Review Test Submission: Exam - Week 7
NURS-6521 Advanced Pharmacology.2020 Summer Qtr 06/01-08/23
1. A patient comes to the clinic asking for help to quit drinking alcohol. She has a 21-year history
of heavy drinking and is worried about developing cirrhosis of the liver. The patient agrees to
take disulfiram (Antabuse). The nurse will teach the patient that the combination of alcohol and
Antabuse will cause which of the following?
a. Nausea
b. Tachycardia
c. diarrhoea
d. Drowsiness
Answer: A. Nausea
2. You decide to start your pt, Ms. Rodrigues, on spironolactone (Aldactone) 50 mg PO daily. As
the NP, you will instruct the patient to call the clinic if which symptoms are experienced?
a. Increased irritability, abdominal cramping, and lower extremity weakness
b. Rash, dizziness, and shortness of breath
c. Headache, blurred vision, and palpitations
d. Dry mouth, constipation, and skin flushing
Answer: a. Increased irritability, abdominal cramping, and lower extremity weakness.
3. A clinic Nurse Practitioner is planning care for a 68-year-old man who has been on
omeprazole (Prilosec) therapy for heartburn for some time. Regarding the patient's safety, which
of the following would be a priority nursing action?
a. Monitor for signs of bleeding
b. Coordinate bone density testing for the patient
c. Assess for weight loss
d. Monitor for signs of anaemia
Answer: b. Coordinate bone density testing for the patient.
4. Your patient is on Atorvastatin 40 mg daily, and presents for their routine follow up
appointment. They complain of extreme fatigue, muscle aches, and dark coloured urine. What is
your best course of action given presentation?
a. Increase water intake and recheck in a week
b. Obtain a liver function test
c. Encourage exercise to improve muscle function
d. Decrease the dose of the medication
Answer: b. Obtain a liver function test
5. The first drugs typically used to treat the symptoms of an allergic reaction or allergic rhinitis
are:
a. Intranasal H1 antihistamines
b. Leukotriene inhibitors
c. Systemic corticosteroids
d. Nasal decongestants
Answer: a. intranasal H1 antihistamines.
6. Glucocorticoids affect the metabolism of carbohydrates, protein, and fats.
a. True
b. False
Answer: b. False
7. Mr. Lastinger was prescribed warfarin sodium (Coumadin). You advise him to avoid eating
large amounts of leafy green vegetables because:
a. The vitamin K can increase the risk of bleeding
b. Leafy greens cause gastrointestinal upset
c. They interact with the medication, making it toxic
d. The high vitamin K levels will decrease the INR
Answer: d. The high vitamin K levels will decrease the INR
8. The nurse practitioner has prescribed elemental iron 6 mg/kg/day in three divided doses for a
toddler diagnosed with iron-deficiency anaemia. What instructions would the family nurse
practitioner include for the parents?
a. Administer with milk to avoid stomach upset
b. Give the medication through a straw to decrease the staining of the teeth
c. Only give the medication at bedtime
d. Crush the tablets and mix them with food
Answer: b. Give the medication through a straw to decrease the staining of the teeth
9. A female patient is taking 0.125 mg of digoxin daily for heart failure. At a recent clinic visit
she reports that since she has been on the drug, she can breathe better and her heart rate has been
around 74 beats per minute. The nurse weighs the patient and notices that she has gained 10
pounds since the digoxin therapy was started. The patient is concerned that the additional weight
will necessitate an increase in the medication. Which of the following is an appropriate response
by the nurse?
a. "Yes, the dose will need to be adjusted based on your weight."
b. "We will need to stop the medication."
c. "No, the drug dosage will likely stay the same."
d. "Let’s try reducing your calorie intake and see if it helps."
Answer: c. "No, the drug dosage will likely stay the same."
10. A male patient is to begin glyburide (Diabetes) for type 2 diabetes. Before the drug therapy
begins, a priority action by the nurse will be to assess the patient's
a. Haemoglobin A1c level
b. Potassium level
c. Liver function tests
d. Kidney function tests
Answer: b. potassium level.
