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11 - ANTIHYPERTENSIVE

 

11 - ANTIHYPERTENSIVE


Item Number: 11201 correct answer: 4 category: Antihypertensives

1. Gynecomastia, hyperkalemia, and menstrual abnormalities are potential adverse

effects associated with:

A. amiloride

B. captopril

C. triamterene

D. spironolactone

1. A,B,C

2. A,C

3. B,D

4. D only

5. All are correct

Item Number: 11218 correct answer: 2 category: Antihypertensives

2. Diuretics which may result in hyperkalemia when used in a patient also

receiving potassium supplementation include:

A. amiloride

B. mannitol

C. triamterene

D. bumetanide

1. A,B,C

2. A,C

3. B,D

4. D only

5. All are correct

Item Number: 11220 correct answer: 1 category: Antihypertensives

3. Metabolic alkalosis may be a complication of the administration of:

A. hydrochlorothiazide

B. bumetanide

C. furosemide

D. acetazolamide

1. A,B,C

2. A,C

3. B,D

4. D only

5. All are correct

Item Number: 11244 correct answer: 2 category: Antihypertensives

4. Beta blockers which are relatively cardioselective include:

A. metoprolol

B. pindolol

C. atenolol

D. timolol

1. A,B,C

2. A,C

3. B,D

4. D only

5. All are correct

Item Number: 11288 correct answer: 2 category: Antihypertensives

5. Reflex tachycardia is not likely to occur during therapy with:

A. clonidine

B. diazoxide

C. reserpine

D. minoxidil

1. A,B,C

2. A,C

3. B,D

4. D only

5. All are correct

Item Number: 11308 correct answer: 3 category: Antihypertensives

6. Beta blockers which may be less likely to produce CNS-related adverse effects

include

A. metoprolol

B. nadolol

C. timolol

D. atenolol

1. A,B,C

2. A,C

3. B,D

4. D only

5. All are correct

Item Number: 11316 correct answer: 4 category: Antihypertensives

7. Guanadrel is pharmacologically similar to:

A. clonidine

B. guanabenz

C. methyldopa

D. guanethidine

1. A,B,C

2. A,C

3. B,D

4. D only

5. All are correct

Item Number: 11335 correct answer: 1 category: Antihypertensives

8. Adverse effects associated with guanethidine include:

A. orthostatic hypotension

B. enhanced sensitivity to sympathomimetics

C. diarrhea

D. sedation

1. A,B,C

2. A,C

3. B,D

4. D only

5. All are correct

Item Number: 11340 correct answer: 2 category: Antihypertensives

9. Adverse effects associated with hydralazine include:

A. reflex tachycardia

B. hypertrichosis

C. lupus syndrome

D. orthostatic hypotension

1. A,B,C

2. A,C

3. B,D

4. D only

5. All are correct

Item Number: 11341 correct answer: 2 category: Antihypertensives

10. Risk factors associated with increased risk of toxicity during captopril

therapy include:

A. bilateral renal artery stenosis

B. congestive heart failure

C. systemic lupus erythematosus

D. female gender

1. A,B,C

2. A,C

3. B,D

4. D only

5. All are correct

Item Number: 684 correct answer: 4 category: Antihypertensives

11. Diazoxide, a drug used for treatment of hypertensive crises, is most closely

related to:

1. nitrofuran

2. sulfonamides

3. dopamine antagonists

4. thiazide diuretics

5. nitrates

Item Number: 807 correct answer: 2 category: Antihypertensives

12. Which of the following drugs is(are) known to induce hyperuricemia and

occasionally to bring about an acute gouty attack?

1. salicylates (6 grams per day)

2. chlorothiazide

3. phenytoin

4. spironolactone

5. All of the above

Item Number: 1186 correct answer: 4 category: Antihypertensives

13. Undesirable side effects of reserpine include:

1. bradycardia

2. postural hypotension

3. diarrhea

4. All of the above

5. None of the above

Item Number: 1858 correct answer: 3 category: Antihypertensives

14. Propranolol may cause all of the following EXCEPT:

1. bradycardia

2. bronchiolar constriction

3. hyperglycemia

4. reduced myocardial contractility

5. prevention of the dilation of vessels caused by circulating epinephrine

Item Number: 2883 correct answer: 5 category: Antihypertensives

15. Alpha methyldopa has been used successfully in the control of hypertension.

Side effects include all of the following, EXCEPT:

