NURS 615: ADVANCED PHARMACOTHERAPEUTICS Maryville
university exam 4 Q&As (correct/Verified Answers)
What is Tiotropium (SPIRIVA) used to treat? – correct answer ✅Used in the
management/ maintenance treatment of chronic obstructive pulmonary
disease (COPD) which includes chronic bronchitis and emphysema.
What is the drug classification of Tiotropium? – correct answer ✅>It is a
long-acting, 24H anticholinergic-bronchodilator.
It is a muscurinic receptor antagonist, often referred to as an
antimuscurinic or anticholinergic agent.
What is the mechanism of action of Tiotropium (SPIRIVA) – correct answer
✅It does not display selectivity for specific muscarinic receptors, when
topically applied it acts mainly on M3 muscarinic receptors[8] located on
smooth muscle cells and submucosal glands. This leads to a reduction in
smooth muscle contraction and mucus secretion and thus produces a
bronchodilatory effect.
What are the adverse effects with montelukast (Singular) – correct answer
✅Anxiety, aggression, depression, suicidal thoughts,
NURS 615: ADVANCED PHARMACOTHERAPEUTICS Maryville
university exam 4 Q&As (correct/Verified Answers)
What patient teaching should accompany the prescription of montelukast
(Singulair)? – correct answer ✅Teach pt regarding adverse effect about
aggression , depression suicidal thoughts that could occur
What patient teaching should be provided when prescribing inhaled
corticosteroids? – correct answer ✅They should be taken 2x a day every day
for the use of prevention of asthma.
Rinse mouth after use to prevent oral thrush.
What ethnic background should not be prescribed long-acting beta agonists?
- correct answer ✅African Americans, increased incidence of death in this
population
What medication would you prescribe for bronchospasm for a patient taking
propranolol? – correct answer ✅Ipratropium
What is the mechanism of action of albuterol? – correct answer ✅Activation
of beta adrenergic receptors lead to relaxation of the muscle of the lung and
opening and dilation of the airway
Nurs 615 Pharm Exam 1 – Maryville Latest 2023 (100%
Correct Answers)
How does hypoalbuminemia affect the process of prescribing? – correct answer
✅Low albumin = more free drug (bc the drug can’t bind to albumin aka protein) =
increased adverse effects
What is a Black Box Warning: – correct answer ✅is considered a contraindication
to administer that drug.
What is the drugs half-life? – correct answer ✅Half-life specifically means the
amount of time it takes for an administered drug to be halfway cleared from the
system.
Peak of action: – correct answer ✅the time between drug administration and
maximum concentration of drug in the blood stream. Best therapeutic effect.
Duration of action: – correct answer ✅the time between onset of action and
metabolism of drug below the minimum needed for an effect. The length of time
you have the drug in your system.
According to the WHO what is the first step in the prescribing process? – correct
answer ✅The first step is to define the patient’s problem
Nurs 615 Pharm Exam 1 – Maryville Latest 2023 (100%
Correct Answers)
The second step is to – correct answer ✅specify the therapeutic objective
The third step is to – correct answer ✅choose which drug or treatment is needed.
Step 4 of the WHO approach: – correct answer ✅Start the treatment
Step 5 of the WHO approach: – correct answer ✅Educate the patient
Step 6 of the WHO approach: – correct answer ✅Monitor the treatment
Phase 1 of drug development: – correct answer ✅The drug is tested on healthy
volunteers
Phase 2 of drug development: – correct answer ✅trials with people who have the
disease for which the drug is thought to be effective
Phase 3 of drug development: – correct answer ✅Large numbers of patients in
medical research centers receive the drug in phase 3. This larger sampling
provides information about infrequent or rare adverse effects. The FFA will
approve a new drug application if phase 3 studies are satisfactory.
Nurs 615 Pharm Exam 1 – Maryville Latest 2023 (100%
Correct Answers)
Phase 4 of drug development: – correct answer ✅This phase is voluntary and
involves postmarket surveillance of the drug’s therapeutic effects at the
completion of phase 3. The pharmaceutical company receives reports from
doctors and other health care professionals about the therapeutic results and
adverse effects of the drug. Some medications, for example, have been found to
be toxic and have been removed from the market after their initial release.
