NR 508 ADVANCED PHARMACOLOGY QUESTIONS WITH ANSWERS AND EXPLANATION

1. Nurse practitioner prescriptive authority is regulated by:
a) The National Council of State Boards of Nursing
b) The U.S. Drug Enforcement Administration
c) The State Board of Nursing for each state
d) The State Board of Pharmacy
Answer. The State Board of Nursing for each state
Explanation. Based on the provided information, the nursing practice of a nurse practitioner prescriptive authority is regulated by the State Board of Nursing for each state. Among the choices of answers provided, the indicated answers given by letters B and D are automatically eliminated from your possible choice since it refers to other field or concept of regulation and practice. While the letter A is about the distinct organization that comprises boards of nursing from the different states.
– Board of Nursing develops and plans the standards for the safe nursing care which includes the issuance of license to practice to those who will be found competent according to set laws by the state.

2. The benefits to the patient of having an Advanced Practice Registered Nurse (APRN) prescriber include:
a) Nurses know more about Pharmacology than other prescribers because they take it both in their basic nursing program and in their APRN program.
b) Nurses care for the patient from a holistic approach and include the patient in decision making regarding their care.
c) APRNs are less likely to prescribe narcotics and other controlled substances.
d) APRNs are able to prescribe independently in all states, whereas a physician’s assistant needs to have a physician supervising their practice.
Answer. Nurses care for the patient from a holistic approach and include the patient in decision making regarding their care.
Explanation. APN has been linked to improved levels of satisfaction, fewer prescription as well as referral instances, and greater consultation commitment in studies. Patients also stated that they were given additional information. All of this implies that nurses deliver high-quality care to all patients, reinforcing their role as the primary care provider.

3. Clinical judgment in prescribing includes:
a) Factoring in the cost to the patient of the medication prescribed
b) Always prescribing the newest medication available for the disease process
c) Handing out drug samples to poor patients
d) Prescribing all generic medications to cut costs
Answer. Factoring in the cost to the patient of the medication prescribed
Explanation. Prescribing all generic medications is essential in reducing the expenses of the patient. It would be a big help for them to save money.
– Generic medicines are also similar in pharmaceutical Professional assignment writing help “NR 508 Advanced Pharmacology Questions with Answers and Explanation” Meet the team that makes it all possible effects to branded ones, differing only in price.
– Aside from the cheaper cost, generic prescribing is a must in clinical judgment in prescribing medications to avoid any biases.

4. Criteria for choosing an effective drug for a disorder include:
a) Asking the patient what drug they think would work best for them
b) Consulting nationally recognized guidelines for disease management
c) Prescribing medications that are available as samples before writing a prescription
d) Following U.S. Drug Enforcement Administration guidelines for prescribing
Answer. Consulting nationally recognized guidelines for disease management
Explanation. The appropriate criteria in choosing the effective drug for a specific disorder is by consulting nationally recognized guidelines for disease management. In choosing an effective drug, the patient must be assessed and gone through series of test that will justify if it’s disorder or disease is appropriate with the medication they’ll be receiving.
– We never ask the patient on what drug they are feeling to take. We don’t do trial and error by taking sample medications before prescribing.
– For option number 4, U.S. Drug Enforcement Administration is focused on controlled substances and not on the effectiveness of a drug to a disorder.

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5. Drugs that have a significant first-pass effect:
a) Must be given by the enteral (oral) route only
b) Bypass the hepatic circulation
c) Are rapidly metabolized by the liver and may have little if any desired action
d) Are converted by the liver to more active and fat-soluble forms
Answer. Are rapidly metabolized by the liver and may have little if any desired action
Explanation. Drugs that are rapidly metabolized by the liver may be broken down before they have a chance to reach the bloodstream and have an effect.
– Drugs that are highly protein bound may have a reduced effect because they are bound to proteins in the blood and are not able to reach the target tissue.
– Drugs that are highly lipid soluble may have a reduced Professional assignment writing help “NR 508 Advanced Pharmacology Questions with Answers and Explanation” Meet the team that makes it all possible effect because they are not able to cross the blood-brain barrier.
– Drugs that have a short half-life may have a reduced effect because they are eliminated from the body before they have a chance to reach the target tissue.

