RN exams pharmacology practice questions set 10

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The correct answer is D: Prescribe amoxicillin/clavulanate and refer the child to an otolaryngologist. Rationale: 1. Amoxicillin/clavulanate is a recommended first-line antibiotic for recurrent otitis media due to its broad spectrum coverage. 2. Referring the child to an otolaryngologist is necessary for further evaluation and management of recurrent ear infections, as this child has had multiple episodes in a year. Summary of other choices: A: Prescribing both high dose amoxicillin and the influenza vaccine is not the best option as the child already has recurrent ear infections and needs a more comprehensive approach. B: Beginning prophylactic antibiotic therapy with trimethoprim/sulfamethoxazole is not recommended as a first-line treatment for recurrent otitis media. C: Prescribing ceftriaxone IV with benzocaine ear drops is not the optimal choice for managing recurrent ear infections in a 2-year-old.

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The correct answer is C: Disease state being treated. This is because the written prescription should include essential information such as the drug name, strength, dosage form, quantity to be dispensed, directions for use, patient information, prescriber information, and date. The disease state being treated is not a required element as it is typically part of the diagnosis and treatment plan discussed between the healthcare provider and the patient, but not necessarily explicitly stated on the prescription. The other choices, A, B, and D, are required elements of a written prescription. Quantity of a drug to be dispensed ensures proper dosing, number of refills indicates how many times the prescription can be refilled, and route of administration specifies how the medication should be administered. These elements are crucial for the pharmacist to accurately dispense and the patient to safely use the medication.

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The correct answer is B: It inhibits hydroxymethyl lutaryl-coenzyme A (HMG-CoA) reductase to reduce the biosynthesis of cholesterol in the liver. Statin drugs work by blocking the enzyme HMG-CoA reductase, which is involved in the synthesis of cholesterol in the liver. By inhibiting this enzyme, statins reduce the production of cholesterol in the body. This mechanism helps lower the levels of LDL (bad) cholesterol in the blood. Incorrect choices: A: It inhibits the absorption of dietary cholesterol in the small intestine - This is incorrect because statins do not affect the absorption of dietary cholesterol but rather target cholesterol synthesis in the liver. C: It binds to bile in the intestinal track forming an insoluble complex that is excreted in the feces - This is incorrect as it describes the mechanism of bile acid sequestrants, not statins. D: It stimulates the biliary system to increase the excretion of

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The correct answer is B: Reduction of angiotensin-mediated vasoconstriction in the kidney. Captopril is an ACE inhibitor that works by blocking the conversion of angiotensin I to angiotensin II. In this patient with systolic heart failure, reducing angiotensin II levels will lead to vasodilation and decreased vasoconstriction in the kidney, improving renal blood flow and reducing fluid retention. This helps to alleviate symptoms of heart failure and improve overall cardiac function. Incorrect choices: A: Increased cardiac contractility - Captopril does not directly increase cardiac contractility. C: Reduction of preload and afterload - While ACE inhibitors can reduce preload and afterload, the primary mechanism of captopril is through the renin-angiotensin-aldosterone system. D: Stimulation of epinephrine release from adrenergic nerves - Captopril does not stimulate epinephrine release; it actually inhibits the

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The correct answer is B: A rich blood supply to the area of absorption leads to better absorption. A rich blood supply enhances drug absorption by allowing for faster diffusion of the drug into the bloodstream. This is because a greater blood flow increases the concentration gradient, facilitating quicker absorption. Explanation for why the other choices are incorrect: A: The statement that the smaller the surface area for absorption, the more rapidly the drug is absorbed is incorrect. Larger surface area typically leads to faster absorption due to increased contact with absorbing surfaces. C: The statement that the less soluble the drug, the more easily it is absorbed is incorrect. Solubility affects dissolution, not absorption. D: The statement that ionized drugs are easily absorbed across the cell membrane is incorrect. Ionized drugs have lower permeability across cell membranes compared to non-ionized drugs.

