Question

1. Question :

The drug recommended as primary prevention of osteoporosis in men over seventy years is:

Alendronate (Fosamax)

Ibandronate (Boniva)

Calcium carbonate

Raloxifene (Evista)

Question 2. Question :

Alterations in drug metabolism among Asians may lead to:

Slower metabolism of antidepressants, requiring lower doses

Faster metabolism of neuroleptics, requiring higher doses

Altered metabolism of omeprazole, requiring higher doses

Slower metabolism of alcohol, requiring higher doses

Question 3. Question :

Some research supports that testosterone replacement therapy may be indicated in which of the following diagnoses in men?

Age-related decrease in cognitive functioning

Metabolic syndrome

Decreased muscle mass in aging men

All of the above

Question 4. Question :

The chemicals that promote the spread of pain locally include _________.

serotonin

norepinephrine

enkephalin

neurokinin A

Question 5. Question :

The DEA:

Registers manufacturers and prescribes controlled substances

Regulates NP prescribing at the state level

Sanctions providers who prescribe drugs off-label

Provides prescribers with a number they can use for insurance billing

Question 6. Question :

The trial period to determine effective anti-inflammatory activity when starting a patient on aspirin for RA is _____.

forty-eight hours

four to six days

four weeks

two months

Question 7. Question :

The route of excretion of a volatile drug will likely be:

The kidneys

The lungs

The bile and feces

The skin

Question 8. Question :

Compelling indications for an ACE inhibitor as treatment for hypertension based on clinical trials include:

Pregnancy

Renal parenchymal disease

Stable angina

Dyslipidemia

Question 9. Question :

The American Diabetic Association has recommended which of the following tests for ongoing management of diabetes?

Fasting blood glucose

Hemoglobin A1c

Thyroid function tests

Electrocardiograms

Question 10. Question :

The angiotensin converting enzyme (ACE) inhibitor lisinopril is a known teratogen. Teratogens cause Type ____ ADR.

A

B

C

D

Question 11. Question :

The goals of therapy when prescribing HRT include reducing:

Cardiovascular risk

Risk of stroke or other thromboembolic event

Breast cancer risk

Vasomotor symptoms

Question 12. Question :

Patients who have angina, regardless of class, who are also diabetic should be on:

Nitrates

Beta blockers

ACE inhibitors

Calcium channel blockers

Question 13. Question :

The New York Heart Association and the Canadian Cardiovascular Society have described grading criteria for levels of angina. Angina that occurs with unusually strenuous activity or on walking or climbing stair after meals is:

Class I

Class II

Class III

Class IV

Question 14. Question :

Patients with allergic rhinitis may benefit from a prescription of:

Fluticasone (Flonase)

Cetirizine (Zyrtec)

OTC cromolyn nasal spray (Nasalcrom)

Any of the above

Question 15. Question :

Kyle has Crohn’s disease and has a documented folate deficiency. Drug therapy for folate deficiency anemia is:

Oral folic acid 1 to 2 mg/day

Oral folic acid 1 gm/day

IM folate weekly for at least six months

Oral folic acid 400 mcg daily

Question 16. Question :

The treatment for vitamin B12 deficiency is:

1,000 mcg daily of oral cobalamin

2 gm/day of oral cobalamin

100 mcg/day vitamin B12 IM

500 mcg/dose nasal cyanocobalamin two sprays once a week

Question 17. Question :

Nonadherence is especially common in drugs that treat asymptomatic conditions, such as hypertension. One way to reduce the likelihood of nonadherence to these drugs is to prescribe a drug that:

Has a short half-life so that missing one dose has limited effect

Requires several dosage titrations so that missed doses can be replaced with lower doses to keep costs down

Has a tolerability profile with less of the adverse effects that are considered “irritating,” such as nausea and dizziness

Must be taken no more than twice a day

Question 18. Question :

Type II diabetes is a complex disorder involving:

Absence of insulin production by the beta cells

A suboptimal response of insulin-sensitive tissues in the liver

Increased levels of GLP in the postprandial period

Too much fat uptake in the intestine

Question 19. Question :

Metformin is a primary choice of drug to treat hyperglycemia in type II diabetes because it:

Substitutes for insulin usually secreted by the pancreas

Decreases glycogenolysis by the liver

Increases the release of insulin from beta cells

Decreases peripheral glucose utilization

Question 20. Question :

Gender differences between men and women in pharmacokinetics include:

More rapid gastric emptying so that drugs absorbed in the stomach have less exposure to absorption sites

Higher proportion of body fat so that lipophilic drugs have relatively greater volumes of distribution

Increased levels of bile acids so that drugs metabolized in the intestine have higher concentrations

Slower organ blood flow rates so that drugs tend to take longer to be excreted

Question 21. Question :

If not chosen as the first drug in hypertension treatment, which drug class should be added as the second step because it will enhance the effects of most other agents?

