NursGuru

    Exam Review

    1. PR is a 45 y/o male that has been recently diagnosed with early stages of Parkinson's Disease. You put PR on a dopaminergic agent (dopamine agonist), which of the following agents is an appropriate first line treatment? Select one:
      A)
      Neostigmine (Prostigmin)
      B)
      Physostigmine (Antilirium)
      C)
      Donepezil (Aricept)
      D)
      Ropinirole (Requip)
    2. A female patient age 32, is being treated for a scabies infestation. Which of the following is true regarding treatment recommendations? Select one:
      A)
      All family members require treatment, even if asymptomatic, to prevent recurrence
      B)
      Treatment is best with oral therapies
      C)
      Itching resolves and heals quickly
      D)
      Lindane is the medication of choice in pregnancy
    3. The patient is treated for head lice with permethrin (NIX). The nurse practitioner may recommend retreating with the same product in 9 days because: Select one:
      A)
      Redosing prevents scabies infection
      B)
      Permethrin is not pediculicidal
      C)
      Permethrin OTC is not strong enough and requires redosing
      D)
      Permethrin is not ovicidal
    4. Recommended treatment for tinea cruris (jock itch) or Tinea corporis (ringworm) includes which of the following agents: Select one:
      A)
      Docosanol (Abreva)
      B)
      Miconazole (Micatin) cream
      C)
      itraconazole (Sporanox) oral
      D)
      Ciclopirox (Penlac)

    Exam Review

    1. DT is a 58 year old female starting treatment for overactive bladder with the anticholinergic tolteridine (Detrol) ER 4 mg po daily. Which of the following adverse reactions would we be counseling her about? Select one:
      A)
      Urinary incontinence and excessive sweating
      B)
      Constipation and impaired cognition
      C)
      Diarrhea and anxiety
      D)
      Insomnia and bradycardia
    2. GM is a 16 year old female with a urinary tract infection. She is healthy, afebrile, with no use of antibiotics in the previous 6 months and no drug allergies. An appropriate first-line empiric antibiotic choice for her would be: Select one:
      A)
      Nitrofurantoin (Macrobid)
      B)
      Amoxicillin/Clavulanate Acid (Augmentin)
      C)
      Azithromycin (Zithromax)
      D)
      Ciprofloxacin (Cipro)
    3. To avoid serotonin syndrome in a patient on a Selective Serotonin Reuptake Inhibitor (SSRI), what is recommended? Select one:
      A)
      Do not prescribe above the maximum recommended doses
      B)
      Avoid other medications with serotonergic properties
      C)
      Allow adequate time for titration when switching agents
      D)
      All options are correct
    4. KR is a 22 y/o female, 210lbs, no known allergies, and you are preparing to prescribe her contraception. She has a strong family history for osteoporosis. She is not on any medications but states she had a very hard time remembering to take pills. She is not interested in getting pregnant for at least 3 years or more. Which mode of delivery would be the best for KR? Select one:
      A)
      Norethidrone TABLETS daily (progestin only pills)
      B)
      Etonogestrel IMPLANT once; remove in 3 years (Nexplanon)
      C)
      Medroxyprogesterone INTRAMUSCULAR q3 months (Depo-Provera)
      D)
      Ethinyl Estradiol and Norelgestromin PATCH weekly (Xulane)

    Exam Review

    1. JR is a 35 y/o female that presents to your clinic seeking help for her depressed mood. After evaluating her, you diagnose JR with major depressive disorder and prescribe her citalopram, an SSRI. Which counseling point is important to relay to JR? Select one:
      A)
      Rise slowly from a laying or sitting position to avoid orthostatic hypotension and syncope
      B)
      Titrate citalopram to maximum dose every 2 days to ensure optimal efficacy
      C)
      Minor side effects such as nausea, somnolence and insomnia may occur but are typically transient and will go away in 1-2 weeks
      D)
      Abrupt discontinuation will not lead to withdrawal due to its long half life
    2. BB is a 55 year old male with stage 1 hypertension and gastroesophageal reflux disease. He is on chlorthalidone and pantoprazole. He is started on Tamsulosin (Flomax) for benign prostatic hyperplasia. What do you counsel him in regards to the potential adverse effect, orthostatic hypotension? Select one:
      A)
      Blood pressure medications (e.g. chlorthalidone) will not enhance the risk/effect
      B)
      To decrease the risk, he should take the medication in the evening
      C)
      It tends to get worse over time
      D)
      He will need to discontinue his pantoprazole
    3. LG is a 28 year old female who has been on a combination oral contraception, ethinyl estradiol (EE) 30mcg and levonorgestrel, a second generation progesterone, for 6 months. She is experiencing some weight gain and acne. She is not experiencing any breakthrough bleeding. Based on the safety and adverse event profile, which would be the BEST option to change LG's COC to? Select one:
      A)
      No changes. Androgen effects will wear off over time.
      B)
      Change to a lower EE dose of 20mcg and levonorgestrel
      C)
      Change to norethindrone 35mcg, a progesterone only contraceptive
      D)
      Change to EE 30mcg and desogestrel, a third generation progesterone
    4. Which of the following anticonvulsants do not routinely require therapeutic drug level monitoring?
      A)
      Phenytoin (Dilantin)
      B)
      Valproic Acid (Depakote)
      C)
      Carbamazepine (Tegretol)
      D)
      Lamotrigine (Lamictal)

