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Pharm Final Moser/Woo Questions
Terms in this set (628)
Chp 13: Michael asks you about why some drugs are over-the-counter and some are prescription. You explain that in order for a drug to be approved for over-the-counter use the drug must:
-Be safe and labeled for appropriate use
-Have a low potential for abuse or misuse
-Be taken for a condition the patient can reliably self-diagnose
Chp 13: In the United States, over-the-counter drugs are regulated by:
The U.S. Food and Drug Administration Center for Drug Evaluation and Research
Chp 13: As drugs near the end of their patent, pharmaceutical companies may apply for the drug to change to over-the-counter status in order to:
Continue to make large profits from their blockbuster brand-name drug
Chp 13: True or False? New over-the-counter drug ingredients must undergo the U.S. Food and Drug Administration New Drug Application process, just as prescription drugs do.
Chp 13: The ailment that generates the greatest over-the-counter annual drug sales is:
Cough and colds
Chp 13: Common over-the-counter pain relievers such as acetaminophen or ibuprofen:
Are harmful if taken in higher than recommended amounts
Chp 13: When obtaining a drug history from Harold, he gives you a complete list of his prescription medications. He denies taking any other drugs, but you find that he occasionally takes aspirin for his arthritis flare ups. This is an example of:
A common misconception that intermittently taken over-the counter medications are not an important part of his drug history
Chp 13: The Combat Methamphetamine Epidemic Act, which is part of the 2006 U.S. Patriot Act:
Restricts the sales of drugs that contain methamphetamine precursors, including a daily and 30-day limit on sales
Chp 13: When prescribing a tetracycline or quinolone antibiotic it is critical to instruct the patient:
Not to take antacids while on these medications, as the antacid decreases absorption
Chp 40: Because primary hypertension has no identifiable cause, treatment is based on interfering with the physiological mechanisms that regulate blood pressure. Thiazide diuretics treat hypertension because they:
Deplete body sodium and reduce fluid volume
Chp 40: Because of its action on various body systems, the patient taking a thiazide or loop diuretic may also need to receive the following supplement:
Chp 40: All patients with hypertension benefit from diuretic therapy, but those who benefit the most are:
Chp 40: Beta blockers treat hypertension because they:
Reduce peripheral resistance
Chp 40: Which of the following disease processes could be made worse by taking a nonselective beta blocker?
Chp 40: Disease states in addition to hypertension in which beta blockade is a compelling indication for the use of beta blockers include:
Chp 40: Angiotensin-converting enzyme (ACE) inhibitors treat hypertension because they:
-Reduce sodium and water retention
Chp 40: Compelling indications for an ACE inhibitor as treatment for hypertension based on clinical trials includes:
Renal parenchymal disease
Chp 40: 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
Chp 40: If not chosen as the first drug in hypertension treatment, which drug class should be added as a second step because it will enhance the effects of most other agents?
Chp 40: Treatment costs are important for patients with hypertension. Which of the following statements about cost is NOT true?
Few antihypertensive drugs come in generic formulations.
Chp 40: Caffeine, exercise, and smoking should be avoided for at least how many minutes before blood pressure measurement?
Chp 40: Blood pressure checks in children:
Should be done during every health-care visit after 3 years of age
Chp 40: Lack of adherence to blood pressure management is very common. Reasons for this lack of adherence include:
-Lifestyle changes are difficult to achieve and maintain.
-Adverse drug reactions are common and often fall into the categories more associated with nonadherence.
-Costs of drugs and monitoring with laboratory tests can be expensive.
Chp 40: Lifestyle modifications for patients with prehypertension or hypertension include:
Adopt the dietary approaches to stop hypertension (DASH) diet.
Chp 40: Which diuretic agents typically do not need potassium supplementation?
The aldosterone inhibitors
Chp 40: Aldactone family medications are frequently used when the hypertensive patient also has:
Advancing liver dysfunction
Chp 40: Hypertensive African Americans are typically listed as not being as responsive to which drug groups?