11. The point in time on the drug concentration curve that indicates the first sign of a therapeutic
effect is the
a. Peak concentration
b. Duration of action
c. Onset of action
d. Therapeutic index
Answer: c. onset of action
12. Metformin (Glucophage) acts by:
a. Stimulating the pancreas to produce more insulin
b. Enhancing insulin secretion
c. Inhibiting glucose absorption in the intestines
d. Suppressing appetite to reduce weight
Answer: b. Enhancing insulin secretion
13. Some first-generation antihistamines are used:
a. For long-term treatment of allergies
b. To prevent motion sickness
c. To manage anxiety
d. For chronic pain management
Answer: b. to prevent motion sickness
14. A Nurse Practitioner is discussing with a patient the efficacy of a drug that his physician has
suggested, and he begin taking. Efficacy of a drug means which of the following?
a. How quickly a drug is metabolized by the liver
b. How well a drug produces its desired effect
c. The potential for a drug to cause side effects
d. How long a drug remains active in the body
Answer: b. How well a drug produces its desired effect
15. Susie is a 40 year old female with Type 2 Diabetes. She reports that over the last several
days, she has been having some hypoglycaemic episodes and feels it is related to medication.
Her medication list is as follows:
a. Victoza (liraglutide) 1.8 mg SC daily
b. Metformin 500mg p.o. Twice a Day
c. Glyburide 5 mg p.o. Twice a day
d. Lisinopril 10mg p.o. daily
Which medication most likely is contributing to her hypoglycaemic episodes
Answer: b. Metformin 500mg p.o. Twice a Day
16. Autonomic drugs have little effect when administered:
a. Intramuscularly
b. Orally
c. Subcutaneously
d. Intravenously
Answer: a. intramuscularly
17. A patient on valproic acid may experience which of the following symptoms?
a. diarrhoea
b. Constipation
c. Hyperactivity
d. Weight loss
Answer: b. Constipation
18. Which of the following is a side effect or precaution associated with ACE inhibitors?
a. Hyperglycaemia
b. Hypokalaemia
c. Angioedema
d. Bradycardia
Answer: Angioedema
19. Mr. Johnson is an 80 year old male who is on Digoxin therapy. The Nurse Practitioner knows
they should monitor the older adult patient for which of the most common adverse reactions of
digoxin?
a. Dizziness
b. Nausea
c. Blurred vision
d. Tinnitus
Answer: c. blurred vision
20. The recommended range for maintaining serum theophylline levels is:
a. 5 to 10 μg/mL
b. 20 to 30 μg/mL
c. 10 to 20 μg/mL
d. 15 to 25 μg/mL
Answer: c. 10 to 20 μg/mL.
21. During a clinic visit, a patient complains of having frequent muscle cramps in her legs. The
nurse's assessment reveals that the patient has been taking over-the-counter laxatives for the past
7 years. The nurse informed the patient that prolonged use of laxatives
a. Dehydration
b. Weight gain
c. Nutrient deficiencies
d. diarrhoea
Answer: c. Nutrient deficiencies
22. A 76-year-old woman has a complex medical history that includes emphysema, osteoporosis,
malnutrition, and hypothyroidism. Recently, the woman fell outside her home as a result of
weakness and suffered a fracture to her femoral head. The woman's subsequent hip replacement
surgery has been scheduled and the care team recognizes that the use of isoflurane will be most
significantly influenced by
a. Her history of osteoporosis
b. Her nutritional status
c. Her history of emphysema
d. Her hypothyroidism
Answer: c. Her history of emphysema
23. The Nurse Practitioner is following up on a patient who is experiencing acute asthma
problems. Albuterol (Proventil) by metered-dose inhaler (MDI) has been ordered as treatment.
Which patient response would indicate to the family nurse practitioner that the patient
understands how to take the medication?
a. “I will take 1 puff immediately after exhaling as hard as I can.”
b. “I will wait 5 minutes between puffs.”
c. “I will take 1 puff of the medication and then wait a minute before taking the second puff.”
d. “I will use the inhaler only when I feel short of breath.”
Answer: c. “I will take 1 puff of the medication and then wait a minute before taking the second
puff.”
