Question 1 A Nurse Practitioner is overseeing the care of a young man whose ulcerative colitis is being treated 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 aociated with prednisone treatment?
Avoid OTC antacids for the duration of treatment
Advocate for intravenous, rather than oral, administration
Teach the patient strategies for dealing with headaches
Carefully ae the patient for infections
Question 2A resident of a long-term care facility receives 12.5 mg metoprolol (Lopreor) at 8 AM and 8 PM daily. Before administering this drug, the nurse should perform and document what aements?
Oxygen saturation and respiratory rate
Heart rate and blood preuress
Level of consciousness and pain level
Temperature and respiratory rate
Question 3JJ is a 62-year-old male who has hypertension. He currently takes HCTZ 25 mg daily, Amlodipine 5 mg daily and Lisinopril 10 mg daily. He has developed a dry cough that has persisted. Which med could this potentially be due to and what is an acceptable alternative?
HCTZ; change to Diltiazem
Lisinopril; change to Spironolactone
Amlodipine; stop Amlodipine
Lisinopril; change to Losartan
Question 5You get bloodwork back on a patient and results show a TSH of 8.68. You diagnose this patient with _____ and start _____.
Hyperthyroidism; Propylthiouracil 50 mg daily
Hypothyroidism; Levothyroxine 50 mcg daily
Hyperthyroidism; Methimazole 15 mg daily
Hypothyroidism; Liothyronine 5 mcg daily
Question 4An elderly postsurgical patient has developed postoperative pneumonia in the days following abdominal surgery and is being treated with a number of medications. Which of the following medications that the nurse will administer has the slowest absorption?
A sublingual benzodiazepine that has been prescribed to help the patient sleep
An intravenous (IV) antibiotic that is being administered by IV piggyback at 150 mL/hour
An oral antidepreant that the patient has been taking daily for several years
An intramuscular (IM) injection of an opioid analgesic
Question 6A patient is being discharged home on Lantus Solostar insulin pens. You counsel the patient:
Prime the pen with 2 units at each dose to insure proper insulin dose
Prime the pen with 5 units at each dose to insure proper insulin dose
Use the same injection site each time medication is given
Time of injection each day is irrelevant
Question 7Which of the following medications is considered a Mucosal Protectant that can be used in treating H.pylori:
A. Sucralfate
B. Famotidine
C. Amoxicillin
D. Pantoprazole
Question 8The mechanism of action of Simvastatin is:
Bile acid binding resin
Triglyceride binding
HMG-CoA reductase inhibitor
NPC1L1/Cholesterol complex inhibitor
Question 9Drugs that use CYP 3A4 isoenzymes for metabolism may:
A. Induce the metabolism of another drug
B. Inhibit the metabolism of another drug
C. Both 1 and 2
D. Neither 1 nor 2
Question 10Drugs 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 be obtained for "investigational use only" by applying to the U.S. Drug Enforcement Agency. Examples include heroin and LSD. Which scheduled drug is this?
Schedule 1
Schedule 2
Schedule 3
Schedule 4
Question 11A 41-year-old African-American male is 30 pounds overweight and has been diagnosed with hypertension. The most likely initial drug therapy for this patient will be
Calcium channel blocker
Statin
ACE inhibitor
ARB
Beta blocker
Question 12You are giving a presentation to medical students and one of them asks you to explain the mechanism of action of Jardiance. You tell them:
The medication stimulate beta cells to increase insulin production
The medication decreases gluconeogenesis in the live
The medication increases uptake of glucose into muscle cells for use and storage
The medication decreases glucose reabsorption in the renal tubule
Question 13A 62-year-old man has been prescribed lovastatin. The Nurse Practitioner will instruct the patient to take the medication
at bedtime.
in the early morning.
in the evening.
in the afternoon.
Question 14
A Nurse Practitioner is 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 ae for which of the following?
Decrease in plasma concentration of lovastatin
Increase in the statin tolerance level
Decrease in LDL
Increase in plasma concentration of lovastatin
Question 15CC is on max doses of Allopurinol but is still having occasional gout flares. You know that there is a med that can be added to his regimen that inhibits anionic transport in the proximal tubule, which decreases renal reabsorption of uric acid by 30-40%. This medication is:
Colchicine
Febuxostat
Azathioprine
Probenecid
Question 16A Nurse Practitioner receives an order to administer a critically ill patient two drugs immediately (stat). The Nurse Practitioner begins the proce by
washing his or her hands before handling the medications.
consulting a drug guide for compatibility.
questioning the patient concerning allergies.
identifying the patient by checking the armband and asking the patient to state his name.
