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NSG 6005 Final Exam / NSG6005 Final Exam (Latest): South University (Already graded A)

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NSG 6005 Final Exam / NSG6005 Final Exam (Latest): South University

 

An ACE inhibitor and what other class of drug may reduce proteinuria in patients with diabetes better than either drug alone?

A. Beta blockers
B. Diuretics
C. Nondihydropyridine calcium channel blockers
D. Angiotensin II receptor blockers

C. Nondihydropyridine calcium channel blockers

 

Adam has type I diabetes and plays tennis for his university. He exhibits knowledge deficit about his insulin and his diagnosis. He should be taught that:

A. He should increase his increase his carbohydrate intake during times of exercise intake during times of exercise.
B. Each brand of insulin is equal in bioavailability, so buy the least expensive.
C. Alcohol produces hypoglycemia and can help control his diabetes when taken in small amounts.
D. If he does not want to learn to give himself injections, he may substitute an oral hypoglycemic to control his diabetes.

A. He should increase his increase his carbohydrate intake during times of exercise intake during times of exercise.

 

Age is a factor in different responses to pain. Which of the following age-related statements about pain is not true?

A. Preterm and newborn infants do not yet have functional pain pathways.
B. Painful experiences and prolonged exposure to analgesic drugs during pregnancy may permanently alter neuronal organization in the child.
C. Increases in pain threshold in older adults may be related to peripheral neuropathies and changes in skin thickness.
D. Decreases in pain tolerance are evident in older adults.

A. Preterm and newborn infants do not yet have functional pain pathways.

 

Alterations in drug metabolism among Asians may lead to:

A. Slower metabolism of antidepressants, requiring lower doses
B. Faster metabolism of neuroleptics, requiring higher doses
C. Altered metabolism of omeprazole, requiring higher doses
D. Slower metabolism of alcohol, requiring higher doses

A. Slower metabolism of antidepressants, requiring lower doses

 

Amiodarone has been prescribed in a patient with a supraventricular dysrhythmia. Patient teaching should include all of the following except:

A. Notify your healthcare provider immediately if you have visual change.
B. Monitor your own blood pressure and pulse daily.
C. Take a hot shower or bath if you feel dizzy.
D. Use a sunscreen on exposed body surfaces.

C. Take a hot shower or bath if you feel dizzy.

 

 

 

Anticholinergic agents, such as benztropine (Cogentin), may be given with a phenothiazine to:

A. Reduce the chance of tardive dyskinesia.
B. Potentiate the effects of the drug.
C. Reduce the tolerance that tends to occur.
D. Increase CNS depression.

A. Reduce the chance of tardive dyskinesia.

 

An appropriate drug for the treatment of depression with anxiety would be:

A. Alprazolam (Xanax)
B. Escitalopram (Lexapro)
C. Buspirone (Buspar)
D. Amitriptyline (Elavil)

B. Escitalopram (Lexapro)

 

Cara is taking levetiracetam (Keppra) to treat seizures. Routine education for levetiracetam includes reminding her:

A. To not abruptly discontinue levetiracetam due to the risk of withdrawal seizures
B. To wear a sunscreen due to photosensitivity from levetiracetam
C. To get an annual eye exam while on levetiracetam
D. To report weight loss if it occurs

A. To not abruptly discontinue levetiracetam due to the risk of withdrawal seizure

 

Cecilia presents with depression associated with complaints of fatigue, sleeping all the time, and lack of motivation. An appropriate initial antidepressant for her would be:

A. Fluoxetine (Prozac)
B. Paroxetine (Paxil)
C. Amitriptyline (Elavil)
D. Duloxetine (Cymbalta)

D. Duloxetine (Cymbalta)

 

Chemical dependency assessment is integral to the initial assessment of chronic pain. Which of the following raises a "red flag" about potential chemical dependency?

A. Use of more than one drug to treat the pain
B. Multiple times when prescriptions are lost with requests to refill
C. Preferences for treatments that include alternative medicines
D. Presence of a family member who has abused drugs

B. Multiple times when prescriptions are lost with requests to refill

 

Common mistakes practitioners make in treating anxiety disorders include:

A. Switching medications after an eight-week trial to a twelve-week trial
B. Maximizing dosing of antianxiety medications
C. Encouraging exercise and relaxation therapy before starting medication
D. Thinking a partial response to medication is acceptable

D. Thinking a partial response to medication is acceptable

 

David presents to clinic with symptoms of allergic conjunctivitis. He is prescribed cromolyn sodium (Opticrom) eyedrops. The education regarding using cromolyn eyedrops includes which one of the following tips?


A. He should not wear his soft contacts while using the cromolyn eyedrops.
B. Cromolyn drops are instilled once a day to prevent allergy symptoms.
C. Long-term use of the eyedrop may cause glaucoma.
D. He may experience bradycardia as an adverse effect.

