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COMPETENCY EXAM 1C weight loss I, sickle cell, smoking cessation, renal disease and dosing

Competency Exam 1C Weight Loss I, Sickle Cell, Smoking Cessation, Renal Disease And Dosing

by leondo, Jul. 2014

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	Choose possible side effects from the use of stimulants for weight loss: (Select ALL that apply.) Answer ATremor BBradycardia CLow blood pressure DDifficulty sleeping ESomnolence	Tremor Difficulty sleeping
	In 2013 new weight loss guidelines were issued. Select a notable issue concerning the new guideline recommendations: Answer AA variety of diet types can be used to lose weight; calorie counting is no longer the only recommended method for weight loss. BCalorie-counting is the only recommended method for weight loss. CTrained personnel such as "weight loss coaches" and "personal trainers" are useless and should not be encouraged. DVery low calorie diets should never be recommended. EBariatric surgery is recommended for adults who are overweight (BMI > 24.9).	AA variety of diet types can be used to lose weight; calorie counting is no longer the only recommended method for weight loss.
	Lorcaserin is a newer drug approved for weight loss. Which of the following statements concerning lorcaserin are correct? (Select ALL that apply.) Answer AThe brand name is Qysmia. BLorcaserin is Pregnancy Category X. CLorcaserin is a serotonin (5-HT2c) receptor agonist. DThe manufacturer is required to conduct Phase IV monitoring for cardiovascular effects in patients using lorcaserin. ELorcaserin is a stimulant agent.	BLorcaserin is Pregnancy Category X. CLorcaserin is a serotonin (5-HT2c) receptor agonist. DThe manufacturer is required to conduct Phase IV monitoring for cardiovascular effects in patients using lorcaserin.
	Complications of being overweight include the following: (Select ALL that apply.) Answer ACoronary heart disease BType 2 diabetes CIncreased quality of life DA higher BMI EIncreased risk of certain types of cancer	ACoronary heart disease BType 2 diabetes DA higher BMI EIncreased risk of certain types of cancer
	Which of the following agents are often present in over-the-counter weight loss products? (Select ALL that apply.) Answer AGreen tea BMood relaxant herbals, such as valerian and melatonin CFiber products, including psyllium DCaffeine containing products that are under different names, including yerba mate and guarana EEphedra like products, including bitter orange	AGreen tea DCaffeine containing products that are under different names, including yerba mate and guarana EEphedra like products, including bitter orange
	If a person has a stable weight and physical activity level, how many days would it take to lose one pound of fat if they decrease their caloric intake by 500 kcal per day? Answer AOne week BTwo weeks COne month DOne day EThree days	AOne week
	What is the most common side effect of orlistat therapy? Answer AConstipation BHeadache CFlatus with discharge, fatty stool DVomiting EVitamin deficiencies	CFlatus with discharge, fatty stool
	Sheila is a 31 year old white female with asthma, diabetes type 2, hypertension and dyslipidemia. Lab results (taken this morning, fasting): Hemoglobin A1C 6.7%, LDL cholesterol 112 g/dL, triglycerides 168 g/dL and hCG+ Medications:Prevacid 30 mg daily, taken 30 minutes before breakfast ProAir HFA, Symbicort, twice daily as directed metformin 500 mg three times daily and lisinopril 20 mg daily. Sheila is asking for a prescription for the new weight loss drug Belviqthat she read about in a magazine add. Which of the following statements are correct? (Select ALL that apply.) Answer ASheila can receive Belviq; she will need to be instructed to stick to a dietary plan. BSheila can use Belviq but will need to stick to a dietary plan and exercise regimen. CThe use of Belviq is contraindicated at this time in this patient. DSheila's medications are unsafe at present and need to be changed. ESheila should immediately discontinue the use of ProAir HFA.	CThe use of Belviq is contraindicated at this time in this patient. DSheila's medications are unsafe at present and need to be changed.
	A woman walks into the pharmacy and asks the pharmacist which over-the-counter product provides the most weight loss. The patient is 5 foot, 3 inches tall. She weighs about 150 pounds. Choose the correct advice that should be provided to the patient: (Select ALL that apply.) Answer AAvoid refined carbohydrates, such as products made with white bread, and avoid products with added sugar; this will help eliminate many unhealthy food choices. BActivity counts; weight loss is maintained longer and people feel better when they are physically active. CDiet pills do not provide long-term benefit. DIncrease your alcohol intake while dieting. EStart smoking if you do not already.	AAvoid refined carbohydrates, such as products made with white bread, and avoid products with added sugar; this will help eliminate many unhealthy food choices. BActivity counts; weight loss is maintained longer and people feel better when they are physically active. CDiet pills do not provide long-term benefit.
