1. Question :
The drug recommended as primary prevention of osteoporosis in men over seventy years is:
Question 2. Question :
Alterations in drug metabolism among Asians may lead to:
Slower metabolism of antidepressants, requiring lower doses
Faster metabolism of neuroleptics, requiring higher doses
Altered metabolism of omeprazole, requiring higher doses
Slower metabolism of alcohol, requiring higher doses
Question 3. Question :
Some research supports that testosterone replacement therapy may be indicated in which of the following diagnoses in men?
Age-related decrease in cognitive functioning
Decreased muscle mass in aging men
All of the above
Question 4. Question :
The chemicals that promote the spread of pain locally include _________.
Question 5. Question :
Registers manufacturers and prescribes controlled substances
Regulates NP prescribing at the state level
Sanctions providers who prescribe drugs off-label
Provides prescribers with a number they can use for insurance billing
Question 6. Question :
The trial period to determine effective anti-inflammatory activity when starting a patient on aspirin for RA is _____.
four to six days
Question 7. Question :
The route of excretion of a volatile drug will likely be:
The bile and feces
Question 8. Question :
Compelling indications for an ACE inhibitor as treatment for hypertension based on clinical trials include:
Renal parenchymal disease
Question 9. Question :
The American Diabetic Association has recommended which of the following tests for ongoing management of diabetes?
Fasting blood glucose
Thyroid function tests
Question 10. Question :
Question 11. Question :
The goals of therapy when prescribing HRT include reducing:
Risk of stroke or other thromboembolic event
Breast cancer risk
Question 12. Question :
Patients who have angina, regardless of class, who are also diabetic should be on:
Calcium channel blockers
Question 13. Question :
The New York Heart Association and the Canadian Cardiovascular Society have described grading criteria for levels of angina. Angina that occurs with unusually strenuous activity or on walking or climbing stair after meals is:
Question 14. Question :
Patients with allergic rhinitis may benefit from a prescription of:
OTC cromolyn nasal spray (Nasalcrom)
Any of the above
Question 15. Question :
Kyle has Crohn’s disease and has a documented folate deficiency. Drug therapy for folate deficiency anemia is:
Oral folic acid 1 to 2 mg/day
Oral folic acid 1 gm/day
IM folate weekly for at least six months
Oral folic acid 400 mcg daily
Question 16. Question :
The treatment for vitamin B12 deficiency is:
1,000 mcg daily of oral cobalamin
2 gm/day of oral cobalamin
100 mcg/day vitamin B12 IM
500 mcg/dose nasal cyanocobalamin two sprays once a week
Question 17. Question :
Nonadherence is especially common in drugs that treat asymptomatic conditions, such as hypertension. One way to reduce the likelihood of nonadherence to these drugs is to prescribe a drug that:
Has a short half-life so that missing one dose has limited effect
Requires several dosage titrations so that missed doses can be replaced with lower doses to keep costs down
Has a tolerability profile with less of the adverse effects that are considered “irritating,” such as nausea and dizziness
Must be taken no more than twice a day
Question 18. Question :
Type II diabetes is a complex disorder involving:
Absence of insulin production by the beta cells
A suboptimal response of insulin-sensitive tissues in the liver
Increased levels of GLP in the postprandial period
Too much fat uptake in the intestine
Question 19. Question :
Metformin is a primary choice of drug to treat hyperglycemia in type II diabetes because it:
Substitutes for insulin usually secreted by the pancreas
Decreases glycogenolysis by the liver
Increases the release of insulin from beta cells
Decreases peripheral glucose utilization
Question 20. Question :
Gender differences between men and women in pharmacokinetics include:
More rapid gastric emptying so that drugs absorbed in the stomach have less exposure to absorption sites
Higher proportion of body fat so that lipophilic drugs have relatively greater volumes of distribution
Increased levels of bile acids so that drugs metabolized in the intestine have higher concentrations
Slower organ blood flow rates so that drugs tend to take longer to be excreted
Question 21. Question :
If not chosen as the first drug in hypertension treatment, which drug class should be added as the second step because it will enhance the effects of most other agents?
Calcium channel blockers
Question 22. Question :
A nineteen-year-old male was started on risperidone. Monitoring for risperidone includes observing for common side effects, including:
Bradykinesia, akathisia, and agitation
Excessive weight gain
Potentially fatal agranulocytosis
Question 23. Question :
Levetiracetam has known drug interactions with:
Few, if any, drugs
Question 24. Question :
When the total daily insulin dose is split and given twice daily, which of the following rules may be followed?
Give two-thirds of the total dose in the morning and one-third in the evening.
Give 50% of an insulin glargine dose in the morning and 50% in the evening.
Give long-acting insulin in the morning and short-acting insulin at bedtime.
Question 25. Question :
Which of the following factors may adversely affect a patient’s adherence to a therapeutic drug regimen?