Chp 40: What educational points concerning fluid intake must be covered with diuretic prescriptions?
Fluid intake should remain near normal for optimal performance.
Chp 40: What is a common side effect concern with hypertensive medications and all individuals, but especially the elderly?
Risk of falls
Chp 39: The overall goal of treating hyperlipidemia is:
To reduce atherogenesis
Chp 39: When considering which cholesterol-lowering drug to prescribe, which factor determines the type and intensity of treatment?
Coronary artery disease risk level
Chp 39: First-line therapy for hyperlipidemia is:
Chp 39: James is a 45-year-old patient with an LDL level of 120 and normal triglycerides. Appropriate first-line therapy for James may include diet counseling, increased physical activity, and:
Chp 39: Joanne is a 60-year-old patient with an LDL of 132 and a family history of coronary artery disease. She has already tried diet changes (increased fiber and plant sterols) to lower her LDL and after 6 months her LDL is slightly higher. The next step in her treatment would be:
Chp 39: Sharlene is a 65-year-old patient who has been on a lipid-lowering diet and using plant sterol margarine daily for the past 3 months. Her LDL is 135 mg/dL. An appropriate treatment for her would be:
Determined by her risk factors
Chp 39: Phil is a 54-year-old male with multiple risk factors who has been on a high-dose statin for 3 months to treat his high LDL level. His LDL is 135 mg/dL and his triglycerides are elevated. A reasonable change in therapy would be to:
Continue the statin and add in ezetimibe.
Chp 39: Jamie is a 34-year-old pregnant woman with familial hyperlipidemia and elevated LDL levels. What is the appropriate treatment for a pregnant woman?
Bile acid-binding resins
Chp 39: Han is a 48-year-old diabetic with hyperlipidemia and high triglycerides. His LDL is 112 mg/dL and he has not tolerated statins. He warrants a trial of a:
Fibric acid derivative
Chp 39: Jose is a 12-year-old overweight child with a total cholesterol 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 6 months.
Chp 39: Monitoring of a patient who is on a lipid-lowering drug includes:
Lipid profile with attention to serum LDL 6 to 8 weeks after starting therapy, then again in 6 weeks
Chp 39: Before starting therapy with a statin, the following baseline laboratory values should be evaluated:
Liver function (ALT/AST) and creatine kinase
Chp 39: When starting a patient on a statin, education would include:
-If they stop the medication their lipid levels will return to pretreatment levels.
-Medication is a supplement to diet therapy and exercise.
-If they have any muscle aches or pain, they should contact their provider.
Chp 39: Omega 3 fatty acids are best used to help treat:
Chp 39: When are statins traditionally ordered to be taken?
With the evening meal
Chp 39: Which the following persons should not have a statin medication ordered?
Someone with 3 first- or second-degree family members with history of muscle issues when started on statins
Chp 39: Fiber supplements are great options for elderly patients who have the concurrent problem of:
Long term issues of constipation
Chp 39: What is considered the order of statin strength from lowest effect to highest?
Lovastatin, Simvastatin, Rosuvastatin
Chp 36: Angiotensin-converting-enzyme (ACE) inhibitors are a central part of the treatment of heart failure because they have more than one action to address the pathological changes in this disorder. Which of the following pathological changes in heart failure is NOT addressed by ACE inhibitors?
Activation of the sympathetic nervous system that increases heart rate and preload.