	Mary is a 44 year-old female. Height 5'7", weight 197 pounds. Her blood pressure taken this morning was 134/78 mmHg. She had lab work done last month which reported an A1C of 8.7% and total cholesterol of 244 g/dL. Maries consumes a primarily carbohydrate-based diet with little vegetable intake because she claims that fresh vegetables "cost a lot of money and are hard to get in Wisconsin in the winter." She has been using over-the-counter weight loss products for years. She loses a little, then puts back on more weight. She went to her physician seeking help. The physician prescribed lorcaserin 10 mg PO ac TID #90, with 11 refills. Maya's other medications include fluoxetine 90 mg Q weekly, tramadol and sumatriptan PRN headaches and atorvastatin 10 mg daily. She refills the prescription for tramadol 1-2 Q 4-6 hours PRN #120 every month. The lorcaserin should not be filled for the following reasons. (SelectALL that apply.) Answer AThe dose schedule is incorrect. BHer weight does not qualify her for the use of this agent. CShe could experience coordination problems, trouble thinking clearly, hallucinations and changes in her blood pressure. DHer medical conditions exclude the use of lorcaserin. ELorcaserin is contraindicated in a patient with migraines.	AThe dose schedule is incorrect. CShe could experience coordination problems, trouble thinking clearly, hallucinations and changes in her blood pressure.
	Qsymia is a weight loss drug approved in 2012. What are the components of Qysmia? Answer APhentermine and fenfluramine BPhentermine and topiramate CPhentermine and lorcaserin DPhentermine and diethylpropion EPhentermine and pseudoephedrine	BPhentermine and topiramate
	Which of the following are contraindications to the use of Qsymia? (Select ALL that apply.) Answer AGlaucoma BPregnancy and lactation CMonoamine oxidase inhibitor use within the previous 14 days. DMorbid obesity, designated by a BMI > 40 EHyperthyroidism	AGlaucoma BPregnancy and lactation CMonoamine oxidase inhibitor use within the previous 14 days. EHyperthyroidism
	A patient gave the pharmacist a prescription for Xenical 120 mg #90, take one with each meal containing fat. Which of the following is an appropriate generic substitution for Xenical? Answer APhentermine BOrlistat CAlli DDiethylpropion EDextroamphetamine	Orlistat
	What is the scheduled (DEA) category of Qsymia? Answer AC II BC III CC IV DC V EThis drug is not controlled.	C IV
	A patient beginning lorcaserin should be counseled on the following likely side effects: (Select ALL that apply.) Answer AHeadache BDizziness CFatigue DHyperhidrosis EDry mouth	AHeadache BDizziness CFatigue EDry mouth
	Counseling points for the use of prescription orlistat therapy should include the following: (Select ALL that apply.) Answer AThis medication must be used with a reduced-calorie diet, exercise, and behavior modification program. BThe brand name for this medicine is Alli. CIf you use medicine for a low thyroid you must take the orlistat at least one hour after taking the thyroid medicine. DTake a multivitamin that contains A, D, E and K at a different time of day than the orlistat (such as at bedtime). EIn order to absorb this medicine your meal must contain at least 30 grams of fat.	AThis medication must be used with a reduced-calorie diet, exercise, and behavior modification program. DTake a multivitamin that contains A, D, E and K at a different time of day than the orlistat (such as at bedtime).
	Choose the safest and most practical use of prescription stimulant agents for weight loss? Answer AUse only short-term, in addition to changes in diet and increased physical activity & only for patients with higher BMIs. BUseful in patients who will not engage in a regular diet and physical activity program. CUseful in patients with cardiovascular disease who require fast weight loss. DUseful long-term to help maintain weight loss in patients who cannot decrease caloric intake by other means. EUseful in patients who have less than ten pounds to lose.	AUse only short-term, in addition to changes in diet and increased physical activity & only for patients with higher BMIs.
	Which of the following goal hemoglobin levels is correct for treatment of anemia associated with sickle cell disease? Answer ANo higher than 8 g/dL BNo higher than 9 g/dL CNo higher than 10 g/dL DNo higher than 11 g/dL ENo higher than 12 g/dL	CNo higher than 10 g/dL
	Folic acid supplementation is generally required with the following conditions: (Select ALL that apply.) Answer AAlcoholics at risk for Wernicke's encephalopathy. BSickle cell disease CFemales of child-bearing age who do not regularly consume folic acid fortified foods (or in any with questionable intake). DScurvy EMacrocytic anemia caused by vitamin B9 deficiency	BSickle cell disease CFemales of child-bearing age who do not regularly consume folic acid fortified foods (or in any with questionable intake). EMacrocytic anemia caused by vitamin B9 deficiency
	Which of the following statements concerning deferoxamine is correct? Answer AThe brand name is Exjade. BIt is the primary antidote for iron overdose. CIt is administered as oral tablets. DIt improves hearing. EIt has low risk of hypersensitivity reactions.	BIt is the primary antidote for iron overdose.
