Primary Care Nursing Test Preparation - 577 Verified Questions

Primary Care Nursing Test Preparation

Course Introduction

Primary Care Nursing introduces students to the foundations of nursing practice within primary care settings, emphasizing health promotion, disease prevention, and the management of acute and chronic conditions across the lifespan. The course covers assessment techniques, development of collaborative care plans, patient education, and culturally competent care within community and family contexts. Students will learn to work as part of interprofessional teams, address social determinants of health, and utilize evidence-based approaches to optimize health outcomes and support the continuity of care in ambulatory and community environments.

Recommended Textbook

Pharmacology for the Primary Care Provider 4th Edition by Edmunds

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73 Chapters

577 Verified Questions

577 Flashcards

Source URL: https://quizplus.com/study-set/962

Page 2

Chapter 1: Prescriptive Authority and Role Implementation:

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3 Verified Questions

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Sample Questions

Q1) Which of the following statements is true about the prescribing practices of physicians?

A) Older physicians tend to prescribe more appropriate medications than younger physicians.

B) Antibiotic medications remain in the top five classifications of medications prescribed.

C) Most physicians rely on a "therapeutic armamentarium" that consists of less than 100 drug preparations per physician.

D) The dominant form of drug information used by primary care physicians continues to be that provided by pharmaceutical companies.

Answer: D

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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

6 Flashcards

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Sample Questions

Q1) 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

Q2) 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

Q3) In every state,prescriptive authority for NPs includes the ability to write prescriptions:

A) for controlled substances.

B) for specified classifications of medications.

C) without physician-mandated involvement.

D) with full, independent prescriptive authority.

Answer: B

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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) The primary care NP should understand that a drug is at a therapeutic level when it is:

A) at peak plasma level.

B) past 4 or 5 half-lives.

C) at its steady plasma state.

D) between minimal effective concentration and toxic levels.

Answer: D

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Chapter 4: Special Populations: Geriatrics

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7 Verified Questions

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Sample Questions

Q1) An NP learns that a 90-year-old patient is chronically constipated and has frequent problems with acid reflux.The NP notes a weight loss of 20 pounds in this patient in the previous 6 months.Which of the following drugs that this patient is taking is cause for concern?

A) Quinidine

B) Naproxen

C) Calcium citrate

D) Calcium channel blocker

Q2) An NP is caring for a 70-year-old patient who reports having seasonal allergies with severe rhinorrhea.Using the Beers criteria,which of the following medications should the NP recommend for this patient?

A) Loratadine (Claritin)

B) Hydroxyzine (Vistaril)

C) Diphenhydramine (Benadryl)

D) Chlorpheniramine maleate (Chlorphen 12)

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Chapter 5: Special Populations: Pediatrics

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Sample Questions

Q1) An NP prescribes an oral elixir medication for a child who is to take 1 tsp PO bid.When counseling the child's parents about administering this drug,the NP should tell them to:

A) shake the medication well before giving each dose.

B) mix the medication with cereal or applesauce to improve its taste.

C) administer the medication on an empty stomach to enhance absorption.

D) use a syringe purchased at the pharmacy to measure the medication accurately.

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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Sample Questions

Q1) A woman is 4 weeks pregnant.The primary care NP sees her for her first prenatal visit and obtains a rubella titer,which is negative.The woman tells the NP that she drinks 2 cups of coffee and smokes 3 to 5 cigarettes each day.She denies alcohol use.The NP should:

A) administer rubella vaccine.

B) provide smoking cessation information.

C) counsel her to avoid caffeine while pregnant.

D) reassure her that her habits are not likely to cause harm.

Q2) A woman who is breastfeeding her infant asks the primary care NP what she can use for headaches while she is nursing.The NP tells her:

A) most medications enter breast milk and are not safe.

B) most over-the-counter medications are safe for the breastfed infant.

C) she may need to interrupt breastfeeding when taking headache medications.

D) she should consider weaning her infant to formula if her headaches are frequent.

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8

Chapter 7: Over-the-Counter Medications

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Sample Questions

Q1) A patient asks a primary care NP whether over-the-counter drugs are safer than prescription drugs.The NP should explain that over-the-counter drugs are:

A) generally safe when label information is understood and followed.

B) safer because over-the-counter doses are lower than prescription doses of the same drug.

C) less safe because they are not well regulated by the Food and Drug Administration (FDA).

D) not extensively tested, so claims made by manufacturers cannot be substantiated.

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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7 Verified Questions

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Sample Questions

Q1) A patient asks a primary care NP why herbal supplements are not regulated by the FDA.The nurse practitioner should tell the patient these products are not regulated by the FDA because they are:

A) natural, plant-based products and not man-made.

B) not marketed as products that can treat or cure disease.

C) regulated by the Dietary Supplement Health and Education Act.

D) covered by the Hatch-Richardson Bill of 1992, which allows them to make health claims without FDA approval.

Q2) A patient develops hepatotoxicity from chronic acetaminophen use.The primary care NP may recommend:

A) milk thistle.

B) chondroitin.

C) coenzyme Q.

D) glucosamine.

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Chapter 9: Establishing the Therapeutic Relationship

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Sample Questions

Q1) A primary care NP writes a prescription for an off-label use for a drug.To help ensure compliance,the NP should:

A) include information about the off-label use on the E-script.

B) provide the patient with written instructions about how to use the medication.

C) tell the patient to let the pharmacist know that the drug is being used for an off-label use.

D) follow up by phone in several days to see if the patient is using the drug appropriately.

Q2) A patient bursts into tears when the primary care NP diagnoses diabetes.The NP should:

A) ask the patient about past experiences with anyone who has this diagnosis.

B) reassure the patient that the medications and blood tests will become routine.

C) call in a social worker to assist the patient to obtain equipment and supplies.

D) refer the patient to a diabetes educator to provide teaching about the disease.

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Chapter 10: Practical Tips on Writing Prescriptions

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Sample Questions

Q1) The primary care NP is prescribing a medication for an off-label use.To help prevent a medication error,the NP should:

A) write "off-label use" on the prescription and provide a rationale.

