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Pharmacology Continuing Education Posttest
DEPARTMENT
Pharmacology Continuing Education
Pharmacology Continuing Education Posttest Kayleen Daly, PharmD, & Elizabeth Farrington, PharmD, FCCP, FCCM, FPPAG, BCPS
Contact hours: 1.0 Passing score: 70% This continuing education activity is administered by the National Association of Pediatric Nurse Practitioners (NAPNAP) as an Agency providing continuing education credit. Individuals who complete this program and earn a 70% or higher score on the post test will be awarded 1.0 NAPNAP contact hour, of which 0.5 is pharmacology content. Earn FREE CE Contact Hours Online Contact hours for this online activity are FREE for NAPNAP members. Non-members will be charged a fee of $10 to receive contact hours for this online activity through PNPSourCE. Payment can be made by credit card through PNPSourCE. 1. To take the Posttest for this article and earn contact hours, please go to PNPSourCESM at www. napnapce.org. 2. In the Course Catalog, search for the name of the CE article.
INSTRUCTIONS To obtain continuing education credit: 1. Read the article carefully. 2. Read each question and determine the correct answer. 3. Visit PNPSourCE, www.napnapce.org, to complete the online posttest and evaluation. 4. You must receive 70% correct responses to receive the certificate. 5. Tests will be accepted up to 12 months from the date of publication.
OBJECTIVES Based on the content of the article, you will be able to: 1. Describe the pathophysiology of potassium homeostasis. 2. Explain the role of potassium in the human body. 3. List the symptoms of hypokalemia and hyperkalemia. 4. Recommend the treatment for hyperkalemia and explain why one treatment regimen might be preferred over another. 5. Recommend the treatment for hypokalemia and explain when one would use intravenous versus oral replacement.
www.jpedhc.org
3. If you already have an account with PNPSourCESM, log in using your user-name and password. If you are a NAPNAP member, log in with your username and password. If you are a first-time user and NAPNAP non-member, click on ‘‘Create New Account.’’ 4. Once you have successfully passed the Posttest and completed the evaluation form, you will be able to print out your certificate immediately.
CE TEST QUESTIONS 1. Which of the following foods has the greatest potassium content? A. Bananas B. Orange juice C. French fries D. Cola 2. What percentage of total body potassium is in the extracellular fluid? A. 2% B. 8% C. 20% D. 98%
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3. Hyperkalemia is most commonly caused by what mechanism? A. Impaired elimination B. Excessive intake C. Increased shift of potassium from intracellular to extracellular space D. ‘‘Pseudo hyperkalemia’’ 4. Hyperkalemia electrocardiographic changes may appear as: A. A prolonged PR interval. B. Widening of the QRS interval. C. Shortening of the QRS interval. D. An inverted T wave. 5. Loss of potassium in children most commonly occurs from which of the following? A. Medications (e.g., diuretics or antibiotics) B. Vomiting or diarrhea C. Constipation D. Incontinence 6. Before administering medication for hypokalemia, which of the following laboratory tests should be obtained? A. Urine potassium B. Serum bicarbonate level C. Blood glucose levels D. Magnesium E. All the above Based on the case presented, answer Questions 7 and 8. Luke is a 15-year-old boy with a medical history of type 2 diabetes, asthma, and seasonal allergies. His current medications are metformin, 1 g twice daily; Singulair, 5 mg daily; albuterol inhaler, 1 puff every 6 hours as needed; and Zyrtec, over the counter daily. Luke was found lying on his bedroom floor and unconscious for an unknown amount of time by his mother. According to assessment in the emergency department (ED), on arrival he is confused and groggy. His weight is 112 kg and his vital signs are as follows: blood pressure, 108/75 mm Hg; pulse, 80 beats per minute; respiratory rate, 16 breaths per minute; and functional oxygen saturation (SpO2, 90% on 2 L of oxygen per nasal cannula). Laboratory results show a potassium level of 6.5 mEq/L, a pH of 7.23, and a blood glucose level of 32 mmol/L. His electrocardiogram appears normal. 7. What is the best option for treating LukeÕs hyperkalemia? A. Calcium chloride, 1 g
