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NSG 308 Exam Study Guide - Exam #2

Total questions: 110

Worksheet time: 2hrs 50mins

Name
Class
Date
1.

What are the normal parameters for temperature, pulse, respirations, BP, and pulse ox for an adult patient?

a)

Pulse: 2+, 60-100 bpm; RR: 12-20; SBP: 130-90; DBP: 90-50; SpO2: 90-100%; Temp: 36.1-37.7°C (97-99.9°F)

b)

Pulse: 3+, 40-60 bpm; RR: 8-16; SBP: 100-60; DBP: 60-30; SpO2: 80-90%; Temp: 35.0-36.0°C (95-96.8°F)

c)

Pulse: 1+, 100-120 bpm; RR: 20-30; SBP: 150-110; DBP: 100-70; SpO2: 85-95%; Temp: 38.0-39.0°C (100.4-102.2°F)

d)

Pulse: 2+, 50-70 bpm; RR: 10-18; SBP: 120-80; DBP: 80-40; SpO2: 88-98%; Temp: 37.8-39.0°C (100-102.2°F)

2.

What would be the priority assessments and nursing actions if a patient's vital signs are abnormal?

a)

ABCs; Determine etiology if possible; Notify provider; Check MAR for adverse effects of medications

b)

Increase the patient's fluid intake immediately; Ignore abnormal readings; Wait for the next scheduled assessment

c)

Document the abnormal vital signs only; Do not inform anyone; Continue routine care

d)

Administer pain medication regardless of the cause; Reassure the patient; Delay further assessment

3.

The problem in the body that causes Parkinson’s disease is:

a)

Loss of dopamine-producing neurons in the brain

b)

Excess production of insulin

c)

Deficiency of thyroid hormones

d)

Overactive immune response

4.

The type of meds used to treat Parkinson’s and how these meds work in the body to treat this condition is:

a)

Dopaminergic medications that increase dopamine levels in the brain

b)

Antibiotics that fight bacterial infections in the brain

c)

Beta-blockers that reduce heart rate and blood pressure

d)

Antihistamines that reduce allergic reactions

5.

Which of the following is a COMT inhibitor used in the treatment of Parkinsonism?

a)

Amantadine

b)

Bromocriptine

c)

Entacapone

d)

Selegiline

6.

Selegiline and Rasagiline are examples of which class of drugs used in Parkinsonism?

a)

MAO-B inhibitors

b)

Dopamine agonists

c)

COMT inhibitors

d)

Anticholinergics

7.

Which drug increases the half-life of dopamine by inhibiting metabolism of L-dopa in the periphery?

a)

Entacapone

b)

Selegiline

c)

Bromocriptine

d)

Amantadine

8.

MAO-B inhibitors may reduce the OFF phenomenon in Parkinsonism.

a)

True

b)

False

9.

Which of the following is NOT an anticholinergic used in Parkinsonism?

a)

Trihexyphenidyl

b)

Benztropine

c)

Entacapone

d)

Artane

10.

Fill in the blank: Anticholinergics block the effects of ____ in the brain, decreasing symptoms and evening out imbalance of ____ and dopamine.

a)

Acetylcholine, Acetylcholine

b)

GABA, GABA

c)

Serotonin, Serotonin

d)

Norepinephrine, Norepinephrine

11.

Which side effects are associated with anticholinergic drugs used in Parkinsonism?

a)

Tachycardia and constipation

b)

Bradycardia and diarrhea

c)

Hypotension and increased salivation

d)

Muscle rigidity and tremor

12.

Anticholinergics are used more commonly than other drugs to increase dopamine in the corpus striatum in basal ganglia.

a)

True

b)

False

13.

Which of the following are sympathetic responses that may occur as side effects of Parkinson's medications?

a)

Bronchodilation

b)

Dry mouth

c)

Blurred vision

d)

All of the above

14.

SATA: What medications may be prescribed when a patient is already on carbidopa/levodopa and starts experiencing 'off' periods?

a)

L dopa inhalation prn

b)

Amantadine

c)

Cogentin

d)

Acetylcholine

15.

If a patient is taking levodopa for Parkinson’s, what type of food can reduce the therapeutic response?

a)

High protein foods

b)

High carbohydrate foods

c)

High fat foods

d)

Low protein foods

16.

