Antipsychotic – Hypertension

1. Which medication for hypertension might be most appropriate for a patient who cannot remember to take his medications regularly? A. Clonidine B. Doxazosin C. Propranolol D. Methyldopa 2. John (age 81) has hypertension and BPH. His hypertension is well controlled, but he needs an additional medication to help control the symptoms of his BPH. You want to recommend an alpha blocker. Which would be the best choice for John? E. Doxazosin F. Prazosin G. Tamsulosin H. Terazosin 3. Which effect of beta blockers is INCORRECTLY matched with its corresponding body system? I. Cardiovascular system – decreased heart rate.

J. Renal system – increased release of renin K. Respiratory system – bronchial constriction L. Ocular system – reduced IOP 4. Which of the following is a known adverse effect of beta blockers? A. Excess salivation B. Increased libido C. Bradycardia D. Hyperhidrosis 5. Which of these agents exhibit both alpha and beta antagonism? M. Carvedilol N. Labetolol O. Propranolol P. A and B 6. Patient counseling for carvedilol includes which of the following? A. If a dose is missed, the next dose should be doubled B. Take on an empty stomach C. Do not discontinue abruptly D. Bradycardia is rarely seen with this agent 7.

What is the primary therapeutic use of bethanechol? A. Hypertension B. Bradycardia C. Bladder atrophy with retention D. Hyperthyroidism 8. Cholinergic agonists promote or mimic the action of what molecule? A. Acetylcholinesterase B. Acetylcholine C. Quinidine D. Epinephrine 9. Which of these agents is NOT an inhibitor of acetylcholinesterase? A. Donepezil B. Rivastigmine C. Galantamine D. Memantine 10. Which is NOT a commercially available form of nicotine replacement therapy? A. Gum B. Patch C. Nasal spray D. Oral tablet 11. Which cholinergic blockers are related to belladonna alkaloids? A. Atropine B. Scopolamine C.

Propantheline D. A and B 12. Which cholinergic blocker is INCORRECTLY matched with its brand name? A. Darifenacin – Enablex B. Fesoterodine – Toviaz C. Solifenacin – Detrol LA D. Trospium – Sanctura 13. Ashley (age 21) has finished her nursing coursework for the semester and plans to go on a Disney Cruise. She is concerned about motion sickness, but doesn’t want to “fool with taking medication” while she’s having fun at sea. What might be the best option for Ashley? A. Clonidine patch B. Dramamine C. Meclizine D. Scopolamine patch 14. Stephanie (age 65) is being treated for hypertension, diabetes, asthma and heart failure.

Her current heart failure regimen includes Lasix and lisinopril. She reports continued symptoms of heart failure, so you decide to add another agent. Stephanie’s other medications include Lantus, Novolog, Symbicort and albuterol. Which of the following statements are TRUE? A. Stephanie should not use Symbicort as a rescue inhaler B. Stephanie should be prescribed a beta blocker today for her heart failure C. Stephanie has a contraindication to beta blockers and should be prescribed something else for her heart failure D. A and B E. A, B and C 15. Andrea (age 60) is being treated for hypertension and tachycardia.

In addition to her current regimen of lisinopril and chlorthalidone, you would like to recommend a beta blocker to help control Andrea’s symptoms. Andrea’s other medications include metformin, Actos, Advair and Proventil. Which of the following beta blockers is LEAST appropriate for Andrea? A. Atenolol B. Acebutolol C. Metoprolol D. Propranolol Cardiac/Circulatory 16. Which medication does NOT affect the renin/angiotensin system? A. Aliskirin B. Amlodipine C. Lisinopril D. Valsartan 17. What endogenous substance is responsible for some of the bothersome side effects of ACE Inhibitors?

A. Angiotensin Converting Enzyme (ACE) B. Bradykinen C. Renin D. Vasopressin 18. Which of the following are non-DHP calcium channel blockers? A. Amlodipine B. Diltiazem C. Verapamil D. B and C 19. Peripheral vasodilators directly relax and dilate arterial smooth muscle, leading to ______________: A. Decreased cardiac output B. Increased cardiac output C. Decreased peripheral vascular resistance D. Increased peripheral vascular resistance Use the image below to match the following diuretic drugs and/or classes to their site of action in the nephron.

