TEST BANK - PHARMACOTHERAPEUTICS FOR ADVANCED
PRACTICE NURSE PRESCRIBERS, 6TH EDITION (WOO, 2024),
CHAPTER 1-57 | ALL CHAPTER
Chapter 1. The Role of the Nurse
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PractitionerMultiple Choice
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Identify the choice that best completes the statement or answers the question.
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r rr 1. Nurse practitioner prescriptive authority is regulated by:
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1. The National Council of State Boards of Nursing
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2. The U.S. Drug Enforcement Administration
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3. The State Board of Nursing for each state
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4. The State Board of Pharmacy
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r rr 2. The benefits to the patient of having an Advanced Practice Registered Nurse
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(APRN) prescriberinclude:
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1. Nurses know more about Pharmacology than other prescribers
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because they take itboth in their basic nursing program and in
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their APRN program.
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2. Nurses care for the patient from a holistic approach and include the patient in
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decision making regarding their care. r r r r
3. APRNs are less likely to prescribe narcotics and other controlled substances.
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4. APRNs are able to prescribe independently in all states,
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whereas a physician’sassistant needs to have a physician
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supervising their practice.
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r rr 3. Clinical judgment in prescribing includes:
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1. Factoring in the cost to the patient of the medication prescribed
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2. Always prescribing the newest medication available for the disease process
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3. Handing out drug samples to poor patients r r r r r r
4. Prescribing all generic medications to cut costs r r r r r r
r rr 4. Criteria for choosing an effective drug for a disorder include:
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1. Asking the patient what drug they think would work best for them
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2. Consulting nationally recognized guidelines for disease management r r r r r r
3. Prescribing medications that are available as samples before writing a r r r r r r r r r
prescription r
4. Following U.S. Drug Enforcement Administration guidelines for prescribing
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r rr 5. Nurse practitioner practice may thrive under health-care reform because of:
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1. The demonstrated ability of nurse practitioners to control costs
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,ASAAS
and improve patientoutcomes
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2. The rfact rthat rnurse rpractitioners rwill rbe rable rto rpractice rindependently
3. The rfact rthat rnurse rpractitioners rwill rhave rfull rreimbursement
under health-carereform
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4. The ability to shift accountability for Medicaid to the state level
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Chapter 1. The Role of the Nurse
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PractitionerAnswer Section
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MULTIPLE CHOICE r
1. ANS: r r r 3 PTS: r 1
2. ANS: r r r 2 PTS: r 1
3. ANS: r r r 1 PTS: r 1
4. ANS: r r r 2 PTS: r 1
5. ANS: r r r 1 PTS: r 1
Chapter 2. Review of Basic Principles of
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rPharmacologyMultiple Choice r r
Identify the choice that best completes the statement or answers the question.
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r rr 1. A patient’s nutritional intake and laboratory results reflect
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hypoalbuminemia. This is critical toprescribing because:
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1. Distribution of drugs to target tissue may be affected. r r r r r r r r
2. The solubility of the drug will not match the site of absorption.
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3. There will be less free drug available to generate an effect.
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4. Drugs bound to albumin are readily excreted by the kidneys.
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r rr 2. Drugs that have a significant first-pass effect:
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1. Must be given by the enteral (oral) route only
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2. Bypass the hepatic circulation r r r
3. Are rapidly metabolized by the liver and may have little if any desired action
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4. Are converted by the liver to more active and fat-soluble forms
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r rr 3. The route of excretion of a volatile drug will likely be the:
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1. Kidneys
2. Lungs
3. Bile and feces r r
4. Skin
r rr 4. Medroxyprogesterone (Depo Provera) is prescribed intramuscularly (IM)
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to create a storagereservoir of the drug. Storage reservoirs:
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1. Assure that the drug will reach its intended target tissue
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2. Are the reason for giving loading doses
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3. Increase the length of time a drug is available and active r r r r r r r r r r
4. Are most common in collagen tissues
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r rr 5. The NP chooses to give cephalexin every 8 hours based on knowledge of the drug’s:
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1. Propensity to go to the target receptor r r r r r r
2. Biological half-life r
3. Pharmacodynamics
4. Safety and side effects r r r
,ASAAS
r rr 6. Azithromycin dosing requires that the first day’s dosage be twice those of the
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other 4 days of theprescription. This is considered a loading dose. A loading
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dose:
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1. Rapidly achieves drug levels in the therapeutic range
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2. Requires four- to five-half-lives to attain r r r r r
3. Is influenced by renal function
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4. Is directly related to the drug circulating to the target tissues
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r rr 7. The point in time on the drug concentration curve that indicates the first sign of
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a therapeutic effectis the:
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1. Minimum adverse effect level r r r
2. Peak of action r r
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3. Onset rof raction
4. Therapeutic rrange
r rr 8. Phenytoin requires that a trough level be drawn. Peak and trough levels are done:
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1. When the drug has a wide therapeutic range
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2. When the drug will be administered for a short time only
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3. When there is a high correlation between the dose and saturation of receptor
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sites r
4. To determine if a drug is in the therapeutic range
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r 9. A laboratory result indicates that the peak level for a drug is above the minimum
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rtoxic concentration.
