NGR 5172 - Advanced Pharmacology - Final Exam

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H. influenzae's primary mechanism of antimicrobial resistance is via:

Which of the following agents is beta 1 selective?Atenolol Which of the following statements about beta-adrenergic blockers is correct?Some beta-adrenergic blockers are cardioselective, blocking only beta 1 receptors; others are not and also block beta 2 receptors in smooth muscle.

The beta-adrenergic agonist nebivolol: Is highly cardioselective.

During diuretic therapy, levels of which electrolyte should be monitored?Potassium Choose an answer 1Coagulase production.2Beta-lactamase production.3Slime layer production.4Alteration in protein binding sites.Don't know?

Thiazide diuretics and loop diuretics have different primary indications because of which important difference between them?Thiazide diuretics require luminal perfusion to reach their active site.During diuretic therapy, which of the following should be monitored?Renal function Which of the following is a mechanism of action of beta-adrenergic blockers?Preventing sympathetic stimulation of the heart Which type of diuretic is available only for oral use?Potassium-sparing diuretics Which of the following best characterizes the mechanism of action of diuretics?Diuretics inhibit the transport of ions across the tubular membrane.Which of the following statements about angiotensin II receptor blockers is correct?Renal alterations are less common than with ACE inhibitors.The baseline laboratory evaluation of patients taking ACE inhibitors should

include:

Urine protein.When prescribing angiotensin-converting enzyme (ACE) inhibitors, the advanced practice nurse may anticipate all of the

following:

Hypokalemia.The only absolute contraindication to ACE

inhibitor use is:

Bilateral renal artery stenosis.The HCN channel blocker ivabradine (Corlanor) is contraindicated for CHF

patients with:

Atrial fibrillation.Angiotensin II stimulates the release of which hormone that causes sodium and water retention in the kidneys?Aldosterone The most common adverse effects of

calcium channel blockers are:

Related to vasodilation.When considering the use of valsartan/sacubitril (Ernesto) for congestive heart failure, the NP considers all of the

following except:

There are few significant drug-drug interactions.Which of the following agents attenuates the hypotensive effects of ACE inhibitors?Nonsteroidal anti-inflammatory agents (NSAIDs) The renin inhibitor, aliskiren, can

significantly reduce the activity of:

Loop diuretics.During triacylglycerol transport, once chylomicrons are in the circulation, ________ cholesterol transfers proteins to the chylomicrons.

HDL Fatty acids (triacylglycerol precursors) are synthesized in the liver with ________as the main precursor.Dietary glucose Which of the following is a characteristic of very low-density lipoprotein (VLDL)?Water-soluble transport for synthesized lipids

________ are the major dietary lipid.Triacylglycerol Fat-soluble vitamins include all of the

following except:

C.Which of the following is a water-soluble transport for ingested lipids?Chylomicron

A major function of bile salts is:Emulsification of dietary fat.

The free cholesterol pool of the liver is supplied primarily by which of the following mechanisms?Intracellular synthesis via the HMG-CoA reductase pathway Cholesterol is obtained either by diet or is synthesized by a pathway that occurs in most body cells but to a greater extent in the cells of which two organs?Liver and intestines During the fed state, free fatty acids are

converted to triacylglycerol and stored in:

Adipose tissue.Which agent may cause flushing?Niacin Which class of lipid-lowering agent interferes with absorption of fat-soluble vitamins?Bile acid sequestrants The primary purpose of HMG-CoA

reductase inhibitors is to:

Decrease circulating LDL levels.When prescribing HMG-CoA reductase

inhibitors, the nurse practitioner should:

Ensure that the patient is neither pregnant nor planning pregnancy.After bile acid salts are ejected into the gut, what happens to them after they have served their purpose?They are reabsorbed from the gut and recycled.While the mechanism of action of niacin is unknown, this agent decreases synthesis of ________ by the liver.

VLDL

Niacin should not be used in patients with: Hyperglycemia.

When considering the use of PCSK9 inhibitors (alirocumab and evolocumab), the NP considers all of the following

except:

Can be used as a relatively inexpensive adjunct to statin therapy Which of the following is a true statement regarding HMG-CoA reductase therapy?Prescribers should be aware that many drugs in this class are CYP3A4 substrates.Which of the following is a mechanism of action of fibric acid derivatives?Increases activity of lipoprotein lipase Which of the following is the drug of choice for anticoagulation in the patient with heparin-induced thrombocytopenia?Argatroban Which of the following laboratory tests is used to monitor the effects of low molecular weight heparin (LMWH)?Anti-Xa assay

Which of the following statements describes the primary difference between direct factor Xa inhibitors and indirect factor Xa inhibitors?Direct factor Xa inhibitors act directly on thrombin; indirect factor Xa inhibitors use antithrombin III as a mediator.

Primary hemostasis is characterized by: Platelet aggregation and adhesion.

Which phase of the clotting process is affected by activated Factor X (Factor Xa) inhibitors?Secondary hemostasis The primary adverse effects of heparin and

warfarin are related to:

Bleeding.Antithrombin III, which limits clotting to the

injured site, is greatly potentiated by:

Heparin

Secondary hemostasis is characterized by: Formation of a fibrin clot.

Peripheral neuropathy and priapism is a

possible adverse effect of:

Heparin Which of the following is indicated for CVA and embolic risk reduction in nonvalvular atrial fibrillation?Dabigatran The laboratory evaluation for a patient taking warfarin should include which of the following tests?International normalized ratio Which of the following statements about prasugrel (Effient) is true?Prasugrel is not indicated for a patient with a previous CVA or TIA.Which platelet inhibitor is indicated for a patient who has had a CVA or TIA while on aspirin therapy?Dipyridamole and ASA (Aggrenox) The mechanism of action of warfarin is: Inhibiting the conversion of prothrombin to thrombin.Warfarin is susceptible to drug-drug interactions of which of its features?Protein binding Used in patients with unstable angina and patients undergoing percutaneous transluminal coronary angioplasty (PTCA) and stent placement, glycoprotein IIb/IIIa

inhibitors are potent:

Platelet inhibitors.1Which is the primary advantage of selective serotonin reuptake inhibitors (SSRI) over heterocyclics in the management of depression?SSRIs do not have negative cardiovascular effects.In addition to treating depression, SSRIs are also effective in treating the following

except:

Neuropathic pain.Citalopram (Celexa) should not be prescribed greater than ________ mg daily due to potential prolongation of the QT interval.40 When using venlafaxine HCl (Effexor) at high doses, it is recommended to monitor

the patient for:

Hypertension.