1103 Pharmacology Study Guide

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1103 Pharmacology Study Guide
2012-10-04 20:23:24

Chapters 11-13, 23
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  1. Histamine, a chemical produced by the body:
    a.       is released in response to mast cells and basophils.
    b.      is released only when infection is present.
    c.       produce the inflammatory response in the body.
    d.      acts to relieve the erythema and swelling caused by inflammation.
  2. Antihistamines act to competitively block the action of:
    a.       histamine by producing vasodilatation and increased capillary permeability.
    b.      histamine by competing with it for receptor sites.
    c.       acetylcholine by occupying the H1 receptor sites at effector structures.
    d.      anticholinergic receptors in effector structures.
  3. Seasonal allergic rhinitis refers to:
    a.       colds that develop only during Christmas season.
    b.      a runny nose in the summer.
    c.       a runny nose caused by perennial allergic phenomena.
    d.      an allergy that develops during the holidays.
  4. The adverse reaction most commonly associated with antihistamines is:
    a.       tachycardia.
    b.      difficult urination.
    c.       insomnia.
    d.      sedation.
  5. The concurrent use of central nervous system (CNS) depressants with antihistamines would produce:
    a.       increased sedation.
    b.      paradoxical excitation.
    c.       urinary retention.
    d.      tachycardia.
  6. Evaluation of a patient with seasonal allergic rhinitis might reveal:
    a.       the presence of a productive cough.
    b.      swollen, pale nasal mucosa and clear, watery nasal discharge.
    c.       red, swollen nasal turbinates and thick, greenish discharge.
    d.      crackles in the lungs and wheezes on expiration.
  7. Antihistamines should be used in young children:
    a.       if the family has a history of sleep apnea.
    b.      if the child has symptoms of Reye's syndrome.
    c.       cautiously, if at all.
    d.      with one large dose at bedtime.
  8. A 48-year-old patient at the clinic asks you if she should be taking an antihistamine for her allergies because she also needs to be on aspirin for her arthritis. Your best response would be:
    a.       "You need to be careful taking an antihistamine with aspirin products because they may cause hearing loss."
    b.      "It is not safe to take these two medications together; you need to stop one of them."
    c.       "You need to talk to your physician about the drug interactions."
    d.      "Because these products are both available over the counter, they are safe together."
  9. You understand the following about the rebound effect that may come up during patient teaching sessions.
    a.       The rebound effect is caused by long-term use of topical nasal antihistamines.
    b.      The rebound effect is caused by taking antihistamines intramuscularly.
    c.       The rebound effect is caused by an increased resistance to the drug.
    d.      The rebound effect is caused by changing medications frequently.
  10. Antitussive agents are used to:
    a.       promote expectoration.
    b.      prevent a cough from developing.
    c.       thin the secretions in the bronchial airways.
    d.      relieve coughing.
  11. Narcotic antitussives act by:
    a.       anesthetizing the stretch receptors in the medulla.
    b.      reducing the cough at its source in the respiratory passages.
    c.       acting peripherally in the pleura.
    d.      suppressing the cough reflex by acting directly on the cough center in the brain.
  12. Antitussive agents are used primarily in:
    a.       patients who cannot sleep or work due to severe productive cough and fever.
    b.      patients with a productive cough that is associated with pneumonia.
    c.       nonproductive coughs.
    d.      chronic allergic conditions.
  13. The most common adverse reactions to antitussives include:
    a.       drowsiness, dry mouth, and tachycardia.
    b.      drowsiness, dry mouth, nausea, and postural hypotension.
    c.       constipation; dry mouth; and dry, cracked mucosa.
    d.      drowsiness, muscle aches, and high blood pressure.
  14. A 72-year-old patient is being seen at the clinic for a chronic nonproductive cough. She has been given a narcotic antitussive to use. What precautions will you instruct her about?
    a.       Do not operate heavy machinery or drink alcohol while taking the medication.
    b.      Drive the care only during the day; take your cough medicine only at night.
    c.       Alter the dose of the medication as your symptoms change.
    d.      If nausea occurs, discontinue taking the medication and call your physician.
  15. A 65-year-old male patient being seen at the clinic for a chronic cough is also taking albuterol for asthma and ibuprofen for headaches. He asks you if it would be okay to take Cordyceps, because he heard it will help his asthma. What would be your best response?
    a.       "The alternative therapies used for asthma should only be used when all else fails."
    b.      "The alternative therapies approved for asthma include Cordyceps, but it may interact with NSAIDs."
    c.       "You need to ask your physician about use of alternative therapies. She would not like you medicating yourself."
    d.      "You need to let us know if it works for you so we can recommend it to our other patients."
