(COMBINED) NSG 6005 Week 6 Pharmacology Quiz, Class 9, Pharm Exam 3 CH 21, Pharm Exam 4 CH 42 Pneumonia, Pain management, Pharmacology Final Review- 5, pharm quiz2 ch15, Pharm Chapter 20- GI drugs, Ch37: Human Immunodeficiency Virus Disease and Acquired I

(COMBINED) NSG 6005 Week 6 Pharmacology Quiz, Class 9, Pharm Exam 3 CH 21, Pharm Exam 4 CH 42 Pneumonia, Pain management, Pharmacology Final Review- 5, pharm quiz2 ch15, Pharm Chapter 20- GI drugs, Ch37: Human Immunodeficiency Virus Disease and Acquired Immunodeficiency. With complete Solution 2024/2025. Patients with RA who are on chronic low-dose prednisone will need co-treatment with which medications to prevent further adverse effects? A. A bisphosphonate B. Calcium supplementation C. Vitamin D D. All of the above D. All of the above Amber is a twenty-four-year-old who has had migraines for ten years. She reports a migraine on average of once a month. The migraines are effectively aborted with naratriptan (Amerge). When refilling Amber's naratriptan education would include which of the following? A. Naratriptan will interact with antidepressants, including selective serotonin reuptake inhibitors and St John's Wort, and she should inform any providers she sees that she has migraines. B. Continue to monitor her headaches; if the migraine is consistently happening around her menses, then there is preventive therapy available. C. Pregnancy is contraindicated when taking a triptan. D. All the given options are correct. D. All the given options are correct. Brainpower Read More Kirk sprained his ankle and is asking for pain medication for his mild-to-moderate pain. The appropriate first-line medication would be __________. A. ibuprofen (Advil) B. acetaminophen with hydrocodone (Vicodin) C. oxycodone (OxyContin) D. oral morphine (Roxanol) A. ibuprofen (Advil) Sallie has been taking 10 mg of prednisone per day for the past six months. She should be assessed for ________. A. gout B. iron deficiency anemia C. osteoporosis D. renal dysfunction C. osteoporosis Henry is eighty-two years old and takes two aspirin every morning to treat the arthritis pain in his back. He states that the aspirin helps him to "get going" each day. Lately, he has had some heartburn from the aspirin. After ruling out an acute GI bleed, what would be an appropriate course of treatment for Henry? A. Add an H2 blocker such as ranitidine to his therapy. B. Discontinue the aspirin and switch him to Vicodin for the pain. C. Decrease the aspirin dose to one tablet daily. D. Have Henry take an antacid fifteen minutes before taking the aspirin each day. A. Add an H2 blocker such as ranitidine to his therapy. Juanita presents to clinic with a complaint of headaches off and on for months. She reports she feels like someone is "squeezing" her head. She occasionally takes Tylenol for the pain but usually just "toughs it out." Initial treatment for tension headache includes asking her to keep a headache diary and a prescription for ________. A. sumatriptan (Imitrex) B. naproxen (Aleve) C. ergotamine (Ergostat) D. Tylenol with codeine (Tylenol #3) B. naproxen (Aleve) Narcotics are exogenous opiates. They act by ______. A. inhibiting pain transmission in the spinal cord B. attaching to receptors in the afferent neuron to inhibit the release of substance P C. blocking neurotransmitters in the midbrain D. increasing beta-lipoprotein excretion from the pituitary B. attaching to receptors in the afferent neuron to inhibit the release of substance P Which of the following statements is true about age and pain? A. Use of drugs that depend heavily on the renal system for excretion may require dosage adjustments in very young children. B. Among the NSAIDs, indomethacin is the preferred drug because of lower adverse effects profiles than other NSAIDs. C. Older adults who have dementia probably do not experience much pain due to loss of pain receptors in the brain. D. Acetaminophen is especially useful in both children and adults because it has no effect on platelets and has fewer adverse effects than NSAIDs. D. Acetaminophen is especially useful in both children and adults because it has no effect on platelets and has fewer adverse effects than NSAIDs. Which of the following is the goal of treatment of acute pain? A. Pain at a tolerable level where patient may return to activities of daily living B. Reduction of pain with a minimum of drug adverse effects C. Reduction or elimination of pain with minimum adverse reactions D. Adequate pain relief without constipation or nausea from the drugs C. Reduction or elimination of pain with minimum adverse reactions Age is a factor in different responses to pain. Which of the following age-related statements about pain is not true? A. Preterm and newborn infants do not yet have functional pain pathways. B. Painful experiences and prolonged exposure to analgesic drugs during pregnancy may permanently alter neuronal organization in the child. C. Increases in pain threshold in older adults may be related to peripheral neuropathies and changes in skin thickness. D. Decreases in pain tolerance are evident in older