Cardiology

Question 1

When prescribing corticosteroid nasal spray in chronic rhinitis, the APN considers:

Answer 1

the patient should be instructed to not inhale too deeply so deposition remains locally in nasal sinuses

Question 2

Which of the following are methods of hydration utilized to enhance absorption of topically applied medications?

Answer 2

occlusion with impermeable film
application of lipophilic occlusive vehicle such as ointment
soaking dry skin prior to occlusion

Question 3

Joe is a 15 year old male with complaints of severe pruritus in localized areas. The APN has diagnosed scabies infestation in this patient. Treatment considerations of dermatological scabies infestation include

Answer 3

patient education to inform the patient that pruritis may persist for weeks following effective treatment

Question 4

What drug demonstrates thromboxane A2 synthesis inhibition and irreversible platelet inhibition?

Answer 4

aspirin

Question 5

A diuretic that demonstrates prevention of potassium secretion and sodium reabsorption and has an indication for heart failure is best described as:

Answer 5

aldosterone antagonist (spironolactone)

Question 6

Choose the correct statement regarding topical decongestants therapy.

Answer 6

Topical decongestants constrict arterioles in the nasal mucosa

Question 7

When considering pharmacologic therapy for a patient with diarrhea, the APN is aware:

Answer 7

antidiarrheal medications are contraindicated in bloody diarrhea and high fever
Bismuth subsalicylate (Pepto-Bismol) may have antimicrobial and antisecretory effects

Question 8

When treating a women of childbearing age for hypertension, the APN is aware that ________ is a drug / drug category that is contraindicated in pregnancy.

Answer 8

ACE inhibitors

Question 9

Daniel, the wonderful new APN, is prescribing montelukast for exercise induced bronchoconstriction. When educating his patient he explains:

Answer 9

the dose should be taken at least 2 hrs prior to exercise

Question 10

Tom Hanks, is a patient with newly diagnosed mild chronic systolic heart failure. His left ventricular ejection fraction (LVEF) is 35%. He appears euvolemic with no symptoms of volume overload. His coronary angiogram demonstrated no evidence of coronary artery disease. Which drug class has shown therapeutic benefit in this patient population and would be the BEST choice for this patient?

Answer 10

ACE inhibitors

Question 11

The APN is managing a patient with coronary artery disease, hypertension and hyperlipidemia. The patient presents for follow up 3 weeks after beginning a new agent and complains of increased lower leg edema and bradycardia. He has had no dietary or activity changes. The new agent most likely responsible for these symptoms is:

Answer 11

a calcium channel blocker

Question 12

Considerations in prescribing topical corticosteroids of which the APN must be aware include:

Answer 12

there is marked region anatomic variation is corticosteroid penetration, for example, absorption is much greater through the skin of the scalp than it is through the forearm

Question 13

The mechanism(s) of action of Beta Blockers can best be described as:

Answer 13

Decreased contractility of the myocardium and inhibition of renin.

Question 14

When choosing a topical anti-infective agent, the APN considers the following:

Answer 14

pathogens most often isolated from dermatologic infections are group A-hemolytic strep, staph aureus or both
pathogens most often isolated from dermatologic infections are group A-hemolytic strep, staph aureus or both
bacitracin and gramicidin are active against many gram positive organisms; including strep and staph
allergic contact dermatitis is a common side effect of bacitracin

Question 15

Which of the following statement(s) is/are correct regarding long-acting beta 2 agonists:

Answer 15

they may be prescribed for routine asthma control, but only in combination with inhaled corticosteroids

Question 16

Which of the following statements is/are correct regarding therapy with ursodiol (Actigall)?

Answer 16

treatment with the drug should be continued for at least 3 months post dissolution of the gallstones
baseline LFTs are not indicated

Question 17

Common decongestant drugs like pseudoephedrine and phenylephrine:

Answer 17

should not be used in patients with mitral valve prolapse and palpitations
are alpha-adrenergic agonists

Question 18

When choosing pharmacological therapy for a patient, the APN is aware that beta blocker agents should be used with caution in patients with:

Answer 18

diabetes
acute decompensated heart failure
severe asthma

Question 19

The drug of choice indicated for persistent mild or moderate asthma symptoms is:

Answer 19

an inhaled corticosteroid

Question 20

The mechanism(s) of action for direct-acting beta 2 agonists is/are:

Answer 20

bronchodilatation

Question 21

Jimmy Fallon is a 35 year old male with mild persistent asthma. You have prescribed an inhaled corticosteroids due to your knowledge that this drug class:

Answer 21

attenuates the inflammatory cascade and activation of macrophages and eosinophils

Question 22

Please choose the correct statement regarding principles of cancer chemotherapy.

