please help answer questions

 

WEEK 10 ASSIGNMENT – 50 QUESTIONS (2 POINTS EACH)

• As an Advanced Nurse Practitioner, you order PCN for a patient with a confirmed diagnosis of Strep.  You order the medication, your nurse calls it into the patient’s pharmacy, and it is filled by the patient.  The patient calls the next day stating that they have hives all over their body and think it is from the PCN.  You recheck their chart and see that you have missed that they are allergic to PCN.  Legal responsibility for the error is:
  • Only on you – You gave the order, the pharmacist was obligated to fill it
  • Only the nurse – She should have checked the allergies before calling in the prescription
  • Only on the pharmacist – The pharmacist should have known about the allergy
  • On all parties involved – The Advanced Nurse Practitioner, Nurse and Pharmacist
• CS is a 20 year old patient of yours.  He has a habit of not seeing you on a regular basis, and using OTC medications whenever he feels sick.  Which of the following statements best describes the danger of self-medicating with OTC medications?
  • Patients are not aware of the action of OTC medications
  • Patients are not aware of the side effects of OTC medications
  • Patients minimize the effects of OTC medications because they are available without a prescription
  • All of the above

 

• You decide to treat a patient with an antihistamine for seasonal allergies.  Which of the following precautions should you provide to the patient?
  • Avoid ingesting alcohol
  • Be aware that you may need to take a decongestant to make the antihistamine effective
  • Be aware that you may have increase salivation
  • You can expect full relief in 24 hours

 

• OP is a 55 year old male who has been taking low-dose steroids daily for the suppression of RA for the last 5 years.  He presents to you for back pain.  You order an X-ray and find a vertebral compression fracture.  This fracture is due to:
  • An entirely separate condition
  • The osteoporotic effect of long-term steroid use
  • Deterioration in rheumatoid arthritis
  • Excessively high dose steroids
• Which of the following groups of patients are most at risk for GI bleeding from the use of NSAIDs?
  • Patients with dysmenorrhea
  • Patients with headaches
  • Patients with arthritis
  • Patients with renal failure

 

 

• You have a 36 year old female patient who is s/p renal transplant x 4 weeks.  They are currently taking Cellcept.  Part of your education to the patient would include:
  • Take the Cellcept with food
  • Avoid the use of any steroids while taking
  • Practice effective contraception
  • None of the above

 

• Which of the following agents can be used in the treatment of rheumatoid arthritis, Sjogren’s syndrome and SLE?
  • Auranofin
  • Allopurinol
  • Sulfasalazine
  • Chloroquine

 

• You have a patient with advanced cirrhosis of the liver and is not tolerating protein well, which is evidenced by abnormal laboratory values.  Which of the following medications would be best to be prescribed for this patient?
  • Lactulose
  • Ethacrynic Acid
  • Folic Acid
  • Thiamine

 

• Which of the following clients is at greatest risk of digoxin toxicity?
  • 25 year old patient with CHF
  • 50 year old client with CHF
  • 60 year old client after MI
  • 80 year old client with CHF

 

• Which of the following is a contraindication for digoxin administration?
  • Blood pressure of 140/90
  • Heart rate above 80
  • Heart rate below 60
  • Respiratory rate above 20
• The action of medication is inotropic when it:
  • Decreases afterload
  • Increases heart rate
  • Increases the force of contraction
  • Is used to treat CHF

 

 

 

 

 

• Which is the most appropriate action for the Advanced Nurse Practitioner to take before administering digoxin?
  • Monitor K+ level
  • Assess blood pressure
  • Evaluate urinary output
  • Avoid giving with a thiazide diuretic

 

• Class IA antiarrhythmic agents have little effect on:
  • AV note
  • SA node
  • Purkinje fibers
  • Bundle of His

 

• The most toxic antiarrhythmic agent is:
  • Digoxin
  • Lidocaine
  • Amiodarone
  • Quinidine

 

• Conduction defects will most likely be an adverse effect associated with the use of:
  • Verapamil
  • Nifedipine
  • Diltiazem
  • Felodipine

 

• Which of the following calcium channel blockers has the most potent peripheral smooth muscle dilator effect?
  • Diltiazem
  • Nifedipine
  • Nimodipine
  • Verapamil

 

