Question 1

When writing a prescription of permethrin 5% cream (Elimite) for scabies, patient education would include:

Accepted Answer

A)  All members of the household and personal contacts should also be treated. 
B)  Infants should have permethrin applied from the neck down. 
C)  The permethrin is washed off after 10 to 20 minutes. 
D)  Permethrin is flammable and to avoid open flame while the medication is applied. 
A)  All members of the household and personal contacts should also be treated. 
B)  Infants should have permethrin applied from the neck down. 
C)  The permethrin is washed off after 10 to 20 minutes. 
D)  Permethrin is flammable and to avoid open flame while the medication is applied. A

Question 2

Patients who are treated with greater than 100 grams per week of topical calcipotriene for psoriasis need to be monitored for:

Accepted Answer

A)  High vitamin D levels 
B)  Hyperkalemia 
C)  Hypercalcemia 
D)  Hyperuricemia 
A)  High vitamin D levels 
B)  Hyperkalemia 
C)  Hypercalcemia 
D)  Hyperuricemia C

Question 3

When Sam used clotrimazole (Lotrimin AF) for athlete's foot he developed a red, itchy rash consistent with a hypersensitivity reaction. He now has athlete's foot again. What would be a good choice of antifungal for Sam?

Accepted Answer

A)  Miconazole (Micatin) powder 
B)  Ketoconazole (Nizoral) cream 
C)  Terbinafine (Lamisil) cream 
D)  Griseofulvin (Grifulvin V) suspension 
A)  Miconazole (Micatin) powder 
B)  Ketoconazole (Nizoral) cream 
C)  Terbinafine (Lamisil) cream 
D)  Griseofulvin (Grifulvin V) suspension C

Question 4

Instructions for the use of selenium sulfide shampoo (Selsun) to treat scalp seborrhea include:

Accepted Answer

A)  Shampoo daily and rinse well. 
B)  Worsening of seborrhea for the first week is normal. 
C)  Seborrhea usually clears up after a few weeks of treatment. 
D)  Shampoo twice a week for 2 weeks, then weekly. 
A)  Shampoo daily and rinse well. 
B)  Worsening of seborrhea for the first week is normal. 
C)  Seborrhea usually clears up after a few weeks of treatment. 
D)  Shampoo twice a week for 2 weeks, then weekly.

Question 5

When prescribing griseofulvin (Grifulvin V) to treat tinea capitis it is critical to instruct the patient or parent to:

Accepted Answer

A)  Mix the griseofulvin with ice cream before administering 
B)  Take the griseofulvin until the tinea clears, in approximately 4 to 5 weeks 
C)  Shampoo with baby shampoo daily while taking the griseofulvin 
D)  Griseofulvin is best absorbed if ingested with a high-fat food. 
A)  Mix the griseofulvin with ice cream before administering 
B)  Take the griseofulvin until the tinea clears, in approximately 4 to 5 weeks 
C)  Shampoo with baby shampoo daily while taking the griseofulvin 
D)  Griseofulvin is best absorbed if ingested with a high-fat food.

Question 6

Drew is a 17-year-old competitive runner who presents with complaint of pain in his hip that occurred after he fell while running. His only medical problem is severe acne for which he takes isotretinoin (Accutane). With this history what would you be concerned for?

Accepted Answer

A)  He may have pulled a muscle and needs to rest to recover. 
B)  He is at risk for bone injuries and needs to be evaluated for fracture. 
C)  Isotretinoin interacts with ibuprofen which is the pain medication of choice. 
D)  Teen athletes are at risk for repetitive stress injuries. 
A)  He may have pulled a muscle and needs to rest to recover. 
B)  He is at risk for bone injuries and needs to be evaluated for fracture. 
C)  Isotretinoin interacts with ibuprofen which is the pain medication of choice. 
D)  Teen athletes are at risk for repetitive stress injuries.

