Question 1

A patient has been using an herbal supplement for 2 years that the primary care NP knows may have toxic side effects.The NP should:

Accepted Answer

A)  tell the patient to stop taking the supplement immediately. 
B)  inform the patient of the risks of toxic side effects with this supplement. 
C)  refer the patient to a CAM provider who can manage this patient's therapy. 
D)  prescribe another herbal drug that has fewer adverse effects than the one the patient is taking. 
A)  tell the patient to stop taking the supplement immediately. 
B)  inform the patient of the risks of toxic side effects with this supplement. 
C)  refer the patient to a CAM provider who can manage this patient's therapy. 
D)  prescribe another herbal drug that has fewer adverse effects than the one the patient is taking. B

Question 2

A primary care NP is aware that many patients in the community use herbal remedies to treat various conditions.The NP understands the importance of:

Accepted Answer

A)  learning about the actions, uses, doses, and toxicities of these agents. 
B)  prescribing these agents when possible to ensure safe dosing. 
C)  counseling patients to stop using herbal products to avoid toxic side effects. 
D)  teaching patients that these products are unregulated and unsafe to use. 
A)  learning about the actions, uses, doses, and toxicities of these agents. 
B)  prescribing these agents when possible to ensure safe dosing. 
C)  counseling patients to stop using herbal products to avoid toxic side effects. 
D)  teaching patients that these products are unregulated and unsafe to use. A

Question 3

A patient with chronic back pain that is unrelieved by prescription analgesic medications asks a primary care nurse practitioner (NP)about acupuncture treatments.The NP should tell this patient:

Accepted Answer

A)  biofield therapy has been shown to be more effective than acupuncture. 
B)  creatine has been shown to be an effective herbal choice to treat back pain. 
C)  there is no valid research documenting the efficacy of this treatment for pain. 
D)  most studies that show benefits of alternative therapies are based on observation. 
A)  biofield therapy has been shown to be more effective than acupuncture. 
B)  creatine has been shown to be an effective herbal choice to treat back pain. 
C)  there is no valid research documenting the efficacy of this treatment for pain. 
D)  most studies that show benefits of alternative therapies are based on observation. D

Question 4

A patient develops hepatotoxicity from chronic acetaminophen use.The primary care NP may recommend:

Accepted Answer

A)  milk thistle. 
B)  chondroitin. 
C)  coenzyme Q. 
D)  glucosamine. 
A)  milk thistle. 
B)  chondroitin. 
C)  coenzyme Q. 
D)  glucosamine.

Question 5

A patient who takes warfarin (Coumadin)experiences excessive bleeding,even though serum drug levels are normal.The primary care NP should question this patient about the use of:

Accepted Answer

A)  feverfew. 
B)  echinacea. 
C)  green tea. 
D)  ginkgo biloba. 
A)  feverfew. 
B)  echinacea. 
C)  green tea. 
D)  ginkgo biloba.

Question 6

A patient is diagnosed with lupus and reports occasional use of herbal supplements.The primary care NP should caution this patient to avoid:

Accepted Answer

A)  ginseng. 
B)  echinacea. 
C)  ginkgo biloba. 
D)  St. John's wort. 
A)  ginseng. 
B)  echinacea. 
C)  ginkgo biloba. 
D)  St. John's wort.

Question 7

A patient asks a primary care NP why herbal supplements are not regulated by the FDA.The nurse practitioner should tell the patient these products are not regulated by the FDA because they are:

Accepted Answer

A)  natural, plant-based products and not man-made. 
B)  not marketed as products that can treat or cure disease. 
C)  regulated by the Dietary Supplement Health and Education Act. 
D)  covered by the Hatch-Richardson Bill of 1992, which allows them to make health claims without FDA approval. 
A)  natural, plant-based products and not man-made. 
B)  not marketed as products that can treat or cure disease. 
C)  regulated by the Dietary Supplement Health and Education Act. 
D)  covered by the Hatch-Richardson Bill of 1992, which allows them to make health claims without FDA approval.

Exam 8: Complementary and Alternative Therapies

A patient has been using an herbal supplement for 2 years that the primary care NP knows may have toxic side effects.The NP should:

A primary care NP is aware that many patients in the community use herbal remedies to treat various conditions.The NP understands the importance of:

A patient with chronic back pain that is unrelieved by prescription analgesic medications asks a primary care nurse practitioner (NP)about acupuncture treatments.The NP should tell this patient:

A patient develops hepatotoxicity from chronic acetaminophen use.The primary care NP may recommend:

A patient who takes warfarin (Coumadin)experiences excessive bleeding,even though serum drug levels are normal.The primary care NP should question this patient about the use of:

A patient is diagnosed with lupus and reports occasional use of herbal supplements.The primary care NP should caution this patient to avoid:

A patient asks a primary care NP why herbal supplements are not regulated by the FDA.The nurse practitioner should tell the patient these products are not regulated by the FDA because they are:

Prescriptive Authority and Role Implementation: Tradition vs.Change

Historical Review of Prescriptive Authority: The Role of Nurses (NPs, CNMs, CRNAs, and CNSs)and Physician Assistants

General Pharmacokinetic and Pharmacodynamic Principles

Special Populations: Geriatrics

Special Populations: Pediatrics

Special Populations: Pregnant and Nursing Women

Over-the-Counter Medications

Establishing the Therapeutic Relationship

Practical Tips on Writing Prescriptions

Evidence-Based Decision Making and Treatment Guidelines

Design and Implementation of Patient Education

Dermatologic Agents

Eye, Ear, Throat, and Mouth Agents

Upper Respiratory Agents

Asthma and Chronic Obstructive Pulmonary Disease Medications

Hypertension and Miscellaneous Antihypertensive Medications

Coronary Artery Disease and Antianginal Medications

Heart Failure and Digoxin

Beta-Blockers

Calcium Channel Blockers

ACE Inhibitors and Angiotensin Receptor Blockers

Antiarrhythmic Agents

Antihyperlipidemic Agents

Agents that Act on Blood

Antacids and the Management of GERD

Histamine-2 Blockers and Proton Pump Inhibitors

Laxatives

Antidiarrheals

Antiemetics

Medications for Irritable Bowel Syndrome and Other Gastrointestinal Problems

Diuretics

Male Genitourinary Agents

Drugs for Urinary Incontinence and Urinary Analgesia

Acetaminophen

Aspirin and Nonsteroidal Antiinflammatory Drugs

Disease-Modifying Antirheumatic Drugs and Immune Modulators

Gout Medications

Osteoporosis Treatment

Muscle Relaxants

Medications for Attention Deficit/Hyperactivity Disorder

Medications for Dementia

Analgesia and Pain Management

Migraine Medications

Antiepileptics

Antiparkinson Agents

Antidepressants

Antianxiety and Insomnia Agents

Antipsychotics

Substance Abuse

Glucocorticoids

Thyroid Medications

Diabetes Mellitus Agents

Contraceptives

Hormone Replacement Therapy

Drugs for Breast Cancer

Principles for Prescribing Antiinfectives

Treatment of Specific Infections and Miscellaneous Antibiotics

Penicillins

Cephalosporins

Tetracyclines

Macrolides

Fluoroquinolones

Aminoglycosides

Sulfonamides

Antitubercular Agents

Antifungals

Antiretroviral Medications

Antiviral and Antiprotozoal Agents

The Immune System and Immunizations

Weight Management

Smoking Cessation

Vitamins and Minerals