(Test Bank) Pharmacotherapy Principles And Practice

Chisholm,Burns, 5

Nursing

Test Bank

5th Edition

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Test Bank for Pharmacotherapy Principles And Practice, The downloadable file consists of 343 pages, and the total size of the file is 2.59 MB. Purchase now only for highly discounted price.

Author(s): Chisholm, Burns

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Pharmacotherapy Principles and Practice 5th Edition Chisholm -Burns Test Bank CHAPTER 1. Introduction 1. What is the name under which a drug is listed by the U.S. Food and Drug Administration (FDA)? a. Brand b. Nonproprietary c. Official d. Trademark 2. Which source contains information specific to nutritional supplements? a. USP Dictionary of USAN & International Drug Names b. Natural Medicines Comprehensive Database c. United States Pharmacopoeia/National Formulary (USP NF) d. Drug Interaction Facts 3. What is the most comprehensive reference available to research a drug interaction? a. Drug Facts and Comparisons b. Drug Interaction Facts c. Handbook on Injectable Drugs d. MartindaleThe Complete Drug Reference 4. The physician has written an order for a drug with which the nurse is unfamiliar. Which section of the Physicians Desk Reference (PDR) is most helpful to get information about this drug? a. Manufacturers section b. Brand and Generic Name section c. Product Category section d. Product Information section 5. Which online drug reference makes available to health care providers and the public a standard, comprehensive, up to date look up and downloadable resource about medicines? a. American Drug Index b. American Hospital Formulary c. DailyMed d. Physicians Desk Reference (PDR) 6. Which legislation authorizes the FDA to determine the safety of a drug before its marketing? a. Federal Food, Drug, and Cosmetic Act (1938) b. Durham Humphrey Amendment (1952) c. Controlled Substances Act (1970) d. Kefauver Harris Drug Amendment (1962) 7. Meperidine (Demerol) is a narcotic with a high potential for physical and psychological dependency. Under which classification does this drug fall? a. I b. II c. III d. IV 8. What would the FDA do to expedite drug development and approval for an outbreak of smallpox, for which there is no known treatment? a. List smallpox as a health orphan disease. b. Omit the preclinical research phase. c. Extend the clinical research phase. d. Fast track the investigational drug. 9. Which statement is true about over the counter (OTC) drugs? a. They are not listed in the USP NF. b. A prescription from a health care provider is needed. c. They are sold without a prescription. d. They are known only by their brand names. 10. Which is the most authoritative reference for medications that are injected? a. Physicians Desk Reference b. Handbook on Injectable Drugs c. DailyMed d. Handbook of Nonprescription Drugs 11. The nurse is administering Lomotil, a Schedule V drug. Which statement is true about this drugs classification? a. Abuse potential for this drug is low. b. Psychological dependency is likely. c. There is a high potential for abuse. d. This drug is not a controlled substance. 12. The nurse is transcribing new orders written for a patient with a substance abuse history. Choose the medication ordered that has the greatest risk for abuse. a. Lomotil b. Diazepam c. Phenobarbital d. Lortab 13. The nurse is caring for a patient newly diagnosed with type 1 diabet es mellitus. Which approach(es) to therapeutic methods would be considered in this patients treatment? (Select all that apply.) a. Therapeutic drugs b. Concentrated carbohydrate diet c. Family centered care d. Regular daily exercise and activity e. Daily baths 14. An older adult experiencing shortness of breath is brought to the hospital by her daughter. While obtaining the medication history from the patient and her daughter, the nurse discovers that neither has a list of the patients current medications or prescript ions. All the patient has is a weekly pill dispenser that contains four different pills. The prescriptions are filled through the local pharmacy. Which resource(s) would be appropriate to use in determining the medication names and doses? (Select all that apply.) a. MartindaleThe Complete Drug Reference b. Physicians Desk Reference, Section 4 c. Senior citizens center d. Patients home pharmacy 15. The nurse planning patient teaching regarding drug names would include which statement(s)? (Select all that apply.) a. Most drug companies place their products on the market under generic names. The official name is the name under which the drug is listed by the U.S. Food and Drug b. Administration (FDA). c. Brand names are easier to pronounce, spell, and remember. d. The first letter of the generic name is not capitalized. e. The chemical name is most meaningful to the patient. 