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Advanced Pharm-2024 > M3: CNS and ANS medications > Flashcards

M3: CNS and ANS medications Flashcards

1
Q

Sympathetic Antagonist

A

AKA: adrenergic antagonist

Blocks sympathetic response

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2
Q

Adrenergic Agonist

A

Stimulate, activate, helper

Stimulate deep sympathetic response

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3
Q

Cholinergic drugs

A

Acetylcholine (ACTH)
agonist-stimulates parasympathetic response (parasympathomimetic)
antagonists:
Parasympatholytic, anticholinergic, or antimuscarinic

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4
Q

Adrenergic

A

Sympathomimetics: Agonists
Sympatholyitics: antagonists

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5
Q
  1. Charlie is a 65-year-old male who has been diagnosed with hypertension and benign prostatic
    hyperplasia. Doxazosin has been chosen to treat his hypertension because it:

a. Increases peripheral vasoconstriction
b. Decreases detrusor muscle contractility
c. Lowers supine blood pressure more than standing pressure
d. Relaxes smooth muscle in the bladder neck

A
  1. Relaxes smooth muscle in the bladder neck

alpha blocker

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6
Q
  1. To reduce potential adverse effects, patients taking a peripherally acting alpha1 antagonist should
    do all of the following EXCEPT:
    a. Take the dose at bedtime
    b. Sit up slowly and dangle their feet before standing
    c. Monitor their blood pressure and skip a dose if the pressure is less than 120/80
    d. Weigh daily and report weight gain of greater than 2 pounds in one day
A
  1. Monitor their blood pressure and skip a dose if the pressure is less than 120/80
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7
Q
  1. John has clonidine, a centrally acting adrenergic blocker, prescribed for his hypertension. He should:
    a. Not miss a dose or stop taking the drug because of potential rebound hypertension
    b. Increase fiber in the diet to treat any diarrhea that may occur
    c. Reduce fluid intake to less than 2 liters per day to prevent fluid retention
    d. Avoid sitting for long periods, as this can lead to deep vein thrombosis
A
  1. Not miss a dose or stop taking the drug because of potential rebound hypertension
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8
Q
  1. Clonidine has several off-label uses, including:
    a. Alcohol and nicotine withdrawal
    b. Post-herpetic neuralgia
    c. Both 1 and 2
    d. Neither 1 nor 2
A

3 Both 1 and 2

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9
Q
  1. Which of the following adverse effects are less likely in a beta1-selective blocker?
    a. Dysrhythmias
    b. Impaired insulin release
    c. Reflex orthostatic changes
    d. Decreased triglycerides and cholesterol
A

2 Impaired insulin release

non-selective BB-propranolol this is more likely

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9
Q
  1. Jim is being treated for hypertension. Because he has a history of heart attack, the drug chosen
    is atenolol. Beta blockers treat hypertension by:
    a. Increasing heart rate to improve cardiac output
  2. Reducing vascular smooth muscle tone
  3. Increasing aldosterone-mediated volume activity
  4. Reducing aqueous humor production
A

2 Reducing vascular smooth muscle tone

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10
Q
  1. Richard is 70 years old and has a history of cardiac dysrhythmias. He has been prescribed nadolol.
    You do his annual laboratory work and find a CrCl of 25 ml/min. What action should you take
    related to his nadolol?
  2. Extend the dosage interval.
  3. Decrease the dose by 75%.
  4. Take no action because this value is expected in the older adult.
  5. Schedule a serum creatinine level to validate the CrCl value.
A

1 Extend the dosage interval.

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11
Q
  1. Beta blockers are the drugs of choice for exertional angina because they:
    a. Improve myocardial oxygen supply by vasodilating the coronary arteries
    b. Decrease myocardial oxygen demand by decreasing heart rate and vascular
    resistance
    c. Both 1 and 2
    d. Neither 1 nor 2
A

2 Decrease myocardial oxygen demand by decreasing heart rate and vascular

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12
Q
  1. Adherence to beta blocker therapy may be affected by their:
    a. Short half-lives requiring twice daily dosing
    b. Tendency to elevate lipid levels
    c. Effects on the male genitalia, which may produce impotence
    d. None of the above
A