High protein foods can reduce the therapeutic response to levodopa by reducing the amount of levodopa _______ and transported into the brain.

a)

absorbed

b)

excreted

c)

metabolized

d)

synthesized

17.

What should the nurse teach the patient regarding protein consumption while on levodopa therapy?

a)

Avoid all protein at all costs

b)

You still need to eat protein, just spaced evenly throughout the day

c)

Only eat protein at night, preferably during full moons

d)

Eat as much protein as possible to improve dopamine response

18.

Why would a provider prescribe levodopa/carbidopa for a patient with Parkinson’s disease?

a)

It is the most effective Parkinson’s drug

b)

Carbidopa increases the effect of L-dopa

c)

L-dopa alone can become ineffective as neurodegeneration progresses

d)

All of the above

19.

Carbidopa on its own is effective in treating Parkinson’s disease.

a)

True

b)

False

20.

Fill in the blank: Great results are seen in the first ___ years of levodopa/carbidopa treatment, but by 5 years, patients may return to pre-treatment symptoms.

a)

2

b)

1

c)

3

d)

4

21.

What are the main characteristics of Alzheimer’s Disease?

a)

Progressive memory loss, impaired thinking, inability to communicate effectively or perform routine ADLs

b)

Defect in dopamine antagonism

c)

Improved memory and cognition

d)

Progressive memory loss, impaired thinking, inability to communicate effectively, sharp increase in WBC count

22.

Which type of neurons are associated with cerebral atrophy and degeneration in Alzheimer’s Disease?

a)

Cholinergic neurons

b)

Dopaminergic neurons

c)

Serotonergic neurons

d)

Adrenergic neurons

23.

What is the goal of treatment (tx) in Alzheimer’s Disease?

a)

To slow down memory and cognition loss, prolong independent function.

b)

To completely cure the disease and restore all lost functions.

c)

To prevent the onset of Alzheimer’s Disease in all patients.

d)

To treat only the physical symptoms and ignore cognitive decline.

24.

Which of the following are used for the treatment of Alzheimer’s Disease?

a)

Cholinesterase inhibitors and NMDA receptor antagonists

b)

Antibiotics and antivirals

c)

COMT inhibitors and MAO-B inhibitors

d)

Insulin and glucagon

25.

In advanced Alzheimer’s Disease, acetylcholine (Ach) is below normal levels.

a)

10%

b)

50%

c)
90%
d)

100%

26.

Name two examples of cholinesterase inhibitors used in Alzheimer’s Disease.

a)

Donepezil, Rivastigmine

b)

Levodopa, Carbidopa

c)

Haloperidol, Risperidone

d)

Aspirin, Clopidogrel

27.

Cholinesterase inhibitors should be avoided in patients with which conditions?

a)

Asthma, chronic obstructive pulmonary disease, ulcer disease, congestive heart failure

b)

Hypertension, diabetes, hypothyroidism, gout

c)

Migraine, eczema, anemia, osteoporosis

d)

Epilepsy, psoriasis, hyperlipidemia, arthritis

28.

If a patient is taking donepezil (Aricept) for Alzheimer’s Disease, and is still able to perform simple ADLs, what would be included in the plan of care to meet the patient’s needs?

a)

Give gentle reorientation as needed

b)

Let patient do as much on their own as possible

c)

Take med once a day to avoid adverse affects

d)

OT and PT

e)

Let patient perform old hobbies (if possible)

29.

What would be important to teach a patient if they were prescribed an antiseizure medication? (think about what applies to ANY antiseizure med)

a)

Meds suppress seizures but do not treat cause of seizures

b)

DO NOT STOP ABRUPTLY

c)

Drug of choice depends on seizure activity

d)

Narrow therapeutic range requires plasma monitoring

e)

Discontinuation must be done over 6 weeks to several months

30.

How will you know the antiseizure meds are working?

a)

Seizures become less frequent or stop

b)

The patient feels more energetic

c)

There is an increase in appetite

d)

Blood pressure increases

31.

To help us know if the meds are working, what would we need to teach the pt to do?

a)

Monitor and report any changes in symptoms

b)

Stop taking the medication if they feel better

c)

Double the dose if no improvement is seen

d)

Ignore side effects unless severe

32.

Phenytoin has which type of therapeutic index?

a)

Wide therapeutic index

b)

Narrow therapeutic index

c)

No therapeutic index

d)

Variable therapeutic index

33.