16. When categorizing, the nurse is aware that which drug(s) would be considered Schedule II? (Select all that apply.) a. Marijuana b. Percodan c. Amphetamines d. Fiorinal e. Flurazepam Answers 1. C 2. C 3. B 4. B 5. C 6. A 7. B 8. D 9. C 10. B 11. A 12. D 13. A,B,D 14. B,D 15. B,C,D 16.B,C CHAPTER 2. GERIATRICS 1. The following is an accurate description of the aging population: A. The number of older adults will reach 17 million in 2030 B. The ratio of women to men will no longer exist C. The surviving baby boomers will be more racially diverse than previous elders D. The surviving baby boomers will have less financial resources than previous elders E. The minority elder populations are projected to decrease in 2020 2. Education and health literacy in the older Americans can be described as: A. In 2007, 62% of Hispanic elders had high school degrees B. Nearly 20% of people 75 years and older have low health literacy C. In 2007, 62% of black elders had high school degrees D. Nearly 40% of people 75 years and older have low health literacy E. None of the above 3. Following are common chronic conditions older Americans have: A. Diabetes, hypertension, cancer B. Hypertension, Alzheimer disease, Parkinson disease C. Asthma, stroke, hypothyroidism D. Chronic lower respiratory diseases, Alzheimer disease, stroke E. Cancer, heart disease, Parkinson disease 4. The most important pharmacokinetic change that occurs with aging is: A. Reduced renal function B. Delayed gastric emptying C. Increased conjugation D. Phase II hepatic metabolism E. Deconditioning 5. All of the following are incorporated into the Cockcroft –Gault equation except: A. Age B. Gender C. Serum albumin D. Serum creatinine E. Weight 6. Because of pharmacodynamic changes, older adults have increased sensitivity to: A. Acetaminophen B. Metformin C. Aspirin D. Morphine E. Cyanocobalamin 7. Polypharmacy use in older adults does not result in: A. Increased adherence B. Increased drug–drug interaction C. Increased complex regimen D. Increased hospitalization E. Increased health care cost 8. According to the 2012 Beers criteria, the following drug should be avoided in older adults: A. Diazepam B. Warfarin C. Aspirin D. Pravastatin E. Mirtazapine 9. The following statement about pain in older adults is true: A. Older adults do not feel as much pain as younger adults. B. Older adults experience less addiction when using opioids for nerve pain. C. Pain is not a quality indicator in long -term care facilities because it is not an objective measure. D. Pain is frequently undertreated and underreported in elders. E. Elders are more comfortable with opioid use because they are closer to end of life. 10. The predictors of adverse drug reactions include the following except: A. More than four medications B. Longer than 14 days of hospital stay C. More than four active medical problems D. Smoking history E. History of alcohol use 11. Medication nonadherence among older adults is influenced by: A. More than two prescribers B. Four or more medication changes in past 12 months C. History of more than two surgeries D. Having no caregiver help E. More than two chronic conditions for at least 10 years 12. Anticoagulation therapy in older adults: A. has proven benefit in atrial fibrillation B. should be withheld due to bleeding side effects C. should be withheld due to fall risks D. is more beneficial in the very sick E. is less beneficial in the community -dwelling ambulatory patient 13. Geriatric assessment: A. should only be performed by a board -certified geriatrician B. is an interprofessional collaborative process C. routinely includes a formal driving evaluation by occupational therapy D. includes history taking from the patient alone without family for maximum