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Insufficient blood flow in the coronary arteries to the heart is common in all of these conditions except:

Select one:

a. arteriosclerosis.

b. atherosclerosis.

c. angina pectoris.

d. arrhythmias.

Question 2

Identify an accurate statement about the nerve supply of the heart.

Select one:

a. The heart receives its nerve supply from only one division of the autonomic nervous system, the sympathetic division.

b. The autonomic nervous system regulates the rate and force of the contractions of the heart.

c. The norepinephrine released by the sympathetic nerves in the heart act on the sinoatrial (SA) node to decrease heart rate.

d. The sympathetic nerves that innervate the heart become active when the body needs to rest and conserve energy.

Question 3

During the “fight or flight” reaction, sympathetic nerves become active and release _____.

Select one:

a. serotonin

b. gamma-aminobutyric acid

c. norepinephrine

d. acetylcholine

Question 4

Which of the following statements is true of angiotensin receptor blockers (ARBs)?

Select one:

a. The effect of using ARBs is similar to the effect of using the ACE inhibitors except that ARBs do not increase bradykinin.

b. The effect of using ARBs is similar to the effect of using the ACE inhibitors except that ARBs do not decrease pre- and afterload.

c. The effect of using ARBs is similar to the effect of using the ACE inhibitors except that ARBs do not increase cardiac output.

d. The effect of using ARBs is similar to the effect of using the ACE inhibitors except that ARBs only decrease preload and not afterload.

Question 5

Which of the following loop diuretics has the shortest duration of action?

Select one:

a. Torsemide (Demadex)

b. Furosemide (Lasix)

c. Bumetanide (Bumex)

d. Eplerenone (Inspra)

Question 6

How do thiazides and loop diuretics differ in their mechanisms of action?

Select one:

a. They have different outcomes in the context of sodium retention.

b. They act at different sites in the kidney.

c. Thiazides are more potent than loop diuretics.

d. Thiazides cause hypokalemia, while loop diuretics cause hyperkalemia.

Question 7

Which of the following is true of Class 2 antiarrhythmic drugs?

Select one:

a. They tend to shorten the cardiac refractory period.

b. They increase the excitability, conduction, and automaticity of ventricular muscle.

c. They decrease heart rate, atrioventricular (AV) conduction, and automaticity of the sinoatrial (SA) and AV nodes.

d. They are mainly indicated for arrhythmias that originate below the AV node.

Question 8

Dr. Cooper notices some irregularities in Alex’s heartbeat. After a thorough examination, he diagnoses Alex with ventricular arrhythmia. Dr. Cooper advises Alex to start taking a Class 1A antiarrhythmic drug in an extended-release tablet form once every 12 hours. On being asked about the drug’s mechanism of action by an assistant, Dr. Cooper states that the drug slows conduction in the heart and prolongs the cardiac refractory period. Based on the information provided in this scenario, which of the following drugs has Dr. Cooper most likely prescribed?

Select one:

a. Sotalol

b. Amiodarone

c. Esmolol

d. Procainamide

Question 9

Which of the following information should be given to an angina patient about nitroglycerin?

Select one:

a. Carry the prescribed medication at all times.

b. Nitroglycerin tablets lose potency if exposed to air or light.

c. Discard unused nitroglycerin tablets that are more than 6 months old.

d. All of the above are .

Question 10

Will, a 38-year-old man, is prone to anginal attacks. Will’s doctor prescribes a combination of drugs for long-term as well as short-term management of angina. Which of the following is the most likely combination of drugs prescribed by Will’s doctor?

Select one:

a. Diltiazem and tadalafil

b. Metoprolol and verapamil

c. Propranolol and atenolol

d. Nadolol and isosorbide dinitrate

Question 11

A unique property of osmotic diuretics is that:

Select one:

a. they can neither be filtered by the glomerulus nor be reabsorbed in the renal tubules.

b. they can be filtered by the glomerulus and be reabsorbed in the renal tubules.

c. they can be filtered by the glomerulus but not be reabsorbed by the renal tubules.

d. they cannot be filtered by the glomerulus but can be reabsorbed by the renal tubules.

Question 12

What are the two mechanisms by which sodium ions can be reabsorbed along the nephron?

