NURS 6521N Advanced Pharmacology

1. Black cohosh is an herb that is commonly used for:
   • Selected Answer: Menopausal symptoms (correct answer)
2. A 6-month-old child has developed skin irritation due to an allergic reaction. He has been prescribed a topical skin ointment. The nurse will consider which of the following before administering the drug?
   • Selected Answer: That the infant’s skin has greater permeability than that of an adult (correct answer)
3. A Nurse Practitioner is caring for a 10-year-old boy who complains of chronic headaches. His mother reports that she gives him Tylenol at least three times a day. Which of the following will the nurse work with the physician to evaluate?
   • Selected Answer: Hepatic function (correct answer)
4. A nurse practitioner has administered filgrastim to a diverse group of patients in recent months. Which of the following patients should the nurse observe for extremely elevated white blood cell counts following administration of the drug?
   • Selected Answer: A 19-year-old male receiving radiotherapy (correct answer)
5. A 51-year-old female patient has been receiving doxorubicin (Adriamycin) for metastatic breast cancer. Her medical record indicates she has cardiomyopathy and a cumulative dose of 300 mg/m2 of doxorubicin. Which of the following measures would help limit the severity of the cardiomyopathy in this patient?
   • Selected Answer: The use of dexrazoxane in conjunction with doxorubicin (correct answer)
6. Women who are prescribed progestin-only contraception need education regarding which common adverse drug effect?
   • Selected Answer: Irregular vaginal bleeding for the first few months (correct answer)
7. A patient has endocarditis and is taking gentamicin. The Nurse Practitioner will be sure to monitor which of the following?
   • Selected Answer: Potassium level
8. A 19-year-old patient reports to a clinic with vaginal discharge with a foul odor. A microscopic exam reveals trichomonas vaginalis. The nurse practitioner is aware that:
   • Selected Answer: Asymptomatic women are diagnosed with trichomoniasis by a routine pap smear.
9. A 59-year-old man with a recent history of erectile dysfunction has been assessed and prescribed sildenafil (Viagra). When providing patient education to this man, the nurse should tell him which of the following?
   • Selected Answer: “You might find that your face becomes flushed or you get a headache after you take Viagra.” (correct answer)
10. A patient with chronic heart failure has begun treatment with epoetin alfa, which she will receive in her own home from a home health nurse. The nurse should teach the patient to supplement this treatment with a diet that is high in:
    • Selected Answer: Iron-rich foods such as beans and leafy green vegetables. (correct answer)
11. A patient is receiving long-term clindamycin therapy for a life-threatening infection. The nurse will begin by monitoring this drug therapy by obtaining:
    • Selected Answer: A baseline complete blood count. (correct answer)
12. A 35-year-old woman is on a weight-loss program and is to begin taking sibutramine (Meridia). After baseline physical data are obtained, the nurse will assess the patient’s childbearing potential. The nurse will inform the patient that during sibutramine therapy she should:
    • Selected Answer: Use adequate contraception. (correct answer)
13. A 71-year-old man has just been prescribed finasteride (Proscar). Which of the following complaints by this patient most likely indicated a need for this drug?
    • Selected Answer: “Lately, I have to get up three or four times a night to go to the bathroom.” (correct answer)
14. A patient is receiving radiotherapy for an overactive thyroid gland and asks whether her milk is safe for her baby. If her treatment cannot be discontinued, what should the nurse recommend?
    • Selected Answer: Advise her to discard her breast milk in a biohazard container, as it is unsafe for the baby. (correct answer)
15. A pregnant patient who has diabetes has been admitted to the hospital to begin labor. Since the patient has diabetes, the physician has decided to use oxytocin (Pitocin) to initiate labor contractions. When talking to the patient about the adverse effects of the drug, the nurse should understand that the most common adverse effects of the drug include:
    • Selected Answer: Uterine tachysystole. (correct answer)
16. A male patient has been brought to the emergency department during an episode of status epilepticus. Diazepam is to be administered intravenously. The APRN will be sure to:
    • Selected Answer: Avoid the small veins in the dorsum of the hand or the wrist. (correct answer)
17. A Nurse Practitioner works at a weight management clinic. To which of the following overweight patients could the nurse safely administer dextroamphetamine?
    • Selected Answer: A 48-year-old Caucasian man who has adult-onset diabetes. (correct answer)
18. All insects have an FDA black box warning regarding:
    • Selected Answer: Potential for causing life-threatening G.I. bleed.