24. The anticoagulant drug that acts as a vitamin K antagonist is:
a. Heparin
b. Dabigatran
c. Coumadin
d. Apixaban
Answer: c. coumadin
25. A 34-year-old male patient is prescribed methimazole (MMI). The Nurse Practitioner will
advise him to report which of the following immediately?
a. Dry mouth
b. Constipation
c. Vertigo
d. Skin rash
Answer: c. Vertigo
26. A Nurse Practitioner is providing care for a patient who suffered extensive burns to his
extremities during a recent industrial accident. Topical lidocaine gel has been ordered to be
applied to the surfaces of all his burns in order to achieve adequate pain control. When
considering this order, the Nurse Practitioner should be aware that
a. Lidocaine may cause further damage to the burned tissue.
b. Pain relief is unlikely to be achieved due to the destruction of nerve endings in the burn site.
c. Lidocaine gel will need to be applied hourly for adequate pain control.
d. Systemic absorption of lidocaine is a significant concern with extensive burns.
Answer: b. pain relief is unlikely to be achieved due to the destruction of nerve endings in the
burn site.
27. Ms. Neely was placed on fluoxetine about 8 weeks ago and is doing well on the medication.
When initially prescribed the medication, she asks you about the common side effects of this
type of medication. Which choice below is correct?
a. Weight loss
b. Hair loss
c. Increased appetite
d. Skin rash
Answer: a. weight loss
28. The Elderly are at high risk of Adverse Drug Reactions due to:
a. Increased liver metabolism
b. More frequent hospital visits
c. Age-related decrease in renal function
d. Higher body mass index
Answer: c. age related decrease in renal function
29. Mr. Contreras is a 64-year-old patient with Type 2 diabetes. He has recently been diagnosed
with hypertension. Which antihypertensive drug is the recommended choice to treat hypertension
in patients with diabetes?
a. Calcium channel blocker
b. Diuretic
c. Beta blocker
d. Angiotensin-converting enzyme (ACE) inhibitor
Answer: c. Beta Blocker
30. Which of the following statements best defines how a chemical becomes termed a drug?
a. A chemical must be available over-the-counter.
b. A chemical must have recreational use.
c. A chemical must have a proven therapeutic value or efficacy without severe toxicity or
damaging properties to become a drug.
d. A chemical must be synthesized in a laboratory.
Answer: c. A chemical must have a proven therapeutic value or efficacy without severe toxicity
or damaging properties to become a drug.
31. Advanced practice nurse prescribing of scheduled medications is affected most by:
a. State nursing boards
b. Hospital policies
c. FDA
d. The American Nurses Association (ANA)
Answer: c. FDA
32. An adult male comes to the clinic with complaints that he is experiencing increased difficulty
breathing over the past few days. He has a history of asthma and coronary artery disease. He was
recently diagnosed with hypertension. Examination reveals no jugular vein distention and no
productive cough. Breath sounds are present, but expiratory wheezes are noted bilaterally, and he
denies any chest pain. His vital signs are pulse of 74 beats/min, respirations of 32 breaths/min,
and BP of 160/100 mm Hg. His current medications are albuterol (Proventil) inhaler 2 puffs
every 4 hours prn for wheezing, nitro-glycerine transdermal patch, and propranolol (Inderal) 60
mg PO bid. What is the best treatment for this patient?
a. Start beclomethasone (Beclovent) inhaler 2 puffs 3 to 4 times daily
b. Increase the dosage of albuterol (Proventil) inhaler to 4 puffs every 4 hours
c. Administer a systemic corticosteroid injection
d. Discontinue propranolol (Inderal) and switch to another antihypertensive medication
Answer: a. Start beclomethasone (Beclovent) inhaler 2 puffs 3 to 4 times daily
33. Which of the following statements accurately describes digoxin?
a. It is primarily used to treat hypertension.
b. It is a first-line treatment for heart failure in all patients.
c. It is widely used to augment cardiac output.
d. It is only prescribed for patients with atrial fibrillation.
Answer: c. It is widely used to augment cardiac output.
34. Typical adverse reactions to oral calcium-channel blockers include:
a. Hypokalaemia
b. Edema
c. Insomnia
d. Hyperglycemia
Answer: b. edema
35. Ms. Simpson has a known history of asthma. She is on Theophylline daily. The NP
contemplates giving her an antibiotic for her respiratory infection. The NP knows that which
choice below could elevate theophylline levels?
a. Azithromycin
b. Mucinex
c. Amoxicillin
d. Albuterol
Answer: b. Mucinex
36. A physician has ordered subcutaneous injections of morphine, a narcotic, every 4 hours as
needed for pain for a motor vehicle accident victim. The nurse is aware that there is a high abuse
potential for this drug and that it is categorized as a
a. C-II drug
b. C-I drug
c. C-III drug
d. C-IV drug
Answer: b. C-I drug.
