NSG 6005 Midterm Exam / NSG6005
Midterm Exam (Latest) : South University (Already graded A)
1) A patient’s nutritional intake and lab work reflect hypoalbuminemia. This is critical to
prescribing because:
Answer: Distribution of drugs to target tissue may be affected.
2) Drugs that have a significant first-pass effect:
Answer: Are rapidly metabolized by the liver and may have little if any desired action.
3) The route of excretion of a volatile drug will likely be:
Answer: The lungs
4) The point in time on the drug concentration curve that indicates the first sign of a
therapeutic effect is the:
Answer: Onset of action
5) Factors that affect gastric drug absorption include:
Answer: Lipid solubility of the drug
6) Which one of the following statements about bioavailability is true?
Answer: Bioavailability issues are especially important for drugs with narrow therapeutic
ranges or sustained release mechanisms.
7) Steady state is:
Answer: When the amount of drug in the body remains constant.
8) The time required for the amount of drug in the body to decrease by 50% is called:
Answer: Halflife
9) An advantage of prescribing a sublingual medication is that the medication is:
Answer: Absorbed rapidly
10) Drugs that use CYP3A4 isoenzymes for metabolism may:
Answer: Both A and B(Induce the metabolism of another drug; inhibit the metabolism of
another drug)
11) A nurse practitioner would prescribe the liquid form of ibuprofen for a six-year-old
because:
Answer: A six-year-old may have problems swallowing a pill
12) The first step in the prescribing process according to the World Health Organization is:
Answer: Diagnosing the patient’s problem
13) Patient education regarding prescribed medication includes:
Answer: Discussion of expected ADRs
14) Pharmacokinetic factors that affect prescribing include:
Answer: Bioavailability
15) Infants and young children are at higher risk of ADRs due to:
Answer: Lack of safety and efficacy studies in the pediatric population.
16) Infants and young children are at higher risk of ADRs due to:
Answer: Lack of safety and efficacy studies in the pediatric population.
17) The elderly are at high risk of ADRs due to:
Answer: Age-related decrease in renal-function
18) The type of ADR that is the result of an unwanted but otherwise normal pharmacological
action of a drug given in the usual therapeutic doses is:
Answer: Type A
19) A patient may develop neutropenia from using topical Silvadene for burns. Neutropenia
is:
Answer: A cytoxic hypersensitivity reaction
20) The angiotensin converting enzyme (ACE) inhibitor Lisinopril is a known teratogen.
Teratogens cause Type __ ADR.
Answer: D
21) A twenty-four-year-old male received multiple fractures in a motor vehicle accident that
required significant amounts of opioid medication to treat his pain. He is at risk for Type __
ADR when he no longer requires the opioids.
Answer: E
22) Which of the following factors may adversely affect a patient’s adherence to a therapeutic
drug regimen?
Answer: Both A and B
23) Nonadherence is especially common in drugs that treat asymptomatic conditions, such as
hypertension. One way to reduce the likelihood of nonadherence to these drugs is to prescribe
a drug that:
Answer: Has a tolerability profile with less of the adverse effects that are considered
“irritating,” such as nausea and dizziness
24) Patients with psychiatric illnesses have adherence rates to their drug regimen between
35% and 60%. To improve adherence in this population, prescribe drugs:
Answer: With a longer half-life so that missed doses produce a longer taper on the drug
curve
25) Genetic polymorphisms account for differences in metabolism, including:
Answer: • All of the above (Poor metabolizers (PMs) that lack a working enzyme;
Intermediate metabolizers
• (IMs) that have on working, wild-type allele and one mutant allele; Extensive metabolizers
(EMs) , with two normally functioning alleles)
26) Warfarin resistance may be seen in patients with VCORC1 mutation, leading to:
Answer: Decreased response to warfarin
27) Genetic testing for VCORC1 mutation to assess potential warfarin resistance is required
prior to prescribing warfarin.
Answer: False
28) Carbamazepine has a black box warning recommending testing for the HLA-B*1502
allele in patients with Asian ancestry prior to starting therapy due to:
Answer: Increased risk for Stevens-Johnson syndrome in Asian patients with HLAB*1502
allele
29) Herbs and supplements are tested for safety by the FDA.
Answer: False
30) Carbamazepine has a black box warning recommending testing for the HLA-B*1502
allele in patients with Asian ancestry prior to starting therapy due to:
Answer: Increased risk for Stevens-Johnson syndrome in Asian patients with HLAB*1502
allele
31) Common OTC pain relievers such as acetaminophen or ibuprofen:
Answer: Educate patients and guide them to appropriate sources of care.
32) Common OTC pain relievers such as acetaminophen or ibuprofen:
Answer: Are harmful if taken in higher-than-recommended amounts
33) When obtaining a drug history from Harold, he gives you a complete list of his
prescription medications. He denies taking any other drugs, but you find that he occasionally
takes aspirin for his arthritis flare-ups. This is an example of:
Answer: A common misconception that intermittently taken OTC medications are not an
important part of his drug history
34) Patients with pheochromocytoma should avoid which of the following classes of drugs
due to the possibility of developing hypertensive crisis?
Answer: Beta 2 agonist
35) Harold, a forty-two-year-old African American, has moderate persistent asthma. Which of
the following asthma medications should he use cautiously, if at all?
