NR565 FINAL EXAM WEEK 8

1. A 35-year-old woman with irritable bowel syndrome with diarrhea (IBS-D) continues to experience frequent cramping and loose stools despite dietary modifications. Which medication is specifically approved for IBS-D in women?

A. Alosetron (Lotronex)
B. Loperamide (Imodium)
C. Lubiprostone (Amitiza)
D. Psyllium (Metamucil)

Correct Answer: A. Alosetron (Lotronex)

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2. Which patient scenario represents an absolute contraindication to methimazole (Tapazole) therapy?

A. A patient with mild leukopenia related to a viral illness
B. A patient in the first trimester of pregnancy
C. A patient in the third trimester of pregnancy
D. A patient with hyperthyroidism awaiting radioactive iodine therapy

Correct Answer: B. A patient in the first trimester of pregnancy

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3. Which statement best explains the mechanism of action of phenothiazine antiemetics such as prochlorperazine (Compazine)?

A. They block dopamine-2 receptors in the chemoreceptor trigger zone (CTZ)
B. They block serotonin (5-HT3) receptors in the CTZ
C. They stimulate acetylcholine release in the vestibular system
D. They block histamine-1 receptors in the vomiting center

Correct Answer: A. They block dopamine-2 receptors in the chemoreceptor trigger zone (CTZ)

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4. A 35-year-old woman with newly diagnosed type 2 diabetes is prescribed metformin (Glucophage). She asks whether she should skip her medication on days when she misses lunch. What is the best response by the NP?

A. “You should hold the dose to prevent hypoglycemia”
B. “You should only take metformin with a high-carbohydrate meal”
C. “You should increase your dose if you consume fewer carbohydrates”
D. “You can continue taking metformin even if you skip a meal”

Correct Answer: D. “You can continue taking metformin even if you skip a meal”

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5. The NP prescribes a stimulant laxative for a patient experiencing opioid-induced constipation. What is the primary mechanism of action of stimulant laxatives?

A. Stimulate osmotic fluid retention in the colon
B. Open chloride channels within the intestinal epithelium
C. Stimulate intestinal peristalsis
D. Decrease fluid movement within the small intestine

Correct Answer: C. Stimulate intestinal peristalsis

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6. Which medication is commonly used as first-line therapy to control symptoms such as tachycardia in hyperthyroidism without directly lowering thyroid hormone levels?

A. Propylthiouracil (Propyl)
B. Propranolol (Inderal)
C. Levothyroxine (Synthroid)
D. Methimazole (Tapazole)

Correct Answer: B. Propranolol (Inderal)

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7. A patient with Graves’ disease is preparing for subtotal thyroidectomy. Which antithyroid medication is most appropriate for short-term preoperative therapy?

A. Levothyroxine (Synthroid)
B. Methimazole (Tapazole)
C. Radioactive iodine
D. Liothyronine (Cytomel)

Correct Answer: B. Methimazole (Tapazole)

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8. A 35-year-old woman with Graves’ disease and severe exophthalmos does not improve after starting methimazole (Tapazole). What is the best next step in management?

A. Increase the methimazole dosage
B. Add propranolol (Inderal)
C. Switch to radioactive iodine therapy
D. Initiate oral glucocorticoid therapy

Correct Answer: D. Initiate oral glucocorticoid therapy

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9. Which patient teaching point is most appropriate for a patient beginning salmeterol (Serevent Diskus) therapy for asthma?

A. Use salmeterol only during severe symptoms
B. Use salmeterol as needed for acute asthma relief
C. Use salmeterol together with an inhaled glucocorticoid
D. Always administer salmeterol with a spacer device

Correct Answer: C. Use salmeterol together with an inhaled glucocorticoid