1. positive direct Coomb's test

2. diarrhea

3. hemolytic anemia

4. fever

5. nephrotic syndrome

Item Number: 3538 correct answer: 3 category: Antihypertensives

16. A 48-year old salesman with known hypertension complains of a decreasing

annual income, a loss of "drive", and a depressed outlook on life. His blood

pressure is normal on medication. The antihypertensive drug most likely to be

the cause of his new complaints is:

1. hydralazine

2. alpha methyldopa

3. reserpine

4. hydrochlorothiazide

5. guanethidine

Item Number: 6258 correct answer: 1 category: Antihypertensives

17. Side effects of medications are often responsible for a patient not complying

with the prescribed drug regimen. An agent which has somnolence as a primary

side effect is:

1. methyldopa

2. hydralazine

3. guanethidine

4. 1,2

5. 1,3

Item Number: 6259 correct answer: 4 category: Antihypertensives

18. One of the mechanisms for 'resistance" to an antihypertensive drug regimen is

a retention of salt and water and an increase in extracellular fluid volume.

Agents which have been shown to cause retention of salt and water include:

1. methyldopa

2. clonidine

3. guanethidine

4. All of the above

5. 1,2

Item Number: 6273 correct answer: 4 category: Antihypertensives

19. Clonidine hydrochloride lowers blood pressure by reducing sympathetic tone.

It is believed to act by inhibiting sympathetic outflow from the vasomotor

center in the medulla. A potentially serious adverse reaction that has been

reported is:

1. ventricular fibrillation

2. anaphylaxis

3. irreversible nephrotoxicity

4. withdrawal syndrome resembling hypertensive crisis

5. systemic lupus erythematosus

Item Number: 6274 correct answer: 4 category: Antihypertensives

20. Propranolol produces most of its important effects by antagonizing the beta

adrenergic effects of catecholamines released by sympathetic nerve stimulation

or from the adrenal medulla. It therefore results in all of the following

EXCEPT:

1. negative inotropic effect on the heart

2. bronchoconstriction

3. lowering plasma renin activity

4. hyperglycemia

5. negative chronotropic effect on the heart

Item Number: 7929 correct answer: 3 category: Antihypertensives

21. The antihypertensive agent most likely to increase cardiac output is:

1. chlorothiazide

2. reserpine

3. hydralazine

4. alpha-methyldopa

5. guanethidine

Item Number: 8117 correct answer: 1 category: Antihypertensives

22. An agent which produces its antihypertensive effect by blocking autonomic

ganglia, thus lowering the sympathetic tone of blood vessels, is:

1. trimethaphan

2. diazoxide

3. phenoxybenzamine

4. reserpine

5. alpha-methyldopa

Item Number: 8236 correct answer: 1 category: Antihypertensives

23. The most useful drugs in the long-term treatment of essential hypertension

are:

1. thiazide diuretics

2. osmotic diuretics

3. mercurial diuretics

4. carbonic anhydrase inhibitors

5. xanthine diuretics

Item Number: 8321 correct answer: 5 category: Antihypertensives

24. Antihypertensive agents that act primarily at arterioles include:

1. hydralazine

2. minoxidil

3. diazoxide

4. nitroglycerin

5. 1,2,3

Item Number: 8332 correct answer: 1 category: Antihypertensives

25. Antihypertensive agents have different modes of action. The expected

onset of action of IV nitroprusside is:

1. seconds

2. several minutes

3. 15 to 30 minutes

4. several hours

5. 12 to 24 hours

Item Number: 8354 correct answer: 4 category: Antihypertensives

26. Antihypertensive agents must be used with caution. The medical condition for

which methyldopa is most contraindicated is:

1. renal insufficiency

2. coronary insufficiency

3. mental depression

4. liver disease

5. asthma

Item Number: 8364 correct answer: 2 category: Antihypertensives

27. Antihypertensive agents must be used with caution. The medical condition for

which hydralazine is most contraindicated is:

1. renal insufficiency

2. coronary insufficiency

3. mental depression

4. liver disease

5. asthma

Item Number: 8375 correct answer: 3 category: Antihypertensives

28. Antihypertensive agents must be used with caution. The medical condition for

which reserpine is most contraindicated is:

1. renal insufficiency

2. coronary insufficiency

3. mental depression

4. liver disease

5. asthma

Item Number: 9618 correct answer: 5 category: Antihypertensives

29. Reduced tissue levels of norepinephrine may result from long-term treatment

with:

1. guanethidine

2. reserpine

3. alpha-methyl-tyrosine

4. All of the above

5. 1,2

Item Number: 11387 correct answer: 1 category: Antihypertensives

30. Propranolol is a potent blocker of beta-adrenergic sympathetic activity. It

has been found to be detrimental, however, in patients with:

1. bronchial asthma

2. hypertension

3. hyperthyroidism

4. atrial fibrillation

5. ventricular arrhythmias

Item Number: 13199 correct answer: 4 category: Antihypertensives

31. It is important to understand the mechanism of action of the various drugs

used in the treatment of hypertension. The antihypertensive action of

propranolol involves all of the following EXCEPT:

1. decreased stroke volume

2. inhibition of renin release

3. central nervous system effect

4. depletion of catecholamines

5. decreased heart rate

Item Number: 13202 correct answer: 4 category: Antihypertensives

32. It is important to understand the side effects of the various antihypertensive

agents. Drugs such as guanethidine that block the function of postganglionic

adrenergic neurons may produce all of the following EXCEPT:

1. orthostatic hypotension

2. bradycardia

3. retrograde ejaculation

4. constipation

5. dry mouth

Item Number: 13701 correct answer: 4 category: Antihypertensives

33. Propranolol is contraindicated in all of the following EXCEPT:

1. bronchial asthma

2. sinus bradycardia

3. second or third degree heart block

4. migraine headache prophylaxis

5. congestive heart failure

Item Number: 13713 correct answer: 4 category: Antihypertensives

34. Which of the following diuretics has a greater antihypertensive activity?

1. hydrochlorothiazide 50 mg

2. chlorothiazide 500 mg

3. spironolactone 100 mg

4. all are equivalent antihypertensive agents

5. 1,2

Item Number: 13717 correct answer: 2 category: Antihypertensives

35. A patient complains of headache and his blood pressure is 120/80. His

medications include hydrochlorothiazide and hydralazine. Which of the

following would seem most likely?

1. The headaches are secondary to thiazide-induced hypokalemia

2. The headaches are secondary to hydralazine therapy

3. The headaches are probably unrelated to drug therapy

4. The headaches are related to hydralazine-induced agranulocytosis

5. 1,2

Item Number: 13718 correct answer: 4 category: Antihypertensives

36. A patient is admitted to the hospital for surgery and has been taking 2.4 mg

of clonidine plus 50 mg hydrochlorothiazide daily for several months prior to

surgery. You would expect in this patient:

1. A low likelihood of problems if the clonidine is continued

2. A possibility of markedly increased blood pressure if the clonidine is

stopped

3. Severe postural hypotension if clonidine is discontinued abruptly

4. 1,2

5. 1,3

Item Number: 13719 correct answer: 5 category: Antihypertensives

37. Drugs which may have their effectiveness diminished if the patient

concomitantly receives a tricyclic antidepressant include:

1. hydralazine

2. guanethidine

3. clonidine

4. 1,2

5. 2,3

Item Number: 13720 correct answer: 4 category: Antihypertensives

38. Tachycardia is a prominent side effect of:

1. diazoxide

2. hydralazine

3. clonidine

4. 1,2

5. 2,3

Item Number: 13722 correct answer: 2 category: Antihypertensives

39. All of the following statements concerning the use of sodium nitroprusside are

true EXCEPT:

1. it is metabolized to thiocyanate

2. it must be given by rapid IV push injection

3. it dilates both arterial and venous vessels

4. 1,3

5. 2,3

Item Number: 488 correct answer: 2 category: Antihypertensives

40. Chronic administration of ethacrynic acid without proper electrolyte

management produces:

1. potassium retention

2. metabolic alkalosis

3. metabolic acidosis

4. excessive inhibition of carbonic anhydrase

5. respiratory alkalosis

Item Number: 578 correct answer: 3 category: Antihypertensives

41. A diuretic agent which has been associated with hearing loss when given

intravenously is:

1. spironolactone

2. triamterene

3. ethacrynic acid

4. chlorothiazide

5. sucrose

Item Number: 579 correct answer: 1 category: Antihypertensives

42. A diuretic agent which has a steroid-like nucleus is:

1. spironolactone

2. triamterene

3. ethacrynic acid

4. chlorothiazide

5. sucrose

Item Number: 580 correct answer: 1 category: Antihypertensives

43. The diuretic agent which acts by inhibiting aldosterone at the distal tubular

renal cell is:

1. spironolactone

2. triamterene

3. ethacrynic acid

4. chlorothiazide

5. bumetanide

Item Number: 581 correct answer: 2 category: Antihypertensives

44. A diuretic agent which is potassium-sparing and does not depend upon the

adrenal cortex for action is:

1. spironolactone

2. triamterene

3. ethacrynic acid

4. chlorothiazide

5. sucrose

Item Number: 583 correct answer: 4 category: Antihypertensives

45. Which of the following diuretic agents may produce hypokalemic alkalosis but

is a very useful drug in the treatment of volume-dependent hypertension?

1. spironolactone

2. triamterene

3. amiloride

4. chlorothiazide

5. sucrose

Item Number: 2787 correct answer: 2 category: Antihypertensives

46. Hypercalcemia following thiazide administration is characterized by which of

the following?

1. hypercalciuria

2. hypocalciuria

3. increased serum phosphorus

4. decreased serum phosphorus

5. increased urinary phosphorus

Item Number: 2804 correct answer: 2 category: Antihypertensives

47. The diuretic agent, furosemide, is known to produce:

1. decreased renin production and aldosterone release

2. increased renal blood flow and glomerular filtration rate

3. redistribution of blood from the renal cortex to the medulla

4. All of the above

5. 1,3

Item Number: 3241 correct answer: 2 category: Antihypertensives

48. Complications of treatment of edema with thiazides include all of the

following EXCEPT:

1. hyperuricemia

2. hyperkalemia

3. hyperglycemia

4. hyponatremia

5. alkalosis

Item Number: 3449 correct answer: 3 category: Antihypertensives

49. Possible consequences of chlorothiazide administration include all of the

following EXCEPT:

1. thrombocytopenia and agranulocytosis

2. jaundice, skin eruptions, and photosensitivities

3. hypoglycemia

4. hypokalemic nephropathy

5. hyperuricemia

Item Number: 3543 correct answer: 4 category: Antihypertensives

50. Which of the following diuretics may cause hyperkalemia:

1. ethacrynic acid

2. mercurials

3. thiazides

4. triamterene

5. acetazolamide

Item Number: 3911 correct answer: 3 category: Antihypertensives

51. The dominant action of the thiazide diuretics (e.g. hydrochlorothiazide)is to

increase the renal excretion of sodium and chloride and an accompanying volume

of water. This results from:

1. alterations in acid-base balance

2. an indirect renal effect

3. inhibition of the tubular mechanisms of electrolyte transport

4. increased glomerular filtration rate

5. inhibition of carbonic anhydrase

Item Number: 3919 correct answer: 3 category: Antihypertensives

52. The oral diuretics are an effective group of drugs in the treatment of

hypertension. The mechanism of action mainly responsible for the reduction of

blood pressure after 2 months of treatment is:

1. reduction in plasma volume

2. reduction in cardiac output

3. drug-induced saluresis

4. reduction in serum potassium concentration

5. effects on the neurotransmission at adrenergic ganglions

Item Number: 4308 correct answer: 4 category: Antihypertensives

53. About 20 percent of adults in north America have arterial blood pressures

above the normal range. The aldosterone antagonist, spironolactone, has been

used to treat hypertension with some success. Side effects of spironolactone

include:

1. hyponatremia

2. azotemia

3. gynecomastia

4. all of the above

5. 1,3

Item Number: 4437 correct answer: 3 category: Antihypertensives

54. The effectiveness of which of the following diuretics is diminished in

metabolic acidosis?

1. triamterene

2. spironolactone

3. acetazolamide

4. All of the above

5. 1,3

Item Number: 4775 correct answer: 3 category: Antihypertensives

55. The inhibition of carbonic anhydrase in proximal renal tubular cells caused by

acetazolamide causes a loss in urine of:

1. hydrogen ions

2. glucose

3. bicarbonate ions

4. glycine

5. None of the above

Item Number: 7278 correct answer: 4 category: Antihypertensives

56. Complications common to ethacrynic acid and thiazides include:

1. alkalosis

2. potassium depletion

3. hyperuricemia

4. All of the above

5. 1,3

Item Number: 7930 correct answer: 5 category: Antihypertensives

57. Hypokalemia may result from all of the following EXCEPT:

1. flumethiazide

2. hydrochlorothiazide

3. chlorthalidone

4. bendroflumethiazide

5. triamterene

Item Number: 8226 correct answer: 5 category: Antihypertensives

58. Hypochloremic alkalosis may result from prolonged use of:

1. furosemide

2. mannitol

3. ethacrynic acid

4. All of the above

5. 1,3

Item Number: 8320 correct answer: 2 category: Antihypertensives

59. Triamterene:

1. antagonizes aldosterone

2. can produce systemic hyperkalemia

3. is classified as a sodium-sparing diuretic

4. is of no clinical usefulness

5. interferes with the diuretic activity of spironolactone

Item Number: 8365 correct answer: 1 category: Antihypertensives

60. Antihypertensive agents must be used with caution. The medical condition for

which spironolactone is most contraindicated is:

1. renal insufficiency

2. coronary insufficiency

3. central depression

4. liver disease

5. asthma

Item Number: 8418 correct answer: 1 category: Antihypertensives

61. With which of the following side effects is spironolactone most closely

identified with?

1. hyperkalemia

2. metabolic acidosis

3. metabolic alkalosis

4. hypoglycemia

5. hypokalemia

Item Number: 8822 correct answer: 3 category: Antihypertensives

62. A diuretic which acts by inhibition of the sodium-hydrogen exchange is:

1. furosemide

2. chlormerodrin

3. acetazolamide

4. mannitol

5. triamterene

Item Number: 10292 correct answer: 2 category: Antihypertensives

63. To achieve smooth reduction of blood pressure, all of the oral diuretics

must be administered at least once daily. Maximum effectiveness is achieved only

after:

1. 1 to 2 weeks

2. 3 to 4 weeks

3. 5 to 6 weeks

4. 7 to 8 weeks

5. 9 to 10 weeks

Item Number: 10293 correct answer: 3 category: Antihypertensives

64. Diuretics may reduce blood pressure through several mechanisms. The critical effect, however, appears to be:

1. reduction of vascular smooth muscle reactivity

2. effect on autonomic control of vascular tone

3. reduction of total body sodium content

4. effect on electrolyte content of arterial tissues

5. reduction of plasma renin activity

Item Number: 11201 correct answer: 4 category: Antihypertensives

65. Gynecomastia, hyperkalemia, and menstrual abnormalities are potential adverse effects associated with:

A. amiloride

B. captopril

C. triamterene

D. spironolactone

1. A,B,C

2. A,C

3. B,D

4. D only

5. All are correct

Item Number: 11218 correct answer: 2 category: Antihypertensives

66. Diuretics which should not be used in a patient also receiving potassium supplementation include:

A. amiloride

B. mannitol

C. triamterene

D. bumetanide

1. A,B,C

2. A,C

3. B,D

4. D only

5. All are correct

Item Number: 11220 correct answer: 1 category: Antihypertensives

67. Metabolic alkalosis is a complication of the administration of:

A. hydrochlorothiazide

B. bumetanide

C. furosemide

D. acetazolamide

1. A,B,C

2. A,C

3. B,D

4. D only

5. All are correct

Item Number: 13710 correct answer: 3 category: Antihypertensives

68. Which of the following drugs may be hazardous if give to a patient receiving spironolactone?

1. epinephrine

2. propranolol

3. potassium chloride

4. monoamine oxidase inhibitors

5. All of the above

Item Number: 13715 correct answer: 1 category: Antihypertensives

69. A side effect of spironolactone, when utilized to treat hypertension is:

1. hyperkalemia

2. acne

3. hypomagnesemia

4. male pattern baldness

5. bronchospasm

Item Number: 13823 correct answer: 1 category: Antihypertensives

70. The principle site of action of furosemide is the:

1. ascending loop of Henle

2. descending loop of Henle

3. proximal tubule

4. distal tubule

5. None of the above

Item Number: 13824 correct answer: 3 category: Antihypertensives

71. The site of action of mannitol is:

1. ascending loop of Henle

2. descending loop of Henle

3. proximal tubule

4. distal tubule

5. None of the above

Item Number: 14202 correct answer: 5 category: Antihypertensives

72. A diuretic which is contraindicated in a patient with hyperkalemia is:

1. acetazolamide

2. chlorothiazide

3. ethacrynic acid

4. furosemide

5. spironolactone


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