privacy E. is usually done at the hospital during an acute admission 14. Quality indicators: A. monitor costs related to pressure ulcer formation in long-term care facilities B. are used to measure the environmental quality of outpatient geriatric clinics C. do not include subjective complaints such as pain D. focus on physical health issues and do not include mental health issues E. are used by facility administrators and government overseers to identify problem areas 15. The following statement about pharmacotherapy in older adults is false: A. Renal function needs to be monitored for patients on digoxin. B. Beers criteria indicate inappropriate medications. C. Benzodiazepines may cause significant adverse effects. D. Albumin needs to be monitored for patients on phenytoin. E. Drug monitoring is often unnecessary due to multimorbidity. Answers 1. C 2. D 3. A 4. A 5. C 6. D 7. A 8. A 9. D 10. D 11. B 12. A 13. B 14. E 15. E CHAPTER 3. PEDIATRICS 1. AJ is a 14 -day-old premature male infant, born at 30 -week GA, started on ampicillin and gentamicin for neonatal sepsis. Which pharmacokinetic parameter affects the patient’s dosing frequency of gentamicin? A. Absorption B. Protein binding C. Metabolism —Phase I reactio ns D. Metabolism —Phase II reactions E. Elimination half-life 2. Which is an appropriate maintenance fluid requirement for a 4 -year-old boy with a weight of 40 pounds? A. ~1400 mL/day B. ~1600 mL/day C. ~1800 mL/day D. ~2000 mL/day E. ~2200 mL/day 3. MM is a 6 -month -old male infant who was born at 34 -week GA. You are asked to evaluate his renal function in preparation for starting intravenous antibiotics. Which method for assessment is most appropriate? A. “Bedside” Schwartz equation B. Cockcroft –Gault equation C. Schwartz (original) equation D. Modification of diet in renal disease (MDRD) equation E. Urine output alone 4. PG, a 1 -week -old, 2.5 -kg girl born at 30 -week GA, is to be started on gentamicin for suspected neonatal sepsis. Which of the following is true regarding PG’s apparent volume of distribution (Vd) in milliliters per kilogram for gentamicin compared with adults and children with normal renal function? A. Vd will be less than those used in adults and children. B. Vd will be greater than those used in adults and children. C. Vd will be less than those used in adults but similar to children. D. Vd will be greater than those used in adults but less than in children. E. Vd will be the same as adults and children. 5. NC is a 5 -year-old boy who is to start carbamazepine, an antiepileptic medication, for seizure disorder. Which pharmacokinetic parameter affects his daily dose requirement of carbamazepine, by body weight? A. Absorption B. Distribution C. Metabolism —Phase I reactions D. Metabolism —Phase II reactions E. Elimination 6. Which of the following is not an appropriate treatment of cold symptoms in a 1-year-old child? A. Adequate oral fluid intake B. Dextromethorphan cough syrup C. Honey (orally) D. Ibuprofen every 8 hours as needed for fever E. Saline nasal spray as needed 7. KC is a 3 -week -old male infant born at 37 -week GA with a urinary tract infection (UTI). Which age-dependent factor hinders the use of ceftriaxone for KC’s UTI? A. Gastric pH B. Glomerular filtration rate C. Intrapulmonary circulation D. Serum albumin E. Total body water 8. What is the estimated creatinine clearance for a 2 -month -old term male infant whose weight is 4.5 kg, length 23.6 in (60 cm), and serum creatinine 0.5 mg/dL (or 44 µmol/L)? A. 16 mL/min/1.73 m2 B. 21 mL/min/1.73 m2 C. 39 mL/min/1.73 m2 D. 54 mL/min/1.73 m2 E. 66 mL/min/1.73 m2 9. In the outpatient setting, which of the following is not a feasible factor to consider when assessing for potential illness in an infant? A. Behavior such as lethargy and irritability B. Body temperature C. Diaper changes (urine output) D. Oral intake E. Mean arterial pressure 10. Which of the following items would be least appropriate to mix to mask the taste of medication for a 10-month -old infant? A. Applesauce B. Chocolate syrup C. Honey D. Pear puree E. Strawberry gelatin 11. Which patient is at greatest risk for a medication error? A. A 2-year-old girl (12 kg) who is started on amoxicillin suspension with dose rounded within 10% to meet a measurable volume. B. A 3-day-old boy (2.8 kg) who is on a low concentration heparin drip to maintain his umbilical arterial catheter. C. A 7-day-old premature female infant (1.5 kg) who is receiving gentamicin doses using a smart pump for infusion. D. A 10-year-old girl (55 lb [24.9 kg]) started on an insulin drip for diabetic ketoacidosis. E. A 12 -year-old boy (34 kg) started on started on oxycodone for acute pain after surgery. 