Question 7

Topical diphenhydramine (Benadryl) is available OTC to treat itching. Patients or parents should be instructed regarding the use of topical diphenhydramine that:

Accepted Answer

A)  For maximum effectiveness in treating itching, combine topical with oral diphenhydramine. 
B)  Topical diphenhydramine is the treatment of choice in treating poison ivy or poison oak. 
C)  Topical diphenhydramine should not be used in children younger than age 2 years. 
D)  When applying topical diphenhydramine, apply the cream liberally to all areas that itch. 
A)  For maximum effectiveness in treating itching, combine topical with oral diphenhydramine. 
B)  Topical diphenhydramine is the treatment of choice in treating poison ivy or poison oak. 
C)  Topical diphenhydramine should not be used in children younger than age 2 years. 
D)  When applying topical diphenhydramine, apply the cream liberally to all areas that itch.

Question 8

Juakeem is a nasal methicillin resistant staphylococcus aureus (MRSA) carrier. Treatment to eradicate nasal MRSA is mupirocin. Patient education regarding treating nasal MRSA includes:

Accepted Answer

A)  Take the oral medication exactly as prescribed. 
B)  Insert one-half of the dose in each nostril twice a day. 
C)  Alternate treating one nare in the morning and the other in the evening. 
D)  Nasal MRSA eradication requires at least 4 weeks of therapy, with up to 8 weeks needed in some patients. 
A)  Take the oral medication exactly as prescribed. 
B)  Insert one-half of the dose in each nostril twice a day. 
C)  Alternate treating one nare in the morning and the other in the evening. 
D)  Nasal MRSA eradication requires at least 4 weeks of therapy, with up to 8 weeks needed in some patients.

Question 9

Catherine calls the clinic with concerns that her acne is worse 1 week after starting topical tretinoin. What would be the appropriate care for her?

Accepted Answer

A)  Change her to a different topical acne medication as she is having an adverse reaction to the tretinoin. 
B)  Switch her to an oral antibiotic to treat her acne. 
C)  Advise her to apply an oil-based lotion to her face to soothe the redness. 
D)  Reassure her that the worsening of acne is normal and it should improve with continued use. 
A)  Change her to a different topical acne medication as she is having an adverse reaction to the tretinoin. 
B)  Switch her to an oral antibiotic to treat her acne. 
C)  Advise her to apply an oil-based lotion to her face to soothe the redness. 
D)  Reassure her that the worsening of acne is normal and it should improve with continued use.

Question 10

Jose has had eczema for many years and reports that he thinks his corticosteroid cream is not working as well as it was previously. He may be experiencing tolerance to the corticosteroid. Treatment options include:

Accepted Answer

A)  Increase the potency of the corticosteroid cream. 
B)  Recommend an interrupted or cyclic schedule of application. 
C)  Increase the frequency of dosing of the corticosteroid. 
D)  Discontinue the corticosteroid because it isn't working any longer . 
A)  Increase the potency of the corticosteroid cream. 
B)  Recommend an interrupted or cyclic schedule of application. 
C)  Increase the frequency of dosing of the corticosteroid. 
D)  Discontinue the corticosteroid because it isn't working any longer .

Question 11

Erika has been prescribed isotretinoin (Accutane) by her dermatologist and is presenting to her primary care provider with symptoms of sadness and depression. A Beck's Depression Scale indicates she has mild to moderate depression. What would be the best care for her at this point?

Accepted Answer

A)  Prescribe a select serotonin reuptake inhibitor (SSRI) antidepressant 
B)  Refer her to a mental health therapist 
C)  Contact her dermatologist about discontinuing the isotretinoin 
D)  Reassure her that mood swings are normal and schedule follow up in a week 
A)  Prescribe a select serotonin reuptake inhibitor (SSRI) antidepressant 
B)  Refer her to a mental health therapist 
C)  Contact her dermatologist about discontinuing the isotretinoin 
D)  Reassure her that mood swings are normal and schedule follow up in a week

Question 12

When prescribing tacrolimus (Protopic) to treat atopic dermatitis patients should be informed that:

Accepted Answer

A)  Tacrolimus is the most effective if it is used continuously for 4 to 6 months. 
B)  Tacrolimus should be spread generously over the affected area. 
C)  The FDA has issued a Black Box warning about the use of tacrolimus and the development of cancer in animals and humans. 
D)  The FDA recommends patients be screened for cancer before prescribing tacrolimus. 
A)  Tacrolimus is the most effective if it is used continuously for 4 to 6 months. 
B)  Tacrolimus should be spread generously over the affected area. 
C)  The FDA has issued a Black Box warning about the use of tacrolimus and the development of cancer in animals and humans. 
D)  The FDA recommends patients be screened for cancer before prescribing tacrolimus.

