Question 69. Question :
Henry presents to clinic with a significantly swollen, painful great toe and is diagnosed with gout. Of the following, which would be the best treatment for Henry?
Acetaminophen with codeine
Question 70. Question :
Jaycee has been on escitalopram (Lexapro) for a year and is willing to try tapering off of the selective-serotonin reuptake inhibitors. What is the initial dosage adjustment when starting a taper off antidepressants?
Change the dose to every other day dosing for a week.
Reduce the dose by 50% for three to four days.
Reduce the dose by 50% every other day.
Escitalopram (Lexapro) can be stopped abruptly due to its long half-life.
Question 71. Question :
Christy has exercise and mild persistent asthma and is prescribed two puffs of albuterol fifteen minutes before exercise and as needed for wheezing. One puff per day of beclomethasone (Qvar) is also prescribed. Teaching regarding her inhalers includes which one of the following?
She should use one to two puffs of albuterol per day to prevent an attack, with no more than eight puffs per day.
Beclomethasone needs to be used every day to treat her asthma.
She should report any systemic side effects she is experiencing, such as weight gain.
She should use the albuterol MDI immediately after her corticosteroid MDI to facilitate bronchodilation.
Question 72. Question :
Asthma exacerbations at home are managed by the patient by:
Increasing the frequency of beta 2 agonists and contacting his or her provider
Doubling inhaled corticosteroid dose
Increasing the frequency of beta 2 agonists
Starting montelukast (Singulair)
Question 73. Question :
A woman with an intact uterus should not be prescribed:
Intramuscular (IM) medroxyprogesterone (Depo Provera)
Question 74. Question :
The drug recommended as primary prevention of osteoporosis in women over seventy years old is:
Question 75. Question :
Patient education when prescribing the vitamin D3 derivative calcipotriene for psoriasis includes:
Applying calcipotriene thickly to affected psoriatic areas two to three times a day
Applying a maximum of 100 grams of calcipotriene per week
Not using calcipotriene in combination with its topical corticosteroids
Augmenting calcipotriene with the use of coal-tar products
Question 76. Question :
Both ACE inhibitors and some angiotensin-II receptor blockers have been approved in treating:
Hypertension in diabetic patients
Both A and B
Neither A nor B
Question 77. Question :
Scott is presenting for follow-up on his lipid panel. He had elevated total cholesterol, elevated triglycerides, and an LDL of 122 mg/dL. He has already implemented diet changes and increased physical activity. He has mildly elevated liver studies. An appropriate next step for therapy would be:
Simvastatin and ezetimibe (Vytorin)
Question 78. Question :
Hypoglycemia can result from the action of either insulin or an oral hypoglycemic. Signs and symptoms of hypoglycemia include:
“Fruity” breath odor and rapid respiration
Diarrhea, abdominal pain, weight loss, and hypertension
Dizziness, confusion, diaphoresis, and tachycardia
Easy bruising, palpitations, cardiac dysrhythmias, and coma
Question 79. Question :
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:
Turning the screen around so the patient can see material being recorded
Not placing the computer screen between the provider and the patient
Both A and B
Neither A nor B
Question 80. Question :
Which one of the below-given instructions can be followed for applying a topical antibiotic or antiviral ointment?
Apply thickly to the infected area, spreading the medication well past the borders of the infection
If the rash worsens, apply a thicker layer of medication to settle down the infection
Wash hands before and after application of topical antimicrobials
None of the above
Question 81. Question :
Sadie is a ninety-year-old patient who requires a new prescription. What changes in drug distribution with aging would influence prescribing for Sadie?
Increased volume of distribution
Decreased lipid solubility
Decreased plasma proteins
Increased muscle-to-fat ratio
Question 82. Question :
First-line therapy for treating topical fungal infections such as tinea corporis (ringworm) or tinea pedis (athlete’s foot) would be:
OTC topical azole (clotrimazole, miconazole)
Oral griseofulvin microsize
Nystatin cream or ointment
Question 83. Question :
Which of the following is true about procainamide and its dosing schedule?
It produces bradycardia and should be used cautiously in patients with cardiac conditions that a slower heart rate might worsen.
GI adverse effects are common, so the drug should be taken with food.
Adherence can be improved by using a sustained-release formulation that can be given once daily.
Doses of this drug should be taken evenly spaced around the clock to keep an even blood level.
Question 84. Question :
A nurse practitioner would prescribe the liquid form of ibuprofen for a six-year-old because:
Drugs given in liquid form are less irritating to the stomach.
A six-year-old may have problems swallowing a pill.
Liquid forms of medication eliminate the concern for first-pass effect.
Liquid ibuprofen does not have to be dosed as often as tablet form.
Question 85. Question :
Kristine would like to start HRT to treat the significant vasomotor symptoms she is experiencing during menopause. Education for a woman considering hormone replacement would include:
Explaining that HRT is totally safe if used for a short term
Telling her to ignore media hype regarding HRT
Discussing the advantages and risks of HRT
Encouraging the patient to use phytoestrogens with the HRT
Question 86. Question :
Xi, a fifty-four-year-old female, has a history of migraine that does not respond well to OTC migraine medication. She is asking to try Maxalt (rizatriptan) because it works well for her friend. Which of the following actions would you take for appropriate decision making?
Prescribe Maxalt, but to monitor the use, only give her four tablets with no refills.
Prescribe Maxalt and arrange to have her observed in the clinic or urgent care with the first dose.
Explain that rizatriptan is not used for postmenopausal migraines and recommend Fiorinal (aspirin and butalbital).
Prescribe sumatriptan (Imitrex) with the explanation that it is the most effective triptan.