  16. Which of the following orders has the correct antitussive dose range for adults?
    a.       Codeine 30 mg orally every 4 to 6 hours
    b.      Tessalon perles 100 mg orally three times daily
    c.       Robitussin 40 mg orally every 4 hours
    d.      Tusstat 50 mg orally every 4 hours
  17. One of the most important points to teach a patient taking an antitussive medication would be:
    a.       to take the medication as ordered by the physician; not to alter the dosage or frequency.
    b.      To drink lots of orange juice or water while taking this drug.
    c.       That the medication may cause drowsiness or nausea.
    d.      To take the drug with food or milk to decrease stomach upset.
  18. What is the physiologic result of bronchospasm?
    a.       More mucus is produced in the respiratory tract.
    b.      Narrowing of the lumen restricts the amount of air that is pulled into or pushed out of the lungs with each breath.
    c.       Vasodilation is produced sympathetically.
    d.      Bronchodilation results.
  19. The two major types of bronchodilators are:
    a.       theophylline and xanthines.
    b.      sympathomimetics and adrenergics.
    c.       sympathomimetics and xanthine derivatives.
    d.      beta2 adrenergics and anticholinergics.
  20. The major difference between asthma and COPD is:
    a.       there is no difference. They are interchangeable terms.
    b.      asthma may only last as an acute illness, but COPD gets worse gradually.
    c.       asthma gets worse over time, but COPD patients may improve and become symptom-free.
    d.      asthma is chronic and seldom symptom-free but COPD involves attacks and exacerbations.
  21. Sympathomimetics cause a response throughout the body which produces vasoconstriction in the blood vessels of the bronchial mucosa, which results in:
    a.       reduction of edema in the mucosa and submucosal tissue of the respiratory tract.
    b.      increased myocardial contractility and condition.
    c.       increased swelling and mucosal edema.
    d.      increased mucus production and ciliary paralysis.
  22. A 37-year-old female patient with a history of moderately severe asthma is complaining of not being hungry, feeling restless, and not able to sleep at night. You attribute her symptoms to:
    a.       not enough bronchodilators which should help her sleep.
    b.      a common adverse reaction from her bronchodilators.
    c.       a severe allergic reaction and a need to discontinue her medications at once.
    d.      a need to educate her on the correct way to take her bronchodilators.
  23. You have a patient who has wheezing and is complaining of shortness of breath. You would expect the physician to order which medication that will be effective in relieving bronchospasms?
    a.       antitussives
    b.      cromolyn sodium
    c.       bronchodilators
    d.      corticosteroids
  24. When sympathomimetic bronchodilators appear to be ineffective, the patient might:
    a.       use two different types of sympathomimetics at the same time.
    b.      alternate two different sympathomimetic drugs.
    c.       stop taking the medication, because an infection may be present.
    d.      report the problem to the physician immediately.
  25. Refractoriness is:
    a.       often caused by too-frequent administration of drugs.
    b.      infrequent with these products.
    c.       caused when the underlying condition worsens.
  26. The main action of sympathomimetic bronchodilators is to:
    a.       constrict the smooth muscles of the bronchi.
    b.      cause bronchial irritation.
    c.       relax the smooth muscles of the bronchi.
    d.      increase the response caused by oxygen in the aerosol.
  27. Mr. Allen complains that the bronchodilators keep him from falling asleep at night. You might suggest:
    a.       taking the medication with a glass of warm milk at bedtime.
    b.      taking a glass of alcohol to help relax before going to bed.
    c.       taking medication several hours before going to bed.
    d.      asking the physician for a mild sedative to counteract the effects of the bronchodilator.
  28. The major differences in action between sympathomimetics and xanthine derivatives is that:
    a.       xanthine derivatives produce significant CNS effects.
    b.      xanthine derivatives act directly on smooth muscle to achieve bronchial constriction.
    c.       xanthine derivatives do not have the systemic effects that sympathomimetics produce.
    d.      sympathomimetics also act directly on the kidney to produce diuresis.
  29. Aminophylline is an important agent to use to determine if the patient has bronchospasms or pulmonary edema. This agent is in the drug family of:
    a.       sympathomimetic bronchodilators.
    b.      leukotriene receptor inhibitors.
    c.       xanthine bronchodilators.
    d.      inhaled corticosteroids.
