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Sample Questions

Chapter1IssuesforthePractitionerinDrugTherapy

MULTIPLECHOICE

1. Nursepractitionerprescriptiveauthorityisregulatedby:

1. TheNationalCouncilofStateBoardsofNursing

2. TheS.DrugEnforcementAdministration

3. TheStateBoardofNursingforeachstate

4. TheStateBoardofPharmacy

2. PhysicianAssistant(PA)prescriptiveauthorityisregulatedby:

1. TheNationalCouncilofStateBoardsofNursing

2. TheS.DrugEnforcementAdministration

3. TheStateBoardofNursing

4. TheStateBoardofMedicalExaminers

3. Clinicaljudgmentinprescribingincludes:

1. Factoringinthecosttothepatientofthemedicationprescribed

2. Alwaysprescribingthenewestmedicationavailableforthediseaseprocess

3. Handingoutdrugsamplestopoorpatients

4. Prescribingallgenericmedicationstocutcosts

4. Criteriaforchoosinganeffectivedrugforadisorderinclude:

1. Askingthepatientwhatdrugtheythinkwouldworkbestforthem

2. Consultingnationallyrecognizedguidelinesfordiseasemanagement

3. Prescribingmedicationsthatareavailableassamplesbeforewritingaprescription

4. S.DrugEnforcementAdministration(DEA)guidelinesforprescribing

5. Nursepractitionerpracticemaythriveunderhealth-carereformdueto:

1. Thedemonstratedabilityofnursepractitionerstocontrolcostsandimprovepatientoutcomes

2. Thefactthatnursepractitionerswillbeabletopracticeindependently

3. Thefactthatnursepractitionerswillhavefullreimbursementunderhealth-carereform

4. TheabilitytoshiftaccountabilityforMedicaidtothestatelevel

Chapter2.PharmacokineticBasisofTherapeuticsandPharmacodynamic

MULTIPLECHOICE

1. Apatient’snutritionalintakeandThisiscriticaltoprescribingbecause:

1. Distributionofdrugstotargettissuemaybeaffected

2. Thesolubilityofthedrugwillnotmatchthesiteofabsorption

3. Therewillbelessfreedrugavailabletogenerateaneffect

4. Drugsboundtoalbuminarereadilyexcretedbythekidney

2. Drugsthathaveasignificantfirst-passeffect:

1. Mustbegivenbytheenteral(oral)routeonly

2. Bypassthehepaticcirculation

3. Arerapidlymetabolizedbytheliverandmayhavelittleifanydesiredaction

4. Areconvertedbythelivertomoreactiveandfat-solubleforms

3. Therouteofexcretionofavolatiledrugwilllikelybe:

1. Thekidneys

2. Thelungs

3. Thebileandfeces

4. Theskin

4. Medroxyprogesterone(DepoProvera)isprescribedIMtocreateastoragereservoirStoragereservoirs:

1. Assurethatthedrugwillreachitsintendedtargettissue

2. Arethereasonforgivingloadingdoses

3. Increasethelengthoftimeadrugisavailableandactive

4. Aremostcommonincollagentissues

5. TheNPchoosestogivecephalexinevery8hoursbasedonknowledgeofthedrug’s:

1. Propensitytogotothetargetreceptor

2. Biologicalhalf-life

3. Pharmacodynamics

4. Safetyandsideeffects

6. Azithromycindosingrequiresthefirstday’sdosebetwicethoseoftheother4daysoftheThisisconsideredaloadingdose.Aloadingdose:

1. Rapidlyachievesdruglevelsinthetherapeuticrange

2. Requiresfourtofivehalf-livestoattain

3. Isinfluencedbyrenalfunction

1. Isdirectlyrelatedtothedrugcirculatingtothetargettissues

7. Thepointintimeonthedrugconcentrationcurvethatindicatesthefirstsignofatherapeuticeffectisthe:

1. Minimumadverseeffectlevel

2. Peakofaction

3. Onsetofaction

4. Therapeuticrange

8. PhenytoinrequiresPeakandtroughlevelsaredone:

1. Whenthedrughasawidetherapeuticrange

2. Whenthedrugwillbeadministeredforashorttimeonly

3. Whenthereisahighcorrelationbetweenthedoseandsaturationofreceptorsites

4. Todetermineifadrugisinthetherapeuticrange

9. AlaboratoryresultindicatesthepeaklevelforadrugisabovetheminimumtoxicThismeansthatthe:

1. Concentrationwillproducetherapeuticeffects

2. Concentrationwillproduceanadverseresponse

3. Timebetweendosesmustbeshortened

4. Durationofactionofthedrugistoolong

10. Drugsthatarereceptoragonistsmaydemonstratewhatproperty?

1. Irreversiblebindingtothedrugreceptorsite

2. Up-regulationwithchronicuse

3. Desensitizationordown-regulationwithcontinuoususe

4. Inverserelationshipbetweendrugconcentrationanddrugaction

11. Drugsthatarereceptorantagonists,suchasbetablockers,maycause:

1. Down-regulationofthedrugreceptor

2. Anexaggeratedresponseifabruptlydiscontinued

3. Partialblockadeoftheeffectsofagonistdrugs

4. Anexaggeratedresponsetocompetitivedrugagonists

12. Factorsthataffectgastricdrugabsorptioninclude:

1. Liverenzymeactivity

2. Protein-bindingpropertiesofthedrugmolecule

3. Lipidsolubilityofthedrug

4. Abilitytochewandswallow

13. Drugsadministeredviaintravenous(IV)route:

1. Needtobelipidsolubleinordertobeeasilyabsorbed

2. Begindistributionintothebodyimmediately

3. Areeasilyabsorbediftheyarenonionized

4. Mayusepinocytosistobeabsorbed

14. Whenamedicationisaddedtoaregimenforasynergisticeffect,thecombinedeffectofthedrugsis:

1. Thesumoftheeffectsofeachdrugindividually

2. Greaterthanthesumoftheeffectsofeachdrugindividually

3. Lessthantheeffectofeachdrugindividually

4. Notpredictable,asitvarieswitheachindividual

15. Whichofthefollowingstatementsaboutbioavailabilityistrue?

1. Bioavailabilityissuesareespeciallyimportantfordrugswithnarrowtherapeuticrangesor

2. Allbrandsofadrughavethe

3. Drugsthatareadministeredmorethanonceadayhavegreaterbioavailabilitythan

4. Combininganactivedrugwithaninertsubstancedoesnotaffect

16. Whichofthefollowingstatementsaboutthemajordistributionbarriers(blood-brainorfetal-placental)istrue?

1. Watersolubleandionizeddrugscrossthese

2. Theblood-brainbarrierslowstheentryofmanydrugsintoandfrombrain

3. Thefetal-placentalbarrierprotectsthefetusfromdrugstakenbythe

4. Lipidsolubledrugsdonotpassthesebarriersandaresafeforpregnant

17. DrugsaremetabolizedmainlybytheliverviaPhaseIorPhaseIIThepurposeofbothofthesetypesofreactionsisto:

1. Inactivateprodrugsbeforetheycanbeactivatedbytargettissues

2. Changethedrugssotheycancrossplasmamembranes

3. Changedrugmoleculestoaformthatanexcretoryorgancanexcrete

4. Makethesedrugsmoreionizedandpolartofacilitateexcretion

18. Oncetheyhavebeenmetabolizedbytheliver,themetabolitesmaybe:

1. Moreactivethantheparentdrug

2. Lessactivethantheparentdrug

3. Totally“deactivated”sothattheyareexcretedwithoutanyeffect

4. Alloftheabove

19. AlldrugscontinuetoactinthebodyuntiltheyarechangedorTheabilityofthebodytoexcretedrugsviatherenalsystemwouldbeincreasedby:

1. Reducedcirculationandperfusionofthekidney

2. Chronicrenaldisease

3. Competitionforatransportsitebyanotherdrug

4. Unbindinganonvolatiledrugfromplasmaproteins

20. Steadystateis:

1. Thepointonthedrugconcentrationcurvewhenabsorptionexceedsexcretion

2. Whentheamountofdruginthebodyremainsconstant

3. WhentheamountofdruginthebodystaysbelowtheMTC

4. Alloftheabove

21. TwodifferentpainmedsaregiventogetherforpainThedrug-druginteractionis:

1. Synergistic

2. Antagonistic

3. Potentiative

4. Additive

22. Actionstakentoreducedrug-druginteractionproblemsincludeallofthefollowingEXCEPT:

1. Reducingthedoseofoneofthedrugs

2. Schedulingtheiradministrationatdifferenttimes

3. Prescribingathirddrugtocounteracttheadversereactionofthecombination

4. Reducingthedosageofbothdrugs

23. PhaseIoxidative-reductiveprocessesofdrugmetabolismrequireWhichofthefollowingwouldreduceorinhibitthisprocess?

1. Proteinmalnutrition

2. Irondeficiencyanemia

3. BothAandB

4. NeitherAnorB

24. Thetimerequiredfortheamountofdruginthebodytodecreaseby50%iscalled:

1. Steadystate

2. Half-life

3. PhaseIImetabolism

4. Reducedbioavailabilitytime

25. AnagonistactivatesareceptorandstimulatesWhengivenfrequentlyovertimethebodymay:

1. Up-regulatethetotalnumberofreceptors

2. Blockthereceptorwithapartialagonist

3. Alterthedrug’smetabolism

4. Down-regulatethenumbersofthatspecificreceptor

26. Drugantagonismisbestdefinedasaneffectofadrugthat:

1. Leadstomajorphysiologicpsychologicaldependence

2. Ismodifiedbytheconcurrentadministrationofanotherdrug

3. Cannotbemetabolizedbeforeanotherdoseisadministered

4. Leadstoadecreasedphysiologicresponsewhencombinedwithanotherdrug

27. Instructionstoaclientregardingself-administrationoforalenteric-coatedtabletsshouldincludewhichofthefollowingstatements?

