Question
1. Question :
The drug recommended as primary prevention of osteoporosis in men over seventy years is:
Alendronate (Fosamax)
Ibandronate (Boniva)
Calcium carbonate
Raloxifene (Evista)
Question 2. Question :
Alterations in drug metabolism among Asians may lead to:
Slower metabolism of antidepressants, requiring lower doses
Faster metabolism of neuroleptics, requiring higher doses
Altered metabolism of omeprazole, requiring higher doses
Slower metabolism of alcohol, requiring higher doses
Question 3. Question :
Some research supports that testosterone replacement therapy may be indicated in which of the following diagnoses in men?
Age-related decrease in cognitive functioning
Metabolic syndrome
Decreased muscle mass in aging men
All of the above
Question 4. Question :
The chemicals that promote the spread of pain locally include _________.
serotonin
norepinephrine
enkephalin
neurokinin A
Question 5. Question :
The DEA:
Registers manufacturers and prescribes controlled substances
Regulates NP prescribing at the state level
Sanctions providers who prescribe drugs off-label
Provides prescribers with a number they can use for insurance billing
Question 6. Question :
The trial period to determine effective anti-inflammatory activity when starting a patient on aspirin for RA is _____.
forty-eight hours
four to six days
four weeks
two months
Question 7. Question :
The route of excretion of a volatile drug will likely be:
The kidneys
The lungs
The bile and feces
The skin
Question 8. Question :
Compelling indications for an ACE inhibitor as treatment for hypertension based on clinical trials include:
Pregnancy
Renal parenchymal disease
Stable angina
Dyslipidemia
Question 9. Question :
The American Diabetic Association has recommended which of the following tests for ongoing management of diabetes?
Fasting blood glucose
Hemoglobin A1c
Thyroid function tests
Electrocardiograms
Question 10. Question :
The angiotensin converting enzyme (ACE) inhibitor lisinopril is a known teratogen. Teratogens cause Type ____ ADR.
A
B
C
D
Question 11. Question :
The goals of therapy when prescribing HRT include reducing:
Cardiovascular risk
Risk of stroke or other thromboembolic event
Breast cancer risk
Vasomotor symptoms
Question 12. Question :
Patients who have angina, regardless of class, who are also diabetic should be on:
Nitrates
Beta blockers
ACE inhibitors
Calcium channel blockers
Question 13. Question :
The New York Heart Association and the Canadian Cardiovascular Society have described grading criteria for levels of angina. Angina that occurs with unusually strenuous activity or on walking or climbing stair after meals is:
Class I
Class II
Class III
Class IV
Question 14. Question :
Patients with allergic rhinitis may benefit from a prescription of:
Fluticasone (Flonase)
Cetirizine (Zyrtec)
OTC cromolyn nasal spray (Nasalcrom)
Any of the above
Question 15. Question :
Kyle has Crohn’s disease and has a documented folate deficiency. Drug therapy for folate deficiency anemia is:
Oral folic acid 1 to 2 mg/day
Oral folic acid 1 gm/day
IM folate weekly for at least six months
Oral folic acid 400 mcg daily
Question 16. Question :
The treatment for vitamin B12 deficiency is:
1,000 mcg daily of oral cobalamin
2 gm/day of oral cobalamin
100 mcg/day vitamin B12 IM
500 mcg/dose nasal cyanocobalamin two sprays once a week
Question 17. Question :
Nonadherence is especially common in drugs that treat asymptomatic conditions, such as hypertension. One way to reduce the likelihood of nonadherence to these drugs is to prescribe a drug that:
Has a short half-life so that missing one dose has limited effect
Requires several dosage titrations so that missed doses can be replaced with lower doses to keep costs down
Has a tolerability profile with less of the adverse effects that are considered “irritating,” such as nausea and dizziness
Must be taken no more than twice a day
Question 18. Question :
Type II diabetes is a complex disorder involving:
Absence of insulin production by the beta cells
A suboptimal response of insulin-sensitive tissues in the liver
Increased levels of GLP in the postprandial period
Too much fat uptake in the intestine
Question 19. Question :
Metformin is a primary choice of drug to treat hyperglycemia in type II diabetes because it:
Substitutes for insulin usually secreted by the pancreas
Decreases glycogenolysis by the liver
Increases the release of insulin from beta cells
Decreases peripheral glucose utilization
Question 20. Question :
Gender differences between men and women in pharmacokinetics include:
More rapid gastric emptying so that drugs absorbed in the stomach have less exposure to absorption sites
Higher proportion of body fat so that lipophilic drugs have relatively greater volumes of distribution
Increased levels of bile acids so that drugs metabolized in the intestine have higher concentrations
Slower organ blood flow rates so that drugs tend to take longer to be excreted
Question 21. Question :
If not chosen as the first drug in hypertension treatment, which drug class should be added as the second step because it will enhance the effects of most other agents?