6. The route of excretion of a volatile drug will likely be the:
a) Kidneys
b) Lungs
c) Bile and feces
d) Skin
Answer. Bile and feces
Explanation. The most prevalent route of medication removal is renal excretion. Many medications, on the other hand, are excreted in bile via the liver, and volatile chemicals such as gaseous anesthetics, alcohol, or drugs with high volatility, are excreted via the lungs into expired air.

7. Medroxyprogesterone (Depo Provera) is prescribed intramuscularly (IM) to create a storage reservoir of the drug. Storage reservoirs:
a) Assure that the drug will reach its intended target tissue
b) Are the reason for giving loading doses
c) Increase the length of time a drug is available and active
d) Are most common in collagen tissues
Answer. Increase the length of time a drug is available and active
Explanation. Certain medications accumulate in certain tissues (e.g, digoxin accumulates in the heart and skeletal muscles), which might function as reservoirs for further drug. These tissues gradually release the medication into the circulation, preventing the drug’s blood levels from quickly falling and so extending the drug’s action.
– Reservoir-based drug delivery systems are a subset of microfabricated drug delivery systems that provide distinct benefits. External or implanted reservoirs offer a well-controlled environment for a medication formulation, enabling for better drug stability and extended delivery durations. Professional assignment writing help “NR 508 Advanced Pharmacology Questions with Answers and Explanation” Meet the team that makes it all possible In contrast to a traditional continuous release profile, reservoir systems are adaptable to a variety of delivery schemes, including zero order, pulsatile, and on demand dosing. Additionally, the development of reservoir-based delivery systems for difficult-to-treat applications (e.g, ophthalmic) has led in the creation of prospective platforms for patient treatment.

8. Azithromycin dosing requires that the first day’s dosage be twice those of the other 4 days of the prescription. This is considered a loading dose. A loading dose:
a) Rapidly achieves drug levels in the therapeutic range
b) Requires four- to five-half-lives to attain
c) Is influenced by renal function
d) Is directly related to the drug circulating to the target tissues
Answer: Rapidly achieves drug levels in the therapeutic range
Explanation. A loading dose is given to rapidly achieve therapeutic drug levels. The loading dose may be influenced by renal function, but it is primarily related to the amount of drug circulating to the target tissues.
Incorrect choices
Choice 2. Requires four- to five-half-lives to attain This is incorrect because a loading dose is given to achieve therapeutic drug levels rapidly, not over the course of four to five half-lives. The loading dose may be influenced by renal function, but it is primarily related to the amount of drug circulating to the target tissues.
Choice 3. Is influenced by renal function Renal function may influence the loading dose, but it is not the primary factor. The loading dose is primarily related to the amount of drug circulating to the target tissues.
Choice 4. Is directly related to the drug circulating to the target tissues The loading dose is directly related to the amount of drug circulating to the target tissues.

9. The point in time on the drug concentration curve that indicates the first sign of a therapeutic effect is the:
a) Minimum adverse effect level
b) Peak of action
c) Onset of action
d) Therapeutic range
Answer: Onset of action
Explanation: The area under the blood (or plasma) concentration-time curve reflects the amount of a xenobiotic that has effectively reached the systemic circulation and as such Professional assignment writing help “NR 508 Advanced Pharmacology Questions with Answers and Explanation” Meet the team that makes it all possible is influenced both by the degree of bioavailability and by the rate at which a xenobiotic is removed from the body.
– The time it takes for a drug to reach the maximum concentration (Cmax) after administration of a drug that needs to be absorbed (e.g. an oral drug). Tmax is governed by the rate of drug absorption and the rate of drug elimination.

10. Drugs that are receptor antagonists, such as beta blockers, may cause:
a) Downregulation of the drug receptor
b) An exaggerated response if abruptly discontinued
c) Partial blockade of the effects of agonist drugs
d) An exaggerated response to competitive drug agonists
Answer: An exaggerated response if abruptly discontinued
Explanation: Receptor antagonists can cause downregulation of the drug receptor. This means that the body will reduce the number of receptors for the drug, making the drug less effective. If receptor antagonists are abruptly discontinued, they may cause an exaggerated response. This is because the body has adapted to the presence of the drug and, when the drug is removed, the body is no longer able to function properly. Receptor antagonists may also cause an exaggerated response to competitive drug agonists. This is because the receptor antagonist will block the agonist from binding to the receptor, causing the agonist to become more active.
– Receptor antagonists work by binding to a receptor and preventing other drugs from binding to that receptor. This can cause downregulation of the receptor, which means that the body will reduce the number of receptors for the drug. If receptor antagonists are abruptly discontinued, the body may have a difficult time adapting and may experience an exaggerated response. Receptor antagonists may also cause an exaggerated response to competitive drug agonists because they prevent the agonists from binding to the receptors.

