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Advanced Pharmacology for Prescribers 1st Edition by Kayingo - Ch. 1-36
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Advanced Pharmacology for Prescribers 1st Edition by Kayingo - Ch. 1-36
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Advanced Pharmacology for Prescribers 1st Edition by Kayingo - Ch. 1-36
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Advanced Pharmacology for Prescribers 1st Edition by Kayingo - Ch. 1-36
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NURS 6521 Advanced Pharmacology Final Exam 2020
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Test Bank: Advanced Pharmacology for Prescribers 1stEdition by Kayingo - Ch. 1-36, 9780826195463, with
Rationales
The American Diabetic Association has recommended which of the following tests for ongoing
management of diabetes? - ANSWER: HbA1C
A patient who has migraine headaches takes sumatriptan as abortive therapy. The patient tells the
primary care nurse practitioner (NP) that the sumatriptan is effective for stopping symptoms but that
the episodes are occurring three to four times per month. The NP should consider the addition of: -
ANSWER: topiramate.
A patient comes to the clinic concerned about possible migraine headaches. The primary care NP
conducts a history and physical examination, and the patient describes vise-like pressure in the back
of the head that occurs almost daily during the work week. The NP should recommend: - ANSWER:
acetaminophen.
A patient comes to the clinic and reports recurrent headaches. The patient has a headache diary,
which reveals irritability and food cravings followed the next day by visual disturbances and unilateral
right-sided headache, nausea, and photophobia lasting 2 to 3 days. The NP should recognize these
symptoms as _____ migraine. - ANSWER: classic
patient who has migraine headaches tells the primary care NP that drinking coffee and taking
nonsteroidal antiinflammatory drugs (NSAIDs) seems to help with discomfort. The NP should tell the
patient that: - ANSWER: this combination can lead to longer lasting headache pain.
A patient takes rizatriptan (Maxalt) to abort migraine headaches but tells the primary care NP that the
headaches have become more frequent since a promotion at work. The NP's initial response should
be to: - ANSWER: stress the importance of establishing new routines.
A primary care NP prescribes sumatriptan for abortive treatment of migraine headaches. The patient
returns to the clinic 1 month later to report increased frequency of the headaches. The NP should: -
ANSWER: ask the patient how often the sumatriptan is used each week.
A patient who has migraine headaches without an aura reports difficulty treating the migraines in
time because they come on so suddenly. The patient has been using over-the-counter NSAIDs. The
primary care NP should prescribe: - ANSWER: sumatriptan (Imitrex).
A patient who has mild to moderate migraine headaches has severe nausea and vomiting with each
episode. For the best treatment of this patient, the primary care NP should prescribe: - ANSWER:
triptan nasal spray.
A patient who has migraine headaches usually has two to three severe migraines each month. The
patient has been using a triptan nasal spray but reports little relief and is concerned about missing so
many days of work. The primary care NP should consider: - ANSWER: an injectable triptan plus an oral
corticosteroid.
,A patient who experiences migraines characterized by unilateral motor and sensory symptoms tells
the primary care NP that despite abortive therapy with a triptan, the frequency of episodes has
increased to three or four times each month. The NP - ANSWER: prescribe an anticonvulsant such as
topiramate.
A patient who is diagnosed with migraine headaches has a history of cardiovascular disease and
hypertension. The NP should prescribe: - ANSWER: cyproheptadine (Periactin).
A patient reports frequent headaches to the primary NP. The patient describes the headaches as
unilateral and moderate in intensity, accompanied by nausea, vomiting, and photophobia. There is no
aura, and the headaches generally last 24 to 48 hours. The NP should: - ANSWER: recognize these as
classic migraines and order sumatriptan (Imitrex).