• β-blockers should be avoided in which of the following conditions?
  • Bronchoconstriction
  • Hypertension
  • Angina
  • Myocardial Infarction
• You have a patient taking the medication Cinacalcet.  You would know to monitor:
  • Serum calcium levels
  • Evaluate bowel function
  • Measure serum acid phosphatase
  • None of the above

 

• A constant dose of estrogen with varying doses of progestin are found in:
  • Monophasic birth control pills
  • Biphasic birth control pills
  • Triphasic birth control pills
  • Quartraphasic birth control pills

 

• A relative contraindication to therapy with antiandrogens is:
  • Hepatic failure
  • Pregnancy
  • Prostate cancer
  • Hypogonadism

 

• A patient who has COPD is taking Theophylline also receives Cipro, which of the following interactions would you expect?
  • Ciprotoxicity
  • Ineffectiveness of Cipro
  • Theophylline toxicity
  • Ineffectiveness of Theophylline

 

• A patient is at highest risk for nephrotoxicity with Aminoglycoside use is:
  • 36 year old male patient with a Cr of 1.7 and BUN of 52 on a 10-day regimen
  • 24 year old female patient with Cr of 0.8 and BUN of 12 on a 7-day regimen
  • 44 year old female patient with a past history of cystitis on 5 days of therapy
  • 25 year old male patient with a history of kidney stones on a 10-day regimen

 

Changes in visual acuity and color perception are associated with treatment by which of the following agents?INH (Isoniazid)PZA (Pyrazinamide)ETH (Ethambutol)SM (Streptomycin)Which choice describes the action of nucleoside analogs?Exert anti-HIV activity at the reverse transcriptase level and cause premature termination of viral DNA chain synthesisCompletely stop the replication of the HIV virusAllow for a patient to become non-contagious after taking for at least 3 daysAre all equally effective and free of side effects.The effects of theophylline may be increased by:Phenobarbital PhenytoinRifampinCimetidineRoutine laboratory monitoring in clients taking β-blockers should include:SodiumGlucoseThyrotropinCreatinine phosphokinase

 

• Cholinergics are contraindicated in:
• Tachycardia
• Hypothyroidism
• Hypotension
• Asthma

 

• Which of the following metabolic effects may be a consequence of administration of adrenergic agents?
• Hypoglycemia
• Metabolic acidosis
• Hyperglycemia
• Respiratory alkalosis

 

• Adrenergic blockers are contraindicated in:
• Hypertension
• Pheochromocytoma
• Migraines
• Obstructive airway disease

 

• A side effect of cholinergic administration is:
• Nausea
• Diarrhea
• Increase salivation
• All of the above

 

• NK is a child who has been diagnosed with Attention Deficit Disorder (ADD).  Which of the following drugs is commonly used for their condition?
• Methylphenidate
• Diethylpropion
• Phendimetrazine
• Caffeine

 

• Amphetamines are included in the category of drugs of abuse because of their ability to:
• Cause nervousness
• Decrease weight
• Raise blood pressure
• Enhance performance

 

• As an Advanced Nurse Practitioner, you will most likely have patients that are on a stimulant medication.  When on the Amphetamines, you would monitor for decreased effect when these drugs are given with:
• Caffeine
• Antidiabetic agnets
• No Doze OTC medication
• All of the above

 

• From your pharmacology course research you have learned that you should never give amphetamines in combination with:
• Oral hyperglycemics
• Oral hypoglycemic
• MAO inhibitors
• Antihypertensives

 

• Use of Methylphenidate for ADD in children can result in:
• Tourette’s syndrome
• Growth suppression
• Growth spurt
• A and B

 

• When administering IV phenytoin, you should:
• Administer it at a rate of 100 mg/min
• Protect the drug from light exposure
• Mix the drug in dextrose solution
• Mix the drug in saline solution

 

• When caring for a patient who is receiving phenytoin and warfarin, which of the following drug-drug interactions would you expect?
• Decreased effectiveness of warfarin
• Increased effectiveness of phenytoin
• Increased effectiveness of warfarin
• Decreased effectiveness of phenytoin

 

 

 

 

 

• You have a new patient that you are meeting for the first time today.  You are going over their medications with them, and you ask them how long they have been taking Bromocriptine.  The patient states that they think they have been on it for 3 years or so.  They state that they don’t really know why they are on it though.  You explain to them:
• It helps treat Parkinson’s by decreasing dopamine levels in the brain
• Bromocriptine decreases the storage of dopamine peripherally, which in turn decreases Parkinson’s symptoms
• Bromocriptine activates dopamine receptors in the brain, and helps treat Parkinson’s
• It inhibits monoamine oxidase type B, which helps Parkinson’s

 

• Which of the patient statements below would make you think twice about administering Amantadine to a patient?
• “My hands are always shaking.”
• “I had to take Dilantin 6 months ago.”
• “I take a low-dose ASA each day.”
• “Simple tasks seem to take so long to perform.”