Question 13

First-line therapy for treating topical fungal infections such as tinea corporis (ringworm) or tinea pedis (athlete's foot) would be:

Accepted Answer

A)  OTC topical azole (clotrimazole, miconazole) 
B)  Oral terbinafine 
C)  Oral griseofulvin microsize 
D)  Nystatin cream or ointment 
A)  OTC topical azole (clotrimazole, miconazole) 
B)  Oral terbinafine 
C)  Oral griseofulvin microsize 
D)  Nystatin cream or ointment

Question 14

A patient has been prescribed silver sulfadiazine (Silvadene) cream to treat burns on his leg. Normal adverse effects of silver sulfadiazine cream include:

Accepted Answer

A)  Transient leukopenia on days 2 to 4 that should resolve 
B)  Worsening of burn symptoms briefly before resolution 
C)  A red, scaly rash that will resolve with continued use 
D)  Hypercalcemia 
A)  Transient leukopenia on days 2 to 4 that should resolve 
B)  Worsening of burn symptoms briefly before resolution 
C)  A red, scaly rash that will resolve with continued use 
D)  Hypercalcemia

Question 15

Instructions for applying a topical antibiotic or antiviral ointment include:

Accepted Answer

A)  Apply thickly to the infected area, spreading the medication well past the borders of the infection. 
B)  If the rash worsens, apply a thicker layer of medication to settle down the infection. 
C)  Wash hands before and after application of topical antimicrobials. 
D)  None of the above 
A)  Apply thickly to the infected area, spreading the medication well past the borders of the infection. 
B)  If the rash worsens, apply a thicker layer of medication to settle down the infection. 
C)  Wash hands before and after application of topical antimicrobials. 
D)  None of the above

Question 16

Jesse is prescribed tazarotene for his psoriasis. Patient education regarding topical tazarotene includes instructing them:

Accepted Answer

A)  That tazarotene is applied in a thin film to the psoriasis plaque lesions 
B)  To apply it liberally to all psoriatic lesions 
C)  To apply tazarotene to nonaffected areas to prevent breakout 
D)  That tazarotene may cause hypercalcemia if it is overused 
A)  That tazarotene is applied in a thin film to the psoriasis plaque lesions 
B)  To apply it liberally to all psoriatic lesions 
C)  To apply tazarotene to nonaffected areas to prevent breakout 
D)  That tazarotene may cause hypercalcemia if it is overused

Question 17

Instructions for the use of malathion (Ovide) for head lice include:

Accepted Answer

A)  Use a blow dryer to dry the hair after applying. 
B)  Malathion (Ovide) is used daily for a week until all lice are dead. 
C)  Rinse the malathion (Ovide) off and shampoo hair after 8 to 12 hours. 
D)  Use gloves to apply the malathion (Ovide). 
A)  Use a blow dryer to dry the hair after applying. 
B)  Malathion (Ovide) is used daily for a week until all lice are dead. 
C)  Rinse the malathion (Ovide) off and shampoo hair after 8 to 12 hours. 
D)  Use gloves to apply the malathion (Ovide).

Question 18

Erik presents with one golden-crusted lesion at the site of an insect bite consistent with impetigo. His parents have limited finances and request the least expensive-treatment. Which medication would be the best choice for treatment?

