[SOLUTION] NURS-6521 Advanced Pharmacology Fall Final Exam – Homework Solution

NURS-6521 Advanced Pharmacology Fall Final Exam Exam – Week 11

1. JC is a 13 year old female to be seen in your clinic today.  You review JC’s medication and realize that which medication is a potential risk of growth suppression in prepubescent children? 2. Mr. Laird is a 49-year-old electrician who experienced severe burns on his trunk, arms, and hands in a workplace accident 2 weeks ago. Part of his current wound care regimen involves the daily application of silver sulfadiazine to his wounds. The nurses who are providing care for Mr. Laird in the burns and plastics unit of the hospital should perform what action when administering this medication? NURS-6521 Advanced Pharmacology Fall Final Exam 3. Cleanse the wound of debris prior to applying the silver sulfadiazine 4. Anxiety related to perceived danger of drug therapy to fetus or infant 5. A patient has endocarditis and is taking gentamicin. The Nurse Practitioner will be sure to monitor which of the following? NURS-6521 Advanced Pharmacology Fall Final Exam 6. A 39-year-old woman is receiving doxorubicin for the treatment of cancer. After each treatment, the patient has acute nausea and vomiting accompanied by a slightly increased heart rate. The nurse will advise her to 7. A child with chronic allergic symptoms uses an intranasal steroid for control of symptoms. At this child’s annual well-child checkup, the NP should carefully review what? 8. The first line drug choice for a previously healthy adult patient who has been diagnosed with community acquired pneumonia would be. NURS-6521 Advanced Pharmacology Fall Final Exam 9. Ms. Shackleford Has been placed on Ambien to help for her insomnia. The NP must educate the patient regarding the rapid onset of Ambien. Which statement below is correct? 10. On the advice of her sister, a 52-year-old woman has visited her nurse practitioner to discuss the potential benefits of hormone replacement therapy in controlling the symptoms of menopause. Which of the following responses by the nurse is most appropriate? 11. A patient asks the nurse practitioner about food sources such as soybeans and soy products. The nurse practitioner understands that these foods are considered 12. A 35-year-old woman is on a weight-loss program and is to begin taking sibutramine (Meridia). After baseline physical data are obtained, the nurse will assess the patient’s childbearing potential. The nurse will inform the patient that during sibutramine therapy she should 13. A 29-year-old woman who is morbidly obese has recently begun a comprehensive, medically-supervised program of weight reduction. Prior to adding dextroamphetamine (Dexedrine) to her regimen, the patient should be questioned about her intake of 14. An immunocompromised patient with a diagnosis of candidiasis has failed to respond to conservative therapy and has consequently begun treatment with amphotericin B. The nurse is aware that this drug achieves a therapeutic effect by way of its influence on 15. Ms. Carter, a 48 year old female was placed on an aminoglycoside. The NP knows that an adverse reaction to aminoglycosides is? NURS-6521 Advanced Pharmacology Fall Final Exam 16. A Nurse Practitioner is reviewing the pre-pregnancy medication regimen of a patient who has just had a positive pregnancy test. The nurse should be aware of which of the following changes in pharmacokinetics that accompanies pregnancy? 16. A male patient is experiencing climacteric symptoms secondary to androgen deficiency. His physician has prescribed testosterone. The nursing assessment reveals that the patient has had a myocardial infarction. The combination of testosterone therapy and a history of myocardial infarction would place that patient at a significantly higher risk of 17. A 67-year-old man who is being treated for prostate cancer is taking epoetin alfa. The nurse will instruct the patient to 18. A 59-year-old man with a recent history of erectile dysfunction has been assessed and prescribed sildenafil (Viagra). When providing patient education to this man, the nurse should tell him which of the following? 19. A Nurse Practitioner is working with a 16-year-old pregnant teen and assessing for behavior that may put the baby at risk. The most important assessment the nurse can make is. NURS-6521 Advanced Pharmacology Fall Final Exam 20. A patient with non-Hodgkin’s lymphoma (NHL) will be starting a course of doxorubicin shortly. When planning this patient’s care, what nursing diagnosis should the nurse prioritize? 21. A Nurse Practitioner is caring for a 64-year-old female patient who is receiving IV heparin and reports bleeding from her gums. The nurse checks the patient’s laboratory test results and finds that she has a very high aPTT. The nurse anticipates that which of the following drugs may be ordered? 22. The Nurse practitioner is considering ordering a medication for a patient. He/she knows that an advantage of prescribing a sublingual medication is that the medication it is: NURS-6521 Advanced Pharmacology Fall Final Exam 23. Which adverse reaction is common in the patient taking buspirone? 