– Pharmacology 1. An 88-year-old male is

– Pharmacology 1. An 88-year-old male is being treated for complicated pyelonephritis with gentamicin IM daily. His daughter calls the office to report that he didn’t hear his alarm clock go off this morning and when his grandchildren called earlier in the day, he was annoyed and handed the phone to the home health aide because he couldn’t understand what they were saying. Based on this information, you are most concerned about which possible serious adverse effect of gentamicin? a. Dementia b. Hepatotoxicity c. Xerophthalmia d. Ototoxicity 2. FNPs are very familiar with precautions about tapering of steroid medications. Which of the following is a true statement about the actual need and/or process of doing so that the FNP understands? a. All dosing regimens, no matter the dose and duration of therapy, require tapering of doses. b. Patients who have had several steroid prescriptions in the past year are at risk of sustaining a poor outcome if the doses are not tapered. c. Dosing regimens lasting longer than 2 weeks require consideration of a tapering schedule d. Pulse does of steroid (3-day bursts) do not require tapering if they occur more than 6 months apart. 3. When prescribing oral medications for an overweight patient with type 2 diabetes who also has a voracious appetite, the FNP is likely to prescribe which medication to encourage weight loss and reduce appetite, as an adjunct to improved diet and exercise? a. Exenatide (Byetta) b. Pioglitazone (Actos) c. Metformin (Glucophage) d. Glyburide (Micronase) 4. Timing of taking thyroid medication has traditionally been in the morning on an empty stomach. If the patient insists on taking the thyroid medication with an evening meal, is this acceptable regimen? Which two responses are appropriate? a. No, the circadian rhythm cycles are best supported with a.m. dosing b. This is acceptable if there is a 2-to4-hour separation from an ingested full evening meal c. There is no difference between am and pm dosing guidelines d. This is a feasible option if there are no other medications taken at that time that would cause interactions or absorption issues. 5. Which of the following is most appropriate for the treatment of an acute episode of gout? a. Indomethacin (Indocin) 25 mg PO prn b. Naproxen (Naprosyn) 100 mg PO bid c. Colchicine 0.6 mg two tablets PO x 1, then repeat in 1 hour x 1 d. Indomethacin (Indocin) 50 mg q 8 hr x 6-8 doses, then 25 mg q8hr until resolution 6. Which product would be the safest choice for an 81-year-old patient with insomnia? a. Diphenhydramine (Benadryl) b. Doxepin (Silenor) c. Oxazepam (Serax) a. Ramelteon (Rozerem) 7. A 67-year-old patient presents with concerns of right-sided facial pain. She describes the pain as burning and sharp. The pain has not awakened her from sleep. She explains she has to “press on it” when it starts, and she tries not to talk or move her mouth because it worsens the pain. What is the management the FNPN will consider? a. Carbamazepine (Tegretol) b. Indomethacin (Indocin) c. Prednisone d. Valacyclovir (Valtrex) 8. What is a primary therapy for patients with mild ulcerative colitis? a. Metronidazole b. Mesalamine (Asacol) c. Ciprofloxacin (Cipro) d. Prednisone (Deltasone) 9. A recently hospitalized 74-year-old male was treated for Clostridium difficile (CD) with oral metronidazole, and symptoms resolved in 6 weeks ago. He is now in the office with a recurrent diarrhea. Enzyme immunoassay (EIA) test results are positive for CD toxin. What is the best course for the treatment? a. Oral metronidazole 250 mg 4x a day for 10 days b. Vancomycin 125 mg 4X a day for 10 days c. Oral metronidazole 250 mg 4X a day for 30 days d. Vancomycin 125 mg 2X a day for 2-8 weeks 10 The FNP determines that an adult male patient has an iron-deficiency anemia and has ruled out gastrointestinal (GI) bleeding as the cause. What is the management? a. Refer the patient to a hematologist b. Orders iron dextran 50 mg IM weekly for 4 weeks and schedules the patient for weekly office visits for the injection c. Prescribes ferrous sulfate 325 mg PO TID and schedules the patient to return in 1 month for a repeat CBC, serum iron, and total iron binding capacity (TIBC) d. Schedules the patient to return in 6 months for additional stool guaiac testing SCIENCE HEALTH SCIENCE NURSING NUR 726

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