WEEK 10 ASSIGNMENT – 50 QUESTIONS (2 POINTS EACH)

1.
As
an Advanced Nurse Practitioner, you order PCN for a patient with a confirmed
diagnosis of Strep. You order the
medication, your nurse calls it into the patient’s pharmacy, and it is filled
by the patient. The patient calls the
next day stating that they have hives all over their body and think it is from
the PCN. You recheck their chart and see
that you have missed that they are allergic to PCN. Legal responsibility for the error is:

a.
Only
on you – You gave the order, the pharmacist was obligated to fill it

b.
Only
the nurse – She should have checked the allergies before calling in the
prescription

c.
Only
on the pharmacist – The pharmacist should have known about the allergy

d.
On
all parties involved – The Advanced Nurse Practitioner, Nurse and Pharmacist

2.
CS
is a 20 year old patient of yours. He
has a habit of not seeing you on a regular basis, and using OTC medications
whenever he feels sick. Which of the
following statements best describes the danger of self-medicating with OTC
medications?

a.
Patients
are not aware of the action of OTC medications

b.
Patients
are not aware of the side effects of OTC medications

c.
Patients
minimize the effects of OTC medications because they are available without a
prescription

d.
All
of the above

3.
You
decide to treat a patient with an antihistamine for seasonal allergies. Which of the following precautions should you
provide to the patient?

a.
Avoid
ingesting alcohol

b.
Be
aware that you may need to take a decongestant to make the antihistamine
effective

c.
Be
aware that you may have increase salivation

d.
You
can expect full relief in 24 hours

4.
OP
is a 55 year old male who has been taking low-dose steroids daily for the
suppression of RA for the last 5 years.
He presents to you for back pain.
You order an X-ray and find a vertebral compression fracture. This fracture is due to:

a.
An
entirely separate condition

b.
The
osteoporotic effect of long-term steroid use

c.
Deterioration
in rheumatoid arthritis

d.
Excessively
high dose steroids

5.
Which
of the following groups of patients are most at risk for GI bleeding from the
use of NSAIDs?

a.
Patients
with dysmenorrhea

b.
Patients
with headaches

c.
Patients
with arthritis

d.
Patients
with renal failure

6.
You
have a 36 year old female patient who is s/p renal transplant x 4 weeks. They are currently taking Cellcept. Part of your education to the patient would
include:

a.
Take
the Cellcept with food

b.
Avoid
the use of any steroids while taking

c.
Practice
effective contraception

d.
None
of the above

7.
Which
of the following agents can be used in the treatment of rheumatoid arthritis,
Sjogren’s syndrome and SLE?

a.
Auranofin

b.
Allopurinol

c.
Sulfasalazine

d.
Chloroquine

8.
You
have a patient with advanced cirrhosis of the liver and is not tolerating
protein well, which is evidenced by abnormal laboratory values. Which of the following medications would be
best to be prescribed for this patient?

a.
Lactulose

b.
Ethacrynic
Acid

c.
Folic
Acid

d.
Thiamine

9.
Which
of the following clients is at greatest risk of digoxin toxicity?

a.
25
year old patient with CHF

b.
50
year old client with CHF

c.
60
year old client after MI

d.
80
year old client with CHF

10.
Which
of the following is a contraindication for digoxin administration?

a.
Blood
pressure of 140/90

b.
Heart
rate above 80

c.
Heart
rate below 60

d.
Respiratory
rate above 20

11.
The
action of medication is inotropic when it:

a.
Decreases
afterload

b.
Increases
heart rate

c.
Increases
the force of contraction

d.
Is
used to treat CHF

12.
Which
is the most appropriate action for the Advanced Nurse Practitioner to take
before administering digoxin?

a.
Monitor
K+ level

b.
Assess
blood pressure

c.
Evaluate
urinary output

d.
Avoid
giving with a thiazide diuretic

13.
Class
IA antiarrhythmic agents have little effect on:

a.
AV
note

b.
SA
node

c.
Purkinje
fibers

d.
Bundle
of His

14.
The
most toxic antiarrhythmic agent is:

a.
Digoxin

b.
Lidocaine

c.
Amiodarone

d.
Quinidine

15.
Conduction
defects will most likely be an adverse effect associated with the use of:

a.
Verapamil

b.
Nifedipine

c.
Diltiazem

d.
Felodipine

16.
Which
of the following calcium channel blockers has the most potent peripheral smooth
muscle dilator effect?

a.
Diltiazem

b.
Nifedipine

c.
Nimodipine

d.
Verapamil

17.
?-blockers
should be avoided in which of the following conditions?