  30. Chris is a 9-year-old boy who takes Theo-Dur regularly to control asthma symptoms. He has been playing in a soccer game today and came into the clinic because of constant coughing. You find that his pulse is irregular. You determine that:
    a.       vigorous exercise commonly causes an irregular pulse in children.
    b.      overdosage with xanthine products often produces ventricular dysrhythmias.
    c.       his symptoms probably indicate a need for increased medication.
    d.      the patient may have developed a respiratory infection and the exertion of playing soccer has caused the cardiac irregularity.
  31. The half-life of xanthine bronchodilators is influence by which of the following specific factors?
    a.       age of the patient
    b.      severity of the bronchospasm
    c.       whether the patient smokes
    d.      state of hydration of the patient
  32. Monitoring the correct dosage of xanthine products is best accomplished by:
    a.       decreasing the dose if the patient begins vomiting.
    b.      determining if the frequency of prn medication use is increasing.
    c.       monitoring symptom relief.
    d.      obtaining the theophylline blood level.
  33. A 48-year-old female patient comes to the clinic complaining that she needs to urinate frequently after taking her asthma medication and is worried that she is getting diabetes. What can you tell her?
    a.       "Yes, it sounds like you are getting diabetes, we need to check your blood sugar."
    b.      "No, it would be impossible for you to get diabetes at this age."
    c.       "I believe that perhaps this is an effect of the medication you are on. Let's review them."
    d.      "Have you had a bladder infection lately?"
  34. Leukotriene receptor inhibitors are drugs that:
    a.       control the severity of asthma.
    b.      treat the acute attacks of asthma.
    c.       prevent the exacerbations of COPD.
    d.      reduce the symptoms of asthma.
  35. Your patient has had asthma for years and takes several different medications for management. The treatment regimen has been changes to include corticosteroids and your patient is anxious about the change. What will you say to reassure him?
    a.       "The addition of corticosteroids means your asthma is out of control and we need to treat it aggressively."
    b.      "I wouldn't worry if I were you; the doctor knows what she's doing."
    c.       "Corticosteroids are used for long-term asthma control and they help to reduce airway hyper-responsiveness."
    d.      "Corticosteroids are wonderful anti-inflammatory drugs that are very safe."
  36. Cromolyn sodium is a medication used for:
    a.       acute treatment of severe asthma attacks.
    b.      acute COPD relapse.
    c.       prophylaxis of asthma attacks.
    d.      acute treatment of exertional asthma.
  37. Leukotriene receptor inhibitors are used primarily to:
    a.       block bronchospasm.
    b.      reduce inflammation.
    c.       thin mucus secretions.
    d.      dilate bronchioles.
  38. Systemic corticosteroids are used primarily for the purpose of:
    a.       enhancing the action of cromolyn sodium.
    b.      decreasing the inflammatory activity in the bronchioles.
    c.       producing direct smooth muscle constriction.
    d.      decreasing the effect of beta-adrenergic drugs.
  39. Use of inhaled corticosteroids in asthma is for:
    a.       severe episodes of asthma that do not respond to other drugs.
    b.      short-term therapy only.
    c.       solo drug therapy only.
    d.      long-term control of symptoms.
  40. Rebound vasodilation refers to:
    a.       a decrease in blood flow from alpha receptor stimulation.
    b.      an increase in blood flow from beta receptor stimulation.
    c.       a decrease in blood flow from beta receptor stimulation.
    d.      an increase in blood flow from alpha receptor
  41. When topical decongestants are used, which of the following can occur?
    a.       hypotension
    b.      dysrhythmias
    c.       rebound congestion
    d.      nervousness
  42. An unpleasant side effect from nasal decongestants is:
    a.       an increase in ear congestion.
    b.      mild throat irritation.
    c.       a burning and stinging of the nasal mucosa.
    d.      a decrease in nasal drainage.
  43. You are reviewing an order from the physician for a patient who has allergic rhinitis. Which of the following orders should be questioned?
    a.       oxymetazoline (Afrin) 2 squeezes each nostril twice daily
    b.      phenylephrine (Sinex) 0.5% strength, 304 drops every 4 hours
    c.       pseudoephedrine (Sudafed) 120 mg orally 3-4 times daily
    d.      tetrahydrozoline (Tyzine) 2 drops each nostril every 4 hours
  44. Your patient asks you which would be better - to take the topical decongestant or the oral one. Your response would include:
    a.       "It is always better to take the oral doses, as they are more effective."
    b.      "I would suggest that you need to find out for yourself which one works best for you."
    c.       "The use of topical decongestants get to the nasal mucosa and usually do not affect your whole system the way an oral preparation would."
    d.      "Topical preparations can be used longer than oral preparations."
