_____ 2. You need to inform a client about the following major side effect associated with the use of niacin:
 a. confusion
 b. fine motor tremor
 c. hypotension
 d. intense flushing

_____ 3. Persons taking oral contraceptives need to be instructed to increase the following vitamin in their diets:
 a. vitamin K
 b. folic acid (Folate)
 c. vitamin D
 d. riboflavin (vitamin B2)

_____4. Mr. Hyronamous Bosch., a 59-year-old truck driver, is experiencing night blindness. An increase in which one of the following vitamins may help improve his vision?
 a. vitamin A
 b. vitamin B2
 c. vitamin C
 d. vitamin D

_____ 5. Mrs. Elaine Fortescue is started on Coumadin and instructed to avoid foods high in vitamin K. These include
 a. carrots, potatoes, squash
 b. apricots, peaches, cantaloupe
 c. meat, whole milk, margarine
 d. green leafy vegetables

_____ 6. You should instruct a client receiving oral iron preparations about this potential side effect:
 a. clay-colored stools
 b. hypotension
 c. constipation
 d. frequent flatus

_____ 7. The following statement by a client receiving potassium chloride (KCl) indicates that your teaching was effective:
 a. ``If I get dizzy, I will stop taking the medication.''
 b. ``I will take the medication with meals and drink extra water.''
 c. ``I must avoid citrus fruits.''
 d. ``I must decrease my fluid intake while taking this medication.''

_____ 8. The following outcome is indicative of successful treatment of anemia:
 a. elevated APTT
 b. increased energy level
 c. decreased anxiety level
 d. decreased bilirubin levels

_____ 9. Which vitamin is involved in the coagulant process?
a. vitamin C
b. vitamin B-6
c. vitamin D
e. vitamin K

_____ 10. Deficiency in which vitamin causes pellagra?
a. vitamin C (ascorbic acid)
b. vitamin B-3 (niacin)
c. vitamin B-6 (pyridoxine)
d. vitamin E (d-alpha tocopherol)

_____ 11. Deficiency in which vitamin causes scurvy?
a. vitamin C (ascorbic acid)
b. vitamin B-2 (thiamine)
c. vitamin B-12 (cyanocobalamin)
d. vitamin D

_____ 12. Which prescription drug depletes both vitamin B-6 and folic acid?
a. methotrexate (Mexate)
b. ibuprofen (Motrin)
c. conjugated estrogen (Premarin)
d. propranolol (Inderal)

_____ 13. The best absorbed version of B-12 for the elderly is called
a. cyanocobalamin
b. niacin
c. methcobalamin
d. all of the above

_____ 14. The recommendations to a patient taking potassium oral supplements would include
a. take with food
b. take on an empty stomach
c. avoid all alcohol
d. drink extra water
e. all of the above
f. a, d only

_____ 15. CoQ 10 is diminished in
a. congestive heart failure
b. “statin” and hypoglycemic therapy
c. AIDs
d. hypertension
e. all of the above

_____ 16. Some antimicrobial drugs work by
 a. enhancing cell metabolism and growth
 b. promoting protein synthesis
 c. inhibiting cell wall synthesis
 d. stimulating bacterial reproduction

_____ 17. An infection acquired in the hospital is
 a. nosocomial infection
 b. communal infection
 c. sustained infection
 d. antimicrobial infection

_____ 18. A condition which can emerge when the balance of normal flora is disturbed during antibiotic therapy is known as
 a. organ toxicity
 b. superinfection
 c. hypersensitivity
 d. allergic reaction

_____19. You have just finished instructing your client on measures to help the body fight infections. Which of the following statements by your client would lead you to believe he needs additional instruction?
 a. ``I will make sure I get adequate rest.''
 b. ``I know I must continue to eat and drink lots of fluids.''
 c. ``I will wash my hands.''
 d. ``I will take my medicine until I no longer have a fever.''
 
_____20. Phenazopyridine (Pyridium) is a urinary tract analgesic used to relieve which of the following symptoms?
 a. urinary retention
 b. hematuria
 c. pain and urgency
 d. hesitancy

_____ 21. Erythromycin is the drug of choice for treating
 a. Legionnaire's disease
 b. bacterial endocarditis
 c. urinary tract infections
 d. acne

_____ 22. It is recommended that erythromycin be administered
 a. with meals
 b. on an empty stomach
 c. with iron supplements
 d. between meals with large amounts of water

_____ 23. Common side effects that occur after the administration of erythromycin include
 a. rash, fever, and itching
 b. urticaria and colitis
 c. nausea, vomiting, and diarrhea
 d. shortness of breath

