question

Nurse practitioner prescriptive authority is regulated by: 1. The National Council of State Boards of Nursing 2. The U.S. Drug Enforcement Administration 3. The State Board of Nursing for each state 4. The State Board of Pharmacy

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3. The State Board of Nursing for each state

question

The benefits to the patient of having an Advanced Practice Registered Nurse (APRN) prescriber include: 1. Nurses know more about Pharmacology than other prescribers because they take it both in their basic nursing program and in their APRN program. 2. Nurses care for the patient from a holistic approach and include the patient in decision making regarding their care. 3. APRNs are less likely to prescribe narcotics and other controlled substances. 4. APRNs are able to prescribe independently in all states, whereas a physician's assistant needs to have a physician supervising their practice.

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2. Nurses care for the patient from a holistic approach and include the patient in decision making regarding their care.

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Clinical judgment in prescribing includes: 1. Factoring in the cost to the patient of the medication prescribed 2. Always prescribing the newest medication available for the disease process 3. Handing out drug samples to poor patients 4. Prescribing all generic medications to cut costs

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1. Factoring in the cost to the patient of the medication prescribed

question

Criteria for choosing an effective drug for a disorder include: 1. Asking the patient what drug they think would work best for them 2. Consulting nationally recognized guidelines for disease management 3. Prescribing medications that are available as samples before writing a prescription 4. Following U.S. Drug Enforcement Administration guidelines for prescribing

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2. Consulting nationally recognized guidelines for disease management

question

Nurse practitioner practice may thrive under health-care reform because of: 1. The demonstrated ability of nurse practitioners to control costs and improve patient outcomes 2. The fact that nurse practitioners will be able to practice independently 3. The fact that nurse practitioners will have full reimbursement under health-care reform 4. The ability to shift accountability for Medicaid to the state level

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1. The demonstrated ability of nurse practitioners to control costs and improve patient outcomes

question

A patient's nutritional intake and laboratory results reflect hypoalbuminemia. This is critical to prescribing because: 1. Distribution of drugs to target tissue may be affected. 2. The solubility of the drug will not match the site of absorption. 3. There will be less free drug available to generate an effect. 4. Drugs bound to albumin are readily excreted by the kidneys.

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1. Distribution of drugs to target tissue may be affected.

question

Drugs that have a significant first-pass effect: 1. Must be given by the enteral (oral) route only 2. Bypass the hepatic circulation 3. Are rapidly metabolized by the liver and may have little if any desired action 4. Are converted by the liver to more active and fat-soluble forms

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3. Are rapidly metabolized by the liver and may have little if any desired action

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The route of excretion of a volatile drug will likely be the: 1. Kidneys 2. Lungs 3. Bile and feces 4. Skin

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2. Lungs

question

Medroxyprogesterone (Depo Provera) is prescribed intramuscularly (IM) to create a storage reservoir of the drug. Storage reservoirs: 1. Assure that the drug will reach its intended target tissue 2. Are the reason for giving loading doses 3. Increase the length of time a drug is available and active 4. Are most common in collagen tissues

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3. Increase the length of time a drug is available and active

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The NP chooses to give cephalexin every 8 hours based on knowledge of the drug's: 1. Propensity to go to the target receptor 2. Biological half-life 3. Pharmacodynamics 4. Safety and side effects

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2. Biological half-life

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Azithromycin dosing requires that the first day's dosage be twice those of the other 4 days of the prescription. This is considered a loading dose. A loading dose: 1. Rapidly achieves drug levels in the therapeutic range 2. Requires four- to five-half-lives to attain 3. Is influenced by renal function 4. Is directly related to the drug circulating to the target tissues

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1. Rapidly achieves drug levels in the therapeutic range

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The point in time on the drug concentration curve that indicates the first sign of a therapeutic effect is the: 1. Minimum adverse effect level 2. Peak of action 3. Onset of action 4. Therapeutic range

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3. Onset of action

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Phenytoin requires that a trough level be drawn. Peak and trough levels are done: 1. When the drug has a wide therapeutic range 2. When the drug will be administered for a short time only 3. When there is a high correlation between the dose and saturation of receptor sites 4. To determine if a drug is in the therapeutic range

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4. To determine if a drug is in the therapeutic range

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A laboratory result indicates that the peak level for a drug is above the minimum toxic concentration. This means that the: 1. Concentration will produce therapeutic effects 2. Concentration will produce an adverse response 3. Time between doses must be shortened 4. Duration of action of the drug is too long

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2. Concentration will produce an adverse response

question

Drugs that are receptor agonists may demonstrate what property? 1. Irreversible binding to the drug receptor site 2. Upregulation with chronic use 3. Desensitization or downregulation with continuous use 4. Inverse relationship between drug concentration and drug action

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3. Desensitization or downregulation with continuous use

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Drugs that are receptor antagonists, such as beta blockers, may cause: 1. Downregulation of the drug receptor 2. An exaggerated response if abruptly discontinued 3. Partial blockade of the effects of agonist drugs 4. An exaggerated response to competitive drug agonists

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2. An exaggerated response if abruptly discontinued

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Factors that affect gastric drug absorption include: 1. Liver enzyme activity 2. Protein-binding properties of the drug molecule 3. Lipid solubility of the drug 4. Ability to chew and swallow

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3. Lipid solubility of the drug

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Drugs administered via IV: 1. Need to be lipid soluble in order to be easily absorbed 2. Begin distribution into the body immediately 3. Are easily absorbed if they are nonionized 4. May use pinocytosis to be absorbed

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2. Begin distribution into the body immediately

question

When a medication is added to a regimen for a synergistic effect, the combined effect of the drugs is: 1. The sum of the effects of each drug individually 2. Greater than the sum of the effects of each drug individually 3. Less than the effect of each drug individually 4. Not predictable, as it varies with each individual

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2. Greater than the sum of the effects of each drug individually

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Which of the following statements about bioavailability is true? 1. Bioavailability issues are especially important for drugs with narrow therapeutic ranges or sustained-release mechanisms. 2. All brands of a drug have the same bioavailability. 3. Drugs that are administered more than once a day have greater bioavailability than drugs given once daily. 4. Combining an active drug with an inert substance does not affect bioavailability.

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1. Bioavailability issues are especially important for drugs with narrow therapeutic

question

Which of the following statements about the major distribution barriers (blood- brain or fetal-placental) is true? 1. Water soluble and ionized drugs cross these barriers rapidly. 2. The blood-brain barrier slows the entry of many drugs into and from brain cells. 3. The fetal-placental barrier protects the fetus from drugs taken by the mother. 4. Lipid-soluble drugs do not pass these barriers and are safe for pregnant women.

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2. The blood-brain barrier slows the entry of many drugs into and from brain cells.

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Drugs are metabolized mainly by the liver via phase I or phase II reactions. The purpose of both of these types of reactions is to: 1. Inactivate prodrugs before they can be activated by target tissues 2. Change the drugs so they can cross plasma membranes 3. Change drug molecules to a form that an excretory organ can excrete 4. Make these drugs more ionized and polar to facilitate excretion

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3. Change drug molecules to a form that an excretory organ can excrete

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Once they have been metabolized by the liver, the metabolites may be: 1. More active than the parent drug 2. Less active than the parent drug 3. Totally "deactivated" so they are excreted without any effect 4. All of the above

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4. All of the above

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All drugs continue to act in the body until they are changed or excreted. The ability of the body to excrete drugs via the renal system would be increased by: 1. Reduced circulation and perfusion of the kidney 2. Chronic renal disease 3. Competition for a transport site by another drug 4. Unbinding a nonvolatile drug from plasma proteins

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4. Unbinding a nonvolatile drug from plasma proteins

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Steady state is: 1. The point on the drug concentration curve when absorption exceeds excretion 2. When the amount of drug in the body remains constant 3. When the amount of drug in the body stays below the minimum toxic concentration 4. All of the above

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2. When the amount of drug in the body remains constant

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Two different pain medications are given together for pain relief. The drug—drug interaction is: 1. Synergistic 2. Antagonistic 3. Potentiative 4. Additive

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4. Additive

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Actions taken to reduce drug—drug interaction problems include all of the following EXCEPT: 1. Reducing the dosage of one of the drugs 2. Scheduling their administration at different times 3. Prescribing a third drug to counteract the adverse reaction of the combination 4. Reducing the dosage of both drugs

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3. Prescribing a third drug to counteract the adverse reaction of the combination

question

Phase I oxidative-reductive processes of drug metabolism require certain nutritional elements. Which of the following would reduce or inhibit this process? 1. Protein malnutrition 2. Iron-deficiency anemia 3. Both 1 and 2 4. Neither 1 nor 2

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4. Neither 1 nor 2

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The time required for the amount of drug in the body to decrease by 50% is called: 1. Steady state 2. Half-life 3. Phase II metabolism 4. Reduced bioavailability time

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2. Half-life

question

An agonist activates a receptor and stimulates a response. When given frequently over time, the body may: 1. Upregulate the total number of receptors 2. Block the receptor with a partial agonist 3. Alter the drug's metabolism 4. Downregulate the numbers of that specific receptor

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4. Downregulate the numbers of that specific receptor

question

Drug antagonism is best defined as an effect of a drug that: 1. Leads to major physiological and psychological dependence 2. Is modified by the concurrent administration of another drug 3. Cannot be metabolized before another dose is administered 4. Leads to a decreased physiological response when combined with another drug

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2. Is modified by the concurrent administration of another drug

question

Instructions to a client regarding self-administration of oral enteric-coated tablets should include which of the following statements? 1. "Avoid any other oral medicines while taking this drug." 2. "If swallowing this tablet is difficult, dissolve it in 3 ounces of orange juice." 3. "The tablet may be crushed if you have any difficulty taking it." 4. "To achieve best effect, take the tablet with at least 8 ounces of fluid."

answer

4. "To achieve best effect, take the tablet with at least 8 ounces of fluid."

