MID-TERM PHARMACOLOGY QUESTIONS

S
1. Which of the following is a common cause of iron deficiency in patient?
a. Rapid grown during adolescence
b. Vegetarian eating pattern
c. Decreased intestinal uptake of iron
d. Chronic blood loss through the gastrointestinal tract.
2. Which of the most common type of anemia?
a. Iron deficiency anemia
3. A patient is taking oral ketoconazole for a systemic fungal infection. The medication
administration record notes that the patient is also taking ho MEPRAZOL for reflux disease .
What instruction will the provider give the patient to maximize medication effectiveness?
a. Take the omeprazole one hour before the ketoconazole
b. Wear sunglasses when outdoors to manage photo sensitivity
c. Take omeprazole at least two hours after keto ketoconazole
d. Restrict intake of dietary products
4. A 70 year old patient with penicillin sensitivity is receiving digoxin and warfarin therapy hey
mark holiday antibiotic is required to treat streptococcal infection which of the following
medication would be best for this patient a. Clarithromycin
b. Telithromycin
c. Azithromycin
d. Erythromycin ???/
5. You are teaching a patient to promptly report any diarrhea after prescribing which of the
following drug is the patient likely being prescribed. Clindamycin
6. which of the following is true about prescriptive authority
a. all the answers are correct
b. some MP's have restricted prescriptive authority
c. some MP's have full prescriptive authority
d. prescriptive authority is the legal right to prescribe drugs
7. which patient statement suggests to the provider that the patient nonadherence with their
medication plan is related to dissatisfaction with the therapy
I have been taking this medication for well ove a week and I lost only a half a pound.
8. which was the first antibiotic class available for the treatment of systemic bacterial infection a.
sulfonamides
b. cephalosporinase
c. penicillin’s
d. tetracycline
9. risk factors for extended spectrum beta lactamase producing Organism include except
10. monitoring for patients who are on long term antifungal therapy with ketoconazole Includes a.
platelet count
b. bun & creatinine
c. AST ALT, alkaline phosphate, and bilirubin
d. WBC
11. Which antipyretic drug would you prescribe the patient of a child with influenza A.
Acetaminophen ?
B. ibuprofen
C. none of the answers are correct
D. naproxen
E. aspirin
12. a patient comes to the clinic and receive valacyclovir for herpes zoster virus when will the
provider instruct the patient to take the medication a. Without regard to meals
b. without any dairy product
c. each morning
d. an empty stomach
13. A patient has been diagnosed with onychomycosis the patient disliked the yellow discoloration
of the toenails and request an oral form of ketoconazole. How would you respond? a.
ketoconazole only treats viral infection
b. ketoconazole taken orally has a higher risk of liver injury
c. ketoconazole is only available in topical formulation
d. the discoloration will subside without treatments in the next few days
14. The Beers criteria is utilized with which population of patient
A. Ob/gyn
B. Pediatrics
C. mental health
D. geriatris ?
15. a Pediatrics provider is teaching nursing student to calculate medication doses for children using
a formula based on body surface area. which statement nursing student indicates understanding
of teaching?
a. This formula can determine medication dosing for a child of any age
b. this formula accounts for pharmacokinetics factors that are different in children
c. this formula helps approximate the first dose other doses should be based on clinical
observations
d. using this formula will prevent side effects of medication and children
16. A 6 month old infant is brought into the clinic with rash on the face and eye. That consists of
linear erythematous burrows. An older sibling has similar rash on his wrist in between his
fingers and appropriate intervention would be? a. mycitracin ointment
b. Permethrin 5% cream (elimite)?
c. bacitracin ointment
d. ACITRETIN (SORIATANE)
17. Patient on chronic long term corticosteroid therapy, needs education regarding
a. Small amount of alcohol are generally tolerated
b. reporting black tarry stools or abdominal pain
c. receiving all vaccination specially delivered flu vaccine
d. eating high carbohydrate diet with plenty of fluids
18. physiological change in elderly that accounts for small volume of distribution and an increase in
plasma concentration of digoxin is a. decreased total body fat
b. increase total body water
c. increased activity of hepatic enzymes that facilitate drug metabolism
d. decrease rate of elimination due to decreased renal function
19. regarding the most common causes of adverse reaction in older adults which of the following
would you find to be decreased in the most common cause of this problem in older adults a.