24. A Nurse Practitioner working in a cancer center is preparing to administer medication to a 5-year-old child. The nurse will calculate the drug dosage by using 25. The nurse recognizes that the potential for teratogenic drug effects is not static throughout the prenatal and postnatal periods. The potential for teratogenic effects is highest during 26. A male patient is receiving heparin by continuous intravenous infusion. The nurse will instruct the patient and family members to report which of the following should it occur? 27. A 15-year-old patient has meningitis caused by Haemophilus influenzae. She is being treated with chloramphenicol. The most important nursing action for this patient would be to monitor 28. A Nurse Practitioner is assigned to a patient who is at 32 weeks’ gestation and is receiving terbutaline (Brethine) IV for 24 hours to control preterm labor. Which of the following nursing actions will the nurse take to decrease the risk of hypotension and promote circulation to the fetus? 29. A 33-year-old man has developed acute gouty arthritis. He has been prescribed colchicine. When developing a care plan for this patient, which factor will be most important for the nurse to consider? NURS-6521 Advanced Pharmacology Fall Final Exam 30. A 2-year-old child is diagnosed with a minor ailment and is to be administered medications at home for 2 weeks. The child lives with his mother, grandmother, and four other children between the ages of 14 months and 7 years. The home health nurse is asked to assess the home environment to determine if it is appropriate for the child to take his medication at home. Which of the following will have the greatest impact on the nurse’s assessment? 31. A Nurse Practitioner is caring for a 10-year-old boy who complains of chronic headaches. His mother reports that she gives him Tylenol at least three times a day. Which of the following will the nurse work with the physician to evaluate? 32. A woman has a Chlamydia infection. Before initiating treatment with a tetracycline antibiotic, the NP should : 33. Which of the following would the nurse include in a teaching plan about the signs and symptoms of thrombophlebitis and thromboembolism that should be reported by a patient taking estrogen? 34. A patient has completed 4 weeks of treatment with epoetin alfa. Which of the following assessment findings would most strongly indicate that treatment has been effective? 35. A Nurse Practitioner is having difficulty administering a bitter drug to a 5-year-old child. The nurse should. NURS-6521 Advanced Pharmacology Fall Final Exam 36. A 54-year-old woman with a history of osteoporosis has been prescribed ciprofloxacin for recurrent cystitis. Because of the patient’s history, the nurse would 37. A 15-year-old boy who has been taking dextroamphetamine for the treatment of ADHD has been experiencing a depressed mood and a sense of hopelessness. He confides in the school nurse that he has begun taking his stepfather’s antidepressant to improve his mood. After immediately phoning the boy’s stepfather, the nurse learns that the drug in question is phenelzine (Nardil), a monoamine oxidase inhibitor (MAOI). The nurse should recognize that this combination of drugs creates a serious risk of what health problem? NURS-6521 Advanced Pharmacology Fall Final Exam 38. A Nurse Practitioner is providing patient education to a 13-year-old girl who was just diagnosed with type 1 diabetes mellitus. Which of the following statements by the patient will alert the nurse that special instructions regarding insulin are necessary? 39. When prescribing Phosphodiesterase type 5 (PDE-5) inhibitors such as sildenafil, the patient should be screened for use of? 40. Alendronate (Fosamax) is prescribed for a 67-year-old postmenopausal woman. In order to help prevent gastrointestinal distress, the nurse will advise the patient to 41. A 38-year-old pregnant patient admits to the Nurse Practitioner that she is an alcoholic and has been consuming alcohol during her pregnancy. The nurse knows that using alcohol during pregnancy may result in a child who presents with 42. A Nurse Practitioner who provides care on a pediatric medicine unit has conducted a medication reconciliation of a recently-admitted patient. In light of the fact that the child takes methylphenidate (Ritalin), the nurse is justified in considering a history of what health problem? 43. Ms. LW is on hyrdroxychloroquine (Plaquenil) for rheumatoid arthritis. Certain tests are recommended before a patient starts this medication. Which of the following is NOT recommended before starting Hydroxychoroquine (Plaquenil)? 44. The clinical nurse educator who oversees the emergency department in a children’s hospital has launched an awareness program aimed at reducing drug errors. What measure addresses the most common cause of incorrect doses in the care of infants and children? NURS-6521 Advanced Pharmacology Fall Final Exam 45. Which of the following agents would not be expected to cause nausea, vomiting, Flushing, dizziness, headache, and abdominal discomfort after consumption of alcohol? 