  45. It is through that expectorants work in which way?
    a.       They increase coughing which allows sputum to be expectorated.
    b.      They increase the thickness of respiratory secretions.
    c.       They decrease the thickness of respiratory secretions.
    d.      They decrease the amount of water in the respiratory tract.
  46. One of the major reason expectorants are used is to relieve symptoms of:
    a.       dry, nonproductive cough.
    b.      loose, productive cough.
    c.       irritating dry cough.
    d.      thick, productive cough.
  47. You understand that common adverse reactions may occur with use of expectorants. What will you instruct your patient with regard to side effects?
    a.       "You will need to drink more water with this medication."
    b.      "The most common reactions people get is some GI upset."
    c.       "The medication will make you cough more."
    d.      "You should take the medication every 4 hours."
  48. It is recommended that patients who are also taking anticoagulants not take which expectorant?
    a.       Robittussin.
    b.      SSKI
    c.       Mucinex
    d.      Iophen R-Gen
  49. Which expectorant must not be used continuously because it may lead to hypothyroidism?
    a.       Robitussin
    b.      SSKI
    c.       Mucinex
    d.      Iophen R-Gen
  50. You are reviewing an order from the physician for a patient who has thick, tenacious secretions. Which of the following orders should be questioned?
    a.       Robitussin 200 mg orally every 4 to 6 hours
    b.      SSKI 300 mg orally every 4 to 6 hours
    c.       Mucinex 400 mg orally every 6 hours
    d.      Iophen R-Gen 100 mg orally four times daily
  51. Expectorants work best when patients who take them also do which of the following?
    a.       Increase their fluid intake.
    b.      Increase their exercise time.
    c.       Increase their coughing.
    d.      Increase their sleep time.
  52. The main action of intranasal steroids is:
    a.       Increasing the local blood supply in the nasal mucosa.
    b.      stimulation of the inflammatory response.
    c.       beta-stimulation of adrenergic receptors.
    d.      suppression of the inflammatory reaction.
  53. Your patient has just been started on intranasal steroids and she asks you if there are any possible drug interactions. You reply:
    a.       "No, they are safe to take."
    b.      "I can check for you using the list of medications you are taking."
    c.       "These medications are only of concern when you get an infection."
    d.      "They only interact with other inhaled medications."
  54. You are reviewing an order from the physician for a patient who has an intranasal steroid ordered. Which of the following orders should be questioned?
    a.       Flovent 250 mcg twice daily
    b.      Azmacort 2 inhalations three times daily
    c.       Pulmicort 400 mg three times daily
    d.      Vanceril 2 inhalations three times daily
  55. Steroids pose a risk in their use because the drug may increase the risk for:
    a.       infections.
    b.      hearing loss.
    c.       dependency.
    d.      asthma.
  56. Common signs of infection include:
    a.       joint stiffness, pain on movement.
    b.      nausea, heartburn, feeling of fullness.
    c.       headache, sore throat, coughing, stuffy nose.
    d.      redness, swelling, pain, fever.
  57. The term of an anti-infective that is effective for a large number of organisms is:
    a.       narrow-spectrum.
    b.      broad-spectrum.
    c.       bacteriostatic.
    d.      bactericidal.
  58. Your 48-year-old patient has just been diagnosed with neuropathy from taking penicillin for treatment of bacterial endocarditis. He asks you what neuropathy means. Your best response would be:
    a.       "I think it has something to do with your kidneys."
    b.      "The drug you were on caused some damage to your muscles."
    c.       "It is an adverse reaction from penicillin that has caused nerve damage."
    d.      "It means you have a superinfection."