Explain first pass metabolism – correct answer ✅much of the drug is lost in the
absorption process. The liver metabolizes many drugs, thus reduces the
bioavailabilty of the drug.
What is the fasted route of absorption: – correct answer ✅The fastest route of
absorption is inhalation, and not as mistakenly considered the IV administration.
Why does the GI tract take longer to absorb? – correct answer ✅The GI tract is
lined with epithelial cells; drugs must permeate through these cells in order to be
absorbed into the circulatory system.
What is One particular cellular barrier that may prevent absorption of a given
drug? – correct answer ✅the cell membrane. Cell membranes are essentially lipid
bilayers which form a semipermeable membrane. Pure lipid bilayers are generally
NURS 615 Pharm Exam 2 Maryville Q&As (Guaranteed
Success) (Latest 2023 )
Carbamazepine (Tegretol) can sometimes show subtherapeutic range due to
what? – correct answer ✅Carbamazepine auto-induces metabolism, leading
to lower levels despite good compliance
What are the black box warnings for Carbamazepine? – correct answer
✅Dermatologic reactions
- Steven’s Johnson
- Toxic epidermal necrolysis
What lab test should be ordered for patients on Carbamazepine? – correct
answer ✅CBC every 3-4 months because it can cause decreased WBC,
decreased platelets, and trouble with RBC
What kind of teaching needs to be done with families of patients who have
seizure disorders? – correct answer ✅Prevention is important, patient safety
is important, Do NOT abruptly stop taking medication.
Ethosuximide (Zarontin), an anti-seizure medication can cause what? –
correct answer ✅Blood dyscrasias
NURS 615 Pharm Exam 2 Maryville Q&As (Guaranteed
Success) (Latest 2023 )
Patients taking Topiramate need to be monitored for what electrolyte
imbalance? – correct answer ✅Decreased sodium bicarb leading to
hyperchloremic metabolic acidosis
Topiramate treats seizures and what is one common side effect? – correct
answer ✅Normal side effect is weight loss, especially in higher dose patients
A child on Topiramate that wants to play sports should monitor what? –
correct answer ✅Don’t get overheated. Topiramate may affect his ability to
sweat in the heat.
What should a pregnant patient be told about taking Valproate (Depakote)? –
correct answer ✅It is a known teratogen and category X medication. It
should not be used in the first trimester, it may be restarted in second
trimester.
What patient population should tricyclic antidepressants be used cautiously
in? – correct answer ✅Heart Disease patients
NURS 615 Pharm Exam 2 Maryville Q&As (Guaranteed
Success) (Latest 2023 )
Phenelzine (Nardil) is a MAOI. What teaching needs to be done with this
medication? – correct answer ✅He should not use serotonergic drugs like
Imitrex. Also, this class of medication interacts with yogurt, sour cream, soy
sauce, etc.
Phenelzine (Nardil) may cause what if there is an interaction with known
contraindicated foods? – correct answer ✅Hypertensive crisis
What are the side effects of tricyclic antidepressants? – correct answer
✅Anticholinergic type effects like dry mouth, sedation, constipation,
increased appetite, blurred vision, tinnitus, euphoria, mania
How long does it take for SSRIs to take effect – correct answer ✅2-6 weeks
SSRIs may cause what onset of action symptoms? – correct answer
✅Nausea, but this will usually resolve in a week.
What is one thing you should not do with SSRIs? – correct answer ✅Drink
alcohol
NURS 615 Pharm test 3 Maryville (questions with
correct answers) 2023.
How do antigout medications work? – correct answer ✅by inhibiting the
infiltration and phagocytosis of leukocytes, thus decreasing the breakdown
of uric acid to urate crystals.
Deposition of urate crystals causes – correct answer ✅pain and
inflammation
What is Colchicine – correct answer ✅anti-gout medication
how does Colchicine work? – correct answer ✅Works by inhibiting
inflammation, reducing pain and swelling
common side effects of Colchicine – correct answer ✅GI problems (diarrhea)
use with caution in elderly
Also can cause blood dyscrasias & abdominal pain
patient education with Colchicine – correct answer ✅Can be given with food
& milk to decrease GI issues
Avoid beer, ale, & wine: may cause gout attack
NURS 615 Pharm test 3 Maryville (questions with
correct answers) 2023.
