Nursing MSN571 final exam questions with answers
Nursing MSN571 final exam questions with answers
1) A 40-year old female patient is being followed up for diabetes mellitus. She is currently on Metformin 1 gram twice a day and has been tolerating it well for about six months. Her hemoglobin A1c a week ago was 8.9%. The plan is to initiate liraglutide therapy in addition to the metformin.
Which of the following statements is true with regards to liraglutide.
▪ Liraglutide may be stored in the refrigerator or freezer prior to first use.
▪ The brand name is Bydureon
▪ Nausea and/or vomiting are common side effects of therapy
▪ It should be administered intramuscularly into the upper arm.
Answer. Nausea and/or vomiting are common side effects of therapy
2) The patient who takes insulin has just been prescribed a beta blocker drug. You recognize that the interaction of the beta blocker and the insulin may have which result?
▪ Decreased activity of the beta blocker drug
▪ Enhanced activity of the beta blocker drug
▪ Masked signs of hypoglycemia
▪ Masked signs of hyperglycemia
Answer. Masked signs of hypoglycemia
3) The drug of choice for type 2 diabetics is metformin. Metformin:
▪ Increases intestinal uptake of glucose
▪ Decreases glycogenolysis by the liver
▪ Increases the release of insulin from beta cells
▪ Prevents weight gain associated with hyperglycemia
Answer. Decreases glycogenolysis by the liver
4) Which classification of oral hypoglycemic drugs decreases hepatic glucose production and increases insulin sensitivity and peripheral glucose uptake?
▪ Sulfonylureas (glyburide)
▪ Meglitinides (glinides)
▪ Biguanide (metformin)
▪ alpha-glycosidase inhibitor (miglitol). Nursing MSN571 final exam, questions with answers.
Answer. Biguanide (metformin)
5) A breast-feeding mother is seen in your clinic wanting contraceptive and plans on breast-feeding for a year. What is an inappropriate choice for this patient?
▪ Depo-Provera 150mg IM every 3 months
▪ Progestin-only OC
▪ Combination OC
▪ Intrauterine device
Answer. Biguanide (metformin). Nursing MSN571 final exam, questions with answers.
6) Which of the following is (are) true about oral contraceptives (OCs)?
▪ Estrostep, Ortho Tri-Cyclen, Beyaz, and YAZ are approved for managing acne in women
▪ All the answers are correct
▪ OCs favorably affect menstrual symptoms: cramps reduction, reduced menstrual flow volume
and duration.
▪ OCs decrease the risk for several disorders, including ovarian cancer, endometrial cancer, ovarian
cysts, pelvic inflammatory disease, benign breast disease.
Answer. All the answers are correct
7) A patient is prescribed ehtinyl estradiol and norelgestromin transdermal contraceptive patch. Which statement, If made by the patient, indicates an understanding of the use of this drug?
▪ The patch prevents pregnancy by acting as barrier.
▪ I will experience minimal side effects because it is a progestin-only device.
▪ I will remove the patch each month and replace it with a new patch 1 week later.
▪ I will apply the patch in my vaginal area prior to having sexual intercourse.
Answer. I will remove the patch each month and replace it with a new patch 1 week later.
8) The NP at the immunization clinic is reviewing the list of patients who are scheduled to receive the varicella vaccination. The NP will cancel all of the following patients except:
▪ A 21-year old patient who is allergic to neomycin
▪ A 12-year old patient with an allergy to gelatin
▪ An 8-year old patient with asthma
▪ A patient who is pregnant
Answer. A patient who is pregnant
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9) The recommended range for maintaining serum theophylline levels is:
▪ 20 to 25 ug/ml
▪ 30 to 40 ug/ml
▪ 0.05 to 2 ug/ml
▪ 10 to 20 ug/ml
Answer. 10 to 20 ug/ml
10) For his asthma, a patient is prescribed albuterol in the form of an inhalant. The patient tells you the medication causes shakes and hand tremors. What is the best response?
▪ I will contact the respiratory therapist about your problem.
▪ Tremors are the most common side effect of this inhalant and will usually fade over time.
▪ The tremors are probably not related to the medication.
▪ I will contact your provider about your problem.
Answer. The tremors are probably not related to the medication.
11) A patient with COPD is acutely hypercapneic. Which respiratory therapy should you prescribe to lower the patient’s carbon dioxide concentration?
▪ Salmeterol
▪ Oxygen via a nasal cannula 2L/minute
▪ Fluticasone propionate
▪ Albuterol nebulizer
Answer. Albuterol nebulizer
12) A patient has been diagnosed with reflux esophagitis (GERD). What instruction by the NP is most appropriate?
▪ Exercise soon after eating to increase gastric emptying
▪ You need to schedule an upper GI endoscopy soon.
▪ Try these proton-pump inhibitors for 2 weeks.
▪ Over-the- counter antiemetics work well for this condition
Answer. Try these proton-pump inhibitors for 2 weeks.