1. “Avoidanyotheroralmedicineswhiletaking”

2. “Ifswallowingthistabletisdifficult,dissolveitin3ouncesoforange”

3. “Thetabletmaybecrushedifyouhaveanydifficultlytaking”

4. “Toachievebesteffect,takethetabletwith”

28. Themajorreasonfornotcrushingasustainedreleasecapsuleisthat,ifcrushed,thecoatedbeadsofthedrugscouldpossiblyresultin:

1. Disintegration

2. Toxicity

3. Malabsorption

4. Deterioration

29. Whichofthefollowingsubstancesisthemostlikelytobeabsorbedintheintestinesratherthaninthestomach?

1. Sodiumbicarbonate

2. Ascorbicacid

3. Salicylicacid

4. Glucose

30. Whichofthefollowingvariablesisafactorindrugabsorption?

1. Thesmallerthesurfaceareaforabsorption,the

2. Arichbloodsupplytotheareaofabsorptionleadstobetter

3. Thelesssolublethedrug,themoreeasilyitis

4. Ionizeddrugsareeasilyabsorbedacrossthecell

31. Anadvantageofprescribingasublingualmedicationisthatthemedicationis:

1. Absorbedrapidly

2. Excretedrapidly

3. Metabolizedminimally

4. Distributedequally

32. DrugsthatuseCYP3A4isoenzymesformetabolismmay:

1. Inducethemetabolismofanotherdrug

2. Inhibitthemetabolismofanotherdrug

3. BothAandB

4. NeitherAnorB

33. TherapeuticdruglevelsaredrawnwhenadrugDrugsreachsteadystate:

1. Aftertheseconddose

2. Afterfourtofivehalf-lives

3. Whenthepatientfeelsthefulleffectofthedrug

4. OnehourafterIVadministration

34. Up-regulationorhypersensitizationmayleadto:

1. Increasedresponsetoadrug

2. Decreasedresponsetoadrug

3. Anexaggeratedresponseifthedrugiswithdrawn

4. Refractorinessorcompletelackofresponse

Chapter3.ImpactofDrugInteractionsandAdverseEventsonTherapeutics

MULTIPLECHOICE

1. Whichofthefollowingpatientswouldbeathigherriskofexperiencingadversedrugreactions(ADRs):

1. A32-year-oldmale

2. A22-year-oldfemale

3. A3-month-oldfemale

4. A48-year-oldmale

2. InfantsandyoungchildrenareathigherriskofADRsdueto:

1. Immaturerenalfunctioninschool-agechildren

2. Lackofsafetyandefficacystudiesinthepediatricpopulation

3. Children’sskinbeingthickerthanadults,requiringhigherdosagesoftopicalmedication

4. Infantboyshavingahigherproportionofmusclemass,leadingtoahighervolumeofdistribution

3. TheelderlyareathighriskofADRsdueto:

1. Havinggreatermusclemassthanyoungeradults,leadingtohighervolumeofdistribution

2. Theextensivestudiesthathavebeenconductedondrugsafetyinthisagegroup

3. Theblood-brainbarrierbeinglesspermeable,requiringhigherdosestoachievetherapeuticeffect

4. Age-relateddecreaseinrenalfunction

4. Thetypeofadversedrugreactionthatistheresultofanunwantedbutotherwisenormalpharmacologicalactionofadruggivenintheusualtherapeuticdosesis

1. TypeA

2. TypeB

3. TypeC

4. TypeD

5. DigoxinmaycauseaTypeAadversedrugreactiondueto:

1. Idiosyncraticeffects

2. Itsnarrowtherapeuticindex

3. Beingateratogen

4. Beingacarcinogen

6. Changesintheindividualpharmacokineticparametersofadsorption,distribution,oreliminationmayresultinhighconcentrationsofthedruginthebody,leadingtowhichtypeofadversedrugreaction?

1. TypeA

2. TypeC

3. TypeD

4. TypeE

7. AccordingtotheWorldHealthOrganizationClassification,TypeBadversereactionsare:

1. Whenadrugisateratogen

2. Whenadrugiscarcinogenic

3. AdelayedADR,suchasrenalfailure

4. Anallergicoridiosyncraticresponse

8. SarahdevelopedarashafterusingatopicalThisisaType allergicdrugreaction.

1. I

2. II

3. III

4. IV

9. ApatientmaydevelopneutropeniafromusingtopicalSilvadeneNeutropeniaisa(n):

1. Cytotoxichypersensitivityreaction

2. Immunecomplexhypersensitivity

3. Immediatehypersensitivityreaction

4. Delayedhypersensitivityreaction

10. Anaphylacticshockisa:

1. TypeIreaction,calledimmediatehypersensitivityreaction

2. TypeIIreaction,calledcytotoxichypersensitivityreaction

3. TypeIIIallergicreaction,calledimmunecomplexhypersensitivity

4. TypeIVallergicreaction,calleddelayedhypersensitivityreaction

11. Jameshashypothalamic-pituitary-adrenalaxissuppressionfromchronicprednisone(acorticosteroid)Heisatriskforwhattypeofadversedrugreaction?

1. TypeB

2. TypeC

3. TypeE

4. TypeF

12. Thetreatmentforapatientwhoexperienceshypothalamic-pituitary-adrenalaxissuppressionwhiletakingthecorticosteroidprednisone,aTypeCadversedrugreaction,isto:

1. Immediatelydiscontinuetheprednisone

2. Administerepinephrine

3. Slowlytaperthepatientoffoftheprednisone

4. Monitorforlong-termeffects,suchascancer

13. TheACEinhibitorlisinoprilTeratogenscauseType adversedrugreaction.

1. A

2. B

3. C

4. D

14. CardiacdefectsareaknownTypeDadversedrugreactiontoLithiumcausesaTypeDadversedrugreactionbecauseitis:

1. Animmunosuppressant

2. Acarcinogen

3. Ateratogen

4. Anantiseizuremedication

15. ImmunomodulatorssuchasazathioprinemaycauseadelayedadversedrugreactionknownasaTypeDreactionbecausetheyareknown:

1. Teratogens

2. Carcinogens

3. Tocausehypersensitivityreactions

4. Hypothalamus-pituitary-adrenal(HPA)axissuppressants

16. A24-year-oldmalereceivedmultiplefracturesinamotorvehicleaccidentthatrequiredsignificantamountsofopioidmedicationtotreathisHeisatriskforType adversedrugreactionwhenhenolongerrequirestheopioids.

1. A

2. C

3. E

4. G

17. DrugsthatmaycauseaTypeEadversedrugreactioninclude:

1. Betablockers

2. Immunomodulators

3. Antibiotics

4. Oralcontraceptives

18. UnexpectedfailureofdrugtherapyisaType adversedrugreaction,commonlycausedby .

1. B;cytotoxichypersensitivity

2. B;idiosyncraticresponse

3. C;cumulativeeffectsofdrug

4. F;drug-druginteraction

19. Clopidogreltreatmentfailuremayoccurwhenitisco-administeredwithomeprazole,knownasaType adversedrug

1. A

2. C

3. E

4. F

Chapter4.PrinciplesofPharmacotherapyinChildren

MULTIPLECHOICE

1. ThePediatricResearchEquityActsrequires:

1. Allchildrenbeprovidedequalaccesstodrugresearchtrials

2. Childrentobeincludedintheplanningphaseofnewdrugdevelopment

3. Thatpediatricdrugtrialsguaranteechildrenofmultipleethnicgroupsareincluded

4. Allapplicationsfornewactiveingredients,newindications,newdosageforms,ornewroutesofadministrationrequirepediatricstudies

2. TheBestPharmaceuticalsforChildrenAct:

1. Includesapediatricexclusivityrulewhichextendsthepatentondrugsstudiedinchildren

2. Establishesacommitteethatwritesguidelinesforpediatricprescribing

3. Providesfundingfornewdrugdevelopmentaimedatchildren

4. Encouragesmanufacturersspecificallytodeveloppediatricformulations

3. ThedevelopmentalvariationinPhaseIenzymeshaswhatimpactonpediatricprescribing?

1. None,PhaseIenzymesarestablethroughout

2. Childrenshouldalwaysbeprescribedlowerthanadultdosesperweightduetolowenzymeactivity

3. Childrenshouldalwaysbeprescribedhigherthanadultdosesperweightduetohigh

4. Prescribingdosageswillvarybasedonthedevelopmentalactivityofeachenzyme,attimesrequiringlowerthanadultdosesandothertimeshigherthanadultdosesbasedontheageofthe

4. Developmentalvariationinrenalfunctionhaswhatimpactonprescribingforinfantsandchildren?

1. Lowerdosesofrenallyexcreteddrugsmaybeprescribedtoinfantsyoungerthanage6

2. Higherdosesofwatersolubledrugsmayneedtobeprescribedduetoincreased

3. Renalexcretionrateshavenoimpact

4. Parentsneedtobeinstructedonwhetherdrugsarerenallyexcretedor

5. Topicalcorticosteroidsareprescribedcautiouslyinyoungchildrendueto:

1. Theymaycauseanintensehypersensitivityreaction

2. Hypothalamic-pituitary-adrenal(HPA)axissuppression

3. Corticosteroidsarelesseffectiveinyoungchildren

4. Youngchildrenmayaccumulatecorticosteroidsleadingtotoxiclevels

6. Lizaisbreastfeedingher2-month-oldsonandhasaninfectionthatrequiresanWhatdrugfactorsinfluencetheeffectofthedrugontheinfant?