liver function
b. plasma albumin level
c. body fat content
d. renal function/clearance
20. an infant develop a pruritic following exposure to an allergen. The infant's parent asked the
provider about using a topical antihistamine. what information should that provider use to
address the parents question
a. anti histamine given by this route are not absorbed as well as in children
b. the child will also need oral medication to achieve effective results
c. applying anti histamine to the skin can cause toxicity in the age group
d. topical medication have fewer side effects than those given by other routes
21. a patient who has congestive heart failure requires a diuretic the patient also has a history of
chronic kidney disease with GFR of less than 30ML per minute which drug prescribed for this
patient
a. Metolazone
b. Methyclothiazide
c. Furosemide
d. Hydrochlorothiazide
22. Which outcomes should the NP establish for patient with trichomoniasis who is receiving
metronidazole?
A. improvement in pain in the back of the testicles
B. decrease in yellow green, odorous vaginal discharge
C. resolution of genital and perianal warts
D. Absence of painful urination and watery discharge
23. a patient is diagnosed with lymphangitis has an allergy to penicillin the allergies are rash. What
would you give to this patient?
A. Clindamycin IV
24. which laboratory tests should be done at baseline when initiating a statin therapy
A. platelets
B. urinalysis
C. LFTs LIVER ENZYME
D. TSH
25. The patient is receiving anticoagulant therapy the INR value of the patients today is 1.5 in
response to this what will you do
a. the level is within the expected target therapeutic level of anticoagulation
b. the level outside the expected target therapeutic level of anticoagulation, it is too low
c. The level cannot be interpreted without knowing the PT and the INR ratio
d. the level is outside the expected target therapeutic level of anticoagulation it's too high
26. A patient with alcohol abuse disorder is admitted to the hospital for surgery the provider is most
concerned when the admission interview determines the patient regularly used to what
medication
a. morphine
b. acetaminophen
c. diazepam
d. thiamine
27. which agent is often found as an adulterant in heroin and has led to increase in overdose death
a. spice
b. marijuana
c. fentanyl
d. cathinone’s
28. What are the three main classes of opioid receptors
a. Theta mu Kappa
b. Kappa delta Theta
c. delta mu Theta
d. delta mu Kappa
29. the providers conducting a smoking session class in the community. which effects will be
included in the discussion about physiological effect on nicotine( select that all apply) a.
Decrease gastric acid
b. increase blood pressure
c. increased alertness
d. suppression of appetite
e. Suppression of nausea
f. vomiting
30. the patient is taking DEPOMYCIN. The NP should obtain a creatinine phosphokinase level when
the patient shows which symptoms
a. Abdominal bloating and diarrhea
b. headache and visual disturbance
c. muscle pain or weakness
d. increase urination and urinary urgency
31. you are taking care of a patient that has an allergy to Bactrim. which of the following medication
would not potentially cause a cross hypersensitivity reaction
32. The Primary Health care provider prescribes a medication along with ampicillin to enhance the
effectiveness of the antibiotic which medication would enhance the effectiveness of the
ampicillin
a. Clavulanic acid
b. Carbamazepine
c. Calcium citrate
d. Acetaminophen
33. which of the following is not an indication for macrolide antibiotic
a. chlamydia
b. whooping cough
c. M. pneumonia
d. Lyme disease
34. treatment of moderate non purulent and Cellulitis include all of the following except
a. Trimethoprim/sulfamethoxazole
b. Doxycycline
c. Nitrofurantoin ?
d. Clindamycin
35. Her patient who is receiving IV Ciprofloxacin for pneumonia develops diarrhea. Stool cultures
positive for C- diff what action will provider take? a. prescribe metronidazole
b. restrict dairy products
c. increase the dose of ciprofloxacin
d. switch to Gemifloxacin
36. what are the upper acceptable values for cholesterol within the blood
a. total cholesterol level 40mg/dl HDL OF 160MG/DL AND LDL of 200mg/dl
b. tcl 200, HDL 160 AND LDL 40
c. TCL 200, HDL 40, AND LDL 60
d. TCL 40, HDL 200 AND LDL 160
37. Bioconversion of prodrug to its active derivative may be enhanced by an enzyme inducer true or
false
38. a patient is being assessed for muscle weakness cramping and leg discomfort. this patient has
been taking hydrochlorothiazide. what else would you do for this patient?