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B. Intravenous sodium bicarbonate, 50 mEq over 2 to 5 minutes C. Oral Kayexalate, 30 g D. Intravenous Lasix, 20 mg, followed by oral Lasix, 40 mg 8. Which medication is probably the main reason for LukeÕs hyperkalemia? A. Singulair B. Albuterol C. Zyrtec D. Metformin Based on the case presented, answer Questions 9 and 10. Lewis is a 14-year-old boy who is training to try out for the cross-country team. He has a medical history of attention deficit–hyperactivity disorder (ADHD) and asthma and is allergic to gluten and red dye. He has been an asthmatic since he was 10 years old and has taken ADHD medication since he was 7 years old. His current medications are Adderall XR, 20 mg every morning; Singulair, 5 mg daily; albuterol inhaler, one to two puffs every 6 hours as needed; Align probiotic daily; and a menÕs multivitamin daily. Lewis presents to the emergency department with uncontrollable shaking, muscle weakness, and cramping, and says that his ‘‘heart is beating out of his chest.’’ While questioning him, he admits to taking 10 puffs of albuterol every 30 minutes while he was out on his long run this afternoon. Assessment in the ED showed that his weight was 65 kg and his vital signs were as follows: blood pressure, 195/104 mm Hg; pulse, 182 beats per minute; respiratory rate, 16 breaths per minute; and SPO2, 94% on 2 L of oxygen per nasal cannula. Laboratory results showed a potassium level of 3.0 mEq/L, a pH of 7.4, and a blood glucose level of 220 mmol/L. His electrocardiogram appears normal. 9. What is the cause of LewisÕs ED visit? A. His Adderall XR dose is too high and is causing tachycardia. B. The cold weather has caused his asthma to worsen. C. He is taking too many puffs of his albuterol inhaler, causing hypokalemia. D. He needs an immediate echocardiogram, because he may have heart failure. 10. What is the best treatment option for Lewis? A. Potassium chloride, 40 mEq orally 1 dose B. Kayexalate, 40 mEq orally C. Intravenous fluids with potassium D. Magnesium, 2 g intravenously 1 dose
Journal of Pediatric Health Care
Pharmacology Continuing Education
Pharmacology Continuing Education Posttest Kayleen Daly, PharmD, & Elizabeth Farrington, PharmD, FCCP, FCCM, FPPAG, BCPS
Contact hours: 1.0 Passing score: 70% This continuing education activity is administered by the National Association of Pediatric Nurse Practitioners (NAPNAP) as an Agency providing continuing education credit. Individuals who complete this program and earn a 70% or higher score on the post test will be awarded 1.0 NAPNAP contact hour, of which 0.5 is pharmacology content. Earn FREE CE Contact Hours Online Contact hours for this online activity are FREE for NAPNAP members. Non-members will be charged a fee of $10 to receive contact hours for this online activity through PNPSourCE. Payment can be made by credit card through PNPSourCE. 1. To take the Posttest for this article and earn contact hours, please go to PNPSourCESM at www. napnapce.org. 2. In the Course Catalog, search for the name of the CE article.
INSTRUCTIONS To obtain continuing education credit: 1. Read the article carefully. 2. Read each question and determine the correct answer. 3. Visit PNPSourCE, www.napnapce.org, to complete the online posttest and evaluation. 4. You must receive 70% correct responses to receive the certificate. 5. Tests will be accepted up to 12 months from the date of publication.
OBJECTIVES Based on the content of the article, you will be able to: 1. Describe the pathophysiology of potassium homeostasis. 2. Explain the role of potassium in the human body. 3. List the symptoms of hypokalemia and hyperkalemia. 4. Recommend the treatment for hyperkalemia and explain why one treatment regimen might be preferred over another. 5. Recommend the treatment for hypokalemia and explain when one would use intravenous versus oral replacement.
www.jpedhc.org
3. If you already have an account with PNPSourCESM, log in using your user-name and password. If you are a NAPNAP member, log in with your username and password. If you are a first-time user and NAPNAP non-member, click on ‘‘Create New Account.’’ 4. Once you have successfully passed the Posttest and completed the evaluation form, you will be able to print out your certificate immediately.
