pharm:4

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itzlinds
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270606
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pharm:4
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2014-04-30 23:31:12
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mock exam
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mock exam
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  1. blood pressure is primarily controlled by the autonomic nervous system, thus

    A. meds. that block cholinergic receptors can effectively dilates arteries
    B. almost all blood pressure meds. are parasympathomimetics
    C. two classes of anti hypertensives work by blocking adrenergic receptors
    D. adrenergic agonists are very effective anti hypertensives
    C. two classes of anti  hypertensives work by blocking adrenergic receptors
    (this multiple choice question has been scrambled)
  2. how can compliance with anti hypertensive drug therapy be improved.

    A. telling the pt. to report any side effects so that they can be placed on a med. that doesnt cause them any side effects
    B. sufficeint explanation of ortho hypotension and the need to change position slowly
    C. use of combination meds. such as an ACEI with a diuretic
    D. explaining to the pt. the dangers of not taking their meds. such as heart disease and debilitating CVAs
    D. explaining to the pt. the dangers of not taking their meds. such as heart disease and debilitating CVAs
    (this multiple choice question has been scrambled)
  3. which of the following are MOAs for anti - HTN meds:

    1. lowering the HR and decreasing contractility, decreasing C.O.
    2. decreaseing Ca++ movement into arterial smooth muscle thus decreasing arterial contraction
    3. decreasing preload by increasing Na+ and fluid excretion
    4. blocking some of the adrenergic receptors on arterial smooth muscle thus blocking some arterial smooth muscle constriction
    5. decreasing angiotensin 2 production or blocking receptors for it, thus decreasing arterial smooth muscle constriction


    a. all of the above
    b. all except #2
    c. none of the above
    d. all except 2 and 5
    a. all of the above
  4. which of the following are possible diruetic adverse effects?

    A. constipation and peripheral edema
    B. bronchospasm
    C. dehydration and K+ imbalance
    D. hypoglycemia
    C. dehydration and K+ imbalance
    (this multiple choice question has been scrambled)
  5. which of the following are possible CCB adverse effects?

    A. dehydration and K+ imbalance
    B. hypoglycemia
    C. bronchospasm
    D. constipation and peripheral edema
    D. constipation and peripheral edema
    (this multiple choice question has been scrambled)
  6. which of the following 2 drugs should not be given together b/c they both increase the K+ level:

    A. CCB and Beta blockers
    B. thiazide diuretics & digoxin
    C. ACEIs/ARBs & aldosterone blockers
    D. nitrates and anti coagulants
    C. ACEIs/ARBs & aldosterone blockers
    (this multiple choice question has been scrambled)
  7. a client to be D/C'ed with a prescription for the thiazide diuretic hydrochlorothiazide (Diuril) should be given which of the following instructions?

    A. weigh your self monthly and report it to HCP
    B. try to sleep in an upright position
    C. drink at least 8-10 glasses of water a day
    D. eat bananas or oranges regularly
    D. eat bananas or oranges regularly
    (this multiple choice question has been scrambled)
  8. which assesment data should the RN obtain prior to adminstering a CCB?

    A. current telemetry reading
    B. serum Ca++ level
    C. radial pulse
    D. client BP
    D. client BP
    (this multiple choice question has been scrambled)
  9. CCBs should never be given with which of the following:

    A. prunes
    B. grapefruit juice
    C. alcohol
    D. food high in complex carbs
    B. grapefruit juice
    (this multiple choice question has been scrambled)
  10. Nitrates should never be given with which of the following:

    A. food high in complex carbs
    B. alcohol
    C. prunes
    D. grapefruit juice
    B. alcohol
    (this multiple choice question has been scrambled)
  11. epinephrine is the drug of choice for anaphylaxis because