Complexity of the drug regimen
Patient’s perception of the potential adverse effects of the drugs
Both A and B
Neither A nor B
Question 26. Question :
The time required for the amount of drug in the body to decrease by 50% is called:
Phase II metabolism
Reduced bioavailability time
Question 27. Question :
Drugs that are absolutely contraindicated in lactating women include:
Selective serotonin reuptake inhibitors
Antiepileptic drugs such as carbamazepine
Antineoplastic drugs such as methotrexate
All of the above
Question 28. Question :
Tobie presents to clinic with moderate acne. He has been using OTC benzoyl peroxide at home with minimal improvement. A topical antibiotic (clindamycin) and a topical retinoid adapalene (Differin) are prescribed. Education of Tobie would include which one of the following instructions?
He should see an improvement in his acne within the first two weeks of treatment.
If there is no response in a week, he should double the daily application of adapalene (Differin).
He may see an initial worsening of his acne that will improve in six to eight weeks.
Adapalene may cause bleaching of clothing.
Question 29. Question :
Martin is a sixty-year-old with hypertension. The first-line decongestant to be prescribed would be:
Question 30. Question :
A woman who is pregnant and has hyperthyroidism is best managed by a specialty team that will most likely treat her with:
Nothing; treatment is best delayed until after her pregnancy ends.
Question 31. Question :
A twenty-four-year-old male received multiple fractures in a motor vehicle accident that required significant amounts of opioid medication to treat his pain. He is at risk for Type __ ADR when he no longer requires the opioids.
Question 32. Question :
Second-generation antihistamines such as loratadine (Claritin) are prescribed for seasonal allergies because they:
Are more effective than first-generation antihistamines
Are less sedating than first-generation antihistamines
Are prescription products and, therefore, are covered by insurance
Can be taken with CNS sedatives, such as alcohol
Question 33. Question :
Steady state is:
The point on the drug concentration curve when absorption exceeds excretion
When the amount of drug in the body remains constant
When the amount of drug in the body stays below the minimum toxic concentration (MTC)
All of the above
Question 34. Question :
Jayla is a nine-year-old who has been diagnosed with migraines for almost two 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?
Prescribe amitriptyline (Elavil) daily, start at a low dose and increase the dose slowly every two weeks until effective in eliminating migraines.
Encourage her mother to give her Excedrin Migraine (aspirin, acetaminophen, and caffeine) at the first sign of a headache to abort the headache.
Prescribe propranolol (Inderal) to be taken daily for at least three months.
Explain that it is rare for a nine-year-old to get migraines and that she needs an MRI to rule out a brain tumor.
Question 35. Question :
Josie is a five-year-old who presents to the clinic with a forty-eight-hour history of nausea, vomiting, and some diarrhea. She is unable to keep fluids down, and her weight is 4 pounds less than her last recorded weight. Besides intravenous (IV) fluids, her exam warrants the use of an antinausea medication. Which of the following would be the appropriate drug to order for Josie?
Question 36. Question :
Long-term use of PPIs may lead to:
Hip fractures in at-risk persons
Vitamin B6 deficiency
All of the above
Question 37. Question :
Many patients self-medicate with antacids. Which patients should be counseled to not take calcium carbonate antacids without discussing with their providers or a pharmacist first?
Patients with kidney stones
Patients with heartburn
IN Postmenopausal women
0 of 2.5
Question 38. Question :
Beta blockers treat hypertension because they:
Reduce peripheral resistance.
Vasoconstrict coronary arteries.
Reduce angiotensin II production.
Question 39. Question :
Precautions that should be taken when prescribing controlled substances include:
Faxing the prescription for a Schedule II drug directly to the pharmacy
Using tamper-proof papers for all prescriptions written for controlled drugs
Keeping any presigned prescription pads in a locked drawer in the clinic
Using only numbers to indicate the amount of drug to be prescribed
Question 40. Question :
The tricyclic antidepressants should be prescribed cautiously in patients with:
Question 41. Question :
An ACE inhibitor and what other class of drug may reduce proteinuria in patients with diabetes better than either drug alone?
Nondihydropyridine calcium channel blockers
Angiotensin II receptor blockers
Question 42. Question :
Metoclopramide improves GERD symptoms by:
Reducing acid secretion
Increasing gastric pH
Increasing lower esophageal tone
Decreasing lower esophageal tone
Question 43. Question :
Patient education regarding prescribed medication includes:
Instructions written at the high school reading level
Discussion of expected ADRs
How to store leftover medication such as antibiotics
Verbal instructions always in English
Question 44. Question :
If a patient with H. pylori positive PUD fails first-line therapy, the second-line treatment is:
A PPI BID plus metronidazole plus tetracycline plus bismuth subsalicylate for fourteen days
Testing H. pylori for resistance to common treatment regimens
A PPI plus clarithromycin plus amoxicillin for fourteen days
A PPI and levofloxacin for fourteen days
Question 45. Question :
A patient with a COPD exacerbation may require:
Doubling of inhaled corticosteroid dose
Systemic corticosteroid burst
Continuous inhaled beta 2 agonists
Question 46. Question :
Angela is a black woman who has heard that women of African descent do not need to worry about osteoporosis. What education would you provide Angela about her risk?