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11. Drugs administered via IV:
a) Need to be lipid soluble in order to be easily absorbed
b) Begin distribution into the body immediately
c) Are easily absorbed if they are nonionized
d) May use pinocytosis to be absorbed
Answer: Begin distribution into the body immediately
Explanation. The intravenous (IV) route of administration of medications is a common one since it enables a high degree of distribution inside the body and has a minimal likelihood for the occurrence of drug interactions. In contrast, medications that are not lipid soluble are poorly absorbed through the IV route and may require pinocytosis in order to be absorbed. Drugs that are easily absorbed Professional assignment writing help “NR 508 Advanced Pharmacology Questions with Answers and Explanation” Meet the team that makes it all possible through the IV route include those that are lipid soluble.
Warfarin, which is a potassium channel blocker, is the medication that is most frequently given to a patient through an intravenous line. When administered via intravenous (IV), warfarin is rapidly transported throughout the body and has a high rate of absorption. Warfarin is also simple to eliminate from the body, which means that it does not build up in the system over time.
– Because it enables the medicine to be absorbed through the small intestine, picocytosis is another typical form of absorption for pharmaceuticals that are administered intravenously. Picocytosis is the process by which minute particles of a medication are able to enter the bloodstream and then be dispersed to the various organs and tissues throughout the body. Because of this, the medicine is able to undergo a significant amount of dispersion and absorption.

12. When a medication is added to a regimen for a synergistic effect, the combined effect of the drugs is:
a) The sum of the effects of each drug individually
b) Greater than the sum of the effects of each drug individually
c) Less than the effect of each drug individually
d) Not predictable, as it varies with each individual
Answer. Greater than the sum of the effects of each drug individually
Explanation. It is much better and greater than the sum of the combination of effects of each drug individual. This makes the combined effect a greater product and a big deal.
– Two or more medications that alone show clearly similar effects will sometimes display greatly amplified effects when given in combination. When the combined effect is greater than that indicated by their individual potencies, the combination is said to be synergistic. A synergistic interaction allows the use of lower doses of the combination elements, a circumstance that may lessen unpleasant responses. Drug combinations are fairly prevalent in the treatment of tumors, infections, pain, and many other diseases and circumstances.

13. Which of the following statements about bioavailability is true?
a) Bioavailability issues are especially important for drugs with narrow therapeutic ranges or sustained-release mechanisms.
b) All brands of a drug have the same bioavailability.
c) Drugs that are administered more than once a day have greater bioavailability than drugs given once daily.
d) Combining an active drug with an inert substance does not affect bioavailability.
Answer: Bioavailability issues are especially important for drugs with narrow therapeutic ranges or sustained-release mechanisms
Explanation: This statement is true. Bioavailability is the amount of a drug that is available to the target tissue after it has been administered. Drugs with narrow therapeutic ranges or sustained-release mechanisms may have different bioavailability than other drugs.
Incorrect choices
Choice 2. Is incorrect because different brands of a drug may have Professional assignment writing help “NR 508 Advanced Pharmacology Questions with Answers and Explanation” Meet the team that makes it all possible different bioavailability.
Choice 3. Is incorrect because the frequency of administration does not necessarily affect the bioavailability of a drug.
Choice 4. Is incorrect because combining an active drug with an inert substance may affect the bioavailability of the drug.

