NAPLEX- Chapter 8 (Answering Case-Based Exam Questions) Flashcards


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1

JY is admitted to the hospital.

Admission Orders: Protonix 40 mg daily Zosyn 4.5 g IV Q8H Solu-Medrol 40 mg IV Q12H Zestril 10 mg dailyJY's first dose of antibiotic is administered at 1600. What times should the next 2 doses be given?

0000 and 0800

2

Vital Signs:
BP: 158/91 mmHg, HR: 58 BPM, RR: 15 BPM, Temp: 98.9°F, O2 Sat: 93% on room air
Height: 5'3", Weight: 144 pounds

Convert SZ's temperature to degrees Celsius. (Answer must be numeric; no units or commas; round the final answer to the nearest TENTH.)

37.2

3

Past Medical History: COPD, heart failure (last EF 30%), alcoholism

Home Medications: Altace 10 mg daily, Lasix 40 mg BID, Coreg CR 40 mg daily, Digox 0.25 mg daily, Combivent Respimat 1 inhalation QID, Procardia XL 60 mg daily, Aldactone 25 mg daily

Which of SZ's medications can decrease her heart rate? (Select ALL that apply.)

Digox and Coreg CR

4

What are the components of Triumeq?

Lamivudine + abacavir + dolutegravir

5

While this patient is receiving Lasix, all of the following are important monitoring parameters EXCEPT:

Hepatic function

6

MI is a 48-year-old male being seen today by his healthcare provider.

Past Medical History: hypertension, heart failure, atrial fibrillation, type 2 diabetes, HIV

Medications:
Toprol XL 50 mg PO daily
Apixaban 5 mg PO BID
Diovan 160 mg PO daily
Lantus 32 units SC QHS
Nexium 20 mg PO daily
Furosemide 20 mg PO daily
Triumeq 1 tab PO daily

Which of the following accurately describes this patient's stroke risk and recommended treatment?

CHADSVASC score is > 2; apixaban at the current dose is appropriate

7

This patient has been using insulin for 12 months. His blood glucose remains high (both fasting and post-prandial). What single intervention should be made now to align his therapy with current ADA guidelines?

Medications:
Toprol XL 50 mg PO daily
Apixaban 5 mg PO BID
Diovan 160 mg PO daily
Lantus 32 units SC QHS
Nexium 20 mg PO daily
Furosemide 20 mg PO daily
Triumeq 1 tab PO daily

Add metformin

8

Which of the following should be discussed with this patient when dispensing Nexium? (Select ALL that apply)

Nexium must be taken every day for the best results; it does not work immediately

Do not crush or chew the medication

9

This patient reports that he has not received any vaccines other than an annual influenza vaccine since he was 14 years old. Which of the following vaccines are recommended in this patient? (Select ALL that apply)

Hepatitis B

Tdap

Menactra

Prevnar 20

10

Convert 88°F to Celsius. (Answer must be numeric; no units or commas; round final answer to the nearest TENTH.)

31.1

Degrees Celsius = (88 - 32) / 1.8 = 31.1111 = 31.1

11

Which of the following technologies has helped the most in eliminating the problem of drug errors due to prescriber's sloppy handwriting?

CPOE is Computerized Prescriber Order Entry.

12

Which mechanisms of action are represented in KB's antihypertensive regimen? (Select ALL that apply.)

ARB

CCB

The patient is taking Benicar (olmesartan, an angiotensin receptor blocker), amlodipine (a dihydropyridine calcium channel blocker), and chlorthalidone (a thiazide-type diuretic) for hypertension.

13

Diagnostic Tests (10/16)
CT Abdomen: acute pancreatitis

Which medication should be considered for discontinuation based on the CT abdomen test results?

Exenatide

14

What additional medication is indicated for KB based on his past medical history?

Atorvastatin

15

Based on KB's medication list, which condition is missing from the past medical history?

Detrol LA (tolterodine) is an anticholinergic medication used to treat urinary incontinence.

16

Which of the following are expected side effects of the diuretic on KB's medication profile? (Select ALL that apply.)

Hypokalemia

Hypomagnesemia
Hyperuricemia

Chlorthalidone can cause low potassium, magnesium and sodium, and elevated calcium and uric acid.

17

A pharmacist is counseling a patient on a new antihypertensive medication. After he finishes the counseling, he says, "any questions?" What is a better way to conclude the counseling session that would likely make the patient feel more comfortable asking questions?

What questions can I answer about your new medication

18

Past Medical History

Parkinson disease (diagnosed 6 weeks ago)

Atrial fibrillationMitral valve repair (bioprosthetic valve)Cerebrovascular accidentModerate-severe

Alzheimer's disease

Ankylosing spondylitis

Cholecystectomy

Arthroscopy of the right knee

BG's medical history and clinical presentation indicate which of the following?

His gallbladder has been removed

19

Which of the following statements is true of health literacy? (Select ALL that apply.)

Low health literacy is linked to poor health outcomes

Health literacy is the degree to which patients are able to obtain/understand health information and make decisions

20

JY is admitted to the hospital with an asthma exacerbation.

Admission Orders:Clindamycin 150 mg PO Q6HProtonix 40 mg PO dailySolu-Medrol 40 mg IV Q8HZestril 10 mg daily

JY's first corticosteroid dose is administered at 1300. When should the next two doses be given?

2100 and 0500

21

KG is an elderly female with osteoporosis, hypertension and glaucoma. She picks up her blood pressure pills and glaucoma drops at the pharmacy near her home. This patient has a Medicare Plan, which covers her inpatient and outpatient medication costs. The pharmacy bills the costs for the hypertension and glaucoma medications to the following Medicare program:

Part D

22

History of Present Illness: AF is a 38-year-old female with worsening symptoms of her inflammatory bowel disease. She presents to her gastroenterologist on 11/3 to discuss treatment options for her disease, which is assessed as moderate-severe.
Allergies: Aspirin (hives)
Past Medical History: Crohn's disease (x 15 years), chronic urinary tract infections
Medications:

Entocort EC 9 mg once daily
Yaz take 1 tablet dailyPataday 0.1% instill 1 drop OU BID
Norvasc 10 mg take 1 daily
Diflucan 150 mg take 1 tablet daily
Prozac 20 mg take 1 capsule daily
Xyzal 5 mg PO QHSWhich of AF's medications do not have a documented indication listed in her Past Medical History? (Select ALL that apply.)

Norvasc

Prozac

Xyzal

Pataday

23

Which of the following describes the predominant effect of Prozac on neurotransmitters?

It increases levels of serotonin

24

What is the generic name of Xyzal?

Levocetirizine

25

Which of the following best describes Yaz?

It contains the progestin drospirenone

26

Which pathogen is covered by Diflucan?

Candida albicans

27

The pharmacy dispenses a 5 mL bottle of Pataday 0.1% for AF. Assuming the patient uses the medication every day as prescribed, how many days should the bottle last? (A standard eyedropper dispenses 0.05 mL/drop.) (Answer must be numeric; no units or commas.)

OU = each eye
0.05 mL/drop x 4 drops per day = 0.2 mL/day
5 mL bottle / 0.2 mL = 25 days

28

AF presents to the pharmacy with a new prescription for phenelzine from her gastroenterologist. The pharmacist should call the prescriber to discuss which of the following?

Prozac needs to be stopped for 5 weeks before starting phenelzine