Select one:

a. Anion exchange and chloride ion transport

b. Anion exchange and sodium ion transport

c. Cation exchange and chloride ion transport

d. Cation exchange and sodium ion transport

Question 13

Under the influence of the pituitary antidiuretic hormone (ADH):

Select one:

a. water molecules migrate away from the sodium ions in the blood.

b. urine volume decreases.

c. the reabsorption of water is inhibited.

d. potassium ions maintain the plasma volume and water balance.

Question 14

Mark suffers from mild hypertension. Which of the following is best suited to treat his condition?

Select one:

a. Diuretics

b. Diazoxide

c. Sodium Nitroprusside

d. Vasodilators

Question 15

Which of the following is true of sodium nitroprusside (Nipride)?

Select one:

a. Sodium nitroprusside is administered by slow intravenous infusion.

b. The duration of action of sodium nitroprusside is short, usually 1 to 5 minutes.

c. The normal dose of sodium nitroprusside is approximately 3 mcg per kg per minute.

d. All of these are .

Question 16

The main concern with the use of potassium-sparing diuretics is the development of _____, especially in patients who are also taking ACEIs, ARBs, or potassium supplements.

Select one:

a. hirsutism

b. thrombosis

c. hyperkalemia

d. thrombocytopenia

Question 17

Use the recommended dose (3 mcg/kg/min) to determine the appropriate dose of sodium nitroprusside that would be administered by slow intravenous infusion to a patient who weighs 242 pounds.

Select one:

a. 240 mcg/kg/min

b. 180 mcg/kg/min

c. 280 mcg/kg/min

d. 330 mcg/kg/min

Question 18

Implementing a patient education session for a patient suffering from essential hypertension requires:

Select one:

a. instructing the patient about the importance of taking their medications at proper times.

b. instructing the patient to undergo routine medical checkups to ensure that their blood pressure is under control.

c. instructing the patient that he or she may not have symptoms but will require lifelong treatment.

d. All of these are .

Question 19

Daily co-administration of both aspirin and ibuprofen can _____ the overall antiplatelet effects of aspirin because _____.

Select one:

a. cancel; ibuprofen is a COX-1 inhibitor and can occupy the same enzymatic site in the platelets but does not have the ability to alter the active site on COX or inhibit thromboxane production

b. increase; ibuprofen is a COX-1 enhancer and has the ability to alter the active site on COX and inhibit thromboxane production

c. delay; aspirin interferes with ibuprofen’s inactivation of COX-1 enzyme

d. have no effect on; ibuprofen seldom interferes with platelet aggregation

Question 20

The formation of _____ practically guarantees the clotting cascade to proceed.

Select one:

a. clotting factor VIII

b. vitamin K

c. Stuart factor

d. thromboplastin

Question 21

Rhabdomyolysis is considered to be a serious side effect of statin medications because:

Select one:

a. immunoglobulin molecules can disrupt blood flow and cause renal failure.

b. myoglobin molecules can disrupt blood flow to kidneys and cause renal failure.

c. immunoglobulin molecules can disrupt blood flow and cause an aneurism.

d. myoglobin molecules can disrupt blood flow and cause myocardial infarction.

Question 22

Why is unstable plaque more dangerous than stable plaque?

Select one:

a. Unlike stable plaque, unstable plaque is associated with an increased likelihood of hemorrhage that can lead to shock.

b. Unlike stable plaque, unstable plaque is associated with an increased likelihood of hemorrhage that can lead to arrhythmias.

c. Unlike stable plaque, unstable plaque is associated with thrombus formation that can cause hypertension.

d. Unlike stable plaque, unstable plaque is associated with thrombus formation that can block blood flow and tissue oxygenation.

Question 23

Identify the definition of the term “hypochromic” by breaking the word into its component parts.

Select one:

a. “Hypo-” refers to less than normal and “-chromic” means size.

b. “Hypo-” refers to more than normal and “-chromic” means color.

c. “Hypo-” refers to less than normal and “-chromic” means color.

d. None of these are .

Question 24

Which of the following statements is true of cobalamin (vitamin B12)?

Select one:

a. Cobalamin is primarily found is green vegetables and fruits.

b. Strict vegetarians are more likely to develop a deficiency of cobalamin.

c. The anemia resulting from cobalamin deficiency is a microcytic hypochromic anemia.

d. Cobalamin has recognized therapeutic value in the treatment of hepatitis, allergies, and sterility.

