NR 508 Advanced Pharmacology Weeks 1-8 Essay Help

Get NR 508 Advanced Pharmacology Weeks 1-8 Essay Help

NR 508 Advanced Pharmacology Weeks 1-8

NR 508 Advanced Pharmacology Entire Coursework Weeks 1 – 8

NR 508 Week 1 Discussion: Legal and Professional Issues in Prescribing (Original Post, Responses)

Legal and Professional Issues in Prescribing (Original Post and Responses)

1. Describe NP practice in Texas
2. Tell the class what Texas laws are … to nurse practitioner prescribing.
3. Include how many continuing education hours are … for Texas.
4. Describe the importance of knowing the specific laws in Texas pertaining to Nurse Practitioners prescribing medications.

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NR-508 Week 1 Homework: The Practicum Team and the FNP Practicum Process

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NR 508 Advanced Pharmacology: Week 1 Quiz

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NR-508 Week 2 RX Writing Assignment (Collection)

NR 508 Week 2 RX Writing Assignment / Approved Abbreviations / Lecture

Advanced Practice Nurses fought long and hard for prescriptive privilege so it is essential that you know how to write them accurately in order to minimize medication errors and adverse events. Prior to starting this assignment, student should read and familiarize themselves with the above mentioned resources. 1. Faculty will present to you a case scenario and you will accurately write a prescription(s). 2. Assignment is worth 50 points, regardless of the number of prescriptions that you are asked to write.

NR 508 Week 2 RX Writing: Escitalopram 10 mg (Dual Versions)

NR 508 Week 2 RX Writing: Celexa (citalopram) 20mgday tablet

John Smith 12/12/1969 needs a prescription for anxiety you decide to prescribe him an SSRI. Which one will you prescribe? What dose will you start him on and how often do you want him to take it. He will need to stay on it for two months with no refills. He lives at 567 Mills Lane Palmdale, CA 93550. Today’s date is Feb 11, 2016 NPI 1405798402

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NR 508 Week 2 Case Study Discussion: 3 Variants (Original Post & Responses)

Claudia is a 36-year-old mother of two G2P2, she recently delivered her last child 9 months ago, and has been using condoms for birth control for the last 7 months. Today she is requesting a more reliable birth control, she is not sure of her current pregnancy plans, however, she does not wish to discuss sterilization. No religious contraindications for treatment. Previous methods include condoms, and oral contraceptive pills. She thought about an IUD but is concerned her husband may feel it during intimacy.

PMH: positive for mild hypertension with first pregnancy, seasonal allergies.

Surgeries: Left inguinal hernia and tonsillectomy.

Family history: Mother HTN and Father colon CA both deceased

Social History: Denies tobacco use, wine one to two glasses a week, denies recreational drugs, exercises twice a week.

Drug allergies-Sulfa causes a rash. Current medications-MVI with Fe, Calcium chews, prn Allegra for allergies. Height 67 inches, weight 157 pounds, BP 110/75, P 70, R 16. PAP collected today, breast exam WNL, urine pregnancy negative.

Physical exam is normal.

1. What are your treatment goals for Claudia today?
2. What are two possible contraceptive methods for Claudia? Please give brief rationale for each.
3. Pick one method and list five (5) patient-centered teaching points for the method you chose today.
4. What would your contraceptive choice be if Claudia smoked 10-15 cigarettes per day? Explain your answer.

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NR-508 Advanced Pharmacology: Week 2 Quiz

NR 508 Advanced Pharmacology: Week 2 Quiz (June 2020)

1. Question: Patient presents with a complaint of vaginal discharge that when tested meets the criteria for bacterial vaginosis. Treatment of bacterial vaginosis in nonpregnant symptomatic women would be
2. Question: The medroxyprogesterone (Depo Provera) injection has a Black Box Warning due to
3. Question: Premenstrual dysphoric disorder (PMDD) occurs in a fairly small number of patients. Theories of the pathology behind PMDD that are supported in research include
4. Question: Factors common in women that can affect adherence to a treatment regimen include all of the following EXCEPT
5. Question: Long-term use of androgens requires specific laboratory monitoring of
6. Question: Which of the following holds true for the pharmacokinetics of women?
7. Question: Besides prescribing antimicrobial therapy, patients with bacterial vaginosis require education regarding the fact that
8. Question: Gender differences between men and women in pharmacokinetics include
9. Question: The mechanism of action of oral combined contraceptives that prevents pregnancy is
10. Question: Your patient comes to the clinic with a request for oral contraceptives. She has successfully used oral contraceptives before and has recently started dating a new boyfriend so would like to restart contraception. She denies recent intercourse and has a negative urine pregnancy test in the clinic. An appropriate plan of care would
    

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NR 508 Advanced Pharmacology: Week 2 Quiz (Spring 2020)

1. Question: Treatment for chancroid in a non-pregnant patient would be
2. Question: Women who are taking an oral contraceptive containing the progesterone drospirenone may require monitoring of
3. Question: Patient presents with a complaint of vaginal discharge that when tested meets the criteria for bacterial vaginosis. Treatment of bacterial vaginosis in non-pregnant symptomatic women would be
4. Question: Women are now the fastest growing population with HIV infection and AIDS. HIV-infected women
5. Question: Your patient comes to the clinic with a request for oral contraceptives. She has successfully used oral contraceptives before and has recently started dating a new boyfriend so would like to restart contraception. She denies recent intercourse and has a negative urine pregnancy test in the clinic. An appropriate plan of care would be
6. Question: The mechanism of action of oral combined contraceptives that prevents pregnancy is
7. Question: Dysmenorrhea is one of the most common gynecological complaints in young women. The first line of drug treatment for this disorder is
8. Question: Treatment for gonorrhea in a patient with a known anaphylactic reaction to Penicillin is
9. Question: Ongoing monitoring is essential after treating for gonorrhea. The patient should be rescreened for gonorrhea and chlamydia is
10. Question: When prescribing medroxyprogesterone (Depo Provera) injections, essential education would include advising of the following potential adverse drug effects
    

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NR 508 Advanced Pharmacology: Week 2 Quiz (Summer 2019)

1. Question: Which of the following drugs does not match with one of its potential side effects? Adverse effects)
2. Question: Lupus like syndrome can be an adverse effect of which of the following anti-arrhythmic agents:
3. Question: Which of the following diuretics is useful in the management of recurrent calcium stones? (Therapeutic use)
4. Question: Which of the following agents is the most appropriate choice as a diuretic in patients with hypertension, heart failure and renal failure? (Therapeutic use)
5. Question: Which of the antiarrhythmic agents has its action best described by decrease in myocardial conduction by inhibiting the influx of sodium through “fast” channels of the myocardial cells: 
   

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NR 508 Advanced Pharmacology: Week 2 Quiz (Possible Q & A)

1. Be familiar with prescriptive authority for nurse practitioners ( ch 2, pg 10)
2. Know the mechanisms of action of Tetracyclines (ch 61, pg 683)
3. … uses of Tetracycline antibiotics ( ch 61,pg 684)
4. Know Contraindications of oral contraceptive pills (OCP) (ch55, pg 634 )
5. Extended cycle monophasic pills, Transdermal and Vaginal Ring contraception. (Ch 54 pg 621)
6. Know how to prescribe a Nuva Ring for contraceptive management ( ch 54 pg, 616)
7. Prescribe oral contraceptive pills ( 54, pg 617)
8. Know how to read a T score or how to interpret a T score greater than 2.5 ( ch 39, pg 431)
9. Indications for progestin only contraception. Chapter 54 pg 621 and 627)
10. … Mechanisms by which pneumococci become resistant. TX of P. Falciparum.
11. ___ education regarding missed contraceptive management and what the patient would do if they did miss their management ( ch 54,pg 605)
12. …. first steps to take when opioid abuse is suspected Physical assessment and labs?
13. … mechanism of action of penicillin ( ch 59,pg 672)
14. Know the treatment for systemic infections caused by Aspegillus, Blastomyces, Candidia albicans, Histoplasma & Cryptoccoccus ( ch 67pg 722)
15. Know the treatment of meningitis in AIDS patients ( ch 67, pg 722)
16. … usage of vancomycin and it’s mechanism of action ( ch 58,m pg 668)
17. Know the vitamin-K Dependent clotting factors ( ch 25,pg 310)
18. … Uses of the different generations of Cephalosporins.( 60,pg 677)
19. Patient education necessary when prescribing Combined Oral Contraceptive Pills (COCPs). (ch 54 pg 617)

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NR 508 Week 3 RX Writing Assignment (Collection)

Metoprolol 50mg

Kathy James 6/12/1960 comes into your office on July 10, 2001, she has hypertension and she needs a prescription for Metoprolol. She will take 25 mg twice a day it comes in 50 mg tablets. She also wants to change to mail-order delivery so she will need her prescription written for a 90 day supply. Her next appt is in 6 months, provide enough medication until the next visit. She lives at 125 Palm Tree Ln., Dallas, TX 99999NPI 1405798402

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NR-508 Week 3 Case Study Discussion: Case of Mr. Russell (Original Post & Responses)

Mr. Russell is a 73-year-old male who presents to your clinic with complaints heart palpitations and light headedness on and off for the past 3 months. He has a history of hypertension and is currently prescribed HCTZ. He also is complaining of heartburn and belching after a large meal.

Vital Signs: B/P 159/95, Irregular HR 88, Resp. 22, Weight 99 kilograms

Lower extremities with moderate 3+edema noted in left leg, 2 + edema in right leg, ABD + BS, Neuro AOX3,

Labs: NA 143mEq/L, CL 99 mmol/L BUN 18mg/dL, Hbg 15, TC 234 mg/dL, LDL 137 mg/dL, HDL 35 mg/dL, triglycerides 241mg/dL,

• What are your treatment goals for Mr. Russell today?
• What is your pharmacologic plan; please state your rationale for your plan?
• What are five key patient education points based on your plan?
• How would your plan change if your patient is African American?

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NR 508 Advanced Pharmacology: Week 3 Quiz

NR 508 Advanced Pharmacology: Week 3 Quiz (June 2020)

1. Question: Ranolazine is … in angina patients to
2. Question: Antacids treat gastroesophageal reflux disease by:
3. Question: Your patient has type 2 diabetes and a high triglyceride level. She has gemfibrozil prescribed to treat her hypertriglyceridemia. A history of which of the following might contraindicate the use of this drug?
4. Question: Joanne is a 60-year-old patient with an LDL of 132 and a family history of coronary artery disease. She has already tried diet changes (increased fiber and plant sterols) to lower her LDL and after 6 months her LDL is still above goal. The next step in her treatment would be
5. Question: Many patients with hyperlipidemia are … with more than one drug. Combining a fibric acid derivative such as gemfibrozil with which of the following is not recommended? The drug and the reason must both be correct for the answer to be correct.
6. Question: Amiodarone has been … in a patient with a supraventricular dysrhythmia. Patient teaching should include all of the following EXCEPT:
7. Question: If a patient with gastroesophageal reflux disease who is taking a proton pump inhibitor daily is not improving, the plan of care would be:
8. Question: Kelly has diarrhea and is wondering if she can take loperamide (Imodium) for the diarrhea. Loperamide:
9. Question: Ray has been … with hypertension and an angiotensin-converting enzyme inhibitor is determined to be needed. Prior to prescribing this drug, the NP should assess for:
10. Question: Rapid-acting nitrates are important for all angina patients. Which of the following are true statements about their use?
    

