NUR641E
Advanced Pathophysiology & Pharamacology for Nurse Educators
Final Exam
1.
Insulin is used to treat
hyperkalemia because it:
stimulates sodium to be removed from the
cell in exchange for potassium.
binds to potassium to remove it through the
kidneys.
transports potassium from the blood to the
cell along with glucose.
breaks down the chemical components of
potassium, causing it to be no longer effective.
2 What is the central component of the
pathogenic model of multiple sclerosis?
Myelination of nerve fibers in the
peripheral nervous system (PNS)
Demyelination of nerve fibers in the CNS
Development of neurofibrillary tangles in
the CNS
Inherited autosomal dominant trait with
high penetrance
s3Which of the following ICU sedatives
should not be used for greater than 24 hours per the FDA-approved labeling?
Midazolam (Versed)
Diazepam (Valium)
Dexmedetomidine (Precedex)
Propofol (Diprivan)
4
What type of necrosis is associated with
wet gangrene?
Coagulative
Liquefactive
Caseous
Coagulative
5 In the absence of susceptibility data for
an acute infection, the choice of an antimicrobial drug is mostly influenced by
the site of infection and the patient's
history.
the sensitivity report and the colony
count.
the source of the infection and the color
of exudate.
the host defense mechanism and the immune
response.
6 Which statement best describes cystic
fibrosis?
Obstructive airway disease characterized by
reversible airflow obstruction, bronchial hyperreactivity, and inflammation.
Respiratory disease characterized by severe
hypoxemia, decreased pulmonary compliance, and diffuse densities on chest x-ray
imaging.
Pulmonary disorder involving an abnormal
expression of a protein-producing viscous mucus that obstructs the airways,
pancreas, sweat ducts, and vas deferens.
Pulmonary disorder characterized by
atelectasis and increased pulmonary resistance as a result of a surfactant
deficiency.
7 What medical term is used to identify an
inflammatory disorder of the skin that is often considered synonymous with
dermatitis and characterized by pruritus with lesions that have an indistinct
border?
Eczema
Psoriasis
Atopic dermatitis
Pityriasis rosea
8 Identify whether the description of the
skin lesion matches the disorder where it is found. (Select True or False)
Elevated, firm circumscribed area less than
1 cm in diameter: Wart (verruca) or lichen planus
True
False
9 Removal of part of the liver leads to the
remaining liver cells undergoing compensatory
atrophy.
metaplasia.
hyperplasia.
dysplasia.
10 Identify whether the description matches
the disorder. (Select True or False)
Abnormal dilation of the vein within the
spermatic cord – Varicocele
True
False
11 The risk of which cancer is greater if
the man has a history of cryptorchidism?
Penile
Testicular
Prostate
Epididymal
12 Which substance is used to correct the
chronic anemia associated with chronic renal failure?
Iron
Erythropoietin
Cobalamin (vitamin B12)
Folate
13 Diabetes insipidus is a result of:
antidiuretic hormone hyposecretion.
antidiuretic hormone hypersecretion.
insulin hyposecretion.
insulin hypersecretion.
14 Obesity acts as an important risk factor
for type 2 diabetes mellitus by:
reducing the amount of insulin the pancreas
produces.
increasing the resistance to insulin by
cells.
obstructing the outflow of insulin from the
pancreas.
stimulating the liver to increase glucose
production.
15 Which statement best describes Raynaud's
disease?
Inflammatory disorder of small- and medium-sized
arteries in the feet and sometimes in the hands
Neoplastic disorder of the lining of the
arteries and veins of the upper extremities
Vasospastic disorder of the small arteries
and arterioles of the fingers and, less commonly, of the toes
Autoimmune disorder of the large arteries
and veins of the upper and lower extremities
16 What is the medical term for a fungal
infection of the nail plate?
Paronychia
Onychomycosis
Tinea corporis
Tinea capitis
17 Which proton-pump inhibitor should be
avoided in a patient taking clopidogrel?
Omeprazole
Lansoprazole
Pantoprazole
Rabeprazole
18 All of the following are important
considerations when prescribing metronidazole except?
Instruct patient to avoid alcohol intake
during therapy
Can lead to development of C. difficile
infection
Monitor INR closely due a DDI with warfarin
Dose adjustments should be made in patients
with renal or hepatic dysfunction
19 Which clinical manifestations of a
urinary tract infection may be demonstrated in an 85-year-old individual?