37. A male patient who is hypertensive takes Hydrochlorothiazide for his blood pressure . He
presents with red, painful swelling of the great toe. In addition to treating gout, you recognize
that you may need to:
a. Decrease his HCTZ
b. Increase his HCTZ
c. Change his antihypertensive medication
d. Prescribe allopurinol
Answer: b. Increase his HCTZ
38. Which effect does the Nurse Practitioner expect may occur when using cholinergic agonists?
a. Increased heart rate
b. Dry mouth
c. Dizziness
d. Bradycardia
Answer: b. dry Mouth
39. Which of the following is a potential adverse side effect of autonomic-anticholinergic agents?
a. Nausea
b. Increased symptoms of benign prostatic hypertrophy
c. Bradycardia
d. Increased secretions
Answer: b. Increased symptoms of benign prostatic hypertrophy
40. A 24-year-old factory worker has been prescribed guaifenesin for the first time. Which of the
following will be a priority assessment by the nurse before the patient's first dose?
a. Respiratory rate
b. The amount of alcohol consumption
c. Allergies to medications
d. Previous history of gout
Answer: b. The amount of alcohol consumption
41. A possible side effect from the use of nifedipine (Procardia XL) is:
a. Hypotension
b. Edema of the ankles and headaches
c. Dry mouth
d. Insomnia
Answer: b. Edema of the ankles and headaches
42. A patient has a history of tonic-clonic seizures that have been successfully treated with
phenytoin (Dilantin) for several years. Phenytoin achieves a therapeutic effect by
a. Enhancing GABA activity
b. Decreasing the influx of sodium into neurons.
c. Increasing calcium levels in neurons
d. Blocking dopamine receptors
Answer: b. decreasing the influx of sodium into neurons.
43. Jillian is a Nurse Practitioner. She recognizes that Nurse Practitioner prescriptive authority Is
regulated by:
a. The American Medical Association
b. The state board of nursing for each state
c. National Nurse Practitioner Association
d. Federal Drug Administration
Answer: b. The state board of nursing for each state
44. Successful treatment for an adult patient with Helicobacter pylori (H. pylori)-induced peptic
ulcer disease requires therapy with which regimen?
a. Amoxicillin and metronidazole
b. Omeprazole and ranitidine
c. Clarithromycin, amoxicillin, and omeprazole (Prilosec).
d. Tetracycline and famotidine
Answer: c. Clarithromycin, amoxicillin, and omeprazole (Prilosec).
45. The Nurse Practitioner is teaching a patient about the role of medications in the treatment of
asthma. Which statement by the patient would require further teaching?
a. "I should take my inhaler before exercising."
b. "I can stop taking my medications once I feel better."
c. “I need to use my peak flow meter to self-monitor how I am doing.”
d. "I will keep my rescue inhaler with me at all times."
Answer: c. “I need to use my peak flow meter to self-monitor how I am doing.”
46. A common side effect of metformin (Glucophage) therapy is:
a. Nausea
b. diarrhoea
c. Constipation
d. Weight gain
Answer: b. diarrhoea
47. Biguanides control hyperglycaemia in type 2 diabetes primarily by acting at which organ?
a. Kidneys
b. Pancreas
c. Liver
d. Muscles
Answer: c. Liver
48. Which of the following oral medications is the safest to use during pregnancy?
a. Lisinopril
b. Methyldopa
c. Metformin
d. Amlodipine
Answer: b. Methyldopa
49. A female patient, age 36, is prescribed inhaled corticosteroid (ICS) for daily use. Which of
the following adverse effects should the nurse closely monitor for in this patient?
a. Bronchospasm
b. Oropharyngeal Candida albicans infection
c. Tachycardia
d. Hypokalaemia
Answer: b. Oropharyngeal Candida albicans infection
50. 60-year-old male presents to your office with a history of seizure disorder. The patient states
that he has been taking valproic acid. Which of the following is a known potential adverse effect
of valproic acid?
a. Hepatotoxicity
b. Pancreatitis
c. Nephrotoxicity
d. Hypoglycaemia
Answer: b. Pancreatitis
51. A patient who is a steroid-dependent asthmatic is started on a beclomethasone inhaler. Which
should be part of patient education?