14. Drugs are metabolized mainly by the liver via phase I or phase II reactions. The purpose of both of these types of reactions is to:
a) Inactivate prodrugs before they can be activated by target tissues
b) Change the drugs so they can cross plasma membranes
c) Change drug molecules to a form that an excretory organ can excrete
d) Make these drugs more ionized and polar to facilitate excretion
Answer: Change drug molecules to a form that an excretory organ can excrete
Explanation: Phase I and phase II reactions in the process of drug metabolism ensures that drugs are more polar and more ionized so that they can be easily excreted. In phase I metabolism, there is reduction, oxidation and hydrolysis reactions. The reactions convert lipophilic drugs into more polar molecules after the addition or exposure of the drug to a polar functional group such as a -NH2 or a -OH group. This reaction will facilitate the excretion or further metabolism of the drug. In phase II reaction, there is a conjugation reaction which adds a large polar metabolite via a high energy cofactor or a chemically reactive substrate. This converts the drug into a polar inactive metabolite for easier excretion (Stanley, 2017).

15. Once they have been metabolized by the liver, the metabolites may be:
a) More active than the parent drug
b) Less active than the parent drug
c) Totally “deactivated” so they are excreted without any effect
d) All of the above
Answer: All of the above
Explanation: The body changes the chemical makeup of several medications (metabolized). The molecules produced by metabolism are called metabolites. The metabolites produced by the liver may be more or less active than the parent drug, or they may be completely “deactivated,” meaning they are excreted with no effect. The rate of drug metabolism varies from patient to patient. Some persons metabolize a drug so quickly that therapeutically effective blood and tissue concentrations are not achieved; others’ metabolism is so sluggish that standard doses are hazardous. It may be inactive, or they may have therapeutic action or toxicity that is comparable to or distinct from the original drug.
– Despite the fact that metabolism usually renders pharmaceuticals inactive, some drug metabolites are pharmacologically active, sometimes even more so than the parent substance. A prodrug is a chemical that is inactive or weakly active but has an active metabolite, especially if it is designed to deliver the active moiety more effectively. Genetic variables, concomitant illnesses (particularly chronic liver disorders and severe heart failure), and drug interactions all influence drug metabolism rates (especially those involving induction or inhibition of metabolism).

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16. Steady state is:
a) The point on the drug concentration curve when absorption exceeds excretion
b) When the amount of drug in the body remains constant
c) When the amount of drug in the body stays below the minimum toxic concentration
d) All of the above
Answer. When the amount of drug in the body remains constant
Explanation. As defined by Wadhwa, R., a STEADY STATE is reached when quantities of both the drug eliminated in the unit of time and the time the drug reaches the systemic circulation in the unit of time are equal. In this sense, concentrations stay within the therapeutic range for a long time and the amount of drug in the body remains constant because the body is in the state of equilibrium.

17. Phase I oxidative-reductive processes of drug metabolism require certain nutritional elements. Which of the following would reduce or inhibit this process?
a) Protein malnutrition
b) Iron-deficiency anemia
c) Both 1 and 2
d) Neither 1 nor 2
Answer: Neither 1 nor 2
Explanation. Protein malnutrition and iron-deficiency Professional assignment writing help “NR 508 Advanced Pharmacology Questions with Answers and Explanation” Meet the team that makes it all possible anemia can both reduce or inhibit the Phase I oxidative-reductive processes of drug metabolism. Protein malnutrition can reduce the activity of enzymes involved in drug metabolism, while iron-deficiency anemia can reduce the availability of cofactors required for these enzymes to function properly.
Protein malnutrition can reduce the activity of enzymes involved in drug metabolism. These enzymes, known as cytochrome P450 enzymes, are responsible for the oxidation and reduction of many drugs. This can lead to reduced drug metabolism and reduced clearance of drugs from the body.
– Iron-deficiency anemia can also reduce the activity of cytochrome P450 enzymes. This is because these enzymes require iron as a cofactor in order to function properly. When iron levels are low, the activity of these enzymes is reduced, leading to reduced drug metabolism. Both protein malnutrition and iron-deficiency anemia can therefore reduce or inhibit the Phase I oxidative-reductive processes of drug metabolism. This can lead to increased levels of drugs in the body and increased side effects.
– It’s vital to remember that various other aspects, such liver health, might also impact drug metabolism. This means that the effects of protein malnutrition and iron-deficiency anemia on drug metabolism may vary depending on the individual. Protein malnutrition and iron-deficiency anemia are both common deficiencies that can occur in a variety of populations. These deficiencies can have a significant impact on drug metabolism and should be considered when prescribing medications.
– Protein malnutrition is a common problem in developing countries. It can be caused by a variety of factors, including poverty, poor diet, and diseases such as HIV/AIDS. This condition can lead to a variety of problems, including muscle wasting, weakness, and impaired immune function.
– Iron-deficiency anemia is also a common problem, particularly in women of childbearing age. A bad diet, blood loss, and specific medical disorders are just a few of the causes. This condition can lead to fatigue, weakness, and shortness of breath. Protein malnutrition and iron-deficiency anemia can both have a significant impact on drug metabolism. These conditions should be considered when prescribing medications, as they may increase the risk of side effects.

