question

Pts need to be questioned about all pain sites because

answer

pts tend to report the most severe or most important in their perception

question

Xi is a 54 y/o female, has a hx of migraine that does not respond well to OTC migraine med. she is asking to try Maxalt because it works well for her friend. appropriate decision making decision would be

answer

prescribe maxalt and arrange to have her observed in the clinic or urgent care with the first dose

question

pain assessment to determine adequacy of pain management is important for all pts. this assessment is done to

answer

all of the above- determine if the dx of source of pain is correct, determine if the current regimen is adequate or different combos are required, determine if the pt is willing and able to be an active participant in his pain management

question

pts with rheumatoid arthritis who are on chronic low dose prednisone will need co treatment with which medication s to prevent further adverse effects

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all of above- bisphosphonate, calcium supplement, vitamin d

question

Sallie has been taking 10mg/day of prednisone for past 6 mths she should be assessed for

answer

osteoporosis

question

pts who are on or who will be starting chronic corticosteroid therapy need monitoring of

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serum glucose

question

daniel has been on 60mg of prednisone for 10 days to tx a severe asthma exacerbation. it is time to d/c the prednisone, how is it d/cd

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develop a taperin schedule to slowly wean daniel off the prednisone

question

preventative therapy for a cluster HA includes

answer

ergotamine nightly before bed

question

which of the following statements is true about chronic pain

answer

referred pain is present in a distant site for the pain source and is based on activation of the same spinal segment as the actual pain site

question

Kasey fractured his ankle in 2 places and is asking for pain medication for his pain. appropriate 1st line medication would be

answer

acetaminophen with hydrocodone (Vicoin)

question

chemical dependency assessment is integral to the initial assessment of chronic pain. which of the following raises a red flag about the potential chemical dependency

answer

multiple times when prescriptions are lost with requests to refill

question

Phil is starting tx with febuxostat (Uloric). education of pts starting febuxostat include

answer

Gout may worsen with therapy

question

when prescribing any HA therapy, appropriate use of medications needs to be discussed to prevent medication overuse HA. the clinical characteristics of medication overuse HA are

answer

HA reoccur when the medication wears off

question

monitoring a pt on a high dose asa level includes

answer

all of above- salicylate level, CBC, urine pH

question

tx plan for management of chronic pain should include

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all of above- negotiation with the pt to set personal goals for pain management, discussion of ways to improve sleep and stress, an exercise program to improve fxn and fitness

question

Juanita presents to clinic with c/o HA off/on for mths. reports squeezing her head and occasionally takes Tylenol for the pain but usually toughs it out. initial tx for tension HA includes asking her to keep HA diary and rx for

answer

Naproxen, aleve

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pts whose total dose of prednisone will exceed 1 gm will most likely need a second rx for

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omeprazole, PPI to prevent peptic ulcer disease

question

Kirk sprained his ankle and is asking for pain medication for his mild-moderate pain. appropriate 1st line medication would be

answer

ibuprofen

question

the chemicals that promote the spread of pain locally include

answer

neurokinin A

question

drug resistant TB is defined as TB that is resistant to

answer

rifampin and isoniazid

question

if an adult pt with comorbitities cannot reliably take oral abx to tx PNA, an appropriate initial tx option would be

answer

IV or IM ceftriaxone

question

1st generation antihistamines such as loratidine (Claritin) are prescribed for seasonal allergies because they are

answer

less sedating than the 1st generation antihistamines

question

pts with COPD require monitoring of

answer

Beta-2-agonist use

question

Leonard is completing a 6 mth regimen to treat TB. Monitoring of a pt on TB therapy includes

answer

Monthly sputum cultures

question

Along with rxing ABX, adults with PNA should be instructed on lifestyle modifications to improve outcomes

answer

adequate fluid intake

question

Instructions for the use of nicotine gum include

answer

the gun should be "parked" in the buccal space between chewing

question

in children 5-11 yrs mild-peristenet asthma symptoms occur

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at night time 3-4 x mth

question

Lila is 24wks pregnant and has been dx with TB. tx regimens for pregnant pt with TB include

answer

pyridoxine

question

Nicotine replacement therapy should not be used in which pts

answer

all of above

question

Long acting beta agonists (LTBAs) received a black box warning from the US FDA due to

answer

increased risk of asthma related deaths when LTBAs are used

question

pts who are at risk of fatal asthma attack are

answer

with a hx of requiring intubation or ICU administration for asthma

question

Giselle is a 14 yr old who presents to clinic with s/s consistent with mycoplasma pna. what is the tx for suspected mycoplasma pna in an adolescent

answer

azithromycin

question

when prescribing montelukast (singulair) for asthma, pts or parents of pts should be instructed

answer

aggression, anxiety and or suicidal thoughts may occur when taking montelukast

question

if a pt wants to quit smoking nicotine replacement therapy is recommended if the pt

answer

smokes within 30 min of awakening in the morning

question

the bronchodilator of choice for pts taking propanolol

answer

ipratropium

question

Montelukast singulair may be rxd for

answer

2 yr old with moderate persistent asthma

question

adults with PNA who are responding to antimicrobial therapy should show improvement in their clinical status in