ACE inhibitors
Beta blockers
Calcium channel blockers
Diuretics
Question 22. Question :
A nineteen-year-old male was started on risperidone. Monitoring for risperidone includes observing for common side effects, including:
Bradykinesia, akathisia, and agitation
Excessive weight gain
Hypertension
Potentially fatal agranulocytosis
Question 23. Question :
Levetiracetam has known drug interactions with:
Oral contraceptives
Carbamazepine
Warfarin
Few, if any, drugs
Question 24. Question :
When the total daily insulin dose is split and given twice daily, which of the following rules may be followed?
Give two-thirds of the total dose in the morning and one-third in the evening.
Give 0.3 units/kg of premixed 70/30 insulin, with one-third in the morning and two-thirds in the evening.
Give 50% of an insulin glargine dose in the morning and 50% in the evening.
Give long-acting insulin in the morning and short-acting insulin at bedtime.
Question 25. Question :
Which of the following factors may adversely affect a patient’s adherence to a therapeutic drug regimen?
Complexity of the drug regimen
Patient’s perception of the potential adverse effects of the drugs
Both A and B
Neither A nor B
Question 26. Question :
The time required for the amount of drug in the body to decrease by 50% is called:
Steady state
Half-life
Phase II metabolism
Reduced bioavailability time
Question 27. Question :
Drugs that are absolutely contraindicated in lactating women include:
Selective serotonin reuptake inhibitors
Antiepileptic drugs such as carbamazepine
Antineoplastic drugs such as methotrexate
All of the above
Question 28. Question :
Tobie presents to clinic with moderate acne. He has been using OTC benzoyl peroxide at home with minimal improvement. A topical antibiotic (clindamycin) and a topical retinoid adapalene (Differin) are prescribed. Education of Tobie would include which one of the following instructions?
He should see an improvement in his acne within the first two weeks of treatment.
If there is no response in a week, he should double the daily application of adapalene (Differin).
He may see an initial worsening of his acne that will improve in six to eight weeks.
Adapalene may cause bleaching of clothing.
Question 29. Question :
Martin is a sixty-year-old with hypertension. The first-line decongestant to be prescribed would be:
Oral pseudoephedrine
Oral phenylephrine
Nasal oxymetazoline
Nasal azelastine
Question 30. Question :
A woman who is pregnant and has hyperthyroidism is best managed by a specialty team that will most likely treat her with:
Methimazole.
Propylthiouracil.
Radioactive iodine.
Nothing; treatment is best delayed until after her pregnancy ends.
Question 31. Question :
A twenty-four-year-old male received multiple fractures in a motor vehicle accident that required significant amounts of opioid medication to treat his pain. He is at risk for Type __ ADR when he no longer requires the opioids.
A
C
E
G
Question 32. Question :
Second-generation antihistamines such as loratadine (Claritin) are prescribed for seasonal allergies because they:
Are more effective than first-generation antihistamines
Are less sedating than first-generation antihistamines
Are prescription products and, therefore, are covered by insurance
Can be taken with CNS sedatives, such as alcohol
Question 33. Question :
Steady state is:
The point on the drug concentration curve when absorption exceeds excretion
When the amount of drug in the body remains constant
When the amount of drug in the body stays below the minimum toxic concentration (MTC)
All of the above
Question 34. Question :
Jayla is a nine-year-old who has been diagnosed with migraines for almost two years. She is missing up to a week of school each month. Her headache diary confirms she averages four or five migraines per month. Which of the following would be appropriate?