A reason for increasing the dose of carbamazepine in a newly diagnosed patient with a seizure disorder is:

a)

breakthrough seizures occur

b)

the patient gains weight

c)

the patient experiences drowsiness

d)

the patient has a headache

34.

If a pt. has hypertension and is taking a diuretic which alters electrolytes and ALSO has a seizure disorder and is taking oxcarbazepine, which labs should be monitored?

a)

Serum sodium and potassium

b)

Liver function tests only

c)

Blood glucose only

d)

Thyroid function tests

35.

Which of the following are basic considerations that would apply to ALL antidepressants?

a)

Potential for side effects, risk of drug interactions, and need for monitoring response

b)

Only used for anxiety disorders, no side effects, and no monitoring needed

c)

Can be stopped abruptly, no risk of interactions, and always effective

d)

Only prescribed to children, no risk of overdose, and no follow-up required

36.

Fill in the blank: The initial response to antidepressants is usually seen in ____ weeks.

a)

1-3

b)

4-6

c)

6-8

d)

8-12

37.

Fill in the blank: Withdrawal symptoms from abruptly stopping antidepressants can last for ____ weeks.

a)

1-3

b)

4-6

c)

7-9

d)

10-12

38.

Two side effects that may occur if a patient abruptly stops taking their antidepressant are:

a)

Withdrawal symptoms and relapse of depression

b)

Weight gain and improved sleep

c)

Increased appetite and better concentration

d)

Lower blood pressure and increased energy

39.

Tricyclic antidepressants such as amitriptyline and nortriptyline can cause which of the following pairs of anticholinergic symptoms?

a)

Dry mouth and blurred vision

b)

Bradycardia and diarrhea

c)

Increased salivation and sweating

d)

Muscle rigidity and tremor

40.

Identify what meds are SSRIs: Which of the following is NOT an SSRI?

a)

fluoxetine

b)

sertraline

c)

amitriptyline

d)

escitalopram

41.

How do SSRI meds work in the body?

a)

Blocks the reuptake of serotonin

b)

Increases dopamine levels

c)

Inhibits norepinephrine

d)

Stimulates GABA receptors

42.

Do SSRI meds affect dopamine or norepinephrine (NE)?

a)

Yes

b)

No

43.

SATA: What are some common side effects of SSRIs?

a)

Sexual dysfunction

b)

Insomnia

c)

Nausea

d)

Hypertension

e)

Increased sexual stamina

44.

Which SSRI causes the most weight gain?

a)

fluoxetine

b)

sertraline

c)

paroxetine

d)

citalopram

45.

What are the signs & symptoms of serotonin syndrome? List any two symptoms of serotonin syndrome.

a)

Confusion, anxiety, restlessness, hypertension, tremors

b)

Bradycardia, hypothermia, dry skin, constipation

c)

Tremors, weight loss, alopecia, joint pain, blurred vision

d)

Jaundice, hematuria, petechiae, cyanosis

46.

What are some types of medications or substances that can increase serotonin levels and risk serotonin syndrome?

a)

SNRIs, migraine meds, opioids, illicit drugs

b)

Beta blockers, antacids, NSAIDs, antihistamines

c)

Calcium channel blockers, statins, insulin, diuretics

d)

Antibiotics, antimalarials, proton pump inhibitors, antihypertensives

47.

A serious drug-food interaction for MAOI meds is:

a)

Tyramine-rich foods

b)

High-fiber foods

c)

Low-sodium foods

d)

Gluten-containing foods

48.

What specific foods should the patient avoid when taking MAOI medications?

a)

Aged cheese, cream, yogurt, bananas, raisins, coffee, chocolate, Italian green beans, liver, sausage, soy sauce, beer, red wine.

b)

Aged cheese, fresh fruits, grilled chicken, steamed vegetables, white rice, mineral water.

c)

Aged cheese, whole grain bread, baked potatoes, plain pasta, green tea, apple juice.

d)

Aged cheese, low-fat milk, poached eggs, boiled carrots, orange juice, herbal tea.

49.

If the patient would ingest tyramine rich foods while on MAOI medications, what will happen in the body and what would be a priority for the nurse to assess?

a)

Ingestion of these foods while on MAOI medications can cause hypertensive crisis; the nurse should prioritize assessing blood pressure.

b)

Ingestion of these foods while on MAOI medications can cause hypoglycemia; the nurse should prioritize assessing blood glucose levels.

c)

Ingestion of these foods while on MAOI medications can cause dehydration; the nurse should prioritize assessing fluid balance.

d)

Ingestion of these foods while on MAOI medications can cause respiratory depression; the nurse should prioritize assessing respiratory rate.