Question 17The following are all categories of drugs used to treat Hypertension except:
A. Diuretics
B. ACE Inhibitors
C. Dipeptyl Peptidase-IV Inhibitors
D. Calcium Channel Blockers
Question 18Which laxative when used may cause aspiration pneumonia especially in the elderly:
A. Bisacodyl
B. Glycerin Suppository
C. Polyethylene Glycol
D. Mineral Oil
Question 19Which of the following statements accurately describes digoxin?
It is widely used to augment cardiac output.
It blocks the Na-K ATPase pump.
It is broken down by the liver.
It increases ventricular contraction by activating the AV node.
Question 20Proton Pump Inhibitors such as Protonix and Omeprazole are very effective at suppreing gastric acid but are aociated with the risk of which of the conditions:
A. Rhinitis
B. Migraines
C. Clostridium difficile
D. Otitis Media
Question 21Which of the following drug employs its antiemetic effect by blocking muscarinic receptors in the pathway from the inner ear to the vomiting center:
A. Scopolamine
B. Ondansetron
C. Dexamethasone
D. Dronabinol
Question 22 A 33-year-old woman has irritable bowel syndrome (IBS). The physician has prescribed simethicone (Mylicon) for her discomfort. Which of the following will the nurse monitor most closely during the patient's drug therapy?
Drug toxicity
Anorexia
Increased abdominal pain and vomiting
Increased urine output
Question 23A Native American man who lives a traditional lifestyle is scheduled to have heart surgery. The tribal chief has requested that the tribe's medicine man perform a ritual before the patient goes to surgery. The nurse's response to this request should be
"I'm sorry, but that will not be poible."
"I will need to inform the doctor and see if he will allow this."
"As long as the ritual does not interfere with the patient's preoperative care, it will be okay."
"I don't think that will help, but you have the right to perform the ritual."
Question 24You are treating a patient with asthma, and they also need something for HTN. You know the following beta blocker is safe for this patient:
Metoprolol
Nadolol
Atenolol
Propranolol
Question 25Which combination of drugs is considered first line therapy in the treatment of nausea and vomiting in pregnancy:
A. Lorazepam and Scopolamine
B. Dronabinol and Diphenhydramine
C. Doxylamine and Vitamin B6
D. Metoclopramide and Vitamin B6
Question 26Opioids can cause constipation and may in some cases act as an antidiarrheal agent through all of the following mechanisms except:
A. Activating opioid receptors in the GI tract
B. Increasing intestinal motility
C. Allows for more time for absorption of fluids and electrolytes
D. Reduces the fluidity and volume of stools
Question 27Which of the following conditions is a contraindication for pioglitazone (Actos).
Chronic infections
Severe congestive heart failure
Underweight patients
Patients with severe depreion
Question 28When treating a patient with Furosemide, which electrolyte is most important to monitor?
Calcium
Potaium
Sodium
Magnesium
Question 29The Elderly are at high risk of Adverse Drug Reactions due to:
having greater muscle ma than younger adults, leading to higher volume of distribution
the extensive studies that have been conducted on drug safety in this age group
age related decrease in renal function
the blood-brain barrier being le permeable, requiring higher doses to achieve therapeutic effects
Question 30A patient has been prescribed 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
is a hormone.
is a bile-acid resin.
inhibits cholesterol syntheses.
consists of a fibric acid derivative.
Question 31A Nurse Practitioner is caring for a patient who has recently moved from Vermont to south Florida. The patient has been on the same antihypertensive drug for 6 years and has had stable blood preures and no adverse effects. Since her move, however, she reports "dizzy spells and weakne" and feels that the drug is no longer effective. The Nurse Practitioner suspects that the change in the effectivene of the drug is related to
the impact of the placebo effect on the patient's response.
the accumulative effect of the drug if it has been taken for many years.
the impact of the warmer climate on the patient's physical state.
problems with patient compliance with the drug regimen due to the move.
