Midterm Exam: NUR635/ NUR 635 (Latest 2023/ 2024 Update) Advanced Pharmacology Exam Review| Graded A| Questions and Verified Answers| 100% Correct – Grand Canyon
Midterm Exam: NUR635/ NUR 635 (Latest
2023/ 2024 Update) Advanced Pharmacology
Exam Review| Graded A| Questions and
Verified Answers| 100% Correct – Grand
Canyon
Q: Anemic pt getting epoetin – what to monitor?
Answer:
Hypertension – monitor BP
Q: Safety warning for erythropoiesis stimulating medications?
Answer:
Can cause tumors
Q: Dx with angina, we know they have underlying what?
Answer:
Athrosclerosis
Q: Medications for athrosclerosis
Answer:
Statin, ASA, nitro
Q: Someone wants to self donate blood for surgery. Give what?
Answer:
Epogen with iron
Q: Prescribing iron for iron deficiency anemia, what do I check 1 week out?
Answer:
Reticulocyte count
Q: Prescribing iron replacement, what education?
Answer:
Empty stomach with orange juice.
Q: What does pernicious anemia mean?
Answer:
Lacking B12
Q: Giving B12, what do we monitor for?
Answer:
Hypokalemia
Q: How long for NPH to take effect?
Answer:
60-90 min
Q: What’s the biggest side effect for treating DM?
Answer:
Hypoglycemia
Q: What s/sx should DM pts look for?
Answer:
Cold and clammy, need some candy
Q: Interaction between insulin and beta blockers?
Answer:
Beta blockers will mask signs of hypoglycemia
Q: Switching pt from NPH to glargine, then what do we do to glargine dosage?
Answer:
Decrease it by 20%
Q: Things to consider when prescribing metformin?
Answer:
Cannot do contrast, overhydrate them, A1C, baseline kidney function
Q: Assess prior to metformin?
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Patient prescribed viagra. What instruction to give patient?
Avoid taking nitroglycerin with this drug
A patient is taking proscar for BPH. Explain that this med has which effect?
Decreases the size of the prostate
Patient taking viagra. Should avoid what food?
Grapefruit juice
Rapid acting insulin
Lispro (Humalog)
Aspart (Novolog)
Glulisine (Apidra)
Short onset and duration insulin
NPH
Drug of choice for type 2 diabetes – why
Metformin – decreases glycogenolysis in liver
Why would we recommend pts take an ASA a day?
Prevents thrombolytic events
Side effect of high dose aspirin
Tinnitus
Anemic pt getting epoetin – what to monitor?
Hypertension – monitor BP
Safety warning for erythropoiesis stimulating medications?
Can cause tumors
Dx with angina, we know they have underlying what?
Athrosclerosis
Medications for athrosclerosis
Statin, ASA, nitro
Someone wants to self donate blood for surgery. Give what?
Epogen with iron
Prescribing iron for iron deficiency anemia, what do I check 1 week out?
Reticulocyte count
Prescribing iron replacement, what education?
Empty stomach with orange juice.
What does pernicious anemia mean?
Lacking B12
Giving B12, what do we monitor for?
Hypokalemia
How long for NPH to take effect?
60-90 min
What’s the biggest side effect for treating DM?
Hypoglycemia
What s/sx should DM pts look for?
Cold and clammy, need some candy
Interaction between insulin and beta blockers?
Beta blockers will mask signs of hypoglycemia
Switching pt from NPH to glargine, then what do we do to glargine dosage?
Decrease it by 20%
Things to consider when prescribing metformin?
Cannot do contrast, overhydrate them, A1C, baseline kidney function
Assess prior to metformin?
Kidney function
How are gliptins different from other DM meds?
Indirectly increase insulin production
How do GLP-1 agonists work?
Bind to receptors in pancreas to stimulate insulin release, work on incretin system
What things to check with iron treatment?
Ferratin, H/H, TIBC – normalize after 4 weeks
NYHA, which one is angina without symptoms?
Variant angina, stage I
NYHA stage 2
Angina with exertion
NYHA Stage 3
Severe symptoms with minimal activity
NYHA stage 4
Symptoms at rest
What do most patients with angina need to do?