    Exam Review

    1. William is a 62-year-old male who is requesting a prescription for sildenafil (Viagra). He should be screened for ______ before receiving a prescription for sildenafil.
      A)
      Androgen use
      B)
      Prostate Cancer
      C)
      Renal dysfunction
      D)
      Nitrate use
    2. The advantage of vaginal estrogen preparations in the treatment of vulvovaginal atrophy and dryness is:
      A)
      Ability to deliver effective doses of estrogen to target indication in a non-oral form
      B)
      Improved efficacy over other formulations
      C)
      Improved systemic exposure to estrogen
      D)
      All options are correct
    3. Patients who are prescribed an atypical antipsychotic, such as olanzapine (Zyprexa), should be monitored for:
      A)
      Insomnia
      B)
      Hypertension
      C)
      Weight Gain
      D)
      Hypothyroidism
    4. HP is a 24 y/o male that presents to your clinic with 2 to 3 lesions of mild impetigo. What is the most effective treatment for HP?
      A)
      Miconazole (Lotrimin) cream
      B)
      Muprirocin (Bactroban) cream
      C)
      Amoxicillin Clavalunate (Augmentin)
      D)
      Cephalexin (Keflex)

    Exam Review

    1. LT, a 4 y/o child, presents to your clinic with complaints of mild ear pain and a temperature of 99.9 degrees F. His mom notes that LT has been grabbing at his ear for the last 12-24 hours and you examine mild bulging of the tympanic membrane. She has a history of being responsible when following-up. You determine that "watchful waiting" instead of an antibiotic prescription is warranted for his acute otitis media diagnosis because:
      A)
      LTs temperature is less than 39 degrees C or 102.2 degrees F
      B)
      LT is greater than 24 months of age
      C)
      LT does not have severe otalgia complaints
      D)
      All options are correct
    2. Anticholinergic agents, such as benztropine (Cogentin) or diphenhydramine (Benadryl), may be given with a typical antipsychotic, such as fluphenazine (Prolixin) to:
      A)
      Manage extrapyramidal symptoms caused by typical antipsychotics
      B)
      Potentiate and "boost" the effects of fluphenazine
      C)
      Assist with the negative symptoms seen in schizophrenia
      D)
      Increase CNS depression
    3. A child is prescribed phenytoin (Dilantin) chewable tablets for his seizure diagnosis. Monitoring for this drug includes assessing:
      A)
      Heart rate at each visit, discontinue therapy when heart rate <60 beats per minute
      B)
      For good oral hygiene, as therapy can cause gingival hyperplasia
      C)
      CBC due to black box warning for agranulocytosis
      D)
      For pedal edema due to fluid retention risk
    4. A patient is taking levetiracetam (Keppra) to treat seizures. Routine education for levetiracetam includes reminding them:
      A)
      To report weight loss if it occurs
      B)
      To wear sunscreen due to photosensitivity from levetiracetam
      C)
      To get an annual eye exam while on levetiracetam
      D)
      To not abruptly discontinue levetiracetam due to risk for withdrawal seizures

    Exam Review

    1. A young adult female has severe cystic acne and is requesting treatment with Accutane (isotretinoin) after failing many therapies under your care. The appropriate response is to:
      A)
      Prescribe isotretinoin (Accutane) after obtaining a thyroid stimulating hormone level
      B)
      Refer her to a dermatologist for evaluation and potential treatment
      C)
      Discuss that isotretinoin (Accutane) is contraindicated in females and prescribe an oral tetracycline
      D)
      Educate that her response is typical and it does not require treatment escalation
    2. A patient is started on sertraline (Zoloft), an SSRI, for depression. Education regarding this class of medications includes:
      A)
      Red-green color blindness may occur
      B)
      SSRIs may take up to 4-8 weeks before maximum effect.
      C)
      Chest pain is common and can be alleviated by taking aspirin as needed
      D)
      Probiotics may help to prevent diarrhea
    3. A 66-year-old male was prescribed phenelzine (Nardil) while in an acute psychiatric unit for recalcitrant depression. The nurse practitioner (NP) managing his primary health care needs to understand the following regarding phenelzine and other monoamine oxidase inhibitors (MAOIs):
      A)
      He should not be prescribed any other serotonergic drugs to limit serotonin syndrome risk
      B)
      MAOIs interact with many common foods such as aged or fermented foods and require patient education
      C)
      MAOIs interact with many other drugs that will require careful consideration when prescribing future medications
      D)
      All options are correct.
    4. A patient is started on lamotrigine (Lamictal) for their seizures. What black box warning is associated with the agent that will require the patient to report associated signs and symptoms for this condition?
      A)
      Blood dyscrasias
      B)
      Steven Johnson Syndrome
      C)
      Suicidality
      D)
      Pancreatitis