NR565 Week 4 Midterm Exam

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NR565 Week 4 Midterm Exam

Question 1
Which approach is commonly recommended to minimize adverse drug reactions in older adults?
Answers: A – D

A. Check drug levels only after symptoms develop
B. Start medications at normal adult doses
C. Use multiple medications to maximize treatment effects
D. Start with a low dose and increase slowly over time ✅

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Question 2
While volunteering at a health fair, an NP explains naloxone (Narcan) use for opioid overdose. If the initial nasal spray dose is ineffective, what instruction should be given?
Answers: A – D

A. Repeat the dose every 2 to 3 minutes until emergency services arrive ✅
B. Switch to an oral form of naloxone if there is no response
C. Dilute the nasal spray with water before administering again
D. Wait at least 10 minutes before giving another dose

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Question 3
Which statement best reflects a safe principle when beginning opioid treatment for chronic noncancer pain?
Answers: A – D

A. Start with long-acting opioids to reduce dosing frequency
B. Use immediate-release opioids initially to decrease overdose risk ✅
C. Standard opioid doses are appropriate for most adults
D. Stop all nonopioid therapies once opioid treatment begins

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Question 4
What is the leading cause of adverse drug reactions in the elderly population?
Answers: A – D

A. Decreased renal clearance of medications ✅
B. Elevated gastric pH levels
C. Slower liver metabolism
D. Lower serum albumin concentrations

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Question 5
A patient is prescribed ezetimibe along with a bile acid sequestrant. Which administration schedule helps reduce interaction between the medications?
Answers: A – D

A. Take both medications separately at bedtime
B. Take both medications at the same time
C. Take ezetimibe 4 hours after the bile acid sequestrant ✅
D. Take the sequestrant 1 hour before ezetimibe

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Question 6
After oral administration of furosemide (Lasix), what is the usual onset and duration of diuretic effect?
Answers: A – D

A. Begins within 15 minutes and lasts 24 hours
B. Begins within 30 minutes and lasts 4 hours
C. Begins within 60 minutes and lasts approximately 6–8 hours ✅
D. Begins within 2 hours and lasts 12 hours

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Question 7
How do Class II β-adrenergic blockers primarily influence cardiac activity?
Answers: A – D

A. Increase calcium influx and improve myocardial contraction
B. Block sodium channels during phase 0 depolarization
C. Slow AV nodal conduction and reduce atrial and ventricular contractility ✅
D. Stimulate the SA node to elevate heart rate

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Question 8
An 82-year-old patient is taking diphenhydramine (Benadryl) for allergy symptoms. According to the Beers Criteria, what is the greatest concern?
Answers: A – D

A. Suppression of CYP450 enzymes causing reduced metabolism
B. Increased risk for liver toxicity
C. Significant potential for gastrointestinal bleeding
D. Anticholinergic side effects such as confusion and urinary retention ✅