pg. 1
NUR 635 MIDTERM EXAM 2024
ADVANCED PHARMACOLOGY GCU
WITH 200 REAL EXAM QUESTIONS AND
CORRECT ANSWERS GRADED A+/ NUR
635 MIDTERM EXAM 2024-2025 (NEW!!)
When prescribing lithium, the NP educates the patient that all of the following will need to be closely monitored throughout therapy except
- Renal function
- Thyroid function
- Liver function
- Sodium levels
Liver function (monitor renal function, thyroid function, and sodium levels)
Long-term use of lithium can cause degenerative changes in the kidneys therefore renal function should be assessed at baseline and every year. Lithium can reduce the incorporation of iodine into the thyroid hormone and can inhibit thyroid hormone secretion. Long-term use can cause goiters and enlargement of the thyroid gland. thyroid functions test should be measured at baseline and yearly thereafter. Low sodium levels can cause the kidneys to retain sodium which will also retain lithium and can cause lithium toxicity.A 32-week pregnant patient comes in complaining of contractions, the NP educates the patient regarding the following Treatment with a beta 2 agonists
(Beta 2 agonists are limited to the lungs and the uterus. Drugs used for their B2 activating abilities include epinephrine, isoproterenol, and albuterol. Activation of B2 receptors in the uterus relaxes uterine smooth muscle. It delays preterm labor.) The Nurse educates the patient to watch for which adverse effects when discontinuing baclofen. 1 / 4
pg. 2 Hallucinations
(Baclofen may be associated with psychosis (hallucinations, confusion, mood changes, mental changes, and depression). Clinicians should consider baclofen- induced psychosis as a differential diagnosis in patients presenting with psychosis during treatment or discontinuation of this medication.) Which condition is appropriate for the NP to prescribe clonidine ER to an adolescent?
ADHD Which medication does the NP order after the patient experiences hallucinations following atropine treatment for their bradycardia?Physostigmine
(physostigmine is a cholinesterase inhibitor used to treat glaucoma and anticholinergic toxicity. Because physostigmine crosses the blood-brain barrier, it is used to treat the central nervous system effects of atropine overdose and other anticholinergic drug overdoses. Physostigmine can reverse both central and peripheral anticholinergia.) Which portion of the patient's history should be thoroughly assessed before prescribing metronidazole for a bacterial vaginosis infection Social history for alcohol intake Your chronic pain patient calls for a refill on their regularly prescribed hydrocodone prescription. The appropriate action of the NP would be to Schedule the patient for an in-person office visit.Ace inhibitors help patients with heart failure by doing all of the following except
- Change the structure of the heart and decrease hypertrophy
- Decreasing contractile force
- Increasing heart rate and preload
- Decreasing renal blood flow. 2 / 4
pg. 3 Increasing heart rate and preload (ace inhibitors change the structure of the heart by decreasing hypertrophy, decreasing contractile force, and decreasing renal blood flow) The NP believes the patient has had adequate education regarding iron supplements when they verbalize I need to have CBC drawn in 4 weeks A patient with chronic renal failure becomes anemic, the NP prepares the patient for Treatment with epoetin alfa After starting a first-Generation Antipsychotic, the patient develops which adverse reaction that the NP must now also treat Tardive dyskinesia The NP believes, the patient-caregiver needs more education when she verbalizes which of the following statement regarding rivastigmine transdermal patches?
- Therapeutic dosing may be easier with a transdermal patch
- There will be fewer side effects using a patch
- I should change the patch every 72 hours
- I should apply the patch to an area not prone to sweating
I should change the patch every 72 hours
(Rivastigmine (Exelon) is a cholinesterase inhibitor used for the treatment of mild to moderate Alzheimer's disease. It can be administered orally or via a transdermal patient; the latter form reduces the prevalence of side effects which usually include nausea and vomiting. The patch is changed every 24 hours and when given through the transdermal administration method the pharmacokinetic profile is smoother with lower peak plasma concentration and reduced fluctuations.) Lab work shows a decrease in creatinine clearance after the patient starts taking memantine. The NP's appropriate course of action should be to Decrease the dosage of memantine The NP understands that diabetics can benefit from GLP-1 agonists because they 3 / 4
pg. 4 Directly bind to the receptor in the pancreatic beta cells The NP knows that gliptins help diabetics because they Act on the incretin system to indirectly increase insulin production The Nurse believes the patient understands the education regarding iron supplements when the patient states I can take this medication on an empty stomach, with orange juice Which education should the NP include when educating patients on erythropoiesis- stimulating agents (ESAs) You may develop tumors with this medication Which educational statement by the patient tells the nurse that the patient understands the use of warfarin I need to avoid foods high in vitamin K (maintain a consistent level of dietary vitamin K without fluctuations) Which statement by the patient tells the nurse that they understand the education regarding heparin?I need to have my platelets drawn every 2-3 days Which does the NP take into account concerning pharmacokinetics Bioavailability Long acting nitro is administered at 8am and 3pm, the NP understands this schedule is important because Nitrate tolerance can develop In addition to ASA, patients with angina who also have arrhythmias should also be prescribed Beta Blockers In addition to ASA, the nurse understands that all diabetics who have angina should also be on which medication?Ace inhibitors
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