersensitivity reaction.

D) cell-mediated hypersensitivity reaction.

Q3) The primary care NP teaches a patient about TMP/SMX before prescribing it to treat a urinary tract infection (UTI).Which statement by the patient indicates a need for further teaching?

A) "I will take this medication with food."

B) "I should drink a full glass of water with each dose."

C) "I should stay out of direct sunlight and use sunscreen."

D) "I should report any ringing in my ears or a sore throat."

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Chapter 66: Antitubercular Agents

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8 Flashcards

Source URL: https://quizplus.com/quiz/19042

Sample Questions

Q1) A patient has a Mantoux tuberculin skin test with a 12-mm area of induration.The patient has a cough,and a chest radiograph is positive.The primary care NP should refer this patient to an infectious disease specialist and should plan to monitor a regimen of:

A) isoniazid for 6 months.

B) isoniazid and rifapentine.

C) isoniazid, rifapentine, and ethambutol.

D) isoniazid, rifampin, pyrazinamide, and ethambutol.

Q2) A patient who takes isoniazid and rifampin for latent TB comes to the clinic with a new-onset cough and night sweats.The primary care NP should evaluate these findings by ordering:

A) a sputum culture.

B) LFTs.

C) renal function tests.

D) tuberculin skin test.

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Chapter 67: Antifungals

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Source URL: https://quizplus.com/quiz/19043

Sample Questions

Q1) A patient was diagnosed with tinea corporis and given topical ketoconazole.The patient tells the primary care nurse practitioner (NP)that the infection is not getting better.The NP should:

A) prescribe griseofulvin.

B) prescribe oral ketoconazole.

C) obtain a culture of the infection site.

D) recommend 3 more weeks of treatment with the topical medication.

Q2) A woman who takes oral contraceptive pills develops vaginal candidiasis.The primary care NP prescribes a single dose of fluconazole.When counseling the patient about this drug,the NP should tell her:

A) that the drug is safe if she were to become pregnant.

B) that she may consume alcohol while taking this medication.

C) to use a backup contraceptive method for the next 2 months.

D) that she may need a lower dose of fluconazole because she takes oral contraceptive pills.

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Chapter 68: Antiretroviral Medications

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6 Verified Questions

6 Flashcards

Source URL: https://quizplus.com/quiz/19044

Sample Questions

Q1) A patient who has HIV is being treated with Emtriva.The patient develops hepatitis B.The primary care NP should contact the patient's infectious disease specialist to discuss:

A) adding zidovudine.

B) changing to Truvada.

C) changing to tenofovir.

D) ordering Combivir and tenofovir.

Q2) A patient who has HIV has been receiving a two-drug combination therapy for 6 months.At an annual physical examination,the primary care NP notes that the patient has a viral load of 60 copies/mL and a CD4 cell count of 350 cells/mm.The NP should contact the patient's infectious disease specialist to discuss:

A) changing one of the medications.

B) changing both of the medications.

C) increasing the dose of both medications.

D) discontinuing the medications for a short period.

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Chapter 69: Antiviral and Antiprotozoal Agents

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Source URL: https://quizplus.com/quiz/19045

Sample Questions

Q1) A patient who is taking metronidazole calls the primary care NP to report severe nausea and vomiting along with heart palpitations.The NP should:

A) counsel the patient to take the medication with food.

B) ask the patient about any recent alcohol consumption.

C) reassure the patient that these symptoms will subside.

D) instruct the patient to go to an emergency department for intravenous fluids.

Q2) A patient comes to the clinic before a trip to an area where malaria is endemic.The primary care NP will prescribe:

A) tinidazole (Tindamax).

B) metronidazole (Flagyl).

C) chloroquine (Plaquenil).

D) amantadine (Symmetrel).

Q3) A patient is taking amantadine to treat a viral infection.The patient calls the primary care NP to report having blurred vision.The NP should:

A) question the patient about suicidal ideation.

