Exam (elaborations)
NR 566 FINAL EXAM QUESTIONS AND ANSWERS
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NR 566 FINAL EXAM QUESTIONS AND ANSWERS
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Name: Score:52 Multiple choice questions
Definition 1 of 52
Intravaginal: Estrogens for intravaginal administration are available as inserts, creams, and
vaginal rings. The intravaginal inserts (Imvexxy, Vagifem, Yuvafem), creams (Estrace Vaginal,
Premarin Vaginal), and one of the two available vaginal rings (Estring) are used only for local
effects, primarily treatment of vulval and vaginal atrophy associated with menopause.
The other vaginal ring (Femring) is used for systemic effects (e.g., control of hot flashes and
night sweats) as well as local effects (e.g., treatment of vulval and vaginal atrophy).
Parenteral: Although estrogens are formulated for intravenous (IV) and intramuscular (IM)
administration, use of these routes is rare. IV administration is generally limited to acute,
emergency control of heavy uterine bleeding.
Androgen therapy o Effects ▪ Therapeutic ▪ Adverse o Monitoring Needs
How to respond to missed doses or changing of contraceptive types from one to
another?
Adverse Effect of Selective α1a Blockers
Silodosin (Rapaflo)
Tamsulosin (Flomax)
- Local vs. systemic estrogen options and why one would be chosen over the other
Definition 2 of 52
Dopamine agonist: non-ergot derivative used in early stages of PD. Side effects include
nausea, dizziness, daytime somnolence, insomnia, constipation, weakness, and hallucinations.
Some people have impulse control disorder (compulsive gambling, shopping, binge eating,
and hypersexuality) which occurs depending on dose and about 9 months after patient is on
medication. Few have reported sleep attacks (overwhelming and irresistible sleepiness that
comes on without warning)
PD on exam is Parkinson Disease
o Adverse Effects ▪ Pramipexole
testosterone replacement o administration o patient teaching
treatment of ▪ syphilis
,Definition 3 of 52
Donepezil:
Mild to moderate AD: 5 mg daily. After 4-6 weeks, may increase to 10 mg daily
Severe AD: 10 mg daily. After 3 months, may increase to 23 mg daily
Memantine:
5 mg/day (5 mg once a day), for 1 week or more
• 10 mg/day (5 mg twice a day), for 1 week or more
• 15 mg/day (5 and 10 mg in separate doses), for 1 week or more
• 20 mg/day (10 mg twice a day), for maintenance
ER capsules:
• 7 mg once daily for 1 week or more
• 14 mg once daily for 1 week or more
• 21 mg once daily for 1 week or more
• 21 mg once daily for maintenance
Reduce dosage in patients with moderate renal impairment and discontinue in patients with
severe renal impairment
Management of Alzheimer Disease o Administration Considerations
▪ Rivastigmine
Management of seizures o Which medication would be the safest choice for someone on
an oral contraceptive?
Management of Alzheimer Disease Dosing considerations ▪ Donepezil ▪ Memantine
Management of seizures o Patient teaching & Drug Interactions ▪ Phenytoin
Definition 4 of 52
Contraindications to use include current pregnancy, history of thromboembolus, breast
cancer, and women over 35 years of age who continue to smoke tobacco. Use with caution in
women with diabetes, hypertension, and cardiac disease.
contraindications For drugs • Sumatriptan
Additional Notes
o Contraindications for Oral Contraceptives
Contraindications for drugs • Sumatriptan
,Definition 5 of 52
Administration
Transdermal Patches - male hypogonadism
Applied daily to the upper arm, back, or abdomen.
Testosterone gel is also available.
o Patient Teaching
Transdermal patches:
good hand washing is required after application
cover application site with clothing after medication has dried
wash the application site before skin-to-skin contact with another person
females and children may experience negative effects from exposure to testosterone
if cross contamination occurs, wash the affected area with soap and water to prevent
absorption
O adverse effects ▪ pramipexole
Adverse Effect of Phosphodiesterase-5 Inhibitor
Tadalafil (Cialis)
▪Time to achieve ▪ Patient education/Provider response ▪ Assessment for therapeutic
effect
Testosterone replacement o Administration o Patient Teaching
Treatment of BPH o Know examples of drugs in each major drug class
, Definition 6 of 52
Hypotension, fainting, dizziness, somnolence, and nasal congestion (from blocking α1
receptors on blood vessels)
alfuzosin do not combine with CYP3A4—such as erythromycin, itraconazole, nefazodone, and
HIV protease inhibitors (e.g., ritonavir)—can dramatically increase levels. doxazosin do not take
if pregnant and do not give to patients older than 65.
What effect does CYP450 inhibitors or inducers have on OCs? o Recall examples of
CYP450 inhibitors and inducers from NR565 (Chapter 4 in textbook) o How does this
impact prescribing of OCs?
Adverse Effect of α1a Blocker/5-α-Reductase Inhibitor
Tamsulosin/dutasteride (Jalyn) Therapeutic Effects ▪ Time to achieve ▪ Patient
education/Provider response ▪ Assessment for therapeutic effect
Adverse Effect of Nonselective α1 Blockers
Alfuzosin (Uroxatral, Xatral)
Doxazosin (Cardura, Cardura XL)
Therapeutic Effects ▪ Time to achieve ▪ Patient education/Provider response ▪
Assessment for therapeutic effect
Adverse Effect of Selective α1a Blockers
Silodosin (Rapaflo)
Tamsulosin (Flomax)
Definition 7 of 52
Dyskinesia (disorders of movement), tremors at rest, rigidity,postural instability, bradykinesia.
Prevention of osteoporosis with hormone replacement therapy
PD on exam is Parkinson Disease
O adverse effects ▪ pramipexole
Drugs that interact with Oral Contraceptives?
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