A. He should not wear his soft contacts while using the cromolyn eyedrops.

 

The DEA:

A. Registers manufacturers and prescribes controlled substances
B. Regulates NP prescribing at the state level
C. Sanctions providers who prescribe drugs off-label
D. Provides prescribers with a number they can use for insurance billing

A. Registers manufacturers and prescribes controlled substances

 

Diagnostic criteria for diabetes include:

A. Fasting blood glucose greater than 140 mg/dl on two occasions
B. Postprandial blood glucose greater than 140 mg/dl
C. Fasting blood glucose 100 to 125 mg/dl on two occasions
D. Symptoms of diabetes plus a casual blood glucose greater than 200 mg/dl

D. Symptoms of diabetes plus a casual blood glucose greater than 200 mg/dl

 

Disease states in addition to hypertension in which beta blockade is a compelling indication for the use of beta blockers include:

A. Heart failure
B. Angina
C. MI
D. Dyslipidemia

C. MI

 

The drug of choice for type II diabetics is metformin. Metformin:

A. Decreases glycogenolysis by the liver
B. Increases the release of insulin from beta cells
C. Increases intestinal uptake of glucose
D. Prevents weight gain associated with hyperglycemia

A. Decreases glycogenolysis by the liver

 

The drug recommended as primary prevention of osteoporosis in men over seventy years is:

A. Alendronate (Fosamax)
B. Ibandronate (Boniva)
C. Calcium carbonate
D. Raloxifene (Evista)

A. Alendronate (Fosamax)

 

 

The drug recommended as primary prevention of osteoporosis in women over seventy years old is:

A. Alendronate (Fosamax)
B. Ibandronate (Boniva)
C. Calcium carbonate
D. Raloxifene (Evista)

A. Alendronate (Fosamax)

 

The drugs recommended by the American Academy of Pediatrics for use in children with diabetes (depending upon type of diabetes) are:

A. Metformin and insulin
B. Sulfonylureas and insulin glargine
C. Split-mixed dose insulin and GLP-1 agonists
D.Biguanides and insulin lispro

A. Metformin and insulin

 

Drugs that have a significant first-pass effect:

A. Must be given by the enteral (oral) route only
B. Bypass the hepatic circulation
C. Are rapidly metabolized by the liver and may have little if any desired action
D. Are converted by the liver to more active and fat-soluble forms

C. Are rapidly metabolized by the liver and may have little if any desired action

 

Dwayne has classic tinea capitis. Treatment for tinea on the scalp is:

A. Rubbing in miconazole cream well for four weeks
B. Intake of oral griseofulvin for six to eight weeks
C. Shampooing with ketoconazole shampoo daily for six weeks
D. Using ciclopirox cream daily for four weeks

B. Intake of oral griseofulvin for six to eight weeks

 

Dwayne was recently started on carbamazepine to treat seizures. He comes to see you, and you note that while his carbamazepine levels had been in the therapeutic range, they are now low. The possible cause for the low carbamazepine levels is:

A. Dwayne hasn't been taking his carbamazepine because it causes insomnia.
B. Carbamazepine auto-induces metabolism, leading to lower levels in spite of good compliance.
C. Dwayne was not originally prescribed the correct amount of carbamazepine.
D. Carbamazepine is probably not the right antiseizure medication for Dwayne.

B. Carbamazepine auto-induces metabolism, leading to lower levels in spite of good compliance.

 

Erik presents with a golden-crusted lesion at the site of an insect bite consistent with impetigo. His parents have limited finances and request the least expensive treatment. Which medication would be the best choice for treatment?

A. Mupirocin (Bactroban)
B. Bacitracin and polymixin B (generic double antibiotic ointment)
C. Retapamulin (Altabax)
D. Oral cephalexin (Keflex)

B. Bacitracin and polymixin B (generic double antibiotic ointment)

First-line therapy for hyperlipidemia is:

A. Statins
B. Niacin
C. Lifestyle changes
D. Bile acid-binding resins

C. Lifestyle changes

 

First-line therapy for treating topical fungal infections such as tinea corporis (ringworm) or tinea pedis (athlete's foot) would be:

A. OTC topical azole (clotrimazole, miconazole)
B. Oral terbinafine
C. Oral griseofulvin microsize
D. Nystatin cream or ointment

A. OTC topical azole (clotrimazole, miconazole)

 

Furosemide is added to a treatment regimen for heart failure, which includes digoxin. Monitoring for this combination includes:

A. Hemoglobin
B. Serum potassium
C. Blood urea nitrogen
D. Serum glucose

B. Serum potassium

 

Genetic polymorphisms account for differences in metabolism, including:

A. Poor metabolizers (PMs) that lack a working enzyme
B. Intermediate metabolizers (IMs) that have one working, wild-type allele and one mutant allele
C. Extensive metabolizers (EMs), with two normally functioning alleles
D. All of the above

D. All of the above

 

Genetic testing for VCORC1 mutation to assess potential warfarin resistance is required prior to prescribing warfarin.

