Advanced Pharmacology NSG 6005

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NSG 6005 Week 1  Assignment 2 Discussion

Select one of the two questions from the discussion questions listed below .By Week 1, Day 3, respond to the selected discussion question and submit your response to this Discussion Area .

Be sure to respond to the question using the lessons and vocabulary found in the reading .Justify your answers using examples and reasoning .Support your answers with examples and research and cite your research using APA format .

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Start reviewing and responding to the postings of your classmates as early in the week as possible .Respond to at least two of your classmates’ posts .Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion .

Discussion Question 1

Interview a pharmacist and ask for his or her thoughts on your role as an APN .Ask the pharmacist to share his or her opinion about how well prepared APNs should be for this responsibility and what suggestions he or she may have for your future success .In your response, talk about who the pharmacist was, what was his or her educational background, and where he or she works and list the questions you asked .Reflect upon his or her words and ideas and discuss how you feel about his or her opinion and how this might help you in your future role .

Discussion Question 2

Informatics has provided multiple avenues for APNs to improve their practice .Identify one electronic source that can help you prescribe medications .Name the source and explain why this will be helpful to you in the clinical setting .List the types of information this resource provides and its limitations .Is there a cost associated with its use? If so, does the cost seem reasonable? Discuss the limitations, if any, the program has .Discuss why this program seems useful for you .

NSG 6005 Week 2  Assignment 1 Discussion

Select one of the two questions from the discussion questions listed below .By Week 2, Day 3, respond to the selected discussion question and submit your response to this Discussion Area .

Be sure to respond to the question using the lessons and vocabulary found in the reading .Justify your answers using examples and reasoning .Support your answers with examples and research and cite your research using APA format .

Start reviewing and responding to the postings of your classmates as early in the week as possible .Respond to at least two of your classmates’ posts .Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion .

Discussion Question 1

Many patients ask for nonprescription medications to use for various health problems, such as insomnia, depression, pain, memory, and anxiety .Select one patient complaint (for example, insomnia) and review the major herbs that have been recommended for treatment .Go to the South University Online Library and locate at least one peer-reviewed research article designed to study the effects of one of these substances .Describe the study and results and explain how this would influence your action as an APN .

Discussion Question 2

Go to the Internet and locate the website for any medication of interest to you .Go to the prescribing directions and locate the section that reports the pharmacology of the medication .Describe the information presented on pharmacodynamics and pharmacokinetics of that drug .Explain all of the areas that are reported in this document, including enzyme activity; medication onset and duration of action; area under the curve; and absorption and distribution, including maximal plasma concentrations .Describe if the medication should be taken with or without food and why .To adequately respond to this question, you must look at the package insert from the company; no other sources will contain the extent of information you need .

NSG 6005 Week 3  Assignment 1 Discussion

Select one of the two questions from the discussion questions listed below .By Week 3, Day 3, respond to the selected discussion question and submit your response to this Discussion Area .

Be sure to respond to the question using the lessons and vocabulary found in the reading .Justify your answers using examples and reasoning .Support your answers with examples and research and cite your research using APA format .

Start reviewing and responding to the postings of your classmates as early in the week as possible .Respond to at least two of your classmates’ posts .Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion .

Discussion Question 1

CF is a sixty-year-old African American male who presents as a new patient for initial evaluation and follow-up .He has been diagnosed with hypertension for the last twelve years and Type 2 diabetes for the same period of time .His current blood pressure is 162/90, with a pulse of 76 .His body mass index (BMI) is 32 .He is currently taking Maxzide 37 .5/25 mg every morning .This is the only antihypertensive medication he has taken .

For this question, focus on the treatment of hypertension .Discuss the influences of his age, gender, and ethnicity on hypertensive medications .On the basis of an analysis of those factors, provide one option for improvement of his blood pressure and provide a clear and specific justification for that choice .Be sure to include dosage and scheduling .Include highlights of patient teaching and/or recommendations for any lifestyle changes .Support your decisions with at least one reference to a published clinical guideline and one peer-reviewed publication .

Discussion Question 2

MT is a fifty-six-year-old obese (BMI 31 .5) Caucasian female with a significant family history of cardiovascular disease .She has uncontrolled hypertension and is currently taking metoprolol 50 mg twice daily .She has dyslipidemia and is taking exetimibe 10 mg daily and garlic .Her current cholesterol is 240 mg/dL, HDL is 41 mg/dL, LDL is 163 mg/dL, and triglycerides are 183 mg/dL .Her blood pressure today is 174/94, and her pulse is 90 .

Review the medications she is taking for hypertension and dyslipidemia .Evaluate the efficacy of these medications .Review them in terms of her age, gender, and ethnicity .Suggest any changes you would recommend, with clear justification for those choices .For medications, include dosages and schedules .Include highlights of patient teaching and/or lifestyle alterations .Support your decisions with at least one reference to a published clinical guideline and one peer-reviewed publication .