adults. A. Preterm and newborn infants do not yet have functional pain pathways. Vicky, age fifty-six years, comes to clinic requesting a refill of her Fiorinal (aspirin and butalbital) that she takes for migraines. She has been taking this medication for over two years for migraine and states one dose usually works to abort her migraine. What is the best care for her? A. Switch her to sumatriptan (Imitrex) to treat her migraines. B. Assess how often she is using Fiorinal and refill medication. C. Switch her to a beta-blocker such as propranolol to prevent her migraine. D. Request her to return to the original prescriber of Fiorinal as you do not prescribe butalbital for migraines. B. Assess how often she is using Fiorinal and refill medication. Pain assessment to determine adequacy of pain management is important for all patients. This assessment is done to determine which of the following options? A. If the diagnosis of source of pain is correct B. If the current regimen is adequate or different combinations of drugs and nondrug therapy are required C. If the patient is willing and able to be an active participant in his or her pain management D. All the given options D. All the given options When prescribing any headache therapy, appropriate use of medications needs to be discussed to prevent medication-overuse headaches. The clinical characteristics of medication-overuse headaches include ________. A. headaches increasing in frequency B. headaches increasing in intensity C. headaches recurring when medication wears off D. headaches beginning to "cluster" into a pattern C. headaches recurring when medication wears off When prescribed an opioid analgesic such as acetaminophen and codeine (Tylenol #3), which of the following instructions should the patient follow? A. The medication may cause sedation, so the patient should not drive. B. Constipation is a common side effect, so the patient should increase fluids and fiber. C. The patient should not take any other acetaminophen-containing medications at the same time. D. All the given options are correct. D. All the given options are correct. Chronic pain is a complex problem. Some specific strategies to deal with it include ________. A. telling the patient to "let pain be your guide" to using treatment therapies B. prescribing pain medication on a pro re nata (PRN) basis to keep down the amount used C. scheduling return visits on a regular basis rather than waiting for poor pain control to drive the need for an appointment D. All the given options C. scheduling return visits on a regular basis rather than waiting for poor pain control to drive the need for an appointment Henry presents to clinic with a significantly swollen, painful great toe and is diagnosed with gout. Of the following, which would be the best treatment for Henry? A. High-dose colchicines B. Low-dose colchicines C. High-dose aspirin D. Acetaminophen with codeine B. Low-dose colchicines The Pain Management Contract is appropriate for which of the following cases? A. Patients with a history of chemical dependency or possible inappropriate use of pain medications B. All patients with chronic pain who will require long-term use of opiates C. Patients who have a complex drug regimen D. Patients who see multiple providers for pain control A. Patients with a history of chemical dependency or possible inappropriate use of pain medications Different areas of the brain are involved in specific aspects of pain. The reticular and limbic systems in the brain influence ______. A. the sensory aspects of pain B. the discriminative aspects of pain C. the motivational aspects of pain D. the cognitive aspects of pain C. the motivational aspects of pain Both men and women experience bone loss with aging. The bones most likely to demonstrate significant loss are: 1. Cortical bones 2. Femoral neck bones 3. Cervical vertebrae 4. Pelvic bones 2. Femoral neck bones Bisphosphonates treat or prevent osteoporosis by: 1. Inhibiting osteoclastic activity 2. Fostering bone resorption 3. Enhancing calcium uptake in the bone 4. Strengthening the osteoclastic proton pump 1. Inhibiting osteoclastic activity Prophylactic use of bisphosphonates is recommended for patients with early osteopenia related to long-term use of which of the following drugs? 1. Selective estrogen receptor modulators 2. Aspirin 3. Glucocorticoids 4. Calcium supplements 3. Glucocorticoids Patients with cystic fibrosis are often prescribed enzyme replacement for pancreatic secretions. Each replacement drug has lipase, protease, and amylase components, but the drug is prescribed in units of: 1. Lipase 2. Protease 3. Amylase 4. Pancreatin 1. Lipase Brands of pancreatic enzyme replacement drugs are: 1. Bioequivalent 2. About the same in cost per unit of lipase across brands 3. Able to be interchanged between generic and brand-name products to reduce cost 4. None of the above 2. About the same in cost per unit of lipase across brands When given subcutaneously, how long until neutral protamine Hagedorn insulin begins to take effect (onset of action) after administration? 1. 15 to 30 minutes 2. 