GCU NUR641E Full Course Discussions and Assignments

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GCU NUR641E Full Course Discussions and Assignments

GCU NUR641E Full Course Discussions and Assignments

NUR 641E Advanced Pathophysiology & Pharamacology for Nurse Educators

Week 1 Discussion

DQ1 Part 1

What are the differences between primary and secondary line of defense? What factors interfere with these mechanisms? How are these levels of immunity affected in a child, an elderly person, or a person with a chronic disease? Include active, passive, innate, and acquired immunity.

Part 2

Choose an inflammatory or infectious process and explain the pathophysiology changes that may occur. What patient education would need to be included related to this disorder? Choose a medical condition different from that of your fellow students.

DQ2 Select a medication used in evidence-based treatment guidelines for the condition chosen in the first discussion question. Share the mechanism of action of this medication and hints for monitoring, side effects, and drug interactions of which one should be aware. Make sure that you select a different medication than your peers. Include the name of the medication in the subject line so that the medications can be followed. Include your references in APA style.

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NUR 641E Advanced Pathophysiology & Pharamacology for Nurse Educators

Week 2 Discussion

DQ1 The Beer’s criteria contain a list of drugs that are potentially unsafe for use in older persons. Go to https://www.sigot.org/allegato_docs/1057_Beers-Criteria.pdf. Select a drug on the “avoid” list that you have administered to an older patient or a drug that you know is prescribed for an older adult. Relate the outcome of using this drug to the pharmacokinetics (absorption, metabolism, distribution, and excretion) of drugs in an older client. In addition to the link, cite one other reference to support your post.

DQ2 Many people are using herbal medications and dietary supplements for the prevention and treatment of medical problems. Review two current research articles about two of these products. Based on the findings, what would be the implications for you as a nurse? What additional research needs to be done in this area? Cite the two references to support your answer.

NUR 641E Advanced Pathophysiology & Pharamacology for Nurse Educators

Week 3 Discussion

DQ1 Choose a medical condition from the fluid, electrolyte, or acid-base system and explain the pathophysiology changes that may occur. What patient education would need to be included related to this disorder? Choose a medical condition different from that of your fellow students.

DQ2 Select a medication used in evidence-based treatment guidelines for the condition chosen in the first discussion question. Share the mechanism of action of this medication and hints for monitoring, side effects, and drug interactions of which one should be aware. Make sure that you select a different medication than your peers. Include the name of the medication in the subject line so that the medications can be followed. Include your references in APA style.

NUR 641E Advanced Pathophysiology & Pharamacology for Nurse Educators

Week 4 Discussion

GCU NUR641E Full Course Discussions and Assignments

DQ1 Choose a medical condition from the respiratory system or HEENT system and explain the pathophysiology changes that may occur. What patient education would need to be included related to this disorder? Choose a medical condition different from that of your fellow students.

DQ2 Select a medication used in evidence-based treatment guidelines for the condition chosen in the first discussion question. Share the mechanism of action of this medication and hints for monitoring, side effects, and drug interactions of which one should be aware. Make sure that you select a different medication than your peers. Include the name of the medication in the subject line so that the medications can be followed. Include your references in APA style.

NUR 641E Advanced Pathophysiology & Pharamacology for Nurse Educators

Week 5 Discussion

DQ1 Choose a medical condition from the cardiovascular system and lymphatic system and explain the pathophysiology changes that may occur. What patient education would need to be included related to this disorder? Choose a medical condition different from that of your fellow students.

DQ2 Select a medication used in evidence-based treatment guidelines for the condition chosen in the first discussion question. Share the mechanism of action of this medication and hints for monitoring, side effects, and drug interactions of which one should be aware. Make sure that you select a different medication than your peers. Include the name of the medication in the subject line so that the medications can be followed. Include your references in APA style.

NUR 641E Advanced Pathophysiology & Pharamacology for Nurse Educators

Week 6 Discussion

DQ1 Choose a medical condition from the gastrointestinal or genitourinary systems and explain the pathophysiology changes that may occur. What patient education would need to be included related to this disorder? Choose a medical condition different from that of your fellow students.

DQ2 Select a medication used in evidence-based treatment guidelines for the condition chosen in the first discussion question. Share the mechanism of action of this medication and hints for monitoring, side effects, and drug interactions of which one should be aware. Make sure that you select a different medication than your peers. Include the name of the medication in the subject line so that the medications can be followed. Include your references in APA style.

NUR 641E Advanced Pathophysiology & Pharamacology for Nurse Educators

Week 7 Discussion

DQ1 Choose a medical condition from the neurological, musculoskeletal, or integumentary system and explain the pathophysiology changes that may occur. What patient education would need to be included related to this disorder? Choose a medical condition different from that of your fellow students.

DQ2 Select a medication used in evidence-based treatment guidelines for the condition chosen in the first discussion question. Share the mechanism of action of this medication and hints for monitoring, side effects, and drug interactions of which one should be aware. Make sure that you select a different medication than your peers. Include the name of the medication in the subject line so that the medications can be followed. Include your references in APA style.