B) call the pharmacist to explain why the instructions deviate from common use.

C) write the alternative drug regimen on the prescription and send it to the pharmacy.

D) tell the patient to ignore the label directions and follow the verbal instructions given in the clinic.

Q2) The primary care nurse practitioner (NP)writes a prescription for an antibiotic using an electronic drug prescription system.The pharmacist will fill this prescription when:

A) the electronic prescription is received.

B) the patient brings a written copy of the prescription.

C) a copy of the written prescription is faxed to the pharmacy.

D) the pharmacist accesses the patient's electronic record to verify.

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Chapter 11: Evidence-Based Decision Making and Treatment Guidelines

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9 Verified Questions

9 Flashcards

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Sample Questions

Q1) A primary care NP is developing a clinical practice guideline for management of a patient population in a midsized suburban hospital.The NP should:

A) use an existing guideline from a leading research hospital.

B) follow the guideline provided by a third-party payer to help ensure reimbursement.

C) review expert opinion and experimental, anecdotal, correlational study data.

D) write the guideline to adhere to long-standing practice protocols already in use.

Q2) The primary care NP prescribes an inhaled corticosteroid for a patient who has asthma.The third-party payer for this patient denies coverage for the brand that comes in the specific strength the NP prescribes.The NP should:

A) provide pharmaceutical company samples of the medication for the patient.

B) inform the patient that the drug must be paid for out of pocket because it is not covered.

C) order the closest formulary-approved approximation of the drug and monitor effectiveness.

D) write a letter of medical necessity to the insurer to explain the need for this particular medication.

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Chapter 12: Design and Implementation of Patient Education

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Sample Questions

Q1) 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.

Q2) The primary care NP is seeing a patient for a hospital follow-up after the patient has had a first myocardial infarction.The patient has a list of the prescribed medications and tells the NP that "no one explained anything about them." The NP's initial response should be to:

A) ask the patient to describe the medication regimen.

B) ask the patient to make a list of questions about the medications.

C) determine what the patient understands about coronary artery disease.

D) give the patient information about drug effects and any adverse reactions.

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Chapter 13: Dermatologic Agents

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12 Verified Questions

12 Flashcards

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Sample Questions

Q1) A primary care NP is preparing to irrigate and suture a laceration on a patient's thumb.To anesthetize the site,the NP should use:

A) lidocaine hydrochloride.

B) lidocaine with epinephrine.

C) bupivacaine hydrochloride.

D) bupivacaine with epinephrine.

Q2) A primary care nurse practitioner (NP)prescribes a topical cream medication.Which statement by the patient indicates understanding of proper application of this medication?

A) "I should apply this medication after bathing."

B) "I need to use a tongue blade to apply this medication."

C) "I should apply this medication liberally to all affected areas."

D) "I will apply this medication using circular strokes to ensure absorption."

Q3) A 5-year-old child has atopic dermatitis that is refractory to treatment with hydrocortisone acetone 2.5% cream.The primary care NP should prescribe:

A) desonide cream 0.01%.

B) triamcinolone acetonide.

C) fluocinolone cream 0.2%.

D) betamethasone dipropionate ointment 0.05%.

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Page 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 nurse practitioner (NP)sees a patient who has a 1-week history of watery,painful eyes with copious amounts of clear discharge and a sore throat.The NP observes bilateral erythema of the conjunctivae and palpates enlarged preauricular lymph nodes.The NP should prescribe _____ drops.

A) ganciclovir

B) ophthalmic antibiotic

C) sympathomimetic ophthalmic

D) nonsteroidal antiinflammatory

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Page 16

Chapter 15: Upper Respiratory Agents

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Sample Questions

Q1) A patient comes to the clinic with a 3-day history of fever and a severe cough that interferes with sleep.The patient asks the NP about using a cough suppressant to help with sleep.The NP should:

A) order a narcotic antitussive to suppress cough.

B) obtain a thorough history of the patient's symptoms.

C) suggest that the patient try a guaifenesin-only over-the-counter product.

D) prescribe an antibiotic to treat the underlying cause of the patient's cough.

Q2) 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.

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Chapter 16: Asthma and Chronic Obstructive Pulmonary Disease

Medications

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Sample Questions

Q1) A primary care NP is evaluating a patient who has COPD.The patient uses a LABA twice daily.The patient reports having increased exertional dyspnea,a frequent cough,and poor sleep.The patient also uses a short-acting b-adrenergic agonist (SABA)five or six times each day.Pulse oximetry reveals an oxygen saturation of 92%.The patient's FEV /forced vital capacity is 65,and FEV1 is 55% of predicted.The NP should prescribe a(n):

A) oral corticosteroid.

B) long-acting anticholinergic.

C) long-acting oral theophylline.

D) combination ICS/LABA inhaler.

Q2) A primary care NP sees a child with asthma to evaluate the child's response to the prescribed therapy.The child uses an ICS twice daily and an albuterol metered-dose inhaler as needed.The child's symptoms are well controlled.The NP notes slowing of the child's linear growth on a standardized growth chart.The NP should change this child's medication regimen to a:

A) combination ICS/LABA inhaler twice daily.

B) short-acting b2-agonist (SABA) with oral corticosteroids when symptomatic.

C) combination ipratropium/albuterol inhaler twice daily.

D) SABA as needed plus a leukotriene modifier once daily.

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Chapter 17: Hypertension and Miscellaneous

Antihypertensive Medications

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Sample Questions

Q1) A patient who has had a previous myocardial infarction has a blood pressure of 135/82 mm Hg.The patient's body mass index is 28,and the patient has a fasting plasma glucose of 105 mg/dL.The primary care NP should prescribe:

A) an angiotensin-converting enzyme inhibitor.

B) a thiazide diuretic.

C) lifestyle modifications.

D) a calcium-channel 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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Page 19

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) A primary care NP prescribes a nitroglycerin transdermal patch,0.4 mg/hour release,for a patient with chronic stable angina.The NP should teach the patient to:

A) change the patch four times daily.

B) use the patch as needed for angina pain.