  59. You are reviewing an order for penicillin for an adult patient. Which order would you need to ask for clarification?
    a.       penicillin G 2.4 million units IM once
    b.      penicillin V 200,000 units orally every 6 hours
    c.       penicillin G 500,000 units orally every 6 hours
    d.      penicillin G 600,000 units IM once
  60. You are caring for a 63-year-old female patient who is being treated with sulfonamides for conjunctivitis. She asks if it is still okay to take Dyazide for her high blood pressure. Your response would include:
    a.       "It should be fine to take your other medications."
    b.      "The effect of Dyazide may be increased with the use of this sulfa drug."
    c.       "Some people are hypersensitive to sulfonamides, but you should not be because you do not have any allergies."
    d.      "The effect of Dyazide may be decreased with the use of this sulfa drug."
  61. What special instructions should you include in your teaching for patients taking sulfonamides?
    a.       "You will need to drink large amounts of water with this drug to prevent urinary stones."
    b.      "You should take this drug on an empty stomach, because food will deactivate it."
    c.       "You should be able to continue your normal outdoor activities."
    d.      "You may get some vertigo and tinnitus with this drug, but it will not be of concern."
  62. The following order for sulfadiazine has been written for your patient who weighs 50 kg. Which order needs to be questioned or verified?
    a.       sulfadiazine 500 mg orally daily
    b.      sulfadiazine 1 g orally every 4 hours
    c.       sulfadiazine 2 tablets orally for 10 days
    d.      sulfadiazine 250 mg IV every 6 hours
  63. Your patient asks you want is meant by the term stomatitis. Your response would be:
    a.       "Stomatitis is an infection in your stomach."
    b.      "Stomatitis is an adverse reaction that will cause you to itch very badly."
    c.       "Stomatitis is an inflammation of the mouth."
    d.      "Stomatitis is just a fancy word for low blood sugar."
  64. Tinnitus refers to:
    a.       drowsiness.
    b.      feeling of dizziness.
    c.       ringing in the ears.
    d.      lack of appetite.
  65. The development of proteinuria, hematuria, and crystalluria can be avoided by giving which of the following instructions to patients taking sulfonamides?
    a.       "Get a good night's sleep."
    b.      "Take the medication on an empty stomach."
    c.       "Avoid the sun."
    d.      "Drink plenty of water with the medication."
  66. Prophylactic use of antibiotics means the use of antibiotics to prevent:
    a.       infections.
    b.      superinfections.
    c.       otitis media.
    d.      dyscrasias.
  67. Broad-spectrum antibiotics commonly have which two mechanisms of action?
    a.       inhibit folic acid synthesis and destroy external cell walls
    b.      interfere with mucopeptide cell wall synthesis and inhibit folic acid synthesis
    c.       attack internal cell processes and inhibit folic acid synthesis
    d.      destroy external cell walls and attach internal cell processes
  68. Bacteriostatic refers to the ability of the anti-infective to:
    a.       kill the bacteria.
    b.      slow the growth of the bacteria.
    c.       attack the internal cell processes.
    d.      destroy the external cell walls.
  69. The term mixed infection refers to:
    a.       one infection following another.
    b.      infections occurring at the same time.
    c.       an overgrowth of organisms.
    d.      mild superinfection.
  70. Your patient asks what the doctor meant when she told him that he has a gram-negative infection. Your response would be:
    a.       "That means that the organism that you have stains positive when the laboratory checks it."
    b.      "That means that the organism that is causing your infection has become resistant to other antibiotics."
    c.       "That means that the organism that you have is negative when the lab stains it, and determines the type it is."
    d.      "That means that the antibiotic that we will use has no grams to it."
  71. Broad-spectrum anti-infectives are used for which types of infections?
    a.       viral
    b.      parasitic
    c.       fungal
    d.      bacterial
  72. The three types of major adverse reactions seen with antibiotic therapy include:
    a.       superinfections, hepatotoxicity, allergic reactions.
    b.      allergic reactions, cross-sensitivity, GI irritations.
    c.       ototoxicity, GI irritations, allergic reactions.
    d.      allergic reactions, secondary infections, mixed infections.
  73. Superinfections are commonly caused by:
    a.       GI irritation.
    b.      allergic reactions.
    c.       long-term use of antibiotics.
    d.      use of broad-spectrum antibiotics.
  74. Your patient who has a history of many drug allergies is asking you about the possibilities of developing an allergy to the antibiotic that has been ordered for him for his urinary tract infection. Your response would be:
    a.       "The possibility of developing another allergy is very remote, don't worry about it."
    b.      "The hypersensitivity reactions that we see in the clinic are very rare."
    c.       "The people most susceptible to develop another allergy are people who have a history of drug allergies."
    d.      "The number of times I have seen cross-sensitivity to antibiotics I could count on one hand."