A. True
B. False

B. False

 

Goals of treatment when treating hypothyroidism with thyroid replacement include:

A. Normal TSH and free T4 levels
B. Resolution of fatigue
C. Weight loss to baseline
D. All of the above

D. All of the above

 

 

 

Heart failure is a chronic condition that can be adequately managed in primary care. However, consultation with or referral to a cardiologist is appropriate when:

A. Symptoms markedly worsen or the patient becomes hypotensive and has syncope.
B. There is evidence of progressive renal insufficiency or failure.
C. The patient remains symptomatic on optimal doses of an ACE inhibitor, a beta blocker, and a diuretic.
D. All the above options are correct.

D. All the above options are correct.

 

Hypoglycemia can result from the action of either insulin or an oral hypoglycemic. Signs and symptoms of hypoglycemia include:

A. "Fruity" breath odor and rapid respiration
B. Diarrhea, abdominal pain, weight loss, and hypertension
C. Dizziness, confusion, diaphoresis, and tachycardia
D. Easy bruising, palpitations, cardiac dysrhythmias, and coma

C. Dizziness, confusion, diaphoresis, and tachycardia

 

If a patient with H. pylori positive PUD fails first-line therapy, the second-line treatment is:

A. A PPI BID plus metronidazole plus tetracycline plus bismuth subsalicylate for fourteen days
B. Testing H. pylori for resistance to common treatment regimens
C. A PPI plus clarithromycin plus amoxicillin for fourteen days
D. A PPI and levofloxacin for fourteen days

A. A PPI BID plus metronidazole plus tetracycline plus bismuth subsalicylate for fourteen days

 

In addition to methimazole, a symptomatic patient with hyperthyroidism may need a prescription for:


A. A calcium channel blocker
B. A beta blocker
C. Liothyronine
D. An alpha blocker

B. A beta blocker

 

Inadequate vitamin D intake can contribute to the development of osteoporosis by:

A. Increasing calcitonin production
B. Increasing calcium absorption from the intestine
C. Altering calcium metabolism
D. Stimulating bone formation

B. Increasing calcium absorption from the intestine

 

Incorporating IT into a patient encounter takes skill and tact. During the encounter, the provider can make the patient more comfortable with the IT the provider is using by:

A. Turning the screen around so the patient can see material being recorded
B. Not placing the computer screen between the provider and the patient
C. Both A and B
D. Neither A nor B

C. Both A and B

 

Infants with reflux are initially treated with:

A. Histamine 2 receptor antagonist (ranitidine)
B. A PPI (omeprazole)
C. Antireflux maneuvers (elevate the head of the bed)
D. Prokinetic (metoclopramide)

C. Antireflux maneuvers (elevate the head of the bed)

 

In five- to eleven-year-old children, mild-persistent asthma is diagnosed when asthma symptoms occur:

A. At nighttime one to two times a month
B. At nighttime three to four times a month
C. Less than twice a week
D. Daily

B. At nighttime three to four times a month

 

Jack, eight years old, has attention deficit disorder (ADD) and is prescribed methylphenidate (Ritalin). He and his parents should be educated about the side effects of methylphenidate, which are:

A. Slurred speech and insomnia
B. Bradycardia and confusion
C. Dizziness and orthostatic hypotension
D. Insomnia and decreased appetite

D. Insomnia and decreased appetite

 

Janie presents to clinic with hard ear wax in both ear canals. Instructions regarding home removal of hard cerumen includes:

A. Moistening a cotton swab (Q-tip) and swabbing the ear canals twice daily
B. Instilling tap water in both ears while bathing
C. Squirting hydrogen peroxide into ears with each bath
D. Instilling carbamide peroxide (Debrox) twice daily until the ear canals are clear

D. Instilling carbamide peroxide (Debrox) twice daily until the ear canals are clear

 

Jim presents with complaints of "heart burn" that is minimally relieved with Tums (calcium carbonate) and is diagnosed with GERD. An appropriate first step therapy would be:

A. Omeprazole (Prilosec) twice a day
B. Ranitidine (Zantac) twice a day
C. Famotidine (Pepcid) once a day
D. Metoclopramide (Reglan) four times a day

B. Ranitidine (Zantac) twice a day

 

Jim presents with fungal infection of two of his toenails (onychomycosis). Treatment for fungal infections of the nail includes:

A. Miconazole cream
B. Ketoconazole cream
C. Oral griseofulvin
D. Mupirocin cream

C. Oral griseofulvin

Josie is a five-year-old who presents to the clinic with a forty-eight-hour history of nausea, vomiting, and some diarrhea. She is unable to keep fluids down, and her weight is 4 pounds less than her last recorded weight. Besides intravenous (IV) fluids, her exam warrants the use of an antinausea medication. Which of the following would be the appropriate drug to order for Josie?

