The bronchodilator of choice for patients taking propranolol is:

Question 1The bronchodilator of choice for patients taking propranolol is:

 

Ipratropium

 

Albuterol

 

Pirbuterol

 

Formoterol

 

Question 2 James is a 52-year-old overweight smoker taking theophylline for his persistent asthma. He tells hisprovider he is going to start the Atkin’s diet for weight loss. The appropriate response would be:

 

Decrease his theophylline dose because a high-protein diet may lead to elevatedtheophylline levels.

 

Schedule him for regular testing of serum theophylline levels during his diet dueto increased excretion of theophylline.

 

Recommend he try stopping smoking instead of the Atkin’s diet.

 

Congratulate him on making a positive change in his life. Incorrect

 

Question 3 Li takes theophylline for his persistent asthma and calls the office with a complaintof nausea,vomiting, and headache. The best advice for him would beto:

 

Have him seen the same day for an assessment and theophyllinelevel

 

Reassure him this is probably a viral infection and should be better soon

 

Schedule him for an appointment in 2 to 3 days, which he can cancel if he is better

 

Order a theophylline level at the laboratory for him

 

Question 4 Tiotropium bromide (Spiriva) is an inhaled anticholinergic:

 

Used in the treatment of asthma

 

Used for the treatment of chronic obstructive pulmonary disease (COPD)

 

Combined with albuterol for treatment of asthma exacerbations

 

Combined with fluticasone for the treatment of persistent asthma

 

Question 5 When prescribing montelukast (Singulair) for asthma, patients or parents of patients should beinstructed:

 

Lethargy and hypersomnia may occur when taking montelukast.

 

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

 

Patients may experience weight gain on montelukast

 

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

 

Question 6 Howard is a 72-year-old male who occasionally takes diphenhydramine for his seasonal allergies.Monitoring for this patient taking diphenhydramine would include assessing for:

 

  Skin rash

 

Urinary retention

 

Cardiac output

 

Peripheral edema

 

Question 7 When recommending dimenhydrinate (Dramamine) to treat motion sickness, patients should beinstructed to:

 

Take the dimenhydrinate after they get nauseated

 

Double the dose if one tablet is not effective

 

Drink lots of water while taking the dimenhydrinate

 

Take the dimenhydrinate 15 minutes before it is needed

 

Question 8The first-line treatment for cough related to an upper respiratory tract infection (URI) in a 5-year- oldchild is:

 

Fluids and symptomatic care

 

Guaifenesin and codeine syrup (Tussin AC)

 

Dextromethorphan and guaifenesin syrup (Robitussin DM for Kids)

 

Chlorpheniramine and dextromethorphan syrup (Nyquil for Kids)

 

Question 9 Bismuth subsalicylate (Pepto Bismol) is a common OTC remedy for gastrointestinal complaints.Bismuth subsalicylate:

 

Is contraindicated in children with flu-like illness

 

All of the above

 

Has antimicrobial effects against bacterial and viral enteropathogens

 

May lead to toxicity if taken with aspirin

 

Question 10 Josie is a 5-year-old patient who presents to the clinic with a 48-hour history of nausea, vomiting,and some diarrhea. She is unable to keep fluids down and her weight is 4 pounds less than her lastrecorded weight. Besides IV fluids, her exam warrants the use of an antinausea medication. Which ofthe following would be the appropriate drug to order for Josie?

 

Ondansetron (Zofran)

 

Prochlorperazine (Compazine)

 

Meclizine (Antivert)

 

Promethazine (Phenergan)

 

Question 11 Patients who are on chronic long-term proton pump inhibitor therapy require monitoring for:

 

Hypokalemia and hypocalcemia

 

 Elevated uric acid levels leading to gout

 

Folate and magnesium deficiency

 

Iron deficiency anemia, vitamin B12 and calcium deficiency

 

Question 12In children age 5 to 11 years mild-persistent asthma is diagnosed when asthma symptoms occur:

 

At nighttime one to two times a month

 

At nighttime three to four times a month

 

Daily

 

Less than twice a week

 

Question 13 Asthma exacerbations at home are managed by the patient by:

 

Starting montelukast (Singulair)

 

Doubling inhaled corticosteroid doses

 

Increasing frequency of beta-2-agonists

 

Increasing frequency of beta-2-agonists and contacting their provider

 

Question 14 Pregnant patients with asthma maysafelyuse           throughout their pregnancy.

 

 Montelukast (Singulair)

 

Inhaled corticosteroids (budesonide)

 

Oral terbutaline

 

Prednisone

 

Question 15Medications used in the management of patients with chronic obstructive pulmonary disease(COPD) include:

 

All of the above

 

Inhaled anticholinergics (ipratropium)

 

Inhaled corticosteroids

 

Inhaled beta-2-agonists

 

 Question 16Patients with COPD require monitoring of:

 

Neuropsychiatric effects of montelukast

 

Beta-2-agonist use

 

Blood pressure

 

Serum electrolytes

 

 Question 17 Lifestyle changes are the first step in treatment of gastroesophageal reflux disease (GERD). Food ordrink that may aggravate GERD include:

 

Soda pop

 

Caffeine

 

Eggs

 

Chocolate

 

Question 18If a patient with gastroesophageal reflux disease who is taking a proton pump inhibitor daily is notimproving, the plan of care would be:

 

Histamine2 receptor antagonist (ranitidine) for 4 to 8 weeks

 

Cytoprotective drug (misoprostol) for 4 to 8 weeks

 

Prokinetic (metoclopramide) for 8 to 12 weeks

 

Proton pump inhibitor (omeprazole) twice a day for 4 to 8 weeks

 

Question 19 Adults with pneumonia who are responding to antimicrobial therapy should show improvement intheir clinical status in:

 

4 or 5 days

 

12 to 24 hours

 

 24 to 36hours

 

48 to 72hours

 

Question 20 John is a 4-week-old infant who has been diagnosed with chlamydial pneumonia. An appropriatetreatment for his pneumonia would be:

 

Amoxicillin

 

Cephalexin

 

Levofloxacin

 

Erythromycin

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