Prescribe amitriptyline (Elavil) daily, start at a low dose and increase the dose slowly every two weeks until effective in eliminating migraines.
Encourage her mother to give her Excedrin Migraine (aspirin, acetaminophen, and caffeine) at the first sign of a headache to abort the headache.
Prescribe propranolol (Inderal) to be taken daily for at least three months.
Explain that it is rare for a nine-year-old to get migraines and that she needs an MRI to rule out a brain tumor.
Question 35. Question :
Josie is a five-year-old who presents to the clinic with a forty-eight-hour history of nausea, vomiting, and some diarrhea. She is unable to keep fluids down, and her weight is 4 pounds less than her last recorded weight. Besides intravenous (IV) fluids, her exam warrants the use of an antinausea medication. Which of the following would be the appropriate drug to order for Josie?
Prochlorperazine (Compazine)
Meclizine (Antivert)
Promethazine (Phenergan)
Ondansetron (Zofran)
Question 36. Question :
Long-term use of PPIs may lead to:
Hip fractures in at-risk persons
Vitamin B6 deficiency
Liver cancer
All of the above
Question 37. Question :
Many patients self-medicate with antacids. Which patients should be counseled to not take calcium carbonate antacids without discussing with their providers or a pharmacist first?
Patients with kidney stones
Pregnant patients
Patients with heartburn
IN Postmenopausal women
0 of 2.5
Question 38. Question :
Beta blockers treat hypertension because they:
Reduce peripheral resistance.
Vasoconstrict coronary arteries.
Reduce norepinephrine.
Reduce angiotensin II production.
Question 39. Question :
Precautions that should be taken when prescribing controlled substances include:
Faxing the prescription for a Schedule II drug directly to the pharmacy
Using tamper-proof papers for all prescriptions written for controlled drugs
Keeping any presigned prescription pads in a locked drawer in the clinic
Using only numbers to indicate the amount of drug to be prescribed
Question 40. Question :
The tricyclic antidepressants should be prescribed cautiously in patients with:
Eczema
Asthma
Diabetes
Heart disease
Question 41. Question :
An ACE inhibitor and what other class of drug may reduce proteinuria in patients with diabetes better than either drug alone?
Beta blockers
Diuretics
Nondihydropyridine calcium channel blockers
Angiotensin II receptor blockers
Question 42. Question :
Metoclopramide improves GERD symptoms by:
Reducing acid secretion
Increasing gastric pH
Increasing lower esophageal tone
Decreasing lower esophageal tone
Question 43. Question :
Patient education regarding prescribed medication includes:
Instructions written at the high school reading level
Discussion of expected ADRs
How to store leftover medication such as antibiotics
Verbal instructions always in English
Question 44. Question :
If a patient with H. pylori positive PUD fails first-line therapy, the second-line treatment is:
A PPI BID plus metronidazole plus tetracycline plus bismuth subsalicylate for fourteen days
Testing H. pylori for resistance to common treatment regimens
A PPI plus clarithromycin plus amoxicillin for fourteen days
A PPI and levofloxacin for fourteen days
Question 45. Question :
A patient with a COPD exacerbation may require:
Doubling of inhaled corticosteroid dose
Systemic corticosteroid burst
Continuous inhaled beta 2 agonists
Leukotriene therapy
Question 46. Question :
Angela is a black woman who has heard that women of African descent do not need to worry about osteoporosis. What education would you provide Angela about her risk?
She is ; black women do not have much risk of developing osteoporosis due to their dark skin.
Black women are at risk of developing osteoporosis due to their lower calcium intake as a group.
If she doesn’t drink alcohol, her risk of developing osteoporosis is low.
If she has not lost more than 10% of her weight lately, her risk is low.
Question 47. Question :
The role of the nurse practitioner in the use of herbal medication is to:
Maintain competence in the prescribing of common herbal remedies.
Recommend common OTC herbs to patients.
Educate patients and guide them to appropriate sources of care.
Encourage patients to not use herbal therapy due to the documented dangers.