NUR 641E Advanced Pathophysiology & Pharamacology for Nurse Educators

Week 8 Discussion

DQ1 Choose a medical condition from the endocrine system and explain the pathophysiology changes that may occur. What patient education would need to be included related to this disorder? Choose a medical condition different from that of your fellow students.

DQ2 Select a medication used in evidence-based treatment guidelines for the condition chosen in the first discussion question. Share the mechanism of action of this medication and hints for monitoring, side effects, and drug interactions of which one should be aware. Make sure that you select a different medication than your peers. Include the name of the medication in the subject line so that the medications can be followed. Include your references in APA style.

NUR 641E Advanced Pathophysiology & Pharamacology for Nurse Educators

Week 2 Assignment

Content Lesson Presentation

Create a 7-8 slide presentation with speaker notes about a selected disease process and drug class. The presentation should provide content specific information on the selected disease process and drug class for staff or students in a clinical environment.

Follow these steps:

Select a disease process and a drug class used to treat the disease process.

Describe pharmacokinetics and pharmacodynamics of the drug related to the pathophysiology of the disease process.

Describe the product, its intended use, side effects, adverse reactions, and safety issues.

Identify ethnic, cultural, and genetic differences in patients that may affect the safety or efficacy of medications.

How would you monitor the desired affect is achieved?

Be sure to include three to five references.

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are not required to submit this assignment to LopesWrite

NUR 641E Advanced Pathophysiology & Pharamacology for Nurse Educators

Week 3 Assignment

Acid-Base and Electrolyte Case Study

A nurse is taking care of an 85-year-old woman in a hospital based skilled nursing facility. In report, the nurse is told the patient has not been breathing well for the past 2 days. She has been lethargic, her skin is warm and dry, and she has a decreased urine output. The following laboratory findings were returned from the laboratory immediately after morning report:

Na: 147

Cl 110

K 4.0

Blood Gases:

pH 7.33

PCO2 48

HCO3 27

Po2 96

Urine:

Urine Specific Gravity 1.040

Address the following:

Identify each of the abnormal laboratory findings in the above results. Specify how they differ from a normal range and identify what condition each abnormality indicates.

What specific electrolyte disturbance does the patient have?

What clinical manifestations would the nurse expect to see with this electrolyte abnormality presented above?

If the patient had an increase in her potassium level, what clinical manifestations would the nurse monitor for?

What blood gas abnormality is seen in this patient? Discuss the rationale for your answer.

What are the three major mechanisms of pH regulation?

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are not required to submit this assignment to LopesWrite

NUR 641E Advanced Pathophysiology & Pharamacology for Nurse Educators

Week 6 Assignment

CLC – Staff Training

This is a Collaborative Learning Community (CLC) assignment.

This assignment requires completion of two parts: a presentation and an educational resource.

Part I: Presentation

Create a 15- to 20-slide PowerPoint presentation with speaker notes for a staff training meeting on the pathophysiology and pharmacologic agents for a select disease process.

Each CLC will choose one disease process from the following list and obtain instructor approval to avoid duplication:

1. Alzheimer’s disease

2. Asthma

3. Diabetes Type 2

4. Epilepsy

5. Gastroesophageal reflux disease (GERD)

6. Hypertension

7. Hypothyroidism

8. Multiple sclerosis

9. Peptic ulcer disease

10. Tuberculosis

Describe the physiology and pathophysiology of the disease, clinical manifestations, and evaluation (e.g., labs, imaging).

Describe the pharmacologic treatment of the disease, including pharmacokinetics, pharmacodynamics, drug interactions, side effects, adverse reactions, and application of the nursing process in monitoring the drug therapy.

Part II: Educational Resource

Using your selected disease process from Part I, develop an educational resource that can assist staff in increasing patient knowledge of medications and medication compliance.

The vehicle for your educational resource could include pamphlets, handouts, or any other brief, concise medium to convey the information to staff.

APA style is not required, but solid academic writing is expected.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Please refer to the directions in the Student Success Center.

NUR 641E Advanced Pathophysiology & Pharamacology for Nurse Educators

GCU NUR641E Full Course Discussions and Assignments Midterm Exam

1 Heparin exerts its therapeutic action by:

upregulating the activity of one of the body’s natural anticoagulant molecules, antithrombin III.

deactivating calcium-dependent clotting factors.

inducing prothrombin formation.

inducing the formation of fibrin.

2 Which method of drug administration can have immediate effects and requires lower doses compared to oral or parenteral administration?

Intravenous

Sublingual

Transdermal

Inhalation

3 High altitudes may produce hypoxemia by:

right-to-left shunts.

atelectasis.

decreased oxygen inspiration.

emphysema.

All of the above

4 Causes of hyperkalemia include:

hyperparathyroidism and malnutrition.

vomiting and diarrhea.

renal failure and Addison’s disease.

hyperaldosteronism and Cushing’s disease.

5 Hypomagnesemia occurs when serum magnesium concentration is less than

1.0 mEq/L.

1.5 mEq/L.

2.0 mEq/L.

3.0 mEq/L.

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6 When looking at arterial blood gas readings, you discover the following: pH 7.26, pCO2 56, HCO3 24. What condition are you dealing with?