r
This means that the:
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1. Concentration will produce therapeutic effects r r r r
2. Concentration will produce an adverse response r r r r r
3. Time between doses must be shortened
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4. Duration of action of the drug is too long r r r r r r r r
r 10. Drugs that are receptor agonists may demonstrate what property?
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1. Irreversible binding to the drug receptor site r r r r r r
2. Upregulation with chronic use r r r
3. Desensitization or downregulation with continuous use r r r r r
4. Inverse relationship between drug concentration and drug action
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r 11. Drugs that are receptor antagonists, such as beta blockers, may cause:
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1. Downregulation of the drug receptor r r r r
2. An exaggerated response if abruptly discontinued
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3. Partial blockade of the effects of agonist drugs
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4. An exaggerated response to competitive drug agonists
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r 12. Factors that affect gastric drug absorption include:
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1. Liver enzyme activity r r
2. Protein-binding properties of the drug molecule r r r r r
3. Lipid solubility of the drug r r r r
4. Ability to chew and swallow r r r r
r 13. Drugs administered via IV:
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1. Need to be lipid soluble in order to be easily absorbed
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2. Begin distribution into the body immediately
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3. Are easily absorbed if they are nonionized
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4. May use pinocytosis to be absorbed
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r 14. When a medication is added to a regimen for a synergistic effect, the combined
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reffect of the drugs is:
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1. The sum of the effects of each drug individually
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2. Greater than the sum of the effects of each drug individually
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3. Less than the effect of each drug individually
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4. Not predictable, as it varies with each individual
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r 15. Which of the following statements about bioavailability is true?
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1. Bioavailability issues are especially important for drugs with r r r r r r r
narrow therapeuticranges or sustained-release mechanisms.
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2. All rbrands rof ra rdrug rhave rthe rsame rbioavailability.
3. Drugs rthat rare radministered rmore rthan ronce ra rday rhave rgreater
bioavailability thandrugs given once daily.
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4. Combining ran ractive rdrug rwith ran rinert rsubstance rdoes rnot raffect rbioavailability.
r 16. Which of the following statements about the major distribution
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barriers (blood-brain orfetal-placental) is true?
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1. Water soluble and ionized drugs cross these barriers rapidly.
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2. The blood-brain barrier slows the entry of many drugs into and from brain cells.
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3. The fetal-placental barrier protects the fetus from drugs taken by the mother.