_____ 24. Tetracycline is
a. bactericidal
b. bacteriostatic
c. bactericidal in high doses, bacteriostatic in low doses
d. antiviral

_____ 25. Tetracycline can chelate with
a. calcium
b. magnesium
c. lithium
d. iron
e. all of the above
f. a, d only

_____ 26. The presence of E.coli in milk or water indicates
a. bovine bladder infections
b. fecal contamination
c. imported strawberries in Marshall cafeterias (uh oh, a topical and local reference guaranteed to be obscure to non-Battle Creek viewers!)
d. none of the above

_____ 27. Mr. Evans Lockworthy is allergic to penicillin.  Which of the following would be a poor substitute?
a. erythromycin ethylsuccinate (EES)
b. clindamycin (Cleocin)
c. cephalexin (Keflex)
d. azithromycin (Zithromax)
 

_____ 28. Mrs. Louisa Quinzy is allergic to penicillin.  Which of the following would be a good substitute?
a. cefamandol (Mandol)
b. carbenicillin
c. erythromycin
d. dicloxacillin

_____ 29. Falconi’s syndrome resembles
a. acute hepatitis
b. interstitial nephritis
c. Crohn’s enteritis
d. a crystal set radio

_____ 30. Patients taking metronidazole (Flagyl) should be advised to avoid
a. dancing
b. cold showers
c. ethanol
d. concurrent use of antacids

_____ 31. Clindamycin (Cleocin) is effective against
a. aerobic bacteria
b. anareobic bacteria
c. methicillin-resistant staph
d. all of the above

_____ 32. Biaxin suspension
a. should be refrigerated
b. should be given with food
c. should be kept at room temperature
d. b, c only
e. a, c only

_____ 33. Patient recommendations for ciprofloxacin (Cipro) should include
a. drink extra water
b. avoid prolonged sunshine
c. avoid concurrent antacid and caffeine use
d. all of the above
e. none of the above

_____ 1. Permanent brain damage occurs within how many minutes of anoxia?
 a. 1-2 minutes
 b. 4-6 minutes
 c. 10-12 minutes
 d. 15-18 minutes

_____ 2. Normal breathing occurs
 a. 3-6 times per minute
 b. 16-20 times per minute
 c. 25-30 times per minute

_____ 3. Bronchoconstriction can be caused by
 a. infection
 b. emotion
 c. acetylcholine
 d. beta blockers
 e. all of the above
 f. 1,2 only

_____ 4. A popular xanthine alkaloid, noteworthy for its bronchodilatory and diuretic properties is
 a. atropine
 b. caffeine
 c. cocaine
 d. propranolol

_____ 5. Regarding leukotriene inhibitors such as zileuton (Zyflo) and zafirlukast (Accolate)
 a. they are not leukotriene inhibitors, they are beta agonists
 b. they are preventative therapy and do not relieve acute asthmatic attacks
 c. they are indicated for use in acute attacks of asthma

_____ 6. Anticholinergic drugs such as ipatropium bromide (Atrovent) or atropine are contraindicated in
 a. cases of excessive mucous production
 b. prostatic hypertrophy
 c. acute ulcer disease

_____ 7. Adrenergic bronchodilators such as albuterol (Proventyl) would be contraindicated in
 a. tachycardia
 b. hypertension
 c. hyperthyroidism
 d. seizure disorders
 e. all of the above

_____ 8. Dosing considerations for respiratory inhalers include
 a. children require lower doses
 b. smokers require higher doses
 c. beta-agonists should be used around the clock

_____ 9. Administration considerations with theophylline include
 a. take on an empty stomach
 b. crush sustained release tablets to enhance absorption
 c. lithium may increase the secretion of theophylline
 d. none of the above are true

_____ 10. Another name for hives is
 a. alopecia
 b. urticaria
 c. xanthoma
 d. icky bad pooky poo

_____ 11. The antihistamine with the most pronounced sedative properties is
 a. chlorpheniramine maleate (Chlor Trimeton)
 b. lortadine (Claritin)
 c. diphenhydramine (Benadryl)
 d. hydroxyzine (Atarax)

_____ 12. The antihistamine also used to reduce nausea is
 a. promethazine (Phenergan)
 b. astemazole (Hismanal)
 c. terfenadine (Seldane)
 d. all of the above
 ***
_____ 1. Use of high doses of anabolic steroids by a female can result in the following:
  a. masculinization
  b. immobility of joints
  c. obesity
  d. hypotension
 
_____2. Mrs. Ignamata is a 31-year-old mother of two with a history of asthma and migraine headaches. She is on a low-residue diet for colitis. Which of the factors in her history may contraindicate the use of birth control pills?
  a. migraine headaches
  b. age
  c. asthma
  d. colitis

