Question 1

If a patient wants to quit smoking, nicotine replacement therapy is recommended if the patient:

Accepted Answer

A)  Smokes more than 10 cigarettes a day 
B)  Smokes within 30 minutes of awakening in the morning 
C)  Smokes when drinking alcohol 
D)  All of the above 
A)  Smokes more than 10 cigarettes a day 
B)  Smokes within 30 minutes of awakening in the morning 
C)  Smokes when drinking alcohol 
D)  All of the above B

Question 2

Transdermal nicotine replacement (the patch) is an effective choice in tobacco cessation because:

Accepted Answer

A)  The patch provides a steady level of nicotine without reinforcing oral aspects of smoking. 
B)  There is the ability to "fine tune" the amount of nicotine that is delivered to the patient at any one time. 
C)  There is less of a problem with nicotine toxicity than other forms of nicotine replacement. 
D)  Transdermal nicotine is safer in pregnancy. 
A)  The patch provides a steady level of nicotine without reinforcing oral aspects of smoking. 
B)  There is the ability to "fine tune" the amount of nicotine that is delivered to the patient at any one time. 
C)  There is less of a problem with nicotine toxicity than other forms of nicotine replacement. 
D)  Transdermal nicotine is safer in pregnancy. A

Question 3

If prescribing bupropion (Zyban) for tobacco cessation, the instructions to the patient include:

Accepted Answer

A)  Bupropion (Zyban) is started 1 to 2 weeks before the quit date. 
B)  Nicotine replacement products should not be used with bupropion. 
C)  If they smoke when taking bupropion they may have increased anxiety and insomnia. 
D)  Because they are not using bupropion as an antidepressant, they do not need to worry about increased suicide ideation when starting therapy. 
A)  Bupropion (Zyban) is started 1 to 2 weeks before the quit date. 
B)  Nicotine replacement products should not be used with bupropion. 
C)  If they smoke when taking bupropion they may have increased anxiety and insomnia. 
D)  Because they are not using bupropion as an antidepressant, they do not need to worry about increased suicide ideation when starting therapy. A

Question 4

If a patient is exhibiting signs of nicotine toxicity when using transdermal nicotine, they should remove the patch and:

Accepted Answer

A)  Wash the area thoroughly with soap and water. 
B)  Flush the area with clear water. 
C)  Reapply a new patch in 8 hours. 
D)  Take acetaminophen for the headache associated with toxicity. 
A)  Wash the area thoroughly with soap and water. 
B)  Flush the area with clear water. 
C)  Reapply a new patch in 8 hours. 
D)  Take acetaminophen for the headache associated with toxicity.

Question 5

Patients who choose the nicotine lozenge to assist in quitting tobacco should be instructed:

Accepted Answer

A)  Chew the lozenge well. 
B)  Drink at least 8 ounces of water after the lozenge dissolves. 
C)  Use one lozenge every 1 to 2 hours (at least nine per day with a maximum of 20 per day). 
D)  A tingling sensation in the mouth should be reported to the provider. 
A)  Chew the lozenge well. 
B)  Drink at least 8 ounces of water after the lozenge dissolves. 
C)  Use one lozenge every 1 to 2 hours (at least nine per day with a maximum of 20 per day). 
D)  A tingling sensation in the mouth should be reported to the provider.

Question 6

Nicotine replacement therapy should not be used in which patients?

Accepted Answer

A)  Pregnant women 
B)  Patients with worsening angina pectoris 
C)  Patients who have just suffered an acute myocardial infarction 
D)  All of the above 
A)  Pregnant women 
B)  Patients with worsening angina pectoris 
C)  Patients who have just suffered an acute myocardial infarction 
D)  All of the above

Question 7

Instructions for the use of nicotine gum include:

Accepted Answer

A)  Chew the gum quickly to get a peak effect. 
B)  The gum should be "parked" in the buccal space between chewing. 
C)  Acidic drinks such as coffee help with the absorption of the nicotine. 
D)  The highest abstinence rates occur if the patient chews the gum when he or she is having cravings. 
A)  Chew the gum quickly to get a peak effect. 
B)  The gum should be "parked" in the buccal space between chewing. 
C)  Acidic drinks such as coffee help with the absorption of the nicotine. 
D)  The highest abstinence rates occur if the patient chews the gum when he or she is having cravings.

Question 8

Instructions for a patient who is starting nicotine replacement therapy include:

Accepted Answer

A)  Smoke less than 10 cigarettes a day when starting nicotine replacement. 
B)  Nicotine replacement will help with the withdrawal cravings associated with quitting tobacco. 
C)  Nicotine replacement can be used indefinitely. 
D)  Nicotine replacement therapy is generally safe for all patients. 
A)  Smoke less than 10 cigarettes a day when starting nicotine replacement. 
B)  Nicotine replacement will help with the withdrawal cravings associated with quitting tobacco. 
C)  Nicotine replacement can be used indefinitely. 
D)  Nicotine replacement therapy is generally safe for all patients.