Question 48. Question :
Ray has been diagnosed with hypertension, and an ACE inhibitor is determined to be needed. Prior to prescribing this drug, the nurse practitioner should assess for:
Hypokalemia
Impotence
Decreased renal function
Inability to concentrate
Question 49. Question :
Long-acting beta-agonists received a black box warning from the US Food and Drug Administration due to the:
Risk of life-threatening dermatological reactions
Increased incidence of cardiac events when long-acting beta-agonists are used
Increased risk of asthma-related deaths when long-acting beta-agonists are used
Risk for life-threatening alterations in electrolytes
Question 50. Question :
Off-Label prescribing is:
Regulated by the FDA
Illegal by NPs in all states (provinces)
Legal if there is scientific evidence for the use
Regulated by the DEA
Question 51. Question :
Adam has type I diabetes and plays tennis for his university. He exhibits knowledge deficit about his insulin and his diagnosis. He should be taught that:
He should increase his increase his carbohydrate intake during times of exercise intake during times of exercise.
Each brand of insulin is equal in bioavailability, so buy the least expensive.
Alcohol produces hypoglycemia and can help control his diabetes when taken in small amounts.
If he does not want to learn to give himself injections, he may substitute an oral hypoglycemic to control his diabetes.
Question 52. Question :
Prior to starting antidepressants, patients should have laboratory testing to rule out:
IN Hypothyroidism
Anemia
Diabetes mellitus
Low estrogen levels
0 of 2.5
Question 53. Question :
What impact does developmental variation in renal function has on prescribing for infants and children?
Lower doses of renally excreted drugs may be prescribed to infants younger than six months
Higher doses of water-soluble drugs may need to be prescribed due to increased renal excretion
Renal excretion rates have no impact on prescribing
Parents need to be instructed on whether drugs are renally excreted or not
Question 54. Question :
All diabetic patients with hyperlipidemia should be treated with:
3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors
Fibric acid derivatives
Nicotinic acid
Colestipol
Question 55. Question :
Treatment failure in patients with PUD associated with H. pylori may be due to:
Antimicrobial resistance
Ineffective antacid
Overuse of PPIs
All of the above
Question 56. Question :
To improve positive outcomes when prescribing for the elderly, the NP should:
Assess cognitive functioning in the elder
Encourage the patient to take a weekly “drug holiday” to keep drug costs down
Encourage the patient to cut drugs in half with a knife to lower costs
All of the above options are
Question 57. Question :
Erik presents with a golden-crusted lesion at the site of an insect bite consistent with impetigo. His parents have limited finances and request the least expensive treatment. Which medication would be the best choice for treatment?
Mupirocin (Bactroban)
Bacitracin and polymixin B (generic double antibiotic ointment)
Retapamulin (Altabax)
Oral cephalexin (Keflex)
Question 58. Question :
Nonselective beta blockers and alcohol create serious drug interactions with insulin because they:
Increase blood glucose levels.
Produce unexplained diaphoresis.
Interfere with the ability of the body to metabolize glucose.
Mask the signs and symptoms of altered glucose levels.
Question 59. Question :
Infants and young children are at higher risk of ADRs due to:
Immature renal function in school-age children
Lack of safety and efficacy studies in the pediatric population
Children’s skin being thicker than adults, requiring higher dosages of topical medication
Infant boys having a higher proportion of muscle mass, leading to a higher volume of distribution
Question 60. Question :
Warfarin resistance may be seen in patients with VCORC1 mutation, leading to:
Toxic levels of warfarin building up
Decreased response to warfarin
Increased risk for significant drug interactions with warfarin
Less risk of drug interactions with warfarin
Question 61. Question :
Jose is a twelve-year-old overweight child with a total cholesterol level of 180 mg/dL and LDL of 125 mg/dL. Along with diet education and recommending increased physical activity, a treatment plan for Jose would include ____ with a reevaluation in six months.
statins
niacin
sterols
bile acid-binding resins
Question 62. Question :
A potentially life-threatening adverse response to ACE inhibitors is angioedema. Which of the following statements is true about this adverse response?
Swelling of the tongue and hoarseness are the most common symptoms.
It appears to be related to a decrease in aldosterone production.
The presence of a dry, hacky cough indicates a high risk for this adverse response.