Chp 36: One of the three types of heart failure involves systolic dysfunction. Potential causes of this most common form of heart failure include:
Myocardial ischemia and injury secondary to myocardial infarction
Chp 36: The American Heart Association and the American College of Cardiology have devised a classification system for heart failure that can be used to direct treatment. Patients with symptoms and underlying disease are classified as stage:
Chp 36: Diagnosis of heart failure cannot be made by symptoms alone because many disorders share the same symptoms. The most specific and sensitive diagnostic test for heart failure is:
Two-dimensional echocardiograms that identify structural anomalies and cardiac dysfunction
Chp 36: Treatments for heart failure, including drug therapy, are based on the stages developed by the ACC/AHA. Stage A patients are treated with:
Drugs for hypertension and hyperlipidemia, if they exist
Chp 36: Class I recommendations for stage A heart failure include:
Treatment of thyroid disorders, especially if they are associated with tachyarrhythmias
Chp 36: Stage B patients should have beta blockers added to their heart failure treatment regimen when:
-They have an ejection fraction less than 40%
T-hey have had a recent MI
Chp 36: Increased life expectancy for patients with heart failure has been associated with the use of:
ACE inhibitors, especially when started early in the disease process
Chp 36: Stage C patients usually require a combination of three to four drugs to manage their heart failure. In addition to ACE inhibitors and beta blockers, diuretics may be added. Which of the following statements about diuretics is NOT true?
Diuretics from the potassium-sparing class should be used when using an angiotensin receptor blocker (ARB).
Chp 36: Digoxin has a very limited role in treatment of heart failure. It is used mainly for patients with:
An audible S3
Chp 36: Which of the following classes of drugs is contraindicated in heart failure?
Calcium channel blockers
Chp 36: Heart failure is a leading cause of death and hospitalization in older adults (greater than 65 years old). The drug of choice for this population is:
Chp 36: ACE inhibitors are contraindicated in pregnancy. While treatment of heart failure during pregnancy is best done by a specialist, which of the following drug classes is considered to be safe, at least in the later parts of pregnancy?
Chp 36: Heart failure is a chronic condition that can be adequately managed in primary care. However, consultation with or referral to a cardiologist is appropriate when:
-Symptoms markedly worsen or the patient becomes hypotensive and has syncope
-There is evidence of progressive renal insufficiency or failure
-The patient remains symptomatic on optimal doses of an ACE inhibitor, a beta blocker, and a diuretic
Chp 36: ACE inhibitors are a foundational medication in HF. Which group of patients cannot take them safely?
-Elderly patients with reduced renal clearance
Chp 36: What assessment that can be done at home is the most reliable for making decisions to change HF medications?
Chp 36: Evidence is strong that the timing of HF interventions are best initiated when:
At the earliest indication
Chp 36: HF patients frequently take more than one drug. When are anticoagulants typically used?
When there is concurrent afib
Chp 36: What can chest x-rays contribute to the diagnosis and management of HF?
They provide an idea of general cardiac size and pulmonary great vessel distribution.
Chp 4: The U.S. Food and Drug Administration regulates:
The official labeling for all prescription and over-the-counter drugs
Chp 4: The U.S. Food and Drug Administration approval is required for:
Medical devices, including artificial joints
Chp 4: An Investigational New Drug is filed with the U.S. Food and Drug Administration:
Prior to human testing of any new drug entity
Chp 4: Phase IV clinical trials in the United States are also known as:
Chp 4: Off-label prescribing is:
Legal if there is scientific evidence for the use
Chp 4: The U.S. Drug Enforcement Administration:
Registers manufacturers and prescribers of controlled substances
Chp 4: Drugs that are designated Schedule II by the U.S. Drug Enforcement Administration:
May not be refilled, a new prescription must be written
Chp 4: Precautions that should be taken when prescribing controlled substances include:
Using tamper-proof paper for all prescriptions written for controlled drugs
Chp 4: Strategies prescribers can use to prevent misuse of controlled prescription drugs include:
-Use of chemical dependency screening tools
-Firm limit-setting regarding prescribing controlled substances
-Practicing "just say no" to deal with patients who are pushing the provider to prescribe controlled substances
Chp 4: Behaviors predictive of addiction to controlled substances include:
Stealing or borrowing another patient's drugs
Chp 4: Medication agreements or "Pain Medication Contracts" are recommended to be used:
Universally for all prescribing for chronic pain
Chp 4: A prescription needs to be written for:
-Most controlled drugs
Chp 34: Gastroesophageal reflux disease may be aggravated by the following medication that affects lower esophageal sphincter (LES) tone:
Chp 34: Lifestyle changes are the first step in treatment of gastroesophageal reflux disease (GERD). Food or drink that may aggravate GERD include:
Chp 34: Metoclopramide improves gastroesophageal reflux disease symptoms by:
Increasing lower esophageal tone
Chp 34: Antacids treat gastroesophageal reflux disease by:
Increasing gastric pH
Chp 34: When treating patients using the "Step-Down" approach the patient with gastroesophageal reflux disease is started on _______ first.
