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43 Cards in this Set
- Front
- Back
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Vital signs include each of the following except: Answer AHeight and Weight BBlood Pressure CRespiratory Rate DHeart Rate ETemperature
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AHeight and Weight |
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A patient with non-small cell lung cancer is receiving cisplatin as part of the treatment regimen. Select the lab test that should be ordered to monitor for myelosuppression: Answer ABMP BCMP CCBC DPMN EBands |
CCBC |
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DA presents to the urgent care clinic and reports that "I can't move my finger since it got pressed back earlier today. I think it may be broken." This information should be recorded in this section of the SOAP note: Answer ASubjective BObjective CAssessment DPlan EVital Signs |
ASubjective |
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TG, a 72 year-old Hispanic male is hospitalized with a pulmonary embolism. He is receiving unfractionated heparin initiated at a rate of 1000 units/hour. The control value at this hospital is 22-38 seconds. Select the correct test and an appropriate treatment level for this patient: Answer AINR, 2 - 3 BaPTT, 18 seconds CINR, 2.5 - 3.5 DaPTT, 44 seconds EPlatelets, above 50
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DaPTT, 44 seconds |
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A patient presents with confusion and rapid breathing. A lab report reveals a low serum bicarb level. Which of the following antiepileptic drugs can cause metabolic acidosis? Answer ADilantin BTegretol CTopamax DKeppra EOnfi |
CTopamax |
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Select the name of the lab test used to distinguish between a microcytic and a macrocytic anemia: Answer ARDW BMCH CMCV DMCHC ETIBC |
CMCV |
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55 year old female presented to the hospital with weakness and dyspnea. She was diagnosed with pneumonia and severe hemolytic anemia. The Coombs test was positive. The patient received a blood transfusion and was treated with prednisone and clarithromycin for pneumonia.
Medications taken at home were aspirin, irbesartan, simvastatin, sertraline, isoniazid, atenolol and pyridoxine.
Medical Conditions: Hypertension, dyslipidemia, depression, TB-test positive (annual work requirement).
Which medication is most likely to have caused the hemolytic anemia? Answer AAspirin BIrbesartan CSimvastatin DSertraline EIsoniazid |
EIsoniazid |
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A 50-year-old male presents to the ED with chest pain. The triage nurse reports to the physician that the patient is diaphoretic and nervous, and is clenching his fist against his shirt over the chest region. What section of the chart note is the correct place to record the nurse's report? Answer ASubjective BObjective CAssessment DPlan EChief Complaint |
BObjective |
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When the liver cells (hepatocytes) are damaged these enzymes are released and will be elevated in the serum: Answer AHgb and Hct BCRP and RF CTSH and FT4 DBUN and SCr EAST and ALT |
EAST and ALT |
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The CBC includes each of the following lab values except: Answer ANeutrophils BErythrocytes CPlatelets DRed blood cells EBlood urea nitrogen |
EBlood urea nitrogen |
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A patient has G6PD-deficiency. What will occur if the patient receives primaquine for malaria prophylaxis? Answer AThe patient will be at higher risk of catching malaria. BThe patient will be at higher risk of developing primaquine-induced neurotoxicity. CThe patient will be at risk for serious internal bleeding. DThe patient will have increased renal excretion of electrolytes. EThe patient will develop leukopenia. |
CThe patient will be at risk for serious internal bleeding. |
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A patient presents with a butterfly-shaped rash on her face and achey joints. The patient's chronic medications includeKlor-Con, Lasix, Toprol XL, BiDil, Atacand and Inspra. Which of the daily medication is most likely contributing to this presentation? Answer ALasix BToprol CBiDil DAtacand EInspra |
CBiDil |
