NURS 6521 FINAL EXAM,MIDTERM EXAM AND STUDY

NURS 6521 FINAL EXAM,MIDTERM EXAM AND STUDY

GUIDE 2024/ACTUAL EXAMS WITH CORRECT

VERIFIED ANS DETAILED ANSWERS/NURS 6521

ADVANCED PHARMACOLOGY EXAMS 2024 -

2025/BRAND NEW!!!

FINAL EXAM

Albuterol - CORRECT ANS-Class: Short acting B2 agonist with minor B1

Used for: Bronchospasms associated with asthma, bronchitis (acute or chronic), and COPD

ADR: Potential drug-induced hyperglycemia, cardiac arrhythmias, some CNS

excitation effects (tremors, dizziness), HA, tachycardia, palpitations

Comments: Safe for children and pregnancy; may combine with ipratropium; least

expensive

Terbutaline - CORRECT ANS-Class: Short acting B2 agonist with minor B1

Used for: Bronchospasms associated with asthma, bronchitis (acute or chronic), and COPD

ADR: Potential drug-induced hyperglycemia, cardiac arrhythmias, some CNS

excitation effects (tremors, dizziness), HA, tachycardia, palpitations

X: Pregnancy category B or C

Salmeterol - CORRECT ANS-Class: Long acting B2 agonist, more selective

Used for: Bronchospasms associated with asthma, bronchitis (acute or chronic), and COPD

ADR: Potential drug-induced hyperglycemia, cardiac arrhythmias, some CNS

excitation effects (tremors, dizziness), HA, tachycardia, palpitations

Comments: Do not use alone for persistent asthma, combine with an inhaled

corticosteroid; don't wash it, powder can get clogged

What are some things you can educate your patients on regarding beta agonist inhalers? - CORRECT ANS-1. Demonstrate and have patient do return demonstration 2. Check correct inhaler use if patient says it's not working

• Encourage use of spacer

Fluticasone - CORRECT ANS-Class: Inhaled

corticosteroid Used for: 1st line treatment for persistent

asthma MOA: Anti-inflammatory, minimal systemic exposure 1 / 4

Budesonide - CORRECT ANS-Class: Inhaled

corticosteroid Used for: 1st line treatment for persistent

asthma

MOA: Anti-inflammatory, minimal systemic exposure

Zafirlukast - CORRECT ANS-Class: Leukotriene

modifier/antagonist Used for: 2nd line to decrease

bronchoconstriction, edema MOA: Works similar to prostaglandins in r/t to inflammation, blocks lipoxygenase

Theophylline - CORRECT ANS-Class: Xanthine;

stimulant Used for: Asthma

MOA: Bronchial smooth muscle relaxation

ADR: cardiovascular effects, increased gastric acid production, CNS effects

(irritability, restlessness, seizures, insomnia), GI effects (reflux, worsens heartburn), cardiac effects (palpitations, tachycardia, hypotension, life-threatening arrhythmias)

X: GERD, HTN, ischemic heart dx, coronary insufficiency, CHF, history of

stroke, cardiac arrhythmias; smoking increases clearance

Comments: Stay away from charcoal-broiled foods (accelerates the hepatic

metabolism), avoid large amounts of caffeine containing beverages; elimination is influenced by diet

What are the signs of Theophylline toxicity? - CORRECT ANS-Vomiting, insomnia, jitteriness, HA, severe GI pain, irregular heartbeat

Ipratropium Bromide - CORRECT ANS-Class: Inhaled

anticholinergic Used for: NOT 1st line, supplemental use in acute

bronchospasm MOA: Blocks the muscarinic cholinergic receptors, causes bronchial smooth muscle relaxation; uses alternate pathway, effects additive with beta receptors

What is asthma? - CORRECT ANS-Chronic inflammatory disorder of the airways, recurrent episodes of wheezing, breathlessness and chest tightness, airflow obstruction is reversible - recommendations by Expert Panel III is to take an aggressive approach to gain quick control