Question 25

David works as a health-care professional at Silver Oak Nursing Home. He is instructed to tend to Alisha Pavel, an undernutritioned patient who has been admitted at the nursing home for treatment. Which of the following instructions should David give Alisha when she is taking her oral hematinics?

Select one:

a. Do not take the supplements on an empty stomach.

b. Chew or crush the supplements prior to swallowing.

c. Take liquid iron preparations with juice or water.

d. Always take antacids simultaneously with oral iron supplements.

Question 26

Which of the following is not true about the use of folic acid?

Select one:

a. Administration of folic acid in a cobalamin deficiency can reverse the production of the megaloblastic cells.

b. Folic acid has no effect on the synthesis of myelin.

c. Folic acid can reverse the neurological changes associated with cobalamin deficiency.

d. Folic acid is not effective in the treatment of aplastic and normocytic anemias.

Question 27

Select the statement related to the mechanism of action of steroids.

Select one:

a. Steroids work as anti-inflammatory agents to inhibit the activation of arachidonic acid.

b. The major effect of steroids in the treatment of asthma is to inhibit the inflammatory process.

c. Steroids act to decrease the formation of prostaglandins and leukotrienes.

d. All of these are .

Question 28

What is the significant therapeutic aim in treating COPD?

Select one:

a. To inhibit the production of mucus

b. To improve lung function

c. To liquefy mucus and thus eliminate mucus from the lungs

d. All of these

Question 29

Select the statement related to the bronchodilators salmeterol and formoterol.

Select one:

a. Salmeterol and formoterol are administered as oral tablets, have an immediate onset of action, and have a duration of action of 12 hours.

b. Salmeterol and formoterol are administered by nebulization, have an immediate onset of action, and have a duration of action of 4 to 6 hours.

c. Salmeterol and formoterol are administered by inhalation, have an onset of action of 10 to 20 minutes, and have a duration of action of 12 hours.

d. None of these are .

Question 30

Select the drug agent that is used to treat allergic rhinitis from the following list of corticosteroids that are administered by oral inhalation or by nasal spray.

Select one:

a. Aerobid

b. Pulmicort

c. Azmacort

d. Flonase

Question 31

Select the statement that ly outlines the synthesis process of prostaglandins and leukotrienes.

Select one:

a. During inflammation, phospholipase A stimulates the release of arachidonic acid from the cell membrane. Cyclooxygenase converts arachidonic acid into several different prostaglandins. At the same time, lipoxygenase converts arachidonic acid into the leukotrienes.

b. During inflammation, phospholipase A stimulates the release of arachidonic acid from the cell membrane. Lipoxygenase converts arachidonic acid into several different prostaglandins. At the same time, cyclooxygenase converts arachidonic acid into the leukotrienes.

c. During inflammation, phospholipase A stimulates the release of arachidonic acid from the cell membrane. Cyclooxygenase converts arachidonic acid into several different prostaglandins and leukotrienes.

d. During inflammation, phospholipase A stimulates the release of arachidonic acid from the cell membrane. Lipoxygenase converts arachidonic acid into several different prostaglandins and leukotrienes.

Question 32

The mechanism of action of sucralfate has it classified as _____.

Select one:

a. an antacid

b. a prostaglandin

c. an anticholinergic

d. none of the above

Question 33

One way to treat a patient with severe GERD is to _____.

Select one:

a. use tissue grafting to replace eroded tissue

b. remove damaged tissue through surgery

c. administer triple therapy in conjunction with NSAIDs

d. administer quadruple therapy

Question 34

Ray is prescribed Carafate for the treatment of peptic ulcers. Which of the following side effects can Ray expect from this medication?

Select one:

a. Constipation

b. Nausea

c. Vomiting

d. Headache

Question 35

Which of the following is not a common cause of peptic ulcers?

Select one:

a. Overproduction of inhibitory enzyme to stop acid secretion

b. Helicobacter pylori (H. pylori)

c. Excess gastric acid secretion

d. Long-term use of nonsteroidal anti-inflammatory drugs

Question 36

Gastric juices are released during the gastric phase when the _____.