3 Effects on the male genitalia, which may produce impotence

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13
Q
  1. Beta blockers have favorable effects on survival and disease progression in heart failure. Treatment
    should be initiated when the:
    a. Symptoms are severe
    b. Patient has not responded to other therapies
    c. Patient has concurrent hypertension
    d. Left ventricular dysfunction is diagnosed
A

4 Left ventricular dysfunction is diagnosed

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14
Q
  1. Abrupt withdrawal of beta blockers can be life threatening. Patients at highest risk for serious
    consequences of rapid withdrawal are those with:
    a. Angina
    b. Coronary artery disease
    c. Both 1 and 2
    d. Neither 1 nor 2
A
  1. both angina and CAD
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15
Q
  1. To prevent life-threatening events from rapid withdrawal of a beta blocker:
    a. The dosage interval should be increased by 1 hour each day.
    b. An alpha blocker should be added to the treatment regimen before withdrawal.
    c. The dosage should be tapered over a period of weeks.
    d. The dosage should be decreased by one-half every 4 days.
A

4 The dosage should be decreased by one-half every 4 days.

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16
Q
  1. Beta blockers are prescribed for diabetics with caution because of their ability to produce
    hypoglycemia and block the common symptoms of it. Which of the following symptoms of
    hypoglycemia is not blocked by these drugs and so can be used to warn diabetics of possible
    decreased blood glucose?
    a. Dizziness
    b. Increased heart rate
    c. Nervousness and shakiness
    d. Diaphoresis
A

4 Diaphoresis

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17
Q
  1. Combined alpha-beta antagonists are used to reduce the progression of heart failure because they:
    a. Vasodilate the peripheral vasculature
    b. Decrease cardiac output
    c. Increase renal vascular resistance
    d. Reduce atherosclerosis secondary to elevated serum lipoproteins
A

1 Vasodilate the peripheral vasculature

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18
Q
  1. Carvedilol is heavily metabolized by CYP2D6 and 2C9, resulting in drug interactions with which of
    the following drug classes?
    a. Histamine 2 blockers
    b. Quinolones
    c. Serotonin re-uptake inhibitors
    d. All of the above
A

Histamine 2 blockers
Quinolones
Serotonin re-uptake inhibitors
4. All of the above

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19
Q
  1. Alpha-beta blockers are especially effective to treat hypertension for which ethnic group?
    a. White
    b. Asian
    c. African American
    d. Native American
A
  1. African American
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20
Q
  1. Bethanechol:
    a. Increases detrusor muscle tone to empty the bladder
    b. Decreases gastric acid secretion to treat peptic ulcer disease
    c. Stimulates voluntary muscle tone to improve strength
    d. Reduces bronchial airway constriction to treat asthma
A

1 Increases detrusor muscle tone to empty the bladder

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21
Q
  1. Clinical dosing of Bethanechol:
    a. Begins at the highest effective dose to obtain a rapid response
    b. Starts at 5 mg to 10 mg PO and is repeated every hour until a satisfactory clinical response is achieved
    c. Requires dosing only once daily
    d. Is the same for both the oral and parenteral route
A
  1. Starts at 5 mg to 10 mg PO and is repeated every hour until a satisfactory clinical
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22
Q
  1. Patients who need to remain alert are taught to avoid which drug due to its antimuscarinic effects?
    a. Levothyroxine
    b. Prilosec
    c. Dulcolax
    d. Diphenhydramine
A
  1. Diphenhydramine
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23
Q
  1. Anticholinesterase inhibitors are used to treat:
  2. Peptic ulcer disease
  3. Myasthenia gravis
  4. Both 1 and 2
  5. Neither 1 nor 2
A
  1. Myasthenia gravis
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24
Q
  1. Which of the following drugs used to treat Alzheimer’s disease is not an anticholinergic?
  2. Donepezil
  3. Memantine
  4. Rivastigmine
  5. Galantamine
A
  1. Memantine

