Walden NURS6521 Week 7 Exam

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NURS6521 Advanced Pharmacology

Week 7 Exam

Question 1A patient taking Metformin (Glucophage) is scheduled for a cardiac cath. The patient asks why he can’t take his metformin the day of the test. What is the most appropriate reply?


Metformin interacts with the dye used in the test.  You can take the Metformin starting the day after the test.

You can develop lactic acidosis if you take metformin and are given dye.  You should have a serum creatinine drawn before restarting the medication.

The combination of metformin and the dye stimulates the liver to release insulin causing hypoglycemia.  You can restart the metformin 48 hours after the test.

Dye is a cytochrome system inducer that affects metformin.   You should wait 3 days before restarting the metform so you don’t develop a toxic level of the drug.

Question 2

A child is prescribed an inhaled corticosteroid agent to decrease respiratory inflammation related to exposure to an animal. The patient’s parent administers a higher than prescribe dose of the medication for 5 days. What should the APRN monitor the child for?



adrenal insufficiency



Question 3

Mr. Lacuna is an 83-year-old resident of a long-term care facility who has a diagnosis of moderate Alzheimer disease. Mr. Lacuna’s physician recently prescribed oral rivastigmine, but he was unable to tolerate the drug due to its gastrointestinal effects. As a result, he has been ordered the transdermal patch form of the medication. When administering this form of rivastigmine, the nurse should


teach Mr. Lacuna about the importance of rotating sites when he applies the patch.

teach Mr. Lacuna’s family to apply a second patch if they notice an acute exacerbation of his confusion.

apply the patch to Mr. Lacuna’s back to reduce the chance that he will remove it.

apply the patch to a mucous membrane to facilitate complete absorption.

Question 4

A 53-year-old man has been treated for severe asthma for several years with prednisone. Recently, his physician initiated alternate-day therapy for him. The patient tells the nurse that he would rather take the medication every day to prevent confusion. Which of the following would be the best response by the nurse?


“This schedule will be more convenient for you.”

“This schedule will enable you to lose weight.”

“This schedule will decrease the cost of your medication.”

“This schedule allows rest periods so that adverse effects are decreased but the anti-inflammatory effects continue.”

Question 5

John is a newly diagnosed diabetic that contacts the office  with complaints of severe nausea and vomiting.  What instructions should the APRN provide related to his insulin doses?


I will call in a prescription for metformin for you to take in place of your insulin.

Monitor your blood sugar every 4  hours and take regular insulin based on the blood sugar reading.

Stop your insulin while you are not eating and restart it at half strength when you can keep liquids down.

There is no need to change your insulin dosage while sick.  Continue your regular doses

Question 6During a clinic visit, a patient complains of having frequent muscle cramps in her legs. The nurse’s assessment reveals that the patient has been taking over-the-counter laxatives for the past 7 years. The nurse informed the patient that prolonged use of laxatives


may cause nutrient deficiencies.

may counter the therapeutic effect of other drugs.

causes acidic urine and urinary tract infections.

inhibits biotransformation of drugs.

Question 7

Which of the following statements best defines how a chemical becomes termed a drug?


A chemical must have a proven therapeutic value or efficacy without severe toxicity or damaging properties to become a drug.

A chemical becomes a drug when it is introduced into the body to cause a change.

A chemical is considered a drug when the Food and Drug Administration (FDA) approves its release to be marketed.

A chemical must have demonstrated therapeutic value to become a drug.

Question 8 The Nurse Practitioner’s assessment of a community-dwelling adult suggests that the client may have drug allergies that have not been previously documented. What statement by the client would confirm this?


“I tend to get sick in the stomach when I take antibiotics.”

“I’ve been told that aspirin might have caused my stomach bleed a few years back.”

“I broke out in hives and got terribly itchy when I started a new prescription last year.”

“When I fell last year, the doctor said that it might have been because of my blood pressure pills.”

Question 9

A Nurse Practitioner is teaching an older adult patient about polypharmacy. Which of the following statements best describe this term?


Taking more than one drug when the patient deems it necessary

Taking several drugs simultaneously

Increasing the dosage of a drug by the patient

Taking one drug one day and another drug the next day

Question 10

A 33-year-old woman has irritable bowel syndrome (IBS). The physician has prescribed simethicone (Mylicon) for her discomfort. Which of the following will the nurse monitor most closely during the patient’s drug therapy?