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NR 508 Advanced Pharmacology: Week 3 Quiz (March 2020)

1. Question: Increased life expectancy for patients with heart failure has been … with the Tuospe of
2. Question: Angina is … by an imbalance between myocardial oxygen supply (MOS) and demand (MOD) in the myocardium. Which of the … drugs help to correct this imbalance by increasing MOS?
3. Question: Colestipol comes in a powdered form. The patient is … to
4. Question: … of the following persons should not have a statin medication ordered?
5. Question: Goals of treating hyperlipidemia include:
6. Question: Laboratory monitoring for patients on angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers should include:
7. Question: — New York Heart … and the Canadian Cardiovascular Society have described grading criteria for levels of angina. Angina that occurs with unusually strenuous activity or on walking or climbing stair after meals is class:
8. Question: Treatments for heart failure, including drug therapy, are … on the stages … by the ACC/AHA. Stage A patients are treated with
9. Question: Rodrigo has been … procainamide after amyocardial infarction. He is monitored for dyspnea, jugular venous distention, and peripheral edema because they may indicate:
10. Question: Which diuretic agents typically do not need potassium supplementation?
    

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NR 508 Advanced Pharmacology: Week 3 Quiz (Spring 2020)

1. Question: Commercials on TV for erectile dysfunction (ED) medications warn about mixing them with nitrates. Why?
2. Question: Which of the following persons should not have a statin medication ordered?
3. Question: Angiotensin-converting enzyme inhibitors are useful in a variety of disorders. Which of the following statements are true about both its usefulness in the disorder and the reason for its use?
4. Question: After H. pylori treatment is completed, the next step in peptic ulcer disease therapy is
5. Question: Which of the following is true about procainamide and its dosing schedule?
6. Question: An acceptable first-line treatment for peptic ulcer disease with positive H. pylori test is:
7. Question: Ray has been diagnosed with hypertension and an angiotensin-converting enzyme inhibitor is determined to be needed. Prior to prescribing this drug, the NP should assess for:
8. Question: Antacids treat gastroesophageal reflux disease by:
9. Question: Bismuth subsalicylate (Pepto Bismol) is a common OTC remedy for gastrointestinal complaints. Bismuth subsalicylate:
10. Question: Direct renin inhibitors have the following properties. They
    

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NR 508 Advanced Pharmacology: Week 3 Quiz (Fall 2019)

Get NR 508 Advanced Pharmacology Weeks 1-8 Essay Help

1. Question: Which of the … agents is useful in treating angina but is avoided in patients with heart failure and atrioventricular nodal conduction abnormalities due to its significant effects of myocardial contractile force: (therapeutic effects and adverse)
2. Question: Which is the anti-lipidemic agent that competitively inhibits HMG CoA reductase enzymes in the biosynthesis of cholesterol? (Dynamics, mechanism)
3. Question: DM is a 46 y/o female with diabetes. Her medicine was recently … to a high HGA1c. One month later she starts to develop reoccurring vaginal candidiasis. Which of the following may be responsible?
4. Question: Which of the following is an antianginal agent … to reduce myocardial oxygen demand by its effects of vascular smooth muscle calcium channels? (dynamics, mechanism)
5. Question: A patient on an antihypertensive drug comes to your office complaining of dry cough. You switched the patient to another drug that inhibits similar pharmacologic mechanisms, and now the pt does not complain of dry cough anymore. Which is the drug that the patient is currently on? (Adverse ACE inhibitors).

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NR 508 Week 4 Midterm Exam: Collection

NR 508 Week 4 Midterm Exam (Spring 2020)

1. Question: A patient may develop neutropenia from using topical Silvadene for burns.
2. Question: Food in GI tract affects absorption by Antacids such as calcium carbonate (Tums) can reduce the absorption of which of the following nutrients?
3. Question: Antacids such as calcium carbonate (Tums) can reduce the absorption of which of the following nutrients?
4. Question: Drug Metabolism; A low-carbohydrate, high-protein diet may-
5. Question: Recommended fiber daily intake?
6. Question: Vitamin that is useful for migraine prophylaxis ;
7. Question: New over-the-counter drug ingredients must undergo the U.S. Food and Drug Administration New Drug Application process, just as prescription drugs do:
8. Question: As drugs near the end of their patent, pharmaceutical companies may apply for the drug to change to over-the-counter status in order to:
9. Question: Adherence to beta blocker therapy may be affected by their:
10. Question: To reduce potential adverse effects, patients taking a peripherally acting alpha₁ antagonist should do all of the following EXCEPT:
11. Question: Which of the following adverse effects are less likely in a beta1-selective blocker?
12. Question: To prevent life-threatening events from rapid withdrawal of a beta blocker:
13. Question: Bethanechol–
14. Question: Beta blockers are prescribed for diabetics with caution because of their ability to produce hypoglycemia and block the common symptoms of it. Which of the following symptoms of hypoglycemia is not blocked by these drugs and so can be used to warn diabetics of possible decreased blood glucose?
15. Question: The benefits to the patient of having an Advanced Practice Registered Nurse (APRN) prescriber include:
16. Question: The route of excretion of a volatile drug will likely be the:
17. Question: Medroxyprogesterone (Depo Provera) is prescribed intramuscularly (IM) to create a storage reservoir of the drug. Storage reservoirs:
18. Question: The NP chooses to give cephalexin every 8 hours based on knowledge of the drug’s:
19. Question: The point in time on the drug concentration curve that indicates the first sign of a therapeutic effect is the:
20. Question: Phenytoin requires that a trough level be drawn. Peak and trough levels are done:
21. Question: Drugs that are receptor agonists may demonstrate what property
22. Question: Factors that affect gastric drug absorption include:
23. Question: Drugs administered via IV:
24. Question: Infants and young children are at higher risk of ADRs due to:
25. Question: The elderly are at high risk of ADRs due to:
26. Question: Digoxin may cause a type A adverse drug reaction due to:
27. Question: Food in the gastrointestinal tract affects drug absorption by:
28. Question: Fasting for an extended period can:
29. Question: Tetracycline needs to be given on an empty stomach because it chelates with:
30. Question: A low-carbohydrate, high-protein diet may:
31. Question: Patients taking warfarin need to be educated about the vitamin K content of foods to avoid therapeutic failure. Foods high in vitamin K that should be limited to no more than one serving per day include:
32. Question: The American Dietetic Association has recommended the use of specific nutritional supplements in the following population(s):
33. Question: There is strong evidence to support that adequate vitamin C intake prevents:
34. Question: Pharmacoeconomics is:
35. Question: When the costs of a specific treatment or intervention are calculated and then compared with the dollar value of the benefit received it is referred to as:
36. Question: Charlie is a 65-year-old male who has been diagnosed with hypertension and benign prostatic hyperplasia. Doxazosin has been chosen to treat his hypertension because it:
37. Question: Richard is 70 years old and has a history of cardiac dysrhythmias. He has been prescribed nadolol. You do his annual laboratory work and find a CrCl of 25 ml/min. What action should you take related to his nadolol?
38. Question: An NP would prescribe the liquid form of ibuprofen for a 6-year-old child because:
39. Question: A comprehensive assessment of a patient should be holistic when trying to determine competence in drug administration. Which of the following factors would the NP omit from this type of assessment?
40. Question: Elena Vasquez’s primary language is Spanish, and she speaks very limited English. Which technique would be appropriate to use in teaching her about a new drug you have just prescribed?
41. Question: Rod, age 68, has hearing difficulty. Which of the following would NOT be helpful in assuring that he understands teaching about his drug?
42. Question: Ralph’s blood pressure remains elevated despite increased doses of his drug. The NP is concerned that he might not be adhering to his treatment regimen. Which of the following events would suggest that he might not be adherent?
43. Question: Antonia is a 3-year-old child who has a history of status epilepticus. Along with her routine antiseizure medication, she should also have a home prescription for_________ to be used for an episode of status epilepticus.
44. Question: Long-term monitoring of patients who are taking carbamazepine includes:
45. Question: Six-year-old Lucy has recently been started on ethosuximide (Zarontin) for seizures. She should be monitored for:
46. Question: Monitoring of a patient on gabapentin to treat seizures includes:
47. Question: Levetiracetam has known drug interactions with:
48. Question: Samantha is taking lamotrigine (Lamictal) for her seizures and requests a prescription for combined oral contraceptives (COCs), which interact with lamotrigine and may cause:
49. Question: A 66-year-old male was prescribed phenelzine (Nardil) while in an acute psychiatric unit for recalcitrant depression. The NP managing his primary health care needs to understand the following regarding phenelzine and other monoamine oxidase inhibitors (MAOIs):
50. Question: Isosorbidedinitrate is a long-acting nitrate given twice daily. The schedule for administration is 7 a.m. and 2 p.m. because:.
    

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NR 508 Week 4 Mid-term Exam (Retired 2018-19)