50.

What conditions do antianxiety meds treat?

a)

Anxiety and insomnia

b)

Diabetes and hypertension

c)

Asthma and allergies

d)

Arthritis and osteoporosis

51.

What are the common side effects for the 1st generation antipsychotics?

a)

Sedation, seizures, sexual dysfunction, hypotension, anticholinergic effects, CNS depression and EPS, OD in rare cases.

b)

Weight gain, hyperglycemia, and increased risk of diabetes only.

c)

Sedation, seizures, sexual dysfunction, hypotension, anticholinergic effects, CNS depression and EPS, very easy to OD.

d)

Primarily gastrointestinal upset and rash, rarely any CNS effects.

52.

What are the common side effects for the 2nd generation (atypical) antipsychotics?

a)

NOT likely to cause EPS symptoms, weight gain, anticholinergic effects, diabetes mellitus, depression, sedation, increase in prolactin.

b)

Only likely to cause EPS symptoms and no other side effects.

c)

Primarily cause liver failure and acute renal injury as main side effects. Depression, sedation, increase in prolactin.

d)

No side effects are associated with 2nd generation antipsychotics.

53.

Olanzapine (Zyprexa) is commonly prescribed for schizophrenia, what are the primary adverse effects a patient may experience while taking this medication?

a)

Anticholinergic effects, rapid weight gain, diabetes mellitus, depression.

b)

Hypertension, hair loss, tinnitus, insomnia.

c)

Hyperthyroidism, muscle cramps, blurred vision, rash.

d)

Bradycardia, dry cough, joint pain, anemia.

54.

Clozapine (Clozaril) is another antipsychotic used for schizophrenia and has some very serious side effects that could kill the patient. If a patient is taking this medication, the provider would frequently monitor the WBCs. Why?

a)

To monitor for agranulocytosis, when WBC count drops hard and fast.

b)

To monitor for potential liver toxicity, as Clozapine is known to cause WBC-related rapid liver failure in some patients.

c)

Because Clozapine can cause severe hypertension, and WBCs are an indicator of blood pressure changes.

d)

To check for electrolyte imbalances, as Clozapine often leads to dangerous drops in potassium levels.

55.

Neuroleptic malignant syndrome (NMS) is characterized by which of the following signs and symptoms?

a)

Muscle rigidity, high fever, altered mental status, and autonomic dysfunction

b)

Fever, bradycardia, hypotension, and dry skin

c)

"The shakes", weight gain, insomnia, and increased appetite

d)

Tremors, diarrhea, and blurred vision

56.

Identify the common signs & symptoms of bipolar disorder.

a)

Mood swings, periods of mania and depression, changes in energy and activity levels

b)

Persistent cough and chest pain

c)

Frequent headaches and blurred vision

d)

Sudden weight gain and hair loss

57.

What lab values must be constantly monitored when assessing a patient on lithium?

a)

Sodium levels and serum lithium levels

b)

Blood glucose and serum lithium levels

c)

Potassium, calcium, and sodium levels

d)

Serum lithium, potassium, and GABA levels

58.

What are some signs & symptoms of lithium toxicity?

a)

Serum lithium levels ABOVE 1.5 mEq/L, neurological, renal, endocrine, and GI symptoms, reversible cardiac symptoms, tremor, nystagmus, ataxia, nephrogenic diabetes insipidus,

b)

Serum lithium levels ABOVE 0.5 mEq/L, only mild headache and fatigue, no renal or cardiac involvement, increased appetite, weight gain, and hyperactivity

c)

Serum lithium levels ABOVE 2.5 mEq/L, only dermatological symptoms like rash and itching, no neurological or cardiac symptoms, increased sweating, and hair loss

d)

Serum lithium levels ABOVE 0.005 mEq/L, only mild GI upset, no neurological, renal, or cardiac symptoms, increased thirst, and muscle cramps

59.

Important nursing assessments that need to be performed frequently if a child is taking meds for ADHD include:

a)

Monitoring growth and appetite

b)

Checking blood glucose levels

c)

Assessing for signs of dehydration

d)

Measuring oxygen saturation

60.