a.
Bronchoconstriction

b.
Hypertension

c.
Angina

d.
Myocardial
Infarction

18.
You
have a patient taking the medication Cinacalcet. You would know to monitor:

a.
Serum
calcium levels

b.
Evaluate
bowel function

c.
Measure
serum acid phosphatase

d.
None
of the above

19.
A
constant dose of estrogen with varying doses of progestin are found in:

a.
Monophasic
birth control pills

b.
Biphasic
birth control pills

c.
Triphasic
birth control pills

d.
Quartraphasic
birth control pills

20.
A
relative contraindication to therapy with antiandrogens is:

a.
Hepatic
failure

b.
Pregnancy

c.
Prostate
cancer

d.
Hypogonadism

21.
A
patient who has COPD is taking Theophylline also receives Cipro, which of the following
interactions would you expect?

a.
Ciprotoxicity

b.
Ineffectiveness
of Cipro

c.
Theophylline
toxicity

d.
Ineffectiveness
of Theophylline

22.
A
patient is at highest risk for nephrotoxicity with Aminoglycoside use is:

a.
36
year old male patient with a Cr of 1.7 and BUN of 52 on a 10-day regimen

b.
24
year old female patient with Cr of 0.8 and BUN of 12 on a 7-day regimen

c.
44
year old female patient with a past history of cystitis on 5 days of therapy

d.
25
year old male patient with a history of kidney stones on a 10-day regimen

23.
Changes
in visual acuity and color perception are associated with treatment by which of
the following agents?

a.
INH
(Isoniazid)

b.
PZA
(Pyrazinamide)

c.
ETH
(Ethambutol)

d.
SM
(Streptomycin)

24.
Which
choice describes the action of nucleoside analogs?

a.
Exert
anti-HIV activity at the reverse transcriptase level and cause premature
termination of viral DNA chain synthesis

b.
Completely
stop the replication of the HIV virus

c.
Allow
for a patient to become non-contagious after taking for at least 3 days

d.
Are
all equally effective and free of side effects.

25.
The
effects of theophylline may be increased by:

a.
Phenobarbital

b.
Phenytoin

c.
Rifampin

d.
Cimetidine

26.
Routine
laboratory monitoring in clients taking ?-blockers should include:

a.
Sodium

b.
Glucose

c.
Thyrotropin

d.
Creatinine
phosphokinase

27.
Cholinergics
are contraindicated in:

a.
Tachycardia

b.
Hypothyroidism

c.
Hypotension

d.
Asthma

28.
Which
of the following metabolic effects may be a consequence of administration of
adrenergic agents?

a.
Hypoglycemia

b.
Metabolic
acidosis

c.
Hyperglycemia

d.
Respiratory
alkalosis

29.
Adrenergic
blockers are contraindicated in:

a.
Hypertension

b.
Pheochromocytoma

c.
Migraines

d.
Obstructive
airway disease

30.
A
side effect of cholinergic administration is:

a.
Nausea

b.
Diarrhea

c.
Increase
salivation

d.
All
of the above

31.
NK
is a child who has been diagnosed with Attention Deficit Disorder (ADD). Which of the following drugs is commonly used
for their condition?

a.
Methylphenidate

b.
Diethylpropion

c.
Phendimetrazine

d.
Caffeine

32.
Amphetamines
are included in the category of drugs of abuse because of their ability to:

a.
Cause
nervousness

b.
Decrease
weight

c.
Raise
blood pressure

d.
Enhance
performance

33.
As
an Advanced Nurse Practitioner, you will most likely have patients that are on
a stimulant medication. When on the
Amphetamines, you would monitor for decreased effect when these drugs are given
with:

a.
Caffeine

b.
Antidiabetic
agnets

c.
No
Doze OTC medication

d.
All
of the above

34.
From
your pharmacology course research you have learned that you should never give
amphetamines in combination with:

a.
Oral
hyperglycemics

b.
Oral
hypoglycemic

c.
MAO
inhibitors

d.
Antihypertensives

35.
Use
of Methylphenidate for ADD in children can result in:

a.
Tourette’s
syndrome

b.
Growth
suppression

c.
Growth
spurt

d.
A
and B

36.
When
administering IV phenytoin, you should:

a.
Administer
it at a rate of 100 mg/min

b.
Protect
the drug from light exposure

c.
Mix
the drug in dextrose solution

d.
Mix
the drug in saline solution

37.
When
caring for a patient who is receiving phenytoin and warfarin, which of the
following drug-drug interactions would you expect?