	A pharmacist has a prescription for deferasirox. What is the correct brand name for this iron chelation agent? Answer AExjade BExtrent CExacto DIron-Off ELoFerrous	Exjade
	Which of the following best describe the mechanism of action of hydroxyurea when used as part of the treatment plan in sickle cell disease? Answer AHydroxyurea blocks painful impulses from traveling to the CNS. BHydroxyurea stimulates production of erythropoetin. CHydroxyurea stimulates production of fetal hemoglobin. DHydroxyurea stimulates production of endogenous endorphins, which limit pain sensations. EHydroxyurea helps neutralize urine, which preserves renal function.	CHydroxyurea stimulates production of fetal hemoglobin.
	Which of the following statements concerning sickle cell disease are correct? (Select ALL that apply.) Answer APainful vaso-occlusive crises occur when sickle-shaped cells get stuck in narrow vessels, preventing blood flow to the subsequent tissue. BThe common organism causing infections in infants children with sickle cell disease is P. aeruginosa. CInfections are common in infants, children and young adults with sickle cell disease. DSickle cell disease is caused by a genetic defect of a single base substitution on the chromosome that codes for the beta chain that forms part of hemoglobin. EHemoglobin carries oxygen in red blood cells.	APainful vaso-occlusive crises occur when sickle-shaped cells get stuck in narrow vessels, preventing blood flow to the subsequent tissue. CInfections are common in infants, children and young adults with sickle cell disease. DSickle cell disease is caused by a genetic defect of a single base substitution on the chromosome that codes for the beta chain that forms part of hemoglobin. EHemoglobin carries oxygen in red blood cells.
	What is the primary cause of iron overload in patients with sickle cell disease? Answer AIncreased gut absorption BChronic transfusions of healthy red blood cells. CChronic use of erythropoietin. DChronic use of hydroxyurea. EChronic use of beta lactam antibiotics.	BChronic transfusions of healthy red blood cells
	Select the correct statement concerning the dosing for folic acid in sickle cell disease: Answer AThe dose of folic acid in children with chronic hemolytic anemia is 1 mg/day, up to 1 year of age, with higher requirements as the child grows older. BChildren with sickle cell disease do not generally require folic acid supplementation. CFolic acid supplementation must be given by injection. DThe dose of folic acid in children with chronic hemolytic anemia is 0.1 mg/day, up to 1 year of age, with higher requirements as the child grows older. EThe dose of folic acid in children with chronic hemolytic anemia is 0.1 mg/day, up to 1 year of age, with lower requirements as the child grows older.	DThe dose of folic acid in children with chronic hemolytic anemia is 0.1 mg/day, up to 1 year of age, with higher requirements as the child grows older.
	A patient using hydroxyurea complains that her stools are "loose and watery." Choose the correct statements. (SelectALL that apply.) Answer AHydroxyurea can cause loose stools, or diarrhea. BHydroxyurea can cause constipation. CHydroxyurea has no effect on stools in most patients. DPatients on hydroxyurea usually require loperamide, taken daily, up to 8 tablets/day. EHydroxyurea causes the stool to appear lighter, or clay-colored.	AHydroxyurea can cause loose stools, or diarrhea. BHydroxyurea can cause constipation.
	A female pharmacist is attempting pregnancy. She has a child with sickle cell disease. She is careful to use the following precaution: Answer AShe uses gloves when handling the hydroxyurea tablets, and washes her hands afterwards; hydroxyurea is pregnancy category A. BShe uses gloves when handling the hydroxyurea tablets, and washes her hands afterwards; hydroxyurea is pregnancy category D. CHydroxyurea poses no risk to an unborn child; after all, it is given to children. DHydroxyurea is beneficial to the unborn child because it stimulates production of fetal hemoglobin. EHydroxyurea is not supposed to be given to children with sickle cell disease; she should contact the prescriber.	BShe uses gloves when handling the hydroxyurea tablets, and washes her hands afterwards; hydroxyurea is pregnancy category D.
	What is the primary cause of sickle cell anemia (anemia associated with sickle cell disease)? Answer AShorter life span of the red blood cells BLack of erythropoietin CLack of iron DRenal disease EOver-use of transfusions	AShorter life span of the red blood cells
	Which of the following are benefits with using deferasirox versus the older deferoxamine therapy for iron chelation? (Select ALL that apply.) Answer ADeferasirox is an oral medication and deferoxamine is an injection. BDeferasirox is easier to tolerate than deferoxamine. CDeferasirox can be used with severe renal impairment while deferoxamine cannot. DDeferasirox has less interactions with other medications in the gut (GI tract) than deferoxamine. EDeferasirox is less time consuming to administer.	ADeferasirox is an oral medication and deferoxamine is an injection. BDeferasirox is easier to tolerate than deferoxamine. EDeferasirox is less time consuming to administer.