A. Prochlorperazine (Compazine)
B. Meclizine (Antivert)
C. Promethazine (Phenergan)
D. Ondansetron (Zofran)

D. Ondansetron (Zofran)

 

Kirk sprained his ankle and is asking for pain medication for his mild-to-moderate pain. The appropriate first-line medication would be __________.


A. ibuprofen (Advil)
B. acetaminophen with hydrocodone (Vicodin)
C. oxycodone (OxyContin)
D. oral morphine (Roxanol)

A. ibuprofen (Advil)

 

Liza is breastfeeding her two-month-old son, and she has an infection that requires an antibiotic. What drug factors influence the effect of the drug on the infant?

A. Maternal drug levels
B. Half-life
C. Lipid solubility
D. All of the above

D. All of the above

 

Long-acting beta-agonists received a black box warning from the US Food and Drug Administration due to the:

A. Risk of life-threatening dermatological reactions
B. Increased incidence of cardiac events when long-acting beta-agonists are used
C. Increased risk of asthma-related deaths when long-acting beta-agonists are used
D. Risk for life-threatening alterations in electrolytes

C. Increased risk of asthma-related deaths when long-acting beta-agonists are used

 

Long-term treatment of moderate atopic dermatitis includes:

A. Topical corticosteroids and emollients
B. Topical corticosteroids alone
C. Topical antipruritics
D. Oral corticosteroids for exacerbations of atopic dermatitis

A. Topical corticosteroids and emollients

 

Medications used in the management of patients with COPD include:

A. Inhaled beta 2 agonists
B. Inhaled anticholinergics (ipratropium)
C. Inhaled corticosteroids
D. All of the above

D. All of the above

 

Monitoring for a child on methylphenidate for ADHD includes:

A. ADHD symptoms
B. Routine height and weight checks
C. Amount of methylphenidate being used
D. All of the above

D. All of the above

 

Narcotics are exogenous opiates. They act by ______.

A. inhibiting pain transmission in the spinal cord
B. attaching to receptors in the afferent neuron to inhibit the release of substance P
C. blocking neurotransmitters in the midbrain
D. increasing beta-lipoprotein excretion from the pituitary

B. attaching to receptors in the afferent neuron to inhibit the release of substance P

 

A nineteen-year-old male was started on risperidone. Monitoring for risperidone includes observing for common side effects, including:

A. Bradykinesia, akathisia, and agitation
B. Excessive weight gain
C. Hypertension
D. Potentially fatal agranulocytosis

A. Bradykinesia, akathisia, and agitation

 

Nonadherence is especially common in drugs that treat asymptomatic conditions, such as hypertension. One way to reduce the likelihood of nonadherence to these drugs is to prescribe a drug that:

A. Has a short half-life so that missing one dose has limited effect
B. Requires several dosage titrations so that missed doses can be replaced with lower doses to keep costs down
C. Has a tolerability profile with less of the adverse effects that are considered "irritating," such as nausea and dizziness
D. Must be taken no more than twice a day

C. Has a tolerability profile with less of the adverse effects that are considered "irritating," such as nausea and dizziness

 

Off-Label prescribing is:

A. Regulated by the FDA
B. Illegal by NPs in all states (provinces)
C. Legal if there is scientific evidence for the use
D. Regulated by the DEA

C. Legal if there is scientific evidence for the use

 

One goal of asthma management in children is:

A. They should independently manage their asthma.
B. They should participate in school and sports activities.
C. There should be no exacerbations.
D. The use of inhaled corticosteroids should be minimal.

B. They should participate in school and sports activities.

 

The ongoing monitoring of patients over the age sixty-five years taking alendronate (Fosamax) or any other bisphosphonate is:

A. Annual dual energy X-ray absorptiometry (DEXA) scans
B. Annual vitamin D level
C. Annual renal function evaluation
D. Electrolytes every three month

C. Annual renal function evaluation

 

A patient has been prescribed silver sulfadiazine (Silvadene) cream to treat burns on his or her leg. Normal adverse effects of silver sulfadiazine cream include:


A. Transient leukopenia on days two to four that should resolve
B. Worsening of burn symptoms briefly before resolution
C. A red, scaly rash that will resolve with continued use
D. Hypercalcemia

A. Transient leukopenia on days two to fou

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