46. A 20-year-old woman will soon begin taking oral contraceptives for the first time. What advice should the nurse provide to this patient? 47. Mr. Samuels has been prescribed olanzapine (Zyprexa). The NP know that he should be monitored for: NURS-6521 Advanced Pharmacology Fall Final Exam 48. A 60-year-old patient experienced a sudden onset of chest pain and shortness of breath and was subsequently diagnosed with a pulmonary embolism in the emergency department. The patient has been started on an intravenous heparin infusion. How does this drug achieve therapeutic effect? 49. Morphine has been prescribed for a 28-year-old man with severe pain due to a back injury. The nurse will advise the patient to avoid 50. A Nurse Practitioner works at a weight management clinic. To which of the following overweight patients could the nurse safely administer dextroamphetamine? 51. A contraindication to the use of combined contraceptives is: 52. A Nurse Practitioner is caring for a 46-year-old female patient who is taking paclitaxel for ovarian cancer. Two or three days after the infusion of the drug, the nurse must closely monitor for which of the following? 53. A woman is receiving magnesium sulfate for intrapartum eclampsia. The patient is perspiring and her blood pressure is 88/50. The serum magnesium level is 10 mg/dL. The nurse will interpret these manifestations as. NURS-6521 Advanced Pharmacology Fall Final Exam 54. A 66-year-old man has made an appointment with his primary care provider to discuss his recent erectile dysfunction (ED) and has requested a prescription for tadalafil (Cialis) based on television commercials he has seen. What characteristic of this patient would most likely contraindicate the use of tadalafil for his ED? 55. An NP is seeing a child who weights 25 pounds, 2 oz and needs a medication. The NP learns that the recommended dosing for this drug is 30-35 mg per kg per day in three divided doses. The NP should order 56. A 66-year-old woman has experienced a significant decline in her quality of life as a result of worsening rheumatoid arthritis. Her physician has prescribed etanercept and the APRN is responsible for facilitating this new aspect of the patient’s drug regimen. This will involve the administration of 57. A nurse practitioner orders a single dose of 2 g Metronidazole orally. How many milligrams will the patient receive in one dose? 58. A female patient is taking oral cyclophosphamide therapy for breast cancer. Because of possible adverse effects of the drug, the nurse will instruct the patient to do which of the following? 59. How do bisphosphonates Treat osteoporosis? 60. What is the first line treatment for hypertension and a male with benign prosthetic hypertrophy? 61. A pregnant patient asks the Nurse Practitioner what over-the-counter medication she can take for recurring headaches. The nurse should recommend. NURS-6521 Advanced Pharmacology Fall Final Exam 62. A Nurse Practitioner will monitor which of the following when assigned to a patient taking allopurinol for chronic gout who visits the clinic every 2 months? NURS-6521 Advanced Pharmacology Fall Final Exam 63. Which antibiotic requires administration of a loading dose? 64. What is the minimum inhibitory concentration (MIC) 65. A Nurse Practitioner is performing patient education for a woman who has just been prescribed a bisphosphonate. Which of the following diagnostic and history findings would have prompted the woman’s care provider to prescribe a bisphosphonate? 66. A woman who is in the second trimester of her first pregnancy has been experiencing frequent headaches and has sought advice from her nurse practitioner about safe treatment options. What analgesic can the nurse most safely recommend? 67. The NP is considering a medication to treat Ms. Robert’s Urinary Tract Infection. The NP knows that Trimethoprim sulfamethazole (Bactrim) Is contra indicated in which of the following conditions: NURS-6521 Advanced Pharmacology Fall Final Exam 68. Which of the following medication classes should be avoided and men with BPH 69. Lily, the nurse practitioner is seeing Mr. Reynolds today. She would recognize that which of the following is a potential adverse side effects of autonomic-anticholinergic agents? 70. The NP is prescribing A medication for six month old infant. That medication comes in the following formulations. Which one should the NP select to improve absorption and distribution of the medication? 71. A 3-year-old boy has developed otitis media and requires antibiotics. In order to increase the chance that the boy will take his prescribed medication, the nurse should 72. A 20-year-old woman has been prescribed estrogen. As with all women taking estrogen, the nurse will carefully monitor the patient for which of the following? 