a. Use the inhaler only during an asthma attack
b. Rinse the mouth well after each use
c. Store the inhaler in the refrigerator
d. Increase the dosage if symptoms worsen
Answer: b. Rinse the mouth well after each use
52. A patient has been started on a treatment regimen that includes levothyroxine. Select the
dosage regimen that is most appropriate for a mean replacement dosage. The patient has been
started on a treatment regimen that includes levothyroxine. Select the dosage regimen that is
most appropriate for a mean replacement dosage.
a. 0.5 mcg/kg of body weight per day
b. 1.7 mcg/kg of body weight per day
c. 2.5 mcg/kg of body weight per day
d. 1.0 mcg/kg of body weight per day
Answer: b. 1.7 mcg/kg of body weight per day
53. Which of the following is a contraindication for antimuscarinic drugs?
a. Asthma
b. Glaucoma
c. Pyloric stenosis
d. Urinary incontinence
Answer: c. pyloric stenosis
54. Which medication class is recognized for the treatment of moderate to severe dementia?
a. NMDA receptor antagonists
b. Cholinesterase inhibitors
c. Antipsychotics
d. SSRIs
Answer: b. Cholinesterase inhibitors.
55. Which mechanism of platelet inhibition is exhibited by aspirin?
a. Thromboxane A2 synthesis inhibition
b. Adenosine diphosphate (ADP) antagonism
c. Glycoprotein IIb/IIIa inhibition
d. Phosphodiesterase inhibition
Answer: b. Adenosine diphosphate (ADP) antagonism
56. When prescribing an antihypertensive medication for a type 2 diabetic patient, the drug
classifications that would tend to reduce insulin sensitivity are:
a. ACE inhibitors and ARBs
b. Diuretics and beta blockers
c. Calcium channel blockers
d. Alpha-1 blockers
Answer: b. Diuretics and beta blockers.
57. You are seeing a 65 year old male with a long history of COPD who has recently developed
hypertension. Which class of antihypertensive agents should the Nurse Practitioner avoid for this
patient?
a. Beta blockers
b. Calcium channel blockers
c. ACE inhibitors
d. Diuretics
Answer: c. ACE inhibitors
58. A Nurse Practitioner is conducting an assessment of a patient who has recently had several
changes made to her drug regimen. What assessment question most directly addresses the safety
implications of the patient's drug regimen?
a. "Have you experienced any side effects from your medications?"
b. "Do you follow a specific diet or exercise program?"
c. "Do you take any herbal supplements or alternative medications?"
d. "How often do you take your medications?"
Answer: c. "Do you take any herbal supplements or alternative medications?"
59. How does cholestyramine lower blood cholesterol?
a. Inhibiting cholesterol synthesis in the liver
b. Sequestering bile salts and thus decreasing absorption and increasing catabolism
c. Increasing hepatic LDL receptor activity
d. Promoting cholesterol excretion in the feces
Answer: b. Sequestering bile salts and thus decreasing absorption and increasing catabolism
60. A 66-year-old woman has a complex medical history that includes poorly-controlled type 1
diabetes, renal failure as a result of diabetic nephropathy and chronic heart failure (CHF). Her
care provider has recently added spironolactone (Aldactone) to the woman's medication regimen.
The nurse should consequently assess for signs and symptoms of
a. Hyponatremia
b. Hyperkalaemia
c. Hypocalcaemia
d. Hyperglycaemia
Answer: d. hyperkalaemia.
61. Some first generation antihistamines are used:
a. as anticonvulsants
b. for depression
c. for anxiety management
d. for hypertension
Answer: a. as anticonvulsants
62. Which antihypertensive agent is associated with hair growth?
a. Propranolol
b. Enalapril
c. Minoxidil
d. Lisinopril
Answer: c. Minoxidil
63. A Nurse Practitioner is providing discharge planning for a 45-year-old woman who has a
prescription for oral albuterol. The Nurse Practitioner will question the patient about her intake
of which of the following?
a. Juice
b. Coffee
c. Alcohol
d. Milk
Answer: b. Coffee
64. A patient with type 1 diabetes has been admitted to the hospital for orthopaedic surgery and
the care team anticipates some disruptions to the patient's blood glucose levels in the days
following surgery. Which of the following insulin regimens is most likely to achieve adequate
glycaemic control?
a. Continuous insulin infusion
b. Small doses of long-acting insulin administered four to five times daily
c. Large doses of short-acting insulin once daily
d. Combination of regular and long-acting insulin twice daily
Answer: b. Small doses of long-acting insulin administered four to five times daily
65. The family of a Parkinson’s patient brings him to the clinic because he is experiencing
increasing difficulty with ambulation. The family nurse practitioner increases the patient’s dose
of carbidopa (25 mg)/levodopa (100 mg) (Sinemet 25–100 mg) from three to four times daily.