Proton pump inhibitors
Chp 34: If a patient with symptoms of gastroesophageal reflux disease states that he has been self-treating at home with OTC ranitidine daily, the appropriate treatment would be:
Proton pump inhibitor (omeprazole) for 12 weeks
Chp 34: If a patient with gastroesophageal reflux disease who is taking a proton pump inhibitor daily is not improving, the plan of care would be:
Proton pump inhibitor (omeprazole) twice a day for 4 to 8 weeks
Chp 34: The next step in treatment when a patient has been on proton pump inhibitors twice daily for 12 weeks and not improving is:
Referral for endoscopy
Chp 34: Infants with reflux are initially treated with:
Anti-reflux maneuvers (elevate head of bed)
Chp 34: Long-term use of proton pump inhibitors may lead to:
Hip fractures in at-risk people
Chp 34: An acceptable first-line treatment for peptic ulcer disease with positive H. pylori test is:
Proton pump inhibitor bid plus clarithromycin plus amoxicillin for 14 days
Chp 34: Treatment failure in patients with peptic ulcer disease associated with H. pylori may be because of:
Chp 34: If a patient with H. pylori-positive peptic ulcer disease fails first-line therapy, the second-line treatment is:
Proton pump inhibitor bid plus metronidazole plus tetracycline plus bismuth subsalicylate for 14 days
Chp 34: After H. pylori treatment is completed, the next step in peptic ulcer disease therapy is:
A proton pump inhibitor for 8 to 12 weeks until healing is complete
Chp 28: Angina is produced by an imbalance between myocardial oxygen supply (MOS) and demand (MOD) in the myocardium. Which of the following drugs help to correct this imbalance by increasing MOS?
Angiotensin-converting-enzyme (ACE) inhibitors
Chp 28: Not all chest pain is caused by myocardial ischemia. Noncardiac causes of chest pain include:
Chp 28: 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 class:
Chp 28: Patients at high risk for developing significant coronary heart disease are those with:
Class III angina
Chp 28: To reduce mortality, all patients with angina, regardless of class, should be on:
Aspirin 81 to 325 mg/d
Chp 28: Patients who have angina, regardless of class, who are also diabetic, should be on:
Chp 28: Management of all types and grades of angina includes the use of lifestyle modification to reduce risk factors. Which of these modifications are appropriate for which reason? Both the modification and the reason for it must be true for the answer to be correct.
Reduce sodium intake to no more than 2,400 mg of sodium. Sodium increases blood volume and cardiac workload.
Chp 28: Nitrates are especially helpful for patients with angina who also have:
Chp 28: Beta blockers are especially helpful for patients with exertional angina who also have:
Chp 28: Rapid-acting nitrates are important for all angina patients. Which of the following are true statements about their use?
Take one nitroglycerine tablet or spray at the first sign of angina; repeat every 5 minutes for no more than two doses. If chest pain is still not relieved, call 911.
Chp 28: Isosorbide dinitrate is a long-acting nitrate given twice daily. The schedule for administration is 7 a.m. and 2 p.m. because:
Nitrate tolerance can develop
Chp 28: Combinations of a long-acting nitrate and a beta blocker are especially effective in treating angina because:
Their additive effects permit lower doses of both drugs and their adverse reactions cancel each other out.
