1103 Pharmacology

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1103 Pharmacology
2012-10-24 09:54:17

Chapters 17, 20, 21, and 23
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  1. Narcotic agonist analgesics are used to treat
    which type of pain? (Select all that apply.)

    a.       acute pain of myocardial infarction
    b.       cough from the common cold
    c.       pain associated with labor and delivery
    d.      dyspnea related to left ventricular failure
    e.      postoperative pain
    f.       acute renal colic
    g.      tension headache
    a, c, d, e, f
  2. What is the difference between acute pain and chronic pain?

    a.      Acute pain refers to a prolonged onset and chronic pain refers to a sudden onset.
    b.     Acute pain is related to prolonged drug use and chronic pain is related to intermittent drug use.
    c.       Acute pain is usually related to an injury and resolves with healing; chronic pain is related to disorders which get progressively worse.
    d.     Acute pain refers to the amount of drug needed to take effect and chronic pain refers to the amount of drug needed to cause adverse effects.
  3. Pre-existing medical problems may be adversely
    affected by narcotics in which of the following situations? (Select all that apply.)

    a.       increased heart rate in patients with heart disease
    b.      increased convulsions on patients with history of seizures
    c.      depressed mobility in patients with arthritis
    d.      depressed cough reflex in patients with lung disease
    a, b, d
  4. When the patient is able to deliver his or her
    own pain medication through an IV, it is referred to as:

    a.      PTA medication administration.
    b.      PCA medication administration.
    c.      TCA medication administration.
    d.     MCA medication administration.
  5. One of the effects of narcotics is to decrease the patient's cough and sigh reflexes which would predispose him or her to:

    a.      asthma.
    b.     lung cancer.
    c.       pneumonia.
    d.     emphysema.
  6. Narcotic agonist analgesics are metabolized by which organ?

    a.      lung
    b.     kidney
    c.      heart
    d.      liver
  7. Which of the following behaviors might be considered signs of dependence? (Select all that apply.)

    a.      asking for pain medication every 3 to 4 hours
    postoperatively for 2 to 3 days
    b.      requesting an increased dosage and
    frequency of medication administration
    c.       receiving care for a problem from several
    different physicians or agencies
    d.      a history of dependence or abuse
    e.     a clinical problem that produces chronic pain
    f.       inability to wean from the drug
    b, d, f
  8. How do the majority of the chemicals that are broken down in the body leave the body?

    a.      through the skin in sweat
    b.      through the kidneys in urine
    c.      through the bowels in stool
    d.     through the lungs during exhalation
  9. How does drug tolerance differ from drug addiction?

    a.      Drug tolerance refers to the changes in the body
    when a drug is stopped versus a drug addiction where the drug has produced psychologic dependence.
    b.     Drug tolerance refers to a decreasing
    effectiveness over time versus a drug addiction where the drug has produced a psychologic dependence.
    c.       Drug tolerance is a psychologic dependence
    on a drug versus drug addiction which is decreasing effectiveness of a drug.
    d.      Drug tolerance is the same as drug abuse versus
    drug addiction which refers to the decreasing effectiveness of the drug over time.
  10. What are signs that your patient is having pain
    even if he or she is unable to tell you?

    a.       crying, tense muscles, and sweating
    b.     increased urination, fever, and hypotension
    c.      regular respirations, normal pupil reaction, and
    d.     laughing, relaxed muscles, and sweating
  11. What are the most common adverse reactions and
    overdosage symptoms of the narcotic agonist-antagonist medications? (Select all that apply.)

    a.     bradycardia
    b.     hypotension
    c.     constipation
    d.     increased salivation

    enlarged pupils

    a, b, c, f
  12. What are the common narcotics found in narcotic
    combination products?

    a.      codeine, ibuprofen, and morphine
    b.     hydrocodone, codeine, and morphine
    c.      codeine, acetaminophen, and aspirin
    d.      codeine, oxycodone, and hydrocodone
  13. What are the most frequently used non-narcotic
    ingredients in narcotic analgesic combination products?

    a.       aspirin, Tylenol, and caffeine
    b.     aspirin, ibuprofen, and caffeine
    c.      Tylenol, ibuprofen, and butalbital
    d.     aspirin, butalbital, and caffeine
  14. Mr. Sykes is an inpatient recovering from surgery following a ruptured appendix. He had a severe post-operative infection with a high temperature and excessive pain. He has been receiving codeine 32 mg prn, Amoxil 500 mg four times daily, and Tylenol 650 mg every 4 hours for the last 4 days. He is complaining of constipation. What has caused the constipation?

    a.      Tylenol is the cause.
    b.     Amoxil is the cause.
    c.       Codeine is the cause.
    d.     High fever and pain are the cause.
  15. What should you say to your patient who is requesting that her codeine be more frequent?

    a.      "I will have the physician increase the frequency for you."
    b.      "Can you tell me about your pain?"
    c.      "You are not allowed to have the frequency changed from what is ordered."
    d.     "Why don't we just back off on pain medications for now, okay?"
  16. What is one way that you can teach your patient to prevent nausea after taking the first dose of a narcotic?