NMDA receptor antagonists

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25
Q
  1. Taking which drug with food maximizes it bioavailability?
  2. Donepezil
  3. Galantamine
  4. Rivastigmine
  5. Memantine
A
  1. Rivastigmine
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26
Q
  1. Which of the following drugs should be used only when clearly needed in pregnant and
    breastfeeding women?
  2. Memantine
  3. Pyridostigmine
  4. Galantamine
  5. Rivastigmine
A
  1. Pyridostigmine
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27
Q
  1. Adherence is improved when a drug can be given once daily. Which of the following drugs can be
    given once daily?
  2. Tacrine
  3. Donepezil
  4. Memantine
  5. Pyridostigmine
A
  1. Donepezil
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27
Q
  1. There is a narrow margin between first appearance of adverse reaction to AChE inhibitors
    and serious toxic effects. Adverse reactions that require immediate action include:
  2. Dizziness and headache
  3. Nausea
  4. Decreased salivation
  5. Fasciculations of voluntary muscles
A
  1. Fasciculations of voluntary muscles
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28
Q
  1. Nicotine has a variety of effects on nicotinic receptors throughout the body. Which of the
    following is NOT an effect of nicotine?
  2. Vasodilation and decreased heart rate
  3. Increased secretion of gastric acid and motility of the GI smooth muscle
  4. Release of dopamine at the pleasure center
  5. Stimulation of the locus coeruleus
A
  1. Vasodilation and decreased heart rate
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28
Q
  1. Nicotine gum products are:
  2. Chewed to release the nicotine and then swallowed for a systemic effect
  3. “Parked” in the buccal area of the mouth to produce a constant amount of nicotine
    release
  4. Bound to exchange resins so the nicotine is only released during chewing
  5. Approximately the same in nicotine content as smoking two cigarettes
A
  1. Bound to exchange resins so the nicotine is only released during chewing
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29
Q
  1. Cholinergic blockers are used to:
  2. Counteract the extrapyramidal symptoms (EPS) effects of phenothiazines
  3. Control tremors and relax smooth muscle in Parkinson’s disease
  4. Inhibit the muscarinic action of ACh on bladder muscle
  5. All of the above
A

Counteract the extrapyramidal symptoms (EPS) effects of phenothiazines
Control tremors and relax smooth muscle in Parkinson’s disease
Inhibit the muscarinic action of ACh on bladder muscle
4. All of the above

29
Q
  1. Nicotine replacement therapy (NRT):
  2. Is widely distributed in the body only when the gum products are used
  3. Does not cross the placenta and so is safe for pregnant women
  4. Delays healing of esophagitis and peptic ulcers
  5. Has no drug interactions when a transdermal patch is used
A
  1. Delays healing of esophagitis and peptic ulcers
30
Q
  1. Success rates for smoking cessation using NRT:
  2. Are about the same regardless of the method chosen
  3. Vary from 40% to 50% at 12 months
  4. Both 1 and 2
  5. Neither 1 nor 2
A
  1. Vary from 40% to 50% at 12 months
30
Q
  1. Several classes of drugs have interactions with cholinergic blockers. Which of the following is
    true about these interactions?
  2. Drugs with a narrow therapeutic range given orally may not stay in the GI tract
    long enough to produce an action.
  3. Additive antimuscarinic effects may occur with antihistamines.
  4. Cholinergic blockers may decrease the sedative effects of hypnotics.
  5. Cholinergic blockers are contraindicated with antipsychotics.
A
  1. Drugs with a narrow therapeutic range given orally may not stay in the GI tract
31
Q
  1. Scopolamine can be used to prevent the nausea and vomiting associated with motion sickness. The
    patient is taught to:
  2. Apply the transdermal disk at least 4 hours before the antiemetic effect is desired.
  3. Swallow the tablet 1 hour before traveling where motion sickness is possible.
  4. Place the tablet under the tongue and allow it to dissolve.
  5. Change the transdermal disk daily for maximal effect
A
  1. Apply patch 4 hrs before