Drug toxicity


Increased abdominal pain and vomiting

Increased urine output

Question 11

Decongestants are recommended to use in which of the following patients?


patients with otitis media

patients with coronary artery disease

patients taking monoamine oxidase inhibitors

patients with hypertension

Question 12

A 70-year-old woman with a history of atrial fibrillation takes digoxin and verapamil to control her health problem. Verapamil achieves a therapeutic effect by


blocking adrenergic receptors and producing antisympathetic effects.

inhibiting the movement of calcium ions across the cardiac muscle cell membrane.

decreasing sodium and potassium conduction.

weakening diastolic depolarization and the action potential duration.

Question 13

Mrs. Houston is a 78-year-old woman who resides in an assisted living facility. Her doctor prescribed digoxin at her last visit to the clinic and she has approached the nurse who makes regular visits to the assisted-living facility about this new drug. What teaching point should the nurse emphasize to Mrs. Houston?


The importance of having required laboratory work performed on time

The need to take the medication at the same time each day regardless of her heart rate

The  technique for using a home blood pressure cuff

Timing household activities to coincide with the administration times of her digoxin

Question 14

The Nurse Practitioner is treating a patient that takes frequent doses of antacids for his heartburn and is also taking an enteric coded aspirin.  What instructions should be provided to the patient?


The aspirin is less effective when taken with an antacid so you need to increase the dose.

There is no effect of the antacid on the aspirin so they can be taken when it is convenient for you

The antacid destroys the aspirin so you should stop taking any antacids

The medications should be taken at least 2 hours apart.

Question 15

A patient has recently been prescribed a drug that treats his hypertension by blocking the sympathetic receptors in his sympathetic nervous system. This action is characteristic of


an adrenergic antagonist.

an adrenergic agonist.


a neurotransmitter.

Question 16

In light of her recent high blood pressure readings, a patient has been started on a thiazide diuretic and metoprolol (Lopressor), which is a beta-adrenergic blocker. What is the most likely rationale for using two medications to address the patient’s hypertension?


The adverse effects of each drug may cancel each other out.

Using two drugs for a health problem tends to increase patient compliance with the drug regimen.

Using lower doses of two separate drugs may lessen the risk of adverse reactions.

Using the two drugs to treat a health problem may create a synergistic effect.

Question 17

An elderly postsurgical patient has developed postoperative pneumonia in the days following abdominal surgery and is being treated with a number of medications. Which of the following medications that the nurse will administer has the slowest absorption?


A sublingual benzodiazepine that has been prescribed to help the patient sleep

An intravenous (IV) antibiotic that is being administered by IV piggyback at 150 mL/hour

An oral antidepressant that the patient has been taking daily for several years

An intramuscular (IM) injection of an opioid analgesic

Question 18

A 79-year-old patient in a long-term care facility is to receive an intravenous fat emulsion. Which of the following lab values would be a priority for the nurse to assess before administration?


Blood glucose levels

Serum potassium levels

Serum sodium levels

Triglyceride levels

Question 19

A woman has a long history of seasonal allergies that are typically accompanied by rhinorrhea, red eyes, and frequent sneezing. Sneezes are a result of


a CNS reflex that is initiated by receptors in the nasal cavities.

a reflex that is caused when irritants come into contact with cilia.

elevated CO2 levels that are detected by chemoreceptors in the large vessels.

stimulation of goblet cells and mast cells by the presence of microorganisms.

Question 20

A Nurse Practitioner is providing discharge planning for a 45-year-old woman who has a prescription for oral albuterol. The Nurse Practitioner will question the patient about her intake of which of the following?






Vitamin C

Question 21

The nurse practitioner orders Amoxicillin 500 mg tid? What is the total amount of medication patient will take per day?


500 mg

1000 mg

1500 mg

150 mg

Question 22

A Nurse Practitioner is caring for a 78-year-old patient with renal insufficiency and chronic heart failure who is receiving rapid infusions of high-dose furosemide. It will be a priority for the Nurse Practitioner to monitor for


hepatic encephalopathy.


vascular thrombosis.


Question 23A 72-year-old man is prescribed theophylline for symptomatic relief of bronchial asthma. Which of the following findings would alert the nurse to the need for close monitoring?


Enlarged prostate gland

Need for additional bronchodilation

Signs of an active lung infection

Hypersensitivity to povidone

Question 24

A patient with type 1 diabetes has been admitted to the hospital for orthopedic surgery and the care team anticipates some disruptions to the patient’s blood glucose levels in the days following surgery. Which of the following insulin regimens is most likely to achieve adequate glycemic control?