19. A Nurse Practitioner is explaining the use of acyclovir therapy to a 72-year-old man. Nephrotoxicity is discussed as a major adverse effect in older patients. To minimize the risk of the patient developing this adverse effect, the nurse will advise him to:
    • Selected Answer: Stay well hydrated by drinking at least eight 8-oz glasses of water daily. (correct answer)
20. A Nurse Practitioner is reviewing the prepregnancy medication regimen of a patient who has just had a positive pregnancy test. The nurse should be aware of which of the following changes in pharmacokinetics that accompanies pregnancy?
    • Selected Answer: Increased drug distribution resulting from hemodynamic changes. (correct answer)
21. What is the first line treatment for hypertension and a male with benign prosthetic hypertrophy?
    • Selected Answer: Alpha blockers (correct answer)
22. Donald is a nurse practitioner student. He recognizes Which option below could be a secondary use for an anxiolytic medication?
    • Selected Answer: Ethanol withdrawal (correct answer)
23. Jennifer, the Nurse Practitioner, is seeing Mr. Johns, a 65-year-old male in the clinic today with c/o Arthritis pain. What is a serious side effect of ibuprofen use in the older adult patient?
    • Selected Answer: Impairment of renal function (correct answer)
24. The Nurse Practitioner knows that Buproprion use (Wellbutrin, Zyban) is contraindicated in which of the following instances?
    • Selected Answer: In conjunction with a MAOI (monoamine oxidase inhibitor) (correct answer)
25. How is hydrocodone eliminated from the body?
    • Selected Answer: Liver (correct answer)
26. The laboratory monitoring required when a patient is on a selective serotonin reuptake inhibitor is?
    • Selected Answer: No laboratory monitoring required (correct answer)
27. The NP is prescribing a medication for a six-month-old infant. That medication comes in the following formulations. Which one should the NP select to improve absorption and distribution of the medication?
    • Selected Answer: Elixir (correct answer)
28. An immunocompromised patient with a diagnosis of candidiasis has failed to respond to conservative therapy and has consequently begun treatment with amphotericin B. The nurse is aware that this drug achieves a therapeutic effect by way of its influence on:
    • Selected Answer: The permeability of fungal cell walls. (correct answer)
29. A patient is to begin taking tobramycin (Nebcin) for a nosocomial infection. Which of the following assessments should the nurse prioritize?
    • Selected Answer: The peak and trough blood levels (correct answer)
30. A 21-year-old has been placed on risperidone. Monitoring for risperidone includes:
    • Selected Answer: Excessive weight gain (correct answer)
31. A Nurse Practitioner is working with a 57-year-old man who is a former intravenous drug abuser. He has been prescribed a weekly dosage of methotrexate for his rheumatoid arthritis. Which of the following will the nurse include in her teaching plan for this patient?
    • Selected Answer: Drink plenty of water every day (correct answer)
32. Terazosin (Hytrin) is classified under which of the following drug classes:
    • Selected Answer: Alpha blockers (correct answer)
33. A 20-year-old woman will soon begin taking oral contraceptives for the first time. What advice should the nurse provide to this patient?
    • Selected Answer: “Make sure to seek care quickly if you experience bad headaches, calf pain, or changes in vision.” (correct answer)
34. A 9-year-old boy was bought to his primary care provider by his mother with signs and symptoms of hookworm infection and will be sent home with a prescription for mebendazole. When provided patient and family education, the nurse should teach the mother with which of the following measures to avoid reinfection following treatment?
    • Selected Answer: The importance of vigilant hygiene for the boy and the other members of the family (correct answer)
35. Which of the following medications will not increase the likelihood of photosensitivity?
    • Selected Answer: Amoxicillin
36. A male patient is receiving heparin by continuous intravenous infusion. The nurse will instruct the patient and family members to report which of the following should it occur?
    • Selected Answer: Presence of blood in urine or stools (correct answer)
37. A 30-year-old woman who is in the first trimester of pregnancy has presented to her primary care provider with a 4-day history of a reddened, itchy left eye that is crusted with purulent exudate. The clinician suspects a bacterial, rather than viral, etiology. How will the patient’s pregnancy affect the potential use of ciprofloxacin to treat her conjunctivitis?
    • Selected Answer: The use of ciprofloxacin is contraindicated in pregnancy. (correct answer)
38. A Nurse Practitioner who provides care on a pediatric medicine unit has conducted a medication reconciliation of a recently-admitted patient. In light of the fact that the child takes methylphenidate (Ritalin), the nurse is justified in considering a history of what health problem?
