Question 1

Patients with allergic rhinitis may benefit from a prescription of:

Accepted Answer

A)  Fluticasone (Flonase) 
B)  Cetirizine (Zyrtec) 
C)  OTC cromolyn nasal spray (Nasalcrom) 
D)  Any of the above 
A)  Fluticasone (Flonase) 
B)  Cetirizine (Zyrtec) 
C)  OTC cromolyn nasal spray (Nasalcrom) 
D)  Any of the above D

Question 2

First-generation antihistamines such as loratadine (Claritin) are prescribed for seasonal allergies because they are:

Accepted Answer

A)  More effective than first-generation antihistamines 
B)  Less sedating than the first-generation antihistamines 
C)  Prescription products, therefore are covered by insurance 
D)  Able to be taken with central nervous system (CNS) sedatives, such as alcohol 
A)  More effective than first-generation antihistamines 
B)  Less sedating than the first-generation antihistamines 
C)  Prescription products, therefore are covered by insurance 
D)  Able to be taken with central nervous system (CNS) sedatives, such as alcohol B

Question 3

Tiotropium bromide (Spiriva) is an inhaled anticholinergic:

Accepted Answer

A)  Used for the treatment of chronic obstructive pulmonary disease (COP
D)  
B)  Used in the treatment of asthma 
C)  Combined with albuterol for treatment of asthma exacerbations 
D)  Combined with fluticasone for the treatment of persistent asthma 
A)  Used for the treatment of chronic obstructive pulmonary disease (COP
D)  
B)  Used in the treatment of asthma 
C)  Combined with albuterol for treatment of asthma exacerbations 
D)  Combined with fluticasone for the treatment of persistent asthma A

Question 4

James is a 52-year-old overweight smoker taking theophylline for his persistent asthma. He tells his provider he is going to start the Atkin's diet for weight loss. The appropriate response would be:

Accepted Answer

A)  Congratulate him on making a positive change in his life. 
B)  Recommend he try stopping smoking instead of the Atkin's diet. 
C)  Schedule him for regular testing of serum theophylline levels during his diet due to increased excretion of theophylline. 
D)  Decrease his theophylline dose because a high-protein diet may lead to elevated theophylline levels. 
A)  Congratulate him on making a positive change in his life. 
B)  Recommend he try stopping smoking instead of the Atkin's diet. 
C)  Schedule him for regular testing of serum theophylline levels during his diet due to increased excretion of theophylline. 
D)  Decrease his theophylline dose because a high-protein diet may lead to elevated theophylline levels.

Question 5

The known drug interactions with the inhaled corticosteroid beclomethasone (QVAR) include:

Accepted Answer

A)  Albuterol 
B)  MMR vaccine 
C)  Insulin 
D)  None of the above 
A)  Albuterol 
B)  MMR vaccine 
C)  Insulin 
D)  None of the above

Question 6

Montelukast (Singulair) may be prescribed for:

Accepted Answer

A)  A 6-year-old child with exercise-induced asthma 
B)  A 2-year-old child with moderate persistent asthma 
C)  An 18-month-old child with seasonal allergic rhinitis 
D)  None of the above; montelukast is not approved for use in children 
A)  A 6-year-old child with exercise-induced asthma 
B)  A 2-year-old child with moderate persistent asthma 
C)  An 18-month-old child with seasonal allergic rhinitis 
D)  None of the above; montelukast is not approved for use in children

Question 7

Long-acting beta-agonists (LTBAs) received a Black Box Warning from the U.S. Food and Drug Administration due to the:

Accepted Answer

A)  Risk of life-threatening dermatological reactions 
B)  Increased incidence of cardiac events when LTBAs are used 
C)  Increased risk of asthma-related deaths when LTBAs are used 
D)  Risk for life-threatening alterations in electrolytes 
A)  Risk of life-threatening dermatological reactions 
B)  Increased incidence of cardiac events when LTBAs are used 
C)  Increased risk of asthma-related deaths when LTBAs are used 
D)  Risk for life-threatening alterations in electrolytes

Question 8

The first-line treatment for cough related to an upper respiratory tract infection (URI) in a 5-year-old child is:

Accepted Answer

A)  Fluids and symptomatic care 
B)  Dextromethorphan and guaifenesin syrup (Robitussin DM for Kids) 
C)  Guaifenesin and codeine syrup (Tussin A
C)  
D)  Chlorpheniramine and dextromethorphan syrup (Nyquil for Kids) 
A)  Fluids and symptomatic care 
B)  Dextromethorphan and guaifenesin syrup (Robitussin DM for Kids) 
C)  Guaifenesin and codeine syrup (Tussin A
C)  
D)  Chlorpheniramine and dextromethorphan syrup (Nyquil for Kids)