CE TEST QUESTIONS 1. Which of the following foods has the greatest potassium content? A. Bananas B. Orange juice C. French fries D. Cola 2. What percentage of total body potassium is in the extracellular fluid? A. 2% B. 8% C. 20% D. 98%
November/December 2013
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3. Hyperkalemia is most commonly caused by what mechanism? A. Impaired elimination B. Excessive intake C. Increased shift of potassium from intracellular to extracellular space D. ‘‘Pseudo hyperkalemia’’ 4. Hyperkalemia electrocardiographic changes may appear as: A. A prolonged PR interval. B. Widening of the QRS interval. C. Shortening of the QRS interval. D. An inverted T wave. 5. Loss of potassium in children most commonly occurs from which of the following? A. Medications (e.g., diuretics or antibiotics) B. Vomiting or diarrhea C. Constipation D. Incontinence 6. Before administering medication for hypokalemia, which of the following laboratory tests should be obtained? A. Urine potassium B. Serum bicarbonate level C. Blood glucose levels D. Magnesium E. All the above Based on the case presented, answer Questions 7 and 8. Luke is a 15-year-old boy with a medical history of type 2 diabetes, asthma, and seasonal allergies. His current medications are metformin, 1 g twice daily; Singulair, 5 mg daily; albuterol inhaler, 1 puff every 6 hours as needed; and Zyrtec, over the counter daily. Luke was found lying on his bedroom floor and unconscious for an unknown amount of time by his mother. According to assessment in the emergency department (ED), on arrival he is confused and groggy. His weight is 112 kg and his vital signs are as follows: blood pressure, 108/75 mm Hg; pulse, 80 beats per minute; respiratory rate, 16 breaths per minute; and functional oxygen saturation (SpO2, 90% on 2 L of oxygen per nasal cannula). Laboratory results show a potassium level of 6.5 mEq/L, a pH of 7.23, and a blood glucose level of 32 mmol/L. His electrocardiogram appears normal. 7. What is the best option for treating LukeÕs hyperkalemia? A. Calcium chloride, 1 g
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B. Intravenous sodium bicarbonate, 50 mEq over 2 to 5 minutes C. Oral Kayexalate, 30 g D. Intravenous Lasix, 20 mg, followed by oral Lasix, 40 mg 8. Which medication is probably the main reason for LukeÕs hyperkalemia? A. Singulair B. Albuterol C. Zyrtec D. Metformin Based on the case presented, answer Questions 9 and 10. Lewis is a 14-year-old boy who is training to try out for the cross-country team. He has a medical history of attention deficit–hyperactivity disorder (ADHD) and asthma and is allergic to gluten and red dye. He has been an asthmatic since he was 10 years old and has taken ADHD medication since he was 7 years old. His current medications are Adderall XR, 20 mg every morning; Singulair, 5 mg daily; albuterol inhaler, one to two puffs every 6 hours as needed; Align probiotic daily; and a menÕs multivitamin daily. Lewis presents to the emergency department with uncontrollable shaking, muscle weakness, and cramping, and says that his ‘‘heart is beating out of his chest.’’ While questioning him, he admits to taking 10 puffs of albuterol every 30 minutes while he was out on his long run this afternoon. Assessment in the ED showed that his weight was 65 kg and his vital signs were as follows: blood pressure, 195/104 mm Hg; pulse, 182 beats per minute; respiratory rate, 16 breaths per minute; and SPO2, 94% on 2 L of oxygen per nasal cannula. Laboratory results showed a potassium level of 3.0 mEq/L, a pH of 7.4, and a blood glucose level of 220 mmol/L. His electrocardiogram appears normal. 9. What is the cause of LewisÕs ED visit? A. His Adderall XR dose is too high and is causing tachycardia. B. The cold weather has caused his asthma to worsen. C. He is taking too many puffs of his albuterol inhaler, causing hypokalemia. D. He needs an immediate echocardiogram, because he may have heart failure. 10. What is the best treatment option for Lewis? A. Potassium chloride, 40 mEq orally 1 dose B. Kayexalate, 40 mEq orally C. Intravenous fluids with potassium D. Magnesium, 2 g intravenously 1 dose
Journal of Pediatric Health Care