Question 32A 70-year-old man with diabetes mellitus is taking metoprolol (Lopreor) to manage his hypertension. The nurse would be sure to instruct the patient to
take his pulse at least four times a day.
weigh himself once a week at the same time of the day.
avoid smoke-filled rooms.
understand the signs and symptoms of hypoglycemia.
Question 33A 58-year-old man is admitted 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?
Furosemide
Digoxin immune fab
Captopril
Dopamine
Question 34A patient is in the clinic for seasonal allergic rhinitis. Loratadine (Claritin) is prescribed. Which of the following statements will the nurse include when providing patient education concerning this drug?
"Be sure to take this medication on a full stomach."
"Determine if the drug is going to make you drowsy before you drive."
"You should take the medication twice a day."
"This drug has to be taken every 4 to 6 hours."
Question 35Which of the following is the strongest statin and dosage combination for the treatment of hyperlipidemia?
atorvastatin 20 mg
simvastatin 20 mg
rosuvastatin 10 mg
pravastatin 40 mg
fluvastatin 80 mg
Question 36How does cholestyramine lowers blood cholesterol?
Feedback inhibition of its synthesis
Hormonal repreion of cholesterol synthesis in the liver
Speeding conversion to steroid hormones
Sequestering bile salts and thus decreasing absorption and increasing catabolism
Question 37An 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
constipation.
falls.
xerostomia (dry mouth).
depreion.
Question 38NP is a 72-year-ol female with Parkinson’s x 3 years. She has been controlled on Amantadine until recently when she has been having more rigidity. You decide to put her on a dopamine agonist. Counseling on the new dopamine agonist would include:
• i. Delusions and hallucinations are common
• ii. The medication can slow disease progreion
• iii. Doses should be tapered slowly if discontinuing
• iv. Dyskinesias are common
• v. Sleep attacks are a poible side effect
i only
i and iii only
ii and iv only
i, iii and v only
All of the above
Question 39Which of the following is a 5HT3 receptor blocker for use in nausea/vomiting?
Ondansetron
Metoclopramide
Promethazine
Dicyclomine
Question 40All the following medications can be used to treat Nonalcoholic Fatty Liver Disease (NAFLD) except:
A. Metformin
B. Vitamin C
C. Pioglitazone
D. Vitamin E
Question 41Which of the following medications could worsen dementia in an Alzheimer patient?
Morphine
Benadryl
Sertraline
Atenolol
Question 42In order to promote therapeutic drug effects, the Nurse Practitioner should always encourage patients to
take their medication with meals.
take their medication at the prescribed times.
increase medication dosages if neceary.
use alternative therapy to increase the effects of their medications.
Question 43Which laxative can be used to treat opioid-induced constipation:
A. Mineral Oil
B. Bisacodyl
Senna
D. Docusate
Question 44A 24-year-old factory worker has been prescribed guaifenesin for the first time. Which of the following will be a priority aement by the nurse before the patient's first dose?
The amount of salt intake
The amount of alcohol consumption
The amount of fatty foods eaten daily
The number of cigarettes smoked per day
Question 45
Which of the following patients should be advised by the Nurse Practitioner to avoid over-the-counter cold and allergy preparations that contain phenylephrine?
A 47-year-old female with hypertension
A 52-year-old male with adult-onset diabetes
A 17-year-old female with symptoms of an upper respiratory infection
A 62-year-old male with gout
Question 46PS is a 54-year-old female who is diagnosed with a LE DVT on the right side due to HRT. The indicated treatment length is:
1 month
3 months
6 months
12 months
Question 47Typical adverse reactions to oral calcium-channel blockers include:
dyspnea
edema
fatigue
cough
Question 48The majority of cytochrome P450 (CYP) enzymes are located where?
heart
kidney
small intestine
brain
liver
Question 49A patient is recovering from an acute episode of thrombophlebitis and is being treated with warfarin (Coumadin) 5 mg PO daily. In reviewing medication information, the Nurse Practitioner would include what information in their teaching?
Maintain close watch on Intake and Output
Do not take a multivitamin supplement
Limit dairy products
Aerobic exercises are the most effective
Question 50A Nurse Practitioner is 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?
Coffee
Alcohol
Salt
Vitamin C
Question 51A 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?