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The major reason for not crushing a sustained-release capsule is that, if crushed, the coated beads of the drugs could possibly result in: 1. Disintegration 2. Toxicity 3. Malabsorption 4. Deterioration

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2. Toxicity

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Which of the following substances is the most likely to be absorbed in the intestines rather than in the stomach? 1. Sodium bicarbonate 2. Ascorbic acid 3. Salicylic acid 4. Glucose

answer

1. Sodium bicarbonate

question

Which of the following variables is a factor in drug absorption? 1. The smaller the surface area for absorption, the more rapidly the drug is absorbed. 2. A rich blood supply to the area of absorption leads to better absorption. 3. The less soluble the drug, the more easily it is absorbed. 4. Ionized drugs are easily absorbed across the cell membrane.

answer

2. A rich blood supply to the area of absorption leads to better absorption.

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An advantage of prescribing a sublingual medication is that the medication is: 1. Absorbed rapidly 2. Excreted rapidly 3. Metabolized minimally 4. Distributed equally

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1. Absorbed rapidly

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Drugs that use CYP 3A4 isoenzymes for metabolism may: 1. Induce the metabolism of another drug 2. Inhibit the metabolism of another drug 3. Both 1 and 2 4. Neither 1 nor 2

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3. Both 1 and 2

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Therapeutic drug levels are drawn when a drug reaches steady state. Drugs reach steady state: 1. After the second dose 2. After four to five half-lives 3. When the patient feels the full effect of the drug 4. One hour after IV administration

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2. After four to five half-lives

question

Upregulation or hypersensitization may lead to: 1. Increased response to a drug 2. Decreased response to a drug 3. An exaggerated response if the drug is withdrawn 4. Refractoriness or complete lack of response

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3. An exaggerated response if the drug is withdrawn

question

An NP would prescribe the liquid form of ibuprofen for a 6-year-old child because: 1. Drugs given in liquid form are less irritating to the stomach. 2. A 6-year-old child may have problems swallowing a pill. 3. Liquid forms of medication eliminate the concern for first-pass effect. 4. Liquid ibuprofen does not have to be dosed as often as the tablet form.

answer

2. A 6-year-old child may have problems swallowing a pill.

question

In deciding which of multiple drugs used to use to treat a condition, the NP chooses Drug A because it: 1. Has serious side effects and it is not being used for a life-threatening condition 2. Will be taken twice daily and will be taken at home 3. Is expensive, but covered by health insurance 4. None of these are important in choosing a drug

answer

2. Will be taken twice daily and will be taken at home

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A client asks the NP about the differences in drug effects between men and women. What is known about the differences between the pharmacokinetics of men and women? 1. Body temperature varies between men and women. 2. Muscle mass is greater in women. 3. Percentage of fat differs between genders. 4. Proven subjective factors exist between the genders.

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3. Percentage of fat differs between genders.

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The first step in the prescribing process according to the World Health Organization is: 1. Choosing the treatment 2. Educating the patient about the medication 3. Diagnosing the patient's problem 4. Starting the treatment

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3. Diagnosing the patient's problem

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Treatment goals in prescribing should: 1. Always be curative 2. Be patient-centered 3. Be convenient for the provider 4. Focus on the cost of therapy

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2. Be patient-centered

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The therapeutic goals when prescribing include(s): 1. Curative 2. Palliative 3. Preventive 4. All of the above

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4. All of the above

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When determining drug treatment the NP prescriber should: 1. Always use evidence-based guidelines 2. Individualize the drug choice for the specific patient 3. Rely on his or her experience when prescribing for complex patients 4. Use the newest drug on the market for the condition being treated

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2. Individualize the drug choice for the specific patient

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Patient education regarding prescribed medication includes: 1. Instructions written at the high school reading level 2. Discussion of expected adverse drug reactions 3. How to store leftover medication such as antibiotics 4. Verbal instructions always in English

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2. Discussion of expected adverse drug reactions

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Passive monitoring of drug effectiveness includes: 1. Therapeutic drug levels 2. Adding or subtracting medications from the treatment regimen 3. Ongoing provider visits 4. Instructing the patient to report if the drug is not effective

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4. Instructing the patient to report if the drug is not effective

question

Pharmacokinetic factors that affect prescribing include: 1. Therapeutic index 2. Minimum effective concentration 3. Bioavailability 4. Ease of titration

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3. Bioavailability

question

Pharmaceutical promotion may affect prescribing. To address the impact of pharmaceutical promotion, the following recommendations have been made by the Institute of Medicine: 1. Conflicts of interest and financial relationships should be disclosed by those providing education. 2. Providers should ban all pharmaceutical representatives from their office setting. 3. Drug samples should be used for patients who have the insurance to pay for them, to ensure the patient can afford the medication. 4. Providers should only accept low-value gifts, such as pens and pads of paper, from the pharmaceutical representative.

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1. Conflicts of interest and financial relationships should be disclosed by those providing education.

question

Under new U.S. Food and Drug Administration labeling, Pregnancy Categories will be: 1. Strengthened with a new coding such as C+ or C- to discern when a drug is more or less toxic to the fetus 2. Changed to incorporate a pregnancy risk summary and clinical considerations on the drug label 3. Eliminated, and replaced with a link to the National Library of Medicine TOXNET Web site for in-depth information regarding pregnancy concerns 4. Clarified to include information such as safe dosages in each trimester of pregnancy

answer

2. Changed to incorporate a pregnancy risk summary and clinical considerations on the drug label

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? 1. Financial status 2. Mobility 3. Social support 4. Sexual practices

answer

4. Sexual practices

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? 1. Use correct medical terminology because Spanish has a Latin base. 2. Use a family member who speaks more English to act as an interpreter. 3. Use a professional interpreter or a reliable staff member who can act as an interpreter. 4. Use careful, detailed explanations.

answer

3. Use a professional interpreter or a reliable staff member who can act as an interpreter.

question

Rod, age 68, has hearing difficulty. Which of the following would NOT be helpful in assuring that he understands teaching about his drug? 1. Stand facing him and speak slowly and clearly. 2. Speak in low tones or find a provider who has a lower voice. 3. Write down the instructions as well as speaking them. 4. If he reads lips, exaggerate lips movements when pronouncing the vowel sounds.

answer

4. If he reads lips, exaggerate lips movements when pronouncing the vowel sounds.

question

Which of the following factors may adversely affect a patient's adherence to a therapeutic drug regimen? 1. Complexity of the drug regimen 2. Patient perception of the potential adverse effects of the drugs 3. Both 1 and 2 4. Neither 1 nor 2

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3. Both 1 and 2

question

The health-care delivery system itself can create barriers to adherence to a treatment regimen. Which of the following system variables creates such a barrier? 1. Increasing copayments for care 2. Unrestricted formularies for drugs, including brand names 3. Increasing the number of people who have access to care 4. Treating a wider range of disorders

answer

1. Increasing copayments for care

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? 1. Ralph states that he always takes the drug "when I feel my pressure is going up." 2. Ralph contacts his NP to discuss the need to increase the dosage. 3. Ralph consistently keeps his follow-up appointments to check his blood pressure. 4. All of the above show that he is adherent to the drug regimen.

answer

1. Ralph states that he always takes the drug "when I feel my pressure is going up."

question

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: 1. Has a short half-life so that missing one dose has limited effect 2. Requires several dosage titrations so that missed doses can be replaced with lower doses to keep costs down 3.Has a tolerability profile with fewer of the adverse effects that are considered "irritating," such as nausea and dizziness 4. Must be taken no more than twice a day

answer

3.Has a tolerability profile with fewer of the adverse effects that are considered "irritating," such as nausea and dizziness

question

Factors in chronic conditions that contribute to nonadherence include: 1. The complexity of the treatment regimen 2. The length of time over which it must be taken 3. Breaks in the usual daily routine, such as vacations and weekends 4. All of the above

answer

4. All of the above

question

While patient education about their drugs is important, information alone does not necessarily lead to adherence to a drug regimen. Patients report greater adherence when: 1. The provider spent a lot of time discussing the drugs with them 2. Their concerns and specific area of knowledge deficit were addressed 3. They were given written material, such as pamphlets, about the drugs 4. The provider used appropriate medical and pharmacological terms

answer

2. Their concerns and specific area of knowledge deficit were addressed

question

Patients with psychiatric illnesses have adherence rates to their drug regimen between 35% and 60%. To improve adherence in this population, prescribe drugs: 1. With a longer half-life so that missed doses produce a longer taper on the drug curve 2. In oral formulations that are more easily taken 3. That do not require frequent monitoring 4. Combined with patient education about the need to adhere even when symptoms are absent

answer

1. With a longer half-life so that missed doses produce a longer taper on the drug curve

question

Many disorders require multiple drugs to treat them. The more complex the drug regimen, the less likely the patient will adhere to it. Which of the following interventions will NOT improve adherence? 1. Have the patient purchase a pill container with compartments for daily or multiple times-per-day dosing. 2. Match the clinic appointment to the next time the drug is to be refilled. 3. Write prescriptions for new drugs with shorter times between refills. 4. Give the patient a clear drug schedule that the provider devises to fit the characteristic of the drug.