    a.      "You can take an antiemetic after taking the first dose to prevent nausea."
    b.      "You can eat a full meal after taking the first dose to prevent nausea."
    c.       "You can lie down for a short period of time after taking the first dose to prevent nausea."
    d.     "You can walk around for a half an hour after taking the first dose to prevent nausea."
  17. You are reviewing an order for morphine for your patient who is recovering from surgery. Which order would you need to clarify with the physician?

    a.      Morphine 8 mg IM every 4 hours prn
    b.     Morphine 2 mg IV every 2 hours prn
    c.       Morphine 25 mg subcutaneously every 2 hours prn
    d.     Morphine 10 mg IM every 4 hours prn
  18. Which non-narcotic central-acting analgesic is given as a continuous epidural infusion?

    a.      Levoprome
    b.     Darvon-N
    c.       Duraclon
    d.     Ultram
  19. You are reviewing an order for Nubain, and you understand that this drug: (Select all that apply.)

    a.       tends to be more expensive than other products of the same classification.
    b.      can be given IM, subcutaneously, or IV.
    c.      is in the non-narcotic central-acting analgesic
    d.      has an onset of 15 minutes.
    a, b, d
  20. Common adverse reactions to non-narcotic
    analgesics include: (Select all that apply.)

    a.      diarrhea.
    b.      disorientation.
    c.       slurring of speech.
    d.      postural hypotension.
    b, c, d
  21. When would you need to have the narcotic analgesics stopped? (Select all that apply.)

    a.       The patient is hallucinating.
    b.      The patient becomes confused.
    c.       The patient is semi-comatose.
    d.     The patient reports relief of pain.
    a, b, c
  22. Which narcotic agonist-antagonist analgesic medication is available in an oral form as well as injectable?

    a.       pentazocine
    b.     nalbuphine
    c.      buprenorphine
    d.     dezocine
  23. Which two non-narcotic analgesic products contain both aspirin and Tylenol?

    a.      Equagesic and Anacin
    b.     Anacin and Vanquish
    c.       Vanquish and Excedrin
    d.     Excedrin and Anacin
  24. Diabetic patients need to have their insulin regulated, which is what type of chemical?

    a.     polypeptide
    b.      hormone
    c.      steroid
    d.     neurotransmitter
  25. How does insulin help lower the blood sugar?

    a.      It decreases the production of sugar.
    b.     It carries the sugar out of the body.
    c.       It allows sugar into the cells.
    d.     It acts as a feedback messenger to convert protein into energy.
  26. Insulin is necessary for the metabolism and useof glucose in the body and is produced by which organ at what site?

    a.      in the lungs by the alveoli
    b.     in the kidneys at the loop of Henle
    c.      in the liver by the hepatocytes
    d.      in the pancreas by the beta cells
  27. If the patient continues to give frequent injections of insulin into the same site, what may be the result?

    a.      polyuria
    b.      lipodystrophy
    c.      Somogyi effect
    d.     systemic acidosis
  28. If a diabetic patient begins taking oral contraceptives, what is the influence on the need for insulin?

    a.      There is no change in the need for insulin.
    b.      There is an increased need for insulin.
    c.      There is a decreased need for insulin.
    d.     There is an increased production of insulin.
  29. Mrs. Halifax is a brittle diabetic - one with wide variations in blood sugar in response to medications. The nurse must watch her carefully for symptoms of hypoglycemia after giving her an insulin injection. What are the signs and symptoms of hypoglycemia? (Select all that apply.)

    a.       cold, clammy skin
    b.      hunger
    c.       diaphoresis
    d.      lethargy
    e.      increased urination
    a, b, c, d, e
  30. Mr. Primrose frequently does not take his insulin at the correct time and he skips doses when he gets busy. He is at risk for hyperglycemia. What are the signs and symptoms of hyperglycemia? (Select all that apply.)

    a.      polymylagia
    b.      polyuria
    c.       polyphagia
    d.      polydipsia
    b, c, d
  31. The American Diabetes Association recommends
    treatment of diabetics to get their glucose levels as normal as possible. What is one way that this can be accomplished?

    a.      switching all diabetics to insulin
    b.      open-loop insulin pumps
    c.      one injection per day routine
    d.     exercise alone
  32. Insulin has multiple functions, one being allowing glucose into the cells. What are some other important functions? (Select all that apply.)

    a.       inhibit lipoprotein lipase
    b.     convert complex compounds to simple substances
    c.       prevent release of fatty acids
    d.      promote glucose transport and storage
    a, c, d
  33. In counseling Mrs. Wilson, a newly diagnosed diabetic, you discover that she has been administering regular insulin deep IM just before meals. She seems to have confidence in giving the injection and can draw up and read the dosage properly. What suggestions would give her?