 

• You decide to start you patient on Amantadine.  Your main teaching point with the patient would be:
• Monitor the pulse for rate and regularity
• Take the last dose of medication at bedtime
• Inspect the skin for erythematous rash
• Stop taking the drug if the mouth becomes dry

 

• Which of the following assessments is most essential before beginning a drug regimen of an antimuscarinic agent?
• Date of birth
• Ethnic background
• History of diabetes
• Activity intolerance
• For which of the following medical conditions would you anticipate that an antianxiety medication would not be indicated?
• Seizure disorders
• Alcohol detox
• Parkinson’s disease
• Panic disorder

 

 

 

 

 

 

• When administering antianxiety medications (benzodiazepines) to an elderly patient, which of the following actions is essential?
• Monitor vital signs
• Suggest reduced doses
• Taper dose before stopping
• Implement a fall prevention protocol
• A and B only
• B and C only
• A, B and D only
• All of the above
• None of the above

 

• When monitoring a client who is taking benzodiazepines, you should be alert for which of the following CNS side effects?
• Diaphoresis
• Sedation
• Seizures
• Tremors
• Edema
• Ataxia
• Libido changes
• Dizziness
• A, B, E and G only
• B, F and H only
• C, D, E and H only
• All of the above
• None of the above

 

• Antidepressants generally exert influence by:
• Increasing the reuptake of norepinephrine
• Altering the action of MOA
• Changing the availability of dopamine
• Changing the availability of select neurotransmitters

 

 

 

 

 

 

 

 

 

• You have a new patient, 67 year old male, at your practice who presents for establishment with you.  During your initial assessment, and history taking you determine that the patient has the following:

Hypertension

Glaucoma

Gout

Hyperlipidemia

Minor Depression (which you just diagnosed at this visit).

EKG is normal, and other parts of the physical exam are WNL.

You want to start him on something to help with his depression.  What is the best option for this patient?

• Amitriptyline 25 mg QHS
• Zyprexa 20 mg QD
• Citalopram 10 mg QD
• None of the above

 

• Antipsychotic drugs are indicated for:
• The treatment of Tourette’s syndrome
• The treatment of major depression with psychosis
• As an adjunct in the management of seizures
• To cure psychotic disorders

 

• Your patient SS has been on a low-potency antipsychotic for 2 weeks, and has shown minimal response to the medications.  The most probably explanation is:
• SS probably has refractory illness
• SS needs a stronger medication
• It is too early to see a full therapeutic response in SS
• SS is not taking the medication as prescribed

 

• Drugs classified as centrally acting skeletal muscle relaxants are most effective in relieving:
• Spasm due to trauma or inflammation
• Chronic spasm due to an old injury
• Pain from arthritis
• Surgical complications

 

• Peripherally acting skeletal muscle relaxants are used:
• To treat neuromuscular diseases
• To treat spinal trauma
• To relieve spasms from trauma
• As adjuncts to general anesthesia
• Choose the following factor(s) that are F314 Surveyor Guidance Risk Factors for Developing Pressure Ulcers:
• Comorbid conditions
• Drugs that may affect ulcer healing
• Exposure of skin to urinary or fecal incontinence
• History of any healed pressure ulcer
• Impaired diffuse or localized blood flow
• Mild cognitive impairment
• A, B and C only
• D and F only
• A, B, C and E only
• All of the above

 

• Which of the following is TRUE about friction and shearing?
• Only friction which causes pressure damages the epidermis
• Friction is the combination of Gravity and Shearing
• Friction stretches and tears vessels, which reduces the amount of pressure necessary to cause ischemia and deep tissue injury
• All of the above are true
• None of the above are true

 

• CMS no longer pays the extra cost of treating certain categories of conditions that occur while the patient is in the hospital.  These are considered events that should “Never” occur through the delivery of quality care.  All pressure ulcers are CMS “never” events.
• True
• False

 