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Calcium levels may decrease with chronic use of these drugs: (Select ALL that apply.) Answer ABumex BTekturna-HCT CBoniva DTopamax EDyazide |
ABumex
CBoniva DTopamax |
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A 77 year old female with hypertension, high cholesterol and heart failure was admitted from the Emergency Department (ED) with chest pain. The patient was initially given aspirin, nitroglycerin and oxygen. The physical exam in the ED was positive for epigastric pain and tachycardia. She was sent for a CT scan of the abdomen. The notes on the preliminary read included “no acute intra-abdominal process and small bilateral PE." The PE was meant to indicate a pulmonary effusion. The inpatient team initiated IV heparin. The patient later died due to internal bleeding. Identify the cause of the medical error: Answer ALack of an advanced direction BThe use of medical abbreviations in a patient's chart CThe use of inappropriate diagnostic tools DThe use of a medication known to have high risk of bleeding EThe miss of a critical value that had been identified earlier
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BThe use of medical abbreviations in a patient's chart |
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TG, a 72 year-old Hispanic male is hospitalized with a pulmonary embolism. He is receiving unfractionated heparin initiated at a rate of 1000 units/hour. The control value at this hospital is 22-38 seconds. Select the correct monitoring parameters for patients receiving heparin: (Select ALL that apply.) Answer AaPTT BSerum creatinine CPlatelets DHgb/Hct and signs of bleeding ESerum phosphate |
AaPTT
CPlatelets DHgb/Hct and signs of bleeding
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A seven year old child is receiving enoxaparin. The clinical team in the pediatric unit is not sure if the medication is being dosed correctly due to the child's age and body weight. They will order a lab test to check if the range is subtherapeutic, therapeutic or supratherapeutic. Which test should be ordered? Answer AINR BaPTT CPlatelets DBNP EAnti-Xa |
EAnti-Xa |
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Everette, an 82 year-old male with COPD, has difficulty breathing. Everette finds little relief from daily use of the Advair Diskus and Spiriva. Which condition is most likely in this patient? Answer ARespiratory acidosis BRespiratory alkalosis CAnion gap acidosis DLactic acidosis EDiabetic ketoacidosis |
ARespiratory acidosis |
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KG is an elderly female with osteoporosis, hypertension and glaucoma. She picks up her blood pressure pills and glaucoma drops at the pharmacy near her home. This patient has a Medicare Plan, which covers her inpatient and outpatient medication costs. The pharmacy bills the costs for the hypertension and glaucoma medications to the following Medicare program: Answer APart A BPart B CPart C DPart D EPart E |
DPart D |
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TG, a 72 year-old Hispanic male is hospitalized with a pulmonary embolism. He is receiving unfractionated heparin for VTE treatment. His lab values were all within normal values when he was admitted. The lab values below were taken on day #5 of the hospitalization. Which of the following lab values are most indicative of an acute decline in renal function?
WBC: 11 (3.5-12) HGB: 16.1(13.4-17.7) HCT: 48.2 (40-53) MCV: 93 (80-97) PLT: 73 (150-420) Glucose: 149 (<199 mg/dl) Chloride: 103 (96-108 mmol/L) HCO3: 27 (24-30 mmol/L) Sodium: 141 (135-145 mmol/L) Potassium: 5.2 (3.5-5 mmol/L) BUN: 26 (6-23 mg/dL) Creatinine: 1.9 (0.7-1.6 mg/dL) Calcium: 9.1 (8.5-10.5mg/dl) PO4: 2.9 (2.5-4.5 mg/dL) Uric acid: 6.6 (2.5-8.5 mg/dL) AST: 20 (0-41 U/L) ALT: 28 (0-41 U/L) Alkaline Phosphate: 85 (45-140 U/L) LDH: 228 (110-220 U/L) Bili, T: 0.5 (0.0-1.6 mg/dL) Protein, T: 7.3 (6.0-8.5 g/dL) Albumin: 3.2 (3.5-5.0 g/dL) Cholesterol: 212 (60-200 mg/dL) Answer ABUN, creatinine, LDH BBUN, creatinine, ALT CBUN, creatinine, albumin DBUN, creatinine, potassium EBUN, creatinine, cholesterol |
DBUN, creatinine, potassium |
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A 50 year-old male with chest pain has presented to the emergency department. After initial questioning the patient is placed in a room for evaluation. The blood pressure is elevated at 192/118 mmHg.
Chest exam: No sign of trauma evident, chest wall is nontender and symmetrical. Circulation: Pulse is rapid and regular; skin is cool, clammy and pale.
