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Pharmacology NSG 6005 WK 4

Asthma exacerbations at home are managed by the patient by:

CORRECT 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)

Howard is a seventy-two-year-old male who occasionally takes diphenhydramine for his seasonal allergies. Monitoring for this patient taking diphenhydramine would include assessing for:

CORRECT Urinary retention
Cardiac output
Peripheral edema
Skin for rash

A patient with a COPD exacerbation may require

Doubling of inhaled corticosteroid dose
CORRECT Systemic corticosteroid burst
Continuous inhaled beta 2 agonists
Leukotriene therapy

Decongestants such as pseudoephedrine (Sudafed):

Are Schedule III drugs in all states
CORRECT Should not be prescribed or recommended for children under four years of age
Are effective in treating the congestion children experience with the common cold
May cause drowsiness in patients of all ages

Many patients self-medicate with antacids. Which patients should be counseled to not take calcium carbonate antacids without discussing with their providers or a pharmacist first?

CORRECT Patients with kidney stones
Pregnant patients
Patients with heartburn
Postmenopausal women

An acceptable first-line treatment for PUD disease with positive H. pylori test is:

Histamine 2 receptor antagonists for four to eight weeks
A PPI twice daily (BID) for twelve weeks until healing is complete
CORRECT A PPI BID plus clarithromycin plus amoxicillin for fourteen days
A PPI BID and levofloxacin for fourteen days

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

At nighttime one to two times a month
CORRECT At nighttime three to four times a month
Less than twice a week

When treating a patient using the “step-down” approach, the patient with GERD is started on ____ first

histamine 2 receptor antagonists

A stepwise approach to the pharmacologic management of asthma:

CORRECT Begins with determining the severity of the asthma and assessing asthma control
Is used when the asthma is severe and requires daily steroids
Allows for each provider to determine his or her personal approach to the care of asthmatic patients
Provides a framework for the management of severe asthmatics but is not as helpful when patients have intermittent asthma

Monitoring a patient with persistent asthma includes:

Monitoring how frequently the patient has a upper respiratory infection during treatment
Monthly in-office spirometry testing
Determining whether the patient has increased use of his or her long-acting beta 2 agonists due to exacerbations
CORRECT Evaluating the patient every one to six months to determine whether the patient needs to step up or down in his or her therapy

Infants with reflux are initially treated with:

Histamine2 receptor antagonist (ranitidine)
Proton pump inhibitor (omeprazole)
CORRECT Anti-reflux maneuvers (elevate the head of the bed)
Prokinetic (metoclopramide)

Education of patients with COPD who use inhaled corticosteroids includes the following:

They should double the dose at the first sign of a upper respiratory infection.
They should use the inhaled corticosteroid first and then the bronchodilator.
CORRECT They should rinse their mouths after use.
They should not smoke for at least thirty minutes after use

Patients with pheochromocytoma should avoid which of the following classes of drugs due to the possibility of developing hypertensive crisis?

CORRECT Beta 2 agonists

One goal of asthma therapy outlined by the NHLBI Expert Panel 3 guidelines is

Use albuterol daily to control symptoms
Minimize exacerbations to once a month
Keep nighttime symptoms at a maximum of twice a week
CORRECT Require infrequent use of beta 2 agonists (albuterol) for relief of symptoms

Metoclopramide improves GERD symptoms by:

Reducing acid secretion
Increasing gastric pH
CORRECT Increasing lower esophageal tone
Decreasing lower esophageal tone

Pregnant patients with asthma may safely use ____ throughout their pregnancies

oral terbutaline
CORRECT inhaled corticosteroids (budesonide)
montelukast (Singulair)

Medications used in the management of patients with COPD include:
Inhaled beta 2 agonists
Inhaled anticholinergics (ipratropium)
Inhaled corticosteroids
CORRECT All of the above
Patients who are on chronic long-term PPI therapy require monitoring for:

CORRECT Iron deficiency anemia, vitamin B12, and calcium deficiency
Folate and magnesium deficiency
Elevated uric acid levels leading to gout
Hypokalemia and hypocalcemia

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