NURS 6521N-28, Advanced Pharmacology: Exam – Week 7 Midterm (100% Correct Uploaded January)

(NURS 6521n Exam Week 7 Midterm January 2020)

1. Question: A patient with bronchial asthma is … a … release preparation of theophylline. To help minimize the adverse effects of the drug, which of the following should the nurse suggest?
2. Question: The most effective therapy for a patient  who is H. pylori positive with a gastric ulcer is:
3. Question: A diabetic patient being … for obesity tells the Nurse Practitionerthat he is having adverse effects from his drug therapy. The patient has been taking dextroamphetamine for 2 weeks as adjunct therapy. Which of the following adverse effects would need the Nurse Practitioner’s immediate attention?
4. Question: A Nurse Practitioneris a member of a research team that is exploring unique differences in responses to drugs that each individual possesses, based on genetic make-up. This area of study is called
5. Question: An older adult who lives in a long-term care facility has recently begun taking losartan (Cozaar) for the treatment of hypertension. The nurse who provides care for this resident should recognize that this change in the resident’s medication regimen make create a risk for
6. Question: A 39-year-old African-American male is 25 pounds overweight and has been … with hypertension after three consecutive above-normal blood pressure readings. The most likely initial drug therapy for this patient will …
7. Question: A 62-year-old man is … to the hospital with a diagnosis of chest pain. He has an order for 0.3 mg of sublingual nitroglycerin prn for chest pain. Which of the following actions should the nurse do first when he complains of chest pain?
8. Question: A Nurse Practitioner working for a drug company is involved in phase III drug evaluation studies. Which of the following might the Nurse Practitioner … responsible for during this stage of drug development?
9. Question: After a recent history of shortness of breath that has become increasingly severe, a woman has been … ipratropium by MDI while she undergoes a diagnostic workup. What patient teaching should the nurse provide to this patient?
10. Question: Which of the following patients is most likely to benefit from the administration of an adrenergic agonist?
11. Question: A 73-year-old woman has scheduled an appointment with her nurse practitioner to discuss her recurrent constipation. The woman states that she experiences constipation despite the fact that she takes docusate on a daily basis and performs cleansing enemas several times weekly. How should the nurse best respond to this patient’s statements?
12. Question: A Nurse Practitionerwho provides care in a busy clinic is aware of the high incidence and prevalence of hyperlipidemia and the consequent need for antihyperlipidemics in many patients. Treatment of high cholesterol using statins would … contraindicated in which of the following patients?
13. Question: During a clinic visit, a patient complains of having frequent muscle cramps in her legs. The nurse’s assessment reveals that the patient has been taking over-the-counter laxatives for the past 7 years. The nurse informed the patient that prolonged use of laxatives
14. Question: The lower respiratory system utilizes a number of different mechanisms that confer protection and maintain homeostasis. Which of the following physiological processes protects the lower respiratory system?
15. Question: A 70-year-old man who enjoys good health began taking low-dose aspirin several months ago based on recommendations that he read in a magazine article. During the man’s most recent visit to his care provider, routine blood work was ordered and the results indicated an unprecedented rise in the man’s serum creatinine and blood urea nitrogen (BUN) levels. How should a nurse best interpret these findings?
16. Question: The Nurse Practitioner is prescribing Salmeterol (Serevent) inhaler for a patient with asthma.  What instructions would be correct to provide the patient?
17. Question: You are seeing a 55 year old patient recently … with a bleeding ulcer. What should … the initial treatment choice for this patient?
18. Question: A patient has been … a drug that can … self-administered at home. Which of the following would … the most important information for the nurse to relate to the patient concerning self-administration of a drug?
19. Question: A man who smokes one pack of cigarettes daily has been … with chronic bronchitis. He has been … theophylline by his family doctor. What effect will the patient’s smoking status have on the therapeutic use of theophylline?
20. Question: A 24-year-old factory worker has been … guaifenesin for the first time. Which of the following will … a priority assessment by the nurse before the patient’s first dose?