Respiratory alkalosis

Metabolic acidosis

Metabolic alkalosis

Respiratory acidosis

7 A drug with a half-life of 10 hours is administered by continuous intravenous infusion. Which of the following best approximates the time for the drug to reach steady state?

10 hours

30 hours

40 hours

60 hours

8 Which NSAID is generally considered the safest for use in patients with coronary artery disease?

Celecoxib

Indomethacin

Naproxen

Acetaminophen

9 Pulmonary hypertension:

shows an enlarged pulmonary artery.

involves deep vein thrombosis.

shows right ventricular hypertrophy.

A and C are correct

10 Which stage of infection is occurring when the immune and inflammatory responses are triggered?

Incubation period

Prodromal stage

Invasion period

Convalescence

11 Which of the following agents is used to treat hypercalcemia of malignancy?

Activated vitamin D

Pamidronate (Aredia)

Hydrochlorothiazide

Kayexalate

12 Which statement is true regarding the pharmacokinetics of drug administration?

The immature liver or kidneys of the very young may accelerate drug metabolism and excretion.

Medications enter the body in solid form and change into solution for absorption and utilization.

It includes medication absorption, distribution to tissues, metabolism, and elimination from the body.

A therapeutic effect occurs as the medication reaches the target cell.

13 Which statement is true regarding the half-life of medications?

Doubling the dose will double the medication half-life.

Approximately 2 half-lives are required for a medication to be completely eliminated.

Patients with renal or hepatic disease usually have decreased half-lives.

The half-life of a drug helps determine how often the drug is to be administered.

GCU NUR641E Full Course Discussions and Assignments Q14

Cell wall inhibitors include all of the following except

penicillins.

cephalosporins.

carbapenems.

tetracylclines.

15 Which of the following factors do not influence bioavailability?

First-pass hepatic metabolism

Solubility of the drug

Bioequivalence

Chemical instability

16 Which class of diuretics treats hypertension by increasing sodium and water retention?

Loop diuretics

Thiazide diuretics

Potassium sparing diuretics

Aldosterone inhibiting diuretics

17 What is the action of calcitonin?

Increases metabolism.

Decreases metabolism.

Increases serum calcium.

Decreases serum calcium.

18 The nurse has a patient who has been on multidrug therapy for pulmonary tuberculosis. When planning patient education, the nurse knows the patient needs to watch for which symptom of an adverse effect of multidrug therapy?

Hearing loss

Changes in vision

Generalized pruritus

Jaundice

GCU NUR641E Full Course Discussions and Assignments

19 The spread of microorganisms from mother to the baby across the placenta is termed

direct transmission.

vertical transmission.

horizontal transmission.

indirect transmission.

20 Which antimicrobial should be avoided in children because it is deposited in tissues undergoing calcification and can stunt growth?

Tetracycline

Ciprofloxacin

Vancomycin

Amoxicillin

21 The primary role of cytochrome p-450, in the liver, is to:

stimulate steroid release as a stress response.

deactivate and detoxify medications and other substances.

produce fibrinogen, prothrombin, and factor V.

eliminate amino acids, forming urea.

22 Death from influenza usually results from

high temperature.

dehydration.

pneumonia.

metabolic alkalosis.

23 Which of the following statements is true regarding bioavailability?

It has little effect on the pharmacokinetics of orally-administered drugs.

It is a drug-specific property; therefore, bioavailability will be the same regardless of the dosage form used.

IV-administered drugs have a bioavailability of between 50 and 75 percent.

It is defined as the amount of administered drug that is available to reach the site of action.

24 Which of the following agents is considered a CYP3A4 inhibitor and should be used with caution in patients taking CYP3A4 substrates?

Phenytoin

Amiodarone

Carbamazepine

Rifampin

25 Which of the following drugs are not considered for use with angina?

Beta blockers

Calcium channel blockers

ACE inhibitors

Nitrates

GCU NUR641E Full Course Discussions and Assignments

26 How many months does it take for the newborn to be sufficiently protected by antibodies produced by its own B cells?

1 to 2

4 to 5

6 to 8

10 to 12

27 Low plasma albumin causes edema as a result of a reduction in which pressure?

Capillary hydrostatic

Interstitial hydrostatic

Plasma oncotic

Interstitial oncotic

28 What mechanism can cause hypernatremia?

Syndrome of inappropriate antidiuretic hormone

Hypersecretion of aldosterone

Brief bouts of vomiting or diarrhea

Excessive diuretic therapy

29 What is the direct action of atrial natriuretic hormone? (Select all that apply.)

Sodium retention

Sodium excretion

Water retention

Water excretion

30 Which of the following increases the potential of cardiac toxicity if taken concurrently with digoxin?

Chloride

Potassium

Sodium

Zinc

31 Which of the following corticosteroids has the shortest half-life and thus must be dosed most frequently?

Dexamethasone

Hydrocortisone

Methylprednisolone

Prednisone

32 What causes the rapid change in the resting membrane potential to initiate an action potential?

Potassium gates open, and potassium rushes into the cell, changing the membrane potential from negative to positive.

Sodium gates open, and sodium rushes into the cell, changing the membrane potential from negative to positive.