answer

4. Give the patient a clear drug schedule that the provider devises to fit the characteristic of the drug.

question

Pharmacologic interventions are costly. Patients for whom the cost/benefit variable is especially important include: 1. Older adults and those on fixed incomes 2. Patients with chronic illnesses 3. Patients with copayments for drugs on their insurance 4. Patients on public assistance

answer

1. Older adults and those on fixed incomes

question

Providers have a responsibility for determining the best plan of care, but patients also have responsibilities. Patients the provider can be assured will carry through on these responsibilities include those who: 1. Are well-educated and affluent 2. Have chronic conditions 3. Self-monitor drug effects on their symptoms 4. None of the above guarantee adherence

answer

4. None of the above guarantee adherence

question

Monitoring adherence can take several forms, including: 1. Patient reports from data in a drug diary 2. Pill counts 3. Laboratory reports and other diagnostic markers 4. All of the above

answer

4. All of the above

question

Factors that explain and predict medication adherence include: 1. Social 2. Financial 3. Health system 4. All of the above

answer

4. All of the above

question

Cultural factors that must be taken into account when prescribing include(s): 1. Who the decision maker is in the family regarding health-care decisions 2. The patient's view of health and illness 3. Attitudes regarding the use of drugs to treat illness 4. All of the above

answer

4. All of the above

question

Ethnic differences have been found in drug: 1. Absorption 2. Hepatic metabolism 3. Filtration at the glomerulus 4. Passive tubular reabsorption

answer

2. Hepatic metabolism

question

The National Standards of Culturally and Linguistically Appropriate Services are required to be implemented in all: 1. Hospitals 2. Clinics that serve the poor 3. Organizations that receive federal funds 4. Clinics that serve ethnic minorities

answer

3. Organizations that receive federal funds

question

According to the National Standards of Culturally and Linguistically Appropriate Services, an interpreter for health care: 1. May be a bilingual family member 2. May be a bilingual nurse or other health-care provider 3. Must be a professionally trained medical interpreter 4. Must be an employee of the organization

answer

3. Must be a professionally trained medical interpreter

question

According to the U.S. Office of Minority Health, poor health outcomes among African Americans are attributed to: 1. The belief among African Americans that prayer is more powerful than drugs 2. Poor compliance on the part of the African American patient 3. The genetic predisposition for illness found among African Americans 4. Discrimination, cultural barriers, and lack of access to health care

answer

4. Discrimination, cultural barriers, and lack of access to health care

question

The racial difference in drug pharmacokinetics seen in American Indian or Alaskan Natives are: 1. Increased CYP 2D6 activity, leading to rapid metabolism of some drugs 2. Largely unknown due to lack of studies of this population 3. Rapid metabolism of alcohol, leading to increased tolerance 4. Decreased elimination of opioids, leading to increased risk for addiction

answer

2. Largely unknown due to lack of studies of this population

question

Pharmacokinetics among Asians are universal to all the Asian ethnic groups. 1. True 2. False

answer

2. False

question

Alterations in drug metabolism among Asians may lead to: 1. Slower metabolism of antidepressants, requiring lower doses 2. Faster metabolism of neuroleptics, requiring higher doses 3. Altered metabolism of omeprazole, requiring higher doses 4. Slower metabolism of alcohol, requiring higher doses

answer

1. Slower metabolism of antidepressants, requiring lower doses

question

Asians from Eastern Asia are known to be fast acetylators. Fast acetylators: 1. Require acetylization in order to metabolize drugs 2. Are unable to tolerate higher doses of some drugs that require acetylization 3. May have a toxic reaction to drugs that require acetylization 4. Require higher doses of drugs metabolized by acetylization to achieve efficacy

answer

4. Require higher doses of drugs metabolized by acetylization to achieve efficacy

question

Hispanic native healers (curanderas): 1. Are not heavily utilized by Hispanics who immigrate to the United States 2. Use herbs and teas in their treatment of illness 3. Provide unsafe advice to Hispanics and should not be trusted 4. Need to be licensed in their home country in order to practice in the United States

answer

2. Use herbs and teas in their treatment of illness

question

Michael asks you about why some drugs are over-the-counter and some are prescription. You explain that in order for a drug to be approved for over-the-counter use the drug must: 1. Be safe and labeled for appropriate use 2. Have a low potential for abuse or misuse 3. Be taken for a condition the patient can reliably self-diagnose 4. All of the above

answer

4. All of the above

question

In the United States, over-the-counter drugs are regulated by: 1. No one. There is no oversight for over-the-counter medications. 2. The U.S. Food and Drug Administration Center for Drug Evaluation and Research 3. The U.S. Drug Enforcement Administration 4. MedWatch

answer

2. The U.S. Food and Drug Administration Center for Drug Evaluation and Research

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: 1. Get a new patent for the over-the-counter form of the drug 2. Lower the costs because most prescription benefit plans do not cover generics 3. Market the drug to a whole new population, as they are able to market to patients instead of just providers 4. Continue to make large profits from their blockbuster brand-name drug

answer

4. Continue to make large profits from their blockbuster brand-name drug

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. 1. True 2. False

answer

1. True

question

The ailment that generates the greatest over-the-counter annual drug sales is: 1. Constipation 2. Cough and colds 3. Heartburn 4. Acute and chronic pain

answer

2. Cough and colds

question

Common over-the-counter pain relievers such as acetaminophen or ibuprofen: 1. Are always safer for the patient than prescription pain medication 2. Are harmful if taken in higher than recommended amounts 3. Have minimal interaction with prescription medications 4. Should never be given to children unless recommended by their provider

answer

2. Are harmful if taken in higher than recommended amounts

question

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: 1. His appropriately only telling you about his regularly prescribed medications 2. His hiding information regarding his inappropriate use of aspirin from you 3. A common misconception that intermittently taken over-the counter medications are not an important part of his drug history 4. A common misuse of over-the-counter aspirin

answer

3. A common misconception that intermittently taken over-the counter medications are not an important part of his drug history

question

The Combat Methamphetamine Epidemic Act, which is part of the 2006 U.S. Patriot Act: 1. Requires all providers to screen their patients for methamphetamine use 2. Restricts the prescribing of amphetamines to U.S. citizens 3. Requires a prescription be written for all methamphetamine precursors in all states 4. Restricts the sales of drugs that contain methamphetamine precursors, including a daily and 30-day limit on sales

answer

4. Restricts the sales of drugs that contain methamphetamine precursors, including a daily and 30-day limit on sales

question

When prescribing a tetracycline or quinolone antibiotic it is critical to instruct the patient: 1. Not to take their regularly prescribed medications while on these antibiotics 2. Regarding the need for lots of acidic foods and juices, such as orange juice, to enhance absorption 3. Not to take antacids while on these medications, as the antacid decreases absorption 4. That there are no drug interactions with these antibiotics

answer

3. Not to take antacids while on these medications, as the antacid decreases absorption

question

Factors that place a patient at risk of developing an antimicrobial-resistant organism include: 1. Age over 50 years 2. School attendance 3. Travel within the U.S. 4. Inappropriate use of antimicrobials

answer

4. Inappropriate use of antimicrobials

question

Infants and young children are at higher risk of developing antibiotic-resistant infections due to: 1. Developmental differences in pharmacokinetics of the antibiotics in children 2. The fact that children this age are more likely to be in daycare and exposed to pathogens from other children 3. Parents of young children insisting on preventive antibiotics so they don't miss work when their child is sick 4. Immunosuppression from the multiple vaccines they receive in the first 2 years of life

answer

2. The fact that children this age are more likely to be in daycare and exposed to pathogens from other children

question

Providers should use an antibiogram when prescribing. An antibiogram is: 1. The other name for the Centers for Disease Control guidelines for prescribing antibiotics 2. An algorithm used for prescribing antibiotics for certain infections 3. The reference also known as the Pink Book, published by the Centers for Disease Control 4. A chart of the local resistance patterns to antibiotics developed by laboratories

answer

4. A chart of the local resistance patterns to antibiotics developed by laboratories

question

There is often cross-sensitivity and cross-resistance between penicillins and cephalosporins because: 1. Renal excretion is similar in both classes of drugs. 2. When these drug classes are metabolized in the liver they both produce resistant enzymes. 3. Both drug classes contain a beta-lactam ring that is vulnerable to beta-lactamase-producing organisms. 4. There is not an issue with cross-resistance between the penicillins and cephalosporins.

answer

3. Both drug classes contain a beta-lactam ring that is vulnerable to beta-lactamase-producing organisms.

question

Jonathan has been diagnosed with strep throat and needs a prescription for an antibiotic. He says the last time he had penicillin he developed a red, blotchy rash. An appropriate antibiotic to prescribe would be: 1. Penicillin VK, because his rash does not sound like a serious rash 2. Amoxicillin 3. Cefadroxil (Duricef) 4. Azithromycin

answer

4. Azithromycin

question

Sarah is a 25-year-old female who is 8 weeks pregnant and has a urinary tract infection. What would be the appropriate antibiotic to prescribe for her? 1. Ciprofloxacin (Cipro) 2. Amoxicillin (Trimox) 3. Doxycycline 4. Trimethoprim-sulfamethoxazole (Septra)

answer

2. Amoxicillin (Trimox)

question

Pong-tai is a 12-month-old child who is being treated with amoxicillin for acute otitis media. His parents call the clinic and say he has developed diarrhea. The appropriate action would be to: 1. Advise the parents that some diarrhea is normal with amoxicillin and recommend probiotics daily. 2. Change the antibiotic to one that is less of a gastrointestinal irritant. 3. Order stool cultures for suspected viral pathogens not treated by the amoxicillin. 4. Recommend increased fluids and fiber in his diet.

answer

1. Advise the parents that some diarrhea is normal with amoxicillin and recommend probiotics daily.

question

Lauren is a 13-year-old child who comes to clinic with a 4-day history of cough, low-grade fever, and rhinorrhea. When she blows her nose or coughs the mucous is greenish-yellow. The appropriate antibiotic to prescribe would be: 1. Amoxicillin 2. Amoxicillin/clavulanate 3. TMP/SMZ (Septra) 4. None

answer

4. None

question

Joanna had a small ventricle septal defect (VSD) repaired when she was 3 years old and has no residual cardiac problems. She is now 28 and is requesting prophylactic antibiotics for an upcoming dental visit. The appropriate antibiotic to prescribe according to current American College of Cardiology and American Heart Association guidelines is: 1. None, no antibiotic is required for dental procedures 2. Amoxicillin 2 grams 1 hour before the procedure 3. Ampicillin 2 grams IM or IV 30 minutes before the procedure 4. Azithromycin 1 gram 1 hour before the procedure

answer

1. None, no antibiotic is required for dental procedures

question

To prevent further development of antibacterial resistance it is recommended that fluoroquinolones be reserved for treatment of: 1. Urinary tract infections in young women 2. Upper respiratory infections in adults 3. Skin and soft tissue infections in adults 4. Community-acquired pneumonia in patients with comorbidities

answer

4. Community-acquired pneumonia in patients with comorbidities

question

Fluoroquinolones have a Black Box Warning regarding ________ even months after treatment. 1. Renal dysfunction 2. Hepatic toxicity 3. Tendon rupture 4. Development of glaucoma

answer

3. Tendon rupture

question

Janet was recently treated with clindamycin for an infection. She calls the advice nurse because she is having frequent diarrhea that she thinks may have blood in it. What would be the appropriate care for her? 1. Encourage increased fluids and fiber. 2. Assess her for pseudomembranous colitis. 3. Advise her to eat yogurt daily to help restore her gut bacteria. 4. Start her on an antidiarrheal medication.