Po form discontinued

32
Q
  1. You are managing the care of a patient recently diagnosed with benign prostatic hyperplasia (BPH).
    He is taking tamsulosin but reports dizziness when standing abruptly. The best option for this patient
    is:
  2. Continue the tamsulosin because the side effect will resolve with continued
    treatment.
  3. Discontinue the tamsulosin and start doxazosin.
  4. Have him double his fluid intake and stand more slowly.
  5. Prescribe meclizine as needed for the dizziness.
A
  1. Discontinue the tamsulosin and start doxazosin.
33
Q
  1. You are treating a patient with a diagnosis of Alzheimer’s disease. The patient’s wife mentions
    difficulty with transportation to the clinic. Which medication is the best choice?
  2. Donepezil
  3. Tacrine
  4. Doxazosin
  5. Verapamil
A
  1. Donepezil
34
Q
  1. A patient presents with a complaint of dark stools and epigastric pain described as gnawing
    and burning. Which of the medications is the most likely cause?
  2. Acetaminophen
  3. Estradiol
  4. Donepezil
  5. Bethanechol
A
  1. Bethanechol
35
Q
  1. Sarah, a 42-year-old female, requests a prescription for an anorexiant to treat her obesity. A trial of
    phentermine is prescribed. Prescribing precautions include:
  2. Understanding that obesity is a contraindication to prescribing phentermine
  3. Anorexiants may cause tolerance and should only be prescribed for 6 months
  4. Patients should be monitored for postural hypotension
  5. Renal function should be monitored closely while on anorexiants
A
  1. Anorexiants may cause tolerance and should only be prescribed for 6 months
36
Q
  1. Your patient calls for an appointment before going on vacation. Which medication should you
    ensure he has an adequate supply of before leaving to avoid life-threatening complications?
  2. Carvedilol
  3. Donepezil
  4. Bethanechol
  5. Tacrine
A
  1. Carvedilol
37
Q
  1. Activation of central alpha2 receptors results in inhibition of cardio acceleration and
    centers in the brain.
  2. Vasodilation
  3. Vasoconstriction
  4. Cardiovascular
  5. Respiratory
A
  1. Vasoconstriction
38
Q
  1. Before prescribing phentermine to Sarah, a thorough drug history should be taken including
    assessing for the use of serotonergic agents such as selective serotonin reuptake inhibitors (SSRIs)
    and St John’s wort due to:
  2. Additive respiratory depression risk
  3. Additive effects affecting liver function
  4. The risk of serotonin syndrome
  5. The risk of altered cognitive functioning
A
  1. The risk of serotonin syndrome
39
Q
  1. Antonia is a 3-year-old child who has a history of status epilepticus. Along with her routine
    antiseizure medication, she should also have a home prescription for to be used for an
    episode of status epilepticus.
  2. IV phenobarbital
  3. Rectal diazepam (Diastat)
  4. IV phenytoin (Dilantin)
  5. Oral carbamazepine (Tegretol)
A
  1. Rectal diazepam (Diastat)
40
Q
  1. Rabi is being prescribed phenytoin for seizures. Monitoring includes assessing:
  2. For phenytoin hypersensitivity syndrome 3 to 8 weeks after starting treatment
  3. For pedal edema throughout therapy
  4. Heart rate at each visit and consider altering therapy if heart rate is less than
    60 bpm
  5. For vision changes, such as red-green blindness, at least annually
A
  1. For phenytoin hypersensitivity syndrome 3 to 8 weeks after starting treatment
41
Q
  1. Dwayne has recently started on carbamazepine to treat seizures. He comes to see you and you note
    that while his carbamazepine levels had been in the therapeutic range, they are now low. The
    possible cause for the low carbamazepine levels include:
  2. Dwayne hasn’t been taking his carbamazepine because it causes insomnia.
  3. Carbamazepine auto-induces metabolism, leading to lower levels in spite of good
    compliance.
  4. Dwayne was not originally prescribed the correct amount of carbamazepine.
  5. Carbamazepine is probably not the right antiseizure medication for Dwayne.
A
  1. Carbamazepine auto-induces metabolism, leading to lower levels in spite of good
    compliance.

The autoinduction process takes about 4 weeks. Carbamazepine stimulates the synthesis of many monooxygenase and conjugating enzymes, which leads to the metabolism of many medications