NSG 6005 Week 4 Assignment 1 Discussion

Select one of the two questions from the discussion questions listed below .By Week 4, Day 3, respond to the selected discussion question and submit your response to this Discussion Area .

Be sure to respond to the question using the lessons and vocabulary found in the reading .Justify your answers using examples and reasoning .Support your answers with examples and research and cite your research using APA format .

Start reviewing and responding to the postings of your classmates as early in the week as possible .Respond to at least two of your classmates’ posts .Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion .

Discussion Question 1

SE is a twenty-two-year-old Caucasian woman who was diagnosed with asthma at age seven .According to her medical record, she has “mild persistent” asthma .Today, she reports that she has been using her albuterol metered-dose inhaler (MDI) approximately three to four days per week over the last two months .Over the past week, she admits to using albuterol once daily .She has been awakened by a cough three nights during the last month .She states she especially becomes short of breath when she exercises .However, she also admits that the shortness of breath is not always brought on by exercise .She also has a fluticasone MDI, which she uses “most days of the week .” She has been hospitalized twice in the last year for poorly controlled asthma and has been to the emergency department (ED) three times in the last six months for the same problem .Her lab work is all within normal limits, with the exception of a positive human chorionic gonadotropin (HCG) .Answer the following questions:

What information in the case study suggests that her asthma is not well controlled?

What factors could possibly lead to this?

How would you classify the symptoms based upon the National Institutes of Health (NIH) guidelines?

With the recognition that she is pregnant, how would you alter her treatment for asthma?

Support your responses with guidelines, including the NIH guidelines, for management of asthma during pregnancy .Use other peer-reviewed articles as needed to support specific aspects of your plan .

Discussion Question 2

TJ is a fifty-five-year-old police officer who presents to the clinic with complaints of epigastric pain for two weeks .He has been taking over-the-counter (OTC) Zantac without relief .He was diagnosed about a year ago with a bleeding ulcer, and he expresses concerns that the current symptoms remind him of that event .At that time, he was given “multiple prescriptions” for his stomach, but he did not complete the course of therapy because he began to feel better .He also has osteoarthritis in his wrists and hips, for which he takes OTC NSAIDs .He smokes one to two packs per week and drinks an average of one alcoholic beverage daily .His vital signs and blood work are all within normal limits .Answer the following questions:

What additional testing would you suggest at this point?

Describe any and all variables that could be contributing to his symptoms .

What alterations would you suggest in his treatment? Be sure to consider additional diagnoses and whether prophylaxis would be appropriate for NSAID-induced ulcers .

Support your responses with guidelines you locate in the literature and peer-reviewed articles as needed to support your ideas .

NSG 6005 Week 5 Assignment 1 Discussion

Select one of the two questions from the discussion questions listed below .By Week 5, Day 3, respond to the selected discussion question and submit your response to this Discussion Area .

Be sure to respond to the question using the lessons and vocabulary found in the reading .Justify your answers using examples and reasoning .Support your answers with examples and research and cite your research using APA format .

Start reviewing and responding to the postings of your classmates as early in the week as possible .Respond to at least two of your classmates’ posts .Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion .

Discussion Question 1

GF is a forty-one-year-old woman who arrives for her first visit at the clinic .She reports that she has been feeling sad and depressed, with crying spells, trouble sleeping, increased appetite, impaired concentration, and fatigue .She has experienced depression in the past but was able to overcome the symptoms without medication .Upon physical exam, she appears to be poorly groomed and with minimal facial expression .She is slow to respond to questions .She admits to being very anxious and worried about “everything .” She denies any current suicidal ideation .However, she expresses concerns about the future and that it may not be an improvement .She has tried over-the-counter medications to help with sleep, but they have not been effective .Answer the following questions:

What additional information would you like before making a decision about what to do with GF?

What approach would you suggest for this patient? Which of her symptoms would concern you and require intervention?

Does she need to be referred to another provider, or can she be managed in a primary care setting?

Are there any nonpharmacological strategies that might be appropriate for her?

For medications, include dosages and schedules .Include highlights of patient teaching and/or lifestyle alterations .Support your decisions with at least one reference to a published clinical guideline and one peer-reviewed publication .

Discussion Question 2

ST is a twenty-five-year-old male who presents to the clinic with a major complaint of insomnia .He has been experiencing problems sleeping for the past month .He has been “borrowing” medication from his mother and friends, such as diazepam and alprazolam, and he finds that these are helpful in allowing him to sleep .He was also diagnosed with asthma at the age of ten .He has been using an inhaler, as needed, but he cannot recall the name of the inhaler .He is currently working part-time through a temporary agency, and he has not been able to find any full-time work .Answer the following questions:

What additional information would you like to obtain from ST?