answer

2. Assess her for pseudomembranous colitis.

question

Keng has chronic hepatitis that has led to mildly impaired liver function. He has an infection that would be best treated by a macrolide. Which would be the best choice for a patient with liver dysfunction? 1. Azithromycin (Zithromax) 2. Clarithromycin (Biaxin) 3. Erythromycin (E-mycin) 4. None of the above

answer

3. Erythromycin (E-mycin)

question

Jamie has glucose-6-phosphate dehydrogenase deficiency (G6PD) and requires an antibiotic. Which class of antibiotics should be avoided in this patient? 1. Penicillins 2. Macrolides 3. Cephalosporins 4. Sulfonamides

answer

4. Sulfonamides

question

If a patient is allergic to sulfonamide antibiotics, he or she will most likely have cross-sensitivity to: 1. Loop diuretics 2. Sulfonylureas 3. Thiazide diuretics 4. All of the above

answer

4. All of the above

question

Tetracyclines such as minocycline are safe to use in: 1. Pregnant women 2. Adolescents 3. Patients with renal dysfunction 4. Patients with hepatic dysfunction

answer

2. Adolescents

question

Tetracyclines should not be prescribed to children younger than 8 years due to: 1. Risk of developing cartilage problems 2. Development of significant diarrhea 3. Risk of kernicterus 4. Adverse effects on bone growth

answer

4. Adverse effects on bone growth

question

Nicole is a 16-year-old female who is taking minocycline for acne. She comes to the clinic complaining of a headache. What would be the plan of care? 1. Advise acetaminophen or ibuprofen as needed for headaches. 2. Prescribe sumatriptan (Imitrex) to be taken at the onset of the headache. 3. Evaluate her for pseudotremor cerebri. 4. Assess her caffeine intake and sleep patterns.

answer

3. Evaluate her for pseudotremor cerebri.

question

Patricia has been prescribed doxycycline for a chlamydia infection. She is healthy and her only medication is an oral combined contraceptive. Patricia's education would include: 1. Use a back-up method of birth control (condom) until her next menses. 2. Doxycycline may cause tendonitis and she should report any joint pain. 3. Her partner will need treatment if her infection doesn't clear with the doxycycline. 4. Doxycycline is used for one-dose treatment of STIs; take the whole prescription at once.

answer

1. Use a back-up method of birth control (condom) until her next menses.

question

To prevent the development of peripheral neuropathy in patients taking isoniazid for tuberculosis the patient is also prescribed: 1. Niacin (vitamin B3) 2. Pyridoxine (vitamin B6) 3. Riboflavin (vitamin B2) 4. Thiamine (vitamin B1)

answer

2. Pyridoxine (vitamin B6)

question

Sadie is an 82-year-old patient who has herpes zoster (shingles) and would benefit from an antiviral such as valacyclovir. Prior to prescribing valacyclovir she will need an assessment of: 1. Complete blood count to rule out anemia 2. Liver function 3. Renal function 4. Immunocompetence

answer

3. Renal function

question

When prescribing acyclovir, patients should be educated regarding the: 1. High risk of developing diarrhea 2. Need to drink lots of fluids during treatment 3. Risk for life-threatening rash such as Stevens-Johnson 4. Eccentric dosing schedule

answer

2. Need to drink lots of fluids during treatment

question

Nicholas has been diagnosed with type A influenza. Appropriate prescribing of oseltamivir (Tamiflu) would include: 1. Starting oseltamivir within the first 48 hours of influenza symptoms 2. Advising the patient he can stop the oseltamivir when his symptoms resolve 3. Educating the patient that oseltamivir will cure influenza 4. Prophylactic treatment of all family members

answer

1. Starting oseltamivir within the first 48 hours of influenza symptoms

question

Monitoring for patients who are on long-term antifungal therapy with ketoconazole includes: 1. Platelet count 2. BUN and creatinine 3. White blood cell count 4. AST, ALT, alkaline phosphatase, and bilirubin

answer

4. AST, ALT, alkaline phosphatase, and bilirubin

question

When prescribing metronidazole (Flagyl) to treat bacterial vaginosis, patient education would include: 1. Metronidazole is safe in the first trimester of pregnancy. 2. Consuming alcohol in any form may cause a severe reaction. 3. Sexual partners need concurrent therapy. 4. Headaches are a sign of a serious adverse reaction and need immediate evaluation.

answer

2. Consuming alcohol in any form may cause a severe reaction.

question

Every antibiotic drug class has resistant organisms that influence prescribing decisions. 1. True 2. False

answer

1. True

question

The goals of treatment when prescribing antiretroviral medication to patients with HIV include: 1. Prevent vertical HIV transmission 2. Improve quality of life 3. Prolong survival 4. All of the above

answer

4. All of the above

question

A challenge faced with antiretroviral therapy (ART) is: 1. Patients abusing ART 2. Drug-resistant mutations of HIV 3. Reduction of transmissibility of HIV 4. Lack of efficacy data

answer

2. Drug-resistant mutations of HIV

question

Predictors for successful treatment with antiretroviral therapy (ART) in HIV- positive patients include: 1. They respond to a low-potency treatment regimen 2. They have demonstrated resistance in the past and should respond to newer ART drugs 3. The patient is strictly adherent to the ART treatment regimen 4. Lower baseline CD4 T-cell count at baseline

answer

3. The patient is strictly adherent to the ART treatment regimen

question

The goal of antiretroviral therapy in HIV-positive patients is: 1. Maximum suppression of HIV replication 2. Eradication of HIV virus from the body 3. Determining a treatment regimen that is free of adverse effects 4. Suppression of CD4 T-cell count

answer

1. Maximum suppression of HIV replication

question

Pregnant women who are HIV positive: 1. Are treated with AZT alone to prevent birth defects 2. Are treated with a combination antiretroviral therapy (ART) regimen 3. Should not be treated with ART due to teratogenicity of the drugs 4. Are at high risk of developing resistance to ART drugs

answer

2. Are treated with a combination antiretroviral therapy (ART) regimen

question

Antiretroviral therapy is recommended for HIV-positive patients with: 1. A history of AIDS-defining illness 2. Pregnant women 3. Hepatitis B co-infection 4. All of the above

answer

4. All of the above

question

If considering starting a patient on the nucleoside reverse transcriptase inhibitor abacavir, the following testing is recommended prior to prescribing: 1. Renal function 2. HLA B*5701 testing 3. Pancreatic enzyme levels 4. CYP 450 enzyme activity

answer

2. HLA B*5701 testing

question

Suzanne is pregnant and has tested HIV positive. Which antiretroviral drug should be avoided in women who are pregnant? 1. Lopinavir/r 2. Zidovudine 3. Ritonavir 4. Lopinavir/ritonavir

answer

1. Lopinavir/r

question

The cost of HIV treatment can be prohibitive for any patient. Patients can receive assistance from the: 1. Best Pharmaceuticals for HIV/AIDS Patient Act 2. Ryan White HIV/AIDS Treatment Modernization Act 3. National Institute of Health HIV/AIDS Assistance Fund 4. Centers for Disease Control HIV/AIDS Treatment Fund

answer

2. Ryan White HIV/AIDS Treatment Modernization Act

question

Resistance to antiretroviral therapy (ART) is measured by: 1. Measuring the DNA viral load in the serum 2. Determining plasma viral RNA on two successive measurements 3. Phenotype assays of the combination of ART the patient is on 4. Elevation of T4 counts

answer

2. Determining plasma viral RNA on two successive measurements

question

Phenotype assays are used to measure _______ of antiretroviral therapy. 1. Effectiveness 2. Genotype 3. Sensitivity 4. Hypersensitivity susceptibility

answer

3. Sensitivity

question

Patient factors that contribute to antiretroviral therapy (ART) failure include: 1. Being a male who has sex with males 2. HIV diagnosis in pregnancy 3. Good compliance with the ART treatment regimen 4. ART adverse effects

answer

4. ART adverse effects

question

Patients who are taking antiretroviral therapy need to have the following monitored: 1. Lipid levels 2. Sexual functioning 3. Platelet count 4. All of the above

answer

1. Lipid levels

question

Successful antiretroviral therapy (ART) in an HIV-positive patient is determined by: 1. Being able to stop ART therapy due to HIV virus eradication 2. Lowering HIV viral load to unmeasurable amounts 3. Individual measures of success based on their personal situation 4. Normal blood hematologic factors

answer

3. Individual measures of success based on their personal situation

question

Drug resistant tuberculosis (TB) is defined as TB that is resistant to: 1. Fluoroquinolones 2. Rifampin and isoniazid 3. Amoxicillin 4. Ceftriaxone

answer

2. Rifampin and isoniazid

question

Goals when treating tuberculosis include: 1. Completion of recommended therapy 2. Negative purified protein derivative at the end of therapy 3. Completely normal chest x-ray 4. All of the above

answer

1. Completion of recommended therapy

question

The principles of drug therapy for the treatment of tuberculosis include: 1. Patients are treated with a drug to which M. tuberculosis is sensitive. 2. Drugs need to be taken on a regular basis for a sufficient amount of time. 3. Treatment continues until the patient's purified protein derivative is negative. 4. All of the above