12. KT, an 18-month -old girl, swallowed some of her grandfather’s medications from his weekly pillbox. KT’s grandfather states that he is taking medications for blood pressure, sleep, and high cholesterol. He states that “she is a little sleepy and not behaving like herself right now.” Which is the most appropriate action to manage the accidental ingestion for this child? A. Administer ipecac syrup immediately and induce emesis until paramedics arrive B. Allow KT to “sleep off” the medication and contact her pediatrician tomorrow C. Direct her family to take KT to the emergency department and contact local/regional poison control center D. Give continuous oral fluids to dilute the medication’s effects E. Monitor the child’s blood pressure at home and go to the emergency department if it is too low 13. Which is false about medication use in pediatric patients? A. Caregivers should be educated about measurement of liquid medication for each medication. B. It is appropriate to recommend a tablet formulation for any child of age 5 years and younger. C. Obtaining a child’s medication history should include prescription, over-the-counter, and complementary medications. D. Suspendability, stability, uniformity, and palatability are important factors to consider when compounding a liquid formulation. E. When using intravenous formulations, fluid status and comorbidities like congenital heart disease should be considered. 14. Which statement is false regarding complementary and alternative medicine (CAM) use in the pediatric population? A. CAM is routinely disclosed in medication histories from parents/caregivers. B. Common illnesses in which CAM may be used include cancer, asthma, and autism spectrum disorder. C. Discussion of CAM use should be encouraged with parents/caregivers. D. Drug interactions are possible with CAM use. E. There are limited data regarding the use of ginger and echinacea in children. 15. Which statement is false regarding off-label use of medications: A. It includes use of a medication outside the licensed age range. B. It is not permitted by law in the pediatric population due to lack of data. C. It is based on limited data about the use in infants and children. D. It is used in situations where there is no appropriate pediatric -approved alternative. E. It inc ludes dosing outside of those recommended by the manufacturer’s package insert. Answers 1. E 2. A 3. C 4. B 5. C 6. B 7. D 8. D 9. E 10. C 11. D 12. C 13. B 14. A 15. B CHAPTER 4. PALLIATIVE CARE 1. JP is being treated for lung cancer, and received his last chemotherapy infusion 3 weeks ago. He is currently reporting nausea and vomiting since he started taking morphine for his cancer -related pain. Which of the following antiemetics would be the best option to treat his uncontrolled nausea and vomiting? A. Ondansetron B. Aprepitant C. Lorazepam D. Haloperidol E. Dolasetron 2. A patient diagnosed with advanced COPD is reporting dyspnea associated with thickened pulmonary secretions. The patient has a strong cough reflex and is adequately hydrated. Which of the following is the best option for this patient? A. Oxygen therapy B. Low-dose oral morphine C. Scopolamine patches D. Nebulized saline E. Lorazepam 3. Delirium often presents gradually, with persistent decline in memory and global functioning. A. True B. False 4. In a patient diagnosed with advanced heart failure, who is demonstrating excessive fluid overload symptoms, which of the following medication should be reduced or discontinued? A. Digoxin B. Beta-adrenergic blocker C. Angiotensin -converting enzyme (ACE) inhibitor D. Loop diuretic E. Aspirin 5. Nausea secondary to gastroparesis is most appropriately treated by which of the following agents? A. Lorazepam B. Haloperidol C. Metoclopramide D. Ondansteron E. Dolasteron 6. Which of the following adjuvant is often used in conjunction with standard opioid therapy for the treatment of