42
Q
  1. Long-term monitoring of patients who are taking carbamazepine includes:
  2. Routine troponin levels to assess for cardiac damage
  3. Annual eye examinations to assess for cataract development
  4. Monthly pregnancy tests for all women of childbearing age
  5. Complete blood count every 3 to 4 months
A
  1. Complete blood count every 3 to 4 months
43
Q
  1. Carbamazepine has a Black Box Warning due to life-threatening:
  2. Renal toxicity, leading to renal failure
  3. Hepatotoxicity, leading to liver failure
  4. Dermatologic reaction, including Steven’s Johnson and toxic epidermal necrolysis
  5. Cardiac effects, including supraventricular tachycardia
A
  1. Dermatologic reaction, including Steven’s Johnson and toxic epidermal necrolysis
44
Q
  1. Six-year-old Lucy has recently been started on ethosuximide (Zarontin) for seizures. She should be
    monitored for:
  2. Increased seizure activity, as this drug may auto-induce seizures
  3. Altered renal function, including renal failure
  4. Blood dyscrasias, which are uncommon but possible
  5. Central nervous system excitement, leading to insomnia
A
  1. Blood dyscrasias, which are uncommon but possible
45
Q
  1. Sook has been prescribed gabapentin to treat neuropathic pain and is complaining of feeling
    depressed and having “strange” thoughts. The appropriate initial action would be:
  2. Increase her dose
  3. Assess for suicidal ideation
  4. Discontinue the medication immediately
  5. Decrease her dose to half then slowly titrate up the dose
A
  1. Assess for suicidal ideation
46
Q
  1. Scott’s seizures are well controlled on topiramate and he wants to start playing baseball. Education
    for Scott regarding his topiramate includes:
  2. He should not play sports due to the risk of increased seizures
  3. He should monitor his temperature and ability to sweat in the heat while playing
  4. Reminding him that he may need higher dosages of topiramate when exercising
  5. Encouraging him to use sunscreen due to photosensitivity from topiramate
A
  1. He should monitor his temperature and ability to sweat in the heat while playing
46
Q
  1. Monitoring of a patient on gabapentin to treat seizures includes:
  2. Routine therapeutic drug levels every 3 to 4 months
  3. Assessing for dermatologic reactions, including Steven’s Johnson
  4. Routine serum electrolytes, especially in hot weather
  5. Recording seizure frequency, duration, and severity
A
  1. Recording seizure frequency, duration, and severity
46
Q
  1. Selma, who is overweight, recently started taking topiramate for seizures and at her follow-up
    visit you note she has lost 3 kg. The appropriate action would be:
  2. Tell her to increase her caloric intake to counter the effects of the topiramate.
  3. Consult with a neurologist, as this is not a common adverse effect of topiramate.
  4. Decrease her dose of topiramate.
  5. Reassure her that this is a normal side effect of topiramate and continue to monitor
    her weight.
A
  1. Reassure her that this is a normal side effect of topiramate and continue to monitor
    her weight.
47
Q
  1. Zainab is taking lamotrigine (Lamictal) and presents to the clinic with fever and lymphadenopathy.
    Initial evaluation and treatment includes:
  2. Reassuring her she has a viral infection and to call if she isn’t better in 4 or 5 days
  3. Ruling out a hypersensitivity reaction that may lead to multi-organ failure
  4. Rapid strep test and symptomatic care if strep test is negative
  5. Observation only, with further assessment if she worsens
A
  1. Ruling out a hypersensitivity reaction that may lead to multi-organ failure
47
Q
  1. Cara is taking levetiracetam (Keppra) to treat seizures. Routine education for levetiracetam
    includes reminding her:
  2. To not abruptly discontinue levetiracetam due to risk for withdrawal seizures
  3. To wear sunscreen due to photosensitivity from levetiracetam
  4. To get an annual eye exam while on levetiracetam
  5. To report weight loss if it occurs
A
  1. To not abruptly discontinue levetiracetam due to risk for withdrawal seizures
48
Q
  1. Levetiracetam has known drug interactions with:
  2. Combined oral contraceptives
  3. Carbamazepine
  4. Warfarin
  5. Few, if any, drugs
A
  1. Few, if any, drugs
49
Q
  1. Samantha is taking lamotrigine (Lamictal) for her seizures and requests a prescription for combined
    oral contraceptives (COCs), which interact with lamotrigine and may cause:
  2. Contraceptive failure
  3. Excessive weight gain
  4. Reduced lamotrigine levels, requiring doubling the dose of lamotrigine
  5. Induction of estrogen metabolism, requiring higher estrogen content OCs
    be prescribed
A
  1. Reduced lamotrigine levels, requiring doubling the dose of lamotrigine
50
Q
  1. A 66-year-old male was prescribed phenelzine (Nardil) while in an acute psychiatric unit for
    recalcitrant depression. The NP managing his primary health care needs to understand the following
    regarding phenelzine and other monoamine oxidase inhibitors (MAOIs):
  2. He should not be prescribed any serotonergic drug such as sumatriptan (Imitrex)
  3. MAOIs interact with many common foods, including yogurt, sour cream, and soy
    sauce
  4. Symptoms of hypertensive crisis (headache, tachycardia, sweating) require
    immediate treatment
  5. All of the above
A