• Choose the following factor(s) that are components of the Braden Scale.
• Sensory perception
• Moisture
• Activity
• Mobility
• Nutrition
• Friction and Shear
• BMI (Over or under weight)

 

• Match the Stage with the description:
• Subcutaneous fat may be visible but bone, tendon or muscles are not exposed.  Slough may be present, but does not obscure the depth of tissue loss.
• Intact skin with nonblanchable redness of a localized area, usually over a bony prominence.
• Full thickness tissue loss with exposed bone, tendon or muscle.
• Partial thickness loss of dermis presenting as a shallow open ulcer with a red pink ulcer bed, without slough.
• Full thickness tissue loss in which the base of the ulcer is covered by slough (yellow, tan, gray, green or brown) and/or eschar (tan, brown or black) in the wound bed

 

• Match the treatments for their specified use:

Alginate               __________

Hydrofiber          __________
Foam                     __________

Hydrocolloid       __________

Hydrogel              __________

Low-adherence

    Dressing          __________

Transparent

    Dressing          __________

 

• Necrotic Wounds
• Clean, dry wounds with minimal exudate
• Exudate
• Skin Tears
• Cleaning granulating wounds

 

• Which of the following medication(s) has been demonstrated to negatively impact wound healing?
• Aricept 10 mg
• Namenda 21 mg
• Lisinopril 5 mg
• Seroquel 25 mg
• ASA EC 81 mg
• Metformin 500 mg
• Percocet 5/325 mg
• Tylenol 500 mg

 

• You have a patient on your rounds in the hospital that is in needs of nutritional supplementation for pressure ulcers.  How would you address the use of nutritional supplements in a patient like this?
• Order high-protein supplements enriched with arginine high-protein supplements
• Order high-protein supplements, arginine, zinc and Vitamin C
• Order studies to evaluate current nutritional status

 

• If you had a patient with a pressure ulcer, is it good practice to order an antibiotic in order to provide prophylaxis for infections?
• Yes
• No

 

Which of the following are components of monitoring pressure ulcers?Determine current number of healed and unhealed ulcersUse visual inspection and palpitation to identify appropriate stageCode all woundsDescribe the current stage of each ulcerAll of the above are trueB and C onlyA, C and D onlyWEEK10 ASSIGNMENT– 50 QUESTIONS (2 POINTS EACH)

1.      Asan Advanced Nurse Practitioner, you order PCN for a patient with a confirmeddiagnosis of Strep.  You order themedication, your nurse calls it into the patient’s pharmacy, and it is filledby the patient.  The patient calls thenext day stating that they have hives all over their body and think it is fromthe PCN.  You recheck their chart and seethat you have missed that they are allergic to PCN.  Legal responsibility for the error is:

 

a.      Onlyon you – You gave the order, the pharmacist was obligated to fill it

 

b.      Onlythe nurse – She should have checked the allergies before calling in theprescription

 

c.      Onlyon the pharmacist – The pharmacist should have known about the allergy

 

d.      Onall parties involved – The Advanced Nurse Practitioner, Nurse and Pharmacist

 

 

 

2.      CSis a 20 year old patient of yours.  Hehas a habit of not seeing you on a regular basis, and using OTC medicationswhenever he feels sick.  Which of thefollowing statements best describes the danger of self-medicating with OTCmedications?

 

a.      Patientsare not aware of the action of OTC medications

 

b.      Patientsare not aware of the side effects of OTC medications

 

c.      Patientsminimize the effects of OTC medications because they are available without aprescription

 

d.      Allof the above

 

 

 

3.      Youdecide to treat a patient with an antihistamine for seasonal allergies.  Which of the following precautions should youprovide to the patient?

 

a.      Avoidingesting alcohol

 

b.      Beaware that you may need to take a decongestant to make the antihistamineeffective

 

c.      Beaware that you may have increase salivation

 

d.      Youcan expect full relief in 24 hours

 

 

 

4.      OPis a 55 year old male who has been taking low-dose steroids daily for thesuppression of RA for the last 5 years. He presents to you for back pain. You order an X-ray and find a vertebral compression fracture.  This fracture is due to:

 

a.      Anentirely separate condition

 

b.      Theosteoporotic effect of long-term steroid use

 

c.      Deteriorationin rheumatoid arthritis

 

d.      Excessivelyhigh dose steroids

 

 

 