Small doses of long-acting insulin administered four to five times daily

Doses of basal insulin twice daily with regular insulin before each meal

Large doses of rapid-acting insulin combined with long-acting insulin each morning and evening

Divided doses of intermediate-acting insulin every 2 hours, around the clock

Question 25A patient with seasonal allergies is exasperated by her recent nasal congestion and has expressed her desire to treat it by using pseudoephedrine. The nurse should inform the patient that


under the Combat Methamphetamine Abuse Act, pseudoephedrine now requires a prescription.

drugs containing pseudoephedrine are available without a prescription but are kept off pharmacy shelves.

she must be prepared to show identification when buying a drug that contains pseudoephedrine.

pseudoephedrine is being phased out of the marketplace in order to combat illegal use.

Question 26

Mr. Penny, age 67, was diagnosed with chronic angina several months ago and has been unable to experience adequate relief of his symptoms. As a result, his physician has prescribed ranolazine (Ranexa). Which of the following statements is true regarding the use of ranolazine for the treatment of this patient’s angina?


Ranolazine confers protection from myocardial infarction but does not relieve symptoms of angina.

Amlodipine will now be contraindicated in the treatment of Mr. Penny’s angina.

Mr. Penny will need to be taught to monitor his blood pressure and heart rate.

Mr. Penny requires concurrent treatment with a beta blocker, nitrate, or a calcium channel blocker.

Question 27

A Nurse Practitioner is caring for a patient who has recently moved from Vermont to south Florida. The patient has been on the same antihypertensive drug for 6 years and has had stable blood pressures and no adverse effects. Since her move, however, she reports “dizzy spells and weakness” and feels that the drug is no longer effective. The Nurse Practitioner suspects that the change in the effectiveness of the drug is related to


the impact of the placebo effect on the patient’s response.

the accumulative effect of the drug if it has been taken for many years.

the impact of the warmer climate on the patient’s physical state.

problems with patient compliance with the drug regimen due to the move.

Question 28

Which of the following patients is most likely to benefit from the administration of an adrenergic agonist?


A man who is in cardiogenic shock following a myocardial infarction

A man who has a diagnosis of primary hypertension

A woman who has been admitted with a suspected ischemic stroke

A woman who is in labor and may require a caesarean section

Question 29The parents of a 7-year-old boy who has just been diagnosed with allergic asthma are being taught about their son’s medication regimen by the nurse. The nurse is currently teaching the parent’s about the appropriate use of a “rescue drug” for acute exacerbations of their son’s asthma. What drug should the nurse suggests the parents to use in these situations?






Question 30A patient with unstable angina pectoris who is NOT controlled with a nitrate would likely benefit most from the addition of:


1. Sodium channel blocker

2. Beta blocker

3. Cardiac glycoside

4. Either 1 or 2

Question 31A 62-year-old woman has been prescribed a fentanyl transdermal patch for chronic cancer pain. The patient asks the nurse how long it will take for her to experience pain relief. The nurse will instruct the patient that she should feel pain relief in approximately


6 hours.

12 hours.

24 hours.

32 hours.

Question 32A patient with bronchial asthma is prescribed a sustained-release preparation of theophylline. To help minimize the adverse effects of the drug, which of the following should the nurse suggest?


Take it on an empty stomach, 1 hour before or 2 hours after meals

Take it with a meal

Take it with foods containing xanthines, such as caffeine

Increase the drug dosage up to 50%

Question 33A patient is taking gabapentin (Neurontin) for spasticity associated with multiple sclerosis. Which of the following should be the priority for monitoring?


Hepatic function

Cardiac function

Respiratory function

Renal function

Question 34A patient in need of myocardial infarction prophylaxis has been prescribed sulfinpyrazone for gout. Which of the following will the nurse monitor the patient most closely for?




Renal dysfunction


Question 35A patient has GERD and is taking ranitidine (Zantac). She continues to have gastric discomfort and asks whether she can take an antacid. Which of the following is an appropriate response by the nurse?


“Sure, you may take an antacid with ranitidine.”

“No, the two drugs will work against each other.”

“Yes, but be sure to wait at least 2 hours to take the antacid after you take the ranitidine.”

“I wouldn’t advise it. You may experience severe constipation.”