Sodium gates close, allowing potassium into the cell to change the membrane potential from positive to negative.

Potassium gates close, allowing sodium into the cell to change the membrane potential from positive to negative.

33 Which factor is responsible for the hypertrophy of the myocardium associated with hypertension?

Increased norepinephrine

Adducin

Angiotensin II

Insulin resistance

34 The major therapeutic actions of NSAIDS include all of the following except

reduction of inflammation.

reduction of pain.

reduction of fever.

reduction of clotting factors.

35 What is an example of compensatory hyperplasia?

Hepatic cells increase cell division after part of the liver is excised.

Skeletal muscle cells atrophy as a result of paralysis.

The heart muscle enlarges as a result of hypertension.

The size of the uterus increases during pregnancy.

36 A patient with type 1 diabetes has been made NPO after midnight for surgery. Knowing that the patient needs to continue the insulin pump to prevent diabetic ketoacidosis, what would be an expectation of treatment?

Bedtime snack before midnight

Dextrose containing intravenous fluids

2am glucose check followed by apple juice if needed

Discontinue the insulin pump

37 Bacteria that produce endotoxins that stimulate the release of inflammatory mediators that produce fever are called

pyrogenic bacteria.

true bacteria.

exotoxins.

spirochetes.

GCU NUR641E Full Course Discussions and Assignments

38 A 68-year-old male has COPD with moderate airway obstruction. Despite using salmeterol daily, as prescribed, he reports continued symptoms of shortness of breath with mild exertion. Which one of the following agents would be an appropriate addition to his current therapy?

Systemic corticosteroids

Albuterol

Tiotropium

Roflumilast

Theophylline

39 Aldosterone directly increases the reabsorption of (select all that apply):

magnesium.

calcium.

sodium.

water.

40 The most common cause of lower respiratory tract infection is

aspiration of oropharyngeal secretions.

not receiving the vaccine.

refusing to cough and take deep breaths.

remaining in bed until postop day two.

41 Which of the following is true regarding prodrugs?

They are affected considerably by renal function.

They are better than amateur drugs.

They are designed to overcome undesirable properties of an active drug.

They may be more effective in patients with liver dysfunction.

42 In the immediate postnatal period, infants lose approximately 5% of body weight due to

loss of body water

inability of the body to digest nutrients

hemolysis of red blood cells

poor sucking reflex

43 Which of the following best describes the mechanism of action of warfarin?

Directly inhibits factor Xa

Inhibits factors II, VII, IX, and X

Blocks the conversion of fibrinogen to fibrin

Upregulates antithrombin III

GCU NUR641E Full Course Discussions and Assignments Q 44

When looking at arterial blood gas readings, you discover the following: pH 7.75, pCO2 24, HCO3 40. What condition are you dealing with?

Respiratory alkalosis

Metabolic acidosis

Metabolic alkalosis

Respiratory acidosis

45 In the absence of susceptibility data for an acute infection, the choice of an antimicrobial drug is mostly influenced by

the site of infection and the patient’s history.

the sensitivity report and the colony count.

the source of the infection and the color of exudate.

the host defense mechanism and the immune response.

46 All of the following can be a likely cause of respiratory acidosis except:

emphysema.

pulmonary edema.

barbiturate overdose.

extreme fear and anxiety.

47 An increase of carbon dioxide in arterial blood causes chemoreceptors to stimulate the respiratory centers to:

decrease respiratory rate.

increase respiratory rate.

develop hypocapnia.

develop hypercapnia.

48 The leading cause of death from a curable infectious disease throughout the world is

pneumonia.

tuberculosis.

HIV infection.

influenza.

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49 Which condition poses the highest risk for a cerebrovascular accident (CVA)?

Insulin-resistant diabetes mellitus

Hypertension

Polycythemia

Smoking

50 Pulmonary emboli do not cause which of the following?

Obstruct blood supply to lung parenchyma

Have origins from thrombi in the legs

Occlude pulmonary vein branches

Occlude pulmonary artery branches

NUR641E Advanced Pathophysiology & Pharamacology for Nurse Educators

Final Exam

1. Insulin is used to treat hyperkalemia because it:

stimulates sodium to be removed from the cell in exchange for potassium.

binds to potassium to remove it through the kidneys.

transports potassium from the blood to the cell along with glucose.

breaks down the chemical components of potassium, causing it to be no longer effective.

2 What is the central component of the pathogenic model of multiple sclerosis?

Myelination of nerve fibers in the peripheral nervous system (PNS)

Demyelination of nerve fibers in the CNS

Development of neurofibrillary tangles in the CNS

Inherited autosomal dominant trait with high penetrance

s3Which of the following ICU sedatives should not be used for greater than 24 hours per the FDA-approved labeling?

Midazolam (Versed)

Diazepam (Valium)

Dexmedetomidine (Precedex)

Propofol (Diprivan)

GCU NUR641E Full Course Discussions and Assignments 4

What type of necrosis is associated with wet gangrene?

Coagulative

Liquefactive

Caseous

Coagulative

5 In the absence of susceptibility data for an acute infection, the choice of an antimicrobial drug is mostly influenced by

the site of infection and the patient’s history.

the sensitivity report and the colony count.

the source of the infection and the color of exudate.

the host defense mechanism and the immune response.