Confusion and poorly localized abdominal
discomfort
Dysuria, frequency, and suprapubic pain
Hematuria and flank pain
Pyuria, urgency, and frequency
20 Which hormone is required for water to
be reabsorbed in the distal tubule and collecting duct?
Antidiuretic hormone
Aldosterone
Cortisol
Adrenocorticotropin hormone
21 All of the following are true regarding
antiepileptics except:
Carbamazepine and phenytoin have numerous
drug-drug interactions.
They are safe to use during pregnancy.
Therapeutic drug monitoring is often
required to ensure therapeutic drug levels.
Phenytoin is a highly protein-bound drug.
22 Alpha1 adrenergic stimulation causes:
bronchial constriction
vascular constriction.
constriction of intestinal smooth muscle.
relaxation of intestinal smooth muscle.
23 Losartan (Cozaar) lowers the blood
pressure by:
blocking calcium channels in the heart and
blood vessels.
directly dilating arterioles without
affecting veins.
suppressing the release of
angiotensin-converting enzyme.
blocking angiotensin II at its receptors.
24 One major reason to discontinue
captopril (Capoten), an ACE inhibitor, is:
hypertension.
hypokalemia.
angioedema.
angina.
25 Which of the following drugs works via
antagonism of 5-HT (serotonin) receptors in the GI tract?
Ondansetron
Droperidol
Prochlorperazine
Aprepitant
26 After a person has a subtotal
gastrectomy for chronic gastritis, which type of anemia will result?
Iron deficiency
Aplastic
Folic acid
Pernicious
27 Orthostatic hypotension refers to a
decrease of at least ___ mmHg in systolic blood pressure or a decrease of at
least _____ mmHg in diastolic blood pressure within 3 minutes of moving to a
standing position.
10; 5
20; 10
30; 15
40; 20
28 Cell wall inhibitors include all of the
following except
penicillins.
cephalosporins.
carbapenems.
tetracylclines.
29 Which of the following agents is
considered a histamine receptor antagonist?
Maalox
Protonix
Zantac
Tums
30 Which of the following drugs is most
likely to reduce the effectiveness of levofloxacin (Levaquin) when given
concomitantly?
Amiodarone (Cordarone)
Metronidazole (Flagyl)
Calcium carbonate (Tums)
Warfarin (Coumadin)
31 Which stage of infection is occurring
when the immune and inflammatory responses are triggered?
Incubation period
Prodromal stage
Invasion period
Convalescence
32 Which of the following is an advantage
of the intravenous route of administration?
Reduced bioavailability
Avoidance of first-pass metabolism
Patient convenience
None of the above are advantages
33 Which of the following antifungal agents
is known to cause significant nephrotoxicity and ototoxicity?
Caspofungin
Fluconazole
Amphotericin B
Nystatin
34 Which NSAID is generally considered the
safest for use in patients with coronary artery disease?
Celecoxib
Indomethacin
Naproxen
Acetaminophen
35 An example of a beta agonist is:
Atenolol (Tenormin)
Clonidine (Catapres)
Isoproterenol (Isuprel)
Amlodipine (Norvasc)
36 Which of the following agents is a
potent vasoconstrictor that can be used to manage acute GI bleeding?
Octreotide
Milrinone
Pantoprazole
Cimetidine
37 What type of fracture occurs at a site
of a preexisting bone abnormality and is a result of a force that would not
normally cause a fracture?
Idiopathic
Incomplete
Pathologic
Greenstick
38 A patient is diagnosed with pulmonary
disease and elevated pulmonary vascular resistance. Which form of heart failure
may result from pulmonary disease and elevated pulmonary vascular resistance?
Right heart failure
Left heart failure
Low-output failure
High-output failure
39 Your patient is taking carbamazepine, a
CYP3A4 substrate, for his seizure disorder. He is experiencing signs of
depression and decides to try St. John's wort, which he purchased
over-the-counter at the local pharmacy. Since St. John's wort is a CYP3A4
inducer, which of the following may occur?
The patient may have an increased risk for
seizure.
The patient may have an increased risk of
carbamazepine-related toxicities.
The patient may need an increased dose of
St. John’s wort.
No clinically-significant drug-drug interaction
is likely to occur.
40 Advair (fluticasone/salmeterol) is a
combination of which of the following?