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When monitoring a patient on Clopidogrel therapy, it is important to monitor for signs of thrombotic thrombolytic purpura (TTP), bleeding during therapy, and changes in blood counts. Clopidogrel is an antiplatelet medication that works by preventing platelets from sticking together and forming clots. Monitoring for signs of TTP is necessary as clopidogrel has been associated with an increased risk of TTP in some patients. Additionally, monitoring for bleeding is crucial as clopidogrel, like other antiplatelet medications, can increase the risk of bleeding complications. Monitoring a complete blood count (CBC) with differential and platelet count allows healthcare providers to assess the patient's blood cell levels and ensure that the medication is not causing any adverse effects on blood counts. Therefore, monitoring all of the above parameters is essential to ensure the safety and efficacy of clopidogrel therapy.

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The correct answer is D: “I will receive parenteral vitamin B12 therapy for the rest of my life.” This statement is correct because pernicious anemia is a lifelong condition requiring ongoing vitamin B12 supplementation. Patients with pernicious anemia lack intrinsic factor, which is needed to absorb vitamin B12 from food. Therefore, they need lifelong B12 therapy to prevent complications such as anemia and neurological damage. Choices A, B, and C are incorrect because they suggest a limited duration of therapy. Pernicious anemia is a chronic condition that necessitates continuous treatment. Choice A implies therapy until signs and symptoms disappear, which may not address the underlying cause of the deficiency. Choice B mentions therapy until vitamin B12 levels normalize, which may not prevent recurrence. Choice C suggests monthly therapy for a fixed period, which may not be sufficient for lifelong management.

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The correct answer is B: Respect for persons. This principle is demonstrated by ensuring the patient's right to self-determination, which means respecting their autonomy and right to make decisions about their own healthcare. This principle is a fundamental aspect of research ethics, emphasizing the importance of treating individuals as autonomous agents. A: Beneficence focuses on doing good for the research subjects and maximizing benefits while minimizing harms, but it does not directly relate to self-determination. C: Justice involves fairness in the selection of research participants and distribution of benefits and burdens, but it is not directly related to self-determination. D: Informed consent is a process that includes providing information to participants to ensure they can make an informed decision about participating in research, which is related to but not the same as respecting self-determination.

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Beta1-selective adrenergic blocking agents have an advantage over the nonselective beta-blockers in some cases. Because they do not usually block beta2-receptor sites, they do not block the sympathetic bronchodilation that is so important for patients with lung diseases or allergic rhinitis. Consequently, these drugs are preferred for patients who smoke or who have asthma, any other obstructive pulmonary disease, or seasonal or allergic rhinitis. Nonselective adrenergic blocking agents block both alpha- and beta-adrenergic receptors exacerbating respiratory conditions by the loss of norepinephrine’s effect of bronchodilation. Nonselective alpha-adrenergic blocking agents are not used to treat angina. Alpha1-selective adrenergic blocking agents are not used to treat angina. The nurse should consider the patient’s medical history when selecting adrenergic blocking agents to ensure safe and effective treatment.

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Enteral (A) administration would provide the lowest serum drug concentration in this patient due to the challenges posed by his dysphagia and limited gag reflex, which impair swallowing and gastrointestinal absorption. Enteral routes (e.g., oral) rely on GI uptake, which can be erratic or reduced in such conditions, further complicated by xerostomia reducing dissolution. Intramuscular (B) and intravenous (D) routes deliver drugs directly into systemic circulation, yielding higher concentrations. Intrathecal (C) targets the CSF, not serum, but still achieves systemic levels. Transdermal (original E) offers steady absorption but higher serum levels than enteral in this context. Given his swallowing difficulties, enteral drugs face significant barriers (e.g., incomplete absorption, first-pass metabolism), making it the least effective for systemic delivery, critical in managing polypharmacy in Alzheimer's patients.