C) use two patches daily and change them every 12 hours.

D) apply one patch daily in the morning and remove in 12 hours.

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Chapter 19: Heart Failure and Digoxin

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Sample Questions

Q1) A patient who has been taking digoxin 0.25 mg daily for 6 months reports that it is not working as well as it did initially.The primary care NP should:

A) recommend a reduced potassium intake.

B) increase the dose of digoxin to 0.5 mg daily.

C) hold the next dose of digoxin and obtain a serum digoxin level.

D) contact the patient's pharmacy to ask if generic digoxin was dispensed.

Q2) 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).

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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) An 80-year-old patient with chronic stable angina has begun taking nadolol (Corgard)20 mg once daily in addition to taking nitroglycerin as needed.After 1 week,the patient reports no change in frequency of nitroglycerin use.The primary care nurse practitioner (NP)should change the dose of nadolol to _____ mg _____ daily.

A) 40; once

B) 80; once

C) 20; twice

D) 40; twice

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22

Chapter 21: Calcium Channel Blockers

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Sample Questions

Q1) A patient who is taking nifedipine develops mild edema of both feet.The primary care NP should contact the patient's cardiologist to discuss:

A) changing to amlodipine.

B) ordering renal function tests.

C) increasing the dose of nifedipine.

D) evaluation of left ventricular function.

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 is taking an ACE inhibitor sees the primary care NP for a follow-up visit.The patient reports having a persistent cough.The NP should: A) consider changing the medication to an ARB. B) order a bronchodilator to counter the bronchospasm caused by this drug. C) ask whether the patient has had any associated facial swelling with this cough. D) reassure the patient that tolerance to this adverse effect will develop over time.

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) The primary care NP sees a new patient for a routine physical examination.When auscultating the heart,the NP notes a heart rate of 78 beats per minute with occasional extra beats followed by a pause.History reveals no past cardiovascular disease,but the patient reports occasional syncope and shortness of breath.The NP should:

A) order an ECG and refer to a cardiologist.

B) schedule a cardiac stress test and a graded exercise test.

C) order a complete blood count (CBC) and electrolytes and consider a trial of procainamide.

D) prescribe a -blocker and anticoagulant and order 24-hour Holter monitoring.

Q2) The primary care NP refers a patient to a cardiologist who diagnoses long QT syndrome.The cardiologist has prescribed propranolol (Inderal).The patient exercises regularly and is not obese.The patient asks the NP what else can be done to minimize risk of sudden cardiac arrest.The NP should counsel the patient to:

A) drink extra fluids when exercising.

B) reduce stress with yoga and hot baths.

C) ask the cardiologist about an implantable defibrillator.

D) ask the cardiologist about adding procainamide to the drug regimen.

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Chapter 24: Antihyperlipidemic Agents

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Sample Questions

Q1) 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).

Q2) A primary care NP sees a 46-year-old male patient and orders a fasting lipoprotein profile that reveals LDL of 190 mg/dL,HDL of 40 mg/dL,and triglycerides of 200 mg/dL.The patient has no previous history of coronary heart disease,but the patient's father developed coronary heart disease at age 55 years.The NP should prescribe:

A) atorvastatin (Lipitor).

B) gemfibrozil (Lopid).

C) cholestyramine (Questran).

D) lovastatin/niacin (Advicor).

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Chapter 25: Agents that Act on Blood

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Sample Questions

Q1) A patient who will undergo surgery in implant a biosynthetic heart valve asks the primary care NP whether any medications will be necessary postoperatively.The NP should tell the patient that it will be necessary to take:

A) daily low-dose aspirin for 1 year.

B) heparin injections as needed based on activated partial thromboplastin time levels.

C) lifelong warfarin combined with enoxaparin as needed.

D) warfarin for 3 months postoperatively plus long-term aspirin.

Q2) A patient who is taking an oral anticoagulant is in the clinic in the late afternoon and reports having missed the morning dose of the medication because the prescription was not refilled.The primary care NP should counsel this patient to:

A) avoid foods that are high in vitamin K for several days.

B) take a double dose of the medication the next morning.

C) refill the prescription and take today's dose immediately.

D) skip today's dose and resume a regular dosing schedule in the morning.

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Chapter 26: Antacids and the Management of GERD

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Sample Questions

Q1) A patient who has gastroesophageal reflux disease (GERD)undergoes an endoscopy,which shows a hiatal hernia.The patient is mildly obese.The patient asks the primary care nurse practitioner (NP)about treatment options.The NP should tell this patient that:

A) a fundoplication will be necessary to correct the cause of GERD.

B) over-the-counter (OTC) antacids can be effective and should be tried first.

C) elevation of the head of the bed at night can relieve most symptoms.

D) a combination of lifestyle changes, medications, and surgery may be necessary.

Q2) An 80-year-old patient asks a primary care NP about OTC antacids for occasional heartburn.The NP notes that the patient has a normal complete blood count and normal electrolytes and a slight elevation in creatinine levels.The NP should recommend:

A) calcium carbonate (Tums).

B) aluminum hydroxide (Amphojel).

C) sodium bicarbonate (Alka-Seltzer).

D) magnesium hydroxide (Milk of Magnesia).

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Chapter 27: Histamine-2 Blockers and Proton Pump

Inhibitors

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Sample Questions

Q1) An 80-year-old patient has a history of renal disease and develops a duodenal ulcer.The primary care NP should order a:

A) normal dose of a histamine-2 blocker.

B) decreased dose of a histamine-2 blocker.

C) normal dose of a PPI.

D) decreased dose of a PPI.

Q2) A patient with a diagnosis of peptic ulcer disease asks the primary care NP about nonpharmacologic treatment.Which statement by the NP is correct?

A) "You should consume a diet that is high in fiber."

B) "One or two cups of coffee each day won't hurt you."

C) "Alcoholic beverages are strictly prohibited when you have an ulcer."

D) "Lifestyle changes and proper diet may eliminate the need for medication."

Q3) A patient with erosive esophagitis is taking lansoprazole (Prevacid).The primary care NP performs a medication history and learns that the patient also takes digoxin.The NP should recommend:

A) decreasing the dose of digoxin.