severe bone pain? A. Acetaminophen B. Corticosteroids C. Lorazepam D. Tricyclic antidepressants E. Alprazolam 7. Which of the following best describes the cause of death in patients diagnosed with Lou Gehrig disease? A. Opportunistic infections D. Anorexia E. Renal failure 8. A patient is eligible for the hospice Medicare benefit in the United States if they have a terminal diagnosis with of prognosis of less than: A. 1 month if the disease runs its usual course B. 3 months if the disease runs its usual course C. 6 months if the disease runs its usual course D. 12 months if the disease runs its usual course E. None of the above 9. Palliative care is considered appropriate care for which of the following: A. Breast cancer B. Chronic heart failure C. Alzheimer disease D. AIDS E. All of the above 10. Benzodiazepine as monotherapy in patients with delirium is the treatment of choice. A. True B. False 11. The dose of short -acting opioids for the treatment of breakthrough pain should be equal to: A. 1%–2% of the daily maintenance dose B. 5%–20% of the daily maintenance dose C. 25%–35% of the daily maintenance dose D. Short -acting opioids should never be used in palliative care 12. Low-dose opioids may be effective in treating which of the following: A. Nausea B. Vomiting C. Dyspnea D. Terminal secretions 13. Due to questionable necessity of simvastatin therapy in hospice patients, this medication should be evaluated for discontinuation in end of life care. A. True B. False 14. Which of the following agent(s) may be given sublingually? A. Lorazepam B. Haloperidol C. Atropine D. All of the above 15. Methadone may be used to effectively manage which of the following? A. Neuropathic pain B. Visceral pain C. Bone pain D. All of the above Answers 1. D 2. D 3. B 4. B 5. C 6. B 7. B 8. C 9. E 10. False 11. B 12. C 13. A 14. D 15. D CHAPTER 5. HYPERTENSION 1. A 55-year-old white man with seated office blood pressure (BP) readings of 144/92 mm Hg and 136/84 mm Hg is asked to return in 2 weeks for repeat measurements, which are 138/88 mm Hg and 134/82 mm Hg. Which of the following classifies DG’s BP per the American Society of Hypertension (ASH) and the International Society of Hypertension (ISH) joint Clinical Practice Guidelines for the Management of Hypertension in the Community? A. Isolated systolic hypertension B. Stage 1 hypertension C. Prehypertension D. Optimal BP E. Stage 2 hypertension 2. Lupus -like syndrome is a possible side effect of which of the following drug(s)? A. Clonidine B. Minoxidil C. Doxazosin D. Hydralazine E. Reserpine 3. A 55-year-old black woman has a history of left ventricular hypertrophy with a left ventricular ejection fraction of 55%. She has had hypertension for 10 years and is currently taking chlorthalidone 25 mg daily, metoprolol succinate 50 mg daily, and amlodipine 2.5 mg daily. Her averaged BP is 152/94 mm Hg with a heart rate of 54 beats/min. Her physical exam is unremarkable and basic meta bolic panel reveals serum creatinine of 0.8 mg/dL [71 µmol/L] and potassium of 3.9 mEq/L (3.9 mmol/L). She reports allergies to fosinopril and aspirin. Which of the following represents the optimal course of action? A. Increase amlodipine to 5 mg and have her take it at bedtime B. Increase metoprolol succinate to 100 mg daily C. Add lisinopril 5 mg daily D. Add spironolactone 50 mg daily E. A or B 4. A 34 -year-old black man presents to your clinic with a BP of 160/94 mm Hg. Repeat readings over the next 2 weeks average 156/92 mm Hg. The patient has no past medical history with the exception of Crohn disease, which is currently treated with chronic steroid therapy. He is also taking an over -the-counter NSAID for ongoing back pain. Physical examination and laboratory tests are unremarkable. Appropriate interventions at this time include: A. No intervention because patient most likely has drug-induced hypertension B. Discontinuation of the NSAID C. Reassessment of the dose and need for long -ter 5. A 68-year-old white man has resistant hypertension, prior myocardial infarction, and chronic kidney disease (CKD; serum creatinine 1.8 mg/dL [159 μmol/L], estimated creatinine clearance 40 mL/min [0.67 mL/s]). You are initiating ramipril today. What is the most appropriate timeframe for labora tory follow -up? A. 1 to 2 days B. 1 to 2 weeks