1. Question: A primary care NP prescribes levothyroxine for a patient to treat thyroid deficiency. When teaching this patient about the medication, the NP should:
2. Question: An African-American patient is taking captopril (Capoten) 25 mg twice daily. When performing a physical examination, the primary care nurse practitioner (NP) learns that the patient continues to have blood pressure readings of 135/90 mm Hg. The NP should:
3. Question: A primary care NP sees a patient who is about to take a cruise and reports having had motion sickness with nausea on a previous cruise. The NP prescribes the scopolamine transdermal patch and should instruct the patient to apply the patch:
4. Question: A 12-year-old patient who is obese develops type 2 diabetes mellitus. The primary care NP should order
5. Question: A patient who has had four to five liquid stools per day for 4 days is seen by the primary care NP. The patient asks about medications to stop the diarrhea. The NP tells the patient that antidiarrheal medications are:
6. Question: In every state, prescriptive authority for NPs includes the ability to write prescriptions
7. Question: A 55-year-old woman has a history of myocardial infarction (MI). A lipid profile reveals LDL of 130 mg/dL, HDL of 35 mg/dL, and triglycerides 150 mg/dL. The woman is sedentary with a body mass index of 26. The woman asks the primary care NP about using a statin medication. The NP should:
8. Question: A patient develops hypertension. The primary care nurse practitioner (NP) plans to begin diuretic therapy for this patient. The NP notes clear breath sounds, no organomegaly, and no peripheral edema. The patient’s serum electrolytes are normal. The NP should prescribe:
9. Question: The primary care nurse practitioner (NP) is using critical thinking skills when
10. Question: A patient comes to the clinic and asks the primary care NP about using a newly developed formulation of the drug the patient has been taking for a year. When deciding whether or not to prescribe this formulation, the NP should:
11. Question: A patient takes a cardiac medication that has a very narrow therapeutic range. The primary care NP learns that the particular brand the patient is taking is no longer … by the patient’s medical plan. The NP knows that the bioavailability of the drug varies from brand to brand. The NP should:
12. Question: In this case, the NP should advocate for the desired drug because changing the drug can have life-threatening consequences. If this fails, other options may have to … explored.
13. Question: To increase the likelihood of successful pharmacotherapy, when teaching a patient about using a medication, the primary care nurse practitioner (NP) should:
14. Question: A patient in the clinic develops sudden shortness of breath and tachycardia. The primary care NP notes thready pulses, poor peripheral perfusion, and a decreased level of consciousness. The NP activates the emergency medical system and should anticipate that this patient will receive:
15. Question: A primary care nurse practitioner (NP) prescribes a drug to an 80-year-old African-American woman. When selecting a drug and determining the correct dose, the NP should understand that the knowledge of how age, race, and gender may affect drug excretion is based on an understanding of:
16. Question: An 80-year-old female patient with a history of angina has increased TSH and decreased T4. The primary care NP should prescribe _____ mcg of _____.
17. Question: A patient who has a history of chronic constipation uses a bulk laxative to prevent episodes of acute constipation. The patient reports having an increased frequency of episodes. The primary care NP should recommend:
18. Question: A patient comes to the clinic to discuss weight loss. The primary care NP notes a BMI of 32 and performs a health risk assessment that reveals no obesity-related risk factors. The NP should recommend:
19. Question: A primary care NP sees a 3-year-old patient who has been vomiting for several days. The child has had fewer episodes of vomiting the past day and is now able to take sips of fluids without vomiting. The child has dry oral mucous membranes, 2-second capillary refill, and pale but warm skin. The child’s blood pressure is 88/46 mm Hg, the heart rate is 110 beats per minute, and the temperature is 37.2° C. The NP should:
20. Question: A primary care NP sees a 5-year-old child who is morbidly obese. The child has an elevated hemoglobin A1c and increased lipid levels. Both of the child’s parents are overweight but not obese, and they tell the NP that they see nothing wrong with their child. They both state that it is difficult to refuse their child’s requests for soda or ice cream. The NP should:
21. Question: The primary care NP refers a patient to a cardiologist who diagnoses long QT syndrome. The cardiologist has prescribed propranolol (Inderal). The patient exercises regularly and is not obese. The patient asks the NP what else can be done to minimize risk of sudden cardiac arrest. The NP should counsel the patient to:
22. Question: A 55-year-old patient with no prior history of hypertension has a blood pressure greater than 140/90 on three separate occasions. The patient does not smoke, has a body mass index of 24, and exercises regularly. The patient has no known risk factors for cardiovascular disease. The primary care NP should:
23. Question: The primary care NP sees a patient who has a history of hypertension and alcoholism. The patient is not taking any medications. The NP auscultates crackles in both lungs and palpates the liver 2 cm below the costal margin. Laboratory tests show an elevated creatinine level. The NP will refer this patient to a cardiologist and should prescribe:
24. Question: An 80-year-old patient has begun taking propranolol (Inderal) and reports feeling tired all of the time. The primary care NP should:
25. Question: A patient reports having occasional acute constipation with large, hard stools and pain and asks the primary care NP about medication to treat this condition. The NP learns that the patient drinks 1500 mL of water daily; eats fruits, vegetables, and bran; and exercises regularly. The NP should recommend:
26. Question: A 40-year-old patient is in the clinic for a routine physical examination. The patient has a body mass index (BMI) of 26. The patient is active and walks a dog daily. A lipid profile reveals low-density lipoprotein (LDL) of 100 mg/dL, high-density lipoprotein (HDL) of 30 mg/dL, and triglycerides of 250 mg/dL. The primary care nurse practitioner (NP) should:
27. Question: An 80-year-old patient asks a primary care NP about OTC antacids for occasional heartburn. The NP notes that the patient has a normal complete blood count and normal electrolytes and a slight elevation in creatinine levels. The NP should recommend:
28. Question: A primary care NP sees a 60-year-old woman for a physical examination. The woman tells the NP she is taking tamoxifen for treatment of breast cancer. To monitor her response to this medication, the NP should order:
29. Question: The primary care NP sees a patient who has heart failure following an MI 6 months before this visit. The patient has been taking an ACE inhibitor, nitroglycerin, furosemide, and hydrochlorothiazide. The NP auscultates crackles in both lungs and notes pitting edema of both feet. The NP should prescribe:
30. Question: A primary care NP prescribes a COCP for a woman who has never taken oral contraceptives before. The woman is in a monogamous relationship, and she and her partner have been using condoms and wish to stop using them. Her last period was 1 week ago. The NP should:
31. Question: A woman is in her first trimester of pregnancy. She tells the primary care nurse practitioner (NP) that she continues to have severe morning sickness on a daily basis. The NP notes a weight loss of 1 pound from her previous visit 2 weeks prior. The NP should consult an obstetrician and prescribe:
32. Question: A thin 52-year-old woman who has recently had a hysterectomy tells the primary care NP she is having frequent hot flashes and vaginal dryness. A recent bone density study shows early osteopenia. The woman’s mother had CHD. She has no family history of breast cancer. The NP should prescribe:
33. Question: Persistent atrial fibrillation (AF) is diagnosed in a patient who has valvular disease, and the cardiologist has prescribed warfarin (Coumadin). The patient is … for electrical cardioversion in 3 weeks. The patient asks the primary care nurse practitioner (NP) why the procedure is necessary. The NP should tell the patient:
34. Question: A patient reports having episodes of dizziness, nausea, and lightheadedness and describes a sensation of the room spinning when these occur. The primary care NP will refer the patient to a specialist who, after diagnostic testing, is likely to prescribe:
35. Question: The primary care NP is seeing a patient for a hospital follow-up after the patient has had a first myocardial infarction. The patient has a list of the prescribed medications and tells the NP that “no one explained anything about them.” The NP’s initial response should be to:
36. Question: A patient who has hypothyroidism has been taking levothyroxine 50 mcg daily for 2 weeks. The patient reports continued fatigue. The primary care NP should:
37. Question: A patient has been taking levothyroxine 100 mcg daily for several months. The patient comes to the clinic with complaints of insomnia and irritability. The primary care NP notes a heart rate of 92 beats per minute. The NP should:
38. Question: A woman with a family history of breast cancer had her last menstrual period 12 months ago and is experiencing hot flashes. She has not had a hysterectomy. The primary care NP should recommend:
39. Question: A patient who has migraine headaches has begun taking timolol and 2 months after beginning this therapy reports no change in frequency of migraines. The patient’s current dose is 30 mg once daily. The primary care NP should:
40. Question: A patient who takes a thiazide diuretic will begin taking an ACE inhibitor. The primary care NP should counsel the patient to:
41. Question: A parent brings a child who has moderate-persistent asthma to the clinic and tells the primary care NP that none of the child’s medications are working. The parent says, “Everybody tells me something different. I don’t know what to do.” The NP suspects that the parent is not administering the medications appropriately. The NP should initially:
42. Question: A patient has been … with IBS and tells the primary care NP that symptoms of diarrhea and cramping are worsening. The patient asks about possible drug therapy to treat the symptoms. The NP should prescribe:
43. Question: A patient who is taking an ACE inhibitor sees the primary care NP for a follow-up visit. The patient reports having a persistent cough. The NP should:
44. Question: The primary care NP is reviewing evidence-based recommendations about the off-label use of a particular drug. Which recommendation should influence the NP’s decision about prescribing the medication?
45. Question: A 50-year-old woman who is postmenopausal is taking an aromatase inhibitor as part of a breast cancer treatment regimen. She calls her primary care NP to report that she has had hot flashes and increased vaginal discharge but no bleeding. The NP should:
46. Question: Which of the following has influenced an emphasis on primary care education in medical schools?
47. Question: A patient who is newly … with type 2 diabetes mellitus has not … to changes in diet or exercise. The patient is mildly obese and has a fasting blood glucose of 130 mg/dL. The patient has normal renal function tests. The primary care NP plans to prescribe a combination product. Which of the following is … for this patient?
48. Question: A patient who has stable angina is taking nitroglycerin and a β-blocker. The patient tells the primary care NP that the cardiologist is considering adding a calcium channel blocker. The NP should anticipate that the cardiologist will prescribe:
49. Question: An adolescent girl has chosen Depo-Provera as a contraceptive method and tells the primary care NP that she likes the fact that she won’t have to deal with pills or periods. The primary care NP should tell her that she:
50. Question: A patient comes to the clinic reporting dizziness and fatigue associated with nausea and vomiting. The primary care NP suspects anemia and orders a complete blood count. The patient’s hemoglobin is … The NP correctly concludes that the patient is not anemic. The NP has made an error in:
51. Question: A patient who takes digoxin reports taking psyllium (Metamucil) three or four times each month for constipation. The primary care NP should counsel this patient to:
52. Question: A patient bursts into tears when the primary care NP diagnoses diabetes. The NP should:
53. Question: A primary care NP orders thyroid function tests. The patient’s TSH is 1.2 microunits/mL, and T4 is 1.7 ng/mL. The NP should:
54. Question: A patient who is obese is preparing to have surgery. To help prevent venous thromboembolism (VTE), the primary care NP should prescribe:
55. Question: CRNAs in most states:
56. Question: A patient who has GERD with erosive esophagitis has been taking a PPI for 4 weeks and reports a decrease in symptoms. The patient asks the primary care NP if the medication may … discontinued. The NP should tell the patient that:
57. Question: A patient with type 2 diabetes mellitus takes metformin (Glucophage) 1000 mg twice daily and glyburide (Micronase) 12 mg daily. At an annual physical examination, the BMI is 29 and hemoglobin A1c is 7.3%. The NP should:
58. Question: The primary care NP prescribes an inhaled corticosteroid for a patient who has asthma. The third-party payer for this patient denies coverage for the brand that comes in the specific strength the NP prescribes. The NP should:
59. Question: A 30-year-old white woman has a BMI of 26 and weighs 150 lb. At an annual physical examination, the patient’s fasting plasma glucose is 130 mg/dL. The patient walks 1 mile three or four times weekly. She has had two children who weighed 7 lb and 8 lb at birth. Her personal and family histories are noncontributory. The primary care NP should:
60. Question: A primary care NP is preparing to prescribe a drug and notes that the drug has nonlinear kinetics. The NP should:

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NR-508 Week 4 Midterm Exam: Real Exam