    a.      "You are having some problems. I will ask
    the doctor to change you to an oral agent, okay?"
    b.     "You are doing a nice job with drawing up
    and reading your insulin well, and I see you are doing everything okay."
    c.       "You need to be giving your injection
    in your adipose tissue, not your muscle. Let's review that technique."
    d.     "Why don't you start to inject your medication
    after meals because we want to switch to a different type."
  34. The oral agents in the class icretins are known to help patients control their blood sugar and also have the effect of: (Select all that apply.)

    a.      stimulating glucagon secretion.
    b.      protecting the beta cells from cytokine injury. 
    c.       decreasing gastric emptying time.
    d.      suppressing the appetite and inducing satiety.
    b, c, d
  35. The doctor decides to order a combination of regular and NPH insulin for Mrs. Wilson. It is important to tell Mrs. Wilson to:

    a.      shake the insulin vial well before withdrawing
    the medication to make certain all chemicals are dissolved.
    b.      draw up the regular insulin before drawing up the NPH insulin in the same syringe.
    c.       use a different syringe for each injection.
    d.     keep the insulin refrigerated until ready to use.
  36. Your patient asked you why she has to take both insulin and an oral hypoglycemic agent to control her blood sugars. Part of your teaching would explain the reason in this way:

    a.      "You are a very brittle diabetic and we need to use both forms of control to get your sugar level normal."
    b.      "The oral agent and the insulin work differently to help control your blood sugar; it is to help you gain better
    c.       "The doctor prescribed it this way. Maybe we better ask her to explain it."
    d.     "You can alternate taking the insulin one day and the oral agent the next to control your sugars."
  37. Mrs. Wilson is instructed to test her sugar level at home in order to determine how much insulin she is to take. She will do this by using a glucometer to:

    a.       test blood glucose levels.
    b.     test urine sugar levels.
    c.      test both the blood and urine levels.
    d.     determine the insulin levels.
  38. Somogyi effect occurs when the patient's:

    a.      blood sugar drops after being hyperglycemic.
    b.     level of insulin is decreased with the use of oral agents.
    c.      level of insulin is increased with the use of oral agents.
    d.      blood sugar rebounds after being hypoglycemic.
  39. The most common adverse reactions with oral
    hypoglycemic agents are: (Select all that apply.)

    a.       GI symptoms.
    b.      allergic reactions.
    c.      high blood pressure.
    d.      hypoglycemia.
    a, b, d
  40. Benny Parks is a 45-year-old homeless alcoholic. He is well-known to the local hospital because of his diabetes. Because he was unable to take insulin while living on the streets, the doctor started him on a sulfonylurea. What would you be concerned about?

    a.      The medication requires that it be taken with food and Benny is not eating.
    b.      The patient must eat three regular meals a day
    while taking this medication.
    c.       A disulfiram-like reaction may result in some patients if the patient takes sulfonylureas and drinks alcohol.
    d.     He will need to use a glucometer to test his blood sugar and he has nowhere to set up the machine.
  41. Miss Eldredge is a 64-year-old retired schoolteacher. She has recently been diagnosed with type 2 diabetes. It is
    important to tell her that:

    a.      a patient who has type 2 diabetes will never
    have to take insulin.
    b.     she can avoid taking any medication if she will
    eliminate all carbohydrates from her diet.
    c.       medication and diet are both important parts of the treatment plan.
    d.     there is no cure and she will only get worse as time goes on.
  42. This oral hypoglycemic agent is in the class of biguanides.

    a.      acarbose
    b.      metformin
    c.      repaglinide
    d.     glipizide
  43. Which blood test is used to assess the patient's ability to control her blood sugar in recent months?

    a.       hemoglobin A1C
    b.     hematocrit
    c.      liver enzymes
    d.     creatinine
  44. Mrs. Ott comes into the hospital in labor. She is 6 weeks premature. The doctor will most likely order:

    a.      an abortifacient.
    b.      a uterine relaxant.
    c.      a muscle relaxant.
    d.     an oxytocic or ergot preparation.
  45. Following delivery of the baby and placenta, the uterus must clamp down to control bleeding. A medication that might help limit uterine bleeding would be:

    a.      an abortifacient.
    b.     a uterine relaxant.
    c.      a muscle relaxant.
    d.      an oxytocic.
  46. Medications given to help stimulate milk to flow include:

    a.       oxytocics.
    b.     muscle relaxants.
    c.      tranquilizers.
    d.     diuretics.
  47. A medication used to expel the fetus from the pregnant uterus, used early in pregnancy, is called:

    a.       an abortifacient.
    b.     a uterine relaxant.
    c.      a muscle relaxant.
    d.     an oxytocic.
  48. Pituitary hormones are important for which ofthe following body functions? (Select all that apply.)

    a.      stimulate the production of insulin
    b.      electrolyte balance
    c.       metabolism
    d.      reproductive cycle
    b, c, d
  49. The adrenal cortex produces which of the following substances? (Select all that apply.)