5.      Whichof the following groups of patients are most at risk for GI bleeding from theuse of NSAIDs?

 

a.      Patientswith dysmenorrhea

 

b.      Patientswith headaches

 

c.      Patientswith arthritis

 

d.      Patientswith renal failure

 

 

 

 

 

6.      Youhave a 36 year old female patient who is s/p renal transplant x 4 weeks.  They are currently taking Cellcept.  Part of your education to the patient wouldinclude:

 

a.      Takethe Cellcept with food

 

b.      Avoidthe use of any steroids while taking

 

c.      Practiceeffective contraception

 

d.      Noneof the above

 

 

 

7.      Whichof the following agents can be used in the treatment of rheumatoid arthritis,Sjogren’s syndrome and SLE?

 

a.      Auranofin

 

b.      Allopurinol

 

c.      Sulfasalazine

 

d.      Chloroquine

 

 

 

8.      Youhave a patient with advanced cirrhosis of the liver and is not toleratingprotein well, which is evidenced by abnormal laboratory values.  Which of the following medications would bebest to be prescribed for this patient?

 

a.      Lactulose

 

b.      EthacrynicAcid

 

c.      FolicAcid

 

d.      Thiamine

 

 

 

9.      Whichof the following clients is at greatest risk of digoxin toxicity?

 

a.      25year old patient with CHF

 

b.      50year old client with CHF

 

c.      60year old client after MI

 

d.      80year old client with CHF

 

 

 

10.  Whichof the following is a contraindication for digoxin administration?

 

a.      Bloodpressure of 140/90

 

b.      Heartrate above 80

 

c.      Heartrate below 60

 

d.      Respiratoryrate above 20

 

 

 

11.  Theaction of medication is inotropic when it:

 

a.      Decreasesafterload

 

b.      Increasesheart rate

 

c.      Increasesthe force of contraction

 

d.      Isused to treat CHF

 

 

 

 

 

 

 

 

 

 

 

12.  Whichis the most appropriate action for the Advanced Nurse Practitioner to takebefore administering digoxin?

 

a.      MonitorK+ level

 

b.      Assessblood pressure

 

c.      Evaluateurinary output

 

d.      Avoidgiving with a thiazide diuretic

 

 

 

13.  ClassIA antiarrhythmic agents have little effect on:

 

a.      AVnote

 

b.      SAnode

 

c.      Purkinjefibers

 

d.      Bundleof His

 

 

 

14.  Themost toxic antiarrhythmic agent is:

 

a.      Digoxin

 

b.      Lidocaine

 

c.      Amiodarone

 

d.      Quinidine

 

 

 

15.  Conductiondefects will most likely be an adverse effect associated with the use of:

 

a.      Verapamil

 

b.      Nifedipine

 

c.      Diltiazem

 

d.      Felodipine

 

 

 

16.  Whichof the following calcium channel blockers has the most potent peripheral smoothmuscle dilator effect?

 

a.      Diltiazem

 

b.      Nifedipine

 

c.      Nimodipine

 

d.      Verapamil

 

 

 

17.  β-blockersshould be avoided in which of the following conditions?

 

a.      Bronchoconstriction

 

b.      Hypertension

 

c.      Angina

 

d.      MyocardialInfarction

 

 

 

18.  Youhave a patient taking the medication Cinacalcet.  You would know to monitor:

 

a.      Serumcalcium levels

 

b.      Evaluatebowel function

 

c.      Measureserum acid phosphatase

 

d.      Noneof the above

 

 

 

19.  Aconstant dose of estrogen with varying doses of progestin are found in:

 

a.      Monophasicbirth control pills

 

b.      Biphasicbirth control pills

 

c.      Triphasicbirth control pills

 

d.      Quartraphasicbirth control pills

 

 

 

20.  Arelative contraindication to therapy with antiandrogens is:

 

a.      Hepaticfailure

 

b.      Pregnancy

 

c.      Prostatecancer

 

d.      Hypogonadism

 

 

 

21.  Apatient who has COPD is taking Theophylline also receives Cipro, which of the followinginteractions would you expect?