Because it takes time to build up a blood level, it occurs after being on the drug for about one week.
Question 63. Question :
Amber is a twenty-four-year-old who has had migraines for ten years. She reports a migraine on average of once a month. The migraines are effectively aborted with naratriptan (Amerge). When refilling Amber’s naratriptan education would include which of the following?
Naratriptan will interact with antidepressants, including selective serotonin reuptake inhibitors and St John’s Wort, and she should inform any providers she sees that she has migraines.
Continue to monitor her headaches; if the migraine is consistently happening around her menses, then there is preventive therapy available.
Pregnancy is contraindicated when taking a triptan.
All the given options are correct.
Question 64. Question :
One of the main drug classes used to treat acute pain is NSAIDs. They are used due to which of the following reasons?
They have less risk for liver damage than acetaminophen.
Inflammation is a common cause of acute pain.
They have minimal GI irritation.
Regulation of blood flow to the kidney is not affected by these drugs.
Question 65. Question :
A patient has been prescribed silver sulfadiazine (Silvadene) cream to treat burns on his or her leg. Normal adverse effects of silver sulfadiazine cream include:
Transient leukopenia on days two to four that should resolve
Worsening of burn symptoms briefly before resolution
A red, scaly rash that will resolve with continued use
Hypercalcemia
Question 66. Question :
Sulfonylureas may be added to a treatment regimen for type II diabetics when lifestyle modifications and metformin are insufficient to achieve target glucose levels. Sulfonylureas have been moved to Step 2 therapy because they:
Increase endogenous insulin secretion.
Have a significant risk for hypoglycemia.
Address the insulin resistance found in type II diabetics.
Improve insulin binding to receptors.
Question 67. Question :
Narcotics are exogenous opiates. They act by ______.
inhibiting pain transmission in the spinal cord
attaching to receptors in the afferent neuron to inhibit the release of substance P
blocking neurotransmitters in the midbrain
increasing beta-lipoprotein excretion from the pituitary
Question 68. Question :
Patients who are on or who will be starting chronic corticosteroid therapy need monitoring of __________.
serum glucose
stool culture
folate levels
vitamin B12
Question 69. Question :
Henry presents to clinic with a significantly swollen, painful great toe and is diagnosed with gout. Of the following, which would be the best treatment for Henry?
High-dose colchicines
Low-dose colchicines
High-dose aspirin
Acetaminophen with codeine
Question 70. Question :
Jaycee has been on escitalopram (Lexapro) for a year and is willing to try tapering off of the selective-serotonin reuptake inhibitors. What is the initial dosage adjustment when starting a taper off antidepressants?
Change the dose to every other day dosing for a week.
Reduce the dose by 50% for three to four days.
Reduce the dose by 50% every other day.
Escitalopram (Lexapro) can be stopped abruptly due to its long half-life.
Question 71. Question :
Christy has exercise and mild persistent asthma and is prescribed two puffs of albuterol fifteen minutes before exercise and as needed for wheezing. One puff per day of beclomethasone (Qvar) is also prescribed. Teaching regarding her inhalers includes which one of the following?
She should use one to two puffs of albuterol per day to prevent an attack, with no more than eight puffs per day.
Beclomethasone needs to be used every day to treat her asthma.
She should report any systemic side effects she is experiencing, such as weight gain.
She should use the albuterol MDI immediately after her corticosteroid MDI to facilitate bronchodilation.