1. Question: A patient may develop neutropenia from using topical Silvadene for burns.
2. Question: Food in GI tract affects absorption by Antacids such as calcium carbonate (Tums) can reduce the absorption of which of the following nutrients?
3. Question: Antacids such as calcium carbonate (Tums) can reduce the absorption of which of the following nutrients?
4. Question: Drug Metabolism; A low-carbohydrate, high-protein diet may-
5. Question: Recommended fiber daily intake?
6. Question: Vitamin that is useful for migraine prophylaxis ;
7. Question: New over-the-counter drug ingredients must undergo the U.S. Food and Drug Administration New Drug Application process, just as prescription drugs do:
8. Question: As drugs near the end of their patent, pharmaceutical companies may apply for the drug to change to over-the-counter status in order to:
9. Question: Adherence to beta blocker therapy may be affected by their:
10. Question: To reduce potential adverse effects, patients taking a peripherally acting alpha₁ antagonist should do all of the following EXCEPT:
11. Question: Which of the following adverse effects are less likely in a beta1-selective blocker?
12. Question: To prevent life-threatening events from rapid withdrawal of a beta blocker:
13. Question: Bethanechol–
14. Question: Beta blockers are prescribed for diabetics with caution because of their ability to produce hypoglycemia and block the common symptoms of it. Which of the following symptoms of hypoglycemia is not blocked by these drugs and so can be used to warn diabetics of possible decreased blood glucose?
15. Question: The benefits to the patient of having an Advanced Practice Registered Nurse (APRN) prescriber include:
16. Question: The route of excretion of a volatile drug will likely be the:
17. Question: Medroxyprogesterone (Depo Provera) is prescribed intramuscularly (IM) to create a storage reservoir of the drug. Storage reservoirs:
18. Question: The NP chooses to give cephalexin every 8 hours based on knowledge of the drug’s:
19. Question: The point in time on the drug concentration curve that indicates the first sign of a therapeutic effect is the:
20. Question: Phenytoin requires that a trough level be drawn. Peak and trough levels are done:
21. Question: Drugs that are receptor agonists may demonstrate what property
22. Question: Factors that affect gastric drug absorption include:
23. Question: Drugs administered via IV:
24. Question: Infants and young children are at higher risk of ADRs due to:
25. Question: The elderly are at high risk of ADRs due to:
26. Question: Digoxin may cause a type A adverse drug reaction due to:
27. Question: Food in the gastrointestinal tract affects drug absorption by:
28. Question: Fasting for an extended period can:
29. Question: Tetracycline needs to be given on an empty stomach because it chelates with:
30. Question: A low-carbohydrate, high-protein diet may:
31. Question: Patients taking warfarin need to be educated about the vitamin K content of foods to avoid therapeutic failure. Foods high in vitamin K that should be limited to no more than one serving per day include:
32. Question: The American Dietetic Association has recommended the use of specific nutritional supplements in the following population(s):
33. Question: There is strong evidence to support that adequate vitamin C intake prevents:
34. Question: Pharmacoeconomics is:
35. Question: When the costs of a specific treatment or intervention are calculated and then compared with the dollar value of the benefit received it is referred to as:
36. Question: Charlie is a 65-year-old male who has been diagnosed with hypertension and benign prostatic hyperplasia. Doxazosin has been chosen to treat his hypertension because it:
37. Question: Richard is 70 years old and has a history of cardiac dysrhythmias. He has been prescribed nadolol. You do his annual laboratory work and find a CrCl of 25 ml/min. What action should you take related to his nadolol?
38. Question: An NP would prescribe the liquid form of ibuprofen for a 6-year-old child because:
39. Question: A comprehensive assessment of a patient should be holistic when trying to determine competence in drug administration. Which of the following factors would the NP omit from this type of assessment?
40. Question: Elena Vasquez’s primary language is Spanish, and she speaks very limited English. Which technique would be appropriate to use in teaching her about a new drug you have just prescribed?
41. Question: Rod, age 68, has hearing difficulty. Which of the following would NOT be helpful in assuring that he understands teaching about his drug?
42. Question: Ralph’s blood pressure remains elevated despite increased doses of his drug. The NP is concerned that he might not be adhering to his treatment regimen. Which of the following events would suggest that he might not be adherent?
43. Question: Antonia is a 3-year-old child who has a history of status epilepticus. Along with her routine antiseizure medication, she should also have a home prescription for_________ to be used for an episode of status epilepticus.
44. Question: Long-term monitoring of patients who are taking carbamazepine includes:
45. Question: Six-year-old Lucy has recently been started on ethosuximide (Zarontin) for seizures. She should be monitored for:
46. Question: Monitoring of a patient on gabapentin to treat seizures includes:
47. Question: Levetiracetam has known drug interactions with:
48. Question: Samantha is taking lamotrigine (Lamictal) for her seizures and requests a prescription for combined oral contraceptives (COCs), which interact with lamotrigine and may cause:
49. Question: A 66-year-old male was prescribed phenelzine (Nardil) while in an acute psychiatric unit for recalcitrant depression. The NP managing his primary health care needs to understand the following regarding phenelzine and other monoamine oxidase inhibitors (MAOIs):
50. Question: Isosorbidedinitrate is a long-acting nitrate given twice daily. The schedule for administration is 7 a.m. and 2 p.m. because:

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NR 508 Week 4 Midterm Exam: Possible Q&A

1. Which of the following … shown to prolong life in patients with chronic congestive failure in spite of having a negative inotropic effect on cardiac contractility?
2. Which of the following statements gives the best explanation for the use beta-blockers in congestive heart failure?
3. — molecular mechanism of action of digoxin (Lanoxin, Cardoxin) used in the management of congestive heart failure?
4. Which of the following is an aldosterone antagonist and is useful in the management of hypertensive patients with hypokalemia?
5. ….. agents is the most appropriate choice as a diuretic in patients with hypertension, heart failure and renal failure?
6. Which is the atypical antidepressant known to block the reuptake of dopamine & norepinephrine (NDRI) and in known to treat depression & nicotine addiction?
7. Which is the drug increase GABA activity & chloride conductance in neuronal cells thus inhibiting action potentials and is known to treat anxiety, convulsions and could cause marked sedation?
8. .-.-.-.- agents is a carbonic anhydrase inhibitor that works at the proximal convolutedtubule and is used in the treatment of ocular hypertension?
9. ____ drugs bind to 30s ribosome units and is used in the treatment of Proponibacterum( acne), mycoplasma, chlamydae, and helicobacterinfections?
10. The primary care NP see a patient several months after a myocardial infarction. The patient has been furosemide to treat heart failure.. The NP notes that the patient has edema of the hands , feet and ankles. The NP should add which drug?
11. MK is a 64-year-old male taking Lisinopril for HTN. One month after starting the drug he noted to have a decline in renal function. Which is true?
12. A 55-year-old patient developsParkinson’s diseasecharacterized by unilateral tumors only. The primary care NP will referrer the patient to a neurologist and should expect initial treatment to be ?
13. Which of the following drugs is a calciumchannel blocker that slows cardiac conduction directly and thus decreases heart rates and oxygen demand?
14. Which of the following is an …. pharmacologic agent … for rapid conversion of atrial arrhythmias? Prior to the approval, electrical cardioversion was the … choice for rapid conversion of atrial fibrillation to normal sinus rhythm?
15. Early stage Alzheimer’s disease is diagnosed in a patient and the primary care NP recommended therapyis necessary because most functioning is intact. The NP should explain that medication may?
16. LO a 38-year-old with a history of depression and migraine headaches. In mid Julyshe calls your office worried because she takes fluoxetine and occasionally Sumatriptan and heard a warningwas issued re : the use of the two together. What is the concern?
17. Which of the following agents is most appropriatechose as a diuretic in patients with hypertension, heart failure and renal failure? ( therapeutic multipleuses )?
18. Which is the antifungal drugs, useful treating fungal meningitis in AIDS patients that reduces ” ergosterol synthesis” in fungal cell membranes by inhibiting 14 alpha demethylases, a fungal cytochomeP450 enzyme?
19. A patient taking hydrochlorothiazideto treat hypertension and ask the primarycare NP why it is necessary to reduce sodium intake while taking this medication. The NP should explain that decreasing sodium is necessary to ?
20. Which of the following agents used in class II and class III heart failures is known to have alpha as well as non-selectivebeta blocking action?
21. in addition to inhibiting proteins C and S, what specificvitamin K dependent clotting factors does warfarin inhibit?
22. What potential side effects would you mention to a patient recently started on mefedipine(Procardia)?
23. Which of the following agents is carbonic anhydrase inhibitor useful in the management of high altitude sicknessand edema with alkalosis? ( therapeuticapplication)?
24. /41? A patient on an antihypertensive drug comes to your office complaining of a dry cough. You switch the patient to another drug that inhibits similar pharmacologic mechanism, and now the patient does not complain about dry cough any more. Which is the drug that the patient is presently on? (adverse ace inhibitors)?
25. Which of the antiarrhythmic agents has its action best described by decrease in myocardial conduction by inhibiting the influx of sodium through ” fast ” channels of the myocardial cells?
26. You have decided to start an SSRI on a 70-year-old patient with major depression. You choose to avoidthe following SSRI due to its increased risk of sedation and drug interactions compared to others in this class?
27. A patient who has Parkinson’sdisease and who takes levodopa reports that the drug effects wear off more quickly than before. The primary care NP should?
28. KL is a 58-year-old female with asthma and angina. Which of the following medications is generallyavoided in those with asthma?
29. ._._._ is an aldosterone antagonist and is useful in the management of hypertensive pt.’swith hypokalemia?
30. Which of the selective serotoninreceptors antagonist with long duration of action lowest potential for discontinuation syndrome, and is used in the management of depression, panic disorder and pre menstaturaldysmorphia?
31. —- steroidal, antihypertensive agent that works on collecting tubuleluminal membrane by direct antagonism of mineralocorticoidreceptors? Pharmacodynamics, mechanism)?
32. Which of the following agents can treat anaerobic bacterial infections as well as protozoal infections by Entamoeba( causes ameobiasis) and has a shorter duration of therapy than metronidazole?
33. Which is the drug clinically useful in the treatmentof systemic infectionscaused by aspergillus, blastomyces, candida albicans, Histoplasma & Cryptococcus?
34. A patient who has Parkinsondisease who takes levodopaand carbidopa reports having drooling episodes that are increasing in frequency. The primary care NP should order?
35. A 38-year-old man who … running a marathon collapses and is … to the emergency department. He is … to have a left ventricular myocardial infarction and heart failure with significant pulmonary edema. The first line rug of choice is most cases of heart failure is?
36. Which of the following agents is … to be equally effective as verapamil in the management of paroxysmalsupraventricular tachycardia bus less toxic than verapamil?
37. ……… typical antipsychotic, blocks DA2 receptors, cause high extrapyramidalsymptoms and is used in patients with severe agitations?
38. Which of the following is a short acting class II beta blocking agent used in acute cardiac arrhythmias and in the management of acute hypertension?
39. All of the following medications are … narrow therapeutic index medications and therefore require monitoring of serum levels except?
40. You are seeing a patient for the first time and they are just …. epilepsy. The primary care NP will refer this patient to a neurologist and should expect this patient to begin taking?
41. /41? A patient on an antihypertensive drug comes to your office complaining of a dry cough. You switch the patient to another drug that inhibits similar pharmacologic mechanism, and now the patient does not complain about dry cough any more. Which is the drug that the patient is presently on? (adverse ace inhibitors)?
42. Which of the following is a dopamine receptor agonist ( stimulates dopaminereceptors) knownto treat Parkinson’s disease ( parkinsonism) & restless leg syndrome?
43. Which of the following diuretics is useful in the management of recurrent calcium stones?
44. Adverse effects the NP should counsel patients taking ACE inhibitors all of the following expect?
45. Which of the following conditions are …. contraindications or relative contraindications for combined oral contraceptive use? All of the above?
46. Which of the following is a … effect or action of mannitol, an osmotic diuretic? Therapeutic application)?
47. A 65-year-old women … admitted to the coronary care unit with left ventricular myocardial infarction. She develops acute severe heart failure with marked pulmonary edema, but no evidence of peripheral edema or weight gain. Which one of the following drugs would be most useful?
48. Which of the melatoninreceptor agonist ( bindsMT1 &MT2 receptors) useful in treating insomnia with delayed sleep onset?
49. A patient who has chronic pain and who takes oxycodone calls the clinic to ask for a refill of the medication. The primary care NP notes that the medication refill is not due for 2 weeks. The patient tells the NP that the refills needed because he is going out of town. The NP should?
50. A patient develops hypertension. The primary care nurse Practitioner, plans to begin diuretic therapy for this patient. The NP notes clear breath sounds, no organomegaly, and no peripheral edema. The patient’s serum electrolytes are normal. The NP should prescribe?