13) A 39-year-old patient who has been taking a specific antibiotic for years without problems develops tachycardia, lowered blood pressure, wheezing, and urticaria when given this antibiotic in
the clinic. The most likely explanation for this occurrence is that the patient:
▪ Has received the wrong medication
▪ Is experiencing an anaphylactic hypersensitivity reaction to the antibiotic.
▪ Has developed autoimmunity.
▪ Is experiencing a reaction to something other than the antibiotic. Nursing MSN571 final exam, questions with answers.
Answer. Is experiencing an anaphylactic hypersensitivity reaction to the antibiotic.
- Which of the following medications has the most potential to significantly impair the ability to drive an automobile?
▪ Ranitidine
▪ Levocetirizine
▪ Diphenhydramine
▪ Fexofenadine
Answer. Diphenhydramine
15) Which of the following histamine receptor antagonists is known to enter the central nervous system readily and is known to be sedative?
▪ Desloratadine
▪ Hydroxyzine
▪ Cetirizine
▪ Loratadine
▪ Fexofenadine
Answer. Hydroxyzine. Nursing MSN571 final exam questions with answers.
16) What mechanism of action or pharmacological action is best associated with memantine?
▪ GABA analog
▪ Increases GABA concentration
▪ NMDA receptor antagonist
▪ NMDA receptor agonist
Answer. NMDA receptor agonist
17) During your assessment of a patient taking gabapentin which of the following side effects is most likely to be seen?
▪ SLE like syndrome
▪ Hypohidrosis
▪ Hypotension
▪ Hypertension
▪ Sedation
Answer. Sedation
18) Which of the following is most appropriate to communicate to a patient receiving specific brands for thyroid hormone replacement?
▪ Disulfiram like reaction with alcohol
▪ Increased risk of endometrial cancer
▪ Contraindicated in pregnancy
▪ No switching brands
Answer. No switching brands. Nursing MSN571 final exam questions with answers.
19) Metformin most likely causes which of the following?
▪ Increased gluconeogenesis
▪ Increased insulin sensitivity
▪ Decreased GI glucose absorption
▪ Increased pancreatic insulin release
Answer. Decreased GI glucose absorption
20) Primary hypothyroidism may be suspected in what scenario?
▪ If T3 high and T4 low
▪ If TSH high
▪ If TSH low
▪ If T3 high
Answer. If TSH high
21) Which mechanism of action or pharmacological action is best associated with sitagliptin (januvia) and saxagliptin (onglyza)?
▪ Binds PPAR-Gamma
▪ Decreases insulin resistance
▪ Increases insulin sensitivity
▪ DDP-4 inhibitor
Answer. DDP-4 inhibitor
22) Which of the following hormones is primarily released by the thyroid gland?
▪ Calcitonin
▪ TRH
▪ Free T4 (FT4)
▪ TSH
Answer. Free T4 (FT4). Nursing MSN571 final exam questions with answers.
23) Which of the following medications is associated with rapid acting insulin?
▪ Insulin glulisine (Apidra)
▪ Determir (Levemir)
▪ Regular insulin (Humulin R)
▪ Insulin glitter
Answer. Insulin glulisine (Apidra)
24) Which of the following diseases or disorders is most likely an indication for the use of levodopa/carbidopa?
▪ Addison’s disease
▪ Alzheimer’s disease
▪ Dent’s disease
▪ Parkinson’s disease
Answer. Parkinson’s disease
25) During your assessment of a patient taking serotonin norepinephrine reuptake inhibitors (SNRIs), which of the following side effects is most likely to be seen?
▪ Ophthalmoplegia
▪ Hyperthyroidism
▪ Decreased libido
▪ Muscle wasting
Answer.
26) A patient receiving doxazosin presents for a routine evaluation. Which assessment finding related to the medication therapy would be most concerning to the provider?
▪ Dizziness when supine
▪ Increased nasal congestion
▪ Blood pressure 80/45 mmHG
▪ Diminished ejaculate volume
Answer. Decreased libido
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27) A patient who receives haloperidol is noted to be shifting in the chair, rocking back and forth, and tapping both feet constantly. What is the most accurate term to document these findings?
▪ Akathisia
▪ Parkinsonism
▪ Dystonia
▪ Tardive dyskinesia
Answer. Akathisia
28) Which of the following statement is true regarding the treatment of Parkinson’s Disease?
▪ Deep brain stimulation is an option used to wean off patients completely from taking Levodopa.
▪ The combination of Levodopa and Carbidopa is the most effective treatment for the motor
symptoms of Parkinson’s disease.
▪ It is best to use Amantadine as a monotherapy as soon as possible.
▪ Dopamine is very effective than Levodopa, and they can be used as a monotherapy.
Answer. The combination of Levodopa and Carbidopa is the most effective treatment for the motor
symptoms of Parkinson’s disease
29) Which inhibitory neurotransmitter is involved in Parkinson’s disease?
▪ Dopamine
▪ Oxytocin
▪ Acetylcholine
▪ Adrenalline
Answer. Dopamine