Chp 28: Drug choices to treat angina in older adults differ from those of younger adults only in:
Consideration of risk factors for diseases associated with and increased in aging
Chp 28: Which of the following drugs has been associated with increased risk for myocardial infarction in women?
Chp 28: Cost of antianginal drug therapy should be considered in drug selection because of all of the following EXCEPT:
Generic formulations may be cheaper but are rarely bioequivalent
Chp 28: Situations that suggest referral to a specialist is appropriate include:
-When chronic stable angina becomes unpredictable in its characteristics and precipitating factors
-When a post-myocardial infarction patient develops new-onset angina
-When standard therapy is not successful in improving exercise tolerance or reducing the incidence of angina
Chp 28: The rationale for prescribing calcium blockers for angina can be based on the need for:
Help with rate control
Chp 28: Medications are typically started for angina patients when:
The start of class I or II symptoms
Chp 28: The most common cause of angina is:
Chp 28: Ranolazine is used in angina patients to:
Restrict late sodium flow in the myocytes
Chp 28: When is aspirin (ASA) used in angina patients?
All angina patients should be taking ASA unless it is contraindicated for allergy or other medical reasons.
Chp 6: A comprehensive assessment of a patient should be holistic when trying to determine competence in drug administration. Which of the following factors would the NP omit from this type of assessment?
Chp 6: Elena Vasquez's primary language is Spanish, and she speaks very limited English. Which technique would be appropriate to use in teaching her about a new drug you have just prescribed?
Use a professional interpreter or a reliable staff member who can act as an interpreter.
Chp 6: Rod, age 68, has hearing difficulty. Which of the following would NOT be helpful in assuring that he understands teaching about his drug?
If he reads lips, exaggerate lips movements when pronouncing the vowel sounds.
Chp 6: Which of the following factors may adversely affect a patient's adherence to a therapeutic drug regimen?
-Complexity of the drug regimen
-Patient perception of the potential adverse effects of the drugs
Chp 6: The health-care delivery system itself can create barriers to adherence to a treatment regimen. Which of the following system variables creates such a barrier?
Increasing copayments for care
Chp 6: Ralph's blood pressure remains elevated despite increased doses of his drug. The NP is concerned that he might not be adhering to his treatment regimen. Which of the following events would suggest that he might not be adherent?
Ralph states that he always takes the drug "when I feel my pressure is going up."
Chp 6: 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 tolerability profile with fewer of the adverse effects that are considered "irritating," such as nausea and dizziness
Chp 6: Factors in chronic conditions that contribute to nonadherence include:
-The complexity of the treatment regimen
-The length of time over which it must be taken
-Breaks in the usual daily routine, such as vacations and weekends
Chp 6: While patient education about their drugs is important, information alone does not necessarily lead to adherence to a drug regimen. Patients report greater adherence when:
Their concerns and specific area of knowledge deficit were addressed
Chp 6: Patients with psychiatric illnesses have adherence rates to their drug regimen between 35% and 60%. To improve adherence in this population, prescribe drugs:
With a longer half-life so that missed doses produce a longer taper on the drug curve
Chp 6: Many disorders require multiple drugs to treat them. The more complex the drug regimen, the less likely the patient will adhere to it. Which of the following interventions will NOT improve adherence?
Give the patient a clear drug schedule that the provider devises to fit the characteristic of the drug.
Chp 6: Pharmacologic interventions are costly. Patients for whom the cost/benefit variable is especially important include:
Older adults and those on fixed incomes
Chp 6: Providers have a responsibility for determining the best plan of care, but patients also have responsibilities. Patients the provider can be assured will carry through on these responsibilities include those who:
Are well-educated and affluent
Have chronic conditions
Self-monitor drug effects on their symptoms
NONE OF THE ABOVE guarantee adherence
Chp 6: Monitoring adherence can take several forms, including:
-Patient reports from data in a drug diary
-Laboratory reports and other diagnostic markers
Chp 6: Factors that explain and predict medication adherence include:
Chp 20: Many patients self-medicate with antacids. Which patients should be counseled to not take calcium carbonate antacids without discussing it with their provider or a pharmacist first?