Question 72. Question :
Asthma exacerbations at home are managed by the patient by:
Increasing the frequency of beta 2 agonists and contacting his or her provider
Doubling inhaled corticosteroid dose
Increasing the frequency of beta 2 agonists
Starting montelukast (Singulair)
Question 73. Question :
A woman with an intact uterus should not be prescribed:
Estrogen/progesterone combination
Intramuscular (IM) medroxyprogesterone (Depo Provera)
Estrogen alone
Androgens
Question 74. Question :
The drug recommended as primary prevention of osteoporosis in women over seventy years old is:
Alendronate (Fosamax)
Ibandronate (Boniva)
Calcium carbonate
Raloxifene (Evista)
Question 75. Question :
Patient education when prescribing the vitamin D3 derivative calcipotriene for psoriasis includes:
Applying calcipotriene thickly to affected psoriatic areas two to three times a day
Applying a maximum of 100 grams of calcipotriene per week
Not using calcipotriene in combination with its topical corticosteroids
Augmenting calcipotriene with the use of coal-tar products
Question 76. Question :
Both ACE inhibitors and some angiotensin-II receptor blockers have been approved in treating:
Hypertension in diabetic patients
Diabetic nephropathy
Both A and B
Neither A nor B
Question 77. Question :
Scott is presenting for follow-up on his lipid panel. He had elevated total cholesterol, elevated triglycerides, and an LDL of 122 mg/dL. He has already implemented diet changes and increased physical activity. He has mildly elevated liver studies. An appropriate next step for therapy would be:
Atorvastatin (Lipitor)
Niacin (Niaspan)
Simvastatin and ezetimibe (Vytorin)
Gemfibrozil (Lopid)
Question 78. Question :
Hypoglycemia can result from the action of either insulin or an oral hypoglycemic. Signs and symptoms of hypoglycemia include:
“Fruity” breath odor and rapid respiration
Diarrhea, abdominal pain, weight loss, and hypertension
Dizziness, confusion, diaphoresis, and tachycardia
Easy bruising, palpitations, cardiac dysrhythmias, and coma
Question 79. Question :
Incorporating IT into a patient encounter takes skill and tact. During the encounter, the provider can make the patient more comfortable with the IT the provider is using by:
Turning the screen around so the patient can see material being recorded
Not placing the computer screen between the provider and the patient
Both A and B
Neither A nor B
Question 80. Question :
Which one of the below-given instructions can be followed for applying a topical antibiotic or antiviral ointment?
Apply thickly to the infected area, spreading the medication well past the borders of the infection
If the rash worsens, apply a thicker layer of medication to settle down the infection
Wash hands before and after application of topical antimicrobials
None of the above
Question 81. Question :
Sadie is a ninety-year-old patient who requires a new prescription. What changes in drug distribution with aging would influence prescribing for Sadie?
Increased volume of distribution
Decreased lipid solubility
Decreased plasma proteins
Increased muscle-to-fat ratio
Question 82. Question :
First-line therapy for treating topical fungal infections such as tinea corporis (ringworm) or tinea pedis (athlete’s foot) would be:
OTC topical azole (clotrimazole, miconazole)
Oral terbinafine
Oral griseofulvin microsize
Nystatin cream or ointment
Question 83. Question :
Which of the following is true about procainamide and its dosing schedule?
It produces bradycardia and should be used cautiously in patients with cardiac conditions that a slower heart rate might worsen.
GI adverse effects are common, so the drug should be taken with food.
Adherence can be improved by using a sustained-release formulation that can be given once daily.
Doses of this drug should be taken evenly spaced around the clock to keep an even blood level.
Question 84. Question :
A nurse practitioner would prescribe the liquid form of ibuprofen for a six-year-old because:
Drugs given in liquid form are less irritating to the stomach.
A six-year-old may have problems swallowing a pill.
Liquid forms of medication eliminate the concern for first-pass effect.
Liquid ibuprofen does not have to be dosed as often as tablet form.
Question 85. Question :
Kristine would like to start HRT to treat the significant vasomotor symptoms she is experiencing during menopause. Education for a woman considering hormone replacement would include:
Explaining that HRT is totally safe if used for a short term
Telling her to ignore media hype regarding HRT
Discussing the advantages and risks of HRT
Encouraging the patient to use phytoestrogens with the HRT
Question 86. Question :
Xi, a fifty-four-year-old female, has a history of migraine that does not respond well to OTC migraine medication. She is asking to try Maxalt (rizatriptan) because it works well for her friend. Which of the following actions would you take for appropriate decision making?
Prescribe Maxalt, but to monitor the use, only give her four tablets with no refills.
Prescribe Maxalt and arrange to have her observed in the clinic or urgent care with the first dose.
Explain that rizatriptan is not used for postmenopausal migraines and recommend Fiorinal (aspirin and butalbital).