    a.       glucocorticoids
    b.      estrogens
    c.      somatotropin
    d.      mineralocorticoids
    a, b, d
  50. One of the anterior pituitary hormones, adrenocorticotropic hormone (ACTH), stimulates the adrenal cortex to secrete: (Select all that apply.)

    a.       corticosterone.
    b.     oxytocin.
    c.       aldosterone.
    d.      cortisol.
    a, c, d
  51. Corticosteroids are commonly given for the following reasons. (Select all that apply.)

    a.      reduce inflammatory responses
    b.      Addison's disease
    c.       collagen diseases
    d.      stimulate ovulation
    b, c, d
  52. Corticosteroids are administered by which route(s)? (Select all that apply.)

    a.      orally
    b.      subcutaneously
    c.       intravenously
    d.      intramuscularly
    b, c, d
  53. What are three of the most common complications from long-term corticosteroid treatment?

    a.      hypoglycemia, weight loss, and cataracts
    b.     hypotension, palpitations, and sweating
    c.       peptic ulcers, fungal infections, and muscle wasting
    d.     anorexia, over-stimulated adrenal cortex, and weight gain
  54. Mrs. McKensey called the clinic to report that she ran out of her prednisone yesterday, of which she takes 40 mg a day, and was hoping to get it refilled. What will you tell her?

    a.      "I think you could wait until you see your
    doctor for your regularly scheduled appointment."
    b.      "We will call the pharmacy to get your prescription refilled right away; you must be sure to take your dose today."
    c.      "You will need to wait until tomorrow because
    we are really busy today, so call back later."
    d.     "The doctor is on vacation until next week,
    can you call back then?"
  55. Androgens are used in weak and debilitated patients because they will:

    a.      increase sodium retention.
    b.     reduce diarrhea, nausea, and vomiting.
    c.       restore a positive nitrogen balance.
    d.     reverse male pattern baldness.
  56. Erythropoiesis is the increase in red blood cell formation that is stimulated with the administration of:

    a.      aldosterone.
    b.      androgens.
    c.      insulin.
    d.     estrogens.
  57. Estrogens are used for which of the following reasons?

    a.      decrease bone growth and decrease serum lipoproteins
    b.     reduce urinary retention and prostate cancer
    c.       hormone replacement therapy and infertility work-ups
    d.     prevent stroke and heart attacks and increase
    sex drive
  58. The hormone given with estrogen in oral contraceptive pills is:

    a.      luteinizing hormone.
    b.     testosterone.
    c.      androgen.
    d.      progesterone.
  59. How do oral contraceptives work?

    a.       prevent ovulation
    b.     decrease sex drive
    c.      stimulate ovulation
    d.     increase uterine bleeding
  60. Adverse reactions to oral birth control pills are caused by: (Select all that apply.)

    a.      corticosteroid excess.
    b.     corticotropin excess.
    c.       progestin excess.
    d.      estrogen excess.
    c, d
  61. Why are women over 35 who smoke and who take oral contraceptives advised to either stop smoking or try other forms of birth control?

    a.      They are too old to have children.
    b.      They are at increased risk for strokes and blood clots.
    c.      They are at increased risk for lung cancer.
    d.     They are going to experience decreased
    effectiveness to the oral contraceptives.
  62. Estrogens have the following effect because they are anabolic. (Select all that apply.)

    a.      decrease in triglycerides
    b.      retention of salt
    c.       retention of water
    d.     increase in cholesterol
    b, c
  63. Generally oral contraceptives are taken how?

    a.       for 21 days then stop for 7 days
    b.     for 28 days then stop for 7 days
    c.      for 30 days then stop for 30 days
    d.     for 7 days then stop for 21 days
  64. Ms. Larkin complains of weight gain, lack of appetite, and a dryness of her skin and hair. She also reports recent difficulty with constipation. The doctor suspects thyroid problems. Thyroid tests would probably show:

    a.      euthyroid.
    b.     hyperthyroid.
    c.       hypothyroid.
    d.     normal thyroid.
  65. An increase in thyroid hormone often produces weight loss in patients because:

    a.      patients lose their appetites and eat less.
    b.      metabolic rate is increased.
    c.      patients develop an inability to metabolize food.
    d.     metabolic rate is decreased.
  66. Thyroid hormones are used in the treatment of which of the following conditions? (Select all that apply.)

    a.       myxedema
    b.     hyperthyroidism
    c.       cretinism
    d.      nontoxic goiter
    a, c, d
  67. Drug interactions may occur when patients take thyroid medications and have which of the following conditions? (Select all that apply.)

    a.       diabetes mellitus
    b.      cardiovascular disease
    c.      hypothyroidism
    d.      pregnancy
    a, b, d
  68. Antithyroid preparations are taken when:

    a.      the thyroid is enlarged and the doctor wants to help it return to its normal size.
    b.     the synthesis of thyroid hormones must be stimulated.
    c.      the patient has very slow reflexes and myxedema.
    d.      synthesis of thyroid hormones must be inhibited.
  69. When patient are taking thyroid medications, they must be instructed to recognize:

    a.       hypothyroid and hyperthyroid signs and symptoms.
    b.     hypoglycemic and hyperglycemic signs and symptoms.
    c.      increased cholesterol and decreased triglyceride effects.
    d.     hypothermia and hyperthermia signs and symptoms.
  70. Which herbal products are taken to treat hypothyroidism?