What are the possible reasons for his insomnia?

What are the possible strategies you can use to help him with the insomnia?

NSG 6005 Week 6 Assignment 1 Discussion

Assignment 1: Discussion Questions

Select one of the two questions from the discussion questions listed below .By Week 6, Day 3, respond to the selected discussion question and submit your response to this Discussion Area .

Be sure to respond to the question using the lessons and vocabulary found in the reading .Justify your answers using examples and reasoning .Support your answers with examples and research and cite your research using APA format .

Start reviewing and responding to the postings of your classmates as early in the week as possible .Respond to at least two of your classmates’ posts .Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion .

Discussion Question 1

MP is a sixty-five-year-old male who has recently retired .He is coming in today for a complaint about pain in his back, knees, and hips .He reports that he has been experiencing this pain for the past six months, and he has been able to control the symptoms with OTC Advil .He describes the pain as stiffness and occasional shooting and aching pains radiating all over .He denies any swelling of his joints .However, the OTC medications are not working well, and he is here to see whether there are any other options he might try .On physical exam, he has tenderness on palpation on the right and left hips and both knees are positive for crepitus .All blood work is within normal limits .Answer the following questions:

What additional information would you like to have? Does MP need any additional testing?

What possible issues could contribute to his symptoms?

He asks about injections to both knees to increase his comfort .How would you respond to that?

What would your treatment plan be?

For medications, include dosages and schedules .Include highlights of patient teaching and/or lifestyle alterations .Support your decisions with at least one reference to a published clinical guideline and one peer-reviewed publication .

Discussion Question 2

EP is a twenty-five-year-old African American female who has just moved to town and comes to the clinic for her first visit .She has been diagnosed with fibromyalgia .She reports that her previous primary care physician (PCP) was treating her with opiates only .She has been taking hydrocodone/ibuprofen 7 .5 mg/200 mg four times daily but notes that this is not helping her .She is asking you for a refill of this medication and any additional treatment you can advise .On physical exam, she is in moderate distress and reports pain when being touched .Answer the following questions:

How would you validate the diagnosis of fibromyalgia?

How would you handle EP’s request for ongoing hydrocodone? Locate any evidence of the efficacy of this treatment for fibromyalgia .

Assuming that the diagnosis is , what would your treatment plan be?

Would you recommend any nontraditional therapies?

NSG 6005 Week 7 Assignment 1 Discussion

Select one of the two questions from the discussion questions listed below .By Week 7, Day 3, respond to the selected discussion question and submit your response to this Discussion Area .

Be sure to respond to the question using the lessons and vocabulary found in the reading .Justify your answers using examples and reasoning .Support your answers with examples and research and cite your research using APA format .

Start reviewing and responding to the postings of your classmates as early in the week as possible .Respond to at least two of your classmates’ posts .Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion .

Discussion Question 1

EP is a fifty-year-old woman who reports experiencing two to three hot flashes per day, occasionally associated with insomnia .She also states she is awakened from sleep about two to three times per week, needing to change her bedclothes and linens due to sweating .Her symptoms began about three months ago, and over that time, her symptoms have worsened to the point where they have become very bothersome .She is concerned about starting any hormonal treatment because she has read news stories that the medication is not safe .She has been successfully treated for depression and is currently doing well on paroxetine .Her current medications include omeprazole 20 mg daily, paroxetine 20 mg, Synthroid 0 .075 mg daily, and hydrochlorothiazide 25 mg daily .Her physical exam is normal; her blood pressure is 128/86, her pulse is 78, and her body mass index (BMI) is 30 .5 .Answer the following questions:

Is there any additional information you would want to collect?

What are the variables you would take into account before deciding how to help her?

What treatment will you recommend?

What nonpharmacological treatment would you suggest?

For medications, include dosages and schedules .Include highlights of patient teaching and/or lifestyle alterations .Support your decisions with at least one reference to a published clinical guideline and one peer-reviewed publication .

Discussion Question 2

VG is a thirty-one-year-old female who comes in for a routine follow-up .She reports that she has been feeling excessive fatigue over the last month .She also notes that she is having some problems at work, not only because of her fatigue but also because of difficulty concentrating .She also notes that she has gained 10 pounds over the last month, and she is unable to identify the cause of the weight gain .She also notes that her periods are a little heavier and more irregular .She is currently taking daily ferrous sulfate and over-the-counter calcium .According to her medical record, she had a TSH level of 4 .2 mIL/L about a year ago .Although this is slightly elevated, no further follow-up was deemed necessary at the time .Repeat blood work today reveals a TSH level of 9 .8 mIL/L and a free T4 of 0 .72 ng/dL .Answer the following questions:

What additional findings on the physical exam would you look for?