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NR-508 Week 4 Midterm Exam: Study Guide

1. First-line treatment for Heart Failure (CHF).
2. Treatment of acute heart failure and pulmonary edema.
3. Side effects of ACE inhibitors and mechanism of action of ACE inhibitors.
4. Which antihypertensive medication classes are contraindicated in patients with asthma.
5. Mechanism of action of Digoxin.
6. Uses and the mechanism of action of Penicillin.
7. …. of action, and side effects of Beta Blockers.
8. Uses, mechanism of action, and side effects of Tetracyclines.
9. Usage of antiarrhythmics, their mechanisms of action, and side effects of antiarrhythmic agents.
10. Treatment of Parkinson’s disease
11. First line treatment of depression.
12. Preferred antidepressants used in the elderly (less anticholgenic effects)
13. Adverse effects associated with SSRIs
14. Medications used to treat depression: including SSRIs, SNRIs, DNRIs, etc.
15. SSRIs can be used in children
16. First line treatment(s) for Alzheimer’s Disease
17. First-line treatment for generalized seizure management
18. Side effects of Carbamazepine and its lab monitoring
19. Which common drugs require serum level monitoring
20. Role of the NP in practice and what guides NP practice.
21. Mechanism of action for oral contraceptives and contraindications of oral contraceptives.
22. Mechanism(s) of action of antiprotozoal agents
23. Antifungal medications, and which antifungals treat different diseases and fungal infections
24. Contraindications when prescribing contraceptive management
25. Treatment(s) for Generalized Anxiety Disorder
26. Treatment(s) for ADHD and its monitoring
27. Role of the Drug Enforcement Administration
28. Treatment(s) for GERD
    

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NR 508 Midterm Exam Consist of 50 Questions From a Random Test Bank of Questions from Chapters 1-4 (including Week 4 Content) and All Embedded Recorded Lectures.  Information is taken from the following Areas: Highlighted areas are areas to help you understand the concepts better they are in NO way an indication of what you are guaranteed to see on the exam. Remember these are random some of your classmates may not have the same question that appear on your exam.

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NR 508 Week 5 Case Study Discussion; Maria (Original Post & Responses)

Variant 1: Maria is a 46-year-old woman who presents for her yearly physical examination. Her medical history is notable for borderline hypertension and moderate obesity. Six months ago, her fasting lipid profile was normal. Maria report that her mother and brother have diabetes and hypertension. She reports that she knows she should be on a low calorie, low fat diet and exercising but with her full time job and four children, she finds it difficult to exercise, and she eats out most of the time. …. is 66″ tall and weighs 219lbs today, no current medication….. does report taking a multivitamin, biotin Vit-C when she remembers. She is a nonsmoker, only drinks sweet tea with each meal, 3-4 cups of coffee per day.

Today: BP 155/95mm Hg, TC 234 mg/dL, LDL 137 mg/dL, HDL 35 mg/dL, triglycerides 241mg/dL, fasting plasma glucose is 179 mg/dL; HgbA1C is 7.4mg/dL. Physical Exam reveals notable for acanthosis nigricans at the neck but otherwise is normal.

1. What are your treatment goals for Maria?
2. What…is your plan for drug therapy? What is the mechanism of action for each drug?
3. Please give five teaching points for each drug prescribed.
4. How would you change the plan if her initial HbgA1C was 10.2mg/dL and her fasting blood glucose was 305mg/dL? Provide a detailed alternative plan with the rationale.
   

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Variant 2: Maria is a 46-year-old woman who presents for her yearly physical examination. Her medical history is notable for mild depression and moderate obesity. Six months ago her fasting lipid profile was normal. Maria report that her mother and brother have diabetes and hypertension. She reports that she knows she should be on a low calorie, low fat diet and exercising but with her full-time job and four children, she finds it difficult to exercise, and she eats out most of the time…. 67″ tall and weighs 225lbs today, no current medication. … does report taking a multivitamin daily but still feels tired, biotin Vit-C when she remembers. She is a nonsmoker, only drinks sweet tea with each meal, 3-4 cups of coffee per day.

Today: BP 120/70 mm Hg, pulse 76, temperature 98.7, respirations 18, weight 225 pounds. Urine dip + glucose, fasting plasma glucose 179 mg/dl, HgbA1C is 7.4%, TSH 5.6. The physical exam is notable for acanthosis nigricans at the neck but otherwise is normal.

• What are your treatment goals for Maria?
• What is your plan for drug therapy? … the mechanism of action for each drug?
• Please give five teaching points for each drug prescribed.
• How would you change the plan if her initial HbgA1C was 10.2mg/dL and her fasting blood glucose was 305mg/dL? Provide a detailed alternative plan with the rationale.

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NR-508 Advanced Pharmacology: Week 5 Quiz

NR 508 Advanced Pharmacology: Week 5 Quiz (June 2020)

1. Question: Your patient is a patient is a 67-year-old male with T2 DM. He is on glipizide and metformin. He presents to the clinic with confusion, sluggishness, and extreme thirst. His wife tells you He does not follow his meal plan or exercise regularly, and hasn’t checked his BG for 1 week. A random glucose is drawn and it is 500. What is a likely … on preliminary .. ?
2. Question: After starting a patient with Grave’s disease on an antithyroid agent such as methimazole, patient monitoring includes TSH and free T4 every
3. Question: Goals when treating hypothyroidism with thyroid replacement include
4. Question: The action of “gliptins” is different from other antidiabetic agents because they
5. Question: Which of the following is not an … that growth hormone supplements should … ?
6. Question: Your patient has type 1 diabetes and plays tennis for his university. He exhibits a knowledge deficit about his insulin and his diagnosis. He should … taught that
7. Question: When methimazole is started for hyperthyroidism it may take ________ to see a total reversal of hyperthyroid symptoms.
8. Question: The drug of choice for type 2 diabetics is metformin. Metformin
9. Question: The decision may … made to switch from twice daily neutral protamine Hagedorn (NPH) insulin to insulin glargine to improve glycemia control throughout the day
10. Question: Before prescribing metformin, the provider should
    

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NR 508 Advanced Pharmacology: Week 5 Quiz (Spring 2020)

1. Question: Prophylactic use of bisphosphonates is recommended for patients with early osteopenia related to long-term use of which of the following drugs?
2. Question: Protein restriction helps slow the progression of albuminuria, glomerular filtration rate, decline, and end stage renal disease in some patients with diabetes. It is useful for patients who
3. Question: Your patient has type 1 diabetes and plays tennis for his university. He exhibits a knowledge deficit about his insulin and his diagnosis. He should be taught that
4. Question: What would one expected assessment finding be for hyperglycemic hyperosmolar syndrome?
5. Question: Your patient is an 18-year-old college student with type 1 diabetes. Her pre-meal BG at 11:30 a.m. is 130. She eats an apple and has a sugar-free soft drink. At 1 p.m. before swimming her BG is 80. What should she do?
6. Question: The drugs recommended by the American Academy of Pediatrics for use in children with diabetes (depending upon type of diabetes) are
7. Question: Treatment of a patient with hypothyroidism and cardiovascular disease consists of
8. Question: GLP-1 agonists
9. Question: A woman who is pregnant and has hyperthyroidism is best managed by a specialty team who will most likely treat her with
10. Question: In addition to methimazole, a symptomatic patient with hyperthyroidism may need a prescription for
    

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NR 508 Advanced Pharmacology: Week 5 Quiz (Fall 2019-20)

1. Question: Peripheral neuropathy is a Microvascular disease in DM.
2. Question: In hyperthyroid states, what organ system other than CV must … evaluated to establish potential adverse issues?
3. Question:Treatment of a patient with hypothyroidism and cardiovascular disease consists of:
4. Question: Allison is an 18-year-old college student with type 1 diabetes. Allison’s pre-meal BG at 11:30 a.m. is 130. She eats an apple and has a sugar-free soft drink. At 1 p.m. before swimming her BG is 80. What should she do?
5. Question: The drugs recommended by the American Academy of Pediatrics for use in children with diabetes (depending upon type of diabetes) are:
6. Question: Type 2 diabetes is a complex disorder involving:
7. Question: When blood glucose levels are difficult to control in type 2 diabetes some form of insulin may … added to the treatment regimen to control blood glucose and limit complication risks. Which of the following statements is accurate … on research?
8. Question: The decision may … made to switch from twice daily neutral protamine Hagedorn (NPH) insulin to insulin glargine to improve glycemia control throughout the day… :
9. Question: Nonselective beta blockers and alcohol create serious drug interactions with insulin because they:
10. Question: The action of “gliptins” is different from other antidiabetic agents because they:

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NR 508 Advanced Pharmacology: Week 5 Quiz (Fall 2018)

1. Question: Which of the following agents is useful in treating angina but is avoided in patients with heart failure and atrioventricular nodal conduction abnormalities due to its significant effects of myocardial contractile force:
2. Question: Which is the anti-lipidemic agent that competitively inhibits HMG CoA reductase enzymes in the biosynthesis of cholesterol?
3. Question: DM is a 46 y/o female with diabetes. Her medicine was … to a high HGA1c. One month later she starts to develop reoccurring vaginal candidiasis. Which of the following may … responsible?
4. Question: Which of the … is an antianginal agent believed to reduce myocardial oxygen demand by its effects of vascular smooth muscle calcium channels?
5. Question: A patient on an antihypertensive drug comes to your office complaining of dry cough. You switched the patient to another drug that inhibits similar pharmacologic mechanisms, and now the pt does not complain of dry cough anymore. Which is the drug that the patient is currently on?

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NR 508 Week 6 Grand Rounds Assignment Using Kaltura

Daniel is a 45 year old male who presents with complaints of shortness of breath, and chest tightness. Audible wheezing is heard and he states he has had a slight cough. He has been a non-smoker for 2 years. He is able to speak in complete sentences, but states he becomes easily out of breath after climbing a few stairs at home. … states he has been coughing frequently which has … him from adequately getting enough sleep at night.

History of Present Illness: Daniel denies any a history of asthma, COPD, or lung disease. He states he becomes winded and SOB with minimal exercise. On exam he is sitting upright with excessive accessory muscle use. While auscultating his lungs he has expiratory wheezing bilaterally.