  75. Anaphylaxis is the most serious form of hypersensitivity and is characterized by:
    a.       shortness of breath, laryngeal edema, shock.
    b.      drowsiness, skin rash, nausea.
    c.       shortness of breath, vomiting, hepatotoxicity.
    d.      drowsiness, ototoxicity, diarrhea.
  76. If a patient is allergic to penicillin, the drug of choice is often:
    a.       sulfonamides.
    b.      cephalosporins.
    c.       aminoglycosides.
    d.      lincosamides.
  77. The anti-infective ceflacor (Ceclor) is considered a:
    a.       first-generation cephalosporin.
    b.      second-generation cephalosporin.
    c.       third-generation cephalosporin.
    d.      fourth-generation cephalosporin.
  78. Symptoms of bone marrow depression caused by the use of anti-infectives include:
    a.       increased blood sugar, malaise, jaundice.
    b.      decreased urine output, fever, skin rash.
    c.       bruising, petechiae, sore throat.
    d.      nausea, vomiting, diarrhea.
  79. The difference between oral and parenteral antibiotics is oral antibiotics are:
    a.       safer, whereas parenteral antibiotics should be used with caution.
    b.      cheaper, whereas parenteral antibiotics are more expensive.
    c.       to be avoided, whereas parenteral antibiotics are better tolerated.
    d.      to be used with caution, whereas parenteral antibiotics are safer.
  80. The effect of gastrointestinal upset can be managed if the oral antibiotics are:
    a.       given with food.
    b.      taken on an empty stomach.
    c.       fully chewed before swallowed.
    d.      swallowed with minimum water.
  81. Which order for mezlocillin should be questioned or clarified?
    a.       mezlocillin 3 g IV every 6 hours
    b.      mezlocillin 2 g IM every 6 hours
    c.       mezlocillin 1.5 g orally every 6 hours
    d.      mezlocillin 1.5 g IV every 6 hours
  82. Your patient asks you about the cephalosporin Maxipine and wants to know what third-generation cephalosporin means. Your response is:
    a.       "The third-generation cephalosporins are cousins of the original cephalosporins like Ancef."
    b.      "The third-generation cephalosporins are more effective against resistant organisms."
    c.       "The first-generation cephalosporins don't work anymore, so we have to use the more effective third generation."
    d.      "The third-generation cephalosporins don't cause as much tissue damage as the older drugs."
  83. Drug resistance is related to the:
    a.       bacterium's very hard cell wall.
    b.      long-term nature of the required treatment.
    c.       expense of the medications.
    d.      toxicity of the combination drugs.
  84. Tuberculosis is a disease that requires new guidelines every year from which organization?
    a.       MDR
    b.      CDC
    c.       PZA
    d.      INH
  85. The drugs used in treating tuberculosis that do not kill the bacterium but prevent its spread through the patient or to other individuals are known as:
    a.       chemoprophylaxis.
    b.      chemotherapy.
    c.       bacteriostatic.
    d.      bactericidal.
  86. Drug resistance is likely to develop when what occurs?
    a.       patient compliance
    b.      active hepatitis
    c.       only one drug is used
    d.      the culture converts to negative
  87. The term anti-tubercular chemoprophylaxis refers to:
    a.       weight loss associated with anti-tubercular drugs
    b.      the use of drugs to treat a disease.
    c.       the use of drugs to prevent a disease.
    d.      psychologic changes or changes in personality.
  88. Many of the medications used to treat tuberculosis are associated with severe tissue damage to the:
    a.       kidneys and nerves.
    b.      brain and spinal cord.
    c.       liver and pancreas.
    d.      bones and muscles.
  89. The difference between primary and secondary agents used for treatment of tuberculosis is that primary agents are:
    a.       cheaper than secondary agents.
    b.      more effective than secondary agents.
    c.       more toxic than secondary agents.
    d.      used for more drug-resistant organisms than secondary agents.
  90. Which of the following orders as written does not have to be verified?
    a.       Isoniazid 600 mg orally daily
    b.      Rifampin 600 mg orally daily
    c.       Rifapentine 150 mg orally daily
    d.      Ethambutol 15 mg orally daily
  91. You are taking care of a 68-year-old male patient who asks you what he should do if he misses a dose of his TB  drugs. Your response should include:
    a.       "You should take the dose as soon as you remember."
    b.      "You will have to skin the dose and take a double dose the next day."
    c.       "You will need to notify the physician if you skip a dose."
    d.      "You will have to come in for more lab tests if you miss a dose."