He should not be prescribed any serotonergic drug such as sumatriptan (Imitrex)
MAOIs interact with many common foods, including yogurt, sour cream, and soy
sauce
Symptoms of hypertensive crisis (headache, tachycardia, sweating) require
immediate treatment
4. All of the above

50
Q
  1. The tricyclic antidepressants should be prescribed cautiously in patients with:
  2. Eczema
  3. Asthma
  4. Diabetes
  5. Heart disease
A
  1. Heart disease
51
Q
  1. Taylor is a 10-year-old child diagnosed with major depression. The appropriate firstline antidepressant for children is:
  2. Fluoxetine
  3. Fluvoxamine
  4. Sertraline
  5. Escitalopram
A
  1. Fluoxetine
52
Q
  1. Suzanne is started on paroxetine (Paxil), a selective serotonin reuptake inhibitor (SSRI),
    for depression. Education regarding her antidepressant includes:
  2. SSRIs may take 2 to 6 weeks before she will have maximum drug effects.
  3. Red-green color blindness may occur and should be reported.
  4. If she experiences dry mouth or heart rates greater than 80, she should stop taking
    the drug immediately.
  5. She should eat lots of food high in fiber to prevent constipation.
A
  1. SSRIs may take 2 to 6 weeks before she will have maximum drug effects.
53
Q
  1. Cecilia presents with depression associated with complaints of fatigue, sleeping all the time, and
    lack of motivation. An appropriate initial antidepressant for her would be:
  2. Fluoxetine (Prozac)
  3. Paroxetine (Paxil)
  4. Amitriptyline (Elavil)
  5. Duloxetine (Cymbalta)
A
  1. Duloxetine (Cymbalta)
53
Q
  1. Jake, a 45-year-old patient with schizophrenia, was recently hospitalized for acute psychosis due to
    medication noncompliance. He was treated with IM long-acting haloperidol. Besides monitoring
    his schizophrenia symptoms, the patient should be assessed by his primary care provider:
  2. For excessive weight loss
  3. With the Abnormal Involuntary Movement Scale (AIMS) for extrapyramidal symptoms (EPS)
  4. Monthly for tolerance to the haloperidol
  5. Only by the mental health provider, as most NPs in primary care do not care for
    mentally ill patients
A
  1. With the Abnormal Involuntary Movement Scale (AIMS) for extrapyramidal symptoms (EPS)
54
Q
  1. Anticholinergic agents, such as benztropine (Cogentin), may be given with a phenothiazine to:
  2. Reduce the chance of tardive dyskinesia
  3. Potentiate the effects of the drug
  4. Reduce the tolerance that tends to occur
  5. Increase central nervous system (CNS) depression
A
  1. Potentiate the effects of the drug
55
Q
  1. Patients who are prescribed olanzapine (Zyprexa) should be monitored for:
  2. Insomnia
  3. Weight gain
  4. Hypertension
  5. Galactorrhea
A
  1. Insomnia
56
Q
  1. A 19-year-old male was started on risperidone. Monitoring for risperidone includes observing
    for common side effects, including:
  2. Bradykinesia, akathisia, and agitation
  3. Excessive weight gain
  4. Hypertension
  5. Potentially fatal agranulocytosis
A
  1. Bradykinesia, akathisia, and agitation
57
Q
  1. In choosing a benzodiazepam to treat anxiety the prescriber needs to be aware of the possibility of
    dependence. The benzo diazepam with the greatest likelihood of rapidly developing dependence
    is:
  2. Chlordiazepoxide (Librium)
  3. Clonazepam (Klonopin)
  4. Alprazolam (Xanax)
  5. Oxazepam (Serax)
A
  1. Alprazolam (Xanax)
58
Q
  1. A patient with anxiety and depression may respond to:
  2. Duloxetine (Cymbalta)
  3. Fluoxetine (Prozac)
  4. Oxazepam (Serax)
  5. Buspirone (Buspar) and an SSRI combined
A
  1. Buspirone (Buspar) and an SSRI combined
59
Q
  1. When prescribing temazepam (Restoril) for insomnia, patient education includes:
  2. Take temazepam nightly approximately 15 minutes before bedtime.
  3. Temazepam should not be used more than three times a week for less than 3 months.
  4. Drinking 1 ounce of alcohol will cause additive effects and the patient will sleep better.
  5. Exercise for at least 30 minutes within 2 hours of bedtime to enhance the effects of temazepam.
A
  1. Temazepam should not be used more than three times a week for less than 3
    months.
60
Q
  1. Tom is taking lithium for bipolar disorder. He should be taught to:
  2. Take his lithium with food
  3. Eat a diet with consistent levels of salt (sodium)
  4. Drink at least 2 quarts of water if he is in a hot environment
  5. Monitor blood glucose levels
A
  1. Eat a diet with consistent levels of salt (sodium)
60
Q
  1. Patients should be instructed regarding the rapid onset of zolpidem (Ambien) because:
  2. Zolpidem should be taken just before going to bed.
  3. Zolpidem may cause dry mouth and constipation.
  4. Patients may need to double the dose for effectiveness.
  5. They should stop drinking alcohol at least 30 minutes before taking zolpidem
A
  1. Zolpidem should be taken just before going to bed.
61
Q
  1. One major drug used to treat bipolar disease is lithium. Because lithium has a narrow
    therapeutic range, it is important to recognize symptoms of toxicity, such as:
  2. Orthostatic hypotension
  3. Agitation and irritability
  4. Drowsiness and nausea
  5. Painful urination and abdominal distention
A
  1. Drowsiness and nausea
62
Q
  1. Cynthia is taking valproate (Depakote) for seizures and would like to get pregnant. What advice
    would you give her?
  2. Valproate is safe during all trimesters of pregnancy.
  3. She can get pregnant while taking valproate, but she should take adequate folic acid.
  4. Valproate is not safe at any time during pregnancy.
  5. Valproate is a known teratogen, but may be taken after the first trimester if necessary.
A
  1. Valproate is a known teratogen, but may be taken after the first trimester if necessary.
63
Q
  1. When prescribing an opioid analgesic such as acetaminophen and codeine (Tylenol #3),
    instructions to the patient should include:
  2. The medication may cause sedation and they should not drive.
  3. Constipation is a common side effect and they should increase fluids and fiber.
  4. Patients should not take any other acetaminophen-containing medications at
    the same time.
  5. All of the above
A