    A. it blocks the effects of histamine
    B. it is a non selective adrenergic agonist so it produces vasoconstriction to increase BP, stimulate beta 1 receptors to increase C.O. and stimulates beta 2 receports to produce bronchodilation
    C. it helps pull fluid from the interstitial space back into the vascular bed
    D. it is the most powerful anti inflammatory
    B. it is a non selective adrenergic agonist so it produces vasoconstriction to increase BP, stimulate beta 1 receptors to increase C.O. and stimulates beta 2 receports to produce bronchodilation
    (this multiple choice question has been scrambled)
  12. colloids are effective in expanding blood volume with shock because they

    A. reverse the increased capillary permeability that occurs with shock
    B. release sodium, pulling water into blood from the interstitial spaces
    C. contain large molecules such as albumin that stay in the blood and increase plasma oncotic pressure thus pulling fluids from the interstitial spaces
    D. are dilute fluids that replenish the vascular and interstitial spaces
    C. contain large molecules such as albumin that stay in the blood and increase plasma oncotic pressure thus pulling fluids from the interstitial spaces
    (this multiple choice question has been scrambled)
  13. regarding vasoconstrictors

    A. they start working quickly after they are given but can cause organ damage
    B. they are most effective with hypotension secondary to blood loss
    C. they have a long half life so their effects persists long after they are stopped
    D. they can cause hemorrhaging
    A. they start working quickly after they are given but can cause organ damage
    (this multiple choice question has been scrambled)
  14. the HCP prescribed a beta blocker for the client diagnosed with arterial HTN. which is the scientific rationale for adminstering this med?

    A. this med decreases the sympathetic stimulation to the heart, thereby decreasing the clients HR, which lowers the BP
    B. this med prevents the release of aldosterone, which decreases the abosorption of Na+ and water which in turn decreases Bp
    C. this med prevents the Ca++ from entering the cell, which helps decrease the clients BP
    D. this med will casuse an increased excretion of water from the vasuclar system, which will decrease the BP
    A. this med decreases the sympathetic stimulation to the heart, thereby decreasing the clients HR, which lowers the BP
    (this multiple choice question has been scrambled)
  15. which of the following are potential side effects of ACEIs

    1. dehydration
    2. poor exercise tolerance
    3. cough
    4. angioedema
    5. pedal edeam
    6. hyperkalemia

    a. 1,2,5
    b. 3,4,6
    c. all of the above
    d. 1,3,4,5
    b.
  16. the anti HTN side effect of ortho hypotension can be managed by:

    A. not smoking
    B. change position slowly
    C. getting adequate potassium
    D. taking anti HTN med early in the day
    B. change position slowly
    (this multiple choice question has been scrambled)
  17. which 2 classes of anti HTN drugs are most likely to be implicated of angioedema?

    A. ACEIs and ARBs
    B. thiazide diuretics & loop diuretics
    C. selective and non selective CCBs
    D. alpha 2 agonists & alpha 1 blockers
    A. ACEIs and ARBs
    (this multiple choice question has been scrambled)
  18. which BP lowering med can cause constipation and heahaches?

    A. alpha 1 blockers
    B. CCBs
    C. BBs
    D. ARBS
    B. CCBs
    (this multiple choice question has been scrambled)
  19. how do ACEIs differ from ARBs?

    1. ACEIs decrease production of enzyme needed to make angiotension II, a powerful vasoconstrictors
    2. ARBs block the receptor for angiotensin II
    3. only ACEIs decrease aldosterone and thus lower the Na++ level but increase K+ level
    4. only ARBs can produce a cough
    5. only ARBS can cause angioedema
    1&2
  20. which anti HTN listed below could cause bronchoconstriction?

    A. alpha 2 agonist
    B. non selective beta blocker
    C. thiazide diuretics
    D. selective CCBs
    B. non selective beta blockers
    (this multiple choice question has been scrambled)
  21. which group of drugs are most often used to tx compensated heart failure?

    A. loop diuretics, CCBs and adrenergic agents
    B. alpha 2 blockers, ACEIs/ARBs and CCBs
    C. thiazides diruetics, ACEIs/ARBs and some beta blockers
    D. alpha 1 blockers, beta blockers and CCBs
    C. thiazide dirjuetics, ACEIs/ARBs, and some beta blockers
    (this multiple choice question has been scrambled)
  22. a client with HF is prescribed the ACEI enalarpil (vasotec). which statement below explains the scientific rational for administering it.