answer

2. Drugs need to be taken on a regular basis for a sufficient amount of time.

question

Isabella has confirmed tuberculosis and is placed on a 6-month treatment regimen. The 6-month regimen consists of: 1. Two months of four-drug therapy (INH, rifampin, pyrazinamide, and ethambutol) followed by Four months of INH and rifampin 2. Six months of INH with daily pyridoxine throughout therapy 3. Six months of INH, rifampin, pyrazinamide, and ethambutol 4. Any of the above

answer

1. Two months of four-drug therapy (INH, rifampin, pyrazinamide, and ethambutol) followed by Four months of INH and rifampin

question

Kaleb has extensively resistant tuberculosis (TB). Treatment for extensively resistant TB would include: 1. INH, rifampin, pyrazinamide, and ethambutol for at least 12 months 2. INH, ethambutol, kanamycin, and rifampin 3. Treatment with at least two drugs to which the TB is susceptible 4. Levofloxacin

answer

3. Treatment with at least two drugs to which the TB is susceptible

question

Lila is 24 weeks pregnant and has been diagnosed with tuberculosis (TB). Treatment regimens for a pregnant patient with TB would include: 1. Streptomycin 2. Levofloxacin 3. Kanamycin 4. Pyridoxine

answer

4. Pyridoxine

question

Bilal is a 5-year-old patient who has been diagnosed with tuberculosis. His treatment would include: 1. Pyridoxine 2. Ethambutol 3. Levofloxacin 4. Rifabutin

answer

1. Pyridoxine

question

Ezekiel is a 9-year-old patient who lives in a household with a family member newly diagnosed with tuberculosis (TB). To prevent Ezekiel from developing TB he should be treated with: 1. 6 months of Isoniazid (INH) and rifampin 2. 2 months of INH, rifampin, pyrazinamide, and ethambutol, followed by 4 months of INH 3. 9 months of INH 4. 12 months of INH

answer

3. 9 months of INH

question

Leonard is completing a 6-month regimen to treat tuberculosis (TB). Monitoring of a patient on TB therapy includes: 1. Monthly sputum cultures 2. Monthly chest x-ray 3. Bronchoscopy every 3 months 4. All of the above

answer

1. Monthly sputum cultures

question

Compliance with directly observed therapy can be increased by: 1. Convenient clinic times 2. Incentives such as food, clothing, and transportation costs 3. Offering gifts for compliance 4. All of the above

answer

4. All of the above

question

Which of the following patients would be at higher risk of experiencing adverse drug reactions (ADRs): 1. A 32-year-old male 2. A 22-year-old female 3. A 3-month-old female 4. A 48-year-old male

answer

3. A 3-month-old female

question

Infants and young children are at higher risk of ADRs due to: 1. Immature renal function in school-age children 2. Lack of safety and efficacy studies in the pediatric population 3. Children's skin being thicker than adults, requiring higher dosages of topical medication 4. Infant boys having a higher proportion of muscle mass, leading to a higher volume of distribution

answer

2. Lack of safety and efficacy studies in the pediatric population

question

The elderly are at high risk of ADRs due to: 1. Having greater muscle mass than younger adults, leading to higher volume of distribution 2. The extensive studies that have been conducted on drug safety in this age group 3. The blood-brain barrier being less permeable, requiring higher doses to achieve therapeutic effect 4. Age-related decrease in renal function

answer

4. Age-related decrease in renal function

question

The type of adverse drug reaction that is idiosyncratic when a drug given in the usual therapeutic doses is type: 1. A 2. B 3. C 4. D

answer

2. B

question

Digoxin may cause a type A adverse drug reaction due to: 1. Idiosyncratic effects 2. Its narrow therapeutic index 3. Being a teratogen 4. Being a carcinogen

answer

2. Its narrow therapeutic index

question

Sarah developed a rash after using a topical medication. This is a type __ allergic drug reaction. 1. I 2. II 3. III 4. IV

answer

4. IV

question

A patient may develop neutropenia from using topical Silvadene for burns. Neutropenia is a(n): 1. Cytotoxic hypersensitivity reaction 2. Immune complex hypersensitivity 3. Immediate hypersensitivity reaction 4. Delayed hypersensitivity reaction

answer

1. Cytotoxic hypersensitivity reaction

question

Anaphylactic shock is a: 1. Type I reaction, called immediate hypersensitivity reaction 2. Type II reaction, called cytotoxic hypersensitivity reaction 3. Type III allergic reaction, called immune complex hypersensitivity 4. Type IV allergic reaction, called delayed hypersensitivity reaction

answer

1. Type I reaction, called immediate hypersensitivity reaction

question

James has hypothalamic-pituitary-adrenal axis suppression from chronic prednisone (a corticosteroid) use. He is at risk for what type of adverse drug reaction? 1. Type B 2. Type C 3. Type E 4. Type F

answer

2. Type C

question

Immunomodulators such as azathioprine may cause a delayed adverse drug reaction known as a type D reaction because they are known: 1. Teratogens 2. Carcinogens 3. To cause hypersensitivity reactions 4. Hypothalamus-pituitary-adrenal axis suppressants

answer

2. Carcinogens

question

A 24-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 a _____ adverse drug reaction when he no longer requires the opioids. 1. Rapid 2. First-dose 3. Late 4. Delayed

answer

3. Late

question

An example of a first-dose reaction that may occur includes: 1. Orthostatic hypotension that does not occur with repeated doses 2. Purple glove syndrome with phenytoin use 3. Hemolytic anemia from ceftriaxone use 4. Contact dermatitis from neomycin use

answer

1. Orthostatic hypotension that does not occur with repeated doses

question

Drugs that are prone to cause adverse drug effects include: 1. Diuretics 2. Inhaled anticholinergics 3. Insulins 4. Stimulants

answer

3. Insulins

question

The U.S. Food and Drug Administration MedWatch system is activated when: 1. There is an adverse event to a vaccine. 2. The patient has a severe reaction that is noted in the "Severe Reaction" section in the medication label. 3. A lactating woman takes a medication that is potentially toxic to the breastfeeding infant. 4. An adverse event or serious problem occurs with a medication that is not already identified on the label.

answer

4. An adverse event or serious problem occurs with a medication that is not already identified on the label.

question

The Vaccine Adverse Events Reporting System is: 1. A mandatory reporting system for all health-care providers when they encounter an adverse vaccine event 2. A voluntary reporting system that health-care providers or consumers may use to report vaccine adverse events 3. Utilized to send out safety alerts regarding emerging vaccine safety issues 4. Activated when a vaccine has been proven to cause significant adverse effects

answer

2. A voluntary reporting system that health-care providers or consumers may use to report vaccine adverse events

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: 1. Increases peripheral vasoconstriction 2. Decreases detrusor muscle contractility 3. Lowers supine blood pressure more than standing pressure 4. Relaxes smooth muscle in the bladder neck

answer

4. Relaxes smooth muscle in the bladder neck

question

To reduce potential adverse effects, patients taking a peripherally acting alpha1 antagonist should do all of the following EXCEPT: 1. Take the dose at bedtime 2. Sit up slowly and dangle their feet before standing 3. Monitor their blood pressure and skip a dose if the pressure is less than 120/80 4. Weigh daily and report weight gain of greater than 2 pounds in one day

answer

3. Monitor their blood pressure and skip a dose if the pressure is less than 120/80

question

John has clonidine, a centrally acting adrenergic blocker, prescribed for his hypertension. He should: 1. Not miss a dose or stop taking the drug because of potential rebound hypertension 2. Increase fiber in the diet to treat any diarrhea that may occur 3. Reduce fluid intake to less than 2 liters per day to prevent fluid retention 4. Avoid sitting for long periods, as this can lead to deep vein thrombosis

answer

1. Not miss a dose or stop taking the drug because of potential rebound hypertension

question

Clonidine has several off-label uses, including: 1. Alcohol and nicotine withdrawal 2. Post-herpetic neuralgia 3. Both 1 and 2 4. Neither 1 nor 2

answer

3. Both 1 and 2

question

Jim is being treated for hypertension. Because he has a history of heart attack, the drug chosen is atenolol. Beta blockers treat hypertension by: 1. Increasing heart rate to improve cardiac output 2. Reducing vascular smooth muscle tone 3. Increasing aldosterone-mediated volume activity 4. Reducing aqueous humor production

answer

2. Reducing vascular smooth muscle tone

question

Which of the following adverse effects are less likely in a beta1-selective blocker? 1. Dysrhythmias 2. Impaired insulin release 3. Reflex orthostatic changes 4. Decreased triglycerides and cholesterol

answer

2. Impaired insulin release

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? 1. Extend the dosage interval. 2. Decrease the dose by 75%. 3. Take no action because this value is expected in the older adult. 4. Schedule a serum creatinine level to validate the CrCl value.

answer

1. Extend the dosage interval.

question

Beta blockers are the drugs of choice for exertional angina because they: 1. Improve myocardial oxygen supply by vasodilating the coronary arteries 2. Decrease myocardial oxygen demand by decreasing heart rate and vascular resistance 3. Both 1 and 2 4. Neither 1 nor 2

answer

2. Decrease myocardial oxygen demand by decreasing heart rate and vascular resistance

question

Adherence to beta blocker therapy may be affected by their: 1. Short half-lives requiring twice daily dosing 2. Tendency to elevate lipid levels 3. Effects on the male genitalia, which may produce impotence 4. None of the above

answer

3. Effects on the male genitalia, which may produce impotence

question

Beta blockers have favorable effects on survival and disease progression in heart failure. Treatment should be initiated when the: 1. Symptoms are severe 2. Patient has not responded to other therapies 3. Patient has concurrent hypertension 4. Left ventricular dysfunction is diagnosed

answer

4. Left ventricular dysfunction is diagnosed

question

Abrupt withdrawal of beta blockers can be life threatening. Patients at highest risk for serious consequences of rapid withdrawal are those with: 1. Angina 2. Coronary artery disease 3. Both 1 and 2 4. Neither 1 nor 2

answer

3. Both 1 and 2

question

To prevent life-threatening events from rapid withdrawal of a beta blocker: 1. The dosage interval should be increased by 1 hour each day. 2. An alpha blocker should be added to the treatment regimen before withdrawal. 3. The dosage should be tapered over a period of weeks. 4. The dosage should be decreased by one-half every 4 days.