Each answer choice will only be used ONCE, and all choices may not be used. 20. Loop diuretics: ______ 21. Spironolactone: ______ 22. Chlorthalidone: ______ Match the following drugs or drug classes indicated for management of hyperlipidemia with their mechanism of action (MOA). All choices will be used only once. | 23. Inhibits HMG-CoA reductase, which is the rate limiting enzyme in cholesterol synthesis: _____24. Inhibits the absorption of cholesterol at the brush border of the small intestine: _____ 25. Increases lipolysis of triglycerides via the enzyme lipoprotein lipase: _____26.

Increases bile acid excretion, resulting in enhanced conversion of cholesterol to bile acids in the liver: _____27. Thought to decrease secretion of VLDL, which in turn decreases production of LDL: _____| A. Niacin B. Ezetimibe C. Fibrates D. Statins E. Colestipol| 28. Atorvastatin is contraindicated in what patient? A. Amy (age 10) who is newly diagnosed with familial hyperlipidemia B. Bob (age 80) who has heart failure C. Clarissa (age 35) who is pregnant D. Doug (age 65) who has diabetes 29. Which dosage form of nitroglycerin is NOT used to treat angina? A. Intra-anal ointment B. Sublingual tablet C. Spray.

D. Patch 30. Which is a potential adverse effect of spironolactone? A. Hypokalemia B. Gynecomastia C. Ototoxicity D. Hypertension Psychiatric Agents 31. KM is a 19 year old nursing student. You have just diagnosed him with his first episode of depression and placed him on Fluoxetine 20mg daily. Which of the following is true regarding KM’s therapy? A. Clinical studies show that KM should be immediately placed on Lithium as well to stabilize his mood and ordered to return to office in 3 months B. KM should be counseled to be patient as he will start seeing antidepressant effects within about 2-4 weeks. C.

KM will need to remain on Fluoxetine 20mg qd for 3-5 years to prevent recurrence of symptoms. D. KM should be counseled that he will see anticholinergic adverse effects with Fluoxetine, but they will subside in a couple of weeks. 32. An effect of the benzodiazepines is: A. Anterograde amnesia, producing memory loss for events that occur before the drug is taken B. Anterograde amnesia, producing memory loss for events that occur after the drug is taken C. Retrograde amnesia, producing memory loss for events that occur before the drug is taken D. Retrograde amnesia, producing memory loss for events that occur after the drug is taken.

33. Which adverse effect of lithium might occur when a person begins therapy but should be less of a problem as they continue to take the medication? A. Increased thirst and urination B. Enlargement of thyroid C. Stomach upset D. Confusion, mental impairment 34. Which of the following statements about typical antipsychotic medications is FALSE? A. Chlorpromazine (Thorazine) has a high incidence of sedation B. Haloperidol (Haldol) is available in a depot form that is administered about every 3 weeks C. Chlorpromazine (Thorazine) may result in urticaria and photosensitivity D.

Haloperidol (Haldol) is associated with a very low incidence of extrapyramidal side effects 35. Which of the following statements concerning SSRI’s (fluoxetine, sertraline, paroxetine) is FALSE? A. May be used for Depression, Obsessive Compulsive Disorder, and Panic Disorder B. A patient discontinued from fluoxetine(Prozac) must wait two weeks before starting an MAOI antidepressant C. All are metabolized through the liver with extensive first pass effect and are highly protein bound D. Frequently cause gastrointestinal side effects such as nausea, vomiting and diarrhea.

36. Which of the following is true about Amitriptyline? A. This medication is only prescribed for depression B. This medication is likely to cause anticholinergic side effects such as dry mouth, blurred vision, and constipation C. This medication may cause priapism D. The brand name of amitriptyline is Zoloft 37. The primary indication for the use of diazepam (Valium) before a surgical procedure is to: A. Reduce the acidity of stomach contents to reduce the adverse outcome if stomach contents enter the lungs B. Reduce nausea and vomiting C. Reducing secretions D.

Reduce memory of events related to the surgical procedure 38. Excess serotonin activity can occur with which of the following? A. Use of a single serotonergic agent B. Use of multiple serotonergic agents in combination C. Use of an SSRI in combination with an MAOI D. All of the above 39. Which of the following drugs has a major drug interaction with diuretics? A. Lithium B. Amitriptyline C. Fluoxetine D. Lorazepam 40. Which antidepressant would be the most appropriate choice for a patient who experienced significant sexual dysfunction while taking Prozac? A. Amitriptyline B. Buproprion C.