B) obtaining a serum digoxin level.

C) changing the PPI to omeprazole.

D) increasing the dose of lansoprazole.

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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 nurse practitioner (NP)sees a patient who is concerned about constipation.The NP learns that the patient has three to four bowel movements per week with occasional hard stools but no straining with defecation.The NP should recommend:

A) increased intake of fluids and fiber.

B) docusate sodium (Colace) as needed.

C) psyllium (Metamucil) on a daily basis.

D) polyethylene glycol (MiraLAX) as needed.

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Chapter 29: Antidiarrheals

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Sample Questions

Q1) A woman who is 4 months pregnant comes to the clinic with acute diarrhea and nausea.Her husband is experiencing similar symptoms.The primary care nurse practitioner (NP)notes a temperature of 38.5° C,a heart rate of 92 beats per minute,and a blood pressure of 100/60 mm Hg.The NP should:

A) prescribe attapulgite to treat her diarrhea.

B) obtain a stool culture and start antibiotic therapy.

C) instruct her to replace lost fluids by drinking Pedialyte.

D) refer her to an emergency department for intravenous (IV) fluids.

Q2) A 12-year-old patient has acute diarrhea and an upper respiratory infection.Other family members have had similar symptoms,which have resolved.The primary care NP should recommend:

A) diphenoxylate (Lomotil).

B) attapulgite (Kaopectate).

C) an electrolyte solution (Pedialyte).

D) bismuth subsalicylate (Pepto-Bismol).

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Chapter 30: Antiemetics

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Sample Questions

Q1) A primary care NP sees a patient who is about to take a cruise and reports having had motion sickness with nausea on a previous cruise.The NP prescribes the scopolamine transdermal patch and should instruct the patient to apply the patch:

A) daily.

B) every 3 days.

C) as needed for nausea.

D) 1 hour before embarking.

Q2) 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).

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

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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 woman with IBS has been taking antispasmodic medications and reports some relief,but she tells the primary care NP that the disease is interfering with her ability to work because of increased pain.The NP should consider prescribing:

A) alosetron (Lotronex).

B) misoprostol (Cytotec).

C) simethicone (Phazyme).

D) tricyclic antidepressants (TCAs).

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Chapter 32: Diuretics

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Q1) A patient has been taking furosemide 80 mg once daily for 4 weeks and returns for a follow-up visit.The primary care NP notes a blood pressure of 100/60 mm Hg.The patient's lungs are clear,and there is no peripheral edema.The patient's serum potassium is 3.4 mEq/L.The NP should:

A) continue furosemide at the current dose.

B) decrease furosemide to 60 mg once daily.

C) increase furosemide to 80 mg twice daily.

D) change furosemide dose the 40 mg twice daily.

Q2) A patient develops hypertension.The primary care nurse practitioner (NP)plans to begin diuretic therapy for this patient.The NP notes clear breath sounds,no organomegaly,and no peripheral edema.The patient's serum electrolytes are normal.The NP should prescribe:

A) furosemide (Lasix).

B) triamterene (Dyrenium).

C) acetazolamide (Diamox).

D) hydrochlorothiazide (HydroDIURIL).

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Chapter 33: Male Genitourinary Agents

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Sample Questions

Q1) A patient tells the primary care NP that he has difficulty getting and maintaining an erection.The NP's initial response should be to:

A) prescribe sildenafil (Viagra).

B) perform a medication history.

C) evaluate his cardiovascular status.

D) order a papaverine injection test to screen for erectile dysfunction.

Q2) A patient who has erectile dysfunction wants a medication to use as needed.The primary care NP should recommend:

A) tadalafil (Cialis).

B) sildenafil (Viagra).

C) avanafil (Stendra).

D) vardenafil (Levitra).

Q3) A patient who has BPH is taking doxazosin and finasteride.The patient asks the primary care NP whether he has an increased risk of prostate cancer.The NP should tell him:

A) his overall cancer risk is increased.

B) he has an increased risk of a certain type of cancer.

C) his cancer risk is the same as any other man his age.

D) doxazosin will increase his cancer risk, but only slightly.

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Page 35

Chapter 34: Drugs for Urinary Incontinence and Urinary Analgesia

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Sample Questions

Q1) 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.

Q2) A parent brings an 8-year-old child to the clinic because the child continues to wet the bed despite using cognitive-behavioral measures and a bed alarm system.The NP should prescribe:

A) solifenacin (VESIcare).

B) tolterodine (Detrol LA).

C) desmopressin (DDAVP).

D) phenazopyridine (Pyridium).

Q3) A serious side effect associated with desmopressin is:

A) dehydration.

B) hypotension.

C) hyponatremia.

D) urinary retention.

Page 36

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Chapter 35: Acetaminophen

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Sample Questions

Q1) A patient in the clinic reports taking a handful of acetaminophen extra-strength tablets about 12 hours prior.The patient has nausea,vomiting,malaise,and drowsiness.The patient's aspartate aminotransferase and alanine aminotransferase are mildly elevated.The primary care NP should:

A) expect the patient to sustain permanent liver damage.

B) reassure the patient that these symptoms are reversible.

C) tell the patient that acetylcysteine cannot be given this late.

D) administer activated charcoal to remove acetaminophen from the body.

Q2) A patient comes to the clinic and reports breaking out in an urticarial rash 1 hour after taking acetaminophen for osteoarthritis symptoms.The primary care NP should:

A) order a complete blood count with differential.

B) order liver and renal function tests.

C) suspect Reye's syndrome and arrange for hospitalization.

D) tell the patient not to take products containing acetaminophen again.

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Chapter 36: Aspirin and Nonsteroidal Antiinflammatory Drugs

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Q1) A primary care NP prescribes a nonselective NSAID for a patient who has osteoarthritis.The patient expresses concerns about possible side effects of this medication.When counseling the patient about the medication,the NP should tell this patient:

A) to avoid taking antacids while taking the NSAID.

B) to take each dose of the NSAID with a full glass of water.