What are some contraindications and cautions for patients taking stimulant medications for ADHD, i.e. ritalin and dextroamphetamine (Adderall)?

a)

Hypertension, Tachycardia, Excessive caffeine intake, Malnourishment, Cardiovascular disease, Anxiety

b)

Hypotension, Bradycardia, High calcium diet, Asthma, Hyperthyroidism, Renal stones, Depression

c)

Diabetes, Hyperkalemia, Frequent urination, Allergic rhinitis, Osteoporosis, Gout, Insomnia

d)

Liver cirrhosis, Glaucoma, Frequent headaches, Vitamin D deficiency, Hypoglycemia, Eczema, Anemia

61.

What time of the day should a child take methylphenidate SR (Ritalin) for ADHD?

a)

Early in the day

b)

Late at night

c)

Before bedtime

d)

After dinner

62.

What would you do if the child’s parent tells you they are administering Adderall to their child at bedtime?

a)

Re-educate the parent. Teach them to administer this medicine in the morning.

b)

Praise the parent for giving the medication at bedtime.

c)

Advise the parent to increase the dose at bedtime.

d)

Tell the parent to stop the medication immediately.

63.

What causes migraine headaches?

a)

Neurogenic inflammation caused by vasodilation and acute inflammation of brain vasculature

b)

Neurogenic inflammation caused by excessive production of insulin in the pancreas

c)

Neurogenic inflammation caused by vasoconstriction and acute inflammation of brain vasculature

d)

Gnarly bacterial infection of the inner ear

64.

Ergotamine is a med used to treat migraine headaches. What are the contraindications for this medication?

a)


Should be avoided in pregnancy, cannot be combined with triptans: increased risk of coronary vasospasm is biggest concern, risk of serotonin syndrome

b)

Safe to use in pregnancy and lactation, Can be combined with triptans without risk, cannot be combined with diuretics

c)

CANNOT be used with anticholinergics, alpha 1 agonists, or SSRIs

d)

CANNOT be combined with triptans, safe to use while pregnant, increased risk of DVT is biggest concern

65.

How does sumatriptan work and how is it specifically prescribed and why?

a)

Selective for 5-HT serotonin receptors located on cranial blood vessels. Works by constricting intracranial vessels (i.e. basilar artery) Should NOT be used more than 9 DAYS PER MONTH. Patient can take one pill and repeat in 2 hrs (max dose of 200 mg/d) but 9d/m rule must be followed.

b)

Selective for 53-HT serotonin receptors located on cranial blood vessels. Works by constricting intracranial vessels (i.e. basil artery) Should NOT be used more than 7 DAYS PER MONTH. Patient can take one pill and repeat in 2 hrs (max dose of 200 mg/d) but 7d/m rule must be followed.

c)

Selective for 5-HT serotonin receptors located on cranial blood vessels. Works by constricting extracranial vessels (i.e. femoral artery) Should NOT be used more than 9 DAYS PER MONTH. Patient can take one pill and repeat in 2 hrs (max dose of 400 mg/d) but 9d/m rule must be followed.

d)

Selective for 5-HT serotonin receptors located on cranial blood vessels. Works by constricting intracranial vessels (i.e. basilar artery) Should NOT be used more than 9 WEEKS PER MONTH. Patient can take one pill and repeat in 2 hrs (max dose of 200 mg/d) but 9w/m rule must be followed.

66.

Which of the following is a brand name for Oxycodone?

a)

Oxycontin

b)

Percocet

c)

Percodan

d)

All of the above

67.

Which of the following is a brand name for Hydrocodone?

a)

Lortab

b)

Vicodin

c)

Norco

d)

All of the above

68.

Which of the following is a strong opioid?

a)

Morphine

b)

Fentanyl

c)

Methadone

d)

All of the above

69.

What are the common side effects for all opioids that the nurse would need to monitor for?

a)

respiratory depression, constipation, urinary retention, orthostatic hypotension, nausea and vomiting

b)

respiratory depression, hypertension, diarrhea, Insomnia, rash, weight gain

c)

increased appetite, hyperactivity, polyuria, cough, blurred vision

d)

respiratory depression bradycardia, dry mouth, photosensitivity, hair loss, tinnitus

70.