answer

4. The dosage should be decreased by one-half every 4 days.

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? 1. Dizziness 2. Increased heart rate 3. Nervousness and shakiness 4. Diaphoresis

answer

4. Diaphoresis

question

Combined alpha-beta antagonists are used to reduce the progression of heart failure because they: 1. Vasodilate the peripheral vasculature 2. Decrease cardiac output 3. Increase renal vascular resistance 4. Reduce atherosclerosis secondary to elevated serum lipoproteins

answer

1. Vasodilate the peripheral vasculature

question

Carvedilol is heavily metabolized by CYP2D6 and 2C9, resulting in drug interactions with which of the following drug classes? 1. Histamine 2 blockers 2. Quinolones 3. Serotonin re-uptake inhibitors 4. All of the above

answer

4. All of the above

question

Alpha-beta blockers are especially effective to treat hypertension for which ethnic group? 1. White 2. Asian 3. African American 4. Native American

answer

3. African American

question

Bethanechol: 1. Increases detrusor muscle tone to empty the bladder 2. Decreases gastric acid secretion to treat peptic ulcer disease 3. Stimulates voluntary muscle tone to improve strength 4. Reduces bronchial airway constriction to treat asthma

answer

1. Increases detrusor muscle tone to empty the bladder

question

Clinical dosing of Bethanechol: 1. Begins at the highest effective dose to obtain a rapid response 2. Starts at 5 mg to 10 mg PO and is repeated every hour until a satisfactory clinical response is achieved 3. Requires dosing only once daily 4. Is the same for both the oral and parenteral route

answer

2. Starts at 5 mg to 10 mg PO and is repeated every hour until a satisfactory clinical response is achieved

question

Patients who need to remain alert are taught to avoid which drug due to its antimuscarinic effects? 1. Levothyroxine 2. Prilosec 3. Dulcolax 4. Diphenhydramine

answer

4. Diphenhydramine

question

Anticholinesterase inhibitors are used to treat: 1. Peptic ulcer disease 2. Myasthenia gravis 3. Both 1 and 2 4. Neither 1 nor 2

answer

2. Myasthenia gravis

question

Which of the following drugs used to treat Alzheimer's disease is not an anticholinergic? 1. Donepezil 2. Memantine 3. Rivastigmine 4. Galantamine

answer

2. Memantine

question

Taking which drug with food maximizes it bioavailability? 1. Donepezil 2. Galantamine 3. Rivastigmine 4. Memantine

answer

3. Rivastigmine

question

Which of the following drugs should be used only when clearly needed in pregnant and breastfeeding women? 1. Memantine 2. Pyridostigmine 3. Galantamine 4. Rivastigmine

answer

2. Pyridostigmine

question

There is a narrow margin between first appearance of adverse reaction to AChE inhibitors and serious toxic effects. Adverse reactions that require immediate action include: 1. Dizziness and headache 2. Nausea 3. Decreased salivation 4. Fasciculations of voluntary muscles

answer

4. Fasciculations of voluntary muscles

question

Adherence is improved when a drug can be given once daily. Which of the following drugs can be given once daily? 1. Tacrine 2. Donepezil 3. Memantine 4. Pyridostigmine

answer

2. Donepezil

question

Nicotine has a variety of effects on nicotinic receptors throughout the body. Which of the following is NOT an effect of nicotine? 1. Vasodilation and decreased heart rate 2. Increased secretion of gastric acid and motility of the GI smooth muscle 3. Release of dopamine at the pleasure center 4. Stimulation of the locus coeruleus

answer

1. Vasodilation and decreased heart rate

question

Nicotine gum products are: 1. Chewed to release the nicotine and then swallowed for a systemic effect 2. "Parked" in the buccal area of the mouth to produce a constant amount of nicotine release 3. Bound to exchange resins so the nicotine is only released during chewing 4. Approximately the same in nicotine content as smoking two cigarettes

answer

3. Bound to exchange resins so the nicotine is only released during chewing

question

Nicotine replacement therapy (NRT): 1. Is widely distributed in the body only when the gum products are used 2. Does not cross the placenta and so is safe for pregnant women 3. Delays healing of esophagitis and peptic ulcers 4. Has no drug interactions when a transdermal patch is used

answer

3. Delays healing of esophagitis and peptic ulcers

question

Success rates for smoking cessation using NRT: 1. Are about the same regardless of the method chosen 2. Vary from 40% to 50% at 12 months 3. Both 1 and 2 4. Neither 1 nor 2

answer

2. Vary from 40% to 50% at 12 months

question

Cholinergic blockers are used to: 1. Counteract the extrapyramidal symptoms (EPS) effects of phenothiazines 2. Control tremors and relax smooth muscle in Parkinson's disease 3. Inhibit the muscarinic action of ACh on bladder muscle 4. All of the above

answer

4. All of the above

question

Several classes of drugs have interactions with cholinergic blockers. Which of the following is true about these interactions? 1. Drugs with a narrow therapeutic range given orally may not stay in the GI tract long enough to produce an action. 2. Additive antimuscarinic effects may occur with antihistamines. 3. Cholinergic blockers may decrease the sedative effects of hypnotics. 4. Cholinergic blockers are contraindicated with antipsychotics.

answer

1. Drugs with a narrow therapeutic range given orally may not stay in the GI tract long enough to produce an action.

question

Scopolamine can be used to prevent the nausea and vomiting associated with motion sickness. The patient is taught to: 1. Apply the transdermal disk at least 4 hours before the antiemetic effect is desired. 2. Swallow the tablet 1 hour before traveling where motion sickness is possible. 3. Place the tablet under the tongue and allow it to dissolve. 4. Change the transdermal disk daily for maximal effect.

answer

2. Swallow the tablet 1 hour before traveling where motion sickness is possible.

question

You are managing the care of a patient recently diagnosed with benign prostatic hyperplasia (BPH). He is taking tamsulosin but reports dizziness when standing abruptly. The best option for this patient is: 1. Continue the tamsulosin because the side effect will resolve with continued treatment. 2. Discontinue the tamsulosin and start doxazosin. 3. Have him double his fluid intake and stand more slowly. 4. Prescribe meclizine as needed for the dizziness.

answer

2. Discontinue the tamsulosin and start doxazosin.

question

You are treating a patient with a diagnosis of Alzheimer's disease. The patient's wife mentions difficulty with transportation to the clinic. Which medication is the best choice? 1. Donepezil 2. Tacrine 3. Doxazosin 4. Verapamil

answer

1. Donepezil

question

A patient presents with a complaint of dark stools and epigastric pain described as gnawing and burning. Which of the medications is the most likely cause? 1. Acetaminophen 2. Estradiol 3. Donepezil 4. Bethanechol

answer

4. Bethanechol

question

Your patient calls for an appointment before going on vacation. Which medication should you ensure he has an adequate supply of before leaving to avoid life-threatening complications? 1. Carvedilol 2. Donepezil 3. Bethanechol 4. Tacrine

answer

1. Carvedilol

question

Activation of central alpha2 receptors results in inhibition of cardioacceleration and ______________ centers in the brain. 1. Vasodilation 2. Vasoconstriction 3. Cardiovascular 4. Respiratory

answer

2. Vasoconstriction

question

Digoxin levels need to be monitored closely when the following medication is started: 1. Loratadine 2. Diphenhydramine 3. Ipratropium 4. Albuterol

answer

4. Albuterol

question

Patients with pheochromocytoma should avoid which of the following classes of drugs because of the possibility of developing hypertensive crisis? 1. Expectorants 2. Beta-2-agonists 3. Antitussives 4. Antihistamines

answer

2. Beta-2-agonists

question

Harold, a 42-year-old African American, has moderate persistent asthma. Which of the following asthma medications should be used cautiously, if at all? 1. Betamethasone, an inhaled corticosteroid 2. Salmeterol, an inhaled long-acting beta-agonist 3. Albuterol, a short-acting beta-agonist 4. Montelukast, a leukotriene modifier

answer

2. Salmeterol, an inhaled long-acting beta-agonist

question

Long-acting beta-agonists (LTBAs) received a Black Box Warning from the U.S. Food and Drug Administration due to the: 1. Risk of life-threatening dermatological reactions 2. Increased incidence of cardiac events when LTBAs are used 3. Increased risk of asthma-related deaths when LTBAs are used 4. Risk for life-threatening alterations in electrolytes

answer

3. Increased risk of asthma-related deaths when LTBAs are used

question

The bronchodilator of choice for patients taking propranolol is: 1. Albuterol 2. Pirbuterol 3. Formoterol 4. Ipratropium

answer

4. Ipratropium

question

James is a 52-year-old overweight smoker taking theophylline for his persistent asthma. He tells his provider he is going to start the Atkin's diet for weight loss. The appropriate response would be: 1. Congratulate him on making a positive change in his life. 2. Recommend he try stopping smoking instead of the Atkin's diet. 3. Schedule him for regular testing of serum theophylline levels during his diet due to increased excretion of theophylline. 4. Decrease his theophylline dose because a high-protein diet may lead to elevated theophylline levels.