C) that a few glasses of wine each day are allowed while taking the NSAID.

D) to decrease the dose of the NSAID if GI symptoms occur.

Q2) A patient reports having persistent mild to moderate pain in both knees usually associated with standing.The patient reports knee stiffness for 15 to 20 minutes each morning.The primary care nurse practitioner (NP)learns that the patient has used heating pads and acetaminophen,which no longer relieve the pain.The NP orders an erythrocyte sedimentation rate,which is normal.The NP should consider prescribing: A) aspirin.

B) a cyclooxygenase-2 (COX-2) inhibitor.

C) glucosamine and chondroitin.

D) a topical nonsteroidal antiinflammatory drug (NSAID).

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Page 38

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) The primary care NP follows a patient who is being treated for RA with methotrexate.The patient asks the NP why the medication does not seem to alleviate pain.The NP tells the patient that:

A) an immunomodulator may be needed to control pain.

B) a higher dose of methotrexate may be needed to achieve pain control.

C) if methotrexate does not control pain, an opioid analgesic may be necessary. D) methotrexate is used to slow disease progression and preserve joint function.

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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 primary care NP prescribes probenecid to treat a patient who has gout.The patient comes to the clinic 2 weeks later with severe flank pain.The NP should:

A) ask the patient about fluid intake.

B) order a urinalysis and urine culture.

C) change the medication to allopurinol.

D) recommend nonsteroidal antiinflammatory drugs (NSAIDs) to treat flank pain.

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Chapter 39: Osteoporosis Treatment

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Sample Questions

Q1) 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).

Q2) A 55-year-old woman who experienced menopause at age 50 years undergoes central dual-energy x-ray absorptiometry and has a T-score greater than 2.5.The patient weighs 130 lb and has a body mass index of 22.She sits at a computer all day at work.The primary care nurse practitioner (NP)caring for this patient should:

A) prescribe a bisphosphonate.

B) prescribe hormone replacement therapy.

C) counsel the patient about diet and exercise.

D) prescribe a selective estrogen receptor modulator.

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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 comes to the clinic complaining of low back pain unrelieved by NSAIDs.The patient has a history of angle-closure glaucoma and renal disease.The primary care NP should prescribe:

A) tizanidine (Zanaflex).

B) metaxalone (Skelaxin).

C) acetaminophen (Tylenol).

D) cyclobenzaprine (Flexeril).

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Chapter 41: Medications for Attention Deficit/Hyperactivity

Disorder

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Sample Questions

Q1) A child is diagnosed with AD/HD after being expelled from school for disruptive behaviors.The child's parents are reluctant to start medication because of the stigma attached.The primary care NP should suggest:

A) Ritalin.

B) Concerta.

C) Adderall.

D) Dexedrine.

Q2) A patient who has recently begun working at night reports having difficulty staying awake at work.The primary care NP should consider prescribing: A) caffeine.

B) modafinil (Provigil).

C) methylphenidate (Ritalin).

D) dextroamphetamine (Dexedrine).

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Chapter 42: Medications for Dementia

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Sample Questions

Q1) A patient who has Alzheimer's disease is taking 10 mg of donepezil daily and reports difficulty sleeping.The primary care NP should recommend:

A) decreasing the dose to 5 mg.

B) increasing the dose to 15 mg.

C) taking the drug in the morning.

D) taking the drug in the evening.

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).

Q3) A patient is newly diagnosed with Alzheimer's disease stage 6 on the Global Deterioration Scale.The primary care NP should prescribe:

A) donepezil (Aricept).

B) rivastigmine (Exelon).

C) memantine (Namenda).

D) galantamine (Razadyne).

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Chapter 43: Analgesia and Pain Management

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Sample Questions

Q1) A patient who is a recovering alcoholic is preparing for surgery and expresses fears about using opioid analgesics postoperatively for pain.The primary care NP should tell the patient:

A) that opioids should not be used.

B) to take a very low dose of the opioid.

C) that nonsteroidal antiinflammatory drugs will be the only safe option.

D) that opioids are safe when taken as directed.

Q2) A patient has pain caused by a chronic condition.The patient is reluctant to take opioids because of a fear of addiction.The primary care NP should tell the patient that opioids:

A) carry a high risk of psychological dependence when used long-term.

B) will help to improve the patient's functional outcomes and quality of life.

C) will eventually become ineffective for treating pain when used over a long period.

D) may require switching from one type of opioid to another to prevent tolerance over time.

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Chapter 44: Migraine Medications

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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 who has migraine headaches takes sumatriptan as abortive therapy.The patient tells the primary care nurse practitioner (NP)that the sumatriptan is effective for stopping symptoms but that the episodes are occurring three to four times per month.The NP should consider the addition of:

A) aspirin.

B) topiramate.

C) ergotamine.

D) opioid analgesics.

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Chapter 45: Antiepileptics

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Sample Questions

Q1) 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.

Q2) A patient who takes carbamazepine (Tegretol)has been seizure-free for 2 years and asks the primary care NP about stopping the medication.The NP should:

A) order an electroencephalogram (EEG).

B) prescribe a tapering regimen of the drug.

C) inform the patient that antiepileptic drug (AED) therapy is lifelong.

D) tell the patient to stop the drug and use only as needed.

Q3) A patient is newly diagnosed with generalized epilepsy.The primary care NP will refer this patient to a neurologist and should expect this patient to begin taking:

A) phenytoin (Dilantin).

B) topiramate (Topamax).

C) lamotrigine (Lamictal).

D) levetiracetam (Keppra).

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Chapter 46: Antiparkinson Agents

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Q1) A patient who takes levodopa and carbidopa for Parkinson's disease reports experiencing freezing episodes between doses.The primary care NP should consider using:

A) selegiline.

B) amantadine.

C) apomorphine.

D) modified-release levodopa.

Q2) A patient who has Parkinson's disease takes levodopa and carbidopa.The patient reports experiencing tremors between doses.The primary care NP should:

A) add entacapone.

B) add amantadine.

C) discontinue the carbidopa.

D) increase the dose of levodopa.

Q3) 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).