21. Question: A 22 year old patient is transitioning from oral agents to insulin.  He will be taking 20 units of lantus at bedtime and regular insulin before meals.  What instructions should the NP provide about the timing and dose of regular insulin?  
22. Question: A patient has been … to the ICU because of multiple traumas due to a motor vehicle accident. The physician has ordered propofol (Diprivan) to be … for maintenance of sedation. Before administration of propofol, a priority assessment by the nurse would … to check for a history of
23. Question: A 68-year-old man complains of a chronic, nonproductive cough. He states that he has to have relief, that he has been coughing every 2 to 3 minutes, and he is worn out. Dextromethorphan is … for him. Before he leaves the clinic he asks how long it will take for the medicine to work. The nurse will advise him that he should experience therapeutic effects in
24. Question: A Nurse Practitioner is caring for a patient who is diabetic and has been … with hypertension. An angiotensin-converting enzyme inhibitor, captopril, has been … for her. Which of the following should the Nurse Practitioner assess before beginning drug therapy?
25. Question: A patient comes to primary clinic for strep throat. A throat swab culture is sent to lab. What information is required for the nurse practitioner to disclose on lab transmittal?
26. Question: A patient has a history of tonic-clonic seizures that have been successfully … with phenytoin (Dilantin) for several years. Phenytoin achieves a therapeutic effect by
27. Question: Advanced practice nurse prescribing of scheduled medications is affected most by:
28. Question: A teenage boy has undergone a diagnostic workup following several months of persistent, bloody diarrhea that appears to lack an infectious etiology. The boy has also experienced intermittent abdominal pain and has lost almost 15 pounds this year. Which of the following medications is most likely to treat this boy’s diagnosis?
29. Question: A 79-year-old patient in a long-term care facility is to receive an intravenous fat emulsion. Which of the following lab values would … a priority for the nurse to assess before administration?
30. Question: A Nurse Practitioneris providing discharge planning for a 45-year-old woman who has a prescription for oral albuterol. The Nurse Practitioner will question the patient about her intake of which of the following?
31. Question: An unconscious patient has been brought to the hospital, and the Nurse Practitioner has … a life-saving drug to be administered parenterally. Which of the following methods would … the most appropriate for the nurse to use when administering the medication?
32. Question: A nurse practitioner understands when prescribing a medication that there are certain questions to address. Check all that apply.
33. Question: A 70-year-old woman with a history of atrial fibrillation takes digoxin and verapamil to control her health problem. Verapamil achieves a therapeutic effect by
34. Question: A Nurse Practitioner has been administering a drug to a patient intramuscularly (IM). The physician discontinued the IM dose and wrote an order for the drug to … given orally. The Nurse Practitioner notices that the oral dosage is considerably higher than the parenteral dose and understands that this due to
35. Question: Drugs have a high potential for abuse. There is no routine therapeutic use for these drugs and they are not available for regular use. They may … obtained for “investigational use only” by applying to the U.S. Drug Enforcement Agency. Examples include heroin and LSD. Which scheduled drug is this?
36. Question: A 22-year-old male college senior has lived with a diagnosis of Crohn’s disease for several years and has undergone several courses of treatment with limited benefit. Which of the following targeted therapies has the potential to alleviate the symptoms of Crohn’s disease?
37. Question: The APRN is caring for a patient taking a calcium channel blockers for hypertension.  The APRN should monitor the patient for what common side effects of this medication?
38. Question: The APRN is seeing Mrs. Smith, age 77, who is here for follow up of hypertension, dyslipidemia, and depression.  What should you consider during her follow-up?
39. Question: A female patient is taking 0.125 mg of digoxin daily for heart failure. At a recent clinic visit she reports that since she has been on the drug, she can breathe better and her heart rate has been around 74 beats per minute. The nurse weighs the patient and notices that she has gained 10 pounds since the digoxin therapy was started. The patient is concerned that the additional weight will necessitate an increase in the medication. Which of the following is an appropriate response by the nurse?
40. Question: A Nurse Practitioner is discussing with a patient the efficacy of a drug that his physician has suggested, and he begin taking. Efficacy of a drug means which of the following?