  92. Most anti-tubercular medications cause gastric irritation and should be taken with food. Identify he one medication that is better absorbed on an empty stomach.
    a.       rifampin
    b.      isoniazid
    c.       pyrazinamide
    d.      ethambutol
  93. If a patient has been treated for tuberculosis previously and becomes symptomatic again, what should be suspected?
    a.       HIV infection
    b.      patient compliance issues
    c.       culture conversion to negative
    d.      drug interactions
  94. Use of ethambutol may lead to the development of:
    a.       drug resistance.
    b.      ototoxicity.
    c.       narrow therapeutic range.
    d.      psychologic changes.
  95. What parasite causes amebiasis?
    a.       Plasmodium flaciparum
    b.      Entamoeba histolytica
    c.       Trichomonas vaginalis
    d.      Chlamydia trachomatis
  96. What is meant by an extraintestinal infection?
    a.       ulcerative colitis
    b.      infection in the heart, such as bacterial endocarditis
    c.       infection outside of the GI tract, such as hepatic abscess
    d.      urticarial rash
  97. What are two of the major drugs used for the treatment of amebiasis?
    a.       metronidazole and paromomycin
    b.      diiodohydroxyquin and ampicillin
    c.       cloroquine and ticarcillin
    d.      paromomycin and gentamicin
  98. Identify the one amebicide known to cause poor coordination.
    a.       metronidazole
    b.      paromomycin
    c.       diiodohydroxyquin
    d.      chloroquine
  99. What happens when a mosquito infected with malaria bites a person?
    a.       The protozoan travels from the blood to the stomach where it reproduces.
    b.      The protozoan travels from the blood to the muscles where it reproduces.
    c.       The protozoan travels from the blood to the salivary glands where it reproduces.
    d.      The protozoan travels from the blood to the red blood cells where it reproduces.
  100. Which protozoan causes malaria?
    a.       Plasmodium
    b.      Trichomonas
    c.       Entamoeba
    d.      Treponema
  101. Anti-malarial preparations are used for:
    a.       preventing malaria.
    b.      treating the symptoms of malaria.
    c.       infections caused by Plasmodium falciparum.
    d.      suppressing and treating acute malaria attacks.
  102. Cinchonism is another name for:
    a.       atrophic glossitis.
    b.      quinine poisoning.
    c.       blood dyscrasias.
    d.      malaria attacks.
  103. The use of any anti-malarial drugs can cause which of the following symptoms?
    a.       ototoxicity
    b.      cardiac dysrhythmias
    c.       nephrotoxicity
    d.      psychologic
  104. The difference between acquired immunodeficiency syndrome (AIDS) and human immunodeficiency virus (HIV) is:
    a.       AIDS is the  retrovirus and HIV is the infection caused by AIDS.
    b.      HIV is the retrovirus and AIDS is the infection caused by HIV.
    c.       AIDS is the retrovirus and HIV is the CD4 protein.
    d.      HIV is the retrovirus and AIDS is the virion.
  105. Retroviruses are:
    a.       messenger RNA that codes for HIV polyprotein.
    b.      viruses that contain RNA and DNA.
    c.       viruses that contain only DNA.
    d.      cellular assembly units inside the lymphocytes.
  106. The two types of antiretroviral medications include:
    a.       reverse transcriptase inhibitors and antibiotics.
    b.      antiviral and protease inhibitors.
    c.       antiviral and antifungal.
    d.      protease inhibitors and reverse transcriptase inhibitors.
  107. AIDS-related opportunistic infections develop because the:
    a.       opportunistic infections damage the body's immune system.
    b.      retrovirus damages the body's immune system.
    c.       infections cause damage to the liver.
    d.      infections cause damage to the P-450 cytochrome system.
  108. Crix belly refers to the development of:
    a.       a large cyst on the leg and decreased plasma glucose.
    b.      elevated triglycerides and accumulated fat in the abdomen.
    c.       weight loss and increase plasma glucose.
    d.      elevated triglycerides and accumulated fat in the arms and legs.
  109. A  mycotic infection  refers to an infection that is caused by:
    a.       reverse transcriptase inhibitors.
    b.      pancreatitis.
    c.       yeast-like organisms.
    d.      bacteria.