What implication does the previous TSH level have?

What therapy would you institute?

If VG becomes pregnant, what adjustment, if any, would be needed in her thyroid medication?

NSG 6005 Week 8 Assignment 1 Discussion

Select one of the two questions from the discussion questions listed below .By Week 8, Day 3, respond to the selected discussion question and submit your response to this Discussion Area .

Be sure to respond to the question using the lessons and vocabulary found in the reading .Justify your answers using examples and reasoning .Support your answers with examples and research and cite your research using APA format .

Start reviewing and responding to the postings of your classmates as early in the week as possible .Respond to at least two of your classmates’ posts .Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion .

Discussion Question 1

There are multiple issues to consider in caring for someone with diabetes II .Your course textbook lists these as:

Race and Ethnic Group

Obesity

Coronary Artery Disease and Heart Failure

Hyperlipidemia

Hypertension

Nephropathy

Neuropathy

Retinopathy

From this group, select two specific issues and explain the importance of that variable in the treatment of diabetes .Explain how a provider needs to approach the patient and how these considerations would influence the selection of agents for the treatment of diabetes and related complications .

Discussion Question 2

AG is a sixty-nine-year-old male who presents for an initial visit with a complaint of blurred vision, fatigue, and lack of energy .He is currently being treated for hypertension, hypothyroidism, and gouty arthritis .He is currently retired and married, with three adult children .His vital signs are unremarkable, with a body mass index (BMI) of 30 .His current medications include lisinopril 20 mg daily, allopurinol 300 mg daily, and levothyroxine 0 .088 mg daily .

As per his blood work today, his A1c level is 7 .8%, his fasting blood sugar is 202, his total cholesterol is 180 mg/dL, his high-density lipoprotein (HDL) is 27 mg/dL, his low-density lipoprotein (LDL) is 193 mg/dL, and his triglycerides are 302 mg/dL .Answer the following questions:

What additional blood work would you like to complete at this point? Is there any additional information that should be collected from the patient?

Evaluate the current therapy and make recommendations concerning any needed changes .

What lifestyle modifications or changes do you think would be appropriate for this patient?

NSG 6005 Week 9 Assignment 1 Discussion

Select one of the two questions from the discussion questions listed below .By Week 9, Day 3, respond to the selected discussion question and submit your response to this Discussion Area .

Be sure to respond to the question using the lessons and vocabulary found in the reading .Justify your answers using examples and reasoning .Support your answers with examples and research and cite your research using APA format .In addition to your textbook, consult the Sanford Guide to help you identify appropriate treatment for specific infections .

Start reviewing and responding to the postings of your classmates as early in the week as possible .Respond to at least two of your classmates’ posts .Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion .

Discussion Question 1

JT is a fifty-five-year-old man with a three-day history of worsening shortness of breath, fever, chills, right-sided chest pain, and productive cough .He states that the initial symptoms started approximately one week ago .He has been taking over-the-counter (OTC) medications to control the fever and the cough .He comes in today because he feels that he is getting worse .He is coughing up rust-colored mucus, and the chest pain has started to make breathing even more difficult .His physical exam is normal, with the exception of tachypnea, labored breathing, coarse rhonchi through the right lung field, and decreased breath sounds on the right .Answer the following questions:

What additional laboratory or radiological tests would be indicated and why? What would you expect to find?

What is your diagnosis?

What medication would be given and for what period of time?

Discussion Question 2

LN is a twenty-six-year-old married woman who presents at the clinic with symptoms of dysuria, frequency, and urgency .Further history yields two days of these symptoms but no fever, chills, or flank pain .She describes a burning discomfort during and immediately following urination and feeling the need to void every half hour .There is no vaginal discharge, itching, or odor .She is not using birth control at this time .She requests “a urine culture and some sulfa pills .” When asked to explain, she says she has had many “bladder infections” over the past three years and “sulfa pills usually work .” She was evaluated approximately five years ago with an IV pyelography and cystogram, and “nothing was wrong .” All her vital signs are normal .Answer the following questions:

What additional information would you like to collect?

What is your working diagnosis?

What are the contributing factors to this potential diagnosis?

What treatment would you implement and why?

What type of follow-up would you recommend?

NSG 6005 Week 10 Assignment 1 Discussion

Select one of the two questions from the discussion questions listed below .By Week 10, Day 3, respond to the selected discussion question and submit your response to this Discussion Area .

Be sure to respond to the question using the lessons and vocabulary found in the reading .Justify your answers using examples and reasoning .Support your answers with examples and research and cite your research using APA format .

Start reviewing and responding to the postings of your classmates as early in the week as possible .Respond to at least two of your classmates’ posts .Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion .

Discussion Question 1

SJ is a sixteen-month-old boy who is brought to the clinic with a one-day history of tugging at his right ear and crying and a two-day history of decreased appetite, decreased playfulness, and difficulty sleeping .His mother has documented a fever, so she has been giving him 5 mL of ibuprofen every twelve hours .He was diagnosed with acute otitis media (AOM) at the age of four months; he has had the same diagnosis three times since .On physical exam, his vital signs are normal with the exception of a temperature of 102°F .His weight is 10 kg .Both tympanic membranes (TMs) are erythematous, with the right one more than the left one .The right TM is bulging with limited mobility, copious cerumen, and purulent fluid behind the TM .The left TM appears normal .The right TM landmarks are difficult to visualize .Answer the following questions:

Of the information provided, what data support the diagnosis of AOM and what would be inconclusive?

How would you distinguish AOM and otitis media with effusion (OME)?

What treatment would you suggest?

What types of cautions or instructions would you provide to his mother?

Discussion Question 2

Administration of ophthalmological medications requires some explanation .What are the important points that you would review with a patient when teaching how to instill ophthalmic drops and when teaching how to instill ointment? What are the differences you would need to consider if the patient was a child or if the patient is a geriatric patient? Search the literature to see whether you are able to locate any guidelines to support this teaching .

 

NSG 6005 All Week Assignment Latest SU

NSG 6005 Week 1 Assignment 3 Quiz

Question 1 .The U .S .Food and Drug Administration (FDA) regulates:

Prescribing of drugs by MDs and NPs

The official labeling for all prescriptions and over-the-counter drugs

Off-label recommendations for prescribing

Pharmaceutical educational offerings

Question 2 .The U .S .Drug Enforcement Administration (DEA):

Registers the manufacturers of, and those who are prescribers of controlled substances .

Regulates NP prescribing at the state level

Sanctions providers who prescribe drugs off-label

Provides prescribers with a number they can use for insurance billing

Question 3 .Precautions that should be taken when prescribing controlled substances include:

Faxing the prescription for a Schedule II drug directly to the pharmacy

Using tamper-proof papers for all prescriptions written for controlled drugs

Keeping any presigned prescription pads in a locked drawer in the clinic

Using only numbers to indicate the amount of drug to be prescribed

Question 4 .Alterations in drug metabolism among Asians may lead to:

Slower metabolism of antidepressants, requiring lower doses

Faster metabolism of neuroleptics, requiring higher doses

Altered metabolism of omeprazole, requiring higher doses

Slower metabolism of alcohol, requiring higher doses

Question 5 .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

 

NSG 6005 Week 2 Assignment 2 Quiz

1 .Question :A patient’s nutritional intake and lab work reflect hypoalbuminemia .This is critical to prescribing because:

Distribution of drugs to target tissue may be affected

The solubility of the drug will not match the site of absorption

There will be less free drug available to generate an effect

Drugs bound to albumin are readily excreted by the kidney

Question 2 .Drugs that have a significant first-pass effect:

Must be given by the enteral (oral) route only

Bypass the hepatic circulation

Are rapidly metabolized by the liver and may have little if any desired action

Are converted by the liver to more active and fat-soluble forms

Question 3 .An advantage of prescribing a sublingual medication is that the medication is:

Absorbed rapidly

Excreted rapidly

Metabolized minimally

Distributed equally

Question 4 .Which one of the following statements about bioavailability is true?

Bioavailability issues are especially important for drugs with narrow therapeutic ranges or sustained release mechanisms .

All brands of a drug have the same bioavailability .

Drugs that are administered more than once a day have greater bioavailability than drugs given once daily .

Combining an active drug with an inert substance does not affect bioavailability .

Question 5 .The route of excretion of a volatile drug will likely be:

The kidneys

The lungs

The bile and feces

The skin

 

NSG 6005  Week 3 Assignment 2 Quiz

Question 1 .Ray has been diagnosed with hypertension, and an ACE inhibitor is determined to be needed .Prior to prescribing this drug, the nurse practitioner should assess for:

Hypokalemia

Impotence

Decreased renal function

Inability to concentrate

Question 2 .A potentially life-threatening adverse response to ACE inhibitors is angioedema .Which of the following statements is true about this adverse response?

Swelling of the tongue and hoarseness are the most common symptoms .

It appears to be related to a decrease in aldosterone production .

The presence of a dry, hacky cough indicates a high risk for this adverse response .

Because it takes time to build up a blood level, it occurs after being on the drug for about one week .

Question 3 .Rodrigo has been prescribed procainamide after an episode of MI .He is monitored for dyspnea, jugular venous distention, and peripheral edema because they may indicate:

Widening of the area of infarction

Onset of congestive heart failure

An electrolyte imbalance involving potassium

Renal dysfunction

Question 4 .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 5 .Furosemide is added to a treatment regimen for heart failure, which includes digoxin .Monitoring for this combination includes:

Hemoglobin

Serum potassium

Blood urea nitrogen

Serum glucose

 

NSG 6005 Week 4 Assignment 2 Quiz

1 .Question : 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?