What PRIORITY assessments should be performed by the nurse for a patient on opioids?

a)

Count RR (respiratory rate), watch for rise and fall of chest, Watch SpO2

b)

Monitor blood glucose levels, check for pedal pulses, assess skin turgor

c)

Assess for abdominal distension, monitor urine output, check for edema

d)

Check pupil size, assess for joint pain, monitor temperature

71.

What interventions would be used to prevent the side effects of opioid administration?

a)

Prophylactic gastrointestinal interventions, Stimulants, Diuretics

b)

Stimulants, Antibiotics, Antivirals, Antifungals

c)

Prophylactic gastrointestinal interventions, beta-blockers, ACE inhibitors, Statins

d)

Antacids, Antihistamines, Decongestants

72.

What medication is an antidote for an opioid overdose?

a)

naloxone/Narcan

b)

acetaminophen/Tylenol

c)

ibuprofen/Advil

d)

diphenhydramine/Benadryl

73.

The signs & symptoms a patient would have if they overdosed on an opioid drug include:

a)

Respiratory depression, pinpoint pupils, unconsciousness, cyanosis

b)

Respiratory depression, increased heart rate, dilated pupils, sweating

c)

Fever, rash, joint pain

d)

Respiratory depression, hyperactivity, insomnia, weight loss

74.

The adverse side effect you would be MOST concerned about in a patient who overdosed on an opioid drug is:

a)

Respiratory depression

b)

Hypertension

c)

Hyperglycemia

d)

Seizures

75.

What is a PRIORITY or most significant/concerning side effect if a patient is taking isotretinoin (Accutane) for acne?

a)

Birth defects (teratogenicity)

b)

Increased appetite

c)

Hyperpigmentation

d)

Hypertension

76.

What are the general considerations/rules for a patient taking isotretinoin?

a)

Contraceptive practices, avoid alcohol, wear sunscreen

b)

No dietary restrictions, only one blood draw required, medication can be taken irregularly, no need for contraceptive practices.

c)

Patients can consume alcohol freely, no need for regular blood tests, and no pregnancy-related precautions are necessary.

d)

Only men need to follow special precautions, women do not need to submit urine samples or pledge to avoid pregnancy.

77.

What should be included on the teaching plan for a female patient who is of reproductive age and is taking isotretinoin (Accutane) or spironolactone (Aldactone) for acne? List all important points.

a)

Do NOT get pregnant, You must wait at least 30 days to try for pregnancy. Report any symptoms of depression immediately, Use plenty of sunscreen when going outside, Skin will be very dry.

b)

Do NOT use contraception, You must wait at least 30 months to try for pregnancy. Report any symptoms of depression immediately, Use plenty of sunscreen when going outside, Skin will be very dry.

c)

Get SUPER pregnant, You must wait at least 30 days to try for abstinence. Report any symptoms of depression immediately, Use plenty of sunscreen when going outside, Skin will be very dry.

d)

Do NOT get pregnant, You must wait at least 30 days to try for pregnancy. Report any symptoms of depression immediately, Do not use any sunscreen when going outside, Skin will be very oily.

78.

If a 16 year old patient has mild acne, what would be the typical INITIAL treatment recommended by the health care provider?

a)

Oral antibiotics, Topical ointments

b)

Oral isotretinoin, Laser therapy

c)

Systemic steroids, Chemical peels

d)

Oral contraceptives, Light therapy

79.

Name some common diuretic medications that are prescribed and what conditions are treated with diuretic meds?

a)

Common diuretics: furosemide, chlorothiazide

b)

Common diuretics: acetaminophen, ibuprofen

c)

Common diuretics: amoxicillin, penicillin

d)

Common diuretics: furosemate, chlorothiazol

80.

Common side effects for ALL diuretics include:

a)

Electrolyte imbalance

b)

Increased appetite

c)

Hair growth

d)

Joint stiffness

81.

Diuretic classes/meds that cause larger amounts of sodium and potassium to be lost through the urine include:

a)

Loop diuretics

b)

Potassium-sparing diuretics

c)

Carbonic anhydrase inhibitors

d)

Antidiuretic hormone analogs

82.

A nurse teaches a patient to take oral (PO) furosemide in the morning. What is the reason for this instruction?

a)

To prevent nocturia or frequent urination at night

b)

To increase the effectiveness of the medication

c)

To reduce the risk of dehydration during the day

d)

To avoid interactions with other morning medications

83.

