NUR 635 NUR 635 ACTUAL EXAM ALL QUESTIONS

NUR 635 | NUR 635 ACTUAL EXAM ALL QUESTIONS

AND WELL ELABORATED ANSWERS LATEST

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The first-line drug choice for a previously healthy adult patient diagnosed with community-acquired

pneumonia would be:

1.Ciprofloxacin 2.Azithromycin 3.Amoxicillin 4.Doxycycline - CORRECT ANSWER-2.Azithromycin

Zainab is taking lamotrigine (Lamictal) and presents to the clinic with fever and lymphadenopathy. Initial

evaluation and treatment includes:

• Reassuring her she has a viral infection and to call if she isn't better in 4 or 5 days
• Ruling out a hypersensitivity reaction that may lead to multi-organ failure
• Rapid strep test and symptomatic care if strep test is negative
• Observation only, with further assessment if she worsens - CORRECT ANSWER-2. Ruling out a

hypersensitivity reaction that may lead to multi-organ failure

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:

• For excessive weight loss
• With the Abnormal Involuntary Movement Scale (AIMS) for extrapyramidal symptoms (EPS)
• Monthly for tolerance to the haloperidol
• Only by the mental health provider, as most NPs in primary care do not care for mentally ill patients -

CORRECT ANSWER-2. With the Abnormal Involuntary Movement Scale (AIMS) for extrapyramidal symptoms (EPS)

Digoxin levels need to be monitored closely when the following medication is started: 1.Loratadine 1 / 4

• Diphenhydramine
• Ipratropium
• Albuterol - CORRECT ANSWER-4. Albuterol

Harold, a 42-year-old African American, has moderate persistent asthma. Which of the following asthma medications should be used cautiously, if at all? A.Betamethasone, an inhaled corticosteroid B.Salmeterol, an inhaled long-acting beta-agonist C.Albuterol, a short-acting beta-agonist D.Montelukast, a leukotriene modifier - CORRECT ANSWER-B.Salmeterol, an inhaled long-acting betaagonist

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:

-Dwayne hasn't been taking his carbamazepine because it causes insomnia.-Carbamazepine auto-induces metabolism, leading to lower levels in spite of good compliance.-Dwayne was not originally prescribed the correct amount of carbamazepine.-Carbamazepine is probably not the right antiseizure medication for Dwayne. - CORRECT ANSWER- Carbamazepine auto-induces metabolism, leading to lower levels in spite of good compliance.

Carbamazepine has a Black Box Warning due to life-threatening:

• Renal toxicity, leading to renal failure
• Hepatotoxicity, leading to liver failure
• Dermatologic reaction, including Steven's Johnson and toxic epidermal necrolysis
• Cardiac effects, including supraventricular tachycardia - CORRECT ANSWER-3. Dermatologic reaction,

including Steven's Johnson and toxic epidermal necrolysis

Carbamazepine has a black box warning recommending testing for the HLA-B*1502 allele in patients with

Asian ancestry prior to starting therapy due to:

• Decreased effectiveness of carbamazepine in treating seizures in Asian patients with the HLA-B*1502

allele 2 / 4

• Increased risk for drug interactions in Asian patients with the HLA-B*1502 allele
• Increased risk for Stevens-Johnson syndrome in Asian patients with HLA-B*1502 allele
• Patients who have the HLA-B*1502 allele being more likely to have a resistance to carbamazepine -

CORRECT ANSWER-C. Increased risk for Stevens-Johnson syndrome in Asian patients with HLA-B*1502 allele

Long-term monitoring of patients who are taking carbamazepine includes:

• Routine troponin levels to assess for cardiac damage
• Annual eye examinations to assess for cataract development
• Monthly pregnancy tests for all women of childbearing age
• Complete blood count every 3 to 4 months - CORRECT ANSWER-4. Complete blood count every 3 to 4

months

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:

• Increase her dose
• Assess for suicidal ideation
• Discontinue the medication immediately
• Decrease her dose to half then slowly titrate up the dose - CORRECT ANSWER-2. Assess for suicidal

ideation

Samantha is taking lamotrigine (Lamictal) for her seizures and requests a prescription for combined oral

contraceptives (COCs), which interact with lamotrigine and may cause:

Contraceptive failure Excessive weight gain Reduced lamotrigine levels, requiring doubling the dose of lamotrigine Induction of estrogen metabolism, requiring higher estrogen content OCs be prescribed - CORRECT ANSWER-Reduced lamotrigine levels, requiring doubling the dose of lamotrigine

Patients with pheochromocytoma should avoid which of the following classes of drugs due to the possibility of developing hypertensive crisis? 3 / 4

• Expectorants
• Beta-2-agonists
• Antitussives
• Antihistamines - CORRECT ANSWER-B. Beta-2-agonists

The nurse is preparing to administer methylnaltrexone (Relistor), a peripherally acting opioid antagonist.This drug is appropriate for which patient?

• A patient with diarrhea
• A terminally ill patient who has opioid-induced constipation
• A patient who is scheduled for a colonoscopy
• A patient who will be having colon surgery in the morning - CORRECT ANSWER-b. A terminally ill

patient who has opioid-induced constipation

Jamie has glucose-6-phosphate dehydrogenase deficiency (G6PD) and requires an antibiotic. Which class of antibiotics should be avoided in this patient?

• Penicillins
• Macrolides
• Cephalosporins
• Sulfonamides - CORRECT ANSWER-4. Sulfonamides

James has been diagnosed with cluster headaches. Appropriate acute therapy would be: 1.Butalbital and aspirin (Fiorinal) 2.Meperidine IM (Demerol) 3.Oxygen 100% for 15 to 30 minutes 4.Indomethacin (Indocin) - CORRECT ANSWER-3.Oxygen 100% for 15 to 30 minutes

18 y.o. patient diagnosed with frequent migraines, what Is abortive therapy for migraines? - CORRECT ANSWER--triptans- (ABORTIVE MEDS FOR MIGRAINES)

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