A. Administer calcium supplement
B. give a lower dose of medication
C. assess the serum potassium level
D. reduce salt and patients diet
39. 85 year old male patient with no known drug allergies has been diagnosed With community
acquired pneumonia. The patient was recently treated with ceftriaxone Rocephin for sinusitis.
which of the following information is relevant to related to a risk for drug resistance S.
pneumonia infection?
40. Isotretinoin (ACCUTANE) Is a drug employed in the treatment of severe recalcitrant cystic acne
which of the following is not adverse effect associated with its use a. Fetal abnormalities
b. hyponatremia
c. Hypertriglyceridemia
d. conjunctivitis
41. your first line treatment for scabies and five year old would be all of the following except a.
permethrin
b. malathion
c. crotamiton
d. lindane
42. How can the prescriber regular collaboration with pharmacist improve positive outcome for
patient (select all that apply)
a. the pharmacist could suggest adequate medication dosing
b. pharmacist have additional information on drug interaction
c. pharmacist have first-hand knowledge of the facility formulary
d. pharmacy can alter prescription when necessary to prevent patient harm
43. prescriptive authority is work related by the State Board of nursing board of medicine
44. what would you prescribe for warfarin overdose
a. aspirin
b. calcium
c. potassium
d. Vitamin K
45. which antibiotic is recommended for the treatment of chlamydia
a. high dose fluoroquinolone
b. high dose Cephalosporin
c. high dose penicillin
d. high dose macrolide
46. a patient is found to have “strawberry spots “ under vagina and cervix. what is the treatment
option?
a. Acyclovir
b. Metronidazole
c. Lindane 1% cream
d. Tetracycline
47. The drugs that produces irreversible blockade of platelet adenosine diphosphate P2Y receptors?
A. Eptifibatide
B. Clopidogrel AND Prasugrel
C. Enoxaparin
D. Dabigatran
48. The drug heparin acts in hemostasis by which process?
a. inhibiting thrombin and antithrombin III (AT-III)
b. preventing the conversion of prothrombin to thrombin
c. shortening the fibrin stands to retract the blood clot
d. degrading the fibrin within blood clots
49. as you formulate a plan for a 72 year old patient you recognize that of the following
medications. Which is the least likely to cause postural hypotension and the older adult?
A. Furosemide
B. Amitriptyline (endep, amitril ?
C. Lisinopril (prinvial, Zesril
D. Clonidine (catapres, Kapvay, nexiclon
50. A pregnant patient who developed hypertension at 28 weeks gestational age. what medication
do you anticipate giving? a. Methyldopa
b. Any of the medication listed here maybe prescribed to a pregnant patient with gestational
HTN
c. Nifedipine
d. Labetalol
51. Which of the following group of antibiotic has a beta-lactam ring in the molecular structure a.
Fluroquinolones
b. Macrolides
c. Cephalosporins
d. Sulfonamides
e. Tetrcyclines
52. By what mechanism does Losartan 50 milligram PO daily promote vasodilation?
a. It blocks the action of angiotensin ll
b. it promotes the release of aldosterone
c. it inhibits calcium influx into the cardiac smooth muscle cell
d. it promotes prostaglandin synthesis
53. the patient is taking an Alpha 1 blocker, Doxazosin 1mg. Of which potential dangerous side
effects should the patient be made aware?