6 Which statement best describes cystic fibrosis?

Obstructive airway disease characterized by reversible airflow obstruction, bronchial hyperreactivity, and inflammation.

Respiratory disease characterized by severe hypoxemia, decreased pulmonary compliance, and diffuse densities on chest x-ray imaging.

Pulmonary disorder involving an abnormal expression of a protein-producing viscous mucus that obstructs the airways, pancreas, sweat ducts, and vas deferens.

Pulmonary disorder characterized by atelectasis and increased pulmonary resistance as a result of a surfactant deficiency.

7 What medical term is used to identify an inflammatory disorder of the skin that is often considered synonymous with dermatitis and characterized by pruritus with lesions that have an indistinct border?

Eczema

Psoriasis

Atopic dermatitis

Pityriasis rosea

8 Identify whether the description of the skin lesion matches the disorder where it is found. (Select True or False)

Elevated, firm circumscribed area less than 1 cm in diameter: Wart (verruca) or lichen planus

True

False

9 Removal of part of the liver leads to the remaining liver cells undergoing compensatory

atrophy.

metaplasia.

hyperplasia.

dysplasia.

10 Identify whether the description matches the disorder. (Select True or False)

Abnormal dilation of the vein within the spermatic cord – Varicocele

True

False

11 The risk of which cancer is greater if the man has a history of cryptorchidism?

Penile

Testicular

Prostate

Epididymal

GCU NUR641E Full Course Discussions and Assignments 12

Which substance is used to correct the chronic anemia associated with chronic renal failure?

Iron

Erythropoietin

Cobalamin (vitamin B12)

Folate

13 Diabetes insipidus is a result of:

antidiuretic hormone hyposecretion.

antidiuretic hormone hypersecretion.

insulin hyposecretion.

insulin hypersecretion.

14 Obesity acts as an important risk factor for type 2 diabetes mellitus by:

reducing the amount of insulin the pancreas produces.

increasing the resistance to insulin by cells.

obstructing the outflow of insulin from the pancreas.

stimulating the liver to increase glucose production.

15 Which statement best describes Raynaud’s disease?

Inflammatory disorder of small- and medium-sized arteries in the feet and sometimes in the hands

Neoplastic disorder of the lining of the arteries and veins of the upper extremities

Vasospastic disorder of the small arteries and arterioles of the fingers and, less commonly, of the toes

Autoimmune disorder of the large arteries and veins of the upper and lower extremities

16 What is the medical term for a fungal infection of the nail plate?

Paronychia

Onychomycosis

Tinea corporis

Tinea capitis

17 Which proton-pump inhibitor should be avoided in a patient taking clopidogrel?

Omeprazole

Lansoprazole

Pantoprazole

Rabeprazole

18 All of the following are important considerations when prescribing metronidazole except?

Instruct patient to avoid alcohol intake during therapy

Can lead to development of C. difficile infection

Monitor INR closely due a DDI with warfarin

Dose adjustments should be made in patients with renal or hepatic dysfunction

19 Which clinical manifestations of a urinary tract infection may be demonstrated in an 85-year-old individual?

Confusion and poorly localized abdominal discomfort

Dysuria, frequency, and suprapubic pain

Hematuria and flank pain

Pyuria, urgency, and frequency

20 Which hormone is required for water to be reabsorbed in the distal tubule and collecting duct?

Antidiuretic hormone

Aldosterone

Cortisol

Adrenocorticotropin hormone

21 All of the following are true regarding antiepileptics except:

Carbamazepine and phenytoin have numerous drug-drug interactions.

They are safe to use during pregnancy.

Therapeutic drug monitoring is often required to ensure therapeutic drug levels.

Phenytoin is a highly protein-bound drug.

22 Alpha1 adrenergic stimulation causes:

bronchial constriction

vascular constriction.

constriction of intestinal smooth muscle.

relaxation of intestinal smooth muscle.

GCU NUR641E Full Course Discussions and Assignments Q23

Losartan (Cozaar) lowers the blood pressure by:

blocking calcium channels in the heart and blood vessels.

directly dilating arterioles without affecting veins.

suppressing the release of angiotensin-converting enzyme.

blocking angiotensin II at its receptors.

24 One major reason to discontinue captopril (Capoten), an ACE inhibitor, is:

hypertension.

hypokalemia.

angioedema.

angina.

25 Which of the following drugs works via antagonism of 5-HT (serotonin) receptors in the GI tract?

Ondansetron

Droperidol

Prochlorperazine

Aprepitant

26 After a person has a subtotal gastrectomy for chronic gastritis, which type of anemia will result?

Iron deficiency

Aplastic

Folic acid

Pernicious

27 Orthostatic hypotension refers to a decrease of at least ___ mmHg in systolic blood pressure or a decrease of at least _____ mmHg in diastolic blood pressure within 3 minutes of moving to a standing position.

10; 5

20; 10

30; 15

40; 20

28 Cell wall inhibitors include all of the following except

penicillins.

cephalosporins.

carbapenems.

tetracylclines.