Answer: Salmeterol, an inhaled long-acting beta-agonist
36) Long-acting beta-agonists received a black box warning from the US Food and Drug
Administration due to the:
Answer: Increased risk of asthma-related deaths when long-acting beta-agonists are used
37) Tiotropium bromide (Spiriva) is an inhaled anticholinergic:
Answer: Used for the treatment of COPD
38) Christy has exercise and mild persistent asthma and is prescribed two puffs of albuterol
fifteen minutes before exercise and as needed for wheezing. One puff per day of
beclomethasone (Qvar) is also prescribed. Teaching regarding her inhalers includes which
one of the following?
Answer: Used in the treatment of asthma
39) When prescribing montelukast (Singulair) for asthma, patients or parents of patients
should be instructed as follows:
Answer: Aggression, anxiety, depression, and/or suicidal throughts may occur when taking
montelukast
40) Montelukast (Singulair) may be prescribed for:
Answer: A two-year-old with moderate persistent asthma
41) Patients with allergic rhinitis may benefit from a prescription of:
Answer: Any of the above (Fluticasone (Flonase) ; Cetrizine (Zyrtec) ; OTC cromolyn nasal
spray (Nasalcrom))
42) Howard is a seventy-two-year-old male who occasionally takes diphenhydramine for his
seasonal allergies. Monitoring for this patient takin diphenhydramine would include assessing
for:
Answer: Urinary retention
43) Second-generation antihistamines such as loratadine (Claritin) are prescribed for seasonal
allergies because they:
Answer: Are less sedating than first-generation antihistamines
44) Decongestants such as pseudoephedrine (Sudafed) :
Answer: Should not be prescribed or recommended for children under four years of age
45) The first-line treatment for cough related to a upper respiratory infection in a five-yearold is:
Answer: Fluids and symptomatic care
46) Prior to developing a plan for the treatment of asthma, the patient’s asthma should be
classified according to the National Heart, Lung, and Blood Institute (NHLBI) Expert Panel 3
guidelines. In adults, mild-persistent asthma is classified as asthma symptoms that occur:
Answer: More than twice a week and less than once a day
47) In five- to eleven-year-old children, mild-persistent asthma is diagnosed when asthma
symptoms occur:
Answer: At nighttime three to four times a month
48) A stepwise approach to the pharmacologic management of asthma:
Answer: Begins with determining the severity of the asthma and assessing asthma control
49) Monitoring a patient with persistent asthma includes:
Answer: Evaluating the patient every one to six months to determine whether the patient
needs to step up or down in his or her therapy
50) Asthma exacerbations at home are managed by the patient by:
Answer: Increasing the frequency of beta 2 agonists and contacting his or her provider
51) One goal of asthma management in children is:
Answer: They should participate in school and sports activities
52) A patient with a COPD exacerbation may require:
Answer: systemic corticosteroid bursts
53) Education of patients with COPD who use inhaled corticosteroids includes the following:
Answer: They should rinse their mouths after use.
54) Many patients self-medicate with antacids. Which patients should be counseled to not
take calcium carbonate antacids without discussing with their providers or a pharmacist first?
Answer: Patients with kidney stones
55) Josie is a five-year-old who presents to the clinic with a forty-eight-hour history of
nausea, vomiting, and some diarrhea. She is unable to keep fluids down, and her weight is 4
pounds less than her last recorded weight. Besides intravenous (IV) fluids, her exam warrants
the use of an antinausea medication. Which of the following would be the appropriate drug to
order for Josie?
Answer: Ondansetron (Zofran)
56) Patients who are on chronic long-term PPI therapy require monitoring for:
Answer: Iron deficiency anemia, vitamin B12, and calcium deficiency
57) Sadie is a seventy-two-year-old who takes omeprazole for her chronic GERD. Chronic
long-term omeprazole use places her at increased risk for:
Answer: osteoporosis
58) Metoclopramide improves GERD symptoms by:
Answer: Increasing lower esophageal tone
59) Infants with reflux are initially treated with:
Answer: Anti-reflux maneuvers (elevate the head of the bed)
60) Patients with pheochromocytoma should avoid which of the following classes of drugs
due to the possibility of developing hypertensive crisis?
Answer: Beta 2 agonists
61) Harold, a forty-two-year-old African American, has moderate persistent asthma. Which of
the following asthma medications should he use cautiously, if at all?
Answer: Salmeterol, an inhaled long-acting beta-agonist
62) Long-acting beta-agonists received a black box warning from the US Food and Drug
Administration due to the:
Answer: Increased risk of asthma-related deaths when long-acting beta-agonists are used
63) Tiotropium bromide (Spiriva) is an inhaled anticholinergic:
Answer: Used for the treatment of COPD
64) Christy has exercise and mild persistent asthma and is prescribed two puffs of albuterol
fifteen minutes before exercise and as needed for wheezing. One puff per day of
beclomethasone (Qvar) is also prescribed. Teaching regarding her inhalers includes which
one of the following?
Answer: Beclomethasone needs to be used every day to treat her asthma.
65) Montelukast (Singulair) may be prescribed for:
Answer: A two-year-old with moderate persistent asthma
66) Howard is a seventy-two-year-old male who occasionally takes diphenhydramine for his
seasonal allergies. Monitoring for this patient takin diphenhydramine would include assessing
for:
Answer: Urinary retention
67) Decongestants such as pseudoephedrine (Sudafed) :
Answer: Should not be prescribed or recommended for children under four years of age
68) In five- to eleven-year-old children, mild-persistent asthma is diagnosed when asthma
symptoms occur:
Answer: At nighttime three to four times a month
69) Monitoring a patient with persistent asthma includes:
Answer: Evaluating the patient every one to six months to determine whether the patient
needs to step up or down in his or her therapy
70) Education of patients with COPD who use inhaled corticosteroids includes the following:
Answer: They should rinse their mouths after use.
