NURS 6512 Pharmacology

Midterm Exam

Question 75

A 65-year-old male presents with a history of worsening urinary urgency, frequency, and

hesitancy. He also tells you that he has to "push really hard" to urinate and that his urine dribbles

a little after he is done urinating. What medication should be avoided

paroxetine

ipratropium inhaler

omeprazole

clonidine

Question 76

A homeless man who is well known to care providers at the local hospital has been admitted to

the emergency department after having a seizure outside a mall. The man is known to be a heavy

alcohol user and is malnourished with a very low body mass index. How are this patient's

characteristics likely to influence possible treatment with phenytoin?

The patient will require oral phenytoin rather than intravenous administration.

Phenytoin is contraindicated within 48 hours of alcohol use due to the possibility of

paradoxical effects.

The patient's heavy alcohol use will compete with phenytoin for binding sites and he will

require a higher-than-normal dose.

The patient's protein deficit will likely increase the levels of the free drug in his blood.

Question 77

The family of a Parkinson's patient brings him to the clinic because he is experiencing increasing

difficulty with ambulation. The family nurse practitioner increases the patient's dose of carbidopa

(25 mg)/levodopa (100 mg) (Sinemet 25–100 mg) from three to four times daily. What is

important for the family nurse practitioner to teach the family regarding the increase in the dose

of this medication?

Sleep disorders and hallucinations are common side effects of carbidopa/levodopa.

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Carbidopa/levodopa has shown efficacy in slowing disease progression.

Orthostatic hypotension can be problematic at higher dosing ranges.

The medication should be given on an empty stomach.

Question 78

The NP is examining a 34-year-old obese man with a body mass index (BMI) of 35 who

complains of almost daily indigestion and heartburn for the past year with a strong acid taste in

the mouth about an hour after meals, and frequent belching and awakening at night with choking.

The history is negative for chronic illnesses and alarm symptoms. A diagnosis of

gastroesophageal reflux disease (GERD) is made. What is the best initial treatment for the

patient?

Omeprazole (Prilosec) 20 mg every morning 30 minutes before breakfast.

Hyoscyamine (Levsin) 0.125 mg tid 15 minutes before eating

Omeprazole (Prilosec) 20 mg after breakfast daily.

Ranitidine (Zantac) 150 mg bid.

Question 77

The family of a Parkinson's patient brings him to the clinic because he is experiencing increasing

difficulty with ambulation. The family nurse practitioner increases the patient's dose of carbidopa

(25 mg)/levodopa (100 mg) (Sinemet 25–100 mg) from three to four times daily. What is

important for the family nurse practitioner to teach the family regarding the increase in the dose

of this medication?

Sleep disorders and hallucinations are common side effects of carbidopa/levodopa.

Carbidopa/levodopa has shown efficacy in slowing disease progression.

Orthostatic hypotension can be problematic at higher dosing ranges.

The medication should be given on an empty stomach.

Question 78

The NP is examining a 34-year-old obese man with a body mass index (BMI) of 35 who

complains of almost daily indigestion and heartburn for the past year with a strong acid taste in

the mouth about an hour after meals, and frequent belching and awakening at night with choking.

The history is negative for chronic illnesses and alarm symptoms. A diagnosis of

gastroesophageal reflux disease (GERD) is made. What is the best initial treatment for the

patient?

Omeprazole (Prilosec) 20 mg every morning 30 minutes before breakfast.

Hyoscyamine (Levsin) 0.125 mg tid 15 minutes before eating

Omeprazole (Prilosec) 20 mg after breakfast daily.

Ranitidine (Zantac) 150 mg bid.

Question 79

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