    a.      ginkgo and chamomile
    b.     bitter melon and garcinia
    c.       valerian and passion flower
    d.     milk thistle and evening primrose
  71. Two antithyroid drugs are:

    a.      Tapazole and Levothyroid.
    b.      Tapazole and propylthiouracil.
    c.      propylthiouracil and Eltroxin.
    d.     Lugol's iodine and Synthroid.
  72. What is the response of the body when it senses an invasion by a foreign protein?

    a.      The body makes antigens.
    b.     The body makes toxins.
    c.       The body makes antibodies.
    d.     The body makes vaccines.
  73. This type of immunity occurs when a patient has an illness and then develops antibodies to the causative agent.

    a.      passive immunity
    b.      naturally acquired active immunity
    c.      antigen response
    d.     artificially acquired active immunity
  74. Immune globulins are injected into a person who does not have immunity to an antigen such as hepatitis B. This is an example of what type of immunity?

    a.      artificially acquired active immunity
    b.     naturally acquired active immunity
    c.       passive immunity
    d.     acquired passive immunity
  75. When is it recommended that children get immunized against Haemophilus influenzae type B?

    a.      birth
    b.      2 months
    c.      12 months
    d.     15 months
  76. The most common side effects of immunologic agents are: (Select all that apply.)

    a.       pain at the injection site.
    b.      fever.
    c.       localized rash and itching.
    d.     hyperglycemia.
    a, b, c
  77. Because of the biologic source of some vaccines, occasionally people may be unusually sensitive to immunologic products if they have an allergy to:

    a.       eggs or feathers.
    b.     grass pollen or trees.
    c.      molds.
    d.     aspirin or aspartame.
  78. Sometimes immunity levels decrease over time. The result of this is that the patient:

    a.      remains immune to the organism.
    b.      requires a booster immunization to raise immunity level.
    c.      will eventually develop a mild case of the disease.
    d.     will have lifelong immunity as long as there is any antigen-antibody memory in cells.
  79. Which of the following vaccines is recommended to be given at birth?

    a.      measles, mumps, rubella
    b.     diphtheria, tetanus, pertussis
    c.      hepatitis B
    d.     inactivated poliovirus
  80. Which of these drugs is/are used for in vivo testing? (Select all that apply.)

    a.       coccidioidin
    b.      mantoux
    c.       histoplasmin
    d.     immune globulin
    a, b, c
  81. What are the recommended vaccines for children who are starting school?

    a.      HepB series, DTap, and varicella
    b.     HepB series, MMR, and IPV
    c.       HepB series, DTap, MMR, IPV, and varicella
    d.     HepB series, IPV, and varicella
  82. Salicylates have which of the following effects? (Select all that apply.)

    a.      antiseptic
    b.      analgesia
    c.       anti-inflammatory
    d.      antipyretic
    b, c, d
  83. In addition to aspirin having the greatest anti-inflammatory effect of all salicylates, it also affects what?

    a.      white blood cells and factor VIII
    b.     red blood cells and factor X
    c.       platelets and factor III
    d.     lymphocytes and factor II
  84. Salicylates are most commonly used in the treatment of which of the following conditions? (Select all that apply.)

    a.      GI bleeding
    b.      pain in muscles and joints
    c.       various forms of arthritis
    d.     thyroid conditions
    b, c
  85. Which of the following are salicylates? (Select all that apply.)

    a.      Aspergum
    b.     Acephen
    c.      Ascriptin
    d.     Nalfon
    a, c
  86. Two common adverse reactions to salicylate analgesics include:

    a.       tinnitus and GI bleeding.
    b.     visual disturbances and metabolic alkalosis.
    c.      bradycardia and anorexia.
    d.     hyperthyroidism and stupor.
  87. What is the initial drug of choice in the treatment of osteoarthritis?

    a.      pencillamine
    b.     ibuprofen
    c.       acetaminophen
    d.     salicylates
  88. What is one important difference between aspirin and acetaminophen?

    a.       Aspirin has anti-inflammatory properties and acetaminophen does not.
    b.     Acetaminophen has anti-inflammatory properties
    and aspirin does not.
    c.      Aspirin has antipyretic properties and acetaminophen does not.
    d.     Acetaminophen has antipyretic properties and aspirin does not.
  89. What are non-steroidal anti-inflammatory drugs (NSAIDs) contraindicated in patients who have a history of allergy to aspirin?