1. Maternaldruglevels

2. Half-life

3. Lipid-solubility

4. Alloftheabove

7. Drugsthatareabsolutelycontraindicatedinlactatingwomeninclude:

1. Selectiveserotoninreuptakeinhibitors

2. Antiepilepticdrugssuchascarbamazepine

3. Antineoplasticdrugssuchasmethotrexate

4. Alloftheabove

8. Ziaisa4montholdwithotitisEducationofhisparentsregardingadministeringoralantibioticstoaninfantincludes:

1. Howtoadministeranoraldrugusingamedicationsyringe

2. Mixingthemedicationwithacoupleouncesofformulaandputtingitinabottle

3. Discontinuingtheantibioticifdiarrheaoccurs

4. Callingforanantibioticchangeiftheinfantchokesandsputtersduringadministration

9. Toincreaseadherenceinpediatricpatientsaprescriptionmedicationshould:

1. Haveashorthalf-life

2. Bethebesttastingoftheeffectivedrugs

3. Betheleastconcentratedformofthemedication

4. Beadministered3or4timesaday

10. Janieisa5-month-oldbreastfedinfantwithaTreatmentforherfevermayinclude:

1. “Baby”aspirin

2. Acetaminophensuppository

3. Ibuprofensuppository

4. Alternatingacetaminophenandibuprofen

Chapter5.PrinciplesofPharmacotherapyinPregnancyandLactation

MULTIPLECHOICE

1. TheclienthasbeenprescribedDoxylamine(Unisom)fortreatmentofnauseaandvomitingduringWhataspectoftheclient’shistorywillcausethenursetocontacttheprimaryhealthcareprovider?

1. Arthritis

2. Depression

3. Asthma

4. Hyperglycemia

2. ThenurseisteachingagroupofpregnantwomentheimportanceofadequatenutritionfortheThenurseinstructstheclientsthatfolicaciddeficiencyduringpreconceptionandearlyinpregnancycanresultin:

1. skeletal

3. intrauterinegrowth

4. small-for-gestational-age

3. AclientisorderedtoreceiveironandThenurseteachestheclientthatironandantacidsshouldbeadministered:

1. at

3. withtheantacid

4. withtheiron

4. Aclient,10weekspregnant,complainsofseverenauseaofMeclizine(Bonine)isprescribed.Theclientreportstothenursethatshehasbeguntoexperiencedizziness.Whatisthehighestprioritynursingintervention?

1. Contactthepharmacist;thisindicatesanoverdosageof

2. Contactthephysician;thisisanexpectedsideeffectofthe

3. Contactthepharmacist;thisindicatesincorrectpreparationofthe

4. Contactthephysician;thisisanadversereactiontothe

5. Aclientcomplainsofseverepregnancy-relatednauseaandisplacedonMeclizine(Bonine).ThenursenotesintheclienthistorythattheclientisundergoingtreatmentforWhatisthehighestprioritynursingintervention?

1. Recognizethatoneoftheoff-labelusesforthedrugistreatmentofglaucoma.

2. Contactthepharmacist;thedosageofthedrugshouldbedecreasedwhenglaucoma

3. Recognizethatuseofthedrugwhenglaucomaispresentmayresultinafatal

reaction.

1. Contactthephysician;thedrugshouldbeusedwithcautionwhenglaucoma

6. Betamethasone(Celestone)isorderedforaclientinpretermTheclientasksthenursewhatthemedicationwilldotohelpher.Thenurseexplainstotheclientthatthemedicationwill:

1. helphertobreathemoreeffectivelyduringthelabor

2. preventherinfantfromdevelopingrespiratory

3. helpherinfanttobreathemoreeffectivelyduringthe

4. preventherfromdevelopingcongestive

7. Aclientisadmittedtothelaboranddeliveryunitandisbeingtreatedwithterbutaline(Brethine).Thenurseplanstheclient’scarewiththeknowledgethatthismedicationisusedto:

2. decreaseuterine

3. stimulatefetalheart

8. Theclientisbeingtreatedwithhydralazinehydrochloride(Apresoline).Whatwouldbeapositiveoutcomefortheclientasaresultoftreatmentwiththismedication?

1. DiastolicBPismaintained

2. DiastolicBPismaintained

3. SystolicBPismaintainedbetween100and120mm

4. SystolicBPismaintainedbetween90and110mm

9. Aclientdiagnosedwithpregnancy-inducedhypertension(PIH)isThenursetellstheclientthatthepurposeofthistreatmentisto:

2. prevent

3. increase

10. AprenatalclientdisclosesthatshetakeshighdosesofWhichisthemostaccurateinstructionthatthenursecanprovideinresponsetotheclient’sstatement?

1. “Highlevelsofvitaminsmaycauseharmto”

2. “Onlywater-solublevitaminsmaybeharmfulduring”

3. “Megadosesofvitaminsareassociatedwithpositivebirth”

4. “Vitaminsupplementationisnotneeded”

11. ApregnantwomanexperiencesThenurseanticipatesthatwhichlaxativemaybeusedfirstafteractivityanddietarymethodsareunsuccessful?

1. Mineraloil

2. Psyllium(Metamucil)

3. Lactulose

4. Milkofmagnesia

12. Theclientisscheduledfortreatmentwithbetamethasone(Celestone).Thenurseanticipatesthatthismedicationwillbeadministeredviathe

1. oral

2. intravenous

3. intramuscular

4. subcutaneous

13. Theclientisscheduledfortreatmentwithbetamethasone(Celestone).Thenurseanticipatesthatthemedicationwillbeadministeredtotheclientduringwhichweekorbeforeofher

a.	38
b.	36
c.	35
d.	33

14. Thehealthcareproviderordershydroxyzine(Vistaril)foraclientToachieveapositiveoutcome,thenurseplanstoadministerthedrugviawhichroute?

1. Intradermally

2. Intravenously

3. IntramuscularlyviaZ-tracktechnique

4. SubcutaneouslyviaZ-tracktechnique

15. AnepiduralblockisorderedforaprimiparaclientThenurseanticipatesthatthisepiduralblockwillbegivenwhenthecervixisdilatedat centimeters.

1. 2to3

2. 3to4

3. 4to5

4. 5to6

16. AclientisbeingtreatedwithanergotWhichobservationwouldcausethenursetocontacttheprimaryhealthcareprovider?

1. Hypertension

2. Itching

1. Jugularveindistention

2. Seizureactivity

17. TheclientisscheduledforanepiduralanestheticWhatwillbethehighestprioritynursingintervention?

1. Administer1LofanisotonicIVsolutionandencourageuseofabedpanafter

2. Administer500mLofahypotonicIVsolutionandassessthelevelofconsciousnessbecausethepatientis

3. Administer500mLofahypertonicIVsolutionandassessfetalheartrateandprogressoflaborasperpregnancy

4. Administer1LofhypotonicIVsolutionandallowtheclienttoambulateduringthespinal

18. Thebestcandidatefortreatmentwithdinoprostone(Cervidil)isthewomanwhoneedsher:

1. labor

2. cervix

3. labor

4. labor

19. Whichwillmostlikelybepartofthenursingcareofawomanpostcaesareansectionwithspinalanesthesia?

1. Earlyambulationtoavoidconstipation

2. Fluidrestrictionstodecreasebloodvolume

3. Lyingflat6to8hourstoavoidspinalheadache

4. IVantibioticstoavoidpostpartuminfection

20. TheclientisscheduledtobetreatedwithOxytocinbynasalThenurseplanstoadministerthedrug:

1. 2to3minutesaftertheclient

2. 2to3minutesbeforetheclient

3. afterdeliveryofthe

4. asdeliveryoftheplacentais

MULTIPLERESPONSE

1. Ayoungwomeninlabor,G1P0,isdiagnosedwithpregnancy-inducedhypertension(PIH).SheisorderedtoWhataretheothercomponentsofhernursingcare?(Selectallthatapply.)

1. Maintainingaquietenvironment

2. Assessingvitalsignsandfetalhearttonesfrequently

1. ProvidinglargeamountsofPOandIVfluidstomaintainfluidvolume

2. Allowingthewomantoambulateadlib

3. Assessingforclonusanddeeptendonreflexes

4. Monitoringurinehourlyforprotein, B,E,F

Chapter6.PrinciplesofPharmacotherapyinOlderAdults

MULTIPLECHOICE

1. Principlesofprescribingforolderadultsinclude:

A.	Avoidingprescribinganynewerhigh-costmedications
B.	Startingatalowdoseandincreasingthedoseslowly
C.	Keepingtotaldoseatlowertherapeuticrange
D.	Alloftheabove

2. Sadieisa90-year-oldpatientwhorequiresanewWhatchangesindrugdistributionwithagingwouldinfluenceprescribingforSadie?

A.	Increasedvolumeofdistribution
B.	Decreasedlipidsolubility
C.	Decreasedplasmaproteins
D.	Increasedmuscletofatratio

3. Glenisan82yearoldwhoneedstobeprescribedWhatchangesineliminationshouldbetakenintoconsiderationwhenprescribingforGlen?

A.	IncreasedGFRwillrequirehigherdosesofsomerenallyexcreteddrugs
B.	Decreasedtubularsecretionofmedicationwillrequiredosageadjustments
C.	Thinskinwillcauseincreasedeliminationviasweat
D.	Decreasedlungcapacitywillleadtomeasurabledecreasesinlungexcretionofdrugs

4. Amedicationreviewofanelderlyperson’smedicationsinvolves:

B.	Havingthepatientbringalloftheirprescription,over-the-counter,andherbalmedicationtothevisit
C.	Askingwhatotherprovidersarewritingprescriptionsforthem
D.	Alloftheabove

5. Stepstoavoidpolypharmacyinclude:

A.	Prescribingtwoorfewerdrugsfromeachdrugclass
B.	Reviewingacompletedrughistoryevery12to18months
C.	Encouragingtheelderlypatienttocoordinatetheircarewithalloftheirproviders
D.	Evaluatingforduplicationsindrugtherapyanddiscontinuinganyduplications