29 Which of the following agents is considered a histamine receptor antagonist?

Maalox

Protonix

Zantac

Tums

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30 Which of the following drugs is most likely to reduce the effectiveness of levofloxacin (Levaquin) when given concomitantly?

Amiodarone (Cordarone)

Metronidazole (Flagyl)

Calcium carbonate (Tums)

Warfarin (Coumadin)

31 Which stage of infection is occurring when the immune and inflammatory responses are triggered?

Incubation period

Prodromal stage

Invasion period

Convalescence

GCU NUR641E Full Course Discussions and Assignments

32 Which of the following is an advantage of the intravenous route of administration?

Reduced bioavailability

Avoidance of first-pass metabolism

Patient convenience

None of the above are advantages

33 Which of the following antifungal agents is known to cause significant nephrotoxicity and ototoxicity?

Caspofungin

Fluconazole

Amphotericin B

Nystatin

34 Which NSAID is generally considered the safest for use in patients with coronary artery disease?

Celecoxib

Indomethacin

Naproxen

Acetaminophen

35 An example of a beta agonist is:

Atenolol (Tenormin)

Clonidine (Catapres)

Isoproterenol (Isuprel)

Amlodipine (Norvasc)

36 Which of the following agents is a potent vasoconstrictor that can be used to manage acute GI bleeding?

Octreotide

Milrinone

Pantoprazole

Cimetidine

37 What type of fracture occurs at a site of a preexisting bone abnormality and is a result of a force that would not normally cause a fracture?

Idiopathic

Incomplete

Pathologic

Greenstick

38 A patient is diagnosed with pulmonary disease and elevated pulmonary vascular resistance. Which form of heart failure may result from pulmonary disease and elevated pulmonary vascular resistance?

Right heart failure

Left heart failure

Low-output failure

High-output failure

39 Your patient is taking carbamazepine, a CYP3A4 substrate, for his seizure disorder. He is experiencing signs of depression and decides to try St. John’s wort, which he purchased over-the-counter at the local pharmacy. Since St. John’s wort is a CYP3A4 inducer, which of the following may occur?

The patient may have an increased risk for seizure.

The patient may have an increased risk of carbamazepine-related toxicities.

The patient may need an increased dose of St. John’s wort.

No clinically-significant drug-drug interaction is likely to occur.

40 Advair (fluticasone/salmeterol) is a combination of which of the following?

Short-acting beta agonist and corticosteroid

Long-acting beta agonist and corticosteroid

Long-acting beta agonist and antihistamine

Short-acting beta agonist and antihistamine

41 Which of the following is true regarding adverse drug events?

They include medication errors, adverse effects, allergic reactions, and idiosyncratic reactions.

They are rarely preventable.

They are infrequent in the inpatient setting.

They are generally over-reported.

42 The function of arachnoid villi is to:

produce cerebrospinal fluid.

provide nutrients to the choroid plexuses.

transmit impulses within the meninges.

absorb cerebrospinal fluid into the cerebral venous sinuses.

43 The calcium and phosphate balance is influenced by which three substances?

Parathyroid hormone, ADH, and vitamin D

Parathyroid hormone, calcitonin, and vitamin D

Thyroid hormone, ADH, and vitamin D

Thyroid hormone, calcitonin, and vitamin D

44 The major therapeutic actions of NSAIDS include all of the following except

reduction of inflammation.

reduction of pain.

reduction of fever.

reduction of clotting factors.

GCU NUR641E Full Course Discussions and Assignments

45 Which of the following agents is available in an injectable form used to treat acute migraine headaches?

Sumatriptan (Imitrex)T7

Naldolol (Corgard)

Naproxen sodium (Anaprox)

Ergot preparations (Cafergot)

46 A patient presents with vomiting a coffee-ground looking substance; fatigue, postural hypotension; new onset systolic murmur; and cool, pale peripheries.

metabolic acidosis with partial respiratory compensation.

partial respiratory compensation.

metabolic acidosis.

acidosis.

47 Which statements are true regarding Koplik spots? (Select all that apply.)

Koplik spots are associated with rubeola.

They appear as white spots.

The lesions are surrounded by a red ring.

The lesions of Koplik spots are large in size.

Koplik spots are primarily found on buccal mucosa.

48 Which of the following medications is most likely to increase fall risk in the elderly?

Diazepam (Valium)

Cetirizine (Zyrtec)

Levofloxacin (Levaquin)

Lisinopril (Prinivil)

49 People with gout are at high risk for which comorbid condition?

Renal calculi

Joint trauma

Anemia

Hearing loss

50 The spread of microorganisms from mother to the baby across the placenta is termed

direct transmission.

vertical transmission.

horizontal transmission.

indirect transmission.

51 Tissue damage caused by the deposition of circulating immune complexes containing an antibody against the host DNA is the cause of which disease?

Hemolytic anemia

Pernicious anemia

Systemic lupus erythematosus

Myasthenia gravis

52 Thomas is admitted for symptoms of acute coronary syndrome. You determine that a nitroglycerin drip is indicated for his chest pain. What medication must you make sure he is not taking before writing this order?