	Children with sickle cell disease have been cured with the following treatment modality: Answer ASpleen and pancreas transplant BRemicade infusions CCyclophosphamide and possibly other anti-inflammatory/chemotherapeutic agents DBone marrow transplant EKidney transplant	DBone marrow transplant
	Which of the following products cannot be taken concurrently with Exjade? (Select ALL that apply.) Answer AMaalox BMilk CFruit juice DOscal EYogurt	AMaalox BMilk DOscal EYogurt
	Select the correct counseling sequence for a patient receiving Exjade: Answer AOpen the capsule. Sprinkle into a small amount (spoonful) of applesauce or fruit juice. Swallow without chewing. BIf the capsule cannot be swallowed whole, sprinkle into a small amount (4 ounces) of water and drink. Follow with another glass of water in the same cup to get any drug that has stuck to the cup. CExjade tablets are taken whole, or ground and mixed with a small amount of applesauce or pudding. DDrop into apple juice, orange juice, or water. Stir until the mixture is even. Drink all of it, including washing down any that is stuck to the cup. EExjade comes only as a suspension that is mixed with fruit juice or water; do not mix with dairy products.	DDrop into apple juice, orange juice, or water. Stir until the mixture is even. Drink all of it, including washing down any that is stuck to the cup.
	Hydroxyurea is difficult for patients to tolerate. Which of the following side effects are common with the use of this drug? (Select ALL that apply.) Answer ABone marrow suppression BIncreased appetite/weight gain CAnorexia, nausea DSedation EHyperpigmentation, scaling skin, rash	ABone marrow suppression CAnorexia, nausea EHyperpigmentation, scaling skin, rash
	Which of the following statements concerning sickle cell disease are correct? (Select ALL that apply.) Answer AThe cell nucleus in white blood cells is misshapen into a concave, sickle shape. BThe hemoglobin in red blood cells is misshapen into a concave, sickle shape. CSickle cell disease is an acquired disorder. DSickle cell disease is a genetic disorder. ESickle cell disease affects 1 of every 500 black Americans.	BThe hemoglobin in red blood cells is misshapen into a concave, sickle shape. DSickle cell disease is a genetic disorder. ESickle cell disease affects 1 of every 500 black Americans.
	A pharmacist has received a prescription for hydroxyurea. She is out of the generic and will substitute a brand product (at no additional cost to the patient). Which of the following products contain hydroxyurea? (Select ALL that apply.) Answer AHydrea BHydrangia CDroxy DHydralazine EDroxia	AHydrea EDroxia
	Which of the following products simulates a "hand-to-mouth" movement and can be useful for patients who wish to repeat a hand-to-mouth habit? Answer ANicotine gum BNicotine patch CNicotine inhaler DNicotine nasal spray EBupropion	CNicotine inhaler
	TC is a 37 year old male who has a significant smoking history. He is determined to quit smoking. Which one of the following are part of the "5 A's" model for treating tobacco use and dependence? (Select ALL that apply.) Answer AAsk about tobacco use BAdvise to quit CAssess willingness to quit DAttempt to intervene EAssist in quit attempt	AAsk about tobacco use BAdvise to quit CAssess willingness to quit EAssist in quit attempt
	Beth has been a pack-a-day smoker for over twenty years. Smoking has put her at additional risk for the following health conditions: (Select ALL that apply.) Answer AMultiple types of cancers BHeart disease CCOPD DComplications if she were to become pregnant EStroke	AMultiple types of cancers BHeart disease CCOPD DComplications if she were to become pregnant EStroke
	Chantix requires dose adjustment for which of the following conditions? Answer AHepatic dysfunction BRenal dysfunction CGeriatric patients DPsychiatric conditions ENone of the above	BRenal dysfunction
	Laura will use bupropion for smoking cessation. Which of the following statements concerning bupropion are correct? (Select ALL that apply.) Answer APatients should not stop smoking until 1 week after starting bupropion. BIf you cannot swallow the tablets it is acceptable to crush them, or cut in half into smaller pieces. CDo not use if you have a seizure disorder. DDo not use if there is any chance you could become pregnant. EDo not use if you have either anorexia or bipolar disorder.	APatients should not stop smoking until 1 week after starting bupropion. CDo not use if you have a seizure disorder. EDo not use if you have either anorexia or bipolar disorder.

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Competency Exam 1C Weight Loss I, Sickle Cell, Smoking Cessation, Renal Disease And Dosing

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