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Page 48

Chapter 47: Antidepressants

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Q1) A 15-year-old patient who is seeing a psychiatrist began taking an antidepressant 1 week before a clinic visit with the primary care NP.The NP should:

A) schedule weekly clinic visits to evaluate response to the medication.

B) encourage the child to report feelings of self-harm to a school counselor.

C) contact the patient by phone every 2 weeks to see how the medication is working.

D) instruct the child's parents to report changes in behavior to the child's psychiatrist.

Q2) The primary care NP sees a 16-year-old patient who reports feeling hopeless and sad.The child's parent reports increased aggression and a decline in school performance.The NP should consider prescribing:

A) fluoxetine (Prozac).

B) nortriptyline (Pamelor).

C) tranylcypromine (Parnate).

D) venlafaxine hydrochloride (Effexor).

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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) An adolescent patient comes to the clinic and reports anxiety and poor sleep that have persisted since experiencing a hurricane 8 months prior.The patient has been receiving cognitive-behavioral therapy,which has helped a little.The primary care NP should order:

A) doxepin.

B) fluoxetine.

C) alprazolam.

D) clonazepam.

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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 takes 150 mg of clozapine (Clozaril)twice daily calls the primary care NP at 10:00 AM one day to report forgetting to take the 8:00 AM dose.The NP should counsel the patient to:

A) take the missed dose now.

B) take 75 mg of clozapine now.

C) wait and take the evening dose at the usual time.

D) take the evening dose 2 hours earlier than usual.

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) The primary care NP is preparing to prescribe acamprosate for a patient who is an alcoholic.Before initiating treatment with this medication,the NP should:

A) assess renal function.

B) obtain liver function tests.

C) teach the patient never to take the drug with alcohol.

D) tell the patient that this medication is used to treat withdrawal symptoms.

Q2) A mother brings her a college-age son to the primary care NP and asks the NP to talk to him about alcohol use.He reports binge drinking on occasion and drinking only beer on weekends.The NP notes diaphoresis,tachycardia,and an easy startle reflex.The NP should:

A) admit him to the hospital for detoxification.

B) ask him how much he had to drink last night.

C) prescribe lorazepam (Ativan) to help with symptoms.

D) suggest that he talk to a counselor about alcohol abuse.

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Chapter 51: Glucocorticoids

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Q1) A patient will require a long course of steroids to treat a chronic inflammatory condition.The primary care NP expects the specialist to order:

A) prednisone daily.

B) triamcinolone daily.

C) hydrocortisone every other day.

D) dexamethasone every other day.

Q2) 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.

Q3) A primary care NP prescribes an oral steroid to a patient and provides teaching about the medication.Which statement by the patient indicates a need for further teaching?

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

B) "I will take the medication at 8:00 AM each day."

C) "I can expect a decreased appetite while I am taking this medication."

D) "I should not stop taking the medication without consulting my provider."

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Page 53

Chapter 52: Thyroid Medications

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Sample Questions

Q1) A child who has congenital hypothyroidism takes levothyroxine 75 mcg/day.The child weighs 15 kg.The primary care NP sees the child for a 3-year-old check-up.The NP should consult with a pediatric endocrinologist to discuss:

A) increasing the dose to 90 mcg/day.

B) decreasing the dose to 30 mcg/day.

C) stopping the medication and checking TSH and T4 in 4 weeks.

D) discussing the need for lifetime replacement therapy with the child's parents.

Q2) A patient has been taking levothyroxine 100 mcg daily for several months.The patient comes to the clinic with complaints of insomnia and irritability.The primary care NP notes a heart rate of 92 beats per minute.The NP should:

A) change to liothyronine 75 mcg/day.

B) discontinue levothyroxine indefinitely.

C) order propylthiouracil to counter the increased thyroid levels.

D) order TSH and T₄ levels and decrease the dose to 75 mcg/day.

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Chapter 53: Diabetes Mellitus Agents

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Sample Questions

Q1) A 30-year-old white woman has a BMI of 26 and weighs 150 lb.At an annual physical examination,the patient's fasting plasma glucose is 130 mg/dL.The patient walks 1 mile three or four times weekly.She has had two children who weighed 7 lb and 8 lb at birth.Her personal and family histories are noncontributory.The primary care NP should:

A) order metformin (Glucophage).

B) order a lipid profile, complete blood count, and liver function tests (LFTs).

C) order an oral glucose tolerance test.

D) set a weight loss goal of 10 to 15 lb.

Q2) A patient who is newly diagnosed with type 2 diabetes mellitus has not responded to changes in diet or exercise.The patient is mildly obese and has a fasting blood glucose of 130 mg/dL.The patient has normal renal function tests.The primary care NP plans to prescribe a combination product.Which of the following is indicated for this patient?

A) Metformin/glyburide (Glucovance)

B) Insulin and metformin (Glucophage)

C) Saxagliptin/metformin (Kombiglyze)

D) Metformin/pioglitazone (ACTOplus met)

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55

Chapter 54: Contraceptives

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12 Flashcards

Source URL: https://quizplus.com/quiz/19030

Sample Questions

Q1) A sexually active patient tells the primary care NP that she has been unable to get her new COCP pill pack until today and has missed 3 days of pills.The NP should tell her to:

A) use backup contraception and take 2 pills each day for the next 2 days.

B) begin a new pack of pills today and use backup contraception for 7 days.

C) begin a new pack of pills today, take a Plan B pill, and use backup contraception for 7 days.

D) Take a pregnancy test, begin a new pack of pills today, and use backup contraception for 7 days.

Q2) An adolescent girl has chosen Depo-Provera as a contraceptive method and tells the primary care NP that she likes the fact that she won't have to deal with pills or periods.The primary care NP should tell her that she:

A) should consider another form of contraception after 1 year.

B) may have irregular bleeding, especially in the first month or so.

C) will need to take calcium and vitamin D every day while using this method.

D) will have to take oral contraceptive pills in addition to Depo-Provera when she takes antibiotics.

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Page 56

Chapter 55: Hormone Replacement Therapy

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12 Verified Questions

12 Flashcards

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

Sample Questions

Q1) 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.