Patients with kidney stones
Chp 20: Patients taking antacids should be educated regarding these drugs, including letting them know that:
-They may cause constipation or diarrhea
-Many are high in sodium
-They should separate antacids from other medications by 1 hour
Chp 20: Kelly has diarrhea and is wondering if she can take loperamide (Imodium) for the diarrhea. Loperamide:
Slows gastric motility and reduces fluid and electrolyte loss from diarrhea
Chp 20: Bismuth subsalicylate (Pepto Bismol) is a common OTC remedy for gastrointestinal complaints. Bismuth subsalicylate:
-May lead to toxicity if taken with aspirin
-Is contraindicated in children with flu-like illness
-Has antimicrobial effects against bacterial and viral enteropathogens
Chp 20: Hannah will be traveling to Mexico with her church group over spring break to build houses. She is concerned she may develop traveler's diarrhea. Advice includes following normal food and water precautions as well as taking:
Bismuth subsalicylate with each meal and at bedtime
Chp 20: Josie is a 5-year-old patient who presents to the clinic with a 48-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 IV fluids, her exam warrants the use of an antinausea medication. Which of the following would be the appropriate drug to order for Josie?
Chp 20: Jim presents with complaints of "heartburn" that is minimally relieved with Tums (calcium carbonate) and is diagnosed with gastroesophageal reflux disease (GERD). An appropriate first-step therapy would be:
Ranitidine (Zantac) twice a day
Chp 20: Patients who are on chronic long-term proton pump inhibitor therapy require monitoring for:
Iron deficiency anemia, vitamin B12 and calcium deficiency
Chp 20: Sadie is a 72-year-old patient who takes omeprazole for her chronic GERD. Chronic long-term omeprazole use places her at increased risk for:
Chp 20: Patrick is a 10-year-old patient who presents with uncomfortable constipation. Along with diet changes, a laxative is ordered to provide more rapid relief of constipation. An appropriate choice of medication for a 10-year-old child would be:
Bisacodyl (Dulcolax) suppository
Chp 20: Methylnaltrexone is used to treat constipation in:
Chp 20: An elderly person has been prescribed lactulose for treatment of chronic constipation. Monitoring with long-term treatment would include:
Electrolytes, including potassium and chloride
Chp 16: Ray has been diagnosed with hypertension and an angiotensin-converting enzyme inhibitor is determined to be needed. Prior to prescribing this drug, the NP should assess for:
Decreased renal function
Chp 16: Angiotensin-converting enzyme inhibitors are the drug of choice in treating hypertension in diabetic patients because they:
-Improve insulin sensitivity
-Improve renal hemodynamics
-Reduce the production of angiotensin II
Chp 16: A potentially life-threatening adverse response to angiotensin-converting enzyme inhibitors is angioedema. Which of the following statements is true about this adverse response?
Swelling of the tongue or hoarseness are the most common symptoms.
Chp 16: Angiotensin-converting enzyme inhibitors are useful in a variety of disorders. Which of the following statements are true about both its usefulness in the disorder and the reason for its use?
-Stable angina because it decreases the thickening of vascular walls due to decreased modified release.
-Heart failure because it reduces remodeling of injured myocardial tissues.
Chp 16: Despite good blood pressure control, an NP might change a patient's drug from an angiotensin-converting enzyme (ACE) inhibitor to an angiotensin II receptor blocker (ARB) because the ARB:
Does not produce a dry, hacky cough
Chp 16: While taking an angiotensin II receptor blocker (ARB), patients need to avoid certain over-the-counter drugs without first consulting the provider because:
-Cimetidine is metabolized by the CYP 3A4 isoenzymes
-Nonsteroidal anti-inflammatory drugs reduce prostaglandin levels
Chp 16: Laboratory monitoring for patients on angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers should include:
Serum creatinine levels with the drug dosage reduced for values greater than 2.5 mg/dL
Chp 16: Jacob has hypertension, for which a calcium channel blocker has been prescribed. This drug helps control blood pressure because it:
Decreases the amount of calcium inside the cell
Chp 16: Which of the following adverse effects may occur due to a dihydropyridine-type calcium channel blocker?
