Unit 7 MN 553 Pharm Exam Questions and Answers

Ray has been diagnosed with hypertension and an angiotensin-converting enzyme inhibitor is determined to be needed. Prior to prescribing this drug, the NP should assess for: Question options: Hypokalemia Impotence Decreased renal function Inability to concentrate - ANSWER Decreased renal function Which of the following create a higher risk for digoxin toxicity? Both the cause and the reason for it must be correct. Question options: Older adults because of reduced renal function Administration of aldosterone antagonist diuretics because of decreased potassium levels Taking an antacid for gastroesophageal reflux disease because it increases the absorption of digoxin Doses between 0.25 and 0.5 mg/day - ANSWER Older adults because of reduced renal function Juanita had a deep vein thrombosis (DVT) and was on heparin in the hospital and was discharged on warfarin. She asks her primary care provider NP why she was getting both medications while in the hospital. The best response is to: Question options: Contact the hospitalist as this is not the normal guideline for prescribing these two medications and she may have had a more complicated case. Explain that warfarin is often started while a patient is still on heparin because warfarin takes a few days to reach effectiveness. Encourage the patient to contact the Customer Service department at the hospital as this was most likely a medication error during her admission. Draw anticoagulation studies to make sure she does not have dangerously high bleeding times. - ANSWER Explain that warfarin is often started while a patient is still on heparin because warfarin takes a few days to reach effectiveness. Robert, age 51 years, has been told by his primary care provider (PCP) to take an aspirin a day. Why would this be recommended? Question options: He has arthritis and this will help with the inflammation and pain. Aspirin has anti-platelet activity and prevents clots that cause heart attacks. Aspirin acidifies the urine and he needs this for prostrate health. He has a history of GI bleed, and one aspirin a day is a safe dosage. - ANSWER Aspirin has anti-platelet activity and prevents clots that cause heart attacks. Education of patients who are taking warfarin includes discussing their diet. Instructions include: Question options: Avoiding all vitamin K-containing foods Avoiding high-vitamin K-containing foods Increasing intake of iron-containing foods Making sure they eat 35 grams of fiber daily - ANSWER Avoiding high-vitamin K-containing foods Pernicious anemia is treated with: Question options: Folic acid supplements Thiamine supplements Vitamin B12 Iron - ANSWER Vitamin B12 Valerie presents to the clinic with menorrhagia. Her hemoglobin is 10.2 and her ferritin is 15 ng/mL. Initial treatment for her anemia would be: Question options: 18 mg/day of iron supplementation 6 mg/kg per day of iron supplementation 325 mg ferrous sulfate per day 325 mg ferrous sulfate tid - ANSWER 325 mg ferrous sulfate tid Kyle has Crohn's disease and has a documented folate deficiency. Drug therapy for folate deficiency anemia is: Question options: Oral folic acid 1 to 2 mg per day Oral folic acid 1 gram per day IM folate weekly for at least 6 months Oral folic acid 400 mcg daily - ANSWER Oral folic acid 1 to 2 mg per day Angina is produced by an imbalance between myocardial oxygen supply (MOS) and demand (MOD) in the myocardium. Which of the following drugs help to correct this imbalance by increasing MOS? Question options: Calcium channel blockers Beta blockers Angiotensin-converting-enzyme (ACE) inhibitors Aspirin - ANSWER Angiotensin-converting-enzyme (ACE) inhibitors The rationale for prescribing calcium blockers for angina can be based on the need for: Question options: Increased inotropic effect in the heart Increasing peripheral perfusion Keeping heart rates high enough to ensure perfusion of coronary arteries Help with rate control - ANSWER Help with rate control Which of the following drugs has been associated with increased risk for myocardial infarction in women? Question options: Aspirin Beta blockers Estrogen replacement *** Lipid-lowering agents - ANSWER Estrogen replacement *** Increased life expectancy for patients with heart failure has been associated with the use of: Question options: ACE inhibitors, especially when started early in the disease process All beta blockers regardless of selectivity Thiazide and loop diuretics Cardiac glycosides - ANSWER ACE inhibitors, especially when started early in the disease process Digoxin has a very limited role in treatment of heart failure. It is used mainly for patients with: Question options: Ejection fractions above 40% An audible S3 Mitral stenosis as a primary cause for heart failure Renal insufficiency - ANSWER An audible S3 Which of the following classes of drugs is contraindicated in heart failure? Question options: Nitrates Long-acting dihydropyridines Calcium channel blockers Alpha-beta blockers - ANSWER Calcium channel blockers What is considered the order of statin strength from lowest effect to highest? Question options: Lovastatin, Simvastatin, Rosuvastatin Rosuvastatin, Lovastatin, Atorvastatin Atorvastatin, Rosuvastatin, Simvastatin Simvastatin, Atorvastatin, Lovastatin - ANSWER Lovastatin, Simvastatin, Rosuvastatin First-line therapy for hyperlipidemia is: Question options: Statins Niacin Lifestyle changes *** Bile acid-binding resins - ANSWER Lifestyle changes *** Han is a 48-year-old diabetic with hyperlipidemia and high triglycerides. His LDL is 112 mg/dL and he has not tolerated statins. He warrants a trial of a: Question options: Sterol Niacin Fibric acid derivative Bile acid-binding resin - ANSWER Fibric acid derivative Hypertensive African Americans are typically listed as not being as responsive to which drug groups? Question options: ACE inhibitors Calcium channel blockers Diuretics Bidil (hydralazine family of medications) - ANSWER ACE inhibitors Because of its action on various body systems, the patient taking a thiazide or loop diuretic may also need to receive the following supplement: Question options: Potassium Calcium Magnesium Phosphates - ANSWER Potassium An ACE inhibitor and what other class of drug may reduce proteinuria in patients with diabetes better than either drug alone? Question options: Beta blockers Diuretics Nondihydropyridine calcium channel blockers Angiotensin II receptor blockers - ANSWER Nondihydropyridine calcium channel blockers