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NSG 533 ADVANCED PHARMACOLOGY TEST 1 LATEST ACTUAL EXAM 100 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES $12.49   Add to cart

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NSG 533 ADVANCED PHARMACOLOGY TEST 1 LATEST ACTUAL EXAM 100 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES

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NSG 533 ADVANCED PHARMACOLOGY TEST 1 LATEST ACTUAL EXAM 100 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES EP is a 38-year-old female patient that comes in for diabetes education and management. She was diagnosed 12 years ago and states lately she is not able to control her diet altho...

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  • September 18, 2024
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  • 2024/2025
  • Exam (elaborations)
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  • 2024/2025
  • 2024/2025
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EmillyCharlotte
TITLE: EMILLYCHARLOTTE 2024/2025 ACADEMIC PERIOD
OWNER: EMILLYCHARLOTTE
COPYRIGHT STATEMENT: ©2024 EMILLYCHARLOTTE. ALL RIGHTS RESERVED
FIRST PUBLISHED: SEPTEMBER 2024

NSG 533 ADVANCED PHARMACOLOGY TEST 1 LATEST 2024-2025
ACTUAL EXAM 100 QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES


EP is a 38-year-old female patient that comes in for diabetes education and

management. She was diagnosed 12 years ago and states lately she is not able to

control her diet although she continues a 1600 calorie diet with appropriate daily

carbohydrate intake (per dietitian prescription) and walks 40 minutes every day of the

week. She states compliance with all medications. She denies any history of

hypoglycemia despite being able to identify signs and symptoms and describe

appropriate treatment strategies.

PMH: T2DM, HTN, obesity, depression, s/p thyroidectomy due to thyroid cancer

FmHx: Noncontributory

SHx: (−) Smoking, alcohol use, past marijuana use while in high school

Medications: Metformin 850 mg tid, glipizide 20 mg bid, lisinopril 20 mg daily, sertraline

100 mg daily, multivitamin daily

Vitals: BP 128/82 mg Hg; P 72 beats/min; BMI 31 m/kg2

Laboratory test results: Na 134 mEq/L, K 5.4 mEq/L, Cl 106 mEq/L, BUN - Answer✔️✔️-

Exenatide - Exenatide (Bydureon) once weekly has been able to demonstrate weight

loss and decrease A1C% by 0.7% to 1.2% in clinical trials; however it is contraindicated

for EP due to the self-reported history of thyroid cancer.

,TITLE: EMILLYCHARLOTTE 2024/2025 ACADEMIC PERIOD
OWNER: EMILLYCHARLOTTE
COPYRIGHT STATEMENT: ©2024 EMILLYCHARLOTTE. ALL RIGHTS RESERVED
FIRST PUBLISHED: SEPTEMBER 2024
Dapagliflozin - Dapagliflozin (Farxiga) is contraindicated in this patient due to

hyperkalemia which could be made worse by this drug. The package insert does not

indicate a specific potassium concentration cut off to no longer use this medication;

however, there are better choices in this patient.

Sitagliptin - Sitagliptin (Januvia) is able to obtain an A1C goal of less than 7% based on

clinical trials and currently the patient does not have any cautionary objective measures

to not use this medication. DPP-IV inhibitors are weight neutral. DPP-IV inhibitors can

be used in patients taking sulfonylureas; however, it may be recommended to reduce or

stop the sulfonylurea dose.

Acarbose - Acarbose (Precose) is not recommended for initial management and is

associated with significant GI side effects. More information would be needed regarding

fasting and post-prandial numbers. In addition, adding acarbose would only lower A1c

by 0.8% at best and therefore would not achieve the desired A1C goal of <7%

JR is a 68-year-old African American man with a new diagnosis of T2DM. He was

classified as having prediabetes (at risk for developing diabetes) 5 years before the

diagnosis and has a strong family history of type 2 diabetes. JR's blood pressure was

150/92 mm Hg. His laboratory results revealed an A1C of 8.1%, normal cholesterol

panel, and normal renal/hepatic function were noted with today's laboratory test results.

Past medical history: Hypertension (diagnosed 4 y ago) Hyperlipidemia (diagnosed 2 y

ago) Pancreatitis (idiopathic) (acute hospitalization 3 y ago)

Family history: Type 2 diabetes

Medication: HCTZ 25 mg daily, simvastatin 10 mg daily

,TITLE: EMILLYCHARLOTTE 2024/2025 ACADEMIC PERIOD
OWNER: EMILLYCHARLOTTE
COPYRIGHT STATEMENT: ©2024 EMILLYCHARLOTTE. ALL RIGHTS RESERVED
FIRST PUBLISHED: SEPTEMBER 2024
Allergies: SMZ/TMP

Vitals: BP: 150/92 mm Hg P: 78 beats/min RR: 12 rpm Waist Circumference: 46 in

Weight: 267 lb Height: 5 ′ 6 ″ BMI: 43.1 kg/m 2




Despite improvements in the past six weeks due to lifestyle changes and exercise, drug

therapy is to be started for JR's diabet - Answer✔️✔️-Metformin is the drug of choice

recommended for most patients with diabetes in addition to lifestyle modifications

assuming no contraindications or intolerabilities are present upon evaluation. Metformin

has also shown to provide positive weight neutral/loss effects in obese patients. It is

crucial to know the renal status of patients commencing metformin therapy to limit the

risk of lactic acidosis (JR is without contraindication).

Since his entry A1C is >7.5%, dual therapy is indicated. There are several potential

choices. The second step can be a dipeptidyl peptidase-4 inhibitor, it can be a

glucagon-like peptide-1 (GLP-1) receptor agonist, it can be a TZD, it can be a

sulfonylurea agent, it can be a SGLT2 inhibitor, or it could be basal insulin. Anything

next can be tried depending on what suits the circumstance

DPP4 inhibitors are weight neutral bet relatively benign side effect profile. Sitagliptin has

been associated with case reports of pancreatitis, so this specific agent should be

avoided. $$$

GLP-1 analog and has data to support an A1C reduction necessary to gain glycemic

control and may assist with weight loss goals for this patient. New information suggests

, TITLE: EMILLYCHARLOTTE 2024/2025 ACADEMIC PERIOD
OWNER: EMILLYCHARLOTTE
COPYRIGHT STATEMENT: ©2024 EMILLYCHARLOTTE. ALL RIGHTS RESERVED
FIRST PUBLISHED: SEPTEMBER 2024
these agents may provide benefits in those with ASCVD. JR has a past history of

pancreatitis and GLP-1 analogs are not recommended due to this contraindication

TZDs have data to support an A1C reduction necessary to gain glycemic control, but

are associated with weight gain, negative effects on lipids and increased risk of fracture.

Until recently, TZDs have also been linked to increased CV events and use has fallen

out of favor

Sulfonylureas provide excellent A1C lowering, but are also associated with weight gain.

They also have the potential to cause hypoglycemia, so patient education is crucial.

Because of his allergies to "sulfa", use would be contr

A patient with type 1 diabetes reports taking propranolol for hypertension. What concern

does this information present for the provider? - Answer✔️✔️-A patient with Type 1 DM is

insulin dependent for glucose control and at high risk for hypoglycemic episodes.

Propanolol causes prolonged hypoglycemic episodes. Needs to switch to ACE or ARB.

A provider teaches a patient who has been diagnosed with hypothyroidism about a new

prescription for levothyroxine. Which statement by the patient indicates a need for

further teaching?

a. "I should not take heartburn medication without consulting my provider first."

b. "I should report insomnia, tremors, and an increased heart rate to my provider."

c. "If I take a multivitamin with iron, I should take it 4 hours after the levothyroxine."

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