a. Increased urinary flow rate
b. decreased heart rate
c. increased urinary output
d. orthostatic hypotension
54. a patient taking an angiotensin converting enzyme (ACE)inhibitor to treat hypertension tells the
provider that she wants to become pregnant what responses will the provider give to the
patient
A. let's discuss using methyldopa instead of the ACE Inhibitor while you are pregnant
B. controlling your blood pressure or decrease your risk of preeclampsia
C. it will be safe to continue taking the ACE inhibitor during your pregnancy
D. we need to consider changing you to an angiotensin receptor blocker during pregnancy
55. which of the following terms best describes the mechanism of action of metropolol
a. Alpha l antagonist effect
b. Beta1 selective
c. nonselective beta with alpha blocking
d. nonselective alpha blocker
56. which of the following best classifieds aminoglycoside, macrolides and Clindamycin
a. folic acid synthesis inhibitor
b. cell wall inhibitor
c. protein synthesis inhibitor
d. Mycolic acid synthesis inhibitor OK
57. which of the following is most likely an intervention for otitis media
a. immunoglobulins
b. aspirin
c. amoxicillin
d. corticosteroids
58. which of the following drug classes should be avoided in peptic ulcer disease
a. avoid proton pump inhibitors
b. avoid diuretics
c. avoid antibiotics
d. avoid NSAIDs
59. which antibiotics bind to the 50S subunit of the bacterial ribosomes and could most likely result
in development of pseudomembranous colitis
A. amoxicillin
B. tetracycline
C. Clindamycin
D. Vancomycin
60. which of the following medication of drug classes is commonly indicated for in managing
gestational hypertension. For emergency treatment in gestational hypertension, IV hydralazine,
labetalol and oral nifedipine can be used.
61. Which of the following drug treatment strategies associated with peptic ulcer disease
A. opioid
B. antibiotics amoxicillin and clarithromycin
C. corticosteroids
D. hormonal therapy
62. which of the following groups of people are at risk of early hypertension
a. African Americans
b. adolescents and young adults
c. Mexican American culture
d. Mediterranean population
e. old females
63. Which of the following disease or disorder are most likely treated with ACE inhibitors?
a. Hyperthyroidism
b. pulmonary hypertension
c. Cushing syndrome
d. angina
e. chronic kidney disease (with or without diabetes)?????
64. Opiates are used mainly to treat moderate to severe pain. Which of the following is not true
about this drugs?
a. All opiate are scheduled drugs which require a DEA license to prescribe
b. Most of the adverse effects of opiates are related to mu receptor stimulation
c. Opiate stimulate only mu receptor for the control of pain
d. Naloxone is an antagonist to opiates
65. Which of the following drug correctly match its clinical use?
a. Naltrexone is used as an appetite stimulant
b. methadone is for opiate toxicity
c. Naloxone is used for opioid overdose
d. Morphine is used for mild pain
66. A patient comes to your clinic having taken undermined amount of heroin. The drug of choice
for heroin overdoses is? Naolxone/Narcan
67. A patient ask you how drug works…..
a. it inhibits the absorption of dietary cholesterol in the small intestine
b. system needs to be re system to increase the acceleration of dietary cholesterol
c. it binds to bile in the intestinal tract forming an insoluble complex that is excreted in the
feces.
d. it inhabits hydroxymethylgulutaryl-coenzyme A (HMG-CoA) reductase to reduce the
biosynthesis of cholesterol liver
68. Which of the following is not unexpected adverse effect of niacin
A. hyperglycemia
B. itching
C. Atrhralgias
D. flushing
69. What is the first line therapy when treating hyperlipidemia
a. statin therapy
b. bile acid sequestrants
c. Niacin
d. lifestyle modification
70. VT has a history of subtherapeutic anticoagulation on warfarin due to poor adherence and to
the administration time was changed from evening to morning the patient also frequently skips
meals and takes antacid for reflex the patient wants to take all medication at the same time
every day. Select the Statin that is optimal for this patient wanting to take medication in the
morning
a. Atorvastatin (Lipitor)
b. Lovastatin (Altoprev)
c. Fluvastatin (lescol)
d. Pravastatin (Pravachol).