18. An advantage of prescribing a sublingual medication is that the medication is:
a) Absorbed rapidly
b) Excreted rapidly
c) Metabolized minimally
d) Distributed equally
Answer: Absorbed rapidly
Explanation: Sublingual administration involves placing a drug under your tongue to dissolve and absorb into your blood through the tissue there.
– Sublingual forms of drugs have their advantages. Because the medication absorbs quickly, these types of administration can be important during emergencies when you need the drug to work right away, such as during a heart attack.
– Further, these drugs do not go through the digestive system, Professional assignment writing help “NR 508 Advanced Pharmacology Questions with Answers and Explanation” Meet the team that makes it all possible so they aren’t metabolized through your liver. This means you may be able to take a lower dose and still get the same results.

19. In deciding which of multiple drugs used to use to treat a condition, the NP chooses Drug A because it:
a) Has serious side effects and it is not being used for a life-threatening condition
b) Will be taken twice daily and will be taken at home
c) Is expensive, but covered by health insurance
d) None of these are important in choosing a drug
Answer: Will be taken twice daily and will be taken at home
Explanation: In the simplest terms, rational use entails “a patient receiving the most appropriate treatment for their clinical needs, in an adequate dose, for the longest feasible time, and at the lowest possible cost.”
– Rational medicine use tactics improve the efficacy, safety, and cost-effectiveness of medications, preserve antimicrobial effectiveness, and contribute to positive health outcomes.
– Prescribers often choose from a variety of pharmacological choices after considering diagnosis, prognosis, and therapy goals. The optimum option should maximize the benefit-to-harm balance based on medicine and patient considerations, while also taking into account availability and cost constraints.
– Patients should receive pharmaceuticals that are appropriate to their clinical needs, in doses that satisfy their own specific requirements for an adequate period of time, and at the lowest cost to them and their community, according to the rational use of drugs.

20. The therapeutic goals when prescribing include(s):
a) Curative
b) Palliative
c) Preventive
d) All of the above
Answer: All of the above
Explanation: Curing a disease, treating symptoms without changing the underlying problem, long-term prevention, replacing inadequacies, and meeting lifestyle wishes are some of the therapeutic goals.

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21. Pharmacokinetic factors that affect prescribing include:
a) Therapeutic index
b) Minimum effective concentration
c) Bioavailability
d) Ease of titration
Answer: Bioavailability
Explanation. Prescription decision making is a complicated phenomenon influenced by many factors including
i. Drug strength
ii. The patient’s context
iii. Prescriber characteristics
iv. Health facilities
v. Payment type
vi. Pharmaceutical marketing.
– Pharmacokinetics describes how a drug moves into, through and out of the body, tracking its absorption, distribution, metabolism and excretion (or ADME, for short), which together control the concentration of the drug in the body over time

22. Off-label prescribing is:
a) Regulated by the U.S. Food and Drug Administration
b) Illegal by NPs in all states (provinces)
c) Legal if there is scientific evidence for the use
d) Regulated by the Drug Enforcement Professional assignment writing help “NR 508 Advanced Pharmacology Questions with Answers and Explanation” Meet the team that makes it all possible Administration
Answer: Legal if there is scientific evidence for the use
Explanation. Off-label use refers to the use of a prescription drug that has not been approved by the FDA. This word can refer to a drug that is being used to treat a disease or medical condition for which it has not been approved, such as when chemotherapy is approved to treat one form of cancer but is being used to treat a different type of cancer by healthcare providers.
– Although some off-label therapies can be effective and even lifesaving for some individuals, there is little or no scientific proof that they function in the vast majority of situations.
– Therefore, off-label prescriptions can be considered legal if there are strong scientific evidence showing efficacy for the indication, during which the drug can be recommended for most or all patients with the indication, and the evidence included at least one Randomized Clinical Trial (the gold standard to assess drug efficacy) to test the indication.