 

a.      Ciprotoxicity

 

b.      Ineffectivenessof Cipro

 

c.      Theophyllinetoxicity

 

d.      Ineffectivenessof Theophylline

 

 

 

22.  Apatient is at highest risk for nephrotoxicity with Aminoglycoside use is:

 

a.      36year old male patient with a Cr of 1.7 and BUN of 52 on a 10-day regimen

 

b.      24year old female patient with Cr of 0.8 and BUN of 12 on a 7-day regimen

 

c.      44year old female patient with a past history of cystitis on 5 days of therapy

 

d.      25year old male patient with a history of kidney stones on a 10-day regimen

 

 

 

23.  Changesin visual acuity and color perception are associated with treatment by which ofthe following agents?

 

a.      INH(Isoniazid)

 

b.      PZA(Pyrazinamide)

 

c.      ETH(Ethambutol)

 

d.      SM(Streptomycin)

 

 

 

24.  Whichchoice describes the action of nucleoside analogs?

 

a.      Exertanti-HIV activity at the reverse transcriptase level and cause prematuretermination of viral DNA chain synthesis

 

b.      Completelystop the replication of the HIV virus

 

c.      Allowfor a patient to become non-contagious after taking for at least 3 days

 

d.      Areall equally effective and free of side effects.

 

 

 

 

 

 

 

 

 

 

 

 

 

25.  Theeffects of theophylline may be increased by:

 

a.      Phenobarbital

 

b.      Phenytoin

 

c.      Rifampin

 

d.      Cimetidine

 

 

 

26.  Routinelaboratory monitoring in clients taking β-blockers should include:

 

a.      Sodium

 

b.      Glucose

 

c.      Thyrotropin

 

d.      Creatininephosphokinase

 

 

 

27.  Cholinergicsare contraindicated in:

 

a.      Tachycardia

 

b.      Hypothyroidism

 

c.      Hypotension

 

d.      Asthma

 

 

 

28.  Whichof the following metabolic effects may be a consequence of administration ofadrenergic agents?

 

a.      Hypoglycemia

 

b.      Metabolicacidosis

 

c.      Hyperglycemia

 

d.      Respiratoryalkalosis

 

 

 

29.  Adrenergicblockers are contraindicated in:

 

a.      Hypertension

 

b.      Pheochromocytoma

 

c.      Migraines

 

d.      Obstructiveairway disease

 

 

 

30.  Aside effect of cholinergic administration is:

 

a.      Nausea

 

b.      Diarrhea

 

c.      Increasesalivation

 

d.      Allof the above

 

 

 

31.  NKis a child who has been diagnosed with Attention Deficit Disorder (ADD).  Which of the following drugs is commonly usedfor their condition?

 

a.      Methylphenidate

 

b.      Diethylpropion

 

c.      Phendimetrazine

 

d.      Caffeine

 

 

 

32.  Amphetaminesare included in the category of drugs of abuse because of their ability to:

 

a.      Causenervousness

 

b.      Decreaseweight

 

c.      Raiseblood pressure

 

d.      Enhanceperformance

 

 

 

33.  Asan Advanced Nurse Practitioner, you will most likely have patients that are ona stimulant medication.  When on theAmphetamines, you would monitor for decreased effect when these drugs are givenwith:

 

a.      Caffeine

 

b.      Antidiabeticagnets

 

c.      NoDoze OTC medication

 

d.      Allof the above

 

 

 

34.  Fromyour pharmacology course research you have learned that you should never giveamphetamines in combination with:

 

a.      Oralhyperglycemics

 

b.      Oralhypoglycemic

 

c.      MAOinhibitors

 

d.      Antihypertensives

 

 

 

35.  Useof Methylphenidate for ADD in children can result in:

 

a.      Tourette’ssyndrome

 

b.      Growthsuppression

 

c.      Growthspurt

 

d.      Aand B

 

 

 

36.  Whenadministering IV phenytoin, you should:

 

a.      Administerit at a rate of 100 mg/min

 

b.      Protectthe drug from light exposure

 

c.      Mixthe drug in dextrose solution

 

d.      Mixthe drug in saline solution

 

 

 

37.  Whencaring for a patient who is receiving phenytoin and warfarin, which of thefollowing drug-drug interactions would you expect?

 

a.      Decreasedeffectiveness of warfarin

 

b.      Increasedeffectiveness of phenytoin

 

c.      Increasedeffectiveness of warfarin

 

d.      Decreasedeffectiveness of phenytoin

 

 

 

 

 

 

 

 

 

 

 

38.  Youhave a new patient that you are meeting for the first time today.  You are going over their medications withthem, and you ask them how long they have been taking Bromocriptine.  The patient states that they think they havebeen on it for 3 years or so.  They statethat they don’t really know why they are on it though.  You explain to them:

 

a.      Ithelps treat Parkinson’s by decreasing dopamine levels in the brain

 

b.      Bromocriptinedecreases the storage of dopamine peripherally, which in turn decreasesParkinson’s symptoms

 

c.      Bromocriptineactivates dopamine receptors in the brain, and helps treat Parkinson’s

 

d.      Itinhibits monoamine oxidase type B, which helps Parkinson’s

 

 

 

39.  Whichof the patient statements below would make you think twice about administeringAmantadine to a patient?

 

a.      “Myhands are always shaking.”

