Question 1Question 1. Many patients self-medicate with antacids. Which patients should be counseled to not take calcium carbonate antacids without discussing with their providers or a pharmacist first?Patients with kidney stonesPregnant patientsPatients with heartburnPostmenopausal womenQuestion 2. A patient with a COPD exacerbation may require:Doubling of inhaled corticosteroid doseSystemic corticosteroid burstContinuous inhaled beta 2 agonistsLeukotriene therapyQuestion 3.When prescribing montelukast (Singulair) for asthma, patients or parents of patients should be instructed as follows:Montelukast twice a day is started when there is an asthma exacerbation.Patients may experience weight gain on montelukast.Aggression, anxiety, depression, and/or suicidal thoughts may occur when taking montelukast.Lethargy and hypersomnia may occur when taking montelukast.Question 4.Lifestyle changes are the first step in the treatment of GERD. A food that may aggravate GERD is:EggsHoney DewChocolateChickenQuestion 5. Kelly has diarrhea and is wondering if she can take loperamide (Imodium) for the diarrhea. Loperamide:Can be given to patients of all ages, including infants and children, for viral gastroenteritisSlows gastric motility and reduces fluid and electrolyte loss from diarrheaIs the treatment of choice for the diarrhea associated with E. coli 0157May be used in pregnancy and by lactating womenQuestion 6.Patients with allergic rhinitis may benefit from a prescription of:Fluticasone (Flonase)Cetirizine (Zyrtec)OTC cromolyn nasal spray (Nasalcrom)Any of the aboveQuestion 7.When treating a patient using the “step-down” approach, the patient with GERD is started on ____ first.antacidshistamine 2 receptor antagonistsprokineticsPPIsQuestion 8.Cough and cold medications that contain a sympathomimetic decongestant such as phenylephrine should be used cautiously in what population?Older adultsHypertensive patientsInfantsAll of the aboveQuestion 9. Josie is a five-year-old who presents to the clinic with a forty-eight-hour history of nausea, vomiting, and some diarrhea. She is unable to keep fluids down, and her weight is 4 pounds less than her last recorded weight. Besides intravenous (IV) fluids, her exam warrants the use of an antinausea medication. Which of the following would be the appropriate drug to order for Josie?Prochlorperazine (Compazine)Meclizine (Antivert)Promethazine (Phenergan)Ondansetron (Zofran)Question 10. Patients with pheochromocytoma should avoid which of the following classes of drugs due to the possibility of developing hypertensive crisis?ExpectorantsBeta 2 agonistsAntitussivesAntihistaminesQuestion 11. Montelukast (Singulair) may be prescribed for:A six-year-old with exercise-induced asthma.A two-year-old with moderate persistent asthma.An eighteen-month-old with seasonal allergic rhinitis.None of the above; montelukast is not approved for use in children.Question 12. Christy has exercise and mild persistent asthma and is prescribed two puffs of albuterol fifteen minutes before exercise and as needed for wheezing. One puff per day of beclomethasone (Qvar) is also prescribed. Teaching regarding her inhalers includes which one of the following?She should use one to two puffs of albuterol per day to prevent an attack, with no more than eight puffs per day.Beclomethasone needs to be used every day to treat her asthma.She should report any systemic side effects she is experiencing, such as weight gain.She should use the albuterol MDI immediately after her corticosteroid MDI to facilitate bronchodilation.Question 13. Prior to developing a plan for the treatment of asthma, the patient’s asthma should be classified according to the National Heart, Lung, and Blood Institute (NHLBI) Expert Panel 3 guidelines. In adults, mild-persistent asthma is classified as asthma symptoms that occur:DailyDaily and limit physical activityLess than twice a weekMore than twice a week and less than once a dayQuestion 14. Metoclopramide improves GERD symptoms by:Reducing acid secretionIncreasing gastric pHIncreasing lower esophageal toneDecreasing lower esophageal toneQuestion 15. Harold, a forty-two-year-old African American, has moderate persistent asthma. Which of the following asthma medications should he use cautiously, if at all?Betamethasone, an inhaled corticosteroidSalmeterol, an inhaled long-acting beta-agonistAlbuterol, a short-acting beta-agonistMontelukast, a leukotriene modifierQuestion 16. Patients who are on chronic long-term PPI therapy require monitoring for:Iron deficiency anemia, vitamin B12, and calcium deficiencyFolate and magnesium deficiencyElevated uric acid levels leading to goutHypokalemia and hypocalcemiaQuestion 17. Decongestants such as pseudoephedrine (Sudafed):Are Schedule III drugs in all statesShould not be prescribed or recommended for children under four years of ageAre effective in treating the congestion children experience with the common coldMay cause drowsiness in patients of all agesQuestion 18. Antacids treat GERD by:Decreasing lower esophageal toneIncreasing gastric pHInhibiting gastric acid secretionIncreasing the serum calcium levelQuestion 19. Education of patients with COPD who use inhaled corticosteroids includes the following:They should double the dose at the first sign of a upper respiratory infection.They should use the inhaled corticosteroid first and then the bronchodilator.They should rinse their mouths after use.They should not smoke for at least thirty minutes after use.Question 20. Asthma exacerbations at home are managed by the patient by:Increasing the frequency of beta 2 agonists and contacting his or her providerDoubling inhaled corticosteroid doseIncreasing the frequency of beta 2 agonistsStarting montelukast (Singulair)
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