Prescribe sumatriptan (Imitrex) with the explanation that it is the most effective triptan.
Question 87. Question :
The elderly are at high risk of ADRs due to:
Having greater muscle mass than younger adults, leading to higher volume of distribution
The extensive studies that have been conducted on drug safety in this age group
The blood-brain barrier being less permeable, requiring higher doses to achieve therapeutic effect
Age-related decrease in renal function
Question 88. Question :
Jim presents with fungal infection of two of his toenails (onychomycosis). Treatment for fungal infections of the nail includes:
Miconazole cream
Ketoconazole cream
Oral griseofulvin
Mupirocin cream
Question 89. Question :
GLP-1 agonists:
Directly bind to a receptor in the pancreatic beta cell.
Have been approved for monotherapy.
Speed gastric emptying to decrease appetite.
Can be given orally once daily.
Question 90. Question :
Prophylactic use of bisphosphonates is recommended for patients with early osteopenia related to long-term use of which of the following drugs?
Selective estrogen-receptor modulators
Aspirin
Glucocorticoids
Calcium supplements
Question 91. Question :
Inadequate vitamin D intake can contribute to the development of osteoporosis by:
Increasing calcitonin production
Increasing calcium absorption from the intestine
Altering calcium metabolism
Stimulating bone formation
Question 92. Question :
Which of the following statements is true about age and pain?
Use of drugs that depend heavily on the renal system for excretion may require dosage adjustments in very young children.
Among the NSAIDs, indomethacin is the preferred drug because of lower adverse effects profiles than other NSAIDs.
Older adults who have dementia probably do not experience much pain due to loss of pain receptors in the brain.
Acetaminophen is especially useful in both children and adults because it has no effect on platelets and has fewer adverse effects than NSAIDs.
Question 93. Question :
Selective estrogen receptor modifiers (SERMs) treat osteoporosis by selectively:
Inhibiting magnesium resorption in the kidneys
Increasing calcium absorption from the gastrointestinal (GI) tract
Acting on the bone to inhibit osteoblast activity
Selectively acting on the estrogen receptors in the bone
Question 94. Question :
When a patient is on selective-serotonin reuptake inhibitors:
The complete blood count must be monitored every three to four months
Therapeutic blood levels must be monitored every six months after a steady state is achieved.
Blood glucose must be monitored every three to four months.
There is no laboratory monitoring required.
Question 95. Question :
Patients whose total dose of prednisone exceed 1 gram will most likely need a second prescription for _________.
metformin, a biguanide to prevent diabetes
omeprazole, a proton pump inhibitor to prevent peptic ulcer disease
naproxen, an NSAID to treat joint pain
furosemide, a diuretic to treat fluid retention
Question 96. Question :
The ongoing monitoring of patients over the age sixty-five years taking alendronate (Fosamax) or any other bisphosphonate is:
Annual dual energy X-ray absorptiometry (DEXA) scans
Annual vitamin D level
Annual renal function evaluation
Electrolytes every three months
Question 97. Question :
Anticholinergic agents, such as benztropine (Cogentin), may be given with a phenothiazine to:
Reduce the chance of tardive dyskinesia.
Potentiate the effects of the drug.
Reduce the tolerance that tends to occur.
Increase CNS depression.
Question 98. Question :
Diagnostic criteria for diabetes include:
Fasting blood glucose greater than 140 mg/dl on two occasions
Postprandial blood glucose greater than 140 mg/dl
Fasting blood glucose 100 to 125 mg/dl on two occasions
Symptoms of diabetes plus a casual blood glucose greater than 200 mg/dl
Question 99. Question :
Insulin preparations are divided into categories based on onset, duration, and intensity of action following subcutaneous inject. Which of the following insulin preparations has the shortest onset and duration of action?
Insulin lispro
Insulin glulisine
Insulin glargine
Insulin detemir
Question 100. Cynthia is taking valproate (Depakote) for seizures and would like to get pregnant. What advice would you give her?
Valproate is safe during all trimesters of pregnancy.
She can get pregnant while taking valproate, but she should take adequate folic acid.
Valproate is not safe at any time during pregnancy.
Valproate is a known teratogen but may be taken after the first trimester if necessary.