41. Question: A Nurse Practitioneris providing care for a patient who … extensive burns to his extremities during a recent industrial accident. Topical lidocaine gel has been ordered to … applied to the surfaces of all his burns in order to achieve adequate pain control. When considering this order, the Nurse Practitioner should be aware that
42. Question: A Nurse Practitioneris teaching an older adult patient about polypharmacy. Which of the following statements best describe this term?
43. Question: A Nurse Practitioneris caring for a female patient who has developed atelectasis because of thick mucus secretions. The Nurse Practitioner is monitoring IV administration of acetylcysteine (Mucomyst) and notices that the patient’s face is flushed. The appropriate nursing action would be to
44. Question: Which statement is FALSEregarding the treatment of hyperthyroidism?
45. Question: Topical inhaled alpha adrenergic blocking agents or nasal vasoconstricting decongestants should not … used chronically (>5 days) because they can cause
46. Question: A 58-year-old man is … dicyclomine (Bentyl) for irritable bowel syndrome. In which of the following conditions is dicyclomine therapy contraindicated?
47. Question: A 58-year-old man is … to the emergency department. A diagnosis of severe digoxin toxicity is made. Bradycardia is present, and an electrocardiogram (ECG) confirms toxicity. The nurse will administer which of the following drugs?
48. Question: A 77-year-old patient has a long-standing history of hypertension, a health problem that is being … with metoprolol and a thiazide diuretic. Before administering the 8 AM dose of these medications, what assessments should the nurse perform and document? (Select all that apply.)
49. Question: A 67-year-old man is … to the hospital with pneumonia. He reports to the nurse that he has chronic arthritis and circulation problems. Further assessment by the nurse reveals that the patient has a history of mild hypertension. He explains that he owns a business and lives alone. The nurse determines that he is within the normal weight range for his height and age but has a fondness for spicy foods and sweets. Which of the mentioned patient variables will have the greatest impact on the effectiveness of the patient’s drug therapy?
50. Question: An elderly patient with a history of congestive heart failure has been … to hospital with failure to thrive and admission blood work reveals a hemoglobin level of 6.9 g/dL. The care team has consequently administered two units of packed red blood cells, but auscultation of the client’s lungs now reveals diffuse crackles. Administration of what drug is likely to resolve the patient’s pulmonary edema?
51. Question: A female patient has been taking zafirlukast for a week and is experiencing diarrhea. The nurse should instruct her to do which of the following?
52. Question: A 62-year-old woman has been … a fentanyl transdermal patch for chronic cancer pain. The patient asks the nurse how long it will take for her to experience pain relief. The nurse will instruct the patient that she should feel pain relief in approximately
53. Question: A patient has been … a histamine-2 (H2) receptor antagonist for the treatment of GERD. Why are H2RAs more effective than H1 receptor antagonists in the treatment of diseases of the upper GI tract?
54. Question: A Nurse Practitioner is instructing a patient in the administration of regular insulin by the subcutaneous route. Which of the following strategies would the Nurse Practitionersuggest if the goal is to promote absorption of the regular insulin?
55. Question: A Nurse Practitionerwho is responsible for administering medications should understand that the goals of the MedWatch program are to (Select all that apply.)
56. Question: A male patient is to begin treatment for pneumonia with an albuterol (Ventolin) inhaler. The nurse will advise the patient that he will most likely experience which of the following common adverse effects of the drug?
57. Question: A Nurse Practitioner is instructing a patient who was recently … with multiple sclerosis about dantrolene (Dantrium). The patient is a 38-year-old-male and the foreman for a construction company. In order to minimize one important adverse effect of the drug, the nurse will give the patient which of the following instructions?
58. Question: A 76-year-old woman has a complex medical history that includes emphysema, osteoporosis, malnutrition, and hypothyroidism. Recently, the woman fell outside her home as a result of weakness and … a fracture to her femoral head. The woman’s subsequent hip-replacement surgery has been scheduled and the care team recognizes that the use of isoflurane will … most significantly influenced by
59. Question: A resident of a long-term care facility receives 12.5 mg metoprolol (Lopressor) at 8 AM and 8 PM daily. Before administering this drug, the nurse should perform and document what assessments?
