1. Nurse practitionerIprescriptive authority is regulated by:
1 The National Council of State Boards of Nursing
.
2 The U.S. DrugIEnforcement Administration
.
3 TheIStateIBoardIofINursingIforIeachIstate
.
4 The State Board ofIPharmacy
.
2. The benefits to the patient of having an Advanced Practice Registered Nurse (APRN) prescriberIinclude:
1 Nurses know more about Pharmacology than other prescribers because they take it both in their basic nursing program & in their APRN pr
. ogram.
2 NursesIcareIforItheIpatientIfromIaIholisticIapproachI&IincludeItheIpatientIinIdecisionImakingIregardingItheirIcare.
.
3 APRNs are less likely to prescribe narcotics & other controlled substances.
.
4 APRNs are able to prescribe independently in all states, whereas a physician’s assistant needs to have aIphysician supervising their practice
. .
3. Clinical judgment in prescribing includes:
1 FactoringIinItheIcostItoItheIpatientIofItheImedicationIprescribed
.
2 Always prescribing the newest medication available for the disease process
.
3 H&ing out drug samples to poorIpatients
.
4 Prescribing all genericImedications to cut costs
.
4. Criteria forIchoosing an effective drug for a disorder include:
1. Asking the patient what drug they think would work best for them
2. ConsultingInationallyIrecognizedIguidelinesIforIdiseaseImanagement
3. Prescribing medications that are available as samples before writing a prescription
4. Following U.S. Drug Enforcement Administration guidelines for prescribing
5. Nurse practitionerIpractice may thrive under health-care reform because of:
1 TheIdemonstratedIabilityIofInurseIpractitionersItoIcontrolIcostsI&IimproveIpatientIoutcomes
.
2 The fact that nurse practitioners will be able to practice independently
.
3 The fact that nurseIpractitioners will haveIfull reimbursement under health-care reform
.
4 The ability to shift accountability forIMedicaid to theIstate level
.
, 2 ADVIPharmI|ITextBookI|IStudyGuide
Chapter 2. Review of Basic Principles of Pharmacology
1. A patient’s nutritional intake & laboratory results reflect hypoalbuminemia. This is critical to prescribing because:
1 DistributionIofIdrugsItoItargetItissueImayIbeIaffected.
.
2 The solubility ofItheIdrug will not match theIsite ofIabsorption.
.
3 There will beIless free drugIavailable to generate an effect.
.
4 Drugs boundIto albumin are readily excreted by theIkidneys.
.
2. Drugs that have a significant first-pass effect:
1 Must be given by the enteral (oral) route only
.
2 Bypass the hepatic circulation
.
3 AreIrapidlyImetabolizedIbyItheIliverI&ImayIhaveIlittleIifIanyIdesiredIaction
.
4 AreIconverted by the liver to more activeI& fat-soluble forms
.
3. The route ofIexcretion ofIa volatile drug will likely be the:
1 Kidneys
.
2 Lungs
.
3 Bile & feces
.
4 Skin
.
4. Medroxyprogesterone (Depo Provera) is prescribed intramuscularly (IM) to create a storage reservoir ofIthe drug. Storage reservoirs:
1 Assure that the drug will reach its intended target tissue
.
2 AreItheIreason for givingIloadingIdoses
.
3 IncreaseItheIlengthIofItimeIaIdrugIisIavailableI&Iactive
.
4 AreImost common in collagen tissues
.
5. The NP chooses to give cephalexin every 8 hours based on knowledge of the drug’s:
1 Propensity to go to theItarget receptor
.
2 BiologicalIhalf-life
.
3 Pharmacodynamics
.
4 Safety & sideIeffects
.
6.
Azithromycin dosingIrequires that the first day’s dosage be twice those of the otherI4 days of the prescription. This is considered a loading dose.
A loading dose:
1 RapidlyIachievesIdrugIlevelsIinItheItherapeuticIrange
.
2 Requires four- to five-half-lives to attain
.
3 Is influenced by renal function
.
4 Is directly related to theIdrug circulatingIto theItarget tissues
.
7. The point in time on the drugIconcentration curve that indicates the first sign of a therapeutic effect is the:
,3 ADVIPharmI|ITextBookI|IStudyGuide
1 Minimum adverse effect level
.
2 Peak of action
.
3 OnsetIofIaction
.
4 Therapeutic range
.
8. Phenytoin requires that a trough level be drawn. Peak & trough levels are done:
1 When theIdrug has a wideItherapeutic range
.