60 to 90 minutes 3. 3 to 4 hours 4. 6 to 8 hours 2. 60 to 90 minutes Hypoglycemia can result from the action of either insulin or an oral hypoglycemic. Signs and symptoms of hypoglycemia include: 1. "Fruity" breath odor and rapid respiration 2. Diarrhea, abdominal pain, weight loss, and hypertension 3. Dizziness, confusion, diaphoresis, and tachycardia 4. Easy bruising, palpitations, cardiac dysrhythmias, and coma 3. Dizziness, confusion, diaphoresis, and tachycardia Nonselective beta blockers and alcohol create serious drug interactions with insulin because they: 1. Increase blood glucose levels 2. Produce unexplained diaphoresis 3. Interfere with the ability of the body to metabolize glucose 4. Mask the signs and symptoms of altered glucose levels 4. Mask the signs and symptoms of altered glucose levels Lispro is an insulin analogue produced by recombinant DNA technology. Which of the following statements about this form of insulin is NOT true? 1. Optimal time of preprandial injection is 15 minutes. 2. Duration of action is increased when the dose is increased. 3. It is compatible with neutral protamine Hagedorn insulin. 4. It has no pronounced peak. 2. Duration of action is increased when the dose is increased. The decision may be made to switch from twice daily neutral protamine Hagedorn (NPH) insulin to insulin glargine to improve glycemia control throughout the day. If this is done: 1. The initial dose of glargine is reduced by 20% to avoid hypoglycemia. 2. The initial dose of glargine is 2 to 10 units per day. 3. Patients who have been on high doses of NPH will need tests for insulin antibodies. 4. Obese patients may require more than 100 units per day. 1. The initial dose of glargine is reduced by 20% to avoid hypoglycemia. When blood glucose levels are difficult to control in type 2 diabetes some form of insulin may be added to the treatment regimen to control blood glucose and limit complication risks. Which of the following statements is accurate based on research? 1. Premixed insulin analogues are better at lowering HbA1C and have less risk for hypoglycemia. 2. Premixed insulin analogues and the newer premixed insulins are associated with more weight gain than the oral antidiabetic agents. 3. Newer premixed insulins are better at lowering HbA1C and postprandial glucose levels than long-acting insulins. 4. Patients who are not controlled on oral agents and have postprandial hyperglycemia can have neutral protamine Hagedorn insulin added at bedtime. 3. Newer premixed insulins are better at lowering HbA1C and postprandial glucose levels than long-acting insulins. Metformin is a primary choice of drug to treat hyperglycemia in type 2 diabetes because it: 1. Substitutes for insulin usually secreted by the pancreas 2. Decreases glycogenolysis by the liver 3. Increases the release of insulin from beta cells 4. Decreases peripheral glucose utilization 2. Decreases glycogenolysis by the liver Prior to prescribing metformin, the provider should: 1. Draw a serum creatinine to assess renal function 2. Try the patient on insulin 3. Tell the patient to increase iodine intake 4. Have the patient stop taking any sulfonylurea to avoid dangerous drug interactions 1. Draw a serum creatinine to assess renal function The action of "gliptins" is different from other antidiabetic agents because they: 1. Have a low risk for hypoglycemia 2. Are not associated with weight gain 3. Close ATP-dependent potassium channels in the beta cell 4. Act on the incretin system to indirectly increase insulin production 4. Act on the incretin system to indirectly increase insulin production Sitagliptin has been approved for: 1. Monotherapy in once-daily doses 2. Combination therapy with metformin 3. Both 1 and 2 4. Neither 1 nor 2 3. Both 1 and 2 GLP-1 agonists: 1. Directly bind to a receptor in the pancreatic beta cell 2. Have been approved for monotherapy 3. Speed gastric emptying to decrease appetite 4. Can be given orally once daily 1. Directly bind to a receptor in the pancreatic beta cell Avoid concurrent administration of exenatide with which of the following drugs? 1. Digoxin 2. Warfarin 3. Lovastatin 4. All of the above 4. All of the above Administration of exenatide is by subcutaneous injection: 1. 30 minutes prior to the morning meal 2. 60 minutes prior to the morning and evening meal 3. 15 minutes after the evening meal 4. 60 minutes before each meal daily 2. 60 minutes prior to the morning and evening meal Potentially fatal granulocytopenia has been associated with treatment of hyperthyroidism with propylthiouracil. Patients should be taught to report: 1. Tinnitus and decreased salivation 2. Fever and sore throat 3. Hypocalcemia and osteoporosis 4. Laryngeal edema and difficulty swallowing 2. Fever and sore throat Elderly patients who are started on levothyroxine for thyroid replacement should be monitored for: 1. Excessive sedation 2. Tachycardia and angina 3. Weight gain 4. Cold intolerance 2. Tachycardia and angina Which of the following is not an indication that growth hormone supplements should be discontinued? 1. Imaging indication of epiphyseal closure