Nurs5334 Pharmacology Practice Exam With Answers (153 Solved Questions)

Name: Nurs5334 Pharmacology Practice Exam With Answers (153 Solved Questions)
Brand: Chamberlain College of Nursing
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Author: Logan King

Sharpen your exam skills with Nurs5334 Pharmacology Practice Exam With Answers, a valuable resource featuring past tests.

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Nurs 5334 Exam 3
1. Drugs for Gestational
Diabetes
Metformin and Insulin
2. A1C Value for Diabetes
Mellitus
6.5% or greater is diabetes, 5.7-6.4% pre-diabetes
3. Fasting and Random
Values for DM
Fasting plasma glucose—126 or greater is dia-
betes. Random plasma glucose—anything greater
than 200 is diabetes
4. Complications of In-
sulin Therapy
Hypoglycemia, Lipohypertrophy, Allergic reac-
tions, Desensitization procedure, Hypokalemia
5. Insulin Drug Interac-
tions
Hypoglycemic agents intensify hypoglycemia, Use
with caution with hyperglycemic agents
6. Beta Blockers' Effect
on Insulin
Delay awareness of hypoglycemia, Impair
glycogenolysis, Prevent counter-regulatory re-
sponse
7. Other Therapeutic Uses Hyperkalemia, Diagnosis of GH deficiency, Diabet-
ic ketoacidosis
8. Coordinating Insulin
Dosage
Carbohydrate intake
9. Blood Pressure Goal in
Diabetes
Controlled within normal 120/80
10. Medication for Diabetic
Nephropathy Risk
ACE inhibitor or ARB
11. Role of Exercise in DM
Treatment
Exercise increases cellular responsiveness to in-
sulin and glucose tolerance. 150 minutes per week
of moderate intensity exercise is recommended.
12. 4-Step Approach Steps Step 1: Diagnosis and lifestyle changes plus met-
formin. Step 2: Lifestyle changes, metformin, and
a second drug. Step 3: Three drug combination.
Step 4: Complex insulin regimen if needed.
1 / 20

13. Insulin Therapy Blood
Glucose Goals
Before meals: 70-130. Bedtime: 100-140.
14. A1C Goal and Excep-
tions
A1C goal is 7% or below. Exceptions: Severe hy-
poglycemia risk, limited life expectancy, advanced
complications.
15. Types of Insulins Short acting: Rapid acting insulins. Intermediate:
NPH insulin, insulin detemir. Long acting: Insulin
glargine.
16. Use of Short Duration
Insulins
Administered with meals to control post-prandial
blood glucose rise.
17. Need for Intermediate
Insulins
Administered 2-3 times daily for glycemic control
between meals and at night.
18. Duration of Insulins Glargine: Up to 24 hours. Levemir: 12-24 hours.
Degludec: Up to 42 hours.
19. Routes of Insulin Ad-
ministration
Subcutaneous injection and IV infusion. Inhalation:
Afrezza for mealtime insulin.
20. Insulin Dosing for Type
1 and Type 2
Type 1: Initial doses 0.5-0.6 units/kg/day. Type 2:
Initial doses 0.2-0.6 units/kg/day, adjusted based
on carb intake and activity.
21. 3 Dosing Schedules o Twice daily dosing
o Intensive basal/bolus strategy
o Continued subcutaneous insulin
22. Metformin Mechanism
of Action
o Inhibits glucose production in the liver
o Reduces glucose absorption in the gut
o Sensitizes insulin receptors in target tissues (fat
and skeletal muscle) to increase glucose uptake
and response to insulin
23. Metformin Side Effects
and BB Warning
o GI effects—diarrhea
o Lactic acidosis
2 / 20

24. Alcohol Effect Inhibits the breakdown of lactic acid
25. Therapeutic Uses Other
Than DM
o Gestational diabetes
o PCOS
26. Sulfonylureas o First generation: Chlorpropamide [Diabinese],
Tolazamide [Tolinase], Tolbutamine [Orinase]
o Second generation: Glyburide [Diabeta, Gly-
nase, Micronase] with metformin [Glucovance],
Glypizide (Glucotrol, Glucotrol XL) with metformin
[metaglip], Glimepiride (Amaryl) with metformin
[Amaryl M] with pioglitazone [Duetact] with rosigli-
tazone [Avandaryl]
27. Sulfonylureas Mecha-
nism of Action and
Main Side Effect
MOA: Promote insulin release
Main side effect: Hypoglycemia, Weight gain
28. Cimetidine Effect and
Beta Blockers
Cimetidine—intensifies the response
Beta blockers—diminish the benefits by suppress-
ing insulin release
29. Meglitinides (Repaglin-
ide and Nateglinide)
o MOA—stimulate pancreatic insulin release
o Drug/Drug interaction—gemfibrozil
30. Thiazolidinediones
(Glitazones)
Reduce glucose levels primarily by decreasing in-
sulin resistance
Only indication is type 2 diabetes, mainly as an
add-on to metformin
Rosiglitazone [Avandia]: Restricted use
Pioglitazone [Actos]
Can they be used in patients with CHF? No
31. Alpha-Glucosidase In-
hibitors
Effective in Latinos and African Americans
32. DPP-4 Inhibitors
(Gliptins)
MOA: Enhance incretin hormones, stimulate in-
sulin release, suppress glucagon
33. 0.5%
3 / 20