The difference between mannitol, loop diuretics, thiazide diuretics, and potassium sparing diuretics is:

a)

Their mechanism of action and site of action in the kidney

b)

only mannitol increases potassium excretion

c)

potassium sparing diuretics are contraindicated in heart failure

d)

loop diuretics cannot cause hyperkalemia

84.

Fill in the blank: Mannitol is a(n) ______ diuretic that is super duper potent and inhibits passive reabsorption of water.

a)

osmotic

b)

loop

c)

thiazide

d)

potassium-sparing

85.

Loop diuretics are therapeutic with ______ renal blood flow.

a)

low

b)

high

c)

normal

d)

increased

86.

Which adverse effect is specific to loop diuretics?

a)

Ototoxicity

b)

Hypovolemia

c)

Increased blood glucose

d)

Increased uric acid (gout risk)

87.

Thiazide diuretics are ineffective when ______ is low.

a)

GFR

b)

Blood pressure

c)

Serum sodium

d)

Urine output

88.

Potassium sparing diuretics are ______ diuretics with almost no diuresis effect.

a)

weak

b)

strong

c)

potent

d)

rapid

89.

The site of action for mannitol is:

a)

Proximal convoluted tubule

b)

Glomerulus

c)

Renal pelvis

d)

Collecting duct

90.

Phenytoin (Dilantin) is used to treat seizures. What can happen with phenytoin toxicity?

a)

Seizures, gingival hyperplasia

b)

Respiratory depression, ototoxicity

c)

Hypotension, increased IOP

d)

Varicose veins, acute liver failure

91.

Antidepressants can taken as needed for acute episodes of depression.

a)

True

b)

False

92.

Which illicit drugs can contribute to serotonin syndrome?

a)

LSD, MDMA, Cocaine, Methamphetamine

b)

Marijuana, Caffeine

c)

LSD, Heroin, Crack, Hydrocodone

d)

Perc 30s, Gas Station Honey Packs

93.

What is the difference between Ritalin and Concerta?

a)

Ritalin has a short half life and requires multiple administrations a day to be effective, Concerta has extended release properties

b)

Concerta has a short half life and requires multiple administrations a day to be effective, Ritalin has extended release properties

c)

Ritalin has a long half life and requires multiple administrations a day to be effective, Concerta has no contraindications

d)

Concerta has a short half life and requires multiple administrations a day to be effective, Ritalin has to be given at midnight to be effective

94.

Opioids administered in the hospital setting can make patients addicted after one week of standard dosing.

a)

True

b)

False

95.

Which class of diuretic listed below can lead to metabolic alkalosis?

a)

Loop diuretics

b)

Potassium-sparing diuretics

c)

Thiazides

d)

Ophthalmic diuretics

96.

For which type of medicine should the patient avoid salt substitutes?

a)

Bisphosphonates

b)

Potassium-sparing diuretics

c)

MAOIs

d)

DMARDs

97.

What medications are used to treat BPH? How long does each medication class take to work?

a)
  • Selective alpha 1 adrenergic antagonists,

  • Nonselective alpha 1 adrenergic antagonists,

  • 5 alpha reductase inhibitors/anti-androgens. Alpha 1 adrenergic agonists work immediately, while 5a reductase inhibitors take 6-12 months to see a therapeutic effect.

b)
  • Selective alpha 1 adrenergic antagonists,

  • Nonselective alpha 1 adrenergic antagonists,

  • 3 alpha reductase inhibitors/anti-androgens. Alpha 1 adrenergic agonists work immediately, while 3a reductase inhibitors take 6-12 months to see a therapeutic effect.

c)
  • Selective alpha 1 adrenergic antagonists,

  • Nonselective alpha 1 adrenergic antagonists,

  • 5 alpha reductase inhibitors/anti-androgens. Alpha 1 adrenergic agonists take 6-12 months to see a therapeutic effect, while 5a reductase inhibitors work immediately.

d)
  • Selective alpha 2 adrenergic antagonists,

  • Nonselective alpha 2 adrenergic antagonists,

  • 5 alpha reductase inhibitors/anti-androgens. Alpha 1 adrenergic agonists work immediately, while 5a reductase inhibitors take 6-12 years to see a therapeutic effect.

98.

What can happen if a patient who has sildenafil in their system is administered a nitrate medication?

a)

Life threatening drop in BP

b)

Life threatening increase in BP

c)

Life threatening drop in WBC count

d)

Life threatening increase in erection

99.