Question 36A patient who takes aluminum hydroxide with magnesium hydroxide (Mylanta) frequently for upset stomach, heartburn, and sour stomach is seen regularly in the clinic. The nurse should assess which of the following?


Blood glucose level

Serum phosphate level

Urine specific gravity

Aspartate transaminase levels

Question 37A 67-year-old man is admitted to the hospital with pneumonia. He reports to the nurse that he has chronic arthritis and circulation problems. Further assessment by the nurse reveals that the patient has a history of mild hypertension. He explains that he owns a business and lives alone. The nurse determines that he is within the normal weight range for his height and age but has a fondness for spicy foods and sweets. Which of the mentioned patient variables will have the greatest impact on the effectiveness of the patient’s drug therapy?


Vascular impairment

Mild hypertension

Dietary habits

Chronic arthritis

Question 38An older adult who lives in a long-term care facility has recently begun taking losartan (Cozaar) for the treatment of hypertension. The nurse who provides care for this resident should recognize that this change in the resident’s medication regimen make create a risk for




xerostomia (dry mouth).


Question 39The APRN is caring for a patient taking a calcium channel blockers for hypertension.  The APRN should monitor the patient for what common side effects of this medication?


peripheral edema, constipation, dizziness

hyperkalemia, dry cough, angioedema

bronchospasm, dry cough, angioedema

peripheral edema, dry cough, hypokalemia

Question 40A home health Nurse Practitioner is performing a home visit to an elderly client who has early-stage dementia. The Nurse Practitioner observes that some of the client’s pill bottles are empty, even though the client is not due for refills for 2 weeks. What nursing diagnosis should the Nurse Practitioner prioritize when planning this client’s care?


Impaired Home Maintenance Management

Ineffective Coping

Knowledge Deficit

Ineffective Therapeutic Regimen Management

Question 41A Nurse Practitioner is discussing with a patient the efficacy of a drug that his physician has suggested, and he begin taking. Efficacy of a drug means which of the following?


The amount of the drug that must be given to produce a particular response

How well a drug produces its desired effect

A drug’s strength of attraction for a receptor site

A drug’s ability to stimulate its receptor

Question 42You are seeing a 55 year old patient recently diagnosed with a bleeding ulcer. What should be the initial treatment choice for this patient?


Sucralfate (Carafate)

A Proton Pump Inhibitor

An H2 Receptor Blocker

Lifestyle Modifications including smoking cessation

Question 43The APRN’s ability to prescribe controlled substances is regulated by:




State Law

All of the above

Question 44

The lower respiratory system utilizes a number of different mechanisms that confer protection and maintain homeostasis. Which of the following physiological processes protects the lower respiratory system?


Goblet cells throughout the lower airways produce phagocytes that trap particles and microorganisms.

The carina, where the trachea bifurcates into two bronchi, closes off the lower airway in response to noxious stimuli.

The alveoli produce positive pressure in order to expel particles that have been inhaled.

Cilia sweep foreign material and mucus upward toward the trachea and larynx where they can then be swallowed.

Question 45Which of the following serves to protect the public by ensuring the purity of a drug and its contents?


American Pharmaceutical Association

United States Adopted Names Council

Nursing drug guides

Federal legislation

Question 46

A female patient has been taking zafirlukast for a week and is experiencing diarrhea. The nurse should instruct her to do which of the following?


Take nonnarcotic analgesics

Schedule blood tests

Drink plenty of fluids

Take the drug with food

Question 47A 45-year-old man who is a construction worker has been diagnosed with hyperlipidemia and has been prescribed lovastatin. The nurse will advise the patient to


use over-the-counter (OTC) drugs to treat any muscle cramps or pain.

drink moderate amounts of alcohol.

avoid prolonged exposure to sunlight.

change to another similar drug if lovastatin proves to be ineffective.

Question 48A 70-year-old woman has experienced peripheral edema and decreasing stamina in recent months and has sought care from her primary care provider. The patient’s subsequent diagnostic workup has resulted in a diagnosis of chronic heart failure. The woman has been prescribed digoxin and the nurse has begun patient education. What should the nurse teach the patient about her new medication?


“By reducing the amount of fluid that your body contains, digoxin will make it easier for your heart to pump.”

“This will lessen the workload of your heart by reducing your blood pressure.”

“Most patients see their heart failure resolve in 2 to 4 months after they begin taking digoxin.”

“This drug won’t cure your disease, but it will help you be able to exercise more and be more comfortable.”