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4. Lipid-soluble drugs do not pass these barriers and are safe for pregnant women. r r r r r r r r r r r r
r 17. Drugs are metabolized mainly by the liver via phase I or phase II reactions. The
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purpose of both ofthese types of reactions is to:
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1. Inactivate prodrugs before they can be activated by target tissues r r r r r r r r r
2. Change the drugs so they can cross plasma membranes r r r r r r r r
3. Change drug molecules to a form that an excretory organ can excrete
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4. Make these drugs more ionized and polar to facilitate excretion
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r 18. Once they have been metabolized by the liver, the metabolites may be:
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1. More active than the parent drug r r r r r
2. Less active than the parent drug r r r r r
3. Totally ―deactivated‖ so they are excreted without any effectr r r r r r r r
4. All of the above r r r
r 19. All drugs continue to act in the body until they are changed or excreted. The
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ability of the body toexcrete drugs via the renal system would be increased
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by: r
1. Reduced circulation and perfusion of the kidney r r r r r r
2. Chronic renal disease r r
3. Competition for a transport site by another drug r r r r r r r
4. Unbinding a nonvolatile drug from plasma proteins r r r r r r
r 20. Steady state is:
r r r r
1. The point on the drug concentration curve when absorption exceeds excretion
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2. When the amount of drug in the body remains constant r r r r r r r r r
3. When the amount of drug in the body stays below the
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minimum toxicconcentration
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4. All of the above r r r
r 21. Two different pain medications are given together for pain relief. The drug—drug
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rinteraction is: r
1. Synergistic
2. Antagonistic
3. Potentiative
4. Additive
r 22. Actions taken to reduce drug—drug interaction problems include all of the
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rfollowing EXCEPT: r
1. Reducing the dosage of one of the drugs r r r r r r r
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2. Scheduling rtheir radministration rat rdifferent rtimes
3. Prescribing ra rthird rdrug rto rcounteract rthe radverse rreaction rof rthe rcombination
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4. Reducing rthe rdosage rof rboth rdrugs
r 23. Phase I oxidative-reductive processes of drug metabolism require certain
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rnutritional elements.
r
Which of the following would reduce or inhibit this process?
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1. Protein malnutrition r
2. Iron-deficiency anemia r
3. Both 1 and 2 r r r
4. Neither 1 nor 2 r r r
r 24. The time required for the amount of drug in the body to decrease by 50% is called:
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1. Steady state r
2. Half-life
3. Phase II metabolism r r
4. Reduced bioavailability time r r
r 25. An agonist activates a receptor and stimulates a response. When given
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frequently over time,the body may:
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1. Upregulate the total number of receptors r r r r r
2. Block the receptor with a partial agonist
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3. Alter the drug’s metabolism r r r
4. Downregulate the numbers of that specific receptor r r r r r r
r 26. Drug antagonism is best defined as an effect of a drug that:
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1. Leads to major physiological and psychological dependence
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2. Is modified by the concurrent administration of another drug
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3. Cannot be metabolized before another dose is administered
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4. Leads to a decreased physiological response when combined with another drug
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r 27. Instructions to a client regarding self-administration of oral enteric-coated
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tablets should includewhich of the following statements?
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1. ―Avoid any other oral medicines while taking this drug.‖
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2. ―If swallowing this tablet is difficult, dissolve it in 3 ounces of orange juice.‖
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3. ―The tablet may be crushed if you have any difficulty taking it.‖
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4. ―To achieve best effect, take the tablet with at least 8 ounces of fluid.‖
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r 28. The major reason for not crushing a sustained-release capsule is that, if
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crushed, the coated beads ofthe drugs could possibly result in:
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r 29. Which of the following substances is the most likely to be absorbed in the
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intestines rather than inthe stomach?
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1. Sodium bicarbonate r
2. Ascorbic acid r
3. Salicylic acid r
4. Glucose
, ASAAS
r 30. Which of the following variables is a factor in drug absorption?
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1. The smaller the surface area for absorption, the more rapidly the drug is
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absorbed.r
2. A rich blood supply to the area of absorption leads to better absorption.
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3. The less soluble the drug, the more easily it is absorbed.
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4. Ionized drugs are easily absorbed across the cell membrane.
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r 31. An advantage of prescribing a sublingual medication is that the medication is:
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1. Absorbed rapidly r
2. Excreted rapidly r
3. Metabolized minimally r
4. Distributed equally r
r 32. Drugs that use CYP 3A4 isoenzymes for metabolism may:
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1. Induce the metabolism of another drug r r r r r
2. Inhibit the metabolism of another drug r r r r r
3. Both 1 and 2 r r r
4. Neither 1 nor 2 r r r
r 33. Therapeutic drug levels are drawn when a drug reaches steady state. Drugs reach
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rsteady state:
r
1. After the second dose r r r
2. After four to five half-lives r r r r
3. When the patient feels the full effect of the drug
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4. One hour after IV administration
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r 34. Upregulation or hypersensitization may lead to:
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1. Increased response to a drug r r r r
2. Decreased response to a drug r r r r
3. An exaggerated response if the drug is withdrawn
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4. Refractoriness or complete lack of response r r r r r
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