60. Question: A Nurse Practitioneris caring for a 70-year-old patient who is taking desmopressin (DDAVP). The patient has a history of cardiovascular disease. The nurse will prioritize the assessment of which of the following?
61. Question: A patient is bothered with nighttime episodes of bronchoconstriction related to asthma. Which of the following medications can … administered to decrease the nighttime episodes and prevent asthma attacks?
62. Question: A patient with seasonal allergies is exasperated by her recent nasal congestion and has … her desire to treat it by using pseudoephedrine. The nurse should inform the patient that
63. Question: The Nurse Practitioner is performing patient education for a woman who will soon begin treatment of hyperlipidemia with simvastatin (Zocor). The patient has asked the Nurse Practitioner if there are any “bad side effects” that she should … aware of. Which of the following statements should underlie the nurse’s response?
64. Question: A patient receives 25 units of NPH insulin at 7.AM. At what time of day should the nurse advise the patient to be most alert for a potential hypoglycemic reaction?
65. Question: A patient is being … for respiratory infection. He is a recovering alcoholic and has impaired liver function. The nurse will instruct the patient to … especially cautious when taking
66. Question: A Nurse Practitioner is providing patient education to a 35-year-old man who has been … clonidine (Catapres) as part of step 2 antihypertensive therapy. The Nurse Practitioner should anticipate that the drug will … administered
67. Question: A 33-year-old woman has irritable bowel syndrome (IBS). The physician has … simethicone (Mylicon) for her discomfort. Which of the following will the nurse monitor most closely during the patient’s drug therapy?
68. Question: A Nurse Practitioneris caring for a 61-year-old man who has … a severe attack of gout while in the hospital for food poisoning. The Nurse Practitioner administers colchicine intravenously in order to
69. Question: A patient has been … an oral drug that is known to have a high first-pass effect. Which of the following measures has the potential to increase the amount of the free drug that is available to body cells?
70. Question: Penny, age 67, was … with chronic angina several months ago and has been unable to experience adequate relief of his symptoms. As a result, his physician has … ranolazine (Ranexa). Which of the following statements is true regarding the use of ranolazine for the treatment of this patient’s angina?
71. Question: To maximize the therapeutic effect of diphenoxylate HCl with atropine sulfate, the nurse will instruct the patient to take the medication
72. Question: Decongestants are recommended to use in which of the following patients?
73. Question: A patient with a variety of chronic health problems is being … by her nurse practitioner, who is currently reviewing the patient’s medication regimen. Which of the patient’s medications should prompt the nurse to teach her to avoid drinking grapefruit juice?
74. Question: A homeless man who is well known to care providers at the local hospital has been … to the emergency department after having a seizure outside a mall. The man is known to … a heavy alcohol user and is malnourished with a very low body mass index. How are this patient’s characteristics likely to influence possible treatment with phenytoin?
75. Question: A Nurse Practitioner is providing care for a 71-year-old woman who was … to emigrate from Mexico to the United States 6 months ago. Earlier this week, the woman slipped while getting off a bus and fractured her hip. How should the woman’s nurse best exemplify cultural competence in the care of this patient?
76. Question: A Nurse Practitioner is overseeing the care of a young man whose ulcerative colitis is being … with oral prednisone. Which of the following actions should the Nurse Practitioner take in order to minimize the potential for adverse drug effects and risks associated with prednisone treatment?
77. Question: A 53-year-old man has been … for severe asthma for several years with prednisone. Recently, his physician initiated alternate-day therapy for him. The patient tells the nurse that he would rather take the medication every day to prevent confusion. Which of the following would … the best response by the nurse?
78. Question: A Nurse Practitionerhas administered a medication to a patient with hypertension. The … drug is supposed to decrease cardiac output. A decrease in cardiac output would most likely
79. Question: Which of the following patients should be … by the Nurse Practitioner to avoid over-the-counter cold and allergy preparations that contain phenylephrine?