Question 49A 48-year-old woman who works as an office manager is prescribed metoclopramide (Reglan) for diabetic gastroparesis. The nurse will be sure to assess the patient for






Question 50

A normal maintenance dose for digoxin is 0.125 to 0.5 mg/day. In which of the following patients would the nurse most likely administer a lower-than-normal maintenance dose of digoxin?


A 25-year-old male with congestive heart failure and atrial fibrillation

A 32-year-old female with cardiomegaly

A 79-year-old male with cardiomegaly

A 42-year-old female with a third heart sound

Question 51

The most effective therapy for a patient  who is H. pylori positive with a gastric ulcer is:


Cephalexin, Bismuth, Omeprazole, and Ranitidine

Bismuth, Metronidazole, Omeprazole, and Tetracycline

Amoxicillin, Cefzil, and omeprazole

Amoxicillin, Metronidazole, and Bismuth

Question 52

A patient has been prescribed a drug that can be self-administered at home. Which of the following would be the most important information for the nurse to relate to the patient concerning self-administration of a drug?


Where to purchase the medication

The cost of the drug

The therapeutic effects and possible adverse effects

The pharmacokinetics of the drug

Question 53A 66-year-old woman has a complex medical history that includes poorly-controlled type 1 diabetes, renal failure as a result of diabetic nephropathy and chronic heart failure (CHF). Her care provider has recently added spironolactone (Aldactone) to the woman’s medication regimen. The nurse should consequently assess for signs and symptoms of


atrial fibrillation.




Question 54

In order to promote therapeutic drug effects, the Nurse Practitioner should always encourage patients to


take their medication with meals.

take their medication at the prescribed times.

increase medication dosages if necessary.

use alternative therapy to increase the effects of their medications.

Question 55

A patient has been prescribed zolpidem (Ambien) for short-term treatment of insomnia. Which of the following will the nurse include in a teaching plan for this patient? (Select all that apply.)


The drug should not be used for longer than 1 month.

It should be taken 1 hour to 90 minutes before going to bed.

The drug does not cause sleepiness in the morning.

One of the most common adverse effects of the drug is headache.

It is available in both quick-onset and continuous-release oral forms.

Question 56

A Nurse Practitioner who provides care on an acute medicine unit has frequently recommended the use of nicotine replacement gum for patients who express a willingness to quit smoking during their admission or following their discharge. For which of the following patients would nicotine gum be contraindicated?


A patient who received treatment for kidney failure due to an overdose of acetaminophen

A patient whose pulmonary embolism was treated with a heparin infusion

A patient with a history of angina who experienced a non-ST wave myocardial infarction

A patient whose stage III pressure ulcer required intravenous antibiotics and a vacuum dressing

Question 57

Which of the following is TRUE about long acting beta agonist use in asthma patients?


It is useful in exercise induced asthma

It is effective to use in acute exacerbations

It may be used as solo treatment in step 2 of asthma treatment

It can be combined with an inhaled corticosteroid to improve asthma control

Question 58

A 49-year-old woman has been diagnosed with myalgia. The physician has recommended aspirin. The patient is concerned that the aspirin will upset her stomach. The nurse will encourage the patient to


crush the tablet before swallowing.

swallow the tablet whole.

swallow the tablet with milk or food.

avoid drinking milk for 3 hours after swallowing the tablet.

Question 59A 72-year-old female patient is prescribed ipratropium aerosol for pulmonary emphysema. The nurse will instruct her to “test spray” the new metered-dose inhaler (MDI) three times before using it to prevent which of the following?


Anaphylactoid reaction

Asymptomatic elevated hepatic enzymes levels

Paradoxic acute bronchospasm

Symptomatic hepatitis with hyperbilirubinemia

Question 60A 68-year-old man complains of a chronic, nonproductive cough. He states that he has to have relief, that he has been coughing every 2 to 3 minutes, and he is worn out. Dextromethorphan is prescribed for him. Before he leaves the clinic he asks how long it will take for the medicine to work. The nurse will advise him that he should experience therapeutic effects in


5 minutes.

10 minutes.

15 to 30 minutes.

60 minutes.

Question 61

A Nurse Practitioner has been following a male patient who is taking hydralazine, clonidine, and a diuretic for hypertension. After 2 weeks of medication therapy, the patient begins to complain of numbness and tingling in his hands and feet. The Nurse Practitioner suspects that these signs or symptoms are


a result of new onset diabetes.

an adverse effect of the diuretic.

signs of peripheral neuritis.

an idiosyncratic reaction to clonidine.