Select one:

a. chyme or partially digested foods enter the intestine.

b. adrenergic receptors on parietal cells are stimulated.

c. brain receives sensory input.

d. stomach distends.

Question 37

Select the statement that best describes the reason why antidiarrheals containing atropine should not be used by patients who have glaucoma.

Select one:

a. Anticholinergic drugs may damage the ciliary cells in the eye.

b. Anticholinergic drugs may increase intraocular pressure by reducing anterior chamber drainage in patients with glaucoma.

c. Anticholinergic drugs may increase the density of the vitreous humor and lead to lowered intraocular pressure.

d. None of these are .

Question 38

Which of the following drugs is a serotonin receptor antagonist?

Select one:

a. Atropine

b. Granisetron

c. Loperamide

d. Diphenoxylate

Question 39

Identify the long-term impact of chronic diarrhea.

Select one:

a. Accumulation of sodium and potassium in the blood

b. Dehydration and electrolyte imbalance

c. Relaxation of the external anal sphincter due to weakening of impulses from the brain

d. All of these

Question 40

Which of the following is the most frequent side effect produced by antidiarrheal drugs?

Select one:

a. Vomiting

b. Constipation

c. Renal failure

d. Hypertension

Question 41

Pituitary secretion is decreased by the:

Select one:

a. inhibiting hormones produced by the hypothalamus.

b. inhibiting hormones produced by the posterior pituitary gland.

c. second messengers produced by the anterior pituitary gland.

d. second messengers produced by the thyroid gland.

Question 42

Which hormone does not induce its action through cAMP activity?

Select one:

a. Testosterone

b. Calcitonin

c. Glucagon

d. Norepinephrine

Question 43

Noah, a 42-year-old, consults Dr. Miller as he has enlarged bones in his hands and feet. Dr. Miller diagnoses him with acromegaly and prescribes lanreotide to him. Dr. Miller should consider switching Noah to octreopeptide if Noah has _____.

Select one:

a. stents in his blood vessels

b. carcinoid tumors

c. adrenal insufficiency

d. Cushing’s disease

Question 44

Which of the following hormones is acutely regulated through a positive feedback loop?

Select one:

a. Antidiuretic hormone

b. Oxytocin

c. Thyroid-stimulating hormone

d. Cortisol

Question 45

Repository preparations of drugs:

Select one:

a. have a quick onset of action.

b. have a long duration of action.

c. are usually made for intravenous administration.

d. are water soluble.

Question 46

Which of the following is true of gluconeogenesis?

Select one:

a. Gluconeogenesis refers to the synthesis of glucose from carbohydrates.

b. Gluconeogenesis refers to the process of converting glycerol and amino acids into glucose.

c. Gluconeogenesis primarily occurs in the skeletal muscles.

d. Gluconeogenesis leads to a decrease in plasma glucose concentration.

.

Question 47

Which of the following is true of the mechanism of action of aldosterone?

Select one:

a. Aldosterone increases the reabsorption of sodium ions and water; in exchange, potassium ions are transported into the urine.

b. Aldosterone increases the discharge of sodium ions and water into the urine.

c. Aldosterone increases the reabsorption of potassium ions and water; in exchange, sodium ions are transported into the urine.

d. None of these are .

Question 48

Identify an adverse effect of glucocorticoids.

Select one:

a. Decrease in sweating

b. Decrease in appetite

c. Weight loss

d. Restlessness

Question 49

As a healthcare professional, which of the following instructions will Dr. Knightley give a patient with lupus erythematosus who intends to discontinue long-term therapy with prednisone?

Select one:

a. He will tell him to gradually reduce the dose of prednisone over a period of a few months.

b. He will tell him to stop taking prednisone immediately.

c. He will tell him to keep reducing the dose of prednisone every other day until he is no longer dependent on the drug.

d. None of these are .

Question 50

What information must be given to a female patient who is on steroid therapy and who has just learned that she is pregnant?

Select one:

a. If she is going to continue treatment, the infant will have to be monitored for adrenal function after birth.

b. Chronic maternal steroid use in the first trimester can result in a cleft palate in newborns (about 1 percent incidence).

c. If she is going to continue treatment, her dose will have to be reduced to the lowest possible effective dose.

d. All of these are .