23. Digoxin may cause a type A adverse drug reaction due to:
a) Idiosyncratic effects
b) Its narrow therapeutic index
c) Being a teratogen
d) Being a carcinogen
Answer: Its narrow therapeutic index
Explanation. Because digoxin has a narrow therapeutic index, minor changes in plasma concentration can quickly lead to hazardous or subtherapeutic levels. As a result, bioavailability uniformity is critical. Furthermore, hazardous symptoms can appear even when digoxin concentrations Professional assignment writing help “NR 508 Advanced Pharmacology Questions with Answers and Explanation” Meet the team that makes it all possible are normal. Doses should be tailored to the patient’s renal function first, then adjusted based on response and plasma concentrations; this is especially critical in the elderly.

24. Drugs that are prone to cause adverse drug effects include:
a) Diuretics
b) Inhaled anticholinergics
c) Insulins
d) Stimulants
Answer: Insulins
Explanation. Insulins are more prone to cause adverse drug effects due to physiologic antagonism.
For example, a glucocorticoid hormone may have catabolic actions which increase the blood sugar of the body. When a person takes insulin for their maintenance, the reaction of the insulin counteracts the action of the glucocorticoid hormone. It is less controllable due to physiologic antagonism.
A physiologic antagonist drug opposes the effects of another by binding to a different receptor that is less specific and not easy to control.

25. You are treating a patient with a diagnosis of Alzheimer’s disease. The patient’s wife mentions difficulty with transportation to the clinic. Which medication is the best choice?
a) Donepezil
b) Tacrine
c) Doxazosin
d) Verapamil
Answer: Donepezil
Explanation. The medication named is the best choice. It leads to better communication between nerve cells; in the treatment of Alzheimer’s disease.

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26. Antonia is a 3-year-old child who has a history of status epilepticus. Along with her routine antiseizure medication, she should also have a home prescription for to be used for an episode of status epilepticus.
a) IV phenobarbital
b) Rectal diazepam (Diastat)
c) IV phenytoin (Dilantin)
d) Oral carbamazepine (Tegretol)
Answer: Rectal diazepam (Diastat)
Explanation. Status epilepticus is a medical emergency that requires immediate treatment. If Antonia has a history of status epilepticus, she should have a home prescription for rectal diazepam (Diastat) to be used in case of another episode. Rectal diazepam is the preferred treatment for status Professional assignment writing help “NR 508 Advanced Pharmacology Questions with Answers and Explanation” Meet the team that makes it all possible epilepticus, as it is effective and has a rapid onset of action. Phenobarbital and phenytoin are also used to treat status epilepticus, but they have a slower onset of action and are less effective. If Antonia has a seizure that lasts longer than five minutes or if she has multiple seizures without regaining consciousness in between, this is considered status epilepticus and she should be given rectal diazepam immediately. The rectal diazepam should be administered at a dose of 0.5 mg/kg, up to a maximum of 20 mg. If the seizure does not stop within 15 minutes of administration, a second dose may be given. If the seizure still does not stop, Antonia should be taken to the nearest emergency room for further treatment.

27. The tricyclic antidepressants should be prescribed cautiously in patients with:
a) Eczema
b) Asthma
c) Diabetes
d) Heart disease
Answer: Heart disease
Explanation. The TCAs affect cardiac contractility and have even been linked to worsening of ischemic heart disease and sudden cardiac death, and thus should be avoided completely in patients at risk of a serious arrhythmia and those with CAD.

28. One major drug used to treat bipolar disease is lithium. Because lithium has a narrow therapeutic range, it is important to recognize symptoms of toxicity, such as:
a) Orthostatic hypotension
b) Agitation and irritability
c) Drowsiness and nausea
d) Painful urination and abdominal distention
Answer: Drowsiness and nausea
Explanation. Many of the side effects of lithium medication appear at different times after treatment begins. Nausea, vomiting, diarrhea, stomach aches, dizziness, and weakness are some of the acute or immediate poisoning symptoms of lithium. Tremor is one of the most prevalent long-term side effects of lithium therapy, and it can happen even at therapeutic dosages. Other chronic toxicity manifestations are edema, hypothyroidism, renal dysfunction, and dysrhythmia.