Question 9

When recommending dimenhydrinate (Dramamine) to treat motion sickness, patients should be instructed to:

Accepted Answer

A)  Take the dimenhydrinate after they get nauseated 
B)  Drink lots of water while taking the dimenhydrinate 
C)  Take the dimenhydrinate 15 minutes before it is needed 
D)  Double the dose if one tablet is not effective 
A)  Take the dimenhydrinate after they get nauseated 
B)  Drink lots of water while taking the dimenhydrinate 
C)  Take the dimenhydrinate 15 minutes before it is needed 
D)  Double the dose if one tablet is not effective

Question 10

Cough and cold medications that contain a sympathomimetic decongestant such as phenylephrine should be used cautiously in what population:

Accepted Answer

A)  Older adults 
B)  Hypertensive patients 
C)  Infants 
D)  All of the above 
A)  Older adults 
B)  Hypertensive patients 
C)  Infants 
D)  All of the above

Question 11

The bronchodilator of choice for patients taking propranolol is:

Accepted Answer

A)  Albuterol 
B)  Pirbuterol 
C)  Formoterol 
D)  Ipratropium 
A)  Albuterol 
B)  Pirbuterol 
C)  Formoterol 
D)  Ipratropium

Question 12

Harold, a 42-year-old African American, has moderate persistent asthma. Which of the following asthma medications should be used cautiously, if at all?

Accepted Answer

A)  Betamethasone, an inhaled corticosteroid 
B)  Salmeterol, an inhaled long-acting beta-agonist 
C)  Albuterol, a short-acting beta-agonist 
D)  Montelukast, a leukotriene modifier 
A)  Betamethasone, an inhaled corticosteroid 
B)  Salmeterol, an inhaled long-acting beta-agonist 
C)  Albuterol, a short-acting beta-agonist 
D)  Montelukast, a leukotriene modifier

Question 13

Digoxin levels need to be monitored closely when the following medication is started:

Accepted Answer

A)  Loratadine 
B)  Diphenhydramine 
C)  Ipratropium 
D)  Albuterol 
A)  Loratadine 
B)  Diphenhydramine 
C)  Ipratropium 
D)  Albuterol

Question 14

When prescribing montelukast (Singulair) for asthma, patients or parents of patients should be instructed:

Accepted Answer

A)  Montelukast twice a day is started when there is an asthma exacerbation. 
B)  Patients may experience weight gain on montelukast. 
C)  Aggression, anxiety, depression, and/or suicidal thoughts may occur when taking montelukast. 
D)  Lethargy and hypersomnia may occur when taking montelukast. 
A)  Montelukast twice a day is started when there is an asthma exacerbation. 
B)  Patients may experience weight gain on montelukast. 
C)  Aggression, anxiety, depression, and/or suicidal thoughts may occur when taking montelukast. 
D)  Lethargy and hypersomnia may occur when taking montelukast.

Question 15

Howard is a 72-year-old male who occasionally takes diphenhydramine for his seasonal allergies. Monitoring for this patient taking diphenhydramine would include assessing for:

Accepted Answer

A)  Urinary retention 
B)  Cardiac output 
C)  Peripheral edema 
D)  Skin rash 
A)  Urinary retention 
B)  Cardiac output 
C)  Peripheral edema 
D)  Skin rash

Question 16

Li takes theophylline for his persistent asthma and calls the office with a complaint of nausea, vomiting, and headache. The best advice for him would be to:

Accepted Answer

A)  Reassure him this is probably a viral infection and should be better soon 
B)  Have him seen the same day for an assessment and theophylline level 
C)  Schedule him for an appointment in 2 to 3 days, which he can cancel if he is better 
D)  Order a theophylline level at the laboratory for him 
A)  Reassure him this is probably a viral infection and should be better soon 
B)  Have him seen the same day for an assessment and theophylline level 
C)  Schedule him for an appointment in 2 to 3 days, which he can cancel if he is better 
D)  Order a theophylline level at the laboratory for him

Question 17

Decongestants such as pseudoephedrine (Sudafed):

Accepted Answer

A)  Are Schedule III drugs in all states 
B)  Should not be prescribed or recommended for children under 4 years of age 
C)  Are effective in treating the congestion children experience with the common cold 
D)  May cause drowsiness in patients of all ages 
A)  Are Schedule III drugs in all states 
B)  Should not be prescribed or recommended for children under 4 years of age 
C)  Are effective in treating the congestion children experience with the common cold 
D)  May cause drowsiness in patients of all ages