What is important for the family nurse practitioner to teach the family regarding the increase in
the dose of this medication?
a. The medication can be taken with any food.
b. The medication should be given on an empty stomach.
c. The medication should be stored in the refrigerator.
d. The medication should be taken at bedtime only.
Answer: b. The medication should be given on an empty stomach.
66. A 65-year-old male presents with a history of worsening urinary urgency, frequency, and
hesitancy. He also tells you that he has to "push really hard" to urinate and that his urine dribbles
a little after he is done urinating. What medication should be avoided
a. Tamsulosin
b. Finasteride
c. Ipratropium inhaler
d. Oxybutynin
Answer: c. ipratropium inhaler
67. The side effects of antihistamines are mostly due to their:
a. Sedative effects
b. Anticholinergic effects
c. Histamine receptor antagonism
d. Serotonin receptor antagonism
Answer: b. Anticholinergic effects
68. What is associated with chronic overtreatment with levothyroxine (Synthroid)?
a. Weight gain
b. Fatigue
c. Tachycardia
d. Hypotension
Answer: c. Tachycardia
69. A patient is recovering from an acute episode of thrombophlebitis and is being treated with
warfarin (Coumadin) 5 mg PO daily. In reviewing medication information, the Nurse Practitioner
would include what information in their teaching?
a. It is safe to take aspirin with warfarin.
b. You can eat as many green leafy vegetables as you like.
c. Do not take a multivitamin supplement.
d. Warfarin can be taken at any time of the day without regard to meals.
Answer: c. Do not take a multivitamin supplement
70. A 39 y/o female is diagnosed with Graves’ disease. She also has a small goiter =. Her
symptoms are not deemed to be severe and propylthiouracil is prescribed. Where is the most
serious potential adverse effect of this medication?
a. Hepatotoxicity
b. Rash
c. Agranulocytosis
d. Nausea
Answer: c. Agranulocytosis
71. Which of the following can block the action of heparin?
a. Vitamin K
b. Warfarin
c. Protamine sulphate
d. Fibrinogen
Answer: c. Protamine sulphate
72. What is a serious side effect of ibuprofen in the older adult patient?
a. Gastrointestinal bleeding
b. Impairment of renal function
c. Liver toxicity
d. Cardiac arrhythmias
Answer: b. Impairment of renal function
73. A mother brings her 4-year-old child, who is vomiting and has a temperature of 103°F into
the emergency department (ED). The ED physician orders acetaminophen (Tylenol) for the fever.
The best form of Tylenol to give the child, considering her presentation, would be
a. Oral suspension
b. Suppository
c. Chewable tablets
d. Effervescent tablets
Answer: b. suppository.
74. The NP knows that lithium levels should be measured while patients are on lithium therapy.
The NP also recognizes that lithium has a
a. High therapeutic index and requires monitoring every 6-12 months
b. Low therapeutic index and requires monitoring every 3-6 months when initiated
c. Wide safety margin and does not require monitoring
d. High likelihood of drug interactions that require frequent monitoring
Answer: b. Low therapeutic index and requires monitoring every 3-6 months when initiated
75. Ginger, a 25 year old female presents at the clinic with known history of depression. She
reports taking an SSRI with only partial relief. Which of the following drugs can be used safely
at any dose in conjunction with an SSRI?
a. St. John's Wort
b. Tricyclic antidepressants
c. Monoamine oxidase inhibitors (MAOIs)
d. None of the above
Answer: d. None of the above
76. Drugs that use CYP 3A4 isoenzymes for metabolism may:
a. Inhibit the metabolism of other drugs
b. Increase the metabolism of other drugs
c. Both 1 and 2
d. Have no effect on other drugs
Answer: c. Both 1 and 2
77. All of the following agents are used to control the inflammatory changes seen in the lungs of
asthmatics except:
a. Inhaled corticosteroids
b. Long-acting beta agonists
c. Cromolyn sodium inhaler (Intal)
d. Leukotriene modifiers
Answer: c. Cromolyn sodium inhaler (Intal)
78. Glargine (Lantus) is an insulin analog that essentially has no peak and is usually
administered:
a. Twice a day
b. Once a day
c. Three times a day
d. As needed
Answer: b. Once a day.