Primary Medical History: Daniel denes any other medical problems. He has NKDA and does not take any medications on a daily basis. He has no other pertinent medical or surgical history. Patient is a non-smoker, does not use alcohol/drugs, and drinks about 3 cups of coffee a day.

Vital Signs: Blood Pressure 145/86, Temperature 99.3, Pulse 105, Respirations 24/min, Oxygen Saturation: 92% on room air. He is 5 ft 11inches and 175 lbs.

EKG: Sinus Tachycardia, WNL

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NR 508 Advanced Pharmacology: Week 6 Quiz

NR 508 Advanced Pharmacology: Week 6 Quiz (June 2020)

1. Question: A treatment plan for management of chronic pain should include
2. Question: Preventative therapy for cluster headaches includes
3. Question: Your patient is taking allopurinol to prevent gout. Monitoring of a patient who is taking allopurinol includes!
4. Question: Chemical dependency assessment is integral to the initial assessment of chronic pain. Which of the following raises a “red flag” about potential chemical dependency?
5. Question: Pain assessment to determine adequacy of pain management is important for all patients. This assessment is done to
6. Question: The trial period to determine effective anti-inflammatory activity when starting a patient on aspirin for rheumatoid arthritis is
7. Question: Patients on long term, high-dose steroids will likely need prophylactic treatment with
8. Question: A patient has fractured his ankle and has received a prescription for acetaminophen and hydrocodone (Vicodin). Education when prescribing Vicodin includes
9. Question: A first-line drug for abortive therapy in simple migraine is
10. Question: The goal of treatment of acute pain is
    

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NR 508 Advanced Pharmacology: Week 6 Quiz (Spring 2020)

1. Question: Phil is starting treatment with febuxostat (Uloric). Education of patients starting febuxostat includes
2. Question: If interventions to resolve the cause of pain (e.g., rest, ice, compression, and elevation) are insufficient, pain medications are given based on the severity of pain. Drugs are given in which order of use?
3. Question: Which of the following statements is true about age and pain?
4. Question: Patient education when prescribing colchicine includesorrect!
5. Question: Patients on long term, high-dose steroids will likely need prophylactic treatment with
6. Question: Opiates are used mainly to treat moderate to severe pain. Which of the following is NOT true about these drugs?
7. Question: Your patient is taking allopurinol to prevent gout. Monitoring of a patient who is taking allopurinol includes
8. Question: Pain assessment to determine adequacy of pain management is important for all patients. This assessment is done to
9. Question: A treatment plan for management of chronic pain should include
10. Question: A 9-year-old patient who has been diagnosed with migraines for almost 2 years. She is missing up to a week of school each month. Her headache diary confirms she averages four or five migraines per month and achieves relief with intranasal sumatriptan (Imitrex) . Which of the following preventative medications would be most appropriate to add to your patient’s regimen?
    

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NR 508 Advanced Pharmacology: Week 6 Quiz (Fall 2019)

1. Question: Chemical dependency assessment is integral to the initial assessment of chronic pain. Which of the following raises a “red flag” about potential chemical dependency?
2. Question:Pain assessment to determine adequacy of pain management is important for all patients. This assessment is done to:
3. Question:If interventions to resolve the cause of pain (e.g., rest, ice, compression, and elevation) are insufficient, pain medications are given based on the severity of pain. Drugs are given in which order of use?
4. Question:Opiates are used mainly to treat moderate to severe pain. Which of the following is NOT true about these drugs?
5. Question:One of the main drug classes used to treat acute pain is NSAIDs. They are used because:
6. Question:Preventative therapy for cluster headaches includes:
7. Question:Henry is 82 years old and takes two aspirin every morning to treat the arthritis pain in his back. He states the aspirin helps him to “get going” each day. Lately he has had some heartburn from the aspirin. After ruling out an acute GI bleed, what would … an appropriate course of treatment for Henry?
8. Question:All nonsteroidal anti-inflammatory drugs (NSAIDS) have an FDA Black Box Warning regarding:
9. Question:Sallie has been taking 10 mg per day of prednisone for the past 6 months. She should … assessed for:
10. Question:Phil is starting treatment with febuxostat (Uloric). Education of patients starting febuxostat includes:
    

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NR 508 Advanced Pharmacology: Week 6 Quiz (Fall 2018-19)

1. A pt who has osteoarthritis is scheduled to have knee surgery. The pt takes asparin for MI prophylaxis and naproxen (Naprosyn) for pain and inflammation. Which statement by the pt to the primary care NP indicates a need for further teaching?
2. A pt who is obese and has hypertension is taking a thiazide diuretic and develops gouty arthritis, which is treated with probenecid. At a follow-up visit, the pts serum uric acid level is 7mg/dl, and the pt denies any current symptoms. The primary care NP should discontinue the probenecid and :
3. A pt who has HTN is taking a thiazide diuretic. The pt has a serum uric acid level of 8 mg/dl. The primary care NP caring for this pt should:
4. A patient with a history of gouty arthritis comes to the clinic with acute pain and swelling of the great toe. The patient is not currently taking any medications. The primary care NP should prescribe:
5. A patient having recurring migraine headaches and you plan to initiate prophylactic therapy. Which class of anti-hypertensive medications has been … to have the greatest efficacy in preventing migraine headache?
   

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NR 508 Advanced Pharmacology: Week 6 Quiz (Study Guide)

1. Acute and prophylactic therapies, including herbal, for migraine headaches
2. What monitoring is necessary for migraine prophylactic medications?
3. Recommended prophylactic therapies for migraine headaches
4. Serotonin syndrome?
5. Drugs are … with serotonin syndrome?
6. Which prophylactic antihypertensive medication … patients with asthma due to risk of bronchospasm?
7. Pharmacologic management of Gout including side effects of medication
8. Pharmacologic management of OA including side effects of the medications
9. Side effects of NSAIDs
10. Uses of aspirin and adverse effects
11. If a patient is to have surgery, does aspirin need to … stopped, if so, how soon before? What about NSAIDs such as naproxen or ibuprofen?
12. Medication that may increase uric acid levels

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NR-508 Week 7 Grand Round Original Post & Response (Multiple Variants)

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NR 508 Week 7 RX Writing Assignment (Collection)

Metoprolol tartrate 50 mg

Prednisone 10 mg

On December 12, 2011 Connie’s daughter Shannon Davis (10/12/1997) has Asthma she needs a three week course of tapering dose of prednisone. She needs 40 mg per day for one week then, 20 mg per day for one week then, 10 mg per day for one week. It comes in 10 mg she should get no refills her address is 444 W. Peachtree Street, Atlanta, GA 55911 NPI 1405798402

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NR-508 Advanced Pharmacology: Week 7 Quiz

NR 508 Advanced Pharmacology: Week 7 Quiz

1. Question: Long-acting beta-agonists (LTBAs) received a Black Box Warning from the U.S. Food and Drug Administration due to the
2. Question: Treatment for mild intermittent asthma is
3. Question: Second-generation antihistamines such as loratadine (Claritin) are … for seasonal allergies because they are
4. Question: Patients with a COPD exacerbation may require
5. Question: The most cost-effective treatment for two or three impetigo lesions on the face is!
6. Question: A 42-year-old African American, has moderate persistent asthma. Which of the following asthma medications should … cautiously, if at all?
7. Question: Patients who are … with greater than 100 grams per week of topical calcipotriene for psoriasis need to be monitored for
8. Question: Tiotropium bromide (Spiriva) is an inhaled anticholinergic
9. Question: Montelukast (Singulair) may be prescribed
10. Question: In children age 5 to 11 years mild-persistent asthma is … when asthma symptoms occur
    

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NR 508 Advanced Pharmacology: Week 7 Quiz (Spring 2020)

1. Question: Patients who are treated with greater than 100 grams per week of topical calcipotriene for psoriasis need to be monitored for
2. Question: Your patient has exercise-induced and mild persistent asthma and is prescribed two puffs of albuterol 15 minutes before exercise and as needed for wheezing. One puff per day of beclomethasone (QVAR) is also prescribed. Teaching regarding her inhalers includes:
3. Question: Education of women who are being treated with ophthalmic antibiotics for conjunctivitis includes
4. Question: Your patient is a football player who presents to the clinic with athlete’s foot. Patients with tinea pedis may be treated with
5. Question:Your patient is a 6-month-old infant with severe eczema. She would benefit from topical corticosteroid therapy. Instructions for using topical corticosteroids in children include
6. Question: Topical immunomodulators such as pimecrolimus (Elidel) or tacrolimus (Protopic) are used for
7. Question: Your patient is a nasal methicillin resistant staphylococcus aureus (MRSA) carrier. Treatment to eradicate nasal MRSA is mupirocin. Patient education regarding treating nasal MRSA includes
8. Question: Topical diphenhydramine (Benadryl) is available OTC to treat itching. Patients or parents should be instructed regarding the use of topical diphenhydramine that
9. Question: Twenty-year-old Annie comes to the clinic complaining of copious yellow-green eye discharge. Gram stain indicates she most likely has gonococcal conjunctivitis. While awaiting the culture results, the plan of care should be
10. Question: Long-term treatment of moderate atopic dermatitis includes
    

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NR 508 Advanced Pharmacology: Week 7 Quiz (Fall 2018-19)

1. Question: A patient asks an NP about usnign an oral OTC decongestant medication for nasal congestion associated with a viral upper respiratory illness. The NP  learns that the patient uses loratadine (Clarritin), a Beta adrenergic blocker, and an intranasal corticosteroid. The NP Would be concerned about which adverse effects?
2. Question: A pt is … with asthma. The primary care NP prescribes an inhaled corticosteroid and an inhaled broncholidalator medication and provides education about how to use inhalers. At a follow-up visiti 2 wks later, the pts pulmonary function tests are worse. The NP should :
3. Question: A patient who was recently … with COPD comes to the clinic for a follow-up evaluation after beginning therapy with a SABA as needed for dyspnea. The pt reports occasional mild exertional dyspnea but is able to sleep well. The pts FEV1 in the clinic is 85% of … , and oxygen sat is 96%. The primary care NP should recommend:
4. Question: A 7 year old patient who has severe asthsma takes oral prednisone daily. At a well-child examination, the primary care NP notes a decrease in the child’s linear growth rate. The NP should consult the child’s asthma specialist about:
5. Question: A patient comes to the clinic with a 2-day history of cough and wheezing. The patient has no previous history of asthma. The patient reports having heartburn for several months, which has … The NP makes a diagnosis of asthma and orders oral steroids and inhaled albuterol. The patient’s condition worsens and a chest radiograph obtained 2 days later shows bilateral infiltrates. The NP has failed to:

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NR 508 Week 8 Final Exam (Questions, Answers, Rationale)