Lubiprostone
Mesalamine
Docusate
Bismuth subsalicylate
Question 52
Metformin (Glucophage) acts by:
Enhancing insulin secretion
Decreasing hepatic glucose production with minor effects on insulin sensitivity in both liver and peripheral tiuess
Increasing sensitivity in the muscle and liver
Suppreing glucagon producrtion
Question 53Which are the following antiviral agents are used to treat influenza:
A. Valcyclovir
B. Oseltamivir
C. Ganciclovir
D. Sofosbuvir
Question 54Mr. Lastinger was prescribed warfarin sodium (Coumadin). You advise him to avoid eating large amounts of leafy green vegetables because:
The high vitamin K levels will decrease the INR
They have too much ascorbic acid, which can interact with the medicine
The high-fiber content will decrease the absorption of the Coumadin
The vitamins in the vegetables will bind with, and inactivate the Coumadin
Question 55In which of the following patients would a Nurse Practitioner expect to experience alterations in drug metabolism?
A 35-year-old woman with cervical cancer
A 41-year-old man with kidney stones
A 50-year-old man with cirrhosis of the liver
A 62-year-old woman in acute renal failure
Question 56The APRN is treating a 56 year old male with diagnosed atrial fibrillation. He is complaining of being light headed. His vital signs are BP 100/68 HR 144 RR 22. The best choice of medication to treat this patient is:
ACE-Inhibitor such as Lisinopril (Zestril®)
Diuretic such as HCTZ
Cardiac glycoside such as Digoxin
Beta blocker such as Metoprolol
Either 2 or 4 would be appropriate
Question 57A 62-year-old man is admitted 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?
Call the physician
Ask the patient to lie back and try to relax
Have the patient swallow a tablet every 5 minutes for 15 minutes
Administer a tablet under his tongue and repeat the action in 5 and 10 minutes if the pain has not subsided
Question 58Frequent episodes of exercise-related chest pain have caused a 79-year-old woman to use her prescribed nitroglycerin spray several times in recent weeks. This patient's age will have what effect on her use of nitroglycerin?
The woman may experience paradoxical vasoconstriction when taking nitroglycerin.
Decreased saliva production will inhibit the absorption of the drug in her mucosa.
The woman will need to allow more time between doses in order to facilitate absorption.
The woman will be more susceptible to hypotension than a younger patient.
Question 59Mr. Penny, age 67, was diagnosed with chronic angina several months ago and has been unable to experience adequate relief of his symptoms. As a result, his physician has prescribed ranolazine (Ranexa). Which of the following statements is true regarding the use of ranolazine for the treatment of this patient's angina?
Ranolazine confers protection from myocardial infarction but does not relieve symptoms of angina.
Amlodipine will now be contraindicated in the treatment of Mr. Penny's angina.
Mr. Penny will need to be taught to monitor his blood preure and heart rate.
Mr. Penny requires concurrent treatment with a beta blocker, nitrate, or a calcium channel blocker.
Question 60A 42-year-old male was started on Lamotrigine for recently diagnosed epilepsy. Which of these side effects is most likely to occur from this medication?
Liver function decrease
Erythematous skin rash
Hallucinations
Microcytic anemia
Question 61To minimize the risk of adverse effects of glucagon when given to an unconscious diabetic patient, as the patient regains consciousne, the nurse should
administer calcium supplements.
position the patient in the side-lying position.
administer carbohydrates.
monitor for nausea and vomiting.
Question 62Which of the following would not be a good choice as treatment for allergic rhinitis in the elderly?
Zyrtec
Flonase
Benadryl
Claritin
Question 63A patient has been prescribed an oral drug that is known to have a high first-pa effect. Which of the following measures has the potential to increase the amount of the free drug that is available to body cells?
Giving the drug with food in order to delay absorption
Administering the drug in small, frequent doses
Limiting the patient's protein intake and encouraging fluids
Administering the drug intravenously rather than orally
Question 64A 72-year-old man is prescribed theophylline for symptomatic relief of bronchial asthma. Which of the following findings would alert the nurse to the need for close monitoring?
Enlarged prostate gland
Need for additional bronchodilation
Signs of an active lung infection
Hypersensitivity to povidone
Question 65A Nurse Practitioner is providing discharge instructions to a patient who will be taking fludrocortisone at home. The Nurse Practitioner will encourage the patient to eat a diet that is
low in sodium and potaium.
low in sodium, high in potaium.
high in iron.
low in proteins.