79. Typical adverse reactions to oral calcium-channel blockers include:
a. Dizziness
b. Edema
c. Constipation
d. Rash
Answer: b. edema
80. A primary therapy for patients with mild ulcerative colitis is:
a. Sulfasalazine (Azulfidine)
b. Corticosteroids
c. Mesalamine (Pentasa)
d. Immunosuppressants
Answer: c. Mesalamine (Pentasa).
81. Jillian is a Nurse Practitioner. She recognizes that Nurse Practitioner prescriptive authority Is
regulated by:
a. The state board of nursing for each state
b. The federal government
c. The American Nurses Association
d. The physician supervising the Nurse Practitioner
Answer: a. The state board of nursing for each state
82. Mr. Penny, age 67, was diagnosed with chronic angina several months ago and has been
unable to experience adequate relief of his symptoms. As a result, his physician has prescribed
ranolazine (Ranexa). Which of the following statements is true regarding the use of ranolazine
for the treatment of this patient's angina?
a. It can be taken with food.
b. Mr. Penny will need to be taught to monitor his blood pressure and heart rate.
c. It is used to treat acute angina attacks.
d. It does not have any drug interactions.
Answer: b. Mr. Penny will need to be taught to monitor his blood pressure and heart rate.
83. The NP is examining a 34-year-old obese man with a body mass index (BMI) of 35 who
complains of almost daily indigestion and heartburn for the past year with a strong acid taste in
the mouth about an hour after meals, and frequent belching and awakening at night with choking.
The history is negative for chronic illnesses and alarm symptoms. A diagnosis of
gastroesophageal reflux disease (GERD) is made. What is the best initial treatment for the
patient?
a. Ranitidine (Zantac) 150 mg twice daily.
b. Omeprazole (Prilosec) 20 mg every morning 30 minutes before breakfast.
c. Sucralfate (Carafate) 1 g four times daily.
d. Antacids as needed.
Answer: b. Omeprazole (Prilosec) 20 mg every morning 30 minutes before breakfast.
84. A Nurse Practitioner is caring for a patient who is diabetic and has been diagnosed with
hypertension. An angiotensin-converting enzyme inhibitor, captopril, has been prescribed for her.
Which of the following should the Nurse Practitioner assess before beginning drug therapy?
a. Serum sodium levels
b. Serum potassium levels
c. Serum glucose levels
d. Serum creatinine levels
Answer: b. Serum potassium levels
85. A 53-year-old man has been treated for severe asthma for several years with prednisone.
Recently, his physician initiated alternate-day therapy for him. The patient tells the nurse that he
would rather take the medication every day to prevent confusion. Which of the following would
be the best response by the nurse?
a. "Taking it daily will prevent any side effects."
b. "This schedule allows rest periods so that adverse effects are decreased but the antiinflammatory effects continue."
c. "You will have to adjust to the alternate-day schedule."
d. "Daily dosing is safer for your condition."
Answer: b. "This schedule allows rest periods so that adverse effects are decreased but the antiinflammatory effects continue."
86. What information would the Nurse Practitioner include in teaching a patient about the
treatment of vitamin B12 deficiency following a total gastrectomy?
a. The patient will receive oral vitamin B12 supplements daily.
b. The patient will receive monthly cyanocobalamin (vitamin B12) injections for life (after being
given daily weekly injections for the first month).
c. The patient will need to have regular blood tests to monitor vitamin B12 levels only.
d. The patient can get enough vitamin B12 from diet alone.
Answer: b. The patient will receive monthly cyanocobalamin (vitamin B12) injections for life
(after being given daily weekly injections for the first month).