ACE inhibitors

Beta blockers

Calcium channel blockers

Diuretics

Question 22. Question :

A nineteen-year-old male was started on risperidone. Monitoring for risperidone includes observing for common side effects, including:

Bradykinesia, akathisia, and agitation

Excessive weight gain

Hypertension

Potentially fatal agranulocytosis

Question 23. Question :

Levetiracetam has known drug interactions with:

Oral contraceptives

Carbamazepine

Warfarin

Few, if any, drugs

Question 24. Question :

When the total daily insulin dose is split and given twice daily, which of the following rules may be followed?

Give two-thirds of the total dose in the morning and one-third in the evening.

Give 0.3 units/kg of premixed 70/30 insulin, with one-third in the morning and two-thirds in the evening.

Give 50% of an insulin glargine dose in the morning and 50% in the evening.

Give long-acting insulin in the morning and short-acting insulin at bedtime.

Question 25. Question :

Which of the following factors may adversely affect a patient’s adherence to a therapeutic drug regimen?

Complexity of the drug regimen

Patient’s perception of the potential adverse effects of the drugs

Both A and B

Neither A nor B

Question 26. Question :

The time required for the amount of drug in the body to decrease by 50% is called:

Steady state

Half-life

Phase II metabolism

Reduced bioavailability time

Question 27. Question :

Drugs that are absolutely contraindicated in lactating women include:

Selective serotonin reuptake inhibitors

Antiepileptic drugs such as carbamazepine

Antineoplastic drugs such as methotrexate

All of the above

Question 28. Question :

Tobie presents to clinic with moderate acne. He has been using OTC benzoyl peroxide at home with minimal improvement. A topical antibiotic (clindamycin) and a topical retinoid adapalene (Differin) are prescribed. Education of Tobie would include which one of the following instructions?

He should see an improvement in his acne within the first two weeks of treatment.

If there is no response in a week, he should double the daily application of adapalene (Differin).

He may see an initial worsening of his acne that will improve in six to eight weeks.

Adapalene may cause bleaching of clothing.

Question 29. Question :

Martin is a sixty-year-old with hypertension. The first-line decongestant to be prescribed would be:

Oral pseudoephedrine

Oral phenylephrine

Nasal oxymetazoline

Nasal azelastine

Question 30. Question :

A woman who is pregnant and has hyperthyroidism is best managed by a specialty team that will most likely treat her with:

Methimazole.

Propylthiouracil.

Radioactive iodine.

Nothing; treatment is best delayed until after her pregnancy ends.

Question 31. Question :

A twenty-four-year-old male received multiple fractures in a motor vehicle accident that required significant amounts of opioid medication to treat his pain. He is at risk for Type __ ADR when he no longer requires the opioids.

A

C

E

G

Question 32. Question :

Second-generation antihistamines such as loratadine (Claritin) are prescribed for seasonal allergies because they:

Are more effective than first-generation antihistamines

Are less sedating than first-generation antihistamines

Are prescription products and, therefore, are covered by insurance

Can be taken with CNS sedatives, such as alcohol

Question 33. Question :

Steady state is:

The point on the drug concentration curve when absorption exceeds excretion

When the amount of drug in the body remains constant

When the amount of drug in the body stays below the minimum toxic concentration (MTC)

All of the above

Question 34. Question :

Jayla is a nine-year-old who has been diagnosed with migraines for almost two years. She is missing up to a week of school each month. Her headache diary confirms she averages four or five migraines per month. Which of the following would be appropriate?

Prescribe amitriptyline (Elavil) daily, start at a low dose and increase the dose slowly every two weeks until effective in eliminating migraines.

Encourage her mother to give her Excedrin Migraine (aspirin, acetaminophen, and caffeine) at the first sign of a headache to abort the headache.

Prescribe propranolol (Inderal) to be taken daily for at least three months.

Explain that it is rare for a nine-year-old to get migraines and that she needs an MRI to rule out a brain tumor.

Question 35. Question :

Josie is a five-year-old who presents to the clinic with a forty-eight-hour history of nausea, vomiting, and some diarrhea. She is unable to keep fluids down, and her weight is 4 pounds less than her last recorded weight. Besides intravenous (IV) fluids, her exam warrants the use of an antinausea medication. Which of the following would be the appropriate drug to order for Josie?

Prochlorperazine (Compazine)

Meclizine (Antivert)

Promethazine (Phenergan)

Ondansetron (Zofran)

Question 36. Question :

Long-term use of PPIs may lead to:

Hip fractures in at-risk persons

Vitamin B6 deficiency

Liver cancer

All of the above

Question 37. Question :

Many patients self-medicate with antacids. Which patients should be counseled to not take calcium carbonate antacids without discussing with their providers or a pharmacist first?

Patients with kidney stones

Pregnant patients

Patients with heartburn

IN Postmenopausal women

0 of 2.5

Question 38. Question :

Beta blockers treat hypertension because they:

Reduce peripheral resistance.

Vasoconstrict coronary arteries.

Reduce norepinephrine.