Accepted Answer

A)  Mupirocin (Bactroban) 
B)  Bacitracin and polymixin B (generic double antibiotic ointment) 
C)  Retapamulin (Altabax) 
D)  Oral cephalexin (Keflex) 
A)  Mupirocin (Bactroban) 
B)  Bacitracin and polymixin B (generic double antibiotic ointment) 
C)  Retapamulin (Altabax) 
D)  Oral cephalexin (Keflex)

Question 19

Li is a 6-month-old infant with severe eczema. She would benefit from topical corticosteroid therapy. Instructions for using topical corticosteroids in children include:

Accepted Answer

A)  Apply liberally to all areas with eczema. 
B)  Double the frequency of application when the eczema is severe. 
C)  Apply sparingly to eczema areas. 
D)  Cover the eczema area with an occlusive dressing after applying a corticosteroid. 
A)  Apply liberally to all areas with eczema. 
B)  Double the frequency of application when the eczema is severe. 
C)  Apply sparingly to eczema areas. 
D)  Cover the eczema area with an occlusive dressing after applying a corticosteroid.

Question 20

When prescribing topical penciclovir (Denavir) for the treatment of herpes labialis (cold sores) patient education would include:

Accepted Answer

A)  Spread penciclovir liberally all over lips and area surrounding lips. 
B)  Penciclovir therapy is started at the first sign of a cold sore outbreak. 
C)  Skin irritation is normal with penciclovir and it should resolve. 
D)  The penciclovir should be used a minimum of 2 weeks to prevent recurrence. 
A)  Spread penciclovir liberally all over lips and area surrounding lips. 
B)  Penciclovir therapy is started at the first sign of a cold sore outbreak. 
C)  Skin irritation is normal with penciclovir and it should resolve. 
D)  The penciclovir should be used a minimum of 2 weeks to prevent recurrence.

Exam 23: Drugs Affecting the Integumentary System

When writing a prescription of permethrin 5% cream (Elimite) for scabies, patient education would include:

Patients who are treated with greater than 100 grams per week of topical calcipotriene for psoriasis need to be monitored for:

When Sam used clotrimazole (Lotrimin AF) for athlete's foot he developed a red, itchy rash consistent with a hypersensitivity reaction. He now has athlete's foot again. What would be a good choice of antifungal for Sam?

Instructions for the use of selenium sulfide shampoo (Selsun) to treat scalp seborrhea include:

When prescribing griseofulvin (Grifulvin V) to treat tinea capitis it is critical to instruct the patient or parent to:

Drew is a 17-year-old competitive runner who presents with complaint of pain in his hip that occurred after he fell while running. His only medical problem is severe acne for which he takes isotretinoin (Accutane). With this history what would you be concerned for?

Topical diphenhydramine (Benadryl) is available OTC to treat itching. Patients or parents should be instructed regarding the use of topical diphenhydramine that:

Juakeem is a nasal methicillin resistant staphylococcus aureus (MRSA) carrier. Treatment to eradicate nasal MRSA is mupirocin. Patient education regarding treating nasal MRSA includes:

Catherine calls the clinic with concerns that her acne is worse 1 week after starting topical tretinoin. What would be the appropriate care for her?

Jose has had eczema for many years and reports that he thinks his corticosteroid cream is not working as well as it was previously. He may be experiencing tolerance to the corticosteroid. Treatment options include:

Erika has been prescribed isotretinoin (Accutane) by her dermatologist and is presenting to her primary care provider with symptoms of sadness and depression. A Beck's Depression Scale indicates she has mild to moderate depression. What would be the best care for her at this point?

When prescribing tacrolimus (Protopic) to treat atopic dermatitis patients should be informed that:

First-line therapy for treating topical fungal infections such as tinea corporis (ringworm) or tinea pedis (athlete's foot) would be:

A patient has been prescribed silver sulfadiazine (Silvadene) cream to treat burns on his leg. Normal adverse effects of silver sulfadiazine cream include:

Instructions for applying a topical antibiotic or antiviral ointment include:

Jesse is prescribed tazarotene for his psoriasis. Patient education regarding topical tazarotene includes instructing them:

Instructions for the use of malathion (Ovide) for head lice include:

Erik presents with one golden-crusted lesion at the site of an insect bite consistent with impetigo. His parents have limited finances and request the least expensive-treatment. Which medication would be the best choice for treatment?

Li is a 6-month-old infant with severe eczema. She would benefit from topical corticosteroid therapy. Instructions for using topical corticosteroids in children include:

When prescribing topical penciclovir (Denavir) for the treatment of herpes labialis (cold sores) patient education would include:

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 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

Smoking Cessation

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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