NUR641E Week 1 | Nursing in Health Care - Grand canyon university

40. What condition are you dealing with?

Respiratory alkalosis Metabolic acidosis Metabolic alkalosis Respiratory acidosis 45 In the absence of susceptibility data for an acute infection, the choice of an antimicrobial drug is mostly influenced by the site of infection and the patient's history. the sensitivity report and the colony count. the source of the infection and the color of exudate. the host defense mechanism and the immune response. 46 All of the

following can be a likely cause of respiratory acidosis except:

emphysema. pulmonary edema. barbiturate overdose. extreme fear and anxiety. 47 An increase of carbon dioxide in arterial blood causes chemoreceptors to stimulate the

respiratory centers to:

decrease respiratory rate. increase respiratory rate. develop hypocapnia. develop hypercapnia. 48 The leading cause of death from a curable infectious disease throughout the world is pneumonia. tuberculosis. HIV infection. influenza. 49 Which condition poses the highest risk for a cerebrovascular accident (CVA)? Insulin-resistant diabetes mellitus Hypertension Polycythemia Smoking 50 Pulmonary emboli do not cause which of the following? Obstruct blood supply to lung parenchyma Have origins from thrombi in the legs Occlude pulmonary vein branches Occlude pulmonary artery branches

NUR641E

Advanced Pathophysiology & Pharamacology for Nurse Educators Final Exam 1. Insulin is used to treat

hyperkalemia because it:

stimulates sodium to be removed from the cell in exchange for potassium. binds to potassium to remove it through the kidneys. transports potassium from the blood to the cell along with glucose. breaks down the chemical components of potassium, causing it to be no longer effective. 2 What is the central component of the pathogenic model of multiple sclerosis? Myelination of nerve fibers in the peripheral nervous system (PNS) Demyelination of nerve fibers in the CNS Development of neurofibrillary tangles in the CNS Inherited autosomal dominant trait with high penetrance s3Which of the following ICU sedatives should not be used for greater than 24 hours per the FDA-approved labeling? Midazolam (Versed) Diazepam (Valium) Dexmedetomidine (Precedex) Propofol (Diprivan) What type of necrosis is associated with wet gangrene? Coagulative Liquefactive Caseous Coagulative 5 In the absence of susceptibility data for an acute infection, the choice of an antimicrobial drug is mostly influenced by the site of infection and the patient's history. the sensitivity report and the colony count. the source of the infection and the color of exudate. the host defense mechanism and the immune response. 6 Which statement best describes cystic fibrosis? Obstructive airway disease characterized by reversible airflow obstruction, bronchial hyperreactivity, and inflammation. Respiratory disease characterized by severe hypoxemia, decreased pulmonary compliance, and diffuse densities on chest x-ray imaging. Pulmonary disorder involving an abnormal expression of a protein-producing viscous mucus that obstructs the airways, pancreas, sweat ducts, and vas deferens. Pulmonary disorder characterized by atelectasis and increased pulmonary resistance as a result of a surfactant deficiency. 7 What medical term is used to identify an inflammatory disorder of the skin that is often considered synonymous with dermatitis and characterized by pruritus with lesions that have an indistinct border? Eczema Psoriasis Atopic dermatitis Pityriasis rosea 8 Identify whether the description of the skin lesion matches the disorder where it is found. (Select True or False) Elevated, firm circumscribed area less than 1 cm in diameter: Wart (verruca) or lichen planus True False 9 Removal of part of the liver leads to the remaining liver cells undergoing compensatory atrophy. metaplasia. hyperplasia. dysplasia. 10 Identify whether the description matches the disorder. (Select True or False) Abnormal dilation of the vein within the spermatic cord – Varicocele True False 11 The risk of which cancer is greater if the man has a history of cryptorchidism? Penile Testicular Prostate Epididymal 12 Which substance is used to correct the chronic anemia associated with chronic renal failure? Iron Erythropoietin Cobalamin (vitamin B12) Folate

