Kelly is a 14-year-old patient who presents to the clinic with a classic migraine. She says she is having a headache two to three times a month. The initial plan would be

Question 1 1 / 1 point
Charlie is a 65-year-old male who has been diagnosed with hypertension and benign prostatic hyperplasia. Doxazosin has been chosen to treat his hypertension because it:
Question options:
Increases peripheral vasoconstriction
Decreases detrusor muscle contractility
Lowers supine blood pressure more than standing pressure
Relaxes smooth muscle in the bladder neck
Question 2 1 / 1 point
Which of the following adverse effects are less likely in a beta1-selective blocker?
Question options:
Impaired insulin release
Reflex orthostatic changes
Decreased triglycerides and cholesterol
Question 3 1 / 1 point
Beta blockers have favorable effects on survival and disease progression in heart failure. Treatment should be initiated when the:
Question options:
Symptoms are severe
Patient has not responded to other therapies
Patient has concurrent hypertension
Left ventricular dysfunction is diagnosed
Question 4 1 / 1 point
You are treating a patient with a diagnosis of Alzheimer’s disease. The patient’s wife mentions difficulty with transportation to the clinic. Which medication is the best choice?
Question options:
Question 5 1 / 1 point
Antonia is a 3-year-old child who has a history of status epilepticus. Along with her routine antiseizure medication, she should also have a home prescription for_________ to be used for an episode of status epilepticus.
Question options:
IV phenobarbital
Rectal diazepam (Diastat)
IV phenytoin (Dilantin)
Oral carbamazepine (Tegretol)
Question 6 1 / 1 point
Dwayne has recently started on carbamazepine to treat seizures. He comes to see you and you note that while his carbamazepine levels had been in the therapeutic range, they are now low. The possible cause for the low carbamazepine levels include:
Question options:
Dwayne hasn’t been taking his carbamazepine because it causes insomnia.
Carbamazepine auto-induces metabolism, leading to lower levels in spite of good compliance.
Dwayne was not originally prescribed the correct amount of carbamazepine.
Carbamazepine is probably not the right antiseizure medication for Dwayne.
Question 7 1 / 1 point
Kasey fractured his ankle in two places and is asking for medication for his pain. The appropriate first-line medication would be:
Question options:
Ibuprofen (Advil)
Acetaminophen with hydrocodone (Vicodin)
Oxycodone (Oxycontin)
Oral morphine (Roxanol)
Question 8 1 / 1 point
Jack, age 8, has attention deficit disorder (ADD) and is prescribed methylphenidate (Ritalin). He and his parents should be educated about the side effects of methylphenidate, which are:
Question options:
Slurred speech and insomnia
Bradycardia and confusion
Dizziness and orthostatic hypotension
Insomnia and decreased appetite
Question 9 1 / 1 point
An appropriate first-line drug to try for mild to moderate generalized anxiety disorder would be:
Question options:
Alprazolam (Xanax)
Diazepam (Valium)
Buspirone (Buspar)
Amitriptyline (Elavil)
Question 10 1 / 1 point
David is a 34-year-old patient who is starting on paroxetine (Paxil) for depression. David’s education regarding his medication would include:
Question options:
Paroxetine may cause intermittent diarrhea.
He may experience sexual dysfunction beginning a month after he starts therapy.
He may have constipation and he should increase fluids and fiber.
Paroxetine has a long half-life so he may occasionally skip a dose.
Question 11 1 / 1 point
An appropriate drug for the treatment of depression with anxiety would be:
Question options:
Alprazolam (Xanax)
Escitalopram (Lexapro)
Buspirone (Buspar)
Amitriptyline (Elavil)
Question 12 1 / 1 point
The longer-term Xanax patient comes in and states they need a higher dose of the medication. They deny any additional, new, or accelerating triggers of their anxiety. What is the probable reason?
Question options:
They have become tolerant of the medication, which is characterized by the need for higher and higher doses.
They are a drug seeker.
They are suicidal.
They only need additional counseling on lifestyle modification.
Question 13 1 / 1 point
A first-line drug for abortive therapy in simple migraine is:
Question options:
Sumatriptan (Imitrex)
Naproxen (Aleve)
Butorphanol nasal spray (Stadol NS)
Butalbital and acetaminophen (Fioricet)
Question 14 1 / 1 point
Xi, a 54-year-old female, has a history of migraines that do not respond well to OTC migraine medication. She is asking to try Maxalt (rizatriptan) because it works well for her friend. Appropriate decision making would be:
Question options:
Prescribe the Maxalt, but only give her four tablets with no refills to monitor the use.
Prescribe Maxalt and arrange to have her observed in the clinic or urgent care with the first dose.
Explain that rizatriptan is not used for postmenopausal migraines and recommend Fiorinal (aspirin and butalbital).
Prescribe sumatriptan (Imitrex) with the explanation that it is the most effective triptan.
Question 15 1 / 1 point
Kelly is a 14-year-old patient who presents to the clinic with a classic migraine. She says she is having a headache two to three times a month. The initial plan would be:
Question options:
Prescribe NSAIDs as abortive therapy and have her keep a headache diary to identify her triggers.
Prescribe zolmitriptan (Zomig) as abortive therapy and recommend relaxation therapy to reduce her stress.
Prescribe acetaminophen with codeine (Tylenol #3) for her to take at the first onset of her migraine.
Prescribe sumatriptan (Imitrex) nasal spray and arrange for her to receive the first dose in the clinic.
Question 16 1 / 1 point
James has been diagnosed with cluster headaches. Appropriate acute therapy would be:
Question options:
Butalbital and aspirin (Fiorinal)
Meperidine IM (Demerol)
Oxygen 100% for 15 to 30 minutes
Indomethacin (Indocin)
Question 17 1 / 1 point
If interventions to resolve the cause of pain (e.g., rest, ice, compression, and elevation) are insufficient, pain medications are given based on the severity of pain. Drugs are given in which order of use?
Question options:
NSAIDs, opiates, corticosteroids
Low-dose opiates, salicylates, increased dose of opiates
Opiates, non-opiates, increased dose of non-opiate
Non-opiate, increased dose of non-opiate, opiate
Question 18 1 / 1 point
Chemical dependency assessment is integral to the initial assessment of chronic pain. Which of the following raises a “red flag” about potential chemical dependency?
Question options:
Use of more than one drug to treat the pain
Multiple times when prescriptions are lost with requests to refill
Preferences for treatments that include alternative medicines
Presence of a family member who has abused drugs
Question 19 1 / 1 point
The Pain Management Contract is appropriate for:
Question options:
Patients with cancer who are taking morphine
Patients with chronic pain who will require long-term use of opiates
Patients who have a complex drug regimen
Patients who see multiple providers for pain control
Question 20 1 / 1 point
Which of the following statements is true about age and pain?
Question options:
Use of drugs that depend heavily on the renal system for excretion may require dosage adjustments in very young children.
Among the NSAIDs, indomethacin is the preferred drug because of lower adverse effects profiles than other NSAIDs.
Older adults who have dementia probably do not experience much pain due to loss of pain receptors in the brain.
Acetaminophen is especially useful in both children and adults because it has no effect on platelets and has fewer adverse effects than NSAID

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