73. A Nurse Practitioner is instructing a 19-year-old female patient on the use of fluconazole for candida vaginitis. A teaching priority will be to 74. How is hydrocodone eliminated from the body? 75. All insects have an FDA black box warning regarding 76. A man is prescribed ciprofloxacin to treat a sexually transmitted infection. The nurse will instruct the patient to 77. Some drugs are given to patients using other routes such as sublingual or topical to avoid movement through the liver and possible side effects.  Which of the following effects is the Nurse Practitioner attempting to avoid by administering certain medications via alternative routes? 78. A patient is prescribed ganciclovir to treat a CMV infection. An oral dosage is prescribed. To help increase bioavailability of the drug, the nurse will encourage the patient to take the medication 79. Which step in the clotting cascade allows prothrombin to be converted to thrombin? 80. LIsa , age 25, has just been placed on Minocycline.  The NP should tell this pt to: NURS-6521 Advanced Pharmacology Fall Final Exam 81. The anticoagulant drug that acts as a vitamin K antagonist is: 82. A 30-year-old African-American woman tested positive for TB and is prescribed isoniazid. The nurse will plan the patient’s care to include close monitoring of the drug therapy because 83. A Nurse Practitioner is working with a 57-year-old man who is a former intravenous drug abuser. He has been prescribed a weekly dosage of methotrexate for his rheumatoid arthritis. Which of the following will the nurse include in her teaching plan for this patient? 84. A patient has been admitted to the critical care unit of the hospital with bacterial septicemia that has failed to respond to initial antibiotic treatment. The patient’s most recent blood cultures reveal the presence of methicillin-resistant Staphylococcus aureus (MRSA) in the patient’s blood. The nurse will anticipate that this patient will likely require intravenous administration of what antibiotic? NURS-6521 Advanced Pharmacology Fall Final Exam 85. An immunocompromised patient in a critical care setting has developed a respiratory infection that has been attributed to methicillin-resistant Staphylococcus aureus (MRSA). The nurse should anticipate that the patient will require treatment with 86. Mr. Lepp is a 63-year-old man who was diagnosed with colon cancer several weeks ago and who is scheduled to begin chemotherapy. He reports to the nurse that he read about the need for erythropoietin in an online forum for cancer patients and wants to explore the use of epoetin alfa with his oncologist. Which of the following facts should underlie the nurse’s response to Mr. Lepp? 87. A nurse practitioner has administered filgrastim to a diverse group of patients in recent months. Which of the following patients should the nurse observe for extremely elevated white blood cell counts following administration of the drug? NURS-6521 Advanced Pharmacology Fall Final Exam 88. A Nurse Practitioner is caring for a patient who is on amphotericin B. On morning rounds the patient reports weakness, numbness, and a tingling sensation in his feet. What would be a priority action by the nurse? 89. A Nurse Practitioner is providing patient education to a 50-year-old woman who is taking methotrexate (MTX) for breast cancer. The nurse will instruct the patient to avoid which of the following drugs? 90. A 12-year-old boy is being discharged from the hospital after major surgery. The boy will be taking two medications at home for an extended period. The nurse who is discharging the patient should provide medication teaching specifically to 91. A man has a demonstrated history of androgen deficiency and the consequences of this health problem include an inability to maintain an erection. Which of the following medications would best address this patient’s erectile dysfunction (ED)? 92. A patient is taking rifampin (Rifadin) for active TB. When discussing this drug with the patient, the nurse should stress that 93. A 7-year-old child has been taking tetracycline for a bacterial infection. The nurse will be sure to inform the parents that this drug could cause 94. The nurse practitioner has prescribed elemental iron 6 mg/kg/day in three divided doses for a toddler diagnosed with iron-deficiency anemia. What instructions would the family nurse practitioner include for the parents? 95. Donald is a nurse practitioner student. He recognizes Which option below could be a secondary use for an anxiolytic medication? 96. Which test should the NP order for monitoring effectiveness of the patient receiving heparin? 97. Monitoring of male patients are using phosphodiesterase type 5 (PDE-5) inhibitors includes which of the following? NURS-6521 Advanced Pharmacology Fall Final Exam 98. During ongoing assessment of a patient receiving 5-FU therapy, the nurse finds the patient’s platelet count to be 92,000 cells/mm3. The nurse should do which of the following? 99. A Nurse Practitioner is aware that the concept of selective toxicity is foundational to antimicrobial therapy. Which of the following statements most accurately describes selective toxicity? 100. A patient has been prescribed oral tetracycline. The nurse will instruct the patient to take the drug

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