What would you treat mild intermittent asthma with? - CORRECT ANS-Step 1

therapy: 1. Use short acting B2 agonists PRN for symptoms - patients may have

symptoms when exposed to triggers (URI, allergens, chemical inhalents, exercise)

• Educate on annual flu shot 2 / 4

What would you treat mild persistent asthma with? - CORRECT ANS-Step 2

therapy: 1. Long-term/low dose inhaled corticosteroids such as Fluticasone or

Budesonide 2. Use short acting B2 agonist PRN, if using more than 2 days/week, then step up therapy

What would you treat moderate persistent asthma with? - CORRECT ANS-Step

3 therapy:

• Treat with medium dose inhaled corticosteroids (Fluticasone or Budesonide)

OR 1. Low dose inhaled steroid (Fluticasone or Budesonide) plus long acting B2 agonist (Advair or Salmeterol) OR

• Medium dose inhaled steroid (Fluticasone or Budesonide) plus leukotriene

receptor antagonist (Zafirlukast)

• May use short acting B2 agonists (Albuterol or Terbutaline)

What would you treat severe persistent asthma with? - CORRECT ANS-Step 4

therapy:

• Medium dose inhaled corticosteroid (Fluticasone or Budesonide) AND long-

acting B2 agonist (Salmeterol) OR

• Medium dose inhaled corticosteroid (Fluticasone or Budesonide) AND a

leukotriene modifier (Zafirlukast) OR Theophylline

Step 5 therapy:

• High dose inhaled corticosteroid AND long acting B2 agonist

Step 6 therapy:

• High dose inhaled corticosteroid AND long acting B2 agonist AND oral

corticosteroid

**Severe persistent asthma requires consultation with asthma specialist

What drugs would you consider for pregnant patients who have asthma? - CORRECT ANS-Inhaled beta agonists are acute drug of choice; inhaled corticosteroids are the long term drug of choice

When would you refer a child with asthma to a specialist? - CORRECT ANS-At step 3 therapy

When would you consider using a long acting B2 agonists as monotherapy? - CORRECT ANS-If your patient has COPD

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Systematic antibiotics are required for ? - CORRECT ANS-Moderate to severe impetigo, boils, abscesses, perianal strep, cellulitis, MRSA suspected skin infections

Mupirocin - CORRECT ANS-Class: Topical

ATB Used for: Mild impetigo, nasal MRSA

carriers Comments: Generic Mupirocin is

less expensive

Bacitracin - CORRECT ANS-Class: Topical

ATB Used for: Mild impetigo

Comments: Can be combined to make double or triple ATB

Retapamulin - CORRECT ANS-Class: Topical

ATB Used for: Mild impetigo or nasal MRSA

carriers

Comments: Cannot be given intranasal or will destroy sense of smell

Polymixin B - CORRECT ANS-Class:

Topical ATB Used for: Mild impetigo

Comments: A double and triple ATB

Neomycin - CORRECT ANS-Class: Topical

ATB Used for: Mild impetigo

Comments: May cause sensitivity in triple ATB

Cephalexin - CORRECT ANS-Class: Oral ATB

Used for: Severe impetigo >5 lesions, or if no improvement in 2-3 days,

furuncles, 2nd line for UTI, therapeutic failure of AOM

MOA: Inhibits CELL WALL

ADR: Diarrhea; don't take if allergic to PCNs

Amoxicillin/Clavulanate - CORRECT ANS-Class: Oral ATB

Used for: Severe impetigo >5 lesions, or if no improvement in 2-3 days, furuncles, infection f/b human bites, AOM (if fever >39C and/or severe otalgia)

MOA: Inhibits CELL WALL

Clindamycin - CORRECT ANS-Class: Oral or topical ATB

Used for: 1st line for MRSA, AOM treatment failure (if allergy to Augmentin or

Amoxicillin), acne, infections in PCN allergies, DSRP, dental infections, 1st line for pregnancy and children, 2nd line for narrow spectrum of aerobic activity

MOA: Inhibits PROTEIN SYNTHESIS

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