 

b.      “Ihad to take Dilantin 6 months ago.”

 

c.      “Itake a low-dose ASA each day.”

 

d.      “Simpletasks seem to take so long to perform.”

 

 

 

40.  Youdecide to start you patient on Amantadine. Your main teaching point with the patient would be:

 

a.      Monitorthe pulse for rate and regularity

 

b.      Takethe last dose of medication at bedtime

 

c.      Inspectthe skin for erythematous rash

 

d.      Stoptaking the drug if the mouth becomes dry

 

 

 

41.  Whichof the following assessments is most essential before beginning a drug regimenof an antimuscarinic agent?

 

a.      Dateof birth

 

b.      Ethnicbackground

 

c.      Historyof diabetes

 

d.      Activityintolerance

 

 

 

42.  Forwhich of the following medical conditions would you anticipate that anantianxiety medication would not be indicated?

 

a.      Seizuredisorders

 

b.      Alcoholdetox

 

c.      Parkinson’sdisease

 

d.      Panicdisorder

 

 

 

 

 

 

 

 

 

 

 

 

 

43.  Whenadministering antianxiety medications (benzodiazepines) to an elderly patient,which of the following actions is essential?

 

a.      Monitorvital signs

 

b.      Suggestreduced doses

 

c.      Taperdose before stopping

 

d.      Implementa fall prevention protocol

 

e.      Aand B only

 

f.       Band C only

 

g.      A,B and D only

 

h.      Allof the above

 

i.       Noneof the above

 

 

 

44.  Whenmonitoring a client who is taking benzodiazepines, you should be alert forwhich of the following CNS side effects?

 

a.      Diaphoresis

 

b.      Sedation

 

c.      Seizures

 

d.      Tremors

 

e.      Edema

 

f.       Ataxia

 

g.      Libidochanges

 

h.      Dizziness

 

i.       A,B, E and G only

 

j.       B,F and H only

 

k.      C,D, E and H only

 

l.       Allof the above

 

m.    Noneof the above

 

 

 

45.  Antidepressantsgenerally exert influence by:

 

a.      Increasingthe reuptake of norepinephrine

 

b.      Alteringthe action of MOA

 

c.      Changingthe availability of dopamine

 

d.      Changingthe availability of select neurotransmitters

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

46.  Youhave a new patient, 67 year old male, at your practice who presents forestablishment with you.  During yourinitial assessment, and history taking you determine that the patient has thefollowing:

 

Hypertension

 

Glaucoma

 

Gout

 

Hyperlipidemia

 

MinorDepression (which you just diagnosed at this visit).

 

EKGis normal, and other parts of the physical exam are WNL.

 

Youwant to start him on something to help with his depression.  What is the best option for this patient?

 

a.      Amitriptyline25 mg QHS

 

b.      Zyprexa20 mg QD

 

c.      Citalopram10 mg QD

 

d.      Noneof the above

 

 

 

47.  Antipsychoticdrugs are indicated for:

 

a.      Thetreatment of Tourette’s syndrome

 

b.      Thetreatment of major depression with psychosis

 

c.      Asan adjunct in the management of seizures

 

d.      Tocure psychotic disorders

 

 

 

48.  Yourpatient SS has been on a low-potency antipsychotic for 2 weeks, and has shownminimal response to the medications.  Themost probably explanation is:

 

a.      SSprobably has refractory illness

 

b.      SSneeds a stronger medication

 

c.      Itis too early to see a full therapeutic response in SS

 

d.      SSis not taking the medication as prescribed

 

 

 

49.  Drugsclassified as centrally acting skeletal muscle relaxants are most effective inrelieving:

 

a.      Spasmdue to trauma or inflammation

 

b.      Chronicspasm due to an old injury

 

c.      Painfrom arthritis

 

d.      Surgicalcomplications

 

 

 

