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NURS 615 EXAM 1 QUESTIONS AND ANSWER
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NURS 615 EXAM 1 QUESTIONS AND ANSWER
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NURS 615 EXAM 1 QUESTIONS AND ANSWERSNurse practitioner prescriptive authority is regulated by:
1. The National Council of State Boards of Nursing
2. The U.S. Drug Enforcement Administration
3. The State Board of Nursing for each state
4. The State Board of Pharmacy - Answers-3. The State Board of Nursing for each state
The benefits to the patient of having an Advanced Practice Registered Nurse (APRN)
prescriber include:
1. Nurses know more about Pharmacology than other prescribers because they take it
both in their basic nursing program and in their APRN program.
2. Nurses care for the patient from a holistic approach and include the patient in
decision making regarding their care.
3. APRNs are less likely to prescribe narcotics and other controlled substances.
4. APRNs are able to prescribe independently in all states, whereas a physician's
assistant needs to have a physician supervising their practice. - Answers-2. Nurses care
for the patient from a holistic approach and include the patient in decision making
regarding their care.
A patient's nutritional intake and laboratory results reflect hypoalbuminemia. This
is critical to prescribing because:
1. Distribution of drugs to target tissue may be affected.
2. The solubility of the drug will not match the site of absorption.
3. There will be less free drug available to generate an effect.
4. Drugs bound to albumin are readily excreted by the kidneys. - Answers-1. Distribution
of drugs to target tissue may be affected.
Drugs that have a significant first-pass effect:
1. Must be given by the enteral (oral) route only
2. Bypass the hepatic circulation
3. Are rapidly metabolized by the liver and may have little if any desired action
4. Are converted by the liver to more active and fat-soluble forms - Answers-3. Are
rapidly metabolized by the liver and may have little if any desired action
The route of excretion of a volatile drug will likely be the:
1. Kidneys
2. Lungs
3. Bile and feces
4. Skin - Answers-2. Lungs
,Medroxyprogesterone (Depo Provera) is prescribed intramuscularly (IM) to create a
storage reservoir of the drug. Storage reservoirs:
1. Assure that the drug will reach its intended target tissue
2. Are the reason for giving loading doses
3. Increase the length of time a drug is available and active
4. Are most common in collagen tissues - Answers-3. Increase the length of time a drug
is available and active
Clinical judgment in prescribing includes:
1. Factoring in the cost to the patient of the medication prescribed
2. Always prescribing the newest medication available for the disease process
3. Handing out drug samples to poor patients
4. Prescribing all generic medications to cut costs - Answers-1. Factoring in the cost to
the patient of the medication prescribed
Criteria for choosing an effective drug for a disorder include:
1. Asking the patient what drug they think would work best for them
2. Consulting nationally recognized guidelines for disease management
3. Prescribing medications that are available as samples before writing a prescription
4. Following U.S. Drug Enforcement Administration guidelines for prescribing - Answers-
2. Consulting nationally recognized guidelines for disease management
Nurse practitioner practice may thrive under health-care reform because of:
1. The demonstrated ability of nurse practitioners to control costs and improve patient
outcomes
2. The fact that nurse practitioners will be able to practice independently
3. The fact that nurse practitioners will have full reimbursement under health-care
reform
4. The ability to shift accountability for Medicaid to the state level - Answers-1. The
demonstrated ability of nurse practitioners to control costs and improve patient
outcomes
The NP chooses to give cephalexin every 8 hours based on knowledge of the drug's:
1. Propensity to go to the target receptor
2. Biological half-life
3. Pharmacodynamics
4. Safety and side effects - Answers-2. Biological half-life
Azithromycin dosing requires that the first day's dosage be twice those of the other
4 days of the prescription. This is considered a loading dose. A loading dose:
,1. Rapidly achieves drug levels in the therapeutic range
2. Requires four- to five-half-lives to attain
3. Is influenced by renal function
4. Is directly related to the drug circulating to the target tissues - Answers-1. Rapidly
achieves drug levels in the therapeutic range
The point in time on the drug concentration curve that indicates the first sign of a
therapeutic effect is the:
1. Minimum adverse effect level
2. Peak of action
3. Onset of action
4. Therapeutic range - Answers-3. Onset of action
Phenytoin requires that a trough level be drawn. Peak and trough levels are done:
1. When the drug has a wide therapeutic range
2. When the drug will be administered for a short time only
3. When there is a high correlation between the dose and saturation of receptor sites
4. To determine if a drug is in the therapeutic range - Answers-4. To determine if a drug
is in the therapeutic range
A laboratory result indicates that the peak level for a drug is above the minimum toxic
concentration. This means that the:
1. Concentration will produce therapeutic effects
2. Concentration will produce an adverse response
3. Time between doses must be shortened
4. Duration of action of the drug is too long - Answers-2. Concentration will produce an
adverse response
Drugs that are receptor agonists may demonstrate what property?
1. Irreversible binding to the drug receptor site
2. Upregulation with chronic use
3. Desensitization or downregulation with continuous use
4. Inverse relationship between drug concentration and drug action - Answers-3.
Desensitization or downregulation with continuous use
Drugs that are receptor antagonists, such as beta blockers, may cause:
1. Downregulation of the drug receptor
2. An exaggerated response if abruptly discontinued
3. Partial blockade of the effects of agonist drugs
, 4. An exaggerated response to competitive drug agonists - Answers-2. An exaggerated
response if abruptly discontinued
Factors that affect gastric drug absorption include:
1. Liver enzyme activity
2. Protein-binding properties of the drug molecule
3. Lipid solubility of the drug
4. Ability to chew and swallow - Answers-3. Lipid solubility of the drug
Drugs administered via IV:
1. Need to be lipid soluble in order to be easily absorbed
2. Begin distribution into the body immediately
3. Are easily absorbed if they are nonionized
4. May use pinocytosis to be absorbed - Answers-2. Begin distribution into the body
immediately
When a medication is added to a regimen for a synergistic effect, the combined effect of
the drugs is:
1. The sum of the effects of each drug individually
2. Greater than the sum of the effects of each drug individually
3. Less than the effect of each drug individually
4. Not predictable, as it varies with each individual - Answers-2. Greater than the sum of
the effects of each drug individually
Which of the following statements about bioavailability is true?
1. Bioavailability issues are especially important for drugs with narrow therapeutic
ranges or sustained-release mechanisms.
2. All brands of a drug have the same bioavailability.
3. Drugs that are administered more than once a day have greater bioavailability than
drugs given once daily.
4. Combining an active drug with an inert substance does not affect bioavailability. -
Answers-1. Bioavailability issues are especially important for drugs with narrow
therapeutic
Which of the following statements about the major distribution barriers (blood-
brain or fetal-placental) is true?
1. Water soluble and ionized drugs cross these barriers rapidly.
2. The blood-brain barrier slows the entry of many drugs into and from brain cells.
3. The fetal-placental barrier protects the fetus from drugs taken by the mother.
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