Answer 22

Cancer chemotherapeutic agents target DNA or metabolic sites essential to cell replication.

Question 23

Following topical ophthalmic instillation, drug absorption is determined by:

Answer 23

the time the drug remains in the cul-de-sac and tear film
elimination by nasolacrimal drainage
drug binding to tear proteins

Question 24

Adverse effects of beta 2 agonists could include:

Answer 24

hypokalemia

Question 25

Which of the following statements is correct?

Answer 25

antiviral agents are typically not indicated for the treatment of viral conjunctivitis caused by adenoviruses
deficiency in vitamin A can result in a loss of ability for dark adaptation and “night blindness”

Question 26

Choose the statement(s) that is correct regarding thiazide diuretics:

Answer 26

they are first line agents in the management of hypertension
they increase sodium reabsorption in distal tubules
they do not cause photosensitivity

Question 27

Potential effects resulting from long term use of proton pump inhibitors include:

Answer 27

decreased risk of gastric ulcers secondary to aspirin and other NSAID use

Question 28

Mary Marvelous APN is choosing topical antimicrobial therapy for an adolescent patient with acne vulgaris. Choice of the antimicrobial agent is based on your knowledge that:

Answer 28

topical antimicrobials typically used in treatment of acne may include: sulfacetamide, clindamycin and metronidazole

Question 29

Indications for pharmacologic therapy with beta blockers may include:

Answer 29

various tachyarrhythmias, such as atrial fibrillation with rapid ventricular response

Question 30

Depletion of intracellular cholesterol and lowering of LDL levels is the action of what drug class used to treat lipid disorders?

Answer 30

statins

Question 31

You are prescribing antihypertensive therapy for a patient with diabetes and asthma. Which drug class would NOT be an optimal choice for a patient with these comorbid conditions?

Answer 31

beta blockers

Question 32

Your patient, Johnny Depp, has started a drug you prescribed for hypertension. He presents for follow-up in two weeks and complains of a nagging, dry cough that began shortly after initiation of therapy and reports swelling of his lips that had just started this morning. The agent that you likely prescribed is:

Answer 32

lisinopril, (Prinivil)

Question 33

Consideration of patient variables to keep in mind when prescribing a topical pharmacologic agent may include:

Answer 33

an amount of medication applied to a pediatric patient may result in a greater systemic dose, than an equal amount applied to an adult

Question 34

The APN is prescribing topical Mupirocin (Bactroban) for a patient who is going to have knee replacement surgery next week. The APN is aware:

Answer 34

mupirocin is often employed preoperatively to eliminate nasal carriage of Staph aureus

Question 35

Which statement(s) regarding dermatological pharmacologic preparations is/are correct?

Answer 35

chronic inflammation with xerosis and lichenification is best treated with lubricating vehicles such as ointments

Question 36

When choosing optimal therapy for treatment of peptic ulcer disease, the knowledgeable APN considers:

Answer 36

The possibility of H. pylori infection must be investigated and appropriately diagnosed/documented

Question 37

A diuretic that demonstrates prevention of potassium secretion and sodium reabsorption and has an indication for heart failure is best described as:

Answer 37

aldosterone antagonist (spironolactone)

Question 38

Jim, your 20 y/o male patient with severe asthma, required three hospitalizations last year for exacerbations. In the past 6 months that you have been treating Jim, he has had no hospitalizations for exacerbation. Which therapy is most likely responsible for this benefit?

Answer 38

an inhaled corticosteroid combined with a long acting beta 2 agonist

Question 39

David Letterman is your 65y/o patient for whom you have recently prescribed an antihypertensive agent. At his follow-up appointment, he is reporting symptoms of dizziness and lightheadedness when getting up to the bathroom at night. What type of agent is most likely responsible for these symptoms?

Answer 39

selective Alpha 1 blocker

Question 40

All of the following are correct statements regarding warfarin EXCEPT:

Answer 40

it is not reversible with administration of Vitamin K or fresh frozen plasma