Patients with kidney stones

Pregnant patients

Patients with heartburn

Postmenopausal women

Question 2 .A patient with a COPD exacerbation may require:

Doubling of inhaled corticosteroid dose

Systemic corticosteroid burst

Continuous inhaled beta 2 agonists

Leukotriene therapy

Question 3 .

When prescribing montelukast (Singulair) for asthma, patients or parents of patients should be instructed as follows:

Montelukast twice a day is started when there is an asthma exacerbation .

Patients may experience weight gain on montelukast .

Aggression, anxiety, depression, and/or suicidal thoughts may occur when taking montelukast .

Lethargy and hypersomnia may occur when taking montelukast .

Question 4 .

Lifestyle changes are the first step in the treatment of GERD .A food that may aggravate GERD is:

Eggs

Honey Dew

Chocolate

Chicken

Question 5 .Kelly has diarrhea and is wondering if she can take loperamide (Imodium) for the diarrhea .Loperamide:

Can be given to patients of all ages, including infants and children, for viral gastroenteritis

Slows gastric motility and reduces fluid and electrolyte loss from diarrhea

Is the treatment of choice for the diarrhea associated with E .coli 0157

May be used in pregnancy and by lactating women

 

NSG 6005 Week 5 Assignment 2 Quiz

1 .Question : Jake, a forty-five-year-old patient with schizophrenia, was recently hospitalized for acute psychosis due to medication noncompliance .He was treated with intramuscular (IM) long-acting haloperidol .Besides being monitored for his schizophrenia symptoms, the patient should be assessed by his primary care provider:

For excessive weight loss

With the Abnormal Involuntary Movement Scale (AIMS) for extrapyramidal symptoms (EPS) symptoms

Monthly for tolerance to the haloperidol

Only by the mental health provider as most nurse practitioners in primary care do not care for mentally ill patients

Question 2 Sarah, a forty-two-year-old female, requests a prescription for an anorexiant to treat her obesity .A trial of phentermine is prescribed .Prescribing precautions include understanding that:

Obesity is a contraindication to prescribing phentermine .

Anorexiants may cause tolerance and should only be prescribed for six months .

Patients should be monitored for postural hypotension .

Renal function should be monitored closely while the patient is on anorexiants .

Question 3 .Cara is taking levetiracetam (Keppra) to treat seizures .Routine education for levetiracetam includes reminding her:

To not abruptly discontinue levetiracetam due to the risk of withdrawal seizures

To wear a sunscreen due to photosensitivity from levetiracetam

To get an annual eye exam while on levetiracetam

To report weight loss if it occurs

Question 4 .A nineteen-year-old male was started on risperidone .Monitoring for risperidone includes observing for common side effects, including:

Bradykinesia, akathisia, and agitation

Excessive weight gain

Hypertension

Potentially fatal agranulocytosis

Question 5 .Prior to starting antidepressants, patients should have laboratory testing to rule out:

Hypothyroidism

Anemia

Diabetes mellitus

Low estrogen levels

 

NSG 6005 Week 6 Assignment 2 Quiz

1 .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 .

Question 2 .Chronic pain is a complex problem .Some specific strategies to deal with it include ________ .

telling the patient to “let pain be your guide” to using treatment therapies

prescribing pain medication on a pro re nata (PRN) basis to keep down the amount used

scheduling return visits on a regular basis rather than waiting for poor pain control to drive the need for an appointment

All the given options

Question 3 .Phil is starting treatment with febuxostat (Uloric) .Education of patients starting febuxostat includes which one of the following instructions?

Gout may worsen with therapy .

Febuxostat may cause severe diarrhea .

The patients should consume a high-calcium diet .

The patients will need frequent CBC monitoring .

Question 4 .The Pain Management Contract is most appropriate for:

Patients with a history of chemical dependency or possible inappropriate use of pain medications

All patients with chronic pain who will require long-term use of opiates

Patients who have a complex drug regimen

Patients who see multiple providers for pain control

Question 5 .Patients whose total dose of prednisone exceed 1 gram will most likely need a second prescription for _________ .

metformin, a biguanide to prevent diabetes

omeprazole, a proton pump inhibitor to prevent peptic ulcer disease

naproxen, an NSAID to treat joint pain

furosemide, a diuretic to treat fluid retention

 

NSG 6005 Week 7 Assignment 2 Quiz

1 .Question :

A twenty-two-year-old woman receives a prescription for oral contraceptives .Education for this patient includes:

Counseling regarding decreasing or not smoking while taking oral contraceptives

Advising a monthly pregnancy test for the first three months she is taking the contraceptive

Advising that she may miss two pills in a row and not be concerned about pregnancy

Informing her that her next follow-up visit is in one year for a refill and “annual exam”

Question 2 .Sallie has been diagnosed with osteoporosis and is asking about the once-a-month pill to treat her condition .How do bisphosphonates treat osteoporosis?