Reduce angiotensin II production.

Question 39. Question :

Precautions that should be taken when prescribing controlled substances include:

Faxing the prescription for a Schedule II drug directly to the pharmacy

Using tamper-proof papers for all prescriptions written for controlled drugs

Keeping any presigned prescription pads in a locked drawer in the clinic

Using only numbers to indicate the amount of drug to be prescribed

Question 40. Question :

The tricyclic antidepressants should be prescribed cautiously in patients with:

Eczema

Asthma

Diabetes

Heart disease

Question 41. Question :

An ACE inhibitor and what other class of drug may reduce proteinuria in patients with diabetes better than either drug alone?

Beta blockers

Diuretics

Nondihydropyridine calcium channel blockers

Angiotensin II receptor blockers

Question 42. Question :

Metoclopramide improves GERD symptoms by:

Reducing acid secretion

Increasing gastric pH

Increasing lower esophageal tone

Decreasing lower esophageal tone

Question 43. Question :

Patient education regarding prescribed medication includes:

Instructions written at the high school reading level

Discussion of expected ADRs

How to store leftover medication such as antibiotics

Verbal instructions always in English

Question 44. Question :

If a patient with H. pylori positive PUD fails first-line therapy, the second-line treatment is:

A PPI BID plus metronidazole plus tetracycline plus bismuth subsalicylate for fourteen days

Testing H. pylori for resistance to common treatment regimens

A PPI plus clarithromycin plus amoxicillin for fourteen days

A PPI and levofloxacin for fourteen days

Question 45. Question :

A patient with a COPD exacerbation may require:

Doubling of inhaled corticosteroid dose

Systemic corticosteroid burst

Continuous inhaled beta 2 agonists

Leukotriene therapy

Question 46. Question :

Angela is a black woman who has heard that women of African descent do not need to worry about osteoporosis. What education would you provide Angela about her risk?

She is ; black women do not have much risk of developing osteoporosis due to their dark skin.

Black women are at risk of developing osteoporosis due to their lower calcium intake as a group.

If she doesn’t drink alcohol, her risk of developing osteoporosis is low.

If she has not lost more than 10% of her weight lately, her risk is low.

Question 47. Question :

The role of the nurse practitioner in the use of herbal medication is to:

Maintain competence in the prescribing of common herbal remedies.

Recommend common OTC herbs to patients.

Educate patients and guide them to appropriate sources of care.

Encourage patients to not use herbal therapy due to the documented dangers.

Question 48. Question :

Ray has been diagnosed with hypertension, and an ACE inhibitor is determined to be needed. Prior to prescribing this drug, the nurse practitioner should assess for:

Hypokalemia

Impotence

Decreased renal function

Inability to concentrate

Question 49. Question :

Long-acting beta-agonists received a black box warning from the US Food and Drug Administration due to the:

Risk of life-threatening dermatological reactions

Increased incidence of cardiac events when long-acting beta-agonists are used

Increased risk of asthma-related deaths when long-acting beta-agonists are used

Risk for life-threatening alterations in electrolytes

Question 50. Question :

Off-Label prescribing is:

Regulated by the FDA

Illegal by NPs in all states (provinces)

Legal if there is scientific evidence for the use

Regulated by the DEA

Question 51. Question :

Adam has type I diabetes and plays tennis for his university. He exhibits knowledge deficit about his insulin and his diagnosis. He should be taught that:

He should increase his increase his carbohydrate intake during times of exercise intake during times of exercise.

Each brand of insulin is equal in bioavailability, so buy the least expensive.

Alcohol produces hypoglycemia and can help control his diabetes when taken in small amounts.

If he does not want to learn to give himself injections, he may substitute an oral hypoglycemic to control his diabetes.

Question 52. Question :

Prior to starting antidepressants, patients should have laboratory testing to rule out:

IN Hypothyroidism

Anemia

Diabetes mellitus

Low estrogen levels

0 of 2.5

Question 53. Question :

What impact does developmental variation in renal function has on prescribing for infants and children?

Lower doses of renally excreted drugs may be prescribed to infants younger than six months

Higher doses of water-soluble drugs may need to be prescribed due to increased renal excretion

Renal excretion rates have no impact on prescribing

Parents need to be instructed on whether drugs are renally excreted or not

Question 54. Question :

All diabetic patients with hyperlipidemia should be treated with:

3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors

Fibric acid derivatives

Nicotinic acid

Colestipol

Question 55. Question :

Treatment failure in patients with PUD associated with H. pylori may be due to:

Antimicrobial resistance

Ineffective antacid

Overuse of PPIs

All of the above

Question 56. Question :

To improve positive outcomes when prescribing for the elderly, the NP should:

Assess cognitive functioning in the elder

Encourage the patient to take a weekly “drug holiday” to keep drug costs down

Encourage the patient to cut drugs in half with a knife to lower costs

All of the above options are

Question 57. Question :

Erik presents with a golden-crusted lesion at the site of an insect bite co