An antihistamine

Sildenafil

A long-acting opioid

An anticoagulant

53 Which of the following laxatives is safest for long-term use?

Mineral oil

Methylcellulose (Citrucel)

Magnesium hydroxide (Milk of Magnesia)

Sennosides (Ex-lax)

54 Identify whether the term matches the corresponding characteristics. (Select True or False)

Gluten sensitivity – Celiac sprue

True

False

55 Identify whether the description of the skin lesion matches the disorder where it is found. (Select True or False)

Elevated, firm, and rough lesion with a flat top surface greater than 1 cm in diameter: Psoriasis or seborrheic and actinic keratoses

True

False

56 During the history portion of a respiratory assessment, it is particularly important to ask if the patient takes which of the following drugs that may contribute to symptoms of a chronic cough?

Beta-2 agonists

Calcium channel blockers

Angiotensin-converting enzyme (ACE) inhibitor

Birth control pills

57 Which laboratory value is consistently low in a patient with diabetes insipidus (DI)?

Urine-specific gravity

Serum sodium

Urine protein

GCU NUR641E Full Course Discussions and Assignments Q 58

Which compensatory mechanism is spontaneously used by children diagnosed with Tetralogy of Fallot to relieve hypoxic spells?

Lying on their left side

Performing the Valsalva maneuver

Squatting

59 When considering hemolytic anemia, which statement is true regarding the occurrence of jaundice?

Erythrocytes are destroyed in the spleen.

Heme destruction exceeds the liver’s ability to conjugate and excrete bilirubin.

The patient has elevations in aspartate transaminase (AST) and alanine transaminase (ALT).

The erythrocytes are coated with an immunoglobulin.

60 The nurse has a patient who has been on multidrug therapy for pulmonary tuberculosis. When planning patient education, the nurse knows the patient needs to watch for which symptom of an adverse effect of multidrug therapy?

Hearing loss

Changes in vision

Generalized pruritus

Jaundice

61 The drug of choice for a patient with right-sided infective endocarditis caused by S. aureus is

vancomycin.

Daptomycin

Telavancin

Clindamycin

62 Which of the following side effects is not commonly seen with ondansetron (Zofran)?

Constipation

Headache

QT-prolongation

Movement disorders

63 Which age group should be targeted for testicular cancer education and screening?

15 to 35 year olds

20 to 45 year olds

30 to 55 year olds

45 to 70 year olds

64 The collateral blood flow to the brain is provided by the:

carotid arteries.

basal artery.

Circle of Willis.

vertebral arteries.

65 Which of the following drugs acts on the parasympathetic nervous system?

Epinephrine

Atropine

Dopamine

Dobutamine

66 What is the primary cause of respiratory distress syndrome (RDS) of the newborn?

Immature immune system

Small alveoli

Surfactant deficiency

Anemia

67 Which of the following drugs has coverage against pseudomonas?

Ceftriaxone (Rocephin)

Linezolid (Zyvox)

Piperacillin/Tazobactam (Zosyn)

Azithromycin (Zithromax)

GCU NUR641E Full Course Discussions and Assignments Question 68

Which of the following agents is considered first-line for management of opioid-induced constipation?

Methylcellulose

Mineral oil

Polyethylene glycol

Docusate

69 Sylvia, age 59, has acute hepatitis. You are told it is from a drug overdose. Which drug do you suspect?

Metronidazole (Flagyl)

Acetaminophen (Tylenol)

Sumatriptan (Imitrex)

Hydrocortisone (Cortisone)

70 What are the primary adverse effects associated with SSRIs?

Weight gain and decreased libido

Weight loss and decreased appetite

Sedation and QT-prolongation

Insomnia and hypertension

71 Identify whether the description of the skin lesion matches the disorder where it is found. (Select True or False)

Elevated circumscribed, superficial lesion filled with serous fluid, less than 1 cm in diameter: Urticaria, allergic reaction

True

False

72 An insufficient dietary intake of which vitamin can lead to rickets in children?

C

B12

B6

D

ORDER GCU NUR641E Full Course Discussions and Assignments

73 Bacteria that produce endotoxins that stimulate the release of inflammatory mediators that produce fever are called

pyrogenic bacteria.

true bacteria.

Exotoxins.

Spirochetes.

74 Serum levels of which of the following antiseizure drugs must be corrected based on the patient’s albumin level due to its high protein binding?

Valproic acid (Depakote)

Phenobarbital (Luminal)

Phenytoin (Dilantin)

Carbamazepine (Tegretol)

75 After a partial gastrectomy or pyloroplasty, clinical manifestations that include increased pulse, hypotension, weakness, pallor, sweating, and dizziness are the results of which mechanism?

Anaphylactic reaction in which chemical mediators, such as histamine, prostaglandins, and leukotrienes, relax vascular smooth muscles, causing shock

Postoperative hemorrhage during which a large volume of blood is lost, causing hypotension with compensatory tachycardia

Concentrated bolus that moves from the stomach into the small intestine, causing hyperglycemia and resulting in polyuria and eventually hypovolemic shock

Rapid gastric emptying and the creation of a high osmotic gradient in the small intestine, causing a sudden shift of fluid from the blood vessels to the intestinal lumen

76 A person diagnosed with type 1 diabetes experiences hunger, lightheadedness, tachycardia, pallor, headache, and confusion. The most probable cause of these symptoms is:

hyperglycemia caused by incorrect insulin administration.

dawn phenomenon from eating a snack before bedtime.

hypoglycemia caused by increased exercise.