    a.      Because aspirin can cause low toxicity in patients taking NSAIDs.
    b.      Because NSAIDs are closely related to aspirin and a cross-sensitivity may develop.
    c.      Because aspirin can cause worsening of joint pain in patients taking NSAIDs.
    d.     Because NSAIDs can cause low toxicity in patients who react to salicylates.
  90. Situations in which salicylate use might be contraindicated would include surgery, before labor, or in patients with transient ischemic attacks (TIAs) because:

    a.       bleeding may be increased.
    b.     weight gain may result.
    c.      hypersensitivity may occur.
    d.     pain may increase.
  91. 1.      
    Reye's syndrome can occur in children who are
    given aspirin for symptoms of a viral illness; it is represented by the
    following symptoms:

    fever, chills, and rash.

    diarrhea, restlessness, hyperactivity, and

    c.       vomiting, lethargy, delirium, and coma.

    joint pain and muscle weakness.
  92. Which vitamin is known to increase the effects of salicylates?

    a.      vitamin B1 (thiamine)
    b.     vitamin K
    c.      vitamin E
    d.     vitamin C (ascorbic acid)
  93. How does aspirin cause the anti-inflammatory and analgesic effects that it has?
    a.       Aspirin blocks the production of cyclooxygenase.
    b.      Aspirin increases production of prostaglandins.
    c.      Aspirin interferes with platelet aggregation.
    d.     Aspirin inhibits the secretion of norepinephrine.
  94. Which of these patients can be given salicylates?

    a.      Mr. Avarado, who has cirrhosis of the liver
    b.      Mrs. Leido, who is in her second trimester of pregnancy
    c.      Bobbie Feldman, who has chickenpox
    d.     Sally Pederson, who has asthma
  95. What will you tell your patient who tells you that her Motrin does not work for her pain anymore?

    a.      "We will have to try another type of pain medication."
    b.     "We will have to start you on aspirin instead."
    c.      "We will have to try a different NSAID, because they work slightly differently from each other."
    d.     "We can try to increase the dose until it does become effective."
  96. COX-1, a form of cyclooxygenase, is found in
    which areas of the body? (Select all that apply.)

    a.       blood vessels
    b.      stomach
    c.      brain
    d.      kidneys
    a, b, d
  97. In diabetic patients taking salicylates, they:

    a.       may give a false reading in those patients using Benedict's Clinitest.
    b.     may give a false reading in those patients using a glucometer.
    c.      have no effect on diabetic urine or blood tests.
    d.      may cause hyperglycemia.
  98. Aspirin is used for relief of pain and inflammation and is available:

    a.      by prescription only.
    b.     as an over-the-counter (OTC) medication.
    c.       as an OTC medication and by prescription.
    d.     exclusively through the Internet.
  99. Tinnitus is describe as a:

    a.      sharp pain in the ocular area.
    b.     sensation of fullness in the ears.
    c.      slight jerking movement of the eyes.
    d.      ringing sensation in the ears.
  100. Drugs that inhibit COX-1 and COX-2 enzymes are considered to have the property of: (Select all that apply.)

    a.       analgesia.
    b.      anti-inflammation.
    c.       antipyretic.
    d.     anti-infection.
    a, b, c
  101. Which of the following medications are
    considered NSAIDs? (Select all that apply.)

    a.      Ecotrin
    b.      Clinoril
    c.       Toradol
    d.      Feldene
    b, c, d
  102. How is the dosage of salicylates in arthritic patients determined?

    a.      Increase the dose of aspirin until the salicylate levels are over the maximum.
    b.      Increase the dose of aspirin until the symptoms improve.
    c.      Increase the dose aspirin until bleeding occurs.
    d.     Increase the dose of aspirin until tinnitus occurs.
  103. Drug interactions between acetaminophen and hydantoin or barbiturates may increase the risk for:

    a.      nephrotoxicity.
    b.      hepatotoxicity.
    c.      neuropathy.
    d.     hyperglycemia.
  104. What is the antidote for acetaminophen overdose?

    a.      ketorolac
    b.     activated charcoal
    c.      rifampin
    d.      acetylcysteine
  105. For which of the inflammatory condition is aspirin useful in relieving symptoms? (Select all that apply.)

    a.       acute rheumatic fever
    b.      systemic lupus erythematosus
    c.       myalgias (muscle pain)
    d.     transient ischemic attacks
    a, b, c
  106. Why is aspirin not recommended to be given to women for prevention of TIAs or strokes?

    a.      It does not seem to work.
    b.     It causes too many adverse reactions.
    c.      It tends to cause increased uterine bleeding.
    d.     It increases GI distress.
  107. Richard Sutton has been taking NSAIDs regularly for a sports injury. He finds that the medications produce gastric irritation. You might tell him that:

    a.       taking the medication with food or milk helps to reduce the problems of gastric irritation.
    b.     these medications should be taken on an empty
    c.      gastric irritation cannot be avoided.
    d.     his medication will need to be changed.
  108. Your patient is going home on acetaminophen and you are reviewing adverse reactions. What will you tell her about her medication?