    • Selected Answer: ADHD (correct answer)
39. Alendronate (Fosamax) is prescribed for a 67-year-old postmenopausal woman. In order to help prevent gastrointestinal distress, the nurse will advise the patient to:
    • Selected Answer: Stand or sit upright for at least 30 minutes after taking alendronate. (correct answer)
40. Gold compounds are contraindicated in patients with all of the following conditions except:
    • Selected Answer: Rheumatoid arthritis
41. Intravenous carmustine has been prescribed for a patient with cancer. The nurse should help relieve the discomfort of pain and burning during the infusion by:
    • Selected Answer: Slowing the infusion. (correct answer)
42. A woman is receiving magnesium sulfate for intrapartum eclampsia. The patient is perspiring and her blood pressure is 88/50. The serum magnesium level is 10 mg/dL. The nurse will interpret these manifestations as:
    • Selected Answer: Magnesium sulfate toxicity. (correct answer)
43. Off label prescribing is:
    • Selected Answer: Legal if there is scientific evidence for the use (correct answer)
44. An immunocompromised patient in a critical care setting has developed a respiratory infection that has been attributed to methicillin-resistant Staphylococcus aureus (MRSA). The nurse should anticipate that the patient will require treatment with:
    • Selected Answer: Vancomycin. (correct answer)
45. How do bisphosphonates treat osteoporosis?
    • Selected Answer: By reducing bone resorption and inhibiting osteoclastic activity (correct answer)
46. The anticoagulant drug that acts as a vitamin K antagonist is:
    • Selected Answer: Coumadin (correct answer)
47. A man is prescribed ciprofloxacin to treat a sexually transmitted infection. The nurse will instruct the patient to:
    • Selected Answer: Complete the entire course of drug therapy. (correct answer)
48. Laboratory testing has confirmed that a patient has chloroquine-resistant malaria and the patient’s physician has prescribed quinine along with an adjunctive drug. The nurse should question the physician’s order if the patient has a history of:
    • Selected Answer: Cardiac arrhythmias.
49. A child is taking permethrin for head lice. The Nurse Practitioner will instruct her mother to:
    • Selected Answer: Stop using creams, ointments, and oils on the child’s skin and scalp.
50. A Nurse Practitioner is caring for a patient with cancer who has been prescribed dronabinol (Marinol) to help reduce nausea and vomiting from chemotherapy. The nurse will inform the patient that he or she is taking an oral form of:
    • Selected Answer: Marijuana.
51. A patient is taking etoposide for a testicular tumor refractory to treatment. The nursing assessment reveals that he is also taking warfarin. The nurse must carefully monitor for which of the following?
    • Selected Answer: Elevated prothrombin time
52. A 36-year-old woman with a history of dysmenorrhea has begun treatment with progesterone, which she will be receiving by the intramuscular route. The nurse participating in the woman’s care should prioritize which of the following potential nursing diagnoses?
    • Selected Answer: Risk for Injury related to loss of vision or thrombotic events
53. Which of the following would a Nurse Practitioner assess for in a patient who is taking polymyxin B systemically?
    • Selected Answer: Nephrotoxicity and hepatotoxicity (correct answer)
54. Some drugs are given to patients using other routes such as sublingual or topical to avoid movement through the liver and possible side effects. Which of the following effects is the Nurse Practitioner attempting to avoid by administering certain medications via alternative routes?
    • Selected Answer: First-Pass effect (correct answer)
55. A patient is taking flavoxate hydrochloride (Urispas) to help control an overactive bladder. On a follow-up visit to the clinic, the nurse will question the patient about which of the following?
    • Selected Answer: Dental hygiene practices
56. When a NP chooses a benzodiazepine to treat anxiety, the prescriber needs to be aware of the possibility of dependence. The Benzodiazepine associated with the greatest likelihood of causing rapid dependence is:
    • Selected Answer: Alprazolam (Xanax)
57. The NP is reviewing Mrs. Oglethorpe’s medication list and recognizes that which drug listed below has been associated with increased risk for MI in women?
    • Selected Answer: Estrogen replacement
58. A male patient is experiencing climacteric symptoms secondary to androgen deficiency. His physician has prescribed testosterone. The nursing assessment reveals that the patient has had a myocardial infarction. The combination of testosterone therapy and a history of myocardial infarction would place that patient at a significantly higher risk of:
    • Selected Answer: Acute urethral obstruction.
59. On the advice of her sister, a 52-year-old woman has visited her nurse practitioner to discuss the potential benefits of hormone replacement therapy in controlling the symptoms of menopause. Which of the following responses by the nurse is most appropriate?
    • Selected Answer: “Actually, most of the current research is suggesting that HRT may not be all that effective in treating the symptoms of menopause.”
