Question 1 A patient takes an oral medication that causes gastrointestinal upset. The patient asks the primary care NP why the drug information insert cautions against using antacids while taking the drug. The NP should explain that the antacid may: A. alter drug absorption. B. alter drug distribution. C. lead to drug toxicity. D. increase stomach upset. 0.3 points Question 2 A patient will begin taking two drugs that are both protein-bound. The primary care NP should: A. stagger the doses of drugs to be given 1 hour apart. B. prescribe increased doses of both drugs. C. monitor drug levels, actions, and side effects. D. teach the patient to increase intake of protein. 0.3 points Question 3 The knowledge of how age, race, and gender may affect drug excretion is based on an understanding of: A. bioavailability. B. pharmacokinetics. C. pharmacodynamics. D. anatomy and physiology. 0.3 points Question 4 A patient receives an inhaled corticosteroid to treat asthma. The patient asks the primary care NP why the drug is given by this route instead of orally. The NP should explain that the inhaled form: A. hasreduced bioavailability. B. provides dosing that is easier to regulate. C. is absorbed less quickly. D. hasfewersystemic side effects. 0.3 points Question 5 The primary care NP is performing a physical examination on a 6-month-old infant with cerebral palsy who has not had previous immunizations. The NP plans to begin vaccinations and should include: A. TD vaccine only. B. TdaP vaccine. C. tetanus vaccine only. D. DTaP vaccine. 0.3 points Question 6 The primary care NP sees a 4-year-old child who has persistent asthma episodes for a well-child visit in October. The child recently completed a 7-day course of oral steroids. The NP plans to give the child flu vaccine and should: A. wait 4 weeks and administer LAIV. B. administer LAIV today. C. wait 4 weeks and administer 0.5 mg TIV. D. administer 0.5 mg TIV today. 0.3 points Question 7 The primary care NP sees an 11-month-old infant for the first time and notes that the infant has not received the Hib vaccine. The NP should: A. give the Hib vaccine now with no boosters. B. give the Hib vaccine now and booster in 2 to 3 months. C. tell the parents that the child is too old to begin receiving the Hib vaccine. D. give the Hib vaccine now and booster at age 4 to 6 years. 0.3 points Question 8 A 5-year-old child who has no previous history of otitis media is seen in clinic with a temperature of 100° F. The primary care NP visualizes bilateral erythematous, nonbulging, intact tympanic membranes. The child is taking fluids well and is playing with toys in the examination room. The NP should: A. initiate antibiotic therapy if the child’s condition worsens. B.prescribe amoxicillin-clavulanate twice daily for 10 days. C.prescribe amoxicillin twice daily for 10 days. D.prescribe azithromycin once daily for 5 days. Question 9 A patient has urethritis. The primary care NP should prescribe: A.doxycycline. B.minocycline. C.demeclocycline. D.tetracycline. Question 10 A patient istaking tetracycline for a rickettsial infection and reports having heartburn. The primary care NP should: A.tell the patient to use antacids when heartburn occurs. B. ask the patient how the medication is taken. C. tell the patient to take the medication with food. D.recommend drinking milk when taking the medication. Question 11 A woman who takes oral contraceptive pills develops vaginal candidiasis. The primary care NP prescribes a single dose of fluconazole. When counseling the patient about this drug, the NP should tell her: A. that the drug is safe if she were to become pregnant. B. to use a backup contraceptive method for the next 2 months. C. that she may consume alcohol while taking this medication. D. thatshe may need a lower dose of fluconazole because she takes oral contraceptive pills. Question 12 A 55-year-old patient with no prior history of hypertension has a blood pressure greater than 140/90 on three separate occasions. The patient does not smoke, has a body mass index of 24, and exercises regularly. The patient has no known risk factors for cardiovascular disease. The primary care NP should: A. prescribe a thiazide diuretic and an angiotensin-converting enzyme inhibitor. B.perform a careful cardiovascular physical assessment. C. counsel the patient about dietary and lifestyle changes. D. order a urinalysis and creatinine clearance and begin therapy with a b-blocker. Question 13 A 55-year-old woman has a history of myocardial infarction (MI). A lipid profile reveals LDL of 130 mg/dL, HDL of 35 mg/dL, and triglycerides 150 mg/dL. The woman is sedentary with a body mass index of 26. The woman asks the primary care NP about using a statin medication. The NP should: A. begin therapy with atorvastatin 10 mg per day. B. recommend dietary and lifestyle changesfirst. C. discuss quality-of-life issues as part of the decision to begin medication. D. tell her there is no clinical evidence of efficacy of statin medication in her case. Question 14 A patient isin the clinic for a follow-up examination after a myocardial infarction (MI). The patient has a history of left ventricular systolic dysfunction. The primary care NP should expect this patient to be taking: A. timolol (Blocadren). B. carvedilol (Coreg). C. propranolol (Inderal). D. nadolol (Corgard). Question 15 A patient is in the clinic for an annual physical examination. The primary care NP obtains a medication history and learns that the patient is taking a b-blocker and nitroglycerin. The NP orderslaboratory tests, performs a physical examination, and performs a review of systems. Which finding may warrant discontinuation of the b-blocker in this patient? A. Wheezing, dyspnea, and cough B. Increased triglycerides C. Decreased exercise tolerance D. Nausea, vomiting, and anorexia Question 16 A patient who has been taking digoxin 0.25 mg daily for 6 months reports that it is not working as well as it did initially. The primary care NP should: A. hold the next dose of digoxin and obtain a serum digoxin level. B. increase the dose of digoxin to 0.5 mg daily. C. contact the patient’s pharmacy to ask if generic digoxin was dispensed. D. recommend a reduced potassium intake. Question 17 A patient who has heart failure has been treated with furosemide and an ACE inhibitor. The patient’s cardiologist has added digoxin to the patient’s medication regimen. The primary care NP who caresfor this patient should expect to monitor: A. complete blood counts (CBCs).