Question 18

When educating patients who are starting on inhaled corticosteroids, the provider should tell them that:

Accepted Answer

A)  They need to get any live vaccines before starting the medication. 
B)  Inhaled corticosteroids need to be used daily during asthma exacerbations to be effective. 
C)  Patients should rinse their mouths out after using the inhaled corticosteroid to prevent thrush. 
D)  They can triple the dose number of inhalations of medication during colds to prevent needing systemic steroids. 
A)  They need to get any live vaccines before starting the medication. 
B)  Inhaled corticosteroids need to be used daily during asthma exacerbations to be effective. 
C)  Patients should rinse their mouths out after using the inhaled corticosteroid to prevent thrush. 
D)  They can triple the dose number of inhalations of medication during colds to prevent needing systemic steroids.

Question 19

Christy has exercise-induced and mild persistent asthma and is prescribed two puffs of albuterol 15 minutes before exercise and as needed for wheezing. One puff per day of beclomethasone (QVAR) is also prescribed. Teaching regarding her inhalers includes:

Accepted Answer

A)  Use one to two puffs of albuterol per day to prevent an attack with no more than eight puffs per day 
B)  Beclomethasone needs to be used every day to treat her asthma 
C)  Report any systemic side effects she is experiencing, such as weight gain 
D)  Use the albuterol metered-dose inhaler (MDI) immediately after her corticosteroid MDI to facilitate bronchodilation 
A)  Use one to two puffs of albuterol per day to prevent an attack with no more than eight puffs per day 
B)  Beclomethasone needs to be used every day to treat her asthma 
C)  Report any systemic side effects she is experiencing, such as weight gain 
D)  Use the albuterol metered-dose inhaler (MDI) immediately after her corticosteroid MDI to facilitate bronchodilation

Question 20

Martin is a 60-year-old patient with hypertension. The first-line decongestant to prescribe would be:

Accepted Answer

A)  Oral pseudoephedrine 
B)  Oral phenylephrine 
C)  Nasal oxymetazoline 
D)  Nasal azelastine 
A)  Oral pseudoephedrine 
B)  Oral phenylephrine 
C)  Nasal oxymetazoline 
D)  Nasal azelastine

Exam 17: Drugs Affecting the Respiratory System

Patients with allergic rhinitis may benefit from a prescription of:

First-generation antihistamines such as loratadine (Claritin) are prescribed for seasonal allergies because they are:

Tiotropium bromide (Spiriva) is an inhaled anticholinergic:

James is a 52-year-old overweight smoker taking theophylline for his persistent asthma. He tells his provider he is going to start the Atkin's diet for weight loss. The appropriate response would be:

The known drug interactions with the inhaled corticosteroid beclomethasone (QVAR) include:

Montelukast (Singulair) may be prescribed for:

Long-acting beta-agonists (LTBAs) received a Black Box Warning from the U.S. Food and Drug Administration due to the:

The first-line treatment for cough related to an upper respiratory tract infection (URI) in a 5-year-old child is:

When recommending dimenhydrinate (Dramamine) to treat motion sickness, patients should be instructed to:

Cough and cold medications that contain a sympathomimetic decongestant such as phenylephrine should be used cautiously in what population:

The bronchodilator of choice for patients taking propranolol is:

Harold, a 42-year-old African American, has moderate persistent asthma. Which of the following asthma medications should be used cautiously, if at all?

Digoxin levels need to be monitored closely when the following medication is started:

When prescribing montelukast (Singulair) for asthma, patients or parents of patients should be instructed:

Howard is a 72-year-old male who occasionally takes diphenhydramine for his seasonal allergies. Monitoring for this patient taking diphenhydramine would include assessing for:

Li takes theophylline for his persistent asthma and calls the office with a complaint of nausea, vomiting, and headache. The best advice for him would be to:

Decongestants such as pseudoephedrine (Sudafed):

When educating patients who are starting on inhaled corticosteroids, the provider should tell them that:

Christy has exercise-induced and mild persistent asthma and is prescribed two puffs of albuterol 15 minutes before exercise and as needed for wheezing. One puff per day of beclomethasone (QVAR) is also prescribed. Teaching regarding her inhalers includes:

Martin is a 60-year-old patient with hypertension. The first-line decongestant to prescribe would be:

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 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

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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