Question 62

A 77-year-old patient has a long-standing history of hypertension, a health problem that is being treated with metoprolol and a thiazide diuretic. Before administering the 8 AM dose of these medications, what assessments should the nurse perform and document? (Select all that apply.)


Respiratory rate

Oxygen saturation


Heart rate

Blood pressure

Question 63Topical inhaled alpha adrenergic blocking agents or nasal vasoconstricting decongestants should not be used chronically (>5 days) because they can cause


rebound insomnia

rebound coughing

rebound rhinitis/congestion

None of the above

Question 64

A patient is taking cholestyramine. The Nurse Practitioner will assess for which of the following common adverse effects of the drug?


Abdominal pain





Question 65

In which of the following patients would a Nurse Practitioner expect to experience alterations in drug metabolism?


A 35-year-old woman with cervical cancer

A 41-year-old man with kidney stones

A 50-year-old man with cirrhosis of the liver

A 62-year-old woman in acute renal failure

Question 66

A 46-year-old white American has been prescribed a drug that binds to acid glycoproteins. The nurse understands that white Americans usually receive


a higher-than-normal dose of drugs that bind to acid glycoproteins.

a lower-than-normal dose of drugs that bind to acid glycoproteins.

the recommended normal dose of drugs that bind to acid glycoproteins.

one half the recommended dose of drugs that bind to acid glycoproteins.

Question 67

A 20-year-old woman calls the clinic at 5 PM and reports to the Nurse Practitioner that she forgot to take her morning dose of fexofenadine (Allegra). She usually takes her evening dose at 8 PM. She wants to know what she should do. The Nurse Practitioner will instruct her to


double her evening dose.

skip the evening dose and start back in the morning.

forget about the morning dose and take the evening dose.

take the morning dose now and the evening dose at the regular time.

Question 68

A patient with a recent diagnosis of acute renal failure has a long-standing seizure disorder which has been successfully controlled for several years with antiseizure medications. The nurse should recognize that the patient’s compromised renal function will likely


increase the half-life of medications that are metabolized by the kidneys.

decrease the first-pass effect of medications that the patient is given.

necessitate intravenous, rather than oral, medications.

make the antiseizure medications less effective than in the past.

Question 69

A 79-year-old woman who takes several medications for a variety of chronic health problems has been prescribed an oral antiplatelet aggregator that is to be taken once daily. The nurse has encouraged the woman to take the pill at the same time of day that she takes some of her other medications. What is the most likely rationale for the nurse’s advice?


Integrating the new drug into the patient’s existing schedule promotes adherence.

Combining a new drug with one or more existing drugs mitigates the risk of adverse effects.

Taking several drugs at one time maximizes recovery time for the liver and kidneys.

Rapid drug clearance fostered when a patient is able to minimize the number of drug administration times.

Question 70

A clinic Nurse Practitioner is planning care for a 68-year-old man who has been on omeprazole (Prilosec) therapy for heartburn for some time. Regarding the patient’s safety, which of the following would be a priority nursing action?


Teach the patient to take omeprazole 1 hour before meals.

Emphasize that the drug should not be crushed or chewed.

Coordinate bone density testing for the patient.

Monitor the patient for the development of diarrhea.

Question 71

An expected outcome for a patient who has just taken sublingual nitroglycerin should be


increased heart rate and decreased blood pressure.

decreased heart rate and decreased blood pressure.

increased heart rate and increased blood pressure.

decreased heart rate and increased blood pressure.

Question 72

A Nurse Practitioner is providing care for a patient who suffered extensive burns to his extremities during a recent industrial accident. Topical lidocaine gel has been ordered to be applied to the surfaces of all his burns in order to achieve adequate pain control. When considering this order, the Nurse Practitioner should be aware that


intravenouslidocaine may be preferable to topical application.

lidocaine must be potentiated with another anesthetic in order to achieve pain control.

pain relief is unlikely to be achieved due to the destruction of nerve endings in the burn site.

there is a risk of systemic absorption of the lidocaine through the patient’s traumatized skin.

Question 73

A 22-year-old male college senior has lived with a diagnosis of Crohn’s disease for several years and has undergone several courses of treatment with limited benefit. Which of the following targeted therapies has the potential to alleviate the symptoms of Crohn’s disease?