60. The NP is considering a medication to treat Ms. Robert’s Urinary Tract Infection. The NP knows that Trimethoprim sulfamethazole (Bactrim) is contraindicated in which of the following conditions:
    • Selected Answer: G6PD deficiency anemia (correct answer)
61. An immunocompromised 7-year-old child was recently discharged home with a peripherally-inserted central line (PIC line) for home antibiotic therapy. He has now been brought to the emergency department by his mother and father with signs and symptoms of line sepsis. Upon questioning, the mother states that she has been removing the PIC dressing daily and washing the site with warm water and a cloth. What nursing diagnosis is most appropriate in this situation?
    • Selected Answer: Ineffective Family Therapeutic Regimen Management (correct answer)
62. A 56-year-old woman will soon begin treatment of her overactive bladder with tolterodine (Detrol). What patient teaching should the nurse provide to this woman?
    • Selected Answer: “You might find that you get a dry mouth or a headache from this drug, but this does not mean it has to be discontinued.” (correct answer)
63. A Nurse Practitioner is caring for a 46-year-old female patient who is taking paclitaxel for ovarian cancer. Two or three days after the infusion of the drug, the nurse must closely monitor for which of the following?
    • Selected Answer: Neurotoxicity
64. Ms. Lewis is a 74-year-old female who presents to your clinic for a routine visit today. You review her medical record and notice she is prescribed aspirin therapy. You provide patient education regarding the signs of aspirin toxicity. An early sign of aspirin toxicity is:
    • Selected Answer: Vomiting
65. Lily, the nurse practitioner is seeing Mr. Reynolds today. She would recognize that which of the following is a potential adverse side effect of autonomic-anticholinergic agents?
    • Selected Answer: Increased symptoms of benign prosthetic hypertrophy
66. The NP student knows that which statement below accurately describes the activity of naloxone?
    • Selected Answer: It may induce immediate withdrawal symptoms and chronic opiate users
67. A Nurse Practitioner is assigned to a patient who is at 32 weeks' gestation and is receiving terbutaline (Brethine) IV for 24 hours to control preterm labor. Which of the following nursing actions will the nurse take to decrease the risk of hypotension and promote circulation to the fetus?
    • Selected Answer: Instruct the patient to lie on her left side during the infusion.
68. Sulconazole has been prescribed for a patient with tinea pedis. The nurse will instruct the patient to use the topical agent:
    • Selected Answer: Once a day.
69. A 5-year-old boy needs an IM injection. The least painful and most effective injection site would be the:
    • Selected Answer: Ventrogluteal muscle.
70. A Nurse Practitioner is caring for a patient who is at 28 weeks' gestation and is receiving terbutaline (Brethine) to control preterm labor. Which of the following assessment parameters should the nurse prioritize?
    • Selected Answer: Fetal heart rate (FHR) (correct answer)
71. A patient has acquired primary hypogonadism and has been prescribed testosterone transdermal (Androderm) patches. When educating the patient on how to administer the drug, the nurse will instruct him to:
    • Selected Answer: Place the patch on the back, abdomen, upper arms, or thighs.
72. Cindy has been on Citalopram (Lexapro) for a year and is willing to try tapering off of the selective serotonin reuptake inhibitor. What is the initial dosage adjustment when tapering off antidepressants?
    • Selected Answer: Reduce dose by 50% for 3 to 4 days.
73. During ongoing assessment of a patient receiving 5-FU therapy, the nurse finds the patient’s platelet count to be 92,000 cells/mm3. The nurse should do which of the following?
    • Selected Answer: Consult the prescriber for discontinuation of the drug.
74. The nurse practitioner orders Amoxicillin 500 mg tid. What is the total amount of medication the patient will take per day?
    • Selected Answer: 1500 mg (correct answer)
75. The NP recognizes that these medications are useful when taken during early symptoms of a migraine. (Select all that apply):
    • Selected Answers: Acetaminophen
76. All of the following systemic drugs interfere with the metabolism of oral contraceptives except:
    • Selected Answer: Corticosteroids
77. The clinical nurse educator who oversees the emergency department in a children’s hospital has launched an awareness program aimed at reducing drug errors. What measure addresses the most common cause of incorrect doses in the care of infants and children?
    • Selected Answer: Having nurses check their math calculations with a colleague before administering a drug.
78. Which of the following drugs can a person with G6PD deficiency take safely?
    • Selected Answer: Acetaminophen
79. A 13-year-old patient has juvenile arthritis. He has recently had oral surgery and was told by the surgeon to take aspirin for the pain. The APRN will monitor for which of the following?