Q2) A perimenopausal woman tells the primary care NP that she is having hot flashes and increasingly severe mood swings.The woman has had a hysterectomy.The NP should prescribe:

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 woman who is being treated with radiotherapy for breast cancer asks her primary care nurse practitioner (NP)about using dietary supplements to improve her chance of recovery.The NP should tell her that:

A) vitamin E is not harmful but has not been shown to change outcomes.

B) no supplements have been shown to alter outcomes or response to therapy.

C) folic acid and other B vitamins may improve ability to tolerate chemotherapy.

D) vitamin C, taken at least 6 days per week, may lower her risk of cancer recurrence.

Q2) 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.

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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 comes to the clinic with a history of fever of 102° F for several days,poor appetite,and cough.A sputum culture is pending,but Gram stain indicates a bacterial infection.The primary care nurse practitioner (NP)should:

A) begin empirical antibiotic therapy.

B) use a broad-spectrum antibiotic for initial treatment.

C) prescribe an antibiotic when culture and sensitivity results are known.

D) offer symptomatic treatment only unless the patient's condition worsens.

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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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 woman has a urinary tract infection (UTI)and has been taking TMP-SMX for 3 days along with increased fluids.She reports continued dysuria and urinary frequency and has a consistent,low-grade fever.The primary care NP should:

A) prescribe ciprofloxacin twice daily for 3 days.

B) order doxycycline twice daily for 7 to 14 days.

C) prescribe amoxicillin-clavulanate twice daily for 7 days.

D) order TMP-SMX DS twice daily for 7 days.

Q2) A primary care NP sees a patient who reports a 2-week history of nasal congestion and runny nose.The NP performs a history and learns that the nasal discharge has changed from yellow to green in the past few days,accompanied by a fever of 102° F and unilateral facial pain.To treat this patient,the NP should:

A) order azithromycin daily for 5 days.

B) prescribe cefdinir twice daily for 10 days.

C) prescribe amoxicillin-clavulanate twice daily for 10 days.

D) recommend symptomatic treatment because this is probably a viral infection.

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Page 60

Chapter 59: Penicillins

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7 Verified Questions

7 Flashcards

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

Sample Questions

Q1) 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.

Q2) A patient was seen in a local emergency department and was treated empirically for pharyngitis with ampicillin and comes to the clinic 2 days later with an urticarial rash.The patient has no previous history of atopy and does not have respiratory symptoms.The primary care NP should suspect:

A) scarlatina.

B) mononucleosis.

C) serum sickness.

D) penicillin allergy.

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Chapter 60: Cephalosporins

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7 Verified Questions

7 Flashcards

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

Sample Questions

Q1) A primary care NP provides teaching to a patient who will begin taking cefadroxil (Duricef).Which statement by the patient indicates a need for further teaching?

A) "I should report any rash that occurs."

B) "I will take this medication twice daily."

C) "I should take this medication with food."

D) "Gastrointestinal (GI) symptoms are common but not worrisome."

Q2) A patient is taking cefadroxil (Duricef)and comes to the clinic complaining of loose stools for several days.The primary care NP notes normal vital signs; warm,pink skin with elastic turgor; and moist mucous membranes.The NP should:

A) order tests for Clostridium difficile-associated disease (CDAD).

B) discontinue the cefadroxil.

C) reassure the patient that loose stools are common with antibiotics.

D) recommend consuming lactobacillus-containing foods to minimize diarrhea.

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Chapter 61: Tetracyclines

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4 Flashcards

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 patient has urethritis.The primary care NP should prescribe:

A) minocycline.

B) doxycycline.

C) tetracycline.

D) demeclocycline.

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Chapter 62: Macrolides

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6 Flashcards

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

Sample Questions

Q1) A patient has had severe diarrhea for 2 weeks.Laboratory testing reveals Clostridium difficile.The primary care NP should prescribe:

A) erythromycin.

B) azithromycin.

C) fidaxomicin.

D) clarithromycin.

Q2) A primary care NP sees a 6-month-old patient who has a persistent staccato cough.The NP is aware that there is a pertussis outbreak in the community.The NP should obtain appropriate cultures and treat empirically with:

A) erythromycin.

B) azithromycin.

C) clarithromycin.

D) telithromycin.

Q3) Which antibiotic requires administration of a loading dose?

A) Ilosone

B) E-Mycin

C) Erythrocin

D) Zithromax

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Chapter 63: Fluoroquinolones

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

Sample Questions

Q1) A patient who is taking a fluoroquinolone antibiotic for pyelonephritis develops Clostridium difficile-associated disease (CDAD).The primary care NP should treat for C.difficile and _____ fluoroquinolone.

A) continue the B) discontinue the C) increase the dose of D) decrease the dose of

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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4 Flashcards

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

Sample Questions

Q1) 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.

Q2) A patient who was hospitalized for an infection was treated with an aminoglycoside antibiotic.The patient asks the primary care nurse practitioner (NP)why outpatient treatment wasn't an option.The NP should tell the patient that aminoglycoside antibiotics:

A) are more likely to be toxic.

B) cause serious adverse effects.

C) carry more risk for serious allergic reactions.

D) must be given intramuscularly or intravenously.

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Chapter 65: Sulfonamides

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7 Flashcards

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

Sample Questions

Q1) 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."

Q2) An 80-year-old patient who has COPD takes TMP/SMX for acute exacerbations,which occur three or four times each year.To monitor this patient for adverse drug reactions,the primary care NP should order:

A) liver function tests.

B) blood urea nitrogen and creatinine.

C) serum bilirubin levels.

D) a complete blood count (CBC) with differential.

Q3) 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.

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Chapter 66: Antitubercular Agents

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8 Verified Questions

8 Flashcards

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

Sample Questions

Q1) A patient who has been taking medications to treat TB tells the primary care NP that the infectious disease specialist has added ethambutol to the drug regimen.The patient asks the NP for information about this drug.The NP should explain that this drug:

A) should be taken 1 hour before or 2 hours after a meal.

B) should not be taken by patients who have renal impairment.