Fluvoxamine D. Lithium 41. Which of the following is NOT a potential adverse effect of antipsychotic medication? A. Extrapyramidal Symptoms B. Diabetes Mellitus C. Electrolyte Disturbances D. Weight gain Match the following medications with the correct description: | 42. Atypical antipsychotic with the highest incidence of weight gain: _____ 43. “Designer” atypical antipsychotic that exhibits partial Dopamine agonism: _____44. Requires WBC monitoring to prevent agranulocytosis: _____45. Atypical antipsychotic with the highest incidence of QT interval prolongation: _____ | A. Clozapine B. Abilify C.

Geodon D. Zyprexa| Respiratory Match the following products to their description, classification, brand name or indication. Answers will only be used only ONCE and not all choices may be used: | 46. This LABA is a dry powder capsule administered via an aerolizer: _____47. This LABA is administered via dry powder DISKUS: _____48. Brand name Xopenex: _____49. This MDI contains albuterol and ipratropium bromide: _____50. Methylxanthine derivative that is sometimes used in the management of asthma: _____51. This long acting inhaled anti-cholinergic is only indicated for treatment of COPD: _____52.

Brand name Accolate: _____53. This leukotriene modifier is indicated for children as young as 12 months of age: _____54. This antihistamine is available in an inhaled dosage form: _____55. Brand name Flonase: _____56. Asmanex Twisthaler: _____57. Subcutaneous injection for asthma: _____58. Inhibits mast cell degranulation: _____59. Brand name QVAR: _____60. Selectively inhibits the enzyme phosphodiesterase-4 (PDE4): _____| A. AlbuterolB. FormoterolC. SalmeterolD. LevalbuterolE. MetaproterenolAB. PirbuterolAC. CombiventAD. RoflumilastAE. BeclomethasoneBC. TerbutalineBD. IpratropiumBE. TiotropiumCD.

MontelukastCE. ZafirlukastDE. OmalizumabABC. FlunisolideABD. FluticasoneABE. AzelastineBCD. BudesonideBCE. NedocromilCDE. TriamcinoloneACD. MometasoneACE. BeclomethasoneADE. TheophyllineABCD. Zyflo| ENT Match the following products to their description, classification, brand name or indication. Answers will only be used only ONCE and not all choices may be used: | 61. Polymixin B and bacitracin ______ 62. Brand name Alphagan ______ 63. Ocular NSAID ______ 64. Ciprofloxacin/dexamethasone ______ 65. Brand name Patanol ______ 66. Causes brown iris pigmentation and growth of eyelashes _____ 67.

Decongestant available as both oral and topical dosage forms ______ 68. Maybe cause rebound nasal congestion with prolonged use ______ 69. Expectorant medication ______ 70. Patients will need a state issued photo ID to purchase this decongestant ______ 71. 1st generation antihistamine available in oral and topical forms ______ 72. This cough medication acts peripherally to stop cough and may cause numbing of the tongue if chewed ______ 73. Brand name Delsym ______ 74. This cough medication is considered a Schedule V controlled substance and may be available to purchase from a Kentucky pharmacist without a prescription ______ 75.

Brand name Claritin ______| A. BetaxololB. TimololC. PilocarpineD. GuaifenesinE. DorzolamideAB. BrimonidineAC. LatanoprostAD. BimatoprostAE. TravoprostBC. Cromolyn sodiumBD. KetorolacBE. AzelastineCD. KetotifenCE. OlopatadineDE. Naphazoline (ophthalmic)ABC. CortisporinABD. CiprodexABE. PolytrimACD. Polysporin ACE. PseudoephedrineADE. PhenylephrineBCD. Oxymetazoline (nasal)BCE. DextromethorphanBDE. CodeineCDE. BenzonatateABCD. DiphenhydramineABCE. ChlorpheniramineACDE. BrompheniramineBCDE. CetirizineABCDE. Loratadine|.


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Introduction : Beta-blockers, also known as beta antagonists, beta-adrenergic blocking agents, or beta-adrenergic antagonists, are drugs that are prescribed to treat several different types of conditions, including hypertension (high blood pressure), angina, some abnormal heart rhythms, heart attack (myocardial infarction), …

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Metoprolol (Toprol XL) is added to the pharmacologic therapy of a diabetic female diagnosed with stage 2 hypertension initially treated with Furosemide (Lasix) and Ramipril (Altace). An expected therapeutic effect is: 1. Decrease in heart rate. 2. Lessening of fatigue. …

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