The notes above should be entered into this section of the medical record: Answer ASubjective BObjective CAssessment DPlan EDiagnostic Tests |
BObjective |
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Which of the following technologies has helped the most in eliminating the problem of drug errors due to prescriber's sloppy handwriting? Answer ABar coding BADCs CCPOE DHIPAA EThe SOAP format |
CCPOE |
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A 44 year-old Asian female with a history of non-Hodgkin's lymphoma received several cycles of chemotherapy. The patient was in remission for 11 years until recently when she presented with relapse. She was admitted for inpatient chemotherapy. The patient received the CODOX-M/VAC regimen (cyclophosphamide, doxorubicin, methotrexate, etoposide, and cytarabine). During the hospitalization she developed sepsis which was positive for Streptococcus viridans and was treated with levofloxacin 500 mg IV Q daily. The patient is found to have decreased serum folate levels. The clinical pharmacist participating in the medical rounds is asked if any of the inpatient medications could have contributed to the low folate levels. Select the best response: Answer AThe most likely drug contributing to the decrease in folate is levofloxacin. BThe most likely drug contributing to the decrease in folate is cytarabine. CThe most likely drug contributing to the decrease in folate is cyclophosphamide. DThe most likely drug contributing to the decrease in folate is methotrexate. EThe most likely drug contributing to the decrease in folate is doxorubicin. |
DThe most likely drug contributing to the decrease in folate is methotrexate. |
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The time that is generally preferred to take drug levels (for most drugs) is called: Answer AThe equilibrium level BThe peak CThe trough DThe therapeutic index ESteady-state |
ESteady-state |
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SS is an 80 year-old Asian female being treated for S. aureus bacteremia. She is receiving Cubicin at a dose of 6 mg/kg at 0800 daily. Of the following lab values, which is most essential to monitor in this patient? Answer ACBC with differential BAlkaline phosphotase CCreatinine phosphokinase DTPMT EELISA test
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CCreatinine phosphokinase |
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The pharmacist on rounds has a patient with an acid-base imbalance. The pharmacist has calculated the patient's anion gap. Why is this calculation performed? Answer ATo identify if the patient has an anion-gap or non-anion-gap induced renal toxicity. BTo identify if the patient has an anion-gap or non-anion-gap induced hepatotoxicity. CTo identify if the patient has an anion-gap or non-anion-gap metabolic alkalosis. DTo identify if the patient has an anion-gap or non-anion-gap metabolic acidosis. ETo identify if the patient has an anion-gap or non-anion-gap lactic acidosis. |
DTo identify if the patient has an anion-gap or non-anion-gap metabolic acidosis. |
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LM is a 55 year-old female with a history of anxiety, hypertension and rheumatoid arthritis. She has been treated with prednisone and methotrexate was recently diagnosed with multiple myeloma. The patient initially presented to her primary care doctor with bilateral ankle edema and a 28 pound weight gain. She was found to be in acute renal failure and was admitted for further evaluation. Abnormal laboratory findings included an elevated serum creatinine, BNP and white blood cell count. The elevated BNP will warrant assessment by the following team: Answer APulmonary BNephrology CCardiac DDermatology EOrthopedic |
CCardiac |
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RM is a 48 year-old female patient who is hospitalized with chest pain and shortness of breath. She uses many drugs, including Cozaar, Coumadin, Coreg, Lasix and Micro-K. An INR is taken and is reported as a critical lab value. At this hospital the critical value for warfarin is an INR ≥ 4. Select the best definition of a critical value from the choices below: Answer AA value that can be life-threatening if corrective action is not taken quickly. BA value that can cause the patient to suffer physical or psychological harm. CA value that has to be acted on within 6 hours. DA value that has to be acted on within 8 hours |
AA value that can be life-threatening if corrective action is not taken quickly |
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TG, a 72 year-old Hispanic male is hospitalized with a pulmonary embolism. He is receiving unfractionated heparin for VTE treatment. All lab values at entry were within normal values. Which of the following lab values would indicate heparin-induced thrombocytopenia?
WBC: 13.5 (3.5-12) HGB: 16.1(13.4-17.7) HCT: 48.2 (40-53) MCV: 93 (80-97) PLT: 73 (150-420) Glucose: 149 (< 180 mg/dl) Chloride: 103 (96-108 mmol/L) HCO3: 27 (24-30 mmol/L) Sodium: 141 (135-145 mmol/L) Potassium: 5.2 (3.5-5 mmol/L) BUN: 22 (6-23 mg/dL) Creatinine: 1.9 (0.7-1.6 mg/dL) Calcium: 9.1 (8.5-10.5mg/dl) PO4: 2.9 (2.5-4.5 mg/dL) Uric acid: 6.6 (2.5-8.5 mg/dL) AST: 20 (0-41 U/L) ALT: 28 (0-41 U/L) Alkaline Phosphate: 85 (45-140 U/L) LDH: 228 (110-220 U/L) Bili, T: 0.5 (0.0-1.6 mg/dL) Protein, T: 7.3 (6.0-8.5 g/dL) Albumin: 3.2 (3.5-5.0 g/dL) Cholesterol: 212 (60-200 mg/dL) Answer AThe hemoglobin BThe hematocrit CThe glucose DThe platelets EThe CBC |
DThe platelets |
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Which of the following drugs should not be dispensed to a patient with known G6PD deficiency? (Select ALL that apply.) Answer ATranexamic acid BTigecycline CChloroquine DDapsone EMethylene blue |
CChloroquine DDapsone EMethylene blue |