a.
Decreased
effectiveness of warfarin

b.
Increased
effectiveness of phenytoin

c.
Increased
effectiveness of warfarin

d.
Decreased
effectiveness of phenytoin

38.
You
have a new patient that you are meeting for the first time today. You are going over their medications with
them, and you ask them how long they have been taking Bromocriptine. The patient states that they think they have
been on it for 3 years or so. They state
that they don’t really know why they are on it though. You explain to them:

a.
It
helps treat Parkinson’s by decreasing dopamine levels in the brain

b.
Bromocriptine
decreases the storage of dopamine peripherally, which in turn decreases
Parkinson’s symptoms

c.
Bromocriptine
activates dopamine receptors in the brain, and helps treat Parkinson’s

d.
It
inhibits monoamine oxidase type B, which helps Parkinson’s

39.
Which
of the patient statements below would make you think twice about administering
Amantadine to a patient?

a.
“My
hands are always shaking.”

b.
“I
had to take Dilantin 6 months ago.”

c.
“I
take a low-dose ASA each day.”

d.
“Simple
tasks seem to take so long to perform.”

40.
You
decide to start you patient on Amantadine.
Your main teaching point with the patient would be:

a.
Monitor
the pulse for rate and regularity

b.
Take
the last dose of medication at bedtime

c.
Inspect
the skin for erythematous rash

d.
Stop
taking the drug if the mouth becomes dry

41.
Which
of the following assessments is most essential before beginning a drug regimen
of an antimuscarinic agent?

a.
Date
of birth

b.
Ethnic
background

c.
History
of diabetes

d.
Activity
intolerance

42.
For
which of the following medical conditions would you anticipate that an
antianxiety medication would not be indicated?

a.
Seizure
disorders

b.
Alcohol
detox

c.
Parkinson’s
disease

d.
Panic
disorder

43.
When
administering antianxiety medications (benzodiazepines) to an elderly patient,
which of the following actions is essential?

a.
Monitor
vital signs

b.
Suggest
reduced doses

c.
Taper
dose before stopping

d.
Implement
a fall prevention protocol

e.
A
and B only

f.
B
and C only

g.
A,
B and D only

h.
All
of the above

i.
None
of the above

44.
When
monitoring a client who is taking benzodiazepines, you should be alert for
which of the following CNS side effects?

a.
Diaphoresis

b.
Sedation

c.
Seizures

d.
Tremors

e.
Edema

f.
Ataxia

g.
Libido
changes

h.
Dizziness

i.
A,
B, E and G only

j.
B,
F and H only

k.
C,
D, E and H only

l.
All
of the above

m.
None
of the above

45.
Antidepressants
generally exert influence by:

a.
Increasing
the reuptake of norepinephrine

b.
Altering
the action of MOA

c.
Changing
the availability of dopamine

d.
Changing
the availability of select neurotransmitters

46.
You
have a new patient, 67 year old male, at your practice who presents for
establishment with you. During your
initial assessment, and history taking you determine that the patient has the
following:

Hypertension

Glaucoma

Gout

Hyperlipidemia

Minor Depression (which you just diagnosed at this visit).

EKG is normal, and other parts of the physical exam
are WNL.