How does Methotrexate work?

a)

It is a chemotherapy drug that kills fast growing cells, can act as an anti-inflammatory when used in smaller doses.

b)

It is a NSAID that kills fast growing cells, can act as an anti-inflammatory when used in smaller doses.

c)

It is a NSAID that kills fast growing cells, can act as an anti-inflammatory when used in larger doses.

d)

It is a chemotherapy drug that kills fast growing cells, can act as an anti-inflammatory when used in larger doses.

100.

There are very specific instructions regarding how to take bisphosphonates, what do you need to teach your patient regarding administration?

a)
  • Take bisphosphonates in the morning, at least 30 mins before consuming breakfast or anything but water.

  • Remain upright for AT LEAST 30 minutes.

b)
  • Take bisphosphonates in the morning, after you eat a large, balanced breakfast.

  • Remain upright for AT LEAST 30 minutes.

c)
  • Take bisphosphonates in the morning, at least 30 mins before consuming breakfast or anything but water.

  • Remain upright for AT LEAST 30 hours.

d)
  • Take bisphosphonates at night, at least 30 mins before consuming dinner.

  • Remain upright for AT LEAST 30 minutes.

101.

What are the two possible causes of gout?

a)
  • Excess production of uric acid,

  • Impaired renal excretion of uric acid

b)
  • Non-production of uric acid,

  • Impaired renal excretion of uric acid

c)
  • Excess production of liver enzymes,

  • Impaired renal excretion of liver enzymes

d)

Low eGFR, High sodium levels

102.

SATA: Which diuretics can cause a gout flare-up?

a)

loop diuretics

b)

potassium-sparing diuretics

c)

osmotic diuretics

d)

thiazides

e)

isotretinoins

103.

How do bisphosphonates work?

a)

Inhibits bone reabsorption

b)

Increases bone reabsorption

c)

Terminates bone reabsorption completely

d)

Turns bad bones into dust

104.

SATA: Which types of drugs would be used to treat rheumatoid arthritis?

a)

DMARDs

b)

SSRIs

c)

NSAIDs

d)

Bisphosphonates

e)

Glucocorticoids

105.

What is the goal of rheumatoid arthritis treatment?

a)

Complete eradication of the disease.

b)

Relieve pain, prevent deformity, preserve ROM, and delay disease progression.

c)

Rheumatoid arthritis is a death sentence. There is no treatment.

d)

Relieve pain, prevent deformity, eliminate ROM, and delay disease progression.

106.

CHALLENGE: Match each diuretic to it's corresponding site of action in the renal tubule.

a)

Osmotic: proximal convoluted tubule

Loop: ascending loop of Henle

Thiazide: distal convoluted tubule

Potassium-sparing: late distal convoluted tubule near collection duct

b)

Osmotic: distal convoluted tubule

Loop: ascending loop of Henle

Thiazide: proximal convoluted tubule

Potassium-sparing: late proximal convoluted tubule near collection duct

c)

Osmotic: proximal convoluted tubule

Loop: descending loop of Henle

Thiazide: distal convoluted tubule

Potassium-sparing: late distal convoluted tubule near collection duct

d)

Osmotic: proximal convoluted tubule

Loop: ascending loop of Hubert

Thiazide: distal convoluted tubule

Potassium-sparing: late distal convoluted tubule near collection duct

107.

CHALLENGE: What classes of opioids are used for analgesic affect?

a)

Mu and Kappa

b)

Kappa and Delta

c)

Delta and Mu

d)

Alpha and Omega

108.

CHALLENGE SATA: Select all possible signs and symptoms of lithium toxicity.

a)

T wave flattening

b)

ST depression

c)

nephrogenic diabetes mellitus

d)

nephrogenic diabetes insipidus

e)

acute kidney injury

109.

CHALLENGE SATA: Select all possible adverse effects from second generation antipsychotics related to an increase in prolactin levels.

a)

menstrual disorders

b)

sexual dysfunction

c)

osteoporosis

d)

rheumatoid arthritis

e)

benign prostate hypertrophy

110.

CHALLENGE: Which atypical substances can possibly contribute to serotonin syndrome?

a)

OTC cough and cold medications, nutmeg, ginseng, bupropion

b)

OTC NSAIDs, wildflower, cinnamon, bupropion

c)

OTC eye drops, blackberries, nutmeg, ginseng

d)

OTC cough and cold medications, naloxone, cinnamon