    A. ACEIs dialte arteries to reduced the heart work load
    B. ACEIs block the actin of antidiuretic hormone in the kideny
    C. ACEIs increase the angiotensin II level in blood vessels
    D. ACEIs decrease the effects of bradykinin in the body
    A. ACEIs dialte arteries to reduced the heart work load
    (this multiple choice question has been scrambled)
  23. what is the role of cardiac glyocsides in the tx of HF?

    A. they are positive inotropics increasing myocyte calcium and thus strengthening contractions
    B. the increase the K+ level in the heart cells and thus increase BP
    C. they mimic catecholamines (thus they're sympathomimetics)
    D. they increase the flow of blood to the heart so that it contracts more often and with greater force
    A. they are positive inotropics increasing myocyte calcium and thus strengthening contractions


    d. they mimic catecholamines (thus they're sympathomimetics) block catecholamines with HF
    (this multiple choice question has been scrambled)
  24. what is the role of CCBs and Beta Blockers in the tx of HF?
    they are negative inotropics, so they decrease HR, decrease contractility, and decrease the O2 demands of the heart
  25. why are cardiac glyosides not longer preferred primary tx for heart failure?

    A. there are many rx-rx interactions
    B. they have a wide therapeutic rage
    C. they can cause hyperkalemia
    D. they have a short half life so frequent dosing is necessary
    A. there are many rx-rx interactions
    (this multiple choice question has been scrambled)
  26. which classes of drugs are usually avoided if a pt. is on a cardiac glycoside?

    A. thiazide diuretics, beta blocker, CCBs
    B. alpha 1 blockers, nitrates and adrenergic agents
    C. anticoagulants and anti platelet drugs, as well as any type of thrombolytic
    D. ACEIs, ARBs, and alpha 2  agonists
    A. thiazide diuretics, beta blocker, CCBs

    cardiac glycosides, like digoxin, are positive inotropics

    beta blockers and CCB are negative inotriopics
    (this multiple choice question has been scrambled)
  27. which of the following indicates that they cardiac glyocside digoxin (lanoxin) for HF has been efffective?

    A. their HR is 78 bmp
    B. they have clear breath sounds bilateraly
    C. their sputum is pink and frothy
    D. they have 2+ pitting edeam of the sacrum
    B. they have clear breath sounds bilateraly


    78 bmp indicates the therapeutic range
    (this multiple choice question has been scrambled)
  28. ACEIs and ARBs decrease aldosterone production.  because of this they...

    A. increase Na+ excretion and thus decrease blood volume, decreasing preload
    B. increase the blood sugar and thus increase energy production and myocyte contractility
    C. decrease K+ and thus lower the BP
    D. decrease Na+ excretion thereby increasing afterload and thus BP as well
    A. increase Na+ excretion and thus decrease blood volume, decreasing preload

    prevents the body from lowering K+
    (this multiple choice question has been scrambled)
  29. a pt. with HF is taking a beta blocker gains 3# in one day, became SOB, and was spitting up pink, frothy sputum. What is the most likely cause of these new problems?

    A. their HF is worsening from teh beta blocker negative inotropic effect
    B. there is insufficient angiotensin II blockade
    C. their beta blocker is causing increased Na+ retention and thus fluid rentention
    D. they need a higher dose of their beta blocker bc they arent getting a sufficient increase in their contratility
    A. their HF is worsening from teh beta blocker negative inotropic effect
    (this multiple choice question has been scrambled)
  30. which of the following are potential side effects of the cardiac glyocside lanoxin (digoxin)?