2 When theIdrug will beIadministered forIaIshort time only
.
3 When there is aIhighIcorrelation between the dose & saturation of receptorIsites
.
4 ToIdetermineIifIaIdrugIisIinItheItherapeuticIrange
.
9. A laboratory result indicates that the peak level forIa drug is above the minimum toxic concentration. This means that the:
1 Concentration will produce therapeutic effects
.
2 ConcentrationIwillIproduceIanIadverseIresponse
.
3 Time between doses must be shortened
.
4 Duration ofIaction of the drugIis too long
.
10. Drugs that are receptorIagonists may demonstrate what property?
1 Irreversible binding to the drugIreceptor site
.
2 Upregulation with chronicIuse
.
3 DesensitizationIorIdownregulationIwithIcontinuousIuse
.
4 InverseIrelationship between drugIconcentration & drug action
.
11. Drugs that are receptor antagonists, such as beta blockers, may cause:
1 Downregulation of the drugIreceptor
.
2 AnIexaggeratedIresponseIifIabruptlyIdiscontinued
.
3 Partial blockade ofItheIeffects of agonist drugs
.
4 An exaggerated response to competitive drug agonists
.
12. Factors that affect gastric drug absorption include:
1 LiverIenzyme activity
.
2 Protein-bindingIproperties of the drugImolecule
.
3 LipidIsolubilityIofItheIdrug
.
4 Ability to chew & swallow
.
13. Drugs administered via IV:
1 Need to beIlipid soluble in order to beIeasily absorbed
.
2 BeginIdistributionIintoItheIbodyIimmediately
.
3 Are easily absorbed ifIthey are nonionized
.
4 May useIpinocytosis to be absorbed
.
, 4 ADVIPharmI|ITextBookI|IStudyGuide
14. When a medication is added to a regimen for a synergistic effect, the combined effect of the drugs is:
1 The sum ofItheIeffects of each drug individually
.
2 GreaterIthanItheIsumIofItheIeffectsIofIeachIdrugIindividually
.
3 Less than the effect of each drug individually
.
4 Not predictable, as it varies with each individual
.
15. Which of the following statements about bioavailability is true?
1 BioavailabilityIissuesIareIespeciallyIimportantIforIdrugsIwithInarrowItherapeuticIrangesIorIsustained-
. releaseImechanisms.
2 All brands of a drugIhaveItheIsame bioavailability.
.
3 Drugs that areIadministered moreIthan once a day have greater bioavailability than drugs given onceIdaily.
.
4 CombiningIan active drug with an inert substance does not affect bioavailability.
.
16. Which of the following statements about the major distribution barriers (blood-brain or fetal-placental) is true?
1 Water soluble & ionized drugs cross these barriers rapidly.
.
2 TheIblood-brainIbarrierIslowsItheIentryIofImanyIdrugsIintoI&IfromIbrainIcells.
.
3 The fetal-placental barrierIprotects the fetus from drugs taken by theImother.
.
4 Lipid-soluble drugs do not pass these barriers & are safe forIpregnant women.
.
17. Drugs are metabolized mainly by the liver via phase I or phase II reactions. The purpose of both of these types of reactions is to:
1 Inactivate prodrugs before they can be activated by target tissues
.
2 ChangeItheIdrugs soIthey can cross plasma membranes
.
3 ChangeIdrugImoleculesItoIaIformIthatIanIexcretoryIorganIcanIexcrete
.
4 MakeIthese drugs moreIionized & polarIto facilitate excretion
.
18. Once they have been metabolized by the liver, the metabolites may be:
1. More active than the parent drug
2. Less active than the parent drug
3. Totally “deactivated” so they are excreted without any effect
4. AllIofItheIabove
19.
All drugs continue to act in the body until they are changed or excreted. The ability of the body to excrete drugs via the renal system would be i
ncreased by:
1 Reduced circulation & perfusion ofItheIkidney
.
2 Chronic renal disease
.
3 Competition forIaItransport site by another drug
.
4 UnbindingIaInonvolatileIdrugIfromIplasmaIproteins
.
20. Steady state is:
1. The point on the drug concentration curve when absorption exceeds excretion
2. WhenItheIamountIofIdrugIinItheIbodyIremainsIconstant
3. When the amount ofIdrug in the body stays below the minimum toxic concentration
4. All ofIthe above
21. Two different pain medications are given together for pain relief. The drug—drug interaction is:
1 Synergistic
.
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