answer

48-72hrs

question

pregnant pts with astham may safely use __ throughout their pregnancy

answer

inhaled corticosteroids (budesonide)

question

if a pt is exhibiting s/s of nicotine toxicity when using trans dermal nicotine, they should remove the patch and

answer

flush the area with clear water

question

goals of treatment when treating TB are

answer

completion of recommended therapy

question

Kaleb has extensively resistant TB. TX would be

answer

treatment with at least 2 drugs the TB is susceptible

question

prior to developing a plan for the tx of asthma, the pts asthma should be classified to the NHLBI panel guidelines. in adults, mild-persitant asthma is classified as asthma s/s that occur

answer

more than twice a week and less than once a day

question

pts who choose the nicotine lozenge to assist in quitting tobacco should be instructed

answer

use 1 lozenge every 1-2 hrs at least 9/day with max of 20/day

question

Li takes theophylline for his peristent asthma and calls the office with a complaint of nausea, vomiting, HA. the best advice would be

answer

have him seen the same day for an assessment and theophylline level

question

JOhn is a 4 week old who has been dx with chlamydial pna. appropriate tx would be

answer

erythromycin

question

pts with COPD exacerbation may require

answer

systemic corticosteroid burst

question

james is a 52 yr old overweight smoker taking theophylline for his persistent asthma. he tells his provider is is going to start the atkins diet. appropriate response would be

answer

schedule him for regular serum theophylline levels during his diet due to increased excretion of theophylline

question

Bilal is a 5 yr old who has been dx with TB. Tx would include

answer

pyridoxine

question

A stepwise approach to the pharmacological management of asthma is

answer

begins with determining the severity of asthma and assessing asthma control

question

the most appropriate smoking cessation prescription for pregnant women is

answer

bupropion /Zyban

question

the known drug interactions with the inhaled corticosteroid beclomethasone QVAR include

answer

none of the above

question

1st line abx choice for a pt with comorbidities or who is immunosuppresed who has pna and can be treated as an outpt would be

answer

levofloxacin

question

tx for mild intermittent asthma is

answer

short acting beta 2 agonists Albuterol as needed

question

transdermal nicotine replacement patch is an effective choice in tobacco cessation because

answer

the patch provides a steady level of nicotine without reinforcing oral aspects of smoking

question

instructions for a pt who is starting nicotine replacement therapy include

answer

nicotine replacement will help with the withdrawal cravings associated with quitting tobacco

question

Wing-Sing is a 4 yr old who has suspected bacterial pna. he has a temp of 102, o2 sat 95%, and is taking fluids adequately. what is the initial tx for pna

answer

ceftriaxone

question

the most common bacterial pathogen in community acquired pna is

answer

streptococcus pneumoniae

question

Harold is a 42 y/o AA with moderate persistent asthma. Which of the following asthma medications should be used cautiously if at all

answer

salmeterol, an inhaled long acting beta agoinist

question

Samantha is 34 weeks pregnant and dx with PNA. she is stable enough to be tx as an outpt. what would appropriate abx be

answer

azithromycin

question

Isabella has confirmed TB and is placed on a 6 mth treatment regimen. the 6 mth regimen consists of

answer

2 mths of 4 drug therapy (INH, rifampin, pyrazaninamide and ethambutol) followed by 4 mths of INH and rifampin

question

medications used in the management of pts with COPD

answer

all of the above

question

monitoring a pt with persistent asthma includes

answer

evaluating the pt every 1-6 mths to determine if the pt needs to step down in their therapy

question

when educating pts who are starting on inhaled corticosteroids, the provider should include

answer

pts should rinse their mouths out after using the inhaled corticosteroid to prevent thrush

question

if prescribing bupropion ZYBAN for tobacco cessation, the instructions to the pt include

answer

bupropion/zyban is started 1-2 wks before the quit date

question

Verenicline (Chantix) may be rxd for tobacco cessation. instructions to the pt who us starting chantix include

answer

neuropsychiatric symptoms may occur

question

Digoxin level need to be monitored closely when the following medication is started

answer

albuterol

question

the 1st line drug choice for a previously healthy adult pt dx with community aquired pna is

answer

azithromycin

question

tiotropium bromide Spiriva is an inhaled anticholinergic

answer

used for tx of COPD

question

nicotine replacement therapy

answer

delays healing of esophagitis and peptic ulcers

question

Infants with congenital hypothyroidism are tx with

answer

levothyroxine

question

metformin is a primary choice of drug to treat hyperglycemia in type 2 dm pt b/c

answer

decreases glycogenolysis in by the liver

question

hypoglycemia can result from the action of either insulin or an oral hypoglycemic. s/s of hypoglycemia include

answer

dizziness, confusion, diaphoresis, tachycardia

question

bisphosphonates treat or prevent osteoporosis by

answer

inhibiting osteoclastic activity

question

when bld glucose levels are difficult to control in DM2, some form of insulin may be added to tx regimen to control blood glucose and limit complications, which following statements are accurate based on research

answer

premixed insulin analogues are better at lowering HbA1C and have less risk for hypoglycemia

question

all dm pts with hyperlipidemia should be treated with

answer

HMG CoA reductase inhibitors

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