Pharmacology Questions and Answers

Directions for the 20 questions.

** Must be in your own words, complete and well thought out to receive full credit.  To receive full credit, 2 paragraphs ( 4 sentences each ) are required for each question. **

** The Book we are using is, Pharmacology Online for Pharmacology and the Nursing Process: 9th Ed.  Lilley ISBN 9780323661164**

1. Why would the Nurse Practitioner consider switching the patient from an ACE inhibitor to an Angiotension II receptor antagonist when treating a patient for hypertension? What type of lab work should be checked when patients take the above medications and why?  How often should lab work be checked?

2. Please explain why the Health Care Provider would prescribe Warfarin instead of Dabigatran or Rivaroxaban to a patient who was recently diagnosed with Paroxsymal Atrial Fibrillation.  The patient states " I don't want to take rat poison ". How should the nurse practitioner respond? For complete credit please list the risks and benefits to each drug. 

3. Please explain possible adverse reactions  when a patient is taking Amiodarone and a Statin. 

4. Mr. Brown was being treated for pneumonia with a 10 day course of Azithromycin . By Day 5, there has been no improvement in his condition. What may be possible reasons for this ? What might be your the nurse practitioners next course of action?

5. After taking Simvastatin for 2 months, Mr. Booker reports weakness and myalgias in his legs. What would be the Nurse Practitioners next steps and why? Would you order any lab tests?  The patient's LDL was 252 prior to starting the medication. Keep in mind that Mr. Booker suffered a myocardial infarction 5 years ago.

6.  A 60 year old man asks the Nurse Practitioner to prescribe Terbinafine to treat his onychomycosis. What should be considered prior to prescribing this medication ? What medical conditions would be considered a contraindication for prescribing Terbinafine? 

7. A woman who is 32 weeks pregnant has developed significant hypertension which must be treated. What medication options does the Nurse Practitioner have and why? What medications cannot be used in this situation and why? 

8. If Ms. Harris has a known allergy to Penicillin, would it be reasonable to treat  her acute sinusitis with Cephalexin and why ? What type of allergic reaction to Penicillin would be an absolute contraindication to prescribing Cephalexin? 

9. Mr. Rubio has been diagnosed with an acute bacterial conjunctivitis. He is allergic to Sulfa. Which ophthalmic medication would be best to use in this case and why?

10. Ms. Warren's TSH level is 41.  What is her diagnosis? What medication, if any, should the Nurse Practitioner prescribe? How often should the Nurse Practitioner monitor a TSH or T4? What should the TSH goal be? 

11.  Mr. Sanders has recently undergone an EGD which revealed a gastric ulcer. What medication would be recommended at this time? Would a H2 blocker or a Proton Pump Inhibitor be more beneficial to him and why? What is the difference between the two classes of medication? What patient instructions would the nurse practitioner give to the patient? 

12. Mr. Biden has been diagnosed with Type 2 diabetes. He injects 10 units of NPH insulin and 5 units of Regular insulin SQ in the morning and evening before meals. Recently, he has been exercising more and reports several episodes of dizziness, shakiness, and diaphoresis. What problem do his symptoms suggest? How might the Nurse Practitioner adjust his insulin dose ? Please explain your rationale. 

13. Ms. Warren is having gastric bypass surgery tomorrow She is a diabetic and injects 30 units of 70/30 insulin SQ  in the evening before dinner and in the morning before her breakfast. What  pre op instructions ( 24 hours before surgery ) should the Nurse Practitioner give her regarding her insulin dose and why ? 

14. Mr. Mc Connell carries a diagnosis of poorly controlled asthma. The Nurse Practitioner is checking the electronic health record and notes that his usage of Albuterol is excessive.  Mr. Mc Connell is going  through 1 canister every 10 days. What would your first steps be and what recommendations would you give this patient ? Please explain your rationale.

15. Mr. Jackson carries a diagnosis of coronary artery disease and sometimes experiences exertional angina. When this occurs he uses 1 tablet of NTG 0.4 mg SL which relieves the discomfort. What medication is absolutely contraindicated when using NTG and why? What should be advised if the patient experiences non exertional chest pain and why? 

16. Colchicine is commonly prescribed for gout exacerbation's. What other conditions might Colchicine be prescribed for and why? 

17. A high dose of Prednisone  ( 80 mg per day ) was prescribed for Mr. Ryan who suffered an exacerbation of COPD. Can Prednisone be stopped abruptly or should the dose be calibrated down slowly? Please explain your answer.

18. Which anti emetic might cause Tardive Dyskinesia? Please explain the signs / symptoms the patient may exhibit. What is the treatment for this? 

19. What class of antibiotics may cause a tendon rupture? What makes it more likely to occur?  What instructions should be given to the patient when prescribing this class of antibiotic? 

20. What drug classification does Naloxone fall under? Please explain exactly how Naloxone reverses the adverse effects of opioids. 

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