Paige has a history of chronic migraines and would benefit from preventative medication. Education
regarding migraine preventive medication includes: - ANSWER: The goal of treatment is to reduce
migraine occurrence by 50%
A first-line drug for abortive therapy in simple migraine is: - ANSWER: Naproxen (Aleve)
Vicky, age 56 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 2 years for migraine and states one
dose usually works to abort her migraine. What is the best care for her? - ANSWER: Assess how often
she is using Fiorinal and refill medication
When prescribing ergotamine suppositories (Wigraine) to treat acute migraine, patient education
would include: - ANSWER: They may need premedication with an antinausea medication
Migraines in pregnancy may be safely treated with: - ANSWER: Acetaminophen with codeine (Tylenol
#3)
Xi, a 54-year-old female, has a history of migraine that does not respond well to OTC migraine
medication. She is asking to try Maxalt (rizatriptan) because it works well for her friend. Appropriate
decision making would be: - ANSWER: Prescribe Maxalt and arrange to have her observed in the clinic
or urgent care with the first dose
Kelly is a 14 year old who presents to clinic with a classic migraine. She says she is having a headache
two to three times a month. The initial plan would be: - ANSWER: Prescribe NSAIDs as abortive
therapy and have her keep a headache diary to identify her triggers
Jayla is a 9 year old who has been diagnosed with migraines for almost 2 years. She is missing up to a
week of school each month. Her headache diary confirms she averages four or five migraines per
month. Which of the following would be appropriate? - ANSWER: Prescribe propranolol (Inderal) to
be taken daily for at least 3 months
Amber is a 24 year old who has had migraines for 10 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: - ANSWER: A.Naratriptan will interact with antidepressants,
including SSRIs 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
there is preventive therapy available
C.
Pregnancy is contraindicated when taking a triptan
When prescribing for migraine, patient education includes: - ANSWER: Stress reduction and regular
sleep are integral to migraine treatment
, Juanita presents to clinic with a complaint of headaches off and on for months. She reports they feel
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: - ANSWER: Naproxen (Aleve)
Nonpharmacologic therapy for tension headaches includes: - ANSWER: A. Biofeedback
B. Stress management
C.Massage therapy
James has been diagnosed with cluster headaches. Appropriate acute therapy would be: - ANSWER:
Oxygen 100% for 15 to 30 minutes
Preventative therapy for cluster headaches includes: - ANSWER: Ergotamine nightly before bed
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: - ANSWER: Headaches recur when medication wears off
Antonia is a 3 year old who has a history of status epilepticus. Along with her routine antiseizure
medication, she should also have a home prescription for____ to be used for an episode of status
epilepticus. - ANSWER: Rectal diazepam (Diastat)
Rabi is being prescribed phenytoin for seizures. Monitoring includes: - ANSWER: Assessing for
phenytoin hypersensitivity syndrome 3 to 8 weeks after starting treatment
Dwayne has recently started on carbamazepine to treat seizures. He comes to see you and you note
that while his carbamazepine levels had been in the therapeutic range, they are now low. The
possible cause for the low carbamazepine levels include: - ANSWER: Carbamazepine auto-induces
metabolism, leading to lower levels in spite of good compliance
Carbamazepine has a Black Box warning due to life-threatening: - ANSWER: Dermatologic reaction,
including Steven's Johnson and toxic epidermal necrolysis
Long-term monitoring of patients who are taking carbamazepine includes: - ANSWER: Complete blood
count every 3 to 4 months
Six-year-old Lucy has recently been started on ethosuximide (Zarontin) for seizures. She should be
monitored for: - ANSWER: Blood dyscrasias, which are uncommon but possible
Selma, who is overweight, recently started taking topiramate for seizures and at her follow-up visit
you note she has lost 3 kg. The appropriate action would be: - ANSWER: Reassure her that this is a
normal side effect of topiramate and continue to monitor her weight
Monitoring of a patient on gabapentin to treat seizures includes: - ANSWER: Recording seizure
frequency, duration, and severity
Scott's seizures are well controlled on topiramate and he wants to start playing baseball. Education
for Scott regarding his topiramate includes: - ANSWER: He should monitor his temperature and ability
to sweat in the heat while playing
Cara is taking levetiracetam (Keppra) to treat seizures. Routine education for levetiracetam includes
reminding her: - ANSWER: To not abruptly discontinue levetiracetam due to risk for withdrawal
seizures
Levetiracetam has known drug interactions with: - ANSWER: Few, if any, drugs
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