answer

2. Recommend he try stopping smoking instead of the Atkin's diet.

question

Li takes theophylline for his persistent asthma and calls the office with a complaint of nausea, vomiting, and headache. The best advice for him would be to: 1. Reassure him this is probably a viral infection and should be better soon 2. Have him seen the same day for an assessment and theophylline level 3. Schedule him for an appointment in 2 to 3 days, which he can cancel if he is better 4. Order a theophylline level at the laboratory for him

answer

3. Schedule him for an appointment in 2 to 3 days, which he can cancel if he is better

question

Tiotropium bromide (Spiriva) is an inhaled anticholinergic: 1. Used for the treatment of chronic obstructive pulmonary disease (COPD) 2. Used in the treatment of asthma 3. Combined with albuterol for treatment of asthma exacerbations 4. Combined with fluticasone for the treatment of persistent asthma

answer

1. Used for the treatment of chronic obstructive pulmonary disease (COPD)

question

Christy 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: 1. Use one to two puffs of albuterol per day to prevent an attack with no more than eight puffs per day 2. Beclomethasone needs to be used every day to treat her asthma 3. Report any systemic side effects she is experiencing, such as weight gain 4. Use the albuterol metered-dose inhaler (MDI) immediately after her corticosteroid MDI to facilitate bronchodilation

answer

2. Beclomethasone needs to be used every day to treat her asthma

question

When prescribing montelukast (Singulair) for asthma, patients or parents of patients should be instructed: 1. Montelukast twice a day is started when there is an asthma exacerbation. 2. Patients may experience weight gain on montelukast. 3. Aggression, anxiety, depression, and/or suicidal thoughts may occur when taking montelukast. 4. Lethargy and hypersomnia may occur when taking montelukast.

answer

3. Aggression, anxiety, depression, and/or suicidal thoughts may occur when taking montelukast.

question

Montelukast (Singulair) may be prescribed for: 1. A 6-year-old child with exercise-induced asthma 2. A 2-year-old child with moderate persistent asthma 3. An 18-month-old child with seasonal allergic rhinitis 4. None of the above; montelukast is not approved for use in children

answer

2. A 2-year-old child with moderate persistent asthma

question

The known drug interactions with the inhaled corticosteroid beclomethasone (QVAR) include: 1. Albuterol 2. MMR vaccine 3. Insulin 4. None of the above

answer

4. None of the above

question

When educating patients who are starting on inhaled corticosteroids, the provider should tell them that: 1. They need to get any live vaccines before starting the medication. 2. Inhaled corticosteroids need to be used daily during asthma exacerbations to be effective. 3. Patients should rinse their mouths out after using the inhaled corticosteroid to prevent thrush. 4. They can triple the dose number of inhalations of medication during colds to prevent needing systemic steroids.

answer

3. Patients should rinse their mouths out after using the inhaled corticosteroid to prevent thrush.

question

Patients with allergic rhinitis may benefit from a prescription of: 1. Fluticasone (Flonase) 2. Cetirizine (Zyrtec) 3. OTC cromolyn nasal spray (Nasalcrom) 4. Any of the above

answer

4. Any of the above

question

Howard is a 72-year-old male who occasionally takes diphenhydramine for his seasonal allergies. Monitoring for this patient taking diphenhydramine would include assessing for: 1. Urinary retention 2. Cardiac output 3. Peripheral edema 4. Skin rash

answer

1. Urinary retention

question

First-generation antihistamines such as loratadine (Claritin) are prescribed for seasonal allergies because they are: 1. More effective than first-generation antihistamines 2. Less sedating than the first-generation antihistamines 3. Prescription products, therefore are covered by insurance 4. Able to be taken with central nervous system (CNS) sedatives, such as alcohol

answer

2. Less sedating than the first-generation antihistamines

question

When recommending dimenhydrinate (Dramamine) to treat motion sickness, patients should be instructed to: 1. Take the dimenhydrinate after they get nauseated 2. Drink lots of water while taking the dimenhydrinate 3. Take the dimenhydrinate 15 minutes before it is needed 4. Double the dose if one tablet is not effective

answer

3. Take the dimenhydrinate 15 minutes before it is needed

question

Decongestants such as pseudoephedrine (Sudafed): 1. Are Schedule III drugs in all states 2. Should not be prescribed or recommended for children under 4 years of age 3. Are effective in treating the congestion children experience with the common cold 4. May cause drowsiness in patients of all ages

answer

2. Should not be prescribed or recommended for children under 4 years of age

question

Cough and cold medications that contain a sympathomimetic decongestant such as phenylephrine should be used cautiously in what population: 1. Older adults 2. Hypertensive patients 3. Infants 4. All of the above

answer

4. All of the above

question

Martin is a 60-year-old patient with hypertension. The first-line decongestant to prescribe would be: 1. Oral pseudoephedrine 2. Oral phenylephrine 3. Nasal oxymetazoline 4. Nasal azelastine

answer

3. Nasal oxymetazoline

question

The first-line treatment for cough related to an upper respiratory tract infection (URI) in a 5-year-old child is: 1. Fluids and symptomatic care 2. Dextromethorphan and guaifenesin syrup (Robitussin DM for Kids) 3. Guaifenesin and codeine syrup (Tussin AC) 4. Chlorpheniramine and dextromethorphan syrup (Nyquil for Kids)

answer

1. Fluids and symptomatic care

question

The Centers for Disease Control recommends all newborn infants receive prophylactic administration of __________ within 1 hour of birth. 1. Gentamicin ophthalmic ointment 2. Ciprofloxacin ophthalmic drops 3. Erythromycin oral suspension 4. Erythromycin ophthalmic ointment

answer

4. Erythromycin ophthalmic ointment

question

Conjunctivitis in a child that is accompanied by acute otitis media is treated with: 1. Sulfacetamide 10% ophthalmic solution (Bleph-10) 2. Bacitracin/polymyxin B (Polysporin) ophthalmic drops 3. Ciprofloxacin (Ciloxan) ophthalmic drops 4. High-dose oral amoxicillin

answer

4. High-dose oral amoxicillin

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: 1. None, wait for the culture results to determine the course of treatment 2. Ciprofloxacin (Ciloxan) ophthalmic drops 3. IM ceftriaxone 4. High-dose oral amoxicillin

answer

3. IM ceftriaxone

question

Education of women who are being treated with ophthalmic antibiotics for conjunctivitis includes: 1. Throwing away eye makeup and purchasing new 2. Redness and intense burning is normal with ophthalmic antibiotics 3. When applying eye ointment, set the tip of the tube on the lower lid and squeeze in inch 4. Use a cotton swab to apply ointment, spreading the ointment all over the lid and in the conjunctival sac

answer

1. Throwing away eye makeup and purchasing new

question

Sadie was prescribed betaxolol ophthalmic drops by her ophthalmologist to treat her glaucoma. Oral beta blockers should be avoided in patients who use ophthalmic beta blockers because: 1. There may be an antagonistic reaction between the two. 2. The additive effects may include bradycardia. 3. They may potentiate each other and cause respiratory depression. 4. The additive effects may cause metabolic acidosis.

answer

2. The additive effects may include bradycardia.

question

David presents to the clinic with symptoms of allergic conjunctivitis. He is prescribed cromolyn sodium (Opticrom) eye drops. The education regarding using cromolyn eye drops includes: 1. He should not wear his soft contacts while using the cromolyn eye drops. 2. Cromolyn drops are instilled once a day to prevent allergy symptoms. 3. Long-term use may cause glaucoma. 4. He may experience bradycardia as an adverse effect.

answer

1. He should not wear his soft contacts while using the cromolyn eye drops.

question

Ciprofloxacin otic drops are contraindicated in: 1. Children 2. Patients with acute otitis externa 3. Patients with a perforated tympanic membrane 4. Swimmer's ear

answer

3. Patients with a perforated tympanic membrane

question

__________ is / are prescribed to prevent swimmer's ear. 1. Ciprofloxacin otic drops (Ciloxan) 2. Isopropyl ear drops (EarSol) 3. Colistin (Coly-Mycin S Otic) 4. Gentamicin otic drops

answer

2. Isopropyl ear drops (EarSol)

question

Patient education regarding the use of ciprofloxacin-hydrocortisone (Cipro HC otic) ear drops includes: 1. Fill the canal with the drops with each dose. 2. Some redness and itching around the ear canal is normal. 3. Warm the bottle of ear drops in his or her hand before administering. 4. Cipro HC otic may cause ototoxicity.

answer

3. Warm the bottle of ear drops in his or her hand before administering.

question

Janie presents to the clinic with hard ear wax in both ear canals. Instructions regarding home removal of hard cerumen include: 1. Moisten a cotton swab (Q-tip) and swab the ear canal twice daily. 2. Instill tap water in both ears while bathing. 3. Squirt hydrogen peroxide into ears with each bath. 4. Instill carbamide peroxide (Debrox) twice daily until canals are clear.

answer

4. Instill carbamide peroxide (Debrox) twice daily until canals are clear.

question

Prior to developing a plan for the treatment of asthma, the patient's asthma should be classified according to the NHLBI Expert Panel 3 guidelines. In adults mild-persistent asthma is classified as asthma symptoms that occur: 1. Daily 2. Daily and limit physical activity 3. Less than twice a week 4. More than twice a week and less than once a day

answer

4. More than twice a week and less than once a day

question

In children age 5 to 11 years mild-persistent asthma is diagnosed when asthma symptoms occur: 1. At nighttime one to two times a month 2. At nighttime three to four times a month 3. Less than twice a week 4. Daily

answer

2. At nighttime three to four times a month

question

One goal of asthma therapy outlined by the NHLBI Expert Panel 3 guidelines is: 1. Ability to use albuterol daily to control symptoms 2. Minimize exacerbations to once a month 3. Keep nighttime symptoms at a maximum of twice a week 4. Require infrequent use of beta 2 agonists (albuterol) for relief of symptoms

answer

4. Require infrequent use of beta 2 agonists (albuterol) for relief of symptoms

question

A stepwise approach to the pharmacologic management of asthma: 1. Begins with determining the severity of asthma and assessing asthma control 2. Is used when asthma is severe and requires daily steroids 3. Allows for each provider to determine their personal approach to the care of asthmatic patients 4. Provides a framework for the management of severe asthmatics, but is not as helpful when patients have intermittent asthma

answer

1. Begins with determining the severity of asthma and assessing asthma control

question

Treatment for mild intermittent asthma is: 1. Daily inhaled medium-dose corticosteroids 2. Short-acting beta-2-agonists (albuterol) as needed 3. Long-acting beta-2-agonists every morning as a preventative 4. Montelukast (Singulair) daily