_____3 and 4  List two medication types that, when administered concurrently with  oral contraceptives, will decrease their effect:

_____5. Persons taking estrogen (whether via oral contraceptives or as hormonal replacement therapy) need to be assessed regularly for the following adverse effect:
  a. hypoglycemia
  b. weight loss
  c. depression
  d. arrhythmias

_____6. The hormone produced by the kidneys that stimulates the bone marrow to produce red blood cells is
  a. prostaglandins
  b. levothyroxine
  c. cytokines
  d. erythropoietin

_____ 7. Anticholinergic drugs such as ipatropium bromide (Atrovent) or atropine are contraindicated in
 a.  cases of excessive mucous production
 b. prostatic hypertrophy
 c. chronic rhinorrhea
 
_____8. Adrenergic bronchodilators such as albuterol (Proventyl) would be contraindicated in
 a. tachycardia
 b. hypertension
 c. hyperthyroidism
 d. seizure disorders
 e. all of the above

_____ 9. A non-narcotic antitussive is
 a. codeine
 b. dextromethrophan
 c. guiafenesin

_____10. Recommendations for benzonatate (Tessalon Pearls) would include:
 a. do not chew
 b. crush and dilute with water for extra antitussive effect
 c. may cause constipation

_____11. Which of the following analgesics causes less respiratory depression  in the newborn if given to the near-term mother:
 a. morphine
 b. meperidine (Demerol)
 c. codeine
 d. none of the above

_____ 12. Vitamin K
 a. is given to the mother at delivery
 b. is synthesized by bacteria in the colon
 c. is found in the combination product PremPro
 d. promotes lactation

_____13. The immunoglobulin most associated with seasonal allergies is
 a. IgA
 b. IgC
 c. IgE
 d. IgD

BONUS:
A. The major organs of the endocrine system include all of the following except
  a. hypothalamus
  b. pituitary
  c. thyroid
  d. gallbladder

B.  A client started on albuterol (Proventil) should be instructed that she may experience
  a. polydipsia
  b. tachycardia
  c. hypotension
  d. diarrhea

_____ 1. Progesterone
 a. decreases HDL and increases LDL
 b. increases HDL and decreases LDL
 c. has no effect on cholesterol levels
 d. is derived from plant sources

_____ 2. Progesterone
 a. predominates during the first part of the menstrual cycle
 b. predominates during the second half of the menstrual cycle
 c. is metabolized by the kidney

_____ 3. Contraindications to oral contraceptive therapy include
 a. liver disease
 b. cerebrovascular disease
 c. women over 35 who smoke
 d. breast cancer
 e. all of the above

_____ 4. Your patient is taking tetracycline and oral contraceptives
 a. she should be told to watch for probable chest pain
 b. she should use additional forms of birth control for the duration of the tetracycline therapy
 c. she should be told that antibiotic therapy needs to be prolonged due to drug interactions with the oral contraceptive

_____ 5. Regarding testosterone supplements
 a. teenage girl use is not a consideration since this is a male hormone
 b. cholesterol levels improve while on testosterone supplements, so the patient may reduce doses of cholesterol-reducing agents to prevent liver damage
 c. male patients are prone to prostate enlargement
 d. all of the above

_____ 6. Regarding testosterone supplements
 a. edema is a concern
 b. hypercalcemia is possible
 c. risk for violence and psychosis is possible
 d. all of the above

_____ 7. Physiological changes during pregnancy that could result in changes in drug dosage include
 a. decrease in plasma volume
 b. decrease in serum albumin
 c. decrease in renal blood flow
 d. decreased cardiac output

_____ 8. Fetal circulation
 a. is stimulated by an active liver
 b. allows for increased drug levels due to low levels of albumin present
 c. is effectively protected by the placenta from exogenous drugs
 d. all of the above

_____ 9. Thalidomide (Thalomid) is in Drug Safety Category
 a. A
 b. B
 c. D
 d. X

_____ 10. Thyroid and digoxin (Lanoxin) had adequate studies in pregnant women to show no risk to the developing fetus.  This fact places them in drug safety catergory
 a. A
 b. C
 c. D
 d. X

_____ 11. Anemia in pregnancy can be due to
 a. expanded volume
 b. lack of iron
 c. deficiency in folic acid
 d. all of the above

_____ 12. Less respiratory depression is seen in the newborn if the near-term mother is given
 a. morphine
 b. meperidine (Demerol)
 c. codeine
 d. none of the above

_____ 13. Vitamin K
 a. is given to the mother at delivery
 b. is synthesized by bacteria in the colon
 c. is found in the combination product Premarin
 d. promotes lactation