71. All of the following are classification of dietary deficiencies causing nutritional anemia except
A. vitamin B12 (cyanocobalamin)
B. folic acid
C. Iron D. vitamin D ??
72. anemia of chronic renal failures caused by the lack of
a. Parathyroid hormone
b. Thyroid hormone
c. Erythropoietin
d. Adrenaline
73. You reviewed the laboratory test results for a patient prescribed atorvastatin. Which laboratory
value is most useful for monitoring this drug a. Blood urea nitrogen (BUN)
b. C-reactive protein (CRP)
c. aspirate aminotransferases (AST)
d. international normalized ratio (INR)
74. The provider orders Furosemide for a patient who takes digoxin and is admitted to the hospital
for treatment of heart failure. Morning assessment identifies an irregular heart rate of 86 beats
payment respiratory rate 22 breaths per minute and a blood pressure of 130/ 82. Crackles are
heard in both lungs which laboratory result would be upgrade is concerning to the provider
A. Potassium level of 3.4 meq/l
B. sodium level 140 meq/l
C. oxygen saturation of 90%
D. Blood glucose level of 120mg/dl
75. A patient presents to your clinic with jaundice he complains of having dark urine light- colored
stool, experience malaise, nausea and vomiting. What is the possible draw complication he's
likely experiencing
a. An allergic reaction
b. an idiosyncratic drug effects on the bone marrow
c. Tetrogenic disease of the kidney
d. drug toxicity of the liver
76. When prescribing medication for the elderly the NP should
a. all the answers are correct
b. none of the answers are correct
c. encourage the patient to cut drugs in half with a knife to lower cost
d. assess cognitive functioning in the elderly
e. encourage the patient to take weekly drug holiday to keep drug costs down
77. which of the following is not required element of the written prescription
a. patient allergies
b. quantity of drugs to be dispensed
c. drug name
d. patient name
78. at which of the following age would it be safe to prescribe tetracycline
a. age 2
b. age 7
c. age 6
d. age 9
79. treatment of moderate non Purulent Cellulitis includes all of the following except
a. Nitrofurantoin
b. Clindamycin
c. Doxycycline
d. Trimethoprim/Sulfamethrozole
80. Primary advantage of using loratadine (Claritin) in treating patients with seasonal allergy is that
it
a. decrease nasal secretion significantly
b. may be prescribed for daily dosing
c. cost less than the other medication used for seasonal allergies
d. may be taken PRN
81. which statement about ciprofloxacin is accurate
a. Ciprofloxacin is active against MRSA strain of Staphylococci
b. Organisms that commonly causes ear infections are highly resistant
c. Most first time UTI are resistant to Ciprofloxacin
d. Tendonitis may occur during treatment
82. Which anti-microbial is ineffective due to beta lactamase producing Organism
a. Doxycycline
b. Levofloxacin
c. Penicillin
d. Azithromycin
83. Which is considered the most widely used group of antibiotics because of their bacterial nature
resistance to beta lactamase and activity against broad spectrum of pathogen a. Penicillin
b. Cephalosporin
c. Aminoglycoside
d. Tetracycline
84. Which Cephalosporin can induce a state of alcohol intolerance select that all play
a. Cefotetan
b. Ceftroline
c. Cefazolin
d. Cefdinir
e. Ceftriaxone
85. A patient diagnosed with otitis externa in taking fluroquinolone/ glucocorticoid combination
medication ask that NP was the benefit is taking the medication together. You reply? a.
glucocorticoid decreases the adverse effect of the fluoroquinolone
b. the glucocorticoid reduces the swelling caused by the inflammation and decreases pain
while the fluroquinolone treats the infection ?
c. the two medications are contraindicated for use together
d. the glucocorticoid decreases the likelihood of antibiotics resistance developing to the
fluoroquinolone
86. Amoxicillin is prescribed for a 12 month child who develop a second middle ear infection since
age a month. three days later the parents call to report that the child continues to have
temperature of 39.5 Celsius and is unable to sleep well because of pain. What action would the
provider take to provide effective care to this child?
