NURS 5334 PHARM FINAL EXAM LATEST

NURS 5334 PHARM FINAL EXAM LATEST

ACTUAL EXAM DETAILED QUES AND

GUARANTEED ANSWERS ALREADY GRADED

A+.

A 32 year old male is starting paroxetine for depression. He is complaining of not being able to obtain an erection. What can the NP do to help.

• Change SSRIs
• Decrease the dose of paroxetine
• Add bupropion
• Add another SSRI - ANSWER- C. Add bupropion

A six year old is being treated with ethosuximide. She should be monitored for:

• Increased seizure activity; this drug can induce seizures
• Renal dysfunction
• Blood dyscrasias which are uncommon but possible
• Hepatoxicity - ANSWER- C. Blood dyscrasias which are uncommon but possible

Sandy is taking lamotrigine for seizures and wants an rx for OCPs which can interact

with lamotrigine and cause:

• Contraceptive failure
• Weight gain
• Reduced lamotrigine levels, requiring an increase in the dose of lamotrigine.
• Increase in estrogen metabolism requiring higher estrogen containing OCPs -

ANSWER- C. Reduced lamotrigine levels, requiring an increase in the dose of lamotrigine.

The tricyclic antidepressants should be prescribed cautiously in patients with:

A. CAD

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• Eczema
• Asthma
• Diabetes - ANSWER- A. CAD

What "onset of action symptoms" should be reviewed with patients who have been newly prescribed an SSRI?

• They will have insomnia for a week.
• They can feel a bit of nausea, but this resolves in about 1 week.
• They will have a huge increase in appetite
• They will not dream. - ANSWER- B. They can feel a bit of nausea, but this resolves

in about 1 week Why do many medications lack pediatric dosing information in their drug labeling?

• Most medications are not used in pediatric patients.
• There is a lack of evidence-based literature on the safe and effective use of

medications in children.

• The FDA does not allow pediatric dosing information in product labeling.
• Only products available as oral liquid formulations are required to contain pediatric

dosing information in their labeling. - ANSWER- B. There is a lack of evidence-based literature on the safe and effective use of medications in children.

Why are Neonates at greater risk for toxicity with highly protein-bound drugs?

• Protein binding is decreased in neonates increasing the amount of free drug

available.

• The protein-bound drugs are not eliminated effectively in neonates.
• Neonates are unable to metabolize these highly protein-bound drugs.
• Protein binding is increased in neonates, making measurement of serum levels of the

drug inaccurate. - ANSWER- A. Protein binding is decreased in neonates increasing the amount of free drug available.

At what age are adult levels of renal function achieved? •

• 6 months

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• 12 months
• 24 months
• 3 years old - ANSWER- B. 12 months

What is the list that identifies drugs with a high likelihood of causing adverse effects in the elderly?

• No use list
• Beers list
• Pharmacists list
• Adverse drug list - ANSWER- B. Beers list

In pediatric patients gastric acidity does not reach adult values for ______ - ANSWER-

• Years

The principles underlying complication to drug therapy in the elderly include___, ____, ____, and ____. - ANSWER- altered pharmacokinetics, multiple and severe illnesses, multiple-drug therapy, and poor adherence.

Altered absorption of drugs in the elderly may result in____drug response - ANSWER- Delay

The four major factors that can alter drug distribution in the elderly include _, _, _, and _? - ANSWER- increased body fat, decreased percentage of lean body mass, decreased total body water, and reduced concentration of serum albumin.

The most important cause of adverse drug reactions in the elderly is___. - ANSWER- drug accumulation secondary to reduced renal excretion.

In the elderly, the proper index of renal function is____. - ANSWER- creatinine clearance or GFR

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Name factors underlying the increase in adverse reactions in the geriatric population: - ANSWER- • Polypharmacy • Severe illness, • multiple pathologies, • greater use of drugs that have a low therapeutic index • Inadequate supervision • Poor patient adherence

What is maximum amount of Sumatriptan that can be taken in 1 day?

• 100 mg
• 200 mg
• 300 mg
• 400 mg - ANSWER- B. 200 mg

The ability of the anesthetic to penetrate the axon membrane is determined by 3 properties. What are they?

• Molecular size
• Protein binding potential
• Lipid solubility
• Degree of ionization at tissue pH
• Water solubility
• Degree of blood flow - ANSWER- A. Molecular size
• Lipid solubility
• Degree of ionization at tissue pH

Which of the following medications will not cause rebound headaches from overuse?

• Propranolol
• Sumatriptan
• Acetaminophen
• Ibuprofen - ANSWER- A. Propranolol

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