B) tell the patient to stop the medication immediately.

C) counsel the patient to avoid driving until this subsides.

D) tell the patient to come to the clinic for an electroencephalogram.

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Chapter 70: The Immune System and Immunizations

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16 Flashcards

Source URL: https://quizplus.com/quiz/19046

Sample Questions

Q1) The parent of a 2-month-old infant who will soon begin daycare refuses the rotavirus vaccine (RV)because of fears of intussusception.The parent tells the primary care NP that the daycare is strict about preventing infants who have fever or gastrointestinal symptoms from attending.The NP should tell the parent that:

A) herd immunity will protect the infant from infection.

B) asymptomatic children can spread rotavirus infection.

C) the risk of intussusception is nonexistent with the newer vaccine.

D) the infant can be treated with antibiotics if rotavirus infection occurs.

Q2) A parent whose child received a fourth DTaP at a recent 15-month visit calls the primary care NP to report that the child is fussy,has a temperature of 38.3° C,and has redness and swelling at the injection site.The NP should:

A) admit the child to the hospital for observation of developing symptoms.

B) flag the child's chart to avoid administration of pertussis vaccine in the future.

C) report these adverse reactions to the Vaccine Adverse Event Reporting System (VAERS).

D) instruct the parent to give the child acetaminophen as needed for fever or localized discomfort.

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Chapter 71: Weight Management

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7 Flashcards

Source URL: https://quizplus.com/quiz/19047

Sample Questions

Q1) A patient comes to the clinic to discuss weight loss.The primary care NP notes a BMI of 32 and performs a health risk assessment that reveals no obesity-related risk factors.The NP should recommend:

A) orlistat (Xenical).

B) surgical intervention.

C) changes in diet and exercise.

D) changes in diet and exercise along with short-term phentermine.

Q2) A patient has a BMI of 35,a fasting plasma glucose of 120 mg/dL,elevated triglycerides,and a history of myocardial infarction.The primary care NP plans to initiate dietary and lifestyle counseling and should consider prescribing: A) ephedra.

B) orlistat (Xenical).

C) phentermine (Adipex-P).

D) phentermine and topiramate (Onexa).

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Chapter 72: Smoking Cessation

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Source URL: https://quizplus.com/quiz/19048

Sample Questions

Q1) A patient reports smoking two or more packs of cigarettes per day and expresses a desire to quit smoking.The primary care NP learns that the patient smokes heavily during breaks at work and during the evening but with no established schedule.The NP should recommend:

A) bupropion (Wellbutrin).

B) nicotine replacement gum or nasal spray.

C) a high-dose 24-hour nicotine patch.

D) intensive smoking cessation counseling.

Q2) A primary care NP has been working with a young woman who wants to quit smoking before she begins having children.She has made several attempts to quit using nicotine replacement therapy and is feeling discouraged.She does not want to take medication at this time.The NP should:

A) discuss the effects of smoking on fetal development.

B) ask her to write down any factors that triggered her relapses.

C) give her information about the long-term effects of smoking.

D) convince her that taking medication will be essential in her case.

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Chapter 73: Vitamins and Minerals

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Source URL: https://quizplus.com/quiz/19049

Sample Questions

Q1) The parent of a 3-year-old is concerned that the child's legs are not straight.The primary care NP notes marked bowing of the child's lower extremities.Radiologic studies show decreased ossification of the child's bones.The NP should:

A) prescribe vitamin D supplements.

B) recommend calcium supplements.

C) counsel the parent to increase the child's milk intake.

D) ensure that the parent is buying vitamin D-fortified milk.

Q2) An adolescent girl has decided to become a vegetarian.The primary care NP should counsel her about iron intake and considering a vitamin containing: A) zinc.

B) vitamin A.

C) vitamin C.

D) potassium.

Q3) As patients age,it becomes particularly important to increase their intake of: A) iron.

B) omega 3.

C) vitamin C.

D) B vitamins.

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