13 Diabetes insipidus is a result of:

antidiuretic hormone hyposecretion. antidiuretic hormone hypersecretion. insulin hyposecretion. insulin hypersecretion. 14 Obesity acts as an important risk factor

for type 2 diabetes mellitus by:

reducing the amount of insulin the pancreas produces. increasing the resistance to insulin by cells. obstructing the outflow of insulin from the pancreas. stimulating the liver to increase glucose production. 15 Which statement best describes Raynaud's disease? Inflammatory disorder of small- and medium-sized arteries in the feet and sometimes in the hands Neoplastic disorder of the lining of the arteries and veins of the upper extremities Vasospastic disorder of the small arteries and arterioles of the fingers and, less commonly, of the toes Autoimmune disorder of the large arteries and veins of the upper and lower extremities 16 What is the medical term for a fungal infection of the nail plate? Paronychia Onychomycosis Tinea corporis Tinea capitis 17 Which proton-pump inhibitor should be avoided in a patient taking clopidogrel? Omeprazole Lansoprazole Pantoprazole Rabeprazole 18 All of the following are important considerations when prescribing metronidazole except? Instruct patient to avoid alcohol intake during therapy Can lead to development of C. difficile infection Monitor INR closely due a DDI with warfarin Dose adjustments should be made in patients with renal or hepatic dysfunction 19 Which clinical manifestations of a urinary tract infection may be demonstrated in an 85-year-old individual? Confusion and poorly localized abdominal discomfort Dysuria, frequency, and suprapubic pain Hematuria and flank pain Pyuria, urgency, and frequency 20 Which hormone is required for water to be reabsorbed in the distal tubule and collecting duct? Antidiuretic hormone Aldosterone Cortisol Adrenocorticotropin hormone 21 All of the following are true regarding

antiepileptics except:

Carbamazepine and phenytoin have numerous drug-drug interactions. They are safe to use during pregnancy. Therapeutic drug monitoring is often required to ensure therapeutic drug levels. Phenytoin is a highly protein-bound drug.

22 Alpha1 adrenergic stimulation causes:

bronchial constriction vascular constriction. constriction of intestinal smooth muscle. relaxation of intestinal smooth muscle. 23 Losartan (Cozaar) lowers the blood

pressure by:

blocking calcium channels in the heart and blood vessels. directly dilating arterioles without affecting veins. suppressing the release of angiotensin-converting enzyme. blocking angiotensin II at its receptors. 24 One major reason to discontinue

captopril (Capoten), an ACE inhibitor, is:

hypertension. hypokalemia. angioedema. angina. 25 Which of the following drugs works via antagonism of 5-HT (serotonin) receptors in the GI tract? Ondansetron Droperidol Prochlorperazine Aprepitant 26 After a person has a subtotal gastrectomy for chronic gastritis, which type of anemia will result? Iron deficiency Aplastic Folic acid Pernicious 27 Orthostatic hypotension refers to a decrease of at least ___ mmHg in systolic blood pressure or a decrease of at least _____ mmHg in diastolic blood pressure within 3 minutes of moving to a standing position. 10; 5 20; 10 30; 15 40; 20 28 Cell wall inhibitors include all of the following except penicillins. cephalosporins. carbapenems. tetracylclines. 29 Which of the following agents is considered a histamine receptor antagonist? Maalox Protonix Zantac Tums 30 Which of the following drugs is most likely to reduce the effectiveness of levofloxacin (Levaquin) when given concomitantly? Amiodarone (Cordarone) Metronidazole (Flagyl) Calcium carbonate (Tums) Warfarin (Coumadin) 31 Which stage of infection is occurring when the immune and inflammatory responses are triggered? Incubation period Prodromal stage Invasion period Convalescence 32 Which of the following is an advantage of the intravenous route of administration? Reduced bioavailability Avoidance of first-pass metabolism Patient convenience None of the above are advantages 33 Which of the following antifungal agents is known to cause significant nephrotoxicity and ototoxicity? Caspofungin Fluconazole Amphotericin B Nystatin 34 Which NSAID is generally considered the safest for use in patients with coronary artery disease? Celecoxib Indomethacin Naproxen Acetaminophen