  110. Fungi are found in which two major forms in the body?
    a.       in the organs such as the liver and the immune system
    b.      in the organs such as the lungs and the nailbeds and skin
    c.       in the organs such as the kidneys and the central nervous system
    d.      in the organs such as the liver and the endocrine system
  111. Four commonly used anti-fungals include:
    a.       nystatin, ketoconozole, amphoteracin B, cidofovir.
    b.      acyclovir, ketoconozole, griseofulvin, efavirenz.
    c.       flucytosine, nystatin, griseofulvin, ketoconozole.
    d.      metronidazole, ketoconozole, nystatin, nelfinavir.
  112. What is the name of the organism that causes fungal vaginal infections in women and that is now seen so commonly in AIDS patients?
    a.       Cryptococcus
    b.      Candida
    c.       Microsporum
    d.      Trichophyton
  113. Adverse drug reactions produced by anti-fungals are:
    a.       associated with hepatotoxicity.
    b.      rare.
    c.       generally mild, transient, and dosage-related.
    d.      generally irritating but not very serious.
  114. Superinfections may result with prolonged use of anti-fungals concurrently with:
    a.       antacids.
    b.      anticholinergics.
    c.       corticosteroids.
    d.      H2 blockers.
  115. Your patient is suffering from allergic conjunctivitis and has nedocromil ordered, and he asks what it will do for him. Your response may be:
    a.       "This eye ointment will be effective in relieving your stuffy nose symptoms."
    b.      "These eye drops help to reduce the itchy eye symptoms from allergies by stabilizing the mast cells."
    c.       "This eye ointment is to relieve your itchy eyes because it has a steroid in it."
    d.      "These eye drops will reduce the pressure in the eye to relieve your symptoms."
  116. When Melissa was born, the nurse put silver nitrate in her eyes. This is done to:
    a.       help open the eye to activate the retina.
    b.      prevent gonorrheal ophthalmia neonatorum.
    c.       improve the baby's visual acuity
    d.       prevent the development of glaucoma.
  117. Amanda Moore has been wearing contact lenses for 4 years. She has been studying late at night, and her eyes are very dry. The doctor may decide she needs to use:
    a.       a local anesthetic.
    b.      antiseptic drops to reduce minor irritation.
    c.       artificial tears
    d.      a topical antibiotic to reduce minor infection.
  118. Topical skin preparations can be used to treat which condition?
    a.       pneumonia
    b.      glaucoma
    c.       hemorrhoids
    d.      toothaches
  119. Products used for the eye must be labeled:
    a.       otic preparation.
    b.      otic or topical preparation.
    c.       ophthalmic preparation.
    d.      ophthalmic or otic preparation.
  120. Richard Egan has noted reduced hearing for the last few months. The doctor tells him his ear is filled with wax. The doctor will probably order:
    a.       erythromycin.
    b.      Debrox.
    c.       hydrogen peroxide.
    d.      Neo-Synephrine.
  121. Antiseborrheic shampoo is used to treat which condition?
    a.       psoriasis
    b.      scabies
    c.       herpes simplex
    d.      dandruff
  122. You are advising your patient on what he needs to use for acne. Which products would you tell him about?
    a.       Alomide
    b.      Azelex
    c.       Americaine
    d.      Aclovate
  123. You are instructing your patient on how to instill eardrops from the removal of wax using the medication Cerumenex. You will be sure to include in your teaching which of the following?
    a.       "Tilt your head at a 45-degree angle and fill the ear canal half-full and flush out immediately."
    b.      "Tilt your head at a 90-degree angle and fill the ear canal full and leave in for 3 hours before flushing out."
    c.       "Tilt your head at a 45-degree angle and fill the ear canal full and leave in for 30 minutes before flushing out."
    d.      "Tilt your head at a 90-degree angle and fill the canal half-full and leave in for 40 minutes before flushing."
  124. When instructing your patient on how to instill eye ointment, you will review the technique and observe the administration of the medication by the patient and watch for application of the medication:
    a.       directly on the eyeball.
    b.      to the lower conjunctival sac.
    c.       to the upper conjunctival sac.
    d.      on a cotton applicator first, then to the inner canthus of the eye.
  125. You are caring for a child who is being seen for head lice. You expect that the classification of medications used for this problem will be:
    a.       pediculocides.
    b.      scabicides.
    c.       keratolytics.
    d.      emollients.
  126. Cauterizing agents are used in the treatment of:
    a.       warts.
    b.      scabies.
    c.       acne.
    d.      dandruff.