    a.      "Tylenol is very safe because you can get
    it over the counter."
    b.     "You need to be careful about taking this after a viral illness' it can cause Reye's syndrome."
    c.       "If you develop severe pain or a high fever, contact your physician."
    d.     "It should be safe for you to take as much as you want; there are very rare incidences of overdose."
  109. You are discussing what side effects to expect with NSAIDs to your patient, and the following would be included in your discussion as symptoms to report to the physician: (Select all that apply.)

    a.       ringing in the ears
    b.      visual disturbances
    c.       drowsiness and lightheadedness may occur
    d.     relief of pain and increased alertness
    a, b, c
  110. Periodic laboratory tests recommended for patients taking NSAIDs include: (Select all that apply.)

    a.       hemoglobin.
    b.     creatinine.
    c.       red blood cell count.
    d.      platelets.
    a, c, d
  111. The main action of skeletal muscle relaxants is to: (Select all that apply.)

    a.       decrease muscle tone and involuntary movement without loss of voluntary motor function.
    b.      inhibit transmission of impulses in the motor pathway at the level of the spinal cord.
    c.       interfere with the contractile mechanism of the skeletal muscle fibers (direct myotophic blocking).
    d.     contract the muscles involuntarily.
    a, b, c
  112. Skeletal muscle relaxants are used in which of the following situations. (Select all that apply.)

    a.       relieving pain in musculoskeletal disorders
    involving peripheral injury and inflammation
    b.      relieving pain in neurologic disorders involving peripheral injury
    c.      reducing tension in joints and ligaments
    d.      relief of pain in low back syndrome
    a, b, d
  113. Common adverse reactions of skeletal muscle relaxants include: (Select all that apply.)

    a.       irritability and insomnia.
    b.     polyphagia and polyuria.
    c.       hypotension and syncope.
    d.      flushing and tachycardia.
    a, c, d
  114. Central nervous system (CNS) depressants that are known to interact additively with skeletal muscle relaxants include: (Select all that apply.)

    a.      hydantoins.
    b.      narcotics.
    c.       hypnotics.
    d.     selective serotonin reuptake inhibitors (SSRIs).
    b, c
  115. Long-term use of skeletal muscle relaxants is not recommended because it can cause:

    a.      idiosyncratic reactions.
    b.     increased muscle spasms.
    c.       hepatotoxicity.
    d.     temporary loss of hearing.
  116. Skeletal muscle relaxants come in which two forms?

    a.      intrathecal and parenteral
    b.     rectal and oral
    c.      intranasal and parenteral
    d.      oral and parenteral
  117. Why are injectable forms of skeletal muscle relaxants purported to be more effective than oral medications?

    a.      They increase muscle tone and involuntary
    b.      They are better absorbed than oral medications.
    c.      They induce more adverse reactions.
    d.     They need to have 10 times the dose of oral
  118. What two drugs are in the combination drug Robaxisal?

    a.       aspirin and methocarbamol
    b.     aspirin and orphenadrine
    c.      aspirin and carisoprodol
    d.     aspirin and tizanidine
  119. You are reviewing an order for Robaxin. Which order would you need to clarify before giving?

    a.       Robaxin 30 mg IV every 8 hours
    b.     Robaxin 10 mg IV every 8 hours
    c.      Robaxin 750 mg orally every 6 hours
    d.     Robaxin 1.5 g orally every 6 hours
  120. Occasionally, an idiosyncratic reaction may follow the first dose of a skeletal muscle relaxant. Symptoms, seen within minutes or hours of the first dose, include:

    a.      severe nausea, vomiting, and weakness.
    b.      temporary loss of vision, weakness, dizziness, and confusion.
    c.      respiratory depression, confusion, and drowsiness.
    d.     paradoxical excitation, insomnia, and tachycardia.
  121. Skeletal muscle relaxants may cause which of the following? (Select all that apply.)

    a.       hepatotoxicity
    b.      nephrotoxicity
    c.      ototoxicity
    d.      blood dyscrasias
    a, b, d
  122. If the skeletal muscle relaxant has been given for 45 days without any signs of improvement:

    a.      discontinue the drug because if cannot be effective.
    b.     increase the dosage to achieve better results.
    c.       discontinue the drug due to an increased risk of hepatotoxicity.
    d.     switch to another skeletal muscle relaxant because the patient may have developed tolerance to the product.
  123. Your patient drives a semi-truck for a living. What can you tell him about his Flexeril that he is taking for his back spasms?

    a.      "You will need to call your health care provider if you ever miss a dose."
    b.      "You should avoid driving and operating heavy machinery while taking this drug."
    c.      "You can take any over-the-counter medication; they will be safe to take with this drug."
    d.     "You will have to quit your job because you will not be allowed to drive a truck anymore."
  124. You need to gradually reduce the dosage of skeletal muscle relaxants before stopping them to avoid what kind of symptoms?

    a.      therapeutic
    b.      withdrawal
    c.      allergic
    d.     adverse reactions
  125. What side effects would you need to instruct your patient to contact a health care provider immediately if they develop? (Select all that apply.)