35 An example of a beta agonist is:

Atenolol (Tenormin) Clonidine (Catapres) Isoproterenol (Isuprel) Amlodipine (Norvasc) 36 Which of the following agents is a potent vasoconstrictor that can be used to manage acute GI bleeding? Octreotide Milrinone Pantoprazole Cimetidine 37 What type of fracture occurs at a site of a preexisting bone abnormality and is a result of a force that would not normally cause a fracture? Idiopathic Incomplete Pathologic Greenstick 38 A patient is diagnosed with pulmonary disease and elevated pulmonary vascular resistance. Which form of heart failure may result from pulmonary disease and elevated pulmonary vascular resistance? Right heart failure Left heart failure Low-output failure High-output failure 39 Your patient is taking carbamazepine, a CYP3A4 substrate, for his seizure disorder. He is experiencing signs of depression and decides to try St. John's wort, which he purchased over-the-counter at the local pharmacy. Since St. John's wort is a CYP3A4 inducer, which of the following may occur? The patient may have an increased risk for seizure. The patient may have an increased risk of carbamazepine-related toxicities. The patient may need an increased dose of St. John’s wort. No clinically-significant drug-drug interaction is likely to occur. 40 Advair (fluticasone/salmeterol) is a combination of which of the following? Short-acting beta agonist and corticosteroid Long-acting beta agonist and corticosteroid Long-acting beta agonist and antihistamine Short-acting beta agonist and antihistamine 41 Which of the following is true regarding adverse drug events? They include medication errors, adverse effects, allergic reactions, and idiosyncratic reactions. They are rarely preventable. They are infrequent in the inpatient setting. They are generally over-reported.

42 The function of arachnoid villi is to:

produce cerebrospinal fluid. provide nutrients to the choroid plexuses. transmit impulses within the meninges. absorb cerebrospinal fluid into the cerebral venous sinuses. 43 The calcium and phosphate balance is influenced by which three substances? Parathyroid hormone, ADH, and vitamin D Parathyroid hormone, calcitonin, and vitamin D Thyroid hormone, ADH, and vitamin D Thyroid hormone, calcitonin, and vitamin D 44 The major therapeutic actions of NSAIDS include all of the following except reduction of inflammation. reduction of pain. reduction of fever. reduction of clotting factors. 45 Which of the following agents is available in an injectable form used to treat acute migraine headaches? Sumatriptan (Imitrex)T7 Naldolol (Corgard) Naproxen sodium (Anaprox) Ergot preparations (Cafergot) 46 A patient presents with vomiting a coffee-ground looking substance; fatigue, postural hypotension; new onset systolic murmur; and cool, pale peripheries. metabolic acidosis with partial respiratory compensation. partial respiratory compensation. metabolic acidosis. acidosis. 47 Which statements are true regarding Koplik spots? (Select all that apply.) Koplik spots are associated with rubeola. They appear as white spots. The lesions are surrounded by a red ring. The lesions of Koplik spots are large in size. Koplik spots are primarily found on buccal mucosa. 48 Which of the following medications is most likely to increase fall risk in the elderly? Diazepam (Valium) Cetirizine (Zyrtec) Levofloxacin (Levaquin) Lisinopril (Prinivil) 49 People with gout are at high risk for which comorbid condition? Renal calculi Joint trauma Anemia Hearing loss 50 The spread of microorganisms from mother to the baby across the placenta is termed direct transmission. vertical transmission. horizontal transmission. indirect transmission. 51 Tissue damage caused by the deposition of circulating immune complexes containing an antibody against the host DNA is the cause of which disease? Hemolytic anemia Pernicious anemia Systemic lupus erythematosus Myasthenia gravis 52 Thomas is admitted for symptoms of acute coronary syndrome. You determine that a nitroglycerin drip is indicated for his chest pain. What medication must you make sure he is not taking before writing this order? An antihistamine Sildenafil A long-acting opioid An anticoagulant 53 Which of the following laxatives is safest for long-term use? Mineral oil Methylcellulose (Citrucel) Magnesium hydroxide (Milk of Magnesia) Sennosides (Ex-lax) 54 Identify whether the term matches the corresponding characteristics. (Select True or False) Gluten sensitivity - Celiac sprue True False 55 Identify whether the description of the skin lesion matches the disorder where it is found. (Select True or False) Elevated, firm, and rough lesion with a flat top surface greater than 1 cm in diameter: Psoriasis or seborrheic and actinic keratoses True False 56 During the history portion of a respiratory assessment, it is particularly important to ask if the patient takes which of the following drugs that may contribute to symptoms of a chronic cough? Beta-2 agonists Calcium channel blockers Angiotensin-converting enzyme (ACE) inhibitor Birth control pills 57 Which laboratory value is consistently low in a patient with diabetes insipidus (DI)? Urine-specific gravity Serum sodium Urine protein 58 Which compensatory mechanism is spontaneously used by children diagnosed with Tetralogy of Fallot to relieve hypoxic spells? Lying on their left side Performing the Valsalva maneuver Squatting 59 When considering hemolytic anemia, which statement is true regarding the occurrence of jaundice? Erythrocytes are destroyed in the spleen. Heme destruction exceeds the liver’s ability to conjugate and excrete bilirubin. The patient has elevations in aspartate transaminase (AST) and alanine transaminase (ALT). The erythrocytes are coated with an immunoglobulin. 60 The nurse has a patient who has been on multidrug therapy for pulmonary tuberculosis. When planning patient education, the nurse knows the patient needs to watch for which symptom of an adverse effect of multidrug therapy? Hearing loss Changes in vision Generalized pruritus Jaundice 61 The drug of choice for a patient with right-sided infective endocarditis caused by S. aureus is vancomycin. Daptomycin Telavancin Clindamycin 62 Which of the following side effects is not commonly seen with ondansetron (Zofran)? Constipation Headache QT-prolongation Movement disorders 63 Which age group should be targeted for testicular cancer education and screening? 15 to 35 year olds 20 to 45 year olds 30 to 55 year olds 45 to 70 year olds 64 The collateral blood flow to the brain