Short-acting beta agonist and
corticosteroid
Long-acting beta agonist and corticosteroid
Long-acting beta agonist and antihistamine
Short-acting beta agonist and antihistamine
41 Which of the following is true regarding
adverse drug events?
They include medication errors, adverse
effects, allergic reactions, and idiosyncratic reactions.
They are rarely preventable.
They are infrequent in the inpatient
setting.
They are generally over-reported.
42 The function of arachnoid villi is to:
produce cerebrospinal fluid.
provide nutrients to the choroid plexuses.
transmit impulses within the meninges.
absorb cerebrospinal fluid into the
cerebral venous sinuses.
43 The calcium and phosphate balance is
influenced by which three substances?
Parathyroid hormone, ADH, and vitamin D
Parathyroid hormone, calcitonin, and
vitamin D
Thyroid hormone, ADH, and vitamin D
Thyroid hormone, calcitonin, and vitamin D
44 The major therapeutic actions of NSAIDS
include all of the following except
reduction of inflammation.
reduction of pain.
reduction of fever.
reduction of clotting factors.
45 Which of the following agents is
available in an injectable form used to treat acute migraine headaches?
Sumatriptan (Imitrex)T7
Naldolol (Corgard)
Naproxen sodium (Anaprox)
Ergot preparations (Cafergot)
46 A patient presents with vomiting a
coffee-ground looking substance; fatigue, postural hypotension; new onset
systolic murmur; and cool, pale peripheries.
metabolic acidosis with partial respiratory
compensation.
partial respiratory compensation.
metabolic acidosis.
acidosis.
47 Which statements are true regarding
Koplik spots? (Select all that apply.)
Koplik spots are associated with rubeola.
They appear as white spots.
The lesions are surrounded by a red ring.
The lesions of Koplik spots are large in
size.
Koplik spots are primarily found on buccal
mucosa.
48 Which of the following medications is
most likely to increase fall risk in the elderly?
Diazepam (Valium)
Cetirizine (Zyrtec)
Levofloxacin (Levaquin)
Lisinopril (Prinivil)
49 People with gout are at high risk for
which comorbid condition?
Renal calculi
Joint trauma
Anemia
Hearing loss
50 The spread of microorganisms from mother
to the baby across the placenta is termed
direct transmission.
vertical transmission.
horizontal transmission.
indirect transmission.
51 Tissue damage caused by the deposition
of circulating immune complexes containing an antibody against the host DNA is
the cause of which disease?
Hemolytic anemia
Pernicious anemia
Systemic lupus erythematosus
Myasthenia gravis
52 Thomas is admitted for symptoms of acute
coronary syndrome. You determine that a nitroglycerin drip is indicated for his
chest pain. What medication must you make sure he is not taking before writing
this order?
An antihistamine
Sildenafil
A long-acting opioid
An anticoagulant
53 Which of the following laxatives is
safest for long-term use?
Mineral oil
Methylcellulose (Citrucel)
Magnesium hydroxide (Milk of Magnesia)
Sennosides (Ex-lax)
54 Identify whether the term matches the
corresponding characteristics. (Select True or False)
Gluten sensitivity - Celiac sprue
True
False
55 Identify whether the description of the
skin lesion matches the disorder where it is found. (Select True or False)
Elevated, firm, and rough lesion with a
flat top surface greater than 1 cm in diameter: Psoriasis or seborrheic and
actinic keratoses
True
False
56 During the history portion of a
respiratory assessment, it is particularly important to ask if the patient
takes which of the following drugs that may contribute to symptoms of a chronic
cough?
Beta-2 agonists
Calcium channel blockers
Angiotensin-converting enzyme (ACE)
inhibitor
Birth control pills
57 Which laboratory value is consistently
low in a patient with diabetes insipidus (DI)?
Urine-specific gravity
Serum sodium
Urine protein
58 Which compensatory mechanism is
spontaneously used by children diagnosed with Tetralogy of Fallot to relieve
hypoxic spells?
Lying on their left side
Performing the Valsalva maneuver
Squatting
59 When considering hemolytic anemia, which
statement is true regarding the occurrence of jaundice?
Erythrocytes are destroyed in the spleen.
Heme destruction exceeds the liver’s
ability to conjugate and excrete bilirubin.
The patient has elevations in aspartate
transaminase (AST) and alanine transaminase (ALT).