You want to start him on something to help with his
depression. What is the best option for
this patient?

a.
Amitriptyline
25 mg QHS

b.
Zyprexa
20 mg QD

c.
Citalopram
10 mg QD

d.
None
of the above

47.
Antipsychotic
drugs are indicated for:

a.
The
treatment of Tourette’s syndrome

b.
The
treatment of major depression with psychosis

c.
As
an adjunct in the management of seizures

d.
To
cure psychotic disorders

48.
Your
patient SS has been on a low-potency antipsychotic for 2 weeks, and has shown
minimal response to the medications. The
most probably explanation is:

a.
SS
probably has refractory illness

b.
SS
needs a stronger medication

c.
It
is too early to see a full therapeutic response in SS

d.
SS
is not taking the medication as prescribed

49.
Drugs
classified as centrally acting skeletal muscle relaxants are most effective in
relieving:

a.
Spasm
due to trauma or inflammation

b.
Chronic
spasm due to an old injury

c.
Pain
from arthritis

d.
Surgical
complications

50.
Peripherally
acting skeletal muscle relaxants are used:

a.
To
treat neuromuscular diseases

b.
To
treat spinal trauma

c.
To
relieve spasms from trauma

d.
As
adjuncts to general anesthesia

1.
Choose the following factor(s)
that are F314 Surveyor Guidance Risk Factors for Developing Pressure Ulcers:

a.
Comorbid conditions

b.
Drugs that may affect ulcer
healing

c.
Exposure of skin to urinary or
fecal incontinence

d.
History of any healed pressure
ulcer

e.
Impaired diffuse or localized
blood flow

f.
Mild cognitive impairment

g.
A, B and C only

h.
D and F only

i.
A, B, C and E only

j.
All of the above

2.
Which of the following is TRUE
about friction and shearing?

a.
Only friction which causes
pressure damages the epidermis

b.
Friction is the combination of
Gravity and Shearing

c.
Friction stretches and tears
vessels, which reduces the amount of pressure necessary to cause ischemia and
deep tissue injury

d.
All of the above are true

e.
None of the above are true

3.
CMS no longer pays the extra
cost of treating certain categories of conditions that occur while the patient
is in the hospital. These are considered
events that should “Never” occur through the delivery of quality care. All pressure ulcers are CMS “never” events.

a.
True

b.
False

4.
Choose the following factor(s)
that are components of the Braden Scale.

a.
Sensory perception

b.
Moisture

c.
Activity

d.
Mobility

e.
Nutrition

f.
Friction and Shear

g.
BMI (Over or under weight)

5.
Match the Stage with the
description:

Stage I ___________

Stage II ___________

Stage III ___________

Stage IV ___________

Unstageable ___________

a.
Subcutaneous fat may be visible
but bone, tendon or muscles are not exposed.
Slough may be present, but does not obscure the depth of tissue loss.

b.
Intact skin with nonblanchable
redness of a localized area, usually over a bony prominence.

c.
Full thickness tissue loss with
exposed bone, tendon or muscle.

d.
Partial thickness loss of
dermis presenting as a shallow open ulcer with a red pink ulcer bed, without
slough.

e.
Full thickness tissue loss in
which the base of the ulcer is covered by slough (yellow, tan, gray, green or
brown) and/or eschar (tan, brown or black) in the wound bed

6.
Match the treatments for their
specified use:

Alginate __________

Hydrofiber __________
Foam __________

Hydrocolloid __________

Hydrogel __________

Low-adherence

Dressing __________

Transparent

Dressing __________

a.
Necrotic Wounds

b.
Clean, dry wounds with minimal
exudate

c.
Exudate

d.
Skin Tears

e.
Cleaning granulating wounds

7.
Which of the following
medication(s) has been demonstrated to negatively impact wound healing?

a.
Aricept 10 mg

b.
Namenda 21 mg

c.
Lisinopril 5 mg

d.
Seroquel 25 mg

e.
ASA EC 81 mg

f.
Metformin 500 mg

g.
Percocet 5/325 mg

h.
Tylenol 500 mg

8.
You have a patient on your
rounds in the hospital that is in needs of nutritional supplementation for
pressure ulcers. How would you address
the use of nutritional supplements in a patient like this?

a.
Order high-protein supplements
enriched with arginine high-protein supplements

b.
Order high-protein supplements,
arginine, zinc and Vitamin C

c.
Order studies to evaluate
current nutritional status

9.
If you had a patient with a
pressure ulcer, is it good practice to order an antibiotic in order to provide
prophylaxis for infections?

a.
Yes

b.
No

10.
Which of the following are
components of monitoring pressure ulcers?

a.
Determine current number of
healed and unhealed ulcers

b.
Use visual inspection and
palpitation to identify appropriate stage

c.
Code all wounds

d.
Describe the current stage of
each ulcer

e.
All of the above are true

f.
B and C only

g.
A, C and D only