    • Selected Answer: Hepatotoxicity
80. Which antibiotic is most frequently associated with “Red man Syndrome”?
    • Selected Answer: Vancomycin (correct answer)
81. A Nurse Practitioner is obtaining baseline physical data from a 7-year-old patient who is to be started on dextroamphetamine for ADHD. After obtaining vital signs, height, and weight, the nurse will prepare the patient for an:
    • Selected Answer: Electrocardiogram (ECG).
82. A Nurse Practitioner is explaining to the parents of a 6-year-old child suffering from angina why nitroglycerin patches for chest pain would not be appropriate. Which of the following will the nurse include in an explanation?
    • Selected Answer: A child has a greater body surface area, creating greater permeability resulting in an increase in absorption of topical agents, which may result in more adverse effects.
83. Which of the following drugs is most likely to cause sexual dysfunction in males?
    • Selected Answer: Selective serotonin reuptake inhibitors
84. The Nurse Practitioner has established peripheral IV access and begun an infusion of magnesium sulfate on a 29-year-old antepartum patient who is 35 weeks pregnant. Which of the following assessment findings most likely prompted the patient’s physician to order magnesium sulfate for this patient?
    • Selected Answer: Systolic blood pressure readings in excess of 190 mmHg
85. Which step in the clotting cascade allows prothrombin to be converted to thrombin?
    • Selected Answer: Activation of factor X to factor Xa (correct answer)
86. What schedule drug is alprazolam?
    • Selected Answer: IV (correct answer)
87. A 43-year-old man has been diagnosed with active TB. He is prescribed a multiple drug therapy, including INH and rifampin. A priority assessment by the nurse will be to monitor which combination of laboratory test results?
    • Selected Answer: Serum alanine transaminase, aspartate transaminase, and bilirubin (correct answer)
88. Tetracyclines are contraindicated in children younger than eight years old because of?
    • Selected Answer: Adverse effects on bone growth (correct answer)
89. A patient who is at risk for DVT tells the NP she has just learned she is pregnant. The NP should expect that this patient will use which of the following anticoagulant medications?
    • Selected Answer: Heparin (correct answer)
90. Combination OCs prevent pregnancy primarily by:
    • Selected Answer: Suppressing ovulation.
91. After 6 months of unsuccessfully trying to conceive, a 31-year-old woman and her husband have sought a referral to a fertility specialist in order to explore their options. A nurse at the clinic should recognize that the woman may benefit from:
    • Selected Answer: Clomiphene.
92. A patient has completed 4 weeks of treatment with epoetin alfa. Which of the following assessment findings would most strongly indicate that treatment has been effective?
    • Selected Answer: The patient’s hemoglobin level is 11 g/dL (correct answer)
93. A 29-year-old pregnant patient is extremely upset about having to take medication for a pre-existing medical condition. She is consumed with fear that her baby will be born with a physical deformity or a congenital anomaly but knows that she has to take the medication. She talks constantly about this and is unable to sleep most nights. Which of the following is the most appropriate nursing diagnosis for this patient?
    • Selected Answer: Anxiety related to perceived danger of drug therapy to fetus or infant (correct answer)
94. A 3-year-old boy has developed otitis media and requires antibiotics. In order to increase the chance that the boy will take his prescribed medication, the nurse should:
    • Selected Answer: Offer a choice between liquid and chewable medications, if possible. (correct answer)
95. Which adverse reaction is common in the patient taking buspirone?
    • Selected Answer: Headache (correct answer)
96. The nurse practitioner, Jill, is deciding what medication to put her patient on. She recognizes that the mechanism of action of triptans is as:
    • Selected Answer: A vasoconstrictor (correct answer)
97. An immunocompromised cancer patient has developed cryptococcal meningitis and been admitted to the intensive care unit for treatment with amphotericin B. How should the nurse most safely administer this drug?
    • Selected Answer: Infuse the drug over 2 to 4 hours into a central line using an infusion pump.
98. Which of the following should not be taken with a selective serotonin reuptake inhibitor?
    • Selected Answer: Alcohol (correct answer)
99. Ms. Carter, a 48-year-old female was placed on an aminoglycoside. The NP knows that an adverse reaction to aminoglycosides is:
    • Selected Answer: Ototoxicity (correct answer)
100. A Nurse Practitioner educator who coordinates the staff education on an oncology unit is conducting an inservice on targeted therapies. What potential benefit of targeted therapies should the nurse highlight in this education session?- Selected Answer: Targeted therapies have the potential to damage cancerous cells while leaving normal body cells less affected.
101. When completing this exam, did you comply with Walden University’s Code of Conduct including the expectations for academic integrity?- Selected Answer: Yes (correct answer)