, NSG 6005 MIDTERM EXAM
(Answers are in Bold letter)
1. The first-line treatment for cough related to a upper respiratory infection in a five-year-old is:
A. Fluids and symptomatic care
B. Dextromethorphan and guaifenesin syrup (Robitussin DM for kids)
C. Guaifenesin and codeine syrup (Tussin AC)
D. Chlorpheniramine and dextromethorphan syrup (NyQuil for kids)
2. Pregnant patients with asthma may safely use ____ throughout their pregnancies.
A. oral terbutaline
B. prednisone
C. inhaled corticosteroids (budesonide)
D. montelukast (Singulair)
3. A stepwise approach to the pharmacologic management of asthma:
A. Begins with determining the severity of the asthma and assessing asthma control
B. Is used when the asthma is severe and requires daily steroids
C. Allows for each provider to determine his or her personal approach to the care of asthmatic patients
D. Provides a framework for the management of severe asthmatics but is not as helpful when patients have
intermittent asthma
4. Infants with reflux are initially treated with:
A. Histamine 2 receptor antagonist (ranitidine)
B. A PPI (omeprazole)
C. Antireflux maneuvers (elevate the head of the bed)
D. Prokinetic (metoclopramide)
5. Many patients self-medicate with antacids. Which patients should be counseled to not take calcium
carbonate antacids without discussing with their providers or a pharmacist first?
A. Patients with kidney stones
B. Pregnant patients
C. Patients with heartburn
D. Postmenopausal women
6. Second-generation antihistamines such as loratadine (Claritin) are prescribed for seasonal allergies
because they:
, A. Are more effective than first-generation antihistamines
B. Are less sedating than first-generation antihistamines
C. Are prescription products and, therefore, are covered by insurance
D. Can be taken with CNS sedatives, such as alcohol
7. Decongestants such as pseudoephedrine (Sudafed):
A. Are Schedule III drugs in all states
B. Should not be prescribed or recommended for children under four years of age
C. Are effective in treating the congestion children experience with the common cold
D. May cause drowsiness in patients of all ages
8. Patients with pheochromocytoma should avoid which of the following classes of drugs due to the
possibility of developing hypertensive crisis?
A. Expectorants
B. Beta 2 agonists
C. Antitussives
D. Antihistamines
9. Education of patients with COPD who use inhaled corticosteroids includes the following:
A. They should double the dose at the first sign of a upper respiratory infection.
B. They should use the inhaled corticosteroid first and then the bronchodilator.
C. They should rinse their mouths after use.
D. They should not smoke for at least thirty minutes after use.
10. Monitoring a patient with persistent asthma includes:
A. Monitoring how frequently the patient has a upper respiratory infection during treatment
B. Monthly in-office spirometry testing
C. Determining whether the patient has increased use of his or her long-acting beta 2 agonists due to
exacerbations
D. Evaluating the patient every one to six months to determine whether the patient needs to step up
or down in his or her therapy
11. Harold, a forty-two-year-old African American, has moderate persistent asthma. Which of the following
asthma medications should he use cautiously, if at all?
A. Betamethasone, an inhaled corticosteroid
B. Salmeterol, an inhaled long-acting beta-agonist
C. Albuterol, a short-acting beta-agonist
D. Montelukast, a leukotriene modifier
, 12. When prescribing montelukast (Singulair) for asthma, patients or parents of patients should be instructed
as follows:
A. Montelukast twice a day is started when there is an asthma exacerbation.
B. Patients may experience weight gain on montelukast.
C. Aggression, anxiety, depression, and/or suicidal thoughts may occur when taking montelukast.
D. Lethargy and hypersomnia may occur when taking montelukast.
13. Lifestyle changes are the first step in the treatment of GERD. Foods that may aggravate GERD include:
A. Eggs
B. White bread
C. Chocolate
D. Chicken
14. Christy has exercise and mild persistent asthma and is prescribed two puffs of albuterol fifteen minutes
before exercise and as needed for wheezing. One puff per day of beclomethasone (Qvar) is also
prescribed. Teaching regarding her inhalers includes which one of the following?
A. She should use one to two puffs of albuterol per day to prevent an attack, with no more than eight puffs
per day.
B. Beclomethasone needs to be used every day to treat her asthma.
C. She should report any systemic side effects she is experiencing, such as weight gain.
D. She should use the albuterol MDI immediately after her corticosteroid MDI to facilitate
bronchodilation.
15. One goal of asthma therapy outlined by the NHLBI Expert Panel 3 guidelines is:
A. Use albuterol daily to control symptoms
B. Minimize exacerbations to once a month
C. Keep nighttime symptoms at a maximum of twice a week
D. Require infrequent use of beta 2 agonists (albuterol) for relief of symptoms
16. Treatment failure in patients with PUD associated with H. pylori may be due to:
A. Antimicrobial resistance
B. Ineffective antacid
C. Overuse of PPIs
D. All of the above
17. When using the "step-up" approach in caring for a patient with GERD, the "step up" from OTC antacid
use is:
A. Prokinetic (metoclopramide) for four to eight weeks
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