A. Discuss prescribing amoxicillin/clavulanate with the child's parent
B. prescribe a medication that promotes sleep
C. discuss with the parents the child needs for probable surgery of tympanostomy tubes
placement to reduce infection
D. advice continuing the amoxicillin as order and provide a schedule PRN dosing ibuprofen for
pain
87. A 2 year old child present to the clinic with otalgia and fever the left tympanic membrane is a
erythematous and bulging the Right TM’s is perforated in draining. The child parent states “this
is the fifth year infection of the year. what can you do? “What action will the provider take to
address the child's ear problem
A. Prescribe amoxicillin and refer the child to An otolaryngologist
B. prescribe both Ceftriaxone (Rocephin) IM with benzocaine ear drops for pain
C. have discuss beginning prophylactic antibiotic therapy with trimethoprim/sulfamethoxazole
D. prescribed both high dose amoxicillin and the influenza vaccine
88. Pharmacokinetics involve the study of which factor
a. distribution rates among various body compartment
b. adverse reaction to the medication
c. interaction among various drugs
d. physiologic interaction of drugs
89. Patient develops short of breath shortly after taking the initial does of a newly prescribed
medication . The patient heart rate is 86 beats/minute the respiratory is 24 breaths/minute , and
the blood pressure is 120/70 . The prescriber would discontinue the drug based on the
assumption to the patient experienced what medication induced effect? a. A side effect
b. An Iatrogenic response
c. An idiosyncratic effect
d. An allergic reaction ?
90. Drugs with a narrow therapeutic window have?
a. High risk of allergic reaction ??
b. High risk for toxicity
c. High risk for abuse by the patient
d. High risk for risk for atypical response.
91. a provider might consider testing for CY92D6 variance prior to starting tamoxifen for breast
cancer to
A. identify poor metabolizer Of tamoxifen ???
B. ensure the patient one not have increased adverse drug reaction to the tamoxifen
C. identify potential drug-drug interaction that might occur with tamoxifen
D. would you say likelihood of therapeutic failure with tamoxifen treatment
92. you administer 100mg ever drug by mouth. After the drug moves through the hepatic system
very little active drug is left in general circulation. What concept explains this occurrence? First
pass effect
a. reduced bioavailability time ???
b. steady state
c. Phase ll metabolism
d. Half-life
93. Which of the following it's not one of the four process of pharmacokinetics
A. absorption
B. administration
C. Distribution
D. excretion
94. A patient who is scheduled to begin warfarin treatment and is currently being treated with
amiodarone. Based on the information, what changes would be made to the medication
regimen?
a. The dosage of Amiodarone will be decreased
b. The dosage of the warfarin will be decreased BY HALF
c. the dosage of amiodarone will be increased
d. the dosage of warfarin would be increased
95. What is plasmin role in the clotting process
a. inhibits platelet adhesion and aggregation
b. stimulates platelet aggregation
c. degrades the fibrin within blood clots
d. prevents the conversion of prothrombin to degrade the fibrin within blood clots
96. An orally administered drug that directly inhibits thrombin .
a. Enoxaparin
b. Dabigatran (Pradaxa)
97. A medication review of an elderly person medication involves
a. asking the patient to bring a list of current prescription medication to the visit
b. asking what other providers are writing prescription for them
c. all the answers are correct
d. having the patient bring all the prescription over the counter and herbal medication to the
visit
98. Prescriptive authority is regulated by the State Board of nursing board of medicine, or board of
pharmacy, depending on the state a. true
b. False
99. Which of the following medication is a fluroquinolone antibiotics? Ciprofloxacin, germifloxacin,
levofloxacin and ofloxacin a. Azithromycin
b. Amikacin
c. Penicillin
d. Ciprofloxacin
Set 2& 3
1. Which of the following hypertension medication or drug classes is commonly indicated
for managing gestational hypertension a. Spironolactone (Aldactone)
b. Loop diuretics
c. Calcium channel blockers ??
d. Dobutamine
e. Calcium gluconate
2. Beta lactamase inhibitor are often indicated in which of the following
a. often combined with penicillin antibiotic ?????
b. First dose effect
c. may decrease absorption of medication