She is ; black women do not have much risk of developing osteoporosis due to their dark skin.
Black women are at risk of developing osteoporosis due to their lower calcium intake as a group.
If she doesn’t drink alcohol, her risk of developing osteoporosis is low.
If she has not lost more than 10% of her weight lately, her risk is low.
Question 47. Question :
The role of the nurse practitioner in the use of herbal medication is to:
Maintain competence in the prescribing of common herbal remedies.
Recommend common OTC herbs to patients.
Educate patients and guide them to appropriate sources of care.
Encourage patients to not use herbal therapy due to the documented dangers.
Question 48. Question :
Ray has been diagnosed with hypertension, and an ACE inhibitor is determined to be needed. Prior to prescribing this drug, the nurse practitioner should assess for:
Decreased renal function
Inability to concentrate
Question 49. Question :
Long-acting beta-agonists received a black box warning from the US Food and Drug Administration due to the:
Risk of life-threatening dermatological reactions
Increased incidence of cardiac events when long-acting beta-agonists are used
Increased risk of asthma-related deaths when long-acting beta-agonists are used
Risk for life-threatening alterations in electrolytes
Question 50. Question :
Off-Label prescribing is:
Regulated by the FDA
Illegal by NPs in all states (provinces)
Legal if there is scientific evidence for the use
Regulated by the DEA
Question 51. Question :
He should increase his increase his carbohydrate intake during times of exercise intake during times of exercise.
Each brand of insulin is equal in bioavailability, so buy the least expensive.
Alcohol produces hypoglycemia and can help control his diabetes when taken in small amounts.
If he does not want to learn to give himself injections, he may substitute an oral hypoglycemic to control his diabetes.
Question 52. Question :
Prior to starting antidepressants, patients should have laboratory testing to rule out:
Low estrogen levels
0 of 2.5
Question 53. Question :
What impact does developmental variation in renal function has on prescribing for infants and children?
Lower doses of renally excreted drugs may be prescribed to infants younger than six months
Higher doses of water-soluble drugs may need to be prescribed due to increased renal excretion
Renal excretion rates have no impact on prescribing
Parents need to be instructed on whether drugs are renally excreted or not
Question 54. Question :
All diabetic patients with hyperlipidemia should be treated with:
3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors
Fibric acid derivatives
Question 55. Question :
Treatment failure in patients with PUD associated with H. pylori may be due to:
Overuse of PPIs
All of the above
Question 56. Question :
To improve positive outcomes when prescribing for the elderly, the NP should:
Assess cognitive functioning in the elder
Encourage the patient to take a weekly “drug holiday” to keep drug costs down
Encourage the patient to cut drugs in half with a knife to lower costs
All of the above options are
Question 57. Question :
Erik presents with a golden-crusted lesion at the site of an insect bite consistent with impetigo. His parents have limited finances and request the least expensive treatment. Which medication would be the best choice for treatment?
Bacitracin and polymixin B (generic double antibiotic ointment)
Oral cephalexin (Keflex)
Question 58. Question :
Nonselective beta blockers and alcohol create serious drug interactions with insulin because they:
Increase blood glucose levels.
Produce unexplained diaphoresis.
Interfere with the ability of the body to metabolize glucose.
Mask the signs and symptoms of altered glucose levels.
Question 59. Question :
Infants and young children are at higher risk of ADRs due to:
Immature renal function in school-age children
Lack of safety and efficacy studies in the pediatric population
Children’s skin being thicker than adults, requiring higher dosages of topical medication
Infant boys having a higher proportion of muscle mass, leading to a higher volume of distribution
Question 60. Question :
Warfarin resistance may be seen in patients with VCORC1 mutation, leading to:
Toxic levels of warfarin building up
Decreased response to warfarin
Increased risk for significant drug interactions with warfarin
Less risk of drug interactions with warfarin
Question 61. Question :
Jose is a twelve-year-old overweight child with a total cholesterol level of 180 mg/dL and LDL of 125 mg/dL. Along with diet education and recommending increased physical activity, a treatment plan for Jose would include ____ with a reevaluation in six months.
bile acid-binding resins
Question 62. Question :
A potentially life-threatening adverse response to ACE inhibitors is angioedema. Which of the following statements is true about this adverse response?
Swelling of the tongue and hoarseness are the most common symptoms.
It appears to be related to a decrease in aldosterone production.
The presence of a dry, hacky cough indicates a high risk for this adverse response.
Because it takes time to build up a blood level, it occurs after being on the drug for about one week.
Question 63. Question :
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?
Naratriptan will interact with antidepressants, including selective s
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