By selectively activating estrogen pathways in the bone

By reducing bone resorption by inhibiting PTH

By reducing bone resorption and inhibiting osteoclastic activity

By increasing PTH production

Question 3 .Elderly patients who are started on levothyroxine for thyroid replacement should be monitored for:

Excessive sedation

Tachycardia and angina

Weight gain

Cold intolerance

Question 4 .Intranasal calcitonin is used in the treatment of osteoporosis .For which patient is Calcitonin therapy appropriate?

Thin, Caucasian perimenopausal women

Men over the age of sixty-five years with osteoporosis

Women over the age of sixty-five years with osteopenia

Women over the age of sixty-five years with severe osteoporosis

Question 5 .The ongoing monitoring of patients over the age sixty-five years taking alendronate (Fosamax) or any other bisphosphonate is:

Annual dual energy X-ray absorptiometry (DEXA) scans

Annual vitamin D level

Annual renal function evaluation

Electrolytes every three months

 

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NSG 6005 Week 8 Assignment 2 Quiz

1 .Question :

When blood glucose levels are difficult to control in type II diabetes, some form of insulin may be added to the treatment regimen to control blood glucose and limit complications risks .Which of the following statements are accurate based on research?

Premixed insulin analogues are better at lowering hemoglobin A1c and have less risk for hypoglycemia .

Premixed insulin analogues and the newer premixed insulins are associated with more weight gain than the oral antidiabetic agents .

Newer premixed insulins are better at lowering hemoglobin A1c and postprandial glucose levels than are long-acting insulins .

Patients who are not controlled on oral agents and have postprandial hyperglycemia can have NPH insulin added at bedtime .

Question 2 .Lispro is an insulin analogue produced by recombinant deoxyribonucleic acid (DNA) technology .Which of the following statements about this form of insulin is not true?

The optimal time of preprandial injection is fifteen minutes .

The duration of action is increased when the dose is increased .

It is compatible with NPH insulin .

It has no pronounced peak .

Question 3 .Unlike most type II diabetics where obesity is a major issue, older adults with low body weight have higher risks for morbidity and mortality .The most reliable indicator of poor nutritional status in older adults is:

Weight loss in previously overweight persons

Involuntary loss of 10% of body weight in less than six months

Decline in lean body mass over a twelve-month period

Increase in central versus peripheral body adiposity

Question 4 .Sulfonylureas may be added to a treatment regimen for type II diabetics when lifestyle modifications and metformin are insufficient to achieve target glucose levels .Sulfonylureas have been moved to Step 2 therapy because they:

Increase endogenous insulin secretion .

Have a significant risk for hypoglycemia .

Address the insulin resistance found in type II diabetics .

Improve insulin binding to receptors .

Question 5 .The drugs recommended by the American Academy of Pediatrics for use in children with diabetes (depending upon type of diabetes) are:

Metformin and insulin

Sulfonylureas and insulin glargine

Split-mixed dose insulin and GLP-1 agonists

Biguanides and insulin lispro

 

NSG 6005 Week 9 Assignment 3 Quiz

Question 1 .Jonathan has been diagnosed with strep throat and needs a prescription for an antibiotic .He says the last time he had penicillin he developed a red, blotchy rash .The appropriate antibiotic to prescribe would be:

Penicillin VK, since his rash does not sound like a serious rash

Amoxicillin

Cefadroxil (Duricef)

Erythromycin

Question 2 .Tetracyclines are contraindicated in children younger than 8 years because of:

Risk of developing cartilage problems

Development of significant diarrhea

Risk of kernicterus

Adverse effects on bone growth

Question 3 .Lisa is a healthy non-pregnant adult woman who recently had a UTI .She is asking about drinking cranberry juice to prevent a recurrence of the UTI .The answer to give her would be:

“Sixteen ounces per day of cranberry juice cocktail will prevent UTIs .”

“100% cranberry juice or cranberry juice extract may decrease UTIs in some patients .”

“There is no evidence that cranberry juice helps prevent UTIs .”

“Cranberry juice only works to prevent UTIs in children .”