29. Digoxin levels need to be monitored closely when the following medication is started:
a) Loratadine
b) Diphenhydramine
c) Ipratropium
d) Albuterol
Answer: Albuterol
Explanation. Albuterol can cause heart rhythm changes and potassium levels to drop lower than normal. Therefore, a health professional should closely monitor digoxin levels when after administering albuterol.

30. Patients with allergic rhinitis may benefit from a prescription of:
a) Fluticasone (Flonase)
b) Cetirizine (Zyrtec)
c) OTC cromolyn nasal spray (Nasalcrom)
d) Any of the above
Answer. Any of the above
Explanation. Fluticasone (Flonase)-Flonase can help with allergic rhinitis symptoms, but it can also help with nonallergic rhinitis symptoms. Flonase can also be used to treat the symptoms of both forms of rhinitis, like itchy, watery eyes. Nasal symptoms of allergic rhinitis can be treated with Professional assignment writing help “NR 508 Advanced Pharmacology Questions with Answers and Explanation” Meet the team that makes it all possible both Flonase and Nasonex, but Flonase can also be used to treat nasal symptoms in nonallergic rhinitis. Flonase can also be used to treat the symptoms of both forms of rhinitis, like itchy, watery eyes.
– Cetirizine (Zyrtec)-Antihistamines like Benadryl (diphenhydramine) as well as Zyrtec (cetirizine hydrochloride) are used to treat allergy symptoms like itchiness, hives, runny nose, watery eyes, as well as sneezing caused by hay fever (allergic rhinitis) or other allergens such mold and dust mite allergies.
– OTC cromalyn nasal spray (Nasalcrom)-Cromolyn prevents the release of inflammatory as well as allergy mediators by inhibiting the degranulation of hypersensitive mast cells.

31. Patients who are being treated with epoetin alfa need to be monitored for the development of:
a) Thrombocytopenia
b) Neutropenia
c) Hypertension
d) Gout
Answer. Thrombocytopenia
Explanation. Thrombocytopenia is correct because epoetin alfa might induce the bone marrow to overproduce white blood cells. As a result, the body starts to make fewer platelets.
– Thrombocytopenia is a condition in which there are not enough platelets in the blood. Because platelets are essential for blood coagulation, thrombocytopenia can manifest in excessive bleeding and bruising.
– Anemia, a disorder in which there are not enough red blood cells in the blood, is treated with epoetin alfa. Epoetin alfa stimulates the bone marrow to make more red blood cells, which is how it functions. Anemia, a disorder in which there are not enough red blood cells in the blood, is treated with epoetin alfa. Epoetin alfa stimulates the bone marrow to make more red blood cells, which is how it functions.
– However, epoetin alfa can also cause thrombocytopenia. This is due to the fact that epoetin alfa might induce the bone marrow to overproduce white blood cells. As a result, the body starts to make fewer platelets.
– The exact mechanism by which epoetin alfa causes thrombocytopenia is not fully understood. However, it is thought that the medication may cause the bone marrow to produce more white blood cells than it can handle. This may lead to a decrease in the production of platelets.
– Thrombocytopenia can be a serious condition, especially if it leads to bleeding. If you are taking epoetin alfa and develop thrombocytopenia, you should contact your healthcare provider immediately.

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32. Elderly patients who are started on levothyroxine for thyroid replacement should be monitored for:
a) Excessive sedation
b) Tachycardia and angina
c) Weight gain
d) Cold intolerance
Answer: Tachycardia and angina
Explanation. Very high heart rates cause tachycardia. This can lead to a variety of heart rhythm problems (arrhythmias). It’s common to have a quick heartbeat from time to time. Angina is chest pain or discomfort caused by a lack of oxygen-rich blood to your heart muscle. In your chest, you may feel pressure or a squeezing sensation. In addition to your shoulders, arms, neck, mouth, and back, you may experience discomfort in your shoulders, arms, neck, jaw, or back. Angina pain might mimic the symptoms of dyspepsia. Angina, on the other hand, is not an illness.