A1C Reduction Per-
centage
34. Colesevelam and
Bromocriptine in DM
Treatment
Colesevelam: Lowers cholesterol, helps lower
blood glucose. Bromocriptine: Adjunct to diet and
exercise (0.5% reduction)
35. Injectables: Amylin
Memetics
Pramlintide. Side effects: Hypoglycemia when
used with insulin
36. Injectables: GLP-1 Re-
ceptor Agonists
Can cause medullary thyroid cancer
37. Treatment of Diabet-
ic Ketoacidosis (DKA)
and Hypoglycemia
Insulin replacement, reverse acidosis with bicar-
bonate, replace fluids/electrolytes. Hypoglycemia:
IV glucose, glucagon if glucose not available
38. Hyperosmolar Hyper-
glycemia State (HHS)
Occurs with type 2 diabetics during acute infec-
tion/illness. Treatment: Correct hyperglycemia/de-
hydration with IV insulin, fluids, electrolytes
39. Iodine and Thyroid Low iodine decreases thyroid hormone production
40. Importance of Normal
Thyroid Function in
First Trimester of Preg-
nancy
Fetus unable to produce hormones, can lead to
neuropsychologic deficits. Requirement may in-
crease up to 50% in pregnant women taking thy-
roid supplements
41. Fetal Thyroid Gland Full
Functionality
At 16 weeks
42. If not treated, what does
Hypothyroidism cause
in an infant?
Large protruding tongue, potbelly, and dwarfish
stature
Development of nervous system, bones, and teeth
impaired
43. When should treatment
be stopped? How long?
At 3 years of age for 4 weeks, then TSH is checked
Rise indicates permanent deficiency, normalize in-
dicates transient deficiency
4 / 20

44. How is Graves' Disease
treated?
Surgical removal, destruction of thyroid tissue,
suppression of thyroid hormone synthesis and/or
beta blockers
Non-radioactive iodine can be used to distract thy-
roid tissue
45. Thyroid Storm? Hyperthermia, severe tachycardia, restlessness,
agitation, tremor
Unconscious, hypotensive, heart failure
Treatment: methimazole, beta blocker, sedation,
cooling, glucocorticoids, IV fluids
46. Levothyroxine T4
Long half life
Morning, 30-60 minutes before breakfast
Side effects: tachycardia, angina tremors
Drug interactions: Warfarin, H2 blockers, PPIs, etc.
47. How is Levothyroxine
dosed?
1.6-1.8 mcg/kg/day
Obese: ideal body weight
Underweight: actual weight
Elderly with CAD: 12.5-25 mcg
Elderly: start low, go slow
Children dosages based on age
48. Liotrix Mixture of synthetic T4 plus synthetic T3 in 4:1 ratio
No advantage over Levothyroxine for most indica-
tions
49. Armour Consists of desiccated animal thyroid glands
Standardized based on iodine, levothyroxine, lio-
thyronine content
Ratio of T4 to T3 not less than 5:1
50. Methimazole Used in hyperthyroidism
Cell form of therapy for Graves' disease
Adjunct to radiation therapy, thyroid gland surgery
Suppresses thyroid hormone synthesis
51. Propylthiouracil
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Inhibits thyroid hormone synthesis
Second line for Graves'
Short half-life
Uses: graves', radiation therapy, thyroid surgery,
thyrotoxic crisis
Adverse effects: agranulocytosis, liver damage
52. Radioactive Iodine 131
(Lugol Solution)
Effect on the thyroid is destruction of thyroid tis-
sue by emission of beta particles. Advantages in-
clude low cost, spared risk of surgery, rare death
risk, and only thyroid tissue is injured. Disad-
vantages include delayed treatment, potential hy-
pothyroidism, and need for levothyroxine. Diag-
nostic uses: hyperthyroidism, hypothyroidism, and
goiter. Contraindicated in pregnancy.
53. Indications for Lugol
Solution
Adults with hyperthyroidism, patients not respond-
ing to other treatments, thyroid cancer. Side ef-
fects: brassy taste, burning sensation, soreness of
teeth and gums, headache, coryza, salvation, and
skin eruptions.
54. Stages of Menstrual Cy-
cle
Follicular phase, luteal phase, full cycle about 28
days.
55. Estrogen Effects on
Sex Characteristics
Influence reproduction processes, affect breast
ductal growth, vaginal epithelium changes, uterine
epithelium proliferation, and endocervical gland
secretion.
56. Metabolic Effects of Es-
trogen
Positive effect on bone mass, favorable cholesterol
effects, impact on blood coagulation, influence on
glucose homeostasis.
57. Adverse Effects of Es-
trogen
Endometrial hyperplasia and carcinoma, in-
creased cardiovascular events, N/V, gallbladder
disease, jaundice, headache, and chloasma.
58. Therapeutic Uses of Es-
trogen
Menopausal hormone therapy, female hypogo-
nadism, acne.
6 / 20

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Nursing

Nurs5334 Pharmacology Practice Exam With Answers (153 Solved Questions)

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