C) requires more frequent monitoring of LFTs.

D) means the patient will need regular vision examinations and evaluation of color vision.

Q2) A patient who is taking isoniazid and rifampin for latent TB is seen by the primary care NP for a routine follow-up visit.The patient reports having nausea,vomiting,and a decreased appetite.The NP should:

A) ask about alcohol intake.

B) suggest taking the medications with food.

C) reassure the patient that these side effects are common.

D) order liver and renal function tests and serum glucose.

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68

Chapter 67: Antifungals

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6 Flashcards

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

Sample Questions

Q1) A female patient has vaginal candidiasis and has taken a single dose of fluconazole without resolution of the infection.The primary care NP obtains a culture and should order:

A) oral ketoconazole.

B) griseofulvin for 4 weeks.

C) another dose of fluconazole.

D) topical miconazole (Monistat).

Q2) A parent brings a 6-year-old child to the clinic for evaluation of a rash.The primary care NP notes three annular lesions with elevated borders and central clearing on the child's face and a similar lesion on the back of the neck that extends above the hairline.The NP should prescribe:

A) fluconazole.

B) griseofulvin.

C) oral ketoconazole.

D) topical ketoconazole.

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Chapter 68: Antiretroviral Medications

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6 Flashcards

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

Sample Questions

Q1) A patient has begun treatment for HIV.The primary care NP should monitor the patient's complete blood count (CBC)at least every _____ months.

A) 1 to 3

B) 3 to 6

C) 6 to 9

D) 9 to 12

Q2) A female patient who is 8 weeks pregnant is seen by a primary care nurse practitioner (NP)after a routine prenatal screen was positive for human immunodeficiency virus (HIV).A CD4 cell count is 750 cells/mm.The NP should:

A) begin immediate therapy with zidovudine and lamivudine.

B) begin therapy with zidovudine when she is in her second trimester.

C) delay treatment with antiretroviral medications until after her pregnancy.

D) initiate therapy with zidovudine if her CD4 cell count decreases to 500 cells/mm.

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Chapter 69: Antiviral and Antiprotozoal Agents

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8 Flashcards

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

Sample Questions

Q1) 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).

Q2) A patient refuses an influenza vaccine and asks the primary care nurse practitioner (NP)if the influenza medications will prevent him from getting influenza.The NP should tell the patient that although the influenza vaccine remains the best protection against influenza:

A) amantadine may be given prophylactically.

B) rimantadine is curative if given early after exposure.

C) zanamivir can be used before or after exposure to influenza A or B.

D) the influenza vaccine is unnecessary because antiviral medications are so effective.

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Chapter 70: The Immune System and Immunizations

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16 Verified Questions

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

Sample Questions

Q1) The primary care NP sees a 6-month-old infant for a routine physical examination and notes that the infant has a runny nose and a cough.The parents report a 2-day history of a temperature of 99° F to 100° F and two to three loose stools per day.Other family members have similar symptoms.The infant has had two sets of immunizations at 2 and 4 months of age.The NP should:

A) administer the 6-month immunizations at this visit today.

B) schedule an appointment in 2 weeks for 6-month immunizations.

C) administer DTaP, Hib, IPV, hepatitis B, and PCV13 today and RV in 2 weeks.

D) withhold all immunizations until the infant's temperature returns to normal and the cough is gone.

Q2) The primary care NP performs a physical examination on an 89-year-old patient who is about to enter a skilled nursing facility.The patient reports having had chickenpox as a child.The NP should:

A) obtain a varicella titer.

B) administer the Varivax vaccine.

C) give the patient the Zostavax vaccine.

D) plan to prescribe Zovirax if the patient is exposed to shingles.

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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 man with a BMI of 38 and a waist size of 48 inches is seen in the clinic for an annual well check-up.The primary care NP orders laboratory tests and notes a fasting plasma glucose of 110 mg/dL,triglyceride level of 220 mg/dL,and high-density lipoprotein level of 40 mg/dL.The man's blood pressure is 160/110 mm Hg.The man has a history of cardiovascular disease and tells the NP he has tried to lose weight numerous times.The NP should consider:

A) orlistat (Xenical).

B) phentermine (Adipex-P).

C) an oral antidiabetic agent.

D) a strict low-fat, low-sodium diet.

Q2) A patient who weighs 170 lb wishes to lose weight,with a target weight goal of 125 lb.To initiate a program that will result in a loss of 1 lb per week,the primary care NP should recommend a dietary intake of _____ kcal.

A) 1000

B) 1200

C) 1700

D) 2000

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Chapter 72: Smoking Cessation

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7 Flashcards

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

Sample Questions

Q1) 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.

Q2) A patient who is using a nicotine patch for smoking cessation is in the clinic for a follow-up examination.The primary care NP notes a heart rate of 96 beats per minute and a blood pressure of 140/90 mm Hg.The patient reports feeling dizzy and complains of ringing in both ears.The NP should suspect:

A) nicotine withdrawal symptoms.

B) that the patient has been smoking. C) hypersensitivity reaction to the nicotine patch.

D) minor cardiovascular effects of the nicotine patch.

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Chapter 73: Vitamins and Minerals

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

Sample Questions

Q1) A patient reports fatigue and increased frequency of stools over the past week and reports having just begun a regimen of dietary changes to prevent hypertension.The primary care NP notes a rapid,irregular heart rate and a blood pressure of 92/58 mm Hg.The NP should question the patient about:

A) caffeine intake.

B) B vitamin intake.

C) fat-soluble vitamins.

D) use of salt substitutes.

Q2) As patients age,it becomes particularly important to increase their intake of:

A) iron.

B) omega 3.

C) vitamin C.

D) B vitamins.

Q3) The parents of a 3-year-old child tell the primary care NP that their child is a very picky eater and they are worried about the child's nutrition.The NP should recommend:

A) giving the child a daily multivitamin containing iron.

B) providing small portions of a variety of foods at each meal.

C) disciplining the child at mealtimes to ensure proper nutrition.

D) making sure the child's cereals are fortified with vitamins and minerals.

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