Tositumomab plus 131I (Bexxar)

Muromonab-CD3 (Orthoclone OKT3)

Infliximab (Remicade)

Eculizumab (Soliris)

Question 74

A Nurse Practitioner is caring for a patient who is diabetic and has been diagnosed with hypertension. An angiotensin-converting enzyme inhibitor, captopril, has been prescribed for her. Which of the following should the Nurse Practitioner assess before beginning drug therapy?


Serum calcium levels

Serum potassium levels

Blood glucose levels

Serum magnesium levels

Question 75

A 60-year-old African-American man lives with a number of chronic health problems. Genetic factors are likely to influence his etiology and/or treatment of



low bone density.

a seizure disorder.

cardiac arrhythmias.

Question 76

A 70-year-old man with diabetes mellitus is taking metoprolol (Lopressor) to manage his hypertension. The nurse would be sure to instruct the patient to


take his pulse at least four times a day.

weigh himself once a week at the same time of the day.

avoid smoke-filled rooms.

understand the signs and symptoms of hypoglycemia.

Question 77

A Nurse Practitioner explains to a patient that nitroglycerin patches should be applied in the morning and removed in the evening. This medication schedule reduces the potential for


adverse effects.

nitrate dependence.

nitrate tolerance.

toxic effects.

Question 78

A patient receives 25 units of NPH insulin at 7.AM. At what time of day should the nurse advise the patient to be most alert for a potential hypoglycemic reaction?


After breakfast

Before lunch

Late afternoon


Question 79

A Nurse Practitioner is a member of a research team that is exploring unique differences in responses to drugs that each individual possesses, based on genetic make-up. This area of study is called







Question 80

A Nurse Practitioner is caring for a patient who is taking digoxin and a loop diuretic. Which of the following would be most important for the Nurse Practitioner to monitor?


Electrocardiogram results

Potassium levels

Sodium levels

Liver enzymes

Question 81

To maximize the therapeutic effect of diphenoxylateHCl with atropine sulfate, the nurse will instruct the patient to take the medication


once a day.

twice a day.

every 2 hours.

four times a day.

Question 82

A man who smokes one pack of cigarettes daily has been diagnosed with chronic bronchitis. He has been prescribed theophylline by his family doctor. What effect will the patient’s smoking status have on the therapeutic use of theophylline?


Theophylline may be contraindicated due to the risk of an anaphylactoid reaction

The patient may require higher doses of theophylline than a nonsmoker

The patient may require administration of an inhaled bronchodilator before each dose of theophylline

The patient will require serial blood testing to ensure a safe serum level of theophylline

Question 83

A 60-year-old man has scheduled a follow-up appointment with his primary care provider stating that the omeprazole (Prilosec) which he was recently prescribed is ineffective. The patient states, “I take it as soon as I feel heartburn coming on, but it doesn’t seem to help at all.” How should the nurse best respond to this patient’s statement?


“It could be that Prilosec isn’t the right drug for you, so it would be best to talk this over with your care provider.”

“Prilosec won’t really decrease the sensation of heartburn, but it is still minimizing the damage to your throat and stomach that can be caused by the problem.”

“Prilosec will help your heartburn but it’s not designed to provide immediate relief of specific episodes of heartburn.”

“A better strategy is to take a dose of Prilosec 15 to 30 minutes before meals or drinks that cause you to get heartburn.”

Question 84

A 34-year-old male patient is prescribed methimazole (MMI). The Nurse Practitioner will advise him to report which of the following immediately?



Intolerance to cold

Loss of appetite

Epigastric distress

Question 85

A Nurse Practitioner is providing patient education to a 35-year-old man who has been prescribed clonidine (Catapres) as part of step 2 antihypertensive therapy. The Nurse Practitioner should anticipate that the drug will be administered






Question 86

It is determined that a patient, who is in a hepatic coma, needs a laxative. Lactulose is prescribed. Which of the following should the nurse monitor to assess the efficacy of the lactulose therapy?


Water levels in the colon

Oncotic pressure in the colon

Blood ammonia levels

Relief from symptoms

Question 87A diabetic patient being treated for obesity tells the Nurse Practitioner that he is having adverse effects from his drug therapy. The patient has been taking dextroamphetamine for 2 weeks as adjunct therapy. Which of the following adverse effects would need the Nurse Practitioner’s immediate attention?



Decreased libido

Increased blood glucose

Dry eyes

Jittery feeling

Question 88

A resident of a long-term care facility receives 12.5 mg metoprolol (Lopressor) at 8 AM and 8 PM daily. Before administering this drug, the nurse should perform and document what assessments?