Edema of the hands and feet
Chp 16: Patient teaching related to amlodipine includes:
Avoid grapefruit juice as it affects the metabolism of this drug.
Chp 16: Vera, age 70, has isolated systolic hypertension. Calcium channel blocker dosages for her should be:
Started at about half the usual dosage
Chp 16: Larry has heart failure, which is being treated with digoxin because it exhibits:
Chp 16: Furosemide is added to a treatment regimen for heart failure that includes digoxin. Monitoring for this combination includes:
Chp 16: Which of the following create a higher risk for digoxin toxicity? Both the cause and the reason for it must be correct.
Older adults because of reduced renal function
Chp 16: Serum digoxin levels are monitored for potential toxicity. Monitoring should occur:
Because a reference point is needed in adjusting a dose
Chp 16: Rodrigo has been prescribed procainamide after a myocardial infarction. He is monitored for dyspnea, jugular venous distention, and peripheral edema because they may indicate:
Onset of congestive heart failure
Chp 16: Which of the following is true about procainamide and its dosing schedule?
Doses of this drug should be taken evenly spaced around the clock to keep an even blood level.
Chp 16: Amiodarone has been prescribed in a patient with a supraventricular dysrhythmia. Patient teaching should include all of the following EXCEPT:
Take a hot shower or bath if you feel dizzy.
Chp 16: The NP orders a thyroid panel for a patient on amiodarone. The patient tells the NP that he does not have thyroid disease and wants to know why the test is ordered. Which is a correct response?
Amiodarone inhibits an enzyme that is important in making thyroid hormone and can cause hypothyroidism.
Chp 16: Isosorbide dinitrate is prescribed for a patient with chronic stable angina. This drug is administered twice daily, but the schedule is 7 a.m. and 2 p.m. because:
Nitrate tolerance can develop.
Chp 16: Art is a 55-year-old smoker who has been diagnosed with angina and placed on nitrates. He complains of headaches after using his nitrate. An appropriate reply might be:
Headaches are common side effects with these drugs. How severe are they?
Chp 16: In teaching about the use of sublingual nitroglycerine, the patient should be instructed:
To place one tablet under the tongue if chest pain occurs and allow it to dissolve
Chp 16: Donald has been diagnosed with hyperlipidemia. Based on his lipid profile, atorvastatin is prescribed. Rhabdomyolysis is a rare but serious adverse response to this drug. Donald should be told to:
Report muscle weakness or tenderness and dark urine to his provider immediately.
Chp 16: Which of the following diagnostic studies would NOT indicate a problem related to a reductase inhibitor?
Increased white blood cell counts
Chp 16: Because of the pattern of cholesterol synthesis, reductase inhibitors are given:
In the evening in a single daily dose
Chp 16: Janice has elevated LDL, VLDL, and triglyceride levels. Niaspan, an extended-release form of niacin, is chosen to treat her hyperlipidemia. Due to its metabolism and excretion, which of the following laboratory results should be monitored?
Chp 16: Niaspan is less likely to cause which side effect that is common to niacin?
Chp 16: Dulcea has type 2 diabetes and a high triglyceride level. She has gemfibrozil prescribed to treat her hypertriglyceridemia. A history of which of the following might contraindicate the use of this drug?
Chp 16: Many patients with hyperlipidemia are treated with more than one drug. Combining a fibric acid derivative such as gemfibrozil with which of the following is not recommended? The drug and the reason must both be correct for the answer to be correct.