answer

2. Short-acting beta-2-agonists (albuterol) as needed

question

The first-line therapy for mild-persistent asthma is: 1. High-dose montelukast 2. Theophylline 3. Low-dose inhaled corticosteroids 4. Long-acting beta-2-agonists

answer

3. Low-dose inhaled corticosteroids

question

Monitoring a patient with persistent asthma includes: 1. Monitoring how frequently the patient has an upper respiratory infection (URI) during treatment 2. Monthly in-office spirometry testing 3. Determining if the patient has increased use of his or her long-acting beta-2-agonist due to exacerbations 4. Evaluating the patient every 1 to 6 months to determine if the patient needs to step up or down in their therapy

answer

4. Evaluating the patient every 1 to 6 months to determine if the patient needs to step up or down in their therapy

question

Asthma exacerbations at home are managed by the patient by: 1. Increasing frequency of beta-2-agonists and contacting their provider 2. Doubling inhaled corticosteroid doses 3. Increasing frequency of beta-2-agonists 4. Starting montelukast (Singulair)

answer

1. Increasing frequency of beta-2-agonists and contacting their provider

question

Patients who are at risk of a fatal asthma attack include patients: 1. With moderate persistent asthma 2. With a history of requiring intubation or ICU admission for asthma 3. Who are on daily inhaled corticosteroid therapy 4. Who are pregnant

answer

2. With a history of requiring intubation or ICU admission for asthma

question

Pregnant patients with asthma may safely use ________ throughout their pregnancy. 1. Oral terbutaline 2. Prednisone 3. Inhaled corticosteroids (budesonide) 4. Montelukast (Singulair)

answer

3. Inhaled corticosteroids (budesonide)

question

One goal of asthma management in children is: 1. They independently manage their asthma 2. Participation in school and sports activities 3. No exacerbations 4. Minimal use of inhaled corticosteroids

answer

2. Participation in school and sports activities

question

Medications used in the management of patients with chronic obstructive pulmonary disease (COPD) include: 1. Inhaled beta-2-agonists 2. Inhaled anticholinergics (ipratropium) 3. Inhaled corticosteroids 4. All of the above

answer

4. All of the above

question

Patients with a COPD exacerbation may require: 1. Doubling of inhaled corticosteroid dose 2. Systemic corticosteroid burst 3. Continuous inhaled beta-2-agonists 4. Leukotriene therapy

answer

2. Systemic corticosteroid burst

question

Patients with COPD require monitoring of: 1. Beta-2-agonist use 2. Serum electrolytes 3. Blood pressure 4. Neuropsychiatric effects of montelukast

answer

1. Beta-2-agonist use

question

Education of patients with COPD who use inhaled corticosteroids includes: 1. Doubling the dose at the first sign of a URI 2. Using their inhaled corticosteroid first and then their bronchodilator 3. Rinsing their mouth after use 4. Abstaining from smoking for at least 30 minutes after using

answer

3. Rinsing their mouth after use

question

Education for patients who use an inhaled beta-agonist and an inhaled corticosteroid includes: 1. Use the inhaled corticosteroid first, followed by the inhaled beta-agonists. 2. Use the inhaled beta-agonist first, followed by the inhaled corticosteroid. 3. Increase fluid intake to 3 liters per day. 4. Avoid use of aspirin or ibuprofen while using inhaled medications.

answer

2. Use the inhaled beta-agonist first, followed by the inhaled corticosteroid.

question

The most common bacterial pathogen in community-acquired pneumonia is: 1. Haemophilus influenzae 2. Staphylococcus aureus 3. Mycoplasma pneumoniae 4. Streptococcus pneumoniae

answer

4. Streptococcus pneumoniae

question

The first-line drug choice for a previously healthy adult patient diagnosed with community-acquired pneumonia would be: 1. Ciprofloxacin 2. Azithromycin 3. Amoxicillin 4. Doxycycline

answer

2. Azithromycin

question

The first-line antibiotic choice for a patient with comorbidities or who is immunosuppressed who has pneumonia and can be treated as an outpatient would be: 1. Levofloxacin 2. Amoxicillin 3. Ciprofloxacin 4. Cephalexin

answer

1. Levofloxacin

question

If an adult patient with comorbidities cannot reliably take oral antibiotics to treat pneumonia, an appropriate initial treatment option would be: 1. IV or IM gentamicin 2. IV or IM ceftriaxone 3. IV amoxicillin 4. IV ciprofloxacin

answer

2. IV or IM ceftriaxone

question

Samantha is 34 weeks pregnant and has been diagnosed with pneumonia. She is stable enough to be treated as an outpatient. What would be an appropriate antibiotic to prescribe? 1. Levofloxacin 2. Azithromycin 3. Amoxicillin 4. Doxycycline

answer

2. Azithromycin

question

Adults with pneumonia who are responding to antimicrobial therapy should show improvement in their clinical status in: 1. 12 to 24 hours 2. 24 to 36 hours 3. 48 to 72 hours 4. 4 or 5 days

answer

3. 48 to 72 hours

question

Along with prescribing antibiotics, adults with pneumonia should be instructed on lifestyle modifications to improve outcomes, including: 1. Adequate fluid intake 2. Increased fiber intake 3. Bedrest for the first 24 hours 4. All of the above

answer

1. Adequate fluid intake

question

John is a 4-week-old infant who has been diagnosed with chlamydial pneumonia. An appropriate treatment for his pneumonia would be: 1. Levofloxacin 2. Amoxicillin 3. Erythromycin 4. Cephalexin

answer

3. Erythromycin

question

Wing-Sing is a 4-year-old patient who has suspected bacterial pneumonia. He has a temperature of 102°F, oxygen saturation level of 95%, and is taking fluids adequately. What would be appropriate initial treatment for his pneumonia? 1. Ceftriaxone 2. Azithromycin 3. Cephalexin 4. Levofloxacin

answer

1. Ceftriaxone

question

Giselle is a 14-year-old patient who presents to the clinic with symptoms consistent with mycoplasma pneumonia. What is the treatment for suspected mycoplasma pneumonia in an adolescent? 1. Ceftriaxone 2. Azithromycin 3. Ciprofloxacin 4. Levofloxacin

answer

2. Azithromycin

question

Caleb is an adult with an upper respiratory infection (URI). Treatment for his URI would include: 1. Amoxicillin 2. Diphenhydramine 3. Phenylpropanolamine 4. Topical oxymetazoline

answer

4. Topical oxymetazoline

question

Rose is a 3-year-old patient with an upper respiratory infection (URI). Treatment for her URI would include: 1. Amoxicillin 2. Diphenhydramine 3. Pseudoephedrine 4. Nasal saline spray

answer

4. Nasal saline spray

question

Patients who should be cautious about using decongestants for an upper respiratory infection (URI) include: 1. School-age children 2. Patients with asthma 3. Patients with cardiac disease 4. Patients with allergies

answer

3. Patients with cardiac disease

question

Jaheem is a 10-year-old low-risk patient with sinusitis. Treatment for a child with sinusitis is: 1. Amoxicillin 2. Azithromycin 3. Cephalexin 4. Levofloxacin

answer

1. Amoxicillin

question

Jacob has been diagnosed with sinusitis. He is the parent of a child in daycare. Treatment for sinusitis in an adult who has a child in daycare is: 1. Azithromycin 500 mg q day for 5 days 2. Amoxicillin-clavulanate 500 mg bid for 7 days 3. Ciprofloxacin 500 mg bid for 5 days 4. Cephalexin 500 mg qid for 5 days

answer

2. Amoxicillin-clavulanate 500 mg bid for 7 days

question

The length of treatment for sinusitis in a low-risk patient should be: 1. 5-7 days 2. 7-10 days 3. 14-21 days 4. 7 days beyond when symptoms cease

answer

1. 5-7 days

question

Patient education for a patient who is prescribed antibiotics for sinusitis includes: 1. Use of nasal saline washes 2. Use of inhaled corticosteroids 3. Avoiding the use of ibuprofen while ill 4. Use of laxatives to treat constipation

answer

1. Use of nasal saline washes

question

Myles is a 2-year-old patient who has been diagnosed with acute otitis media. He is afebrile and has not been treated with antibiotics recently. First-line treatment for his otitis media would include: 1. Azithromycin 2. Amoxicillin 3. Ceftriaxone 4. Trimethoprim/sulfamethoxazole

answer

2. Amoxicillin

question

Alyssa is a 15-month-old patient who has been on amoxicillin for 2 days for acute otitis media. She is still febrile and there is no change in her tympanic membrane examination. What would be the plan of care for her? 1. Continue the amoxicillin for the full 10 days. 2. Change the antibiotic to azithromycin. 3. Change the antibiotic to amoxicillin/clavulanate. 4. Change the antibiotic to trimethoprim/sulfamethoxazole.

answer

3. Change the antibiotic to amoxicillin/clavulanate.

question

A child that may warrant "watchful waiting" instead of prescribing an antibiotic for acute otitis media includes patients who: 1. Are low risk with temperature of less than 39oC or 102.2oF 2. Have reliable parents with transportation 3. Are older than age 2 years 4. All of the above

answer

4. All of the above

question

Whether prescribing an antibiotic for a child with acute otitis media or not, the parents should be educated about: 1. Using decongestants to provide faster symptom relief 2. Providing adequate pain relief for at least the first 24 hours 3. Using complementary treatments for acute otitis media, such as garlic oil 4. Administering an antihistamine/decongestant combination (Dimetapp) so the child can sleep better

answer

2. Providing adequate pain relief for at least the first 24 hours

question

First-line therapy for a patient with acute otitis externa (swimmer's ear) and an intact tympanic membrane includes: 1. Swim-Ear drops 2. Ciprofloxacin and hydrocortisone drops 3. Amoxicillin 4. Gentamicin ophthalmic drops

answer

2. Ciprofloxacin and hydrocortisone drops

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