80. Question: A 62 year old male who … a myocardial infarction one year ago is being … for hypertension. Which medication has the best evidence in mortality reduction? 
81. Question: What critical piece of information is missing from the following medication order: Amoxicillin 250 mg every 8 hours?
82. Question: The APRN’s ability to prescribe … substances is … by:
83. Question: A Nurse Practitioner is teaching a patient about his newly … drug, colchicine, for gout. The Nurse Practitioner will instruct the patient to avoid which of the following foods?
84. Question: Which of the following is TRUE about long acting beta agonist use in asthma patients?
85. Question: A Nurse Practitioner is caring for a patient who is taking digoxin and a loop diuretic. Which of the following would … most important for the Nurse Practitioner to monitor?
86. Question: A 70-year-old man with diabetes mellitus is taking metoprolol (Lopressor) to manage his hypertension. The nurse would be sure to instruct the patient to
87. Question_: A 79-year-old woman with a medical history that includes osteoporosis has recently … to a long-term care facility. Medication reconciliation indicates that the woman has been taking calcitonin, salmon for several years. The nurse should recognize that the most likely route for the administration of this drug is
88. Question_: A patient with mild low back pain has been … to take acetaminophen. The nurse will inform him that excessive intake of acetaminophen may result in
89. Question_: A 77-year-old man’s chronic heart failure is being … with a regimen of quinapril (Accupril) and furosemide (Lasix). Which of the following assessment findings would suggest that the loop diuretic is contributing to a therapeutic effect?
90. Question_: Shirley, age 58, has been diabetic for 7 years. Her blood pressure for the last three office visits have been 154/100, 144/94, and 144/90. What would you prescribe today during her routine office visit?
91. Question_: A Nurse Practitioneris caring for a male patient who has a diagnosis of coronary artery disease (CAD). His drug therapy includes lovastatin. Because the patient has a history of severe renal disease, the nurse will assess for which of the following?
92. Question_: A patient with diabetes has … a cough for 1 week and has been … a cough syrup (an expectorant). What special instructions should the nurse include in the patient teaching for this situation?
93. Question_: A Nurse Practitioneris administering drugs to a 70-year-old patient who has a reduced plasma albumin level. When assessing the patient for therapeutic outcomes of drug therapy, the Nurse Practitioner will also … careful to observe for
94. Question_: A patient has been … lovastatin for a high cholesterol level. The nurse’s teaching plan will include a basic explanation of how the drug produces its therapeutic effect. The nurse will explain that lovastatin lowers cholesterol levels because it
95. Question_: A patient comes to the clinic asking for help to quit drinking alcohol. She has a 21-year history of heavy drinking and is worried about developing cirrhosis of the liver. The patient agrees to take disulfiram (Antabuse). The nurse will teach the patient that the combination of alcohol and Antabuse will cause which of the following?
96. Question_: A 72-year-old female patient is … ipratropium aerosol for pulmonary emphysema. The nurse will instruct her to “test spray” the new metered-dose inhaler (MDI) three times before using it to prevent which of the following?
97. Question_: A female patient calls the clinic and reports that since she has been taking dextromethorphan (Robitussin), she has been extremely drowsy and dizzy. The nurse will question the patient about which of the following?
98. Question_: A 34-year-old male patient is … methimazole (MMI). The Nurse Practitionerwill advise him to report which of the following immediately?
99. Question_: A Nurse Practitioneris caring for a patient who has recently … from Vermont to south Florida. The patient has been on the same antihypertensive drug for 6 years and has … stable blood pressures and no adverse effects. Since her move, however, she reports “dizzy spells and weakness” and feels that the drug is no longer effective. The Nurse Practitioner suspects that the change in the effectiveness of the drug is related to
100. Question_: A child with sinusitis has been on antibiotics for seven days and his symptoms are not improving. All of the following are options to prescribe for the patient now EXCEPT:
101. Question_: When completing this exam, did you comply with Walden University’s Code of Conduct including the expectations for academic integrity?