Question 9

Varenicline (Chantix) may be prescribed for tobacco cessation. Instructions to the patient who is starting varenicline include:

Accepted Answer

A)  The maximum time varenicline can be used is 12 weeks. 
B)  Nausea is a sign of varenicline toxicity and should be reported to the provider. 
C)  The starting regimen for varenicline is start taking 1 mg twice a day a week before the quit date. 
D)  Neuropsychiatric symptoms may occur. 
A)  The maximum time varenicline can be used is 12 weeks. 
B)  Nausea is a sign of varenicline toxicity and should be reported to the provider. 
C)  The starting regimen for varenicline is start taking 1 mg twice a day a week before the quit date. 
D)  Neuropsychiatric symptoms may occur.

Question 10

When a patient is prescribed nicotine nasal spray for tobacco cessation, instructions include:

Accepted Answer

A)  Inhale deeply with each dose to ensure deposition in the lungs. 
B)  The dose is one to two sprays in each nostril per hour, not to exceed 40 sprays per day. 
C)  If they have a sensation of "head rush" this indicates the medication is working well. 
D)  Nicotine spray may be used for up to 12 continuous months. 
A)  Inhale deeply with each dose to ensure deposition in the lungs. 
B)  The dose is one to two sprays in each nostril per hour, not to exceed 40 sprays per day. 
C)  If they have a sensation of "head rush" this indicates the medication is working well. 
D)  Nicotine spray may be used for up to 12 continuous months.

Question 11

The most appropriate smoking cessation prescription for pregnant women is:

Accepted Answer

A)  A nicotine replacement patch at the lowest dose available 
B)  Bupropion (Zyban) 
C)  Varenicline (Chantix) 
D)  Nonpharmacologic measures 
A)  A nicotine replacement patch at the lowest dose available 
B)  Bupropion (Zyban) 
C)  Varenicline (Chantix) 
D)  Nonpharmacologic measures

Question 12

Nicotine withdrawal symptoms include:

Accepted Answer

A)  Nervousness 
B)  Increased appetite 
C)  Difficulty concentrating 
D)  All of the above 
A)  Nervousness 
B)  Increased appetite 
C)  Difficulty concentrating 
D)  All of the above

Question 13

The most common adverse effect of the transdermal nicotine replacement patch is:

Accepted Answer

A)  Nicotine toxicity 
B)  Tingling at the site of patch application 
C)  Skin irritation under the patch site 
D)  Life-threatening dysrhythmias 
A)  Nicotine toxicity 
B)  Tingling at the site of patch application 
C)  Skin irritation under the patch site 
D)  Life-threatening dysrhythmias

Exam 43: Smoking Cessation

If a patient wants to quit smoking, nicotine replacement therapy is recommended if the patient:

Transdermal nicotine replacement (the patch) is an effective choice in tobacco cessation because:

If prescribing bupropion (Zyban) for tobacco cessation, the instructions to the patient include:

If a patient is exhibiting signs of nicotine toxicity when using transdermal nicotine, they should remove the patch and:

Patients who choose the nicotine lozenge to assist in quitting tobacco should be instructed:

Nicotine replacement therapy should not be used in which patients?

Instructions for the use of nicotine gum include:

Instructions for a patient who is starting nicotine replacement therapy include:

Varenicline (Chantix) may be prescribed for tobacco cessation. Instructions to the patient who is starting varenicline include:

When a patient is prescribed nicotine nasal spray for tobacco cessation, instructions include:

The most appropriate smoking cessation prescription for pregnant women is:

Nicotine withdrawal symptoms include:

The most common adverse effect of the transdermal nicotine replacement patch is:

The Role of the Nurse Practitioner

Review of Basic Principles of Pharmacology

Rational Drug Selection

Legal and Professional Issues in Prescribing

Adverse Drug Reactions

Factors That Foster Positive Outcomes

Cultural and Ethnic Influences in Pharmacotherapeutics

An Introduction to Pharmacogenomics

Nutrition and Nutraceuticals

Herbal Therapy and Nutritional Supplements

Information Technology and Pharmacotherapeutics

Pharmacoeconomics

Over-The-Counter Medications

Drugs Affecting the Autonomic Nervous System

Drugs Affecting the Central Nervous System

Drugs Affecting the Cardiovascular and Renal Systems

Drugs Affecting the Respiratory System

Drugs Affecting the Hematopoietic System

Drugs Affecting the Immune System

Drugs Affecting the Gastrointestinal System

Drugs Affecting the Endocrine System

Drugs Affecting the Reproductive System

Drugs Affecting the Integumentary System

Drugs Used in Treating Infectious Diseases

Drugs Used in Treating Inflammatory Processes

Drugs Used in Treating Eye and Ear Disorders

Anemia

Chronic Stable Angina and Low-Risk Unstable Angina

Anxiety and Depression

Asthma and Chronic Obstructive Pulmonary Disease

Contraception

Dermatologic Conditions

Diabetes Mellitus

Gastroesophageal Reflux and Peptic Ulcer Disease

Headaches

Heart Failure

Human Immunodeficiency Virus Disease and Acquired Immunodeficiency Syndrome

Hormone Replacement Therapy and Osteoporosis

Hyperlipidemia

Hypertension

Hyperthyroidism and Hypothyroidism

Pneumonia

Sexually Transmitted Infections and Vaginitis

Tuberculosis

Upper Respiratory Infections, Otitis Media, and Otitis Externa

Urinary Tract Infections

Women As Patients

Men As Patients

Children As Patients

Geriatric Patients

Pain Management: Acute and Chronic Pain

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