is provided by the:

carotid arteries. basal artery. Circle of Willis. vertebral arteries. 65 Which of the following drugs acts on the parasympathetic nervous system? Epinephrine Atropine Dopamine Dobutamine 66 What is the primary cause of respiratory distress syndrome (RDS) of the newborn? Immature immune system Small alveoli Surfactant deficiency Anemia 67 Which of the following drugs has coverage against pseudomonas? Ceftriaxone (Rocephin) Linezolid (Zyvox) Piperacillin/Tazobactam (Zosyn) Azithromycin (Zithromax) 68 Which of the following agents is considered first-line for management of opioid-induced constipation? Methylcellulose Mineral oil Polyethylene glycol Docusate 69 Sylvia, age 59, has acute hepatitis. You are told it is from a drug overdose. Which drug do you suspect? Metronidazole (Flagyl) Acetaminophen (Tylenol) Sumatriptan (Imitrex) Hydrocortisone (Cortisone) 70 What are the primary adverse effects associated with SSRIs? Weight gain and decreased libido Weight loss and decreased appetite Sedation and QT-prolongation Insomnia and hypertension 71 Identify whether the description of the skin lesion matches the disorder where it is found. (Select True or False) Elevated circumscribed, superficial lesion filled with serous fluid, less than 1 cm in diameter: Urticaria, allergic reaction True False 72 An insufficient dietary intake of which vitamin can lead to rickets in children? C

B12

B6 D 73 Bacteria that produce endotoxins that stimulate the release of inflammatory mediators that produce fever are called pyrogenic bacteria. true bacteria. Exotoxins. Spirochetes. 74 Serum levels of which of the following antiseizure drugs must be corrected based on the patient's albumin level due to its high protein binding? Valproic acid (Depakote) Phenobarbital (Luminal) Phenytoin (Dilantin) Carbamazepine (Tegretol) 75 After a partial gastrectomy or pyloroplasty, clinical manifestations that include increased pulse, hypotension, weakness, pallor, sweating, and dizziness are the results of which mechanism? Anaphylactic reaction in which chemical mediators, such as histamine, prostaglandins, and leukotrienes, relax vascular smooth muscles, causing shock Postoperative hemorrhage during which a large volume of blood is lost, causing hypotension with compensatory tachycardia Concentrated bolus that moves from the stomach into the small intestine, causing hyperglycemia and resulting in polyuria and eventually hypovolemic shock Rapid gastric emptying and the creation of a high osmotic gradient in the small intestine, causing a sudden shift of fluid from the blood vessels to the intestinal lumen 76 A person diagnosed with type 1 diabetes experiences hunger, lightheadedness, tachycardia, pallor, headache, and confusion.