Question 66The APRN's ability to prescribe controlled substances is regulated by:
FDA
DEA
State Law
All of the above
Question 67A patient with seasonal allergies is exasperated by her recent nasal congestion and has expreed her desire to treat it by using pseudoephedrine. The nurse should inform the patient that
under the Combat Methamphetamine Abuse Act, pseudoephedrine now requires a prescription.
drugs containing pseudoephedrine are available without a prescription but are kept off pharmacy shelves.
she must be prepared to show identification when buying a drug that contains pseudoephedrine.
pseudoephedrine is being phased out of the marketplace in order to combat illegal use.
Question 68A Nurse Practitioner is caring for a 61-year-old man who has had a severe attack of gout while in the hospital for food poisoning. The Nurse Practitioner administers colchicine intravenously in order to
avoid aggravating the gastrointestinal tract.
ensure quick distribution of the drug.
prevent the risk of infection or bleeding.
minimize the risk of depreed bone marrow function.
Question 69The point in time on the drug concentration curve that indicates the first sign of a therapeutic effect is the
Minimum adverse effect level
peak of action
therapeutic range
onset of action
Question 70A mother brings her 4-year-old child, who is vomiting and has a temperature of 103°F into the emergency department (ED). The ED physician orders acetaminophen (Tylenol) for the fever. The best form of Tylenol to give the child, considering her presentation, would be
liquid.
lozenge.
tablet.
suppository.
Question 71Which effect does the Nurse Practitioner expect may occur when using cholinergic agonists?
dry mouth
tachycardia
increased bladder tone
pupil dilation
Question 72A normal maintenance dose for digoxin is 0.125 to 0.5 mg/day. In which of the following patients would the nurse most likely administer a lower-than-normal maintenance dose of digoxin?
A 25-year-old male with congestive heart failure and atrial fibrillation
A 32-year-old female with cardiomegaly
A 79-year-old male with cardiomegaly
A 42-year-old female with a third heart sound
Question 73Which of the following medications is not included on Beers Criteria?
diphenhydramine
naproxen
glyburide
metformin
amitriptyline
Question 74Which are the following may result in a concerning drug-drug interaction when given with Omeprazole:
A. Tylenol
B. Metronidazole
C. Clopidogrel
D. Amoxicillin
Question 75A 42-year-old male with asthma has been using beta agonists for years. He has no developed arrhythmias. His PCP has started him on a higher dose of Atenolol. What would you expect to happen?
Atenolol is a beta agonist so the arrythmia worsened but asthma improved
Atenolol is beta nonselective to both improved
Atenolol increases airway obstruction worsening asthma but helped the arrythmia
Atenolol is cardioselective so it help the arrhythmia but did not exacerbate asthma
Question 76A Nurse Practitioner is caring for a patient who is diabetic and has been diagnosed with hypertension. An angiotensin-converting enzyme inhibitor, captopril, has been prescribed for her. Which of the following should the Nurse Practitioner ae before beginning drug therapy?
Serum calcium levels
Serum potaium levels
Blood glucose levels
Serum magnesium levels
Question 77What is the main difference between a first- and second-generation antihistamine drug?
First generation antihistamines cause le drowsine
First generation antihistamines case more dry mouth
Second generation antihistamines cause more dry eyes
Second generation antihistamines cause le headaches
Question 78A patient on valproic acid may experience which of the following symptoms?
Weight gain
Nausea
Constipation
All of the above
Question 79What is a serious side effect of ibuprofen in the older adult patient?
rebound headaches
Impairment of renal function
neuropathy
pancreatic failure
Question 80A 67-year-old man is admitted to the hospital with pneumonia. He reports to the nurse that he has chronic arthritis and circulation problems. Further aement by the nurse reveals that the patient has a history of mild hypertension. He explains that he owns a busine and lives alone. The nurse determines that he is within the normal weight range for his height and age but has a fondne for spicy foods and sweets. Which of the mentioned patient variables will have the greatest impact on the effectivene of the patient's drug therapy?
Vascular impairment
Mild hypertension
Dietary habits
Chronic arthritis