Somogyi effect from insulin sensitivity.

77 Which of the following agents is preferred for the treatment of a patient who is asymptomatic with a serum sodium of 126?

3% NaCl

Tolvaptan

0.45% NaCl

0.9% NaCl

GCU NUR641E Full Course Discussions and Assignments Q 78

What is the most common cause of uncomplicated urinary tract infections?

Staphylococcus

Klebsiella

Proteus

Escherichia coli

79 Renal failure is the most common cause of which type of hyperparathyroidism?

Primary

Secondary

Exogenous

Inflammatory

80 Dilation of the ipsilateral pupil, following herniation, is the result of pressure on which cranial nerve (CN)?

Optic (CN I)

Abducens (CN VI)

Oculomotor (CN III)

Trochlear (CN IV)

81 Which of the following places a patient at risk for polypharmacy?

Lack of understanding of their medication regimen

Using multiple pharmacies

Seeing multiple providers

All of the above place a patient at risk for polypharmacy

82 Where is antidiuretic hormone (ADH) synthesized, and where does it act?

Hypothalamus; renal tubular cells

Renal tubules; renal collecting ducts

Anterior pituitary; posterior pituitary

Posterior pituitary; loop of Henle

GCU NUR641E Full Course Discussions and Assignments

83 Which diuretic acts by inhibiting sodium chloride reabsorption in the thick ascending limb of the loop of Henle?

Furosemide (Lasix)

Mannitol (Osmitrol)

Hydrochlorathiazide (HCTZ)

Acetazolamide (Diamox)

84 Which medical diagnosis is described as a chronic inflammatory joint disease characterized by stiffening and fusion of the spine and sacroiliac joints?

Ankylosing spondylitis

Rheumatoid arthritis

Paget disease

Fibromyalgia

85 Which antimicrobial should be avoided in children because it is deposited in tissues undergoing calcification and can stunt growth?

Tetracycline

Ciprofloxacin

Vancomycin

Amoxicillin

86 The nurse is caring for a patient who has chronic renal failure and hypertension. The correct classification for the hypertension is

primary.

secondary.

tertiary.

87 What type of immunity is produced when an immunoglobulin crosses the placenta?

Passive-acquired immunity

Active-acquired immunity

Passive-innate immunity

Active-innate immunity

88 Which agent is used to treat hepatic encephalopathy and works via “ion trapping,’ converting ammonia into ammonium in the GI tract?

Rifaximin

Lactulose

Octreotide

Neomycin

89 Which of the following is a potential risk associated with overuse of proton-pump inhibitors?

C. difficile infection

Gastroparesis

Hyponatremia

Esophageal cancer

90 What is the effect of increased secretions of epinephrine, glucagon, and growth hormone?

Hyperglycemia

Hypertension

Bronchodilation

Pupil dilation

91 Identify whether the description matches the disorder. (Select True or False)

Rotation of a testis, which twists blood vessels of the spermatic cord – Testicular torsion

True

False

92 Which of the following agents is useful to treat COPD because of its anticholinergic effects?

Salmeterol (Serevent)

Tiotropium (Spiriva)

Albuterol (Proventil)

Prednisone (Deltasone)

93 Which disorder is characterized by the formation of abnormal new bone at an accelerated rate beginning with excessive resorption of spongy bone?

Osteomalacia

Paget’s disease

Osteoporosis

Osteosarcoma

94 Jaundice can be attributed to the following except?

Cholecystitis

Pyelonephritis

Sickle-cell anemia

Pancreatitis

GCU NUR641E Full Course Discussions and Assignments

95 Which of the following agents is considered a long-acting beta-agonist (LABA)?

Albuterol

Salmeterol

Fluticasone

Ipratropium

96 An infant has a continuous machine-type murmur best heard at the left upper sternal border throughout systole and diastole, as well as a bounding pulse and a thrill on palpation. These clinical findings are consistent with which congenital heart defect?

Atrial septal defect (ASD)

Ventricular septal defect (VSD)

Patent ductus arteriosus (PDA)

Atrioventricular canal (AVC) defect

97 Which of the following best describes a Phase IV clinical trial?

Dose-finding study in healthy volunteers

Post-marketing study to detect potentially rare adverse effects

Randomized clinical trial in patients with the disease of interest done prior to FDA approval

Exploratory study done in animals to assess potential toxicities

98 Which second-generation antipsychotic comes in an injectable formulation approved for use in acute psychosis?

Olanzapine

Quetiapine

Aripiprazole

Ziprasidone

99 Which of the following benzodiazepines is preferred for the treatment of alcohol withdrawal in the inpatient setting due to its short half-life?

Lorazepam

Chlordiazepoxide

Clonazepam

100 Stress-induced sympathetic stimulation of the adrenal medulla causes the secretion of:

epinephrine and aldosterone.

norepinephrine and cortisol.

epinephrine and norepinephrine.

acetylcholine and cortisol.

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