87. The APRN's ability to prescribe controlled substances is regulated by:
a. Federal Law
b. State Law
c. The Drug Enforcement Administration (DEA)
d. The American Medical Association (AMA)
Answer: b. State Law
88. A patient with a known history of benign prostatic hyperplasia (BPH) presents to the clinic 4
days after developing a cold. He tells you he began experiencing a sore throat and nasal
congestion and began to take an over the counter decongestant. Today, he complains of not
urinating over the last 12 hours. He also has suprapubic fullness on exam. Which of the
following medications are most likely responsible for this patient's urinary retention?
a. Pseudoephedrine
b. Tamsulosin
c. Phenylephrine
d. Dextromethorphan
Answer: b. Tamsulosin
89. A patient with a history of bronchial asthma is seen in the clinic for increased episodes of
difficulty breathing. He has been taking theophylline 100 mg PO tid. He is 40 years old and
obese with a 16-pack-year history of cigarette smoking and excessive intake of coffee daily. He
eats a low-carbohydrate, high-protein diet. Which identified factors decrease the therapeutic
effects of the theophylline?
a. Obesity and age
b. Smoking history and diet
c. Coffee intake only
d. History of asthma only
Answer: b. Smoking history and diet
90. Classes of medications typically used to treat hyperthyroid conditions include:
a. Beta blockers and antithyroid drugs
b. Calcium channel blockers and corticosteroids
c. Antidepressants and sedatives
d. Diuretics and antihistamines
Answer: a. Calcium channel blockers and corticosteroids.
91. What drug class will decrease the facial flushing that occurs with niacin?
a. Corticosteroids
b. NSAIDs
c. Antihistamines
d. Beta blockers
Answer: b. NSAIDS
92. Which of the following conditions is a contraindication for pioglitazone (Actos).
a. Hypertension
b. Severe congestive heart failure
c. Asthma
d. Hyperlipidaemia
Answer: b. Severe congestive heart failure
93. To minimize the risk of adverse effects of glucagon when given to an unconscious diabetic
patient, as the patient regains consciousness, the nurse should
a. Administer carbohydrates
b. Monitor blood glucose levels
c. Offer fluids immediately
d. Provide protein-rich snacks
Answer: a. administer carbohydrates.
94. Which of the following serves to protect the public by ensuring the purity of a drug and its
contents?
a. Federal legislation
b. State laws
c. Institutional policies
d. Professional standards
Answer: a. Federal legislation
95. A patient in need of myocardial infarction prophylaxis has been prescribed sulfinpyrazone for
gout. Which of the following will the nurse monitor the patient most closely for?
a. Hypertension
b. Bleeding
c. Hyperglycaemia
d. Liver dysfunction
Answer: b. Bleeding
96. Which type of antihistamines are used to inhibit the secretion of gastric acid in patients with
gastrointestinal disorders?
a. First-generation antihistamines
b. Second-generation antihistamines
c. H2 antagonists
d. Leukotriene modifiers
Answer: c. H2 antagonists
97. Which can elevate theophylline levels?
a. Increased dietary caffeine
b. Concomitant treatment with cimetidine (Tagamet)
c. Smoking cessation
d. Decreased protein intake
Answer: b. Concomitant treatment with cimetidine (Tagamet).
98. A Nurse Practitioner is caring for a 73-year-old man who is receiving drug therapy. He is
beginning to exhibit signs of decline in his renal system, yet his current serum creatinine level is
normal. The Nurse Practitioner will base the patient's plan of care on the understanding that there
is
a. Increased glomerular filtration rate (GFR)
b. A decrease in the amount of creatinine to be filtered
c. A normal renal function for his age
d. Compensatory mechanisms maintaining serum creatinine levels
Answer: b. A decrease in the amount of creatinine to be filtered
99. A 39 y/o female is diagnosed with Graves’ disease. She also has a small goiter =. Her
symptoms are not deemed to be severe and propylthiouracil is prescribed. Where is the most
serious potential adverse effect of this medication?
a. Liver failure
b. Agranulocytosis
c. Hypothyroidism
d. Hyperthyroidism
Answer: b. Agranulocytosis
100. The Family nurse practitioner prescribed losartan 50 mg PO daily for a hypertensive patient.
This medication promotes vasodilation by:
a. Blocking the action of aldosterone
b. Blocking the action of angiotensin II
c. Inhibiting norepinephrine reuptake
d. Stimulating beta-adrenergic receptors
Answer: b. Blocking the action of angiotensin II
101. When completing this exam, did you comply with Walden University’s Code of Conduct
including the expectations for academic integrity?
a. Yes
b. No
Answer: a. Yes