The erythrocytes are coated with an
immunoglobulin.
60 The nurse has a patient who has been on
multidrug therapy for pulmonary tuberculosis. When planning patient education,
the nurse knows the patient needs to watch for which symptom of an adverse
effect of multidrug therapy?
Hearing loss
Changes in vision
Generalized pruritus
Jaundice
61 The drug of choice for a patient with
right-sided infective endocarditis caused by S. aureus is
vancomycin.
Daptomycin
Telavancin
Clindamycin
62 Which of the following side effects is
not commonly seen with ondansetron (Zofran)?
Constipation
Headache
QT-prolongation
Movement disorders
63 Which age group should be targeted for
testicular cancer education and screening?
15 to 35 year olds
20 to 45 year olds
30 to 55 year olds
45 to 70 year olds
64 The collateral blood flow to the brain
is provided by the:
carotid arteries.
basal artery.
Circle of Willis.
vertebral arteries.
65 Which of the following drugs acts on the
parasympathetic nervous system?
Epinephrine
Atropine
Dopamine
Dobutamine
66 What is the primary cause of respiratory
distress syndrome (RDS) of the newborn?
Immature immune system
Small alveoli
Surfactant deficiency
Anemia
67 Which of the following drugs has
coverage against pseudomonas?
Ceftriaxone (Rocephin)
Linezolid (Zyvox)
Piperacillin/Tazobactam (Zosyn)
Azithromycin (Zithromax)
68 Which of the following agents is
considered first-line for management of opioid-induced constipation?
Methylcellulose
Mineral oil
Polyethylene glycol
Docusate
69 Sylvia, age 59, has acute hepatitis. You
are told it is from a drug overdose. Which drug do you suspect?
Metronidazole (Flagyl)
Acetaminophen (Tylenol)
Sumatriptan (Imitrex)
Hydrocortisone (Cortisone)
70 What are the primary adverse effects
associated with SSRIs?
Weight gain and decreased libido
Weight loss and decreased appetite
Sedation and QT-prolongation
Insomnia and hypertension
71 Identify whether the description of the
skin lesion matches the disorder where it is found. (Select True or False)
Elevated circumscribed, superficial lesion
filled with serous fluid, less than 1 cm in diameter: Urticaria, allergic
reaction
True
False
72 An insufficient dietary intake of which
vitamin can lead to rickets in children?
C
B12
B6
D
73 Bacteria that produce endotoxins that
stimulate the release of inflammatory mediators that produce fever are called
pyrogenic bacteria.
true bacteria.
Exotoxins.
Spirochetes.
74 Serum levels of which of the following
antiseizure drugs must be corrected based on the patient's albumin level due to
its high protein binding?
Valproic acid (Depakote)
Phenobarbital (Luminal)
Phenytoin (Dilantin)
Carbamazepine (Tegretol)
75 After a partial gastrectomy or
pyloroplasty, clinical manifestations that include increased pulse,
hypotension, weakness, pallor, sweating, and dizziness are the results of which
mechanism?
Anaphylactic reaction in which chemical
mediators, such as histamine, prostaglandins, and leukotrienes, relax vascular
smooth muscles, causing shock
Postoperative hemorrhage during which a
large volume of blood is lost, causing hypotension with compensatory
tachycardia
Concentrated bolus that moves from the
stomach into the small intestine, causing hyperglycemia and resulting in
polyuria and eventually hypovolemic shock
Rapid gastric emptying and the creation of
a high osmotic gradient in the small intestine, causing a sudden shift of fluid
from the blood vessels to the intestinal lumen
76 A person diagnosed with type 1 diabetes
experiences hunger, lightheadedness, tachycardia, pallor, headache, and confusion.
The most probable cause of these symptoms is:
hyperglycemia caused by incorrect insulin
administration.
dawn phenomenon from eating a snack before
bedtime.
hypoglycemia caused by increased exercise.
Somogyi effect from insulin sensitivity.
77 Which of the following agents is
preferred for the treatment of a patient who is asymptomatic with a serum
sodium of 126?
3% NaCl
Tolvaptan
0.45% NaCl
0.9% NaCl
78 What is the most common cause of
uncomplicated urinary tract infections?
Staphylococcus
Klebsiella
Proteus
Escherichia coli
79 Renal failure is the most common cause
of which type of hyperparathyroidism?