Reductase inhibitors, due to an increased risk for rhabdomyolysis
Chp 16: Felicity has been prescribed colestipol to treat her hyperlipidemia. Unlike other anti-lipidemics, this drug:
Exchanges chloride ions for negatively charged acids in the bowel
Chp 16: Because of their site of action, bile acid sequestering resins:
Should be administered separately from other drugs by at least 4 hours
Chp 16: Colestipol comes in a powdered form. The patient is taught to:
Mix the powder with 4 to 6 ounces of milk or fruit juice
Chp 16: The choice of diuretic to use in treating hypertension is based on:
Level of kidney function with a thiazide diuretic being used for an estimated glomerular filtration rate higher than the mid-40mL/min range
Chp 16: Direct renin inhibitors have the following properties. They:
"Shut down" the entire RAAS cycle
Chp 16: When comparing angiotensin-converting enzyme (ACE) and angiotensin II receptor blocker (ARB) medications, which of the following holds true?
Both contribute to some retention of potassium
Chp 16: What does the provider understand about the issue of "Diabetic Renal Protection" with angiotensin-converting enzyme (ACE) medications? Diabetes mellitus patients:
Have a reduced rate of renal progression, but still need to be discontinued when advanced renal issues present
Chp 16: What dermatological issue is linked to Amiodarone use?
Progressive change of skin tone toward a blue spectrum
Chp 16: Commercials on TV for erectile dysfunction (ED) medications warn about mixing them with nitrates. Why?
Chp 41: When methimazole is started for hyperthyroidism it may take ________ to see a total reversal of hyperthyroid symptoms.
6 to 12 months
Chp 41: In addition to methimazole, a symptomatic patient with hyperthyroidism may need a prescription for:
A beta blocker
Chp 41: After starting a patient with Grave's disease on an antithyroid agent such as methimazole, patient monitoring includes TSH and free T4 every:
3 to 4 weeks
Chp 41: A woman who is pregnant and has hyperthyroidism is best managed by a specialty team who will most likely treat her with:
Chp 41: Goals when treating hypothyroidism with thyroid replacement include:
-Normal TSH and free T4 levels
-Resolution of fatigue
-Weight loss to baseline
Chp 41: When starting a patient on levothyroxine for hypothyroidism the patient will need follow-up measurement of thyroid function in:
Chp 41: Once a patient who is being treated for hypothyroidism returns to euthyroid with normal TSH levels, he or she should be monitored with TSH and free T4 levels every:
Chp 41: Treatment of a patient with hypothyroidism and cardiovascular disease consists of:
Chp 41: Infants with congenital hypothyroidism are treated with:
Chp 41: When starting a patient with hypothyroidism on thyroid replacement hormones patient education would include:
It may take 4 to 8 weeks to get to euthyroid symptomatically and by laboratory testing.
Chp 41: In hyperthyroid states, what organ system other than CV must be evaluated to establish potential adverse issues?
Chp 41: Why are "natural" thyroid products not readily prescribed for most patients?
-There is no reliability for the amount of hormone per dose.
-There is higher incidence of allergic reactions.
-There is a more reliable dose of T3 to T4 per batch.
Chp 41: What is the desired mixed of T3 to T4 drug levels in newly diagnosed endocrine patients?
Most needs to be T4 to mimic natural ratios of hormone.
Chp 41: Laboratory values are actually different for TSH when screening for thyroid issues and when used for medication management. Which of the follow holds true?
Therapeutic values are kept between 0.05 and 3.0 ideally. Screening values are considered acceptable up to 10.
Chp 41: What happens to the typical hormone replacement dose when a woman becomes pregnant?
The average woman needs more medication during pregnancy.
Chp 38: The goals of therapy when prescribing hormone replacement therapy (HRT) include reducing:
Chp 38: The optimal maximum time frame for HRT or estrogen replacement therapy (ERT) is:
Chp 38: Dosage changes of conjugated equine estrogen (Premarin) are made at _________ intervals.
6 to 8 week
Chp 38: The advantage of vag