6. Robertisa72yearoldwhohashypertensionandHeisatriskforcommonmedicationpracticesseenintheelderlyincluding:

A.	Useofanotherperson’smedications
B.	Hoardingmedications
C.	Changinghismedicationregimenwithouttellinghisprovider
D.	Alloftheabove

7. Toimprovepositiveoutcomeswhenprescribingfortheelderlythenursepractitionershould:

A.	Assesscognitivefunctioningintheelder
B.	Encouragethepatienttotakeaweekly“drugholiday”tokeepdrugcostsdown
C.	Encouragethepatienttocutdrugsinhalfwithaknifetolowercosts
D.	Alloftheabove

8. Whenanelderlydiabeticpatientisconstipatedthebesttreatmentoptionsinclude:

A.	Mineraloil
B.	Bulk-forminglaxativessuchaspsyllium
C.	Stimulantlaxativessuchassenna
D.	Stoolsoftenerssuchasdocusate

9. Deltaisan88yearoldwhohasmildWhatguidelinesshouldbefollowedwhenprescribingpainmanagementforDelta?

A.	Keepthedoseofoxycodonelowtopreventdevelopmentoftolerance
B.	Acetaminophenisthefirst-linedrugofchoice
C.	AvoidprescribingNSAIDs
D.	Addinashort-actingbenzodiazepineforasynergisticeffectonpain

10. RobertiscomplainingofpoorMedicationsthatmaycontributetosleepproblemsintheelderlyinclude:

A.	Diuretics
B.	Trazodone
C.	Clonazepam
D.	Levodopa

Chapter7PrinciplesofPharmacotherapyinPainManagement

MULTIPLECHOICE

1. DifferentareasofthebrainareinvolvedinspecificaspectsofThereticularandlimbicsystemsinthebraininfluence:

1. Thesensoryaspectsofpain

2. Thediscriminativeaspectsofpain

3. Themotivationalaspectsofpain

4. Thecognitiveaspectsofpain

2. Patientsneedtobequestionedaboutallpainsitesbecause:

1. Patientstendtoreportthemostsevereorimportantintheirperception

2. Paintolerancegenerallydecreaseswithrepeatedexposure

3. Thereportedpainsiteisusuallythemostimportanttotreat

4. Painmaybereferredfromadifferentsitetotheonereported

3. Thechemicalsthatpromotethespreadofpainlocallyinclude:

1. Serotonin

2. Norepinephrine

3. Enkephalin

4. NeurokininA

4. NarcoticsareexogenousTheyactby:

1. Inhibitingpaintransmissioninthespinalcord

2. AttachingtoreceptorsintheafferentneurontoinhibitthereleaseofsubstanceP

3. Blockingneurotransmittersinthemidbrain

4. Increasingbeta-lipoproteinexcretionfromthepituitary

5. AgeisafactorindifferentresponsestoWhichofthefollowingage-relatedstatementsaboutpainisNOTtrue?

1. Pretermand

2. Painfulexperiencesandprolongedexposuretoanalgesicdrugsduringpregnancymaypermanentlyalterneuronalorganizationin

3. Increasesinpainthresholdinolderadultsmayberelatedtoperipheralneuropathiesandchangesinskinthickness

4. Decreasesinpaintoleranceareevidentinolderadults

6. Whichofthefollowingstatementsistrueaboutacutepain?

1. Somaticpaincomesfrombodysurfacesandisonlysharpandwell-localized.

2. Visceralpaincomesfromtheinternalorgansandismostresponsiveto

acetaminophenandopiates.

1. Referredpainispresentinadistantsiteforthepainsourceandisbasedonactivationofthesamespinalsegmentastheactualpain

2. Acuteneuropathicpainiscausedbylackofbloodsupplytothenervesinagiven

7. OneofthemaindrugclassesusedtotreatacutepainisTheyareusedbecause:

1. Theyhavelessriskforliverdamagethanacetaminophen

2. Inflammationisacommoncauseofacutepain

3. TheyhaveminimalGIirritation

4. Regulationofbloodflowtothekidneyisnotaffectedbythesedrugs

8. OpiatesareusedmainlytotreatmoderatetoWhichofthefollowingisNOTtrueaboutthesedrugs?

1. AllopiatesarescheduleddrugswhichrequireaDEAlicense

2. Opiatesstimulateonlymureceptorsforthecontrol

3. Mostoftheadverseeffectsofopiatesarerelatedtomureceptor

4. Naloxoneisanantagonistto

9. Ifinterventionstoresolvethecauseofpain(RICE)areinsufficient,painmedicationsaregivenbasedontheseverityofDrugsaregiveninwhichorderofuse?

1. NSAIDs,opiates,corticosteroids

2. Low-doseopiates,salicylates,increaseddoseofopiates

3. Opiates,non-opiates,increaseddoseofnon-opiate

4. Non-opiate,increaseddoseofnon-opiate,opiate

10. Thegoaloftreatmentofacutepainis:

1. Painatatolerablelevelwherepatientmayreturntoactivitiesofdailyliving

2. Reductionofpainwithaminimumofdrugadverseeffects

3. Reductionoreliminationofpainwithminimumadversereactions

4. Adequatepainreliefwithoutconstipationornauseafromthedrugs

11. Whichofthefollowingstatementsistrueaboutageandpain?

1. Useofdrugsthatdependheavilyontherenalsystemforexcretionmayrequiredosageadjustmentsinveryyoung

2. AmongtheNSAIDs,indomethacinisthepreferreddrugbecauseofloweradverseeffectsprofilesthanother

3. Olderadultswhohavedementiaprobablydonotexperiencemuchpainduetolossofpainreceptorsinthe

4. Acetaminophenisespeciallyusefulinbothchildrenandadultsbecauseithasnoeffectonplateletsandhasfeweradverseeffectsthan

12. PainassessmenttodetermineadequacyofpainmanagementisimportantforThisassessmentisdoneto:

1. Determineifthediagnosisofsourceofpainiscorrect

2. Determineifthecurrentregimenisadequateordifferentcombinationsofdrugsandnon-drugtherapyarerequired

3. Determineifthepatientiswillingandabletobeanactiveparticipantinhisorherpainmanagement

4. Alloftheabove

13. Pathologicalsimilaritiesanddifferencesbetweenacutepainandchronicpaininclude:

1. Bothhavedecreasedlevelsofendorphins

2. ChronicpainhasapredominanceofC-neuronstimulation

3. Acutepainismostcommonlyassociatedwithirritationofperipheralnerves

4. Acutepainisdiffuseandhardtolocalize

14. Atreatmentplanformanagementofchronicpainshouldinclude:

1. Negotiationwiththepatienttosetpersonalgoalsforpainmanagement

2. Discussionofwaystoimprovesleepandstress

3. Anexerciseprogramtoimprovefunctionandfitness

4. Alloftheabove

15. ChronicpainisacomplexSomespecificstrategiestodealwithitinclude:

1. Tellingthepatientto“letpainbeyourguide”tousingtreatmenttherapies

2. Prescribingpainmedicationona“PRN”basistokeepdowntheamountused

3. Schedulingreturnvisitsonaregularbasisratherthanwaitingforpoorpaincontroltodrivetheneedforanappointment

4. Alloftheabove

16. ChemicaldependencyassessmentisintegraltotheinitialassessmentofchronicWhichofthefollowingraisesa“redflag”aboutpotentialchemicaldependency?

1. Useofmorethanonedrugtotreatthepain

2. Multipletimeswhenprescriptionsarelostwithrequeststorefill

3. Preferencesfortreatmentsthatincludealternativemedicines

4. Presenceofafamilymemberwhohasabuseddrugs

17. ThePainManagementContractisappropriatefor:

1. Patientswithahistoryofchemicaldependencyorpossibleinappropriateuseofpainmedications

2. Allpatientswithchronicpainwhowillrequirelong-termuseofopiates

3. Patientswhohaveacomplexdrugregimen

1. Patientswhoseemultipleprovidersforpaincontrol

Chapter8.PrinciplesofAntimicrobialTherapy

MULTIPLECHOICE

1. AnurseisorderedtodrawbloodlevelsforapersonreceivinganThenurseisawarethatpeaksandtroughsofserumantibioticlevelsaremonitoredfordrugswitha:

1. narrowtherapeutic

2. largetherapeutic

3. longhalf-life.

4. shorthalf-life.

2. Aclient’smedicationwarrantspeakandtroughThenurseisawarethatifthepeaklevelofthedrugistoohigh,whatcouldoccur?

1. Mildsideeffects

2. Inadequatedrugaction

3. Slowonsetofdrugaction

4. Drugtoxicity

3. DrugconcentrationisimportantfortheeradicationofItisdesiredtokeepthedrugdose:

1. below

2. above

3. belowminimumtoxic

4. aboveminimumtoxic

4. Withcontinuoususeofantibiotics,antibioticresistanceresultbecause:

1. bacteriaareproducing

2. theimmunesystemhasenhancedabilitytofight

3. mutantbacteriaaresurvivingantibiotic

4. fewernewantibioticshavebeen

5. Aclientwithotitismediaisorderedtoreceiveamoxicillin(Amoxil).TheclientdisclosestothenursethatsheisallergictoWhatisthehighestpriorityactiononthepartofthenurse?

1. Notifythehealthcareproviderthatthe

2. Encouragetheclienttotakethedoseunderclose

3. Administerhalfoftheamoxicillindoseunder

4. Reporttheamoxicillinordertothe

6. AclienthasrelayedinstructionsfromaphysicianregardinganallergyThenursewouldquestionwhichinstruction?

1. WearaMedicAlertbraceletthatindicates

2. Avoidallpenicillin-type

3. Informallhealthcareprovidersofthe

4. Restrictfluidswhentaking

7. Whenantibacterialsareprescribedforthetreatmentofaninfectionandacultureisordered,whatshouldhappennext?

1. Theinitialdoseoftheantibioticshould

2. Thecultureshouldbetakenbeforetheinitialdoseoftheantibiotic

3. Thecultureshouldbetakenanytimeaftertheantibiotictherapy

4. Theculturemaybetakenatanytimebeforeorduringantibiotic

8. Aclientatanoutpatientclinicisorderedtoreceiveampicillin(Omnipen)foranWhichnursinginterventionrelatedtopenicillinswouldthenursequestion?