Oxygen saturation and respiratory rate

Heart rate and blood pressure

Level of consciousness and pain level

Temperature and respiratory rate

Question 89

A 35 year old patient presents with a concern of two high blood pressures at local health fairs in the past month. The patient has a history of Type 2 Diabetes, Chronic Constipation, and Obesity. Today her pressure is 145/93. You will:


Begin hydrochlorothiazide 12.5 mg daily.

Begin furosemide 20 mg daily.

Ask the patient to monitor their BP’s at home and reduce their sodium intake only.

Begin amlodipine 10 mg daily.

Question 90Which statement is FALSE regarding the treatment of hyperthyroidism?


Propylthiouracil (PTU) reduces peripheral conversion of T4 to the more potent T3

Since methimazole (Tapazole) is stronger than Propylthiouracil (PTU), Methimazole should be initiated at 15 mg/day compared to 300 mg/day for Propylthiouracil for treatment of mild disease

Long-acting beta-blocking agents are given as adjunctive therapy until Propulthiouracil (PTU) or methimazole (Tapazole) restores the patient to euthyroid

Methimazole (Tapazole) is the drug of choice for pregnant or lactating females.

Question 91A 58-year-old man is prescribed dicyclomine (Bentyl) for irritable bowel syndrome. In which of the following conditions is dicyclomine therapy contraindicated?



Diabetes mellitus


Rheumatoid arthritis

Question 92

Mr. Tan is a 69-year-old man who prides himself in maintaining an active lifestyle and a healthy diet that includes adequate fluid intake. However, Mr. Tan states that he has experienced occasional constipation in recent months. What remedy should be the nurse’s first suggestion?


Bismuth subsalicylate

A bulk-forming (fiber) laxative

A stimulant laxative

A hyperosmotic laxative

Question 93

A mother brings her 4-year-old child, who is vomiting and has a temperature of 103°F into the emergency department (ED). The ED physician orders acetaminophen (Tylenol) for the fever. The best form of Tylenol to give the child, considering her presentation, would be






Question 94

A Nurse Practitioner is caring for a male patient who has a diagnosis of coronary artery disease (CAD). His drug therapy includes lovastatin. Because the patient has a history of severe renal disease, the nurse will assess for which of the following?


Decrease in plasma concentration of lovastatin

Increase in the statin tolerance level

Decrease in LDL

Increase in plasma concentration of lovastatin


Question 95

A 24-year-old factory worker has been prescribed guaifenesin for the first time. Which of the following will be a priority assessment by the nurse before the patient’s first dose?


The amount of salt intake

The amount of alcohol consumption

The amount of fatty foods eaten daily

The number of cigarettes smoked per day

Question 96 A patient has been prescribed a Scheduled 5 drug, an example of this drug is



Narcotic Analgesics



Question 97 A high school student was diagnosed with asthma when he was in elementary school and has become accustomed to carrying and using his “puffers”. In recent months, he has become more involved in sports and has developed a habit of administering albuterol up to 10 times daily. The nurse should teach the student that overuse of albuterol can lead to


permanent liver damage.

rebound bronchoconstriction.

community-acquired pneumonia.

severe anticholinergic effects.

Question 98 Drugs have a high potential for abuse. There is no routine therapeutic use for these drugs and they are not available for regular use. They may be obtained for “investigational use only” by applying to the U.S. Drug Enforcement Agency. Examples include heroin and LSD. Which scheduled drug is this?


Schedule 1

Schedule 2

Schedule 3

Schedule 4

Question 99 A patient has a history of tonic-clonic seizures that have been successfully treated with phenytoin (Dilantin) for several years. Phenytoin achieves a therapeutic effect by


decreasing the influx of sodium into neurons.

increasing the levels of available glutamate.

simultaneously potentiating the effects of GABA and inhibiting reuptake.

by slowing the function of calcium channels within the neurological system.

Question 100  A 29-year-old female patient has been prescribed orlistat (Xenical) for morbid obesity. The nurse is providing patient education concerning the drug. An important instruction to the patient would be to


omit the dose if the meal does not contain fat.

takeorlistat and multivitamins together.

takeorlistat in one dose at breakfast.

omit the dose if the meal does not contain protein.

Question 101 When completing this exam, did you comply with Walden University’s Code of Conduct including the expectations for academic integrity?




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