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NR508 adavanced pharmacology Final practice Questions and answers
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- Chamberlain College Of Nursing
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Chapter 1NR508 adavanced pharmacology Final practice Questions and answers1.Nurse practitioner prescriptive authority is regulated by:1The National Council of State Boards of Nursing
.2The U.S. Drug Enforcement Administration
.
3The State Board of Nursing for each state
.4The State Board of Pharmacy
.
2.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.
3.Clinical judgment in prescribing includes:1.Factoring in the cost to the patient of the medication prescribed2.Always prescribing the newest medication available for the disease process3.Handing out drug samples to poor patients
4.Prescribing all generic medications to cut costs
4.Criteria for choosing an effective drug for a disorder include:1.Asking the patient what drug they think would work best for them2.Consulting nationally recognized guidelines for disease management3.Prescribing medications that are available as samples before writing a prescription
4.Following U.S. Drug Enforcement Administration guidelines for prescribing
5.Nurse practitioner practice may thrive under health-care reform because of:1.The demonstrated ability of nurse practitioners to control costs and improve patient outcomes2.The fact that nurse practitioners will be able to practice independently
3.The fact that nurse practitioners will have full reimbursement under health-
care reform4.The ability to shift accountability for Medicaid to the state level
Chapter 2. Review of Basic Principles of Pharmacology
1.Apatient’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.
2.Drugs that have a significant first-pass effect:1.Must be given by the enteral (oral) route only2.Bypass the hepatic circulation
3.Are rapidly metabolized by the liver and may have little if any desired action4.Are converted by the liver to more active and fat-soluble forms
3.The route of excretion of a volatile drug will likely be the:1.Kidneys2.Lungs
3.Bile and feces4.Skin
4.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 tissue2.Are the reason for giving loading doses
3.Increase the length of time a drug is available and active4.Are most 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 the target receptor
2.Biological half-life3.Pharmacodynamics4.Safety and side effects
6.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 range2.Requires four- to five-half-lives to attain3.Is influenced by renal function4.Is directly related to the drug circulating to the target tissues
7.The point in time on the drug concentration curve that indicates the first sign of a therapeutic effect is the:1.Minimum adverse effect level2.Peak of action
3.Onset of action4.Therapeutic range
8.Phenytoin requires that a trough level be drawn. Peak and trough levels are done:1.When the drug has a wide therapeutic range2.When the drug will be administered for a short time only3.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
9.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 response3.Time between doses must be shortened4.Duration of action of the drug is too long
10.Drugs that are receptor agonists may demonstrate what property?1.Irreversible binding to the drug receptor site2.Upregulation with chronic use
3.Desensitization or downregulation with continuous use4.Inverse relationship between drug concentration and drug action
11.Drugs that are receptor antagonists, such as beta blockers, may cause:1.Downregulation of the drug receptor
2.An exaggerated response if abruptly discontinued3.Partial blockade of the effects of agonist drugs4.An exaggerated response to competitive drug agonists
12.Factors that affect gastric drug absorption include:1.Liver enzyme activity2.Protein-binding properties of the drug molecule
3.Lipid solubility of the drug4.Ability to chew and swallow
13.Drugs administered via IV:1.Need to be lipid soluble in order to be easily absorbed
2.Begin distribution into the body immediately3.Are easily absorbed if they are nonionized4.May use pinocytosis to be absorbed
14.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 individually3.Less than the effect of each drug individually4.Not predictable, as it varies with each individual
15.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.
16.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.4.Lipid-soluble drugs do not pass these barriers and are safe for pregnant 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 tissues2.Change the drugs so they can cross plasma membranes
3.Change drug molecules to a form that an excretory organ can excrete4.Make these drugs more ionized and polar to facilitate excretion
18.Once they have been metabolized by the liver, the metabolites may be:1.More active than the parent drug2.Less active than the parent drug3.Totally “deactivated” so they are excreted without any effect
4.All of the above
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 increased by:1.Reduced circulation and perfusion of the kidney2.Chronic renal disease3.Competition for a transport site by another drug
4.Unbinding a nonvolatile drug from plasma proteins
20.Steady state is:1.The point on the drug concentration curve when absorption exceeds excretion
2.When the amount of drug in the body remains constant
3.When the amount of drug in the body stays below the minimum toxic
concentration4.All of the above
21.Two different pain medications are given together for pain relief. The drug—drug interaction is:1.Synergistic2.Antagonistic3.Potentiative
4.Additive
22.Actions taken to reduce drug—drug interaction problems include all of the following EXCEPT:1.Reducing the dosage of one of the drugs2.Scheduling their administration at different times
3.Prescribing a third drug to counteract the adverse reaction of the combination4.Reducing the dosage of both drugs
23.Phase I oxidative-reductive processes of drug metabolism require certain nutritional elements. Which of the following would reduce or inhibit this process?1.Protein malnutrition2.Iron-deficiency anemia3.Both 1 and 2
4.Neither 1 nor 2
24.The time required for the amount of drug in the body to decrease by 50% is called:1.Steady state
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