1. Verifythattheclientisnotallergicto

2. Obtainculturebeforeadministeringthefirstdoseof

3. Instructclienttodiscontinuepenicillinwhentemperatureis

4. Encouragetheclienttoincreasefluid

9. Mostbeta-lactamantibioticsareexcretedthroughThenurseshouldassesstheclient’srenalfunctionbymonitoringwhichlevels?

1. Bloodureanitrogenandserumcreatinine

2. Creatininephosphokinaseandalkalinephosphatase

3. Whitebloodcellcountandredbloodcellcount

4. Hemoglobinandhematocrit

10. AclientisorderedtoreceiveacephalosporintotreataRegardingmonitoringoftheclient,thehighestpriorityactiononthepartofthenurseincludesassessingtheclientforwhichsideeffects?

1. Nausea,vomiting,anddiarrhea

2. Photophobiaandphototoxicity

3. Painwithurinationandbloodintheurine

4. Highfeversandsweating

11. Aclienthasbeenreceivingacephalosporinfor20daystotreataTheclientcomplainsofmouthpain,andthenurseassesseswhitepatchesintheclient’smouth.Whatisthehighestpriorityactiononthepartofthenurse?

2. Encouragetheclienttodrinkmore

1. Notifythephysiciananddescribe

2. Administeranalgesia

12. Aclientwhoreportsanallergytopenicillinisorderedtoreceivecephalexin(Keflex).Thecorrectactionforthenurseisto:

1. administerthemedicationasorderedwithadditional

2. administerthemedicationandcarefullyobservefor

3. callthephysiciantochangetheorderbecauseoftheallergy

4. administeranotherantibioticafterconsulting

13. TheclienthasbeenorderedtreatmentwithCefacloraswellasThenurseanticipateswhateffectfromtheinteractionofthemedications?

1. IncreasedactionoftheCefaclor

2. DecreasedactionoftheCefaclor

3. AnaphylacticreactiontotheCefaclor

4. ToxicactionoftheCefaclor

14. TheclienthasbeenThenurseanticipatesanincreaseintheclient’s

fromthismedication?

1. BUNandserumcreatinine

2. serumpotassium

3. serumcalcium

4. serumwhitebloodcells

15. TheclienthasbeenorderedtobeThehighestpriorityinstructionthatthenurseshouldgivetheclientrelatedtodietwhileonthemedicationistoavoid:

1. green

2. beefandotherred

3. coffee,tea,and

4. acidicfruitsand

16. TheclienthasbeenThenursenotesthatthesolutionismilkyincolor.Whatisthehighestpriorityactiononthepartofthenurse?

1. Callthepharmacist

2. Addnormalsalinetodilutethe

3. Callthephysicianandreportthe

4. Administerthemedicationasorderedbythe

17. TheclienthasbeenTheclientreportstothenursethatshehasdevelopedsymptomsofvaginitis.Thehighestpriorityactiononthepartofthenurseistorecognizethisas:

1. anexpectedsideeffectofthe

2. alife-threateningreactionto

3. evidenceofdevelopmentofa

4. evidenceofan

Chapter9.ComplementaryandAlternativeMedicines

MULTIPLECHOICE

1. Agoodhistoryofherbandsupplementuseiscriticalbeforeprescribingbecauseapproximately ofpatientsintheUnitedStatesareusingherbalA.10%

2. 5%

3. 38%

D.70%

2. Apotentialharmfuleffecttopatientswhotakesomeherbalmedicationis:

1. Constipation

2. Leadpoisoning

3. Diarrhea

4. Life-threateningrash

3. AthoroughunderstandingofherbsiscriticaltopatientAnexampleistheuseofcinnamontotreatTypeIIdiabetes.ItisimportantthepatientusesCeyloncinnamon,asthecommerciallyavailablecassiacinnamoncontains:

1. Coumadin,whichmayleadtobleedingproblems

2. Coumarin,whichcancauseliverandkidneydamage

3. Cinnamicaldehyde,whichistoxictothekidney

4. Cinnamateeugenol,whichistoxictotheliver

4. TraditionalChinesemedicineutilizesyin(cooling)versusyang(warming)inassessingandtreatingMenopauseisconsideredatimeofimbalance,thereforetheChineseherbalistwouldprescribe:

1. Herbswhichareyanginnature

2. Herbsthatareyininnature

3. Ginger

4. Goldenseal

5. AccordingtoTraditionalChineseMedicine,ifapersonwhohasafeverisgivenaherbthatisyanginnature,suchasgoldenseal,thepatient’sillnesswill:

1. Getworse

2. Getbetter

3. Notbeadequatelytreated

4. Needadditionalherbstotreattheyang

6. InAyurvedicmedicinetreatmentisbasedonthepatient’sdominantdosha,whichisreferredtoastheperson’s:

1. Vata

2. Pitta

3. Kapha

4. Prakriti

7. HerbsandsupplementsareregulatedbytheFoodand

1. True

2. False

8. Whenmelatoninisusedtoinducesleep,therecommendationisthepatient:

1. Take10mg30minutesbeforebednightly

2. Take1to5mg30minutesbeforebednightly

3. Nottakemelatoninmorethanthreenightsaweek

4. Combinemelatoninwithzolpidem(Ambien)forthegreatestimpactonsleep

9. ValerianteacausesrelaxationandcanbeusedtohelpapatientfallOverdosageofvalerian(morethan2.5gm/dose)mayleadto:

1. Cardiacdisturbances

2. Centralnervoussystemdepression

3. Respiratorydepression

4. Skinrashes

10. ThestandarddosageofStJohn’sWortforthetreatmentofmilddepressionis:

1. 300mgdaily

2. 100mgthreetimesaday

3. 300mgthreetimesaday

4. 600mgthreetimesaday

11. PatientsneedtobeinstructedregardingthedruginteractionswithStJohn’sWort,including:

1. MAOinhibitors(MAOIs)

2. Serotoninreuptakeinhibitors(SSRIs)

3. Over-the-counter(OTC)coughandcoldmedications

4. Alloftheabove

12. Ginseng,whichistakentoassistwithmemory,maypotentiate:

1. Aricept

2. Insulin

3. Digoxin

4. Propranolol

13. LicoricerootisacommontreatmentDruginteractionswithlicoriceinclude:

1. Antihypertensives,diuretics,anddigoxin

2. Antidiarrheals,antihistamines,andomeprazole

3. Penicillinantibioticclassandbenzodiazepines

4. Noneoftheabove

14. Patientsshouldbewarnedabouttheoveruseoftopicalwintergreenoiltotreatmusclestrains,asoverapplicationcanleadto:

1. Respiratorydepression

2. Cardiacdisturbance

3. Salicylatespoisoning

4. Life-threateningrashes

15. TheroleoftheNPintheuseofherbalmedicationisto:

1. Maintaincompetenceintheprescribingofcommonherbalremedies

2. Recommendcommonover-the-counterherbstopatients

3. Educatepatientsandguidethemtoappropriatesourcesofcare

4. Encouragepatientstonotuseherbaltherapyduetothedocumenteddangers

Chapter10.Pharmacogenomics

MULTIPLECHOICE

1. Geneticpolymorphismsaccountfordifferencesinmetabolism,including:

1. Poormetabolizers(PMs)wholackaworkingenzyme

2. Intermediatemetabolizers(IMs)whohaveoneworking,wild-typealleleandonemutantallele

3. Extensivemetabolizers(EMs),withtwonormallyfunctioningalleles

4. Alloftheabove

2. Upto21%ofAsiansareultra-rapid2D6metabolizers,leadingto:

1. Aneedtomonitordrugsmetabolizedby2D6fortoxicity

2. Increaseddosagesneededofdrugsmetabolizedby2D6,suchastheSSRIs

3. DecreasedconversionofcodeinetomorphinebyCYP2D6

4. Theneedforlowereddosagesofdrugs,suchasbetablockers

3. RifampinisanonspecificCYP450inducerthatmay:

1. Leadtotoxiclevelsofrifampinandmustbemonitoredclosely

2. Causetoxiclevelsofdrugs,suchasoralcontraceptives,whenco-administered

3. Inducethemetabolismofdrugs,suchasoralcontraceptives,leadingtotherapeuticfailure

4. Causenonspecificchangesindrugmetabolism

4. InhibitionofP-glycoproteinbyadrugsuchasquinidinemayleadto:

1. Decreasedtherapeuticlevelsofquinidine

2. Increasedtherapeuticlevelsofquinidine

3. Decreasedlevelsofaco-administereddrug,suchasdigoxin,thatrequiresP-glycoproteinforabsorptionandelimination

4. Increasedlevelsofaco-administereddrug,suchasdigoxin,thatrequiresP-glycoproteinforabsorptionandelimination

5. WarfarinresistancemaybeseeninpatientswithVCORC1mutation,leadingto:

1. Toxiclevelsofwarfarinbuildingup

2. Decreasedresponsetowarfarin

3. Increasedriskforsignificantdruginteractionswithwarfarin

4. Lessriskofdruginteractionswithwarfarin

6. GenetictestingforVCORC1mutationtoassesspotentialwarfarinresistanceisrequiredpriorto

1. True

1. False

7. PharmacogenetictestingisrequiredbytheFoodandDrugAdministration(FDA)priortoprescribing:

1. Erythromycin

2. Digoxin

3. Cetuximab

4. Rifampin

8. CarbamazepinehasaBlackBoxwarningrecommendingtestingfortheHLA-B*1502alleleinpatientswithAsianancestrypriortostartingtherapydueto:

1. DecreasedeffectivenessofcarbamazepineintreatingseizuresinAsianpatientswiththeHLA-B*1502allele

2. IncreasedriskfordruginteractionsinAsianpatientswiththeHLA-B*1502allele

3. IncreasedriskforStevens-JohnsonsyndromeinAsianpatientswithHLA-B*1502

allele

1. PatientswhohavetheHLA-B*1502allelebeingmorelikelytohavearesistancetocarbamazepine

9. AgeneticvariationinhowthemetaboliteofthecancerdrugirinotecanSN-38isinactivatedbythebodymayleadto:

1. Decreasedeffectivenessofirinotecaninthetreatmentofcancer

2. Increasedadversedrugreactions,suchasneutropenia

3. DelayedmetabolismoftheprodrugirinotecanintotheactivemetaboliteSN-38

4. Increasedconcernsforirinotecanbeingcarcinogenic

10. Patientswhohaveapoormetabolismphenotypewillhave:

1. Slowedmetabolismofaprodrugintoanactivedrug,leadingtoaccumulationofprodrug

2. Accumulationofinactivemetabolitesofdrugs

3. Aneedforincreaseddosagesofmedications

4. Increasedeliminationofanactivedrug

11. Ultra-rapidmetabolizersofdrugsmayhave:

1. Tohavedosagesofdrugsadjusteddownwardtopreventdrugaccumulation

2. Activedrugrapidlymetabolizedintoinactivemetabolites,leadingtopotentialtherapeuticfailure

3. Increasedeliminationofactive,nonmetabolizeddrug

4. Slowedmetabolismofaprodrugintoanactivedrug,leadingtoaccumulationofprodrug

12. AprovidermayconsidertestingforCYP2D6variantspriortostartingtamoxifenforbreastcancerto:

1. Ensurethepatientwillnothaveincreasedadversedrugreactionstothetamoxifen

2. Identifypotentialdrug-druginteractionsthatmayoccurwithtamoxifen

3. Reducethelikelihoodoftherapeuticfailurewithtamoxifentreatment

4. Identifypoormetabolizersoftamoxifen

Chapter 11. ContactDermatitis

MULTIPLECHOICE

1. Whenchoosingatopicalcorticosteroidcreamtotreatdiaperdermatitis,theidealmedicationwouldbe:

1. Intermediatepotencycorticosteroidointment(Kenalog)

2. Acombinationofacorticosteroidandanantifungal(Lotrisone)

3. Alowpotencycorticosteroidcreamappliedsparingly(hydrocortisone1%)

4. Ahighpotencycorticosteroidcream(DiproleneAF)

2. Topicalimmunomodulatorssuchaspimecrolimus(Elidel)ortacrolimus(Protopic)areusedfor:

1. Short-termorintermittenttreatmentofatopicdermatitis

2. Topicaltreatmentoffungalinfections(Candida)

3. Chronic,inflammatoryseborrheicdermatitis

4. Recalcitrantnodularacne

3. Long-termtreatmentofmoderateatopicdermatitisincludes:

1. Topicalcorticosteroidsandemollients

2. Topicalcorticosteroidsalone

3. Topicalantipruritics

4. Oralcorticosteroidsforexacerbationsofatopicdermatitis

4. Severecontactdermatitiscausedbypoisonivyorpoisonoakexposureoftenrequirestreatmentwith:

1. Topicalantipruritics

2. Oralcorticosteroidsfor2to3weeks

3. Thicklyappliedtopicalintermediate-dosecorticosteroids

4. Isolationofthepatienttopreventspreadofthedermatitis

5. Whenapatienthascontactdermatitis,wetdressingswithDomeborosolutionareusedfor:

1. Cleaningtheweepingareaofdermatitis

2. Bathingthepatienttopreventinfection

3. Reliefofinflammation

4. Providingabarrierlayertoprotectthesurroundingskin

6. TopicalcorticosteroidsareusedtotreatseveralTopicalcorticosteroidsarecontraindicatedfortreatmentofwhichofthefollowingconditions?

a.	Psoriasis	c.	Eczema
b.	Contactdermatitis	d.	Rosacea

7. AtopicalcorticosteroidmaybeusedtoWhatinstructionmustbegiventoapatientforwhomatopicalcorticosteroidisprescribedfortreatmentoffacialeczema?

8. “Becarefulnottogetanyofthemedicationinyour”

9. “Stayoutofstrongsunlightwhileusingthe”

10. “Putathinlayerofmedicationononceadayjustbeforeyougoto”

11. “Checkbeforeyouuseitthatthemedicationislabeledfluorinated.”

8. GroupItopicalcorticosteroidsmaycauseadverseApatientwhoisbeingtreatedwithagroupItopicalcorticosteroidmustbecloselymonitoredfor

a.	increasedhepaticenzymes.	c.	epithelialkeratopathy.
b.	HPAsuppression.	d.	bonemarrowdepression.

9. Treatmentwithgentamicin(Garamycin)maypresentdisadvantagesfortheArenalpatient’suseofthedrugmayleadto

10. deteriorationofthe

11. riskofliverdamagesecondarytosystemic

12. occurrenceof

13.

9. Thetopicalantiviraldrugacyclovir(Zovirax)isusedtotreatseveraldifferentWhichofthefollowingconditionsisanunlabeleduseforacyclovir(Zovirax)?

a.	Herpesgenitalis	c.	Herpeslabialis
b.	HerpessimplexvirustypesIandII	d.	Epstein-Barrvirus

10. Lindane(Kwell,Scabene)isusedtotreatseveralForwhichdisorderistheuseoflindane(Kwell,Scabene)contraindicated?

a.	Pediculosispubis	c.	Scabies
b.	Sarcoptesscabiei	d.	Seizures

15. Scabiestreatmentfora4-year-oldchildincludesaprescriptionfor:

1. Permethrin5%creamappliedfromtheneckdown

2. Pyrethrinlotion

3. Lindane1%shampoo

4. Alloftheabove

16. VanessahasbeenHereducationwouldinclude:

1. Sheshouldapplythescabiestreatmentcreamforanhourandwashitoff

2. Scabiesmayneedtoberetreatedinaweekafterinitialtreatment

3. Allmembersofthehouseholdandclosepersonalcontactsshouldbetreated

4. Malathionisflammableandsheshouldtakecareuntilthesolutiondries

17. CatherinehasheadliceandhermotherisaskingaboutwhatproductsareavailablethatarenotTheonlynon-neurotoxinheadlicetreatmentis:

1. Permethrin1%(Nix)

2. Lindaneshampoo

3. Malathion(Ovide)

4. Benzoylalcohol(Ulesfia)

Chapter12.FungalInfections ofthe Skin

MULTIPLECHOICE

1. AnurseiscaringforapatientwhoisonamphotericinOnmorningroundsthepatientreportsweakness,numbness,andatinglingsensationinhisfeet.Whatwouldbeapriorityactionbythenurse?

1. Encouragethepatientto

2. Usestrictaseptictechniquefordrugadministration

1. Keepthebedinalowpositionandthesiderailsupatall

2. Reducethe

2. Anurseismonitoringthefluidinputandoutputofa26-year-oldwomanwhoisonamphotericinWhichofthefollowingwouldthenursereportimmediatelytothephysician?

1. Orange-coloredurine Ahighconcentrationofthedrugintheurine

1. Urineoutputabove500mL/gofthedrugadministered

D.Serumcreatininelevelof3.5mg/dL

3. ThenurseisassessingapatientwhoisabouttoreceiveantifungaldrugWhichcondition,iffoundinthepatient,wouldbeofmostconcern?

1. Diabetesmellitus

2. Liverdisease

3. Pulmonarydisease

4. Bleedingdisorders

4. ThenurseispreparinganinfusionofamphotericinBforapatientwhohasaWhichinterventionisappropriateregardingthepotentialadverseeffectsofamphotericinB?

1. Discontinuingtheinfusionimmediatelyiffever,chills,ornauseaoccur

2. Graduallyincreasingtheinfusionrateuntiltheexpectedadverseeffectsoccur

3. Iffever,chills,ornauseaoccurduringtheinfusion,administeringmedicationstotreatthesymptoms

4. Beforebeginningtheinfusion,administeringanantipyreticandanantiemeticdrug

5. ThenurseisadministeringoneofthelipidformulationsofamphotericinWhengivingthisdrug,whichconceptisimportanttoremember?

1. Thelipidformulationsmaybegiveninoral

2. Thedosesaremuchlowerthanthe

3. Thelipidformulationsareassociatedwithfeweradverseeffectsthan

4. Thereisnodifferenceincostbetweenthenewerand

6. Apatientisinfectedbyinvasiveaspergillosis,andthemedicalhistoryrevealsthatthepatienthasnotbeenabletotolerateseveralantifungalThenurseanticipatesanorderforwhichmedicationtotreatthisinfection?

1. fluconazole(Diflucan)

2. micafungin(Mycamine)

3. caspofungin(Cancidas)

4. nystatin(Mycostatin)

7. DuringtherapywithamphotericinB,thenursewillmonitorthepatientforknownadverseeffectsthatwouldbereflectedbywhichlaboratoryresult?

2. Serumpotassiumlevel7mEq/L

3. Serumpotassiumlevel8mEq/L

4. Whitebloodcellcountof7000cells/mm3

5. Plateletcountof300,000permicroliter

8. Apatienthasreceivedaprescriptionfora2-weekcourseofantifungalsuppositoriesforavaginalyeastSheasksthenurseifthereisanalternativetothismedication,saying,“Idon’twanttodothisfor2weeks!”Whichisapossibilityinthissituation?