    a.       dizziness or fainting
    b.      shortness of breath and wheezing
    c.       unusually fast heart rate
    d.     relief of spasms
    a, b, c
  126. These are slow-acting antirheumatic drugs
    (SAARDs) used in the treatment of severe rheumatoid arthritis. (Select all that apply.)

    a.       methotrexate
    b.     remeron
    c.       pencillamine
    d.      gold compounds
    e.      hydroxychloroquine sulfate
    f.       simethicone
    a, c, d, e
  127. The difference between rheumatoid arthritis and osteoarthritis is that rheumatoid arthritis is: (Select all that apply.)

    a.      a more local process and osteoarthritis is a
    systemic disease.
    b.      a systemic disease and osteoarthritis is a more local process.
    c.      a result of overuse and osteoarthritis is an autoimmune response.
    d.      an autoimmune response and osteoarthritis is a result of overuse.
    b, d
  128. Patients who suffer from arthritis find:

    a.       great difficulty getting good relief from
    anti-arthritis drugs.
    b.     it helpful to use acupuncture instead of drugs.
    c.      using anti-arthritis drugs works best for
    symptom relief.
    d.     the drugs prescribed help with the swelling but
    not the pain.
  129. Which herbal products are popular to use in the
    treatment of osteoarthritis? (Select all that apply.)

    a.       chondroitin
    b.      glucosamine
    c.      bromelain
    d.      ginger
    a, b, d
  130. What are the first-line drugs used for the treatment of arthritis?

    a.       salicylates and NSAIDs
    b.     SAARDs and SSRIs
    c.      beta-blockers and anti-dysrhythmics
    d.     narcotics and antiemetics
  131. Which anti-arthritis drug has the FDA warning label on it that alerts health care providers not to give to pregnant women?

    a.      infliximab
    b.     pencillamine
    c.       leflunomide
    d.     gold salts
  132. This arthritis medication is toxic to the bone marrow and used for patients who are unresponsive to other treatments.

    a.      pencillamine
    b.     gold salts
    c.      hydroxychloroquine sulfate
    d.      methotrexate
  133. Which anti-arthritis drug is also in the category of anti-malarial drugs?

    a.      methotrexate
    b.     pencillamine
    c.      gold compounds
    d.      hydroxychloroquine sulfate
  134. What is a nitritoid reaction?

    a.      an adverse reaction causing hepatotoxicity
    caused by gold compounds
    b.      a mild and benign reaction that is caused
    by gold compounds
    c.      a withdrawal reaction after patients take gold
    for too long
    d.     a severe allergic reaction to gold compounds
  135. What is the irreversible side effect from taking hydroxychloroquine sulfate?

    a.      nephropathy
    b.      retinopathy
    c.      ototoxicity
    d.     anaphylactic shock
  136. A uricosuric agent is a drug that:

    a.       increases excretion of uric acid.
    b.     reduces the inflammation caused by gout.
    c.      increases uric acid levels in the blood.
    d.     increases tubular reabsorption of urate.
  137. What are the two mechanisms producing high uric acid levels in the body?

    a.      underproduction and over-excretion
    b.      overproduction and over-excretion
    c.      overproduction and under-excretion
    d.     underproduction and under-excretion
  138. What other medications in addition to uricosurics are used in treating patients with acute high uric acid levels?

    a.      anti-inflammatories and diuretics
    b.      anti-inflammatories and analgesics
    c.      anti-infectives and diuretics
    d.     antidepressants and muscle relaxants
  139. Probenecid has another action not related to gout. It acts to:

    a.       increase levels of penicillin.
    b.     increase levels of aspirin.
    c.      decrease levels of penicillin.
    d.     decrease levels of aspirin.
  140. Which antigout medication should not be started
    unless the patient does not respond to all other drugs?

    a.      colchicine
    b.      sulfinpyrazone
    c.      allopurinol
    d.     probenecid
  141. Which antigout medication inhibits the production of uric acid?

    a.      colchicine
    b.     probenecid
    c.       allopurinol
    d.     pencillamine
  142. Gout caused by uric acid forming crystals in the kidneys and joints presents with what symptoms? (Select all that apply.)

    a.      soft flow emanating from the area of crystals
    b.      severe pain in the area of crystals
    c.       warmth and increased heat in the area of crystals
    d.      inflammation in the area of the crystals
    b, c, d
  143. What is the only drug used for treatment of gouty attacks?

    a.      allopurinol
    b.     pencillamine
    c.       colchicine
    d.     probenecid
  144. Uricosuric agents are started:

    a.       usually after more than one acute attack.
    b.     after the first attack.
    c.      only after other agents have been tried.
    d.     after kidney stones are documented by flat plate x-ray.
  145. The joint in which gouty attacks occur in at least 50% of the cases is the:

    a.      phalangeal.
    b.     metacarpal.
    c.      metatarsal.
    d.      podagra.