50.  Peripherallyacting skeletal muscle relaxants are used:

 

a.      Totreat neuromuscular diseases

 

b.      Totreat spinal trauma

 

c.      Torelieve spasms from trauma

 

d.      Asadjuncts to general anesthesia

 

 

 

 

 

1.      Choose the following factor(s) that are F314Surveyor Guidance Risk Factors for Developing Pressure Ulcers:

 

a.      Comorbid conditions

 

b.      Drugs that may affect ulcer healing

 

c.      Exposure of skin to urinary or fecalincontinence

 

d.      History of any healed pressure ulcer

 

e.      Impaired diffuse or localized blood flow

 

f.       Mild cognitive impairment

 

g.      A, B and C only

 

h.      D and F only

 

i.        A, B, C and E only

 

j.        All of the above

 

 

 

2.      Which of the following is TRUE about frictionand shearing?

 

a.      Only friction which causes pressure damages theepidermis

 

b.      Friction is the combination of Gravity andShearing

 

c.      Friction stretches and tears vessels, whichreduces the amount of pressure necessary to cause ischemia and deep tissueinjury

 

d.      All of the above are true

 

e.      None of the above are true

 

 

 

3.      CMS no longer pays the extra cost of treatingcertain categories of conditions that occur while the patient is in thehospital.  These are considered eventsthat should “Never” occur through the delivery of quality care.  All pressure ulcers are CMS “never” events.

 

a.      True

 

b.      False

 

 

 

4.      Choose the following factor(s) that arecomponents of the Braden Scale.

 

a.      Sensory perception

 

b.      Moisture

 

c.      Activity

 

d.      Mobility

 

e.      Nutrition

 

f.       Friction and Shear

 

g.      BMI (Over or under weight)

 

 

 

5.      Match the Stage with the description:

 

Stage I                  ___________

 

Stage II                 ___________

 

Stage III                ___________

 

Stage IV                ___________

 

Unstageable       ___________   

 

 

 

a.      Subcutaneous fat may be visible but bone, tendonor muscles are not exposed.  Slough maybe present, but does not obscure the depth of tissue loss.

 

b.      Intact skin with nonblanchable redness of alocalized area, usually over a bony prominence.

 

c.      Full thickness tissue loss with exposed bone,tendon or muscle.

 

d.      Partial thickness loss of dermis presenting as ashallow open ulcer with a red pink ulcer bed, without slough.

 

e.      Full thickness tissue loss in which the base ofthe ulcer is covered by slough (yellow, tan, gray, green or brown) and/oreschar (tan, brown or black) in the wound bed

 

 

 

6.      Match the treatments for their specified use:

 

Alginate               __________

 

Hydrofiber          __________
Foam                     __________

 

Hydrocolloid       __________

 

Hydrogel              __________

 

Low-adherence

 

   Dressing          __________

 

Transparent

 

   Dressing          __________

 

 

 

a.      Necrotic Wounds

 

b.      Clean, dry wounds with minimal exudate

 

c.      Exudate

 

d.      Skin Tears

 

e.      Cleaning granulating wounds

 

 

 

7.      Which of the following medication(s) has beendemonstrated to negatively impact wound healing?

 

a.      Aricept 10 mg

 

b.      Namenda 21 mg

 

c.      Lisinopril 5 mg

 

d.      Seroquel 25 mg

 

e.      ASA EC 81 mg

 

f.       Metformin 500 mg

 

g.      Percocet 5/325 mg

 

h.      Tylenol 500 mg

 

 

 

8.      You have a patient on your rounds in thehospital that is in needs of nutritional supplementation for pressureulcers.  How would you address the use ofnutritional supplements in a patient like this?

 

a.      Order high-protein supplements enriched witharginine high-protein supplements

 

b.      Order high-protein supplements, arginine, zincand Vitamin C

 

c.      Order studies to evaluate current nutritionalstatus

 

 

 

9.      If you had a patient with a pressure ulcer, isit good practice to order an antibiotic in order to provide prophylaxis forinfections?

 

a.      Yes

 

b.      No

 

 

 

10.  Which of the following are components ofmonitoring pressure ulcers?

 

a.      Determine current number of healed and unhealedulcers

 

b.      Use visual inspection and palpitation to identifyappropriate stage

 

c.      Code all wounds

 

d.      Describe the current stage of each ulcer

 

e.      All of the above are true

 

f.       B and C only

 

 

g.      A, C and D only

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