The medication may cause sedation and they should not drive.
Constipation is a common side effect and they should increase fluids and fiber.
Patients should not take any other acetaminophen-containing medications at
the same time.
4. All of the above

64
Q
  1. Kirk sprained his ankle and is asking for pain medication for his mild-to-moderate pain.
    The appropriate first-line medication would be:
  2. Ibuprofen (Advil)
  3. Acetaminophen with hydrocodone (Vicodin)
  4. Oxycodone (Oxycontin)
  5. Oral morphine (Roxanol)
A
  1. Ibuprofen (Advil)
65
Q
  1. Kasey fractured his ankle in two places and is asking for medication for his pain. The appropriate
    first-line medication would be:
  2. Ibuprofen (Advil)
  3. Acetaminophen with hydrocodone (Vicodin)
  4. Oxycodone (Oxycontin)
  5. Oral morphine (Roxanol)
A
  1. Acetaminophen with hydrocodone (Vicodin)
66
Q
  1. Jack, age 8, has attention deficit disorder (ADD) and is prescribed methylphenidate (Ritalin). He
    and his parents should be educated about the side effects of methylphenidate, which are:
  2. Slurred speech and insomnia
  3. Bradycardia and confusion
  4. Dizziness and orthostatic hypotension
  5. Insomnia and decreased appetite
A
  1. Insomnia and decreased appetite
67
Q
  1. Monitoring for a child on methylphenidate for attention deficit hyperactivity disorder
    (ADHD) includes:
  2. ADHD symptoms
  3. Routine height and weight checks
  4. Amount of methylphenidate being used
  5. All of the above
A

ADHD symptoms
Routine height and weight checks
Amount of methylphenidate being used
4. All of the above

68
Q
  1. When prescribing Adderall (amphetamine and dextroamphetamine) to adults with ADHD the
    nurse practitioner will need to monitor:
  2. Blood pressure
  3. Blood glucose levels
  4. Urine ketone levels
  5. Liver function
A
  1. Blood pressure

Advanced Pharm-2024 (19 decks)

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