2. Asingledoseofavaginalantifungalcream

3. Aone-timeinfusionofamphotericinB

4. Asingledoseofafluconazole(Diflucan)oraltablet

5. Thereisnobetteralternativetothe

9. DwaynehasclassicTreatmentfortineaonthescalpis:

0. Miconazolecreamrubbedinwellfor4weeks

1. Oralgriseofulvinfor6to8weeks

2. Ketoconazoleshampoodailyfor6weeks

3. Ciclopiroxcreamdailyfor4weeks

10. Nicolasisafootballplayerwhopresentstoclinicwithathlete’sPatientswithtineapedismaybetreatedwith:

1. OTCmiconazolecreamfor4weeks

2. Oralketoconazolefor6weeks

1. Mupirocinointmentfor2weeks

2. Nystatincreamfor2weeks

11. Jimpresentswithfungalinfectionoftwoofhistoenails(onychomycosis).Treatmentforfungalinfectionsofthenailincludes:

1. Miconazolecream

2. Ketoconazolecream

3. Oralgriseofulvin

4. Mupirocincream

Chapter 13 Viral Infections ofthe Skin

MULTIPLECHOICE

1. Apatientwhoisdiagnosedwithshinglesistakingtopicalacyclovir,andthenurseisprovidinginstructionsaboutadverseThenursewilldiscusswhichadverseeffectsoftopicalacyclovirtherapy?

1. Insomniaandnervousness

2. Temporaryswellingandrash

3. Transientburningwhenapplied

4. Thismedicationhasnoadverse

2. Thenurseisadministeringintravenousacyclovir(Zovirax)toapatientwithaviralWhichadministrationtechniqueiscorrect?

1. Infuseintravenousacyclovirslowly,overat

2. Infuseintravenousacyclovirbyrapid

4. Restrictoralfluidsduringintravenousacyclovir

3. Apatientisreceivingcidofovir(Vistide)aspartoftreatmentforaviralinfection,andthenurseispreparingtoadministerprobenecid,whichisalsoWhichistherationaleforadministeringprobenecidalongwiththecidofovirtreatment?

1. Probenecidhasasynergisticeffectwhengivenwithcidofovir,thusmakingtheantiviralmedication

2. Theprobenecidalsopreventsreplication

3. Concurrentdrugtherapywithprobenecidreducesthenephrotoxicityofthe

4. Theprobenecidreducestheadversegastrointestinaleffectsofthe

4. Instructionsforapplyingatopicalantibioticorantiviralointmentinclude:

1. Applythicklytotheinfectedarea,spreadingthemedicationwellpastthebordersoftheinfection

2. Iftherashworsens,applyathickerlayerofmedicationtosettledowntheinfection

3. Washhandsbeforeandafterapplicationoftopicalantimicrobials

4. Noneoftheabove

5. Whenprescribingtopicalpenciclovir(Denavir)forthetreatmentofherpeslabialis(coldsores)patienteducationwouldinclude:

1. Spreadpenciclovirliberallyalloverlipsandareasurroundinglips

2. Penciclovirtherapyisstartedatthefirstsignofcoldsoreoutbreak

3. Skinirritationisnormalwithpencicloviranditshouldresolve

4. Thepenciclovirshouldbeusedaminimumof2weekstopreventrecurrence

MULTIPLERESPONSE

1. ApatientwhoisdiagnosedwithgenitalherpesistakingtopicalThenursewillprovidewhichteachingforthispatient?(Selectallthatapply.)

1. “Besuretowashyourhandsthoroughlybeforeandafterapplyingthis”

2. “Applythisointmentuntilthelesionstops”

3. “Useacleanglovewhenapplyingthis”

4. “Ifyourpartnerdevelopstheselesions,thenhecanalsouse”

5. “Youwillneedtoavoidtouchingtheareaaround”

6. “Youwillhavetopracticeabstinencewhentheselesionsare”, C,E,F

Chapter14BacterialInfectionsoftheSkinTest Bank

MULTIPLECHOICE

1. Whenreviewingtheallergyhistoryofapatient,thenursenotesthatthepatientisallergictoBasedonthisfinding,thenursewouldquestionanorderforwhichclassofantibiotics?

1. Tetracyclines

2. Sulfonamides

3. Cephalosporins

4. Quinolones

2. ThenurseisprovidingteachingtoapatienttakinganoralWhichstatementbythenurseiscorrect?

1. “Avoiddirectsunlightandtanningbedswhileon”

2. “Milkandcheeseproductsresultinincreasedlevelsof”

3. “Antacidstakenwiththemedication”

4. “Takethemedicationuntilyouarefeeling”

3. Whenreviewingthemedicationordersforapatientwhoistakingpenicillin,thenursenotesthatthepatientisalsotakingtheoralanticoagulantwarfarin(Coumadin).Whatpossibleeffectmayoccurastheresultofaninteractionbetweenthesedrugs?

1. Thepenicillinwillcauseanenhancedanticoagulanteffectofthe

2. Thepenicillinwillcausetheanticoagulanteffectofthewarfarinto

3. Thewarfarinwillreducetheantiinfectiveactionofthe

4. Thewarfarinwillincreasetheeffectivenessofthe

4. ApatientisreceivinghisthirdintravenousdoseofapenicillinHecallsthenursetoreportthatheisfeeling“anxious”andishavingtroublebreathing.Whatwillthenursedofirst?

1. Notifythe

2. Takethepatient’svitalsigns.

3. Stopthe

4. Checkfor

5. Duringdrugtherapywithatetracyclineantibiotic,apatientcomplainsofsomenauseaandWhichstatementisthenurse’sbestadvicetothepatient?

1. “Takeitwithcheese”

2. “Takeeachdosewithaglassof”

3. “Takeanantacidwitheachdoseas”

4. “Drinkafullglassof”

6. Thenurseismonitoringapatientwhohasbeenonantibiotictherapyfor2Todaythepatienttellsthenursethathehashadwaterydiarrheasincethedaybeforeandishavingabdominalcramps.Hisoraltemperatureis101°F(38.3°C).Basedonthesefindings,whichconclusionwillthenursedraw?

1. Thepatient’soriginalinfectionhasnotrespondedtotheantibiotic

2. Thepatientisshowingtypicaladverseeffects

3. ThepatientneedstobetestedforClostridiumdifficile

4. Thepatientwillneedtotakeadifferent

7. ThenurseismonitoringfortherapeuticresultsofantibiotictherapyinapatientwithanWhichlaboratoryvaluewouldindicatetherapeuticeffectivenessofthistherapy?

1. Increasedredbloodcellcount

2. Increasedhemoglobinlevel

3. Decreasedwhitebloodcellcount

4. Decreasedplateletcount

8. Thenurseisreviewingthesputumcultureresultsofapatientwithpneumoniaandnotesthatthepatienthasagram-positiveinfection.Whichgenerationofcephalosporinismostappropriateforthistypeofinfection?

1. First-generation

2. Second-generation

3. Third-generation

4. Fourth-generation

9. Apatientwillbehavingoralsurgeryandhasreceivedanantibiotictotakefor1weekbeforetheThenurseknowsthatthisisanexampleofwhichtypeoftherapy?

1. Empirical

2. Prophylactic

3. Definitive

4. Resistance

10. Duringdrugtherapyforpneumonia,afemalepatientdevelopsaThenurseexplainsthatthisinfectioniscausedby

1. largedosesofantibioticsthatkillnormal

2. theinfectionspreadingfromherlungstothenewsite

3. resistanceofthepneumonia-causingbacteria

4. anallergicreactiontothe

11. ThenurseispreparingtouseanWhichstatementiscorrectregardinghowantisepticsdifferfromdisinfectants?

1. Antisepticsareusedtosterilizesurgical

2. Disinfectantsareusedas

3. Antisepticsareusedonlyonlivingtissuetokill

4. Disinfectantsareusedonlyonnonlivingobjectstodestroy

12. Apatientwithalong-termintravenouscatheterisgoingThenurseknowsthatifheisallergictoseafood,whichantisepticagentiscontraindicated?

1. chlorhexidinegluconate(Hibiclens)

2. hydrogenperoxide

3. povidone-iodine(Betadine)

4. isopropylalcohol

MULTIPLERESPONSE

1. Duringantibiotictherapy,thenursewillmonitorcloselyforsignsandsymptomsofaWhichoftheseassessmentfindingsmaybeanindicationofahypersensitivityreaction?(Selectallthatapply.)

1. Wheezing

2. Diarrhea

3. Shortnessofbreath

4. Swellingofthetongue

5. Itching

6. Black,hairytongue

2. ThenurseisreviewingthemedicationhistoryofapatientwhowillbetakingaDuringsulfonamidetherapy,asignificantdruginteractionmayoccurwithwhichofthesedrugsordrugclasses?(Selectallthatapply.)

1. Opioids

2. Oralcontraceptives

3. Sulfonylureas

4. Antihistamines

5. phenytoin(Dilantin)

6. warfarin(Coumadin)

OTHER

1. Apatientwillbereceivingamoxicillinsuspension300mgviaagastrostomytubeeveryThemedicationcomesinabottlethatcontains400mg/5mL.Howmanymilliliterswillthenurseadministerwitheachdose?(Recordanswerusingonedecimalplace.)

2. ApatientwillbereceivingpenicillinGpotassium,12millionunitsdailyHowmanyunitswillthepatientreceiveforeachdose?

Chapter15.Psoriasis

MULTIPLECHOICE

1. Appropriateinitialtreatmentforpsoriasiswouldbe:

1. Animmunomodulator(ProtopicorElidel)

2. WetsoakswithBurrow’sorDomeborosolution

3. Intermittenttherapywithintermediatepotencytopicalcorticosteroids

4. Anthralin(Drithocreme)

2. PatienteducationwhenprescribingtheVitaminD3derivativecalcipotrieneforpsoriasisincludes:

1. Applythicklytoaffectedpsoriaticareastwotothreetimesaday

2. Amaximumof100gramsperweekmaybeapplied

3. Donotusecalcipotrieneincombinationwiththeirtopicalcorticosteroids

4. Calcipotrienemaybeaugmentedwiththeuseofcoaltarproducts

3. WhartisthepeakonsetageofPsoriasis

A.16-22 C. 57-60

1. 30-34 D.BothAandC

4. ApatientwithpsoriasisneedstoapplyalubricatinglotiontoaThehealthproviderrecommendswhichofthefollowingtypesofsubstances?