Diet and exercise
What are the 2 reasons patients go into heart failure?
Infarct
Myocardial ischemia
What is contraindicated with flagyl?
Alcohol – nasty reaction
Baseline labs for hepatotoxicity?
Hepatic function panel
Why can NP and PAs prescribe?
Access to healthcare
When is it most dangerous for a pregnant person to consume a teratogen?
1st trimester – neural tube defects
Education for breastfeeding mom taking potentially harmful med?
Pump and dump
Take meds right after pumping
Neostigmine treats…
myasthenia gravis
Treating myasthenia gravis with oral med, what do we assess?
Swallow ability
When would a peds pt get klonidine?
ADHD
What are some side effects of Parkinson’s meds?
Extrapyramidal symptoms
Risky behaviors
Hallucinations
Sleep attacks
What type of Parkinsons medication is not associated with sleep attacks?
Dopamine agonists, Pramieprexole
What can you add into levadopa-carbadopa?
Bromocriptine
When adding bromocriptine to the levadopa-carbadopa, what do we do with doses?
Decrease doses
Why do our CNS drugs cause sleepiness?
Crosses the BBB
What side effects result from abruptly stopping baclofen?
Hallucinations
Who would you give baclofen to?
Spasticity – MS, spinal cord injury, & cerebral palsy
What is rivastigmine used for?
Alzheimer’s
How often to change rivastigmine patch?
Daily
Medications for preventing frequent migraines?
Propranolol
Instead of propranolol in gen anxiety asthmatic patient, what medication should you give?
Topiramate (Topamax)
If pt is on oxycodone and it is no longer working, what would you explain is happening?
Tolerance
What to do if patient has developed tolerance to opioid?
Increase to stronger, longer acting. Fentanyl patch
Why do you not like prescribing methadone?
Strongest, with exponential increase in doses. Have to monitor QT.
Biggest side effects of first gen psych drugs?
Tardive dyskinesia
Want to start pt on SSRI, but on MAOI, what has to happen?
Stop for 2 weeks before starting the other
What kind of drug for a pt with generalized panic attacks?
SSRI
Hormone replace therapy for post-menopaused pt, what formula would we utilize?
Anything transdermal has least amt of side effects.
Oral contraceptive in young woman, biggest concern?
Compliance, next choice is medroxyprogesterone acetate
Pt on oral contraceptive, has major surgery coming up, what to do?
Switch to progesterone only, lower chance of clots
Androgen therapy should only be prescribed for?
Hypogonadism
Why is it concerning if hypogonadism patient has sudden weight gain?
Could be undertreating
How to assess for effectiveness of BPH meds?
Easier urination
What is the peak of lispro?
60 min
Can you mix lispro and NPH?
yes
When do you take lispro?
15 min before meal
Which patient cannot receive tizanidine?
Liver issues
Patient on heparin in hosp is started on warfarin. Why?
Warfarin takes a few days to kick in.
How many hours between nitro patch replacement, why?
8 hours, pt builds tolerance
What does plavix interact with?
Many herbal/vitamins/supplements
What do you check when pt is on coumadin, and when?
INR, 6 hours from last dose
What can happen on heparin gtt?
HIT (thrombocytopenia).
3-5 days after starting
Check PLT at 4 days
If you start teenage pt on coumadin, what is important?
Need backup birth control
What blood thinner can you give to pregnant pt?
Heparin
What lab value do you monitor with pregnant pt on heparin?
Anti Xa
What should you avoid on coumadin?
Leafy green veggies high in K
What do you tell your pt if they miss a dose of coumain?
If less than 12 hours, take the dose, and then the normal schedule
Treatment for anemia related to chronic renal fx?
Epogen
Pt bipolar on lithium, should check what?
Lithium level
Patient on lithium, what lab values should be check regularly?
Sodium, potassium, & thyroid function
How to stop pre-term labor?
Alpha adrenergic beta agnosts
Pregnant pt has hypertension, how do you treat?
Labetalol
Methyldopa