1. Question: A patient who has diabetes reports intense discomfort when needing to void. A urinalysis is normal. To treat this, the primary care NP should consider prescribing:
2. Question: A patient reports difficulty returning to sleep after getting up to go to the bathroom every night. A physical examination and a sleep hygiene history are noncontributory. The primary care NP should prescribe:
3. Question: A 5-year-old child who has no previous history of otitis media is seen in clinic with a temperature of 100° F. The primary care NP visualizes bilateral erythematous, non bulging, intact tympanic membranes. The child is taking fluids well and is playing with toys in the examination room. The NP should:
4. Question: An 80-year-old patient with congestive heart failure has a viral upper respiratory infection. The patient asks the primary care NP about treating the fever, which is 38.5° C. The NP should:
5. Question: A patient who takes levodopa and carbidopa for Parkinson’s disease reports experiencing freezing episodes between doses. The primary care NP should consider using:
6. Question: A patient is being tapered from long-term therapy with prednisolone and reports weight loss and fatigue. The primary care NP should counsel this patient to:
7. Question: The primary care nurse practitioner (NP) sees a 50-year-old woman who reports frequent leakage of urine. The NP learns that this occurs when she laughs or sneezes. She also reports having an increased urge to void even when her bladder is not full. She is not taking any medications. The NP should:
8. Question: A 7-year-old patient who has severe asthma takes oral prednisone daily. At a well-child examination, the primary care NP notes a decrease in the child’s linear growth rate. The NP should consult the child’s asthma specialist about:
9. Question: A patient who is taking isoniazid and rifampin for latent TB is seen by the primary care NP for a routine follow-up visit. The patient reports having nausea, vomiting, and a decreased appetite. The NP should:
10. Question: A primary care NP sees a child with asthma to evaluate the child’s response to the prescribed therapy. The child uses an ICS twice daily and an albuterol metered-dose inhaler as needed. The child’s symptoms are well controlled. The NP notes slowing of the child’s linear growth on a standardized growth chart. The NP should change this child’s medication regimen to a:
11. Question: A patient is newly diagnosed with Alzheimer’s disease stage 6 on the Global Deterioration Scale. The primary care NP should prescribe:
12. Question: The primary care NP sees a 12-month-old infant who needs the MMR, Varivax, influenza, and hepatitis A vaccines. The child’s mother tells the NP that she is pregnant. The NP should:
13. Question: A parent brings a 5-year-old child to a clinic for a hospital follow-up appointment. The child is taking a medication at a dose equal to an adult dose. The parent reports that the medication is not producing the desired effects. The NP should:
14. Question: An NP orders an inhaled corticosteroid 2 puffs twice daily and an albuterol metered-dose inhaler 2 puffs every 4 hours as needed for cough or wheezing for a 65-year-old patient with recent onset of reactive airways disease who reports symptoms occurring every 1 or 2 weeks. At a follow-up appointment several months later, the patient reports no change in frequency of symptoms. The NP’s initial action should be to:
15. Question: A patient is diagnosed with a condition that causes chronic pain. The primary care NP prescribes an opioid analgesic and should instruct the patient to:
16. Question: A patient tells the primary care NP that he has difficulty getting and maintaining an erection. The NP’s initial response should be to:
17. Question: A 55-year-old patient develops Parkinson’s disease characterized by unilateral tremors only. The primary care NP will refer the patient to a neurologist and should expect initial treatment to be:
18. Question: A patient who has migraine headaches without an aura reports difficulty treating the migraines in time because they come on so suddenly. The patient has been using over-the-counter NSAIDs. The primary care NP should prescribe:
19. Question: A woman tells a primary care NP that she is considering getting pregnant. During a health history, the NP learns that the patient has seasonal allergies, asthma, and epilepsy, all of which are well controlled with a second-generation antihistamine daily, an inhaled steroid daily with albuterol as needed, and an antiepileptic medication daily. The NP should counsel this patient to:
20. Question: A patient who has partial seizures has been taking phenytoin (Dilantin). The patient has recently developed thrombocytopenia. The primary care nurse practitioner (NP) should contact the patient’s neurologist to discuss changing the patient’s medication to:
21. Question: A patient is taking dicloxacillin (Dynapen) 500 mg every 6 hours to treat a severe penicillinase-resistant infection. At a 1-week follow-up appointment, the patient reports nausea, vomiting, and epigastric discomfort. The primary care NP should:
22. Question: A 75-year-old patient who lives alone will begin taking a narcotic analgesic for pain. To help ensure patient safety, the NP prescribing this medication should:
23. Question: A patient has been taking intramuscular (IM) meperidine 75 mg every 6 hours for 3 days after surgery.When the patient is discharged from the hospital, the primary care NP should expect the patient to receive a prescription for _____ mg orally every _____ hours:
24. Question: A patient who is obese and has hypertension is taking a thiazide diuretic and develops gouty arthritis, which is treated with probenecid. At a follow-up visit, the patient’s serum uric acid level is 7 mg/dL, and the patient denies any current symptoms. The primary care NP should discontinue the probenecid and:
25. Question: A mother brings her a college-age son to the primary care NP and asks the NP to talk to him about alcohol use. He reports binge drinking on occasion and drinking only beer on weekends. The NP notes diaphoresis, tachycardia, and an easy startle reflex. The NP should:
26. Question: A primary care NP sees a patient who has fever, flank pain, and dysuria. The patient has a history of recurrent urinary tract infections (UTIs) and completed a course of trimethoprim-sulfamethoxazole (TMP/SMX) the week before. A urine test is positive for leukocyte esterase. The NP sends the urine for culture and should treat this patient empirically with:
27. Question: A patient who takes carbamazepine (Tegretol) has been seizure-free for 2 years and asks the primary care NP about stopping the medication. The NP should:
28. Question: A primary care NP has been working with a young woman who wants to quit smoking before she begins having children.She has made several attempts to quit using nicotine replacement therapy and is feeling discouraged. She does not want to take medication at this time. The NP should:
29. Question: A primary care NP prescribes a nonselective NSAID for a patient who has osteoarthritis. The patient expresses concerns about possible side effects of this medication. When counseling the patient about the medication, the NP should tell this patient:
30. Question: A patient has been taking a COX-2 selective NSAID to treat pain associated with a recent onset of RA. The patient tells the primary care NP that the pain and joint swelling are becoming worse. The patient does not have synovitis or extraarticular manifestations of the disease. The NP will refer the patient to a rheumatologist and should expect the specialist to prescribe:
31. Question: A patient has been taking an opioid analgesic for 2 weeks after a minor outpatient procedure. At a follow-up clinic visit, the patient tells the primary care NP that he took extra doses for the past 2 days because of increased pain and wants an early refill of the medication. The NP should suspect:
32. Question: An elderly patient with dementia exhibits hostility and uncooperativeness. The primary care NP prescribes clozapine (Clozaril) and should counsel the family about:
33. Question: A patient who was hospitalized for an infection was treated with an aminoglycoside antibiotic. The patient asks the primary care nurse practitioner (NP) why outpatient treatment wasn’t an option. The NP should tell the patient that aminoglycoside antibiotics:
34. Question: A woman who is pregnant tells an NP that she has been taking sertraline for depression for several years but is worried about the effects of this drug on her fetus. The NP will consult with this patient’s psychiatrist and will recommend that she:
35. Question: A patient who has HIV is being treated with Emtriva. The patient develops hepatitis B. The primary care NP should contact the patient’s infectious disease specialist to discuss:
36. Question: A patient who was in a motor vehicle accident has been treated for lower back muscle spasms with metaxalone (Skelaxin) for 1 week and reports decreased but persistent pain. A computed tomography scan is normal. The primary care NP should:
37. Question: A primary care NP sees a patient who has dysuria, fever, and urinary frequency. The NP orders a urine dipstick, which is positive for nitrates and leukocyte esterase, and sends the urine to the laboratory for a culture. The patient is allergic to sulfa drugs. The NP should:
38. Question: A patient comes to the clinic several days after an outpatient surgical procedure complaining of swelling and pain at the surgical site. The primary care NP notes a small area of erythema but no abscess or induration. The NP should:
39. Question: A patient who has genital herpes has frequent outbreaks. The patient asks the primary care NP why it is necessary to take oral acyclovir all the time and not just for acute outbreaks.The NP should explain that oral acyclovir may:
40. Question: A patient is taking isoniazid, pyrazinamide, rifampin, and streptomycin to treat TB. The primary care NP should routinely perform:
41. Question: A primary care NP sees a patient who was recently hospitalized for infection and treated with gentamicin for 10 days. The patient tells the NP that the drug was discontinued early because “my blood level was too high.” The NP should order:
42. Question: A 40-year-old woman asks the primary care NP what she can do to minimize her risk of osteoporosis. She takes 800 mg of calcium and drinks 2 cups of skim milk each day. The NP should recommend that she:
43. Question: A patient has a sore throat with fever. The primary care NP observes erythematous 4+ tonsils with white exudate.A rapid antigen strep test is negative, and a culture is pending. The NP orders amoxicillin as empiric treatment. The patient calls the next day to report a rash. The NP should suspect:
44. Question: A patient is taking sulfisoxazole. The patient calls the primary care NP to report abdominal pain, nausea, and insomnia. The NP should:
45. Question: A patient is in the clinic with acute symptoms of anxiety. The patient is restless and has not slept in 3 days.The primary care NP observes that the patient is irritable and has moderate muscle tension. The patient’s spouse reports that similar symptoms have occurred before in varying degrees for several years. The NP should refer the patient to a psychologist and should prescribe which drug for short-term use?
46. Question: A woman who takes oral contraceptive pills develops vaginal candidiasis. The primary care NP prescribes a single dose of fluconazole. When counseling the patient about this drug, the NP should tell her:
47. Question: A patient in the clinic reports taking a handful of acetaminophen extra-strength tablets about 12 hours prior. The patient has nausea, vomiting, malaise, and drowsiness. The patient’s aspartate aminotransferase and alanine aminotransferase are mildly elevated. The primary care NP should:
48. Question: An NP sees a preschooler in clinic for the first time. When obtaining a medication history, the NP notes that the child is taking a medication for which safety and effectiveness in children has not been established in drug information literature. The NP should:
49. Question: A patient who has Parkinson’s disease who takes levodopa and carbidopa reports having drooling episodes that are increasing in frequency. The primary care NP should order:
50. Question: The primary care NP sees a 6-month-old infant for a routine physical examination and notes that the infant has a runny nose and a cough. The parents report a 2-day history of a temperature of 99° F to 100° F and two to three loose stools per day. Other family members have similar symptoms. The infant has had two sets of immunizations at 2 and 4 months of age. The NP should:
51. Question: A patient who was recently hospitalized and treated with gentamicin tells the primary care NP, “My kidney function test was abnormal and they stopped the medication.” The patient is worried about long-term effects. The NP should:
52. Question: A patient has begun treatment for HIV. The primary care NP should monitor the patient’s complete blood count (CBC) at least every _____ months.
53. Question: A patient who was recently diagnosed with COPD comes to the clinic for a follow-up evaluation after beginning therapy with a SABA as needed for dyspnea. The patient reports occasional mild exertional dyspnea but is able to sleep well. The patient’s FEV1 in the clinic is 85% of …, and oxygen saturation is 96%. The primary care NP should recommend:
54. Question: A patient who takes 150 mg of clozapine (Clozaril) twice daily calls the primary care NP at 10:00 AM one day to report forgetting to take the 8:00 AM dose. The NP should counsel the patient to:
55. Question: A patient has been taking fluoxetine 20 mg every morning for 5 days and calls the primary care NP to report decreased appetite, nausea, and insomnia. The NP should:
56. Question: A female patient presents with grayish, odorous vaginal discharge. The primary care NP performs a gynecologic examination and notes vulvar and vaginal erythema. Testing of the discharge reveals a pH of 5.2 and a fishy odor when mixed with a solution of 10% potassium hydroxide. The NP should:
57. Question: An 80-year-old patient has a diagnosis of glaucoma, and the ophthalmologist has prescribed timolol (Timoptic) and pilocarpine eye drops. The primary care NP should counsel this patient:
58. Question: An 18-month-old child who attends day care has head lice and … treated with permethrin 1% (Nix). The parent brings the child to the clinic 1 week later, and the primary care NP notes live bugs on the child’s scalp. The NP should order:
59. Question: An adult patient who has a viral upper respiratory infection asks the primary care nurse practitioner (NP) about taking acetaminophen for fever and muscle aches. To help ensure against possible drug toxicity, the NP should first:
60. Question: The primary care NP follows a patient … for RA with methotrexate. The patient asks the NP why the medication does not seem to alleviate pain. The NP tells the patient that:
61. Question: A patient has a UTI and will begin treatment with an antibiotic. The patient reports moderate to severe suprapubic pain. The primary care NP should prescribe:
62. Question: The parent of an 8-year-old child recently diagnosed with AD/HD verbalizes concerns about giving the child stimulants. The primary care NP should recommend:
63. Question: The primary care NP is performing a medication reconciliation on a patient who takes digoxin for congestive heart failure and learns that the patient uses ibuprofen as needed for joint pain. The NP should counsel this patient to:
64. Question: A patient who takes valproic acid for a seizure disorder is preparing to have surgery. The primary care NP should order:
65. Question: A patient who has Alzheimer’s disease is taking 10 mg of donepezil daily and reports difficulty sleeping. The primary care NP should recommend:
66. Question: A child has been taking methylphenidate 5 mg at 8 AM, 12 PM, and 4 PM for 30 days after a new diagnosis of AD/HD and comes to the clinic for evaluation. The child’s mother reports that the child exhibits some nervousness and insomnia but is doing much better in school. The primary care NP should suggest:
67. Question: A 60-year-old woman is in the clinic for an annual well-woman examination. She has been taking alendronate (Fosamax) 10 mg daily for 4 years. Her last bone density test yielded a T-score of 2.0. Her urine NTx level today is 22. She walks daily. Her fracture risk is low. The primary care NP should recommend that she:
68. Question: The primary care nurse practitioner (NP) is seeing a patient who reports chronic lower back pain. The patient reports having difficulty sleeping despite taking ibuprofen at bedtime each night. The NP should prescribe:
69. Question: A patient reports smoking two or more packs of cigarettes per day and expresses a desire to quit smoking. The primary care NP learns that the patient smokes heavily during breaks at work and during the evening but with no established schedule. The NP should recommend:
70. Question: A patient is … in the clinic with a 1-week history of frequent watery stools. The primary care NP learns that a family member had gastroenteritis a week prior. The patient was … for a UTI with a sulfonamide antibiotic 2 months prior. The NP should suspect:
71. Question: A female patient has vaginal candidiasis and has taken a single dose of fluconazole without resolution of the infection. The primary care NP obtains a culture and should order:
72. Question: A patient reports difficulty falling asleep and staying asleep every night and has difficulty staying awake during the commute to work every day. The NP should:
73. Question: A patient who is newly … with schizophrenia is overweight and has a positive family history for type 2 diabetes mellitus. The primary care NP should consider initiating antipsychotic therapy with:
74. Question: A patient asks an NP about using an oral over-the-counter decongestant medication for nasal congestion associated with a viral upper respiratory illness. The NP learns that this patient uses loratadine (Claritin), a ?-adrenergic blocker, and an intranasal corticosteroid. The NP would be concerned about which adverse effects?
75. Question: A patient has been taking paroxetine (Paxil) for major depressive symptoms for 8 months. The patient tells the primary care NP that these symptoms improved after 2 months of therapy. The patient is experiencing weight gain and sexual dysfunction and wants to know if the medication can … discontinued. The NP should:

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NR-508 Week 8 Final Exam Guide Multiple Variants

NR 508 Final Exam Consist of 100 Questions From a Random Test Bank of Questions from All 8 weeks and All Embedded Recorded Lectures.  Information is taken from the following Areas listed below:

Final Exam Guide – 55 Pages

Cardiovascular management:

• Ace inhibitors and ARBs
• Thiazides
• Thiazide diuretics
• Loop diuretics
• Potassium sparing diuretics
• Carbonic anhydrase inhibitors
• Angiotensin II Receptor Blockers (or Inhibitors) ARBs or Angiotensin-2 Receptor Antagonists)
• Angiotensin-Receptor Neprilysin Inhibitors (ARNIs)
• Beta Blockers are one of the most widely prescribed classes of drugs to treat hypertension (high blood pressure)
• Aldosterone Antagonists

Hydralazine and isosorbide dinitrate (specifically benefits African Americans with heart failure)

What do these types of medication do:

• Anticoagulants (blood thinners)
• Cholesterol lowering drugs (statins)

Neuro/Psych:

• Migraine management and prophylactics
• Migraine medications to avoid in patients with asthma.
• Stimulants
• Nonstimulants
• Strattera (atomoxetine)

Alzheimer’s

Know the treatment of Alzheimer’s and the education behind the medication management of the disease.

Cholinesterase inhibitors (ChE inhibitors) for Alzheimers (AD)

• TACRINE
• METRIFONATE
• RIVASTIGMINE
• PHYSOSTIGMINE’s
• EPTISTIGMINE (MF-201)
• GALANTAMINE (GALANTHAMINE; GAL 9301)
• MEMANTINE

Parkinson Disease:

• Levodopa
• Benztropine
• MAOI:
  • Selegiline
  • Rasagiline

Amantadine:

Pramipexole

Apomorphine

Effect of protein on absorption of levodopa

Depression medications

SSRIs include:

Monitoring of depression.

Antipsychotics, Serentil/mesoridazine

Clozaril labs to monitor CBC, ANC

Carbamazepine lab monitoring

Seizure management: Know first line treatment for generalized seizure management not adjunct therapies

Absence seizures

Myoclonic seizures

Tonic or atonic seizures

4 Types of incontinence

Anti-cholinergics

Erectile dysfunction

• SILDENAFIL CITRATE (Viagra)
• TADALAFIL (Cialis)
• VARDENAFIL HYDROCHLORIDE (Levitra, Staxyn)
• ALPROSTADIL
• Avanafil (Stendra)

Hyperthyroid

Medications

Radioactive iodine.

Methimazole (Tapazole).

Hypothyroidism

Diabetic medications

• Metformin or Glucaphage-
• Metformin ER or Glucaphage XR
• Micronase or glyburide
• Glucotrol or glipizide
• Avandia or rosiglitazone
• Actos or pioglitazone
• Starlix or nateglinide
• Prandin or repaglinide

Insulin

• Rapid acting
• Short acting
• Precose or Acarbose
• Glyset or miglitol

Canaglifozin

GI/nutrition:

Irritable bowel syndrome (IBS)

MOA:

Drugs OTC

Antacids – Calcium salts, calcium carbonate (Tums®)

xAntacids – Sodium bicarbonate

Antacids – Aluminum salts,  aluminum hydroxide (Amphojel®)

Nystatin

Fluconazole

Vitamin deficiency questions

What side effect can occur with Salt substitutes?

Vitamins a vegetarian may require

Smoking cessation:

Nicotrol

Rocky Mountain Spotted Fever

Doxycycline (Monodox, Vibramycin,

Indications for the use of Vancomycin

• Staphylococcal Enterocolitis
• Clostridium difficile-associated Diarrhea
• Endocarditis
• Preoperative Antimicrobial Prophylaxis (Off-label)
• Surgical Prophylaxis (Off-label)
• Dosing Modifications
• Dosing Considerations

Vancomycin

MOA

Cephalosporins

• First Generation:
• Second Generation:
• Third Generation:
• Fourth Generation:

Cephalosporin Mode of Action

Analgesia:

Acetaminophen

Acetaminophen Toxicity

NSAID  

Topical NSAIDs

Non-selective NSAIDs (COX-1 and COX-2 inhibitors)

Selective NSAIDs (COX-2 selective)

• Know the Management of Osteoarthritis
• Treatment
• Medications Commonly Used for Osteoarthritis
  

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Final Exam Guide – 8 Pages

Children – Drug — Adverse Reaction

Ear infections

ANTIBIOTICS

• First line therapy for otitis media
• Alternative treatment (if allergy to penicillin)
• Alternative treatment after 48-72 H of failure of initial antibiotic treatment.
• Dermatologic:
• Gastrointestinal:
• Neurologic:
• Reproductive: Vulvovaginitis & Mycotic.
• Dermatologic:
• Gastrointestinal:
• Immunologic:

Contraindications

• Individuals who have hypersensitivity to penicillin’s should avoid amoxicillin.
• … with allergies or atopic conditions including asthma, eczema, hives (urticaria), or hay fever are at increased risk for hypersensitivity reactions to amoxicillin.
• Individuals who have mononucleosis should avoid amoxicillin (Increased risk for rash).
• Caution should be used with the use of amoxicillin in pregnant and breast feeding women.

Interactions:

• Amoxicillin decreases the effectiveness of oral contraceptives.
• B-Blockers may potentate anaphylactic reaction to amoxicillin.
• Tetracycline decreases the effectiveness of amoxicillin.
• Allopurinol increases rate of rash in individual taking amoxicillin.
• Probenecid increases the amount of amoxicillin renally excreted.

Otitis Externa

UTI’s

Nitrofurantoin monohydrate/macro crystals (Furadantin, Macrobid, Macrodantin)

(100 mg twice daily for 5 days)

Trimethoprim-sulfamethoxazole (Bactrim)

(160/800 mg [1 double-strength tablet] twice-daily for 3 days

Fosfomycin (Monurol)

Uncomplicated UTI: 3 g by mouth x1

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NR 508 Week 8 Final Exam Summary & Review

Final examination covered all topics covered over this past eight week to include this week’s topics.

• Cardiovascular management
• Neuro/Psych
• GU
• Endocrine
• ENT
• GI/nutrition
• Smoking cessation
• Infectious Disease
• Pain Management/ Analgesia

Test Analytics

Test Analytics performed showed that the majority of the questions were moderately easy to moderately difficult. Overall students performed well on the final exam as a whole on the materials covered in the study guide. Material not covered in the study where students received randomized test questions students performed poorly. Also, materials covered in the reading for week 8 students did not perform well on the final exam.

In addition we did find several duplicate questions that we will be giving students credit for if they missed these questions twice. Please note only students who received duplicate question will receive credit.

Test analysis revealed several areas of weakness in student performance as well as lack of the subject matter in the course. Lab interpretation, Men’s health and pediatric health.

Credited Test Questions= a total of 47 questions

• 13 Questions Appeared on the test twice: If you were tested on the same question twice and got this question wrong you will be awarded credit for those questions once (Questions Available in Download)
• 34 Questions Too Difficult (Questions Available in Download)

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