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A patient complains of abdominal pain, nausea, itching, dark urine and jaundice. The physician suspects that the bile ducts may be obstructed (closed). Which of the following tests would help confirm the suspicion? Answer ABUN BThiopurine methyltransferase CAlkaline phosphatase DAmylase ELipase
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CAlkaline phosphatase |
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The BMP includes each of the following lab values except: Answer APhosphate BGlucose CBicarbonate DChloride EPotassium |
APhosphate |
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A pharmacist wishes to take a drug level at steady-state. The drug is started on Monday at 14:00 hours. It has a half-life of 8 hours and is dosed twice daily. Of the following options, which is the earliest reasonable time to order a steady-state drug level? Answer ATuesday at 06:00 BTuesday at 12:00 CWednesday at 06:00 DWednesday at 22:00 EThursday at 06:00 |
CWednesday at 06:00 |
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Elaine is beginning amiodarone therapy. She is easily stressed and worried about having another "racing heart and dizziness" or what her doctor said was an "arrhythmia". Elaine uses furosemide and has had hypokalemia in the past. She has been told that her potassium and magnesium need to be within normal limits to keep her heart at a normal rhythm, and that she should try to relax. The physician has decided that she wants to check magnesium and potassium and orders a Basic Metabolic Panel (BMP). Select the correct statement: Answer AThe physician should also order the potassium level; this is not included in the BMP. BThe physician should also order the magnesium level; this is not included in the BMP. CThe potassium level has no effect on the risk of arrhythmia. DThe magnesium level has no effect on the risk of arrhythmia. EThe physician should also order the sodium level; this is not included in the BMP. |
BThe physician should also order the magnesium level; this is not included in the BMP. |
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A drug that is highly protein bound (95% or higher bound to albumin) will have a large change in free drug concentration when the protein level changes. If a patient was using warfarin and the albumin decreased from 2.5 g/dL to 1.5 g/dL what would be expected to happen to the warfarin and the INR result? Answer AThe free warfarin level would increase, and the INR would stay the same. BThe free warfarin level would decrease, which would cause the INR to decrease. CThe free warfarin level would decrease, which would cause the INR to increase. DThe free warfarin level would increase, which would cause the INR to increase. EThe free warfarin level would increase, which would cause the INR to decrease.
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DThe free warfarin level would increase, which would cause the INR to increase. |
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A lab report indicates an elevated CRP. Which of the following causes is most likely? Answer AAcute renal failure BHIV infection CAn inflammatory condition, such as heart failure DProstate cancer EAcute gouty crystallization
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CAn inflammatory condition, such as heart failure |
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Possible causes of a patient's condition will be entered into this section of the SOAP note: Answer ASubjective BObjective CAssessment DPlan EIn the Diagnostic Results Section |
CAssessment |
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Which lab test is used to detect early or mild B12 deficiency? Answer AFolic acid BErythropoietin CReticulocyte count DMethylmalonate (MMA) ETransferrin |
DMethylmalonate (MMA) |
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A patient's albumin level is 2. Which of the following would need to have the level adjusted due to this albumin level? (Select ALL that apply.) Answer AWarfarin BCalcium CPhenytoin DGlatiramer EValproate
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AWarfarin BCalcium CPhenytoin
EValproate |
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Which of the following drugs can contribute to low serum sodium levels? (Select ALL that apply.) Answer ALithobid BDemadex CLexapro DTrileptal ETegretol |
BDemadex CLexapro DTrileptal ETegretol |
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What lab values will be present in a patient with a metabolic acidosis? Answer ALow pH, low serum bicarbonate BLow pH, high serum bicarbonate CHigh pH, low serum bicarbonate DHigh pH, high serum bicarbonate ELow pH, low alkaline phosphatase |
ALow pH, low serum bicarbonate |
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Which of the following medications are known to contribute to drug-induced hemolysis and would require discontinuation in a patient who developed hemolysis after use of the drug? (Select ALL that apply.) Answer AMethyldopa BQuinidine CQuinine DNaloxone ELinezolid |
AMethyldopa BQuinidine CQuinine |
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KG is an elderly female with osteoporosis, hypertension and glaucoma. She picks up her blood pressure pills and glaucoma drops at the pharmacy near her home. KG has come to the pharmacy to get her annual flu shot and to pick up a new walker that was ordered by her physician. The pharmacy bills the costs for the vaccine and the walker to the following Medicare program: Answer APart A BPart B CPart C DPart D EPart E |
BPart B |
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A 50 year-old male has presented in the emergency department with chest pain. Initial assessments include anxiety and hypertension.
The attending physician orders labetalol 10 mg IV and lorazepam 2 mg IV and writes the following notes in the chart:
Refer to cardiac clinic for outpatient care. Refer to psychiatry for anxiety.
What section of the chart note should the medication and referrals be recorded under in order to follow the SOAP note format?
Answer AS BO CA DP EDiagnostic Tests |
DP |