    1. tachycardia
    2. easy brusing
    3. blurred vision
    4. halos around lights
    5. anorexia, nausea, vomitting
    6. muscle twitching
    7. yellow tint appearance
    3,4,5,7
  31. nesiritide (natrecor), a synthetic drug similar to natriuretic peptide (hBNP) made by the heart with volume overload, produces diureses and vasodilation, decreasing preload and afterload?

    a. true
    b. false
    a. true
  32. how can tolerance ot the therapeutic effect of long acting nitrates such as a nitro patch be avoided?

    A. use only as needed, such a before a peroid of increased activity
    B. apply tape over the patch
    C. remove the patch 10-12 hours/day
    D. apply the patch on a hairy or open area of skin
    C. remove the patch 10-12 hours/day
    (this multiple choice question has been scrambled)
  33. which drugs decrease the oxygen demand by the heart and thus improve heart fxn?

    A. ACEIs and ARBs
    B. diruetics and anticoagulants
    C. class 3 anti arrhythmics
    D. BBs and CCBs
    D. BBs and CCBs
    (this multiple choice question has been scrambled)
  34. NSAIDs ....

    A. are only available by prescription
    B. includes drugs such as Ibuprofen, asprini, and acteaminophen
    C. are the most poweful ant inflamm. drug
    D. are anti pyretics, analgesics, and in high doeses anti inflammatories
    D. are anti pyretics, analgesics, and in high doeses anti inflammatories
    (this multiple choice question has been scrambled)
  35. Name the most powerful anti inflammatory drugs:
    steroids
  36. which one of the following is not an NSAID:

    ibuprofen
    aspirin
    acetaminophen
    acetaminophen
  37. those on long term NSAIDs should be monitored for:

    A. dysrhythmias and new onset of back pain
    B. accelerated dental decay and fx
    C. s/sx of bleeding, renal/liver impairment, hyperglycemia
    D. bleeding, HTN, liver impairment
    D. bleeding, HTN, liver impairment
    (this multiple choice question has been scrambled)
  38. what is the drug class of predinsone:
    steroid anti inflammatory
  39. why should predinsone IM injections be given deep into the muscle:
    to avoid atrophy and infection in the muscle
  40. which of the following can occur with the long term use of prednisone:

    A. decreased pituitary gland production of ACTH - the tropic hormone that stimulates cortisol production
    B. increased blood clots
    C. increased susceptibility to hypoglycemia
    D. new onset of hypersensitivity rxns
    A. decreased pituitary gland production of ACTH - the tropic hormone that stimulates cortisol production
    (this multiple choice question has been scrambled)
  41. acetaminophen OD can cause:

    A. permanent blindness
    B. HF
    C. hepatic necrosis then failure if not reversed
    D. diabetic ketoacidosis
    C. heaptic necrosis then failure if not reversed
    (this multiple choice question has been scrambled)
  42. immunosuppressants are effective in suppresssing the immune response but:
    make infections and cancer more likely to develop
  43. if a pt is immunocompromised:
    the should NEVER receive any live vaccines
  44. how a drug interacts with the body to produce its effects is called:
    the drugs MOA
  45. movement of the drug from where it enters the body, across membranes to the circulation is called:
    absorption
  46. the transport of meds throughtout the body are called:
    distribution
  47. chemical changes of a drug, usually occuring in the liver and to a lesser extent in the GI and kidneys is called:
    metabolizm
  48. the difference between a drugs minimum effective concentration and toxic concentration is called:
    therapeutic range
  49. a drugs absorption by the stomach or small intestines causes it to travel to the liver before going to other tissues, thus the drug can be changed to the inactive form before it reaches the target tissues called:
    first pass metabolizm effect
  50. for the transdermal rx route, all of the following are necessary, except:

    the should be applied on areas with hair to enhance adhereence of the patch
    b. the old patch needs to be removed and the area cleaned before applying the patch to avoid rx overdose
    c. the date, time, and initals of the person applying it should always be written on the patch
    d. the person applying the patch should wear gloves to avoid rx absorption
    the should be applied on areas with hair to enhance adhereence of the patch
  51. the assigned drug name is called:
    generic name
  52. the drug company name for a drug is called the:
    brand name
  53. a representive drug from a drug class is called:
    prototype

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