Question 4 .Rose is a 3 year old with an upper respiratory infection (URI) .Treatment for her URI would include:

Amoxicillin

Diphenhydramine

Pseudoephedrine

Nasal saline spray

Question 5 .Patient education for a patient who is prescribed antibiotics for sinusitis includes:

Use of nasal saline washes

Use of inhaled corticosteroids

Avoiding the use of ibuprofen while ill

Use of laxatives to treat constipation

 

NSG 6005 Week 10 Assignment 2 Final Exam

1 .Question :

The drug recommended as primary prevention of osteoporosis in men over seventy years is:

Alendronate (Fosamax)

Ibandronate (Boniva)

Calcium carbonate

Raloxifene (Evista)

Question 2 .Question :

Alterations in drug metabolism among Asians may lead to:

Slower metabolism of antidepressants, requiring lower doses

Faster metabolism of neuroleptics, requiring higher doses

Altered metabolism of omeprazole, requiring higher doses

Slower metabolism of alcohol, requiring higher doses

Question 3 .Question :

Some research supports that testosterone replacement therapy may be indicated in which of the following diagnoses in men?

Age-related decrease in cognitive functioning

Metabolic syndrome

Decreased muscle mass in aging men

All of the above

Question 4 .Question :

The chemicals that promote the spread of pain locally include _________ .

serotonin

norepinephrine

enkephalin

neurokinin A

Question 5 .Question :

The DEA:

Registers manufacturers and prescribes controlled substances

Regulates NP prescribing at the state level

Sanctions providers who prescribe drugs off-label

Provides prescribers with a number they can use for insurance billing

Question 6 .Question :

The trial period to determine effective anti-inflammatory activity when starting a patient on aspirin for RA is _____ .

forty-eight hours

four to six days

four weeks

two months

Question 7 .Question :

The route of excretion of a volatile drug will likely be:

The kidneys

The lungs

The bile and feces

The skin

Question 8 .Question :

Compelling indications for an ACE inhibitor as treatment for hypertension based on clinical trials include:

Pregnancy

Renal parenchymal disease

Stable angina

Dyslipidemia

Question 9 .Question :

The American Diabetic Association has recommended which of the following tests for ongoing management of diabetes?

Fasting blood glucose

Hemoglobin A1c

Thyroid function tests

Electrocardiograms

Question 10 .Question :

The angiotensin converting enzyme (ACE) inhibitor lisinopril is a known teratogen .Teratogens cause Type ____ ADR .

A

B

C

D

Question 11 .Question :

The goals of therapy when prescribing HRT include reducing:

Cardiovascular risk

Risk of stroke or other thromboembolic event

Breast cancer risk

Vasomotor symptoms

Question 12 .Question :

Patients who have angina, regardless of class, who are also diabetic should be on:

Nitrates

Beta blockers

ACE inhibitors

Calcium channel blockers

Question 13 .Question :

The New York Heart Association and the Canadian Cardiovascular Society have described grading criteria for levels of angina .Angina that occurs with unusually strenuous activity or on walking or climbing stair after meals is:

Class I

Class II

Class III

Class IV

Question 14 .Question :

Patients with allergic rhinitis may benefit from a prescription of:

Fluticasone (Flonase)

Cetirizine (Zyrtec)

OTC cromolyn nasal spray (Nasalcrom)

Any of the above

Question 15 .Question :

Kyle has Crohn’s disease and has a documented folate deficiency .Drug therapy for folate deficiency anemia is:

Oral folic acid 1 to 2 mg/day

Oral folic acid 1 gm/day

IM folate weekly for at least six months

Oral folic acid 400 mcg daily

 

NSG 6005 Week 9 Assignment 2 Latest SU

Assignment 2: Evidence-Based Pharmacology Paper

The purpose of this assignment is to provide an opportunity for you to review an area of interest and apply the concepts you have learned in this course to a patient situation .In clinical decision making, you must combine knowledge and evidence to make a good decision .Using critical thinking and reading skills, you will meet multiple objectives for this assignment .

Criteria

Synthesize relevant information, including research related to the diagnosis and treatment of the selected disorder .

Recognize the assumptions inherent in the current literature and identify any unstated or missing information .

Develop and justify various approaches to the stated problem, including nonpharmacological and pharmacological treatment .

Clearly articulate at least two approaches to the treatment of the condition .

Defend the choice of the treatment option .This must include a reflection on the availability of peer-reviewed information and your analysis of the credibility of that information .

Create a plan for follow-up and referral if needed .

The following are examples of disease states that you might want to study .These are just examples .You can select whatever area is of interest to you .

Asthma

Chronic Obstructive Pulmunory Disease (COPD)

Hypertension

Diabetes Mellitus Type II

Major Depression

Migraine Headaches

Pneumonia

Tuberculosis

Human Immunodeficiency Virus (HIV)

Hyperlipidemia

Submit your answers in a Microsoft Word document of 10–15 pages .Include peer-reviewed references in APA format .Be sure to review the directions and grading criteria to assure that you will cover the content well.

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