Increase fluid intake: increases excretion of uric acid
Avoid smoked meats & high-protein diets
Low dose of Colchicine – correct answer ✅Low dose colchicine is 1.2mg
followed by 0.6mg one hour later or 1.8 milligrams total
High dose of Colchicine – correct answer ✅high dose colchicine is 1.2mg
followed by 0.6mg every four to six hours; or 4.8mg total.
Difference between high dose and low dose Colchicine – correct answer
✅The difference between the two is low dose is as effective as high dose
with a lower side effect profile.
Lab values to monitor with Colchicine – correct answer ✅Check renal
function test, BUN, Creatine
Patient education with Colchicine – correct answer ✅Almost always causes
some degree of diarrhea, make sure patients are aware of this side effect
NURS 615 Pharm test 3 Maryville (questions with
correct answers) 2023.
Patient education with Febuxostat (Uloric) – correct answer ✅Gout may
worsen with therapy initially
Dietary changes to decrease gout attacks and uric acid deposits. – correct
answer ✅Avoid beer, ale, & wine
Increase fluid intake: increases excretion of uric acid
Avoid smoked meats & high-protein diets
WHO 3 step ladder for pain medication – correct answer ✅
What is not a first line for pain medication? – correct answer ✅Narcotics
Recommendations for pain treatment – correct answer ✅You want to start
with NSAIDs first and then work your way up from there.
types of Corticosteroid treatment – correct answer ✅Prednisone, Cortisone,
Dexamethasone
NURS 615 Pharm test 3 Maryville (questions with
correct answers) 2023.
how do Corticosteroids work? – correct answer ✅Suppress the
inflammatory & immune systems by inhibiting the synthesis of chemical
mediators.
what are the chemical mediators that Corticosteroids work on? – correct
answer ✅Prostaglandins, leukotrienes, & histamines
Corticosteroids and inflammation – correct answer ✅Decreases
inflammation which decreases swelling, warmth, redness, & pain.
Uses for corticosteroid treatment – correct answer ✅Addison’s disease,
hormone replacement, cancer therapy
SLE, arthritis, IBD, & to suppress graft rejection
contraindications for corticosteroid treatment – correct answer ✅Systemic
fungal infections & with live vaccine
Use corticosteroids cautiously with: – correct answer ✅Pregnancy, kids,
HTN, heart failure, renal impairment, & with infections resistant to
treatment
Nursing 615 Exam 3 Review Maryville University Latest
2023 (Solved questions)
1.2 mg at first sign of flare, followed by 0.6 mg one hour later for a total dose
of 1.8 mg. – correct answer ✅Low-dose colchine
1.2 mg followed by 0.6 mg every 4-6 hours totaling 4.8 mg. – correct answer
✅High-dose colchine
BUN, creatinine, and creatinine clearance should be monitored in the
treatment of this disease – correct answer ✅Gout
This medication can cause severe diarrhea, nausea, vomiting, abdominal
pain – correct answer ✅Colchine
When prescribing this medication, patients should be taught that gout may
worsen with therapy before it improves – correct answer ✅Febuxostat
(Uloric)
These medications can cause the following adverse effects if taken for six
months or more: Osteoporosis and poor diabetic control. Patients should
report black, tarry stools or abdominal pain. – correct answer
✅Corticosteroids
Nursing 615 Exam 3 Review Maryville University Latest
2023 (Solved questions)
These medications should be tapered to avoid recurrent activity of the
underlying disease and possible cortisol deficiency resulting from the
hypothalamic-pituitary-adrenal axis suppression during the period of steroid
therapy. – correct answer ✅Corticosteroids
Increased risk of serious cardiovascular thrombotic events, such as
myocardial infarction and stroke. These medications can also cause serious
GI events such as bleeding, ulceration or perforation of stomach or
intestines, which can be fatal. – correct answer ✅Black Box Warning on
NSAIDS
When treating this common issue, it is recommended to begin with NSAIDS
and work up from there as needed – correct answer ✅Pain management
This medication works by inhibiting the COX enzymes; however, the exact
mechanism of action for this particular medication is unknown. – correct
answer ✅Ibuprofen