1. Alcohol Emollient

2. Astringent Antiseptic

5. Patientswhoaretreatedwithgreaterthan100gramsperweekoftopicalcalcipotrieneforpsoriasisneedtobemonitoredfor:

1. HighvitaminDlevels

2. Hyperkalemia

3. Hypercalcemia

4. Hyperuricemia

2. JesseisprescribedtazaroteneforhisPatienteducationregardingtopicaltazaroteneincludes:

1. Tazaroteneisappliedinathinfilmtothepsoriasisplaquelesions

1. Applyliberallytoallpsoriaticlesions

2. Applytazarotenetonon-affectedareastopreventbreakout

3. Tazarotenemaycausehypercalcemiaifoverused

Chapter16.AcneVulgarisandRosacea

MULTIPLECHOICE

1. Mildacnemaybeinitiallytreatedwith:

1. Topicalcombinedantibiotic

2. Minocycline

3. Topicalretinoid

4. OTCbenzoylperoxide

2. TobiepresentstoclinicwithHehasbeenusingOTCbenzoylperoxideathomewithminimalimprovement.Atopicalantibiotic(clindamycin)andatopicalretinoidadapalene(Differin)areprescribed.EducationofTobiewouldinclude:

1. Heshouldseeanimprovementinhisacnewithinthefirst2weeksoftreatment

2. Ifthereisnoresponseinaweek,doublethedailyapplicationofadapalene(Differin)

3. Hemayseeaninitialworseningofhisacnethatwillimprovein6to8weeks

4. Adapalenemaycausebleachingofclothing

3. JosiehasseverecysticacneandTheappropriatetreatmentforherwouldbe:

1. Orderapregnancytestandifitisnegativeprescribetheisotretinoin(Accutane)

2. OrderAccutaneaftereducatingherontheadverseeffects

3. Recommendshetryoralantibiotics(minocycline)

4. Referhertoadermatologistfortreatment

4. Themostcost-effectivetreatmentfortwoorthreeimpetigolesionsonthefaceis:

1. Mupirocinointment

2. Retapamulin(Altabax)ointment

3. Topicalclindamycinsolution

4. Oralamoxicillin/clavulanate(Augmentin)

5. Rodesausuallystartsinthispartofaperson’slifespan

A.Adolescant

Teen

B. Midlife

Todler

6. Initialdrugtherapychoicesshouldincludea

1. topical C. isotrentinion

2. oralantibiotics benzoylperoxide

Chapter17OphthalmicDisorders

MULTIPLECHOICE

1. TheCentersforDiseaseControlrecommendsallnewborninfantsreceiveprophylacticadministrationof within

1. Gentamicinophthalmicointment

2. Ciprofloxacinophthalmicdrops

3. Erythromycinoralsuspension

4. Erythromycinophthalmicointment

2. Conjunctivitisinachildthatisaccompaniedbyacuteotitismediaistreatedwith:

1. Sulfacetamide10%ophthalmicsolution(Bleph-10)

2. Bacitracin/polymyxinB(Polysporin)ophthalmicdrops

3. Ciprofloxacin(Ciloxan)ophthalmicdrops

4. High-doseoralamoxicillin

3. Twenty-year-oldAnniecomestocliniccomplainingofcopiousyellow-greeneyeGramstainindicatesshemostlikelyhasgonococcalconjunctivitis.Whileawaitingthecultureresults,theplanofcareshouldbe:

1. None;waitforthecultureresultstodeterminethecourseoftreatment

2. Ciprofloxacin(Ciloxan)ophthalmicdrops

3. IMceftriaxone

4. High-doseoralamoxicillin

4. Educationofwomenwhoarebeingtreatedwithophthalmicantibioticsforconjunctivitisincludes:

1. Throwingawayeyemakeupandpurchasingnew

2. Rednessandintenseburningisnormalwithophthalmicantibiotics

3. Whenapplyingeyeointment,setthetipofthetubeonthelowerlidandsqueezeininch

4. Useacottonswabtoapplyointment,spreadingtheointmentalloverthelidandintheconjunctivalsac

5. SadiewasprescribedbetaxololophthalmicdropsbyherophthalmologisttotreatherOralbetablockersshouldbeavoidedinpatientswhouseophthalmicbetablockersdueto:

1. Theremaybeanantagonisticreactionbetweenthetwo

2. Theadditiveeffectsmayincludebradycardia

3. Theymaypotentiateeachotherandcauserespiratorydepression

4. Theadditiveeffectsmaycausemetabolicacidosis

6. DavidpresentstoclinicwithsymptomsofallergicHeisprescribedcromolynsodium(Opticrom)eyedrops.Theeducationregardingusingcromolyneyedropsincludes:

1. Heshouldnotwearhissoftcontactswhileusingthecromolyneyedrops

2. Cromolyndropsareinstilledonceadaytopreventallergysymptoms

3. Long-termusemaycauseglaucoma

4. Hemayexperiencebradycardiaasanadverseeffect

7. Choosethetypeofophthalmicmedicationthatcanresultinglaucoma,cataracts,or

1. Sympathomimetics Anesthetics

2. Antivirals Steroids

Treatmentwithsympathomimetics,antivirals,oranestheticsisnotknowntoleadtodevelopmentoftheseproblems.Treatmentwithcorticosteroidsmayallowfordevelopmentofsecondaryeyeinfection,aswellasglaucomaorcataracts.

.163

8. PrescriptionoftimololmaleatecanresultinseveralseriousadverseSelecttheconditionthatisconsideredtobeacommonsideeffectoftreatmentwithtimololmaleate.

1. Chronicheartfailure Diabetes

2. Bradycardia Blurredvision

Chronicheartfailureisaconditionthatrequiresthatawarning/precautionbeprovidedifthepatientwhoistoreceivetimololmaleatehasthispreexistingcondition.Bradycardiaisaconditionthatrequiresthatawarning/precautionbeprovidedifthepatientwhoistoreceivetimololmaleatehasthispreexistingcondition.Diabetesisaconditionthatrequiresthatawarning/precautionbeprovidedifthepatientwhoistoreceivetimololmaleatehasthispreexistingcondition.Blurredvisionisconsideredtobeacommonsideeffectoftreatmentwithtimololmaleate.

.164

9. Whichsituationshowsappropriateuseofanophthalmicanestheticforapatientwitheyepain?

1. Presenceofaforeignobjectintheeye

2. Facilitationofexaminationoftheeye

3. Painthatisworsenedbylight

4. Underlyingproblemofaherpessimplexinfection

Topicalanestheticsareusedonlywheneyepainmakesitimpossibleforthepractitionertoexaminetheeye.

.160

10. Thepatientissufferingfromglaucomaandisscheduledtobegintreatmentwithcarbachol(Carboptic).Thehealthcareproviderknowstomonitorthepatientcloselyforevidenceofwhicheffectofthedrug?

1. Dilationoftheiridicsphincter Mydriasis

2. Increasedoutflowofaqueoushumor Vasoconstrictionofcollecting

channels

Carbacholisacholinergicmioticdrugthatincreasesoutflowofaqueoushumorbycontractingtheiridicsphincter,causingmiosisandvasodilatingbloodvesselsandcollectionchannelsperipheraltothecanalofSchlemm.

DIF: CognitiveLevel:Comprehension REF: Page1137

11. Thepatientisbeingtreatedwiththedrugpilocarpine(Pilocar).HecomplainsofeyeThemostappropriateresponseofthehealthcareprovideris:

1. Thiscouldbesymptomatic

2. Thisisanunexpected,idiosyncraticresponsetothe

3. Thisisanexpectedadversereactiontothe

4. Thiscouldbesymptomatic

Adverseeffectscommonlyassociatedwithcholinergicmioticssuchaspilocarpineincludeirritation,conjunctivitis,andblepharitis.

REF: Page1137

12. Asthepatientcontinuestoundergotreatmentwithpilocarpine(Pilocar),hebeginstoexperienceitchingThemostappropriateresponseofthehealthcareprovideris:

1. Thiscouldbesymptomaticofpinpointhemorrhagingwithinthe

2. Thisisanexpectedadversereactiontothemedication,andtreatmenttorelievethissymptomwillbe

3. Thisisanunexpected,idiosyncraticresponsetothemedication;thepatientmustbeswitchedto

4. Thiscouldbesymptomatic

Adverseeffectscommonlyassociatedwithcholinergicmioticssuchaspilocarpineincludeirritation,conjunctivitis,andblepharitis.Itchingwouldbecausedbytheconjunctivitis.

REF: Page1137

13. ApatientwithaneyeinjuryrequiresanocularexaminationtodetectWhichdrugwouldahealthcareproviderexpecttobeofmostuseinthisexamination?

1. Rosebengal Fluorexon

2. Fluorocaine Isoflurophate

Fluoracaine,acombinationoffluoresceinandproparacaine,isusedtofacilitateremovalofforeignbodiesfromtheeye.

REF: Page1139

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Pharmacotherapeutics for Advanced Practice 4th Edition by Virginia Poole – Test Bank

Sample Questions

Chapter5.PrinciplesofPharmacotherapyinPregnancyandLactation

MULTIPLERESPONSE

Chapter8.PrinciplesofAntimicrobialTherapy

MULTIPLECHOICE

MULTIPLERESPONSE

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