Primary
Secondary
Exogenous
Inflammatory
80 Dilation of the ipsilateral pupil,
following herniation, is the result of pressure on which cranial nerve (CN)?
Optic (CN I)
Abducens (CN VI)
Oculomotor (CN III)
Trochlear (CN IV)
81 Which of the following places a patient
at risk for polypharmacy?
Lack of understanding of their medication
regimen
Using multiple pharmacies
Seeing multiple providers
All of the above place a patient at risk
for polypharmacy
82 Where is antidiuretic hormone (ADH)
synthesized, and where does it act?
Hypothalamus; renal tubular cells
Renal tubules; renal collecting ducts
Anterior pituitary; posterior pituitary
Posterior pituitary; loop of Henle
83 Which diuretic acts by inhibiting sodium
chloride reabsorption in the thick ascending limb of the loop of Henle?
Furosemide (Lasix)
Mannitol (Osmitrol)
Hydrochlorathiazide (HCTZ)
Acetazolamide (Diamox)
84 Which medical diagnosis is described as
a chronic inflammatory joint disease characterized by stiffening and fusion of
the spine and sacroiliac joints?
Ankylosing spondylitis
Rheumatoid arthritis
Paget disease
Fibromyalgia
85 Which antimicrobial should be avoided in
children because it is deposited in tissues undergoing calcification and can
stunt growth?
Tetracycline
Ciprofloxacin
Vancomycin
Amoxicillin
86 The nurse is caring for a patient who
has chronic renal failure and hypertension. The correct classification for the
hypertension is
primary.
secondary.
tertiary.
87 What type of immunity is produced when
an immunoglobulin crosses the placenta?
Passive-acquired immunity
Active-acquired immunity
Passive-innate immunity
Active-innate immunity
88 Which agent is used to treat hepatic encephalopathy
and works via "ion trapping,' converting ammonia into ammonium in the GI
tract?
Rifaximin
Lactulose
Octreotide
Neomycin
89 Which of the following is a potential
risk associated with overuse of proton-pump inhibitors?
C. difficile infection
Gastroparesis
Hyponatremia
Esophageal cancer
90 What is the effect of increased
secretions of epinephrine, glucagon, and growth hormone?
Hyperglycemia
Hypertension
Bronchodilation
Pupil dilation
91 Identify whether the description matches
the disorder. (Select True or False)
Rotation of a testis, which twists blood
vessels of the spermatic cord - Testicular torsion
True
False
92 Which of the following agents is useful
to treat COPD because of its anticholinergic effects?
Salmeterol (Serevent)
Tiotropium (Spiriva)
Albuterol (Proventil)
Prednisone (Deltasone)
93 Which disorder is characterized by the
formation of abnormal new bone at an accelerated rate beginning with excessive
resorption of spongy bone?
Osteomalacia
Paget's disease
Osteoporosis
Osteosarcoma
94 Jaundice can be attributed to the
following except?
Cholecystitis
Pyelonephritis
Sickle-cell anemia
Pancreatitis
95 Which of the following agents is
considered a long-acting beta-agonist (LABA)?
Albuterol
Salmeterol
Fluticasone
Ipratropium
96 An infant has a continuous machine-type
murmur best heard at the left upper sternal border throughout systole and
diastole, as well as a bounding pulse and a thrill on palpation. These clinical
findings are consistent with which congenital heart defect?
Atrial septal defect (ASD)
Ventricular septal defect (VSD)
Patent ductus arteriosus (PDA)
Atrioventricular canal (AVC) defect
97 Which of the following best describes a
Phase IV clinical trial?
Dose-finding study in healthy volunteers
Post-marketing study to detect potentially
rare adverse effects
Randomized clinical trial in patients with
the disease of interest done prior to FDA approval
Exploratory study done in animals to assess
potential toxicities
98 Which second-generation antipsychotic
comes in an injectable formulation approved for use in acute psychosis?
Olanzapine
Quetiapine
Aripiprazole
Ziprasidone
99 Which of the following benzodiazepines
is preferred for the treatment of alcohol withdrawal in the inpatient setting
due to its short half-life?
Lorazepam
Chlordiazepoxide
Clonazepam
100 Stress-induced sympathetic stimulation
of the adrenal medulla causes the secretion of:
epinephrine and aldosterone.
norepinephrine and cortisol.
epinephrine and norepinephrine.
acetylcholine and cortisol.