The most probable cause of these symptoms is:

hyperglycemia caused by incorrect insulin administration. dawn phenomenon from eating a snack before bedtime. hypoglycemia caused by increased exercise. Somogyi effect from insulin sensitivity. 77 Which of the following agents is preferred for the treatment of a patient who is asymptomatic with a serum sodium of 126? 3% NaCl Tolvaptan

0.45% NaCl

0.9% NaCl

78 What is the most common cause of uncomplicated urinary tract infections? Staphylococcus Klebsiella Proteus Escherichia coli 79 Renal failure is the most common cause of which type of hyperparathyroidism? Primary Secondary Exogenous Inflammatory 80 Dilation of the ipsilateral pupil, following herniation, is the result of pressure on which cranial nerve (CN)? Optic (CN I) Abducens (CN VI) Oculomotor (CN III) Trochlear (CN IV) 81 Which of the following places a patient at risk for polypharmacy? Lack of understanding of their medication regimen Using multiple pharmacies Seeing multiple providers All of the above place a patient at risk for polypharmacy 82 Where is antidiuretic hormone (ADH) synthesized, and where does it act? Hypothalamus; renal tubular cells Renal tubules; renal collecting ducts Anterior pituitary; posterior pituitary Posterior pituitary; loop of Henle 83 Which diuretic acts by inhibiting sodium chloride reabsorption in the thick ascending limb of the loop of Henle? Furosemide (Lasix) Mannitol (Osmitrol) Hydrochlorathiazide (HCTZ) Acetazolamide (Diamox) 84 Which medical diagnosis is described as a chronic inflammatory joint disease characterized by stiffening and fusion of the spine and sacroiliac joints? Ankylosing spondylitis Rheumatoid arthritis Paget disease Fibromyalgia 85 Which antimicrobial should be avoided in children because it is deposited in tissues undergoing calcification and can stunt growth? Tetracycline Ciprofloxacin Vancomycin Amoxicillin 86 The nurse is caring for a patient who has chronic renal failure and hypertension. The correct classification for the hypertension is primary. secondary. tertiary. 87 What type of immunity is produced when an immunoglobulin crosses the placenta? Passive-acquired immunity Active-acquired immunity Passive-innate immunity Active-innate immunity 88 Which agent is used to treat hepatic encephalopathy and works via "ion trapping,' converting ammonia into ammonium in the GI tract? Rifaximin Lactulose Octreotide Neomycin 89 Which of the following is a potential risk associated with overuse of proton-pump inhibitors?

C. difficile infection

Gastroparesis Hyponatremia Esophageal cancer 90 What is the effect of increased secretions of epinephrine, glucagon, and growth hormone? Hyperglycemia Hypertension Bronchodilation Pupil dilation 91 Identify whether the description matches the disorder. (Select True or False) Rotation of a testis, which twists blood vessels of the spermatic cord - Testicular torsion True False 92 Which of the following agents is useful to treat COPD because of its anticholinergic effects? Salmeterol (Serevent) Tiotropium (Spiriva) Albuterol (Proventil) Prednisone (Deltasone) 93 Which disorder is characterized by the formation of abnormal new bone at an accelerated rate beginning with excessive resorption of spongy bone? Osteomalacia Paget's disease Osteoporosis Osteosarcoma 94 Jaundice can be attributed to the following except? Cholecystitis Pyelonephritis Sickle-cell anemia Pancreatitis 95 Which of the following agents is considered a long-acting beta-agonist (LABA)? Albuterol Salmeterol Fluticasone Ipratropium 96 An infant has a continuous machine-type murmur best heard at the left upper sternal border throughout systole and diastole, as well as a bounding pulse and a thrill on palpation. These clinical findings are consistent with which congenital heart defect? Atrial septal defect (ASD) Ventricular septal defect (VSD) Patent ductus arteriosus (PDA) Atrioventricular canal (AVC) defect 97 Which of the following best describes a Phase IV clinical trial? Dose-finding study in healthy volunteers Post-marketing study to detect potentially rare adverse effects Randomized clinical trial in patients with the disease of interest done prior to FDA approval Exploratory study done in animals to assess potential toxicities 98 Which second-generation antipsychotic comes in an injectable formulation approved for use in acute psychosis? Olanzapine Quetiapine Aripiprazole Ziprasidone 99 Which of the following benzodiazepines is preferred for the treatment of alcohol withdrawal in the inpatient setting due to its short half-life? Lorazepam Chlordiazepoxide Clonazepam 100 Stress-induced sympathetic stimulation

of the adrenal medulla causes the secretion of:

epinephrine and aldosterone. norepinephrine and cortisol. epinephrine and norepinephrine. acetylcholine and cortisol.