AGNP BOARD EXAM QUESTIONS Respiratory Prescribing (Questions 100)

AGNP BOARD EXAM QUESTIONS Respiratory Prescribing (Questions 100)
Question:
Treatment of Bordetella pertussis in a patient with a hypersensitivity to
macrolides is: doxycycline.
clindamycin
(Cleocin).
metronidazole
(Flagyl).
sulfamethoxazole/trimethoprim (Bactrim). Correct
Explanation:
Sulfamethoxazole/trimethoprim (Bactrim) is an alternative choice for patients in
whom a macrolide is contraindicated.
Question:
The mainstay of treatment in the management of mild and moderate croup is
symptomatic relief that includes:
antibiotics.
beta-2 agonists.
corticosteroids.
Correct
decongestants.
Explanation:
The mainstay of treatment in the management of mild and moderate croup is
symptomatic relief, which includes corticosteroids (inhaled or oral). Antibiotics,
beta-2 agonists and decongestants have not been studied, and their use is
discouraged.
Question:
In adults with community-acquired pneumonia in which B-lactamase
producing Haemophilus influenzae is identified as the causative
organism, the outpatient treatment of choice is:
amoxicillin (Amoxil).
azithromycin
(Zithromax). Cefixime
(Suprax). Correct
oseltamivir (Tamiflu).
Explanation:
The treatment of choice in adults with B-lactamase producing Haemophilus
influenzae community acquired pneumonia is cefixime (Suprax). Amoxicillin is
recommended in the presence of non-B-lactamase producing Haemophilus
influenzae. Alternate antibiotics include fluoroquinolones (ie. moxifloxacin
[Avelox]), doxycycline, azithromycin and clarithromycin.
Question:
A patient with sinusitis is treated with amoxicillin. Caution is advised with
concomitant use of:
lisinopril (Zestril).
fexofenadine
(Allegra).
warfarin (Coumadin). Correct
furosemide (Lasix).
Explanation:
Amoxicillin should be used with caution with warfarin (Coumadin). The
combination will increase the INR and thus increase the risk of bleeding,
possibly due to altered vitamin K production by gut flora. Amoxicillin can be
co- administered with lisinopril (Zestril), fexofenadine (Allegra), and
furosemide (Lasix).
Question:
A patient with bacterial sinusitis taking an oral penicillin should be
instructed: to monitor capillary blood glucose readings if they have
diabetes.
that additional protection against pregnancy is necessary if they are taking an
oral contraceptive. Correct
to use an anti-diarrheal if they experience diarrhea.
to avoid penicillin if they are pregnant or trying to become pregnant.
Explanation:
Penicillin is a beta-lactam antibiotic. The drug interactions of most concern
with the beta-lactam antibiotics are those with oral contraceptive products,
methotrexate and
valproic acid. In the case oral contraceptives, even though a small percentage
of women may potentially experience decreased effectiveness of these birth
control products while taking beta-lactam antibiotic, alternative birth control
methods should be considered while taking these antibiotics. Anti-diarrheal
medicine should not be taken because it may worsen or prolong diarrhea. Most
penicillins are safe to use during pregnancy. Penicillins may cause false
readings with some urine glucose tests.
Question:
An example of a beta2-adrenergic receptor agonist used in the treatment of
asthma is: dobutamine.
denopamine.
xamoterol.
albuterol. Correct
Explanation:
ß2 (beta2) adrenergic receptor agonists, also known as adrenergic ß2 receptor
agonists, act on the ß2 adrenergic receptor. Like other ß adrenergic agonists,
they cause smooth muscle relaxation. ß2 adrenergic agonists' effects on
smooth muscle cause dilation of bronchial passages. They are primarily used
to treat asthma and other pulmonary disorders, such as COPD. Examples of a
beta2-adrenergic receptor agonists are albuterol, xamoterol, and terbutaline.
The others are examples of beta1-adrenergic receptor agonists.
Question:
Benzonatate (Tessalon Perles), a non-narcotic
antitussive,: does not cause sedation.
is centrally acting on cough
receptors. is safe in children 6
years and older. should be
swallowed whole. Correct
Explanation:
Benzonatate (Tessalon Perles) capsules act peripherally by anesthetizing the
stretch receptors located in the respiratory passages, lungs, and pleura by
dampening their activity and thereby reducing the cough reflex. It is approved
for the relief of cough in adults and children older than 10 years. Benzonatate
capsules should be swallowed whole. Severe hypersensitivity reactions
(including bronchospasm, laryngospasm and cardiovascular collapse) have
been reported from sucking or chewing the capsule instead of swallowing it.
This is thought to be related to a local anesthetic property of the drug. The
most common side effects of benzonatate are sedation, headache and
dizziness.
Question:
Which of the following medications, when combined with pulmonary
rehabilitation, enhances exercise performance?
Ipratropium bromide
(Atrovent). Levalbuterol
(Xopenex) inhaled.
Salmeterol (Serevent
Diskus).
Tiotropium (Spiriva HandiHaler). Correct
Explanation:
Tiotropium (Spiriva HandiHaler), a long-acting antimuscarinic antagonist,
enhances the effectiveness of pulmonary rehabilitation in increasing exercise
performance.

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